Unified Clinical Archive Version 9.5. DICOM Conformance Statement

Transcription

1 Unified Clinical Archive Version 9.5 DICOM Conformance Statement

2 This conformance statement applies to version of the NTT Data Unified Clinical Archive product. Future versions of the product should maintain compatibility with this conformance statement, but will include added features and enhancements. Information in this document is subject to change without notice NTT Data Inc. All rights reserved

3 Contents 1 Conformance Statement Overview Introduction Revision History Audience Remarks Definitions, Terms and Abbreviations References Networking Implementation Model for the NTT Data Unified Clinical Archive Application Data Flow Diagram Functional Definitions of Application Entities Sequence of Real World Activities Application Entity Specifications indexstore Application Entity Specification indexpush/indexforward Application Entity - Specification indexquery Application Entity - Specification Network Interfaces Physical Network Interfaces Additional Protocols IPv4 and IPv6 Support Configuration AE Title/Presentation Address Mapping i

4 4 Media Interchange Support of Extended Character Sets Security Security Profiles The Basic TLS Secure Transport Connection Profile The AES TLS Secure Transport Connection Profile Audit Trail Message Format Profile Audit Trail Message Transmission Profile Association Level Security... 84

5 1 Conformance Statement Overview The NTT Data Unified Clinical Archive (UCA), is the secure DICOM storage and retrieval system of NTT Data, Inc. The Archive is intended to receive patient and image data over the network and store it for retrieval. The Archive conforms to the DICOM standard to allow medical information to be shared. Table 1-1 Network Services SOP Classes User of Service () Provider of Service (SCP) Transfer Computed Radiography Image Yes Yes Digital X-Ray Image - For Presentation Yes Yes Digital X-Ray Image - For Processing Yes Yes Digital Mammography Image - For Presentation Yes Yes Digital Mammography Image - For Processing Yes Yes Digital Intra-oral X-Ray Image - For Presentation Yes Yes Digital Intra-oral X-Ray Image - For Processing Yes Yes CT Image Yes Yes Enhanced CT Image Yes Yes Ultrasound Multi-frame Image (Retired) Yes Yes Ultrasound Multi-frame Image Yes Yes MR Image Yes Yes MR Enhanced Image Yes Yes MR Spectroscopy Yes Yes Enhanced MR Color Image Yes Yes Nuclear Medicine Image (Retired) Yes Yes Ultrasound Image (Retired) Yes Yes Ultrasound Image Yes Yes Enhanced US Volume Yes Yes Secondary Capture Image Yes Yes Multi-frame Single Bit Secondary Capture Image Yes Yes Multi-frame Grayscale Byte Secondary Capture Image Yes Yes Multi-frame Grayscale Word Secondary Capture Image Yes Yes Multi-frame True Color Secondary Capture Image Yes Yes Standalone Overlay Yes Yes Standalone Curve Yes Yes 12-Lead ECG Waveform Yes Yes General ECG Waveform Yes Yes Ambulatory ECG Waveform Yes Yes Hemodynamic Waveform Yes Yes Cardiac Electrophysiology Waveform Yes Yes Basic Voice Audio Waveform Yes Yes General Audio Waveform Yes Yes Arterial Pulse Waveform Yes Yes NTT Data, Inc. DICOM Conformance Statement Page 3

6 Table 1-1 Network Services SOP Classes User of Service () Provider of Service (SCP) Respiratory Waveform Yes Yes Grayscale Softcopy Presentation State Yes Yes Color Softcopy Presentation State Yes Yes Pseudo Color Softcopy Presentation State Yes Yes Blending Softcopy Presentation State Yes Yes XA/XRF Grayscale Softcopy Presentation State Yes Yes X-Ray Angiographic Image Yes Yes Enhanced XA Image Yes Yes X-Ray Radiofluoroscopic Image Yes Yes Enhanced XRF Image Yes Yes X-Ray Angiographic Bi-plane Image (Retired) Yes Yes 3D X-Ray Angiographic Image Yes Yes X Ray 3D Craniofacial Image Yes Yes Breast Tomosynthesis Image Yes Yes Intravascular Optical Coherence Tomography Image For Presentation Intravascular Optical Coherence Tomography Image For Processing Nuclear Medicine Image Yes Yes Raw Data Yes Yes Spatial Registration Yes Yes Spatial Fiducials Yes Yes Deformable Spatial Registration Yes Yes Segmentation Yes Yes Surface Segmentation Yes Yes Real World Value Mapping Yes Yes Surface Scan Mesh Yes Yes Surface Scan Point Cloud Yes Yes VL Endoscopic Image Yes Yes Video Endoscopic Image Yes Yes VL Microscopic Image Yes Yes Video Microscopic Image Yes Yes VL Slide-Coordinates Microscopic Image Yes Yes VL Photographic Image Yes Yes Video Photographic Image Yes Yes Ophthalmic Photography 8 Bit Image Yes Yes Ophthalmic Photography 16 Bit Image Yes Yes Stereometric Relationship Yes Yes Ophthalmic Tomography Image Yes Yes VL Whole Slide Microscopic Image Yes Yes Lensometry Measurements Yes Yes Yes Yes Yes Yes

