Appendix A

DICOM Communications

This appendix provides a brief overview of the DICOM concepts and describes how DICOM is
implemented on the Digital Radiography Operating Console.

CONTENTS

APPENDIX A DICOM COMMUNICATIONS .................................................................................... 1

DICOM OVERVIEW .................................................................................................................................. 2
DICOM CONNECTIVITY ........................................................................................................................... 8
SEQUENCE OF DICOM IMAGE TRANSMISSION ......................................................................................... 9
IMPLEMENTING DICOM ON DROC ....................................................................................................... 10

Appendix A1
DICOM Communications

DICOM Overview

What Is DICOM

The Digital Radiography Operating Console uses the DICOM v.3.0 protocol to send images and
related information to output devices. DICOM is a standard that defines the characteristics of data
communication between medical imaging equipment. It was developed by the National Electrical
Manufacturer’s Association and the American Council of Radiology. Earlier versions of the
standard were referred to as ACR-NEMA.

Network protocols can be conceptually represented as a hierarchy of layers, with each layer
defining a specific set of operations and characteristics for data transfer. Refer to the diagram
below. The DICOM standard operates using TCP/IP to handle the lower layer tasks such as packet
transmission and data delivery to the host destination. The DICOM model defines the upper layer
protocol tasks such as message passing, connection methods, and service classes.

Hosts use several different DICOM service classes, depending on the functions to be performed.
For example, DICOM Storage Service Class and DICOM Print Service Class are supported by the
Digital Radiography Operating Console.

Figure 1：Conceptual Illustration of Data Transfer and Network Layering

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 DICOM Communications

DICOM and the Client/Server Model

The DICOM protocol handles communications between hosts using a client/server model. In the
client/server model, the host requesting a service is referred to as the client. The host providing the
requested service is referred to as the server. A host can operate exclusively as a client or a server,
or can take on both roles.

In DICOM terminology, the client is referred to as the Service Class User, because it is the user of
a DICOM service. The server is referred to as the Service Class Provider, because it is the
provider of a DICOM service. The DICOM terms are used throughout this appendix (for example,
User refers to the client and Provider refers to the server).

Figure 2: Data Transmission Direction

DICOM Service Classes

The DICOM standard encompasses many Service Classes, which are sets of services that can be
performed on a specific information object. The Digital Radiography Operating Console supports
three of these Service Classes: Storage, Print, and Verification.

A given TCP/IP device may support any set of Service Classes, depending on the device
functionality. The Service Classes the device supports determines how the device can operate in a
DICOM network.

For two TCP/IP devices (hosts) to communicate with each other using the DICOM protocol:

 They must support the same Service Class (for example, Storage or Print).
 One device must support the service class as a User (to send data) and the other device must
support the service class as a Provider (to receive data).

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DICOM Communications

Figure 3： Example 1

Device 1 supports DICOM Storage Service Class User.

Device 2 supports both DICOM Storage Service Class User and Provider.

In this example, Device 1 (user) can use DICOM Storage Service Class to send images to Device
2 (provider). However, Device 2 cannot send images to Device 1, because Device 1 is not a
provider of DICOM Storage Service Class.

Figure 4： Example 2

Device 1 supports DICOM Print Service Class User.

Device 2 supports DICOM Storage Service Class Provider.

In this example, the two devices cannot communicate because they support different Service
Classes.

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 DICOM Communications

DICOM Service Classes Supported by DROC

DICOM Storage Service Class

DICOM Storage Service Class (SSC) is used to send particular classes of image data from one
device to another for storage. The SSC User sends images individually to the SSC Provider,
which groups the images into studies and stores them along with any demographic data.

The Digital Radiography Operating Console supports DICOM Storage Service Class as a SSC
User. This means the Digital Radiography Operating Console can send images to a SSC
Provider, but cannot receive them.

Archives and workstations are typical DICOM Storage Service Class Providers.

DICOM Print Service Class

DICOM Print Service Class (PSC) is used to send preformatted images to a hardcopy output
device such as a laser printer for printing. Preformatted images (“image boxes” in DICOM
terminology) are sent as part of a preformatted “sheet” (“film box” in DICOM terminology) and
“study” (“film session” in DICOM terminology).

