DICOM Overview

e Medical Systems
Dicom
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DICOM / CONNECTIVITY
Training Seminar
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Copyright 1998 General Electric Company
DICOM Training
Seminar Overview
Who / What is the Global Connectivity Center?

What is DICOM?
DICOM Version 3.0 Standard
DICOM Terminology
Image Transfer Networking Model
DICOM Service Class Overview
Reading DICOM Conformance Statements
Integration
DICOM Tools
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Who is the
Global Connectivity Center
Jeff Jasica
Global Connetcivity Center
Manager
Paul Burby Paul Hayden Hervy Hoehn Steve Metz Charles Parisot Jeff Seuro Sharrod Woods
America's Validation Cross Testing Tools Europe DICOM Standards Validation Validation
Sales Service Support Cross Testing Team Leader Sales Service Support Commitie Cross Tesing Cross Testing
Support Support Support
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What Does the GCC Provide
New Product Connectivity Sales/Service Support Installed Base Solutions
Improve Connectivity of new Provide the Field tools and a Leverage IB revenue
GEMS focal point for opportunities.
products by working with questions/issues/answers. Work with HNS as distribution.
modalities Facilitate closure of issues.
Mktg and Eng teams.
• Modality Connectivity
• Connectivity Platform SCP- • Connectivity Database • Targeted IB connectivity
Compliant Products • DICOM Training solutions delivered as
supported products
• Design Consulting • Single point of contact for
connectivity questions • Synergistic plays with HNS,
• Testing Strategy - Tools Sales, Systems Integration
• Cross-modality / vendor • Issue escalation process and
focal point for investigation • Vendor agreements
testing
support
• Industry Committees
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What Does the GCC
Need from You
• Learn and use GCC Provided DICOM and Networking tools.
• Use the escalation process when DICOM / Connectivity issues arise.
• Go to the GCC database first, feed GCC DICOM Connectivity issues
• Identify 3rd party connectivity solution opportunities
• Leverage customer contacts to build a connectivity business for the future:
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DICOM Training
Seminar Overview

What is DICOM?
DICOM Terminology
Integration
DICOM Tools
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The DICOM Acronym
DIGITAL: Medical Information is acquired in a DIGITAL format, Such

devices are: CT, MR, UltraSound... Non digital devices may require a
Analog to Digital Converter / Gateway to convert alalog information to a
digital format. Such devices are: Film Digitizers, Frame Grabbers....
IMAGING: Historically referred to as the Patient Information such as the

patient images. DICOM is expanding it’s more than just images it’s
DIGITAL INFORMATION.
COMMUNICATIONS: Uses standard networking protocols and Media

File Formats to exchange Digital Information.
(in) MEDICINE: Refers to the aid in treatment of patients in a

standardized electronic format
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Implementing DICOM
DICOM V3.0 Standard Manufacturers study Manufactures make significant software

and strategize how and hardware design commitments to
Part 1 Introduction
DICOM may be used implement DICOM features in products
in their product offerings
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What DICOM Can
and Cannot Guarantee
DICOM Can / Does Provide:
• Sets Foundation for interoperability between devices that
claim to support DICOM features.
• Increase Customer Productivity. More DICOM features =

more facility / departmental productivity.
DICOM Can Not / Does Not Provide:

• DICOM does not guarantee interoperability /connectivity
between products or between manufacturers.
• No DICOM police
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DICOM Training
Seminar Overview

What is DICOM?
DICOM Terminology
Integration
DICOM Tools
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The DICOM 3.0 Standard
Grayscale Stnd Display Function

