The document describes the IHE Teaching File and Clinical Trial Export (TCE) profile. It allows clinical systems to connect to external teaching file and clinical trial systems through DICOM in a way that meets de-identification requirements. It standardizes how teaching files and clinical trial data are collected and exported. Implementing the TCE profile allows systems to add teaching file and clinical trial capabilities.

1. 1September, 2005 What IHE Delivers
John Perry (Fujifilm Medical Systems),John Perry (Fujifilm Medical Systems), IHE Radiology Planning CmteIHE Radiology Planning Cmte
Cor Loef (Philips Medical Systems),Cor Loef (Philips Medical Systems), Co-chair, IHE Radiology Technical CmteCo-chair, IHE Radiology Technical Cmte
Teaching File and ClinicalTeaching File and Clinical
Trial ExportTrial Export

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Patient
Info.
Recon-
ciliation
Access to Radiology Information
Consistent
Presentation
of
Images
Audit Trail & Node Authentication - Radiology Option
Evidence
Docs
Key
Image
Notes
Simple
Image &
Numeric
Reports
Presentation
of
Grouped
Procedures
Post-
Processing
Workflow
Reporting
Workflow
Charge
Posting
XDS for Imaging
NM
Image
Scheduled Workflow
Teaching
Files &
Clinical Trials
Export
Portable Data for Imaging
Teaching Files & Clinical Trials - TCETeaching Files & Clinical Trials - TCE

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TCE Abstract/ScopeTCE Abstract/Scope
DICOM-based mechanism for connecting
clinical systems to:
 External teaching file systems
 External clinical trial systems
Meets de-identification requirements for:
 Teaching files (HIPAA)
 Clinical trials (pseudonymization)

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Value Proposition for CustomersValue Proposition for Customers
Brings digital imaging to traditionally film-based
activities
Facilitates clinical research and grant acquisition
Standardizes clinical trial data collection
Improves the efficiency of teaching file production
Supports meeting the Accreditation Council on
Graduate Medical Education requirements for
teaching files

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Value Proposition for CompaniesValue Proposition for Companies
You can add TF and CT capability to your
products just by implementing the TCE profile
MIRC is available as a TF and CT Receiver
 Teaching File and Clinical Trial system
 In use at many universities
 Selected by the NCI for clinical trial image transport
 Developed, supported and promoted by the RSNA
 Free & open source (mirc.rsna.org)
 Supported by other CT and TF systems

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ActorsActors
Export Selector
 a system that identifies information to be sent to a teaching file or
clinical trial system
 example: a user at a PACS diagnostic workstation
Export Manager
 de-identifies and re-identifies the images, reports, evidence documents,
presentation states and additional information with pseudonymous
values
 supports the Remap Identifiers option to pseudonymize the images with
the trial-specific identifiers and to populate the clinical trial specific
attributes.
 sends the pseudonymized DICOM objects and an updated manifest to a
Receiver.
Receiver
 a local teaching file or clinical trial system
 a clinical trial system responsible for transferring images to the central
review facility

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Example Teaching File Use CaseExample Teaching File Use Case
- Part 1: Selection -- Part 1: Selection -
Radiologist views images for primary diagnosis on
Image Display grouped with Export Selector.
Export Selector allows images, series and studies to
be selected “For Teaching File Export”.
Export Selector may also provide a UI allowing the
user to enter text notes and select additional items
(SR, KIN, GSPS, etc.) for inclusion in exported objects.

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Example Teaching File Use CaseExample Teaching File Use Case
- Part 2: Export -- Part 2: Export -
User action triggers Export Selector to send objects and a Key
Image Note manifest to Export Manager.
 Document Title of the KIN specifies “For Teaching File Export”.
 Export Manager de-identifies objects.
Export Manager collects objects selected and sends to Receiver.
 Receiver may be part of a Teaching File system.
TF system receives objects and manifest and stores them for
later use by radiologist when authoring the teaching file case.
…other use cases are in the Technical Framework

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Example Clinical Trial Use CaseExample Clinical Trial Use Case
- Part 1: Selection -- Part 1: Selection -
A clinical trial administrator views images on Image
Display grouped with Export Selector.
The Export Selector allows images, series and studies
to be selected “For Clinical Trial Export”.
The administrator identifies the trial.
The Export Selector sends images and a KIN manifest
to the Export Manager.
 The Document Title of the KIN specifies “For Clinical Trial Export”.
 Export Manager de-identifies objects.

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Example Clinical Trial Use CaseExample Clinical Trial Use Case
- Part 2: Export -- Part 2: Export -
The Export Manager collects all the objects selected and sends
them to the Receiver which may be part of a Clinical Trial
communication system.
The CT system receives the objects and the manifest and
forwards the relevant data to the central facility of the Clinical
Trial.
…other use cases are in the Technical Framework

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Export SelectionExport Selection
Key Image Note used as a manifest of
exported objects:
 List of images and other DICOM objects
 Coded Document Title
• “For Clinical Trial Export”
• “For Teaching File Export”
 Text “disposition”
 Information about the requesting user
Sent via conventional C-STORE
 Not a new SOP Class

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Export Selector Export Manager Receiver
Export Instances [Rad 53]
Store Export Selection [Rad 51]
Store Instances [Rad 50]
Store Additional TF Info [Rad 52]
Delay for pathology
De-identify attributes
De-identify pixel data
Re-map identifiers
SequenceSequence

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TransactionsTransactions
Export Selector
Export Manager
Receiver
Export Instances [Rad 53]
Store Export Selection [Rad 51]
Store Instances [Rad 50]
Store Additional teaching File Information [Rad 52]
Image
Archive/
Manager
Portable
Media
Creator
Image
Manager/
Archive
Report
Manager
Report
Repository
Image
Display
Evidence
Creator
Report
Creator
Acquisition
Modality

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IHE Web site: www.IHE .netIHE Web site: www.IHE .net
 Frequently Asked QuestionsFrequently Asked Questions
 Integration Profiles in Technical Frameworks:Integration Profiles in Technical Frameworks:
 CardiologyCardiology
 IT InfrastructureIT Infrastructure
 LaboratoryLaboratory
 Patient Care CoordinationPatient Care Coordination
 RadiologyRadiology
 Connectathon ResultsConnectathon Results
 Vendor Products Integration StatementsVendor Products Integration Statements
 Participation in Committees & ConnectathonsParticipation in Committees & Connectathons

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