Enhanced DICOM Objects - Detailed Proposal

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1. Proposed Workitem: Enhanced DICOM Image Profile

  • Proposal Editor: <Name of author/editor/contact for the proposal>
  • Editor: <Name of candidate Lead Editor for the Profile, if known>
  • Date:
  • Domain: Radiology

Summary

<Summarize in a few lines the existing problem . E.g. "It is difficult to monitor radiation dose for individual patients and almost impossible to assemble and compare such statistics for a site or a population.">

<Demonstrate in a line or two that the key integration features are available in existing standards. E.g. "DICOM has an SR format for radiation dose events and a protocol for exchanging them.">

<Summarize in a few lines how the problem could be solved. E.g. "A Radiation Dose profile could require compliant radiating devices to produce such reports and could define transactions to actors that collect, analyze and present such information.">

<Summarize in a line or two market interest & available resources. E.g. "Euratom and ACR have published guidelines requiring/encouraging dose tracking. Individuals from SFR are willing to participate in Profile development.">

<Summarize in a line or two why IHE would be a good venue to solve the problem. E.g. "The main challenges are dealing with the chicken-and-egg problem and avoiding inconsistent implementations.">

2. The Problem

The original DICOM cross-sectional and multi-frame projectional objects needed a significant revision because of technology advancements, and the introduction of new acquisition protocols for which there was no standard description.

DICOM has created a new "enhanced family" of multi-frame image objects for MR, CT, PET, and most recently XA, XRF and 3D X-Ray (cone beam CT and tomosynthesis), and there is a new 3D Ultrasound object in development. In addition, new types of data such as raw data and MR spectroscopy can now be stored in a standard manner. Products have now entered the market that are capable of creating some of these new objects. There is a need to promote their adoption for storage in and retrieval from Image Managers and Archives as well as their display by Image Displays.

It is desirable to profile the multitude of possible clinical acquisition protocols supported by these objects in order to constrain alternative means of encoding the same information and to make feasible and interoperable the consistent hanging and display on workstations.

Additional profiles for improved query requirements for these objects, as well as per-frame retrieval of image contents may also be warranted.

3. Key Use Case

Profiles for a few clinical use cases have already be defined by WG16 and the committee for the advancement of DICOM, and have been demonstrated at the SCAR and RSNA conference by a number of vendors. DICOM WG16 and the NEMA (MITA) Advanced CT/MR Taskforce has requested that these profiles be elaborated and promoted to IHE profiles:

3.1 CT/MR Cardiac Imaging

New CT/MR cardiac images containing standard attributes for location and timing information.

3.2 MR Diffusion

MR diffusion images containing standard attributes for diffusion B values, direction and diffusion image type.

3.3 CT/MR Contrast Perfusion

Intra-venous contrast enhanced images containing standard attributes for timing and phase.

3.4 Multi-stack Spine Imaging

Images are acquired at multiple disk space levels of the spine such that multiple slices at each level are parallel to the disk space, each in a separate stack from slices at different angles through other disks. These images are exchanged in an interoperable way with standard attributes describing the stacks and their geometries.

3.5 MR Spectroscopy

Single-voxel, multi-voxel or multi-slice 1D MR spectra are exchanged with reference and metabolite images that contain information to allow correct display, post-processing and analysis.

3.6 PET-CT

Consider adding PET-CT to this growing list (Comment added by J. Wallis)

4. Standards & Systems

For the use-cases proposed, the Enhanced CT, MR and MR Spectroscopy SOP Classes provide the necessary functionality to be profiled.

For additional query and retrieval, DICOM Sup 119, Instance and Frame Level Retrieve SOP Classes, may or may not be sufficiently advanced in its process through the standardization process to use in this profile.

5. Discussion

The use cases may constitute the basis for a new IHE CT/MR Image profile, which specifies for each all that are applicable of the following:

  • The required attributes (mostly already defined as mandatory in the standard),
  • The relevant functional grouping
  • The content of the dimension module
  • The use of a Real World Values LUT
  • The use of a Supplemental Color LUT
  • The relevant attributes for display on a workstation


This Delta Proposal Template is for expanding copy of a Brief Proposal into a Detailed Proposal. This template and the Detailed Proposal Template should be updated in sync.

  • Paste this text into a copy of your Brief Proposal
  • Move the Summary section to the end of Section 1
  • Expand details in the Use Case Section
  • Distribute material in the Discussion Section into the other bottom sections.


5. Technical Approach

<This section can be very short but include as much detail as you like. The Technical Committee will flesh it out when doing the effort estimation.>

<Outline how the standards could be used/refined to solve the problems in the Use Cases. The Technical Committee will be responsible for the full design and may choose to take a different approach, but a sample design is a good indication of feasibility.>

<If a phased approach would make sense indicate some logical phases. This may be because standards are evolving, because the problem is too big to solve at once, or because there are unknowns that won’t be resolved soon.>

Existing actors

<Indicate what existing actors could be used or might be affected by the profile.>

New actors

<List possible new actors>

Existing transactions

<Indicate how existing transactions might be used or might need to be extended.>

New transactions (standards used)

<Describe possible new transactions (indicating what standards would likely be used for each. Transaction diagrams are very helpful here. Feel free to go into as much detail as seems useful.>

Impact on existing integration profiles

<Indicate how existing profiles might need to be modified.>

New integration profiles needed

<Indicate what new profile(s) might need to be created.>

Breakdown of tasks that need to be accomplished

<A list of tasks would be helpful for the technical committee who will have to estimate the effort required to design, review and implement the profile.>

6. Support & Resources

<List groups that have expressed support for the proposal and resources that would be available to accomplish the tasks listed above.>

7. Risks

<List technical or political risks that will need to be considered to successfully field the profile.>

8. Open Issues

<Point out any key issues or design problems. This will be helpful for estimating the amount of work and demonstrates thought has already gone into the candidate profile.>

9. Tech Cmte Evaluation

<The technical committee will use this area to record details of the effort estimation, etc.>

Effort Evaluation (as a % of Tech Cmte Bandwidth):

  • 35% for ...

Responses to Issues:

See italics in Risk and Open Issue sections

Candidate Editor:

TBA
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