Strategic Document

Version 2.1, February 7, 2003

The purpose of this document is to provide a summary of the current activities and future directions of the DICOM standard. The content of the document is largely based on information submitted by individual working group chairs. WG10 will update this document on an annual basis and submit it for review and approval by the DICOM Committee at the committee’s annual RSNA meeting.

A Brief Background of the DICOM Standard

The introduction of digital medical image sources in the 1970’s and the use of computers in processing these images after their acquisition led the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) to form a joint committee in order to create a standard method for the transmission of medical images and their associated information. This committee, formed in 1983, published in 1985 the ACR-NEMA Standards Publication No. 300-1985. Prior to this, most devices stored images in a proprietary format and transferred files of these proprietary formats over a network or on removable media in order to perform image communication. While the initial versions of the ACR-NEMA effort (version 2.0 was published in 1988) created standardized terminology, an information structure, and unsanctioned file encoding, most of the promise of a standard method of communicating digital image information was not realized until the release of version 3.0 of the Standard in 1993. The release of version 3.0 saw a name change, to Digital Imaging and Communications in Medicine (DICOM), and numerous enhancements that delivered on the promise of standardized communications.

The DICOM standard now specified a network protocol utilizing TCP/IP, defined the operation of Service Classes beyond the simple transfer of data, and created a mechanism for uniquely identifying Information Objects as they are acted upon across the network. DICOM was also structured as a multi-part document in order to facilitate extension of the Standard. Additionally, DICOM defined Information Objects not only for images but also for patients, studies, reports, and other data groupings. With the enhancements made in DICOM (Version 3.0), the Standard was now ready to deliver on its promise not only of permitting the transfer of medical images in a multi-vendor environment, but also facilitating the development and expansion of picture archiving and communication systems (PACS) and interfacing with medical information systems.

Scope of DICOM

The DICOM Standards Committee exists to create and maintain international standards for communication of biomedical diagnostic and therapeutic information in disciplines that use digital images and associated data. The goals of DICOM are to achieve compatibility and to improve workflow efficiency between imaging systems and other information systems in healthcare environments worldwide. DICOM is a cooperative standard. Therefore, connectivity works because vendors cooperate in testing via scheduled public demonstration, over the Internet, and during private test sessions. Every major diagnostic medical imaging vendor in the world has incorporated the standard into their product design and most are actively participating in the enhancement of the Standard. Most of the professional societies throughout the world have supported and are participating in the enhancement of the standard as well.

DICOM is used or will soon be used by virtually every medical profession that utilizes images within the healthcare industry. These include cardiology, dentistry, endoscopy, mammography, opthamology, orthopedics, pathology, pediatrics, radiation therapy, radiology, surgery, etc. DICOM is even used in veterinary medical imaging applications.

Technology Overview

The DICOM Standard addresses multiple levels of the ISO OSI network model and provides support for the exchange of information on interchange media. DICOM currently defines an upper layer protocol (ULP) that is used over TCP/IP (independent of the physical network), messages, services, information objects and an association negotiation mechanism. These definitions ensure that any two implementations of a compatible set of services and information objects can effectively communicate.

Independence from the underlying network technology allows DICOM to be deployed in many functional areas of application, including but not limited to communication within a single site (often using various forms of Ethernet), between sites over leased lines or virtual private networks (VPNs), within a metropolitan area (often using ATM), across dial-up or other remote access connections (such as by modem, ISDN or DSL), and via satellite (with optimized protocol stacks to account for increased latency).

At the application layer, the services and information objects address five primary areas of functionality:

DICOM does not define an architecture for an entire system; nor does it specify functional requirements, beyond the behavior defined for specific services. For example, storage of image objects is defined only in terms of what information must be transmitted and retained, not how images are displayed or annotated. DICOM can be considered as a standard for communication across the "boundaries" between heterogeneous or disparate applications, devices and systems.

The services and objects that are defined in DICOM are designed to address specific, real-world applications (such as the performance of an imaging study on an acquisition device). As such, DICOM is not a general-purpose tool for distributed object management. In general, information is transferred "in bulk" according to a "document" paradigm.

