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DICOM General Purpose Worklist. The next major political battle in PACS Dr David Harvey. Why a DICOM Talk today ?. DICOM General Purpose worklist is to reporting workstations what basic DICOM is to a CT Scanner You wouldn’t (I hope!) since 1995 buy a CT without checking the DICOM conformance

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dicom general purpose worklist

DICOM General Purpose Worklist

The next major political battle in PACS

Dr David Harvey

why a dicom talk today
Why a DICOM Talk today ?
  • DICOM General Purpose worklist is to reporting workstations what basic DICOM is to a CT Scanner
  • You wouldn’t (I hope!) since 1995 buy a CT without checking the DICOM conformance
  • You shouldn’t buy a reporting station (or PACS) in 2004 without doing the same
traditional dicom queries
“Traditional” DICOM Queries
  • Concerned with “static” data, which once generated is never altered.
    • Images
    • RT plans etc.
  • Provides excellent methods for creating, storing, querying and retrieving such data, if your starting point is a particular patient or study
why original dicom queries are not suitable for workstations
Why original DICOM Queries are not suitable for workstations
  • No information or reporting status(unreported / reported / in progress)
  • No way of querying for “things to do”
  • If patient IDs etc. are entered by hand, then there is a delay while images are actually retrieved.

Radiologists need a “NEXT” button

key features of gp worklist
Key Features of GP Worklist


  • A vendor independent method of interfacing efficient reporting stations to a PACS
  • A mechanism to simulate the “reporting pile”(but in multiple places simultaneously)
  • A Locking mechanism to prevent accidental double reporting
  • Wide range of query and priority fields to support chosen working practices.
  • Sufficient information to allow images to be pre-fetched.
why have a dicom interface
Why Have a DICOM Interface?
  • Is the best RIS/PACS supplier also the best workstation supplier?
  • Is the best workstation supplier also the best RIS/PACS supplier
  • Or do you compromise?
hot it works the technical bit
Hot it works (the technical bit)
  • Modelled on the existing modality worklist (MWL) and modality performed procedure step (MPPS) services
  • Workstation first queries for items of a requested type
  • Then it selects and locks an item
  • Then marks it compeleted
mwl mpps overall data flow

GP Worklist

Query for Work Items

Query for Examinations

List of those available

Lock (In Progress)



Lock OK

Mark Complete


MWL/MPPS Overall Data Flow







worklist data source
Worklist Data Source
  • Exactly the same options as used by proprietary systems:
    • RIS
    • PACS
    • Broker
vendors have no technical excuses
Vendors have no technical excuses
  • Data sources already exist (used for their proprietary systems)
  • DICOM mechanisms already exist(used for MWL/MPPS)
  • So where is it ?
can i use it now
Can I use it Now?

At present, NO – because:

  • It has only been in DICOM for 3 years (short time by development scales)
  • Like all such protocols, it requires support from both SCP (server/PACS) and SCU (client/workstation)
  • PACS suppliers don’t like it’s potential to eat into the very lucrative proprietary workstation market
  • Only a few independent workstations support it yet
  • Users haven’t yet learnt about it and demanded it!
will it become available
Will it become available?

Perhaps ?

  • Negative Features
    • Not all DICOM features become adopted widely
    • Arguments from major PACS vendors:
      • Responsibility, Reliability etc.
    • User ignorance
    • May become an expensive retrofit option
  • Positive Features
    • Adoption into IHE will push implementation by vendors
    • Some smaller vendors are already using it
    • Like original DICOM, a few knowledgeable users may be sufficient to push the market
but won t the national program make this obsolete
But won’t the national Program make this obsolete?
  • Life of your RIS ~7-10 yrs
  • Life of Government Initiatives ~2-4 yrs
    • Trusts 4ys (then merged)
    • Information for Health – 3 yrs
    • NPfIT – 3 yrs ?
  • You will still be using your system long after the LSP has lost interest or gone bankrupt!
  • In 1994, you could buy a CT scanner which worked well with it’s own expensive secondary console, but if you wanted flexibility and choice for the future, you needed to insist on DICOM C-STORE
  • In 2004, you can buy a PACS which works well with it’s own expensive tied reporting stations, but if you want flexibility and choice in the future, you need to insist on DICOM General Purpose Worklist
    • If not there yet (insist on a firm, dated commitment, with guaranteed interconnection)
  • DICOM Standard Home Page
    • http://www.dclunie.com/dicom-status/status.html
  • DICOM Newsgroup
    • news:comp.protocols.dicom
  • My E-mail (Dave Harvey)
    • mailto:dave@medicalconnections.co.uk