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DICOM
From Wikipedia, the free encyclopedia
DICOM (Digital Imaging and Communications in Medicine ) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard.[1] It was developed by the DICOM Standards Committee, whose members[2] are also partly members of NEMA.[3] DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into a picture archiving and communication system (PACS). The different devices come with DICOM conformance statements which clearly state which DICOM classes they support. DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists' and doctors' offices. DICOM is known as NEMA standard PS3, and as ISO standard 12052:2006 "Health informatics -- Digital imaging and communication in medicine (DICOM) including workflow and data management".
Contents
1 Parts of the DICOM standard 2 History 2.1 Derivations 3 DICOM data format 4 DICOM image display 5 DICOM value representations 6 DICOM services 6.1 Store 6.2 Storage commitment 6.3 Query/Retrieve 6.4 Modality worklist 6.5 Modality performed procedure step 6.6 Printing 6.7 Off-line media (DICOM files) 7 Application areas 8 DICOM transmission protocol port numbers over IP 9 Disadvantages of DICOM 10 DICOM AND HL7 11 DICOM and IHE 12 See also 13 References 14 External links
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The DICOM standard is divided into related but independent parts:[4] The links below are to the 2011 version. Additions to the standard (Supplements and Change Proposals) since that publication are available through the DICOM Web site (http://dicom.nema.org). PS 3.1: Introduction and Overview (http://medical.nema.org/Dicom/2011/11_01pu.pdf) PDF (241 KB) PS 3.2: Conformance (http://medical.nema.org/Dicom/2011/11_02pu.pdf) PDF (6.46 MB) PS 3.3: Information Object Definitions (http://medical.nema.org/Dicom/2011/11_03pu.pdf) PDF (6.96 MB) PS 3.4: Service Class Specifications (http://medical.nema.org/Dicom/2011/11_04pu.pdf) PDF (1.07 MB) PS 3.5: Data Structure and Encoding (http://medical.nema.org/Dicom/2011/11_05pu.pdf) PDF (588 KB) PS 3.6: Data Dictionary (http://medical.nema.org/Dicom/2011/11_06pu.pdf) PDF (7.32 MB) PS 3.7: Message Exchange (http://medical.nema.org/Dicom/2011/11_07pu.pdf) PDF (1.97 MB) PS 3.8: Network Communication Support for Message Exchange (http://medical.nema.org/Dicom/2011/11_08pu.pdf) PDF (901 KB) PS 3.9: Retired (formerly Point-to-Point Communication Support for Message Exchange) PS 3.10: Media Storage and File Format for Media Interchange (http://medical.nema.org/Dicom/2011/11_10pu.pdf) PDF (406 KB) PS 3.11: Media Storage Application Profiles (http://medical.nema.org/Dicom/2011/11_11pu.pdf) PDF (398 KB) PS 3.12: Media Formats and Physical Media for Media Interchange (http://medical.nema.org/Dicom/2011/11_12pu.pdf) PDF (302 KB) PS 3.13: Retired (formerly Print Management Point-to-Point Communication Support) PS 3.14: Grayscale Standard Display Function (http://medical.nema.org/Dicom/2011/11_14pu.pdf) PDF (478 KB) PS 3.15: Security and System Management Profiles (http://medical.nema.org/Dicom/2011/11_15pu.pdf) PDF (753 KB) PS 3.16: Content Mapping Resource (http://medical.nema.org/Dicom/2011/11_16pu.pdf) PDF (5.03 MB) PS 3.17: Explanatory Information (http://medical.nema.org/Dicom/2011/11_17pu.pdf) PDF (11.40 MB) PS 3.18: Web Access to DICOM Persistent Objects (WADO) (http://medical.nema.org/Dicom/2011/11_18pu.pdf) PDF (203 KB) PS 3.19: Application Hosting (http://medical.nema.org/Dicom/2011/11_19pu.pdf) PDF (1.22 MB) PS 3.20: Transformation of DICOM to and from HL7 Standards (http://medical.nema.org/Dicom/2011/11_20pu.pdf) PDF (570 KB)
History
DICOM is the First version of a standard developed by American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA). In the beginning of the 1980s, it was very difficult for anyone other than manufacturers of computed tomography or magnetic resonance imaging devices to decode the images that the machines generated. Radiologists and medical physicists wanted to use the images for dose-planning for radiation therapy. ACR and NEMA joined forces and formed a standard committee in 1983. Their first standard, ACR/NEMA 300, was released in 1985. Very soon after its release, it became clear that improvements were needed. The text was vague and had internal contradictions. In 1988 the second version was released. This version gained more acceptance among vendors. The image transmission was specified as over a dedicated 2 pair cable (EIA-485). The first demonstration of ACR/NEMA V2.0 interconnectivity technology was held at Georgetown University, May 2123, 1990. Six companies participated in this event, DeJarnette Research Systems, General Electric Medical Systems, Merge
