1September, 2005 What IHE Delivers

Donald Van SyckleDonald Van SyckleDVS Consulting, Inc.DVS Consulting, Inc.www.dvsconsult.comwww.dvsconsult.com

IHE Eye CareIHE Eye Care

Evidence DocumentsEvidence Documents

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Evidence DocumentsEvidence Documents

An extension of the Eye Care SWF profile(i.e. actors must support SWF before supporting Eye Care ED)Measurements, observations and coded data created using DICOM objectsTypically created by either an Acquisition Modality or Evidence Creator(i.e. eye care instruments, standalone workstations, EMRs, etc.)

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Evidence DocumentsEvidence Documents

Produced during acquisition or post-processing workflows

May be Interpreted along with imagesor stand alone

Either DICOM Structured Reports (SR) or DICOM Encapsulated PDF

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Eye Care EvidenceEye Care EvidenceDocuments ExamplesDocuments Examples

Glaucoma progression analysis performed on visual field analyzersRNFL analysis performed on an OCT device Measurements on fundus imagesMeasurements on anteriour chamber OCT images for phakis IOL implantation planningCorneal ablation planning based on corneal topography mapsOthers….

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Eye Care ExampleEye Care Example

Does anyone have a clinical eye care example that we could use here. I’m looking for a picture of a typical report plus a view bullets with words to describe

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DICOM Structured Report (SR)DICOM Structured Report (SR)

Reports that include actual measurement values, observations and/or coded data to describe eye care evidenceEye Care specific DICOM SRs being defined by WG9 – IHE will adopt upon completion Keratometer, Autorefractor, Lensometer, biometry, visual fields

Could use the currently defined Simple Image and Numeric report for measurements on Fundus images (is this true)

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Eye Care ExtensionEye Care ExtensionDICOM Encapsulated PDFDICOM Encapsulated PDF

Also includes measurement values, observations and/or coded data to describe eye care evidenceHowever, DICOM Encapsulated PDF is a “display only” solutionIs used when no specific DICOM SR solution is definedI need the current examples being worked upon

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Would Like pics to show two Would Like pics to show two examplesexamples

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Managed Like ImagesManaged Like ImagesEvidence Documents can be transferred, stored, and query/retrieve just like imagesExists in the same study as images

Patient Patient InformationInformation

Study Study InformationInformation

Series Series InformationInformation

ImageImage

Series Series InformationInformation

SR Evidence SR Evidence Document Document

Series Series InformationInformation

DICOM Encp.DICOM Encp.PDFPDF

Series Series InformationInformation

OtherOtherComposite IODsComposite IODs

Patient IDPatient ID

Study Inst. UIDStudy Inst. UID

Series Inst. UIDSeries Inst. UID

SOP Inst. UIDSOP Inst. UID

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ED a Part of Performed Procedure Step`ED a Part of Performed Procedure Step`

Image

PatientPatient

Imaging Serv. Req. (Order)Imaging Serv. Req. (Order)

RequestedRequestedProcedureProcedure

ScheduledScheduledProcedure StepProcedure Step

Study MgtStudy Mgt

PerformedPerformedProcedure StepProcedure Step

Study

SeriesSeries

EDEDImage

ImageA PPS is an “Atomic Imaging/Measurements Exam”A PPS is an “Atomic Imaging/Measurements Exam”• A PPS Starts and Ends. It is never resumed !A PPS Starts and Ends. It is never resumed !• A PPS produces one or more series of images/evidence documentsA PPS produces one or more series of images/evidence documents• Once a PPS is completed, images/evidence documents cannot be added to a seriesOnce a PPS is completed, images/evidence documents cannot be added to a series• Additional PPS can always be performedAdditional PPS can always be performed• A Study usually holds the work product for a Requested ProcedureA Study usually holds the work product for a Requested Procedure• A Study may be multi-modality (I.e. multiple instruments)A Study may be multi-modality (I.e. multiple instruments)

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WorkflowWorkflow

CARD-3: Storage Commitment

EYECARE-2 Modality Images/Evidence Stored

Evidence Creator

Acquisition Modality

Image Manager

Image Archive

Image Display

EYECARE-2 Modality Images/Evidence Stored

CARD-3: Storage Commitment EYECARE-4: Query Evidence

Documents [RAD45]: Retrieve Evidence Documents

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Example – Acquisition ModalityExample – Acquisition Modality

Images have been taken at an Acquisition ModalityAfter image acquisition, the Acquisition Modality performs post processing such as: a glaucoma progression analysis RNFL analysis performed on an OCT device Others…..

