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MINUTES
DICOM STANDARDS COMMITTEE (DSC)
November 29, 2012
Chicago, IL (@RSNA)
Members Present – Manufacturers
Agfa Healthcare
CoreLab Partners
Etiam
GE Healthcare
Hologic
Philips Healthcare
Siemens Healthcare
Toshiba Medical Research Institute USA
Represented by
Rob Horn for Geert Claeys
David Clunie
Emmanuel Cordoniere
Harry Solomon
Janet Keyes
Cor Loef
Nikolaus Wirsz
Kevin O’Donnell
Members Present – Users
AAPM
ACR
American Dental Association
American Academy of Oral and Maxillofacial
Radiology
French Radiological Society
Society for Imaging Informatics in Medicine
Represented by
Donald Peck
John Carrino
Trishul Allareddy
Allan Farman
Members Present – General Interest
JAHIS (Japan)
JIRA (Japan)
Medical Imaging & Technology Alliance
Represented by
Takashi Nakashima
Yukio Ito
Stephen Vastagh
Joel Chabrieux
Paul Nagy
Alternate Voting Member Representatives, Observers and Others Present
Combs, Laura
ACR
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2012-11-29
Moore, Steve
Parisot, Charles
Suzuki, Makoto
Trianni, Annalisa
Wash. Univ. St. Louis
GE Healthcare
JIRA
WG-02/EFOMP
Members Not Represented –Manufacturers
*Boston Scientific
*Carestream Health
*Carl Zeiss Meditec
*Corista
*DeJarnette Research Systems
Fujifilm Medical Systems
*Konica Minolta Medical & Graphic
McKesson Medical Imaging Group
*MEDIS Medical Imaging
*Merge Healthcare North America
Panasonic
*Sony Corp.
*SuperSonic Imagine
Varian Medical Systems
Voting Representative
Tan-Jin Teo
Jonathan Belanger
Tobias Kurzke
Eric Wirch
Charles Stockham
Masao Murata
Michael Laconti
David Heaney
Robert Goedhart
Ronald Cowan
Masayuki Takahashi
Yuji Kohga
Jacques Souquet
Ulrich Busch
Members Not Represented –Users
*American College of Cardiology
*American College of Veterinary Radiology
Brazilian College of Radiology
*College of American Pathologists
*European Society of Cardiology
*Medical Image Standards Assn. of Taiwan
*Spanish Health Informatics Society
Voting Representative
Thomas Gerber
Dennis Ballance
Alair Sarmet. Santos
Ron Ranauro
Nico Bruining
Jenn-Lung Su
Marcial Garcia Rojo
Members Not Represented-General Interest
*Brazil Nat’l Inst. of Science&Technology
*Canada Health Infoway
*FDA Center for Devices and Radiological Health
*India Centre for Development of Adv.
Computing
*Korean PACS Standards Committee
*National Cancer Institute
*Web3D Consortium
Voting Representative
Richard Schafer-De-Martini
Attila Farkas
Kish Chakrabarti
J.S. Bhatia
Hee-Joung Kim
C. Carl Jaffe
Nicholas Polys
* = Does not count toward a quorum at this meeting.
^ = Has not submitted Patent Agreement.
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DICOM Standards Committee
2012-11-29
K. O’Donnell, Co-chair
Presiding Officers:
1. Opening
The meeting was called to order at 9:00 am. The Secretary reviewed the antitrust rules. The
Agenda was approved. The minutes of the June meeting were approved.
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2012-11-29
2. ACR Dose Registry Update
Laura Coombs, Statistician for NRDR http://www.acr.org/Quality-Safety/National-RadiologyData-Registry (lcoombs@acr.org) reported on the increasing customer base of CT dose registry.
The registry is used primarily for benchmarking and quality assurance within the health
providers’ organization.
Coombs further reported that dual energy CTs are reporting dose data. She also discussed the
need for adding a DICOM flag for Iterative Reconstruction (CP-1232.)
Next the group discussed how effectively can radiologists view Dose SR reports and the
benefits of generating a ‘dose screen’ and/or SR (which is machine readable.