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Technologies, Siemens Medical Systems, Vortech (acquired by Kodak that same year) and 3M. Commercial equipment supporting ACR/NEMA 2.0 was presented at the annual meeting of the Radiological Society of North America (RSNA) in 1990 by these same vendors. Many soon realized that the second version also needed improvement. Several extensions to ACR/NEMA 2.0 were created, like Papyrus (developed by the University Hospital of Geneva, Switzerland) and SPI (Standard Product Interconnect), driven by Siemens Medical Systems and Philips Medical Systems. The first large-scale deployment of ACR/NEMA technology was made in 1992 by the US Army and Air Force, as part of the MDIS (Medical Diagnostic Imaging Support) (http://www.ncbi.nlm.nih.gov/pubmed/7612705?dopt=Abstract) program run out of Ft. Detrick, Maryland. Loral Aerospace and Siemens Medical Systems led a consortium of companies in deploying the first US military PACS (Picture Archiving and Communications System) at all major Army and Air Force medical treatment facilities and teleradiology nodes at a large number of US military clinics. DeJarnette Research Systems and Merge Technologies provided the modality gateway interfaces from third party imaging modalities to the Siemens SPI network. The Veterans Administration and the Navy also purchased systems off this contract. In 1993 the third version of the standard was released. Its name was then changed to "DICOM" so as to improve the possibility of international acceptance as a standard. New service classes were defined, network support added and the Conformance Statement was introduced. Officially, the latest version of the standard is still 3.0. However, it has been constantly updated and extended since 1993. Instead of using the version number, the standard is often versionnumbered using the release year, like "the 2007 version of DICOM". While the DICOM standard has achieved a near universal level of acceptance amongst medical imaging equipment vendors and healthcare IT organizations, the standard has its limitations. DICOM is a standard directed at addressing technical interoperability issues in medical imaging. It is not a framework or architecture for achieving a useful clinical workflow. RSNA's Integrating the Healthcare Enterprise (IHE) initiative layered on top of DICOM (and HL-7) provides this final piece of the medical imaging interoperability puzzle.
Front page of ACR/NEMA 300, version 1.0, which was released in 1985
Derivations
There are some derivations from the DICOM standard into other application areas. These include: DICONDE - Digital Imaging and Communication in Nondestructive Evaluation, was established in 2004 as a way for nondestructive testing manufacturers and users to share image data.[5] DICOS - Digital Imaging and Communication in Security was established in 2009 to be used for image sharing in airport security.[6]
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A DICOM data object consists of a number of attributes, including items such as name, ID, etc., and also one special attribute containing the image pixel data (i.e. logically, the main object has no "header" as such: merely a list of attributes, including the pixel data). A single DICOM object can have only one attribute containing pixel data. For many modalities, this corresponds to a single image. But note that the attribute may contain multiple "frames", allowing storage of cine loops or other multi-frame data. Another example is NM data, where an NM image, by definition, is a multi-dimensional multi-frame image. In these cases, three- or four-dimensional data can be encapsulated in a single DICOM object. Pixel data can be compressed using a variety of standards, including JPEG, JPEG Lossless, JPEG 2000, and Run-length encoding (RLE). LZW (zip) compression can be used for the whole data set (not just the pixel data), but this has rarely been implemented. DICOM uses three different Data Element encoding schemes. With Explicit Value Representation (VR) Data Elements, for VRs that are not OB, OW, OF, SQ, UT, or UN, the format for each Data Element is: GROUP (2 bytes) ELEMENT (2 bytes) VR (2 bytes) LengthInByte (2 bytes) Data (variable length). For the other Explicit Data Elements or Implicit Data Elements, see section 7.1 of Part 5 of the DICOM Standard. The same basic format is used for all applications, including network and file usage, but when written to a file, usually a true "header" (containing copies of a few key attributes and details of the application which wrote it) is added.
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Value Representation AE AS AT CS DA DS DT FL FD IS LO LT OB OF OW PN SH SL SQ SS ST TM UI UL UN US UT
Description Application Entity Age String Attribute Tag Code String Date Decimal String Date/Time Floating Point Single (4 bytes) Floating Point Double (8 bytes) Integer String Long String Long Text Other Byte Other Float Other Word Person Name Short String Signed Long Sequence of Items Signed Short Short Text Time Unique Identifier Unsigned Long Unknown Unsigned Short Unlimited Text
In addition to a Value Representation, each attribute also has a Value Multiplicity to indicate the number of data elements contained in the attribute. For character string value representations, if more than one data element is being encoded, the successive data elements are separated by the backslash character "\".
