1. Advances in X-Ray Angiography Projection Imaging and 3D
DICOM WG-02
Advances in X-Ray Angiography
Projection Imaging and 3D
SPIE Medical Imaging
2010, San Diego
Authors:
Heinz Blendinger Siemens Healthcare
Bas Revet Philips Healthcare
Francisco Sureda GE Healthcare (Chair DICOM WG-02)

2. Presentation Outline Introduction
Overview of X-Ray Angiography in DICOM
X-Ray N-Dimensional Presentation Cases
3D Shutter
Volume Subtraction
Stabilized Region in Moving Volume
Trajectory Tracking in Volume
2D-3D Blending
Conclusion

3. Approved in the Standard
Overview of X-Ray Angiography in DICOM
Approved in the Standard
Work in Progress
X-Ray Acquisition
Follow-up of IHE REM Profile
Supp 94:
Radiation Dose Reporting
CR-DX Dose Reporting
2D Projection Images
Supp 83:
Enhanced XA/XRF
Supp 139-LB: Enhanced XA Informative Annex
Supp 140: Presentation State
3D Reconstruction
X-Ray 3D Informative Annex
Supp 116:
X-Ray 3D Storage
N-Dimensional Presentation State

4. Workflow in X-Ray N-Dimensional Presentation
Enhanced XA Storage SOP Class
X-Ray Acquisition Procedure
X-Ray 3D Storage SOP Class
Reconstruction
Procedure
In progress
N-D Presentation State SOP Class
X-Ray Calibration Procedure
Calibration Data Proprietary
Visualization
Visualization
X-Ray Acquisition System
X-Ray 3D Reconstruction System
3D Visualization Systems

5. X-Ray 3D Angiography – Rotational Acquisition
Frame #5:
X-ray settings 5
Geometry settings 5
Frame #4:
X-ray settings 4
Geometry settings 4
Optimized 3D Reconstruction
Frame #3:
X-ray settings 3
Geometry settings 3
Frame #2:
X-ray settings 2
Geometry settings 2
Frame #1:
X-ray settings 1
Geometry settings 1

6. X-Ray 3D Angiography – Presentation State
Needs for 3D Angiography Presentation
Presentation features common to all 3D modalities (rendering...)
Speficic presentation of X-Ray 3D Angiography:
Acquisition 3D shutter (e.g. collimation)
Volume Subtraction and voxel shift
Stabilized point in all volumes (e.g. cardiac wall motion, stent stabilized)
Catheter tracking trajectory in one volume
2D-3D blending presentation (3D conic projection on 2D fluoroscopy)
N-Dimensional Presentation State
Work Item C. Addresses needs of multi-modalities
Led by Working Group 11, participation of Web3D Consortium and other DICOM working groups
Supplement in progress...

7. X-Ray 3D Angiography – Presentation State
Volume Regions to define 3D shutter
Punch Holes
Clipping Planes
Frames
Proposal for Volume Region Sequence:
Region Purpose : DT: “DISPLAY SHUTTER“ or “ROI“
Region Display Mode : DT: “DISPLAY“ or “HIDE“
Region Definition Method : Enumerated Values
...
Punch Hole: EV: “ELLIPSE“ or “POLYGON“
Plane: Orientation, Position, inside or outside
Frame: EV: “ELLIPSE“ or “POLYGON“ or “BITMAP“

8. X-Ray 3D Angiography – Presentation State
Volume Subtraction
Subtracted
Contrast
Mask Frames
Contrast Frames
Proposal for 3D Mask Subtraction Sequence:
Mask Operation: DT: “Volume Selection“
Applicable Volume: Pair of Frame Numbers (e.g. N+1, N+k)
Mask Volume: Pair of Frame Numbers (e.g. 1, N)
Mask Voxel Shift: Triple of Float Numbers
Mask Contrast Registration 4x3 matrix
Mask Operation Explanation: Free Text
Mask Selection Mode: DT: SYSTEM or USER
Recommended Viewing Mode: DT: SUB or NAT

9. X-Ray 3D Angiography – Presentation State
Stabilized region in moving volume
Applicable to 4D data (i.e. 3D volumes with time)
Goal: Stabilize the position and orientation of an object during the dynamic view
Proposal for Stabilized Region Sequence:
// contains as many items as number of volumes
Applicable Volume: Pair of Frame Numbers
Point: 3D coordinates
View Angle: 3D view angle
The result is an animated sequence to view the volumes stabilized at a given point:
a) with same volume orientation
b) or changing the orientation of the volume to keep the same orientation of the object of interest

10. X-Ray 3D Angiography – Presentation State
Trajectory Tracking in Volume
Applicable to 3D data
Goal: View the volume along a pre-defined trajectory of the camera
Example:
During the planning phase of a catheterization intervention
Define a 3D curve from point A to point B inside an artery (i.e. catheter trajectory)
Define an animated sequence to view the progress of the curve:
a) from the outside of the volume, with same volume orientation
b) from the outside of the volume, changing the orientation of the volume to be perpendicular to the tip of the curve
c) from inside the artery (fly-thru) as virtual endoscopy A B

11. 2D-3D Blending in X-Ray Angiography (1/2)
X-Ray 3D Reconstruction
X-Ray Rotational Acquisition
3D Viewing Settings
X-Ray 2D Projection SOP Class
3D View
X-Ray 3D Storage SOP Class
new
3D Segmentation
Segmentation SOP Class
Conic Projection
2D Presentation
3D Presentation
Same Frame Of Reference
X-Ray 2D Projection SOP Class
2D-3D Blending
X-Ray Acquisition 2D
View
2D Presentation SOP Class
X-Ray Acquisition System

12. 2D-3D Blending in X-Ray Angiography (2/2)
3D Image (CT, …)
3D Viewing Settings
3D View
CT Storage SOP Class
new
3D Segmentation
Segmentation SOP Class
new
Registration to Isocenter System
Conic Projection
2D Presentation
3D Presentation
X-Ray 2D Projection SOP Class
2D-3D Blending
X-Ray Acquisition 2D
View
2D Presentation SOP Class
X-Ray Acquisition System

13. Conclusion Enhanced XA (2D) XA Presentation State (2D)
Supplement 139 in Letter Ballot. Informative (DICOM Part 17)
Will facilitate the adoption of the Enhanced XA SOP Class (Sup 83)
XA Presentation State (2D)
Supplement 140 in Final Text
X-Ray 3D Angiography
New IOD approved in Standard 2007 (Supplement 116)
Application cases (Informative) - Work In Progress
N-D Presentation State
N-D Presentation State - Work In Progress
To get involved in WG-02 developments: contact chairman at