Debriefing on DICOM Standard of China
Goldisc DICOM Key Laboratory of UESTC
Chengdu Goldisc UESTC Multimedia Technology Co., Ltd.
University of Electronic and Science Technology of China(UESTC)
March,2011
Beijing
Main contents
Introduction to drafting standard
The progress of Standard staffing
Introduction on Standard submission draft
The clinical application of the DICOM standard
Future work
GD R-PACS Solution
1 Introduction to drafting standard
 Background
Health Standards Board authorized the University of Electronic Science and Technology of China(UESTC)
and Chengdu Goldisc UESTC Multimedia Technology Co., Ltd to complete the work of drafting the DICOM
Standard of China, which has been listed into the projects of 2009 of Health Standards Board.NO.2009-16-01.
 The aim
1. Through the draft and application of the DICOM standard of China, we want to realize the ability of
processing information in Chinese in some large medical equipments. Especially in some key process for
PACS, such as the input of image information, image processing, the transmission of images, image archiving
and the films print.
2. Add DICOM standard of China to the National DICOM standard, and make the DICOM standard of China
become a major part of the national one.
 The procedure for standard drafting
(1) As the organizational units and main drafting units of the DICOM standard of China, UESTC and the
Chengdu Electronic Science and Technology Multimedia Technology Co., Ltd. conducted researches on
National DICOM standard from 1998, at the same time, they set up a work group. They issued the Draft
Standard in 2006.
(2) The work group who worked for CIMICS(China) made a comprehensive survey on the structure of PACS in
medical institutions in China, and made a evaluation on the application of National DICOM standard in
China's medical industry. They establish the basic framework for the Draft Standard, and conducted an
extensive clinical testing.
(3) They held Experts forums to discuss and modify the Draft Standard from 2008 to 2010. Finally they
completed and submitted the Draft of DICOM standard of China on December 2010.
GD R-PACS Solution
1 Introduction to drafting standard
 The principle for drafting
1. It can promote the medical images transfer ,archive and output correctly in
Chinese environment, and ensure the consistency of medical information.
2. Reflect the Universality and Applicability
 The national DICOM Standard specify the image format and communication process, but
it doesn’t give the corresponding solutions on supporting and affecting extension in
character set, data types and service types. The subject is focusing on these problems,
propose the solution, and take university and applicability into consideration. And on this
basis, we provide compliance test of film print and WORKLIST class for DICOM
Standard. We promote to realize the application of the DICOM standard in China and the
capacity of supporting Chinese.
 At the same time, the standard refer to the Japanese and Korean DICOM standard,
propose a “direct way” and a “composite approach ”,The two kinds of processing
methods maximized the standard universality and applicability.
GD R-PACS Solution
Main contents
Introduction to drafting standard
The progress of Standard staffing
Introduction on Standard submission draft
The clinical application of the DICOM standard
Future work
GD R-PACS Solution
2 The progress of Standard staffing
 The project is in first reading state
Finished works
 Completed the standard setting, Completed the standard draft in the form of Technical
Guidelines of Health standard；
 Completed the compile of the documents；
 Validation reports in standard methods(test reports from 3 hospitals, and equipment
manufacturers ,such as agfa CR, fuji CR)
 Completed the diagram for summary the consultation(18 copies sent and 12 copies
received)
 Completed the condition of funds consumption diagram
GD R-PACS Solution
Main contents
Introduction to drafting standard
The progress of Standard staffing
Introduction on Standard submission draft
The clinical application of the DICOM standard
Future work
GD R-PACS Solution
3 The introduction of the submit version of the
Standard
(1) Range
This standard specifies the "China DICOM standard " character set standard and DICOM
character set which is associated with the service class specifications, including format and
communication, and at the same time we provide the description and methods for compliance
test.
