Debriefing on DICOM Standard of China

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Debriefing on DICOM Standard of China
Goldisc DICOM Key Laboratory of UESTC Chengdu
Goldisc UESTC Multimedia Technology Co.,
Ltd. University of Electronic and Science
Technology of China(UESTC) March,2011 Beijing
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Main contents

• Introduction to drafting standard
• The progress of Standard staffing
• Introduction on Standard submission draft
• The clinical application of the DICOM standard
• Future work

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1 Introduction to drafting standard

• Background
• Health Standards Board authorized the
  University of Electronic Science and Technology
  of China(UESTC) and Chengdu Goldisc UESTC
  Multimedia Technology Co., Ltd to complete the
  work of drafting the DICOM Standard of China,
  which has been listed into the projects of 2009
  of Health Standards Board.NO.2009-16-01.
• The aim
• 1. Through the draft and application of the
  DICOM standard of China, we want to realize the
  ability of processing information in Chinese in
  some large medical equipments. Especially in some
  key process for PACS, such as the input of image
  information, image processing, the transmission
  of images, image archiving and the films print.
• 2. Add DICOM standard of China to the
  National DICOM standard, and make the DICOM
  standard of China become a major part of the
  national one.
• The procedure for standard drafting
• (1) As the organizational units and main
  drafting units of the DICOM standard of China,
  UESTC and the Chengdu Electronic Science and
  Technology Multimedia Technology Co., Ltd.
  conducted researches on National DICOM standard
  from 1998, at the same time, they set up a work
  group. They issued the Draft Standard in 2006.
• (2) The work group who worked for CIMICS(China)
  made a comprehensive survey on the structure of
  PACS in medical institutions in China, and made a
  evaluation on the application of National DICOM
  standard in China's medical industry. They
  establish the basic framework for the Draft
  Standard, and conducted an extensive clinical
  testing.
• (3) They held Experts forums to discuss and
  modify the Draft Standard from 2008 to 2010.
  Finally they completed and submitted the Draft of
  DICOM standard of China on December 2010.

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1 Introduction to drafting standard

• The principle for drafting
• 1. It can promote the medical images transfer
  ,archive and output correctly in Chinese
  environment, and ensure the consistency of
  medical information.
• 2. Reflect the Universality and Applicability
• The national DICOM Standard specify the image
  format and communication process, but it doesnt
  give the corresponding solutions on supporting
  and affecting extension in character set, data
  types and service types. The subject is focusing
  on these problems, propose the solution, and take
  university and applicability into consideration.
  And on this basis, we provide compliance test of
  film print and WORKLIST class for DICOM Standard.
  We promote to realize the application of the
  DICOM standard in China and the capacity of
  supporting Chinese.
• At the same time, the standard refer to the
  Japanese and Korean DICOM standard, propose a
  direct way and a composite approach ,The two
  kinds of processing methods maximized the
  standard universality and applicability.

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Main contents

• Introduction to drafting standard
• The progress of Standard staffing
• Introduction on Standard submission draft
• The clinical application of the DICOM standard
• Future work

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2 The progress of Standard staffing

• The project is in first reading state
• Finished works
• Completed the standard setting, Completed the
  standard draft in the form of Technical
  Guidelines of Health standard
• Completed the compile of the documents
• Validation reports in standard methods(test
  reports from 3 hospitals, and equipment
  manufacturers ,such as agfa CR, fuji CR)
• Completed the diagram for summary the
  consultation(18 copies sent and 12 copies
  received)
• Completed the condition of funds consumption
  diagram

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Main contents

• Introduction to drafting standard
• The progress of Standard staffing
• Introduction on Standard submission draft
• The clinical application of the DICOM standard
• Future work

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3 The introduction of the submit version of the
Standard

• (1) Range
• This standard specifies the "China
  DICOM standard " character set standard and DICOM
  character set which is associated with the
  service class specifications, including format
  and communication, and at the same time we
  provide the description and methods for
  compliance test.
• (2) Normative Reference
• GB/T 2312 Guo-Biao Tuijian 2312
• GBK Guo-Biao Kuozhan
• GB 18030-2000 Guo-Biao 18030-2000
• DICOM Standard(2009)
• (3) Terminology and Definition
• DICOM (Digital Imaging and Communications in
  Medicine)
• PACS (Picture Archiving and Communication
  Systems)
• RIS (Radiology Information System)
• HIS (Hospital Information System)
• (4)Character Set solutions
• Chinese character set adopt
  GB2312(including GBK 12345 and GBK13000) or GBK
  or GB18030, we recommend GB18030.

