1 DICOM Anniversary 2003 Monday, September 22nd, 2003 15:00-15:20 Renaissance Harborplace Hotel...
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Transcript of 1 DICOM Anniversary 2003 Monday, September 22nd, 2003 15:00-15:20 Renaissance Harborplace Hotel...
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Advances in DICOM will Advances in DICOM will Enhance the clinical operation of Enhance the clinical operation of
MRMR
Kees Verduin, Philips Medical Systems
Chair DICOM WG16
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Presentation outlinePresentation outline
• The new MR StandardThe new MR Standard
• The clinical examples of its benefitsThe clinical examples of its benefits
• Roadmap for effective implementation Roadmap for effective implementation
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What is new ?What is new ?
Three new object definitionsThree new object definitions:
– Enhanced MR Image
– MR Spectroscopy
– Raw Data
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A new set of DICOM MR objectsA new set of DICOM MR objects
Not this time:Not this time:
the new Enhanced MR Image object serves the whole range of DICOM users: – from the modality specialist – to the user of a simple viewer in the same way.
So…. what is so exiting about it?So…. what is so exiting about it?
A new object, as such, is not great news.
7Multi-stack
Color
Spectroscopy
Dimensions
Multi-frame
Real World Values
Raw Data
A new MR Standard A new MR Standard (Supplement 49)(Supplement 49)
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The basics of Supplement 49The basics of Supplement 49
• Support of newest applications by New attributes• Less ambiguity through Stricter definitions and rules• Clear relationships through Reference mechanism• Header size reduction through Multi-frame technique• Context information from Image Type and Dimensions• File size flexibility through Concatenations• Functional images with Real World Values • Functional images with Palette Color LUT information
ALL these improve InteroperabilityALL these improve Interoperability
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What is really new ?What is really new ?
• Multi-Frame module with its Shared and Non-Shared header parts
• Dimensions and Dimension Organizations• Coded Object relationships
All these provide CONTEXT INFORMATION !
• Further: – Real World Values– Grayscale images with Color information
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The Multi-frame propertiesThe Multi-frame properties
• Whenever possible, all images of a scan-series shall become frames in one object.
• What is common to all frames, shall not be repeated: Elements that do not change vs. elements that change.
These have a different place in the object header.
• Related elements are defined in functional groups.
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From Single Image to Multi-frameFrom Single Image to Multi-frameN Objects, N Headers
Pixel data (not to scale)Non-Shared (per-frame) HeaderShared Header
N Frames, One Header
HEADER SIZE REDUCTION = less MB, faster transfer
KV
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From Single-frame to MultiFrameFrom Single-frame to MultiFrameN Objects, N Headers
N Frames, One Header
Pixel data (not to scale)Dimension data (not to scale)Per-frame headerFixed Header
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Multi-Frame not only for MR!Multi-Frame not only for MR!
The
Enhanced MR Image and
MR Spectroscopy
have a multi- frame structure that is
also useful for adoption by other modalitiesalso useful for adoption by other modalities.
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DimensionsDimensionsMR images can have many attributes that change from MR images can have many attributes that change from
frame to frame.frame to frame.• When such a change in an attribute is fundamental
for the object, this data element can be structured by the creator as part of the Dimension ModuleDimension Module.
• It supplies the Context Information required for a specialized workstation.
• It also provides an explicit display ordering for the frames in the MR object, that can be used by viewing systems without specific MR application knowledge.
