As shown in Figure PPPP.1-1, the DICOM Real-Time Video (DICOM-RTV) communication is used to connect various video or multi-frame sources to various destinations, through a standard IP switch, instead of using a video switch. In the future, the equipment producing video will support DICOM-RTV natively but it is anticipated that the first implementations will rely on the use of converters to create a DICOM-RTV stream from the video stream (e.g., SDI) and associated metadata coming from information systems, through existing mechanisms (e.g., DICOM Worklist). Such converters have to be synchronized with the Grand Master which is delivering a very precise universal time. Similarly, the video receivers (e.g., monitors) will be connected to the central switch via a converter which has also to be synchronized via the Grand Master. The different DICOM-RTV streams can be displayed, recorded, converted or combined together for different use cases. The medical metadata in the DICOM-RTV streams can be used to improve the quality of the whole system, as explained in the following use cases.
As shown in Figure PPPP.1-2, the DICOM Real-Time Video stream is comprised of typically three different flows ("essences") for respectively video, audio and medical metadata information, using the intrinsic capability of IP to convey different flows on the same medium, multiplexing three kinds of blocks. There will be thousands of blocks for each video frame, hundreds for each audio sample and one for the medical metadata associated to each video frame, respectively represented as "V" (video) , "A" (audio) and "M" (metadata) on the Figure PPPP.1-3, which is the network view of the real-time streaming.
