Current IHE Topics: 1. PDI, Portable Data Imaging Integration Profile 2. MAMMO, Mammography
IHE Workshop – June 2006What IHE Delivers 1 Carolyn Reynolds Hologic, Inc. Vendor co-chair, IHE...
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Transcript of IHE Workshop – June 2006What IHE Delivers 1 Carolyn Reynolds Hologic, Inc. Vendor co-chair, IHE...
1IHE Workshop – June 2006 What IHE Delivers
Carolyn ReynoldsCarolyn Reynolds
Hologic, Inc.Hologic, Inc.
Vendor co-chair, IHE Mammography CommitteeVendor co-chair, IHE Mammography Committee
Mammography Image Mammography Image Integration ProfileIntegration Profile
2IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageThe Problem/AssumptionsThe Problem/Assumptions
What’s the big deal?
Full Field Digital Mammography (FFDM) is just another modality to PACS
Most existing PACS will handle FFDM fine once: the FDA approves the monitor hardware, and workstations have 510K approval for FFDM
applications
3IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageNot just another modality!Not just another modality!
What makes it different or challenging: Two types of image data Variances among vendors in image data and
attributes Common use of CAD (Computer Aided Detection) Importance of prior study comparisons Image size, orientation, & layout Regional governance such as MQSA
(Mammography Quality Standards Act – USA)
4IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageUse CaseUse Case
ModalityModality
CADCAD
ArchiveArchive WorkstationWorkstation
““For Presentation” Image DataFor Presentation” Image Data““For Processing” Image DataFor Processing” Image DataMammo CAD Structured RptMammo CAD Structured Rpt
PrinterPrinter
5IHE Workshop – June 2006IHE Workshop – June 2006
Hanging Protocol DifferencesHanging Protocol DifferencesExample Preferred LayoutExample Preferred Layout
Hanging protocol determined by:Hanging protocol determined by:
View Type (i.e. CC vs. MLO)View Type (i.e. CC vs. MLO)
Specialty View Type (i.e. Spot, Mag)Specialty View Type (i.e. Spot, Mag)
Laterality Laterality
Patient OrientationPatient Orientation
R CCR CC L CCL CC
L MLOL MLOR MLOR MLO
6IHE Workshop – June 2006IHE Workshop – June 2006
Generic Image Display LayoutsGeneric Image Display LayoutsApplied to Mammo ImagesApplied to Mammo Images
Stacked series exampleStacked series example
Hanging based upon series or Hanging based upon series or study descriptionsstudy descriptions
Image order as acquired Image order as acquired Image orientation as acquiredImage orientation as acquired
R MLOR MLO
R CCR CC L CCL CC
L MLOL MLO
7IHE Workshop – June 2006IHE Workshop – June 2006
Variances in FFDM Vendor DataVariances in FFDM Vendor DataDetector Size ExampleDetector Size Example
RR RRLL LL
RR LL
Prior Exam fromPrior Exam fromVendor A’s systemVendor A’s system
RR LL
Typical “Fit to Viewport” effectTypical “Fit to Viewport” effect
Current Exam fromCurrent Exam fromVendor B’s systemVendor B’s systemDifferent resolutionDifferent resolutionDifferent pixel matrixDifferent pixel matrix
8IHE Workshop – June 2006IHE Workshop – June 2006
Workstation Tool EnhancementsWorkstation Tool EnhancementsTissue vs. Air Detection ExampleTissue vs. Air Detection Example
Window/Center Adjustments Window/Center Adjustments
9IHE Workshop – June 2006IHE Workshop – June 2006
Printing ConsiderationsPrinting ConsiderationsTrue SizeTrue Size
Precision of <2% errorPrecision of <2% error
10in x12in10in x12inFilm sizeFilm size
8inx10in8inx10inFilm sizeFilm size
Film size vs. Detector SizeFilm size vs. Detector Size
10IHE Workshop – June 2006IHE Workshop – June 2006
Printing ConsiderationsPrinting ConsiderationsPositioning-minimal borders at chestwallPositioning-minimal borders at chestwall
Centered images canCentered images cancreate large borders create large borders at chestwallat chestwall
Image offset with Image offset with chestwall side having chestwall side having minimal bordersminimal borders
