th
1300 North 17 Street, Suite 1847
Rosslyn, VA 22209
(703) 841-3285
Fax (703) 841-3385
MINUTES
DICOM Standards Committee
Rosslyn, Virginia
September 24, 2002
MEMBERS PRESENT
VENDORS
AGFA Healthcare
ETIAM
Eastman Kodak
Fuji Medical Systems USA
GE Medical Systems
IBM
IDX Systems Corporation
Merge Technologies Inc.
Philips Medical Systems
R2 Technology, Inc.
RadPharm
Siemens Medical Systems
Sony-Europe
Toshiba
Rob Horn
Emmanuel Cordonnier
David Best
Makota Ogoda
Charles Parisot
Jill Kaufman
Andrei Leontiev
Dwight Simon
Cor Loef
Janet Keyes
David Clunie
Nikolaus Wirsz
Jan Rorive
Hidenori Shinoda
USERS
American College of Radiology
Deutsche Rontgengesllschaft
Societe Francaise de Radiologie
Alan Rowberg
Peter Mildenberger
Joel Chabriais
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DICOM Standards Committee
September 24, 2002
GENERAL INTEREST
National Electrical Manufacturers Assn.
Robert Britain
Others Present
IBM
Siemens
Sony Medical Systems
Sony Europe
NEMA
Eric Goodall
Lawrence Tarbox
Mark Barrow
Juergen Thiem
Howard Clark
MEMBERS ABSENT
VENDORS
ALI Technologies
*Bio-Imaging Technologies
*Camtronics Medical Systems
DeJarnette Research Systems
*IFA Systems Group
*Infimed
Konica
Lorad
RASNA Imaging Systems
David Heaney
John Ceccoli
Keith Klassy
Michael Galuza
Rainer Waedlich
Andrew Beardslee
Mohammeed Aleem
William Johnson
Auro Pampaloni
USERS
American Academy of Ophthalmology
*American College of Cardiology
American Dental Association
American College of Radiology
Biomedical Engineering Society of Taiwan
*College of American Pathologists
*European Society of Cardiology
European Society of Cardiology
Korean PACS Standards Committee
Societa Italiana di Radiologia Medica
Lloyd Hildebrand
Tori Pharr
Allan Farman
Steven Horii
Jenn-Lung Su
Ulysses Balis
Johan H. C. Reiber
Ruediger Simon
Hee-Joung Kim
Palmino Sacco
GENERAL INTEREST
*Canadian Institute for Health
Center for Devices and Radiological Health
JIRA
*National Cancer Institute
Laura Sato
Loren Zaremba
Isao Ohbayashi
Edward Staab
* = Does not count toward a quorum at the meeting
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DICOM Standards Committee
September 24, 2002
Presiding Officers:
Dwight Simon, Chair Pro Tem
Lloyd Hildebrand, Co-Chair
1. Preliminary Events



Members introduced themselves and identified their employers
There were no requests to modify the agenda.
Minutes of the June 25 meeting in Paris, France were approved as submitted.
2. Election of New Members
Members reviewed and unanimously approved requests to join the Committee from Sony-Europe and
Boston Scientific.
3. Requests to Join Working Groups
Members approved the request from WG-04 to appoint Aware, Inc. as a member. Mr. Lev
Weisfeiler <lev@aware.com> will be its voting representative. Alexis Tzannes
<alexis@aware.com> will be the alternate.
Additionally, there were requests from both WG-01 and WG-02 to appoint Boston Scientific as a
member. No action was required. As a member of the DSC, Boston Scientific can simply declare
its interest in participating on these or other working groups.
4. Nominate Candidates for “Biomedical Professional Organization” Co-chair
The term of our “biomedical professional organization” co-chair, Dr. Lloyd Hildebrand, will expire at
the conclusion of the December meeting at RSNA. As Dr. Hildebrand is completing his second twoyear term, he is not eligible for reelection. The Nominating Committee, which was appointed at the
June meeting in Paris, has identified two members of the DICOM community who are well qualified
for this position and have agreed to serve if elected. They are:


