What’s New in DICOM Robert Horn, Agfa Healthcare SPIE Medical Imaging, 2008
DICOM Administrative Information <ul><li>DICOM is also ISO 12052. </li></ul><ul><ul><li>The most recent published version,...
Multiframe Image SOP Classes <ul><li>Multiframe objects to support 1000+ slice studies </li></ul><ul><ul><li>Image header ...
Multiframe object structure N Objects, N Headers N Frames,  One  Header Pixel data Dimension data Per-frame header Fixed H...
The Per-Frame Header
Sup 119 Frame Level Retrieve <ul><li>If we have 1000+ slice image objects, how do we access the slice identified in the re...
Sup 43 Ultrasound <ul><li>Pixel frames may represent echo power, doppler shift, or doppler variance </li></ul><ul><li>Mult...
Sup 111 Segmentation Image <ul><li>Derived image object </li></ul><ul><ul><li>Multiframe, using functional group mechanism...
Sup 132 Surface Segmentation <ul><li>Segmentation using 3-D surface mesh (rather than voxel volume) </li></ul><ul><li>Firs...
Sup 112 Deformable Spatial Registration <ul><li>Composite Object that supports multi-image alignment </li></ul><ul><li>3 s...
Structured Reporting <ul><li>Additional Templates for standard SR SOP Classes </li></ul><ul><ul><li>Sup 128 Cardiac Stress...
Sup 107 Substance Administration <ul><li>Patient safety issue – “five rights” checking for contrast agents </li></ul><ul><...
Sup 96 Unified Procedure Steps <ul><li>Simplification and merger of Worklist Management and Performed Procedure Steps  </l...
Sup 74 Radiotherapy Worklist <ul><li>Supports automated worklist management and machine parameter verification for the int...
Sup 122 Specimen Identification <ul><li>Support for pathology lab workflow, specimen-based imaging </li></ul><ul><ul><li>G...
Specialties <ul><li>Biomed engineering </li></ul><ul><ul><li>Supp 124 Communication of Display Parameters (in preparation)...
Sup 118 Application Hosting <ul><li>Experimental trials are underway </li></ul><ul><li>February 2008 meeting to prepare pu...
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R-Horn_What's New in DICOM 2008.ppt - DICOM Update

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R-Horn_What's New in DICOM 2008.ppt - DICOM Update

  1. 1. What’s New in DICOM Robert Horn, Agfa Healthcare SPIE Medical Imaging, 2008
  2. 2. DICOM Administrative Information <ul><li>DICOM is also ISO 12052. </li></ul><ul><ul><li>The most recent published version, Supplements, Change Items, etc. remain at NEMA </li></ul></ul><ul><li>MITA (Medical Imaging and Technology Alliance) </li></ul><ul><ul><ul><li>is the new name for the medical division of NEMA. </li></ul></ul></ul><ul><li>2008 Version is published </li></ul><ul><ul><ul><li>ftp://medical.nema.org/dicom/medical/2008 </li></ul></ul></ul>
  3. 3. Multiframe Image SOP Classes <ul><li>Multiframe objects to support 1000+ slice studies </li></ul><ul><ul><li>Image header supports functional group attributes changing during acquisition </li></ul></ul><ul><ul><li>Dimensions allow multiple views of data </li></ul></ul><ul><li>Common structure used for all new image IODs </li></ul><ul><ul><li>Sup 110 Ophthalmic Coherence Tomography (Adopted August 2007) </li></ul></ul><ul><ul><li>Sup 116 3-D X-ray (Adopted January 2007) </li></ul></ul><ul><ul><li>Sup 117 Enhanced PET (in Letter Ballot) </li></ul></ul><ul><ul><li>Sup 43 Enhanced Ultrasound (in Public Comment) </li></ul></ul><ul><ul><li>Sup 125 Breast Tomosynthesis (in Public Comment) </li></ul></ul>
  4. 4. Multiframe object structure N Objects, N Headers N Frames, One Header Pixel data Dimension data Per-frame header Fixed Header
  5. 5. The Per-Frame Header
