consistent presentation of images - integration profile ellie avraham kodak health imaging ihe...

Consistent Presentation of Consistent Presentation of Images - Integration ProfileImages - Integration Profile

Ellie AvrahamEllie Avraham

Kodak Health Imaging Kodak Health Imaging

IHE Planning and Technical CommitteesIHE Planning and Technical Committees

April 8, 2002Year 4 Vendor Workshop

HIMSS / RSNA2

Patient Information

Reconciliation

Unknown patients and unscheduled

orders

Scheduled WorkflowAdmit, order, schedule, acquire images, notify of completed steps

IHE Integration ProfilesIHE Integration Profiles

ConsistentPresentation of

Images

Hardcopy and softcopy

grayscale and presentation state

ConsistentPresentation of

Images

Hardcopy and Softcopy

Image Consistency


HIMSS / RSNA3

Consistent Presentation of Images Consistent Presentation of Images ObjectivesObjectives

• Consistent distribution of Images across the Consistent distribution of Images across the healthcare enterprise healthcare enterprise

• Consistency among Hardcopy Images Printed on Consistency among Hardcopy Images Printed on different Printers (from different Vendors).different Printers (from different Vendors).

• Consistency among Softcopy Images view on Consistency among Softcopy Images view on different Display devices different Display devices (from different Vendors).(from different Vendors).

• Consistency among Hardcopy and Softcopy Image viewConsistency among Hardcopy and Softcopy Image view

• This IHE Integration Profile is the cost effective This IHE Integration Profile is the cost effective solution to esolution to ensure that image quality is maintained nsure that image quality is maintained across different monitors and film producing across different monitors and film producing devices.devices.


HIMSS / RSNA4

Consistent Presentation of Consistent Presentation of Images Requires:Images Requires:

• Calibration of the Softcopy Display and the Calibration of the Softcopy Display and the Hardcopy Output Devices using DICOM Hardcopy Output Devices using DICOM Grayscale Standard Display FunctionGrayscale Standard Display Function

• Creating Hardcopy Output Using DICOM Creating Hardcopy Output Using DICOM Basic Print with Presentation LUT SupportBasic Print with Presentation LUT Support

• Saving the Softcopy Display Viewing Saving the Softcopy Display Viewing Parameters using DICOM Grayscale Parameters using DICOM Grayscale Softcopy Presentation StateSoftcopy Presentation State

11

22

33


HIMSS / RSNA5

The Grayscale Image The Grayscale Image Presentation Problems:Presentation Problems:

Device capabilities/ characteristics varyDevice capabilities/ characteristics vary

* Device Luminance range* Display Characteristic Curve:DDL -> Luminance

* Device Display Resolution:

Non-Standard Interpretation of Pixel

value to Output Device Luminance


HIMSS / RSNA6

• The appearance of grayscale images displayed on different types of softcopy display devices or printed on different types of hardcopy output devices is in general inconsistent and at times may impact clinical perception

The Grayscale Consistency The Grayscale Consistency Problem:Problem:


HIMSS / RSNA7

• Optimal image viewing parameters (e.g. window/ Optimal image viewing parameters (e.g. window/ level) selected on one device appear different level) selected on one device appear different when displayed on a different devicewhen displayed on a different device

• Device capabilities/ characteristics vary - the same Device capabilities/ characteristics vary - the same number of gray levels cannot be rendered or number of gray levels cannot be rendered or perceived on different devicesperceived on different devices

• Displayed images look different from printed Displayed images look different from printed imagesimages

• ……otherother

The Grayscale Consistency The Grayscale Consistency Problem:Problem:


