HL7 May 2001 Working Group Meeting DICOM Tutorial Introduction to DICOM

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HL7 May 2001 Working Group MeetingDICOM
TutorialIntroduction to DICOM

• May 8, 2001, 900 1030 a.m.
• Fred M. Behlen, Ph.D.

Kurt Rossmann Laboratories for Radiologic Image
Research Department of Radiology
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DICOM Standard

• ACR-NEMA 1.0
• Published as NEMA PS3-1985
• ACR-NEMA 2.0
• Published as NEMA PS-1988
• Digital Imaging and Communications in Medicine
  (DICOM) 3.0
• Published as NEMA PS3-1993(94?), and (almost)
  annual updates thereafter.PS3-2000 now available.

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DICOM Scope
Medical Informatics
. . .
PatientBedsideMonitoring
Administrative HIS/RIS
Lab Data
. . .
DiagnosticImaging
Scope ofDICOM
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Scope of standards

• Information Repre- Transfer Signaling model sent
  ation mech- method
• syntax anism
• DICOM X X X
• HL7 X X X
• XML X
• CORBA X X
• HTTP, FTP X
• TCP/IP, Ethernet X

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DICOM Standard
The DICOM Standard is structured as a multi-part
document using the guidelines established in the
following document ISO/IEC Directives, 1989
Part 3 Drafting and Presentation of
International Standards.
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DICOM Standard

• PS 3.1 Introduction and Overview
• PS 3.2 Conformance
• PS 3.3 Information Object Definitions
• PS 3.4 Service Class Specifications
• PS 3.5 Data Structure and Encoding
• PS 3.6 Data Dictionary
• PS 3.7 Message Exchange
• PS 3.8 Network Communication Support for Message
  Exchange
• PS 3.9 Point-to-Point Communication Support for
  Message Exchange
• PS 3.10 Media Storage and File Format for Data
  Interchange
• PS 3.11 Media Storage Application Profiles
• PS 3.12 Storage Functions and Media Formats for
  Data Interchange
• PS 3.13 Print Management Point-to-Point
  Communication Support
• PS 3.14 Grayscale Standard Display Function
• PS 3.15 Security Profiles
• PS 3.16 Content Mapping Resource (2001)

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DICOM Supplements
Balloted Supplement
Published Standard

• PS 3.1
• PS 3.2
• PS 3.3
• PS 3.4
• PS 3.5
• PS 3.6
• PS 3.7
• PS 3.8
• PS 3.9
• PS 3.10
• PS 3.11
• PS 3.12
• PS 3.13
• PS 3.14
• PS 3.15

Introduction Part 1 changes Part
3changes Part 6 changes
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Conformance

• DICOM Conformance Statement
• Format and Content specified in Part 2
• Required for every claimed DICOM implementation
• If theres no Conformance Statement, its not
  DICOM.
• Intended audience for Conformance Statement is
  engineer, not customer.

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conformance
Vendor A
contractscope
interoperation
STANDARD
conformance
contract
Customer
Vendor B
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contract Ascope
conformance
Vendor A
contract A
Customer
interoperation
(voila!)
STANDARD
contract B
conformance
Vendor B
contract Bscope
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Key Sections

• PS 3.3 Information Object Definitions
• PS 3.4 Service Class Specifications
• PS 3.6 Data Dictionary

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DIMSE Services
Composite Normalized C-STORE N-EVENT-REPORT C-GET
N-GET C-MOVE N-SET C-FIND N-ACTION C-ECHO N-CREATE
N-DELETE
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PS 3.3 Information Object Definitions

• Computed Radiography Image
• Computed Tomography Image
• Magnetic Resonance Image
• Nuclear Medicine Image
• Ultrasound Image
• Ultrasound Multi-Frame Image
• Secondary Capture Image
• X-Ray Angiographic Image
• X-Ray RF Image
• Positron Emission Tomography Image
• Hardcopy Grayscale Image
• Hardcopy Color Image
• Digital X-Ray Image
• Digital Mammography X-Ray Image
• Digital Intra-Oral X-Ray Image

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PS 3.3 Information Object Definitions

