Digital Imaging and Communications in Medicine (DICOM) is a standard for communicating and managing medical imaging data. It defines a file format and network protocol for transmitting images and associated patient information between systems. DICOM allows different medical devices to store, transmit and display diagnostically accurate medical images, facilitating data sharing across systems.

1. Digital Imaging and Communications in Medicine (DICOM)
 Digital Imaging and Communications in Medicine (DICOM) is
the standard for the communication and management of
medical imaging information and related data.
 Is a software integration standard used in Medical Imaging,
It’s a set of specifications and interfaces to provide a
diagnostically accurate representation of medical imaging
data and includes tools to transfer, store, and display the
information.

2. CONT…
 DICOM files can be exchanged between two entities that are
capable of receiving image and patient data in DICOM format.
 The standard includes a file format definition and a
network communications protocol that uses TCP/IP to
communicate between systems.
 A DICOM image file is an outcome of the Digital Imaging and
Communications in Medicine standard.

3. Standards and protocols used by DICOM
 DICOM Makes use of the OSI network model. It uses the 2
network protocols on which the Internet is based and which
allow data transfer, TCP / IP, and the HTTP hypertext transfer
protocol. Additionally DICOM has its own MIME content type.
 DICOM uses other protocols such as DHCP, SAML ...
 DICOM makes use of a coding system called SNOMED CT that
is based on medical and clinical terms.
 DICOM uses an external alphabet known as LOINC.

4. Types of equipment
• The DICOM information object definitionsencode the data
produced by a wide variety of imaging device types,
including, CT (computed tomography), MRI (magnetic
resonance imaging), ultrasound, X-
ray, fluoroscopy, angiography, mammography.
• DICOM is also implemented by devices associated with
images or imaging workflow including, PACS (picture archiving
and communication systems), image viewers and display
stations.

5. Data format
• DICOM groups information into data sets. For example, a file
of a chest x-ray image may contain the patient ID within the
file, so that the image can never be separated from this
information by mistake.
• This is similar to the way that image formats such as JPEG can
also have embedded tags to identify and otherwise describe
the image.

6. Who uses DICOM image
• It has been widely adopted by hospitals and is making inroads
into smaller applications such as dentists' and doctors' offices.
• DICOM files can be exchanged between two entities that are
capable of receiving image and patient data in DICOM format.

7. Advantages
 Single network transactions will transfer both image and
patient details.
 Enhanced patient safety (images and data kept together)
 Consistent standard across multiple devices means better
compatibility.
 Store rich acquisition and imaging protocol data.
 Complete Scanning and Image Reviewing
 Collaboration with Existing IT Systems

8. Disadvantages
• Disadvantage of the DICOM standard relates to data entry. If
optional fields are added to the file but not filled in correctly
then that could cause image objects to be incomplete and
cause issues elsewhere.

9. What are the main DICOM functions?
 The DICOM standard is concerned with five main functions in medical imaging:
 to transmit and persist images and related data between
endpoints
 to query and retrieve files;
 to perform specific actions like printing or archiving
 to support digital imaging workflows; and
 To provide high quality images for diagnostics.

10. A picture archiving and communication system (PACS)
 A picture archiving and communication system (PACS) is
a medical imaging technology which provides economical
storage and convenient access to images from multiple
modalities.
 PACS manages images from various sources, such as
Ultrasound, Magnetic Resonance Imaging (MRI), Computed
Tomography (CT), Radiology (plain x-rays) and so .

11. Cont..
 Electronic images and reports are transmitted digitally via
PACS.
 this eliminates the need to manually file, retrieve, or
transport film jackets, the folders used to store and protect X-
ray film. It comprises of data storage, image display and links
to equipment that acquires the diagnostic images (digital x-
rays).

12. The acronym PACS can best be explained as
follows:
• P—Picture: the digital medical image(s)
• A—Archiving: the “electronic” storage of the images
• C—Communication: the routing (retrieval/sending) and
displaying of the images
• S—System: the specialized computer network that manages
the complete system

13.  PACS has four main uses:
 Hard copy replacement:
 Remote access:
 Electronic image integration platform:
 Radiology Workflow Management
main uses of PACS

14. Component of Picture Archiving and Communication Systems
 Picture Archiving and Communication Systems consists of four major components:
 Imaging modalities such as computed tomography (CT) and
magnetic resonance imaging (MRI).
 A secured network for the transmission of patient
information.
 Workstations for interpreting and reviewing images.
 Archives for the storage and retrieval of images and reports.

15. Clinical Benefits of Picture Archiving and Communication
Systems
o Increased availability of images.
o Increased processing, no lost film, multiple copies of the same
image can be generated.
o Image manipulation to overcome under or over exposure.
o Increased speed and quality of reporting.
o Transmission of the hospital to other hospitals.
o Reliability.
o Ease of use.