John A. Carrino, Assistant Professor of Radiology, Jefferson Medical College and
Peter Mildenberger, Assistant Professor of Radiology, University Hospital Mainz, Germany
and voting representative of the Deutsche Roentgengesellschaft.
As noted in the Committee’s Procedures additional nominations may be made from the floor at the
September meeting. Members will vote by letter ballot after the September meeting and before the
December meeting.
No additional nominations were made. Members requested that the secretary invite the two
candidates to provide a one-paragraph statement of their credentials for this position.
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DICOM Standards Committee
September 24, 2002
5. Staff Report
Staff provided a report on the status of supplements approaching maturity:
STATUS OF RECENT SUPPLEMENTS
Sup.
No.
Title
Approved
for
26
OB-GYN Ultrasound Procedure Reports
Ltr. Ballot
44
Clarify Network Addressing and Retire NonTCP/IP Communication
Final Text
Sept. 2002
45
Ultrasound Staged Protocol Data Management
Pub. Cmts.
55
Attribute Level Confidentiality (including Deidentification)
Final Text
Sept. 2002
58
Enhanced CT Image Storage SOP Class
65
Due
Outcome
???
Rev. for FT
in Jan. 2003
9/16/02
Rev. for LB
in Oct. 2002
Pub. Cmts.
3/18/02
Rev. for LB
in Oct. 2002
Chest CAD SR SOP Class
Pub. Cmts.
1/4/02
Rev. for LB
in Oct. 2002
66
Catheterization Lab Structured Reports
Ltr. Ballot
???
Rev. for FT
in Jan. 2003
67
Configuration Management
Pub. Cmts.
5/9/02
Rev. for TU
in Oct. 2002
69
640 MB and 1.3 GB 90mm MOD Medium
Format and Use in US Profiles
Final Text
Sept. 2002
70
Clinical Trials Identification
Pub. Cmts.
3/18/02
Rev. for LB
in Oct. 2002
71
Vascular Ultrasound Procedure Reports
Pub. Cmts.
10/28/02 Rev. for LB
in Jan. 2003
72
Echocardiography Procedure Reports
Pub. Cmts.
???
Rev. for LB
in Jan. 2003
Committee Secretary Howard Clark has been working with WG-06 Chair Andrei Leontiev over the
last year to gather the answers to frequently asked questions regarding the detailed process for
preparing a supplement to the DICOM Standard. This information has been compiled, edited and
enhanced to form a comprehensive guide that should be especially useful to champions who are
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DICOM Standards Committee
September 24, 2002
preparing their first supplement. A draft of this document, “How to Develop a Supplement to the
DICOM Standard,” was placed in the “Other Documents” folder on the Committee’s private ftp site
for this meeting.
6. XML Encoding of the DICOM Standard
This topic was covered during the report of WG-10 that appears in Item 14, below.
7. DICOM Training Certification
This idea was initially proposed by:



Herman Oosterwijk (OTech Inc.)
Dwight Simon (Merge Technologies) and
Don Van Syckle (DVS consulting).
all of whom are engaged in training personnel to work in the DICOM community. Several questions
were raised during previous meetings regarding the details of organizing and operating such a service.
A written statement regarding this matter was received from Mr. Oosterwijk and reviewed by
members of the Committee. However, after an extensive discussion of the advantages and
disadvantages of proceeding with this proposal, members voted (with one abstention) to give the
matter no further consideration.
8. Proposed Work Items
Members reviewed and dispatched the following four work-item requests as shown below:

WG-05 to “Add Media Application Profiles for Flash Media” – Approved unanimously.

WG-12 on “Ultrasound 2.3 GB Capacity 90mm MOD Media” – Approved with two
abstentions.

WG-13 on “DICOM MPEG2 VL Application Profile” – Approved unanimously.

WG-10 on “DICOM Standard Publication and Maintenance in XML” – Approved as
amended. The amended version of this work item proposal appears at:
http://medical.nema.org/Dicom/minutes/Committee/2002/2002-09-24/WG-10_WorkitemReq_DICOMinXML.doc.
9. Report on International DICOM Activities
Committee members from various geographic areas reported on activities in their area that may be of
potential interest to the broader DICOM community:


Europe – Cor Loef reported that representatives of the user community are often present at
DICOM meetings in Europe. Therefore, NNI is no longer needed as the DICOM European
Secretariat. This responsibility will now be handled by COCIR.
Japan – Hidenori Shinoda gave a PowerPoint presentation focused on IHE-Japan. A copy of
that presentation may be found at:
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DICOM Standards Committee
September 24, 2002
http://medical.nema.org/Dicom/minutes/Committee/2002/2002-09-24/Report_on_Japanese_Activities.ppt.


Korea – No representative from Korea was present.
Taiwan – No representative from Taiwan was present.
10. Translating the DICOM Standard into Chinese
Committee Secretary Howard Clark reported that he had received an inquiry from DICOM personnel
in Taiwan regarding the possibility of translating the DICOM Standard into Chinese. Dr. Clark, then,
informed them of NEMA’s policy regarding the payment of royalties associated with printing and
publishing the Standard vs. the opportunity of distributing it free on the Internet. There has been no
response subsequent to this communication.
11. Report on International Standards Organizations

HL7 – Working Group 20 Chair Fred Behlen provided an illustrated report on HL7 activities
of interest to the DICOM community. A copy of his presentation may be found at:
http://medical.nema.org/Dicom/minutes/Committee/2002/2002-09-24/HL7_Activities_of_Interest_to_DICOM.doc

IHE – Charles Parisot gave a short oral report on activities of IHE of interest to the DICOM
community. The following items were covered:
o Three new profiles.
o Exceptions to scheduled workflow.
o No demonstrations at RSNA. Instead, IHE will focus on success stories from users.
Additionally, there will be a series of educational lectures – including some sessions
on DICOM.
12. ISO/TC215
Hidenori Shinoda and Charles Parisot, the Committee’s liaisons with ISO TC215 reported on
developments that occurred at the ISO meeting in Melbourne, Australia in August. A copy of their
presentation may be found at:
http://medical.nema.org/Dicom/minutes/Committee/2002/2002-09-24/ISO_Liaison_Report(forDSC).ppt.
NEMA staff has identified a number of significant administrative issues that need to be considered in
conjunction with potential, joint standards-development activities. A list of these items may be found
in the “Other Documents” folder on the ftp site for this meeting.
13. Committee for Advancement of DICOM
Charles Parisot briefed members on recent and planned activities of this group. The key
development since the Committee’s last meeting was the award of a contract to PixelMed for the
Enhanced MR Multi-frame Image SOP Class Test Tool Development Project stemming from the
approval of Supplement 49. The Committee also plans to conduct a workshop on Monday,
February 17, 2003 in conjunction with the SPIE meeting in San Diego. The Committee is also
considering a possible demonstration on Security.
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DICOM Standards Committee
September 24, 2002
14. Reports from the Working Groups
Written and oral reports prepared by working group chairs were presented and discussed as noted
below:

The written report on the activities of Working Group One (Cardiac and Vascular
Information) was reviewed and accepted by the Committee. A copy of this report may be
found at Exhibit A.

