MINUTES
DICOM WORKING GROUP TEN
(Strategic Advisory)
April 12, 2010
Bordeaux, France
Members Present
American College of Radiology
ETIAM
Fujifilm Medical Systems
GE Healthcare
JAHIS
Merge Healthcare North America
Philips Healthcare
Siemens Healthcare
Societe Francaise de Radiologie
Toshiba Medical Research Inst. USA
Represented by
Charles Kahn
Emmanuel Cordonnier
Takashi Nakashima
Charles Parisot
Takashi Nakashima
Ronald Cowan
Cor Loef
Niki Wirsz
Joel Chabriais
Kevin O’Donnell
Members Absent
Agfa HealthCare Imaging
JIRA
Represented by
Geert Claeys
Makoto Suzuki
Others Present
Associated with
Trophy – Carestream Dental
MITA Staff
Xavier Carayol
Howard Clark
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Working Group 10 (Strategic Advisory)
of the DICOM Standards Committee
April 12, 2010
Presiding Officers
Joel Chabriais, Co-chair
Cor Loef, Co-chair
1. Preliminary Events



Participants identified themselves and their employers. The secretary noted that a quorum
was present.
Members reviewed the agenda. No changes were made.
Members reviewed the minutes from the meeting of January 21, 2010 in Phoenix, Arizona.
After making a few editorial changes, members approved them unanimously.
All documents discussed during this meeting may be found in the WG-10 Minutes Folder for this
meeting:
ftp://medical.nema.org/MEDICAL/Private/Dicom/WORKGRPS/Wg10/2010/2010-04-12
http://medical.nema.org/Dicom/minutes/Committee/2010/2010-04-12
2. White Papers
At the WG-10 meeting in January of 2010, members participated in a strategic brainstorming
session aimed at identifying topics that are expected to relevant for the future of DICOM and need
to be addressed now. Seven specific topics were identified and various members offered to develop
short white papers indicating the nature of the problem or opportunity and suggesting a possible
course of action. Five of these white papers were introduced during a teleconference on April 2. At
this meeting, members expanded upon these ideas, identified issues, and looked for ways to resolve
them. Copies of the white papers may be found in the Minutes Folder for this meeting. The
following topics were covered:

IHE Profiling in DICOM by Kevin O’Donnell. There was general agreement that it would
be useful to continue the DICOM tradition of providing instructions for implementing
technology that has already been standardized (e.g., JPEG, MPEG, or Enhanced XA/XRF
IOD Informative Annex). Members felt that because DICOM’s technical experts are the
ones who write the standard, they are best equipped to write the profile. IHE, on the other
hand, should review, publish and test it. The IHE Planning Committee should be informed
of these plans early in the process. The development of testing tools would not be
appropriate for DICOM, but it might be handled by MITA’s Committee for the
Advancement of DICOM.

Imaging Object Change Management by Kevin O’Donnell. Mr. O’Donnell emphasized the
need for a process to manage changes in image objects. He cited numerous reasons for
distributing and modifying DICOM objects. Acting through IHE, Agfa and McKesson have
achieved some progress in defining ways to handle change management. Also, the topic
has received some attention at meetings of WG-06. One problem is that DICOM does not
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Working Group 10 (Strategic Advisory)
of the DICOM Standards Committee
April 12, 2010
provide guidelines for when UIDs need to change. Mammography is one specific area
where some progress has already been made. Perhaps, those results could be generalized
for use with other modalities. However, distributed workflow brings a whole new set of
challenges. Members agreed that this is very much an IT issue. Unfortunately, there was no
clear path forward and no obvious champion to lead future work.

CDA Report Templates by Harry Solomon and Charles Parisot. Mr. Parisot presented a
draft Proposal for New Work Item on CDA Report Templates prepared by Harry Solomon.
Members expect to see this work performed as a joint effort involving personnel from WG08, WG-20/HL7, and RSNA, which has offered to provide the secretariat for WG-08.
Several refinements were made to the proposal to prepare it for presentation to the DSC on
April 13.

Multi-vendor Clinical Applications by Cor Loef. As Mr. Loef reviewed the draft white
paper, he pointed out that in addition to writing a conformance statement for the modality,
details about encoding specifics for certain clinical use cases could be provided in an
application profile. As the discussion proceeded, members focused on the idea of having
some reference images that could be made available to the vendors. Mr. Loef agreed to
contact the Committee for the Advancement of DICOM and offer his services to help
collect a substantial group of reference images. Members noted a similarity of purpose with
QIBA (Quantitative Imaging Biomarkers Alliance) and see a need to get users involved in
providing images.

Multispecialty imaging report templates by Helmut Koenig and Niki Wirsz. As the review
proceeded, members saw significant value in report templates that integrate relevant genetic
testing and anatomic pathology results. However, they think it is not consistent with typical
medical workflow. It may be the oncologist or the surgeon who integrates the results of the
medical specialists (radiologists, pathologists, laboratory, etc.). Members considered this to
be more of an HL7 issue than a task for DICOM.
No progress was reported on the following topics:
 Change the Perception of DICOM as Static Thing
 Marketing Plan for REM Applications
Charles Parisot
Joel Chabriais
3. Update on Radiation Exposure Monitoring
Kevin O’Donnell gave a short oral report on recent developments concerned with the measurement
and control of radiation exposure. He noted that on February 18, 2010, the FDA issued an Initiative
to Reduce Unnecessary Radiation Exposure from Medical Imaging. This was followed by a
meeting on March 30 and 31 at FDA in which he participated. He also noted that several CPs on
Radiation Dose are working their way through the DICOM development/approval process.
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Working Group 10 (Strategic Advisory)
of the DICOM Standards Committee
April 12, 2010
4. Status of Previously Assigned Action Items
At the September 2009 meeting of WG-10, Dr. Chabriais gave a PowerPoint presentation regarding
the motivation and process for exercising Quality Control of Radiology equipment and procedures
in France. At the conclusion of his presentation, Dr. Chabriais identified a number of problems
with this process and listed his goals for improving these processes. He hopes to eliminate a great
deal of the manual paper work – especially copying results from one paper document to another by
hand. The key question was whether DICOM SR might provide a means to assist with this Quality
Control process. Since there is a need to collect data from the imaging modalities (e.g., scans of
phantoms), SR seems to have a role. Dr. Chabriais urged each of the vendors to conduct a survey
of what the various departments in their companies are already doing. No progress was reported on
other previously assigned Action Items.
5. Tour of the IHE Europeann Connectathon
At 4 p.m. Emmanuel Cordonnier provided an executive tour of the IHE Connect-a-thon that was
taking place in an adjacent room.
6. New Business
No new business was introduced at this time.
7. Future Meetings
The next three meetings of WG-10 are scheduled for:
 October 2010 following the DICOM Conference in Rio de Janeiro
 January 13, 2011 at HL7 in Orlando Florida
 January 14, 2011 – Joint meeting with ISO TC215 WG2
8. Adjournment
The meeting was formally adjourned at 4:50 p.m.
Submitted by:
Howard E. Clark, Secretary
May 27, 2010
Reviewed by Legal Counsel:
May 27, 2010
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Working Group 10 (Strategic Advisory)
of the DICOM Standards Committee
April 12, 2010