The Digital Radiography Operating Console supports DICOM Print Service Class as a PSC
User. This means it can send images to a PSC provider, but cannot receive them.

DICOM PSC User allows operators to:

 Select DICOM print devices on a TCP/IP network

 Control DICOM print device parameters (for example, format or density)
 Send sheets of preformatted images for printing
 Receive alarms and status messages from the DICOM printer (if the DICOM printer
sends them)

Laser printers are typical DICOM Print Service Class Providers.

DICOM Verification Service Class

The Verification Service-Object Pair (SOP) Class is a feature used for network diagnostic
purposes. This service class has no configurable parameters and is not invoked directly by the
Digital Radiography Operating Console user.

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DICOM Communications

DICOM Associations

Two TCP/IP devices determine whether they can use DICOM to communicate during a Service
Class negotiation phase. If this phase is successful (for example, the devices support the same
service class and one device is a user while the other is a provider), a virtual connection is
established between the two devices. This virtual connection is called a DICOM association.

Up to sixteen simultaneous associations can be established between a Digital Radiography

Operating Console and DICOM devices on a TCP/IP network, with the Digital Radiography
Operating Console serving as the DICOM user.

TCP Port Assignment

A DICOM provider is generally only “listening” for association requests from a DICOM user at
one dedicated TCP port for each application. At a result, when configuring the Digital
Radiography Operating Console to send data to DICOM output devices, the configuration
information for each device must include the TCP Port number to send the data to.

Application Entities (AEs)

The DICOM application at a particular IP device port is called an Application Entity (AE). The
DICOM provider application is assigned a Called AE Title that a DICOM user can “call” for
service. The DICOM user application is assigned a Calling AE Title which tells the provider
“who’s calling.”

Figure 5: Application Entities

The Digital Radiography Operating Console has a Calling AE Title assigned to it during
installation. Output devices can accept data from any Calling AE Title, or can be configured to
accept data only from selected Calling AE Titles.

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 DICOM Communications

When DICOM output devices are configured at the Digital Radiography Operating Console, the
configuration information for each device must include the Called AE Title for the device (also
referred to as “device name”). The identical Called AE Title must be configured at the output
device itself.

Alarm Handling

Alarms that originate on DICOM Provider devices appear on the Digital Radiography
Operating Console. However, for the Digital Radiography Operating Console to receive alarms,
the DICOM Provider must support alarm handling. Alarm support for print jobs is optional in
DICOM.

The descriptive alarm information that the DICOM Standard supports has at most 16 characters
of text (as allowed by the standard DICOM response field), and the text contains only generic
descriptive information. The Digital Radiography Operating Console simply displays the alarm
message that it receives from the DICOM Provider.

Alarms can only be received from the Provider as long as the DICOM

Association remains intact. Normally, the DICOM Association breaks as soon as the Provider
successfully receives the data. However, if Print Job SOP Class in the DICOM Print Client is
used, the association continues until a preset time period has elapsed, thereby allowing the
Digital Radiography Operating Console to continue receiving alarms from the Provider while
the job prints.

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DICOM Communications

DICOM Connectivity

Manufacturers of DICOM-capable devices must provide a DICOM

Conformance claim that defines the Service Classes supported by the device along with details
about the specific functions can be performed using these Service Classes. However, before
approving any DICOM connections to devices, E-COM, Inc. requires that the manufacturers’
Conformance claims be obtained, analyzed, and tested. The DICOM Standard mandates the
organization and content of this document.

E-COM, Inc. publishes a DICOM conformance claim for the Digital Radiography Operating
Console. This statement is publicly available to our customers and to other vendors.

Although the Digital Radiography Operating Console complies with the DICOM Standard,
communication with other DICOM-compliant devices must be verified through a connectivity test.
The DICOM Conformance Claim allows users to communicate how they comply with the
standard in their implementations. However, references to specific DICOM functionality in a
Conformance Claim are not sufficient to guarantee inter-operability between components. The
following should be considered when evaluating network inter-operability:

 Use the Digital Radiography Operating Console Conformance Claim to ensure the product
can communicate with another particular component on a protocol level.
 The only way to know for certain whether the Digital Radiography Operating Console can
inter-operate with other DICOM components is to perform a connectivity test. This test must
be completed before a field installation can occur. E-COM, Inc. is equipped to do this testing
in cooperation with the suppliers of other DICOM components.

