Dicom pathology c daniel le bozec gp hospital users j klossa tribvn vendors
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DICOM & pathology C. Daniel Le Bozec (GP Hospital) - USERS J. Klossa (TRIBVN) - VENDORS PowerPoint PPT Presentation


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DICOM & pathology C. Daniel Le Bozec (GP Hospital) - USERS J. Klossa (TRIBVN) - VENDORS. Working groups (users & vendors) about pathology workflow. US: CAP-LDIP (B..Beckwith ) US based, began in 2004 Goal is to define XML pathology image specification for both research and clinical use

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DICOM & pathology C. Daniel Le Bozec (GP Hospital) - USERS J. Klossa (TRIBVN) - VENDORS

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Dicom pathology c daniel le bozec gp hospital users j klossa tribvn vendors

DICOM & pathologyC. Daniel Le Bozec (GP Hospital) - USERS J. Klossa (TRIBVN) - VENDORS


Working groups users vendors about pathology workflow

Working groups (users & vendors) about pathology workflow

  • US: CAP-LDIP (B..Beckwith )

    US based, began in 2004

    Goal is to define XML pathology image specification for both research and clinical use

    www.ldip.org

    • Users : UPMC, Harvard University

    • Vendors: Aperio, Trestle, Dmetrix

  • Europe: IHE-Pathology Europe

    • France (C. Le Bozec), Spain (M. Rojo), Hungary, Italy, Germany

      • Began in 2004, first meeting 5 september 2005

    • Users

      • ADICAP, French Society of Pathology (SFP), AFAQAP, GFHC (French Group for CytoHematology), SFCC (French Society for Clinical Cytology)

      • Spanish Society of Health Informatics

    • Vendors

      • Modalities: Leica MicroSystems, Zeiss, 3d Histech, Tribvn/Aperio, SAMBA Tech, etc

      • LIS: TECHNIDATA, INFOLOGIC, etc

      • PACS Vendors: AGFA

      • EHR: MEDASYS

  • Japan: IHE-Pathology Japan

    • Users:. Tofukuji, Kyoto University, Iwate Medical School

    • Vendors: Olympus, Nikon


Outlines

Outlines

  • Working groups about pathology workflow (PWF)

    • Specific workflow

      • Specific new attributes are needed in DICOM

  • First issue: Whole Slide Images (WSI)

    • Digital images (including WSI) for daily practice

      • Non specific issues about storage & access to “large images”

  • Agenda?

    • Ad-hoc working group within WG 6

    • New DICOM WG for pathology (P-DICOM)


Objectives

Objectives

  • Defining the specific workflow in pathology

    • Defining specific IHE integration profiles

  • Making the best use of existing standards to operate this WF

    • HL7

    • DICOM

    • Others: BPML, OWL,…


Pathology workflow p wf standards

Pathology workflow (P-WF)& standards

Cyto & Histo pathology Hematopathology

IHE

WfMC

Image & Report Access

Patient registration

Order

Image Acquisition

Report

Multimodality

GPWL, Mod WL, Post Process-WL,

Compression,

Color Presentation

Evidence Documents

DICOM SR

WADO

DICOM

DICOM WL

HL7 v3 CDA

HL7 v2 & v3 Messages (Order)

HL7 v2

ADT

HL7

OWL

SNOMED CT, ontologies, etc…


Images in pathology

Images in pathology

  • Blocks and Slides are the primary archive

  • They contain much more info than any individual file even WSI

  • They need iterative and multimodalities studies for catching the info inside the specimen in a diagnostic perspective

    • Gross imaging

    • Still images & Whole Slide Images (WSI)

    • Tissue Micro Arrays (TMA)


Images in pathology gross imaging

Sampling for histology

Sampling for tissue bank

4

2

2

2

1

3

1

5

3

6

Images in pathologyGross imaging


Images in pathology still images whole slide images wsi

Images in pathologyStill images & Whole Slide Images (WSI)


Structure model of objects in preprocess of pathology service make slides and scan

Structure model of objects in Preprocess of Pathology Service (Make slides and Scan*)

Study: One report will be made corresponding to the order

Series

Patient

Image

Removed organ

Biopsy specimen

Gross Image

Order

Cutting Drawing

Image

Whole slide Image

(Virtual slide only)*

Block

Glass slide

Whole slide Image

(Virtual slide only)*

Glass slide

*Note: In case of optical microscopy, no-whole slide image

Block

Removed organ

Biopsy specimen


Images in pathology tissue micro arrays

Images in pathology Tissue Micro Arrays

  • Hundred of patients

…etc…


Dicom pathology

DICOM & Pathology

  • Historically: Visible Light (WG-13)

  • First issue: Storage & access to “large data sets” (Whole Slide Image)

    • Enhanced CT,MR & XA IODs, OP IOD

    • Base standard (WG-06)

    • Compression (DICOM WG-04)

      • JPEG2000 in DICOM files (Supp 61, supp 105, 106)

        • Data Streaming & Multi-Component Compression


Dicom pathology1

DICOM & Pathology

  • Specific DICOM WG in pathology

    • “Good” definition of imaging folder and related information

    • Acquisition context

    • Multimodality management: transfer between equipments from different vendors

      • Multi-Frame CT & CR

      • Spatial Representation

      • General Purpose WL, Mod WL, Post Process. WL, Direct push between modalities ??

    • Color Presentation State

    • Structured Reporting (DICOM WG-8)

    • Image & report access (WADO)


Acquisition context

Acquisition context

4

2

2

1

5

3

6


Multimodalities issues link with radiological images

Multimodalities issuesLink with radiological images


Histo and cytopathology hematology needs user side

Histo and Cytopathology + Hematology needs User side

  • Clients need be able to build an optimized WorkFlow for digital image in Pathology through the creation of IHE profiles

  • Clients are pathologists, clinicians, patients or image analysis machines

  • Different modalities produce images that need to be combined or/and registered for individual diagnostic strategy: macro images, medium resolution (x20 to x40) RGB images, multispectral or chemical imaging, ...

  • Clients need quick and selective access (Zoom, Pan, Multi Z, ..) to this multidimensional set of data which is available from the vendors through different modalities


Dicom pathology c daniel le bozec gp hospital users j klossa tribvn vendors

Histo and Cytopathology + Hematology needs Vendor side

  • Vendors provide for different WSI system offering 2d, 3d or more dimension possibilities, but

    • size of individual file and

    • quality of service provided (Selective, Quick and Smooth zoom and pan needed),

      prevent them from using current DICOM VL objects

  • Vendors want to access the clinical market; so they need to implement IHE profiles based upon a standardized DICOM solution for archiving and handling those data


Dicom pathology c daniel le bozec gp hospital users j klossa tribvn vendors

Whole Slide Imaging (WSI) needs: Technical side

  • PACS systems manage only images which are DICOM-compliant

  • DICOM files are limited in size to 2GB

  • Most DICOM components cannot use the vendors files

    • TIFF files with a tiled and pyramidal organization

    • jp2 files

  • The entire image is transmitted from the server to the client, and loaded into the client’s memory: large images are slow to load, slow to view, and slow (when no impossible) to process


Agenda

Agenda?

  • Whole Slide Image: Ad-hoc working group within WG 6

    • Vendors: Aperio, Dmetrix, Leica Microsystems, Zeiss, 3DHistech, Tribvn, Samba Tech, Apollo, Aurora, Trestle

    • Users: UPMC, Harvard, AFIP, ADICAP-France

  • New WG for pathology

    • Members from LDIP, ATA, IHE Japan & IHE-Europe


Dicom with jpip diagram

DICOM with JPIP: Diagram


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