By contrast, general-purpose standards for distributed object or database management generally provide lower level, more atomic access to individual attributes. Though the DICOM standard does provide the so-called "normalized" services for patient and study management, these have not proven popular, and the "composite", document-oriented, services have prevailed. This is mostly likely a consequence of the natural division of functionality between different vendors, devices and applications. For example, the ability to "set" or "change" a patient’s name is generally implemented in a proprietary and centralized manner. To safely distribute responsibility for such a change across boundaries between different applications requires more underlying support than DICOM currently possesses (such as support for transactions and two-phase commitment).

At the present time, the pressing needs in DICOM (as indicated by the priorities of the various working groups) are to address issues relating to security, performance, new modality technology, and workflow management. These needs are being successfully addressed using the conventional "underlying" DICOM technology. Where there are interfaces to standards based on other technologies (such as HL7 V2.x and 3), the focus for harmonization is on a shared "information model". It may be the case that the nature of the underlying technology needs to be revisited in the future, whether it is to make use of more sophisticated off-the-shelf distributed object management tools such as CORBA, or less sophisticated encoding tools such as XML. However, the current priority is to address improvements in functionality to better meet the needs of the end-user, rather than to adopt an alternative technology for the sake of it. This priority is continually reinforced by a desire to remain compatible with the installed base of equipment.

When specific new technology is required, such as in support of new features such as security and compression, the strategy is to adopt proven international, industry or de facto standards. Accordingly, network confidentiality and peer authentication in DICOM are provided by the use of either TLS (an Internet standard) or ISCL (an ISO-based standard). Similarly, rather then develop medical-image-specific compression schemes, DICOM adopts standards developed by ISO/IEC JTC 1/SC 29/WG 1 such as JPEG and JPEG 2000. For interchange media, standard file systems compatible with conventional software (such as ISO 9660 and UDF) are used.

DICOM’s Relationship to Other Standards

Throughout the development of DICOM, much attention was devoted to establishing working relationships with other related standard initiatives throughout the world. The initial version of the standard leveraged prior work by ASTM. The Internet protocol TCP/IP was adopted in 1993. In the nineties, solid cooperation with CEN, the European Committee for Standardization, resulted in a number of jointly developed supplements. In parallel, the convergence of a Japanese interchange media format (IS&C) with DICOM required much joint work where JIRA, the Japan Industries Association of Radiological Systems played a major role. In the USA, DICOM participated in the early coordination efforts for healthcare standards with the ANSI-HISBB from which DICOM adopted a harmonized patient name structure, and started progressively to define links with HL7. This cooperation has now entered in a very active phase with the creation, in 1999, of a joint DICOM-HL7 working group. Finally, it was a logical step for DICOM to establish a Type A liaison with the ISO Technical Committee 215 at its creation in 1999. ISO TC 215 has decided not to create an imaging working group, but to rely on DICOM for bio-medical imaging standards.

DICOM is also focusing its attention to the evolution of standards linked to the Internet. DICOM strategy is to integrate Internet Recommendations as soon as they are stable and largely disseminated in consumer commercial products. In this evolution, much care is taken to ensure that the consistency of the DICOM standard is maintained with its large installed base. DICOM already uses standard healthcare enterprise intranets, and the e-mail exchange of DICOM objects (using a Standard MIME type) is possible. It is clear that the use of DICOM objects and services in commonly used information technology applications will grow in the future.

DICOM’s Organizational Structure

DICOM is a standards organization administered by the NEMA Diagnostic Imaging and Therapy Systems Division. The complete bylaws of the DICOM Standards Committee are available on the NEMA web site at www.nema.org. Working groups of the DICOM Committee perform the majority of work on the extension of and corrections to the Standard. Working groups are formed by the DICOM Committee to work on a particular classification of tasks. Once formed, working groups petition the DICOM Committee to approve work items for which the working group will execute the plan delineated in the work item. Once the output of a work item (generally a supplement or correction proposal) has been completed, it is submitted to Base Standards Working Group (WG6), for their review. Supplements to the standard then go through a public comment period, after which the DICOM Committee authorizes the supplement for letter ballot by DICOM members. Letter ballots require approval by two-thirds of those voting affirmative or negative and return of more than one-half of the ballots sent to members in good standing relative to letter ballots. Since the working groups perform the majority of work on the extension of and corrections to the Standard, the current status and future directions of the DICOM standard are best represented by review of each working group.

