Peter F. Jensch

Digital Imaging and Communications in Medicine

Over the past 15 years Digital Imaging and Communications in Medicine (DICOM) has established itself as the international standard for medical image communication. Most medical imaging equipment uses DICOM network and media services to export image data, thus making this standard highly relevant for medical image processing. The first section of this chapter provides a basic introduction into DICOM with its more than 3,600 pages of technical documentation, followed by a section covering selected advanced topics of special interest for medical image processing. The introductory text familiarizes the reader with the standard’s main concepts such as information objects and DICOM media and network services. The rendering pipeline for image display and the concept of DICOM conformance are also discussed. Specialized DICOM services such as advanced image display services that provide means for storing how an image was viewed (“Softcopy Presentation States”) and how multiple images should be aligned on an output device (“Structured Display” and “Hanging Protocols”) are described. We further describe DICOM’s sophisticated approach (“Structured Reporting”) for storing structured documents such as CAD information, which is then covered in more detail. Finally, the last section provides an insight into a newly developed DICOM service called “Application Hosting”, which introduces a standardized plug-in architecture for image processing, thus permitting users to utilize cross-vendor image processing plug-ins in DICOM applications.

DICOM Structured Reporting—a prototype implementation

Abstract About 1 year ago, Digital Imaging and Communications in Medicine (DICOM) Structured Reporting (SR) has been released as an official extension of the DICOM standard. Structured Reporting introduces a new concept for structuring and encoding medical reports in a standardised manner. Since this approach is quite different from any other extension that has been added to the DICOM standard in the past, it is not surprising that there is no “real” application available up to now. However, we have developed a DICOM SR editor and viewer, and demonstrated this prototype at RSNA infoRAD 2000 and ECR 2001 together with two of DICOMs new security extensions: secure network transmission and digital signatures.

Hypermedia cooperative work in an OSI/ODP standard environment

Cooperative working with hypermedia documents has applications in many areas where it is necessary for geographically dispersed people to jointly and interactively converse over a common information pool. Scenarios within the medical sphere include: remote and tele- consultation, remote diagnosis and wide area conferencing. In this paper we outline a cooperative working system (TeCo) for hypermedia documents in the medical sphere. With this background we examine the OSI/ODP concepts necessary when realizing such a system. In particular, we demonstrate the document structure facilities supported by the SGML/HyTime standard to express user needs in viewing and handling documents for specific user roles.

DICOM V3.0--the CEN trial implementation

This paper gives an overview about the DICOM trial implementation by CEN/TC251/WG4 and some background information about the development approach. It also highlights the integration of requirements into runtime software and related tools to follow future DICOM updates (additional parts) and to set-up a testbed of services for specific user orientations. Furthermore, this paper gives an status report about currently implemented DICOM features and explains the necessary future steps to install DICOM in operational environments existing in Europe.

Conformance in the Context of Import/Export for DICOM 3.0 Information Objects

The recent publication of the DICOM 3.0 standard for transferring images and other medical information between computers promises greatly enhanced communication and interoperability for medical applications. As part of a prototype implementation of the DICOM 3.0 standard we have also considered the problem of converting DICOM Information Objects into other standard image formats. This paper concentrates on the issues involved in converting DICOM image formats into IPI (Image Processing and Interchange) formats. The issue of conformance is restricted to consideration of information attributes which can be adequately represented in IPI formats and the tradeoffs involved when using different encoding schemes.

ISDN-PACS concepts and groupware essentials for telediagnosis

The integrated combination of images from different modalities (signal, data, and text) yields a qualitative finding or helps with therapy. The communication medium ISDN (Integrated Services Digital Network) supports the integration of different communication forms to handle integrated information remotely. ISDN is therefore well suited to joint processing possibilities in the field of groupware for remote diagnosis, collective surgical planning, joint archiving, remote expert-guided training and teaching. This paper reports the functionality of groupware and the implementation of standards in specific software and conceptional levels to realize manufacturer independence for workstations. For practical reasons and for conformance tests the concept of journaling is used.© (1992) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Kooperatives Arbeiten im Kontext wechselnder Anwendungen

Computerunterstutztes kooperatives Arbeiten erleichtert es, mit mehreren Personen an verschiedenen Orten uber ein Problem zu diskutieren. Die Informationen zu dem Problem werden dabei mit Hilfe des Computers verwaltet und konnen aus verschiedenen Modalitaten zusammengesetzt sein (Text, Graphiken, Bilder).

Fenberatung in der Lebensmittelindustrie über ISDN

Bei der Herstellung von Lebensmitteln wird eine strenge Uberwachung der Qualitat und Hygiene des Produktionsprozesses und der Endprodukte gefordert. Dieses kann im Extremfall nur durch Experten gewahrleistet werden, die z. B. mit Hilfe eines Fernberatungssystems eine Begutachtung von Proben durchfuhren konnen. Dieser Artikel beschreibt ein System zur Qualitatskontrolle in der Lebensmittelindustrie, bei dem ISDN als Kommunikationsmedium genutzt wird. Es werden verschiedene Anwendungsszenarien, die Konzepte des kooperativen Systems (z. B. das 3-Phasen Modell) und ein Anwendungsbeispiel vorgestellt.

European project RETAIN: new approach for IBC in teleradiology and PACS based on full ATM network

This paper describes the RETAIN project (radiological examination transfer on ATM Integrated Network), which is supported by the European Community, in the frame of the TEN-IBC program (trans-European networks integrated broad band communication). It links together three European sites in France (Rennes), Spain (Barcelona), and Germany (Oldenburg) and involves a partnership between the public national operators France Telecom, Telefonica, and Telekom. One important reason to explicitly consider asynchronous transfer mode (ATM) for medical imaging is that multimedia applications on such networks allow integration of digital data and person-to-person communication. The RETAIN project includes trials of teleworking sessions between radiologists of Rennes and Barcelona within a clinical and/or scientific context based on ATM equipments performing DICOM transfer on examination, digital remote manipulation within a comprehensive dialogue, and high quality visiophony on ATM adaptation layer (AAL) type 1. The project includes also visiophony trials with Oldenburg and preparation of harmonized regional experimentation within an emergency context. The network used is a full 10 Mbits/s ATM network directly connected to local PACSs.

Conformance testing strategies for DICOM protocols in a heterogenous communications system

The goal of the DICOM standard is to define a standard network interface and data model for imaging devices from various vendors. It shall facilitate the development and integration of information systems and picture archiving and communication systems (PACS) in a networked environment. Current activities in Oldenburg, Germany include projects to establish cooperative work applications for radiological purposes, comprising (joined) text, data, signal and image communications, based on narrowband ISDN and ATM communication for regional and Pan European applications. In such a growing and constantly changing environment it is vital to have a solid and implementable plan to bring standards in operation. A communication standard alone cannot ensure interoperability between different vendor implementations. Even DICOM does not specify implementation-specific requirements nor does it specify a testing procedure to assess an implementations conformance to the standard. The conformance statements defined in the DICOM standard only allow a user to determine which optional components are supported by the implementation. The goal of our work is to build a conformance test suite for DICOM. Conformance testing can aid to simplify and solve problems with multivendor systems. It will check a vendors implementation against the DICOM standard and state the found subset of functionality. The test suite will be built in respect to the ISO 9646 Standard (OSI-Conformance Testing Methodology and Framework) which is a standard devoted to the subject of conformance testing implementations of Open Systems Interconnection (OSI) standards. For our heterogeneous communication environments we must also consider ISO 9000 - 9004 (quality management and quality assurance) to give the users the confidence in evolving applications.