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Working Group 13 (Visible Light)

Working Group 13 (Visible Light). Berlin, September 15th, 2006. Emmanuel Cordonnier ETIAM , (Interim) co-chair Juergen Thiem SONY , (Interim) co-chair. Update in Orange. Agenda. Introduce participants (10 people from ESC, Uni. Liepzig, Olympus, Philips, Sony, Stryker, Tribvn, Etiam)

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Working Group 13 (Visible Light)

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  1. Working Group 13(Visible Light) Berlin, September 15th, 2006 Emmanuel Cordonnier ETIAM, (Interim) co-chair Juergen Thiem SONY, (Interim) co-chair Update in Orange

  2. Agenda • Introduce participants (10 people from ESC, Uni. Liepzig, Olympus, Philips, Sony, Stryker, Tribvn, Etiam) • WG-13 objectives and activities • Participation of users from medical societies • End-user feedback on video acquisition in xx-scopy • Need for acquisition context information in Endoscopy • Feedback on DICOM MPEG-2 implementation • Examples of DICOM video sequences • Perspectives of high definition video (HDTV) • Cooperation with WG-24, WG-26, IHE-J-Endoscope • Work item proposal, if required • Other business DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  3. WG-13 objectives and activities (1) • Scope: • To accompany the adoption of DICOM standards for still and motion Visible Light color images, produced by endoscopes, microscopes, or photographic cameras, and propose new DICOM standards if required, on both sides, creation and use. • Roadmap: • To contribute to accelerate the adoption of the DICOM MPEG2 Sup. 42 & 47. • To enlarge (number of modalities) and enrich (quantity of information) the DICOM VL standard. • To see if other topics must be specifically addressed around the existing standards, like, for example, streaming video, and/or, automation of workflow based on simple acquisition modalities ("unscheduled" and/or "one button" operation based). • To accompany/anticipate the adoption of HD video by the medical arena. DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  4. WG-13 objectives and activities (2) • Short Term Goals: • To develop and populate DICOM video sequence MPEG2 examples. • To propose a way for selecting sub-sequences using existing Key Object Selection. Postponed. • To refine acquisition context for Visible Light images (equipment and anatomy). Extended to other “touchy” attributes. • To accompany adoption of MPEG2 Transfer syntax for Ultra Sound. No real demand for the moment. • To accompany adoption of DICOM for VL images in Pathology. Responsibility transferred to the newly formed WG26. • Current Status: • WG-13 has been "reactivated" for the successful development and the adoption of DICOM ML@MP MPEG2 (Sup. 42 and Sup. 47). It is actually focusing of its real use by the actors of the domain. • Future Work Items: • TBD on HDTV to be prepared for the next WG13 meeting DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  5. WG-13 objectives and activities (3) • Risks: • Not enough participation from the key players of the domain (users and vendors), based in America, Asia and Europe. • No acceptance of the DICOM video objects by PACS vendors and administrators. • Challenges and Opportunities: • The use of VL images is rapidly growing (non/less invasive surgery, advanced diagnosis, surgery monitoring…). All equipment is migrating from analog to digital technology, thanks to consumer multimedia technologies. Targeted modalities are Gastroenterology, Laparoscopy, Orthopedics, Ophthalmology, Ear Nose Throat, Gynecology, Bronchoscopes. • The manufacturers and users are facing to the necessary integration with other equipment and information system, for quality, safety and efficiency objectives. DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  6. Participation of users from medical societies • Challenge: How to enroll users and vendors from the different medical specialties using Visible Light imaging systems? • Organize WG13 at dedicated medical conferences, such as EAES OK for vendors but not possible to meet users, yet. Probably in Gastroenterology user are more advanced. Next meeting in this domain and in North-America. • Cooperate with parallel initiatives (WG24, WG26, IHE-J-Endoscope…). Makes senses. DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  7. End-user feedback on video acquisition in xx-scopy • The video acquisition has different origin: • Image guided diagnosis • Image guided surgery • Surgical operation recording • Monitoring (vital signs…): in video only for display? • Record the video aims to: • Facilitate the workflow from admission to reporting • Enrich the Electronic Healthcare Record (EHR) • Contribute to research and education • Create audit trails only few demand for the moment DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  8. Image source / Interest for storing DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  9. to be studied by implementers IODs Modules To be sure the PACS is accepting the object, many xx-scopy vendors Are exporting SC only. But to add additional attributes, they are ready to export VL