Radiology Image Sharing Roadmap

<WARNING: Half-baked sketch follows>

Aspects of Image Sharing

Awareness

Knowing there are images that might be of use.

• Sink Approach - depend on systems to push potentially useful images.
• Notification Approach - depend on systems to tell you about potentially useful images.
• Query Approach - ask systems what images they have
• Subscribe Approach - sort of a cross between Query and Notification

Selection

Choosing images to make use of.

• Keep-or-Dump Approach - get all potential images, evaluate directly and dump unneeded ones
• Query Approach - evaluate/select based on image details returned in the query
• Notification Approach - see above; trust other system to have selected appropriately

Access

Getting the images.

• Sink Approach - see above
• Pull Approach -

Do we need to elabourate on whether access is direct from the source, or indirect through an intermediary? (latter raises synchronization issues) Do we need to elabourate on whether access is synchronous/immediate, or asynchronous/delayed?

Different approaches have advantages and disadvantages depending on many factors such as network bandwidth, local storage capacity, image persistence times, immediacy of access needs, quality of image metadata, dependence on new software/systems, configuration/maintenance overhead, security needs, privacy needs, etc., etc., etc.

What do we have to work with

DICOM Mechanisms

• C-Store
  • push across a typical network

• Retrieve
  • pull across a network, basically a C-Store invoked by the receiver

• Part 10 - Files
  • almost by definition push, asynchronous
  • profiled for a large variety of media
  • CD, DVD, USB
  • with/without compression
  • Email, FTP
  • includes a MIME type

• Supplement 119

• Part 18 - WADO - Web Access to Persistent DICOM Objects
  • pull across the web
  • HTTP based

• Supplement 118 - Application Hosting
  • includes mechanisms for accessing objects
  • File based or abstract model

• WG-10 Web Services
  • NADO - Notification of Availability of DICOM Objects
  • QIDO - Query for DICOM Objects

• (DICOM Print)
  • Push to hardcopy

Current Image Sharing Profiles

Grouped by primary intended application. Other applications are likely possible, but this reflects design intentions.

• Local Network Push
  • SWF - Scheduled Workflow
  • PIR
  • Content: NM Image, Mammo Image, (Enhanced DICOM)

• Local Network Pull
  • ARI - Access to Radiology Information
    • Basically DICOM Query/Retrieve

• Media-based push
  • PDI - Portable Data for Imaging
    • Store images onto media
  • IRWF - Import Reconciliation Workflow
    • Import images from media (and "integrate" into local databases)

• Regional Federated Network Pull
  • XDS-I - XDS for Imaging
    • Consumer pulls from Source based on manifest pushed to "public" repository;

• Image Routing based on tags
  • TCE - Teaching Files and Clinical Trials

• Other Referencing
  • KIN
  • CPI, PGP
  • Image Fusion