Download IHE Mammography Image Integration Profile

Integrating the Healthcare Enterprise
Mammography Image – MAMMO
Chris Lindop, GE Healthcare
Co-Chair Radiology Planning Committee
Feb 7-8, 2007
1
IHE Participant's Workshop
A content profile for Mammo
Patient Info. Reconciliation
Import Reconciliation Workflow
Charge
Posting
Scheduled Workflow
-
Teaching
Files &
Clinical
Export
Key
Image
Notes
Presentation
of Grouped
Procedures
NM
Image
Mammo
Image
Consist.
Present.
of
Images
PostProcessing
Workflow
Evidence
Docs
Reporting
Workflow
Key
Image Image
Fus- Notes
ion
Simp.
Image
& Num
Reports
Access to Radiology Information
Portable Data for Imaging
Cross-Enterprise Document Sharing for Imaging
Feb 7-8, 2007
2
Mammo Image – The Problem
Mammography image review relies on comparison with priors
 increases the occurrence of simultaneous review of images from
different systems
Multi-vendor Mammography Systems
 Vary with detector technologies and sizes result in varying image
matrices sizes.
 Vary with contrast presentation methods result in varying image
presentation
Mammography Image Review requires a minimal set of display
features
 zoom, LUT rendering, hanging protocols
Feb 7-8, 2007
3
Example of different image sizes
Image Contrast Adjustment
VOI LUT
Linear LUT
MAMMO – Value proposition
Minimum contents for the generated DICOM instances
 Image Data (for processing and for presentation SOP Classes)
 CAD data (CAD SR)
Basic display capabilities of Image displays to suit specific
mammography review requirements
CAD acting as Evidence Creators
Mammography Workflow
 Managing the process of creating, storing and using Mammography
Image content is similar to workflow for other image content (e.g.
see Scheduled Workflow and Post-Processing Workflow Profiles).
Feb 7-8, 2007
6
Mammography Image
Actors and Transactions
Acquisition
Modality
Evidence
Creator
[RAD 8] Modality Images Stored ↓
[RAD 10] Storage Commitment ↓
↓ [RAD 18] Evidence Document Stored
↓ [RAD 10] Storage Commitment
Image
Manager
Image
Archive
↓ [RAD 14] Query Images
↓ [RAD 16] Retrieve Images
↓ [RAD 44] Query Evidence Documents
↓ [RAD 45] Retrieve Evidence Documents
Image
Display
Print
Composer
↓[RAD-23] Print Request with Presentation LUT
Print Server
Feb 7-8, 2007
7
Mammography Image
Process Flow
Evidence
Creator
(CAD System)
Acquisition
Modality
Perform
Acquisition
Imag e Manager/
Imag e Archive
Imag e Display
Modality Images
Stored [8] - Mammo
Images
Storage
Commi tment [10]
Perform
CAD
Evidence Document
Stored [43] Mammo CAD
Storage
Commi tment [10]
Query Ima ges [14]
Retrieve Ima ges [16] - Mammo Imag es
Present Mammo
Images
to User
Query Evidence Document [44]
Retrieve Evidence Document [45] Mammo CAD
Present Mammo
Images with CAD
to User
Feb 7-8, 2007
8
Mammo Image Profile
Acquisition Modality
 FFDM & CR are required to create MG objects
 Create MG objects as specified
•
•
40 Attributes with specific requirements defined
Including new pixel padding range limit (0x0028,0x0121)
Evidence Creator
 Mammo CAD systems
 Support Evidence Document Stored with Storage
Commitment
 Support Mammography CAD SR objects
Feb 7-8, 2007
9
Mammo Image Profile (cont’d)
Image Manager/Archive
 Support both Modality Images and Evidence Document Stored
with Storage Commitment
 Support Query/Retrieve of both Images and Evidence
Documents
Image Display
 Support Query/Retrieve of both Images and Evidence
Documents
 Support specified display capabilities including background air
suppression, LUT rendering, zoom management and CAD SR
display
Feb 7-8, 2007
10
Mammo Image Profile (cont’d)
Print Composer
 Support Print Request with Presentation LUT
• including the LIN-OD presentation LUT shape
 Use Requested Image Size to achieve true size printing
 Support 12 bits printing
Print Server
 Support Print Request with Presentation LUT
• including the LIN-OD presentation LUT shape
 Use Requested Image Size to achieve true size printing
 Support 12 bits printing
Feb 7-8, 2007
11
Mammo Image contents
Background air suppression
 New tag in DICOM (CP692) extending the pixel padding
concept
Mammo CR generate MG instances only
 specific fields (i.e. gantry ID) have been added to the
required attribute list.
Tiled Views option defined
 Allows for large breast imaging (multiple images of the same
breast)
Feb 7-8, 2007
12
Image Display
Zoom
 Adjust zoom accounting for varying acquisition pixel sizes
 True size zoom accounting for display (monitor) pixel size
Background air suppression
 When inverting/windowing the image, the detected background
stays black
Image orientation
 Flipping according to Patient Orientation ((0x20,0x20))
Annotations
 Set of required annotations to be displayed is defined
CAD rendering (using CAD SR)
Feb 7-8, 2007
13
Feb 7-8, 2007
14