1. HIMSS/RSNAParticipant Workshop, Oct 2004 Nuclear Medicine Image (NM) Integration Profile Kevin O’Donnell IHE Radiology Technical Committee Member, Toshiba Medical Systems Company

2. HIMSS/RSNAParticipant Workshop, Oct 2004 NM – Actors and Transactions

3. HIMSS/RSNAParticipant Workshop, Oct 2004 Points of Interest Appendix E, Volume 1 (Informative) – New to Nuclear Medicine? – Trouble matching NM to Scheduled Workflow? – E.2 NM Workflow – What happens in NM procedures – E.3 NM Worklists – How to schedule/model it – E.4 NM Data – What to expect in the DICOM – E.5 NM Display – How it should be presented – Lots of subtleties

4. HIMSS/RSNAParticipant Workshop, Oct 2004 Points of Interest Acquisition Modality – Modality Images Stored [8] – Create NM objects as specified additional attribute & vector handling –e.g. Cardiac context codes, slice spacing, patient orientation Study & Series UID creation clarification –e.g. After PPS complete, new images MUST be new series –e.g. Reconstructed images MUST be new series

5. HIMSS/RSNAParticipant Workshop, Oct 2004 Points of Interest Image Manager/Archive – Store/Retrieve NM Objects – Store/Retrieve Secondary Capture Objects Refer to list in the spec. – “Level 2” storage requirement clarification e.g. keep private tags – Support for Series Description as Query matching/return key

6. HIMSS/RSNAParticipant Workshop, Oct 2004 Points of Interest Evidence Creator – Creator Images Stored [18] – Ditto. (See Acquisition Modality) – Result Screen Export Option

7. HIMSS/RSNAParticipant Workshop, Oct 2004 Result Screen Export Option: Evidence Creators Render Static and Dynamic Result Screens – Based on the following DICOM Objects: Secondary Capture Multi-Frame Grayscale Byte Secondary Capture Multi-Frame True Color Secondary Capture – Generate appropriate Secondary Capture objects from any Result Screens created.

8. HIMSS/RSNAParticipant Workshop, Oct 2004 Example Result Screen

9. HIMSS/RSNAParticipant Workshop, Oct 2004 Points of Interest – Image Display Image Display – Retrieve Images [16] – Display NM and Secondary Capture Images Note requirement for Color, Greyscale, Static & Dynamic Secondary Capture – Support specified NM essential display capabilities – Additional attribute handling e.g. Patient State, Image Orientation, Detector Sequence, View Code Sequence – Review Option

10. HIMSS/RSNAParticipant Workshop, Oct 2004 Handle multi-frame / multi-vector images Multiple simultaneous cines Grayscale and color result screens Dynamic and static result screens Original resolution and scaled Separate adjustment of upper and lower window levels Apply local color tables to grayscale screens Add color tables to system Change intensity of grayscale result screens – (strongly recommended) Display Series Description tag Points of Interest – Image Display

11. HIMSS/RSNAParticipant Workshop, Oct 2004 Points of Interest – Image Display Scale “intelligently” to avoid presenting postage-stamp size NM images – Just because it was acquired at 64x64 doesn’t mean they want to review it at 64x64

12. HIMSS/RSNAParticipant Workshop, Oct 2004 Points of Interest – Image Display Scale “intelligently” to avoid presenting postage-stamp size NM images Allow user to select different vectors/framesets of complex multi-frame images Allow user to separately adjust intensity for different framesets (eg, phases) in the same “image”

13. HIMSS/RSNAParticipant Workshop, Oct 2004 Review Option Adds requirements to the Image Display to allow Review of NM Images Image Displays – Must additionally support MPR Display, more series, selected different series types together, etc.

14. HIMSS/RSNAParticipant Workshop, Oct 2004 Display Formats Grid display – One image set A1A1 A2A2 A3A3 A4A4 A5A5 A6A6 A7A7 A8A8 A9A9 ………………… …………………… …………………A 32 … A1A1 A2A2 A3A3 A4A4 A5A5 A6A6 A7A7 A8A8 B1B1 B2B2 B3B3 B4B4 B5B5 B6B6 B7B7 B8B8 A1A1 A2A2 B1B1 B2B2 C1C1 C1C1 Fit display – Multiple image sets Comparison display – Multiple image sets

15. HIMSS/RSNAParticipant Workshop, Oct 2004 More information…. IHE Web sites: http://www.rsna.org/IHE Technical Frameworks: RAD V5.5 Technical Framework Supplements - Trial Implementation May 2004: Radiology

16. HIMSS/RSNAParticipant Workshop, Oct 2004 Questions?