objects. DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  10. Typical « touchy » Attributes to be studied by implementers • General Image / Image Type (ORIGINAL\PRIMARY) • SC Equipment / Secondary Capture Device Manufacturer vs. SOP Common / Manufacturer • General Series / Performing Physician’s Name vs. General Study / Referring Physician’s Name • General Study / Study Description vs. Acquisition Context Module / Acquisition Context Description • VL Image / Anatomic Region Sequence • Acquisition Context DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  11. Anatomic Region Sequence 1C to be studied by implementers DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  12. Anatomic Region Codes for VL « ES » to be studied by implementers DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  13. Acquisition Context for Endoscopy to be studied by implementers DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  14. Examples of DICOM video sequences • Availability of such sequences? Some are ready to provide such sequence • Objective of such a repository? To improve the interoperability (“touchy” attributes…) • Qualification of examples? Decided by the vendor but shall be a “real” object, “not patched” • Interest to share them between vendors? Yes • Management of the repository? NEMA • Level of access (public / DSC members…)? onlycontributingDICOM DSC “vendor” members DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  15. Perspectives of high definition video • Use case(s): the general demand for highest accessible quality. Some medical cases where HD is required could emerge • Limitations of the present DICOM MPEG2 for such use cases: too early to say • Possibilities afforded by HDTV (demonstration): three vendors shown it • Standards used (MPEG2 HD, MPEG4…): MPEG2 MP@HL seems to be the best candidate, up to 1080p, typically 1080i or 722p, OK for the MPEG2 HD decoders • Link with media storage (DVD…): could be the different DVD HD format supported by the HD DVD readers, but too early to say DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  16. WG-24, WG-26, IHE-J-Endoscope Maintain the “link” with the three groups • WG-24 (Surgery): use case definition, analysis of the workflow in surgery, depending of the domains: needs for analysis of the workflow at a more global (but simple) level (unscheduled…) • WG-26 (Pathology): analysis of the DICOM object model to fit with pathology context (specimen, blocks, slides…); whole slide images (WSI) and object format. Interesting but quite different approach than for endoscopy where the diagnosis is done by the physician during the act • IHE-J-Endoscope: workflow in diagnosis endoscopy and related acquisition context. Even in surgical endoscopy, need for link with the pathology. DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  17. IHE-J Diagnosis Endoscopy Workflow 1 not yet come 2 arrival 3 start premedication 4 completed premedication 5 start exam 6 completed exam 7 start recovery 8 completed recovery And so on Status Manager ADT Pt.Registration Pt.Registration Pt.Update Pt.Update Placer Order Management Order Filler Order Placer Filler Order Management Procedure Scheduled Image Availability Query Pt.Update B/W: HL7 Messages Green: DICOM Messages Image Creator Creator PPS Storage Commitment Creator Image Stored PPS Query Images Image Display PPS Manager Image Manager Image Archive Retrieve Images Key issue :Tight relation between the Endoscopy and pathology PPS Storage Commitment Modality Image Stored Modality PPS Acquisition Modality Modality Worklist Provided Report Manager Biopsy # Order Requester Report Creator Will be communicated to the WG26 ③ Report Repository IHE Pathology Pathology Order Placer Pathology Order Filler ① Report Reader ② DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  18. Feedback on DICOM MPEG-2 implementation • Difficulty to implement on the source side? No, on the standard point of view (interoperability works) • Ability to retrieve video from other file formats? Yes, DVDs, DV, AVI, MPEG4, HDTV… • Average length of DICOM MPEG2 video? 10s to xxx, very dependant of the user and the context. Very often limited by the system to avoid trouble • Acceptable image quality? Comparable to source • Compatibility with PACS servers? THE MAIN ISSUE • Compatibility with DICOM viewers? The second one • Ability to edit object? (sub-sequences…) no clear demand for the moment, especially in routine (no time to spend). • Use of DVD for patient and doctor to doctor (education) DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  19. Work Item proposal • If required • To be prepared by mail interchange for being discussed and reviewed at the next meeting: extension of the VL video to HDTV. To be checked if interest in other domains (cardiology, ophthalmology…). The time frame anticipated for users demand is 3 years. So it is time to start now. DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

  20. Conclusion • Other business • Next WG13 meeting (date, place): to take place at the next Digest of Disease Week (May-2007? in the US) DICOM WG13 (Visible Light) Berlin, Sept. 15th, 2006

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