  6. 6. Sup 119 Frame Level Retrieve <ul><li>If we have 1000+ slice image objects, how do we access the slice identified in the report as the Key Image? </li></ul><ul><ul><li>Or, how to access a short video clip of a long endoscopy video image object? </li></ul></ul><ul><ul><li>Many similar use cases needing one frame or a small subset of frames from large multiframe image </li></ul></ul><ul><ul><li>Purpose of retrieval may not be diagnostic; compression OK </li></ul></ul><ul><li>Proposed new Retrieve SOP Classes for subsets of frames </li></ul><ul><ul><li>Request can include a preferred transfer syntax (i.e., type of compression) </li></ul></ul><ul><ul><li>Returned object is a derived image with the requested subset of frames, but with a different Instance UID </li></ul></ul>In Letter Ballot
  7. 7. Sup 43 Ultrasound <ul><li>Pixel frames may represent echo power, doppler shift, or doppler variance </li></ul><ul><li>Multiple frames (up to 3) can be blended for proper display </li></ul><ul><li>An enhanced blending pipeline is required to render images </li></ul>In Public Comment
  8. 8. Sup 111 Segmentation Image <ul><li>Derived image object </li></ul><ul><ul><li>Multiframe, using functional group mechanism </li></ul></ul><ul><li>Multiple segments per object </li></ul><ul><ul><li>Each segment linked to a categorization </li></ul></ul><ul><ul><li>Pixels show presence of category at pixel location </li></ul></ul><ul><ul><li>Binary (1-bit/pixel) or fractional (probability or occupancy) </li></ul></ul><ul><li>Segments can be 2-D or 3-D </li></ul><ul><li>3-D segmentation is typically in same Frame of Reference as source image </li></ul><ul><li>Segments can be displayed as overlays on source image </li></ul>Adopted August 2006
  9. 9. Sup 132 Surface Segmentation <ul><li>Segmentation using 3-D surface mesh (rather than voxel volume) </li></ul><ul><li>First use of mesh technology in DICOM </li></ul><ul><ul><li>Will also be used for future volumetric work, including implant specification and surgical planning </li></ul></ul>In Public Comment
  10. 10. Sup 112 Deformable Spatial Registration <ul><li>Composite Object that supports multi-image alignment </li></ul><ul><li>3 step algorithm </li></ul><ul><ul><li>Pre-deformation matrix transform </li></ul></ul><ul><ul><li>Deformation using 3D grid of 3D deformation vectors </li></ul></ul><ul><ul><li>Post-deformation matrix transform </li></ul></ul><ul><li>Facilitates further image processing, especially multi-modality image fusion and image pasting applications </li></ul>Adopted August 2006
  11. 11. Structured Reporting <ul><li>Additional Templates for standard SR SOP Classes </li></ul><ul><ul><li>Sup 128 Cardiac Stress Testing (Frozen Draft – passed Ballot, awaiting final SNOMED and IEEE codes) </li></ul></ul><ul><ul><li>Sup 129 Cardiac Electrophysiology (in Public Comment) </li></ul></ul><ul><li>Templates for specialty SR SOP Classes </li></ul><ul><ul><li>Sup 127 CT Radiation Dose (Adopted October 2007) </li></ul></ul><ul><ul><li>Sup 130 Ophthalmic Refractive SR (Adopted January 2008) </li></ul></ul><ul><ul><li>Sup 126 Colon CAD (Public Comment) </li></ul></ul><ul><li>Harmonization with HL7 </li></ul><ul><ul><li>Sup 114 DICOM Encapsulation of CDA Documents (Adopted January 2007) </li></ul></ul><ul><ul><li>Sup 135 SR HL7 CDA Mapping (Public Comment) </li></ul></ul><ul><ul><ul><li>Mapping is only for Basic Imaging Reports </li></ul></ul></ul>
  12. 12. Sup 107 Substance Administration <ul><li>Patient safety issue – “five rights” checking for contrast agents </li></ul><ul><ul><li>Point of use verification for substances often “out of the loop” of hospital pharmacy systems </li></ul></ul><ul><li>Three new DICOM services </li></ul><ul><ul><li>Typically Modality as SCU interacting with HIS via gateway SCP </li></ul></ul><ul><li>Query: Look up product characteristics </li></ul><ul><ul><li>Given a barcode ID (from contrast agent bottle), get name, active ingredient, concentration, etc. </li></ul></ul><ul><li>Query: Get substance administration approval </li></ul><ul><ul><li>Based on agent, patient, route of administration; get approval or warnings </li></ul></ul><ul><li>Report contrast used to HIS Medication Administration Record </li></ul>Adopted January 2007
