DICOM News

DICOM News

November 2017 Bjoern.Nolte@siemens.com
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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.



Transform AIM/DICOM-SR

Sup 200 100% (Final Text)


This Supplement defines patterns for transformation of measurement and annotation information for use-cases related to reporting of quantitative imaging results.

Annotation and Image Markup (AIM) defines a UML model and an XML schema for describing the observations that humans or machines make about specific semantic entities in images such as: anatomic, observations and quantitative imaging features.

AIM information is captured using user-defined lexicons and/or well-defined medical lexicons such as RadLex, UMLS, SNOMED CT®, CPT, ICD-9/10, etc.

Image annotations in AIM have been used for cancer lesion evaluation, and it is desirable to harmonize this effort with similar capabilities that exist in DICOM, to allow AIM and DICOM systems to interoperate.

DICOM PS3.16 defines various templates for different applications.

The TID 1500 Measurement Report template describes a generic pattern that is similar to AIM and has been used for the same use cases.

This supplement defines a mapping between compatible components of the AIM model and the DICOM SR TID 1500 Measurement Report applicable to quantitative and categorical description of regions of interest in images.

After a complete document walk-through and inline updates, the meeting members voted supplement 200 to become part of the standard.

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Contrast Agent Admin

Sup 164 80% (Letter Ballot)


This supplement introduces IODs that describe the administration of imaging agents.

The supplement applies to all modalities in which radiographic and ultrasonic imaging agents are introduced into a circulatory system in a controlled fashion (CT, MR, XA, US).

The new SOP Classes describe administration events, flows, pressure, timings, physio-chemical attributes and pharmacological attributes of the agent administration and consumables related to the administration.

These SOP classes do not describe administration of radiopharmaceuticals, addressed by R-RDSR.

With the document presentation and discussion the presenter cleaned up uniqueness and referencing between TIDs. Further, the presenter improved the codes within the TIDs.

The meeting members voted supplement 164 go out for letter ballot review.

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TLS Security Profiles

Sup 204 80% (Letter Ballot)


This supplement adds two new Secure Connection profiles to make DICOM consistent with the latest RFCs and best practices for Transport Layer Security, TLS:

The first one is a down gradable profile based on IETF BCP 195. The second one is non-down gradable.

The old Basic TLS Secure Transport Connection Profile is retired. IETF considers it inadequate security, because the methods for breaking in are well known.

The old AES TLS Secure Transport Connection Profile is retired. Implementations that use it will interoperate only with the down gradable variant because it is acceptable as one of the lower levels of protection that can be negotiated.

The old ISCL Secure Transport Connection Profile is retired.

A recommendation notes the advantage to use different tcp ports when several profile variants are available.

The base standard urged the presenters to scrutinize patent coverage for the technology. It is vital that the standard text is clear regarding which patents if any are used and their fair use conditions.

Supplement 206 carves out information related to the TLS CRYPTREC profile.

The meeting members voted supplement 204 to go out for letter ballot review.

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2Gen RT C-Arm Treatment

Sup 175 60% (After Public Comment)


This Supplement specifies IODs for Radio Therapy Radiation and Radiation Sets in the areas of C-Arm techniques. A Radiation Set defines a Treatment Fraction as a collection of instances of RT Radiation IODs. Each RT Radiation IOD represents a different treatment modality. This supplement is uses the concepts and model found in supplement 147.

The new IODs support all current treatment modalities and to be extensible for future modalities and new equipment.

Separate IODs define specific treatment modalities, these include Tomotherapeutic treatments, C-Arm beams and Robotic beams.

The presenter walked through the concepts of radiation generation. The use of codes, description text, and references underwent a cleaned up.

The meeting members concluded to review supplement 175 further in upcoming meetings. The next milestone is letter ballot voting.

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Multi Energy CT

Sup 188 60% (After Public Comment)


This Supplement extends the CT Image IOD and Enhanced CT Image IOD to support new types of images generated by Multi-energy (ME) CT scanners.

It describes various ME imaging techniques. While different vendors apply different techniques to achieve ME Images, there is large commonality in the generated diagnostic images. It adapts existing attributes of the CT / Enhanced CT IOD to fit ME techniques.

