medicine image dicom display update: color presentation states … · 2005. 1. 11. ·...
TRANSCRIPT
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The
MedicineBehind the
Image DICOM Display Update:DICOM Display Update:Color Presentation StatesColor Presentation States
Hanging ProtocolsHanging Protocols
Dr. David A. Clunie, MB.,BS., FRACRChief Technology Officer
Princeton Radiology Pharmaceutical Research
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OverviewOverview
• Review of Grayscale Presentation State• Color Presentation States
– Color Consistency– Presentation States applied to Color Images– Color Blending - CT-PET fusion
• Hanging Protocols
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Distributed ImageDistributed ImageConsistencyConsistency
Digital Modality
Workstation
Laser Printer
Workstation
Identical perceived contrast
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Spatial TransformationsSpatial Transformations
Original Image
Entire Image Selected
Transformed Image
Scale To FitFlip Horizontal
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Spatial TransformationsSpatial Transformations
Original Image
Part of Image Selected
Transformed Image
Scale To FitFlip Horizontal
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Transformation &Transformation &AnnotationAnnotation
Original Image
Part of Image Selected
Transformed Image
Scale To FitFlip Horizontal
Mass behind heart
Mass behind heart
In this example,- text annotation is specified by image relative visible anchor point- the circle is a separate image relative graphic annotation
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Limitations of GrayscaleLimitations of GrayscalePresentation StatesPresentation States
• Apply to grayscale images– no means to specify spatial transformations or graphic
annotations for color images
• Only grayscale consistency– standard display function defined only for luminance
• No pseudo-color capability• No blending or fusion capability
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Distributed ImageDistributed ImageConsistencyConsistency
Digital Modality
Workstation
Printer
Workstation
Different perceived color
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Distributed ImageDistributed ImageConsistencyConsistency
Digital Modality
Workstation
Printer
Workstation
Identical perceived color
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TrueTrue and Pseudo-Colorand Pseudo-Color
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Goals for ColorGoals for Color
• Color consistency– standard function– defined for image output space of existing color images
• Transformation and annotation pipeline• Pseudo-color for grayscale images• Blending of grayscale images
– alpha blending function– colorizing superimposed image
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StandardStandard Color SpaceColor Space• GSDF filled a void• Color consistency already standardized• ICC - International Color Consortium• Graphics and pre-press industry• CIE Colorimetry• Profiles of input and output devices• COTS color management software handles conversion• Perceptual rendering intent
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Three New SOP ClassesThree New SOP Classes
• Color Presentation State• Pseudo-Color Presentation State• Blending Presentation State
• ICC Profile– Defines output of all color presentation states– Optionally present in all color images
• PCS-Values (analogous to grayscale P-Values)– Profile Connection Space (CIELAB or CIEXYZ)
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CommonalityCommonality
• All presentation states share identical– Spatial transformation pipeline– Graphic and text annotation pipeline
• Choice of output space– P-Values for grayscale– PCS-Values for color and pseudo-color and blending
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Old Grayscale PipelineOld Grayscale Pipeline
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Grayscale & Color PipelineGrayscale & Color Pipeline
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Common Spatial &Common Spatial &Annotation PipelineAnnotation Pipeline
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Blending PipelineBlending Pipeline
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
selectunderlying
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
[register]selectunderlying
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
[register]
resample
selectunderlying
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
[register]
resamplewithin slices
selectunderlying
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
[register]
resamplewithin slices
[between slices]
selectunderlying
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
[register]
resamplewithin slices
[between slices]
selectunderlying
rescale andwindow
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
[register]
resamplewithin slices
[between slices]
selectunderlying
rescale andwindow
pseudo-color
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Blending for CT-PETBlending for CT-PET
selectsuperimposed
[register]
resamplewithin slices
[between slices]
selectunderlying
rescale andwindow blend
pseudo-color
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Color - ConclusionColor - Conclusion
• Color consistency using industry standard• Transformation/annotation for color images• Exchange of pseudo-color information• Support for specifying sets of images to be
blended, and how to blend (but not registeror resample) them
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OverviewOverview
• Review of Grayscale Presentation State• Color Presentation States
– Color Consistency– Presentation States applied to Color Images– Color Blending - CT-PET fusion
• Hanging Protocols
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Hanging ProtocolsHanging Protocols
• “Default display protocols”• A set of instructions• How to layout a class of images for display• Order, orientation, windowing, processing
• Not specific to a particular patient’s images• Hence a protocol, not a presentation state
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Hanging ProtocolsHanging Protocols
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Hanging ProtocolsHanging Protocols
New Study
OldLateral
NewLateral
NewFrontal
NewTownes
L L L L
FFFF
Old Study
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Hanging Protocol GoalsHanging Protocol Goals
• Encode– Applicability of protocol (type of display & images)– Selection of images– Display of selected images
• Store centrally, retrieve and exchange– Persistent composite objects– Query, retrieval and media encoding
• Vendor neutrality– Interchange between sites, PACS and workstations– Survive upgrades and replacements– “Public” library of “good” hanging protocols ?
