DICOM INTERNATIONALCONFERENCE & SEMINAR

Oct 9-11, 2010 Rio de Janeiro, Brazil

DICOM in Surgery - Recent activities and

new DICOM Supplements

Dr.-Ing. Oliver Burgertoliver.burgert@medizin.uni-leipzig.de

Innovation Center Computer Assisted Surgery (ICCAS)

Universität Leipzig

Germany

Overview

1. DICOM WG-24 “Surgery”

2. Recently developed Supplements– Surface Segmentation– Implant Templates– Implantation Plan

3. Current project– Optical Surface Scan– Others

4. Conclusion

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DICOM WG-24 „Surgery“

• DICOM WG-24 aims on writing DICOM Supplements for Surgery.

• It has one permanent voting representative in WG-06• DICOM WG-24 has currently over 100 members from

industry, medical practice and academia.• Organization in

– Clinical Project Groups– Technical Project Groups

• Everyone of you can participate!

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DICOM WG-24 „Surgery“

DICOM Working Group 24 „Surgery“– Surface Mesh– Implant Templates– Implantation Plans

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DICOM Surface Mesh Module

• DICOM Sup. 132 contains module for description of polyonal surfaces• Methods:

– Analysis of Surgical Workflows (DICOM WG-24)– Analysis of more than 25 file formats– Development of a DICOM data structure based on points and meshing

Implantation Planning

Digital implantation planning is of increasing importance Issue: No commonly accepted file format for implant templates

Digital 2D PlanningDigital 3D Planning

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Workflow Implantation Planning

StartPlanning

Select & LoadImages

Extract Models

Locate AnatomicalLandmarks

Select Template(s)

Register Template(s)

FinishPlanning

Predict Outcome

Leg length change: 5mm

Mobility: 60°

Implant Templates

• 2D Drawings• 3D Models

• Anatomical landmarks

• Combination of components

• Meta-data– vendor– withdrawal– indication– …

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Implantation Plan

Implantations Plan

RegistrationVisualization

Intraoperative Information

Component ListComponents

Combination

Connection templates

Component connections

Derived landmarks

Planing Information

User definedlandmarks

Patient Data

Information flow

Modality (CT,MRT,…)

Planing Workstation

Navigation-system

OR Display

OR report

Bilder

Plan

OR-Room

PACS

PlanBilder

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Information Objects

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Attribute-Structure of Implant Templates

ManufacturerFrame of Reference UIDImplant NameImplant SizeImplant Part NumberImplant Template VersionReplaced Implant Template SequenceImplant TypeOriginal Implant Template SequenceDerivation Implant Template SequenceEffective DateTimeImplant Target Anatomy SequenceNotification from Manufacturer Sequence[…]Materials Code Sequence[…]HPGL Document SequenceContour Surface Number ReferenceSurface Model Parameter SequenceSurface Model Scaling FactorMating Feature Sets Sequence[…]

Analog for:Implant Assembly TemplateImplant Template Group

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• Responsibility• Update• Withdrawal • Archiving

Data flow

Implant Manufacturer

Planning Software Vendor

PACS Vendors

Health care provider13

Optical Surface Scanner - Use cases

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Use Case: Septorhinoplasty

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Optical Surface Scan, WG-24 meeting, 2010-06-23, C. Dressler

Optical Surface Scanners

• Two possibilities to store scanner data

Raw data3d object

Scanner

ExternalPost-processing PACS

Point clouds, surface meshes, textures, device-specific attributes,3d models

Changes to the DICOM Standard

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Two new IODs

Raw data Surface

New IEs each

New Modules

Point cloud module

UV-Mapping module

Using existing

Points Macro

New Macro

Use the Mesh Module

IE

Module

IOD

Macro

Add Module

New DCM codes

Add Module

Frame of Reference

VL Photo IOD

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Attributes for Meshes

• In 2008, DICOM Supplement 132 “Surface Segmentation” was accepted.

• Points

• Topology

• Normals

• Properties X

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Coordinate Systems

• This request for DICOM Work Item is for the development of a Universal Coordinate System (or Universal DICOM Frame of Reference).

• This system will select as a “standard” one of several existing DICOM IOD’s or definitions (e.g. the image-centric, patient-centric, or environmental-centric coordinates).

• Work Plan:– 1.Recruit members to contribute to this Work Item– 2.Agree on “approach”– 3.Select Universal Coordinate System or “Universal DICOM Frame of Reference” – 4.Create list of IODs to be selected or written– 5.Check for overlap with Workgroup 2– 6.Select “Use-Case” to serve as example– 7.Complete request for Work Item– 8.Review at next meeting (RSNA 2009)– 9.Submit request for work item

• Interested? Leonard Berliner, NY Methodist Hospital

DICOM WG-24 „Surgery“ - Conclusions

• Current Status:– Sup. 132 “Surface Segmentation”, introduces surface meshes

(Standard since 2008, jointly with WG-17)– Sup. 131 defines “Implants”, (Letter Ballot finished)– Sup. 134 defines “Implantation Plans”, (Letter Ballot finished)

• Other Supplements are in preparation:– Optical Surface Scan Modality (Work Item granted)– Coordinate Systems– Attributes for Meshes– Volumetric Meshes– Patient Specific Implants

• We appreciate any input and discussion

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DICOM INTERNATIONALCONFERENCE & SEMINAR

Oct 9-11, 2010 Rio de Janeiro, Brazil

Thank you for your attention!

I’m looking forward to your questions and contributions

AcknowledgementsThe Innovation Center Computer Assisted Surgery (ICCAS) at the Faculty of Medicine at the University of Leipzig is funded by the German Federal Ministry for Education and Research (BMBF) and the Saxon Ministry of Science and the Fine Arts (SMWK) in the scope of the initiative “Unternehmen Region” with the grant numbers 03 ZIK 031 and 03 ZIK 032.

It is also sponsored by funds of the European Regional Development Fund (ERDF) and the state of Saxony within the frame of measures to support the technology sector.