1. What’s New in DICOM – it’s been a very busy year!
Robert Horn, Agfa Healthcare Harry Solomon, GE Medical Systems
RSNA 2003

2. Multi-frame MR/CT Enhanced MR Image, MR Spectroscopy, CT Image
More rigorous attribute definition (less need for private data elements)
Multi-frame object to support image studies
Dynamic image header supports attributes changing during acquisition
Dimensions allow multiple views of data
Functional imaging with color and real-world value mapping
File size flexibility through concatenations
MR in 2003 Standard, CT in Ballot

3. Chinese / Unicode
Official DICOM support for Unicode and GB18030 (PRC standard)
GB character set is harmonized with Unicode
Objects in Unicode do not need character set switching (and there is no mechanism for it)
Japanese uses JIS X 0208/0212 Katakana/Kanji, Korean uses KS X 1001 Hangul/Hanja, in accordance with national policies
W. Europe has installed base of IR-100 (Latin 1), but no formal impediment to using Unicode

4. DVD / JPEG2000
JPEG2000 is now an official compression method under DICOM
Wavelet based, up to 16-bit pixel depth
Lossless and lossy
DVD is now an official exchange medium under DICOM
Can use any DVD flavor (-R, -RW, +R, +RW, -ROM)
Reader must support JPEG or JPEG2000 lossy compression

5. More and More SR Templates
Done:
Ob-Gyn, Vascular, and Cardiac Ultrasound
Cath Lab Procedure Log, Hemodynamics, and Final Report
Breast Imaging Report
In Process:
Fetal/Pediatric Echocardiography
Intravascular Ultrasound
Quantitative Arteriography and Ventriculography
CT/MR Angiography

6. Conformance
Major enhancement to Part 2 Conformance based on experience using Conformance Statements to prepare for and troubleshoot DICOM installations
1 page Executive Summary
Documentation details for behavior at the attribute level
New sections on error handling, coded terminology, security
Example Conformance Statements reflecting real types of systems
Modality with MWL, MPPS, GSPS, Print w/P-LUT, and Storage Commitment
RIS as MWL and MPPS Service Class Provider
Multi-modality Workstation, including Media Exchange
Print Server
Archive

7. Configuration Management
Introduces use of LDAP with a standard LDAP schema to maintain configuration parameters of DICOM devices
LDAP query to retrieve configuration from LDAP server
Device obtains its own parameters, and those of communication partners (addresses, capabilities)
Also uses DHCP, DNS, and NTP to cover:
Installation and auto-configuration of a new device
Portable, mobile devices
Mixed networks with legacy equipment
Synchronized time across devices
Objective to decrease service cost while maintaining reliable standard-based configuration management
Currently Frozen for Trial Use, In balloting now

8. Web Access to Images Web Access to DICOM Persistent Objects (WADO)
Joint project of DICOM and ISO
Standard HTTP URL to web image server
Images returned as vanilla JPEG, or as MIME-encapsulated DICOM
Can request entire image, or just ROI
Currently in Ballot, final release will be synchronized with ISO balloting during 2004.

9. Image Registration
Composite Objects that support multi-image alignment
Transform based
Matrix operation to map one Frame of Reference to another
Frame of Reference may be synthetic (e.g., Talairach Brain Atlas)
Fiducial based
Fiducial points identified in image, or in 3-D Frame of Reference space
May be used with projection images
Facilitates further image processing, especially multi-modality image fusion and image pasting applications

10. Relevant Patient Info Query
Address need for more detailed patient clinical history affecting image acquisition or interpretation
Risk factors, chronic diseases
Detailed allergies, medical problems
Prior findings for follow-up exam
DICOM mechanism to obtain extended patient info
Query (C-FIND) message model
Patient ID is Query Key
Query Response has patient info in Structured Report format
Specific and general queries
Breast imaging, cardiac, general

11. Image-based Specialties
New work under way in Ophthamology (WG9)
Ophthalmic Photography (fundoscopy, fluorescein angiography)
New working group for Dentistry (WG22)
Media exchange on CD
New work under way in Endoscopy (WG13)
Visible Light Video (endoscopy, microscopy, photography)
MPEG video image encoding in DICOM

12. Coming soon Hanging protocols Radiotherapy workflow
Non-radiology workflow
Advanced X-ray angiography
Advanced ultrasound
3-D and n-D
Media creation service (CD burner)
Color consistency
Privacy and Audit services
User Identity Authentication
Parts 3, 6, and 16 tables published in XML

13.
DICOM home page now includes presentations and tutorials
Especially new MR IOD and Structured Reporting