The DICOM Standards Committee and its Working Groups

The DICOM Standards Committee

WG1: Cardiac and Vascular Information

WG12: Ultrasound

WG2: Projection Radiography and Angiography

WG13: Visible Light

WG3: Nuclear Medicine

WG14: Security

WG4: Compression

WG15: Digital Mammography

WG5: Exchange Media

WG16: Magnetic Resonance

WG6: Base Standard

WG17: 3D

WG7: Radiotherapy

WG18: Clinical Trials and Education

WG8: Structured Reporting

WG19: Dermatologic Standards

WG9: Ophthalmology

WG20: Integration of Imaging and Information Systems

WG10: Strategic Advisory

WG21: Computed Tomography

WG11: Display Function Standard

 

The DICOM Standards Committee

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Vendor Co-Chair David Clunie, M.D., RadPharm

dclunie@dclunie.com

User Co-Chair Lloyd Hildebrand, M.D., American Academy of Ophthalmology

lloyd-hildebrand@ouhsc.edu

Date of Last Update: March 6, 2002

Scope:

The DICOM Standards Committee exists to create and maintain international standards for communication of bio-medical diagnostic and therapeutic information in disciplines that use digital images and associated data. The goals of DICOM are to achieve compatibility and to improve workflow efficiency between imaging systems and other information systems in healthcare environments worldwide.

 

WG-01 (Cardiac and Vascular Information)

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Co-Chair Jon Elion, MD, FACC, Heartlab

jle@heartlab.com

Co-Chair Harry Solomon, GE Medical Systems

harry.solomon@med.ge.com

Date of Last Update: November 27, 2002

Scope:

To develop standards for the digital interchange of the cardiovascular images, physiologic waveforms and core clinical information, which characterize a patient undergoing a catheterization procedure.

Roadmap:

The WG-01 roadmap is a long-term strategy to specify information objects and services to fully digitize and integrate data flow within and beyond the catheterization laboratory. The ultimate goal is a comprehensive digital cardiovascular record for the patient, of which the cath lab record is a significant part.

The cath lab is a multi-modality mix of many types of equipment from many different manufacturers. Moreover, cardiovascular medicine requires consultation and interaction between many medical disciplines. Standardized data interchange is critical in this environment.

The initial WG-01 work effort was directed toward the definition of DICOM data acquisition object formats:

The next level of integration involves definition of various structured data interchanges in the cath lab, to support the interpretation and effective use of the basic images and waveforms. This structured data includes procedure logs, quantitative and qualitative measurements, and clinical reports, and requires specialization of the DICOM Structured Report services.

 

Finally, the overall workflow management of the cath lab within the cardiology department and within the larger institution will be evaluated. This will be done with regard to adapting the DICOM Study Management services to the particular needs of cardiology practice (as distinct from radiology).

Short Term Goals:

The first elements of this work are expected to be standardized by 1Q2003 (as of December 2002, Supplement 66 is in Letter Ballot).

Current Status:

WG-01 plans to meet approximately four times per year for 1-2 days each, plus interim discussions by telephone conference.

WG-01 maintains active liaisons, and has conducted joint meetings, with:

Current Work Items:

Risks:

The integrated data flow in the cath lab requires the implementation of multiple DICOM Services in the equipment, such as DICOM image and waveform interchange, and various types of structured reports. It will be important to establish a forum (not within WG-01) that will promote the adoption of comprehensive interoperation profiles for the cath lab, similar to the effort of IHE in radiology.

Further, the various types of objects must be synchronized to provide clinically meaningful and accurate data acquisition. For example, IVUS images must be accurately synchronized to ECG and audio waveforms, and to the procedure log, to post-process for 3-D reconstruction and to be able to identify the sites imaged and the acquisition context. These multiple objects of different SOP classes must be effectively managed as coordinated whole, and effective technical mechanisms for inter-equipment synchronization need to be developed.

Most of WG-01’s current work is based on DICOM Structured Reporting, which is just emerging in practice. This presents several risks to the work of WG-01:

Challenges and Opportunities:

The WG-01 effort has the potential to significantly improve the operation of the catheterization laboratory, with consequent improvement in both patient care and facility administration. Major improvements in lab productivity and clinical response time to emergent cardiovascular conditions can result from integrated data flow within and between the cath department and the hospital. This integration includes both data moving into the lab (e.g., demographics, blood lab results), and data moving out (e.g., images and reports to the emergency department). The structured coding of cath lab data can facilitate analysis and improvement of patient outcomes, quality assurance, automated support for billing, as well as administrative analysis of organizational effectiveness. Beyond the institution, this data can support broad clinical research and regional or national clinical data registries.

