1. Enhanced family of Image SOP Classes
Wim Corbijn van Willenswaard
Philips Healthcare
Interoperability Architect Bangalore, India
Chair WG16 (MRI)

2. Enhanced family of Image SOP Classes
Enhanced Multi-Frame
Introduction Multi Frame model Functional benefits Performance benefits Modalities and policy Conversion approach Conclusions
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

3. Enhanced family of Image SOP Classes
Introduction
Why Multi-Frame
> 10 Years
Why should we start implementing, it is new, nobody is supporting it!
This is the classic chicken egg question.
Modalities need to implement it but if PACS, Viewing stations and Workstation don’t support it why should the modalities create it.
For most systems it still seems to feel as a completely new mechanism of storing images or frames.
Well it is not new, exists already for more than 10 years.
Has a “compact” format with a possibly a whole series in ONE object.
And for most of the area’s a lot more standardized information that is available.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

4. Enhanced family of Image SOP Classes
Introduction
Standard object structure
Sup XXX Enhanced Nuclear Medicine (Proposed)
Sup 43 Enhanced US Volume (Approved 2010)
Sup 141 Enhanced MR Color (Approved 2009)
Sup 43 Enhanced Ultrasound (Approved 2009)
Sup 125 Breast Tomosynthesis (Approved 2008)
Sup 117 Enhanced PET (Approved 2008)
Sup 110 Ophthalmic Coherence Tomography (Approved 2007)
Sup D X-Ray (Approved 2007)
Sup 83 Enhanced XA/XRF Image (Approved 2004)
Sup 58 Enhanced CT (Approved 2003)
Sup 49 Enhanced MR (Approved 2001)
This is the standard structure for all new objects.
And there are already 10 SOP Classes released and there are more under development.
For several area’s it is the only structure available there is no “classic” single frame variant!
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

5. Enhanced family of Image SOP Classes
Multi Frame model
Structure is the same as the standard structure having:
Patient, Study and Series information
The image level is present but is however different organized.
Extra is the Dimension Organization
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

6. Enhanced family of Image SOP Classes
Multi Frame model
Organization is basically the same with only two major differences:
It has several FRAMES in the image
There is the DIMENSION ORGANIZATION that explains the relation between the different frames.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

7. Single-frame to MultiFrame
N Objects, N Headers
One Header
N frames
Dimension data
+ Dimension data
How does this look in the object
Single Frame objects have many parameters in common.
Fixed Header
Per-frame header
Object specific
Pixel data
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes 7

8. Enhanced family of Image SOP Classes
Functional benefits
Single Frame (Classic objects) Multi-Frame
Single frames can be compared to a jigsaw out of the box, you hope you have all the pieces.
Multi frame gives you all the pieces and even tells you how they are organized.
Most cases you will have only one multiframe object for a series, but with growing sizes you made have more.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

9. Enhanced family of Image SOP Classes
Functional benefits
Dimension organization makes it easier to view
The dimension organization makes it a lot easier for the viewer as it tells were to put the pieces.
So you not only get all the pieces of the puzzle but also their location.
Even when there are multiple volumes available the dimension organization tells you all.
You don’t need to know what it means, if you follow the instructions in the dimension organization you will get an overall image that the user will understand and can traverse in a sensible way.
As display system you only need to be able to handle multi dimensional information.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

10. Enhanced family of Image SOP Classes
Functional benefits
Latest technology
Dimension Organization
Functional groups
Dimension organization we have seen enables to guide the viewing system in the way the data should be displayed.
This way there is a real decoupling between the viewing station and the acquisition station.
Even images coming from new acquisition technologies that are unknown during development a viewer will be able to display them in a logical way.
Functional groups means that the parameters are logical grouped together, no longer everything at the root level of the object.
Through sequences the data is split in logical groups, gives you the opportunity to easily skip sets of parameters.
For all new objects the standard is that all parameters are mandatory, so most of them are 1 or 1C. Where the functional group is mandatory under specific conditions. So if you have a diffusion scan the diffusion group macro is mandatory and will have all the standard attributes, only as technology is evolving you will see again type 3 attributes coming in again.
But for new techniques this is even not necessary as the functional group can be made mandatory if the technique is used it can be added with type 1(C) attributes without any problem.
This way viewers can rely much more on consistency over different vendors, as soon as there is agreement on a technique and the parameters involved the description can be made.
This is not possible in a Classic object as you have no level to use for this
Reducing the overhead by supplying all information once and in one object.
This way you don’t have to traverse the total tree of Patient, Study, Series with every object coming in just to add the image data.
Also when storing the objects as files this will save a lot of overhead, the gain in space might be not that much as the Pixel data is mostly the major part. But it makes quite of difference if you have to store 2000 Classic objects or only 1 Enhanced object.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