Nikolaus Wirsz presented a written report on the activities of Working Group Two (Projection
Radiography and Angiography). A copy of this report may be found at Exhibit B. Members
of WG-02 were encouraged to focus on the existing approved work item before launching into
other areas.

The written report on the activities of Working Group Three (Nuclear Medicine) was reviewed
and accepted by the Committee. A copy of this report may be found at Exhibit C.

Alan Rowberg presented a written report on the activities of Working Group Four
(Compression). A copy of this report may be found at Exhibit D.

David Clunie made a short oral presentation on planned activities of Working Group Five
(Exchange Media).

Andrei Leontiev presented a written report on the activities of Working Group Six (Base
Standard). A copy of this report may be found at Exhibit E. Additionally, Rob Horn of Agfa
Health Care provided a short, oral report on the application of Unicode.

Charles Parisot presented a written report on the activities of Working Group Seven
(Radiotherapy). A copy of this report may be found at Exhibit F.

Nikolaus Wirsz presented a written report on activities of Working Group Eight (Structured
Reporting). A copy of this report may be found at Exhibit G.

No report was available on the activities of Working Group Nine (Ophthalmology).

Cor Loef presented a PowerPoint presentation on the activities of Working Group Ten
(Strategic Advisory). A copy of this report may be found at:
http://medical.nema.org/Dicom/minutes/Committee/2002/2002-09-24/WG-10_report_09_2002.ppt.
Members agreed that there was a need to review and vote on revisions to the New Work Item
request that had been submitted to ISO’s TC215. However, since there was no capability for
highlighting the changes, members postponed the review until the meeting at RSNA.

Janet Keyes presented the written report on activities of Working Group 11 (Display Function
Standard). A copy of the report may be found at Exhibit H. Ms. Keyes also reviewed the
WG-11 response to questions raised by the DSC at its June meeting. That response may be
found at Exhibit I.
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DICOM Standards Committee
September 24, 2002

Jan Rorive and Emmanuel Cordonnier, co-chairs of Working Group 13 (Visible Light),
reported on the reactivation of this group and its first meeting on September 17 in Frankfurt.
A copy of the report may be found at Exhibit J.

Lawrence Tarbox, chair of Working Group 14 (Security), presented a written report on
activities of this group. Members met on the day following the DSC (June 25, 2002) in the
same room. A copy of this report may be found at Exhibit K.

Janet Keyes presented the written report on activities of Working Group 15 (Digital
Mammography). A copy of that report appears as Exhibit L.

David Clunie presented an oral report on activities of WG-16.

No report was received from WG-17.

No report was received from WG-18. However, David Clunie noted that members of WG-18
are scheduled to present a draft of Supplement 70 (Clinical Trials Identification) to Working
Group Six during its October meeting. They will be seeking authorization for letter ballot.

Fred Behlen presented a written report on the activities of WG-20. A copy of that report may
be found in Exhibit M.

No report was available from WG-21. However, David Clunie and Andrei Leontiev indicated
that representatives of WG-21 plan to attend the October meeting of WG-06 to present their
CT supplement.
15. New Business and Agenda Items for the September Meeting

Report on the NEMA/COCIR/JIRA Security and Privacy Committee (SPC) – Dwight Simon
and Rob Horn gave a short presentation on the origins and activities of the SPC. A copy of
their presentation may be found at:
http://medical.nema.org/Dicom/minutes/Committee/2002/2002-09-24/SPC_Slides_for_DICOM_Cmte_2002-09-24.ppt.

Charles Parisot noted that DICOM will celebrate its 20th anniversary in 2003. He solicited
suggestions on how to acknowledge this event. One possibility is to convene a DICOM
Congress that involves all members of the committee and all working group chairs. Persons
having additional suggestions are encouraged to forward them either to Mr. Parisot
charles.parisot@med.ge.com or to Committee Secretary Howard Clark
How_Clark@nema.org.

