Rad Tech Minutes 2009.01.27-30

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Participants

  • David Clunie - RadPharm
  • Christoph Dickmann - Siemens
  • Dick Donker - Philips
  • Lynn Felhofer - MIR
  • Jay Gaeta - ACR
  • Bob Haworth - GE
  • Chris Lindop - GE, Co-chair
  • Kevin O'Donnell - Toshiba
  • Bas Revet - Philips
  • Paul Seifert - Agfa
  • Chris Carr - RSNA

Minutes

A. HL7 2.5 Refactoring

  • Chris Lindop presented the proposed supplement with revisions and reviewed open issues
  • Chris Lindop will integrate input provided by committee
  • Profile will be updated to refer to HL7 versioning document being developed by ITI

B. Joint ITI/WG 26 DICOM Webservices Review and Discussion

  • Radiology presented an update on its current relevant activities and its use cases for image sharing
  • Currently revising XDS-I profile to use XDS.b only
  • Tracking progress of supplemental profiles in ITI needed to support Web services model--such as XUA for role-based access control--but not currently confident that these solutions are ready for implementation
  • Radiology Use Cases for Image Sharing
  • Access to prior images and reports
  • Access to diagnostic images and reports for referring physicians
  • Point-to-point transfer of images and reports from site to site or from a site to an outside provider of longitudinal patient record, such as a Personal Health Record system vendor
  • Remote reading model employed frequently requires access by radiologist to multiple image sources
  • Moving Radiology to shared model of ITI XDS for Web services
1. Retrieve Transactions: Radiology should replace DICOM/Wado transport mechanisms with Web Services image retrieve transaction as compatible as possible with document retrieve method in XDS.b
  • DICOM WG27 will help with specification of those transactions; ITI needs to coordinate with DWG27 to review divergences between the transactions defined for radiology and the general XDS retrieve model (retrieve document set)
  • Need to consider responsiveness needs of the use case (synch/asynch; pipeline/non-pipeline queries and responses)
  • DICOM WG27 needs to review "Appendix V" being developed by ITI to make sure that the Web services profiled "fit" imaging model; perform "gap" analysis and provide feedback to ITI
  • Timing issue: need to have transactions specified before issuing XDS.b; standards would have to be specified by August 2009 in order to be implemented in 2009-2010 IHE Rad development cycle
  • Should DICOM WG 27 own this activity or ITI? Need a teleconference to settle ownership
  • Same model likely to be used for inter- and intraenterprise access
  • Intra model has higher performance requirements
  • Intra model has more precise query requirements
2. Query Issues
  • Can Radiology simplify the "three-layer" model of XDS-I: query to registry/reference to repository (with manifest only)/image source by enabling storage of images themselves in the repository layer
  • Need new queries based on Web services (using their query engine) to address specific issues of discovering and retrieving imaging studies: DICOM WG 20 is working on new query standards
  • Images need to be indexed (via manifest) so that large studies don't appear as multiple query entries
  • XDS-I adds two query keys to basic XDS: body part and procedure code
  • Manifest provides useful information about imaging study
  • Currently not all general query keys are included in the radiology manifest to fit into optimized XDS.b model
  • Extend in conformance with pattern for extensions developed by ITI
  • Event code is expandable attribute/value list that could be used for Radiology specific keys (body part, procedure code); IHE Rad will propose list of extensions to ITI
  • CP 228 in ITI that specifies "and/or" requirement for query response
3. Point-to-point push of images/reports
  • Does XDR enable pushing large image studies site to site (adheres to "provide and register" model)
  • Push manifest and require receiver to retrieve
  • Could include images (mime type) in provide and register transaction (convert DICOM metadata into XDS metadata)
4. Distributed updates and image management functions (change in reason for study, etc)
  • Metadata versioning profile in ITI allows you to inform registry
  • Under Pub/Sub, if new payload is sent, it is designated as a replace transaction
  • Radiology to review Pub/Sub white paper
5. Security mechanisms: role-based access control and authentication
  • ITI has Authorization White Paper under development: general architecture (defined) to support different policies (not defined in white paper)
  • Rad Tech to review and comment on draft white paper
6. Notification of availability
  • Next Joint ITI/Rad Tech/DICOM WG27
  • Feb. 5, 10-11:30am CT
  • Feb. 13, 10:30am-12:00pm CT

C. Enhanced CT/MR Profile

  • Bas Revet recorded committee input on draft of Perfusion and Diffusion supplement documents
  • Committee suggests combining the two use cases into a single profile supplement document


D.

Radiology Technical Committee

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