HIMSS / RSNA8

Problems of InconsistencyProblems of Inconsistency

mass visible mass invisible

•VOI chosen on one display device

•Rendered on another with different display

•Mass expected to be seen is no longer seen

Slide Provided by David Clunie


HIMSS / RSNA9


0.5

1.5

1.0

3.0

•Not all display levelsare perceivable on alldevices



HIMSS / RSNA10

Problems of InconsistencyProblems of Inconsistency0.5

1.5

1.0

3.0

•Not all display levelsare perceivable on alldevices



HIMSS / RSNA11


Digital Modality Laser Printer

•Printed images don’t looklike displayed images



HIMSS / RSNA12

Causes of InconsistencyCauses of Inconsistency

1.0 .66

•Display devicesvary in the maximumluminance they canproduce

•Display CRT vs. film on a light box is an extreme example



HIMSS / RSNA13

Standardize Display Systems to Standardize Display Systems to Achieve Grayscale Consistency, Achieve Grayscale Consistency, Hardcopy Output and Softcopy Hardcopy Output and Softcopy

Viewing Devices Have to Be Properly Viewing Devices Have to Be Properly CalibratedCalibrated

The DICOM Standard Defines:The DICOM Standard Defines: A standard curve, the Grayscale A standard curve, the Grayscale

Standard Display Function (GSDF), Standard Display Function (GSDF), against which different types of against which different types of display and hardcopy output display and hardcopy output devices should be calibrateddevices should be calibrated

11


HIMSS / RSNA14

The GSDF Standard Characteristic The GSDF Standard Characteristic Display Systems CurveDisplay Systems Curve

The The GSDF transformation defines the GSDF transformation defines the mapping of the P-values to the view mapping of the P-values to the view Luminance or optical density value, Luminance or optical density value, and preserving the Human and preserving the Human perceptual response, based on the perceptual response, based on the Human Contrast Sensitivity.Human Contrast Sensitivity.

11


HIMSS / RSNA15

ModalityValues

ofInterest

Polarity Presentation

ImagePresentationDICOM

StandardizedDisplaySystem

Note: The Presentation LUT may be an identity function if, forexample, the Polarity is unchanged and the Values ofInterest transformation outputs P-Values.


HIMSS / RSNA16

Standardized Display System

LuminanceP-ValuesDisplaySystem

P-Values toDDLs

DDLs


HIMSS / RSNA17

Printer Calibration Tools Printer Calibration Tools (Densitometer)(Densitometer)


HIMSS / RSNA18

Display Calibration Tools Display Calibration Tools (Photometer)(Photometer)


HIMSS / RSNA19

DICOM GSDFDICOM GSDF

.01

.1

1

10

100

1000

0 200 400 600 800 1000

Grayscale Standard Display Function

JND Index

Monitors

Film



HIMSS / RSNA20

Perceptual LinearizationPerceptual Linearization

.01

.1

1

10

100

1000

0 200 400 600 800 1000


JND Index

Same number of Just Noticeable Difference == Same perceived contrast

Despite different changein absolute luminance



HIMSS / RSNA21

Monitor Characteristic CurveMonitor Characteristic Curve

Monitor Characteristic Curve

0.01

0.1

10

100

0 50 100 150 200 250 300Digital Driving Level

Ambient Light



HIMSS / RSNA22

Standard Display FunctionStandard Display Function

.01

.1

1

10

100

1000

0 200 400 600 800 1000


JND Index

Monitor’s Capability

Jmax == P-Value of 2n-1

Jmin == P-Value of 0

Minimum Luminance+ Ambient Light

Maximum Luminance+ Ambient Light



HIMSS / RSNA23

Standardizing a DisplayStandardizing a Display

0.1

1

10

100

0 50 100 150 200 250

DDL or P-Values

Standard

Characteristic Curve



HIMSS / RSNA24

Standardizing a DisplayStandardizing a Display

Mapping P-Values to Input of Characteristic Curve (DDL’s)

0

50

100

150

200

250

300

0 50 100 150 200 250 300

P-Values

DD

L



HIMSS / RSNA25

To Achieve Consistent Presentation To Achieve Consistent Presentation of Images, the DICOM Standard of Images, the DICOM Standard

Defines:Defines:

Basic Print Management with Basic Print Management with Presentation Look Up Table, for Presentation Look Up Table, for controlling the consistent appearance controlling the consistent appearance of preformatted images on printed of preformatted images on printed outputoutput

22


HIMSS / RSNA26

DICOM Grayscale Image DICOM Grayscale Image Transformation ModelTransformation Model

Transformation

VOI LUT(Subtraction)

MaskModality

LUT

Transformation

Annotation

Image

Transformation

Shutter SpatialTransformation

Annotation

Disp. Area

Presentation LUT

Presentation LUT

Transformation

Window/Levelor VOI LUT

Rescale Slope/Interceptor Modality LUT

OriginalImage

DisplayP-Values

Grayscale Transformations

Shutter, Annotation and Spatial Transformations


HIMSS / RSNA27

Basic Print Management Meta SOP ClassBasic Print Management Meta SOP Class

Print (SCU)Print (SCU) Print (SCP)

Association Negotiation - “Contract Agreement”Association Negotiation - “Contract Agreement”

Agreed set of SOP Classes and Transfer SyntaxesAgreed set of SOP Classes and Transfer Syntaxes( Basic Print Meta SOP Class)( Basic Print Meta SOP Class)

Film SheetFilm Sheet

Basic Print Meta SOP Class consist of four SOP ClassesBasic Print Meta SOP Class consist of four SOP Classes(Film Session, Film Box, Image Box, and Printer)(Film Session, Film Box, Image Box, and Printer)

N-Create (create film sheet, format printer)N-Create (create film sheet, format printer)

N-Set (place images on film sheet)N-Set (place images on film sheet)

N-Action (request to print the film sheet)N-Action (request to print the film sheet)

N-Event-Report (status of the printer)N-Event-Report (status of the printer)

Slide Provided by Don Van Syckle


HIMSS / RSNA28

Basic Print Request with Presentation Basic Print Request with Presentation LUTLUT

PrintComposer

PrintServer

DICOM Film Session N-CREATE

DICOM Presentation LUT N-CREATE

DICOM Film Box N-CREATE

DICOM Image Box N-SET

DICOM Film Box N-ACTION

DICOM Film Session N-ACTION

Print Status (DICOM N-EVENT-REPORT)

Print Composer

Print Server

Print Request

Printer Status


HIMSS / RSNA29


• IHE Transaction - a Print Composer Actor IHE Transaction - a Print Composer Actor issues a DICOM Print request to a Print issues a DICOM Print request to a Print Server Actor. The Print request includes a Server Actor. The Print request includes a Presentation LUT for display consistencyPresentation LUT for display consistency. .

PrintServer

Print Request withPresentation LUT

23

PrintComposer


HIMSS / RSNA30


• Print Composer – A system that generates DICOM print Print Composer – A system that generates DICOM print requests as a DICOM Print SCU. requests as a DICOM Print SCU. Print composer has to Print composer has to apply image processing manipulations, and requests to apply image processing manipulations, and requests to Print server will specify P-Values in the form of Print server will specify P-Values in the form of Presentation Look-Up Tables (Presentation LUTs) or Presentation Look-Up Tables (Presentation LUTs) or implicitly by Presentation LUT Shapeimplicitly by Presentation LUT Shape..

• Print Server – A system that accepts and processes Print Server – A system that accepts and processes DICOM print requests as a DICOM Print SCP and DICOM print requests as a DICOM Print SCP and performs image rendering on hardcopy media. performs image rendering on hardcopy media. The The system must support pixel rendering to optical density system must support pixel rendering to optical density according to the DICOM Grayscale Standard Display according to the DICOM Grayscale Standard Display FunctionFunction..