D. Clunie noted the need for more work on the display and layout of the dose report. D. Peck
spoke of the difficulties of finding SR data in PACS. Members noted that the DICOM
community looks for guidance on the format of the SR.
It was noted that a an IHE REM profile may be added: “Dose Display Actor.”
Dose data of CBCTs was discussed. A working group within AAPM has been formed.
Lastly DICOM member reported on the work on the Nuclear Medicine RDSR and on the
currently available RDSR for CR/DR fluoroscopy.
3. Private Attributes, National Cancer Institute, Cancer Imaging Archive
https://wiki.nci.nih.gov/display/TCGA/The+Cancer+Imaging+Archive
http://www.cancerimagingarchive.net/
Lawrence Tarbox, Chair, WG-23 and WG-14, and Steve Moore, IHE, MIR, Wash.U. are
working on the referenced archives. They described the challenge of deleting PHI without
deleting private elements. They pleaded for clear conformance statements and for contacts of
manufacturers to determine whether data contains private elements. Deleting private tags can
break applications.
Further they asked for correct use of DICOM tags. They cited the database by D. Clunie and S.
Langer (how private tags are utilized.)help to that CT equipment makersn reconsider populating
fields with private data. Lack of access to such date handicaps private data fields
D. Clunie referenced Sup. 142 – and possible new CP to list private elements and whether the
private elements contain PHI. K. O’Donnell referenced Sup. 121 under development and its
relevance to this issue.
Manufacturers noted that there is an increasing interest among vendors to eliminate private tags.
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DICOM Standards Committee
2012-11-29
Moore and Tarbox noted that they are creating software that will allow users to search a
database of private elements. That software is now operational at:
https://queries.cancerimagingarchive.net/PrivateElementKnowledgeBase/faces/index.xhtml
They also maintain a wiki page with more explanation on private elements and how we de-identify
images. The link to that page is https://wiki.cancerimagingarchive.net/x/ZwA2
4. Membership Application - DICOM Standards Committee
No new applications.
5. Membership Application - Working Groups
The following were approved for WG voting membership.
Tom Nelson WG-11 and WG-12 - AIUM
James Philbin WG-06 - ACR
6. New Work Item Proposals (NWIP)
The Committee reviewed NWIPs that were submitted in due time for Committee approval:
NWIP
Number
NWIP2012-11-A
WG
12
NWIP2012-11-B
23
NWIP2012-11-C
28
Title of Proposal
Simplified Adult
Echocardiography Report
Supplements
Structured Report Model for
Application Hosting
Patient Radiation Dose
Structured Report
Discussion
Resolution
2-3 years’ work was
estimated
Approved
WG-23 needs to be
revived. Coordinate
with WG-20 and WG08
The goal is to
communicate dose
information
independent of
modality. Convertible
to organ dose.
Approved
Approved
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DICOM Standards Committee
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7. Working Group 6 Report
The detailed report of the Chair, Bas Revet was reviewed. The Committee thanked B. Revet
for the comprehensive report and thanked WG-06 for its work.
8. Reports from the Working Groups
The Committee received written reports from WG-02, -04, -06, -15, -20, -22, and -27. The WGCo-Chairs present and the Secretary provided verbal updates, as well. The Committee discussed
the working groups’ activities.
WG-01
The work on the IVOCT Work Item is on hold.
WG-03
The Group reported excellent vendor participation and progress.
WG-08
Progress was reported on work in the IHE; the White Paper turned into integration profile.
Members reported on the work on CDA reporting. The challenge is not to over-specify the
coded content. Plan for next year is to define schema based on Sup. 155. Discussed similar
activities in ESR. In addition the apparent lack of progress on implementation guides was
noted.
The imaging report templates have been discussed together with DICOM’s perceived role. A
White paper to be written by WG-08 was suggested to outline the roles and activities of HL7,
DICOM, and IHE.
WG-10
Identified the need to align DICOM and HL7 FHIR.
WG-11
Reported on Presentation State progress and on Sup. 124.
WG-12
Reported on work on SR. Work on strain imaging is not active.
WG-14
No change since last report.
WG-18
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2012-11-29
The change odf name was suggested to Clinical Trials and Education. ACR will be asked to
serve as the Secretariat. J. Carrino will discuss within ACR.
