Perlman eventually came upon a possible solution to her diagnostic dilemma: evaluating patients with dysphagia through remote, real-time medical assessments conducted over broadband Internet connections. As part of the NCSA/UIUC Faculty Fellows Program, Perlman has spent the past two years developing a method for capturing and transmitting high-quality video data from the fluoroscopic examinations that are used to assess a patient's swallowing. Such a system, she hopes, will make real-time remote assessment of fluoroscopy exams a common practice.

"We are testing the system with videofluoroscopic examinations of the oral and pharyngeal stages of the swallow in patients with dysphagia, but the system could be used for assessments in other areas of medicine," she says. "It is simply a system for interactive, real-time assessment of video images."

			Weerasak Witthawaskul, a doctoral student in computer science at the U of I and Perlman's research assistant, and NCSA staff assisted Perlman by creating a Java-based interface that allows a desktop computer in a hospital X-ray suite to communicate with a similar computer in Perlman's laboratory on the U of I campus. This system allows Perlman to control the hospital-based PC from her lab and provides an interface for examining high-resolution MPEG versions of the video fluoroscopic images taken at the hospital.
	Joseph Barkmeier, a radiologist at Carle Foundation Hospital in Urbana, IL, demonstrating the X-ray equipment used to perform a fluoroscopy exam with University of Illinois researcher Adrienne Perlman. While most hospitals have the equipment needed for the exam, not all have the experts on staff who can analyze the results.

"The process is completely controlled from the computer in our lab" explains Perlman. "All the technician at the hospital has to do is turn on the computer in the X-ray suite."

Following the examination, Perlman is able to observe the swallow event at full speed, in slow motion, or frame by frame on her laboratory computer. Moreover, she has the expertise to analyze the test data more precisely than most hospital clinics or labs. While staff at most clinics or labs can look at fluoroscopic images and determine whether cartilage, bone, or other structures move during the swallowing process, Perlman can measure displacement—how much and how long a structure moves and whether the movement is more or less pronounced than in previous exams. Displacement measurements can help determine both whether a dysphagia patient is recovering and the rate of recovery.