CT/MR Perfusion Imaging

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.

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

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:

Specification

Profile Status: Trial Implementation

Documents:

• CT/MR Perfusion with Contrast Supplement
• CP 221 - Update to not insist on all frames in one file - Ballot

Underlying Standards:

• DICOM

See Also

Related Profiles

• Scheduled Workflow [SWF] can manage the production of CT/MR Perfusion Images.

• Patient Information Reconciliation [PIR] is expected to reconcile CT/MR Perfusion Images along with the rest of the patient data record.

• Consistent Presentation of Images [CPI] can facilitate the Consistent Display and Print of CT/MR Perfusion Images

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

• Cross-enterprise Document Sharing for Imaging [XDS-I] can be used to share CT/MR Perfusion Images between sites over a network.

• Portable Data for Imaging [PDI] can store CT/MR Perfusion Images on media such as CDs.

• Import Reconciliation Workflow [IRWF] can fix patient ids, etc. of CT/MR Perfusion Images when importing.

• Radiation Exposure Monitoring [REM] can record radiation details associated with the creation of the CT Perfusion Images.

Consumer Information

Implementer Information

Reference Articles

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