1. A D A C Internal Use Only DICOM Training SNM Sales Meeting June 23, 2001

2. A D A C Internal Use Only Agenda What is DICOM? SNM DICOM Demonstration Philips Support Compatibility Matrix & FAQs

3. A D A C Internal Use Only What is DICOM 3.0 DICOM 3.0 is a standard that facilitates communication and image exchange between medical imaging devices Not all services are supported by all vendors Vendors required to provide a DICOM Conformance Statement to describe level of support to DICOM 3.0 Pegasys DICOM 4.22 is ADACs latest release, compliant with DICOM 3.0 standard

4. A D A C Internal Use Only SNM DICOM Demonstration Nuclear Medicine is lagging other modalities in network connectivity and data interchange First society initiative to facilitate DICOM compliance and interconnectivity among vendors Similar to InfoRad and IHE initiatives at RSNA Vendor cooperation to identify & fix data networking & interoperability issues

5. A D A C Internal Use Only SNM DICOM Demonstration Data Exchange and Interoperability DICOM compatibility is a two step process –Network connectivity Ability of devices to establish network connections and exchange data –Data interoperability Ability of devices to process & display data received from other devices SNM 2001 DICOM demonstration focuses on data interoperability

6. A D A C Internal Use Only SNM DICOM Demonstration Participating Vendors ADAC Areeda Associates GE Medical Systems / SMV Marconi MedImage NUMA Siemens Medical Systems (ICON, E-Soft) Toshiba

7. A D A C Internal Use Only SNM DICOM Demonstration Data Sets Used Whole Body Bone Dynamic Renal Ventilation Lung Perfusion Gated Blood Pool (MUGA) Bone SPECT Non-Gated Myocardial Perfusion Gray Scale Snapshot Color Snapshot Gated Myocardial SPECT

8. A D A C Internal Use Only SNM DICOM Demonstration Plan Each vendor has already completed testing with other participating vendors data Each participating vendor will have a workstation displaying other vendors images at their booth Each vendor will have a data report of receiving, displaying and processing other vendors images Vendors have mutually agreed not to hand-out results to booth visitors and customers

9. A D A C Internal Use Only SNM DICOM Demonstration ADAC Results - GE eNTEGRA TranslatedDisplayedProcessed Whole Body BoneYYY Dynamic RenalYYY VentilationYYN/A Lung PerfusionYYY Gated Blood Pool (MUGA)YYY Bone SPECTYYN/A Non-Gated Myocardial PerfusionYYY* Gray Scale SnapshotYYN/A Color SnapshotYYN/A Gated Myocardial SPECTYYY* * after editing header as it had some information missing N/A - Not Applicable

10. A D A C Internal Use Only SNM DICOM Demonstration ADAC Results - Siemens ICON TranslatedDisplayedProcessed Whole Body BoneYYN/A Dynamic RenalYYY VentilationN/PN/AN/A Lung PerfusionN/PN/AN/A Gated Blood Pool (MUGA)YYY Bone SPECTYYN/A Non-Gated Myocardial PerfusionYYY Gray Scale SnapshotN/PN/AN/A Color SnapshotYYN/A Gated Myocardial SPECTN/PN/AN/A N/P - Not Provided N/A - Not Applicable

11. A D A C Internal Use Only SNM DICOM Demonstration ADAC Results - Siemens E-Soft TranslatedDisplayedProcessed Whole Body BoneYYN/A Dynamic RenalYYY VentilationYYN/A Lung PerfusionYYY Gated Blood Pool (MUGA)YYY Bone SPECTYYN/A Non-Gated Myocardial PerfusionYYY Gray Scale SnapshotN/PN/AN/A Color SnapshotYYN/A Gated Myocardial SPECTYYN N/P - Not Provided N/A - Not Applicable

12. A D A C Internal Use Only SNM DICOM Demonstration ADAC Results - Marconi Odyssey TranslatedDisplayedProcessed Whole Body BoneYYN/A Dynamic RenalYYY VentilationYYN/A Lung PerfusionYYY Gated Blood Pool (MUGA)YYY Bone SPECTYYN/A Non-Gated Myocardial PerfusionYYY Gray Scale SnapshotYYN/A Color SnapshotYYN/A Gated Myocardial SPECTYYY N/A - Not Applicable

13. A D A C Internal Use Only SNM DICOM Demonstration Summary ADAC was able to translate, display and process all received images from: –GE eNTEGRA –Marconi Odyssey –Siemens ICON ADAC was able to translate, display and process all, but one, image types received from Siemens E-Soft –Could not process gated myocardial SPECT Investigating why some competitors are not able to process some of ADACs myocardial images

14. A D A C Internal Use Only Philips Support for DICOM DICOM Interoperability lab in Holland All Philips equipment available for DICOM testing Several popular peripheral devices available in the lab (printers from most vendors, digitizers, etc.) DICOM simulators Competitor equipment arranged upon request ADAC has completed preliminary validation with most Philips equipment in the lab

15. A D A C Internal Use Only ADAC Compatibility Matrix Philips GE GE-SMV GE-Elscint Siemens Marconi AGFA CEMAX NMCTMRIPACSRIS N/AE,RAllQR E,R*RAll E,RN/AN/AN/AN/A E,RN/AN/AN/A E,RRAllN/A E,RRRN/A N/AN/AN/AE N/AN/AN/AEN/A Export (E), Receive (R), Query/Retrieve (QR) remote system *GE-GENIE Export only

16. A D A C Internal Use Only DICOM FAQs 1. What is a DICOM Conformance Statement? –Defines functionality of implementation –Lists optional components and extensions –By comparing conformance statements from 2 vendors, user can determine if interoperability is possible 2. Is a conformance statement sufficient to guarantee interoperability? –No, proper validation is required to ensure interoperability

17. A D A C Internal Use Only DICOM FAQs 3. Can you test DICOM interoperability before hand? –Standard doesnt specify test suites –Some public domain software (e.g. AGFA) –Only way is to connect two devices and test 4. What do I need to know about the site before a DICOM sale? –What devices customer wants to connect to? –Are they DICOM 3.0 compliant? –Are the devices networked? Can Pegasys reach them? Networking hardware is NOT part of DICOM package –READ ADACs and/or third partys compatibility matrix