Difference between revisions of "CT/MR Perfusion Imaging"

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'''CT/MR Perfusion with Contrast (PERF)''' facilitates the exchange of contrast enhanced images containing standard attributes for timing and position.
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'''CT/MR Perfusion with Contrast (PERF)''' facilitates the exchange and display of contrast perfusion CT or MR images.
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__TOC__
 
__TOC__
  
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==Summary==
  
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==Summary==
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The Profile uses the DICOM Enhanced CT and Enhanced MR objects to encode contrast perfusion images.  Images are organized into stacks at different timeslots and indexed by their spatial position and time point.
  
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The CT/MR Perfusion Imaging with Contrast Integration Profile facilitates the exchange of contrast enhanced images containing standard attributes for timing and position. The exchange of these attributes allows for correct and convenient display.
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By requiring the use of standard attributes (instead of variable private tags) Image Displays can reliably display perfusion imaging correctly and conveniently.  
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This profile creates a stack of images at different timeslots, in order to display the contrast agent over time. The images need to be stored with indices along their position in the stack and the progress of time. Additional functional and data requirements are defined for the Modality Image Creator and Image Display actors, which allow for correct and convenient display of the Perfusion with Contrast.
 
 
   
 
   
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<center>[[Image:Perfusion Fig1.jpg]]</center>
 
<center>[[Image:Perfusion Fig1.jpg]]</center>
  
 
==Benefits==
 
==Benefits==
  
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'''Defines the correct and convenient display of the Perfusion with Contrast'''
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'''Improves display'''
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* View uptake of a contrast agent over time by using stacks of images at different timeslots.
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* Defines how the perfusion images are stored and archived into frames of one Enhanced DICOM (Multi-frame) object so that they can later be retrieved and displayed in an unambiguous way on image viewers supporting Enhanced DICOM objects
  
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'''Improves the Consistency and Interoperability of the Perfusion Display with Contrast applications'''
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'''Improves the Consistency and Interoperability of the Perfusion Display with Contrast, clinical applications'''
 
* Provides standard attributes for “timing” and “position” information for the Workstation being capable of Display consistently and Interoperable
 
* Provides standard attributes for “timing” and “position” information for the Workstation being capable of Display consistently and Interoperable
 
* Reduce implementations diversity of choices for improving interoperability
 
* Reduce implementations diversity of choices for improving interoperability
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'''Enables widespread and adequate review and interpretation of contrast-enhanced frames by radiologists in an IT environment where all Actors support the Enhanced CT or Enhanced MR DICOM objects
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'''Improves the acceptance of the Enhanced SOP Classes by industry and users'''
 
'''Improves the acceptance of the Enhanced SOP Classes by industry and users'''
  
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==Details==
 
==Details==
  
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The '''''Scheduled Workflow (SWF) Integration Profile''''':
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The '''CT/MR Perfusion Imaging with Contrast (PERF) Integration Profile''':
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* Establishes the continuity and integrity of basic departmental imaging data by profiling specific usage of HL7 messaging across multiple systems including: Patient registration (ADT), Order Placing (CPOE) and Order SCheduling (RIS) systems.
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* Facilitates the exchange of contrast enhanced images containing standard attributes for timing and position
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* Bridges the gap between HL7-based systems (like RIS) and DICOM-based systems (like acquisition modalities and PACS) within the radiology department by specifying the semantic mappings between messages.
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* Defines how the perfusion images are stored and archived into frames of one Enhanced DICOM (Multi-frame) object so that they can later be retrieved and displayed in an unambiguous way on image viewers supporting Enhanced DICOM objects.
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* Maintains the consistency of patient demographic and ordering information across multiple systems by making that information available to image acquisition modalities via the DICOM Modality Worklist (MWL) Service.  
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* The images need to be stored with indices along their position in the stack and the progress of time.
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* Ensures that acquired images are not inadvertently lost by specifying that the DICOM Storage Commitment Service is used to transfer the custodianship of images from the modality to the PACS.
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* A stack of images is being created at different timeslots, in order to display the contrast agent over time
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* Ensures that the status of acquisition workflow steps are known throughout the department by specifying the use of the DICOM Modality Performed Procedure Step (MPPS) Service to convey that status from the modality to the RIS and the PACS.
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* Defines the correct and convenient display of the Perfusion with Contrast
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* Requirements for the Perfusion Creator modality are:
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:1. Create an Enhanced CT or MR  SOP Instance
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:2. Modality provides Dimension indices: Stack ID, In Stack Position Number, Temporal Position Index
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:3. Data requirements: Image and Frame Type should be: Value 1: ORIGINAL, Value 2: PRIMARY, Value 3: PERFUSION
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* Requirements for Image Display Perfusion with contrast:
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:1. Provide at least one viewport for display of frames with the same  In-Stack Position Number (Slice-index). More viewports may be used for displaying images for other In-Stack Position Numbers= simultaneous scrolling
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:2. Scroll by Temporal Position Index then Stack ID / In-Stack Position Number and by Stack ID / In-Stack Position Number then Temporal Position Index 
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:3. Provide the time since the start, deducted from Frame Reference DateTime
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:4. Display the values of the dimension attributes and contrast attributes
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:5. Display Frame annotations for Frame Number, Slice offset, relative time.
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* CT/MR Perfusion Imaging with Contrast Process Flow
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[[Image:Perfusion Proc Flow.jpg]]
  