The Digital Radiography Operating Console DICOM Conformance Claim is the best effort of
E-COM, Inc. at documenting the DICOM functionality of the commercial version of the Digital
Radiography Operating Console, and is not a functional specification of any E-COM, Inc.
component or product. E-COM, Inc. reserves the right to make changes at any time to the
functionality of the DICOM components described therein. E-COM, Inc. is also committed to
following the evolution of the DICOM Standard with either modifications or additions to its
DICOM functionality.

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Sequence of DICOM Image Transmission

A user initiates a DICOM transfer automatically using the Digital Radiography Operating Console
application by acquiring and accepting a digital radiography image into an exam with an output
setup that contains a DICOM destination(s). The user can also manually initiate a DICOM transfer
by resending a previously acquired image to an output setup with a DICOM destination. The
following steps occur:

 Depending on the type of selected output device (storage, print, and so on), the Digital
Radiography Operating Console DICOM Client requests an association to the Called AE of
the DICOM Provider corresponding to that output device.
 The desired SOP classes are negotiated and utilized to perform either a print job or storage
job as requested by the Digital Radiography Operating Console DICOM Client. The use of
optional Print Management SOP classes by the Digital Radiography Operating Console’s
DICOM Print Client is configurable.
 The Exam-Specific Algorithm (ESA) that the user has accepted is used to derive an LUT for
viewing the acquired image.
 If the DICOM Print Client is being used, the ESA is incorporated directly into the
preformatted grayscale image.
 If the DICOM Storage Client is being used, the ESA is incorporated into the Modality LUT,
the VOI LUT, or the image depending on a configuration parameter.
 The images are transferred from the DICOM Client to the DICOM Server using the
negotiated SOP Classes.
 If the Print Job SOP Class has been negotiated, the DICOM Print Client obtains status
reports from the DICOM Print Server for a period equal to the configured timeout or until the
Print Job status is DONE or FAILURE. If the Print Job SOP Class has not been negotiated
(the default situation), the DICOM Client disconnects the association once all tasks are
completed, or after a configurable timeout period expires, which usually means as soon as the
Print Server has successfully received the print job.
 If the Storage SOP has been used and there is a zero time-out value configured, the Digital
Radiography Operating Console DICOM Storage SCU disconnects the association
immediately after acknowledgment of the image transfer by the Storage SCP. If a non-zero
timeout is configured, the association is left open for the duration of the timeout and may be
used to transfer subsequent images in the exam, depending on the length of the timeout and
how quickly the user acquires the next image.

In the case of errors during a job with a transmission from a Digital Radiography Operating
Console DICOM Client, the job is re-tried if it contains a temporary error condition, otherwise it
is aborted. When an error occurs, the user is always notified and may be able to abort the job if
desired, depending on the error condition.

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DICOM Communications

Implementing DICOM on DROC

There are three functional blocks on the Digital Radiography Operating Console which make use
of the DICOM protocol. These are the DICOM Storage Client, the DICOM Print Client, and a
service utility that implements the DICOM Verification Class User. The DICOM Storage and
Print Clients are configured during site installation.

User Setups and Device Configuration Files

The DICOM Client (Storage or Print) supports various output devices, each of which is defined by
a unique set of configurable attributes. These attributes appear in a model file for each DICOM
device type. During the Digital Radiography Operating Console installation, a configuration file
for each individual output device is added to the system configuration. Each configuration file is
based on one of the output device model files. At a minimum, the installer customizes the IP
address, Called AE Title (device name), and TCP Port in each output device configuration file. All
other parameters in the files can remain at their default settings.

After the specific output devices are defined, the installer creates user setups that correspond to
one or more output device configuration files.

These user setups are available to the system operator. When a user setup is selected before the
image capture, the images are automatically sent to the predetermined output devices.

DICOM Storage Client

The Digital Radiography Operating Console supports the DICOM Storage Service Class in the
role of Service Class User (SCU).

When a storage job is to be transmitted from the Digital Radiography Operating Console, DICOM
Storage Client initiates an association to the Storage SCP using the CR SOP Class. If the
association is successfully created, the C-Store request is made to effectively transfer the storage
object to the destination.

