DICOM Exchanging Imaging Data Various Modality Images, Presentation States, Structured Reports Finding and Retrieving Imaging Objects DICOM Course – Singapore April 2005
DICOM... Is aGLOBAL STANDARDof Communication, developed under joint efforts of ACR (American College of Radiology) NEMA (National Electrical ManufacturersAssoc.) 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……
Since 1997 –Too many to count ! DICOM first release approved October ’9310 year anniversary • 20 Vendors at the ‘93 DICOM RSNA Demonstration • 40 Vendors at the ‘94 and 95 DICOM RSNA Demonstrations • More than 100 Vendors at RSNA 96
DICOM documents updated yearly DICOM 2004 is a compatible extension of DICOM 2003 + 27 Clarifications/Changes + 80 Supplements Available for free from the DICOM website:dicom.nema.org But DICOM 3.0, DICOM 96, DICOM 98, DICOM 99, DICOM 2000 DICOM 2003 are only document publishing names. This has no direct impact on existing Product Conformance !
IMAGE IMAGE INFORMATION OBJECTS QUERY RETRIEVE STORAGE Networking Support, e.g.. TCP/IP DICOM forImage Transfer Understanding Image transfer with DICOM ...
CT, MR, CR Second. Capt. (SC) 1993 INFORMATIONOBJECTS X-Ray Cardio/Vasc X-Ray Fluoro 1995 US NM PET 1996 IMAGE 1997 RT QUERY RETRIEVE X-Ray Digital RAD X-Ray Digital Mammo X-ray Intra-Oral Stored Print 1998 STORAGE 1999 Pathology, Optalmo. Vaweform 2001 Structured Reporting , KOS, Present. States 2003enhanced MR, eCT, ….. DICOM Spans Most of Medical Imaging DICOM runs on Internet and Intranet Networking Support TCP/IP
CT, MR, CR Second. Capt. (SC) 1993 X-Ray Cardio/Vasc X-Ray Fluoro 1995 US NM PET 1996 1997 RT X-Ray Digital RAD X-Ray Digital Mammo X-ray Intra-Oral Stored Print 1998 1999 Pathology, Optalmo. Vaweform 2001 Structured Reporting, KOS, Present. States 2003enhanced MR, eCT, ….. DICOM Spans Most of Medical Imaging DICOM transfers not only Images, but also: - Therapy Plans, Structures, etc. - Soon Waveforms - Structured Reports DICOM transfers not only Radiology images, but also: - Cardiology (X-Ray Angio, US, NM) - Oncology (RT Portal images) - Dentistery (X-ray Intra-Oral) - Pathology, Endoscopy, Microscopy, Optalmology, etc.
Build simple and easy-to-implement networks Reap efficiency and productivity benefits Invest in a necessary step for future PACS What can I really do with DICOM TODAY ?
Simple Networks in Radiology and Teleradiology CT, MR, NM, US, Digitizer, CR, digital X-ray, PET CT, MR, NM, US, Digitizer, CR, digital X-ray, PET Imaging Equipment Imaging Equipment DICOM SERVICES USED Local Area Network DICOM STORAGE QUERY/RETRIEVE DICOM STORAGE Analysis or Review Workstation ISDN Link or Dial-Up DICOM STORAGE Remote Workstation A DICOM Network, today’s common foundation both inside Radiology and for Teleradiology
Networks in Radiology and Care Units with Cluster Archiving CT, MR, NM, US, Digitizer, CR, digital X-ray CT, MR, NM, US, Digitizer, CR, digital X-ray Local Area Network DICOMSTORAGE DICOMSTORAGE Imaging Equipment Imaging Equipment DICOM SERVICES USED Cluster Archive Cluster Archive DICOMQUERY/RETRIEVE Care Unit DICOM STORAGE ISDN Link or Dial-Up Analysisor Review Workstation Analysisor Review Workstation DICOMSTORAGE Remote WS A DICOM Network is the common foundation both inside Radiology and for Teleradiology
What should I do to build a DICOM Image Transfer Network ? Three Steps: 1 - Clarify my Clinical Needs for Image Transfer and Image processing Applications 2 - Match Those Needs with DICOM Service Classes using the DICOM Conformance Statements 3 - Validate the Imaging Application Interoperability
Step 2 - Compare DICOM Conformance Statements CT ScannerConformance Statement WorkstationConformance Statement 1-CT STORAGE SCP 2-QUERY SCU 3-RETRIEVE SCU 4-MR STORAGE SCP 5- BASIC PRINT SCU 1-CT STORAGE SCU 2-QUERY SCP 3-RETRIEVE SCP 4-MODALITY WORKLIST SCU SCU = Service Class USER SCP = Service Class PROVIDER Matching DICOM Service ClassesThe necessary step to find what will work
CR Image StorageSOP Class CT Image StorageSOP Class Patient Module General Study Module Patient Study Module* Frame of Reference Module General Series Module General Equipment Module Image Plane Module Image Pixel Module Contrast/Bolus Module General Image Module Overlay Plane Module* VOI LUT Module* Image Module SOP Common Module Service Object Pair (SOP) Class + = DICOMCommunication (SOP Class) Image Info. Obj. (the Data) Store Command (the Service) Modified Slide from Don Van Syckle
Frame of Reference Module General Series Module General Equipment Module Series Information Image Plane Module Image Pixel Module Contrast/Bolus Module Image Information General Image Module VOI LUT Module* Overlay Plane Module* Image Module SOP Common Module Image IODs Patient’s Name Patient Module Patient Information Patient’s ID Patient’s Birth Date Patient’s Sex General Study Module Study Information Patient Study Module* Patient’s Weight* Referring Physician’s Name Accession Number Study Instance UID Not only contains pixel data but also key information about the image Modified Slide from Jay Gaeta
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 Storage DICOM does NOT define an “one size fits all” image
Digital Modality C-STORE-RQ … - C-STORE-RQ Command - Image Header Data (i.e. Name, ID, Row, Col..) - Pixel Data C-STORE-RSP… • C-STORE-RSP Command (Status) Shared Archive Storage Transfer – Push Images Storage SCU Storage SCP Multiple transfers usually occur on the same association Modified Slide fromDon Van Syckle
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 Query/Retrieve Enables the “pulling” of images Modified Slide fromDon Van Syckle
“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 Digital Modality Shared Archive Verification C-ECHO-RQ (no data set) C-ECHO-RSP (success status) Verification SCU Modified Slide fromDon Van Syckle Verification SCP
Workstation C-FIND-RQ • C-FIND-RQ Command- Study=today, give me name/ID, etc. 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 Shared Archive -C-FIND-RSP Command (Success Status) Query Remote Device Query SCU Query SCP -Query remote database -Pending rsp for each match-One rsp for final status Modified Slide fromDon Van Syckle
Workstation C-MOVE-RQ • C-MOVE-RQ Command- Study Inst UID for images to pull. C-STORE-RQ Separate association then Move C-STORE-RSP (Typically for Multiple Images) Same association as Move-RQ C-MOVE-RSP • C-MOVE-RSP Command (Status) Shared Archive Retrieve – Pull Images Retrieve SCU Retrieve SCP -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 Modified Slide fromDon Van Syckle
Workstation A Workstation B C-MOVE-RQ After the image transfer completed C-MOVE-RSP C-STORE-RQ C-STORE-RSP Shared Archive Three Device Move Retrieve SCU Retrieve SCP -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 Storage SCP Modified Slide fromDon Van Syckle
We hope you understood DICOM and are now ready to use it. Thank You ! charles . parisot @ med . ge . com