DICOM services
DICOM consists of many different services, most of which involve transmission of data over a network, and the file format below is a later and relatively minor addition to the standard.
Store
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The DICOM Store service is used to send images or other persistent objects (structured reports, etc.) to a PACS or workstation.
Storage commitment
The DICOM storage commitment service is used to confirm that an image has been permanently stored by a device (either on redundant disks or on backup media, e.g. burnt to a CD). The Service Class User (SCU: similar to a client), a modality or workstation, etc., uses the confirmation from the Service Class Provider (SCP: similar to a server), an archive station for instance, to make sure that it is safe to delete the images locally.
Query/Retrieve
This enables a workstation to find lists of images or other such objects and then retrieve them from a PACS.
Modality worklist
This enables a piece of imaging equipment (a modality) to obtain details of patients and scheduled examinations electronically, avoiding the need to type such information multiple times (and the mistakes caused by retyping).
Printing
The DICOM Printing service is used to send images to a DICOM Printer, normally to print an "X-Ray" film. There is a standard calibration (defined in DICOM Part 14) to help ensure consistency between various display devices, including hard copy printout.
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The MIME type for DICOM files is defined by RFC 3240 as application/dicom. The Uniform Type Identifier type for DICOM files is org.nema.dicom. There is also an ongoing media exchange test and "connectathon" process for CD media and network operation that is organized by the IHE organization. MicroDicom is free Windows software for reading DICOM data.
Application areas
Modality AS BI CD CF CP CR CS CT DD DG DM DS DX EC ECG EM ES FA FS GM HC LP LS MA MG MR MS NM Description Modality of type Angioscopy - Retired Modality of type Biomagnetic Imaging Modality of type Color Flow Doppler - Retired 2008 Modality of type Cinefluorography - Retired Modality of type Colposcopy - Retired Modality of type Computed Radiography Modality of type Cystoscopy - Retired Modality of type Computed Tomography Modality of type Duplex Doppler - Retired 2008 Modality of type Diaphanography Modality of type Digital Microscopy - Retired Modality of type Digital Subtraction Angiography - Retired Modality of type Digital Radiography Modality of type Echocardiography - Retired Modality of type Electrocardiograms Modality of type Electron Microscope Modality of type Endoscopy Modality of type Fluorescein Angiography - Retired Modality of type Fundoscopy - Retired Modality of type General Microscopy Modality of type Hard Copy Modality of type Laparoscopy - Retired Modality of type Laser Surface Scan Modality of type Magnetic Resonance Angiography (retired) Modality of type Mammography Modality of type Magnetic Resonance Modality of type Magnetic Resonance Spectroscopy - Retired Modality of type Nuclear Medicine
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Modality of type Ophthalmic Photography Modality of type Ophthalmic Mapping Modality of type Ophthalmic Refraction Modality of type Ophthalmic Visual Field Modality of type Other Modality of type Positron Emission Tomography (PET) Modality of type Panoramic X-Ray Modality of type Radiotherapy Dose (a.k.a. RTDOSE) Modality of type Radio Fluoroscopy Modality of type Radiographic Imaging (conventional film screen) Modality of type Radiotherapy Plan (a.k.a. RTPLAN) Modality of type Radiotherapy Structure Set (a.k.a. RTSTRUCT) Modality of type Radiation Therapy Modality of type Secondary Capture Modality of type Slide Microscopy Modality of type Structured Reporting Modality of type Single-Photon Emission Computed Tomography (retired 2008) Modality of type Thermography Modality of type Ultrasound Modality of type Videofluorography - Retired Modality of type Visible Light Modality of type X-Ray Angiography Modality of type External Camera (Photography)
Disadvantages of DICOM
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According to a paper presented at an international symposium in 2008, the DICOM standard has problems related to data entry. "A major disadvantage of the DICOM Standard is the possibility for entering probably too many optional fields. This disadvantage is mostly showing in inconsistency of filling all the fields with the data . Some image objects are often incomplete because some fields are left blank and some are filled with incorrect data."[9]
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and HL7). The specifics of these transactions have been worked out in great detail so that vendors have been free to independently develop solutions to meet the goals of the technical framework. In the year 2001 to 2002, 30 companies took part in the testing and implementation of the IHE demonstrations.[15]
See also
OsiriX - Image processing application dedicated to DICOM images GDCM - DICOM library for medical files Orthanc - Lightweight, RESTful DICOM store MicroDicom - DICOM viewer for Windows Ginkgo CADx Cross-platform DICOM viewer HL7 HL7 Integrating the Healthcare Enterprise IHE
File:Dicom3.0
A diagram showing a variety of equipment using the DICOM.