HIMSS / RSNA31


• Required transaction for both Print Composer Required transaction for both Print Composer and Print Server Actorsand Print Server Actors

• Print Composer shall be grouped with one of the Print Composer shall be grouped with one of the following:following:– Acquisition Modality ActorAcquisition Modality Actor– Image Manager ActorImage Manager Actor– Image Display ActorImage Display Actor– Image Creator ActorImage Creator Actor


HIMSS / RSNA32

To Achieve Consistent Presentation To Achieve Consistent Presentation of Images, the DICOM Standard of Images, the DICOM Standard

Defines:Defines: Grayscale Softcopy Presentation State (GSPS), Grayscale Softcopy Presentation State (GSPS),

an object for storing and communicating the an object for storing and communicating the parameters that describe how an image or set of parameters that describe how an image or set of images should be displayed. A GSPS object images should be displayed. A GSPS object contains references to the images it applies to, contains references to the images it applies to, and the transformations (grayscale and the transformations (grayscale transformations, shutter transformation, image transformations, shutter transformation, image annotation, spatial transformations, and annotation, spatial transformations, and displayed area annotation) that should be displayed area annotation) that should be applied when the images are presented on a applied when the images are presented on a softcopy display, or printed on film.softcopy display, or printed on film.

33


HIMSS / RSNA33

Consistent Presentation of ImagesConsistent Presentation of ImagesReporting Radiologist Referring Physician or

Reviewing Radiologist

Presentation StatePresentation LUT

Grayscale Standard

Original Image

Window Level

Flip

Zoom

Area Of

Interest

Annotate

WithoutConsistent Presentation

AchievingConsistent Presentation

Area Of

Interest


HIMSS / RSNA34

IEIE ModuleModule UsageUsage

PatientPatient PatientPatient MM

StudyStudy General StudyGeneral Study MM

Patient StudyPatient Study UU

SeriesSeries General SeriesGeneral Series MM

Presentation SeriesPresentation Series MM

EquipmentEquipment General EquipmentGeneral Equipment MM

PresentationPresentation Presentation StatePresentation State MM

Modality LUTModality LUT C - Required if to be appliedC - Required if to be applied

MaskMask C - Required if multi-frame and to be appliedC - Required if multi-frame and to be applied

VOI LUTVOI LUT C - Required if to be appliedC - Required if to be applied

Softcopy Presentation LUTSoftcopy Presentation LUT MM

Graphic AnnotationGraphic Annotation C - Required if to be appliedC - Required if to be applied

Spatial TransformationSpatial Transformation C - Required if rotation, flipping or magnification are to be appliedC - Required if rotation, flipping or magnification are to be applied

Displayed AreaDisplayed Area MM

Display ShutterDisplay Shutter C - Required if to be applied and the Bitmap Display Shutter Module is notC - Required if to be applied and the Bitmap Display Shutter Module is notpresentpresent

Bitmap Display ShutterBitmap Display Shutter C - Required if to be applied and the Display Shutter Module is not presentC - Required if to be applied and the Display Shutter Module is not present

Overlay PlaneOverlay Plane C - Required if to be applied or the BM C - Required if to be applied or the BM Displ. Shutter Module is presentDispl. Shutter Module is present

Overlay/Curve ActivationOverlay/Curve Activation C- Required if image contains curve or overlay which is to be displayedC- Required if image contains curve or overlay which is to be displayed

Graphic LayerGraphic Layer C - Required if Graphic Annotation or Overlays or Curves are to be appliedC - Required if Graphic Annotation or Overlays or Curves are to be applied

SOP CommonSOP Common MM

GSPS Module Table:GSPS Module Table:


HIMSS / RSNA35

Composite object containing the image display Composite object containing the image display settings parameterssettings parameters

Composite object links to one or more images (Series, Composite object links to one or more images (Series, filters); stored using same Study Instance UID (same filters); stored using same Study Instance UID (same Storage SOP Class!)Storage SOP Class!)