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New Information ModelNew Information Model
• Required for storage and query/retrieval• No Patient/Study/Series hierarchy
• New Storage Service Class• New Query Model• Still C-STORE, C-FIND, C-MOVE
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Using a Hanging ProtocolUsing a Hanging Protocol
• Given a current exam (e.g. reading worklist)• Find potentially applicable protocols• Retrieve them from archive• Select one from those available• Select image +/- other studies to which it
applies• Display selected images as instructed
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Finding a ProtocolFinding a Protocol
• Definition Module– Name, description, level, creator, creation datetime– Modality, anatomy, laterality– Procedure, reason for procedure– Number of priors
• Environment Module– Number of screens– Size(s) of screens– Color or grayscale bit depth
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Selecting ImagesSelecting Images
• Definition of “image sets”• By attribute values
– Specific attributes, e.g. Modality, Anatomy– Specific values, e.g, CT, Chest– Supports all VRs, coded sequences, private elements and multi-
frame functional groups
• By time– Relative time (today, yesterday, within last week)– Abstract priors (last, oldest, pre-operative, etc.)
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Successful SelectionSuccessful Selection
• All hanging protocols depend on consistent andreliable (and standard) information being presentin the images
• DICOM Hanging Protocols don’t solve thisintegration problem
• Ideally - modality inserts correct anatomy andprocedure and reason and orientation codes, anduses standard technique descriptions
• Worst case (typically?) - modality protocol (oroperator) inserts recognizable Series Description
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Information for HangingInformation for Hanging
Modality: MammographyAnatomic Region: BreastImage Laterality: LView Code: Medio-Lateral ObliquePatient Orientation: A\FR
Anterior
FootRight
L
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PriorsPriors
• Concept of the “current” study required• Protocol chooses priors based on
– Relative time– Abstract temporal ranges (previous, last, etc.)– Abstract coded descriptions (“pre-operative”)
• Does NOT specify how to find them or get them• May have been pushed, may need a query• May be hard to find by abstract descriptions• Creative use of queries or out-of-band information
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Mapping to Image BoxesMapping to Image Boxes
• Image Sets are mapped to Image Boxes• Image Box types
– Tiled (e.g. 3x4)– Stack (single image paged manually)– Cine (time-based play back)– Processed (e.g. MPR, 3D)– Single (e.g. a place for a report or waveform)
• Specify– Scrolling mode– Playback rate
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Mapping to Image BoxesMapping to Image Boxes
• Filtering– By attribute, or abstract, e.g. “category” of “image plane” “axial”
• Sorting– By attribute, or abstract, e.g. “along axis” “increasing”
• Orientation– E.g. rotate/flip until row left column posterior (L\P)
• Annotation– Patient demographics, technique and graphics on or off
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Processing & PresentationProcessing & Presentation• Reformatting, e.g., MPR, 3D, slab• Thickness, interval• View direction, e.g., axial, sagittal, coronal• Type, e.g., MIP, surface, volume• VOI Type (windowing), e.g., brain, bone• Pseudo-color type, e.g., hot iron• Invert grayscale• True size• Synchronized scrolling (by Display Set number)• Navigation and localization
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Display of Image BoxesDisplay of Image Boxes
• Entire display environment from 0,0 to 1,1• Individual screens are not distinguished
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Display of Image BoxesDisplay of Image Boxes
• Image Sets displayed in Image Boxes• Image Boxes rendered at relative location
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Hanging Protocols - ConclusionHanging Protocols - Conclusion
• Interchangeable• Vendor neutral• Multi-modality• Support selection of priors• Full richness of current display modes• Flexible• Extensible
• Non-trivial to implement and retrofit• Dependent on reliable image attributes