The work effort must studiously adhere to the roadmap for progressive and incremental integration of the cath lab data flow, focusing on pragmatic next steps in the standardization process which bring real benefit to the cardiovascular user community (clinicians and administrators). A major challenge will be developing standards that facilitate the conversion of legacy cath lab systems to DICOM standard data interchange. The standards must be effective even in environments that have a mix of fully DICOM-compliant subsystems and legacy systems that may support only a limited subset of DICOM functionality.

Strong participation in WG-01 from the European Society of Cardiology, as well as the American College of Cardiology, has helped ensure a broad international applicability of the work. It is critical to maintain this liaison and engagement.

 

WG-02 – Projection Radiography and Angiography

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Chair Heinz Blendinger

Date of Last Update: August 30th, 2002

Scope:

Roadmap:

Short Term Goals:

Future Work Items:

Risks:

Challenges and Opportunities:

 

WG-03 (Nuclear Medicine)

Secretariat NEMA

Secretary Richard Eaton, NEMA

ric_eaton@nema.org

Chair Jeff Pohlhammer, Philips Medical Systems

jeff.pohlhammer@philips.com

Date of Last Update: September 11, 2002

Scope:

To develop standards for the digital interchange of Nuclear Medicine and PET images.

Roadmap:

Potential work items would be generation of CPs to address the goals listed below.

Short Term Goals:

Working with the Society for Nuclear Medicine and the joint task force on cardiac NM, address issues with the NM IOD. These include:

Current Status:

Current Work Items:

None.

Risks:

None, yet.

Challenges and Opportunities:

Outside groups, such as the Society of Nuclear Medicine have recently become more interested in DICOM, and have expressed concerns related to the issues mentioned above. This presents an opportunity to work with the SNM, and other related groups, to address these issues in a manner consistent with the architecture of the current NM IOD. The challenge is to do so in a timely manner.

 

WG-04 (Compression)

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Chair Alan Rowberg, MD, University of Washington (ACR)

arowberg@earthlink.net

Date of Last Update: July 6, 2001

Scope:

To provide data compression facilities for the DICOM standard and to advise on application or object-related definitions of data compression parts of the DICOM Standard created by other working groups.

Roadmap:

Develop appropriate DICOM transfer syntaxes for JPEG 2000 when it is released.

Expectations for the next few years, after the current work items are finished:

Use of Future Image Schemes

Future schemes for other data

Beyond JPEG 2000 Part 1 (ISO 15444-1)

Short Term Goals:

We plan to serve a maximal number of modalities and clinical situations, with support for growing areas such as telemedicine and the use of new technologies such as DVD. We shall develop the appropriate DICOM transfer syntaxes for JPEG 2000 when it is released.

Current Status:

Compression that is already available in the standard:

JPEG (ISO 10918-1) - all processes

RLE (aka TIFF Packbits)

JPEG-LS (ISO 14495-1) (DICOM CP-174)

Current Work Items:

Tracking the progress of the JPEG 2000 standard, evaluating its performance in medical imaging, and planning to develop appropriate DICOM transfer syntaxes for JPEG 2000 when it is released.

Risks:

The risk of JPEG 2000 not issuing as an international standard is low. We expect no problems in creating the proper transfer syntaxes. The success of other items will depend on support from the DICOM vendor community.

Challenges and Opportunities:

In the area of multi-frame and 3D compression, WG-12 is making progress on the incorporation of MPEG compression into the DICOM Standard. We now have a technical expert on MPEG to assist us in our work. The first phase of our work is to determine whether MPEG really offers considerably greater compression ratios and/or performance for Ultrasound cine than Lossy JPEG or JPEG 2000 compression. We have been concentrating on MPEG2 and have found that one of the key issues is the limited capability of most decoders. Most current MPEG2 decoders can only handle certain image frame sizes. We need to investigate this issue further to determine if we want to create a transfer syntax for MPEG2 with restricted allowable image frame sizes.

Relationships to other Standards:

DICOM has cross-representation to JPEG 2000.