The DICOM Storage Client then waits for the C-Store response to be returned from the Storage
Provider.

The DICOM Storage Client supports the status and error messages specified by the DICOM
Standard in support of the A-ASSOCIATE and C-STORE services. The Storage Client does not
make use of private DICOM attributes.

The Storage Client sends the ESA that is acquired from Digital Radiography using one of the
following mechanisms, as configured at installation:

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 DICOM Communications

 DICOM Modality LUT, contained as a sequence within the storage object.

 DICOM VOI LUT, contained as a sequence within the storage object.
 No LUT sequence, in which case the LUT is pre-applied to the image data.

The DICOM Storage Client supports the configurable parameters found in Table 1.

Table 1: DICOM Storage Client Configuration

Parameter
Description Range
Called Application Digital Radiography Operating Console supports service
Entities (AEs) configurable application entities representing physical devices. Each
application entity represents a physical device, and there may be
more than one AE associated with a single physical device. The
Digital Radiography Operating Console supports up to 64 Called
AEs.

Remote Host/IP A valid IP address and hostname associated with the Storage SCP
Address and its Application Entity. The Digital Radiography Operating
Console supports up to 64 Remote Host/IP Addresses for use with
DICOM.

Remote Port Number A valid port number to be used when establishing TCP/IP
connection to the Storage SCP. Range = 1 to 32767

Calling AE Title Calling Application Entity Title of the Presentation Address for the
Digital Radiography Operating Console instance of the Storage
Client. The Digital Radiography Operating Console supports one
Calling AE Title.

Max PDU size 1024 to 65535. The Digital Radiography Operating Console
supports a default PDU size of 16384.

Association Time-out The Digital Radiography Operating Console supports a service

Period configurable time-out period defined as the number of seconds
following the transmission of an image before the Storage SCU
closes an open association. This time-out has the following options:

- Immediately release association, that is, don't reuse them

- Never release association (unless a new destination is
specified, or an error has occurred)
- Wait 1 to 32000 seconds before automatically releasing the
association

ESA LUT The Digital Radiography Operating Console supports the inclusion
of the Exam Specific Algorithm (ESA) into one of the following:

- Use VOI LUT

- Use Modality LUT
- Incorporate ESA into image

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DICOM Communications

Annotation text is not available with Storage Service Class outputs.

The DICOM Storage Client supports up to 16 simultaneous DICOM Storage Service Class
associations.

DICOM Print Client

The Digital Radiography Operating Console supports the DICOM Print Service Class in the role
of Service Class User (SCU). For a given sheet to be printed, the DICOM Print Client requests the
establishment of an association with the DICOM Print Provider (SCP), the printer, using the Basic
Grayscale Print Management SOP Class. Additionally, if configured to do so, the Digital
Radiography Operating Console DICOM Print Client negotiates for the optional Print Job SOP
Class and the Annotation Box SOP Class.

After an association is established, the Print Client sends print jobs to the DICOM Print Server.
Each print job consists of the following steps:

 The Print Client sends the server an N-GET request to ascertain that the status of the printer
is NORMAL. The Print Client requests the server to N-CREATE a film session SOP instance.
The Print Client then requests the server to N-CREATE a film box SOP instance containing a
single image box SOP instance and, optionally, an annotation box SOP instance. The Print
Client always uses one film box per film session, one image box per film box, and, optionally,
up to 12 annotation boxes (each box with up to 4 lines), per film box.
 For the image to be printed as part of the film box, the Print Client requests the server to
N-SET (update) the image box with the image information. This causes the transfer of the
image and pixel data from the client to the server. For an optional annotation box to be
included on the film, the Print Client requests the server to N-SET the annotation box with
text.
 Once the image has been transferred, the Print Client requests the server to N-ACTION the
film box. This causes the film to be printed.
 If the Print Job SOP class has been negotiated, the Print Client polls the SCP using the
N-GET DIMSE on the Print Job and Printer SOPs until an execution status of either
“FAILURE” or “DONE” is received on the Print Job or until a configurable timeout expires.
If the Print Job SOP class has not been negotiated (the default condition), the Print Client
considers the print to be complete as soon as the confirmation of the N-ACTION (Print) is
received. The Print Client does not accept N-EVENT-REPORTs from the Print SCP and if it
receives them, ignores them.

