DICOM News

DICOM News

January 2018 Bjoern.Nolte@siemens.com
...

Current progress is shown below from the most recent meeting of the DICOM Base Standard (WG-06) and associated official telephone conferences.

WG-06 meets five times a year to do technical review and harmonization of the output from the 31 DICOM Working Groups.

These DICOM supplements add new "chapters" to the standard and the grouped DICOM change proposals, called CPacks or voting packages contain minor tweaks or bug fixes.



2ndGen RT Objects
Prescription and Segment
annotation

Sup 147 80% (Letter Ballot)


This supplement addresses the need for a new generation of IODs and processes required for use in radiotherapy. This new generation model centers around the following concepts:

  • Different representations of data are encoded in different IODs.
  • Follows the “enhanced multi-frame” paradigm.
  • Support legacy and full-featured, modern equipment.
  • The concept of workflow management using Unified Procedure Step has been fully integrated into the new IODs.

New techniques in oncology: The existence of new treatment techniques (such as robotic therapy and tomotherapy) have been taken into account, along with new treatment strategies (such as image-guided therapy and adaptive therapy).

Further supplements of RT Second Generation objects include:

  • Supplement 175 C-Arm RT Treatment Modalities
  • Supplement 176 Additional RT Treatment Modalities
  • Supplement 177 RT Dose Objects
  • Supplement 178 RT Course

The comments and learnings from the trial implementation and the suggested changes to the document were presented and discussed.

Especially the text around conceptual volumes got detailed attention. It resulted in a simplified text.

The supplement was voted to go out for Letter Ballot voting.

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Thumbnail Service
over
DICOMweb

Sup 203 80% (Letter Ballot)


This supplement affects Part 18 of the DICOM standard; however, it is based on the re-documentation in Supplement 183. The reader should be familiar with Supplement 183, Section 11.4.

This supplement defines Thumbnail resources on the WADO-RS Study, Series, Instance, and Frame resources in the DICOM RESTful web services standard. These resources provide representative images that reflect the content of the parent resources. The origin server determines the pixel content of the Thumbnail.

The primary use cases are Thumbnails for:

  • image viewers, or
  • EMR/EHRs, e.g., as referenced from HL7 FHIR Imaging Study resources.

This resource allows a web client to retrieve a representative image without having to retrieve a full study structure.

The comments and responses from after the last base standard presentation were discussed.

The supplement was voted to go out for Letter Ballot voting.

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DICOM Encapsulation of
STL Models
for 3D Manufacturing

Sup 205 80% (Letter Ballot)


This supplement adds a new DICOM IOD to encapsulate Stereolithography (STL) 3D model file formats (see StereoLithography Interface Specification, 3D Systems, Inc., October 1989).

The new IOD allows 3D manufacturing models to be exchanged between various types of equipment using DICOM messages. This adds the ability to store, query and retrieve 3D models as DICOM objects. Updates are addressed by storing new instances, with reference back to earlier instances.

The 3D model files are a type of document that contains geometric instructions on how an object could be created by a 3D printer, milling machine, or other type of device capable of manufacturing a physical object.

To exchange these 3D models in an efficient manner in an imaging environment, especially as part of patient care planning and the patient’s imaging record, it is useful to be able to “wrap” these model documents in a DICOM container.

Additionally, the identity of the patient (and any source image series) of the encapsulated 3D models can be ascertained through the attributes that the DICOM information model adds on top of the 3D model’s general purpose geometric information.

A walk through of the comments and corresponding changes from after the last presentation to the base standard group took place.

The supplement was voted to go out for Letter Ballot voting.

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2Gen RT
C-Arm Treatment

Sup 175 60% (After Public Comment)


This Supplement introduces RT Radiation IODs and RT Radiation Set IODs. A Radiation Set IOD defines a Radiotherapy Treatment Fraction as a collection of instances of RT Radiation IODs. RT Radiation IODs represent different treatment modalities.

