DICOM Structured Reporting Recent Standards Activity Doug Sluis SPIE, Feb 18, 2003.

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Transcript of DICOM Structured Reporting Recent Standards Activity Doug Sluis SPIE, Feb 18, 2003.

  • DICOM Structured ReportingRecent Standards ActivityDoug SluisSPIE, Feb 18, 2003

    D Sluis*

    Overview

    Recent Template SupplementsInteroperability ConsiderationsTemplates for Measurement FindingsDCMR Developments

    D Sluis*

    SupplementsWG15WG12WG12001200220032004Breast Report (79)Mammography CAD (50)Key Object (59)OB-GYN (26)Patient History (75)Chest CAD (65)QCA&QVA(76)Cath, Hemo, ECG (66)Echocardiography (72)IVUS (77)Vascular (71)MRA/CTA (XX)Fetal &Ped. (78)DCMR (53)

    D Sluis*

    Image Derived FindingsFindingsAnalysis, CAD, Quantification,ObservationsReportImagesRecent Focus/ Evidence

    D Sluis*

    Software Roles for Evidence & FindingsStreamline differential diagnosis, trendingTask-optimized presentationIndices and ratiosCompare to normsEase data navigationOutcomesImagesMeasurements, estimations

    D Sluis*

    SR Interoperability Contrast to ImageImage SOPsProduct, engineering realmIOD is one, or few discrete objectsBehavior is simple displayInteroperability mostly depends on data conformanceSR SOPsUser clinical realmMany discrete findings, many typesInteroperability criteria depend on behaviorVariety of product behaviorProduct XProduct DomainImageUser DomainProduct Z

    D Sluis*

    Interoperability: Comparable FindingsFindings comparability is key goalUnambiguous, well defined Coded Concepts

    Product XProduct YSR

    D Sluis*

    Comparable ConceptsPhrase may evoke multiple conceptsComparability depends on concept oriented codes

    Umbilical vein(fetal)Umbilical vein(portal)(T-F1820, SRT, umbilical vein)(T-F8817, SNM3, umbilical vein)

    D Sluis*

    DCMR Role in InteroperabilityClinical ConceptsUser Domainfindings images

    D Sluis*

    Measurement Finding ConceptsFindingsProperty Diameter, area, volume, blood velocity, indices, ratios Anatomy Finding site, Site Modifier, LateralityPhysiological phase Cardiac - systole, diastole Respiratory exp., insp. Procedural phase Induced stress state Intervention stateAcquisition Image view Image modeDerivation Mean, max, min Method/Technique

    D Sluis*

    Direct Concept MappingClinical ConceptsDCMRLOINCFetal femur lengthDirect pre-coordinated conceptTemplate has marginal role

    D Sluis*

    Molecular ConceptsDCMRClinical ConceptsLNSRTSRTLeftPeak VelocityTemplate binds concept atomsBased on model (implicit)Femoral Artery

    D Sluis*

    Choosing Concept AtomsDCMRClinical ConceptsPeak VelocityIssues Coupled concepts Degrees of specificity

    Solution options Many Templates Mapping Annex (72)Aortic ValveDiastolicRegurgitant

    D Sluis*

    Quick ReviewValue TypeConcept Name = ValuerelationshipValue TypeConcept Name = ValueValue Types CONTAINER, NUM, CODE, IMAGE Concept Names and Values of type CODE are triplets Code Value Coding Scheme Designator Code Meaning (actually, just some text to evoke meaning to user)relationshipValue TypeConcept Name = Value

    D Sluis*

    Typical Top Level Template StructureCONTAINERFinding HeadingCONTAINERFinding HeadingCONTAINERDocument TitleCONTAINERPatientCharacteristicsTemplate specified titleOB-GYN, Adult Echo, IVUSUltrasound Vascular, Cath/Hemo TID 1002 Observation ContextCONTAINERSummaryOther Contexte.g. procedureCONTAINERSummary FindingsCONTAINERFindings HeadingFindings

    D Sluis*

    Document HeadingsCONTAINERHeadingFindingsCONTAINERDocument TitleThe heading may have semantics shared by children findingsSpecific: Exercise Challenge Generic: Findingscontains

    D Sluis*

    Discrete Numeric FindingsCONTAINERGroupNUMMeasurementDiameter, Area, Volume, Blood Velocity, Indices, Ratios, Time Interval or pre-coordinated concept: BPD, FL CODEModifier Concepthas concept modifierCODEModifier Concepthas concept modifierLaterality, Finding Site, Anatomic Site Modifier, Cardiac Phase containsDistributed semantics

    D Sluis*

    Vascular Content HierarchyCONTAINERAnatomyCONTAINERFindingsCODELateralityhas concept modifierhas concept modifierNUMMeasurementCODETopographical ModifiercontainscontainsCONTAINERVascular ReportDocument TitleSection HeadingGroupDiscrete FindingMinimumConceptscontainsproperty

    D Sluis*

    Vascular TemplatesCONTAINERFindingsCODELateralityhas concept modifierTID 5103Content Item Value SetRight, Left, or Unilateral

    D Sluis*

    Vascular TemplatesTID 5104CONTAINERAnatomyCONTAINERFindingsCODELateralityhas concept modifiercontainsContent Item Value Set