The Digital Radiography Operating Console supports up to 16 simultaneous DICOM Print Service
Class associations and does not support asynchronous events.

The DICOM Print Client supports the configurable parameters found in Table 2.

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 DICOM Communications

Table 2: DICOM Print Client Configuration Parameter

Parameter
Description Range
Application Entities Representing physical devices can be
Called Application configured at installation. More than one application entity can
Entities (AEs) be assigned to a physical device. The Digital Radiography
Operating Console supports up to 64 Called AEs.

A valid IP address and hostname associated with the physical

Remote Host/IP printer and its Application Entity. The Digital Radiography
Address Operating Console supports up to 64 Remote Host/ IP
Addresses for use with DICOM.
A valid port number to be used when establishing TCP/IP
connection to the physical printer
Remote Port Number
Range = 1 to 32767
Calling Application Entity Title of the Presentation Address for
Calling AE Title this instance of the Print Client. The Digital Radiography
Operating Console supports one Calling AE Title.
1024 to 65535. The Digital Radiography Operating Console
Max PDU size
supports a default PDU size of 16384.
The print client can be configured to control associations by:

Association Control - Requesting the use of the optional Annotation Box SOP
class
- Requesting the use of the optional Print Job SOP class
This parameter controls the number of seconds between the
issuing of N-GETs by the Digital Radiography Operating
Print Job Poll Period
Console Print Client after a successful N-ACTION (Print) for
either the Printer SOP or Print Job SOP Class (if negotiated).
Only if the Print Job SOP is negotiated, this parameter controls
the total amount of time after a successful N-ACTION (Print)
that the Print Client polls the Print Job SOP before releasing the
Print Complete association.
Time-out Period
-1 = wait indefinitely
0 = immediate timeout
1 to 32767 (seconds) timeout period
This parameter controls the amount of time that the client keeps
an association active after receiving a print complete.
Association Time-out
-1 = Never automatically release association (unless a new
Period
destination is specified, or an error has occurred)
0 = immediate timeout (default)
1 to 32767 (seconds) timeout period
Association Time-out 0 to 32767. Printer SOP Class only. This value controls how

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DICOM Communications

Parameter
Description Range
long the print SCU keeps the association open to poll for printer
status. A value of 0 means to release the association
immediately. A value greater than zero keeps the association
opens for that number of seconds.

Note: This should only be used when Association Control is not set
for Print Job SOP Class.
1 to 32767. Printer SOP Class only. This parameter controls the
number of seconds between the issuing of N-GETs for printer
Print Poll Period
status by the Digital Radiography Operating Console Print
Client after a successful N-ACTION (Print).

The Print Client populates and exports the DICOM attributes found in the specific Print SOP class
tables below. The supported attributes are configurable at a service level, a user level, or not at all
as shown in the tables. The Digital Radiography Operating Console Print Client does not make
use of private DICOM attributes.

Table 3：Basic Film Session SOP Class: Supported Attributes

Attribute Name Options Configuration Comment

NUMBER OF COPIES 1-99 User
MED No DirectRay
PRINT PRIORITY Console supports
only MED
MEDIUM TYPE BLUE PAPER
FILM
CLEAR FILM Service
FILM DESTINATION Not Used
FILM SESSION LABEL 64 characters max. Service
MEMORY Not Used
ALLOCATION

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 DICOM Communications

Table 4: Basic Film Box SOP Class: Supported Attributes

Attribute Name Options Configuration Comment

IMAGE DISPLAY STANDARD\1,1 No
FORMAT
ANNOTATION 1-6 No
DISPLAY FORMAT ID
PORTRAIT No
FILM ORIENTATION
LANDSCAPE
FILM SIZE ID 14 x 17 in. No
REPLICATE No Configured at
MAGNIFICATION TYPE BILINEAR CUBIC Image Box
NONE
SMOOTHING TYPE Not Used
BLACK No
WHITE
numeric,
BORDER DENSITY
OD times 100
(ex. 1.5 OD =
150)
EMPTY IMAGE Not Used
DENSITY
numeric, User Range Limits
MIN DENSITY OD times 100 (desirable):
0 to max. density
numeric, User Range Limits
MAX DENSITY OD times 100 (desirable):
min. density to 4
TRIM Not Used
CSxxx Service xxx = Code
CONFIG.
Value, obtained
INFORMATION
from SCPs
REF. FILM SESSION
SEQ.
REF. IMAGE BOX SEQ.
REF. ANNOTATION
BOX SEQ.