 

WG-05 (Exchange Media)

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Chair David Clunie, RadPharm

dclunie@dclunie.com

Date of Last Update: November 26, 2002

Scope:

To develop DICOM standards for interchange media.

Roadmap:

Potential work items:

Short Term Goals:

Current Status:

Current Work Items:

Risks:

DVD:

Flash RAM:

Media device management:

Challenges and Opportunities:

Relationships to other Standards:

An "informal" liaison with OSTA exists to harmonize efforts with respect to UDF, MOD and DVD, though no interaction has taken place with this group since UDF 2.0 was standardized.

 

WG-06 (Base Standard)

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Chair Andrei Leontiev, IDX Systems Corporation

Andrei_Leontiev@idx.com

Date of Last Update: June 12, 2001

Scope:

WG-06 maintains the overall consistence of the DICOM standard. Some of the responsibilities include:

Roadmap:

On-going DICOM Maintenance Process:

Potential work items of other Working Groups:

Potential work items with respect to Workflow Management:

Potential work items with respect to the Structured Reporting:

Potential work items with respect to Conformance:

Short Term Goals:

Current Status:

The following Supplements developed by WG-06 have recently been completed and are in Final Text :

Current Work Items:

Risks:

Challenges and Opportunities:

Relationships to other Standards:

Progress of the IHE initiative is being regularly reviewed by WG-06.

 

WG-07 (Radiotherapy)

Secretariat NEMA

Secretary Stephen Vastagh, NEMA

ste_vastagh@nema.org

Chair David Murray, TomoTherapy Incorporated

dmurray@tomotherapy.com

Date of Last Update: November 12, 2002

Scope:

To develop and maintain radiotherapy information objects for the DICOM Standard and promote their implementation and acceptance within the industry.

Roadmap:

In the next few years, the RT-specific objects in the standard need to be maintained to completely stabilize existing implementations. Extensions to existing objects have been and will be introduced to accommodate new techniques. Ion therapy is being addressed, and work in this emerging area will continue. Another major goal is to address how workflow in the RT department can be enhanced using existing and upcoming DICOM objects and concepts. In conjunction with the Radiation Therapy Section of NEMA, WG-07 is also providing support for the RT Objects Interoperability Clearing House initiative and, also, demonstrations of DICOM in radiotherapy at the AAPM and ASTRO meetings of 2003.

Short Term Goals:

The primary work of WG7 involves maintenance of existing RT-specific DICOM objects, correcting issues discovered during detailed implementation and introducing minor extensions to deal with new techniques and approaches in radiotherapy. A number of Change Proposals are awaiting ratification or under development.

Current Status:

Supplement 11 (RT Image, RT Structure Set, RT Dose, RT Plan) and Supplement 29 (RT Treatment Record objects and Media Support) are part of the DICOM 1999 standard. Work is continuing on Supplement 74 (Radiotherapy General Purpose Worklist Extensions and Calculation Service Model).

Current Work Items:

Several CPs are under discussion. These will extend brachtherapy and external beam therapy, correct some errors and clarify wording. Work is continuing on Supplement 74 (Radiotherapy General Purpose Worklist Extensions and Calculation Service Model). Extension of DICOM to handle ion therapy is being worked on and a draft proposal exists.

Risks:

Implementation of existing standardized objects is well advanced. There is no clearly identifiable risk to achieving short-term goals. Incorporation of workflow concepts into RT may depend on other working groups introducing the concepts needed by RT departments (such as studies distributed over time).

Challenges and Opportunities:

Smooth incorporation of RT procedures into DICOM workflow concepts, in particular Interpretation Worklist and Modality Performed Procedure Step.

Relationships to Other Standards:

RT objects use IEC-61217 for treatment machine descriptions and ICRU concepts for dosimetry. The DICOM patient-based coordinate system (Amendment to IEC 61217, 62C/269) also has a well-defined relationship to the IEC Patient coordinate system. IEC/TR 62266 ("Medical Electrical Equipment - Guidelines for Implementation of DICOM in Radiotherapy") is now published. WG7 is active in review of a new IEC standard under development – IEC 62274 ("Safety of Radiotherapy Record and Verify Systems").

