& what now & what’s next
DESCRIPTION
Kevin O’Donnell, Toshiba Medical Research Inst . Co-Chair, DICOM Standards Cmte. Member, IHE Radiology Technical Cmte. & what now & what’s next. Presenter perceives no conflict of interest with this presentation but discloses being an employee of: - PowerPoint PPT PresentationTRANSCRIPT
&
WHAT NOW & WHAT’S NEXT
Kevin O’Donnell, Toshiba Medical Research Inst.Co-Chair, DICOM Standards Cmte.Member, IHE Radiology Technical Cmte.
DISCLOSURE
Presenter perceives no conflict of interest with this presentation but discloses being an employee of:
Toshiba Medical Research Institute USA,
a division of Toshiba Medical Systems Corp.
DICOM is the standard for medical imaging. Widely implemented; basis of DI
marketplace Managed process (NEMA/MITA) International scope (ISO-12052) and many pages of detail information…
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IHE IN ONE SLIDE IHE helps vendors implement & test
functions that span multiple systems
Profiles are implementation guides how to use existing standards to address a specific problem scenario
Connectathons are test events managed testing of Profile
implementations
IHE helps users purchase & integrate multi-system solutions list required IHE Profile support in RFPs
COMMUNICATION STANDARDSX
X
X
XY
XX
X? ?Y
X?
x
COMMUNICATION STANDARDS
X
X !
LEVEL OF IMPLEMENTATION product-registry.ihe.net
Integration Statement Database IS = specific version of specific product
connectathon-results.ihe.net Vendor Participation Database
IMAGING WORKFLOWWhat Now…
IHE Scheduled Workflowo DICOM Modality Worklisto DICOM Imageso DICOM MPPS (Performed Procedure Step)
Unscheduled or Modified Procedureso DICOM Storage Commit (turn it on)
IHE Mammography Image
IMAGING WORKFLOWWhat’s Next…
DICOM Enhanced CT, MR, XA, PET, 3D USo Faster o Better Processing
DICOM Multiframe Converted Legacyo Supplement 157o Addresses Mixed Environment
DICOM MULTI-FRAME CONVERSION
Classic View
Enhanced View
Legacy WorkstationLegacy Modality
Advanced WorkstationAdvanced Modality
&
&
IMAGING WORKFLOWWhat’s Next…
IHE Scheduled Workflow.bo HL7 2.5.1o Replaces 2.5.1 Option in SWF
RadLex Playbook (RSNA)o Standard codeset for orderables
Code: RPID7 Short Name: CT HEAD ANGIO WO & W IVCON Long Name: CT HEAD ANGIOGRAPHY WITHOUT THEN
WITH IV CONTRASTo playbook.radlex.org
Confidential
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STANDARD PROCEDURE CODES
Radlex Playbook:RPID7- CT HEAD ANGIO WO & W IVCON
P7->Protocol
RSNA
RIS
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Templates
P7
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EMR
CDA
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Guidelines
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Registry
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IMAGING WORKFLOWWhat’s Next…
DICOM Protocol Storage (CT)o Supplement 121 (WIP)
DICOM Contrast Administration Recordo Supplement 164 (WIP)
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Clinical Trial
Semi-auto Scan Setup
Defined & Planned Protocol
Performed Protocol
Device=Aquilion Series…Pat. Pos. : Feet First / SupinePat. Instruct : Single Breath Hold / Full Inspiration…kVp : 80~140Slice Thickness : 1.0~2.5mmRecon. Kernel : Std.…
Device=Aquilion ONEVersion=3.0.4…Pat. Pos=Feet First / SupinePat. Instruct=Given…kVp=120Slice Thickness=1.0mmRecon. Kernel=FC12…
Modality
Vendor
SOURCES APPLICATIONS
SharingBest Practice
Scan QA / Troubleshooting
Acquisition Validation
Best Practice
Protocol Library
Clinical Trial Protocol
Prior Comparability
Protocol Backups
ACR / RSNA AAPM
or
Patient Positioning
Local Standard
Prior Scan
Hospital
PROTOCOL STORAGE
RADIATION MANAGEMENTWhat Now…
DICOM RDSR (CT, XA, CR, DR, MG) IHE Radiation Exposure Monitoring
o CT Now, Others appearing Dose Analysis
o ACR Dose Registry (2Mil+ studies)o Open Source (Radiance, etc.)o Commercial Packages
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IHE RADIATION EXPOSURE MONITORING PROFILE
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National Registry
ArchiveDose Information
Reporter
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Outlier: #Performing Phys.Over Target: 12.2%Outlier: #Performing Phys.Over Target: 12.2%
Outlier: #Performing Phys.Over Target: 12.2%
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RADIATION MANAGEMENTWhat’s Next…
DICOM Radiopharmaceutical SRo Supplement 159 (WIP)
DICOM Patient Dose SRo Supplement TBA
IMAGE DISTRIBUTIONWhat Now…
DICOM Push/Pull (configure firewalls) IHE PDI compliant DICOM CDs IHE XDS-I.b
o Some Canadian DIRs already using IHE Import Reconciliation Workflow.b
Store
(Fix IDs, Codes & Demographics)
IMAGE DISTRIBUTIONWhat’s Next
DICOM WADO-RSo Web Access to DICOM Objects - RESTful
DICOM STOW-RSo Store Over the Web - RESTful
DICOM QIDO-RSo Query – RESTful
IHE Invoke Image Display
MEASUREMENTWhat Now…
Ultrasound Measurementso OB/Gyno Adult Echoo Fetal, Pediatric and Congenital Echo
Record & Dataflow
MEASUREMENTWhat’s Next…
Ultrasound Measurementso (Simplified) Adult Echo
POST-ACQUISITION WORKFLOWWhat’s Next…
IHE Post-Acquisition Workflowo DICOM Unified Procedure Stepo DICOM Application Hosting (“DICOM plugins”)o Worklist managed processing
Automated & manualo Progress notifications
Any interested system (RIS, Billing, Reading Worklist, Dashboard, Analytics)
Subscription-basedo Cancelation requests
With reason & contact
IHE PAWFExample “Workitem” Tasks: 3D View Generation Computer Aided Detection Clinical Applications Pre-fetching Image Routing CD Burning Image Importing …
REPORTINGWhat Now…
IHE Consistent Presentation of Imageso DICOM GSDF (Calibration)o DICOM Greyscale Presentation State
REPORTINGWhat’s Next…
IHE Management of Rad. Report Templateso Format for dictation/authoring templateso Vehicle for RSNA Template Libraryo www.radreport.org
DICOM Radiology CDA Templateso Supplement 155 (WIP)
DICOM Multi-dimensional Presentation Stateso Supplement 156 (WIP)
USEFUL LINKS DICOM
dicom.nema.org
IHE www.ihe.net – Technical Frameworks wiki.ihe.net - (click “Integration Profiles”) product-registry.ihe.net connectathon-results.ihe.net
QIBA qibawiki.rsna.org – Profiles, Project status