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DICOM Communications

Table 5: Basic Image Box SOP Class: Supported Attributes

Attribute Name Options Configuration Comment

1 No DirectRay Console:
IMAGE POSITION
one image only
NORMAL No
POLARITY
REVERSE
PREFORMATTED No
GRAYSCALE IMAGE
SEQUENCE
>SAMPLES PER PIXEL 1 No
>PHOTOMETRIC MONOCHROME2 No
INTERPRETATION
2560 or 3270 No *Image Scale
extends number of
>ROWS
rows in landscape
mode
3270 or 2560* No *Image Scale
extends number of
>COLUMNS
columns in portrait
mode
>PIXEL ASPECT RATIO 1\1 No
>BITS ALLOCATED 16 No
>BITS STORED 12 No
>HIGH BIT 11 No
>PIXEL 0000 No
REPRESENTATION
>PIXEL DATA No
REPLICATE User Overrides
BILINEAR corresponding
MAGNIFICATION TYPE
CUBIC Film Box attribute
NONE
SMOOTHING TYPE Not Used
No Indicates required
REQUESTED IMAGE
row size (true size)
SIZE
in mm.
REFERENCED Not Used
OVERLAY SEQUENCE

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 DICOM Communications

Per the Image Box SOP attribute list above, the DICOM Print Client supports the REQUESTED
IMAGE SIZE attribute. This attribute allows a DICOM Print Client to set the desired output size
of the image. True size is a user configurable parameter for a printer device, selectable in the
parameter list of the Procedure Editor function, as either OFF or ON.

When true size is turned on, the DICOM Print Client sets the REQUESTED IMAGE SIZE
attribute, per the DICOM Standard to:

 Length in mm that image rows of the image are to be printed. This value overrides the
size that corresponds with optimal filling of the Image Box, and exactly equals the length
of a row of the image as acquired from Digital Radiography.

NOTE: The Digital 400 printer supports true size and the LINX Version 2.7/2.8.x LP300/400 Print
SCP does not.

True size is a parameter of the printer device as it appears in the Digital Radiography Operating
Console user Procedure Editor; however, its correct operation is contingent upon support for this
parameter in the DICOM Print SCP.

The Print Client applies the ESA LUT which it receives from Digital Radiography to the
preformatted grayscale image when it builds the Image Box SOP specified above.

Optionally, the Print Client places a scale into the image data when it builds the Image Box SOP.
This is to give the reading physician a size reference for objects in the film. Refer to the following
topic “Annotation Box SOP Class (Text on Film)” for more information.

Annotation Box SOP Class (Text on Film)

The DICOM Print Client supports DICOM Annotation Box SOP Class in order to display text for
printers capable of printing text-on-film. The exact format of the printed text is completely
dependent on the DICOM Print Server and the connected printer.

The Digital Radiography Operating Console does not support embedding text into the image
object. As a result, text on film is available from DICOM Print Client, but not from DICOM
Storage Client.

Annotation display formats are not standardized by DICOM. The Digital Radiography Operating
Console Print Client is based on the E-COM, Inc. LINX Print Server Annotation Box format.

For clarity, the following describes the annotation display format utilized by the LINX Print SCP.

The LINX Print SCP format describes a text area consisting of 4 lines, each of which is the width
of the film. Three columns of annotation positions are available in each line. The left-most column
is left justified text. The center column is centered text. The right-most column is right-justified
text. The annotation position sequence is in row-major order (from left-to-right and top-to-bottom).
The numbers inside the boxes below indicate the annotation positions that are available:

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DICOM Communications

Figure 6: The annotation position sequence

The Digital Radiography Operating Console Print Service Class User (SCU) service supports a
minimum of a 2 line text annotation. An additional rule enforced by the Digital Radiography
Operating Console Print SCU is that the number of characters for any annotation position are less
than or equal to 64.

