toward dicom n-dimensional presentation state joe luszcz, co-chair dicom working group 11
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Toward DICOM n-Dimensional Presentation State
Joe Luszcz, Co-ChairDICOM Working Group 11
Viewing 3D/4D Volume Data
A volume dataset isn’t visually useful by itselfWe need meaningful Views of the volume data
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Viewing 3D/4D Volume Data
There are a number of ways of viewing volume data Multi-Planar Reformatted (MPR) slices of the volume Rendering of the voxels in the volume (VR) Rendering of surfaces derived from the volume
dataset or from a library of implantable devices (SR)
Fusion of above representations
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axial slice MPR views VR view VR + SR view
Multi-Planar Reformatting
Multi-Planar Reformatting is a visualization technique that creates a 2D image depicting only volume data lying on or within a specified slice thickness of a planar or curved surface through a volume
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Rendering of Volumes
Volume Rendering is a visualization technique in which a view of a volume dataset from a particular viewpoint is obtained while possibly allowing both near and far structures to be visualized by making nearer structures semi-transparent.
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Cropping may also be performed to removed unwanted foreground structures.
Rendering of Surfaces
Surface Rendering is a visualization technique in which a surface derived from voxel data or models (rather than volume data) are viewed from a particular viewpoint
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These surfaces may be obtained by
segmentation from a volume dataset
geometric models from a library of objects such as implants or surgical tools
co-aligned with voxel data in a fusion image
Presentation State The processing required to create a View from a volume and
its related inputs I’ll call a “Display Algorithm”
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Display Parameters
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Persistent Storage
Presentation State
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SourceInformation
ViewDisplay
Algorithm
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These Display Parameters may be saved so that the particular View might be re-created at a later time (on the same device or on a different device). This saved set of Display Parameters is called a Presentation State
The Display Algorithm requires a set of Display Parameters to specify the particular View to create
Clinical Perspectives
Presentation workflow varies depending on the role of the clinician Diagnosis Intervention and Surgery
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Diagnosis
Physician or technician acquires volume data and creates MPR and volume render views on the imaging device
Reviewing physician displays Views on a review device Views may be changed or added during review Measurements may be taken on the image Views or
calculated algorithmically from the volume data Annotations may be made on the Views and new Views
saved as documentation of the diagnosis A report is created, which may reference one or more
Views
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Diagnosis Workflow
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Modality-specifi c image
creation
Modality.
Cartesian Volume
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Volume Slice
Volume Render
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Volume Render
Parameters
Slicing Parameters
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Persistent Storage
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Presentation States
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Export of Volume Dataset
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Volume Slice
Volume Render
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Volume Render
Parameters
Slicing Parameters
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Presentation States
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Changes
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Presentation States
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New
Intervention and Surgery
There are many different types of interventional treatment specialists and procedures, each with specific needs
Cardiologist patching a ventricular septal defect – needs to size the patch and guide it into place
Orthopedic surgeon repairing a complex fracture – needs to plan the procedure (including choice of implants) and refine the plan during the procedure
Oncologist planning radiotherapy – needs to visualize iso-dose profiles and prepare a treatment plan
Each clinical specialty and each type of procedure utilizes different volume viewing techniques
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Intervention/Surgery Procedure Support
Views are created to determine Exact locations and shapes of lesions Specific tissue types and structure surfaces for segmentation Size and type of implants and surgical tools Routes for surgical or interventional access Mapping of specific actions (e.g., animated procedure views)
Views are dynamically updated to guide the work Fusion of pre-procedure imagery (e.g. CT, MR, PET, etc.) with
intra-procedure real-time imagery (e.g. US) to track progress Removal of surfaces or objects obscuring desired view Illustration of steps to stay on-plan Guidance of tools and/or implants to procedure site Before and after Views to document and support follow-up
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text
Persistent Storage
Presentation State
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Intervention/Surgery Pre-Procedure
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Display Parameters
ViewDisplay
Algorithm
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Input List
0..*
0..*
0..*
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Primary Patient Info(e.g., Volume Data)
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Data Derived from Primary Patient Info
Derivation Parameters
Derivation Algorithms
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Data Models(e.g., Implant
Devices)
Intervention/Surgery Procedure
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Presentation State
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textDisplay Parameters
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Input List
Display Parameters
ViewDisplay
Algorithm
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Input List
0..*
0..*
0..*
Presentation State
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New
Modify View
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.Persistent Storage
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Data Models(e.g., Implant
Devices)
Primary Patient Info(e.g., Volume Data)
Data Derived from Primary Patient Info
DICOM Working Group 11
Presentation State is the charter of DICOM Working Group 11
WG-11’s current goal is to create a DICOM standard for Multi-Dimensional Presentation States
Process and current status Gathering and reviewing clinical use cases Deriving requirements from clinical use cases Seeking consensus on requirement glossary Creating the draft supplement document
capturing the approach we plan to use, preparing for First Read
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Call for Participation
We would value your participation in the development of the n-D Presentation States standard:
To provide or review clinical use cases To review requirements To monitor the ongoing development work To actively participate in the development …
Contact: the author joe.luszcz@philips.com, or MITA secretary Stephen Vastagh
svastagh@medicalimaging.com
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Thank you for your attention
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Agenda
How do we view volume data? Role of Presentation State Clinical application of Presentation State
Diagnostics Intervention and Surgery
DICOM Standardization of Multi-Dimensional Presentation State
Call for Participation
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Standardization Challenges
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Most ObjectiveMost Interoperable
Most ProprietaryLeast Interoperable
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InputsInput characteristicsCropping, Clip Planes, VOIMPR geometry Plane/Curve location MPR view size Slice thicknessRender geometry Camera Lighting2D View Decorations Graphics TextAnatomic View designationEtc.
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Blending Grayscale/color maps Grayscale/color thresholdGeneral classification of algorithms Intensity Projection MIP MinIP AveIP Surface rendering Scanline rendering Ray casting Ray tracing
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Opacity mapsOpacity algorithmsRender space Scalar RGB
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Slicing algorithmsRendering algorithmsEdge Detection algorithmsSmoothing algorithmsFiltering algorithmsCropping and Sculpting algorithm parameters
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DICOM Standardization Process
DICOM Committee assigns work item Working Group (WG) chooses approach to follow
First Read review of approach WG creates a draft of the new standard
Public Comment review, release for comments WG revises draft to respond to comments
Letter Ballot review, release for letter ballot WG revises document to address ballot
comments Final Text review, create Final Text version of doc
Final Text document is now part of DICOM
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