PS 3.1: Introduction and Overview
Print Management
PS 3.2: Conformance Media Formats and Physical Media
Media
PS 3.3: Information Object Storage Application Profiles
Definitions
PS 3.4: Service Class Specifications
Media Storage and File Format
Pt.-Pt.Comm.Suppt
PS 3.5: Data Structures and Encoding Message Exchange
Ntk.Comm. Suppt. for Message Exchange
PS 3.6: Data Dictionary
PS 3.7: Message Exchange Message Exchange
PS 3.8: Network Communication Data Dictionary
Support for Message Exchange
*PS 3.9: Point-to-Point Communications
Structures andSupport for Message Exchange
Encoding
PS 3.10: Media Storage and Service Class Specifications
File Format
Information
PS 3.11: Media Storage Application Object Definitions
Profiles
PS 3.12: Media Formats and Physical Conformance
Media
Introductionand
PS 3.13: Print ManagementIntroduction andOverview
Overview
*PS 3.14: Grayscale Standard Display Function
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DICOM Standard Structure
PS 3.1: Overview
PS
3.2 PS 3.4 Service Class Spec.
C
o PS 3.6 Data
PS 3.3 IOD
n Dictionary
f
o PS 3.5 Data Structures
r
m
a PS 3.7 Message Exchange
n
c
e PS 3.8 Network Communication PS 3.9 Point to Point
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Historical Overview of DICOM
• 1983: ACR and NEMA form joint committee to find or develop an interface
between imaging equipment
• 1985: ACR-NEMA 300-1985 (ACR-NEMA Version 1.0) distributed at RSNA
• In 1988 ACR-NEMA Version 2.0 adds new elements and corrects a number of
errors.
• 1993: DICOM (Digital Imaging Communications in Medicine) addresses Image

Information Management, Image Transfer, and Print Management over networks
• 1994: DICOM standardizes media interchange
• 1995: DICOM enhances / adds full support for XA, RF, US, and NM
• 1996: Modality Worklist, Storage Commitment, Structured Reporting support for

RT objects
• 1998: Digital X-Ray Objects
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DICOM in ‘98 - Alive and Growing Standard
• Cooperation with JPEG 2000 for better Lossless/Lossy.
• DICOM reaches well beyond Radiology. It is in Cardiology,

Radiotherapy and enters Pathology, Gastroenterology,
Opthalmology.
• New Objects are under definition for advanced MR, RT Treatment,

and now VITAL SIGNS.
• Reporting is a growing area of focus. A Trial Structured Reporting

object and Interpretation Worklist under development.
• A Security supplement is ready (TLS & ISCL Authentication).
• DICOM is looking outwards for integration (IHE) with other

emerging and complementary healthcare standards HL7 as well as
future Internet standards.
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DICOM Training
Seminar Overview

What is DICOM?
DICOM Terminology
Integration
DICOM Tools
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DICOM Terminology
• Information Object Definition (IOD)

• DICOM Services / Service Class (SC)
• Service Class User (SCU)
• Service Class Provider (SCP)
• Service Object Pair (SOP)
• DICOM Message Service Element (DIMSE)
• Application Entity (AE)
• Unique Identifier (UID)
• Abstract Syntax
• Transfer Syntax
• DICOM Conformance Statement
• Others ??????
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Information Object Definition
Data Dictionary
Data Element TAG

Data Element TAG
Pixel Data
Rows, Cols, etc
.
Real World Object

An IOD is an object oriented data model used to specify information about real-world objects
g
Patient Entity
Study Entity
Rows
Series Entity General Image
Columns
Frame of Ref.Entity Image Pixel
...
Equip. Entity Cine Module
Pixel Data
Image Entity ...
Data Elements
Modules
- Attribute Name
CT -IOD - Element Tag
- Type (1 to 3 )
(Mandatory to Optional)
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- Value Multiplicity
Composite Vs. Normalized IOD’s
• Composite IOD’s Represent parts of several “real-world”

entities such as CT, MR Images ......
• Normalized IOD’s Represent a single “real-world” entity.