 
==Systems Affected==
 
==Systems Affected==
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Systems involved in this profile are:
 
Systems involved in this profile are:
  
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* Enterprise-wide information systems that manage patient registration and services ordering (i.e., admit-discharge-transfer (ADT)/registration system and hospital information system (HIS ))
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* Acquisition modalities, create the Enhanced CT or MR images
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* Radiology departmental information systems that manage department scheduling (i.e., radiology information system (RIS))
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* PACS systems store the Enhanced images
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* Radiology image management/archiving (i.e., picture archiving and communication system (PACS))
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* Image Displays retrieve enhanced CT/MR images and provide advanced display
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* Acquisition modalities
 
  
 
'''Actors & Transactions:'''
 
'''Actors & Transactions:'''
  
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[[Image:Swf-actor-transaction.JPG]]
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[[Image:Perfusion Fig4.JPG]]
  
 
==Specification==
 
==Specification==
  
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'''Profile Status:''' [[Comments| Final Text]]   
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'''Profile Status:''' [[Comments| Trial Implementation]]   
  
 
'''Documents:'''  
 
'''Documents:'''  
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[http://www.ihe.net/Technical_Framework/index.cfm#radiology IHE Radiology Technical Framework:]
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:* [http://www.ihe.net/Technical_Framework/upload/IHE-RAD_TF_Suppl_PERF_2009-06-21.pdf CT/MR Perfusion with Contrast Supplement]
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:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8.pdf Vol. 1] - Section 3 (SWF profile overview)
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:* [ftp://iheyr2:interop@ftp.ihe.net//Radiology/TF_Maintenance/4.Balloting_CPs/CP-RAD-221-PC.doc CP 221 - Update to not insist on all frames in one file - Ballot]
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:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8.pdf Vol. 2] - Sections 4.1 to 4.8, 4.10 to 4.14, 4.16, 4.18, 4.20 to 4.21, and Appendices A, B and D.
 
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:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8.pdf Vol. 3] - Sections 4.42, and 4.48 to 4.49.
 
  
 
'''Underlying Standards:'''
 
'''Underlying Standards:'''
 
:* [http://dicom.nema.org DICOM]
 
:* [http://dicom.nema.org DICOM]
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:* [http://www.hl7.org HL7]
 
  
 
==See Also==
 
==See Also==
  
 
'''Related Profiles'''
 
'''Related Profiles'''
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* [[Scheduled Workflow]] [SWF] can manage the production of CT/MR Perfusion Images.
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* [[Patient Information Reconciliation]] [PIR] is expected to reconcile CT/MR Perfusion Images along with the rest of the patient data record.
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* [[Consistent Presentation of Images]] [CPI] can facilitate the Consistent Display and Print of CT/MR Perfusion Images
  
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* [[Patient Information Reconciliation]] [PIR] extends the capability of SWF by handling cases of unidentified (e.g. trauma), or misidentified patients.
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* [[Reporting Workflow]] [RWF] may use CT/MR Perfusion Images as inputs to the reporting process.
  
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* [[Cardiac Cath Workflow]] [CATH] - uses many of the mechanisms of SWF to integrate ordering, scheduling, imaging acquisition, storage and viewing for Cardiac Catheterization procedures.  
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* [[Cross-enterprise Document Sharing for Imaging]] [XDS-I] can be used to share CT/MR Perfusion Images between sites over a network.
  
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* [[Echocardiography Workflow]] [ECHO] - uses many of the mechanisms of SWF to integrate ordering, scheduling, imaging acquisition, storage and viewing for digital echocardiography
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* [[Portable Data for Imaging]] [PDI] can store CT/MR Perfusion Images on media such as CDs.
  
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* There are a a number of "content profiles" describing the details of creating and storing various types of image or image related objects, and frequently they would be created in the context of SWF. These content profiles include:
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* [[Import Reconciliation Workflow]] [IRWF] can fix patient ids, etc. of CT/MR Perfusion Images when importing.
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** [[Nuclear Medicine Image]] [NM] specifies how Nuclear Medicine images and result screens are created, exchanged, used and displayed.
 
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** [[Mammography Image]] [MAMMO] specifies how Mammography images and evidence objects are created, exchanged, used and displayed.
 
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** [[Evidence Documents]] [ED] specifies how data objects such as digital measurements are created, exchanged, and used.
 
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** [[Key Image Note]] [KIN] lets users flag images as significant (e.g. for referring, for surgery, etc.) and add notes.
 
  
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'''Consumer Information'''
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* [[Radiation Exposure Monitoring]] [REM] can record radiation details associated with the creation of the CT Perfusion Images.
  
