nuclear medicine image profile: kevin o'donnell
TRANSCRIPT
Sept 13-15, 2004 IHE Interoperability Workshop1
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
Nuclear Medicine Image - NM
Dr. Jerry Wallis (SNM)
IHE Radiology Technical Cmte
Kevin O’Donnell (Toshiba Corp.)
Co-Chair, IHE Radiology Planning Cmte
Sept 13-15, 2004 IHE Interoperability Workshop2
Nuclear Medicine Image - NMNuclear Medicine Image - NM
Patient Info.
Recon-ciliation
Access to Radiology Information
Consistent Present-ation of Images
Basic Security
-
EvidenceDocs
KeyImageNotes
Simple Image & Numeric Reports
Presentation of Grouped Procedures
Post-
Processing Workflow
Reporting Workflow
Charge Posting
Scheduled Workflow
Portable Data for Imaging
NMImage
NMImage
Sept 13-15, 2004 IHE Interoperability Workshop3
NM Image – The ProblemNM Image – The ProblemDICOM NM objects are different and support in products is inconsistent
NM clinical display practices are different and support in products is inconsistent
Clinical Analysis Programs are used extensively (particularly for Cardiology), but no support for distribution and display of those Result Screens
NM Users are not adept at getting these requirements accurately included in RFPs
Vendors (especially of general purpose systems) are not adept at accurately representing their support for such features
Sept 13-15, 2004 IHE Interoperability Workshop4
NM Image FormatNM Image Format
Understood by dedicated NM systems
Often Misunderstood by general storage and display systems
Multiframe Dynamic
Anterior Posterior Multi-energy
NM Image
Image vectors
Sept 13-15, 2004 IHE Interoperability Workshop5
NM ImageNM Image
NM PACS
Sept 13-15, 2004 IHE Interoperability Workshop6
NM ImageNM Image
NM PACS
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NM ImageNM Image
Click and move mouse down to adjust window level, right to adjust window center
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NM – The SolutionNM – The SolutionNew Profile
for Users to request and Vendors to claim
No New Actors or Transactions
Additional requirements on existing actors and transactions
Two New Options
New Informative Text in Vol. 1
Clarifications of NM Workflow mapping to SWF Explanation of NM Data Explanations of NM Clinical Display concepts
New Normative Text in Vol. 2
<See Following Slides>
Connectathon to help test and confirm
Sept 13-15, 2004 IHE Interoperability Workshop9
NM – Actors and TransactionsNM – Actors and Transactions
Sept 13-15, 2004 IHE Interoperability Workshop10
NM Image ProfileNM Image Profile
Acquisition Modalities (Modality Images Stored [8]) Create NM objects as specified (additional attribute & vector
handling) Include specific codes in Cardiac studies
Evidence Creators (Creator Images Stored [18]) Create NM objects as specified (additional attribute & vector
handling) Include specific codes in Cardiac studies
Image Manager/Archives Store/Retrieve NM & Secondary Capture (SC & MFSC) Objects
Image Displays (Retrieve Images [16]) Display NM and Secondary Capture (SC & MFSC) Images Support specified display capabilities
Sept 13-15, 2004 IHE Interoperability Workshop11
Result Screen Export OptionResult Screen Export Option
Provides storage, retrieval and display of Static and Dynamic Result Screens
Based on the following DICOM Objects:• Secondary Capture• Multi-Frame Grayscale Byte Secondary Capture• Multi-Frame True Color Secondary Capture
Evidence Creators
Generate appropriate Secondary Capture objects from any Result Screens created.
Sept 13-15, 2004 IHE Interoperability Workshop12
Review OptionReview Option
Adds requirements to the Image Display to allow Review of NM Images
Image Displays
Must additionally support MPR Display, more frames, different series types together, etc.
Sept 13-15, 2004 IHE Interoperability Workshop13
PACS PACS →→ NM Workstation ? NM Workstation ?
No !
No filtering No ROI No TAC No renal, lung … processing No reframing No cardiac processing
Sept 13-15, 2004 IHE Interoperability Workshop14
Image DisplayImage Display
Support separate adjustment of upper and lower window levels
Show multiple cines
Display grayscale and color result screens
Display dynamic result screens
Apply local color tables to grayscale screens
Add color tables to system
Change intensity of grayscale result screens (strongly recommended)
Sept 13-15, 2004 IHE Interoperability Workshop15
Image DisplayImage Display
Must use “intelligent” scaling to avoid presenting postage-stamp size NM images Just because it was acquired at 64x64
doesn’t mean they want to review it at 64x64
Sept 13-15, 2004 IHE Interoperability Workshop16
Image DisplayImage Display
Must use “intelligent” scaling to avoid presenting postage-stamp size NM images
Must allow the user to select different vectors/framesets of complex multi-frame images
Must allow the user to separately adjust intensity for different framesets (eg, phases) in the same “image”
Sept 13-15, 2004 IHE Interoperability Workshop17
Display FormatsDisplay Formats
Grid display
One image set
A1 A2 A3 A4 A5 A6 A7 A8
A9 … … … … … … …
… … … … … … … …
… … … … … … … A32
…
A1 A2 A3 A4 A5 A6 A7 A8
B1 B2 B3 B4 B5 B6 B7 B8
A1 A2 B1 B2
C1 C1
Fit display Multiple image sets
Comparison display Multiple image sets
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Multiple CinesMultiple Cines
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Multiple CinesMultiple Cines
Sept 13-15, 2004 IHE Interoperability Workshop20
More information….More information….IHE Web sites:
http://www.himss.org/IHEhttp://www.rsna.org/IHEhttp://www.acc.org/quality/ihe.htm.
Technical Frameworks:• ITI V1.0, RAD V5.5, LAB V1.0
Technical Framework Supplements - Trial Implementation• May 2004: Radiology• August 2004: Cardiology, IT Infrastructure
Non-Technical Brochures :• Calls for Participation• IHE Fact Sheet and FAQ• IHE Integration Profiles: Guidelines for Buyers• IHE Connect-a-thon Results• Vendor Products Integration Statements