This Supplement introduces the representation of the C-Arm techniques.

The presenter walked through the changes from after the last presentation.

The supplement will be presented to the base standard meeting again before being ready for Letter Ballot voting.

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Web Services
Redocumentation

Sup 183 60% (After Public Comment)


PS3.18 specifies web services (using the HTTP family of protocols) for managing and distributing DICOM (Digital Imaging and Communications in Medicine) Information Objects, such as medical images, annotations, reports, etc. to healthcare organizations, providers, and patients. The term DICOMweb is used to designate the RESTful Web Services described here.

Security considerations, including access control, authorization, and auditing are beyond the scope of PS3.18. Refer to PS3.15 Security and System Management Profiles.

The open issues and correpsonding changes were presented.

It was suggested to make it more clear what server and client have to support. For example support on study, series and instance level. The server has to support all these levels but the client can choose which levels to support.

How to indicate DICOM web services apart from general web services with naming conventions was a larger discussion topic. The importance of clarity was agreed upon.

The supplement will be presented to the base standard meeting again before being ready for Letter Ballot voting.

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Real-Time
Video

Sup 202 30% (Draft)


This Supplement describes several new DICOM IODs and associated transfer syntaxes for the transport of real-time video and/or audio and associated medical data. These are referred to collectively as DICOM Real-Time Video (DICOM-RTV).

DICOM specified storage of medical video in endoscopy, microscopy or echography. But medical theaters such as the operating room (OR) are for the moment still using proprietary solutions to handle communication of real-time video and associated information like patient demographics, study description or 3D localization of imaging sources.

The new Real-Time Video Service supports interoperable devices inside the OR and beyond, enabling a better management of imaging information, impacting directly the quality of care.

Professional video (e.g., TV studios) equipment providers and users have defined in SMPTE (ST 2110 family of standards) a new standardized approach for conveying video and associated information (audio, ancillary data, metadata…) enabling the deployment of equipment in a distributed way (vs. peer-to-peer).

The supplement defines an IP-based new DICOM Service for the transport of real-time video including quality compatible with the communication inside the operating room (OR). SMPTE ST 2110 suite, elaborated on the basis of Technical Recommendation TR03 originated by the VSF (Video Services Forum) is used as a platform. DICOM is defining a mechanism to convey specific medical metadata along with the video in compliance with SMPTE ST 2110-10 which specifies the communication architecture.

The format of recording is not defined in the supplement, nor the way of replaying the recorded videos. Only the method for feeding the recorder with the synchronized videos and associated metadata is specified by the present supplement.

Security aspects are out of scope of the present document. Other security solutions (e.g.; IPSEC, VLAN mechanisms) would work with the proposed specification.

The open issues and the corresponding changes to the document were presented.

During the public comment phase the question of which photometric interpretation and transfer syntax to support, shall be clarified.

The supplement will be presented to the base standard meeting again before being ready for Public Comment voting.

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DICOM
3D Printing
Additional Models

Sup 208 20% (Draft)


This supplement adds a new DICOM IOD to encapsulate Extensible 3D Graphics (X3D) and The Virtual Reality Modeling Language (VRML) 3D model file formats [see (Information technology — Computer graphics, image processing and environmental representation — Extensible 3D (X3D), Web3D Consortium, 2008) and (Information technology – Computer graphics and image processing – The Virtual Reality Modeling Language (VRML), Web3D Consortium, 1997)].

The new IOD allows 3D manufacturing models to be exchanged between various types of equipment using DICOM messages. This adds the ability to store, query and retrieve 3D models as DICOM objects. Updates are addressed by storing new instances, with reference back to earlier instances similar to the IOD for STL encapsulation (supplement 205).

The 3D model files are a type of document that contains geometric instructions on how an object could be created by a 3D printer, milling machine, or other type of device capable of manufacturing a physical object.