(2) Normative Reference




GB/T 2312
Guo-Biao Tuijian 2312
GBK
Guo-Biao Kuozhan
GB 18030-2000
Guo-Biao 18030-2000
DICOM Standard(2009)
(3) Terminology and Definition




DICOM (Digital Imaging and Communications in Medicine)
PACS (Picture Archiving and Communication Systems)
RIS (Radiology Information System)
HIS (Hospital Information System)
(4)Character Set solutions
Chinese character set adopt GB2312(including GBK 12345 and GBK13000) or GBK or
GB18030, we recommend GB18030.
GD R-PACS Solution
3 The introduction of the submit version of the
Standard
(5) The Chinese rule for DICOM standard of China(Extended
character set and the rules)
DICOM application entity can use extended character set to supply or replace the default character set.
Extended character set is defined by attribute of Tag(0008,0005),Chinese character set defined as follows two
ways:
① Direct way
(0008,0005) domain for GB18030 or GBK or GB2312.The methods for processing the name
and long text is as follows:
a) the method for processing name:
The format definition：Name(in PINYIN)= Chinese name = English (Name(in PINYIN) and English name
can be omitted)
For example: Chen^ShengBo=陈胜波=
Chinese character internal code: 0x43 0x68 0x65 0x6E 0x5E 0x53 0x68 0x65 0x6E 0x67 0x42 0x6F 0x3D
0xB3 0xC2 0xCA 0xA4 0xB2 0xA8 0x3D
b) the method for processing long text:
For example:
The first line.
The second line.
Chinese character internal code(GB18030、GB2312 character code ) such as:
0xB5 0xDA 0xD2 0xBB 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3 0x0D 0x0A
0xB5 0xDA 0xB6 0xFE 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3 0x0D 0x0A
GD R-PACS Solution
3 The introduction of the submit version of the
Standard
(5) The Chinese rule for DICOM standard of China(Extended
character set and the rules)
② Composite Patten
(0008,0005)domain is ISO 2022 GBK or ISO 2022 GB2312 or ISO 2022 GB18030, list in the following form
charact
er set
GB2312
GBK
GB18030
(0008,0005)
domain
\ISO 2022 GB2312
\ISO 2022 GBK
\ISO 2022
GB18030
Internal Code
ESC Sequence
（Hexadecimal）
ESC
Sequence(character)
ASCII
0x1B 0x28 0x42
ESC ( B
Chinese characters (Double byte ,
most significant digit is 1 for every
byte)
0x1B 0x24 0x29 0x41
ESC $ ) A
ASCII
0x1B 0x28 0x42
ESC ( B
Chinese characters (Double byte ,
most significant digit is 1 for every
byte)
0x1B 0x24 0x29 0x41
ESC $ ) A
ASCII
0x1B 0x28 0x42
ESC ( B
Chinese characters (Double byte ,
most significant digit is 1 for every
byte)
0x1B 0x24 0x29 0x41
ESC $ ) A
At the same time, in order to content with the specification of number of DICOM data bytes in even,
we specify that every row must begin in ASCII and end in ASCII either.
GD R-PACS Solution
3 The introduction of the submit version of the
Standard
(5) The Chinese rule for DICOM standard of China(Extended
character set and the rules)
② Composite Patten
a) the method for processing name
The format definition: Name(in PINYIN)= Chinese name = English (Name(in PINYIN) and English name can
be omitted)
For example: Chen^ShengBo=陈胜波=
Chinese character internal code:
0x43 0x68 0x65 0x6E 0x5E 0x53 0x68 0x65 0x6E 0x67 0x42 0x6F 0x3D 0x1B 0x24 0x29 0x41 0xB3 0xC2 0xCA 0xA4 0xB2 0xA8
0x1B 0x28 0x42 0x3D 0x20
b)the method for processing long text
For example:
1. The first line
2. The second line
3. The third line
Chinese character internal code(1.2.3 are ASCII code ) such as:
0x31 0x2e 0x1B 0x24 0x29 0x41 0xB5 0xDA 0xD2 0xBB 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3 0x1B 0x28 0x42 0x0D 0x0A
0x32 0x2e 0x1B 0x24 0x29 0x41 0xB5 0xDA 0xB6 0xFE 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3 0x1B 0x28 0x42 0x0D 0x0A
0x33 0x2e 0x1B 0x24 0x29 0x41 0xB5 0xDA 0xC8 0xFD 0xD0 0xD0 0xCE 0xC4 0xD7 0xD6 0xA1 0xA3 0x1B 0x28 0x42 0x0D 0x0A
0x20
GD R-PACS Solution
3 The introduction of the submit version of the
Standard
(5) The Chinese rule about DICOM standard of China(Impact the data
type of DICOM)
LO(Long String)
SH(Short String)
PN(Name)
LT(Long Text)
ST(Short Text)
UT(Unconstrained Text)
VR
name
LO
Definition
String that are filled with
spaces in the first place or the
end.