 

WG-08 (Structured Reporting)

Secretariat College of American Pathologists

Secretary John Kilbourne, SNOMED

jkilbou@cap.org

Chair Frank Krickhahn, Siemens

Frank.Krickhahn@siemens.com

Date of Last Update: November 12, 2002

Scope:

To develop and maintain the DICOM Structured Reporting specification, and to collaborate with DICOM working groups and other standards development committees in the development of specialized reports and other documents based on the generic SR specification.

Goals:

Current Status:

Working Group Eight meets quarterly. The meetings usually take place at the College of American Pathologists (CAP) in Chicago.

Additional telephone conferences are scheduled as necessary.

Work Items:

In a close cooperation, DICOM WG-08 supported other DICOM Working Groups in the creation of Structured Reporting-related supplements:

Working Group Eight continued working on Supplement 75 Patient Clinical History. The supplement is planned to be published for Public Comments in October 2002.

Working Group Eight reviewed and created Correction Proposals to correct and clarify the Structured Reporting related parts of the DICOM Standard.

Risks:

Since the assignment of Clinical Codes to DICOM SR Documents is an essential part of the development process of SR related Supplements, the quality of the resulting Supplements as well as the development speed depends on a close co-operation with providers of Coding Schemes used by DICOM SR.

Challenges and Opportunities:

Relationship to Other Standards:

WG-09 (Ophthalmology)

Secretariat American Academy of Ophthalmology

Secretary Flora Lum, M.D.

Co-Chair Lloyd Hildebrand, M.D., American Academy of Ophthalmology

lloyd-hildebrand@ouhsc.edu

Co-Chair Rainer Waedlich, IFA Systems Group

rwaedlich@ifasystems.de

Date of Last Update: January 24, 2001

Scope:

To address all issues relating to imaging and reporting of image-based studies in ophthalmic applications.

Roadmap:

The implementation of ophthalmology relevant objects (e.g. VL, SR, U/S) will be emphasized in eye care environments. Coordinated education and demonstration projects for vendors and users will be essential to get broad adoption of the standard in eye care. Extensions/refinements to existing objects will be introduced to accommodate new techniques. Visual field and corneal topography will be addressed.

Current Work Items:

Risks:

Implementation of existing standardized objects is just beginning. While there has been heightened awareness of DICOM in the vendor and user communities, many major vendors still do not participate in the standard development process or use the standard in their products.

Relationships to other Standards:

WG-09 anticipates working closely with SNOMED in the development of structured terminology for use in Structured Reporting object for ophthalmic applications.

 

WG-10 (Strategic Advisory)

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Co-chair Cor Loef, Philips Medical Systems

Cor.loef@philips.com

Co-chair Joel Chabriais, Societe Francaise de Radiologie

joel.chabriais@nck.ap-hop-paris.fr

Date of Last Update: November 12, 2002

Scope:

To consider issues and opportunities related to the strategic evolution of DICOM; to provide liaison to other standards developing organizations; to review standards and technology in healthcare, biomedical imaging, commerce, telecommunications, and informatics; and to develop and maintain the long-term strategic plan of the DICOM Standards Committee.

Roadmap:

Short Term Goals:

Current Status:

Current Work Items:

See Short Term Goals

Risks:

Challenges and Opportunities:

Challenges:

Relationship to Other Standards:

 

WG-11 (Display Function Standard)

Secretariat NEMA

Secretary Howard Clark, NEMA

how_clark@nema.org

Chair Brad Hemminger, University of North Carolina

bmh@ils.unc.edu

Date of Last Update: March 28, 2002

Scope:

To develop a display function standard and DICOM services related to image presentation objects.

Roadmap:

  • Advanced Presentation State, and Structured Display, which is combining presentation state with structured reporting and potentially hanging protocols.
  • Short Term Goals:

    Current Status:

    Current Work Items:

    Risks:

    Short Term

    Long Term

    Challenges and Opportunities:

    Challenges

    Opportunities

    Relationships to Other Standards:

     

    WG-12 (Ultrasound)

    Secretariat NEMA

    Secretary Richard Eaton, NEMA

    ric_eaton@nema.org

    Chair David Heaney, McKesson MIG

    dheaney@alitech.com

    Date of Last Update: Nov. 23, 2002

    Scope:

    To develop extensions to DICOM that are specific to the needs of the ultrasound imaging community. This includes all aspects of ultrasound acquisition related workflow and generated data, such as single and multi-frame images, 3D/4D images, waveforms, and reports of measurements and other evidence.

