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DICOM Digital Imaging Communications in Medicine Communication Protocols: Key to Connectivity • Layered Model, each layer performs a specific function • Set of Services and Protocols • Connectivity requires sharing of a complete protocol • Communication requires a shared Semantic Context ISO Reference Model APPLICATION Upper Layers (DICOM) PRESENTATION SESSION Lower Layers File Transfer, E-mail, HTTP Data Formatting, Compression,Encryption Synchronization,Comm. Management TRANSPORT End-to-End communication NETWORK Internetworking DATA LINK LLC MAC PHYSICAL Ethernet, FDDI, etc. Fiber, Coax, UTP, µWave Communication Standards • Protocols are defined by standards • A Standard is an agreement which may be voluntary, Government mandated, or International Law • Protocols may also be proprietary Who Defines Communication Standards? • User Consortia (e.g., HL7) • Organizations (e.g., NEMA, IEEE) • US Government Agencies (e.g., ANSI, NIST) • Foreign Government Agencies (e.g., CEN) • United Nations (e.g., ISO, CCITT) ACR-NEMA • • • • • 1982 - ACR and NEMA form a joint committee 1985 - Publication of Version 1.0 1988 - Compression and Mag Tape Standards 1988 - Publication of Version 2.0 1989 - Began work on Network Version with HIS/RIS DICOM • The name was changed to separate the standard from the originating body • 1991 - Release of Parts 1 and 8 of DICOM • 1992 - RSNA demonstration, Part 8 • 1993 - DICOM Parts 1-9 approved, RSNA demonstration of ALL parts • 1994 - Part 10: Media Storage and File Format • 1995 - Parts 11,12, and 13 plus Supplements The Parts of the DICOM Standard • • • • • • • • Part 1 - Introduction and Overview Part 2 - Conformance Part 3 - Information Object Definitions Part 4 - Service Class Definitions Part 5 - Data Structures & Semantics Part 6 - Data Element Listing and Typing Part 7 - Message Exchange Protocol Part 8 - Network Support for Message Exchange • Part 9 - Point-to-Point Support The Parts of the DICOM Standard • Part 10 - Media Storage and File Format • Part 11 - Media Storage Application Profiles • Part 12 - Media Formats and Physical Media • Part 13 - Print Management Point-toPoint DICOM Application Domain Storage, Query/Retrieve, Study Component LiteBox MAGN ETOM Print Management Query/Retrieve Results Management Media Exchange Query/Retrieve, Patient & Study Management Information Management System Summary of DICOM Features • NETWORK PROTOCOL – DICOM incorporates negotiation to permit nodes to agree on the functions to be performed • MESSAGE ENCODING – DICOM defines 24 data types (V2.0 had 4) – DICOM message encoding includes JPEG compression (17 varients) – DICOM includes encapsulated image and multiframe syntaxes – DICOM supports multiple character repertoires Summary of DICOM Features • OBJECT DATA MODEL – DICOM is based on a completely specified data model – DICOM includes a robust UID mechanism • DATA DICTIONARY – DICOM includes a large number of new data elements • SERVICE CLASSES – DICOM defines classes of service for specific applications (e.g. image management, printing) and conformance levels Summary of DICOM Features • Off-Line Media Support – DICOM defines a directory structure and media profiles • CONFORMANCE – DICOM requires conformance statements and contains detailed conformance requirements DICOM Terminology • DICOM Message Service Element (DIMSE) - The set of DICOM Application Layer communication services. • DIMSE Service Group (DSG) - A subset of the full DIMSE services which is applicable to a specific IOD. • Information Object Definition (IOD) - A data abstraction of a class of real-world objects. A collection of related attributes (data elements). DICOM Terminology • Service Class - A set of functionality relating to a single type or real-world activity. Composed of a set of SOP Classes plus rules and associated semantics. • Service-Object-Pair Class (SOP) - The atomic unit of DICOM functionality. Composed of an IOD and a DIMSE Service Group plus restrictions or extensions of the IOD. (Equivalent to an Object Class) Service-Object Pair Class Data Dictionary Information Object DIMSE Service Group SOP Real-World Object DICOM Service Classes • Composite – Verification – Storage – Query/Retrieve – Study Content Notification • Normalized – Patient Management – Study Management – Results Management – Basic Print Management Conformance • DICOM Part 2 specifies the structure of a conformance statement • DICOM does not specify a test suite or a compliance verification mechanism • All DICOM implementations must be supported by a properly constructed conformance statement DICOM Conformance Statement • Implementation Model which describes the Application Entities in the implementation • Detailed specification of Application Entities – SOP Classes supported – policies for initiation and acceptance of associations • • • • • Presentation Contexts SOP options Supported communications protocols Specializations Configuration Purpose of a Conformance Statement • Allow a user to determine which optional components of the DICOM Standard are supported by a particular implementation, and what extensions or specializations an implementation adds. • By comparing the Conformance Statements from two implementations, a knowledgeable user should be able to determine whether or not interoperability is possible. DICOM Conformance Testing • No Formal Mechanism is Defined in the Standard • Committee for the Advancement of DICOM • Define initial test plan and cross-connect matrix • Future RFP for organization to monitor the process • Problem: How to Map DICOM Conformance Statements into Test Plans The DICOM Explosion • • • • • • Joint CEN-DICOM development Medicom = DICOM MIPS 95 work is underway with JIRA IS&C Harmonization is also in progress HL7 Harmonization continuing interest New DICOM organization – Companies: NEMA and non-NEMA – ACR, ACC, CAP, ... – individuals Summary • Networking is a critical component of all medical imaging systems • Support for Open Communication Standards is a MUST • DICOM is here, NOW • DICOM products exist on the market • DICOM is emerging as THE common protocol for medical image communication - WORLD WIDE!