1. Anniversary Conference and Workshop Summary

2. PACS DICOM services supporting PACS Realities of deploying DICOM in a PACS Transport between PACS Internationalization challenges

3. Expanding Modality Coverage Widely accepted –Radiology –Cardiology –Radiotherapy Growing in terms of use of standards –Dentistry –Video for visible light modalities –(and Ophthalmology, and …) New technology –Enhanced MR ( and CT, and XA, and …)

4. Integration of Standards HL7 –V2.x –V3 –CDA ( DICOM SR) IHE –Beyond radiology –Internationally The web and ISO TC215 –Web Access to DICOM Objects (WADO) AAPM TG18 –Image quality and consistency

5. Standards and Reporting Narrative versus structured ? Integration of speech recognition Persistent forms: DICOM, CDA, other ? Standard versus proprietary ? Complexity of workflow Challenges of distribution & externalization

6. Infrastructure Auditing and logging –Security and privacy across standards boundaries Configuration management –Towards holy grail of “Plug and Play” Conformance Requirements –Perhaps one of DICOM’s greatest strengths

7. Future Challenges Information overload … huge data sets –New visualization paradigms - role of DICOM ? –Interaction with datasets, point-of-care delivery New vision for interaction with fused imagery –Minimally/non invasive computer-assisted intervention Increased demand for care & quality –Yet there is a workforce challenge - need for automation –Reporting of errors/stats - federal standards requirements “Re-invention” of modalities –More functional imaging, planning & localization –Into the hands of ordinary physicians, more screening

8. Whither goest DICOM ? Remain focused on appropriate scope Challenge of the demand for an ExR What should be standard and what left up to the application ? Where are the interface boundaries ? Moving to a world of software-only PACS and commodity storage solutions Greater user participation to define direction

9. Thanks Charles Parisot and Program Committee Howard Clark and the NEMA team Speakers and guests All of you …

10. Thanks Charles Parisot and Program Committee Howard Clark and the NEMA team Speakers and guests All of you … Follow-up … Steve Drew of RSNA