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3 The introduction of the submit version of the
Standard

• (5) The Chinese rule for DICOM standard of
  China(Extended character set and the rules)
• DICOM application entity can use extended
  character set to supply or replace the default
  character set. Extended character set is defined
  by attribute of Tag(0008,0005),Chinese character
  set defined as follows two ways
• Direct way
• (0008,0005) domain for GB18030 or GBK or
  GB2312.The methods for processing the name and
  long text is as follows
• a) the method for processing name
• The format definitionName(in PINYIN)
  Chinese name English (Name(in PINYIN) and
  English name can be omitted)
• For example ChenShengBo???
• Chinese character internal code 0x43
  0x68 0x65 0x6E 0x5E 0x53 0x68 0x65 0x6E 0x67 0x42
  0x6F 0x3D 0xB3 0xC2 0xCA 0xA4 0xB2 0xA8 0x3D
• b) the method for processing long text
• For example
• The first line.
• The second line.
• Chinese character internal
  code(GB18030?GB2312 character code ) such as
• 0xB5 0xDA 0xD2 0xBB 0xD0 0xD0 0xCE 0xC4
  0xD7 0xD6 0xA1 0xA3 0x0D 0x0A
• 0xB5 0xDA 0xB6 0xFE 0xD0 0xD0 0xCE 0xC4
  0xD7 0xD6 0xA1 0xA3 0x0D 0x0A

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3 The introduction of the submit version of the
Standard

• (5) The Chinese rule for DICOM standard of
  China(Extended character set and the rules)
• Composite Patten
• (0008,0005)domain is ISO 2022 GBK or ISO
  2022 GB2312 or ISO 2022 GB18030, list in the
  following form

character set (0008,0005) domain Internal Code ESC Sequence(Hexadecimal) ESC Sequence(character)
GB2312 \ISO 2022 GB2312 ASCII 0x1B 0x28 0x42 ESC ( B
GB2312 \ISO 2022 GB2312 Chinese characters (Double byte , most significant digit is 1 for every byte) 0x1B 0x24 0x29 0x41 ESC ) A
GBK \ISO 2022 GBK ASCII 0x1B 0x28 0x42 ESC ( B
GBK \ISO 2022 GBK Chinese characters (Double byte , most significant digit is 1 for every byte) 0x1B 0x24 0x29 0x41 ESC ) A
GB18030 \ISO 2022 GB18030 ASCII 0x1B 0x28 0x42 ESC ( B
GB18030 \ISO 2022 GB18030 Chinese characters (Double byte , most significant digit is 1 for every byte) 0x1B 0x24 0x29 0x41 ESC ) A
At the same time, in order to content with the
specification of number of DICOM data bytes in
even, we specify that every row must begin in
ASCII and end in ASCII either.
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3 The introduction of the submit version of the
Standard

• (5) The Chinese rule for DICOM standard of
  China(Extended character set and the rules)
• Composite Patten
• a) the method for processing name
• The format definition Name(in PINYIN)
  Chinese name English (Name(in PINYIN) and
  English name can be omitted)
• For example ChenShengBo???
• Chinese character internal code
• 0x43 0x68 0x65 0x6E 0x5E 0x53 0x68 0x65
  0x6E 0x67 0x42 0x6F 0x3D 0x1B 0x24 0x29 0x41
  0xB3 0xC2 0xCA 0xA4 0xB2 0xA8 0x1B 0x28 0x42 0x3D
  0x20
• b)the method for processing long text
• For example
• 1. The first line
• 2. The second line
• 3. The third line
• Chinese character internal code(1.2.3 are ASCII
  code ) such as
• 0x31 0x2e 0x1B 0x24 0x29 0x41 0xB5 0xDA 0xD2
  0xBB 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3 0x1B
  0x28 0x42 0x0D 0x0A
• 0x32 0x2e 0x1B 0x24 0x29 0x41 0xB5 0xDA
  0xB6 0xFE 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3
  0x1B 0x28 0x42 0x0D 0x0A
• 0x33 0x2e 0x1B 0x24 0x29 0x41 0xB5 0xDA
  0xC8 0xFD 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3
  0x1B 0x28 0x42 0x0D 0x0A 0x20

