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How to purchase interoperable Mammo Equipment Carolyn Reynolds Connectivity Manager Hologic, Inc. IHE Mammography Committee Stanford Conference on Breast.

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Presentation on theme: "How to purchase interoperable Mammo Equipment Carolyn Reynolds Connectivity Manager Hologic, Inc. IHE Mammography Committee Stanford Conference on Breast."— Presentation transcript:

1 How to purchase interoperable Mammo Equipment Carolyn Reynolds Connectivity Manager Hologic, Inc. IHE Mammography Committee Stanford Conference on Breast Imaging April 27, 2006

2 How to purchase interoperable Mammo Equipment vs. What to include in the RFP

3 Be careful of what you ask for…… …….you just may get it -Author Unknown

4 Be careful what you DONT ask for…… …….because it may not work

5 A True Story Asked if PACS could store mammography images modality PACS Mammo Workstation

6 A True Story Asked if PACS could store mammography images Did NOT ask if they could be retrieved modality PACS Mammo Workstation

7 A True Story Contd PACS did not offer –A diagnostic mammo workstation –Ability to print original quality mammo images Facility ended up investing in a separate storage solution for mammography with more efficient workflow modality PACS Mammo Workstation

8 Education – RFPs for Digital Mammography So, how do you know what to ask for? For a start, ask for the: IHE Mammography Image Integration Profile

9 Things to keep in mind Profile was just published this week 1 st real world test at Connectathon Jan 2007 Vendor adoption takes time Product development takes time Not all equipment is replaced at the same time

10 The Good News Many IHE Mammo features are available, today Other applicable IHE profiles may be of interest –Have been around for a while –Are widely adopted –Increase success in various clinical challenges –e.g. scheduling exams, storing data to CDs Education and knowledge are key

11 IHE Mammography Image Integration Profile Digital Mammography User Handbook Framework IHE Users Handbook Digital Mammography Goal: Provide education on deploying IHE to solve mammography interoperability challenges !! Section on RFPs !!

12 Mammography Deployment Handbook – RFP Section Example RFP language for –General product information –FFDM Modalities –Diagnostic Workstations –PACS, Archives –Printers –CAD Systems –Film Digitizers –Other IHE Profiles of interest

13 General RFP Recommendations Ask vendor(s) for commitment to the IHE Mammography Image Integration Profile (MAMMO). Ask about: –Upgrade to existing product or new product –Anticipated availability –Budgetary pricing or other possible charges

14 General RFP Recommendations For each of the components that you will be purchasing…. –Request a DICOM Conformance Statement –Request an IHE Integration Statement

15 IHE Integration Statement VendorProductVersionDate Integrated Medical System Awesome FFDM July 2006 This product implements all transactions required in the IHE Technical Framework to support the IHE Integration Profiles, Actors and Options listed below: Integration Profiles Implemented Actors ImplementedOptions Implemented Mammography Image Integration Acquisition Modality Partial View Scheduled WorkflowAcquisition Modality Assisted Acquisition Protocol Setting PPS Exception Management Option Broad Worklist Query Patient Based Worklist Query Patient Information Reconciliation Acquisition Modality None Portable Data for Imaging Media Creator None Links to Standards Conformance Statements for the Implementation HL7Not applicable DICOMhttp://integratedmedsys/dicom.htm Links for general information on IHE In North America: In Europe: In Japan: j Example IHE Integration Statement

16 Acquisition Modality- Presentation Requirements Does your modality: Differentiate spot and magnified views from regular views (i.e. CC View)? Yes___No___ Detect the skin line and differentiate breast tissue from non-breast tissue in the image? Yes___No___ Contain any private or proprietary methods of image display not communicated through the standard DICOM img path? Yes___No___ In General Does your system encode data in a way that will be compatible with my downstream devices?

17 Workstations Data Requirements Does your workstation: Support and display DICOM Digital Mammography X-Ray objects with an intent type of FOR PRESENTATION? Yes___No___ Support and display Mammography CAD Structured Reports? Yes___No___ Use the Referenced Source Image Sequence attributed to tie for presentation images to CAD results performed on for processing images? Yes___No___ In General: Can the workstation handle the necessary data for mammography images and CAD results? Does it know how to tie the two together?