Patient, Study, Basic Film Session, Basic Worklist, ect.....
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DICOM Services
Service classes are defined in DICOM:
Services Product Examples
Verification (AW,HSA,LX,ect...)
Storage (AW,HSA,DLX,US,Horizon,ect...)
Query/Retreive (AW, CTi, Horizon,LX PACS,ect...)
Print Management (Cti, LX, ACRQA,AW3.1,ect...)
Media Storage (AW, Cti, QXI, LX, ect...)
Modality Worklist (Cti/Qxi, LX, US,ect...)
Storage Commitment (Qxi, etc...)
Stored Procedure Step
Performed Procedure Step
Results Management
Que Management
OTHERS........
DICOM Services are actions that are applied to

Information Objects
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Service Object Pair
DICOM Data Dictionary
IOD Service Class
(group, element)
(group, element)
SOP
Pixel Data
Real World Object
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Users and Providers
Concepts
“ I am sending a CT Image to you “
User Service IOD Provider
SCU SOP Class SCP
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Unique Identifier (UID)
A UID is a string including numbers and “.” that

MUST be UNIQUE around the world.
• e.g. 1.2.840.12345.19980924
• e.g. no leading zero’s in UID allowed!!
UIDs are an internal DICOM mechanism to uniquely

identify SOP Classes, Studies, Equipment's, Series,
Images, etc.......
To
Tobe
besure
surethat
thattwo
twoSOP
SOPClasses
Classesare
arethe
thesame,
same,
COMPARE
COMPAREUIDs.
UIDs.
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Unique Identifier (UID)
A UID is Formed Using a Registered ROOT and a
organization specific SUFFIX
eg SOP instance UID
1.2.840.xxxxx.3.152.235.2.12.187636473
Root Suffix
1. = Identifies ISO
2. = Identifies ANSI Member Body
840. = Country code
xxxx. = Identifies a specific Organization - eg. GEMS
3. = Manufacturer or user defined device type
152. = Manufacturer or user defined serial number
235. = Study number
2. = Series number
12. = Image number
187636473 = Encoded date and time stamp of image
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Maximum Length PDU
The Maximum length PDU (Protocol Data Unit) is the

maximum size of messages the DRS is able to handle.
Association Negotiation extract
Don’t Send me messages greater than 4K Bytes
R&F
Dont Send me messages greater than 16K Bytes
Storage SCU Storage SCP
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Implementation UID
An Implementation UID uniquely identifies a

manufacturer’s equipment and its version.
Association Negotiation extract

My Implementation UID is 1.2.840.113619.6.15
R&F
My Implementation UID is 1.2.840.xxxx.xx.xxx
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Application Context Name
Refers to the current release of DICOM
1.2.840.10008.3.1.1.1
(Version 3.0)
1.2.840.113619.3.1
(ACR-NEMA Version 2.0( pre-DICOM))
This may change with a next version of the Standard

(not envisioned today)
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DICOM Data Structure
Data Set
Data Data Data
... ... ...
Attributes are assigned
Element Element Element
a unique Tag
(group + element)
tag=(0x0010, 0x0010)
groups deals with patient
Value Value
Tag VR
Length Field
information for example
element is patient name
for example
Optional Field
Dependent on Transfer Syntax Attribute encoding is
defined by Value
Representation (PN).
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Example DICOM Tag’s
Group / Element Type Attribute Name Attribute Desc.
0010 , 0010 2 Patient Name Patient full Name
0010 , 101C 3 Patient Age Age of Patient
0010 , 1030 3 Patient Weight Wt. of Patient kg
0010 , 0030 2 Patient Birthdate Pat. Date of Birth
0010 , 2180 3 Patient Occupation Occ. of Patient
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Value Representation (VR)
Specifies data type / format of the values
contained in the value field
• AE - Application Entity • PN - Person Name
• AS - Age String • SH - Short String
• AT - Attribute Tag • SL - Signed Long
• CS - Code String • SQ - Sequence of Items
• DA - Date (e.g. 19981012) • SS - Signed Short
• DS - Decimal String • ST - Short Text
• DT - Date Time • TM - Time
• FL - Floating Point Single • UI - Unique Identifier
• FD - Floating Point Double • UN - Unknown VR
• IS - Integer String • UL - Unsigned Long
• LO - Long String • US - Unsigned Short
• LT - Long Text
• OB - Other Byte String
• OW - Other Word String
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Data Element Types
• TYPE 1
Required Data Elements
Value Field shall not be zero length
• TYPE 1C
Type 1C elements have the same requirements as Type 1
elements under certain specified conditions
• Type 2
Required Data Elements
Value Field may be zero length
• Type 2C
Type 2C elements have the same requirements as Type 2
elements under certain specified conditions
• Type 3
Optional Data Elements
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DICOM Training
Seminar Overview