    Roadmap:

    Work items related to ultrasound Procedure Reports:

    Work item related to spatially 3 dimensional ultrasound acquisition and processing:

    Work item related to ultrasound workflow:

    Work items related to ultrasound removable media:

    Work item related to ultrasound waveform data:

    Short Term Goals:

    Current Status:

    Risks:

    Challenges and Opportunities:

    Relationships to other Standards:

     

    WG 13 (Visible Light)

    Secretariat European Society of Cardiology

    Secretary Pr. Dr. Med. Rudieger Simon

    Co-Chairman Emmanuel Cordonnier ETIAM (pro tem)

    emmanuel.cordonnier@etiam.com

    Co-Chairman Jan Rorive, SONY (pro tem)

    jan.rorive@eu.sony.com

    Date of Last Update: June 25, 2002

    Scope:

    To extend the DICOM standard beyond still Visible Light images, with still and motion color images produced by endoscopes, microscopes, or photographic cameras.

    Roadmap:

    Short Term Goals:

    Current Status:

    Future Work Items:

    Risks:

    Challenges and Opportunities:

    Relationships to other Standards:

     

    WG-14 (Security)

    Secretariat NEMA

    Secretary Howard Clark, NEMA

    how_clark@nema.org

    Chair Lawrence Tarbox, Siemens Corporate Research, Inc.

    larry.tarbox@scr.siemens.com

    Date of Last Update: April 30, 2002

    Scope:

    To develop extensions to DICOM that address the technical details of providing secure information exchange.

    Roadmap:

    1. Local and governmental regulations dictating the level of security needed;
    2. Areas where security holes exist in DICOM with respect to meeting that level of security in DICOM transactions.
    1. Utilizing existing standards wherever possible;
    2. Jointly developing standards where appropriate;
    3. Developing DICOM-specific standards only if no appropriate alternative is available.

    Short Term Goals:

    Current Status:

    Current Work Items:

    Risks:

    Challenges and Opportunities:

    Relationships to other Standards:

    WG-15 (Mammography and CAD)

    Secretariat American College of Radiology

    Secretary Melody Ballesteros, ACR

    MelodyB@acr.org

    Co-Chairman Dr. Carl Vyborny, ACR/LaGrange Memorial Hospital

    CVYBES@aol.com

    Co-Chairman Janet E. Keyes, R2 Technology, Inc.

    jkeyes@r2tech.com

    Date of Last Update: November 12, 2002

    Scope:

    To develop extensions to DICOM to support digital mammography and the structured reporting of Computer-Aided Detection / Diagnosis (CAD) results.

    Roadmap:

    The following are potential work items with respect to Structured Reporting:

    The following are potential work items with respect to Image IODs:

    Risks:

    Short Term Goals:

    Current Status:

    Current Work Items:

    Challenges and Opportunities:

    Relationships to other Standards:

     

    WG-16 (Magnetic Resonance)

    Secretariat NEMA

    Secretary Howard Clark

    How_Clark@nema.org

    Chair Kees Verduin, Philips Medical Systems

    kees.verduin@philips.com

    Date of Last Update: April 18, 2002

    Scope:

    A new MR object has been developed that contains a more extensive set of descriptive attributes and makes use of a new multi-frame mechanism suitable not only for MR but also for other modalities. It is currently also adopted by CT.

    Roadmap:

    WG-16 will focus on the testing and promotional aspects as well on the issues related to practical implementation into valid DICOM objects.

    After this, members will request a work item for Presentation of Spectroscopy Data with WG11.

    Short Term Goals:

    Current Status:

    Current Work Items:

    Risks:

    Challenges and Opportunities:

    Challenges:

    Opportunities:

     

    WG-17 (3D)

    Secretariat NEMA

    Secretary Richard Eaton, NEMA

    ric_eaton@nema.org

    Chair Doug Sluis, ATL

    doug.sluis@philips.com

    Date of Last Update: June 10, 2002

    Scope:

    To extend the DICOM Standard with respect to 3D and other multi-dimensional data sets that relate to real world domains of space, time, and physical properties, both measured or derived. The general classes of DICOM capabilities required are:

    Representative applications include: connectivity for 3D and 4D imaging modalities; data fusion; tissue classification and segmentation; Computer Assisted Detection; quantification; treatment planning; and intra-operative applications/Image Guided Therapy.

