Download Digital Imaging and Communications in Medicine (DICOM(

Class of Bio2012
Digital Imaging and Communications
in Medicine (DICOM(
By Group 4:
1.
2.
3.
4.
5.
Ahmed Al HoseinyAfifyAlazwak
Hossam Ahmed Muhammad
HossamEldinAlaaAbd Al Rahaman
Hossam Muhammad Fawzi
Hisham Abu El Soud El Sayem
Under Supervision:
Dr. Ahmed H. Kandil
Eng: Ahmed Abdul Hady
Faculty Of Engineering- Cairo University
Eng: Enas Abdul Fattah
SBME – Class of Bio2012
INTRODUCTION
History:
-With the introduction of computed tomography (CT) followed by other digital
diagnostic imaging modalities in the 1970's, and the increasing use of computers in
clinical applications, the American College of Radiology (ACR) and the National
Electrical Manufacturers Association (NEMA) recognized the emerging need for a
standard method for transferring images and associated information between devices
manufactured by various vendors. These devices produce a variety of digital image
formats.
The American College of Radiology (ACR) and the National Electrical Manufacturers
Association (NEMA) formed a joint committee in 1983 to develop a standard to:
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Promote communication of digital image information, regardless of device
manufacturer
Facilitate the development and expansion of picture archiving and
communication systems(PACS) that can also interface with other systems of
hospital information
Allow the creation of diagnostic information data bases that can be
interrogated by a wide variety of devices distributed geographically.
ACR-NEMA Standards Publication No. 300-1985, published in 1985 was designated
version 1.0. The Standard was followed by two revisions: No. 1, dated October 1986
and No. 2, dated January 1988. ACR-NEMA Standards Publication No. 300-1988,
published in 1988 was designated version 2.0. It included version 1.0, the published
revisions, and additional revisions. It also included new material to provide command
support for display devices, to introduce a new hierarchy scheme to identify an image,
and to add data elements for increased specificity when describing an image.
These Standards Publications specified a hardware interface, a minimum set of
software commands, and a consistent set of data formats.
Front page of ACR/NEMA 300, version 1.0, which was released in 1985
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The Dicom Standard:
- This Standard, which is currently designated Digital Imaging and Communications
in Medicine (DICOM), embodies a number of major enhancements to previous
versions of the ACR-NEMA Standard:
a. It is applicable to a networked environment. The ACR-NEMA Standard was
applicable in a point-to-point environment only; for operation in a networked
environment a Network Interface Unit (NIU) was required. DICOM supports
operation in a networked environment using the industry standard networking
protocol TCP/IP.
b. It is applicable to an off-line media environment. The ACR-NEMA
Standard did not specify a fileformat or choice of physical media or logical
filesystem. DICOM supports operation in an offline media environment using
industry standard media such as CD-R and MOD and logical filesystems such
as ISO 9660 and PC File System (FAT16).
c. It specifies how devices claiming conformance to the Standard react to
commands and data being exchanged. The ACR-NEMA Standard was
confined to the transfer of data, but DICOM specifies, through the concept of
Service Classes, the semantics of commands and associated data.
d. It specifies levels of conformance. The ACR-NEMA Standard specified a
minimum level of conformance. DICOM explicitly describes how an
implementor must structure a Conformance Statement to select specific
options.
e. It is structured as a multi-part document. This facilitates evolution of the
Standard in a rapidly evolving environment by simplifying the addition of new
features. ISO directives which define how to structure multi-part documents
have been followed in the construction of the DICOM Standard.
f. It introduces explicit Information Objects not only for images and graphics
but also for waveforms, reports, printing, etc.
g. It specifies an established technique for uniquely identifying any
Information Object. This facilitates unambiguous definitions of relationships
between Information Objects as they are acted upon across the network.
Current Direction:
-
The DICOM Standard is an evolving standard and it is maintained in
accordance with the Procedures of the DICOM Standards Committee.