NOTE: It is the responsibility of the configuration personnel to understand these limitations and to
refrain from choosing combinations of adjacent text strings which cause truncation.

The DICOM Print Client builds the possible annotation text strings from the following parameter
list. Any of the following parameters can be used for any annotation text position. The connection
between annotation text position and parameter are user configurable:

 Site Name
 Node Name
 Patient Name
 Study ID
 Medical Record Locator
 Study Description
 Series Description
 Accession Number
 Procedure Description
 Acquisition Date/Time
 ESA
 True Size
 Requested Size (OFF/ON)
 Digital Radiography Detector Information
 Technologist ID
 Patient ID
 Image Comments
 kVp
 X-ray Tube Current
 Exposure
 Generator Power

Availability of the following attributes for annotation is desirable, though not required:

 Sheet: Number x of DICOM (0020,1002)

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 DICOM Communications

 Copy: Number x of DICOM (2000,0010)

 Print Date: Supplied when the sheet is sent to the printer
 Print Time: Supplied when the sheet is sent to the printer

Image Scale

This function defines a scale for use on Digital Radiography Operating Console systems so that
physical measurements can be made even though the film is printed in relative mode (non-true)
size. This is desired so that the full image from the plate can be presented without cropping to fit
within the hardcopy border.

Constraints on the image scale functionality are as follows:

 Scale is placed only on full size images (2560 x 3270).

 The image size constraint is on the vertical direction.
 Avoid modification of the image content (overlay of scale on image).

Functional requirements of the image scale are:

 Scale is a user-configurable parameter for a printer device, selectable in the parameter list of
the Procedure Editor function, as either OFF or ON.
 Scale is appended to the image when the Image Box is built. The scale is not included in the
DICOM Storage Client implementation.
 Scale is white text and lines on black background.

Printer/Print Job Support

The DICOM Print Client provides a function within the Printer SOP class to poll for printer status
using the N-GET DICOM service. When in this mode, the Digital Radiography Operating
Console Print SCU allows new print requests to proceed immediately upon receipt, unlike the
print job SOP class, which blocks new jobs until it receives an EXECUTION_STATUS of DONE,
or it times out.

NOTE: The service user should only configure this function when the optional Print Job SOP class is
not selected.

This function is activated when a positive value for the association timeout parameter is
configured, causing the DICOM Print Client to poll at a period set by the Printer Poll Period
parameter. If a printer warning or failure status is received during the polling period, an erasable
alarm is posted.

This forces the user to acknowledge the condition, even if the user is not present at the console
when the association is released.

NOTE: If the alarm was non-erasable, the Digital Radiography Operating Console would remove it

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DICOM Communications

immediately upon release of the association.

When a printer status of Normal is again received from that printer, an erasable alarm is posted,
indicating that the alarm condition is no longer present. Note that it could be hours later, since the
Digital Radiography Operating Console may not create an association with the problem printer
again for quite some time.

The Digital Radiography Operating Console Print Client supports the status and error messages
specified by the DICOM Standard in support of the A-ASSOCIATE and normalized services for
the print SOP classes specified above.

Exam-Specific Algorithms

When the Digital Radiography Operating Console acquires an image from Digital Radiography, it
also reads a LUT from Digital Radiography which represents an Exam-Specific Algorithm (ESA)
for optimal viewing of the image. The operator is given the opportunity to either accept or modify
the acquired ESA LUT. After the user accepts the image and ESA and exports the acquired image
object from the Digital Radiography Operating Console, the accepted ESA LUT is incorporated
into the image object using the following rules, depending on the method of export:

 If the DICOM Print Client is being used, the ESA is incorporated directly into the
preformatted grayscale image.
 If the DICOM Storage Client is being used, the ESA is incorporated into either the Modality
LUT, the VOI LUT, or the image, depending on a configuration parameter.
 The method of exporting the LUT is configurable to allow support for various Storage Class
Providers.

Physical Media Support

DICOM is indifferent to the physical medium over which TCP/IP executes (for example, IEEE
802.3, ATM).

The Digital Radiography Operating Console is tested with the following media:

 ATM: OC3 (fiber and copper)

 Ethernet: 10BaseT, 100BaseT, and 10Base2

Appendix A20 MAY.2009V4 DROC Service Manual