String code 5CH("\" in ISO-IR)
cannot appear, because it is
the separator of values of
multi-valued data elements.
Besides ESC,
long string cannot contain
control character B.
Character
instruction set
The definitions
of the default
character
instruction set
and "/" are
in(0008,0005)
Value length
64
bytes(maximum),
Chinese
characters
occupy two bytes
GD R-PACS Solution
3 The introduction of the submit version of the
Standard
(5) The Chinese rule for DICOM standard of China(DICOM server class that are
impact by extended character set)
This standard focus on input source DICOM WorkList service class 、output source DICOM Print
service class and DICOM Image format service class
Relationship with the Patient
DICOM WorkList
service class
DICOM Print service
class
DICOM image
format service class
Module
Patients identity Module
Property Name
TAG
Property Description
Patient Name
(0010,0010)
Patient's full name
Patient ID
(0010,0020)
Statistic of patient Module
Patients medical Module
Consultation relationship
The publisher of Patient
(0010,0021)
Other Patient ID
(0010,1000)
modules
other identification number or
patients
Other Patient Name
(0010,1001)
The name when patient
(0010,1005)
Other name that can identify
Patient's birth name
(0010,1060)
Patient' s mother's birth name
(0010,1090)
Identification number of existing
patient
was both
The
The requested process
The medical establishment who
code which was used to identify
Consultation state Module
Booking process steps module
identification
publish the patients’ ID
ID
Consultation identity Module
module
original
code
Module
Consultation acceptance
The
number from hospital or patient's
name
of
the
patient’s mother when she
was born
Medical record locator
medical records GD
used
to locate
R-PACS
Solution
3 The introduction of the submit version of the
Standard
(6) Conformance Testing for DICOM standard of China
① Conformance Testing of WORKLIST
a) The SCU port request Protocol Data Unit(PDU) when it build C-FIND, it must use character
set TAG(0008,0005) which are defined in 5.1 in DATA ELEMENT of PDU’s message
segment.
b) After SCP port receive C-FIND request PDU from SCU port, when detect SCU port special
character set which are defined in 5.1, and then package the character set into the data
segment of PDU which response to C-FIND(TAG(0008,0005)), in addition, it should meet the
corresponding rule for package the standard character set when package the data of (VALUE
REPRESENTAION) SH,LO,ST,PN,LT,UT.
c)After SCP port receive C-FIND request PDU from SCU port, it will detect the data segment
TAG(0008,0005) of response PDU. If the data which are defined in 5.1, SCU port will resolve
this data in corresponding package rules when it detect the data which equal to (VALUE
REPRESENTATION) SH, LO,ST,PN,LT,UT. If the data equal to TAG(0008,0005) is not the
character set which is defined in 5.1, we think that the SCP port is not satisfied with DICOM
standard of China.