To detect the different X-Ray spectra, Multi-energy (ME) CT imaging uses combinations of different Source(s) and Detector(s) technologies such as current switching X-Ray tubes, spectral detectors, multi-layer detectors, multi-source and detector pairs.

Multi-energy CT data can be reconstructed and processed in different ways to serve a variety of purposes.

  • To differentiate materials that look similar on conventional CT images, e.g., to differentiate Iodine and Calcium in vascular structures or to differentiate vascular structures from adjacent bone.
  • To quantify materials and to extract regions and organs based on their composition.
  • To generate virtual non-contrast images from a contrast-enhanced image rather than having to scan the patient twice.
  • To enhance the effect of contrast such as highlighting Iodine and soft tissue or to reduce artifacts.

The presentation included a walkthrough of all changes from the last base standard meeting. The elaboration circled around interoperability especially different generations of CT scanners: Pre-enhanced, scanners supporting multi energy attributes in private attributes and systems fully supporting this supplement.

The meeting members concluded to review supplement 188 further in upcoming meetings. The next milestone is letter ballot voting.

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Realtime Video

Sup 202 20% (Draft)


This Supplement describes a new DICOM Service for the transport of real-time video and associated medical data, titled Real-Time Video Transport Protocol.

Professional video (e.g., TV studios) equipment providers and users have defined a new standardized approach for conveying video and associated information, such as audio, ancillary data and metadata, enabling the deployment of equipment in a distributed way beyond 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.

The SMPTE ST 2110 suite is the platform for this supplement. It builds on the Technical Recommendation, TR03, originated by the Video Services Forum, VSF.

This supplement tailors the recommendations to meet the specific medical needs and adds medical metadata along with the video.

It specifies the method for feeding the recorder with the synchronized videos and associated metadata. The format of recording is out of the scope of the supplement, as well as the way of replaying the recorded videos and security aspects in general.

The presentation triggered to the question: How can an implementer practically obtain the information to construct the Session Description Protocol object and the concept of “meta data essence”?

The base standard group wished for an engineering implementation example.

The meeting members concluded to review supplement 202 further in upcoming meetings. The next milestone is public comment review.

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3D Printing

Sup 205 20% (Draft)


This supplement adds a new DICOM IOD to encapsulate Stereolithography (STL) 3D model file formats.

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.

3D model files contains geometric instructions for 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.

The presenter explained the updates from the open and closed issues.

The meeting members concluded to review supplement 205 further in upcoming meetings. The next milestone is public comment review.

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TLS CRYPTREC Profile

Sup 206 20% (Draft)


This supplement adds one new Secure Connection profile to make DICOM consistent with the latest recommendations from the Japanese CRYPTREC committee:

A CRYPTREC TLS Profile that requires compliance with the IETF BCP 195 Recommendations for Secure Use of Transport Layer Security (TLS) and Datagram Transport Layer Security (DTLS) plus support for the additional cypher suites specified by the CRYPTREC committee. This profile requires that TLS negotiation start with the strong security protection parameters, and allows progressive negotiation of weaker protection down to a minimum protection limit.

The CYPTREC committee has extended the BCP195 recommendation by adding cyphersuites that must be available for negotiation.

This supplement factors out the TLS (Transport Layer Security) CRYPTREC (Cryptography Research and Evaluation Committees) profile from supplement 204.

The meeting members concluded to review supplement 206 further in upcoming meetings. The next milestone is public comment review.

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Conformance Assertions

Sup 207 20% (Draft)


This supplement extends the standard with Conformity Assessment aspects, including an extension of the requirements, and new sections on test scenarios, test cases, and product conformity assessment reporting.

This together forms a test framework that, when used, will guarantee that a well verified product – conforming to its DICOM Conformance Statement – will be released, with proper evidence of the associated validation activities.

The meeting discussed the presented slide overview. A longer exchange of ideas focused on relations and grouping. How do conformance claims relate to assertions, test scenarios and test cases? The concluding idea is to try to use a reference model (oasis-open.org). One of the next steps will be to validate if the oasis model and the base conformance requirements in the DICOM standard match.

The meeting members concluded to review supplement 207 further in upcoming meetings. The next milestone is public comment review.

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CPack 93

WG-06 approved Final Text in November 2017.
Now part of the DICOM standard.

CPack 94

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

CPack 95 candidates

Current candidates for final text in March 2018


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