Hammersmith PACS DICOM Made Easy

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DICOM Ved Bo Sørensen Medico Teknisk Afd.
Århus Amt
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Formål / Hensigt

• Efter foredraget ved I noget om
• DICOM definition DICOM historie
• Hvad - og hvor/hvorfor bruges DICOM
• Værktøjer og praktisk brug

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Hvad er DICOM ?

• Digital
• Imaging and
• COmmunication in
• Medicine

• Standard der anvendes til udveksling af billeder
  og relaterede data !!
• Udviklingen af standarden startede i 80erne
• Demokratisk udvikling(Mindre del anvendes ofte
  store dele anvendes sjældent)

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Hvad skal vi bruge DICOM til ?

• Vi skal sikre at udstyret kan snakke sammen !
• DICOM skal overvejes ved- nyindkøb af udstyr
  der skal kommunikere billeder- udvidelse af
  funktionalitet på udstyr- opsætning af
  kommunikation mellem eksisterende
  udstyr/systemer
• I dag hovedsagelig begrænset til udstyr til
  ultralyd, røntgen, MR

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DICOM...
Er en GLOBAL STANDARD for kommunikation,
udviklet I samarbejde mellem ACR (American
College of Radiology) NEMA (National Electrical
Manufacturers Assoc.) ESC (European Society of
Cardiology) ACC (American College of
Cardiology) SFR (Société Française de
Radiology) DRG (Deutschen Röntgengesellschaft) AAO
(American Academy of Ophthalmology) IRS (Italian
Radiology Association) AAD (American Academy of
Dermatology) CAP (College of American
Pathology) JIRA (Japaneese Radiology Vendors
Association)COCIR (European Radiology Vendors
Association) And 25 plus vendors
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• DICOM 3.0 approved October 93
• 20 Vendors at the 93 DICOM RSNA
  Demonstration
• 40 Vendors at the 94 and 95 DICOM RSNA
  Demonstrations
• More than 100 Vendors at RSNA 96RSNA 97
  through 99-Too many to count !

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Standarder I Sundhedssektoren
Sundhed styrelsen
Praktiserende læger
Forsikring
Hospital
EDIFACT
HIS
CPR
Laboratorier
Radiologi
Kardiologi
ICU
Apotek
HL7
Onkology (RT)
O P Kirurgi
Klinikken
DICOM
Patologi
Teleradiologi Til klinikken
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Standards Domain of Application
DICOM
Both the PACS and the RISneed to be bilingual
Image Information Manager
PACS
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DICOM spænder over størstedelen af den
medicinske digitale billedproduktion
DICOM overfører ikke kun billeder, men også -
Therapy Plans, Structures, etc. - Snart DICOM
Waveforms - Structured Reports
DICOM overfører ikke kun Radiologiske billeder,
men også - Cardiology (X-Ray Angio, US, NM) -
Oncology (RT Portal images) - Dentistery (X-ray
Intra-Oral) - Pathology, Endoscopy, Microscopy,
Optalmology, etc.
2001 Advanced MR, Advanced CT, ..
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Networks in Radiology and Care Units with Cluster
Archiving
CT, MR, NM, US, Digitizer, CR, digital X-ray
CT, MR, NM, US, Digitizer, CR, digital X-ray
Local Area Network
DICOMSTORAGE
DICOMSTORAGE
Imaging Equipment
Imaging Equipment
DICOM SERVICES USED
Cluster Archive
Cluster Archive
DICOMQUERY/RETRIEVE
Care Unit
ISDN Link or Dial-Up
DICOM STORAGE
Analysisor Review Workstation
Analysisor Review Workstation
DICOMSTORAGE
Remote WS
A DICOM Network is the common foundation both
inside Radiology and for Teleradiology
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Hvor bruges DICOM?
?
?
?
Procedure Step
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DICOM Services

• Storage Service
• Query/Retrive Service
• Print Service
• Modality Worklist Service
• Performed Procedure Step Service
• Storage Commitment Service
• Printer Configuration Service

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DICOM Modality Worklist

• Provides integration of modalities with Radiology
  Information Systems and PACS

• Automatic download of patient demographics, study
  identifiers, scheduling, procedure into a
  modality.

Increases operator productivity and avoids typing
errors First Products available since 1997, Broad
Availability in 1998
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DICOM Storage Commitment

• Enables an image source to obtain the commitment
  that images have been stored for safekeeping.
• Modality image deletion is only allowed if
  storage has been committed

First Products available in 1999
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DICOM Performed Procedure Step

• Allows Modalities to Upload in HIS/RIS/PACS of
  Acquisition Administrative Data (Proc.
  Started/Complete, Contrast, Dose, etc.).

• Complement to Modality W/L. Increases Overall
  Radiology Department Productivity.

Standard Approved early 1998Products in
1999/2000 time frame.
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4 DICOM Service Classes for Integration
RIS
PACS Archive

• A Closed Loop
• Match Procedure with Order
• Update IS Scheduling
• Support Billing Based on MPPS

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DICOM Conformance Statement

• Bruges til at parre udstyrs SOP klasser
• Application DataFlow Diagram

host, ip, port
DICOMheader
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Compare DICOM Conformance Statements
CT ScannerConformance Statement
WorkstationConformance Statement
1-CT STORAGE SCP 2-QUERY SCU 3-RETRIEVE
SCU 4-MR STORAGE SCP 5- BASIC PRINT SCU
1-CT STORAGE SCU 2-QUERY SCP 3-RETRIEVE
SCP 4-MODALITY WORKLIST SCU
SCU Service Class USER SCP Service Class
PROVIDER
Matching DICOM Service ClassesThe necessary step
to find what will work
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DICOM Troubleshuting

• Manglende funktionalitet -
• Start med at kigge i loggen
• Check Conformance statements
• Capture netværkskommunikation
• Analysér netværkskommunikation med DICOM
  analysatorer
• Tilkald hjælp

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Integration of PACS and HIS/RIS

• The solution is in sight ? RSNA and HIMSS work
  with a group of leading HIS, RIS, PACS and
  Modality Vendors to support a joint Initiative
  called IHE.

• Integrating the Healthcare Enterprise is
  resulting in a series of demonstrations of
  standards-based integration steps, starting end
  of 1999
• IHE is not a new standard. It proposes a
  technical framework for integrating DICOM and HL7
  standard transactions across modalities, PACS,
  RIS and HIS www.rsna.org/ihe

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Agfa-Gevaert N.V.Algotec Systems LTD.Analogic
CorporationCanon Medical SystemsCedara Software
(formerly ISG Technologies)Cerner
CorporationCSIST (Taiwan)DeJarnette Research
Systems, Inc.Direct Radiography Corp., a Hologic
CompanyeMed Technologies CorporationFuji
Medical Systems U.S.A., Inc.GE Medical
SystemsIDX Systems CorporationMerge
Technologies Inc.MitraPhilips Medical
SystemsPicker International, Inc.RASNA Imaging
Systems Siemens Medical Systems,
Inc.SoftmedicalStorCOMM, Inc.Toshiba Medical
SystemsVital Images, Inc.
47 Products demonstrated by 23 companies
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IHE at RSNA 2000 HIMSS 2001 ECR 2001
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IHE Integration Profiles