GD R-PACS Solution
3 The introduction of the submit version of the
Standard
(6)Conformance Testing for DICOM standard of China
②
Conformance Testing of DICOM PRINT
a) while requesting PDU with the SCU port structuring c-find ,it must use character set TAG(0008,0005) defined in
5.1 in data element of PDU’s message segment attribute list; The SCU port request Protocol Data Unit(PDU) when it
build N-GET, it must use character set TAG(0008,0005) which are defined in 5.1 in DATA ELEMENT of PDU’s
message segment.
b) After SCP port receive N-GET request PDU from SCU port, when detect SCU port special character set which are
defined in 5.1, and then package the character set into the data segment of PDU which response to NGET(TAG(0008,0005)), in addition, it should meet the corresponding rule for package the standard character set
when package the data of (VALUE REPRESENTAION) SH,LO,ST,PN,LT,UT.
c) After SCP port receive N-GET request PDU from SCU port, it will detect the data segment TAG(0008,0005) of
response PDU. If the data which are defined in 5.1, SCU port will resolve this data in corresponding package rules
when it detect the data which equal to (VALUE REPRESENTATION) SH, LO,ST,PN,LT,UT. If the data equal to
TAG(0008,0005) is not the character set which is defined in 5.1, we think that the SCP port is not satisfied with
DICOM standard of China.
d) When SCU affirm the character set which is form SCP port, it would packaging such series of server objects as
BASIC FILM SESSION SOP CLASS, BASIC FILM BOX SOP CLASS, BASIC IMAGE BOX SOP CLASS and so on,
and while the PDU’s data segment that request these class have VALUE REPRESENTATION as data elements SH,
LO, ST, PN, LT, UT, SCU will packaging the data appoint to the corresponded standard of character.
e) It is the same when SCP received each PDU which is sent form the port SCU, SCU will analysis these data
element follow the corresponding rule packaging of the appoint character set when SCU has detected data element
equal to(VALUE REPRESENTATION) SH,LO,ST,PN,LT,UT.
GD R-PACS Solution
Main contents
Introduction to drafting standard
The progress of Standard staffing
Introduction on Standard submission draft
The clinical application of the DICOM standard
Future work
GD R-PACS Solution
4 The status for clinical application of the
standard
(1) The testing result for Large-scale medical equipment
①The testing result of CR
AGFA ADC SOLO CR are satisfied with DICOM standard of China(Verified by West China Second
University Hospital of SiChuan University, The second people’s hospital of SiChuan)
Fuji CR Console is partially satisfied with DICOM standard of China.(WORKLIST is satisfied but achive
not, Verified by The No.2 People’s Hospital of Yinbin)
② CT, MR and film printer are not satisfied with the DICOM standard of China.
(2) The verify state of Regional PACS
①The regional PACS of Nanhai District, Foshan City, Guangdong Province(19 hospitals) are fully satisfied
with DICOM standard. The films which are achiving amount to 10T, about a hundred million films.
② The regional PACS of Zhongshan City, Guangdong Province(8 hospitals) are fully satisfied with DICOM
standard. The films which are achiving amount to 30T, about three hundred million films.
③The project which is carrying out in Shenzhen(58 hospitals), the PACS are all fully satisfied with DICOM
standard. The films which are achiving amount to 100T, about a billion films.
From the above, the manufacturers from home or abroad are partially satisfied with the
DICOM standard of China in their equipments and applications, but a large amount
equipment are not. We hope we can promote the application area in Medical imaging fields
GD R-PACS Solution
through the release of the DICOM standard of China.
Main contents
Introduction to drafting standard
The progress of Standard staffing
Introduction on Standard submission draft
The clinical application of the DICOM standard
Future work
GD R-PACS Solution
5 Future work
(1) Complete the work of First Review, Preliminary Review and Discussion of the DICOM
standard of China before June,2011, On June, we will submit the standard and the
standard will be announced.
(2) At the end of 2011, CIMICS(China) will submit the standard to National DICOM
institution, at that time, DICOM standard of China will add into the National DICOM
standard.
(3) We would like to build a Conformance Testing station for DICOM standard of China, and
complete the procedure for testing and the construction of the testing platform for
standard, under the leadership of the Ministry of Health and supervised by
CIMICS(China).
GD R-PACS Solution
Thank you!
CIMICS(China)
March 2011
GD R-PACS Solution