What's New in DICOM

What’s New in DICOM –
it’s been a very busy year!
Robert Horn, Agfa Healthcare
Harry Solomon, GE Medical Systems
RSNA 2003
Multi-frame MR/CT
• Enhanced MR Image, MR Spectroscopy, CT Image
• More rigorous attribute definition (less need for
private data elements)
• Multi-frame object to support 1000+ image studies
– Dynamic image header supports attributes changing
during acquisition
– Dimensions allow multiple views of data
• Functional imaging with color and real-world value
• File size flexibility through concatenations
• MR in 2003 Standard, CT in Ballot
Chinese / Unicode
• Official DICOM support for Unicode and
GB18030 (PRC standard)
– GB 18030 character set is harmonized with Unicode
• Objects in Unicode do not need character set
switching (and there is no mechanism for it)
• Japanese uses JIS X 0208/0212 Katakana/Kanji,
Korean uses KS X 1001 Hangul/Hanja, in
accordance with national policies
• W. Europe has installed base of IR-100 (Latin 1),
but no formal impediment to using Unicode
DVD / JPEG2000
• JPEG2000 is now an official compression
method under DICOM
– Wavelet based, up to 16-bit pixel depth
– Lossless and lossy
• DVD is now an official exchange medium under
– Can use any DVD flavor (-R, -RW, +R, +RW, -ROM)
– Reader must support JPEG or JPEG2000 lossy
More and More SR Templates
• Done:
– Ob-Gyn, Vascular, and Cardiac Ultrasound
– Cath Lab Procedure Log, Hemodynamics, and Final
– Breast Imaging Report
• In Process:
Fetal/Pediatric Echocardiography
Intravascular Ultrasound
Quantitative Arteriography and Ventriculography
CT/MR Angiography
• Major enhancement to Part 2 Conformance based on
experience using Conformance Statements to prepare
for and troubleshoot DICOM installations
– 1 page Executive Summary
– Documentation details for behavior at the attribute level
– New sections on error handling, coded terminology, security
• Example Conformance Statements reflecting real types
of systems
– Modality with MWL, MPPS, GSPS, Print w/P-LUT, and
Storage Commitment
– RIS as MWL and MPPS Service Class Provider
– Multi-modality Workstation, including Media Exchange
– Print Server
– Archive
Configuration Management
• Introduces use of LDAP with a standard LDAP schema to
maintain configuration parameters of DICOM devices
– LDAP query to retrieve configuration from LDAP server
– Device obtains its own parameters, and those of communication
partners (addresses, capabilities)
• Also uses DHCP, DNS, and NTP to cover:
Installation and auto-configuration of a new device
Portable, mobile devices
Mixed networks with legacy equipment
Synchronized time across devices
• Objective to decrease service cost while maintaining
reliable standard-based configuration management
• Currently Frozen for Trial Use, Ballot 1Q2004
Web Access to Images
• Web Access to DICOM Persistent Objects
– Joint project of DICOM and ISO
• Standard HTTP URL to web image server
• Images returned as vanilla JPEG, or as MIMEencapsulated DICOM
• Can request entire image, or just ROI
• Currently in Ballot
Image Registration
• Composite Objects that support multi-image alignment
• Transform based
– Matrix operation to map one Frame of Reference to another
– Frame of Reference may be synthetic (e.g., Talairach Brain Atlas)
• Fiducial based
– Fiducial points identified in image, or in 3-D Frame of Reference
– May be used with projection images
• Facilitates further image processing, especially multimodality image fusion and image pasting applications
• Ballot closed December 2, 2003
Relevant Patient Info Query
• Address need for more detailed patient clinical history
affecting image acquisition or interpretation
– Risk factors, chronic diseases
– Detailed allergies, medical problems
– Prior findings for follow-up exam
• DICOM mechanism to obtain extended patient info
– Query (C-FIND) message model
– Patient ID is Query Key
– Query Response has patient info in Structured Report format
• Specific and general queries
– Breast imaging, cardiac, general
• Ballot closed December 2, 2003
Image-based Specialties
• New work under way in Ophthamology (WG-9)
– Ophthalmic Photography (fundoscopy, fluorescein
• New working group for Dentistry (WG-22)
– Media exchange on CD
• New work under way in Endoscopy (WG-13)
– Visible Light Video (endoscopy, microscopy,
– MPEG video image encoding in DICOM
Coming soon
Hanging protocols
Radiotherapy workflow
Non-radiology workflow
Advanced X-ray angiography
Advanced ultrasound
3-D and n-D
Media creation service (CD burner)
Color consistency
Parts 3, 6, and 16 tables published in XML
• DICOM home page now includes presentations
and tutorials
– Especially new MR IOD and Structured Reporting