  13. 13. Sup 96 Unified Procedure Steps <ul><li>Simplification and merger of Worklist Management and Performed Procedure Steps </li></ul><ul><ul><li>1:1 relationship between scheduled and performed steps </li></ul></ul><ul><ul><li>A single IOD that combines attributes of both </li></ul></ul><ul><ul><li>C-FIND to query worklists </li></ul></ul><ul><ul><li>N-CREATE to create new scheduled procedure steps </li></ul></ul><ul><ul><li>N-GET/N-SET to update </li></ul></ul><ul><ul><li>N-EVENT-REPORT to monitor and report progress </li></ul></ul><ul><li>Intended to meet the needs of </li></ul><ul><ul><li>Radiation Therapy Scheduling and Monitoring </li></ul></ul><ul><ul><li>Scheduling and Monitoring CAD systems </li></ul></ul><ul><ul><li>Proposed new scheduling activities </li></ul></ul>Frozen Draft for Trial Implementation
  14. 14. Sup 74 Radiotherapy Worklist <ul><li>Supports automated worklist management and machine parameter verification for the integration of multi-system radiation therapy planning and treatment </li></ul><ul><li>First usage of Unified Procedure Step </li></ul><ul><li>Also defines three new objects / SOP Classes </li></ul><ul><ul><li>RT Beams Delivery Instruction (Composite) </li></ul></ul><ul><ul><li>RT Conventional Machine Verification (Normalized) </li></ul></ul><ul><ul><li>RT Ion Machine Verification (Normalized) </li></ul></ul><ul><li>Real implementation and evaluation needed – in conjunction with IHE Radiation Oncology </li></ul>Frozen Draft for Trial Implementation
  15. 15. Sup 122 Specimen Identification <ul><li>Support for pathology lab workflow, specimen-based imaging </li></ul><ul><ul><li>Gross specimens, blocks, vials, slides </li></ul></ul><ul><ul><li>Image-guided biopsy samples </li></ul></ul><ul><li>Retires current Specimen Identification Module, adds new Specimen Module at image level of hierarchy </li></ul><ul><li>Update to Modality Worklist to allow Specimen Module </li></ul><ul><ul><li>Enables automated slide scanning devices to fully populate header </li></ul></ul><ul><li>Update to Modality Performed Procedure Step to identify imaged specimen </li></ul><ul><ul><li>Allows LIS to track images for specimens </li></ul></ul>In Letter Ballot
  16. 16. Specialties <ul><li>Biomed engineering </li></ul><ul><ul><li>Supp 124 Communication of Display Parameters (in preparation) </li></ul></ul><ul><ul><li>Administrative support for monitor calibration </li></ul></ul><ul><li>Surgery </li></ul><ul><ul><li>Sup 131 Implant Description (in preparation) </li></ul></ul><ul><ul><li>Supports 3D model of bone-mountable implants </li></ul></ul><ul><li>Dentistry / Radiology </li></ul><ul><ul><li>Sup 123 Structured Display (in preparation) </li></ul></ul><ul><ul><li>Captured screen layout of multiple images (with presentation states) for dental series, radiology conference, etc. </li></ul></ul>
  17. 17. Sup 118 Application Hosting <ul><li>Experimental trials are underway </li></ul><ul><li>February 2008 meeting to prepare public comment text for March 2006 WG-06 meeting </li></ul><ul><li>New approaches to DICOM Information Object exchange </li></ul><ul><ul><li>Native (shared memory) using DICOM encoding </li></ul></ul><ul><ul><li>Native Model </li></ul></ul><ul><ul><ul><li>DOM-like model defined using DICOM terminology </li></ul></ul></ul><ul><ul><li>Abstract Model </li></ul></ul><ul><ul><ul><li>DOM-like model of generic image attributes </li></ul></ul></ul><ul><ul><ul><li>Usable for any image type (TIFF, DICOM, etc.) </li></ul></ul></ul>

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