Advances in DICOM will enhance the clinical operation of XA.

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
Presentation outline

• The emerging XA/XRF Standard
• Difference to other Enhanced IODs
• Clinical Benefit of Enhanced XA
• Call for Participation

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
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
ECG-gated Cardiac Application
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
Multi-Frame Presentation Module
Edge Enhancement
XA Object private encoding Reason Hard to
standardize Algorithms Approximation XA
enhanced Attribute for applied percentage
Not the same, but closer
8
Dedicated Calibration Module

• Attributes to describe iso-centric geometry
• Include Table plane in geometric context
• Object plane relative to table

9
Internal Calibration for Quantitative Assessments
D Px ? Px SOD / SID SOD (ISO - (TH-TO)
/ cosRot) cosAng
Rot
SID
Ang
TH
Object Plane
SOD
TO
gt Practical solution based on user experience
10
Supplement 83 Roadmap


2002

2003

2004

2005



Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4





WG
-
02 writes the draft
WG
-
06
WG
-
02
Public
WG
-
02
WG
-
06
Re
-
activation of

of the supplement
review
updates
updates
includes the
comm
the WG
-
02.



Enhanced XA

.

s the
the
the
supplement
Identify list of
e
nts


draft

supplem
supplem
in the
requirements of

ent

ent

standard

the new XA





Supplement

Supplement

Supplement

Supplement



issued for
Draft

In letter
In final text


public
ballot

comments






Meeting of the WG
-
02 (green indicates the meetings already hold)


Meeting of the WG
-
06 (green indicates the meetings already hold)

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Further work

• 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
• Further new attributes to support new
  applications or procedures.

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Summary

• 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 input
• Use Cases
• Requirements for new applications and
• Procedures

13
Further Information / Contacts

• Please contact WG-02 chairman
• Heinz.Blendinger_at_siemens.com
• Supplement 83 Draft can be found at
• http//dclunie.com/dicom-status/status.html

• Next meetings
• March 4th and 5th, 2004 at NEMA
• May 4th and 5th, 2004 at SFR, Paris
• End of August, 2004 in Munich (ESC)

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Thank you for your attention