& what now & what’s next

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Kevin O’Donnell, Toshiba Medical Research Inst . Co-Chair, DICOM Standards Cmte. Member, IHE Radiology Technical Cmte. & what now & what’s next. Presenter perceives no conflict of interest with this presentation but discloses being an employee of: - PowerPoint PPT Presentation

Transcript of & what now & what’s next

&

WHAT NOW & WHAT’S NEXT

Kevin O’Donnell, Toshiba Medical Research Inst.Co-Chair, DICOM Standards Cmte.Member, IHE Radiology Technical Cmte.

DISCLOSURE

Presenter perceives no conflict of interest with this presentation but discloses being an employee of:

Toshiba Medical Research Institute USA,

a division of Toshiba Medical Systems Corp.

DICOM is the standard for medical imaging. Widely implemented; basis of DI

marketplace Managed process (NEMA/MITA) International scope (ISO-12052) and many pages of detail information…

4

IHE IN ONE SLIDE IHE helps vendors implement & test

functions that span multiple systems

Profiles are implementation guides how to use existing standards to address a specific problem scenario

Connectathons are test events managed testing of Profile

implementations

IHE helps users purchase & integrate multi-system solutions list required IHE Profile support in RFPs

COMMUNICATION STANDARDSX

X

X

XY

XX

X? ?Y

X?

x

COMMUNICATION STANDARDS

X

X !

LEVEL OF IMPLEMENTATION product-registry.ihe.net

Integration Statement Database IS = specific version of specific product

connectathon-results.ihe.net Vendor Participation Database

IMAGING WORKFLOWWhat Now…

IHE Scheduled Workflowo DICOM Modality Worklisto DICOM Imageso DICOM MPPS (Performed Procedure Step)

Unscheduled or Modified Procedureso DICOM Storage Commit (turn it on)

IHE Mammography Image

IMAGING WORKFLOWWhat’s Next…

DICOM Enhanced CT, MR, XA, PET, 3D USo Faster o Better Processing

DICOM Multiframe Converted Legacyo Supplement 157o Addresses Mixed Environment

DICOM MULTI-FRAME CONVERSION

Classic View

Enhanced View

Legacy WorkstationLegacy Modality

Advanced WorkstationAdvanced Modality

&

&

IMAGING WORKFLOWWhat’s Next…

IHE Scheduled Workflow.bo HL7 2.5.1o Replaces 2.5.1 Option in SWF

RadLex Playbook (RSNA)o Standard codeset for orderables

Code: RPID7 Short Name: CT HEAD ANGIO WO & W IVCON Long Name: CT HEAD ANGIOGRAPHY WITHOUT THEN

WITH IV CONTRASTo playbook.radlex.org

Confidential

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STANDARD PROCEDURE CODES

Radlex Playbook:RPID7- CT HEAD ANGIO WO & W IVCON

P7->Protocol

RSNA

RIS

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P7

P7

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Templates

P7

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EMR

CDA

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Guidelines

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Registry

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IMAGING WORKFLOWWhat’s Next…

DICOM Protocol Storage (CT)o Supplement 121 (WIP)

DICOM Contrast Administration Recordo Supplement 164 (WIP)

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Clinical Trial

Semi-auto Scan Setup

Defined & Planned Protocol

Performed Protocol

Device=Aquilion Series…Pat. Pos. : Feet First / SupinePat. Instruct : Single Breath Hold / Full Inspiration…kVp : 80~140Slice Thickness : 1.0~2.5mmRecon. Kernel : Std.…

Device=Aquilion ONEVersion=3.0.4…Pat. Pos=Feet First / SupinePat. Instruct=Given…kVp=120Slice Thickness=1.0mmRecon. Kernel=FC12…

Modality

Vendor

SOURCES APPLICATIONS

SharingBest Practice

Scan QA / Troubleshooting

Acquisition Validation

Best Practice

Protocol Library

Clinical Trial Protocol

Prior Comparability

Protocol Backups

ACR / RSNA AAPM

or

Patient Positioning

Local Standard

Prior Scan

Hospital

PROTOCOL STORAGE

RADIATION MANAGEMENTWhat Now…

DICOM RDSR (CT, XA, CR, DR, MG) IHE Radiation Exposure Monitoring

o CT Now, Others appearing Dose Analysis

o ACR Dose Registry (2Mil+ studies)o Open Source (Radiance, etc.)o Commercial Packages

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IHE RADIATION EXPOSURE MONITORING PROFILE

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National Registry

ArchiveDose Information

Reporter

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Outlier: #Performing Phys.Over Target: 12.2%Outlier: #Performing Phys.Over Target: 12.2%

Outlier: #Performing Phys.Over Target: 12.2%

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some text: #Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9

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RADIATION MANAGEMENTWhat’s Next…

DICOM Radiopharmaceutical SRo Supplement 159 (WIP)

DICOM Patient Dose SRo Supplement TBA

IMAGE DISTRIBUTIONWhat Now…

DICOM Push/Pull (configure firewalls) IHE PDI compliant DICOM CDs IHE XDS-I.b

o Some Canadian DIRs already using IHE Import Reconciliation Workflow.b

Store

(Fix IDs, Codes & Demographics)

IMAGE DISTRIBUTIONWhat’s Next

DICOM WADO-RSo Web Access to DICOM Objects - RESTful

DICOM STOW-RSo Store Over the Web - RESTful

DICOM QIDO-RSo Query – RESTful

IHE Invoke Image Display

MEASUREMENTWhat Now…

Ultrasound Measurementso OB/Gyno Adult Echoo Fetal, Pediatric and Congenital Echo

Record & Dataflow

MEASUREMENTWhat’s Next…

Ultrasound Measurementso (Simplified) Adult Echo

POST-ACQUISITION WORKFLOWWhat’s Next…

IHE Post-Acquisition Workflowo DICOM Unified Procedure Stepo DICOM Application Hosting (“DICOM plugins”)o Worklist managed processing

Automated & manualo Progress notifications

Any interested system (RIS, Billing, Reading Worklist, Dashboard, Analytics)

Subscription-basedo Cancelation requests

With reason & contact

IHE PAWFExample “Workitem” Tasks: 3D View Generation Computer Aided Detection Clinical Applications Pre-fetching Image Routing CD Burning Image Importing …

REPORTINGWhat Now…

IHE Consistent Presentation of Imageso DICOM GSDF (Calibration)o DICOM Greyscale Presentation State

REPORTINGWhat’s Next…

IHE Management of Rad. Report Templateso Format for dictation/authoring templateso Vehicle for RSNA Template Libraryo www.radreport.org

DICOM Radiology CDA Templateso Supplement 155 (WIP)

DICOM Multi-dimensional Presentation Stateso Supplement 156 (WIP)

USEFUL LINKS DICOM

dicom.nema.org

IHE www.ihe.net – Technical Frameworks wiki.ihe.net - (click “Integration Profiles”) product-registry.ihe.net connectathon-results.ihe.net

QIBA qibawiki.rsna.org – Profiles, Project status