DICOM News

An overview of the latest progress of the DICOM standard from the recent base standard meeting








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Sup176
2nd Gen. Other non C-Arm RT Treatment



The scope of this supplement is the introduction of new RT Radiation IODs for non-C-Arm treatment devices.

This supplement adds support for instances of the following RT devices:

  • Tomotherapeutic Radiation
  • Multiple Fixed Source Radiation
  • Robotic Radiation Storage


This supplement was voted to be ready as final text. It is now being incorporated into the standard.

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Sup208
Encapsulated Additional Models 3D Manufacturing



Supplement 208 extends the DICOM Standard to better address medical 3D manufacturing and uses of Virtual Reality, Augmented Reality, and Mixed Reality.

These extensions fall in three areas:

  • Support for a new 3D model type: Object File (OBJ)
  • Identification of models for assembly into a larger object
  • Capturing a preferred color for manufacturing or display of a model OBJ Encapsulation


The supplement incorporates not just Object Files (OBJ), and also any supporting Material Library Files (MTL) and texture map files (JPG or PNG) on which an OBJ may rely.

As with Encapsulated STL, the new Encapsulated OBJ, Encapsulated MTL and texture image IODs allow 3D manufacturing models to be exchanged between various types of equipment using DICOM messages. This adds the ability to store, query and retrieve complete OBJ models as DICOM Instances.

Updates are addressed by storing new instances, with reference back to earlier instances in a manner similar to the IOD for STL encapsulation.

This supplement was voted to be ready as final text. It is now being incorporated into the standard.

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Sup219
JSON Representation of AI Structured Reports



This Supplement describes a simplified JSON representation of DICOM Structured Report content to allow AI developers to encode image-derived results.

First, the minimal necessary information for a result payload itself may be encoded in JSON for simplicity and ease of use by AI/ML algorithm developers.

Second, this result JSON is merged with the necessary JSON representation of the composite context and other mandatory, or relevant optional, SR content (such as UIDs, image libraries, hierarchical identification and report status management information), which, when transformed, would result in a valid SR IOD with a template-compliant content.

Third and finally, the JSON is transformed into the traditional binary DICOM SR representation for transport, storage and management in an interoperable form.

The TID 1500 Measurement Report template is central to this supplement and describes a generic pattern that is suitable for encoding AI results.

The JSON representation leverages the "business name" concept from HL7 Green CDA, such that simple meaningful strings can be used in the JSON for coded tuples for concept names and values, as well as for DICOM Attributes in the top level Data Set. The business names are defined in a separate, potentially reusable, JSON file.

Using an appropriate tool, a complete and compliant binary Structured Report can be created automatically from the JSON, with the subtleties of DICOM encoding hidden from the user.

Supplement 219 was voted to be ready for Trial Implementation by interested vendors and organisations. The Trial Implementation phase will run for 12 months. The achieved learning from this phase will be incorporated into the supplement before going to Letter Ballot voting.

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Sup199
RT Radiation Records



The SOP Classes in this document are defined to record how a treatment was performed.

This comprises acquired machine values, measured dose values, overrides, etc.

In addition, recording of a manual implementation of a radiation is covered.

The scope of this Supplement is on treatment delivery and it introduces the concept of RT Radiation Records.

This Supplement is based on the real-world model and specifications defined in Supplement 147. References, definitions etc. not present in this Supplement can be found in Supplement 147.

Supplement 199 was voted to go out for Public Comment.

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Sup211
DicomWeb Retrieve via Zip



Supplement 211 adds the application/zip media type to the RESTful Web Services in PS3.18. It enables retrieving an entire DICOM study or series as a single zip format file.

The primary use case is to enable researchers in analytics / machine learning to use DICOMweb to retrieve studies, series, or other collections of images for training purposes.

DICOMweb currently provides a means to retrieve an entire study or an entire series using the multipart/related media type, but this requires special non-browser implementations to retrieve the content because multipart/related is not currently supported by any of the major browsers.

A secondary use case is to provide consumers with browser access to a DICOM study using a ZIP file, which will provide patients or caregivers browser access that is simpler than that provided by a multipart/related response must be programmatically interpreted.

Usage of this application/zip payload on interchange media is not addressed.

Supplement 211 was voted to go out for Public Comment.

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Sup209
DICOM Conformance Statement



This supplement focuses on rewriting part two, DICOM conformance, of the standard.

The goal is to achieve better interoperability and machine processing of DICOM conformance statements.

It was considered advantageous if the template is a separate generated MS Word template.

Supplement 209 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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Sup212
XA Protocols



This Supplement defines a pair of storage SOP Classes to distribute defined XA protocols and to record performed XA protocols:

  • XA Defined Procedure Protocol Storage SOP Class, which includes acquisition, reconstruction and storage tasks.
  • XA Performed Procedure Protocol Storage SOP Class that describes the values actually used in a performed procedure.


The SOP Classes address details including:
  • patient preparation & positioning
  • equipment characteristics
  • acquisition technique
  • reconstruction technique
  • preliminary image handling such as filtering, enhancement
  • results data storage (auto-sending)


The primary goal is to set up the acquisition (and reconstruction) equipment, not to script the entire behavior of the department, or the angiographic suite.

Methods of specification of tube current modulation (and other technical features) vary between vendors and models and are not addressed in standard DICOM data elements.

It is expected that the vast majority of protocol objects will be specific to a certain model and version of acquisition equipment.