    D Sluis*

    Vascular TemplatesTID 5104CONTAINERAnatomyCONTAINERFindingsCODELateralityhas concept modifierCODE Longitudinal Modifierhas concept modifiercontainsOptional specificityContent Item Value Set

    D Sluis*

    Vascular TemplatesTID 5104CONTAINERAnatomyCONTAINERFindingsCODELateralityhas concept modifierCODE Branch Modifierhas concept modifiercontainsContent Item Value Set

    D Sluis*

    Vascular TemplatesCONTAINERAnatomyCONTAINERFindingsCODELateralityhas concept modifierhas concept modifierNUMMeasurementCODETopographical ModifiercontainscontainsTID 5104Content Item Value Set

    D Sluis*

    Findings Origin and ContextNUMMeasurementSCOORDInferred fromIMAGECODECODEInferred fromEquation or TableInferred fromhas acquisition contextImage ModeImage ViewCODE, TEXTNormality, SignificanceNormal Range, has propertiesCoordinatesImageNUMInferred fromNumeric dependencyTID 300 Measurements

    D Sluis*

    HarmonizationCONTAINERFindingsCONTAINERFindingsCODEProcedure Reportedhas concept modifierhas concept modifierCODEWall SegmentCODEFinding SitecontainscontainsCONTAINEREcho ReportMyocardial WallLeft VentriculographyWall Motion AnalysiscontainsCONTAINERHemo ReportCODECardiac Wall MotionCODEAssociated MorphologyDCID 3704 Wall MorphologyDCID 3703 Wall Motionhas propertiesBCID 3717 Wall SegmentsSup 66Sup 72Content Item Value Set

    D Sluis*

    DCMR UsabilityText formatNeedless translation step for developmentHard to maintain!Quality impactDICOMStandardApplication DeveloperProduct SW

    D Sluis*

    DCMR in XMLReferentialintegrityDCMR InterchangeStandard(XML Schema)PDFInteractive Web AccessProduct configurationWeb servicesDCMRMaintenanceEnvironmentDCMR (XML)Information model

    Extensibility

    EXTENSIBILE

    NON-EXTENSIBLE

    ReqType

    M

    C

    U

    UC

    ValueType

    CODE

    TEXT

    NUM

    DATETIME

    DATE

    TIME

    UIDREF

    PNAME

    COMPOSITE

    WAVEFORM

    SCOORD

    TCOORD

    CONTAINER

    RelationshipType

    CONTAINS

    HAS PROPERTIES

    HAS CONCEPT MOD

    HAS OBS CONTEXT

    HAS ACQ CONTEXT

    INFERRED FROM

    SELECTED FROM

    R-INFERRED FROM

    R-SELECTED FROM

    R-HAS PROPERTIES

    CodeRefType

    DT

    EV

    ContextGroupRefType

    ECID

    DCID

    TemplateRefType

    DTID

    ETID

    CodeMember

    CID : string

    CodeValue : string

    CGMember

    IncludedCID : string

    CID : string

    ContentConstraint

    RelationshipType : RelationshipType

    RequirementType : ReqType

    ValueMultiplicity : string

    RequirementCondition : string

    0..1

    1

    +successor's constraint

    0..1

    1

    ContextGroupValueConstraint

    ContextGroupRefType : ContextGroupRefType

    ReferencedCID : string

    CodeLabel

    Text : string

    TranslationCodeLabel

    Language : string

    Text : string

    ContextGroup

    0..*

    0..*

    +is included by

    0..*

    +includes

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    has

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    CodeValueConstraint

    CodeRefType : CodeRefType

    Code : Code

    0..*

    0..*

    0..*

    0..*

    ContentItemConstraint

    ValueType : ValueType

    0..*

    1

    +child constraint

    0..*

    1

    is a

    Template

    Title : string

    TID : string

    RootConstraint : boolean

    Version : string

    Description : string

    Extensibility : Extensibility

    1..*

    1

    +has

    1..*

    1

    TemplateConstraint

    ReferencedTID : string

    TemplateRefType : TemplateRefType

    is a

    1

    0..*

    1

    0..*

    uses

    ValueConstraint

    0..1

    0..1

    0..1

    0..1

    has concept name constraint

    0..1

    0..1

    0..1

    0..1

    has unit constraint

    0..1

    0..1

    0..1

    0..1

    has content value constraint

    DeclaredParameter

    Name : string

    Usage : string

    1

    0..*

    1

    0..*

    has parameters

    ParameterAssignment

    0..*

    1

    0..*

    1

    has parameter constraints

    1

    0..1

    1

    0..1

    gets a value of

    1

    1..*

    1

    assigns the value to

    is a context group

    is a parameter

    is a code

    D Sluis*

    Future3D coordinates3D shapes

    HL7 V3 Harmonization

    D Sluis*

    Behavior is simple even taken for granted

    SRCompletely different domain of expertiseSR Document has many different findings: interoperability depends on each; not just one.Behavior: Display? (probably the least interesting possible behavior). Other interpretation role? Numeric analysis? Reporting?What does interoperability mean? There is no consensus yet, on how to deal with this new situation.

    For the purposes of this discussion, this is the only thing you need to know about DICOM SR..