David Clunie suggested that it might be desirable to provide some awards at RSNA for
persons have made significant contributions to the DICOM community over the years.
16. Time and Place of Future Meetings
The next meeting of the DICOM Standards Committee is planned for December 5, 2002 at RSNA in
Chicago. In 2003, the Committee’s spring meeting will be held in Taipei, Taiwan on April 3. Its
summer meeting is scheduled for June 24th in London. Charles Parisot will work with David
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DICOM Standards Committee
September 24, 2002
Harvey to obtain a meeting space for us in London. The fall meeting will be held at NEMA on
September 23, 2003 and the RSNA meeting will occur on December 4, 2003.
17. Adjournment
The meeting was adjourned at 3:30 PM.
Reported by:
Howard E. Clark
Secretary
October 3, 2002
Reviewed by Counsel:
October 4, 2002
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DICOM Standards Committee
September 24, 2002
Exhibit A
WG-01 Report 2002-09-24
Harry Solomon, Co-Chair
WG-01 continues to meet regularly, including a two-morning telephone conference in June, and
most recently a meeting on August 30 in Berlin (in conjunction with the European Society of
Cardiology Congress). That meeting included a joint session with the newly reconstituted WG-02.
Supplement 66 – Cath Lab Structured Reports has been approved by WG-06 for Letter Ballot.
This has been the principal effort of WG-01 for the past five years, and is finally coming to
fruition.
It is important to recognize the close working relationship with WG-08 and WG-12 to develop
common approaches and common templates for the class of Evidence Document structured
reports. That liaison included a week of meetings in April during which all three groups met and
were able to coordinate their approaches.
WG-01 continues to work on additional cath lab structured reports, including quantitative
arteriography and ventriculography, and intravascular ultrasound measurements.
Our next meeting will be in November, again in conjunction with WG-08 and WG-12.
Exhibit B
DICOM Working Group Two
(Projection Radiography and Angiography)
Status Report
The Working Group Two was revived by accepted Work Item Proposals from DSC June meeting.
The 1st meeting took place in Berlin, August 29th and 30th. A joint meeting with WG-01 was
held.
The new WG-02 managed to:
 Constitute the group and elaborate a Strategy Document for the new WG2 scope.
 Agree on a meeting frequency (four meetings/year) that permits joint meetings with WG-01
(two per year at least).
 Identify a first draft of requirements (incl. details) for improving the XA IOD.
 Discuss a strategy to proceed on the remaining two Work Items.
 Prepare a presentation of WG-02 activity to WG-01 and discuss it in a joint meeting. No
conflicts were identified; agreement on procedure was achieved. The current XA IOD
should be updated moderately. A new enhanced XA IOD shall be developed in parallel.
The current WG-01 supplements dealing with reports shall be checked by WG-02 use to
provide solution for the “Simple Report” Work Item.
 Assign home-work items for the members to prepare next meeting: “review proposed
supplements #66 and #76 to determine how they may influence WG-02’s plans and
priorities” and “identify further requirements for changes to the XA IOD.”
WG-02 will also contact WG-05 for a joint strategy on the “Single Patient Medium” Work Item
proposal.
On October 22nd a Phone-Conference is scheduled to discuss the results and status of assigned
homework and to prepare the next meeting.
Next Meeting:
The group’s next face-to-face meeting will be held on November 21 and 22 in Chicago, IL in
conjunction with the American Heart Association and WG-01. The Nov. 21 meeting will be for the
afternoon only and will include a joint meeting with WG-01.
The next steps are to:
 Set up a first draft for amending the current XA IOD.
 Review and refine the requirements for a new enhanced XA IOD.
 Continue with other Work Items.
Respectfully submitted,
Heinz Blendinger, Chair
Exhibit C
Report to DICOM Committee on WG-03 (NM) Business
Jeff Pohlhammer, August 19, 2002
Since the last WG-03 report to the DICOM Committee, WG-03 members have been involved
in two meetings. First, came a joint meeting between WG-03 members and the ad-hoc
Nuclear Cardiology committee sponsored by the SNM. This meeting took place at the SNM
annual meeting in Los Angeles in June. This meeting was part of a series of meetings that
have occurred over the last two years to help promote and improve DICOM implementations,
improve inter-operability among NM systems, and to educate the NM community. Second, an
official WG-03 meeting was held (via phone conference) in late June. The purpose of this
meeting was to finalize four CPs that were a direct result of the joint SNM discussions. These
four CPs were approved for submission to WG-06 at their next meeting.
Due to some early feedback about one of the CPs, the chairman expects to conduct another
WG-03 meeting before the end of August to discuss the feedback and possibly revise the CP.
Jeff Pohlhammer
Philips Medical Systems, Inc.
NM Division
595 Miner Road
Highland Hts, OH 44143
Tel: (440) 483-7366
Email: jeff.Pohlhammer@philips.com
Exhibit D
WG-04 (Compression) Report
September 24, 2002
Alan Rowberg, Chair
Working Group Four (Compression) held a meeting on February 27, 2002 during the SPIE Medical
Imaging meeting in San Diego and a WebEx teleconference on April 11, 2002.
Committee members reviewed the work item on the flexible transmission of compressed images that
has been approved by the DICOM Standards Committee and the draft use cases. Both may be found
in: http://medical.nema.org/Dicom/minutes/WG-04/2002/2002-02/Wg4WorkItem.doc. After
extensive discussion of various options, participants decided to prepare a white paper that reviews
each of the potential options. The draft of this is at the private ftp site WORKGRPS/Wg04 as
WG-04_Alternative_Syntax_2002-05-24.doc. The goal is to have it ready for presentation to
Working Group Six at its October meeting, but it might not get on their agenda until the following
meeting.
At the July 2002 meeting of JPEG 2000, they issued calls for proposals for:
 Part 8 - JPSEC for security addressing content protection for image files, including
encryption and access protocol
 Part 9 - JPIP for interactive protocol
 Part 10 - JP3D for 3D and volumetric imaging
 Part 11 - JPWL for wireless applications
Their next meeting is October 21-25 in Shanghai, China. DICOM will be represented.
Chris Brislawn brislawn@lanl.gov of Los Alamos Labs, the co-editor of JPEG 2000 Part 10,
volumetric imaging (JP3D), has expressed great interest in having the medical community more
involved in defining specifications for this standard. He also requested that use cases be supplied
and data was made available for testing. They are still in early stages of defining requirements. WG17 may be interested in supporting this activity.
WG-13 is proposing a work item for MPEG-2, since JPEG 2000 will not offer anything better for
compressing video.
The next meeting of WG-04 is not yet scheduled, and will depend on the results the review and
discussion of the white paper.
Exhibit E
DICOM Working Group 6 (Base Standard)
Status Report
June 22, 2002
Scope of WG6 work
WG6 maintains the overall consistence of the DICOM standard. It provides technical guidance to
all DICOM working groups and serves as the technical coordination point. It also develops
extensions (Supplements) to DICOM typically related to overall systems enhancements. Some of
the responsibilities include:
 Executing the DICOM Maintenance Process (Correction Proposals). The process is used to
make “corrections and minor changes” to the current versions of the Standard. Any
corrections made are processed using the normal Letter Ballot procedures as defined by
NEMA.
 Provision of technical coordination and guidance for all WGs. This includes review and
official approval before the Public Comment, Letter Ballot, and Final Text draft releases of
all supplements.
 Development of Supplements to the standard related to Print, Image Management, etc.
 Coordination of joint development efforts with CEN, JIRA, and Medis DC.
 Coordination with NEMA for the publication of DICOM.
Meetings Held Since Last Report

