April 2014 Bjoern.Nolte@siemens.com

Here are the summary notes from the latest DICOM Working Group 6 Meeting (WG-06).

A selection out of the 30 DICOM Working Groups are meeting and harmonizing their content with WG-06 on up to five occasions per year.

Progress in new DICOM supplements (new chapters to the standard) is reflected. Further change proposals (bug fixes in the standard) are shown in their maturity groups (CPacks).

Planar MPR Volumetric Presentation State

Sup 156 Revisit planned for June 2014
In Public Comment Phase

This supplement introduces the Planar MPR Volumetric Presentation State object to the standard.

The goal is to be able to present the same or close to the same volume view on imaging data (XA-3D, MR, CT enhanced objects and others) with a general volumetric presentation state object regardless of computing and displaying system and vendor. The supplement is the first of a series of supplements. The first one focuses on MPR.

Working group 11 presented what they have been working on since the last WG6 meeting. This included: Segmentation references and cropping; How should clinically significant annotations be presented, by secondary capture reference or augmented in the presentation?

A discussion on clinical context took place. It was proposed to change this to presentation description as clinical would indicate a very broad scope. It was asked why this is useful in addition to the information in the source images.

Excellent 3D figures have been added to visually explain the concepts and how they are encoded.

A walk through and discussions of Annex X took place. There was an agreement on concepts.

The supplement was voted ready for Public Comment after cleanup of language issues.

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Server Options for RESTful Services

Sup 170 Revisit planned for June 2014 In Public Comment phase

This supplement introduces Server Options for RESTful Services.

It coveres the client discoveringwhich server DICOM RESTful services are available and which options are supported on the server e.g.:

  • Supported services
  • Supported transfer syntaxes and media types
  • Supported accept header values
  • Supported query parameters
A client makes an HTTP request and receives and objects describing the server capabilities (similar to info in the conformance statement).

As a comparison: For normal non DICOM WebServices, WSDL has become a standard.

This supplement is voted to go into public comment.

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Unified Procedure Step RESTful Services

Sup 171 Revisit planned for June 2014 Still in concept discussion phase

This Supplement defines a set of Representational State Transfer (REST) Services for interfacing with the Unified Procedure Step Services. This could be implemented as a proxy to an existing UPS service or as a web service interacting directly with a Workflow Manager.

A discussion took place on status codes and status text messages. The idea is to use the concept of a status line which includes the status code and text. This is also in line with the HTTP naming convention.

Among the open issues are: How to make sure that the overall flow is external and is not represented explicitly in any of the individual artifacts. How to handle involved SCPs on different hardware or as different entities on one piece of hardware. How to ensure push workflows? How to handle both cases with or without an overall workflow manager? Shall payloads be handled flexibly: Binary, JSON, XML?

This supplement is in the draft state.

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X-Ray 3D info annex

Sup 167 Revisit planned for June 2014 In Public Comment phase

This supplement contains the X-Ray 3D Angiographic IOD Informative Annex. It delivers explanatory information on the usage of DICOM attributes for X-Ray 3D Angiographic Image IOD. It adds information: Identify scenarios where the X-Ray 3D Angiographic Image will be applied; Restrictions on defined terms recommended, values ranges, recommended presence of attributes; Recommend the use of Type 3 and conditional attributes under particular scenarios; Emphasizes the use of private attributes as a "last resort only".

The comments from the January meeting and how they have been incorporated into the supplement was presented. In the document the phrasing shall be changed from "The value nnn is expected" to "The value will be nnn".

A longer discussion took place regarding the number of projections in one cardiac cycle, especially irregular cycles. It was decided to make this an open issue to discuss for WG-02.

The seven scenario cases, illustrating examples of how 3D reconstructions, projections and registrations may be used in real clinical situations, were discussed and the text was made more clear.

The supplement was voted to be sent out to the industry for public comments.

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Dose SR

Sup 159
Final Text

This supplement introduces a template for reporting of radiation dose due to administration of radiopharmaceuticals, as in NM or PET imaging, in DICOM. Structured Reporting is the base.

The dose report records radiopharmaceutical activity amount, and administration time and other information. NM and PET modalities can read the reports to complete administration information essential for PET SUV calculations. Dose Registry and Dose Reporter systems will consume these reports.

