June-September 2009 www.ihe.net

North American 2010 Connectathon & Interoperability Showcase Series

Chris LindopChris LindopInteroperability & Standards MgrInteroperability & Standards MgrGE HealthcareGE HealthcareRadiology Planning Committee Co-chairRadiology Planning Committee Co-chairRadiology Technical Committee Co-chairRadiology Technical Committee Co-chair

Radiology UpdateProfiles for Media Exchange

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Profiles for Imaging Media Exchange

IHE two core profiles for Imaging media exchange

Portable Data for Imaging (PDI) Standardize CD media

Import Reconciliation Workflow Fix demographics, IDs and codes

Now include:

Portable Data for Imaging (PDI) – Extensions New media(DVD & USB), Compression & Security

IHE Basic Image Review (BIR) Profile Baseline behavior for viewer software

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Easier, perhaps.

You may be part of the problem.

Portable Data for Imaging (PDI)– Value Statement

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and…

or…

Portable Data for Imaging (PDI)– Value Statement

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Portable Data for Imaging (PDI)

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Compatibility requirements

Standard CD format and file system

Consistent disc organization

Use most generic DICOM media profile

Images MUST be present in DICOMo May have copies as “web content” (i.e. JPEGs)

Avoid most common mistakes (highlighted)

Portable Data for Imaging (PDI)

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Additional Media:

Compression Optionally allowed

• Both Lossless and lossy specified; but lossless is recommended

On-board “Sender Software” recommended.

Encryption Optionally allowed; password-based or key-based Please consider support needs before creating

DVD

PDI –Extensions

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1) Insert CD; Run Sending Software

2) “Enter Password:”

5) DICOM Association Negotiation

7) Send Images (C-STORE)

4) “Enter Destination:”3) Sending Software Decrypts CD Images

6) Sending Software decompresses & convertsImages (as needed)

PDI –Extensions

Sending SoftwareSending Software

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PDI - Extensions Actors/Transactions

New Actor for PDI

Portable Media Sender

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New Media type OptionsBaseline Media: CD

DICOM STD-GEN-CD Media Application Profile

New Media Options:

DVD Option • Creator Uses DICOM STD-GEN-DVD-JPEG or

• DICOM STD-GEN-DVD-J2K Media Application Profile*

USB Option • Creator UsesDICON STD-GEN-USB-JPEG or

• DICON STD-GEN-USB-J2K Media Application Profile*

Both options require support for compression

JPEG lossy and lossless

JPEG 2000 reversible and irreversible

NOTE: DVD option will allow for CD Compression

* Importer must support both Media Application Profiles

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Privacy Protection Options

Privacy Protection Options

Standard Password-Based Encryption (PBE) RSA Public Key Infrastructure (PKI)

Use the secure DICOM Media Application Profiles

STD-GEN-SEC-CD for CD STD-GEN-SEC-DVD-JPEG or STD-GEN-SEC-DVD-J2K for DVD STD-GEN-SEC-USB-JPEG or STD-GEN-SEC-USB-J2K for USB

Options require encryption of all DICOM files

including the DICOMDIR, and any files with Patient identifiable information

Note: Options NOT compatible with the Web Option

Media supplied viewers or sending SW must be capable of requesting

password (PBE option) or use the RSA private key (PKI Option)

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Portable Media Sender Option

Required when disk is encrypted (Privacy Protection Option)

Only required to be capable of decryption if encrypted

decrease risk of unreadable data by recipient

Transfers objects on the media

to an Image Manager and/or Report Manager

Reconciles key patient and study attributes

Decompresses instances if necessary

Decrypts instances if necessary

Required to convert multi-frame to single frame if necessary

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Import Reconciliation Workflow (IRWF)

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“The Images are in the PACS but are messed up” The patient ID is wrong, it doesn’t come up in a query I can’t hang the new images with the old The unknown procedure codes mess up my hanging protocols The images aren’t linking to the EMR.

Patient’s chart won’t come up

Impact: Lost time Incomplete data Drags on effectiveness

Import Reconciliation Workflow – Value Statement

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During image import, details are fixed to match (or not conflict with) local values Patient IDs, Name Procedure Codes, Accession Numbers, etc.