What is DICOM?
DICOM Terminology
Integration
DICOM Tools
g
The DICOM Protocol
Medical Imaging Application
DICOM Application Entity
OSI Association Control

DICOM Service Element (ACSE)
Upper Level
Protocol OSI Presentation Kernel
for TCP/IP OSI Session Kernel
OSI Transport
TCP OSI Network
IP LLC
Standard Network Physical Layer
(i.e. Ethernet, FDDI, ISDN, etc.)
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DICOM Message Service Element
(DIMSE)
Service Classes
-Storage
-Print
-Q/R
IOD
Normalized Composite
-Patient - CT Image
-Study - MR Image
-Visit - DR Image
DIMSE
Upper Layer Protocol for TCP/IP
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Transfer Syntax
A transfer syntax is the encoding used to send data
over the network
Two Transfer Syntax's to represent the same information
RAMSES II
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DICOM Transfer Syntax's
DICOM defines several transfer syntax's :
• Implicit VR Little Endian (Default Network Xfer Syntax)

• Explicit VR Little Endian (Default for Media Storage)
• Explicit VR Big Endian
• JPEG Lossless
• JPEG Lossy
• Others.......
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Transfer Syntax's
Little Endian versus Big Endian byte ordering
DICOM defines two different byte orderings that affect binary

values sent on more than 1 byte (typically, Integer, long integer,
float values).
Example on a 2 byte value: 0x4528
Little Endian Big Endian
Least Significant Most Significant Most Significant Least Significant
Byte Byte Byte Byte
28 45 45 28
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Transfer Syntax's
Implicit VR versus Explicit VR

• VR stands for Value Representation. It describes
the type and the format of the information sent in
a DICOM Message. For instance, the Patient
Date of Birth format is a 8 characters string
following the format : YYYYMMDD
• Explicit VR means that the VR is (explicitly) sent in

the DICOM Message.
• Implicit VR means that no VR is sent in the message,
and the VR that must be used to decode the DICOM
Message is specified in the Standard.
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Presentation Context
A Presentation Context is the association of:
• One SOP Class
• One or several Transfer Syntax(es)
Implicit VR LE
Explicit VR LE
etc.
CT Image Storage
Presentation Context
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Application Entity Title
During the negotiation, the two

Implementations present themselves each
other
• This presentation is done using Application Entity

Title (AE Title)
• This AE Title is a 16 character string that must be

unique on a given network. It is used to identify an
application on the network.
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DICOM Training
Seminar Overview

What is DICOM?
DICOM Terminology
Integration
DICOM Tools
g
Service Class “Verification”
Association Establishment :
- send AE Title, Impl. UID, Max PDU Length
- offer the Presentation Context
(SOP Class / Transfer Syntax)
R&F
A-ASSOCIATE-RQ
Remote Node
Local SCU Association accepted : SCP
- agreed on the proposed Presentation Context
A-ASSOCIATE-AC
Are you there?

C-ECHO-RQ
I’m Here!
C-ECHO-RSP
Release the Association

A-RELEASE-RQ
Association Released
A- RELEASE- RSP
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Service Class “Storage”
Association Establishment :
- offer the Presentation Context
(SOP Class / Transfer Syntax)
R&F A-ASSOCIATE-RQ
Remote Node
Association accepted : SCP
Xray R&F -SCU - send AE Title, Impl. UID, Max PDU Length
- agreed on the proposed Presentation Context
A-ASSOCIATE-AC
Store (send) Image #1-n

C-STORE-RQ
Store Image response (success / failure)

C-STORE-RSP
A-RELEASE-
RQ
A-RELEASE-RSP
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Service Class “Query Retrieve”
A-ASSOCIATE-RQ
Association accepted :
R&F A-ASSOCIATE-AC
Remote Node
Query for Patient/Study/Image Q/R SCU
Q/R SCP C-FIND-RQ
Query Results (one for each hit)

