DICOM PS3.17 2024b - Explanatory Information

TTTT.3.2 Use Case 2: Longitudinal Lesion Tracking

This use case proposes a workflow, and the use of a DICOM Structured Report for longitudinal lesion tracking of dermoscopic images.

In dermatology, successive images of a skin lesion at different time points are compared to detect suspicious lesions. Monitoring of lesions may be short-term or long-term. Clinical photography and dermoscopy can both be used for longitudinal lesion tracking. However, comparison requires images from the same modality. The longitudinal tracking of images using dermoscopy is often termed sequential digital dermoscopy.

TTTT.3.2.1 Potential workflow for the acquisition of lesion tracking information


  1. The user displays a dermoscopic image that requires longitudinal tracking on an image display / evidence creator actor and invokes a lesion tracking reporting window (see Figure TTTT.3-3).

  2. The user invokes a lesion tracking dialogue box (e.g., by right mouse click) and selects:

    1. New Lesion when there is no existing skin lesion label and will input a unique skin lesion label (e.g., Lesion_1, L1) for the patient.

    2. New reporting on existing lesion when there is an existing skin lesion label from a previous imaging study or a skin lesion label has been assigned when linking dermoscopic images to regional image. The lesion tracking dialogue box will contain a software generated list of skin lesion labels (e.g., New report on Lesion 1, New report on Lesion 2, New report on Lesion 3, etc.).

  3. The user inputs information via the lesion tracking reporting window (see Figure TTTT.3-3) for the currently displayed dermoscopic image. This information may include time point descriptor (e.g., baseline/follow-up), long diameter of lesion, and short diameter lesion. Other information may be derived (e.g., sum of diameters). Other information may auto populate (e.g., study date).

  4. The user inputs information for one or more lesions (Steps 2 and 3).

  5. After completion of data entry, the user will save the data entry which will invoke the creation of a DICOM Structured Report object for the study.

Potential Lesion Tracking Reporting Window

Figure TTTT.3-3. Potential Lesion Tracking Reporting Window

DICOM PS3.17 2024b - Explanatory Information