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


complete in standard.

Realtime Video

This supplement adds realtime video handling to the DICOM standard.

It 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).

The supplement defines an new IP-based DICOM Service for the broadcasting of real-time video to subscribers with a quality of service which is compatible with the communication inside the operating room (OR).

Professional video (e.g., TV studios) equipment providers and users have defined in SMPTE (ST 2110 family of standards). ST 2110-10 uses a multicast model rather than a peer-to-peer communication model. DICOM-RTV builds upon ST 2110.

DICOM-RTV restricts real-time communication to uncompressed video.

This supplement was voted as Final Text. It will be part of the next edition of the standard.

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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 ready to go out for Letter Ballot voting.

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

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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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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.

Supplement 211 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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XA Protocol

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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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 is capable of representing 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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Neurophysiology Waveforms

This Supplement introduces a number of Services Classes for Storage of Neurophysiology Waveforms by adding the related Neurophysiology IODs and the necessary Neurophysiology Waveform Context Groups.

It adds a SOP Class to store routine (clinic) electroencephalography (EEG) data recording the electrical activity of the brain collected on the skull surface using electrode positions of the international 10/10 or 10/20 localization scheme.

It adds a SOP Class to store electromyography (EMG) data recording the electrical activity of skeletal muscles.

It adds a SOP Class to store electrooculography (EOG) data collected near the eyes recording eye movement.

It adds a SOP Class to store generic neurophysiology signals.

It adds a transfer syntax for DICOM waveforms using RED compression.

Supplement 217 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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JSON Representation of DICOM Structured Reports

This Supplement describes a simplified JSON representation of DICOM Structured Reports, similar to the PS3.18 JSON representation, to allow AI developers to encode image-derived results.

This supplement describes a mapping between a simple JSON representation of the measurement and annotation result payload expected from an AI system, and the traditional binary DICOM SR encoding of the same information.

This supplement defines a new Part, PS3.22, to contain the alternative representation, and includes the existing Attribute level XML and JSON encodings factored out of PS3.19 and PS3.18.

DICOM PS3.16 defines templates for different applications. The TID 1500 Measurement Report template describes a generic pattern that is suitable for encoding AI results as well as other quantitative and qualitative (categorical or descriptive) results. The JSON representation is exemplified using TID 1500, but the conversion supports full fidelity round-trip encoding of any DICOM SR instance, regardless of the template.

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.

Supplement 219 will be further presented and discussed with the Base Working Group in a coming meeting before Public Comment voting.

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CPack 103
In ballot voting, Release November 2019

Add a bulkdata subresource to study, series and instance WADO-RS
Clarification of Distances in Ion Beams
Add clarification note that C-FIND SCP should ignore unknown standard and private tags
Derivation of Photometric Interpretation in STOW-RS
Add code for bounding box for SR
Add codes for AI visual explanation maps
Update PS3.18 Status Codes to be correct HTTP
Update PS3.18 Header Fields to include origin server and user agent requirements
Notification Connections need to be improved
Clarify suspending global subscriptions in UPS-RS
Correct conflict in number of values between General Anatomy Optional and Required Macros causing conflict in DX introduced by CP 1744
Add trans-rectal to ultrasound beam path context group
Reverse sense of all other encoding based on VR to follow rule for new VRs
Add more renal vessels
Add generic echocardiography measurements missing from vascular ultrasound context groups
Correct code meanings for body surface area codes
Fix inconsistent Relationship Content Constraints (SR IODs from Supplement 164)
Add translocator protein tracers
Add presentation address to file meta information for DULP and Web Services
Number of Frames attribute should never have a value of zero
WADO-RS Transfer Syntax to use when cannot be decompressed
Return in query response what Transfer Syntax is available for retrieval
Some IODs that need it are missing the Synchronization Module
Add laterality parameter to TID 300
Correct code for anatomical structure in CID 7150 and CID 9501
Additional Category codes for CID 9502
Add Laterality to Treatment Site Code
UPS-RS Support for Query Only
Add Institution and Admission attributes to UPS
Add "all other attributes" row for Patient Demographics to UPS
Add Reason For Requested Procedure Query Keys to UPS
Correct Retired Attributes in PS3.15 E
Coding Scheme Version requires Coding Scheme Designator to be present
CPack 104
Release Candidates for january 2020

Update PS3.4 for expanded Code Sequence
Consistency between DICOM VR definition of DS & IS, and JSON Value Representation
Necessity of returning the Specific Character Set (0008,0005) attribute in a QIDO-RS response
Add IEC 62985 Size Specific Dose Estimation
Recently added OV, SV and UV VRs were not included in PS3.18 or PS3.19
The grammar for the quality Query Parameter in wrong
Clarify Character Set handling
Clarify the Media Type sections for Studies Service
Padding in DICOM JSON and XML (Native) Models
Update PS3.19 WADO-RS and STOW-RS to PS3.18 Studies Service Retrieve and Store
PS3.18 Section 5.1.1 does not have a definition for NON-ZERO-DIGIT
PS3.18 Section 8.3.1 has syntax mistakes
Add multi-energy CT attributes to de-identification profile
Add precoordinated measurement CODE content item parameter to TID 300
Erectile dysfunction test drug administration
SCOORD3D should be allowed for Planar ROIs in TID 1411 and be more flexible for Volumetric ROIs in TID 1410
Add Series Date and Time to missing Modules
Add PIRADS V2.1 base PZpm sector anatomy
Correction of "Consumable is New" child node relation to parent node within TID 11005
Correction of "Adverse Event" child node relation to parent node within TID 11021 and 11022
Extend semantic of TID 11003 to be more flexible to the needs and correct node numbering in example
Inconsistent representation of CODE values in example MMMM
Semantic issue in consumable parts
Correction of incorrect datetime value in example
Rename Imaging Agent Administration Syringe/Pump Phase Activity template
Revise Part 15 Annex F (DHCP)
Incorrect Frame Time's value for Video Type 60 Hz HD
Add coding scheme designator for RadElement
Update Part 15 Annex H (add conformance)
Add security considerations for encapsulated formats
Part 10 Format security considerations
Specify the identity window level values
Remove common name from taxonomic rank code meanings
Add more specific tumor graft histologic types
Fix inconsistent DIMSE status code meaning