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The [[Scheduled Workflow FAQ]] answers typical questions about what the Profile does.
 
  
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[[Scheduled Workflow Purchasing]] describes considerations when purchasing equipment to deploy this Profile.
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'''Consumer Information'''
  
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'''Implementer Information'''
 
'''Implementer Information'''
  
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[[Scheduled Workflow Implementation]] provides additional information about implementing this Profile in software.
 
  
 
'''Reference Articles'''
 
'''Reference Articles'''
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* Using the IHE Scheduled Work Flow Integration Profile to Drive Modality Efficiency, Moore, Stephen M., 2003, [http://radiographics.rsnajnls.org/cgi/content/full/23/2/523 Radiographics, Vol. 23, pp 523-529]
 
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* Considerations for Setting Up an Order Entry System for Nuclear Medicine Tests, Hara, Narihiro, et al., [http://tech.snmjournals.org/cgi/content/abstract/35/4/259 Journal of Nuclear Medicine Technology, 2007, Vol. 35, Num. 4, pp 259-271]
 
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* IHE technical framework and its application (Article in Chinese), Feng JY, et al., [http://www.ncbi.nlm.nih.gov/pubmed/16124630 Chinese Journal of Medical Instrumentation, 2005, May, Vol. 29, Num. 3, pp. 199-201]
 
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[[Category:Profiles]]
 
[[Category:Profiles]]
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[[Category:RAD Profile]]
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[[Category:DICOM]]

Latest revision as of 15:10, 25 May 2018

CT/MR Perfusion with Contrast (PERF) facilitates the exchange and display of contrast perfusion CT or MR images.

Summary

The Profile uses the DICOM Enhanced CT and Enhanced MR objects to encode contrast perfusion images. Images are organized into stacks at different timeslots and indexed by their spatial position and time point.

By requiring the use of standard attributes (instead of variable private tags) Image Displays can reliably display perfusion imaging correctly and conveniently.

Perfusion Fig1.jpg

Benefits

Improves display

  • View uptake of a contrast agent over time by using stacks of images at different timeslots.
  • Defines how the perfusion images are stored and archived into frames of one Enhanced DICOM (Multi-frame) object so that they can later be retrieved and displayed in an unambiguous way on image viewers supporting Enhanced DICOM objects

Improves the Consistency and Interoperability of the Perfusion Display with Contrast, clinical applications

  • Provides standard attributes for “timing” and “position” information for the Workstation being capable of Display consistently and Interoperable
  • Reduce implementations diversity of choices for improving interoperability

Enables widespread and adequate review and interpretation of contrast-enhanced frames by radiologists in an IT environment where all Actors support the Enhanced CT or Enhanced MR DICOM objects

Improves the acceptance of the Enhanced SOP Classes by industry and users

Reduces Deployment Cost/Time

Details

The CT/MR Perfusion Imaging with Contrast (PERF) Integration Profile:

  • Facilitates the exchange of contrast enhanced images containing standard attributes for timing and position
  • Defines how the perfusion images are stored and archived into frames of one Enhanced DICOM (Multi-frame) object so that they can later be retrieved and displayed in an unambiguous way on image viewers supporting Enhanced DICOM objects.
  • The images need to be stored with indices along their position in the stack and the progress of time.
  • A stack of images is being created at different timeslots, in order to display the contrast agent over time
  • Defines the correct and convenient display of the Perfusion with Contrast
  • Requirements for the Perfusion Creator modality are:
1. Create an Enhanced CT or MR SOP Instance
2. Modality provides Dimension indices: Stack ID, In Stack Position Number, Temporal Position Index
3. Data requirements: Image and Frame Type should be: Value 1: ORIGINAL, Value 2: PRIMARY, Value 3: PERFUSION
  • Requirements for Image Display Perfusion with contrast:
1. Provide at least one viewport for display of frames with the same In-Stack Position Number (Slice-index). More viewports may be used for displaying images for other In-Stack Position Numbers= simultaneous scrolling
2. Scroll by Temporal Position Index then Stack ID / In-Stack Position Number and by Stack ID / In-Stack Position Number then Temporal Position Index
3. Provide the time since the start, deducted from Frame Reference DateTime
4. Display the values of the dimension attributes and contrast attributes
5. Display Frame annotations for Frame Number, Slice offset, relative time.
  • CT/MR Perfusion Imaging with Contrast Process Flow

Perfusion Proc Flow.jpg

Systems Affected

Systems involved in this profile are:

  • Acquisition modalities, create the Enhanced CT or MR images
  • PACS systems store the Enhanced images
  • Image Displays retrieve enhanced CT/MR images and provide advanced display

Actors & Transactions:

Perfusion Fig4.JPG

Specification

Profile Status: Trial Implementation

Documents:

Underlying Standards:

See Also

Related Profiles

  • Reporting Workflow [RWF] may use CT/MR Perfusion Images as inputs to the reporting process.


Consumer Information


Implementer Information


Reference Articles


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