September 3 – 6, 2002.
Specific Deliverables
DICOM Maintenance Process
 In the meeting, total of 44 CPs were processed.
 Correction Item Packet 17 (19 CPs) has been approved for Final Text.
 Correction Item Packet 18 (6 CPs) was issued for Letter Ballot.
 Correction Proposal 304 was cancelled.
 See attached document for detailed Correction Proposal Log.
Supplements Currently Being Developed by WG6
 Supplement 44: Clarify Network Addressing and Retire Non-TCP/IP Communication has
been reviewed and approved for Final Text
 Supplement 64: Revised Part 2 Conformance - development work on items for it continues.


Supplement 67: Configuration Management completed Public comment period with appx.
100 comments; updated revision of this supplement has been reviewed and it is expected
that it will be subjected to the trial-use phase after all comments are addressed.
See attached document for detailed Supplement Status.
Review and Approval of Supplements Developed by Other WGs
 Supplement 26: Ultrasound Procedure Reports has been reviewed and approved for Letter
Ballot.
 Supplement 45: Ultrasound Staged Protocol Data Management has not completed Public
Comment period. It will be reviewed at the next meeting.
 Supplement 55: Attribute Level Confidentiality has been reviewed and the comments from
the letter ballot addressed by the WG14. The Supplement has been approved for Final Text.
 Supplement 58: Enhanced CT Image Storage SOP Class has completed Public Comment
period, however, no updated version of the Supplement was presented by WG21. Currently,
WG6 will not be able to take on this supplement until its meeting in October 2002.
 Supplement 63: Multi-Dimensional Interchange has not been acted upon.
 Supplement 65: Chest CAD SR SOP Class has completed public comment period and is
now being worked on by WG15.
 Supplement 66: Catheterization Lab Structured Reports has been approved for Letter Ballot.
 Supplement 69: 640 MB and 1.3 Gbyte 90mm MOD Medium format and use in US profiles
has been approved for Final Text.
 Supplement 70: Clinical Trials Identification has completed Public Comment period and is
now being worked on by WG18.
 Supplement 71: Vascular Ultrasound SR has been reviewed with members of WG12 and
approved for Public Comment.
 Supplements 72: Echocardiography SR, 73: Multi-Dimensional Registration, 74: RT
Worklist Extensions and Calculation Service Model, 75: Patient Clinical History, 76:
Quantitative Arteriography and Ventriculography SR, 77: Intravascular Ultrasound SR, 78:
Fetal and Pediatric Echocardiography SR; 79: Breast Imaging Report; 80: DVD-R Media
Application Profile have not been acted upon
 See attached document for detailed Supplement Status
Miscellaneous
 Miscellaneous support was provided to review and answer other WG questions and/or
documents, in particular, WG1, WG12, WG15.
 WG6 developed and approved a policy for coded term review and collaboration with WG8
in preparation of Correction Items and Supplements that require modification of DCMR; it
is expected that (upon agreement by WG8) this policy will become effective in Sep 2002.
See attached document for further details.
 WG6 will meet at the following dates and places in 2002:
o September 3-6, NEMA
o October 28-31, NEMA
DICOM Publication
 No date for DICOM 2002 has yet been set; since the standard is now being published
electronically, it is the goal of WG6 to prepare it for publication on the DICOM web-site
before the end of the year.
New Work Items
WG6 continued to work on the work item request for revision of the Annex M in Part 4 (modality
workflow support) which is being submitted for the Committee’s approval.
Respectfully submitted by:
Andrei Leontiev
Chairman, DICOM WG6
Exhibit F
Report to DICOM Committee on WG7 (Radiotherapy) Business
David Murray, September 15, 2002
Since the last WG7 report to the DICOM Committee (June 11, 2002), a WG7 (RT) Meeting
was held on Thursday July 18, 2002 in Montreal (during this year’s AAPM).
A significant number of RT-related CP’s were discussed at this meeting, as reported in the
WG7 meeting minutes. Currently three CP’s (306,307,308) are ready for presentation to WG6,
and will be presented whenever a WG7 representative is available to attend. A number of
other CP’s are nearing completion and will be ready for introduction following the next WG7
meeting.
The Ion Therapy subgroup has been active in developing a new proposal. This work is
ongoing, and will continue at a subgroup meeting at ASTRO.
The NEMA RT Section Meeting (held the same day as the WG7 Meeting) discussed the topic
of DICOM demonstrations at AAPM and ASTRO in 2003. This discussion was continued in
WG7, and subsequently in a phone conference. The current plan is to demonstrate connectivity
of RT Structure Set, RT Plan, and RT Image objects, and develop publicity material and hold a
seminar on the show floor(s). This project also has the support of the AAPM Computer
Committee. Planning will continue at the ASTRO WG7 Meeting.
An issue was raised regarding the importance of providing patient position information in PET
images that are to be used in radiation therapy. It appears that often this information is not
provided in PET images. Communication with WG6 and WG3 is ongoing to determine how
to encourage the passing of this information.
The next WG7 will be held at ASTRO (New Orleans), Thursday October 10, 2002.
David C. Murray, PhD
Director of Product Development
TomoTherapy, Inc.
1240 Deming Way
Madison, WI 53717-1954
Tel: (608) 824 2821
Email: dmurray@tomotherapy.com
Exhibit G
Working Group 8 (Structured Reporting) Report
September 09, 2002
Frank Krickhahn, Chairman
Working Group 8 (Structured Reporting) met 3 times in year 2002. The meetings usually take place at
the College of American Pathologists (CAP) in Chicago. WG 8 has scheduled the next meeting for
November 2002.
In a close cooperation DICOM WG8 supported other DICOM Working Groups in the creation of
Structured Reporting related supplements:
 Supplement 26: OB-GYN Ultrasound Procedure Reports (Responsibility: WG 12)
 Supplement 65: Chest Computer-Aided Detection SR SOP Class (Responsibility: WG 15)
