what‟s new in dicom

Whatõs New in DICOM

DICOM Workshop @ SPIE MEDICAL IMAGING

February 2011

Bas Revet, Philips Healthcare ð(Chair WG 6)

ÅThe DICOM Standard

ÅImages

ÅBeyond Radiology, Cardiology and Radio Therapy

ÅManipulating with Images

ÅAnalyzing Image Data and Documenting the Results

ÅImaging Workflow

ÅImage Distribution

ÅApplication Distribution

ÅFitting DICOM in the IT world

ÅThe Standard is still evolving

Content

2SPIE Medical Imaging ð Feb 2011

What and Who is DICOM

3SPIE Medical Imaging - Feb 2011

The DICOM Standard

All almost 30 years going strong é

• DICOM is the International Standard for Medical Imaging and related information

Å images,

Åwaveforms,

Å derived measurements and assessments,

Å image presentation controls,

Åworkflow management in the imaging dept.

ÅBeyond Radiology and Cardiology: Pathology, Ophthalmology, Surgery, Dermatology, é

ÅPublished as NEMA PS3 and as ISO 12052

SPIE Medical Imaging - Feb 2011 4

The DICOM Standard

The DICOM Work Process

Å Continuous process for evolution of the standard

ð Itõs just òDICOMó, not DICOM 3.0, 3.1, etc.

ð Conformance is to SOP Classes, not to a ôversionõ of the Standard

Å Change Proposals for minor corrections

ð About 100 / year

ð Anybody can submit

Å Supplements for major changes ðnew object types, services, compression schemes

ð About 10 / year

ð Require Work Item approved by DICOM Standards Committee

Å Consolidated edition published every year

ð Most recently, January 2010 (2009 version)

ð Available free at DICOM web site


The DICOM Working Groups

Produced by 27 Working Groups:


1 Cardiac and Vascular Information 15 Digital Mammography and CAD

2 Projection Radiography and Angiography 16 Magnetic Resonance

3 Nuclear Medicine 17 3D

4 Compression 18 Clinical Trials and Education

5 Exchange Media 19 Dermatologic Standards

6 Base Standard (coordination, main editor) 20 Integration of Imaging and

Information Systems7 Radiotherapy

8 Structured Reporting 21 Computed Tomography

9 Ophthalmology 22 Dentistry

10 Strategic Advisory 23 Application Hosting

11 Display Function Standard 24 Surgery

12 Ultrasound 25 Veterinary Medicine

13 Visible Light 26 Pathology

14 Security 27 Web Technology for DICOM

Images

Where it all started é


ôClassicõ Images

First Generation of images:

ÅCR, CT, MR, US, MN

ÅSecondary Capture (for what not fit)

ÅMulti -frame XA and XRF, US, NM, PET

ÅDigital Detector: DX, MG (mammo), IO (inter-

oral)

ÅVisible Light: Microscopy, Photographic, Video

ÅFamily RT data object, including Images


ôEnhancedõ Images


Extension of classic multi-frame images allowing the

specification of properties of each frame

ÅEnhanced MR, spectroscopy

ÅEnhanced CT

ÅEnhanced XA and XRF

ÅEnhanced PET

ÅEnhanced US (3D)

ÅOphthalmic Tomography

ÅX-Ray 3D Angiographic, Craniofacial, Breast Tomosynthesis

ÅIn development: Enhanced NM

ÅAlso used by: Segmentation, IVUS-OCT, etc.

Å Multiframe objects to support 1000+ slice studies

Å Image header supports functional group attributes changing during acquisition

Å Dimensions allow multiple views of data

Å Common structure used for all new image IODs

Å Sup XXX Enhanced Nuclear Medicine (Proposed)

Å Sup 43 Enhanced US Volume (Approved 2010)

Å Sup 141 Enhanced MR Color (Approved 2009)

Å Sup 43 Enhanced Ultrasound (Approved 2009)

Å Sup 125 Breast Tomosynthesis (Approved 2008)

Å Sup 117 Enhanced PET (Approved 2008)

Å Sup 110 Ophthalmic Coherence Tomography (Approved 2007)

Å Sup 116 3-D X-Ray (Approved 2007)

Å Sup 83 Enhanced XA/XRF Image (Approved 2004)

Å Sup 58 Enhanced CT (Approved 2003)

Å Sup 49 Enhanced MR (Approved 2001)


ôEnhancedõ Images

Single-frame to MultiFrame

N Objects, N Headers

N Frames, One Header

Pixel dataDimension dataPer-frame headerFixed Header


New Clinical Domains


Beyond Radiology, Cardiology and

Radio Therapy

Reusing proven concepts é

New Imaging Domains

Ophthalmology

ÅSup 144 Ophthalmic Axial Measurements (Approved 2010)

ÅSup 146 Ophthalmic Visual Field (OPV) (Approved 2010)

Pathology

ÅSup 145 Whole Slide Imaging (Approved 2010)

– Splits (Hugh) image into tiles and uses enhanced multi-

frame framework

– Enable existing viewing pipelines to be used

– Compression Transfer Syntaxes to reduce amount data


Whole Slide Imaging

planes, color planes

Thumbnail Image

Intermediate Image Tiles

Baseline Image Tiles

Multi - frame image (single object)

Multi - frame image (single object) may include multiple Z -

Single frame image

ÅPyramid concept to navigate across matrix of tiles


ÅIntravascular Ultrasound (IVUS) (Approved 2001)

ÅIntravascular OCT (Optical Coherence

Tomography) (in progress)


New Technologies Cardiology

Radiotheraphy

RT Second Generation

ÅRadiotherapy Working Group decided to

create a new family of SOP Classes

ÅBased on the new Enhanced Multi-frame

paradigm and other new DICOM

developments

ÅPreparing version for Public Comment (Supplement 147)


Å Surgery

ÅSup 131 Implant Description (Approved 2010)

Å 2 D and 3D modelsand surgical plans for bone-mountable implants

ÅSup 134 Implantation Plan SR Document Storage (Approved 2010)

Å containing the used impants and positioning

Surgery


what‟s new in dicom

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