    Roadmap:

    Short Term Goals:

    Current Status:

    Current Work Items:

    Risks:

    Challenges and Opportunities:

    Relationships to Other Standards:

     

    WG-18 (Clinical Trials and Education)

    Secretariat National Cancer Institute

    Secretary Edward Staab, NIH

    staabe@mail.nih.gov

    Co-Chair Curtis Langlotz, University of Pennsylvania

    langlotz@rad.upenn.edu

    Co-Chair Andrew Kraus, BioCor

    akraus@biocor.com

    Date of Last Update: November 20, 2000

    Scope:

    To extend the DICOM Standard with respect to clinical trials information and the storage of images for educational purposes.

    DICOM WG-18 was first convened in 1999 to address issues unique to the use of images in clinical trials and education. The working group elected to focus first on clinical trials before devoting significant time to education and imaging teaching files.

    In its initial meetings, the Working Group determined that there are several shortcomings of the current DICOM standard when it is used in the context of clinical trials. First, there are no standard methods for "scrubbing" patient-identifying information from the DICOM header while retaining identifiers to reestablish the patient’s identity for audit purposes. Second, a variety of clinical trials attributes are missing, including the ability to capture a unique subject identifier, the protocol for which an image was obtained, and the sponsor of the clinical trial. Third, even when some of this information is stored in optional fields, the storage arrangement varies according to vendor and frequently cannot be displayed on off-the-shelf workstations. Fourth, certain common imaging parameters that are essential for the conduct of clinical trials, such as MR echo time and repetition time, are not stored in consistent locations.

    Roadmap:

    The Working Group believes that the establishment of standard optional attributes for clinical trials information would assist organizations that conduct clinical trials in which images are a key component. The Working Group hopes that the establishment of DICOM standards for clinical trials information would lead to an increasing role for DICOM in submissions to the Food and Drug Administration and the National Cancer Institute, as well as other organizations that support or regulate research on medical imaging.

    Short Term Goals:

    The Working Group has determined that it is desirable to add optional attributes to existing DICOM Image Storage Information Object Definitions (IODs) that will allow standard locations for certain basic information for clinical trials, as well as certain modality specific attributes (e.g., MR TR/TE) that are commonly encountered in clinical trials images. A work item has been approved for that purpose.

    Current Work Items:

    The DICOM Clinical Trials WG-18 has determined that it is desirable to add optional attributes to existing DICOM Image Storage IODs. There are two groups of attributes missing:

    It is proposed to create a supplement describing the additional attributes and the information model supporting them.

    Challenges and Opportunities:

     

    WG-19 – This working group is not currently active.

     

    WG-20 (Integration of Imaging and Information Systems)

    Secretariat NEMA

    Secretary Howard Clark, NEMA

    how_clark@nema.org

    Chair Fred Behlen, ACR

    fbehlen@laitek.com

    Date of Last Update: August 9, 2002

    Scope:

    To develop DICOM and HL7 standards for image-related information for areas where the consistent use of HL7 and DICOM is of prime concern, and the coordination and mutual education and understanding between the HL7 and DICOM organizations and their technical committees/working groups.

    Roadmap:

    Short Term Goals:

    Current Status:

    Current Work Items:

    Risks:

    Challenges and Opportunities:

    Relationship to Other Standards:

     

    WG-21 (Computed Tomography)

    Secretariat NEMA

    Secretary Howard Clark, NEMA

    how_clark@nema.org

    Chair Stephen Metz, GE Medical Systems

    stephen.metz@med.ge.com

    Date of Last Update: November 12, 2002

    Scope:

    To develop an extended CT image object to support the many technological and clinical advances in Computed Tomography. In particular, the increase in the number of slices in an exam and the real-time capabilities of CT technology makes it desirable to create a new DICOM object with a multi-frame capability. Consistency with the MR Multi-Frame IOD under specification is important as many workstations support both CT and MR applications. Consistency with the new XA Multi-frame IOD is also important so that Cardiology or Angiography applications can benefit from both CT and X-ray acquisitions.

    Roadmap:

    Short Term Goals:

    Current Status:

    Current Work Items:

    Challenges and Opportunities: