Ihe radiology dbt supplement
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IHE Radiology – DBT Supplement. Supplement Development Kick-Off. Renate Höcker , Antje Schroeder, Siemens Healthcare. Introduction. Huge success of MAMMO Image Profile 21 Modalities, 44 Image Manager/Archives, 30 Image Displays in Product Registry

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IHE Radiology – DBT Supplement

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Ihe radiology dbt supplement

IHE Radiology – DBT Supplement

  • Supplement Development Kick-Off

Renate Höcker, Antje Schroeder, Siemens Healthcare


Introduction

Introduction

Huge success of MAMMO Image Profile

21 Modalities, 44 Image Manager/Archives, 30 Image Displays in Product Registry

Tomosynthesis shares many features with 2D Mammography but has additional specific requirements, which are needed for interoperability

Use cases

Review DBT Images (simple Usecase)

In repeated screening mammography current and prior Mammograms/DBT images are reviewed

prior exam was Tomosynthesis

prior exam was ordinary digital mammography (FFDM) only

current or prior Tomosynthesis also includes FFDM ("combination study")

current or prior Tomosynthesis also includes synthetic (MIP) view


Scope

Scope

In addition to functionality defined in MAMMO

Storage of digital breast Tomosynthesis image

Viewingofbreast Tomosynthesis Images

Simultaneous review of Tomosynthesis images and mammograms

In scope? Out of scope?

Storage/Review of Projection X-Ray objects?

What are requirements / use cases that mandate support for this object

Support of CAD on Tomosynthesis images?

Can existing SR templates be used or would new ones be needed

Synthetic Images?

Partial View?

Is this an option to MAMMO or a new profile?


Dbt supplement

DBT Supplement

Topic to be addressed in a DBT Supplement:

Volume 1

If option: update Option Table for relevant actors (MOD, IM/IA, ID)

Add use case for Tomosynthesis review including the following scenarios

BreastTomosynthesis Images

prior exam was Tomosynthesis

prior exam was ordinary digital mammography (FFDM) only

current or prior Tomosynthesis also includes FFDM ("combination study")

current or prior Tomosynthesis also includes synthetic (MIP) view


Dbt supplement1

DBT Supplement

Volume 2

Creation and Storage of relevant objects (Rad-4)

Define additional SOP Classes that are needed

Define restrictions on DICOM Header for each additionally supported SOP Class

Information that is needed in order to properly hang and display images

Patient Orientation/Plane Position/View information/…

Information that is needed for annotation

Patient Information/Acquisition Parameters/…


Dbt supplement2

DBT Supplement

Volume 2

Retrieval and display of relevant objects (Rad-16)

Display ofBreastTomosynthesis Images

Describe simultaneous display of involved objects

FFDM images/Tomosynthesis objects/Projection images/synthetic images

Which objects need to be displayed simultaneously (screen real-estate)?

Describe hanging and ‘proper’ orientation of displayed objects

Describe how different sizing options (image size, same size, true size and actual pixel viewing) effect display of Tomosynthesis objects (in simultaneous as well as full size display)


Dbt supplement3

DBT Supplement

Retrieval and display of relevant objects (Rad-16) - continued

Describe contrast adjustments (in simultaneous as well as full size display)

Do we need to say something toggling between different LUTs when displaying multiple object types?

Scrolling through the Tomosynthesis object / Projection images

User driven / automatic

Synchronized scrolling of different views

Scrolling performance

Scrolling direction


Dbt supplement4

DBT Supplement

Retrieval and display of relevant objects (Rad-16) – continued

Describe annotations

Patient Information

Acquisition parameters (per supported object type) including e.g. acquisition angle, dose

View information

Orientation in volume

which is the detector side, where in the volume is the current frame located

Frame numbers

Identify synthetic images


Dbt supplement5

DBT Supplement

Depending on the decision on CAD additional changes to the following transactions are needed:

Storage of Evidence Objects (Rad-43)

How to record findings on DBT images

Does current TID 4000 work or are there any changes necessary (how to reference coordinates)?

Retrieval and display of CAD marks (Rad-16)

Effects on MAWF and SMI still need to be investigated


Clinical questions

Clinical Questions

Are thereanyUseCasesmissing?

Is support of projection images necessary? How are those clinically used?

Is there a use case for simultaneously reviewing all type of images (FFDM, Tomosynthesis, Projection images, synthetic Images)? If yes, how should all these objects be displayed simultaneously

Are partial views used/relevant in Tomosynthesis

How should orientation information be displayed

Do contrast adjustments need to be performed on a per image basis or for the complete object?


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