11IHE Workshop – June 2006IHE Workshop – June 2006
Mammography Image IntegrationMammography Image IntegrationValue propositionValue proposition
Helps meet desire to have multiple FFDM vendors and use any vendor’s workstation for diagnosis
Ensures that FFDM modalities provide adequate information to facilitate downstream applications
12IHE Workshop – June 2006IHE Workshop – June 2006
Mammography Image IntegrationMammography Image IntegrationValue propositionValue proposition
Ensures systems support required data objects for interoperability
Defines image display and printing operations required for effective and efficient diagnoses
13IHE Workshop – June 2006IHE Workshop – June 2006
Mammography Image IntegrationMammography Image IntegrationScopeScope
Based upon existing actors and transactions
Expanded requirements within each transactionActors Transactions Optionality Section in Vol. 2/3
Acquisition Modality Modality Images Stored [RAD-8] R 4.8
Storage Commitment [RAD-10] R 4.10
Evidence Creator Evidence Document Stored R 4.43
Storage Commitment [RAD-10] R 4.10
Image Manager/Archive Modality Images Stored [RAD-8] R 4.8
Evidence Document Stored R 4.43
Storage Commitment [RAD-10] R 4.10
Query Images [RAD-14] R 4.14
Retrieve Images [RAD-16] R 4.16
Query Evidence Documents [RAD-44] R 4.44
Retrieve Evidence Documents [RAD-45] R 4.45
Image Display Query Images [RAD-14] R 4.14
Retrieve Images [RAD-16] R 4.16
Query Evidence Documents [RAD-44] R 4.44
Retrieve Evidence Documents [RAD-45] R 4.45
Print Composer Print Request with Presentation LUT [RAD-23] R 4.23
Print Server Print Request with Presentation LUT [RAD-23] R 4.23
14IHE Workshop – June 2006IHE Workshop – June 2006
Mammography Image IntegrationMammography Image IntegrationScopeScope
15IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageExpanded RequirementsExpanded Requirements
Acquisition Modality Send both for processing and for presentation
images with reference that ties them together Additionally required DICOM attributes Detection and indication of tissue vs. air gap Partial View Option (breast is larger than detector) Modified requirements for film digitizers
16IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageExpanded RequirementsExpanded Requirements
Image Display Hanging protocols based upon view, laterality, patient
orientation, and specialty views Maintain a black air gap during window/center
operations and inverted pixel data Sizing
• Same relative size• True size• 1:1 detector pixels to display pixels
17IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageExpanded RequirementsExpanded Requirements
Image Display cont’d Measurement calculation requirements Display calibration and grayscale rendering Labeling requirements Mammo CAD Structured Report rendering on “for
presentation” images Partial View Option (breast larger than detector)
18IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageExpanded RequirementsExpanded Requirements
Image Manager
Storage and retrieval of For Presentation and For Processing SOP Classes for Digital Mammography X-Ray
Storage and retrieval of Mammography CAD Structured Report SOP Class
19IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageExpanded RequirementsExpanded Requirements
Evidence Creator (CAD)
Support for Mammography CAD SR SOP Class and Storage Commitment
No specifics on how Evidence Creator obtains mammography images
20IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography ImageExpanded RequirementsExpanded Requirements
Print Composers/Print Servers True Size printing (Requested Image Size) Justify chestwall and print with 5mm borders or less Render VOI LUTS if present Specify/Support maximum density Specify/Support Presentation LUT Labeling requirements Support for 12 bit pixel depth
21IHE Workshop – June 2006IHE Workshop – June 2006
Mammography ImageMammography Image
Questions???
22IHE Workshop – June 2006IHE Workshop – June 2006