What

1
Whats New in DICOM its been a very busy year!

• Robert Horn, Agfa HealthcareHarry Solomon, GE
  Medical Systems
• RSNA 2003

2
Multi-frame MR/CT

• Enhanced MR Image, MR Spectroscopy, CT Image
• More rigorous attribute definition (less need for
  private data elements)
• Multi-frame object to support 1000 image studies
• Dynamic image header supports attributes changing
  during acquisition
• Dimensions allow multiple views of data
• Functional imaging with color and real-world
  value mapping
• File size flexibility through concatenations
• MR in 2003 Standard, CT in Ballot

3
Chinese / Unicode

• Official DICOM support for Unicode and GB18030
  (PRC standard)
• GB 18030 character set is harmonized with Unicode
  
• Objects in Unicode do not need character set
  switching (and there is no mechanism for it)
• Japanese uses JIS X 0208/0212 Katakana/Kanji,
  Korean uses KS X 1001 Hangul/Hanja, in accordance
  with national policies
• W. Europe has installed base of IR-100 (Latin 1),
  but no formal impediment to using Unicode

4
DVD / JPEG2000

• JPEG2000 is now an official compression method
  under DICOM
• Wavelet based, up to 16-bit pixel depth
• Lossless and lossy
• DVD is now an official exchange medium under
  DICOM
• Can use any DVD flavor (-R, -RW, R, RW, -ROM)
• Reader must support JPEG or JPEG2000 lossy
  compression

5
More and More SR Templates

• Done
• Ob-Gyn, Vascular, and Cardiac Ultrasound
• Cath Lab Procedure Log, Hemodynamics, and Final
  Report
• Breast Imaging Report
• In Process
• Fetal/Pediatric Echocardiography
• Intravascular Ultrasound
• Quantitative Arteriography and Ventriculography
• CT/MR Angiography

6
Conformance

• Major enhancement to Part 2 Conformance based on
  experience using Conformance Statements to
  prepare for and troubleshoot DICOM installations
• 1 page Executive Summary
• Documentation details for behavior at the
  attribute level
• New sections on error handling, coded
  terminology, security
• Example Conformance Statements reflecting real
  types of systems
• Modality with MWL, MPPS, GSPS, Print w/P-LUT, and
  Storage Commitment
• RIS as MWL and MPPS Service Class Provider
• Multi-modality Workstation, including Media
  Exchange
• Print Server
• Archive

7
Configuration Management

• Introduces use of LDAP with a standard LDAP
  schema to maintain configuration parameters of
  DICOM devices
• LDAP query to retrieve configuration from LDAP
  server
• Device obtains its own parameters, and those of
  communication partners (addresses, capabilities)
• Also uses DHCP, DNS, and NTP to cover
• Installation and auto-configuration of a new
  device
• Portable, mobile devices
• Mixed networks with legacy equipment
• Synchronized time across devices
• Objective to decrease service cost while
  maintaining reliable standard-based configuration
  management
• Currently Frozen for Trial Use, Ballot 1Q2004

8
Web Access to Images

• Web Access to DICOM Persistent Objects (WADO)
• Joint project of DICOM and ISO
• Standard HTTP URL to web image server
• Images returned as vanilla JPEG, or as
  MIME-encapsulated DICOM
• Can request entire image, or just ROI
• Currently in Ballot

9
Image Registration

• Composite Objects that support multi-image
  alignment
• Transform based
• Matrix operation to map one Frame of Reference to
  another
• Frame of Reference may be synthetic (e.g.,
  Talairach Brain Atlas)
• Fiducial based
• Fiducial points identified in image, or in 3-D
  Frame of Reference space
• May be used with projection images
• Facilitates further image processing, especially
  multi-modality image fusion and image pasting
  applications
• Ballot closed December 2, 2003

10
Relevant Patient Info Query

• Address need for more detailed patient clinical
  history affecting image acquisition or
  interpretation
• Risk factors, chronic diseases
• Detailed allergies, medical problems
• Prior findings for follow-up exam
• DICOM mechanism to obtain extended patient info
• Query (C-FIND) message model
• Patient ID is Query Key
• Query Response has patient info in Structured
  Report format
• Specific and general queries
• Breast imaging, cardiac, general
• Ballot closed December 2, 2003

11
Image-based Specialties

• New work under way in Ophthamology (WG-9)
• Ophthalmic Photography (fundoscopy, fluorescein
  angiography)
• New working group for Dentistry (WG-22)
• Media exchange on CD
• New work under way in Endoscopy (WG-13)
• Visible Light Video (endoscopy, microscopy,
  photography)
• MPEG video image encoding in DICOM

12
Coming soon

• Hanging protocols
• Radiotherapy workflow
• Non-radiology workflow
• Advanced X-ray angiography
• Advanced ultrasound
• 3-D and n-D
• Media creation service (CD burner)
• Color consistency
• Parts 3, 6, and 16 tables published in XML

13
http//dicom.nema.org

• DICOM home page now includes presentations and
  tutorials
• Especially new MR IOD and Structured Reporting