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WADO and beyond. Emmanuel Cordonnier emmanuel.cordonnier@etiam.com ETIAM . Presentation Contents. WADO Objectives & Definition WADO Implementation Examples WADO Implementation Note WADO Evolution. WADO Objectives & Definition. DICOM WG10 NEMA Vienna - March 20, 1999 -.

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wado and beyond

WADO and beyond

Emmanuel Cordonnier



presentation contents
Presentation Contents
  • WADO Objectives & Definition
  • WADO Implementation Examples
  • WADO Implementation Note
  • WADO Evolution
wado origin proposal to dicom iso in 1999

DICOM WG10 NEMA Vienna - March 20, 1999 -

WADO Origin: Proposal to DICOM & ISO in 1999
  • Because no specific Ad Hoc Group on Biomedical Imaging will be set up in ISO / TC215, new works on medical imaging must be done into DICOM (with a Category A Liaison Group between both)
  • More and more it will be important that DICOM makes recommendations on the medical imaging aspects within non «pure» DICOM protocols

DICOM «object»

DICOM «world»

DICOM «world»

non DICOM world

syntax of the wado http get method
Syntax of the WADO HTTP GET method
  • Syntax defined by the RFC2396 (URI)
  • http://<authority><path>?<query>
  • e.g:
      • http://www.hosp.fr/dicom/wado.asp?studyUID=1…
  • The « Web Access to DICOM Persistent Object » standard defines only the <query>

Path of the Web Enabled DICOM Server

WADO Parameter(s)

selection parameters
Selection Parameters
  • studyUID&seriesUID&objectUID[&frameNumber]
    • studyUID => UID of the study containing the object(s)
    • seriesUID=> UID of the series containing the object(s)
    • objectUID => UID of the single object (Service Object Pair SOP)
    • frameNumber => number of the selected frame (multiframe image objects) – if NOT retrieved as application/dicom
parameters when the object is return as application dicom
Parameters when the object is return as application/dicom


  • transferSyntax => DICOM UID of the transferSyntax to be applied to the image (lossy/lossless compression). Implicit and Big Endian TS shall not be used.
  • anonymize => “=yes” for blanking all the personal healthcare information (patient name, study date…) as described in Sup. 55. Potentially the server can refuse to deliver an object if there are some risk the personal information is burned into the image (secondary capture…)
  • charset => for converting the text fields in a different character set (available also if object return as text/xxx)
parameters when the object is return as image xxx 1
Parameters when the object is return as image/xxx (1)


[presentationUID & presentationSeriesUID |[windowCenter & windowWidth]]

  • imageQuality => controls the level of compression (from 1 to 100)
  • presentation => UIDs of the Presentation State SOP and of its series to be applied on the image (P-values, and display size set to the original size if undefined)
  • windowCenter / windowWidth => controls the luminosity and the contrast of the B&W image
parameters when the object is return as image xxx 2
Parameters when the object is return as image/xxx (2)


  • region=> part of the image to be displayed, in relative coordinates (top left hand corner and bottom right hand extent)
  • rows => maximum number of pixels (vertical)
  • columns => maximum number of pixels (horizontal)
  • annotation => text to be superimposed of the image (“patient” and / or “technique” for demographic information and technical information, respectively)
providing a image as image xxx

Select the object


presentationUID&…or windowCenter…

Apply the presentation

Select a region


Build the pixel area

CT WC-800 WW200


Burn the annotations


Content-Type: image/jpeg;


Content-Transfer-Encoding: base64

Content-Disposition: attachment;










Generate the MIME type


DOE 2003-9-22

Providing a image as image/xxx
implementation of dicom
Implementation of DICOM
  • Principles of implementation
  • Initial examples
principles of implementation
Principles of implementation