 Supplement 66: Catheterization Lab Structured Reports (Responsibility: WG 1)
 Supplement 71: Vascular Ultrasound SR (Responsibility: WG 12)
 Supplement 72: Echocardiography Procedure Reports (Responsibility: WG 12)
Working Group 8 continued working on Supplement 75 Patient Clinical History. The
supplement is planned to be published for Public Comments in October 2002.
Working Group 8 reviewed and created Correction Proposals to correct and clarify the
Structured Reporting related parts of the DICOM Standard.
As already reported by the last report, Working Group 8 created a document that
addresses some issues related to the creation and maintenance of codes and sent it to
WG 10 for decisions. In result of this document WG10 recommended the transfer of the
Ad Hoc Group on Codes from WG6 to WG8.
The last meeting of WG8 in August was the first joint meeting between WG8 and the Ad
Hoc Group, represented by Richard Crane. The cooperation works very well and a lot of
coding related work was done.
Another work item of WG6 is the determination of DICOM SR related information for
inclusion into DICOM Conformance Statements. First drafts were created. This topic is
still in an early phase.
First steps were gone to develop a machine readable representation of Part 16 of the
DICOM Standard. A
database is under construction with the goal to include all codes used by DICOM as well
as related information (e.g. point of use, maintenance information).
Respectfully submitted,
Frank Krickhahn
Exhibit H
Report from DICOM Working Group 11 (Display)
Sept 19, 2002
We have had one meeting since the last report.
We met for two days in July at NEMA. We are focussed on finishing up our Hanging
Protocols workitem. We made good progress on this.
The remaining work is on encapsulating the filtering portion in DICOM text. We
now expect to have an initial draft by the end of this year.
We responded to several questions raised in email, including issues put forth by a
Siemens representative at the DICOM standards committee meeting on June 25th.
We have scheduled the next two two-day meetings (Sept at DC and Dec at RSNA). At
Dec, we will also include a 1/2 workshop discussion on color in DICOM as part of our
2-day meeting.
Work on Interactive Collaboration has mostly been tabled until we complete Hanging
Protocols.
Next meetings are Sept 19th and 20th in DC, and Dec 2nd and 3rd in Chicago at
McCormick Place at RSNA.
Bradley Hemminger
WG 11 chairman
Exhibit I
WG 11 response (7/9/2002) to questions raised by Niki Wirsz of Siemens on June 22, 2002.
Michael Jonas, the Siemens representative to WG11, raised several important points that Niki
Wirsz asked the DICOM Standards Committee (DSC) to address at their June 25th meeting. A
brief discussion at the June DSC meeting was held, and the DSC asked WG 11 to follow-up on this
at their next meeting. At our WG 11 meeting on July 9-10th, we discussed this and wrote this
response to help clarify some of these issues for Siemens and the DSC. Also, Janet Keyes and Alan
Rowberg will be available at the next DSC meeting to help answer any further questions. Below is
the WG11 response to the questions raised in the Siemens email discussed at the DSC meeting.
New query models. Hanging protocols do indeed use a new definition of sequence matching
methods within the C-FIND query model. This decision in Feb 2001 was based on feedback from
WG6 as to how we should fit HP into the DICOM model (normalized). This was required because
a HP definition is made up of variable combinations of abstract concepts (modality, anatomy,
procedure intent). In Oct 2001 we constructed the initial query model to do multiple item sequence
matching to identify hanging protocols. This was further refined to allow for multiple item
matches within nested sequences. This is crucial to allow sufficient power to differentiate when
selecting between different hanging protocols. The sequence matching definitions are based
directly on other parts of DICOM (PS 3.4 section C.2.2.2.6). This work has been completed (as of
the July WG 11 meeting).
Invisible image boxes. The virtual image boxes were defined to enable the exchange of different
parts of a presentation. For instance in digital mammography, the radiologist views right and left
CCs at full resolution, then right and left MLOs at full resolution because the electronic display
resolution is not capable of displaying all four images at full resolution at once (like on film). If the
hanging protocol communicates only the initial presentation of right and left CCs, then, it does not
capture what the standard softcopy or hardcopy (film) presentations would display (CCs and
MLOs). However, by having virtual image boxes, the intent to present additional material (in this
case the MLOs) can be indicated.
We do not believe this to be a complicated concept. It has already been defined in the HP IOD and
requires only two attributes (group value and description text for group value). Note that vendors
can easily choose whether or not to support the “invisible” virtual views. Simply rendering only the
initial presentation views (Display Set Presentation Group value = 1) would be equivalent to not
supporting virtual views.
Currently the WG 11 is not well staffed by the industry. This is a very important point, and a major
concern of WG 11 and probably other working groups. Since September 11, 2001, our attendance
has significantly decreased. Because of security and financial concerns, attendance at WG11,
especially from vendors, is about half of what it was previously. This has caused us to make
slower progress than desired, as well as to attempt to try other ways to facilitate vendors’ attendance
(increased meetings at conferences or other locales).
Other important work items are being postponed or neglected, for example there is no
proposal on Color Soft Copy Presentation States, due to the amount of work on complex HP
definitions and due to the unavailability of members in WG 11 meetings. While the lack of
attendance has certainly had an effect on WG 11’s overall progress, the progress on HP has been
good. We will have an initial review after our next meeting, and hope to go to public comment
