R-Horn_What's New in DICOM 2008.ppt - DICOM Update

What’s New in DICOM

Robert Horn, Agfa Healthcare

SPIE Medical Imaging, 2008

2 SPIE February 2008, San Diego

DICOM Administrative Information

• DICOM is also ISO 12052.• The most recent published version, Supplements,

Change Items, etc. remain at NEMA

• MITA (Medical Imaging and Technology Alliance)• is the new name for the medical division of NEMA.

• 2008 Version is published• ftp://medical.nema.org/dicom/medical/2008


Multiframe Image SOP Classes

• Multiframe objects to support 1000+ slice studies• Image header supports functional group attributes

changing during acquisition• Dimensions allow multiple views of data

• Common structure used for all new image IODs• Sup 110 Ophthalmic Coherence Tomography (Adopted

August 2007)• Sup 116 3-D X-ray (Adopted January 2007)• Sup 117 Enhanced PET (in Letter Ballot)• Sup 43 Enhanced Ultrasound (in Public Comment) • Sup 125 Breast Tomosynthesis (in Public Comment)


Multiframe object structure

N Objects, N Headers

N Frames, One Header

Pixel dataDimension dataPer-frame headerFixed Header


The Per-Frame Header

Other attributes

Per-frame Functional Groups Sequence

Shared Functional Groups Sequence

> Functional Group A

> Functional Group B

> Functional Group M

…..

Other attributes

Functional Groups with attributes constant

for all frames

Item 1 (Frame 1) Sequence of

Functional Groups for each individual frame

Pixel Data

Frame 1

Frame 2

Frame n

…..

> Functional Group C



…..

Item n (Frame n)




Item 2 (Frame 2)


…..

…..

…..

…..

> Functional Group K


Sup 119 Frame Level Retrieve

• If we have 1000+ slice image objects, how do we access the slice identified in the report as the Key Image?• Or, how to access a short video clip of a long endoscopy video

image object?• Many similar use cases needing one frame or a small subset of

frames from large multiframe image• Purpose of retrieval may not be diagnostic; compression OK

• Proposed new Retrieve SOP Classes for subsets of frames• Request can include a preferred transfer syntax (i.e., type of

compression)• Returned object is a derived image with the requested subset of

frames, but with a different Instance UIDIn Letter Ballot


Sup 43 Ultrasound

• Pixel frames may represent echo power, doppler shift, or doppler variance

• Multiple frames (up to 3) can be blended for proper display

• An enhanced blending pipeline is required to render images

Data Frame Modality

LUT (identity)

VOI LUT(optional)

PrimaryRGBAPalette

Color LUT

(optional)

Data Frame

Data Frame Modality

LUT (identity)

VOI LUT(optional)

SecondaryRGBAPalette

Color LUT

(optional)

OpacityLUT

(optional)

RGB

ProfileConnection

Space Transformation

RGB

ICC Input Profile

Real World Value Mapping


Presentation LUT

(identity)

Gray Scale Output asP-Values

Color Output as

PCS-Values

RGB (Input 1)

Real World Value +Units

Alpha 1

Alpha 2

RGB

RGB (Input 1)


Real World Value +Units

Alpha, Beta(Constants)

RGB (Input 2)

Convert to RGB (R=B=G)

Blending Operation

Multiply inputs and add the result

(Alpha 1) x Input 1 +

(Alpha 2) x Input 2

CLAMP

OR

OR

Alpha

(1-Alpha), Alpha

Alpha

MSB’s

LSB’s

Alpha,BetaLUT

outputs

OR

Modality LUT

(identity)

VOI LUT(optional)

In Public Comment


Sup 111 Segmentation Image

• Derived image object• Multiframe, using functional group mechanism

• Multiple segments per object• Each segment linked to a categorization• Pixels show presence of category at pixel location• Binary (1-bit/pixel) or fractional (probability or occupancy)

• Segments can be 2-D or 3-D• 3-D segmentation is typically in same Frame of Reference

as source image• Segments can be displayed as overlays on source image

Adopted August 2006


Sup 132 Surface Segmentation

• Segmentation using 3-D surface mesh (rather than voxel volume)

