DICOM Fields of Use Allan G. Farman Professor of Radiology & Imaging Science, University of Louisville, Kentucky, USA < Founding Co-Chair DICOM Working Group 22 (Dentistry) AAOMR Representative-Designate to DICOM Standards Committee President, AAOMR DICOM fields of use • DICOM Standard contains: – Services, SOP Classes, Templates, etc. – Cross-Discipline Standards [Preferred] – Field of Use Specific Standards [Where needed] • DICOM Working Groups – Cross-Discipline [n=17] – Field Specific [n=10] • DICOM Member Organizations – Vendors + Users + General Interest – Users represent Specific Fields of Use DICOM fields of use http://medical.nema.org/ Working Groups Listed Include Those Specific to Fields of Use Fields of Use Represented by Member Organizations Fields of Use Represented in Standard DICOM fields of use 10 of 27 WGs represent specific fields of use Mammography Cardiology Nuclear Med Dermatology Radiation Therapy Veterinary Med Dentistry Ophthalmology Surgery Pathology WG-27 Web Services DICOM fields of use Ophthalmology Cardiology WG 1 Veterinary Medicine Dentistry WG 22 Pathology Diagnostic Radiology AAOMR & AAO APPLICATIONS PENDING Diagnostic Radiology Cardiology WG 1 Diagnostic Radiology Health Informatics Diagnostic Radiology Diagnostic Radiology Diagnostic Radiology Health Informatics DICOM fields of use •Therefore DICOM has something for you if you make or use systems in any of the following fields: – – – – – – – – – – – – – – – – Diagnostic Radiology Radiation Therapy Image Guided Surgery Mammography Cardiology Dentistry Pathology Ophthalmology Dermatology Veterinary Medicine Endoscopy Microscopy Clinical Photography/Video Computed Tomography Magnetic Resonance Imaging Ultrasound – – – – – – – – – – – – – – – – Nuclear Medicine Positron Emission Tomography Molecular Imaging Optical Coherence Tomography Tomosynthesis Image Fusion Structured Reporting Structured Displays Picture Archiving and Communications Systems Web Access to DICOM Objects Implants Angiography Image-Generated Models Teaching Case Files Surgery (Endosseous Implants) Prosthetic Chain and CAD/CAM DICOM fields of use • Discipline Unique Supplements – e.g. – – – – – – – – – – Supplement 32 - Dental Digital Radiographs Supplement 74 - Radiation Therapy General Purpose Worklist Supplement 91 - Ophthalmic Photography Supplement 92 - Dental Grayscale Image Application Profiles Supplement 97 - CT/MR Cardiovascular Analysis Supplement 122 - Specimen Identification in Pathology Supplement 125 - Breast Tomosynthesis Image Storage Supplement 126 - Colon CAD Structured Reports Supplement 128 - Cardiac Stress Test Structured Reports Supplement 130 - Ophthalmic Refractive Structured Reports DICOM fields of use Supplement 92: Grayscale Media Applications for Dentistry A lternative Digital S ystem in S ame O ffice Possible N etwork for DIC O M N etwork Interchange Removable Media Hospital or Physician Removable Media Images referred to specialist e.g. O rthodontist Removable Media Domain of DIC O M Dental O ffice Media Data Removable Media e.g. Maxillofacial S urgeon Interchange Removable Media Removable Media e.g. E ndodontist Removable Media Practice management data base archive Removable Media S atellite Dental O ffice DICOM fields of use the Dentist’s viewpoint… for Dentistry Supplement Or 92:from Grayscale Media Applications Forensics Patient Hospital or Physician Images referred to specialists Orthodontist 2y Admin Uses General Dentist Satelite Dental Office Oral Surgeon Endodontist Practice management data base archive Alternative Digital System in Same Office DICOM fields of use • Cross-Discipline Supplements – e.g. – – – – – – – – Supplement 47 - Visible Light (Endoscopy/Photography/Microscopy) Supplement 85 - Web Access to DICOM Objects Supplement 104 - Encapsulation of PDF Document Supplement 113 - DICOM e-mail Transport Supplement 116 - 3D X-Ray Supplement 123 - Structured Display Supplement 131 – Polygonal Surface Description Supplement 132 - Implant Description Storage SOP Class DICOM fields of use Structured Display Supplement 123 WG 9 WG 22 Dentistry Intraoral X-Ray Series Cardiology WG 1 Ophthalmology Eye Charts Radiology Teaching Cases WG 10 & 20 DICOM fields of use Structured Display Image Boxes (1.0, 1.0) (0,0) BLHC One of Many Standard Dental Radiographic Display Templates DICOM fields of use Standard Ophthalmology Charts DICOM fields of use 3D-X-ray Supplement 116 WG 15 WG 22 WG 2 Dentistry CBCT Mammography Tomosynthesis & CBCT Angiography Radiation Therapy Planning WG 7 CBCT ≥180o Rotation Solid State Detector Patient Raw (basis) Images CBCT Image (Isotrophic Data) Procedure Control Image Processing DICOM fields of use Dental impaction TMJ Osteoarthrosis “Bisphosphonate” R L L Osteonecrosis Mucous Extravasation R. Maxillary Sinus L L R L Carotid Calcified Atheroma Unerupted maxillary third molars without cysts DICOM fields of use • DICOM provides – A set of basic rules for all disciplines – Discipline specific rules where necessary – The aim has been to keep the Standard as coherent as possible by having disciplines interact to develop answers with as wide a scope as possible… and to provide use cases from representative disciplines concerned.