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3 The introduction of the submit version of the
Standard

• (5) The Chinese rule about DICOM standard of
  China(Impact the data type of DICOM)

LO(Long String)
SH(Short String)
PN(Name)
LT(Long Text)
ST(Short Text)
UT(Unconstrained Text)
VR name Definition Character instruction set Value length
LO String that are filled with spaces in the first place or the end. String code 5CH("\" in ISO-IR) cannot appear, because it is the separator of values of multi-valued data elements. Besides ESC, long string cannot contain control character B. The definitions of the default character instruction set and "/" are in(0008,0005) 64 bytes(maximum), Chinese characters occupy two bytes
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3 The introduction of the submit version of the
Standard

• (5) The Chinese rule for DICOM standard of
  China(DICOM server class that are impact by
  extended character set)
• This standard focus on input source DICOM
  WorkList service class ?output source DICOM Print
  service class and DICOM Image format service
  class

Property Name TAG Property Description
Patient Name (0010,0010) Patient's full name
Patient ID (0010,0020) The original identification number from hospital or patient's code
The publisher of Patient ID (0010,0021) The medical establishment who publish the patients ID
Other Patient ID (0010,1000) other identification number or code which was used to identify patients
Other Patient Name (0010,1001) Other name that can identify patient
The name when patient was both (0010,1005) Patient's birth name
The name of the patients mother when she was born (0010,1060) Patient' s mother's birth name
Medical record locator (0010,1090) Identification number of existing medical records used to locate patients
Relationship with the Patient Module
Patients identity Module
Statistic of patient Module
Patients medical Module
Consultation relationship Module
Consultation identity Module
Consultation state Module
Consultation acceptance module
Booking process steps module
The requested process modules
Image service request module
DICOM WorkList service class
DICOM Print service class
DICOM image format service class
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3 The introduction of the submit version of the
Standard

• (6) Conformance Testing for DICOM standard of
  China
• Conformance Testing of WORKLIST
• a) The SCU port request Protocol Data
  Unit(PDU) when it build C-FIND, it must use
  character set TAG(0008,0005) which are defined
  in 5.1 in DATA ELEMENT of PDUs message segment.
• b) After SCP port receive C-FIND request PDU
  from SCU port, when detect SCU port special
  character set which are defined in 5.1, and then
  package the character set into the data segment
  of PDU which response to C-FIND(TAG(0008,0005)),
  in addition, it should meet the corresponding
  rule for package the standard character set when
  package the data of (VALUE REPRESENTAION)
  SH,LO,ST,PN,LT,UT.
• c)After SCP port receive C-FIND request PDU
  from SCU port, it will detect the data segment
  TAG(0008,0005) of response PDU. If the data which
  are defined in 5.1, SCU port will resolve this
  data in corresponding package rules when it
  detect the data which equal to (VALUE
  REPRESENTATION) SH, LO,ST,PN,LT,UT. If the data
  equal to TAG(0008,0005) is not the character set
  which is defined in 5.1, we think that the SCP
  port is not satisfied with DICOM standard of
  China.