16. Advantages of PACS
 Convenient search for and retrieval of images
 Rapid (electronic) transfer of images within the hospital
 Ease in consulting outside specialists.
 Simultaneous viewing of images at multiple locations
 Elimination of misplaced, damaged, or missing films
 Increase in efficiency of reporting exams with soft-copy
images (compared with hard-copy images)

17. disadvantages of PACS
 Its cost
 the need for specialized personnel for its installation and
maintenance
 training of users
 the possibility of breakdown
 data security issues

18. PACS fundamental parts
Image acquisition
Display workstations
 Archive servers

19. Cont…

20. Clinical decision support system (CDSS)
 Clinical decision support system (CDSS) is an application that
analyses data to help healthcare providers make decisions and
improve patient care.
 is a specialized software developed to assist healthcare
practitioners in analyzing the patients’ records and making
well-informed decisions.
 CDSS focuses on using knowledge management to get clinical
advice based on multiple factors of patient-related data.

21. Cont…..
 The clinical decision support system assists healthcare
practitioners to access person-specific detailed information
about patients, which can easily be filtered.
 The system comes with a variety of powerful tools to enhance
the decision-making process on behalf of healthcare
practitioners.
 The tools offered by the clinical decision support systems
include alerts, reminders, patient’s history, discharge
summaries, and various other high-utility tools.

22. Types of CDSS
1.knowledge base CDSS
 CDSS, which uses a knowledge base, applies rules to patient data
using an inference engine and then displays the results.
 In knowledge-based systems, rules (IF-THEN statements) are
created, with the system retrieving data to evaluate the rule, and
producing an action or output.
 Knowledge-based CDSSs contain a knowledge base as well as an
inference engine and a mechanism to communicate.
 for example, IF drug X is taken AND drug Y is taken, THEN alert the
user. The inference engine combines the rules from the knowledge
base with the patient's data, while the communication mechanism
allows the system to show the results and allow user input into the
system.

23. Con….
2.Non-knowledge-based CDSS
 CDSSs that do not use a knowledge base.
 use a form of artificial intelligence called machine learning, which
allow computers to learn from past experiences and/or find
patterns in clinical data.
 This eliminates the need for writing rules and for expert input.
 machine learning systems are often referred to as "black boxes"
because no meaningful information about how they work can be
discerned by human inspection
 clinicians do not use them directly for diagnoses due to reliability
and accountability reasons. Nevertheless, they can be useful as
post-diagnostic systems that suggest data patterns for further
investigation

24. Con….
 CDSS that are non-knowledge based still require a data
source, but the decision leverages artificial intelligence (AI),
machine learning (ML), or statistical pattern recognition,
rather than being programmed to follow expert medical
knowledge.
 They are functionally similar to neural networks in that they
are also "black boxes" that attempt to derive knowledge from
patient data.

25. Con….
Fig. 1: Diagram of key interactions in knowledge-based and non-knowledge based CDSS.

26. Con….
• They are composed of (1) base: the rules that are
programmed into the system (knowledge-based), the
algorithm used to model the decision (non-knowledge based),
as well as the data available, (2) inference engine: takes the
programmed or AI-determined rules, and data structures, and
applies them to the patient’s clinical data to generate an
output or action, which is presented to the end user (eg.
physician) through the (3) communication mechanism: the
website, application, or EHR frontend interface, with which
the end user interacts with the system

27. Advantages of CDSS
 Minimize chances of medication errors
 Lower risks of misdiagnosis
 Enhancing the efficiency of healthcare practitioners
 Improving the quality of healthcare services
 Increased quality of care and enhanced health outcomes.
 Avoidance of errors and adverse events.
 Improved efficiency, cost-benefit, and provider and patient
satisfaction.

28. Disadvantages
 Not all alerts made by CDSS will be correct, which means
healthcare providers might struggle with alert-related fatigue.
 In addition, there are always some chances of low-value
prompts and alerts.
 If CDSS isn’t implemented correctly, it might not be able to
identify medication errors, which puts patients at risk.

29. Purpose of CDSS
 clinical decision support system is to assist healthcare providers, enabling an
analysis of patient data and using that information to aid in formulating a
diagnosis.
 A CDSS offers information to clinicians and primary care providers to improve the
quality of the care their patients receive.
 Clinical decision support delivers precise knowledge to improve patients' health
and wellbeing. It also helps professionals deliver better quality health care.
 In addition, CDSS can improve the quality of clinical documentation by providing
support for coding, ordering of procedures and tests, and patient triage.

30. CON….
 alert clinicians to possible redundant testing their patient has
been scheduled to undergo. As such, using a CDSS can lower
costs and increase efficiency.
 It encompasses a wide range of computerized tools directed
at improving patient care, including computerized reminders
and advice regarding drug selection, dosage, interactions,
allergies, and the need for subsequent orders.
 Medi-Span drug databases provide drug vocabularies,
attributes, and clinical screening modules integrated into
EMRs, pharmacy systems, and other healthcare applications
to aid in decision support.
 They are trusted worldwide to help elevate quality, reduce
costs, and improve patient outcomes

31. Examples of clinical decision support systems?
• First Databank
• Medispan
• Allscripts
• Cerner
• Elsevier

32. Terminology management system (TMS)
 Terminology is the language used to describe a specific thing,
or the language used within a specific field.
 Special language used by scientists is an example of science
terminology.
 Terminology management is a set of activities that ensures
correct terms are used consistently in all materials.
 These activities include collecting, developing, storing,
reviewing, harmonizing, updating and distributing
terminology data

33. CON….
 Terminology data is stored in a terminology database, or
termbase, and a terminologist is the person managing it.
 A Terminology management system (TMS) is a software tool
specifically designed to collect, maintain, and access
terminological data. It is used by translators, terminologists,
technical writers, and various other users.
 TMS is necessary for translation projects, multilingual
organizations, terminographical activities, terminology
projects associated with term extraction and term analyses.

