What’s New in DICOM – it’s been a very busy year! Robert Horn, Agfa Healthcare Harry Solomon, GE Medical Systems RSNA 2003

Multi-frame MR/CT Enhanced MR Image, MR Spectroscopy, CT Image More rigorous attribute definition (less need for private data elements) Multi-frame object to support 1000+ image studies Dynamic image header supports attributes changing during acquisition Dimensions allow multiple views of data Functional imaging with color and real-world value mapping File size flexibility through concatenations MR in 2003 Standard, CT in Ballot

Chinese / Unicode Official DICOM support for Unicode and GB18030 (PRC standard) GB 18030 character set is harmonized with Unicode Objects in Unicode do not need character set switching (and there is no mechanism for it) Japanese uses JIS X 0208/0212 Katakana/Kanji, Korean uses KS X 1001 Hangul/Hanja, in accordance with national policies W. Europe has installed base of IR-100 (Latin 1), but no formal impediment to using Unicode

DVD / JPEG2000 JPEG2000 is now an official compression method under DICOM Wavelet based, up to 16-bit pixel depth Lossless and lossy DVD is now an official exchange medium under DICOM Can use any DVD flavor (-R, -RW, +R, +RW, -ROM) Reader must support JPEG or JPEG2000 lossy compression

More and More SR Templates Done: Ob-Gyn, Vascular, and Cardiac Ultrasound Cath Lab Procedure Log, Hemodynamics, and Final Report Breast Imaging Report In Process: Fetal/Pediatric Echocardiography Intravascular Ultrasound Quantitative Arteriography and Ventriculography CT/MR Angiography

Conformance Major enhancement to Part 2 Conformance based on experience using Conformance Statements to prepare for and troubleshoot DICOM installations 1 page Executive Summary Documentation details for behavior at the attribute level New sections on error handling, coded terminology, security Example Conformance Statements reflecting real types of systems Modality with MWL, MPPS, GSPS, Print w/P-LUT, and Storage Commitment RIS as MWL and MPPS Service Class Provider Multi-modality Workstation, including Media Exchange Print Server Archive

Configuration Management Introduces use of LDAP with a standard LDAP schema to maintain configuration parameters of DICOM devices LDAP query to retrieve configuration from LDAP server Device obtains its own parameters, and those of communication partners (addresses, capabilities) Also uses DHCP, DNS, and NTP to cover: Installation and auto-configuration of a new device Portable, mobile devices Mixed networks with legacy equipment Synchronized time across devices Objective to decrease service cost while maintaining reliable standard-based configuration management Currently Frozen for Trial Use, In balloting now

Web Access to Images Web Access to DICOM Persistent Objects (WADO) Joint project of DICOM and ISO Standard HTTP URL to web image server Images returned as vanilla JPEG, or as MIME-encapsulated DICOM Can request entire image, or just ROI Currently in Ballot, final release will be synchronized with ISO balloting during 2004.

Image Registration Composite Objects that support multi-image alignment Transform based Matrix operation to map one Frame of Reference to another Frame of Reference may be synthetic (e.g., Talairach Brain Atlas) Fiducial based Fiducial points identified in image, or in 3-D Frame of Reference space May be used with projection images Facilitates further image processing, especially multi-modality image fusion and image pasting applications

Relevant Patient Info Query Address need for more detailed patient clinical history affecting image acquisition or interpretation Risk factors, chronic diseases Detailed allergies, medical problems Prior findings for follow-up exam DICOM mechanism to obtain extended patient info Query (C-FIND) message model Patient ID is Query Key Query Response has patient info in Structured Report format Specific and general queries Breast imaging, cardiac, general

Image-based Specialties New work under way in Ophthamology (WG9) Ophthalmic Photography (fundoscopy, fluorescein angiography) New working group for Dentistry (WG22) Media exchange on CD New work under way in Endoscopy (WG13) Visible Light Video (endoscopy, microscopy, photography) MPEG video image encoding in DICOM

Coming soon Hanging protocols Radiotherapy workflow Non-radiology workflow Advanced X-ray angiography Advanced ultrasound 3-D and n-D Media creation service (CD burner) Color consistency Privacy and Audit services User Identity Authentication Parts 3, 6, and 16 tables published in XML

http://dicom.nema.org DICOM home page now includes presentations and tutorials Especially new MR IOD and Structured Reporting