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Object RelationshipsObject Relationships
Image
PriorImage
Spectro-scopy
RawData
0 -n
0-n
Source ImageSequence for derivedimages
Ref. Image Sequencerequired if planned onprior images
0 - n0 - n
Ref. ImageSequencerequired if plannedon prior images
Ref. Raw DataSequence
Ref. Image SequenceOnly if image type isMETABOLITE MAP
0-n
Ref. Raw DataSequence
Source Image Sequencefor derived spectroscopydata
Ref. Image Sequencerequired if planned onprior spectroscopy data
0 - n PriorSpectro-
scopy
Ref. Image Sequence if planned onprior image
0-n
Referenced Image Sequence Source Image Sequence
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Clinical ExamplesClinical Examples
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Diffusion ImagingDiffusion Imaging
“Diffusion b-values” from 0 to 8000 and an ADC image
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Diffusion Tensor Imaging dataDiffusion Tensor Imaging data
Reconstructed Fiber Maps in the colors as seen by the creator
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MR Perfusion ImagingMR Perfusion Imagingtime
non perfused stroke area
Sig
nal
delayed perfusion
time-to-peak map
Real World Value Slope (0040,9225)
Real World Value Intercept
(0040,9224)
RW values
Sto
red
va
lues
Quantitative data with Real World Values
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Cardiac Cine LoopsCardiac Cine Loops
Enables automatic multi-slice / multi-phase display, even for standard workstations
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Total body ImagingTotal body Imaging
Display the correct image at the correct spot using Stacks and In-stack positions
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3
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1 2 3 54
2
5
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Functional Brain ImagingFunctional Brain Imaging
• 10-60 slices• all slices measured
in one TR• repeated 100-1000
times to get sufficient signal
• leading to > 60,000 images in one object
Store thousands of images in one object and display them in a consistent way using Multi-frame Header and Dimension Module
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Relative NAA peak-height
Ratio ofCholine andCreatinine peaks
Spectroscopy ImagingSpectroscopy Imaging
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Spectroscopy RelationsSpectroscopy Relations
Relation:MR Image
Metabolite map
Ratio ofCholine andCreatinine peaks
Relative NAA peak-height
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CT Multi-frameCT Multi-frame
• The CT Multi-frame solution addresses the same data-explosion issues as for MR.
• Multi-detector CTMulti-detector CT generates large volumes of images that need to be provided with sufficient and adequate context information.
• Multi-frame solutions may provide more interoperability for navigation and processing.
• But, 3D processing requires more than a Multi-frame structure.
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Multi-modality - Multi-frame
• Implementations for processing of the generated volumetric data will largely benefit from multi-modality implementations of the multi-frame concept.
• Common structures may lead to common architecture, which in turn will speed up the implementations.
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Implementation RoadmapImplementation Roadmap
Who should be the first ?Who should be the first ?
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The timing dilemma The timing dilemma for the Enhanced MR objectfor the Enhanced MR object
• For the MR vendorsFor the MR vendors:– Why implement it, while nobody is ready to
use it?
• For the Workstation vendors:For the Workstation vendors:– Why implement it, when no one is creating it?
• For the PACS vendorsFor the PACS vendors:– Support it, but how to deal with the mix of
workstations that can yes/no receive it ?
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MRMR
ArchiveArchive
WorkstationWorkstation
NegotiateNegotiateNegotiateNegotiate
The Negotiation scenarioThe Negotiation scenarioDecide to Decide to
send New object send New object or send Old objector send Old object
Negotiate Decide to Decide to send New object send New object or send Old objector send Old object
Decide to send New object
or Cancel
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MRMR
ArchiveArchive
WorkstationWorkstation
NegotiateNegotiateNegotiateNegotiate
The Partial Conversion scenarioThe Partial Conversion scenarioDecide to Decide to
send New object send New object or send Old objector send Old object
Negotiate Decide to Decide to send New object send New object or send Old objector send Old object
Decide to send New object
or Convert object
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MRMR
ArchiveArchive
WorkstationWorkstation
NegotiateNegotiateNegotiateNegotiate
The Full Conversion scenarioThe Full Conversion scenarioDecide to Decide to
send New object send New object or or Convert Convert
Negotiate Decide to Decide to send New object send New object
or or Convert Convert
Decide to send New object
or Convert object
All old objects
will be identical
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When will implementationWhen will implementation be required ? be required ?
• As soon as stability is proven.• As soon as the object definition is tested• As soon as resulting changes are implemented
in the standard.