Proposals for enhancements are forthcoming from the DICOM Committee
member organizations based on input from users of the Standard. These
proposals are considered for inclusion in future editions of the Standard. A
requirement in updating the Standard is to maintain effective compatibility
with previous editions.
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Who needs DICOM?
-
Hospitals ,clinics, imaging centers and specialists .Bypurchasing only
equip-ment and information systems that con-form tothe DICOM
Standard, you can ensure that these tools will worktogether to produce,
manage and distribute your images regardless ofyour previous, current or
future vendors .
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Manufacturersof imaging equipment and imaging information
systems.DICOMconformance ensures that every medical imaging facility
is apotential customer, because your equipment can work with any
workflowor electronic health record systems .
-
Manufacturersof peripheral equipment (e.g., film scanners, printers,
computermonitors
and
workstations,
image
archives
.)
DICOMconformance ensures that your products can work with all cur-rent
orfuture imaging modalities and re-lated peripheral equipment – regardless
of vendor .
DICOMwill be required by all HER -Electronic Health Records - systems that
include imaging informationas an integral part of the patient record .
DICOMis used in :
1. radiology ·
2. breastimaging.
3. cardiology.
4. radiotherapy.
5. oncology ·
6. ophthalmology.
7. dentistry·
8. pathology.
9. surgery·
10. veterinary.
11. neurology ·
12. pneumology.
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Scope and field of application:
-The DICOM Standard facilitates interoperability of medical imaging equipment by
specifying:
 For network communications, a set of protocols to be followed by devices
claimingconformance to the Standard.
 The syntax and semantics of Commands and associated information which can
be exchangedusing these protocols.
 For media communication, a set of media storage services to be followed by
devices claimingconformance to the Standard, as well as a File Format and a
medical directory structure tofacilitate access to the images and related
information stored on interchange media.
 Information that must be supplied with an implementation for which
conformance to theStandard is claimed.
The DICOM Standard does not specify:
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The implementation details of any features of the Standard on a device
claiming conformance.
The overall set of features and functions to be expected from a system
implemented byintegrating a group of devices each claiming DICOM
conformance.
A testing/validation procedure to assess an implementation's conformance
to the Standard.
-The DICOM Standard pertains to the field of Medical Informatics. Within that field,
it addresses theexchange of digital information between medical imaging equipment
and other systems. Because suchequipment may interoperate with other medical
devices, the scope of this Standard needs to overlap with other areas of medical
informatics. However, the DICOM Standard does not address the breadth of this
field.
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How does DICOM work?
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All real world data patients students medical devices are viewed by DICOM as
objects with respective properties or attribute .the definition of this objects
standardized according to DICOM information object definition(IODS).think
about IODS as collections of attributes, describing each particular data object,
for example patient can be described by name ,id ,age ,weight smoking status
maintains a list of attribute knowing as DICOM data dictionary for example
our patient attributes name sex and so on are included in DICOM data
dictionary. All DICOM attributes are formatted according to 27 value
representation (VR) types corresponding to data ,times ,names and so on.
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As soon as data is captured as DICOM data attributes it can be transmitted and
processed between DICOM devices and software. DICOM represents this
processing with service rendering model .Because each service usually
involves some data exchange it becomes natural to associate particular service
type s with the data (IODS) that they process DICOM calls these associations
service object pairs(sops) and group them into sop classes for example ,sorting
ct image from a digital ct scanner to a digital PACS archive corresponds to the
ct storage sop ,in particular example the ct image represents the DICOM IOD.
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Establishment DICOM handshake when the two connecting applications
exchange information about each other . This information is called the
presentation context .if the two applications can match their context ,they can
connect and start SCU-SCP processing.
