Consistent Presentation of Images Integration Profile - Tutorial

1. Consistent Presentation of Images Integration Profile - Tutorial Ellie Avraham Kodak Health Imaging IHE Planning and Technical Committees HIMSS / RSNA

2. Consistent Presentation of Images Objective I • Resolving the Consistency problem among Softcopy Images viewed on different Display devices (from different Vendors). • Display Devices vary in their capabilities: Luminance range, Monitor Display Resolution and Display Characteristic Curve. HIMSS / RSNA

3. Problems of Inconsistency 0.5 1.0 • Not all display levelsare perceivable on alldevices 1.5 3.0 HIMSS / RSNA

4. With the CPI Profile Different Workstations display the same Image Consistently • I. Show two different CalibratedDiagnostic Workstations (from different Vendors) • Retrieving and displaying the same image consistently with the same reading view. • II. Show [Slide #5] an Image that the display presentation is adjusted for the best view (Image Quality) on a • Workstation-A, Applying image processing: Windowing Level, Flip, Zoom and Annotate (called the • Softcopy Display Viewing parameters). • When this image is distributed to a different Workstation-B, with all the display viewing parameters, • the viewing parameters are applied on the image at the destination Workstation-B and as result of it the • displayed image on Workstation-B is consistent to the viewing of the same image on the Workstation-A. HIMSS / RSNA

5. What the Radiologist Displays: What the Reviewing Physician Sees: Area Of Interest Area Of Interest Flip Zoom Annotate Original Image Original Image Window Level Consistent Presentation of Images On a Calibrated Display With Presentation State The Radiologist’s Transformations Are Saved Original Image Inconsistent Presentation On an Uncalibrated Display Original Image The Radiologist’s Transformations Are Lost HIMSS / RSNA

6. Consistent Presentation of Images Objective II • Resolving Consistency among Hardcopy Images Printed on different Laser Printers (from different Vendors). • Hardcopy Devices vary in their capabilities: Optical Density range, Printer Resolution and Printer Characteristic Curve. HIMSS / RSNA

7. With the CPI Profile, Different Printers Prints the same image Consistently • [Show on a Light-box two Films printed on different Calibrated Laser Printers (labeled from different Vendors) having consistently the same reading view.] HIMSS / RSNA

8. Consistent Presentation of Images Objective III • Resolving the Image Consistency view of a Softcopy Display image and and it Printed Hardcopy view. • Printed images don’t look like displayed images HIMSS / RSNA

9. Inconsistency between Softcopy and Hardcopy AcquisitionModality Console Laser Printer • Printed images don’t looklike the displayed images HIMSS / RSNA

10. With the CPI Profile the Softcopy display image has the same view reading as the Printed image film on the Light-box. • [Retrieve an Image and display it on a Workstation • (that have a Print Composer) and then send the same • displayed image to a Laser Printer]. • Show the image consistency among the Softcopy displayed • image on the Workstation and the Hardcopy printed image • displayed on the light-box. HIMSS / RSNA

11. Consistent Presentation of Images Solutions: 1 • Calibrate (Standardize) the Softcopy/Hardcopy Output Device using the DICOM Grayscale Standard Display Function (GSDF). • 1. [Show the calibration of a Softcopy Workstation with a Photometer, Slide #12] • 2. [Show a picture of calibrating a Hardcopy Printer with a Densitometer, Slide #13] The GSDF transformation is the solution for mapping the Image Presentation values to the display Luminance values, and preserving the Human perceptual response, that is based on the Human Contrast Sensitivity [Barten model]. HIMSS / RSNA

12. Printer Calibration Tools (Densitometer) HIMSS / RSNA

13. Display Calibration Tools (Photometer) HIMSS / RSNA

14. Consistent Presentation of Images Solutions (Continue): 2 • Preparing the image for Hardcopy Output Using the DICOM Basic Print with Presentation values Supported for controlling the consistent appearance of pre-formatted images on printed hardcopy. [Show the Basic Print Management with Presentation LUT, slide #15] HIMSS / RSNA

15. Basic Print Request with Presentation LUT AcquisitionModality Console Laser Printer Print Print Composer Server Print Composer Print Request Send Images and Presentation Information Print Server Print Status Printer Status HIMSS / RSNA

16. Consistent Presentation of Images Solutions (continue): • The Softcopy Display Viewing parameters: Windowing Level, Zoom, Flip, Annotate, etc are preserved through the DICOM Grayscale Softcopy Presentation State (GSPS) object. 3 The Grayscale Softcopy Presentation State (GSPS), is an object for storing and communicating the parameters that describes how an image or a set of images should be displayed. A GSPS object contains references to the images it applies to, and the transformations (grayscale transformations, shutter transformation, image annotation, spatial transformations, and displayed area annotation) that should be applied when the images are presented on a softcopy display. HIMSS / RSNA

17. What the Radiologist Displays: What the Reviewing Physician Sees: Area Of Interest Area Of Interest Flip Zoom Annotate Original Image Original Image Window Level Consistent Presentation of Images On a Calibrated Display With Presentation State The Radiologist’s Transformations Are Saved Original Image Inconsistent Presentation On an Uncalibrated Display Original Image The Radiologist’s Transformations Are Lost HIMSS / RSNA