7 Table 1-1 Network Services SOP Classes User of Service () Provider of Service (SCP) Autorefraction Measurements Yes Yes Keratometry Measurements Yes Yes Subjective Refraction Measurements Yes Yes Visual Acuity Measurements Yes Yes Spectacle Prescription Report Yes Yes Ophthalmic Axial Measurements Yes Yes Intraocular Lens Calculations Yes Yes Macular Grid Thickness and Volume Report Yes Yes Ophthalmic Visual Field Static Perimetry Measurements Yes Yes Ophthalmic Thickness Map Yes Yes SR Comprehensive Draft (retired) Yes Yes Basic Text SR Yes Yes Enhanced SR Yes Yes Comprehensive SR Yes Yes Procedure Log Yes Yes Mammography CAD SR Yes Yes Key Object Selection Documentation Yes Yes Chest CAD SR Yes Yes X-Ray Radiation Dose SR Yes Yes Colon CAD SR Yes Yes Implantation Plan SR Yes Yes Encapsulated PDF Yes Yes Encapsulated CDA Yes Yes Positron Emission Tomography Image Yes Yes Basic Structured Display Yes Yes RT Image Yes Yes RT Dose Yes Yes RT Structure Set Yes Yes RT Beams Treatment Record Yes Yes RT Plan Yes Yes RT Brachy Treatment Record Yes Yes RT Treatment Summary Record Yes Yes RT Ion Plan Yes Yes RT Ion Beams Treatment Record Yes Yes Practice Builder Report Text Yes Yes Practice Builder Report Dictation Yes Yes GE Private CT Image Yes Yes GE Private Display Image Yes Yes GE Private MR Image Yes Yes GE Private 3D Model Yes Yes NTT Data, Inc. DICOM Conformance Statement Page 5

8 Table 1-1 Network Services SOP Classes User of Service () Provider of Service (SCP) GE Private Nuclear Medicine Yes Yes Philips Private Specialized X-Ray Image Yes Yes Philips Private 3D Presentation State Yes Yes Philips Private Gyroscan MR Series Data Yes Yes Siemens Private Syngo CSA Non-Image Yes Yes Query/Retrieve Patient Root Q/R FIND Yes Yes Study Root Q/R FIND Yes Yes Patient Root Q/R MOVE Yes Yes Study Root Q/R MOVE Yes Yes Patient Root Q/R GET Yes Yes Study Root Q/R GET Yes Yes Workflow Management Commitment Push Model Yes Yes Modality Performed Procedure Step Yes Yes Modality Worklist Find Yes No NOTE: Relational Queries are not supported either as or SCP.