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Because hundreds of DICOM devices and applications are produced by
hundreds of DICOM Manufactures, each DICOM unite will be accompanied
by its own DICOM conformance statement From the manufacturer. This
statements explains which SOPS the unite supports
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The DICOM conformance statement is most essential roadmap for any
DICOM related object . The brief summary reflects the core DICOM
functionality and as you can see it is quite straightforward .in fact
understanding the theory of DICOM is easy dealing with DICOM in real life
is often the challenge
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Convert ANY Modality to DICOM
we do mean any modality including ultrasound, endoscopy, interventional radiology,
nuclear medicine, CT, MR, X-ray angiography, fluoroscopy, motion X-ray, speech
pathology systems, and more. Unlike other DICOM converter boxes, TIMS can
acquire from any modality that has a video signal or has a monitor. TIMS can capture
from any modality because of the specialized, high technology video capture boards
inside the system. Foresight Imaging has been supplying these specialized capture
boards to major medical vendors such as GE, Siemens, Kodak, HeartLab, Witt
Biomedical, and more for nearly 20 years. This experience allows TIMS to capture
any video signal. Other solutions are limited to only standard video signals or have to
publish limited compatibility lists. TIMS can calibrate to any video signal and does
not have to publish a "list".
Because TIMS is a universal DICOM converter, one TIMS system can be
used for many different modalities in a hospital or department, providing that they are
not in use at the same time. TIMS can also be easily moved to another modality in
the hospital should the original equipment that it was connected to become
obsolete. This is not possible with other DICOM converters that are limited by
standard video signalS.
\
Benefit: By converting any modality, the TIMS DICOM System enables you to go
digital right away and eliminate film. This saves your hospital money and eliminates
the need to purchase new modalities or expensive DICOM upgrades. This translates
into real savings of hundreds of thousands or millions of dollars for your hospital.
DICOM Send to PACS
TIMS conforms to the DICOM 3.0 standard and sends DICOM studies to any PACS
system. For a list of the PACS partners that we have validated with.
We guarantee compatibility with any PACS system that conforms to the DICOM 3.0
standard. If for any reason, we are unable to send to your PACS system, we will take
the TIMS system back. To date, we have never had to do so.
Benefit: Once the studies are sent to PACS, physicians are able to digitally view the
studies anywhere on the hospital network. This increases efficiency and eliminates
the use of film and videotape
VI
Future of DICOM:

The DICOM standard is never more than 2 months old.Every two months
a new addition to the standard is created and released.Does this mean that
you will have to upgrade your system every two months? Definitely not.A
CT device that could send images in a DICOM format,supporting the
DICOM Storage SOP Class in 1993 would still be able to do so in 2004.
However,if you want to exchange MR spectroscopy data, your device
would have to support the new MR SOP Class.So, when technology
advances, you can expect the DICOM standard to follow it and
accommodate it.The latest additions to the DICOM standard,including a
draft version of the complete standard can be found at the NEMA website

An example of a recent addition to the DICOM standard is Visible Light,
which will accommodate endoscopy,pathology, ophthalmology and
dermatology. Radiation Therapy (RT) is also feeling the pinch for
increased integration. They require the import of regular images such as
CT scans and radiographs andthe creation of objects such as therapy plans,
RT images, and treatment records. RT modalities are just starting to
implement these services and to become integrated. They are where main
radiology was 5 years ago with regard to connectivity; they are just
starting to implement and offer the basic level of image communication.

Other new additions that are in the pipeline include a new MR object that
can accommodate the new acquisition techniques and the exchange of
spectroscopy data, new CT objects and also 3-D objects (for Ultrasound,
for example). In general, acquisition is moving to multi-dimensional, 3-D
or more, and DICOM is followingthat trend.
VII
References
1.Digital Imaging and Communications in Medicine (DICOM)
Published by National Electrical Manufacturers Association
2.http://medical.nema.org/
3.http://en.wikipedia.org/wiki/Digital_Imaging_and_Communications_in_Medici
ne#Parts_of_the_DICOM_Standard
4.http://www.mfdigital.com/dicomimaging.html
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