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3 The introduction of the submit version of the
Standard

• (6)Conformance Testing for DICOM standard of
  China
• Conformance Testing of DICOM PRINT
• a) while requesting PDU with the SCU port
  structuring c-find ,it must use character set
  TAG(0008,0005) defined in 5.1 in data element of
  PDUs message segment attribute list The SCU
  port request Protocol Data Unit(PDU) when it
  build N-GET, it must use character set
  TAG(0008,0005) which are defined in 5.1 in DATA
  ELEMENT of PDUs message segment.
• b) After SCP port receive N-GET request PDU
  from SCU port, when detect SCU port special
  character set which are defined in 5.1, and then
  package the character set into the data segment
  of PDU which response to N-GET(TAG(0008,0005)),
  in addition, it should meet the corresponding
  rule for package the standard character set when
  package the data of (VALUE REPRESENTAION)
  SH,LO,ST,PN,LT,UT.
• c) After SCP port receive N-GET request PDU
  from SCU port, it will detect the data segment
  TAG(0008,0005) of response PDU. If the data which
  are defined in 5.1, SCU port will resolve this
  data in corresponding package rules when it
  detect the data which equal to (VALUE
  REPRESENTATION) SH, LO,ST,PN,LT,UT. If the data
  equal to TAG(0008,0005) is not the character set
  which is defined in 5.1, we think that the SCP
  port is not satisfied with DICOM standard of
  China.
• d) When SCU affirm the character set which
  is form SCP port, it would packaging such series
  of server objects as BASIC FILM SESSION SOP
  CLASS, BASIC FILM BOX SOP CLASS, BASIC IMAGE BOX
  SOP CLASS and so on, and while the PDUs data
  segment that request these class have VALUE
  REPRESENTATION as data elements SH, LO, ST, PN,
  LT, UT, SCU will packaging the data appoint to
  the corresponded standard of character.
• e) It is the same when SCP received each PDU
  which is sent form the port SCU, SCU will
  analysis these data element follow the
  corresponding rule packaging of the appoint
  character set when SCU has detected data element
  equal to(VALUE REPRESENTATION) SH,LO,ST,PN,LT,UT.

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Main contents

• Introduction to drafting standard
• The progress of Standard staffing
• Introduction on Standard submission draft
• The clinical application of the DICOM standard
• Future work

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4 The status for clinical application of the
standard

• (1) The testing result for Large-scale medical
  equipment
• ?The testing result of CR
• AGFA ADC SOLO CR are satisfied with DICOM
  standard of China(Verified by West China Second
  University Hospital of SiChuan University, The
  second peoples hospital of SiChuan)
• Fuji CR Console is partially satisfied
  with DICOM standard of China.(WORKLIST is
  satisfied but achive not, Verified by The No.2
  Peoples Hospital of Yinbin)
• ? CT, MR and film printer are not satisfied
  with the DICOM standard of China.
• (2) The verify state of Regional PACS
• ?The regional PACS of Nanhai District, Foshan
  City, Guangdong Province(19 hospitals) are fully
  satisfied with DICOM standard. The films which
  are achiving amount to 10T, about a hundred
  million films.
• ? The regional PACS of Zhongshan City,
  Guangdong Province(8 hospitals) are fully
  satisfied with DICOM standard. The films which
  are achiving amount to 30T, about three hundred
  million films.
• ?The project which is carrying out in
  Shenzhen(58 hospitals), the PACS are all fully
  satisfied with DICOM standard. The films which
  are achiving amount to 100T, about a billion
  films.

From the above, the manufacturers from home or
abroad are partially satisfied with the DICOM
standard of China in their equipments and
applications, but a large amount equipment are
not. We hope we can promote the application area
in Medical imaging fields through the release of
the DICOM standard of China.
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Main contents

• Introduction to drafting standard
• The progress of Standard staffing
• Introduction on Standard submission draft
• The clinical application of the DICOM standard
• Future work

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5 Future work

• (1) Complete the work of First Review,
  Preliminary Review and Discussion of the DICOM
  standard of China before June,2011, On June, we
  will submit the standard and the standard will be
  announced.
• (2) At the end of 2011, CIMICS(China) will
  submit the standard to National DICOM
  institution, at that time, DICOM standard of
  China will add into the National DICOM standard.
  
• (3) We would like to build a Conformance Testing
  station for DICOM standard of China, and complete
  the procedure for testing and the construction of
  the testing platform for standard, under the
  leadership of the Ministry of Health and
  supervised by CIMICS(China).

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Thank you!
CIMICS(China) March 2011