WG-20
Republished CDA template as Joint DIICOM-HL7 publication.
WG-21
Engaged in development of Sup 121.
WG-22
Work on Prosthetic Value Chain will continue.
WG-23
Feedback from implementers was reported about how to handle distributed applications in the
cloud. It was asked whether WG-23 should look into mobile devices. E. Cordonniere urged
DICOM to be involved with mobile devices and keep up with other new technologies. L. Tarbox
suggested more interaction and cooperation with other organizations.
WG-24
H.Lemke reported on the implementation of Sup 154. They expect a connectathon in three
years.
WG-26
The Group is working on sharing information between the modalities and the LIS.
WG-28
The work on NM RDSR was discussed between WG-03 and WG-28. The dose accounting in
nuclear medicine is complex. Organ dose can be calculated, multiple organs can be involved. It
was suggested to consider reusing RT objects for volumetric data vs. DR 2D data.
The Committee discussed that the physics community is interested in absorbed dose, not effective
dose. It would be desired to record organ dose from which effective dose may be calculated if
needed.
Also discussed occupational safety and concluded that without the vendors of the protection and
monitoring equipment no standardization is possible.
The provision and storage of raw data was also discussed. Noted that there is a raw data object in
DICOM now but it is for MR data. Possible uses by various stakeholders of the raw CT data was
noted. No action item was decided.
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DICOM Standards Committee
2012-11-29
8. Updates of Strategic Statements
The Committee received an update from WG-16.
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9. XML Encoding of the DICOM Standard
The Secretary reported that plans are formulated for a 2013 conversion. More discussion will be
needed when a more detailed proposal is available. It was noted however that Pts 3 and 16 are
available in XML form, now.
10. External Organization Reports
User organizations present provided updates on activities.
ACTION: H.. Solomon suggested that ACR engage with the Clinical Interoperability Council to
stake out position.
The various domains of IHE , as well as IHE Europe reported.
RSNA reported that the uploading of images to EMRs is a priority issue.
ONC – The commnet period was open on MU Stage 2
ACTION:
It was decided that the DSC Executive Committee be authorized
consider and decide whether and what to comment on behalf of
DICOM. (P. Mildenberger and Allan Farman abstained.)
FDA Color management Workshop: outstanding issues for color consistency
ACTION:
It was uinanimously decided that DICOM will participate, D. Clunie
will represent.
FDA Standardized data collection for cardiac imaging was brought to the DSC’s attention.
Echocardiovascular Research Grid –
Conclusion: it would be appropriate for WG-12 to contact and set-up
liaison.
11. DICOM Conference-2013- 20 Year Anniversary
The Conference Committee met during RSNA. A brief status report was given.
12. New Business
No new business was proposed.
13. Time and Place of Future Meetings

Tuesday, March 19, 2013, Bangalore, India
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2012-11-29

Tuesday, August 20, 2013, hosted by RaySearch in Stockholm.

Thursday, Dec. 5, 2013, RSNA, Chicago, IL, USA
14. Adjournment
The meeting was adjourned at 4:45 p.m.
Submitted by
Stephen Vastagh, Secretary
Reviewed by counsel: CRS
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DICOM Standards Committee
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EXHIBIT A
DICOM Working Group 6 (Base Standard)
Status Report
November 16, 2012
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, Workflow
Management, etc.
 Tracking the progress of workitems and supplement and report stalled items (no activity over a
period of three years) to the DICOM Standards Committee.
 Coordination of joint development efforts with ASTM, CEN, ISO, JIRA, and Medis DC.
 Coordination with NEMA for the publication of DICOM.
Meetings Held Since Last Report
27 – 31 August 2012 Washington DC, MITA
3 – 9 November 2012 Washington DC, MITA
Schedule and Quality Issues
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The workload of WG-06 is decreasing because the number of supplements in progress is
substantial reduced. However, a number of the remaining supplement requires substantial
review effort because the complexity and missing experience of the editors (e.g., Sup 148
Second Generation RT and Sup 124 Display Parameters).