shortly after that. With respect to color, we would be glad to see a concerted effort by DICOM in
this area. WG 11 has investigated this several times in the past two years, with an intensive effort
during the last six months in response to renewed discussion in other DICOM groups. However,
we still have not found champions in DICOM with clear needs or use cases. We have identified
possible standards to utilize (e.g., ICC, in WG 11 color subdirectory on the NEMA Server) and
ways to accomplish this under DICOM (preliminary proposal for Color Softcopy Presentation State,
July 2001 WG 11 meeting minutes). We are continuing to investigate this, and will be holding a
one day discussion workshop on color in DICOM at RSNA to try to identify the needs and
functional requirements, to help DICOM determine whether to formally pursue color as a work
item (whether in WG11 or another group).
The following suggestions were proposed in the email.
1. WG 11 to apply a more pragmatic staged method for defining HP starting with minimal HP
requirements to emulate the way users are using an alternator today. Follow up with incremental
functionality. Much thought has been given to the scope of the current HP object. Some parts are
inherently complex (needing to define new query matching), but we believe we are implementing a
minimal object that meets the needs that have been identified to us.
2. An initial simpler HP concept would make HP more interesting for real-world applications.
Again, we would welcome hearing any proposals that are simpler yet meet the application needs
that have been identified to us. Also, the early draft work is nearly complete at this time; any
change would likely delay the HP object further.
3. Ensure increased contribution from other vendors in WG 11. We welcome any suggestions on
how to accomplish this. We have scheduled some of our meetings to overlap with other groups
(like WG 17) to increase attendance and attempt to get more input on the color issue, and we are
scheduling a meeting at RSNA this year, as well as SPIE 2003, because our members have
indicated that they can attend then (and not at other times). The biggest issues seem to be cutbacks
in company finances. We have had the return of Kodak representation (Craig Cornelius) beginning
in July, and we hope that other vendors will begin attending again. Both Siemens (Michael Jonas)
and R2 (Janet Keyes) have been consistently present, and major contributors.
4. Start work in parallel on Color Presentation States. This is occurring. More progress would
occur if we had more active participation from DICOM members (both in WG 11 and other
groups). We will send out an invitation to the entire DICOM membership in the fall to advertise
the RSNA discussion workshop (December 2). We welcome any suggestions on how to proceed
with respect to color.
Siemens has made significant contributions to WG 11, and we appreciate their support, especially
when other companies have not been able to make such commitments in recent times. We appreciate
their comments, and we hope these responses help clarify the work ongoing in WG 11. The
chairman, Brad Hemminger, would be glad to answer any questions, and Janet Keyes (Supplement 60
editor) and Alan Rowberg will be available at the next DSC meeting to answer any follow-up
questions to this.
Exhibit J
Report to DICOM Committee on WG-13 (Visible Light) Business
Emmanuel Cordonnier, September 18, 2002
Overview
Following the DSC recommendation, WG13 "kick off" meeting has been organized in
Frankfurt on September 17, 2002. The MPEG2 Work Item definition has been refined to be
submitted to the DSC.
Organization
The interim organization: secretariat (European Society of Cardiology) and co-Chairmen (Jan
Rorive from Sony Europe and Emmanuel Cordonnier from Etiam) will be maintained until the
next meeting. DSC should tell how to proceed for official WG management and membership.
Attendees at the meeting
Thirteen people participated to the meeting, including one through t/con from the US. Three
user organizations including European Society of Cardiology and College of American
Pathologist, and seven companies were represented from Europe and USA, active in
Endoscopy, Ophthalmology, Microsurgery, and Dentistry.
Work Item definition agreement
All agreed to focus first on MPEG2 MP@ML VL Application Profile for CD-R and DVD-R.
Main Profile / Main Level has been chosen to fit with existing analog and digital video
equipment.
Working Group Rationale Update
Potential Future Work Item have been anticipated:
 Extension to Streaming Video can be studied.
 Extend the VL Microscopic Image IOD to large pixel dimension objects.
 Color Display Function Standard with calibration of color equipment
Next Meeting
A meeting of WG-13 will be held on Wednesday, November 20, 2002, in Dusseldorf,
Germany (in conjunction with the annual MEDICA Show).
Emmanuel Cordonnier, Co-chair
Exhibit K
Working Group 14 (Security) Report
Apr 30, 2002
Dr. Lawrence Tarbox, Chair
Working Group 14 (Security) met once since the last DICOM Committee meeting. WG 14 has
scheduled meetings for September at NEMA and at RSNA 2002.
WG 14 continues its work on the audit trail message work item in collaboration with the HL7 Security
and Accountability SIG. The HL7 and DICOM editors have bee cooperating to produce a draft
standard. Due to the unique nature of this joint effort, the editors have suggested an alternate route for
publication, where the base work is published as an RFC through the IETF, which is then referenced
by the individual organizations. WG 14 will discuss this proposal along with other possible
alternatives at its September 25th meeting.
WG 14 also is progressing on the work item for adding Digital Signatures to Structured Reports, and
will be considering drafts in coming meetings. The WG 14 will continue to coordinate with WG 8 in
this effort.
Respectfully submitted,
Lawrence Tarbox, Ph.D.
Exhibit L
WG 15 (Mammography and CAD)
Report to DICOM Standards Committee: September 16, 2002
WG 15 had a teleconference on June 27, at 3:00pm EDT. The next meeting is October 1-2, 2002 at
the ACR in Reston, VA.
1.


