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May 8, 2001, 9:00 – 10:30 a.m. Fred M. Behlen, Ph.D. HL7 May 2001 Working Group Meeting DICOM Tutorial Introduction to DICOM. Kurt Rossmann Laboratories for Radiologic Image Research Department of Radiology. ACR-NEMA 1.0 Published as NEMA PS3-1985 ACR-NEMA 2.0 Published as NEMA PS-1988

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HL7 May 2001 Working Group Meeting DICOM Tutorial Introduction to DICOM

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Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

May 8, 2001, 9:00 – 10:30 a.m.

Fred M. Behlen, Ph.D.

HL7 May 2001 Working Group MeetingDICOM TutorialIntroduction to DICOM

Kurt Rossmann Laboratories

for Radiologic Image Research

Department of Radiology


Dicom standard

ACR-NEMA 1.0

Published as NEMA PS3-1985

ACR-NEMA 2.0

Published as NEMA PS-1988

Digital Imaging and Communications in Medicine (DICOM) 3.0

Published as NEMA PS3-1993(94?), and (almost) annual updates thereafter.PS3-2000 now available.

DICOM Standard


Dicom scope

DICOM Scope

Medical Informatics

. . .

PatientBedsideMonitoring

Administrative HIS/RIS

Lab Data

. . .

DiagnosticImaging

Scope ofDICOM


Scope of standards

InformationRepre-TransferSignalingmodelsentationmech-method

syntaxanism

DICOMXXX

HL7XXX

XMLX

CORBAXX

HTTP, FTPX

TCP/IP, EthernetX

Scope of standards


Dicom standard1

DICOM Standard

“The DICOM Standard is structured as a multi‑part document using the guidelines established in the following document:

— ISO/IEC Directives, 1989 Part 3: Drafting and Presentation of International Standards.”


Dicom standard2

PS 3.1:Introduction and Overview

PS 3.2:Conformance

PS 3.3:Information Object Definitions

PS 3.4:Service Class Specifications

PS 3.5:Data Structure and Encoding

PS 3.6:Data Dictionary

PS 3.7:Message Exchange

PS 3.8:Network Communication Support for Message Exchange

PS 3.9:Point‑to‑Point Communication Support for Message Exchange

PS 3.10: Media Storage and File Format for Data Interchange

PS 3.11: Media Storage Application Profiles

PS 3.12: Storage Functions and Media Formats for Data Interchange

PS 3.13: Print Management Point-to-Point Communication Support

PS 3.14: Grayscale Standard Display Function

PS 3.15: Security Profiles

PS 3.16:Content Mapping Resource (2001)

DICOM Standard


Dicom supplements

PS 3.1:

PS 3.2:

PS 3.3:

PS 3.4:

PS 3.5:

PS 3.6:

PS 3.7:

PS 3.8:

PS 3.9:

PS 3.10:

PS 3.11:

PS 3.12:

PS 3.13:

PS 3.14:

PS 3.15:

DICOM Supplements

Balloted Supplement

Published Standard

Introduction

Part 1 changes

Part 3changes

Part 6 changes


Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

PS 3.1: Introduction and Overview

PS 3.6:DataDictionary

PS 3.2: Conformance

PS 3.4: Service Class

Specifications

PS 3.3:InformationObject Definitions

PS 3.5: Data Structureand Semantics

Part 7: Message Exchange

PS 3.8: NetworkCommunication Supportfor Message ExchangeTCP/IP OSI

PS 3.9: Point toPoint Communication

Support for

Message Exchange


Conformance

DICOM Conformance Statement

Format and Content specified in Part 2

Required for every claimed DICOM implementation

“If there’s no Conformance Statement, it’s not DICOM.”

Intended audience for Conformance Statement is engineer, not customer.

Conformance


Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

conformance

Vendor A

contractscope

interoperation

STANDARD

contract

conformance

Customer

Vendor B


Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

contract Ascope

conformance

Vendor A

contract A

Customer

interoperation

(voila!)

