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DICOM Exchanging Imaging Data Various Modality Images, Presentation States, Structured Reports  Finding and Retrieving Imaging Objects DICOM Course – Singapore April 2005. DICOM. Is a GLOBAL STANDARD of Communication, developed under joint efforts of ACR (American College of Radiology)

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slide1

DICOM

Exchanging Imaging Data

Various Modality Images, Presentation States, Structured Reports 

Finding and Retrieving Imaging Objects

DICOM Course – Singapore April 2005

slide2

DICOM...

Is aGLOBAL STANDARDof Communication,

developed under joint efforts of

ACR (American College of Radiology)

NEMA (National Electrical ManufacturersAssoc.)

ESC (European Society of Cardiology)

ACC (American College of Cardiology)

SFR (Société Française de Radiology)

DRG (Deutschen Röntgengesellschaft)

AAO (American Academy of Ophthalmology)

AAD (American Academy of Dermatology)

CAP (College of American Pathology)

JIRA (Japaneese Radiology Vendors Association)COCIR (European Radiology Vendors Association)

And 25 plus vendors……

slide3

Since 1997 –Too many to count !

DICOM first release approved October ’9310 year anniversary

  • 20 Vendors at the ‘93 DICOM RSNA Demonstration
  • 40 Vendors at the ‘94 and 95 DICOM RSNA Demonstrations
  • More than 100 Vendors at RSNA 96
slide4

DICOM documents updated yearly

DICOM 2004 is a compatible extension of DICOM 2003 + 27 Clarifications/Changes + 80 Supplements

Available for free from the DICOM website:dicom.nema.org

But DICOM 3.0, DICOM 96, DICOM 98, DICOM 99, DICOM 2000 DICOM 2003 are only document publishing names.

This has no direct impact on existing

Product Conformance !

slide5

IMAGE

IMAGE INFORMATION OBJECTS

QUERY

RETRIEVE

STORAGE

Networking Support, e.g.. TCP/IP

DICOM forImage Transfer

Understanding Image transfer with DICOM ...

slide6

CT, MR, CR

Second. Capt. (SC)

1993

INFORMATIONOBJECTS

X-Ray Cardio/Vasc

X-Ray Fluoro

1995

US

NM

PET

1996

IMAGE

1997

RT

QUERY

RETRIEVE

X-Ray Digital RAD

X-Ray Digital Mammo

X-ray Intra-Oral

Stored Print

1998

STORAGE

1999

Pathology, Optalmo.

Vaweform

2001

Structured Reporting , KOS, Present. States

2003enhanced MR, eCT, …..

DICOM Spans Most of Medical Imaging

DICOM runs on

Internet and Intranet

Networking Support

TCP/IP

slide7

CT, MR, CR

Second. Capt. (SC)

1993

X-Ray Cardio/Vasc

X-Ray Fluoro

1995

US

NM

PET

1996

1997

RT

X-Ray Digital RAD

X-Ray Digital Mammo

X-ray Intra-Oral

Stored Print

1998

1999

Pathology, Optalmo.

Vaweform

2001

Structured Reporting, KOS, Present. States

2003enhanced MR, eCT, …..

DICOM Spans Most of Medical Imaging

DICOM transfers not only Images, but also:

- Therapy Plans, Structures, etc.

- Soon Waveforms

- Structured Reports

DICOM transfers not only Radiology images, but also:

- Cardiology (X-Ray Angio, US, NM)

- Oncology (RT Portal images)

- Dentistery (X-ray Intra-Oral)

- Pathology, Endoscopy, Microscopy, Optalmology, etc.

slide8
Build simple and easy-to-implement networks

Reap efficiency and productivity benefits

Invest in a necessary step for future PACS

What can I really do with DICOM TODAY ?

slide9

Simple Networks in Radiology and Teleradiology

CT, MR, NM, US, Digitizer, CR, digital X-ray, PET

CT, MR, NM, US, Digitizer, CR, digital X-ray, PET

Imaging

Equipment

Imaging

Equipment

DICOM SERVICES USED

Local Area Network

DICOM STORAGE QUERY/RETRIEVE

DICOM STORAGE

Analysis

or Review

Workstation

ISDN Link

or Dial-Up

DICOM STORAGE

Remote

Workstation

A DICOM Network, today’s common foundation both inside Radiology and for Teleradiology

slide10

Networks in Radiology and Care Units with Cluster Archiving

CT, MR, NM, US, Digitizer, CR, digital X-ray

CT, MR, NM, US, Digitizer, CR, digital X-ray

Local Area Network

DICOMSTORAGE

DICOMSTORAGE

Imaging

Equipment

Imaging

Equipment

DICOM SERVICES USED

Cluster

Archive

Cluster Archive

DICOMQUERY/RETRIEVE

Care Unit

DICOM STORAGE

ISDN Link

or Dial-Up

Analysisor Review

Workstation

Analysisor Review

Workstation

DICOMSTORAGE

Remote

WS

A DICOM Network is the common foundation both inside Radiology and for Teleradiology

slide11

What should I do to build

a DICOM Image Transfer Network ?

