What’s New in DICOM 2004 Robert Horn Agfa Healthcare Chair DICOM WG-06 (Base Standard)

29 November 2004RSNA New in the 2004 DICOM Publication New Image Objects Enhanced CT Ophthalmic Photography MPEG-2 and Visible Light (for endoscopy) New Structured Reports OB-Gyn Procedure, Catheterization Lab Procedure Vascular Ultrasound Procedure, Echocardiography Intravascular Ultrasound, Quantitative Arteriography Breast Imaging Media Related USB and Flash Memory Media Creation Services

29 November 2004RSNA New in DICOM 2004 (contd) Other services Relevant Patient Information Query Spatial Registration Instance Availability Notification Used with other standards Configuration Management Web Access to DICOM Objects

29 November 2004RSNA New Structured Reports All of these reports are designed to capture precise measurements taken by equipment during various diagnostic procedures. Examples include: –Fetal bone measurements –Vascular flow and diameter measurements Customized reports are defined for: –OB-Gyn procedures –Catheterization Lab Procedures –Vascular Ultrasound Procedures –Echocardiography –Intravascular Ultrasound (IVUS) –Quantitative Arteriography and Vasculography –Breast Imaging

29 November 2004RSNA Enhanced CT CT has been enhanced in a manner very similar to that done for MR last year. Instead of one object per slice, use multi-frame images Support segmenting the study into more conveniently sized objects. Support flexible structuring of slice descriptions and slice parameters. There is a CT and MR taskforce To avoid compatibility problems in the field To simplify the upgrade process To help ensure that a hospital can upgrade all of their equipment in a synchronized manner To reduce development costs for vendors

29 November 2004RSNA Enhanced CT and Enhanced MR Taskforce The implementations of Enhanced CT and Enhanced MR are really taking off now! The implementations of Enhanced CT and Enhanced MR are really taking off now! – Test Tool for MR is available – Test Tool for CT being prepared – Test and demonstration of Vendor implementations at SCAR 2005 – Vendor application for SCAR sessions still open. Interested parties should join the special session tomorrow hosted by NEMA: RSNA 2004 Interested parties should join the special session tomorrow hosted by NEMA: RSNA 2004 – Tuesday, November 30th, 13:00 – 14:00 McCormick Place: Room S105BC

29 November 2004RSNA Ophthalmic Photography Supports the many different forms of traditional ophthalmic photography, both still and moving, with and without contrast. – Fundus Photography, – Bio-microscopy (slit lamp) – External Photography Added generic support for describing stereo pairs for stereo viewing. All ophthalmic objects are potentially stereo components.

29 November 2004RSNA MPEG-2 and Visible Light Video The MPEG-2 standard for compressed video has been added as a transfer syntax. This syntax is presently limited to the broadcast television parameters, not other higher resolution configurations. Suitable for replacing videotape capture from standard television cameras. Defined a generic endoscopy object that supports this transfer syntax. This object is expected to be used as a functional replacement for the present video camera and video tape used during endoscopic procedures.

29 November 2004RSNA Media Related Additions USB and Flash removable media Generic removable USB devices. Compact Flash SD Flash Media Creation Services Similar to Print Services, but used to create CD’s and DVD’s.

29 November 2004RSNA Relevant Patient Information Query Simple Interface to HIS or other services for important patient information such as allergies. Intended for use in modalities and other equipment that is already DICOM enabled.

29 November 2004RSNA Spatial Registration Defines spatial relationships between multiple DICOM image objects. E.g.: Mapping PET and CT images to a common coordinate system. Mapping MR and CT images to a common coordinate system. Captures fiducial marker information: Location of fiducial marks on images Matching of fiducial marks between images

29 November 2004RSNA Instance Availability Notification Used by PACS, RIS, and other systems to coordinate scheduling of activity with the transfer of image data between systems. Recipient of images will notify other systems after image data transfer is complete. Prior DICOM messages had a way for a modality to notify the managing system that it was sending images to the archive, but lacked a way for the archive to indicate that all the images had arrived. The result was excessive queries by workstations asking the archive whether images had arrived yet.

29 November 2004RSNA Configuration Management Defines proper use of DNS, DHCP, and NTP for automatic assignment of IP addresses and automatic maintenance of correct time. Defines an LDAP information structure that describes the DICOM application configuration for a network. This is different from the other extensions in that it is intended to improve administration and network operations. Quicker installation, maintenance, and upgrades Easier reconfiguration of networks and facilities More potential for customer performed maintenance More potential for automatic and semi-automatic new equipment installation. Consistent time on images, reports, and user displays on all systems.

29 November 2004RSNA Web Access to DICOM Objects This is a joint effort together with ISO and is issued as both part of DICOM and an ISO standard A URL format is defined so that a web query from a web browser can be supported by a DICOM aware server. URL parameters indicate the desired patient, study, image, frame, and area of the frame that is to be returned as a JPEG image. Similar URL parameters are defined for some other operations on DICOM information.

29 November 2004RSNA Under development for future use Display related Hanging Protocol Softcopy color presentation state Display state capture Revised and New Imaging objects Enhanced XA and XRF Ion Therapy (Radiotherapy) Additional Ophthalimic objects Reports Fetal Ultrasound CT/MR Cardiovascular Analysis

29 November 2004RSNA Under development for future use RadioTherapy workflow and push model workflow Security Related Digital Signatures in Structured Reports Audit Trail Creation User Identity Management Substance Administration Management and Information Query Related to other standards HL7 CDA references from DICOM DICOM SR extensions to ease transcoding to CDA Encapsulation of PDF Objects Retirement of various old, unused, or redundant features