34. Benefits of the use of TMS
o High-quality translations
o Efficient communication (in multilingual organizations or
settings)
o Glossaries created from automated extraction tools
o Customized terminology solutions for organizations
o Retrieving the most appropriate information with the least
noise
o Increased customer satisfaction

35. Type of information recorded in a termbase
 Term in source language
 Definition in source language
 Grammatical information
 Term in target language
 Definition in target language

36. Tools of TMS
 crossTerm
 MemoQ
 qTerm
 SDL MultiTerm
 TermWeb
 TermWiki (Pro)

37. Text without Terminology
The is a by which
from a is absorbed by
, and is re-radiated in all
. Since part of this
the and the lower
of the
is back towards
, it results in an
above
what it would be in the
at the
of the .
of largely passes

38. Text with Terminology
The greenhouse effect is a process by which thermal radiation
from a planetary surface is absorbed by atmospheric greenhouse
gases, and is re-radiated in all directions. Since part of this re-
radiation is back towards the surface and the lower atmosphere,
it results in an elevation of the average surface temperature
above what it would be in the absence of the gases.

39. Computer-aided translation (CAT)
• CAT tools are software applications that support the translation of
text from one language to another.
• Computer-aided translation (CAT), also referred to as machine-
assisted translation (MAT) or machine-aided human
translation (MAHT), is the use of software to assist a human
translator in the translation process.
• CAT tools for translation are used for submitting, editing, managing,
and storing translations
• The translation is created by a human, and certain aspects of the
process are facilitated by software
• A CAT tool works by breaking the source text down into smaller
segments and storing all the source and translated segments in a
database

40. What does a CAT tool do?
• CAT tools for translation are engineered to automate
translation-related tasks. The translator can input text
into the CAT software in the source language and use the
interface to divide it into segments—a phrase, sentence,
or paragraph. Meanwhile, the software saves each
source segment and its corresponding translation as an
entry in a database called translation memory. The more
content you translate, the more translation matches the
software will be able to reuse. This kind of automation
significantly speeds up the translation process and
ensures consistency with past translations.

41. How does a CAT tool for translation work?
 The translator opens the source text in a CAT program.
 The CAT tool extracts the content that can be translated (source
content with images or other non-text elements will not appear as
translatables in the user interface).
 The CAT tool splits the text into translation units—normally phrases,
sentences, or paragraphs. These units are also known as segments.
 The CAT tool displays the source text field and the translation field
side by side, one segment after another.
 The translator types translations into the empty target segments
until the translation job is complete.
 Once a translation segment has been completed, the CAT tool saves
the source text and its translation together as a pair in a translation
memory. The translator can return to this pair at any time to make
changes, and the translation memory will update accordingly.

42. Common features of modern CAT tools
• Translation memory
• Term base (translation glossary)
• Real-time collaborative teamwork
• Quality assurance functionality

43. the advantages of CAT tools
 You can save time, as the software can translate large texts
quickly.
 Such programs are freely available, which is their main
advantage, compared to seeking out a competent
professional translator.
 Computer aided translation is very convenient to use when
translating text with repetitive words from specific areas of
interest into various languages, as it can translate material in
most languages.

44. the disadvantages and problems caused by CAT tools
 There is one specific type of error that should have actually been
completely eliminated via the use of CAT tools. During my professional
career as a translation manager on the buyer side, I have encountered
many different translation errors in the delivered documents. These errors
ranged from minor mistakes to severe safety-critical faults.
• Different error types
• Let’s consider the following three incorrect translations from the area of
human medicine:
• English source text:
Do not leave missing or broken-off components inside the patient.
French translation:
Ne jamais laisser de pièces manquantes ou brisées dans l’animal.
Meaning of the French translation:
Do not leave missing or broken-off components inside the animal (instead
of the patient).

45. the disadvantages and problems caused by CAT tools
 Accuracy is a major problem. Translation software provides
only literal, word for word translation. It is unable to
understand the complexities and nuances of language.
 The software cannot comprehend context or solve ambiguity
issues.
 Confidentiality is an important issue with machine translation.
Entrusting sensitive corporate or personal information to a
Web-based tool is a risky proposition. With a professional
translator your confidentiality is protected.

46. main benefits of CAT tools
 Help to produce high-quality translations.
 Improve translation productivity.
 Yields significant cost savings.
 Reduce the amount of time and effort needed to produce
translations.
 Improved consistency of translations