C-FIND-RSP
C-FIND-RSP
Retrieve Patient/Study/Image
C-MOVE-RQ
Note: Retrieve Status

Images are C-STORE’d C-MOVE-RSP(pending)
on a separate Association
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Service Class “Print”
DICOM Print
A-ASSOCIATE
DICOM Print
SCU
N-GET (PRINTER SOP Instance) SCP
N-CREATE (FILM Session SOP Instance)
For each Film of Session N-CREATE (FILM Box SOP Instance)
For each Image of Film N-SET (Image Box SOP Instance + Image)
N-ACTION(PRINT)
N-DELETE (Film Box and Film Session)
A-RELEASE
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Service Class
Modality
“Modality Worklist” HIS/ RIS
MWL-SCU MWL-SCP
A-ASSOCIATE-RQ
R&F
A-ASSOCIATE-AC
Today’s Find match 1-n

C-FIND REQ.
CT
C-FIND RSP. 1-n J. Frog

P. Smith
C-FIND RSP. 1-n

A-RELEASE-RQ
A-RELEASE-RSP
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Service Class
“Storage Commitment”
Modality Archive
S.C. - SCU Device
A-ASSOCIATE-RQ
R&F
A-ASSOCIATE-AC
ct Find match 1-n

C- FIND-RQ
today
j.smith
C-FIND RSP. 1-n
p.frog

A-RELEASE-RQ
A-RELEASE-RSP
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DICOM Training
Seminar Overview

What is DICOM?
DICOM Terminology
Integration
DICOM Tools
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DICOM Conformance Statements
What do I need to compare?
The vital information to determine connectivity
between two or more products are contained in the
CONFORMANCE STATEMENT of any given product
claiming to support DICOM functions.
Connectivity is contained in two tables of a

DICOM conformance statement
• Proposed Presentation Context list
• Accepted Presentation Context list.
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Match Proposed with Accepted
Storage Class User Storage Class Provider
CT - Workstation -
DICOM Conformance Statement DICOM Conformance Statement
•Proposed •Proposed
•Presentation •Presentation
•Context •Context
•Table •Table
•Accepted •Accepted
•Presentation •Presentation
•Context •Context
•Table •Table
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Storage SOP Classes
SOP Class Name UID
CR Image Storage 1.2.840.10008.5.1.4.1.1.1

CT Image Storage 1.2.840.10008.5.1.4.1.1.2
MR Image Storage 1.2.840.10008.5.1.4.1.1.4
NM Image Storage 1.2.840.10008.5.1.4.1.1.5
US Image Storage 1.2.840.10008.5.1.4.1.1.6
SC Image Storage 1.2.840.10008.5.1.4.1.1.7
RF Image Storage 1.2.840.10008.5.1.4.1.1.12.2
Others...... Others..........
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Query/Retrieve SOP Classes
SOP Class Name SOP Class UID
Q/R Patient Root FIND 1.2.840.10008.5.1.4.1.2.1.1
Q/R Patient Root MOVE 1.2.840.10008.5.1.4.1.2.1.2
Q/R Study Root FIND 1.2.840.10008.5.1.4.1.2.2.1
Q/R Study Root MOVE 1.2.840.10008.5.1.4.1.2.2.2
Q/R Patient/Study Only FIND 1.2.840.10008.5.1.4.1.2.3.1
Q/R Patient/Study Only MOVE 1.2.840.10008.5.1.4.1.2.3.2
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Other SOP Classes
SOP Class Name SOP Class UID
Verification 1.2.840.10008.1.1
Basic Grayscale Print 1.2.840.10008.5.1.1.9
Modality Worklist FIND 1.2.840.10008.5.1.4.31
Storage Commitment PUSH 1.2.840.10008.1.20.1
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Transfer Syntax's
Transfer Syntax UID
Implicit VR Little Endian 1.2.840.10008.1.2
Explicit VR Little Endian 1.2.840.10008.1.2.1
Explicit VR Big Endian 1.2.840.10008.1.2.2
JPEG Lossless 1.2.840.10008.1.2.4.70
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Configurable Parameters
• I.P. Address
• AE Title
• Port Number
• PDU Length
Watch for PDU Length equal to 0
• Site Configurable Parameters
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Conformance Statement Review
Exercise
• Compare two DICOM Conformance Statements
• Identify Features that are supported on each
• Identify Features that are not supported on each
• Identify potential issues “customer requirements”
• Complete DICOM Conformance Statement Template
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DICOM Training
Seminar Overview

