1 DICOM Singapore 2005 C. Parisot - GE DICOM Exchanging Imaging Data Various Modality Images,...

1 DICOM Singapore 2005C. Parisot - GE

DICOMDICOMExchanging Imaging DataExchanging Imaging Data

Various Modality Images, Presentation States, Structured Reports Various Modality Images, Presentation States, Structured Reports Finding and Retrieving Imaging ObjectsFinding and Retrieving Imaging Objects

DICOM Course – Singapore April 2005DICOM Course – Singapore April 2005


DICOM...Is a GLOBAL STANDARD of Communication, developed under joint efforts ofACR (American College of Radiology) NEMA (National Electrical Manufacturers Assoc.)ESC (European Society of Cardiology) ACC (American College of Cardiology)SFR (Société Française de Radiology)DRG (Deutschen Röntgengesellschaft)AAO (American Academy of Ophthalmology)AAD (American Academy of Dermatology)CAP (College of American Pathology)JIRA (Japaneese Radiology Vendors Association)COCIR (European Radiology Vendors Association)And 25 plus vendors……


• 20 Vendors 20 Vendors at the ‘93 DICOM RSNA Demonstration at the ‘93 DICOM RSNA Demonstration

• 40 Vendors40 Vendors at the ‘94 and 95 DICOM RSNA Demonstrations at the ‘94 and 95 DICOM RSNA Demonstrations

• More than More than 100 Vendors100 Vendors at RSNA 96 at RSNA 96

Since 1997 Since 1997 –– Too many to count !Too many to count !

DICOM first release approved October ’93DICOM first release approved October ’93

10 year anniversary10 year anniversary


DICOMDICOM documents updated yearly documents updated yearly

DICOM DICOM 20042004 is a is a compatible extensioncompatible extension of DICOM 2003 of DICOM 2003 + + 2727 Clarifications/Changes + 80 Supplements Clarifications/Changes + 80 Supplements

But DICOM 3.0, DICOM 96, DICOM 98But DICOM 3.0, DICOM 96, DICOM 98, DICOM 99, DICOM 2000, DICOM 99, DICOM 2000 DICOM 2003 are only document publishing name DICOM 2003 are only document publishing namess..

This has no direct impact on existing This has no direct impact on existing Product Conformance !Product Conformance !

Available for free from the DICOM website:Available for free from the DICOM website:

dicom.nema.orgdicom.nema.org


STORAGE

Networking Support, e.g.. TCP/IP

IMAGE INFORMATION OBJECTSQUERY

RETRIEVE

IMAGE

DICOM forDICOM forImage TransferImage Transfer

Understanding Image transfer with DICOM ...Understanding Image transfer with DICOM ...


DICOM Spans Most of Medical ImagingDICOM Spans Most of Medical Imaging

INFORMATIONINFORMATIONOBJECTSOBJECTS

STORAGESTORAGE

Networking SupportNetworking SupportTCP/IPTCP/IP

QUERYQUERY

RETRIEVERETRIEVE

IMAGEIMAGE

DICOM runs onDICOM runs onInternet and Internet and

IntranetIntranet

CTCT, , MRMR, , CRCRSecond. Capt. (SC)Second. Capt. (SC)19931993

19951995X-Ray Cardio/VascX-Ray Cardio/VascX-Ray FluoroX-Ray Fluoro

19961996USUSNMNMPETPET

19971997 RTRT

19981998X-Ray Digital RADX-Ray Digital RADX-Ray Digital MammoX-Ray Digital MammoX-ray Intra-OralX-ray Intra-OralStored PrintStored Print

1999 Pathology, Optalmo.Pathology, Optalmo.VaweformVaweform

20032003 enhanced MR,enhanced MR, eCT, ….. eCT, …..

2001 Structured Reporting , Structured Reporting , KOS, Present. StatesKOS, Present. States


19971997 RTRT

19981998X-Ray Digital RADX-Ray Digital RADX-Ray Digital MammoX-Ray Digital MammoX-ray Intra-OralX-ray Intra-OralStored PrintStored Print

DICOM Spans Most of Medical ImagingDICOM Spans Most of Medical Imaging

CTCT, , MRMR, , CRCRSecond. Capt. (SC)Second. Capt. (SC)19931993

19951995X-Ray Cardio/VascX-Ray Cardio/VascX-Ray FluoroX-Ray Fluoro

19961996USUSNMNMPETPET

1999 Pathology, Optalmo.Pathology, Optalmo.VaweformVaweform

20032003 enhanced MR,enhanced MR, eCT, ….. eCT, …..

