1. DICOM Conformance Statement (DCS) A Proven Power within DICOM
Dwight A. Simon,
Medical Standards Director & Senior Integration Specialist
Merge eFilm

2. A 10 year Proven track record of Power
It is Required
It is a Public document
It describes the DICOM Features / Functions implemented in a Product
It allows connectivity comparisons
It defines the information that is required to perform specific functions

3. Content of DCS Using 2003 Publication of Std
A brief introduction that is specified in general terms
A simple data flow diagram and description
The functional definition of each DICOM feature
More detail on specifics later
How this product communicates to another product

4. Content of DCS Using 2003 Std continued
Specification of any enhancements or changes to standard DICOM features
A list of configurable parameters
A list of character sets that are supported (i.e., Japanese or French)
Any codes and controlled terminology
A specification of all DICOM security features

5. Functional Definitions … more detail
Specification of each feature/function within the application
Utilizes specific terminology of DICOM
Benefit - defined in an unambiguous way
Disadvantage - must understand the terminology in order to get all the information one needs to:
Understand the products DICOM features
Compare this DICOM product with another

6. The common format is a huge benefit
Almost Everyone follows the Templates from the Standard for writing a DCS
The common format is a huge benefit
Easy to find information, because always in same place
Easy to compare one DICOM product with another

7. Who has ability to use this information with a high degree of understanding?
Those that have taken DICOM training
Those that have read and understood the DICOM Standard
Unfortunately, the common healthcare user who does not have this background can probably only understand less than 40% of the information in the DCS

8. Presentation Context Tables
Association Initiation
Presentation Context Table - Proposed
Abstract Syntax
Transfer Syntax
Role
Expanded
Name
UID
Name List
UID List
Negotiation
X-ray RF Image
Implicit VR LE
SCU
None
Storage
JPEG-14
Lossless (70)
Secondary
Implicit VR LE
SCU
None
Capture Image
Explicit VR BE
Storage
Association Acceptance
Presentation Context Table - Accepted
Abstract Syntax
Transfer Syntax
Role
Expanded
Name
UID
Name List
UID List
Negotiation
Study Root
Query/Retrieve - FIND
2.2.1
Implicit VR LE
SCP
None
Query/Retrieve -
MOVE
2.2.2
Verification

9. Other Likely Unknown Terms
AE Specification
Application Entity Title
Application Profile
SOP Class
SOP Instance
Standard Extended SOP Class
Unique Identifier (UID)

10. After 10 years DICOM Conformance Statement has become even more Powerful
It includes an enhanced template
It has a wider range of examples that deal with the majority of possible DICOM features
It has grown from 50 pages to over 330 pages

11. Enhancement is called Supplement 64
Already balloted and approved to become part of the DICOM Standard
Minor corrections and editing still to be done by Working Group 6 prior to making it a final document

12. Supplement 64 Enhancements (Sup64)
Will benefit the non-DICOM literate user directly
Will enable the DICOM literate user to more easily find and compare DICOM features
Will be additive to most of what is in the current 2003 publication

13. Sup64 – New Additions DICOM Conformance Statement Overview
Includes a description of the implementation in "layman's terms“
Requires that the tables for both Networking and Media Storage
List all used DICOM features (SOP Classes)
List be organized and grouped by categories

14. Sup64 – New Additions … continued
Requires a Table of Contents (some vendors already do this)
New "Introduction" section
The "Definitions, Terms and Abbreviations" item will be one key addition for the non-DICOM literate
If vendors do a good job with this item, then these users should be able to have an 80% or higher understanding of the DCS

15. Sup64 – New Additions … continued
Enhancements to "Sequencing of Real-World Activities"
Defines interactions between this product’s various DICOM connections and other products
It is strongly recommended to incorporate UML Sequence Diagrams
Sequence diagrams emphasize the sequence of the DICOM messages between two products
Even without a formal understanding of the Unified Modeling Language (UML) the average user should be able to interpret the diagrams

16. UML Sequencing Diagram
Storage Application
Image / Info Manager
1. Open Association
2. C-STORE (CT Image) [1 to N images to be sent]
3. C-STORE (GSPS) [1 to N grayscale image consistency information sets to be sent]
4. N-ACTION (Storage Commitment Request for Images & GSPS) [Are they reliably stored]
5. N-EVENT-REPORT (Storage Commitment Response) [Each are or are not reliably stored]
6. Close Association

17. Sup64 – New Additions … continued
The "Configuration" section has also been enhanced.
Requires a much more definitive description of the configurable parameters that the application will utilize when it is running
The parameters refer to application name(s), networking relationships, remote application connectivity, node level security, etc.
There is a recommended set of operational parameters that are required to be represented

18. Sup64 – New Additions … continued
The powerful "Annexes" section helps define some of the operational aspects of the product
Within the Annexes one must describe
the data that is created,
put in the DICOM message and
sent to another product.

19. Sup64 – New Additions … continued
Within the Annexes" each piece of information (called an attribute) must be specified
by name and
DICOM identifier (called attribute tag),
range of values that might be present
type of value
person name
date
time
floating point double precision number
integer number

20. Sup64 – New Additions … continued
Within the Annexes each attribute must be defined
whether it will or will not exist within a DICOM message and under what conditions it will exist
If its value is present, then from where will it come
from user input
be generated automatically
come from functional information like a work list
be a configurable parameter.

21. Sup64 – New Additions … continued
other important items within "Annexes"
specification of attributes that are required
mapping of attributes between different information sets
HL7 mapped into a DICOM work list
DICOM work list mapped into a CT image
specify whether key attributes are allowed to be modified
patient name
patient identifier
study instance UID

22. Sup64 – New Additions … continued
A data dictionary of all private attributes
The support of coded terminology and/or templates, if utilized
The support for "Grayscale Image Consistency", if applicable
A definition of any enhancements or changes to standard DICOM features that have been implemented, including feature specialization or new private features
All private encoding of information that is support, if applicable

23. Sup64 – New Additions … continued
Many informative sections in PS3.2
specifically to give examples of DICOM Conformance Statements for various types of products
a huge benefit to both the vendors and the users
for the vendors, they are used as a guideline for interpreting the DCS template for a specific kind of product
for the user, it will insure that multiple vendors with similar products will have DCSes that look alike.

24. DCS Examples available in Sup64
A DICOM modality that has connectivity to an archive, a workflow manager and a print server, along with have the capability to create a DICOM generic CD-Rs
A product that interfaces to a Radiology Information System via DICOM
A DICOM image viewer that can handle a wide range of modality images, including radiation therapy planning information. It also can query and retrieve information from a remote application and can read both DICOM generic CD-R and DVD-RAM
A DICOM print server
A DICOM query/retrieve server

25. DICOM would truly only have Half the Power it currently has without the DICOM Conformance Statement!

26. With the Enhanced DICOM Conformance Statement
ability to better understand how products connect to each other via DICOM
what information they communicate and under what conditions
what information must be received for the application to function properly
how parameters must be configured to make the application function in specific ways
a formal way to describe the sequencing of messages between DICOM applications