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DICOM for Physicians : What can it do for you?

DICOM for Physicians : What can it do for you?. Kevin O’Donnell Toshiba Medical Research Institute. DICOM: A Standard. DICOM is the standard for medical imaging. Widely implemented Managed process (NEMA) International scope (ISO) and many pages of detail information….

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DICOM for Physicians : What can it do for you?

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  1. DICOM for Physicians :What can it do for you? Kevin O’Donnell Toshiba Medical Research Institute

  2. DICOM: A Standard DICOM is the standard for medical imaging. • Widely implemented • Managed process (NEMA) • International scope (ISO) • and many pages of detail information…

  3. DICOM: A Family of Protocols • Protocol • Specifies how two systems exchange information • Many kinds of Systems: • Modalities, PACS, RIS, Workstations, EMR,… • Many kinds of Information: • Images, worklists, measurements, surfaces, audit logs, …

  4. Why should I care? • Can I just ask for “DICOM”? * • Yes, if you don’t care what pieces you get • Pieces can be implemented independently • Depends on what the product needs to do • Won’t vendors just give me what I need? • (We try to, but …) your input matters • DICOM has it ≠ vendors use it (intelligently) • Know what is possible • Ask about your top priorities

  5. Store Images • DICOM stores your images * • All kinds of images • CT, MR, X-Ray, Ultrasound, Angiography, PET, SPECT, Mammography, Dentistry*, Dermatology,Endoscopy, Ophthalmology, IVUS, Pathology *Scanned Documents, … • Single & Multiframe; Volumes & Cines; B&W & Color; Original & Processed • DICOM helps manage your Images • Not just pixels; Significant meta-data • Patient identification & demographics, the order, equipment, acquisition, workflow context, … • PACS = database; DICOM = machine readable • Can query/sort/autoroute/manage

  6. Store (Imaging) Data * • Measurements • OB-GYN (fetal size metrics, etc.) • Echocardiography (size, flow, motion) • CT/MR Vascular (vascular flow metrics) • Ophthalmology (axial meas., perimetry) • Analysis • Location & characteristics of CAD findings • for Mammography, Chest X-Ray, Colonoscopy • Data • Waveforms (ECG, EEG, Voice)

  7. Manage Acquisition Workflow * • DICOM meets HL7 • Patient management, order placement in HL7 • RIS through Reporting in DICOM • Modality Worklist • Scheduled patient & exam information (electronic) • Exam Status & Coordination • Exam in-progress; complete; cancelled • Storage Commitment • Verify images on PACS before Modality deletes

  8. Display Images * • Accuracy • Screen calibration method & data (GSDF) • Consistent presentation (GSPS) • Modality calibration (Modality LUT) • Also works for Printing • Convenience • Key image flagging • Hanging Protocols • Structured Display • Information • Meta-data can be overlaid • Time & Space correlation

  9. Distribute Images * • by Local Network • Push & Pull (Query/Retrieve) • by Media • CD, DVD, BluRay, … • USB Memory, USB HardDrive • by Internet • Email attachment • Web Access to DICOM Objects (WADO) • DICOM Data and/or Rendered pictures • Registry & Repository architecture(XDS-I.b)

  10. Manage Other Workflows • Reporting Workflow • Worklists, status reporting • Post-processing Workflow • Worklists, status reporting • Radiotherapy • Procedure plans, worklists, verification • Substance Administration • Identification Service (barcode) • Verification Service

  11. Store Advanced Image Processing & Visualizations • Registrations • Rigid & Deformable • Different studies, modalities, atlases • Segmentations • Voxel Classification & Surface Definition • Fusion • Blended presentation • Surgical Implants • Implant models & implantation plans

  12. Support Security & Privacy * • Audit Trails • Record creation, access & modification in central log • De-identification • Remove identifying details to various degrees * • Encryption • Encrypt data elements or entire objects • Configuration • Autoconfigure DICOM devices

  13. Measure Quality & Performance • Workflow Timestamps • in data objects and workflow messages • Report Turnaround Time, Exam Times, … • QA Scans • Store and flag phantom scans • Radiation Dose • Summary & detail for each procedure • CT, Angiography/Fluoroscopy, Mammography, CR/DR • Work in Progress for PET

  14. … and More • DICOM does a lot • And we add to it every year. * • Today’s talks • most widely deployed features • Tomorrows talks • some of the exciting new features • Future • Tell us your needs • Physicians have directly driven a number of additions

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