Supplement 212 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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Sup214
Cone Beam CT in RDSR



This Supplement creates a structured report with the necessary flexibility to address cone-beam CT acquisitions.

This generic radiation description can represent previously addressed acquisition types:

  • Angiography
  • Mammography
  • CR/DR
  • CT


Radiotherapy treatment dose and radiopharmaceutical dose are out of scope.

Supplement 214 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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Sup218
MR Protocols



This Supplement defines a pair of storage SOP Classes to distribute defined MR protocols and to record performed MR protocols.

The two storage SOP Classes are:

  • MR Defined Procedure Protocol Storage SOP Class that describes desired values (and/or value ranges) for various parameters of an acquisition procedure.

    Defined Protocols are independent of a specific patient. Defined Protocols are typically specific to a certain scanner model and/or version (identified by device attributes in the protocol), but model-non-specific protocols are not prohibited.

  • MR Performed Procedure Protocol Storage SOP Class that describes the values actually used in a performed acquisition. Performed protocols are patient specific.


The SOP Classes address details including:
  • patient preparation
  • equipment characteristics (including coils)
  • acquisition technique.


Defined Procedure Protocol instances exist in the equipment hierarchy and can be accessed with the Defined Procedure Protocol query/retrieve service.

Performed Procedure Protocol instances exist in the traditional Patient-Study-Series hierarchy and can be accessed with the conventional query/retrieve service.

The primary goal is to set up the MR scanner, not to script the entire behavior of the department, or the scan suite.

It is also not the intent to serialize the internal state of the system.

The Defined Procedure Protocol represents are starting point for setting up an MR scan for a given patient and the Performed Procedure Protocol represents the actual parameters when the initial MR scan is completed, but there is no record of the intermediate states between those.

It is expected that most protocol objects will be specific to a certain model and version of the MR scanner.

There is no requirement that an MR scanner be able to run a protocol from another MR scanner.

Supplement 218 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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Sup221
Dermoscopy



This Supplement introduces a new IOD and a new storage SOP for encoding and storing dermoscopic images.

Dermoscopy is a diagnostic technique that enables visualization of the morphological structures of the skin.

Dermoscopy (also known as dermatoscopy and epiluminescence microscopy) is a non-invasive, in vivo skin examination that has demonstrated to be an important aid in the early recognition of malignant melanoma and other skin tumors.

Dermoscopy is also used for disease conditions (e.g. inflammatory) other than skin cancer.

A dermoscope is hand-held device that consists of magnifier and light source.

Emitted light can be polarized light or non-polarized.

Dermoscopic examination can be by direct contact with skin or non-contact.

Dermoscopy using non-polarized light require direct contact between the skin and the device.

For direct contact dermoscopy an immersion medium is placed on the skin surface and a glass plate on the dermoscope is placed directly against the skin.

Non-contact dermoscopy does not require the dermoscope to be in contact with the skin surface.

Three techniques are used in dermoscopy:

  • polarized non-contact dermoscopy
  • polarized contact dermoscopy
  • non-polarized contact dermoscopy


This was the first presentation of the supplement to the base standard meeting.

Supplement 221 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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CPack 104
Final Text, released January 2020

CP1479
Update PS3.4 for expanded Code Sequence
CP1861
Consistency between DICOM VR definition of DS & IS, and JSON Value Representation
CP1862
Necessity of returning the Specific Character Set (0008,0005) attribute in a QIDO-RS response
CP1889
Recently added OV, SV and UV VRs were not included in PS3.18 or PS3.19
CP1919
Clarify the Media Type sections for Studies Service
CP1920
Padding in DICOM JSON and XML (Native) Models
CP1922
Update PS3.19 WADO-RS and STOW-RS to PS3.18 Studies Service Retrieve and Store
CP1924
PS3.18 Section 5.1.1 does not have a definition for NON-ZERO-DIGIT
CP1925
PS3.18 Section 8.3.1 has syntax mistakes
CP1928
Add multi-energy CT attributes to de-identification profile
CP1929
Add precoordinated measurement CODE content item parameter to TID 300
CP1930
Erectile dysfunction test drug administration
CP1931
SCOORD3D should be allowed for Planar ROIs in TID 1411 and be more flexible for Volumetric ROIs in TID 1410
CP1932
Add Series Date and Time to missing Modules
CP1933
Add PIRADS V2.1 base PZpm sector anatomy
CP1935
Correction of "Consumable is New" child node relation to parent node within TID 11005
CP1936
Correction of "Adverse Event" child node relation to parent node within TID 11021 and 11022
CP1937
Extend semantic of TID 11003 to be more flexible to the needs and correct node numbering in example
CP1938
Inconsistent representation of CODE values in example MMMM
CP1939
Semantic issue in consumable parts
CP1940
Correction of incorrect datetime value in example
CP1941
Rename Imaging Agent Administration Syringe/Pump Phase Activity template
CP1942
Revise Part 15 Annex F (DHCP)
CP1943
Incorrect Frame Time's value for Video Type 60 Hz HD
CP1945
Add coding scheme designator for RadElement
CP1946
Update Part 15 Annex H (add conformance)
CP1947
Add security considerations for encapsulated formats
CP1948
Part 10 Format security considerations
CP1949
Specify the identity window level values
CP1952
Remove common name from taxonomic rank code meanings
CP1953
Add more specific tumor graft histologic types
CP1954
Fix inconsistent DIMSE status code meaning