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Advances in DICOM will Enhance the clinical operation of MR. Kees Verduin, Philips Medical Systems Chair DICOM WG16. Presentation outline. The new MR Standard The clinical examples of its benefits Roadmap for effective implementation . What is new ?. Three new object definitions :

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Advances in DICOM will Enhance the clinical operation of MR

Kees Verduin,

Philips Medical Systems

Chair DICOM WG16

presentation outline
Presentation outline
  • The new MR Standard
  • The clinical examples of its benefits
  • Roadmap for effective implementation
what is new
What is new ?

Three new object definitions:

  • Enhanced MR Image
  • MR Spectroscopy
  • Raw Data
a new set of dicom mr objects
A new set of DICOM MR objects

So…. what is so exiting about it?

A new object, as such, is not great news.

Not this time:

the new Enhanced MR Image object serves the whole range of DICOM users:

  • from the modality specialist
  • to the user of a simple viewer in the same way.
a new mr standard supplement 49

Spectroscopy

Color

Multi-stack

Dimensions

Raw Data

A new MR Standard (Supplement 49)

Multi-frame

Real World Values

the basics of supplement 49
The basics of Supplement 49
  • Support of newest applications by New attributes
  • Less ambiguity through Stricter definitions and rules
  • Clear relationships through Reference mechanism
  • Header size reduction through Multi-frame technique
  • Context information from Image Type andDimensions
  • File size flexibility through Concatenations
  • Functional images with Real World Values
  • Functional images with PaletteColor LUT information

ALL these improve Interoperability

what is really new
What is really new ?
  • Multi-Frame module with its Shared and Non-Shared header parts
  • Dimensions and Dimension Organizations
  • Coded Object relationships

All these provide CONTEXT INFORMATION !

  • Further:
    • Real World Values
    • Grayscale images with Color information
the multi frame properties
The Multi-frame properties
  • Whenever possible, all images of a scan-series shall become frames in one object.
  • What is common to all frames, shall not be repeated:

Elements that do not change vs. elements that change.

These have a different place in the object header.

  • Related elements are defined in functional groups.
from single image to multi frame

Shared Header

Pixel data (not to scale)

Non-Shared (per-frame) Header

From Single Image to Multi-frame

N Objects, N Headers

HEADER SIZE REDUCTION = less MB, faster transfer

N Frames, One Header

KV

from single frame to multiframe

Fixed Header

Dimension data (not to scale)

Pixel data (not to scale)

Per-frame header

From Single-frame to MultiFrame

N Objects, N Headers

N Frames, One Header

multi frame not only for mr
Multi-Frame not only for MR!

The

Enhanced MR Image and

MR Spectroscopy

have a multi- frame structure that is

also useful for adoption by other modalities.

dimensions
Dimensions
  • MR images can have many attributes that change from frame to frame.
  • When such a change in an attribute is fundamental for the object, this data element can be structured by the creator as part of the Dimension Module.
  • It supplies the Context Information required for a specialized workstation.
  • It also provides an explicit display ordering for the frames in the MR object, that can be used by viewing systems without specific MR application knowledge.
object relationships
Object Relationships

Referenced Image Sequence

Source Image Sequence

diffusion imaging
Diffusion Imaging

“Diffusion b-values” from 0 to 8000 and an ADC image

diffusion tensor imaging data
Diffusion Tensor Imaging data

Reconstructed Fiber Maps in the colors as seen by the creator

slide18

time

Stored values

Real World Value Slope (0040,9225)

non perfused

stroke area

Real World Value Intercept (0040,9224)

RW values

delayed perfusion

Signal

time-to-peak map

MR Perfusion Imaging

Quantitative data with Real World Values

cardiac cine loops
Cardiac Cine Loops

Enables automatic multi-slice / multi-phase display, even for standard workstations

total body imaging
Total body Imaging

5

4

3

2

1

1

2

3

4

5

Display the correct image at the correct spot using Stacks and In-stack positions

functional brain imaging
Functional Brain Imaging
  • 10-60 slices
  • all slices measured in one TR
  • repeated 100-1000 times to get sufficient signal
  • leading to > 60,000 images in one object

Store thousands of images in one object and display them in a consistent way using Multi-frame Header and Dimension Module

spectroscopy imaging
Spectroscopy Imaging

Relative NAA peak-height

Ratio of

Choline and

Creatinine peaks

spectroscopy relations
Spectroscopy Relations

Relation:

