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MINUTES
DICOM WG-27
(Web Technology for DICOM)
June 6, 2011
MITA / NEMA Headquarters
Arlington, VA USA
Members Present
Represented by
ACR/Johns Hopkins University
James Philbin
Agfa Healthcare Imaging
Rob Horn
Aspera, Inc.
Diego Dugatkin
Corelab Partners
David Clunie
GE Healthcare
Chris Lindop (P)
Harris Healthcare Solutions
Timothy Culp
Merge Healthcare
William Lingley
Newport Instruments
Robert Leif (P)
Philips Healthcare
Cor Loef
Tarbox, Lawrence
Lawrence Tarbox (P)
Toshiba Med. Research Institute, USA Kevin O’Donnell
Members Absent
Voting Representative
AAOMR
Allan Farman
Canada Health Systems
Carl Zeiss Medical Software GmbH
Compressus
DeJarnette Research Systems
Ben Macerola
Tobias Kurzke
Laszlo Gasztonyi
Fred Ganong
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DICOM Working Group Twenty-seven
June 6, 2011
ETIAM
Medical Connections, Ltd
Siemens AG – Healthcare Sector
Emmanuel Cordonnier
David Harvey
Nikolaus (Niki) Wirsz
Alternate Representatives, Observers and Others Present:
Coelho Prado, Thiago
Cowan, Ron
Csipo, Dezso
Dawson, Tim
Fauquex, Jaques
Kumi. Daniel
Laconti, Michael
Lacroix, Marie-Jose
Lee, Andy
McNamara, David
Medema, Jeroen
Nolte, Bjorn
Revet, Bas
Schafer De Martini, Richard Augusto
Solomon, Harry
Stockham, Charlie
Tsannes, Alexis
Vastagh, Stephen
Presiding Officer:
Brazil, Fed. Univ. of Santa Catarina, Dept. of
Informatics
Merge Healthcare-WG-06
Object Forge
Vital Images
Open DICOM (P)
Aspera
Konica Minolta-WG-06
GE Healthcare – WG-06
Harris Healthcare Solutions
Virtual Radiologic Corp.
Philips Healthcare
Siemens Healthcare-WG-06
Philips Healthcare-WG-06
Brazil, Fed. Univ. of Santa Catarina, Dept. of Comp.
Sciences
GE Healthcare – WG-06
DeJarnette – WG-06
Aware, Inc.
MITA, Secretariat
(P) =By phone and web meeting
Cor Loef, Co-Chair
James Philbin, Co-Chair
1. Preliminary Events
Participants identified themselves and their employers. The meeting was called to order at 9:00 a.m.
USA Eastern time. S. Vastagh reviewed the antitrust rules for the meeting.
2. The “MINT” Proposal
Note: WI or WIP means a DICOM Work Item/Work Item Proposal (a project to make substantial
changes/additions to the DICOM Standard.)
The group met in joint session with WG-06 in the morning, continued in a breakout session after
lunch until 3 pm and rejoined WG-06 thereafter.
2.1
Jim Philbin’s Presentation:
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DICOM Working Group Twenty-seven
June 6, 2011
Disclosures: CTO of H2MI, Hopkins/Harris startup focused on cross enterprise medical imaging and
Med. Advisory Boards: Siemens, Merge, Vital Imaging (Toshiba Med. Sys. Group)
Jim Philbin made a presentation titled: Problems with DICOM (posted in the meeting folder) to
argue for the MINT proposal (to transfer of images with a web-based protocol versus the current
TCP/IP.
Lengthy discussion followed that mentioned:

DICOM Push model is complicated and involves lots of storage overhead.

Core of discussion: is it a problem in the protocol, or in a bad implementation.

One member spoke for DICOM in the meeting: 200 destinations, 1.2 M studies a year
transmitted with no problems.

Issues with unique identifiers, and accession numbers.

For some, or even most of the issues, IHE is mentioned by David as the place to
resolve these.

Viewing: it was argued that DICOM is too slow. The group concluded that it must be
clear what is the Handshake referenced and need to know about parsing Meta data as
well as about the transfer of the images to the processing servers. Will be clarified that
it is a transfer between servers.

Problem: why cannot DICOM saturate the wire? The transfer today will not fill-up the
wire. This is still controversial without apparently sufficient evidence. Evidence
should be presented.

The proposal needs to list the DICOM issues, and the use cases. With that information
the Group can decide what to address.

Keeping the Meta data up-to-date: this has always been outside of DICOM, the
internal database representation. However, the outside behavior has to be specified.
IHE work includes separating the Image Manager and Image Archive. Normalizing
data is a huge issue. Archives detached from database are out-of-date.

Enhanced objects on the Study level: what is the need for this? Breast MR example of
hundreds of series. A specific implementation could be one multi-frame object. It
could be an IHE profile for Breast MR.

Separate out the issue: end of transmission.

Gap in WADO: push/post C-STORE.

Performance over the network: Memory mapped protocols seem to work well;
although, at certain moment the latency is an issue. A proposal from Aspera (posted in
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DICOM Working Group Twenty-seven
June 6, 2011
the meeting folder) was presented: to negotiate a network transport method. If not
supported, fall back to existing DICOM. What to use for the handshake?

There was a long discussion on application layer vs. socket layer solutions.
WG-27 proposed the following Action Items to WG-06:
ACTION 1:
Create a new SOP class for PACS to take classic CT/MR/PET objects
and create an enhanced object for it what the workstation can use for
their applications. In the meantime use Multi-Frame SC: stop gap, and
learning experience for writing new SOP class. WG-06 will propose a
WI item for this for the September DSC committee, and will set up AdHoc Group to define the SOP Class.
ACTION 2:
WG27 can define the web based equivalents for C-STORE, C-GET, CMOVE and Query methods for this SOP Class. Unanimous approval in
WG-27. Already being done in different environments, and we cannot
and don’t want break this. C-STORE does not pass easily thru firewalls.
Availability and reliability, you want to replicate as soon as possible.
Use HTTP or any other protocol that could transport over available
ports. Adding new objects to an existing study is possible.
ACTION 3:
Restful approach equivalent to Web Services in supplement 148. We
want to support the full functionality in both methods
ACTION 4:
Continue with our WG27 actions for QIDO, both Restful and Web
Services based, and later address NADO. Create a paper along the way
listing and explaining the characteristics of both methods. Unanimous
approval in WG-27. Already being done in different environments, and
we cannot and don’t want to break this.
ACTION 5:
Create a web based solution for UPS. (This action was not presented to
WG-06.)
WG-06 concurred with the ACTION items proposed by WG-27.
3. Future Meetings of WG-27
Several t-cons were be scheduled to discuss and follow-up on the action items: June 29, July 13,
Aug. 8, 2011.
4. Adjournment
The meeting was adjourned at 4:30 p.m. USA Eastern Time
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DICOM Working Group Twenty-seven
June 6, 2011
Submitted by:
Reviewed by Legal Counsel:
Stephen Vastagh, Secretary, June 29, 2011
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DICOM Working Group Twenty-seven
June 6, 2011