CT/MR Perfusion Imaging

CT/MR Perfusion with Contrast (PERF) facilitates the exchange of contrast enhanced images containing standard attributes for timing and position.

Summary

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. 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.

Benefits

Defines the correct and convenient display of the Perfusion with Contrast

• Creates stacks of images at different timeslots, in order to demonstrate the uptake of a contrast agent over time.
• 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

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.

• 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.
• 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.
• 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.
• 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.

Systems Affected

Systems involved in this profile are:

• Enterprise-wide information systems that manage patient registration and services ordering (i.e., admit-discharge-transfer (ADT)/registration system and hospital information system (HIS ))
• Radiology departmental information systems that manage department scheduling (i.e., radiology information system (RIS))
• Radiology image management/archiving (i.e., picture archiving and communication system (PACS))
• Acquisition modalities

Actors & Transactions:

Specification

Profile Status: Final Text

Documents: IHE Radiology Technical Framework:

• Vol. 1 - Section 3 (SWF profile overview)
• 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.
• Vol. 3 - Sections 4.42, and 4.48 to 4.49.

Underlying Standards:

• DICOM
• HL7

See Also

Related Profiles

• Patient Information Reconciliation [PIR] extends the capability of SWF by handling cases of unidentified (e.g. trauma), or misidentified patients.

• Cardiac Cath Workflow [CATH] - uses many of the mechanisms of SWF to integrate ordering, scheduling, imaging acquisition, storage and viewing for Cardiac Catheterization procedures.

• Echocardiography Workflow [ECHO] - uses many of the mechanisms of SWF to integrate ordering, scheduling, imaging acquisition, storage and viewing for digital echocardiography

• 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:
  • Nuclear Medicine Image [NM] specifies how Nuclear Medicine images and result screens are created, exchanged, used and displayed.
  • Mammography Image [MAMMO] specifies how Mammography images and evidence objects are created, exchanged, used and displayed.
  • Evidence Documents [ED] specifies how data objects such as digital measurements are created, exchanged, and used.
  • Key Image Note [KIN] lets users flag images as significant (e.g. for referring, for surgery, etc.) and add notes.

Consumer Information

The Scheduled Workflow FAQ answers typical questions about what the Profile does.

Scheduled Workflow Purchasing describes considerations when purchasing equipment to deploy this Profile.

Implementer Information

Scheduled Workflow Implementation provides additional information about implementing this Profile in software.

Reference Articles

• Using the IHE Scheduled Work Flow Integration Profile to Drive Modality Efficiency, Moore, Stephen M., 2003, Radiographics, Vol. 23, pp 523-529

• Considerations for Setting Up an Order Entry System for Nuclear Medicine Tests, Hara, Narihiro, et al., Journal of Nuclear Medicine Technology, 2007, Vol. 35, Num. 4, pp 259-271

• IHE technical framework and its application (Article in Chinese), Feng JY, et al., Chinese Journal of Medical Instrumentation, 2005, May, Vol. 29, Num. 3, pp. 199-201

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