What is DICOM?
DICOM Terminology
Integration
DICOM Tools
g
DICOM Solutions Require
Complete Integration
Infrastructure Design
“DICOM requires • Equipment • Network
• Network • DICOM
complete
Integration in
order to fully Integration
capitalize on
functionality and
DICOM Equipment
compatibility” Compatibility Configuration
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What’s needed to make
DICOM work???
MultiSuite
! Physical Network Coaxial Interface
Fiber
Infrastructure
! DICOM Cabling UTP NIC’s
Compatibility &
IMAGE
Interoperability
! Configuration of WS
Network Equip. Configuration

MR
Devices
Hubs
Dicom
Switches Conformance
Routers
DICOM Compatibility
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How to Proceed?
1. Survey Site
– Physical Layer Requirements Ass
ess A
– Datalink Layer Requirements Cuss
setos
– Network Layer Requirements s
ey
m
er
rv
– Application Layer Requirements
Su
Nee
– Work Flow Requirements
ds
– Application Requirements
2. Assess Customer Needs
– Add, Move or Change cabling?
Te
– Add, Move or Change Network
nfig
st
devices (switches, routers, hubs)?
/
Tr
Co
– Network interfaces Cards needed? ou
bl &
e ll
– Software modules needed? sho s t a
– Performance requirement
ot In
– Compatible Phys, Datalink,
Network & Application protocols?
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Site Survey
Cabling Worksheet
Survey Site Network Identifier: First floor Radiology
Cable Type: 10Base2 Ethernet
Topology: Bus
Physical Network Infrastructure Number of Nodes: 5
Notes: Collision Rate=40%, Utiliz=60%
– Physical Layer Diagram:
» New or Existing network?
» How much growth in 1 - 5 XR
years?
» Topology? US
» How many drops?
» Robust Bandwidth?
» Cable performance
» NIC’s needed?
» NIC Performance?
CT MR WS
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Site Survey
Application Layer
» DICOM? End-Node Worksheet
» AdvantageNet? Application Layer Information
" Dicom 3.0 " AdvantageNet
» StarLink? " ID/Net II # Starlink
» Other Protocols? # Other:_________________
» Proper Service Class Service Class supported

" Verification scu " Verification scp
support offered?
» Customer understand Storage SCU
" CT " MR
limitations (if any) " Secondary Capture " Standalone Overlay
» Know Interoperability
Issues Storage SCP
" CT " MR
" Secondary Capture " Standalone Overlay
Print SCU
" Basic Gray Scale # Reference Gray Scale
DICOM supports BUT does NOT # Annotation Box # Standalone Overlay
guarantee interoperability!! Refer to
GCC Web page: 3.45.13.153/gscp
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Assess Customer Needs
Assess Customer Needs Customer objective:

– Customer objectives
– Short Term, Long Term “We want the fastest network
– Immediate Needs known to mankind which must be
– Budgetary Constraints compatible with every protocol
– Limitations with existing situation ever devised on a really small
– Future Plans budget by next week!”
– Roadmap
– Identify all parties involved
No, I dont think so. We also need to
Let’s sit down with discuss with the
Tom,
Okaydoes the here’s
Team, the customer and customer a detailed
what thereally
customer identify what they implementation
customer know
wants us to do... really need and want Roadmap
what they are
asking for?????
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Performance Considerations
Modality Study Sizes (Mbytes) My DICOM print jobs
aren’t working every
CT 21 morning and after lunch…
What’s wrong with these
MR 13 systems!!!
XR ANGIO 84
XR R&F 168
XR RAD CR 23
DIGITIZED FILM 8
PET 11
NM 25
US GREY 9
US COLOR 28
Devices connected on a shared 10Mbps shared networks can