References
1. 2. 3. 4. ^ DICOM brochure (http://medical.nema.org/dicom/geninfo/Brochure.pdf), nema.org. ^ MEMBERS of the DICOM STANDARDS COMMITTEE (http://medical.nema.org/members.pdf) ^ http://www.nema.org/About/Pages/Members.aspx ^ "6.1 DIMSE Services" (ftp://medical.nema.org/medical/dicom/2009/08_01pu.pdf). Digital Imaging and Communications in Medicine (DICOM) Part 1: Introduction and Overview. National Electrical Manufacturers Association. 2006. p. 11. ^ http://www.astm.org: If a Picture Is Worth 1,000 Words, then Pervasive, Ubiquitous Imaging Is Priceless (http://www.astm.org/SNEWS/OCTOBER_2003/voelker_oct03.html) ^ http://www.nema.org: Industrial Imaging and Communications Section (http://www.nema.org/prod/security/indust-Img.cfm) ^ http://medical.nema.org/Dicom/2011/11_14pu.pdf ^ Shiroma, J. T. (2006). An introduction to DICOM. Veterinary Medicine, , 19-20. Retrieved from http://0search.proquest.com.alpha2.latrobe.edu.au/docview/195482647?accountid=12001 ^ Mustra, Mario; Delac, Kresimir; Grgic, Mislav (10-12 Sept. 2008). "Overview of the DICOM Standard" (http://www.vcl.fer.hr/papers_pdf/Overview%20of%20the%20DICOM%20Standard.pdf). ELMAR, 2008. 50th International Symposium. Zadar, Croatia. pp. 3944. ISBN 978-1-4244-3364-3. ^ http://www.dicombuzz.blogspot.in/p/dicom.html ^ http://www.hl7.org/about/index.cfm ^ Kimura, M; Ohe, K; Yoshihara, H; Ando, Y; Kawamata, F; Tsuchiya, F; Furukawa, H; Horiguchi, S et al. (1998). "MERIT-9: A patient information exchange guideline using MML, HL7 and DICOM". International Journal of Medical Informatics 51 (1): 5968. doi:10.1016/S1386-5056(98)00090-2 (http://dx.doi.org/10.1016%2FS1386-5056%2898%2900090-2). PMID 9749900 (//www.ncbi.nlm.nih.gov/pubmed/9749900). ^ Knig, H. (2005). "Access to persistent health information objects: Exchange of image and document data by the use of DICOM and HL7 standards". International Congress Series 1281: 9327. doi:10.1016/j.ics.2005.03.186 (http://dx.doi.org/10.1016%2Fj.ics.2005.03.186). ISBN 978-0-444-51872-9. ^ Integrating the Healthcare Enterprise ^ Flanders, A.E., Carrino, J.A., 2003. Understanding DICOM and IHE. Seminars in Roentgenology 38, 270 281.
5. 6. 7. 8. 9.
13.
14. 15.
External links
DICOM standard (http://dabsoft.ch/dicom/index.html), Dabsoft.ch. The latest DICOM specification (http://medical.nema.org/standard.html) DICOM Standard Status (approved and proposed changes) (http://www.dclunie.com/dicomen.wikipedia.org/wiki/DICOM 10/11
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status/status.html) Brief introduction to DICOM (http://www.cabiatl.com/mricro/dicom/index.html) Introduction to DICOM using OsiriX (http://www.saravanansubramanian.com/Saravanan/Articles_On_Software/Entries/2010/2/10_Introducti on_to_the_DICOM_Standard.html) Introduction to DICOM using RZDCX (http://dicomiseasy.blogspot.co.il/p/introduction-to-dicom.html) Medical Image FAQ part 2 (http://www.dclunie.com/medical-image-faq/html/part2.html) - Standard formats including DICOM. Medical Image FAQ part 8 (http://www.dclunie.com/medical-image-faq/html/part8.html) - Contains a long list DICOM software. Collection of DICOM images (clinical images and technical testpatterns) (http://www.aycan.de/main/lp/sample_dicom_images.html) Example of an applet based DICOM Viewer (http://legeneraliste.perso.sfr.fr/?p=dicom_eng) DICOM is a standard (http://www.dicombuzz.blogspot.in/p/dicom.html) - For Medical Images handling, storing, printing, and transmitting information [1] (http://0-search.proquest.com.alpha2.latrobe.edu.au/docview/195482647) Retrieved from "http://en.wikipedia.org/w/index.php?title=DICOM&oldid=565728550" Categories: Medical imaging Application layer protocols Telehealth Health standards This page was last modified on 25 July 2013 at 09:29. Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
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