We still make use of tcons to resolve routine review and use the face-to-face meetings for more
substantial reviews and discussion, but the frequency is lower by the reduced workload:
 A regular CP teleconference one week in advance of the face to face meeting to clear simple
CP activity has worked well. This is replacing about 2hrs of meeting time with a 2hr tcon.
 We continue using tcons for supplements that appear to have no technical issues, complex
edits, or other demands for face to face discussions. This worked well for Supplements that are
in the stage of the review progress that require a line-by-line review. All new activity is being
forced to obtain a work item before discussion at WG-06. All the current supplement activity
has an approved work item.
The meeting agendas and attendance issues are improving with the use of a two stage agenda
setting. We first distribute a candidate list of meeting times and allow self-selection of removal
from groups that are going to be busy, unavailable, or willing to wait. This has improved the
productivity of the meeting time.
For first reads and minor reviews we have started using web display to reduce the travel burden
on presenters.
Much of the WG-06 face to face meeting time is spent dealing with clarity, precision, and
consistency. This is dealt with somewhat during public comment, and extensively in the final
text and letter ballot discussions.
Specific Deliverables
DICOM Maintenance Process
 In the August and November meetings since last report, 23 CPs are added to the standard
(CPack 67 and 68) and 35 new CPs were processed.
Supplements Currently Being Developed by WG6
 Supplement 115: Evidence SOP Class. In early draft. Discussed in a t-con to reactivate the
progress.
 Supplement 121: Modality Procedure Plan and Protocol Storage. Reviewed in the August and
November meetings. Planned for the February 2013 meeting.
 Supplement 157: Multi-Frame Converted Legacy Images. Reviewed in the August and
November meetings and approved for Public Comment.
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 Supplement 158: Retirement of General Purpose Worklist and Procedure Step. Reviewed in
the August and November meetings and approved as Final Text.
 Supplement 162: Comprehensive 3D SR. Reviewed in the August and November meetings
and approved for Letter Ballot.
 Whitepapers on change management and long term consistency is finished. A new workitem
proposal is on hold, due to the lack of a new champion.
 Application profiles. Discussed in the January 2010 meeting. A white paper to describe the
process of specifying application profiles in conjunction with the IHE Radiology Technical
Committee is in preparation.
Review and Approval of Supplements Developed by Other WGs
 Supplement 124: Communication of Display Parameters. Reviewed in the August meeting.
Planned for the February 2013 meeting.
 Supplement 129: Electrophysiology SR and Procedure Log. No progress over the last 3 years.
 Supplement 138: Crestal Implant Storage. Not reviewed.
 Supplement 147: Second Generation Radiotherapy. Reviewed in the August and November
meetings. Planned for the February 2013 meeting.
 Supplement 154: Optical Surface Scanners Storage. Reviewed in the August and November
meetings and approved as Final Text.
 Supplement 155: Templates for Imaging Procedure Reports encoded in CDA. No progress.
 Supplement 156: Multi-Dimensional Presentation State. In progress.
 Supplement 159: Radiopharmaceutical Administration Radiation Dose Reporting. Reviewed in
the August and November meetings. Planned for the February 2013 meeting.
 Supplement 160: Second Generation Radiotherapy Patient Positioning and Workflow. No
progress
 Supplement 161: WADO Restful Services. Reviewed in the August and November meetings.
Planned for t-con in December.
 Supplement 163: STore Over the Web by RESTful Services (STOW-RS). Reviewed in August
meeting. Planned for February 2013 meeting.
 Supplement 164: Contrast Agent Administration SR Storage. Reviewed in the August and
November meetings. Planned for the February 2013 meeting.
 Supplement 165: Breast Projection X-Ray Image Storage SOP Class. Reviewed in November
meeting.
Currently 17 supplements have been assigned a number and are in progress (draft, public
comment, frozen or letter ballot).
Miscellaneous
 WG6 will meet at the following dates and places 2013:
 February 4 – 8, 2013 at MITA
 April 8 –12, 2013 at MITA
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 June 17 – 21, 2013 at MITA
 August 12 – 16, 2013 at Stockholm, Sweden
 October 14 - 18, 2013 at MITA
DICOM Publication
 Some progress is being made on the DICOM in XML effort. This will be reported separately.
Respectfully submitted by:
Bas Revet
Chairman, DICOM WG6
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