suffer from poor performance & intermittent failed transmissions!
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Installation & Configuration
Install & Configuration
– Cable Plant (EIA/TIA Standards)
– Network Interfaces (NIC’s) Can I put this CT system
» MultiSuite Interface Card on the network without
a MultiSuite Interface
» Ethernet Interface Card card?
» Fast Ethernet Card
» Media Interfaces
– Configure Layer2 & 3 Devices
» IP Address Map
» NetMasks
» Routing Tables
» Access lists
– Configure Application Layer
Devices (Dicom, AdvNet, etc.)
» AE Titles
» IP Port Numbers
» Query via Patient or Study Root?
Poor planning can result in added
g
UNRECOVERABLE cost to the installation
(e.g. missing NIC cards, gateways...)!
Installation & Configuration
My A.E.T. is MROC0, My A.E.T. is AW-PCO,

And my Port # is 104, And my Port # is 4006,
and this system’s I.P. and this system’s I.P.
address is 3.7.52.3 address is 3.7.52.4
Application Entity Title Application Entity Title
DICOM Port Number DICOM Port Number
I.P Address I.P. Address
Other Integration Info. Other Integration Info.
Required DICOM Information in most cases will

need to be configured into each system
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Test & Troubleshoot
Test & Troubleshoot I never received the exam that
was sent to this system
– Cable Plant (EIA/TIA Standards)
– Network Interfaces (NIC’s)
» MultiSuite Interface Card
» Ethernet Interface Card
» Fast Ethernet Card
» Media Interfaces
– Configure Layer2 & 3 Devices
» IP Address Map I sent the exam an hour ago
» NetMasks You didn't get the exam???
» Routing Tables
» Access lists
– Configure Application Layer
Devices (Dicom, AdvNet, etc.)
» AE Titles
» IP Port Numbers
» Query via Patient or Study Root?
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Test & Troubleshoot
Test & Troubleshoot
– Physical cabling issue(s)
» Verify physical connection(s)
» Verify NIC configuration APPL
» Verify plant infrastructure configuration LAYER
– Transport issue(s)
» Verify I.P. routing scheme
• I.P. Numbers NETWORK
• Routing tables LAYER
– Image Transmission issue(s) on product
» Verify required DICOM information DATALINK
» Review DICOM error logs on product LAYER
– Image Transmission using diagnostic tools
» Use DICOM store scu/scp when necessary
PHYSICAL
» Use DICOM dcmdump to identify header
information
LAYER
» Use NetXray to capture TCP/IP information
» Use Merge DPM to analysis TCP/IP
information.
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Laptop Configuration
• Right click on Network Neighborhood and Select Properties
• Click on TCP/IP
• Click on Properties
• Enter TCP/IP information eg. IP Address, Netmaks, Gateway...
IP and Netmask
should be valid!!!
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Laptop Based DICOM “ECHO”
C:echoscu -v -t echoscu -c MR_OC0 3.57.166.77 104

Requesting Association
Association Accepted (Max Send PDV: 16372)
Echo [1], Complete [Status: Success]
Application
Entity Title =
MR_OC0
I.P. Address =
3.57.166.77
Port Number
for MR = 104
g
Laptop Based DICOM “StoreSCP”
C:echoscp +V 4006ssociation Received
Association Acknowledged (Max Send PDV: 16372)
Received C-Store RQ: MsgID: 0
AffectedSOPClassUID: =MRImageStorage
AffectedSOPInstanceUID: 1.2.840.113619.2.XXX
Priority: 0
Data Set: Present
RECV:.................
.........................
Application
Entity Title =
MR_OC0
I.P. Address =
3.57.166.77
Port Number
for MR = 104
g
DICOM “Dump” (dcmdump) Tool
(0008,0020) DA [1992.02.05] # 10, 1 StudyDate
(0008,0021) DA [1998.09.02] # 10, 1 SeriesDate
(0008,0022) DA [1992.02.05] # 10, 1 AcquisitionDate
(0008,0023) DA [1998.09.02] # 10, 1 ImageDate
(0008,0030) TM [10:02:55.0000] # 14, 1 StudyTime
(0008,0032) TM [10:28:36.1200] # 14, 1 AcquisitionTime
(0008,0033) TM [10:28:45.0000] # 14, 1 ImageTime
(0008,0040) US 0 # 2, 1 OldDataSetType
(0008,0041) LT [REFORMATTED] # 12, 1
OldDataSetSubtype
(0008,0060) CS [CT] # 2, 1 Modality
(0008,0070) LO [GE MEDICAL SYSTEMS] # 18, 1 Manufacturer
(0008,0080) LO [ST. PETE’s] # 22, 1 InstitutionName
(0008,0090) PN [SMITH] # 10, 1
ReferringPhysiciansName
(0008,1010) SH [ZEUSOC0] # 8, 1 StationName
g
GCC WEB PAGE
DICOM Connectivity - Answers
GCC Web page: 3.45.13.153/gcc
g