Web Client System

Web Access to Dicom Persistent Objects

Web Access to Dicom Persistent Objects


Web Gateway



DICOM Interface

Web Interface


DICOM Interface

DICOM Objects Database

DICOM Objects Database

Flexibility for the client

to be implemented either

as new system

or on existing system

a retrieval of dicom images in jpeg format
A) retrieval of DICOM images in jpeg format
  • Proof-of-concept implementation
  • Windows NT-based host
  • Microsoft IIS 5.1 Web Server
  • WADO JPEG functionality added to the Web Extension for the DICOM server product
  • Images retrieved using Internet Explorer 6.0 running on Windows XP using pre-determined UIDs
  • Full implementation, including retrieval of images in native DICOM format, likely available in next release of the product
ihe xds i
  • The IHE Radiology Domain has defined a « XDS content profile » for linking a Cross-Enterprise Document Sharing to the PACS
  • The solution has been proposed as a « Manifest » (DICOM KOS) stored in the Document Repository
  • The images are still stored in the PACS and accessed through their reference
  • Because the XDS Consumer is web enabled, WADO is the natural retrieving method
  • XDS-I has been largely demonstrated
wado implementation note
WADO Implementation Note
  • Retrieving Multiple Objects
  • Managing WADO Reference
  • Managing WADO URL “Left Part”
  • Association of WADO and JPIP
retrieving multiple objects
Retrieving Multiple Objects
    • Applications aim to manage a reference to multiple DICOM Information Objects
    • WADO does not provide any mechanism for retrieving multiple Objects
    • Multiple references
      • The Application maintains all the reference to individual DICOM objects
    • Key Object Selection
      • The Server can create a DICOM Key Object Selection for each set of DICOM Objects the Application has to access using WADO.
      • The Application stores the link to this KOS and retrieve it first
      • It opens it, and accesses all the referenced DICOM Objects
managing wado reference
Managing WADO Reference
    • The Applications aim to display DICOM objects without necessarily activate a DICOM viewer
    • WADO URL string implies only one kind of display (e.g. Jpeg thumbnail)
    • As defined in the HL7, the application manages the link as follow:
      • a. Reference of the (WADO) Server (WADO URL “left part”);
      • b. DICOM UID of the Study;
      • c. DICOM UID of the Series;
      • d. DICOM UID of the SOP Instance;
      • e. DICOM UID of the Class of the Object.
    • The Application may then build any WADO request
managing wado url left part
Managing WADO URL “left part”
    • Application have to maintain persistent links to DICOM objects
    • DICOM WADO does not define the “left part” of the URL/URI
    • The Application maintains a “WADO Server ID” enabling to update the Server address for each object
    • Into a document (e.g. PDF), the “left part” is a “virtual” DICOM server (e.g. http://LocalDICOMServer/WADO), mapped on both emission and reception sides on the actual WADO Server:
      • Local DNS proxy for defining the correspondence between the server names (e.g. “LocalDICOMServer” alias of “server234”)
      • Mapping between the URL invocation and the actual script page (e.g. “WADO” alias of “scripts/wado.js”)
association of wado and jpip
Association of WADO and JPIP*
    • Providing streaming on referenced images
    • WADO does not propose means for gradual retrieving of images
    • Set WADO transferSyntax attribute to <JPIP>
    • Initiate a DICOM JPIP session

* See presentation made by Lev Weisfeiler

evolution of wado
Evolution of WADO
  • Limitation of WADO
  • Web Services
  • New Work Item and Planning
limitation of wado
Limitation of WADO
  • One SOP Instance only in one call (no way for retrieving all the series/study)
  • Suited for Web Browser based solution, less for direct with applications
  • The URL based query is easy to write, but not adapted for being parsed
  • No easy way to help the application development through WSDL
web services why now
Web Services… why now?
  • The WS are now “maturing”
  • The deployment beyond web server to web server is emerging (application to appli.)
  • The WS-I Profiles are defining a real interoperable solution, including (more or less!) the security and reliability aspects
  • The MTOM mechanism for conveying binary content is now supported by development platforms (.Net, Java…)
web services for dummies
Web Services for Dummies
  • Submitting a form to a Web Server, you are using http POST based structured message, containing the « input fields »
  • It may also contain files to be uploaded
  • WS are using such mechanism for the request and the response, and define the structure of message in XML SOAP
  • A WSDL (XML) file defines the syntax of the communication (request and response)
mtom for dummies
MTOM for Dummies

Date: Thu, 09 Sep 2004 18:47:52 GMT

Server: Apache/2.0.48 (Win32) mod_ssl/2.0.48 OpenSSL/0.9.7d

Keep-Alive: timeout=15, max=100

Connection: Keep-Alive

Transfer-Encoding: chunked

Content-Type: Multipart/Related;boundary=MIME_Boundary;type=application/xop+xml;charset=UTF-8;start-info="application/soap+xml"


Content-ID: <mymainpart@crf.canon.fr>

Content-Type: application/xop+xml;charset=UTF-8;type="application/soap+xml"

Content-Transfer-Encoding: binary

<soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope" xmlns:xmlmime="http://www.w3.org/2004/06/xmlmime" xmlns:xop="http://www.w3.org/2004/08/xop/include"><soap:Header></soap:Header><soap:Body><ns1:EchoTest xmlns:ns1="http://example.org/mtom/data"><ns1:Data xmlmime:contentType="image/jpeg"><xop:Include href="cid:thismessage:/resource0.jpeg"></xop:Include></ns1:Data><ns1:Data xmlmime:contentType="image/jpeg"><xop:Include href="cid:thismessage:/resource1.jpeg"></xop:Include></ns1:Data><ns1:Data xmlmime:contentType="image/jpeg"><xop:Include href="cid:thismessage:/resource2.jpeg"></xop:Include></ns1:Data></ns1:EchoTest></soap:Body></soap:Envelope>


Content-ID: <thismessage:/resource0.jpeg>

Content-Type: image/jpeg

Content-Transfer-Encoding: binary



Content-ID: <thismessage:/resource1.jpeg>

Content-Type: image/jpeg

Content-Transfer-Encoding: binary



wado in ws which form
WADO in WS, which form?
  • IHE ITI wrote White Paper on WS implementation, based on WS-I
  • The XDS.b Retrieve Document Set transaction is similar to WS/WADO
  • All the WADO query parameters can be directly transposed « as is » in WS
  • The response structure can be derived from the Retrieve Document Set structure
wado brothers
WADO « brothers »
  • WADO implies to have the reference
  • A notification mechanism may be developed on WS (NADO)
  • A Query by IDs mechanism may enable an application to obtain the reference (QIDO)
  • A New Work Item will be propose at the next DSC (April 11, 2008)
conclusion for today
Conclusion (for today)
  • WADO is still in its “emerging” implementation, but promising
  • WADO contributes to facilitate to co-existence of IS and PACS (e.g. XDS-I)
  • Its evolution through Web Services may enhance the integration between PACS and EHRs