2001 Structured Reporting, Structured Reporting, KOS, Present. StatesKOS, Present. States

DICOM transfers not only DICOM transfers not only ImagesImages, but also:, but also:

- Therapy Plans, Structures, etc. - Therapy Plans, Structures, etc. - Soon Waveforms- Soon Waveforms- Structure- Structuredd Reports Reports

DICOM transfers not only DICOM transfers not only RadiologyRadiology images, but also: images, but also:

- Cardiology (X-Ray Angio, US, NM)- Cardiology (X-Ray Angio, US, NM)- Oncology (RT Portal images)- Oncology (RT Portal images)- Dentistery (X-ray Intra-Oral)- Dentistery (X-ray Intra-Oral)- Pathology, Endoscopy, Microscopy, - Pathology, Endoscopy, Microscopy,

Optalmology, etc.Optalmology, etc.


What can I really do with DICOM TODAY ?What can I really do with DICOM TODAY ?

• Build simple and easy-to-implement networksBuild simple and easy-to-implement networks

• Reap efficiency and productivity benefitsReap efficiency and productivity benefits

• Invest in a necessary step for future PACSInvest in a necessary step for future PACS


Simple Networks in Radiology and TeleradiologySimple Networks in Radiology and Teleradiology

Analysis or Review

Workstation

CT, MR, NM, US, Digitizer, CT, MR, NM, US, Digitizer, CR, digital X-ray, PETCR, digital X-ray, PET

ISDN LinkISDN Linkor Dial-Upor Dial-Up

Local Area NetworkLocal Area Network

CT, MR, NM, US, Digitizer, CT, MR, NM, US, Digitizer, CR, digital X-ray, PETCR, digital X-ray, PET

ImagingImagingEquipment Equipment

ImagingImagingEquipment Equipment DICOM DICOM

SERVICES SERVICES USED USED

DICOM STORAGE DICOM STORAGE QUERY/RETRIEVEQUERY/RETRIEVE

DICOM DICOM STORAGE STORAGE

DICOM DICOM STORAGE STORAGE

A DICOM Network, today’s common foundation A DICOM Network, today’s common foundation both inside Radiology and for Teleradiology both inside Radiology and for Teleradiology

RemoteWorkstation


Networks in Radiology and Care Units with Cluster ArchivingNetworks in Radiology and Care Units with Cluster Archiving

Analysisor Review

Workstation

ImagingImagingEquipment Equipment DICOM DICOM

SERVICES SERVICES USED USED

DICOMDICOMSTORAGE STORAGE

ImagingImagingEquipment Equipment


RemoteWS

ISDN LinkISDN Linkor Dial-Upor Dial-Up


Local Area NetworkLocal Area Network

ClusterClusterArchiveArchive

CT, MR, NM, US, Digitizer, CT, MR, NM, US, Digitizer, CR, digital X-rayCR, digital X-ray

CT, MR, NM, US, Digitizer, CT, MR, NM, US, Digitizer, CR, digital X-rayCR, digital X-ray

Cluster Archive Cluster Archive

DICOMDICOMQUERY/RETRIEVEQUERY/RETRIEVE

A DICOM Network is the common foundation both A DICOM Network is the common foundation both inside Radiology and for Teleradiology inside Radiology and for Teleradiology

Care UnitCare Unit

Analysisor Review

Workstation

DICOM STORAGEDICOM STORAGE


What should I do to buildWhat should I do to build a DICOM Image Transfer Network ?a DICOM Image Transfer Network ?

Three Steps:Three Steps:

1 - Clarify my Clinical Needs for Image Transfer and 1 - Clarify my Clinical Needs for Image Transfer and Image processing Applications Image processing Applications

2 - Match Those Needs with DICOM Service Classes 2 - Match Those Needs with DICOM Service Classes using the using the DICOM Conformance StatementsDICOM Conformance Statements

3 - Validate the Imaging Application Interoperability3 - Validate the Imaging Application Interoperability


Step 2 - Compare DICOM Conformance StatementsStep 2 - Compare DICOM Conformance Statements

SCU = Service Class USERSCU = Service Class USER

SCP = Service Class PROVIDERSCP = Service Class PROVIDER

CT ScannerCT ScannerConformance StatementConformance Statement

WorkstationWorkstationConformance StatementConformance Statement

1-CT STORAGE SCU1-CT STORAGE SCU

2-QUERY SCP2-QUERY SCP

3-RETRIEVE SCP3-RETRIEVE SCP

4-MODALITY WORKLIST SCU4-MODALITY WORKLIST SCU

1-CT STORAGE SCP1-CT STORAGE SCP

2-QUERY SCU2-QUERY SCU

3-RETRIEVE SCU3-RETRIEVE SCU

4-MR STORAGE SCP4-MR STORAGE SCP

5- BASIC PRINT SCU5- BASIC PRINT SCU

Matching DICOM Service ClassesMatching DICOM Service ClassesThe necessary step to find what will workThe necessary step to find what will work