11. Enhanced family of Image SOP Classes
Functional benefits
Looking closer at the CT Image IOD we see not much difference at the top level
The Synchronization module is really an addition
And we see the mechanism used to make clear when a Functional Group must be available. Here we see that the Synchronization is required when time synchronization is used during the acquisition.
The Enhanced General Equipment module is just introduced to tighten the requirements for 4 parameters, which are now mandatory (type 1).
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

12. Enhanced family of Image SOP Classes
Functional benefits
Looking closer at the CT Image IOD we see not much difference at the top level
The Synchronization module is really an addition
And we see the mechanism used to make clear when a Functional Group must be available. Here we see that the Synchronization is required when time synchronization is used during the acquisition.
The Enhanced General Equipment module is just introduced to tighten the requirements for 4 parameters, which are now mandatory (type 1).
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

13. Enhanced family of Image SOP Classes
Functional benefits
Looking closer at the CT Image IOD we see not much difference at the top level
The Synchronization module is really an addition
And we see the mechanism used to make clear when a Functional Group must be available. Here we see that the Synchronization is required when time synchronization is used during the acquisition.
The Enhanced General Equipment module is just introduced to tighten the requirements for 4 parameters, which are now mandatory (type 1).
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

14. Enhanced family of Image SOP Classes
Functional benefits
Looking closer at the CT Image IOD we see not much difference at the top level
The Synchronization module is really an addition
And we see the mechanism used to make clear when a Functional Group must be available. Here we see that the Synchronization is required when time synchronization is used during the acquisition.
The Enhanced General Equipment module is just introduced to tighten the requirements for 4 parameters, which are now mandatory (type 1).
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

15. Enhanced family of Image SOP Classes
Functional benefits
Dimension organization we have seen enables to guide the viewing system in the way the data should be displayed.
This way there is a real decoupling between the viewing station and the acquisition station.
Even images coming from new acquisition technologies that are unknown during development a viewer will be able to display them in a logical way.
Functional groups means that the parameters are logical grouped together, no longer everything at the root level of the object.
Through sequences the data is split in logical groups, gives you the opportunity to easily skip sets of parameters.
For all new objects the standard is that all parameters are mandatory, so most of them are 1 or 1C. Where the functional group is mandatory under specific conditions. So if you have a diffusion scan the diffusion group macro is mandatory and will have all the standard attributes, only as technology is evolving you will see again type 3 attributes coming in again.
But for new techniques this is even not necessary as the functional group can be made mandatory if the technique is used it can be added with type 1(C) attributes without any problem.
This way viewers can rely much more on consistency over different vendors, as soon as there is agreement on a technique and the parameters involved the description can be made.
This is not possible in a Classic object as you have no level to use for this
Reducing the overhead by supplying all information once and in one object.
This way you don’t have to traverse the total tree of Patient, Study, Series with every object coming in just to add the image data.
Also when storing the objects as files this will save a lot of overhead, the gain in space might be not that much as the Pixel data is mostly the major part. But it makes quite of difference if you have to store 2000 Classic objects or only 1 Enhanced object.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