• Visible Light Image
• VL Endoscopic Image
• VL Microscopic Image
• VL Slide-Coordinates Microscopic Image
• VL Photographic Image
• Standalone Overlay
• Standalone Curve
• Standalone Pet Curve
• Stored Print
• Standalone Modality Lut
• Standalone VOI Lut
• Grayscale Softcopy Presentation State
• Basic Study Descriptor

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PS 3.3 Information Object Definitions

• RT Image
• RT Dose
• RT Structure Set
• RT Plan
• RT Beams Treatment Record
• RT Brachytherapy Treatment Record
• RT Treatment Summary Record
• Waveform
• Basic Voice Audio
• 12-Lead Electrocardiogram
• General Electrocardiogram
• Ambulatory Electrocardiogram
• Hemodynamic
• Basic Cardiac Electrophysiology
• Structured Report Document
• Basic Text SR
• Enhanced SR
• Comprehensive SR

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PS 3.4 Service Class Specifications

• Verification
• Storage
• Query/Retrieve
• Study Content Notification
• Patient Management
• Study Management
• Results Management
• Print Management
• Media Storage
• Storage Commitment
• Basic Worklist Management
• Queue Management
• Grayscale Softcopy Presentation State Storage
• Structured Reporting Storage

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Service-Object Pairs (SOPs)
Information Objects
X X
X X X X X X X X X X
X
X X
X
X X
X
X X
X X
X
STORE
Services
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PS 3.5 Data Structure and Encoding

• Presentation Context
• Abstract Syntax
• Endianism
• Big Endian
• Little Endian
• Value Representation
• Implicit VR
• Explicit VR
• Transfer Syntax
• Uncompressed
• Compressed modes

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Data Set and Data Elements
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PS 3.3 Annex A IOD Modules
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PS 3.3 Annex C Patient ID Module
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PS 3.3 Annex C Pixel Module
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PS 3.3 Annex C Pixel Module
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Pixel Encoding
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PS 3.6 Data Dictionary

• Tag Assignments
• xxxx,xxxx
• Name (non-canonical)
• Value Representation
• Value Multiplicity
• DICOM-assigned UIDs
• Terminology Mapping Resource Registry
• Registry of Templates

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Diagnostic Imaging in the Patient Care Process

• Patient arrives
• Physician sees patient, writes order
• Patient goes to Imaging Department
• Patient is imaged
• Radiologist interprets images, writes report
• Physician looks at report (and often images)
• Physician treats patient based on report
• Patient discharged

ImagingDepartment
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Diagnostic Imaging in the Patient Care Process
Hospital Enterprise
Exam context
Results, Images
Radiology
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Exam Context
Imaging department obtains from the enterprise

• Patient identification
• Orders
• Other clinical information
• Scheduling (of some resources)
• Financial authorizations

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Patient visit
Study acquisition
Storeddata
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Patient visitIODs
Study acquisitionIODs
StoreddataIODs
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10-n
1
11-n
11-n
0-n
Requested Procedure
Requested Procedure IDRP Study Instance UID
1 1-n
0-n 0-m
1 1-n
0-n 0-m
Performed Procedure Step
Performed Proc. Step UID
11-n
Series
An Order Placer typically submit a single
order (ORM), however, an Order Filler can expand
that single order into multiple Requested
Procedures. See IHE Y2TF Section 6 for more
details. See Section 6 for a thorough
description of the cardinality relationship
options of Modality Performed Procedure Step.
The Performed Procedure Step UID is present
as the Affected SOP Instance UID.
Series UID
1 0-n
Instance
SOP Instance UID
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10-n
1
11-n
11-n
0-n
Requested Procedure
Requested Procedure IDRP Study Instance UID
1 1-n
0-n 0-m
1 1-n
0-n 0-m
Performed Procedure Step
Performed Proc. Step UID
11-n
Series
Series UID
1 0-n
Instance
SR Instance
SOP Instance UID
SOP Instance UID
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Results
Imaging department delivers to the enterprise

• Reports
• Images
• Exam status

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IHE Home Pages

• http//www.rsna.org/IHE
• http//www.himss.org/IHE

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DICOM Home Pages

• http//medical.nema.org/dicom.html
• Committee for the Advancement of DICOM
• DICOM Resources Page
• http//www.merge.com/dicom/resources/