1. 1 A Glimpse at the emerging Enhanced XA/XRF Object (DICOM Supplement 83) Heinz Blendinger (Chair DICOM WG-02), Rainer Thieme Siemens Medical Solutions Presented by Bas Revet, Philips Medical Systems

2. 2 Presentation outline The emerging XA/XRF StandardThe emerging XA/XRF Standard –Difference to other Enhanced IODs –Clinical Benefit of Enhanced XA Call for ParticipationCall for Participation

3. 3 The add-ons of Supplement 83 (Rev 11) New Functional groups (not complete) –Projection Pixel Calibration Macro –Table Position Macro –X-Ray Collimator Macro –Reversed Modality LUT Macro –X-Ray Field of View Macro –Frame Pixel Shift Macro Multi-frame Presentation Module Enhanced XA/XRF Image Module Attributes X-Ray Detector / X-Ray Image Intensifier Modules XA/XRF Mask Module ALL these improve Functionality & Interoperability

4. 4 New functionality: an example Dimension Module in enhanced XA images. Rotational Angiography examination can include frame “position” relative to the cardiac cycle as structural information. Dimensions can be used to group multi-frame image frames taken at identical positions of a stepping table device.

5. 5 ECG-gated Cardiac Application

6. 6 New attributes Simple Filter Factor DSA Window Values (Contrast/Brightness) Dedicated Reversed Modality DeLog LUT Dedicated Sequence to Reference other plane for Biplane Acquisition Context attributes

7. 7 Multi-Frame Presentation Module Edge Enhancement Not the same, but “closer” XA Object: private encoding Reason: Hard to “standardize” Algorithms Approximation XA enhanced: Attribute for “applied percentage”

8. 8 Dedicated Calibration Module Attributes to describe iso-centric geometry Include Table plane in geometric context Object plane relative to table

9. 9 Internal Calibration for Quantitative Assessments => Practical solution based on user experience °Rot °Ang D = # Px *  Px * SOD / SID SOD = (ISO - (TH-TO) / cos°Rot) * cos°Ang Object Plane SID SOD TO TH

10. 10 Supplement 83 Roadmap = Meeting of the WG-02 (green indicates the meetings already hold) = Meeting of the WG-06 (green indicates the meetings already hold) Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2002 2003 2004 Q1 Q2 Q3 Q4 2005 WG-02 writes the draft of the supplement « Enhanced XA ». Re-activation of the WG-02. Identify list of requirements of the new XA WG-06 review s the draft WG-02 updates the supplem ent Public comm ents WG-02 updates the supplem ent Supplement Draft Supplement issued for public comments Supplement In letter ballot Supplement In final text WG-06 includes the supplement in the standard

11. 11 Further work Differentiation on “processed” or “original” contents needed?Differentiation on “processed” or “original” contents needed? –Super SOP Class and SOP Classes for particular use –Allowed / blocked applications “Cut-line” between shared and non-shared contents“Cut-line” between shared and non-shared contents Further new attributes to support new applications or procedures.Further new attributes to support new applications or procedures.

12. 12 Summary The New DICOM enhanced XA/XRF Objects:The New DICOM enhanced XA/XRF Objects: –will enhance interoperability –will increase cross system functionality –will create platform for new applications Success requires more clinical inputSuccess requires more clinical input –Use Cases –Requirements for new applications and –Procedures

13. 13 Further Information / Contacts Please contact WG-02 chairman Heinz.Blendinger@siemens.com Supplement 83 Draft can be found at : http://dclunie.com/dicom-status/status.html Next meetings:  March 4 th and 5 th, 2004 at NEMA  May 4 th and 5 th, 2004 at SFR, Paris  End of August, 2004 in Munich (ESC)

14. 14 Thank you for your attention