DICOM Overview

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DICOM Overview

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e Medical Systems

Who / What is the Global Connectivity Center?

New Product Connectivity Sales/Service Support Installed Base Solutions

• Learn and use GCC Provided DICOM and Networking tools.

• Use the escalation process when DICOM / Connectivity issues arise.

• Go to the GCC database first, feed GCC DICOM Connectivity issues

• Identify 3rd party connectivity solution opportunities

• Leverage customer contacts to build a connectivity business for the future:

Who / What is the Global Connectivity Center?

DIGITAL: Medical Information is acquired in a DIGITAL format, Such

IMAGING: Historically referred to as the Patient Information such as the

COMMUNICATIONS: Uses standard networking protocols and Media

(in) MEDICINE: Refers to the aid in treatment of patients in a

DICOM V3.0 Standard Manufacturers study Manufactures make significant software

• Increase Customer Productivity. More DICOM features =

DICOM Can Not / Does Not Provide:

Who / What is the Global Connectivity Center?

Grayscale Stnd Display Function

• 1985: ACR-NEMA 300-1985 (ACR-NEMA Version 1.0) distributed at RSNA

• 1993: DICOM (Digital Imaging Communications in Medicine) addresses Image

• 1994: DICOM standardizes media interchange

• 1996: Modality Worklist, Storage Commitment, Structured Reporting support for

• 1998: Digital X-Ray Objects

• DICOM reaches well beyond Radiology. It is in Cardiology,

• New Objects are under definition for advanced MR, RT Treatment,

• Reporting is a growing area of focus. A Trial Structured Reporting

• A Security supplement is ready (TLS & ISCL Authentication).

• DICOM is looking outwards for integration (IHE) with other

Who / What is the Global Connectivity Center?

• Information Object Definition (IOD)

Information Object Definition

Data Element TAG

Real World Object

• Composite IOD’s Represent parts of several “real-world”

• Normalized IOD’s Represent a single “real-world” entity.

DICOM Services are actions that are applied to

Real World Object

User Service IOD Provider

SCU SOP Class SCP

A UID is a string including numbers and “.” that

UIDs are an internal DICOM mechanism to uniquely

The Maximum length PDU (Protocol Data Unit) is the

Association Negotiation extract

Don’t Send me messages greater than 4K Bytes

Dont Send me messages greater than 16K Bytes

Storage SCU Storage SCP

An Implementation UID uniquely identifies a

Association Negotiation extract

My Implementation UID is 1.2.840.xxxx.xx.xxx

Refers to the current release of DICOM

This may change with a next version of the Standard

0010 , 0010 2 Patient Name Patient full Name

0010 , 101C 3 Patient Age Age of Patient

0010 , 1030 3 Patient Weight Wt. of Patient kg

0010 , 0030 2 Patient Birthdate Pat. Date of Birth

0010 , 2180 3 Patient Occupation Occ. of Patient

Who / What is the Global Connectivity Center?

Medical Imaging Application

DICOM Application Entity

OSI Association Control

Two Transfer Syntax's to represent the same information

DICOM defines several transfer syntax's :

• Implicit VR Little Endian (Default Network Xfer Syntax)

Little Endian versus Big Endian byte ordering