3D/4D Echo Workflow White Paper - Detailed Information

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  • Antje Schroeder (Siemens Healthcare)
  • Lars Linmarker (GE)
  • Joe Luszcz (Philips)


Advances in ultrasonography have progressively moved from 1D imaging (A-mode), to 2D (B-mode), to 3D (M-mode), and now to 4D volumetric rendering through time. However, clinicians have not been able to exchange volumetric images between systems of different vendors, as until recently there was not an agreed standard for such exchange. DICOM has now approved Supplement 43 to handle volumetric ultrasound, and IHE is the preferred venue for promoting interoperable implementations

The Problem

3D volumetric echocardiography is gaining more and more importance in clincial routine, as more and more vendors provide support for Real Time 3D (RT3D) imaging. However, until 2008 there was no standard for the storage and exchange of the acquired volume data. Each ultrasound vendor developed a proprietary way of storing the volume data, which was only compatible with their own workstations. In 2008 DICOM approved the Enhanced US Volume Storage IOD to address the need of exchanging Ultrasound volume data between different vendor systems.

Key Use Cases

  • 3D quantification
  • Visualization and analysis of heart valves and congenital defects
  • Volume stress echo
  • Volume Contrast Echo
  • Interoperative 3D Ultrasound

Standards & Systems

  • Echo Workflow
  • DICOM Supplement 43 (Enhanced US Volume Storage IOD)

Technical Approach

Preliminary discussions indicate that 3D presentation states are an integral part of the 3D/4D Echo workflow. Unfortunately currently there is no support for this object type in DICOM. Therefore a two step approach is taken in order to address the 3D/4D Echo workflow:

  1. During the IHE Cardiology Year 5 (2009-2010) a use paper with detailed clinical use cases will be developed. In parallel IHE Cardiology will work closely with DICOM WG12 and WG11 to develop the nD presentation state object
  2. During IHE Cardiogloy Year 6 (2010-2011) a supplement will be developed based on the use cases identified in Year 5.

Support & Resources


Open Issues

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