Patient dose from background activity is not recorded in the report.

All comments were accepted apart from the ones in red in Working Group 3. The Siemens comments were discussed with Tom Milo ahead of the meeting and clarified up front.

The supplement is approved for final text after minor editorial work offline.

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Echocardiography Report

Sup 169 Revisit planned for June 2014
In Draft state

This supplement introduces an SR template called Simplified Adult Echocardiography Report IOD to the standard. It provides similar content to that of TID 5200 while addressing details that were the source of interoperability issues; in particular, varying degrees and patterns of pre- and post-coordination, multiple codes for the same concept and numerous optional descriptive modifiers.

A conformance section will be supplied with content. The structure is defined in fig. A.x-1.

A general discussions took place on a number of open issues: Retiring and conversion support from TID 5200; How to support processing and reporting systems well on the consumer side; How to handle vendor specific information.

The supplement is in a draft state.

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Contrast Inj. SR

Sup 164 Revisit planned for June 2014 Close to ready for Public Comment

The supplement describes Reports (Defined, Planned and performed) of Substance Administration. It describes administration events, flows, pressure, timings, physio-chemical attributes and pharmacological attributes of the agent administration and also consumables related to the administration. These SOP classes do not describe radioactivity or dosimetry administered.

The structure of the supplement has been revised. A new annex D has been added. Very few comments have been made since the last iteration. A review and walk through of several TIDs followed.

SNOMED relations between substances and products were discussed. The editor of this supplement will improve the table with general codes. The "new" codes in the present version can be traced back to the general code in SNOMED.

The supplement is in a draft state.

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2nd Gen RT

Sup 147 Revisit planned for June 2014 Close to ready for Public Comment

This supplement describes the second generation of radiotherapy objects. A new generation of radiotherapy objects was needed to address workflow management, the enhanced multiframe paradigm, the newer model of having different types of data to be stored in separate IODs. New powerful approaches in DICOM are used: e.g. 3D segmentation, mesh representation, rigid and deformable registrations.
A clarification was added to the RT Treatment phase definition: The treatment phases serve as the basis to define the chronological relationship between radiation sets, which are concurrently and/or subsequently treated in a defined relationship to each other.

In the radiotherapy common instance it was decided to add a UPS reference (performed procedure step with a new attribute).

A discussion took place regarding the Patient Frame of Reference to Equipment Mapping Matrix. The requirement of the attribute is that the information has to be a rigid homogenous 4x4 matrix. The "required" part of the attribute was improved to be easier to validate.

Which context groups and IDs to use in this supplement was debated. The user content description explanation will be reworked. A line by line walk trough of all macros was done.

A longer discussion arose regarding how to code how fractions are related. A diagram will be added to illustrate and make the concept more clear. The progress of presenting and reviewing this supplement is progressing very slowly.

The supplement is in a draft state and will be revisited in June.

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Reports using HL7 CDA

Sup 155 Revisit planned for June 2014
In Draft state

This Supplement introduces a new mechanism for specifying templates for imaging reports. Such reports are intended to be encoded using the HL7 Clinical Document Architecture Release 2 (CDAr2, or simply CDA) Standard.

The goals of this supplement are: To create a new a family of imaging reports. Initially there will be templates for radiology reports, aligned with RSNA RadLex and Reporting Initiative. Primarily the reports will be narrative with some discrete data. The reports are planned to evolve to containing more and more discrete data: Diagnostic and screening; evolving to interventional, cardiac, anatomic path and further.

The document model and key concepts of CDA were presented.

The core concepts of are: Entity / Role / Participation / Act / ActRelationship.

E.g. A person / playing the role of being a patient / subject of / observation of asthma / which is the reason of an administration of Albuterol.

See http://radreport.org/ for templates.

RadLex is an RSNA lexical designed to tag concepts for indexing and retrieval. http://www.rsna.org/RadLex.aspx and http://radlex.org/

The supplement is in a draft state.

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Display Parameters

Sup 124
Final Text

This Supplement defines a Display System Information Object and SOP Class allowing retrieval of standardized display system characteristics and performance information including image quality factors. Color display is not addressed in this supplement.

A line by line presentation took place regarding all the changes which has been added since the last public comment phase.

The supplement was approved for final text and is now part of the standard.

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