Evidence Documents are created using DICOM SR or DICOM Encapsulated PDFEvidence Documents are: stored in the same Study as the images (in a separate series) tracked using DICOM MPPS sent to the storage server securely stored using Storage Commitment

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Example – Workstation, EMRExample – Workstation, EMRUnscheduled post-processing done after the acquisition, products support both the Image Display Actor and Evidence Creator ActorUse DICOM query/retrieve to acquire previous images and/or measurements then perform post-processing measurements on fundus images corneal ablation planning based on corneal topography maps measurements on anterior chamber OCT images for phakic IOL implantation planning Others…

Evidence documents are: either DICOM SR or DICOM Encapsulated PDF stored in the same study as created by the Acquisition Modality sent to the storage server securely stored using Storage Commitment

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IHE Generic IHE Generic Keys for Keys for Query Query

Retrieve of:Retrieve of:- Images- Images

- Evid. Doc.- Evid. Doc.- SR- SR

Query Keys Matching Query Keys ReturnAttributes Name TagSCU SCP SCU SCP

Study Level

Study Date (0008,0020) R+ R R+ R

Study Time (0008,0030) R+ R R+ R

Accession Number (0008,0050) R+ R R+ R

Patient Name (0010,0010) R+ R R+ R

Patient ID (0010,0020) R+ R R+ R

Study ID (0020,0010) R+ R R+ R

Study Instance UID (0020,000D) R+ R O R

Modalities in Study (0008,0061) R+ R+ R+ R+

Referring Physician’s Name (0008,0090) R+ R+ R+ R+

Patient’s Birth Date (0010,0030) O O R+ R+

Patient’s Sex (0010,0040) O O R+ R+

Number of Study Related Series (0020,1206) N/A N/A O R+

Number of Study Related Instances (0020,1208) N/A N/A O R+

Series Level

Modality (0008,0060) R+ R R+ R

Series Number (0020,0011) R+ R R+ R

Series Instance UID (0020,000E) R+ R O R

Number of Series Related Instances (0020,1209) N/A N/A O R

Request Attribute Sequence (0040,0275) R+ R+ R+ R+

>Requested Procedure ID (0040,1001) R+ R+ R+ R+

>Scheduled Procedure Step ID (0040,0009) R+ R+ R+ R+

Performed Procedure Step Start Date (0040,0244) R + R+ R+ R+

Performed Procedure Step Start Time (0040,0245) R + R+ R+ R+

Composite Object Instance Level

Instance Number (0020,0013) R R O R

SOP Instance UID (0008,0018) R+ R O R

SOP Class UID (0008,0016) O R O R+

R = Required and the R = Required and the SCU shall be able SCU shall be able to display to displayR+ = IHE RequirementR+ = IHE Requirement on top of DICOM on top of DICOM

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Extension for PDF QueryExtension for PDF Query

How to store, query, retrieve for Evidence Documents is defined by SWFDICOM SR queries for Evidence Documents have been defined by radiologyEye Care added the storage and query for DICOM Encapsulated PDF Added a new display field for the Image Display actors

from query, the PDF “Document Title”

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More information….More information….

IHE Web site: www.ihe.netTechnical Frameworks ihe_eyecare_tf_rev1.0TI_vol1_2006_xx_xx ihe_eyecare_tf_rev1.0TI_volw_2006_xx_xx

Non-Technical Brochures :• Anything else we want to point to?

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