Service Object Pair (SOP) Class

•CR Image Storage SOP Class•CT Image Storage SOP Class

+

Store Command (the Service)

=

DICOMCommunication

(SOP Class)

Image Info. Obj.(the Data)

Modified Slide from Don Van Syckle

Patient Modul

e

General

Study Modul

e

Patient Study

Module*

General Series

Module

Frame of Reference Module

General Equipment

Module

Imag

e Module

General

Image Modul

e

Image Plane Modu

le

Contrast/

Bolus Modul

eOverlay

Plane Modul

e*

VOI LUT

Module*

SOP Comm

on Modul

e

Image Pixel

Module


Image IODsImage IODs

Patient Module

General Study

Module

Patient Study

Module*

Patient Information

Study Information

General Series

Module

Frame of Reference Module

General Equipment

Module

Series Information

Image Module

General Image

Module

Image Plane

Module

Contrast/Bolus

ModuleOverlay

Plane Module*

VOI LUT

Module*

SOP Common Module

Image Pixel

Module

Image Information

Not only contains pixel data butalso key information about the image

Patient’s Name

Patient’s ID

Patient’s Birth Date

Patient’s Sex

Patient’s Weight*Referring Physician’s NameAccession NumberStudy Instance UID

Modified Slide from Jay Gaeta


Storage

• Send/Receive (i.e. push images on the network)

• SOP Class dependent on IOD– CT, MR, US, CR/DR, X-ray, Secondary Capture, RT, NM, Structured

Report… (i.e. not only images)

• How the SCP stores the image is not defined by DICOM (i.e. storage of all data not guaranteed)

• May send a study via multiple associations

• May send more than one study on an association

DICOM does NOT definean “one size fits all” image


Storage Transfer – Push Images

Shared ArchiveDigital Modality

- C-STORE-RQ Command

- Image Header Data (i.e. Name, ID, Row, Col..)

- Pixel Data

C-STORE-RQ …

C-STORE-RSP…

-C-STORE-RSP Command (Status)

Multiple transfers usuallyoccur on the same association

Storage SCU Storage SCP

Modified Slide fromDon Van Syckle


Query/Retrieve• Typically used by workstations for remote

access and image retrieval from archives

• Simple queries such as - “give me the patient name and ID for studies performed today”

• Simple retrievals such as -“give me images for Study XYZ

• Based on information models– Patient model, Study model and Patient/Study only

Enables the “pulling” of images Modified Slide fromDon Van Syckle


Verification• “Echo” to verify application level communication

between two DICOM products

• Often used for service diagnostics to determine if another product is on-line or off-line

• Products who accept DICOM associations are required to support Verification as an SCP

Verification SCU Verification SCP

C-ECHO-RQ (no data set)

C-ECHO-RSP (success status)

Shared ArchiveDigital Modality



Query Remote Device

Query SCP

-C-FIND-RQ Command- Study=today, give me name/ID, etc.

C-FIND-RQ

C-FIND-RSP

-C-FIND-RSP Command (Pending Status)- Study=Today, Joe Smith, 13456-7

C-FIND-RSP

-C-FIND-RSP Command (Pending Status)- Study=Today, Phil Jones, 2761-2

C-FIND-RSP

-C-FIND-RSP Command (Success Status)

-Query remote database

-Pending rsp for each match

-One rsp for final status

Query SCU

Shared ArchiveWorkstation



Retrieve – Pull Images

Workstation

Retrieve SCUShared Archive

Retrieve SCP

-C-MOVE-RQ Command- Study Inst UID for images to pull.

C-MOVE-RQ

-Request Move “Pull” of images-Archive opens second association to send images (the roles change for storage)-Response on same association as C-Move-RQ

C-STORE-RSP

C-STORE-RQ

(Typically for Multiple Images)

Separate association then Move

C-MOVE-RSPSame association as Move-RQ

-C-MOVE-RSP Command (Status)



Three Device Move

Workstation A

Retrieve SCU

Shared Archive

Retrieve SCP

C-MOVE-RQ

-A requests the Move of images to B

-Archive opens second association to B

-Archive sends images to B then closes assoc

-Association between A and archive open during image transfer

-Archive provides final Move-RSP status to A

-All Retrieve SCPs required to support the Three Device Move

C-S

TOR

E-R

SP

C-S

TOR

E-R

Q

C-MOVE-RSPAfter the image transfer completed

Workstation B

Storage SCP Modified Slide fromDon Van Syckle


We hope you understood DICOMand are now ready to use it.

Thank You !

charles . parisot @ med . ge . com

1 DICOM Singapore 2005 C. Parisot - GE DICOM Exchanging Imaging Data Various Modality Images,...

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