1. DICOM and NM Taking the next step Jerold Wallis, MD

2. DICOM in Nuclear Medicine SNM DICOM Working Group SNM DICOM Demo 2001 SNM DICOM Demo 2002 Joint IHE Demo 2003 SNM ASNC ACC RSNA

3. Integrating the Healthcare Enterprise Achieving Real-World Interoperability ( & What’s in it for NucMed? ) IHE slides edited from a presentation by Kevin O’Donnell, Toshiba Corp. Co-chair IHE Planning Committee

4. NM Image NMPACS

5. NM Image NMPACS

6. NM Image Problem NMPACS

7. NM Image Problem Click and move mouse down to adjust window level, right to adjust window center

8. SPECT NMPACS

9. SPECT NMPACS

10. PET NMPACS

11. NMPACS Cardiac

12. Gated Cardiac NMPACS

13. Gated Cardiac NMPACS

14. Areas for Improvement Color image transfersColor image transfers Vendor independent labeling of Cardiac SPECT filesVendor independent labeling of Cardiac SPECT files Cardiac DICOMCardiac DICOM –Easy export of statics –Export of gated Window level controlsWindow level controls Consistency of image presentationConsistency of image presentation Three-plane tomographic image displayThree-plane tomographic image display Gated cardiac displayGated cardiac display Color tablesColor tables NMPACS

15. Past and Future SNM DICOM Demo 2001 SNM DICOM Demo 2002 Joint IHE Demo 2003 SNM ASNC ACC RSNA NM PACS NM

16. Integrating the Healthcare Enterprise Achieving Real-World Interoperability

17. What is IHE about?  IHE is an initiative promoting and supporting the integration of systems in the healthcare enterprise.  Goal: Improve the efficiency and effectiveness of clinical practice by:  Improved Information Flow  Advanced Multi-System Functions

18. How is IHE related to Standards? Standards provide tools & technologiesStandards provide tools & technologies –HL7 and DICOM provide dictionaries IHE specifies how to apply them to real world scenarios & integration problemsIHE specifies how to apply them to real world scenarios & integration problems –IHE defines a “phrasebook”

19. What Does IHE Do? Users and vendors work together to identify and design solutions for integration problemsUsers and vendors work together to identify and design solutions for integration problems Intensive process with annual cycles:Intensive process with annual cycles: –Identify key healthcare workflows and integration problems –Research & select standards to specify a solution –Write, review and publish IHE Technical Framework –Perform cross-testing at “Connectathon” –Demonstrations at tradeshows (HIMSS/RSNA)

20. SNM, Vendor & IHE Cooperation Integrate NM into IHE demosIntegrate NM into IHE demos Use established IHE “network” to help distribute and get support for all parts of NM DICOM standardUse established IHE “network” to help distribute and get support for all parts of NM DICOM standard Work with PACS vendors on display issues unique to NMWork with PACS vendors on display issues unique to NM

21. Key Areas General NMGeneral NM CardiacCardiac PETPET

22. General NM Add support for consistent presentation of images at NM endAdd support for consistent presentation of images at NM end Comply with consistent presentation of images at PACS endComply with consistent presentation of images at PACS end Add support for 3-view tomographic imaging on PACSAdd support for 3-view tomographic imaging on PACS

23. Cardiac Support DICOM cardiac view codesSupport DICOM cardiac view codes Support for gated screen DICOM output by allSupport for gated screen DICOM output by all Easy export of DICOM screensEasy export of DICOM screens 3rd party cardiac software authors Camera vendors systems and databases PACS systems and databases Low cost generic viewers Other NM systems

24. PET Transmission between NM systemsTransmission between NM systems PACS displaysPACS displays PET-CT displaysPET-CT displays –on NM systems –on PACS systems

25. What’s Next? Commit to concept of an IHE NM profileCommit to concept of an IHE NM profile Work toward achieving it for the October connect-a-thonWork toward achieving it for the October connect-a-thon Continue cooperative efforts within the NM communityContinue cooperative efforts within the NM community