DICOM Fields of Use

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Allan G. Farman

Professor of Radiology & Imaging Science, University of Louisville, Kentucky, USA

Founding Co-Chair DICOM Working Group 22 (Dentistry)

AAOMR Representative-Designate to DICOM Standards Committee

President, AAOMR

DICOM fields of use

• DICOM Standard contains:– Services, SOP Classes, Templates, etc.– Cross-Discipline Standards [Preferred]– Field of Use Specific Standards [Where needed]

• DICOM Working Groups– Cross-Discipline [n=17]– Field Specific [n=10]

• DICOM Member Organizations– Vendors + Users + General Interest– Users represent Specific Fields of Use

DICOM fields of use

Fields of Use Represented in

StandardWorking GroupsListedInclude ThoseSpecific toFields of Use

Fields of Use Represented by

Member Organizations

http://medical.nema.org/

DICOM fields of use

WG 1

Cardiology

WG 3

Nuclear Med

WG 7

Radiation Therapy

WG 9Ophthalmology

WG 15

Mammography

WG 19

Dermatology

WG 22 Dentistry

WG 24 Surgery

WG

25Veterinary Med

WG 26Pathology

10 of 27 WGs represent specific fields of use

WG-27 Web Services

DICOM fields of use

WG 1Cardiology

WG 1Cardiology

WG 22Dentistry

WG 26Pathology

WG 25VeterinaryMedicine

WG 9Ophthalmology

Diagnostic Radiology

Diagnostic Radiology

Diagnostic Radiology

Diagnostic Radiology

Health Informatics

Health Informatics

Diagnostic Radiology

Diagnostic Radiology

AAOMR & AAO APPLICATIONS PENDING

DICOM fields of use

– Diagnostic Radiology– Radiation Therapy– Image Guided Surgery– Mammography– Cardiology– Dentistry– Pathology– Ophthalmology– Dermatology– Veterinary Medicine– Endoscopy– Microscopy– Clinical Photography/Video– Computed Tomography– Magnetic Resonance Imaging– Ultrasound

•Therefore DICOM has something for you if you make or use systems in any of the following fields:

– Nuclear Medicine– Positron Emission Tomography– Molecular Imaging– Optical Coherence Tomography– Tomosynthesis– Image Fusion– Structured Reporting– Structured Displays– Picture Archiving and

Communications Systems– Web Access to DICOM Objects– Implants– Angiography– Image-Generated Models– Teaching Case Files– Surgery (Endosseous Implants)– Prosthetic Chain and CAD/CAM

DICOM fields of use

• Discipline Unique Supplements– e.g.– Supplement 32 - Dental Digital Radiographs– Supplement 74 - Radiation Therapy General Purpose Worklist– Supplement 91 - Ophthalmic Photography – Supplement 92 - Dental Grayscale Image Application Profiles– Supplement 97 - CT/MR Cardiovascular Analysis– Supplement 122 - Specimen Identification in Pathology– Supplement 125 - Breast Tomosynthesis Image Storage– Supplement 126 - Colon CAD Structured Reports– Supplement 128 - Cardiac Stress Test Structured Reports– Supplement 130 - Ophthalmic Refractive Structured Reports

DICOM fields of use

e.g. Orthodontist

e.g. MaxillofacialSurgeon

e.g. Endodontist

Imagesreferred to specialist

Practice management

data base archive

SatelliteDental Office

Alternative Digital System

in Same Office

Hospital orPhysician

Domain

of DICOM

Media Data

Interchange

Dental Office

Pos

sibl

e N

etw

ork

for D

ICO

MN

etw

ork

Inte

rcha

nge

Removable Media

Removable Media

Removable Media

Removable Media

Removable Media

Removable Media

Removable Media

Removable Media

Supplement 92: Grayscale Media Applications for Dentistry

DICOM fields of use

Supplement 92: Grayscale Media Applications for Dentistry

OrthodontistOrthodontist

OralOralSurgeonSurgeon

EndodontistEndodontist

Images referred to specialists

Practice managementPractice managementdata base archivedata base archive

2y Admin2y AdminUsesUses

SateliteSateliteDental Dental OfficeOffice

PatientPatient

Alternative Digital System in Same OfficeAlternative Digital System in Same Office

Hospital orHospital orPhysicianPhysician

ForensicForensicss

GeneralGeneral DentistDentist

Or from the Dentist’s viewpoint…

DICOM fields of use

• Cross-Discipline Supplements– e.g.– Supplement 47 - Visible Light (Endoscopy/Photography/Microscopy)– Supplement 85 - Web Access to DICOM Objects– Supplement 104 - Encapsulation of PDF Document– Supplement 113 - DICOM e-mail Transport – Supplement 116 - 3D X-Ray– Supplement 123 - Structured Display – Supplement 131 – Polygonal Surface Description– Supplement 132 - Implant Description Storage SOP Class

DICOM fields of use

DentistryIntraoral X-Ray

Series

OphthalmologyEye Charts

Cardiology

Structured DisplaySupplement 123

RadiologyTeaching

CasesWG 1

WG 22 WG 9

WG 10 & 20

DICOM fields of use

(1.0, 1.0)

(0,0) BLHC

Structured Display Image Boxes

One of Many Standard Dental Radiographic Display Templates

DICOM fields of use

Standard Ophthalmology Charts

DICOM fields of use

DentistryCBCT

MammographyTomosynthesis

& CBCT

Angiography

3D-X-raySupplement 116

RadiationTherapyPlanning

WG 2

WG 22

WG 7

WG 15

Image Processing

Raw (basis) Images

Solid State DetectorX

-ray

So

urc

e

Patient

CBCT≥180o Rotation

CBCT Image (Isotrophic Data) Procedure Control

DICOM fields of use

Mucous Extravasation R. Maxillary Sinus

R L

L

“Bisphosphonate”

LL

Dental impaction

R L Carotid Calcified Atheroma Unerupted maxillary third

molars without cysts

Osteonecrosis

TMJOsteoarthrosis

DICOM fields of use

• DICOM provides– A set of basic rules for all disciplines– Discipline specific rules where necessary

– The aim has been to keep the Standard as coherent as possible by having disciplines interact to develop answers with as wide a scope as possible… and to provide use cases from representative disciplines concerned.