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Note to IHE Committees:

Note to IHE Committees: This is my draft of the IHE Mammography Image Integration Profile talk for the workshop. If I have the time between now and the final draft, my intention is to add a few more examples of the problems customers face w/o the profile and to review my topics for coverage.

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Note to IHE Committees:

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  1. Note to IHE Committees: This is my draft of the IHE Mammography Image Integration Profile talk for the workshop. If I have the time between now and the final draft, my intention is to add a few more examples of the problems customers face w/o the profile and to review my topics for coverage. I also will add a little animation in stepping through bulleted points. I tried to follow Kevin’s basic outline, but took a few liberties with it to share the info that I felt was important for the time allotted. I welcome your feedback which you can send me at creynolds@hologic.com Thanks, Carolyn Reynolds

  2. Mammography Image Integration Profile Carolyn Reynolds Hologic, Inc. Vendor co-chair, IHE Mammography Committee

  3. What’s the big deal? Full Field Digital Mammography (FFDM) is just another modality to PACS Most existing PACS will handle FFDM fine once: the FDA approves the monitor hardware, and workstations have 510K approval for FFDM applications Mammography Image IntegrationThe Problem/Assumptions

  4. Mammography Image IntegrationNot just another modality! • What makes it different or challenging: • Image layout & orientation • Variances among vendors in image data and attributes • Two types of image data • Common use of CAD (Computer Aided Detection) • Importance of prior study comparisons • Regional governance such as MQSA (Mammography Quality Standards Act – USA)

  5. Mammography Image IntegrationTypical components & data Modality Workstation Archive “For Processing” Image Data “For Presentation” Image Data CAD Mammo CAD Structured Rpt

  6. Display in order of images taken • Image orientation as acquired • Stacked series example R L L R Generic Image Display LayoutsApplied to Mammo Images

  7. R L L R R L R L Example Preferred Layout • Hanging protocol determined by: • View Type • Laterality • Patient Orientation vs. or

  8. R L Variances in FFDM Vendor DataDetector Size Example Typical “Fit to Viewport” effect L R Prior Exam from Vendor A’s system L R R L Current Exam from Vendor B’s system

  9. Mammography Image IntegrationValue proposition • Initiated by Radiologist’s challenges of having multiple FFDM vendors and desire to use PACS vendor’s workstation • Ensures that FFDM modalities provide adequate information to facilitate downstream applications

  10. Mammography Image IntegrationValue proposition • Ensures components support required data objects for interoperability • Defines image display and printing operations required for effective and efficient diagnoses

  11. Mammography Image IntegrationScope • Based upon existing actors and transactions • Expanded requirements within each transaction

  12. Mammography Image IntegrationScope

  13. Mammography Image IntegrationExpanded Requirements • Acquisition Modality • Send both for processing and for presentation images with reference that ties them together • Additionally required DICOM attributes • Detection and indication of tissue vs. air gap • Partial View Option (breast is larger than detector) • Modified requirements for film digitizers

  14. Mammography Image IntegrationExpanded Requirements • Image Display • Hanging protocols based upon view, laterality, patient orientation, and specialty views • Maintain a black air gap during window/center operations and inverted pixel data • Sizing • Same relative size • True size • 1:1 detector pixels to display pixels

  15. Mammography Image IntegrationExpanded Requirements • Image Display cont’d • Measurement calculation requirements • Display calibration and grayscale rendering • Labeling requirements • Mammo CAD Structured Report rendering on “for presentation” images • Partial View Option (breast larger than detector)

  16. Mammography Image IntegrationExpanded Requirements • Image Manager • Storage and retrieval of For Presentation and For Processing SOP Classes for Digital Mammography X-Ray • Storage and retrieval of Mammography CAD Structured Report SOP Class

  17. Mammography Image IntegrationExpanded Requirements • Evidence Creator (CAD) • No specifics on how CAD obtains mammography images • Support for Mammography CAD SR SOP Class and Storage Commitment

  18. Mammography Image IntegrationExpanded Requirements • Print Composers/Print Servers • True Size printing • Justify chestwall and print with 5mm borders or less • Render VOI LUTS if present • Specify maximum density • Specify Presentation LUT • Labeling requirements • Support for 12 bit pixel depth

  19. Mammography Image Integration Questions???

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