Basic Image Review

Basic Image Review (BIR) defines a set of baseline features and user interface relevant to the simple review of DICOM images.

Summary

Compliant software must provide a predictable user interface and functionality sufficient to review images for the purpose of clinical decision-making by ordering physicians:

• display of grayscale and color images from any modality
• visual navigation of the available series of images through the use of thumbnails
• side-by-side comparison of at least two sets of images (with synchronized scroll, pan and zoom for cross-sectional modalities)
• annotation of laterality, orientation, and spatial localization
• annotation of demographics, management and basic technique information for safe identification and usage
• simple measurements of linear distance and angle
• cine capability for images that involve cardiac motion (e.g., cardiac US, XA, 500 CT or MR)

BIR is not intended to be a reading workstation.

Benefits

Reduce Errors or Delays in Patient Care

• Reduce the need to work with unfamiliar interfaces
• Reduce CD data that is effectively inaccessible by making sure viewers are runnable and usable
• Reduce interpretation problems by ensuring critical basic functions are present

Improve Efficiency

• Reduce time spent learning new viewer interfaces by requiring similar layout, icons and interactions
• Reduce time wasted on viewers that do not run and images that do not load by requiring support for a basic reference platform and minimum installation footprint.

Reduce Cost and Dose

• Avoid repeating scans by making the original results properly accessible

Details

To ensure adequate, predictable functionality, the profile defines a specific, simplified set of functions.

To minimize errors and learning time, the user interface elements are described to the level needed for consistency, while allowing the implementer some flexibility with the fine details.

The BIR user interface includes:

• a strip or panel containing a thumbnail for each series
• one or more viewports which open to display selected series following predictable default image guidance
• a toolbar or panel containing a standard set of icons for the specified functions
  • patient selection
  • image, series, study navigation within a patient
  • viewport and tile layout control
  • viewport selection and synchronization control
  • windowing and greyscale inversion control and presets
  • scrolling, rotation, panning and zooming control
  • annotation, localizer and crosshair display control
  • distance and angle measurement
  • cine control
  • report display control
  • printing

The profile allows implementers to include an "Advanced" button which gives users the choice of moving past the initial familiar interface and gives vendors a place to demonstrate their creativity.

The profile does not require (or permit) advanced image processing like pseudo-coloring, multi-planar reconstruction, multi-modality fusion, surface rendering, volume rendering, etc. in the basic interface. Vendors may choose to provide such functionality in their Advanced interface.

An implementation may choose to support screen calibration such as that described in the Consistent Presentation of Images Profile however the profile does not mandate it since this often depends on hardware which may not be present on the system where the BIR software is being run. As a result, the software may inform the user that the display environment may or may not be adequate for diagnostic purposes. However to comply with the profile there shall be nothing about the software or the data which precludes diagnostic use so the software may NOT declare either to be unsuitable.

Finally, the profile does not address application or modality specific requirements, such as may be needed for primary interpretation of mammography by radiologists, or primary interpretation of nuclear medicine image, which are addressed by other profiles.

A Basic Review Option in Portable Data for Imaging specifies media creators be capable of including a BIR compliant viewer.

To address installation issues, BIR viewers on PDI media are required to be able to run on a basic reference platform and install with a minimum footprint.

To address performance issues, BIR viewers on PDI media are required to meet certain performance targets on the reference platform, e.g. take no more than 60 seconds to go from startup to series selection for a standard "large" test dataset, or to take no more than 2 seconds to go from series selection to display of the first image.

Systems Affected

• Simple Display Workstations or Viewing Software might comply with BIR.
• CD Burning Workstations might offer to put a BIR compliant viewer on the media.
• PACS systems might provide a web portal that complies with BIR.
• EHR systems might provide image viewing that complies with BIR.

Actors & Transactions:

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Specification

Profile Status: Trial Implementation

Documents:

Basic Image Review Supplement

Underlying Standards:

• DICOM

See Also

Related Profiles

• Portable Data for Imaging [PDI] includes a Basic Image Review option for putting a BIR Compliant viewer on the media.
• Cross-enterprise Document Sharing for Imaging [XDS-I] can be used to access images which could be displayed by a BIR viewer.

Basic Image Review does not address domain specific needs such as those described in:

• Nuclear Medicine Image specifies how Nuclear Medicine images and result screens are created, exchanged, used and displayed.
• Mammography Image specifies how Mammography images and evidence objects are created, exchanged, used and displayed.

Consumer Information

The Basic Image Review FAQ answers typical questions about what the Profile does.

Basic Image Review Purchasing describes considerations when purchasing equipment to deploy this Profile.

Implementer Information

The Basic Image Review Implementation provides additional information about implementing this Profile in software.

Reference Articles

This page is based on the Profile Overview Template