Transcript Interoperability Showcase Marketing

North American 2010
Connectathon & Interoperability Showcase Series
Radiology Update
Profiles for Media Exchange
Chris Lindop
Interoperability & Standards Mgr
GE Healthcare
Radiology Committee Co-chair
June-September 2009
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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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Portable Data for Imaging (PDI)– Value Statement
Easier, perhaps.
You may be part of the problem.
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Portable Data for Imaging (PDI)– Value Statement
and…
or…
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Portable Data for Imaging (PDI)
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Portable Data for Imaging (PDI)

Compatibility requirements
 Standard CD format and file system
 Consistent disc organization
 Use most generic DICOM media profile
 Images MUST be present in DICOM
o
May have copies as “web content” (i.e. JPEGs)
 Avoid most common mistakes (highlighted)
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PDI –Extensions

Additional Media:

Compression
DVD
 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
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PDI –Extensions
Sending Software
1) Insert CD; Run Sending Software
2) “Enter Password:”
3) Sending Software Decrypts CD Images
4) “Enter Destination:”
6) Sending Software decompresses &
convertsImages (as needed)
5) DICOM Association
Negotiation
7) Send Images (C-STORE)
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PDI - Extensions Actors/Transactions
New Actor for PDI
Portable Media
Sender
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New Media type Options
Baseline 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 include 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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Import Reconciliation Workflow – Value Statement

“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
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Import Reconciliation Workflow (IRWF)

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
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Basic Image Review (BIR)

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
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Basic Image Review ( BIR) - Value Statement
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Basic Image Review (BIR) – Value Statement

Facilities distribute images; Physicians review them
 Often a physician has own viewer but may need to rely on the
media-supplied viewer

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.
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Basic Image Review (BIR)

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
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SOP Class Support
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
Notes:
PDI Basic Viewer Option - requires only SOP Class support on media
non-PDI requires a partial display requirement for SOP classes not listed
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Simple Restricted Feature Set
Display 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
Benchmark
Target for Large Target for Small
Dataset
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
30 slices/per second for 311
slice PET/CT 512x512x12 bit
CT series
n.a.
0.5 seconds
for1880 x 2016 DX
PA Chest 20051208
n.a.
approximately 0.1 seconds
(near visually imperceptible)
for1880 x 2016 DX
PA Chest 20051208
n.a.
Scroll frame rate
Zoom time
Window center and width
change response time.
NOTE:
PDI- BIR Option Only
Reference platform and image set specified for testing
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Large data-set and small data set available
in the IHE website
June - September 2009
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