16. Enhanced family of Image SOP Classes
Functional benefits
Dimension organization we have seen enables to guide the viewing system in the way the data should be displayed.
This way there is a real decoupling between the viewing station and the acquisition station.
Even images coming from new acquisition technologies that are unknown during development a viewer will be able to display them in a logical way.
Functional groups means that the parameters are logical grouped together, no longer everything at the root level of the object.
Through sequences the data is split in logical groups, gives you the opportunity to easily skip sets of parameters.
For all new objects the standard is that all parameters are mandatory, so most of them are 1 or 1C. Where the functional group is mandatory under specific conditions. So if you have a diffusion scan the diffusion group macro is mandatory and will have all the standard attributes, only as technology is evolving you will see again type 3 attributes coming in again.
But for new techniques this is even not necessary as the functional group can be made mandatory if the technique is used it can be added with type 1(C) attributes without any problem.
This way viewers can rely much more on consistency over different vendors, as soon as there is agreement on a technique and the parameters involved the description can be made.
This is not possible in a Classic object as you have no level to use for this
Reducing the overhead by supplying all information once and in one object.
This way you don’t have to traverse the total tree of Patient, Study, Series with every object coming in just to add the image data.
Also when storing the objects as files this will save a lot of overhead, the gain in space might be not that much as the Pixel data is mostly the major part. But it makes quite of difference if you have to store 2000 Classic objects or only 1 Enhanced object.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

17. Enhanced family of Image SOP Classes
Functional benefits
Latest technology
Functional groups
Most attributes are mandatory
Reducing overhead
Dimension organization we have seen enables to guide the viewing system in the way the data should be displayed.
This way there is a real decoupling between the viewing station and the acquisition station.
Even images coming from new acquisition technologies that are unknown during development a viewer will be able to display them in a logical way.
Functional groups means that the parameters are logical grouped together, no longer everything at the root level of the object.
Through sequences the data is split in logical groups, gives you the opportunity to easily skip sets of parameters.
For all new objects the standard is that all parameters are mandatory, so most of them are 1 or 1C. Where the functional group is mandatory under specific conditions. So if you have a diffusion scan the diffusion group macro is mandatory and will have all the standard attributes, only as technology is evolving you will see again type 3 attributes coming in again.
But for new techniques this is even not necessary as the functional group can be made mandatory if the technique is used it can be added with type 1(C) attributes without any problem.
This way viewers can rely much more on consistency over different vendors, as soon as there is agreement on a technique and the parameters involved the description can be made.
This is not possible in a Classic object as you have no level to use for this
Reducing the overhead by supplying all information once and in one object.
This way you don’t have to traverse the total tree of Patient, Study, Series with every object coming in just to add the image data.
Also when storing the objects as files this will save a lot of overhead, the gain in space might be not that much as the Pixel data is mostly the major part. But it makes quite of difference if you have to store 2000 Classic objects or only 1 Enhanced object.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

18. Enhanced family of Image SOP Classes
Functional benefits
General mechanism
The enhanced structure is used as blueprint for all new objects
So you will find the generic header, the shared information and the per-frame information in all new objects.
Also the idea of attributes being mandatory is the same for all new objects
This leads to the same kind of objects so interpretation of these objects is made simple, you can rely on the structure.
It might not be nice if you would live in a city were all buildings would be exactly the same, but if you had to move it would help you in settling down again.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

19. Enhanced family of Image SOP Classes
Functional benefits
“Complete” set of frames Dimension makes it easier to view Latest technology General mechanism for all new objects.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

20. Enhanced family of Image SOP Classes
Performance benefits
One object defines full series
Typically an object will describe a whole series, only when a series is too big it will be split in logical parts.
So this means that all data for a whole body scan will be present in only one object.
Together wit the dimension organization there is little logic needed to present the set of frames.
In this case based on files it would mean only accessing one file instead of 25.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

21. Enhanced family of Image SOP Classes
US volume example?
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

22. Enhanced family of Image SOP Classes
Performance benefits
Storage simpler
N Objects, N Headers
Pixel data
Per-frame header
Fixed Header
One Header
N frames
Dimension data
+ Dimension data
We have already seen that there is a lot of duplication removed with the introduction of the enhanced multi-frame concept.
Although this is not the major part of the objects it will lead to space reduction.
The number of files involved makes that storage overhead is reduced significantly.
Opening one file instead of 10, 20, 1000 or
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