Uses regular Storage services (C-STORE); uses Uses regular Storage services (C-STORE); uses Query/Retrieve servicesQuery/Retrieve services

GSPS SOP Instances are immutable: changes require a GSPS SOP Instances are immutable: changes require a new SOP Instance UIDnew SOP Instance UID

Note: generation and specific application of GSPS is Note: generation and specific application of GSPS is outside the scope of DICOM, but not outside the scope outside the scope of DICOM, but not outside the scope of IHE (e.g. Presentation of Grouped Procedures)of IHE (e.g. Presentation of Grouped Procedures)

Grayscale Softcopy Presentation StateGrayscale Softcopy Presentation State::


HIMSS / RSNA36

Image Creator

Modality PresentationState Stored

9

AcquisitionModality

Creator PresentationState Stored

19

Image Display

QueryPresentation State

15

RetrievePresentation State

17

ImageArchive

GSPS Stored, and Query/Retrieve GSPS Stored, and Query/Retrieve GSPSGSPS

• IHE Transaction - an IHE Transaction - an Acquisition Modality or Image Acquisition Modality or Image Creator Actor sends a DICOM Creator Actor sends a DICOM GSPS C-STORE request to an GSPS C-STORE request to an Image Archive ActorImage Archive Actor

• IHE Transaction - an Image IHE Transaction - an Image Display Actor issues a C-FIND Display Actor issues a C-FIND request to an Image Manager request to an Image Manager ActorActor

• IHE Transaction - an Image IHE Transaction - an Image Display Actor issues a C-Display Actor issues a C-MOVE request to an Image MOVE request to an Image Archive ActorArchive Actor


HIMSS / RSNA37

Creator Presentation State Creator Presentation State StoredStored

ImageCreator

ImageArchive

C-STORE (Presentation State Stored)


HIMSS / RSNA38

Query for Grayscale Softcopy Query for Grayscale Softcopy Presentation StatesPresentation States

ImageDisplay

ImageArchive

Query/Retrieve Presentation States (C-FIND/C-MOVE)

Presentation States (C-STORE)


HIMSS / RSNA39

IHE Year 4: Presentation State IHE Year 4: Presentation State Specific Query Matching and Specific Query Matching and

Return KeysReturn KeysQuery Keys MatchingQuery Keys Matching Query Keys ReturnQuery Keys ReturnAttribute NameAttribute Name TagTag

SCUSCU SCPSCP SCUSCU SCPSCP

Presentation LabelPresentation Label (0070,0080)(0070,0080) OO OO R+R+ R+R+

Presentation DescriptionPresentation Description (0070,0081)(0070,0081) OO OO OO R+R+

Presentation Creation DatePresentation Creation Date (0070,0082)(0070,0082) OO OO R+R+ R+R+

Presentation Creation TimePresentation Creation Time (0070,0083)(0070,0083) OO OO R+R+ R+R+

Presentation Creator’s NamePresentation Creator’s Name (0070,0084)(0070,0084) OO OO R+R+ R+R+

Referenced Series SequenceReferenced Series Sequence (0008,1115)(0008,1115) OO OO R+R+ R+R+

>Series Instance UID>Series Instance UID (0020,000E)(0020,000E) OO OO OO R+R+

>Referenced Image Sequence>Referenced Image Sequence (0008,1140)(0008,1140) OO OO OO R+R+

>>Referenced SOP Class UID>>Referenced SOP Class UID (0008,1150)(0008,1150) OO OO OO R+R+

>>Referenced SOP Instance UID>>Referenced SOP Instance UID (0008,1155)(0008,1155) OO OO OO R+R+


HIMSS / RSNA40

Acquire DisplayPrint

Consistent Presentation of ImagesConsistent Presentation of Images



HIMSS / RSNA41

Questions?Questions?

Documents Available On the Web at:Documents Available On the Web at:

www.rsna.org/IHE or www.himss.orgwww.rsna.org/IHE or www.himss.orgwww.rsna.org/IHE or www.himss.orgwww.rsna.org/IHE or www.himss.org

consistent presentation of images - integration profile ellie avraham kodak health imaging ihe...

Documents

different display devices

different types of display

different display mass

display levels

display crt

hardcopy images

device display resolution

different vendors