STANDARD

contract B

conformance

Vendor B

contract Bscope


Key sections

PS 3.3:Information Object Definitions

PS 3.4:Service Class Specifications

PS 3.6:Data Dictionary

Key Sections


Dimse services

DIMSE Services

CompositeNormalized

C-STOREN-EVENT-REPORT

C-GETN-GET

C-MOVEN-SET

C-FINDN-ACTION

C-ECHON-CREATE

N-DELETE


Ps 3 3 information object definitions

Computed Radiography Image

Computed Tomography Image

Magnetic Resonance Image

Nuclear Medicine Image

Ultrasound Image

Ultrasound Multi-Frame Image

Secondary Capture Image

X-Ray Angiographic Image

X-Ray RF Image

Positron Emission Tomography Image

Hardcopy Grayscale Image

Hardcopy Color Image

Digital X-Ray Image

Digital Mammography X-Ray Image

Digital Intra-Oral X-Ray Image

PS 3.3:Information Object Definitions


Ps 3 3 information object definitions1

Visible Light Image

VL Endoscopic Image

VL Microscopic Image

VL Slide-Coordinates Microscopic Image

VL Photographic Image

Standalone Overlay

Standalone Curve

Standalone Pet Curve

Stored Print

Standalone Modality Lut

Standalone VOI Lut

Grayscale Softcopy Presentation State

Basic Study Descriptor

PS 3.3:Information Object Definitions


Ps 3 3 information object definitions2

RT Image

RT Dose

RT Structure Set

RT Plan

RT Beams Treatment Record

RT Brachytherapy Treatment Record

RT Treatment Summary Record

Waveform

Basic Voice Audio

12-Lead Electrocardiogram

General Electrocardiogram

Ambulatory Electrocardiogram

Hemodynamic

Basic Cardiac Electrophysiology

Structured Report Document

Basic Text SR

Enhanced SR

Comprehensive SR

PS 3.3:Information Object Definitions


Ps 3 4 service class specifications

Verification

Storage

Query/Retrieve

Study Content Notification

Patient Management

Study Management

Results Management

Print Management

Media Storage

Storage Commitment

Basic Worklist Management

Queue Management

Grayscale Softcopy Presentation State Storage

Structured Reporting Storage

PS 3.4:Service Class Specifications


Service object pairs sops

Service-Object Pairs (SOPs)

Information Objects

STORE

Services


Ps 3 5 data structure and encoding

Presentation Context

Abstract Syntax

Endianism

Big Endian

Little Endian

Value Representation

Implicit VR

Explicit VR

Transfer Syntax

Uncompressed

Compressed modes

PS 3.5:Data Structure and Encoding


Data set and data elements

Data Set and Data Elements


Ps 3 3 annex a iod modules

PS 3.3 Annex A IOD Modules


Ps 3 3 annex c patient id module

PS 3.3 Annex C Patient ID Module


Ps 3 3 annex c pixel module

PS 3.3 Annex C Pixel Module


Ps 3 3 annex c pixel module1

PS 3.3 Annex C Pixel Module


Pixel encoding

Pixel Encoding


Ps 3 6 data dictionary

Tag Assignments

[xxxx,xxxx]

Name (non-canonical)

Value Representation

Value Multiplicity

DICOM-assigned UIDs

Terminology Mapping Resource Registry

Registry of Templates

PS 3.6:Data Dictionary


Diagnostic imaging in the patient care process

Patient arrives

Physician sees patient, writes order

Patient goes to Imaging Department

Patient is imaged

Radiologist interprets images, writes report

Physician looks at report (and often images)

Physician treats patient based on report

Patient discharged

Diagnostic Imaging in the Patient Care Process

ImagingDepartment


Diagnostic imaging in the patient care process1

Diagnostic Imaging in the Patient Care Process

Hospital Enterprise

Exam

context

Results,

Images

Radiology


Exam context

Patient identification

Orders

Other clinical information

Scheduling (of some resources)

Financial authorizations

Exam Context

Imaging department obtains from the enterprise:


Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

Patient& visit

Study &acquisition

Storeddata


Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

Patient& visitIODs

Study &acquisitionIODs

StoreddataIODs


Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

Patient

Placer Order

I-Study

Filler Order

I-Patient

Scheduled Procedure Step

Study Instance UID

IDdomain^PatientID

Scheduled Proc. Step ID

Filler Order Number

Placer Order Number

IDdomain^PatientID

10-n

1

11-n*

11-n*

0-n

Requested Procedure

1

1-n

Requested Procedure IDRP Study Instance UID

0-n**

0-m**

1

1-n

0-n**

0-m**

Performed Procedure Step

Performed Proc. Step UID

11-n

*An Order Placer typically submit a single order (ORM), however, an Order Filler can expand that single order into multiple Requested Procedures. See IHE Y2TF Section 6 for more details.

**See Section 6 for a thorough description of the cardinality relationship options of Modality Performed Procedure Step.

***The Performed Procedure Step UID is present as the Affected SOP Instance UID.

Series

Series UID

1

0-n

Instance

SOP Instance UID


Hl7 may 2001 working group meeting dicom tutorial introduction to dicom

Patient

I-Study

Scheduled Procedure Step

Filler Order

I-Patient

Placer Order

Filler Order Number

Study Instance UID

Placer Order Number

IDdomain^PatientID

Scheduled Proc. Step ID

IDdomain^PatientID

10-n

1

11-n*

11-n*

0-n

Requested Procedure

1

1-n

Requested Procedure IDRP Study Instance UID

0-n**

0-m**

1

1-n

0-n**

0-m**

Performed Procedure Step

Performed Proc. Step UID

11-n

Series

Series UID

1

0-n

SR Instance

Instance

SOP Instance UID

SOP Instance UID


Results

Reports

Images

Exam status

Results

Imaging department delivers to the enterprise:


Ihe home pages

http://www.rsna.org/IHE

http://www.himss.org/IHE

IHE Home Pages


Dicom home pages

http://medical.nema.org/dicom.html

Committee for the Advancement of DICOM

DICOM Resources Page

http://www.merge.com/dicom/resources/

DICOM Home Pages


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