Supplement 65, Chest CAD SR:
Decided to downsize, and re-submit to WG 6 for Letter Ballot at the October meeting.
WG members are obtaining clinical feedback on the latest revision.

Supplement 79, Breast Imaging Report (SR):
Incorporated feedback from WG 6. Preparing to submit to WG 6 for Public Comment at the
October meeting.

Supplement 75, Patient Clinical History (for Breast Imaging):
Incorporated feedback from WG 8 and WG 12. Preparing to submit to WG 6 for Public
Comment at the October meeting.
2.
3.
4.




Correction Proposals
CP-275, Transitivity of Enumerated and Defined Templates: Passed Letter Ballot. Final
text approved. The three Supplements are being updated accordingly.
CP-290, SNOMED code updates for Mammography CAD SR context groups: Passed Letter
Ballot. Final text approved.
CP-305, Fix requested for Mammography CAD SR TID 4006, Row 17, Relationship with
Parent error: Included in Ballot Packet 18.
CP-339, Add missing Code Definitions to PS 3.16, Annex D: Reviewed by WG 6 and
assigned a number. WG 15 will complete and review the definitions.
There are no requests of the Committee at this time. WG 15 will update its section of the DICOM
Strategy document during the October 1-2 meeting.
Respectfully submitted,
Janet Keyes
WG 15 co-chair
Exhibit M
DICOM Standards Committee
September 24, 2002
Report from WG20 (Imaging Integration)
The chartered mission of the working group is:
 The development of DICOM and HL7 standards for image related information for areas where
the consistent use of HL7 and DICOM is of prime concern.
 The coordination and mutual education and understanding between the HL7 and the DICOM
organizations and their technical committees / working groups.
Development activities are focused on Imaging Support in HL7 Version 2.5, HL7 Version 3
messaging, and Version 2 of the Clinical Document Architecture (CDA).
Version 2.5: The new message OMI (“Order Message for Imaging”), an order message
containing the new imaging information segment “IIS”, was in the Version 2.5 committee-level
ballot. All issues have been resolved with this message, and Verssion 2.5 is scheduled for
Membership Ballot following the Baltimore meeting in next week. Thus, Version 2.5 is expected
to become a Standard after January 2003.
CDA: A Mapping of SR Content Items to RIM constructs has been presented and reviewed, and
work on this mapping is ongoing. Separately, in the Structured Documents Technical Committee,
which some members of WG20 attended:
 CDA Release 2, which is to have a revised header and Level 3 content, is planned for a
public comment draft after the September meetings, and first Committee ballot after the
January meeting. Thus the earliest date for CDA Level 3 standard would be May, or more
likely October, of 2003.
 Level 2 will be accomplished by Templates constraining the content of Level 1 documents.
Template efforts in HL7 remain strong.
HL7 Version 3 Messaging: A draft Refined Message Information Model (RMIM) for Version 3
messaging was reviewed. Much remains to be done before a Version 3 ballot document with
messages for IHE interfaces can be completed, but recent progress is highly encouraging.
Conclusions
The Version 2.5 facilities for Imaging Integration are essentially complete. The working group
appears to have reached the critical mass of HL7 Version 3 understanding to make significant
progress in producing HL7 CDA and Version 3 messaging standards for imaging integration. This
is fortuitously coincident with the maturation of Version 3 and the CDA. While we can continue to
make progress with the existing resources, we remain limited by the lack of a RIM Harmonization
Facilitator. Version 3 messaging cannot be brought to ballotable form without someone in this role,
which requires annual attendance of three RIM Harmonization meetings as well as the three
working group meetings. HL7 will provide training and tools for this person, but we will have to
identify a resource with time and travel support sufficient for this role. In the meantime, progress
toward CDA representation of DICOM SR documents can will be made with present resources.