Two ways of getting demographics DICOM Worklist Query HL7 Patient Demographics Query

Import Reconciliation Workflow (IRWF)

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BASIC Image Review

Defines a Baseline Feature set Look and feel Performance* Minimum Platform*

“Advanced” Button = Show me what else you can do

* PDI-Basic viewer Option only

Basic Image Review (BIR)

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Basic Image Review ( BIR) - Value Statement

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Facilities distribute images; Physicians review them Often a physician has own viewer but may need to rely on the media-

supplied veiwer

Rising frustration; too often the viewer: requires installation on a locked down machine does not successfully run starts up too slowly does not successfully load the images warns the images are of “non-diagnostic quality” is missing some basic critical function has Yet Another GUI where basic operations are non-obvious

Impact: delayed care, inaccessible information, repeat examination and irradiation,

and poor use of valuable clinician time.

Basic Image Review (BIR) – Value Statement

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Trial Implementation Spec released

Potential applications of BIR Spec. Media Viewer (PDI Option)

o Requires a BIR Compliant viewer be placed on media Clinician’s Desktop Viewer Basic Radiology Review Station Web Portal

Basic Image Review (BIR)

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SOP Class Support

Notes: PDI Basic Viewer Option - requires only SOP Class support on media

non-PDI requires a partial display requirement for SOP classes not listed

SOP Class UID SOP Class Name 1.2.840.10008.5.1.4.1.1.1 Computed Radiography Image Storage

1.2.840.10008.5.1.4.1.1.2 CT Image Storage

1.2.840.10008.5.1.4.1.1.1.1 Digital X-Ray Image Storage – For Presentation

1.2.840.10008.5.1.4.1.1.4 MR Image Storage

1.2.840.10008.5.1.4.1.1.7.2 Multi-frame Grayscale Byte Secondary Capture Image Storage

1.2.840.10008.5.1.4.1.1.7.3 Multi-frame Grayscale Word Secondary Capture Image Storage

1.2.840.10008.5.1.4.1.1.7.1 Multi-frame Single Bit Secondary Capture Image Storage

1.2.840.10008.5.1.4.1.1.7.4 Multi-frame True Color Secondary Capture Image Storage

1.2.840.10008.5.1.4.1.1.20 Nuclear Medicine Image Storage

1.2.840.10008.5.1.4.1.1.128 Positron Emission Tomography Image Storage

1.2.840.10008.5.1.4.1.1.7 Secondary Capture Image Storage

1.2.840.10008.5.1.4.1.1.6.1 Ultrasound Image Storage

1.2.840.10008.5.1.4.1.1.3.1 Ultrasound Multi-frame Image Storage

1.2.840.10008.5.1.4.1.1.12.1 X-Ray Angiographic Image Storage

1.2.840.10008.5.1.4.1.1.12.2 X-Ray Radiofluoroscopic Image Storage

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Simple Restricted Feature SetDisplay of grayscale and color images from any modality

basic grayscale or color rendering of the images as encoded without additional image processing

visual navigation of series through the use of thumbnails

side-by-side comparison of at least two sets of image with synchronized scrolling, panning and zooming

annotation of laterality, of body part and sagittal side, orientation

Simple nuclear medicine windowing mode

spatial localization of cross-sectional images

annotation of demographics, management and basic technique

simple measurements of linear distance and angle

cine capability Example: cardiac US, XA, CT or MR

Reference ICONS are provided to enhance common look & feel

NO FUSION or MPR

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Performance Requirements

NOTE:

PDI- BIR Option Only

Reference platform and image set specified for testing

Large data-set and small data set available in the IHE website

Benchmark Target for Large Dataset

Target for Small Dataset

Start-up to ready to select 60 seconds 30 seconds

Series thumbnail select to first image of series displayed

2 seconds for any series 2 seconds for any series

Series thumbnail select to last image of series displayed

20 seconds for 311 slice PET/CT CT series

10 seconds for 21 slice MR localizer series

Select different series 2 seconds for any series 2 seconds for any series

Scroll frame rate 30 slices/per second for 311 slice PET/CT 512x512x12 bit

CT series

n.a.

Zoom time 0.5 seconds for1880 x 2016 DX PA Chest 20051208

n.a.

Window center and width change response time.

approximately 0.1 seconds (near visually imperceptible)

for1880 x 2016 DX PA Chest 20051208

n.a.

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