Three Steps:

1 - Clarify my Clinical Needs for Image Transfer and Image processing Applications

2 - Match Those Needs with DICOM Service Classes using the DICOM Conformance Statements

3 - Validate the Imaging Application Interoperability

slide12

Step 2 - Compare DICOM Conformance Statements

CT ScannerConformance Statement

WorkstationConformance Statement

1-CT STORAGE SCP

2-QUERY SCU

3-RETRIEVE SCU

4-MR STORAGE SCP

5- BASIC PRINT SCU

1-CT STORAGE SCU

2-QUERY SCP

3-RETRIEVE SCP

4-MODALITY WORKLIST SCU

SCU = Service Class USER

SCP = Service Class PROVIDER

Matching DICOM Service ClassesThe necessary step to find what will work

service object pair sop class
CR Image StorageSOP Class

CT Image StorageSOP Class

Patient Module

General Study Module

Patient Study Module*

Frame of Reference Module

General Series Module

General Equipment Module

Image Plane Module

Image Pixel Module

Contrast/Bolus Module

General Image Module

Overlay Plane Module*

VOI LUT Module*

Image Module

SOP Common Module

Service Object Pair (SOP) Class

+

=

DICOMCommunication

(SOP Class)

Image Info. Obj.

(the Data)

Store Command

(the Service)

Modified Slide from Don Van Syckle

image iods

Frame of Reference Module

General Series Module

General Equipment Module

Series Information

Image Plane Module

Image Pixel Module

Contrast/Bolus Module

Image Information

General Image Module

VOI LUT Module*

Overlay Plane Module*

Image Module

SOP Common Module

Image IODs

Patient’s Name

Patient Module

Patient Information

Patient’s ID

Patient’s Birth Date

Patient’s Sex

General Study Module

Study Information

Patient Study Module*

Patient’s Weight*

Referring Physician’s Name

Accession Number

Study Instance UID

Not only contains pixel data but

also key information about the image

Modified Slide from Jay Gaeta

storage
Send/Receive (i.e. push images on the network)

SOP Class dependent on IOD

CT, MR, US, CR/DR, X-ray, Secondary Capture, RT, NM, Structured Report… (i.e. not only images)

How the SCP stores the image is not defined by DICOM (i.e. storage of all data not guaranteed)

May send a study via multiple associations

May send more than one study on an association

Storage

DICOM does NOT define

an “one size fits all” image

storage transfer push images

Digital Modality

C-STORE-RQ …

- C-STORE-RQ Command

- Image Header Data (i.e. Name, ID, Row, Col..)

- Pixel Data

C-STORE-RSP…

  • C-STORE-RSP Command (Status)

Shared Archive

Storage Transfer – Push Images

Storage SCU

Storage SCP

Multiple transfers usually

occur on the same association

Modified Slide fromDon Van Syckle

query retrieve
Typically used by workstations for remote access and image retrieval from archives

Simple queries such as - “give me the patient name and ID for studies performed today”

Simple retrievals such as -“give me images for Study XYZ

Based on information models

Patient model, Study model and Patient/Study only

Query/Retrieve

Enables the “pulling” of images

Modified Slide fromDon Van Syckle

verification
“Echo” to verify application level communication between two DICOM products

Often used for service diagnostics to determine if another product is on-line or off-line

Products who accept DICOM associations are required to support Verification as an SCP

Digital Modality

Shared Archive

Verification

C-ECHO-RQ (no data set)

C-ECHO-RSP (success status)

Verification SCU

Modified Slide fromDon Van Syckle

Verification SCP

query remote device

Workstation

C-FIND-RQ

  • C-FIND-RQ Command- Study=today, give me name/ID, etc.

C-FIND-RSP

-C-FIND-RSP Command

(Pending Status)

- Study=Today, Joe Smith, 13456-7

C-FIND-RSP

-C-FIND-RSP Command

(Pending Status)

- Study=Today, Phil Jones, 2761-2

C-FIND-RSP

Shared Archive

-C-FIND-RSP Command

(Success Status)

Query Remote Device

Query SCU

Query SCP

-Query remote database

-Pending rsp for each match-One rsp for final status

Modified Slide fromDon Van Syckle

retrieve pull images

Workstation

C-MOVE-RQ

  • C-MOVE-RQ Command- Study Inst UID for images to pull.

C-STORE-RQ

Separate association then Move

C-STORE-RSP

(Typically for Multiple Images)

Same association as Move-RQ

C-MOVE-RSP

  • C-MOVE-RSP Command (Status)

Shared Archive

Retrieve – Pull Images

Retrieve SCU

Retrieve SCP

-Request Move “Pull” of images

-Archive opens second association to send images (the roles change for storage)-Response on same association as C-Move-RQ

Modified Slide fromDon Van Syckle

three device move

Workstation A

Workstation B

C-MOVE-RQ

After the image transfer completed

C-MOVE-RSP

C-STORE-RQ

C-STORE-RSP

Shared Archive

Three Device Move

Retrieve SCU

Retrieve SCP

-A requests the Move of images to B

-Archive opens second association to B-Archive sends images to B then closes assoc

-Association between A and archive open

during image transfer

-Archive provides final Move-RSP status to A

-All Retrieve SCPs required to support the

Three Device Move

Storage SCP

Modified Slide fromDon Van Syckle

slide22

We hope you understood DICOM

and are now ready to use it.

Thank You !

charles . parisot @ med . ge . com

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