• First use of mesh technology in DICOM• Will also be used for future volumetric work, including

implant specification and surgical planning

In Public Comment


Sup 112 Deformable Spatial Registration

• Composite Object that supports multi-image alignment

• 3 step algorithm• Pre-deformation matrix transform • Deformation using 3D grid of 3D deformation vectors• Post-deformation matrix transform

• Facilitates further image processing, especially multi-modality image fusion and image pasting applications

Adopted August 2006


Structured Reporting

• Additional Templates for standard SR SOP Classes• Sup 128 Cardiac Stress Testing (Frozen Draft – passed Ballot,

awaiting final SNOMED and IEEE codes)• Sup 129 Cardiac Electrophysiology (in Public Comment)

• Templates for specialty SR SOP Classes• Sup 127 CT Radiation Dose (Adopted October 2007)• Sup 130 Ophthalmic Refractive SR (Adopted January 2008)• Sup 126 Colon CAD (Public Comment)

• Harmonization with HL7• Sup 114 DICOM Encapsulation of CDA Documents (Adopted

January 2007)• Sup 135 SR HL7 CDA Mapping (Public Comment)

• Mapping is only for Basic Imaging Reports


Sup 107 Substance Administration

• Patient safety issue – “five rights” checking for contrast agents• Point of use verification for substances often “out of the loop” of hospital

pharmacy systems

• Three new DICOM services• Typically Modality as SCU interacting with HIS via gateway SCP

• Query: Look up product characteristics • Given a barcode ID (from contrast agent bottle), get name, active

ingredient, concentration, etc.

• Query: Get substance administration approval• Based on agent, patient, route of administration; get approval or warnings

• Report contrast used to HIS Medication Administration Record

Adopted January 2007


Sup 96 Unified Procedure Steps

• Simplification and merger of Worklist Management and Performed Procedure Steps • 1:1 relationship between scheduled and performed steps• A single IOD that combines attributes of both • C-FIND to query worklists• N-CREATE to create new scheduled procedure steps• N-GET/N-SET to update • N-EVENT-REPORT to monitor and report progress

• Intended to meet the needs of• Radiation Therapy Scheduling and Monitoring• Scheduling and Monitoring CAD systems• Proposed new scheduling activities

Frozen Draft for Trial Implementation


Sup 74 Radiotherapy Worklist

• Supports automated worklist management and machine parameter verification for the integration of multi-system radiation therapy planning and treatment

• First usage of Unified Procedure Step• Also defines three new objects / SOP Classes

• RT Beams Delivery Instruction (Composite)• RT Conventional Machine Verification (Normalized)• RT Ion Machine Verification (Normalized)

• Real implementation and evaluation needed – in conjunction with IHE Radiation Oncology

Frozen Draft for Trial Implementation


Sup 122 Specimen Identification

• Support for pathology lab workflow, specimen-based imaging• Gross specimens, blocks, vials, slides• Image-guided biopsy samples

• Retires current Specimen Identification Module, adds new Specimen Module at image level of hierarchy

• Update to Modality Worklist to allow Specimen Module• Enables automated slide scanning devices to fully populate

header

• Update to Modality Performed Procedure Step to identify imaged specimen• Allows LIS to track images for specimens

In Letter Ballot


Specialties

• Biomed engineering• Supp 124 Communication of Display Parameters (in

preparation)• Administrative support for monitor calibration

• Surgery• Sup 131 Implant Description (in preparation) • Supports 3D model of bone-mountable implants

• Dentistry / Radiology• Sup 123 Structured Display (in preparation) • Captured screen layout of multiple images (with

presentation states) for dental series, radiology conference, etc.


Sup 118 Application Hosting

• Experimental trials are underway• February 2008 meeting to prepare public

comment text for March 2006 WG-06 meeting• New approaches to DICOM Information Object

exchange• Native (shared memory) using DICOM encoding• Native Model

• DOM-like model defined using DICOM terminology

• Abstract Model• DOM-like model of generic image attributes• Usable for any image type (TIFF, DICOM, etc.)

R-Horn_What's New in DICOM 2008.ppt - DICOM Update

Documents

Transcript of R-Horn_What's New in DICOM 2008.ppt - DICOM Update