9 Table 1-2 UID Values UID Value UID Name Category Commitment Push Model Workflow Modality Performed Procedure Step Workflow Modality Worklist Find Workflow Computed Radiography Image Transfer Digital X-Ray Image - For Presentation Transfer Digital X-Ray Image - For Processing Transfer Digital Mammography Image - For Presentation Digital Mammography Image - For Processing Digital Intra-oral X-Ray Image - For Presentation Digital Intra-oral X-Ray Image - For Processing Transfer Transfer Transfer Transfer CT Image Transfer Enhanced CT Image Transfer Ultrasound Multi-frame Image (Retired) Transfer Ultrasound Multi-frame Image Transfer MR Image Transfer MR Enhanced Image Transfer MR Spectroscopy Transfer Enhanced MR Color Image Transfer Nuclear Medicine Image (Retired) Transfer Ultrasound Image (Retired) Transfer Ultrasound Image Transfer Enhanced US Volume Transfer Secondary Capture Image Transfer Multi-frame Single Bit Secondary Capture Image Multi-frame Grayscale Byte Secondary Capture Image Multi-frame Grayscale Word Secondary Capture Image Multi-frame True Color Secondary Capture Image Transfer Transfer Transfer Transfer Standalone Overlay Transfer Standalone Curve Transfer Lead ECG Waveform Transfer General ECG Waveform Transfer Ambulatory ECG Waveform Transfer Hemodynamic Waveform Transfer NTT Data, Inc. DICOM Conformance Statement Page 7

10 Table 1-2 UID Values UID Value UID Name Category Cardiac Electrophysiology Waveform Transfer Basic Voice Audio Waveform Transfer General Audio Waveform Transfer Arterial Pulse Waveform Transfer Respiratory Waveform Transfer Grayscale Softcopy Presentation State Transfer Color Softcopy Presentation State Transfer Pseudo Color Softcopy Presentation State Transfer Blending Softcopy Presentation State Transfer XA/XRF Grayscale Softcopy Presentation State Transfer X-Ray Angiographic Image Transfer Enhanced XA Image Transfer X-Ray Radiofluoroscopic Image Transfer Enhanced XRF Image Transfer X-Ray Angiographic Bi-plane Image (Retired) Transfer D X-Ray Angiographic Image Transfer X Ray 3D Craniofacial Image Transfer Breast Tomosynthesis Image Transfer Intravascular Optical Coherence Tomography Image For Presentation Intravascular Optical Coherence Tomography Image For Processing Transfer Transfer Nuclear Medicine Image Transfer Raw Data Transfer Spatial Registration Transfer Spatial Fiducials Transfer Deformable Spatial Registration Transfer Segmentation Transfer Surface Segmentation Transfer Real World Value Mapping Transfer Surface Scan Mesh Transfer Surface Scan Point Cloud Transfer VL Endoscopic Image Transfer Video Endoscopic Image Transfer VL Microscopic Image Transfer Video Microscopic Image Transfer VL Slide-Coordinates Microscopic Image Transfer VL Photographic Image Transfer Video Photographic Image Transfer Ophthalmic Photography 8 Bit Image Transfer

11 Table 1-2 UID Values UID Value UID Name Category Ophthalmic Photography 16 Bit Image Transfer Stereometric Relationship Transfer Ophthalmic Tomography Image Transfer VL Whole Slide Microscopic Image Transfer Lensometry Measurements Transfer Autorefraction Measurements Transfer Keratometry Measurements Transfer Subjective Refraction Measurements Transfer Visual Acuity Measurements Transfer Spectacle Prescription Report Transfer Ophthalmic Axial Measurements Transfer Intraocular Lens Calculations Transfer Macular Grid Thickness and Volume Report Ophthalmic Visual Field Static Perimetry Measurements Transfer Transfer Ophthalmic Thickness Map Transfer SR Comprehensive Draft (retired) Transfer Basic Text SR Transfer Enhanced SR Transfer Comprehensive SR Transfer Procedure Log Transfer Mammography CAD SR Transfer Key Object Selection Documentation Transfer Chest CAD SR Transfer X-Ray Radiation Dose SR Transfer Colon CAD SR Transfer Implantation Plan SR Transfer Encapsulated PDF Transfer Encapsulated CDA Transfer Positron Emission Tomography Image Transfer Basic Structured Display Transfer RT Image Transfer RT Dose Transfer RT Structure Set Transfer RT Beams Treatment Record Transfer RT Plan Transfer RT Brachy Treatment Record Transfer RT Treatment Summary Record Transfer RT Ion Plan Transfer RT Ion Beams Treatment Record Transfer Practice Builder Report Text Transfer NTT Data, Inc. DICOM Conformance Statement Page 9