X3D/VRML have distinct differences to the STL file format. These file formats have the capability of storing color information; the information is either coded to a vertex or face of a polygon or as a texture map that is wrapped around the 3D model. X3D is also specifically developed utilizing the XML file-scheme to enhance human-readability and extensibility.

In the interest of simplicity and minimizing SOP Instance size, only iterations of X3D Specification 3.0 and greater as well as VRML2.0 (also known as VRML97) is supported for DICOM encapsulation.

A discussion took place on which attributes from the encapsulated structure to copy the outer DICOM level.

The initial slide set was presented and explained.

The supplement will stay in work. Advances will be presented at a future base standard meeting.

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Improved
DICOM
Conformance Statement

Sup 209 20% (Draft)


The goal with this supplement is to Improve the content and structure of the DICOM Conformance Statement to:

  • Better meet needs of all user groups (service, R&D, testing, sales …)
  • Better facilitate comparability of different product’s DICOM functionality
  • Avoid ambiguities/inconsistencies between different vendor documentation

The chosen approach is to:

  • Perform a survey among different user groups to identify areas of improvement
  • Develop a proposal for the structure/content of the new DCS
  • Create an extensive example document for a DCS and use this as a template later on
  • Provide normative text for DICOM PS3.2
  • Decide on examples and develop them according to the new template

The initial slide set was presented and explained.

The base standard advised to keep error codes separate in section 7.

Further slides were presented on how to include web services in the concept.

The supplement will stay in work. Advances will be presented at a future base standard meeting.

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Functional Acquisition
Paradigm
Protocol Storage

Sup 210 20% (Draft)


This IOD describes the storage of Paradigm Protocols, both Defined and Performed instances.

A paradigm (a temporal allocation of stimuli) creation app is used to present paradigms and to capture responses from a patient. The responses are detected with an MRI or other scanner. The paradigm specifications, execution and analysis recordings are stored in DICOM instances for later use with post processing and displaying systems.

The initial slide set was presented and explained.

The supplement will stay in work. Advances will be presented at a future base standard meeting.

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CPack 94

WG-06 approved Final Text in January 2018.
Now part of the DICOM standard.

CPack 95

Current set for March 2018 Final Text.
Currently undergoing Letter Ballot approval.

CPack 96 candidates

Current candidates for final text in June 2018


1670 Add number of items for Responsible Group Code Sequence 1671 Clarify use of Equivalent Meaning of Concept Name for codes 1717 Add WIP Flag to Defined Procedure Protocol instances 1746 Add a new code to CID 4270 OCT-A Algorithm Families for ratio analysis 1748 Add reference to LOINC Panel for Imaging Report 1750 Change the defined term for Modality to reflect the object type for En face Image and B-scan Volume Analysis 1751 MR Spectroscopy Functional Group Macros definition contains an improper reference of a Macro 1752 Corneal Topography Map IOD definition contains an improper reference of a Module 1753 Tractography Results IOD definition incorrectly references a retired Module 1757 Patient Orientation should not be required for Whole Slide Images 1758 Incorrect data element tag and name for Center Point Location in Slide Coordinates 1759 Real World Value Map only permitted for monochrome Whole Slide Images 1760 Add flag to distinguish studies imported from outside 1761 Correct Acquisition Context and DateTime in Confidentiality Profile Attributes 1762 Fix Omitted Attribute in Verification Control Points 1765 Retire DICOMDIR reference to unencapsulated CDA on media 1767 Correct PS3.3 Figure 7.13.4-1 Protocol Storage 1768 Correct PS3.17 Figure FFF.2.3-1 1769 Add Dose Units for Parametric Maps 1771 Update PS3.16 Context Group Table Conventions 1772 Add PathLex as Coding Scheme 1773 Correct code for common femoral artery in CID 12109 1774 Make code meaning of Great Saphenous Vein consistent 1775 Add NDC as Coding Scheme and correct codes

Clicking on one specific Change Proposal above will open the actual content.