MR Image

Metabolite map

Relative NAA peak-height

Ratio of

Choline and

Creatinine peaks

ct multi frame
CT Multi-frame
  • The CT Multi-frame solution addresses the same data-explosion issues as for MR.
  • Multi-detector CT generates large volumes of images that need to be provided with sufficient and adequate context information.
  • Multi-frame solutions may provide more interoperability for navigation and processing.
  • But, 3D processing requires more than a Multi-frame structure.
multi modality multi frame
Multi-modality - Multi-frame
  • Implementations for processing of the generated volumetric data will largely benefit from multi-modality implementations of the multi-frame concept.
  • Common structures may lead to common architecture, which in turn will speed up the implementations.
implementation roadmap
Implementation Roadmap

Who should be the first ?

the timing dilemma for the enhanced mr object
The timing dilemma for the Enhanced MR object
  • For the MR vendors:
    • Why implement it, while nobody is ready to use it?
  • For the Workstation vendors:
    • Why implement it, when no one is creating it?
  • For the PACS vendors:
    • Support it, but how to deal with the mix of workstations that can yes/no receive it ?
the negotiation scenario
The Negotiation scenario

Decide to

send New object

or send Old object

Negotiate

Negotiate

Decide to

send New object

or Cancel

Archive

MR

Workstation

Decide to

send New object

or send Old object

Negotiate

the partial conversion scenario
The Partial Conversion scenario

Decide to

send New object

or send Old object

Negotiate

Negotiate

Decide to

send New object

or

Convert object

Archive

MR

Workstation

Decide to

send New object

or send Old object

Negotiate

the full conversion scenario
The Full Conversion scenario

Decide to

send New object

or Convert

All

old objects

will be

identical

Negotiate

Negotiate

Decide to

send New object

or

Convert object

Archive

MR

Workstation

Decide to

send New object

or Convert

Negotiate

when will implementation be required
When will implementation be required ?
  • As soon as stability is proven.
  • As soon as the object definition is tested
  • As soon as resulting changes are implemented in the standard.
  • Or…..

So, pacing may be needed

As soon as possible!

nema members are funding a demonstration test tool
NEMA Members are funding a Demonstration & Test Tool

Purpose:

  • Prove that implementation is possible
  • Prove the multi-frame header construction
  • Prove the use of dimensions
  • Provide a test tool for vendors and other implementers
  • Validate implemented objects
tool availability
Tool availability
  • The tool is available to the funding participants
  • It is currently under test
  • The tool will become available in the public domain in 2003

But…No need to wait with implementation

collective support is needed
Collective support is needed

The benefits of Supplement 49 as described in this presentation will only be visible if and when:

  • MR scanners (creators)
  • DICOM workstations (receivers)
  • PACS systems (intermediaries)

will collectively support the new MR DICOM objects.

what should be done
What should be done?
  • Vendors of Workstations / PACSneed to prepare for implementation:
what should be done37
What should be done?
  • Vendors of Workstations / PACS need to prepare for implementation:
    • Prepare the color pipeline
what should be done38
What should be done?
  • Vendors of Workstations / PACS need to prepare for implementation:
    • Prepare the color pipeline
    • Prepare your databases for large objects
what should be done39
What should be done?
  • Vendors of Workstations / PACS need to prepare for implementation:
    • Prepare the color pipeline
    • Prepare your databases for large objects
    • Create your real-world values UI
what should be done40
What should be done?
  • Vendors of Workstations / PACS need to prepare for implementation:
    • Prepare the color pipeline
    • Prepare your databases for large objects
    • Create your real-world values UI
    • Prepare for Dimensions and Dimension Organizations
what should be done41
What should be done?
  • Vendors of Workstations / PACS need to prepare for implementation:
    • Prepare the color pipeline
    • Prepare your databases for large objects
    • Create your real-world values UI
    • Prepare for Dimensions and Dimension Organizations
what should be done42
What should be done?

And finally… or first ?

Vendors of Workstations / PACS need to decide on the conversion scenario.

summary
Summary
  • The New DICOM MR Objects:
    • will enhance interoperability
    • will increase cross system functionality
    • will reduce transfer time
  • Success requires also action by Workstation and PACS implementers.
further information
Further Information

More in-depth discussions

and presentations about:

  • Relationships between images
  • Concatenations
  • Dimension Organization
  • Real World Value mapping
  • Extended Image Type
  • Color Mapping

can be found at :

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

acknowledgement and copyright
Acknowledgement and copyright

Images for this presentation were provided by:

    • GE Medical Systems
    • Philips Medical Systems
    • Siemens Medical Systems
  • The slides of this presentation may be quoted if reference and credit to DICOM WG-16 is properly indicated