18 Workstations Hanging Protocols Can your product handle mammography hanging protocols correctly? VS.

19 Workstations Hanging Protocols There is not one size fits all protocol for mammography As part of your RFP, clarify your own preferred layouts and desired sequence of layouts Make sure HPs are determined by factors on next slide, not the traditional study and series description attributes.

20 Workstations Hanging Protocols Can your hanging protocols simultaneously display current & prior 4 view screening mammographic images? Yes___No___ Do your hanging protocols use the following attributes to determine placement and orientation of mammography images? View Code Sequence Laterality Patient Orientation View Code Sequence Modifier Yes___ No___ Do your hanging protocols require specific values in study description or series description attributes? Yes___No___ Sample language for RFP

21 Workstations Size Presentation Can your workstation: Display a patients images the same relative size, based upon the imager pixel spacing attribute, even if images were captured on detectors of different size and resolution? Yes___No___ Display images in the actual physical size as on the detector by using the imager pixel spacing attribute and the physical size of the monitor in calculations? (true size mode) Yes___No___ Display image pixels such that one pixel on the monitors resolution equates to one pixel of the detector resolution? (1:1 pixel mode) Yes___No___ Does your product handle sizing correctly? VS.

22 Workstations Display & Contrast Adjustment Can the workstation be calibrated according to the DICOM Grayscale Display Function which site control over maximum and minimum luminance? Yes___No___ When adjusting contrast and inverting image pixels, can the workstation keep the air gap black. Yes___No___ Use imager pixel padding value multiplied by radiographic magnification for the basis of measurement tools? Yes___No___ Does the workstation provide a method to render and apply all available window/center, VOI LUTs, or VOI LUT Function attributes? Yes___No___ Will you get the grayscale right? Can you keep the air gap (non breast tissue) area black during contrast adjustments and inversions? Will my measurements be correct?

23 PACS / Archive Data Requirements Does your archive: Support storing and returning in tact all attributes for DICOM Digital Mammography-for presentation image objects? Yes___No___ Support storing and returning in tact all attributes DICOM Digital Mammography for processing image objects? Yes___No___ Support storing and returning in tact all DICOM Mammography CAD Structured Reports? Yes___No___ Knowingly add, change, or delete any DICOM attributes related to the above objects? If so, explain______________________________ Yes___No___ Can I store all the data necessary to support digital mammography on my PACS? Can I get back out all the data that I stored, or has it been modified in some way? Is it possible that a PACS data modification could break the functionality of other components ?

24 Print Application Modality, Workstation, or PACS When printing: Does your product use the Imager Pixel Spacing attribute to send the Requested Image Size attribute to the printer (a.k.a. true size printing)? Yes___No___ Does your product justify the chestwall to the edge of the image before printing? Yes___No___ Can your product send the maximum density attribute to the printer for mammography images, recognizing that it is likely different than that used for other modalities? Yes___No___ Can your product print film with: The proper maximum density? The proper physical size? Annotations per MQSA requirements? Minimum to no border at chestwall?

25 Printers Can your printer: Print true size based on the Requested Image Size (2020,0030) within a precision of a maximum 2% error in linear distance? Yes___No___ Justify and print mammography images such that film borders are less than 5mm at the chestwall (edge of the image)? Yes___No___ Apply the requested Maximum Density attribute, printing with a maximum optical density no less than 3.5? Yes___No___ Can your printer: Print images true size? Print at a maximum density appropriate for mammography? Print with minimal borders at the chestwall?

26 CAD System Can your CAD system: Provide results using the Mammography CAD Structured Report DICOM object? Yes___No___ Send results to both PACS and workstations automatically? Yes___No___ Use DICOM Storage Commitment transaction for reports sent to any destination? Yes___No___ How can I have confidence in the sending and receipt of CAD results?

27 Summary Educate yourself on what to ask for Ask vendors about their commitment to IHE Mammo Get a copy of the existing IHE Users Handbook Get a copy of the IHE Mammography User handbook – RSNA 2006 Have technical resources read the IHE Mammo Technical Framework

28 More information…. IHE Web site: –Technical Frameworks –Users Handbooks –IHE Fact Sheet and FAQ –IHE Integration Profiles: Guidelines for Buyers –IHE Connect-a-thon Results –Presentations –Vendor Products Integration Statements

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