• Or…..
So, pacing may be neededSo, pacing may be needed
As soon as possible!As soon as possible!
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NEMA Members are funding NEMA Members are funding a Demonstration & Test Toola Demonstration & Test Tool
PurposePurpose:• Prove that implementation is possible• Prove the multi-frame header construction• Prove the use of dimensions• Provide a test tool for vendors and other
implementers• Validate implemented objects
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NEMA Demonstration &Test-toolNEMA Demonstration &Test-tool
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Tool availabilityTool availability
• The tool is available to the funding participants
• It is currently under test
• The tool will become available in the public domain in 2003
But…No need to wait with implementation
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Collective support is neededCollective support is needed
The benefits of Supplement 49 as described in The benefits of Supplement 49 as described in this presentation will this presentation will onlyonly be visible if and be visible if and whenwhen:: – MR scanners (creators)– DICOM workstations (receivers)– PACS systems (intermediaries)
will collectively support the newwill collectively support the new MR DICOM objects MR DICOM objects.
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• Vendors of Workstations / PACS need to prepare for implementation:
What should be done? What should be done?
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• Vendors of Workstations / PACS need to prepare for implementation:
– Prepare the color pipeline
What should be done? What should be done?
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Functional Color on Anatomic Grayscale Images
....
Palette Color
Number of
entries
Range of Stored
Values to be mapped to grayscale
Range of Stored
Values to be mapped to
color
R G B
Largest Monochrome Pixel Value
ModalityLUT
Color Display
Mapped to gray level RGB values by display deviceVOI
LUTP-
LUT
+
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• Vendors of Workstations / PACS need to prepare for implementation:
– Prepare the color pipeline– Prepare your databases for large objects
What should be done? What should be done?
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Functional Color on Anatomic Grayscale Images
....
Palette Color
Number of
entries
Range of Stored
Values to be mapped to grayscale
Range of Stored
Values to be mapped to
color
R G B
Largest Monochrome Pixel Value
ModalityLUT
Color Display
Mapped to gray level RGB values by display deviceVOI
LUTP-
LUT
+
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Concatenations
• An object may be split up into two or more SOP Instances, using the same concatenation UID
Legend:
Pixel data (not on scale)
Dimension data (not on scale)
Per-frame header
Fixed Header
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• Vendors of Workstations / PACS need to prepare for implementation:
– Prepare the color pipeline– Prepare your databases for large objects– Create your real-world values UI
What should be done? What should be done?
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Functional Color on Anatomic Grayscale Images
....
Palette Color
Number of
entries
Range of Stored
Values to be mapped to grayscale
Range of Stored
Values to be mapped to
color
R G B
Largest Monochrome Pixel Value
ModalityLUT
Color Display
Mapped to gray level RGB values by display deviceVOI
LUTP-
LUT
+
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Concatenations
• An object may be split up into two or more SOP Instances, using the same concatenation UID
Legend:
Pixel data (not on scale)
Dimension data (not on scale)
Per-frame header
Fixed Header
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Real World Values
• Relates the pixel value to the actual value and unit it represents (e.g., velocity in mm/sec)
Value Unit
StoredValues
RealValueLUT
VOILUT
PLUT Display
Real worldvalue
Modality
LUT
MeasurementUnits CodeSequence
(0040,08EA)
Real WorldValue LUT
Data(0040,9212)
Real WorldValue Intercept
and Slopeattributes
or
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• Vendors of Workstations / PACS need to prepare for implementation:
– Prepare the color pipeline– Prepare your databases for large objects– Create your real-world values UI – Prepare for Dimensions
and Dimension Organizations
What should be done? What should be done?
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Real World Values
• Relates the pixel value to the actual value and unit it represents (e.g., velocity in mm/sec)
Value Unit
StoredValues
RealValueLUT
VOILUT
PLUT Display
Real worldvalue
Modality
LUT
MeasurementUnits CodeSequence
(0040,08EA)
Real WorldValue LUT
Data(0040,9212)
Real WorldValue Intercept
and Slopeattributes
or
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Functional Color on Anatomic Grayscale Images
....
