NN.7 Specimen Data in Pathology Imaging Workflow Management

Workflow management in the DICOM imaging environment utilizes the Modality Worklist (MWL) and Modality Performed Procedure Step (MPPS) services. Within the pathology department, these services support both human controlled imaging (e.g., gross specimen photography), as well as automated slide scanning modalities.

While this section provides an overview of the DICOM services for managing workflow, the reader is referred to the IHE Anatomic Pathology Domain Technical Framework for specific use cases and profiles for pathology imaging workflow management.

NN.7.1 Modality Worklist

The contents of the Specimen Module may be conveyed in the Scheduled Specimen Sequence of the Modality Worklist query. This feature allows an imaging system (Modality Worklist SCU) to query for work items by Container ID. The worklist server (SCP) of the laboratory information system can then return all the necessary information for creating a DICOM specimen-related image. This information includes patient identity and the complete slide processing history (including stain applied). It may be used for imaging set-up and/or inclusion in the Image SOP Instance.

NN.7.1.1 MWL for Whole Slide Imaging

In addition to the Specimen Module attributes, the set up of an automated whole slide scanner requires the acquisition parameters such as scan resolution, number of Z-planes, fluorescence wavelengths, etc. A managed set of such parameters is called a Protocol (see PS3.3), and the MWL response may contain a Protocol Code to control scanning set up. Additional set-up parameters can be passed as Content Items in the associated Protocol Context Sequence; this might be important when the reading pathologist requests a rescan of the slide with slightly different settings.

NN.7.2 Modality Performed Procedure Step

When scanning is initiated, the scanner reports the procedure step in a Modality Performed Procedure Step (MPPS) transaction.

Upon completion (or cancellation) of an image acquisition, the modality reports the work completed in an update to the MPPS. The MPPS can convey both the Container ID and the image UIDs, so that the workflow manager (laboratory information system) is advised of the image UIDs associated with each imaged specimen.