23. Performance benefits Network overhead reduced. Multi- frame transfer
time
A s s o c i a t i o n DB
1delay only for the whole series=
3 hours gained
Multi-
frame
transfer
Imagine: images = delays of 1 sec
~3 hours delay
Single
frame
transfer DB DB DB
Store, parse, check
C-Store request
Dataset (attributes+pixels)
C-Store response (acknowledgement)
* Slide Courtesy: David A.Clunie
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

24. Modalities INTRAVASCULAR OCT IMAGE IOD
18 IOD’s with Multi-Frame Dimension group
ENHANCED X-RAY RF IMAGE IOD
VL WHOLE SLIDE MICROSCOPY IOD
ENHANCED MR IMAGE IOD
BREAST TOMOSYNTHESIS IMAGE IOD
MULTI-FRAME GRAYSCALE BYTE SC IMAGE IOD
SEGMENTATION IOD MODULES
X-RAY 3D Craniofacial Image IOD
MR SPECTROSCOPY IOD
ENHANCED X-RAY ANGIOGRAPHIC IMAGE IOD
X-RAY 3D ANGIOGRAPHIC IMAGE IOD
ENHANCED ULTRASOUND VOLUME IOD
INTRAVASCULAR OCT IMAGE IOD
MULTI-FRAME TRUE COLOR SC IMAGE IOD
OPHTHALMIC TOMOGRAPHY IMAGE IOD
Looking in the standard (2011 version) you will find 18 IOD’s based on the Enhanced mechanism and as said earlier more are in definition.
I don’t expect you to memorize these if you can read them, the message is that it is already a large family of IOD’s and still growing.
So if you are dealing with image objects you better start understanding the mechanism and implementing it in your product.
ENHANCED MR COLOR IMAGE IOD
MULTI-FRAME GRAYSCALE WORD SC IMAGE IOD
ENHANCED CT IMAGE IOD
ENHANCED PET IMAGE IOD
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

25. Enhanced family of Image SOP Classes
Conversion
New supplement coming: Multi-Frame Converted Legacy Images
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

26. Enhanced family of Image SOP Classes
Conversion workflow
Heterogeneous environment with conversion from single to multi-frame objects
Idea is that it is easier and more beneficial for PACS and Workstations to have a faster mechanism for transportation.
The installed base of Classic SF objects will stay there for several years.
So by converting the objects in the PACS the most of the benefits of the MF will be there.
Transfer speed, easier storage and full sets of images.
The one that is only partly possible is the full set of parameters, as the information might not all be available in the Classic SF object.
Some will be through Private attributes so it might be possible to use these during the conversion.
But not all information will be there as new elements were defined.
And the first basic conversion will not be cheap, but most likely will be compensated by the gain in the further workflow.
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

27. Enhanced family of Image SOP Classes
Conversion
Why conversion
Enormous archive of Classic objects
Supports the transition from Classic to Enhanced environment
More often used on different places
Transportation needs speeding up
Leverage most of the benefits
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

28. Enhanced family of Image SOP Classes
Conversion
Requires
Conversion done by independent stations
Build knowledge for various vendors
Relaxation of Manditoriness
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

29. Enhanced family of Image SOP Classes
Conclusion
Huge potential benefit for using Enhanced objects
Support is growing
Pushed by
Increased Interoperability
Increasing datasets
Potential Speed gain
Higher availability
Coming conversion definition
Start using
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

30. Enhanced family of Image SOP Classes
References
B. Revet:
What’s New in DICOM SPIE 2012
B. Erickson, D. Clunie:
The New CT and MR DICOM Objects: Why All the Fuss? SCAR 2005
ftp://medical.nema.org/medical/dicom/Multiframe/Presentations/SCAR-2005/
K. Verduin:
Enhanced MR addresses Multi-Vendor Interoperability issues in clinical radiology DICOM Conference China 2008
ftp://medical.nema.org/MEDICAL/Private/Dicom/Conferences/2008_China/Day_2/
March 2013 DICOM International Conference & Seminar
Enhanced family of Image SOP Classes

31. Author Contact Wim Corbijn van Willenswaard
Philips Innovation Campus
Bengaluru
Thank you for your attention !
March 2013 DICOM International Conference & Seminar
Enhanced Multi-Frame