Palette Color
Number of
entries
Range of Stored
Values to be mapped to grayscale
Range of Stored
Values to be mapped to
color
R G B
Largest Monochrome Pixel Value
ModalityLUT
Color Display
Mapped to gray level RGB values by display deviceVOI
LUTP-
LUT
+
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Concatenations
• An object may be split up into two or more SOP Instances, using the same concatenation UID
Legend:
Pixel data (not on scale)
Dimension data (not on scale)
Per-frame header
Fixed Header
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Multi Stack
Stack ID3
Frame Number1 - 5
Frame Number6-10
Frame Number11-15
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1In-Stack Position
Stack ID2
Stack ID1
54
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1In-Stack Position
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1In-Stack Position
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• Vendors of Workstations / PACS need to prepare for implementation:
– Prepare the color pipeline– Prepare your databases for large objects– Create your real-world values UI– Prepare for Dimensions
and Dimension Organizations
What should be done? What should be done?
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Real World Values
• Relates the pixel value to the actual value and unit it represents (e.g., velocity in mm/sec)
Value Unit
StoredValues
RealValueLUT
VOILUT
PLUT Display
Real worldvalue
Modality
LUT
MeasurementUnits CodeSequence
(0040,08EA)
Real WorldValue LUT
Data(0040,9212)
Real WorldValue Intercept
and Slopeattributes
or
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Functional Color on Anatomic Grayscale Images
....
Palette Color
Number of
entries
Range of Stored
Values to be mapped to grayscale
Range of Stored
Values to be mapped to
color
R G B
Largest Monochrome Pixel Value
ModalityLUT
Color Display
Mapped to gray level RGB values by display deviceVOI
LUTP-
LUT
+
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Concatenations
• An object may be split up into two or more SOP Instances, using the same concatenation UID
Legend:
Pixel data (not on scale)
Dimension data (not on scale)
Per-frame header
Fixed Header
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Multi Stack
Stack ID3
Frame Number1 - 5
Frame Number6-10
Frame Number11-15
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1In-Stack Position
Stack ID2
Stack ID1
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1In-Stack Position
54
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1In-Stack Position
BH
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And finally… or first ?
Vendors of Workstations / PACS need to decide on the conversion scenario.
What should be done? What should be done?
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MRMR
ArchiveArchive
WorkstationWorkstation
NegotiateNegotiateNegotiateNegotiate
The Full Conversion scenarioThe Full Conversion scenarioDecide to Decide to
send New object send New object or or Convert Convert
Negotiate Decide to Decide to send New object send New object
or or Convert Convert
Decide to send New object
or Convert object
All old objects
will be identical
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MRMR
ArchiveArchive
WorkstationWorkstation
NegotiateNegotiateNegotiateNegotiate
The Negotiation scenarioThe Negotiation scenarioDecide to Decide to
send New object send New object or send Old objector send Old object
Negotiate Decide to Decide to send New object send New object or send Old objector send Old object
Decide to send New object
or Cancel
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SummarySummary
• The New DICOM MR Objects:The New DICOM MR Objects:
– will enhance interoperability
– will increase cross system functionality
– will reduce transfer time
• Success requires also action by Workstation Success requires also action by Workstation and PACS implementers.and PACS implementers.
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Further InformationFurther InformationMore in-depth discussions and presentations about:• Relationships between images • Concatenations• Dimension Organization• Real World Value mapping• Extended Image Type• Color Mappingcan be found at :http://medical.nema.org/dicom/presents.html
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Acknowledgement and copyrightAcknowledgement and copyright
Images for this presentation were provided by:
– GE Medical Systems– Philips Medical Systems– Siemens Medical Systems
• The slides of this presentation may be quoted if reference and credit to DICOM WG-16 is properly indicated
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Thank you for your attentionThank you for your attention
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