12 Table 1-2 UID Values UID Value UID Name Category Practice Builder Report Dictation Transfer GE Private CT Image Transfer GE Private Display Image Transfer GE Private MR Image Transfer GE Private 3D Model Transfer GE Private Nuclear Medicine Transfer Philips Private Specialized X-Ray Image Transfer Philips Private 3D Presentation State Transfer Philips Private Gyroscan MR Series Data Transfer Siemens Private Syngo CSA Non-Image Transfer Patient Root Q/R Information Model FIND Query/Retrieve Patient Root Q/R Information Model MOVE Query/Retrieve Patient Root Q/R Information Model GET Query/Retrieve Study Root Q/R Information Model FIND Query/Retrieve Study Root Q/R Information Model MOVE Query/Retrieve Study Root Q/R Information Model GET Query/Retrieve

13 2 Introduction This section provides information about the purpose, scope and contents of the NTT Data Unified Clinical Archive DICOM conformance statement. 2.1 Revision History Document Version Date Author Description 6.1 April 30, 2010 RoseAnn Sibilio Modifications for 6.1 Release 6.1 June 9, 2011 Everett Peabody Added three new SOP Classes 6.1 July 18, 2011 RoseAnn Sibilio New SOP Class 7.1 June 24, 2013 Todd Lomaro Modification for UCA Version 7.x 8.1 Sept 15, 2014 Todd Lomaro Updates for UCA Version Oct 1, 2015 Todd Lomaro Updates for UCA Version and Added new SOP Classes Mar 16, 2016 Todd Lomaro Updated section and on Store Commit Response Associations 9.5 Jan 10, 2017 Todd Lomaro Update for UCA Version 9.5. Rebranded for NTT Data Oct 1, 2017 Todd Lomaro Added support for MPEG2 and MPEG- 4 Transfer Syntax 2.2 Audience This document is intended for potential clients, system integrators and software designers interested in acquiring and working with the NTT Data Unified Clinical Archive (UCA). The document assumes familiarity with the DICOM Standard as defined by ACR-NEMA. It should be interpreted in conjunction with the published standard. 2.3 Remarks The NTT Data Unified Clinical Archive is a product of NTT Data, Inc. The DICOM application will evolve in the future to meet user requirements and to incorporate new features and technologies. NTT Data plans to adapt its software to future versions of the DICOM standard. This may result in changes to the support of the communications features listed in this Conformance Statement. The user should ensure that other devices conform to the evolving standard. Failure to do so could result in the loss of function and/or connectivity. NTT Data reserves the right to make changes to its products or to discontinue its delivery. This Conformance Statement by itself does not guarantee successful interconnection. It is the responsibility of the user to carry out additional validation tests to ensure the functionality, performance, accuracy and stability of the transmitted image and patient data. NTT Data will make every effort to keep the NTT Data Unified Clinical Archive Product backwards compatible with previous versions of the product and continue to support retired DICOM capabilities where feasible. NTT Data participates in testing sponsored by Integrated Healthcare Enterprise (IHE) and the NTT Data Unified Clinical Archive Integration Statement can be found on our Website. 2.4 Definitions, Terms and Abbreviations Big Endian: A form of byte ordering where multiple byte binary values are encoded with the most significant byte encoded first; and the remaining bytes encoded in decreasing order of significance. NTT Data, Inc. DICOM Conformance Statement Page 11

14 Little Endian: A form of byte ordering where multiple byte binary values are encoded with the least significant byte encoded first; and the remaining bytes encoded in increasing order of significance. Pixel Data: Graphical data (e.g. images or overlays) of variable pixel-depth encoded in the Pixel Data Element. Standard Data Element: A Data Element defined in the DICOM Standard, and therefore listed in the DICOM Data Element Dictionary in PS 3.6. Private Data Element: Additional Data Element, defined by an implementer, to communicate information that is not contained in Standard Data Elements. Data Element Tag: A unique identifier for a Data Element composed of an ordered pair of numbers (a Group Number followed by an Element Number). Sometimes the word Tag is used to indicate a Data Element Tag. Transfer Syntax: A set of encoding rules that allow Application Entities to unambiguously negotiate the encoding techniques (e.g. Data Element structure, byte ordering, compression, etc.) they are able to support, thereby allowing these Application Entities to communicate. Unique Identifier: A string of characters that uniquely identifies a wide variety of items; guaranteeing uniqueness across multiple countries, sites, vendors and equipment. Security Profile: A set of mechanisms, such as encryption, user authentication, or digital signatures, used by an Application Entity to ensure confidentiality, integrity, and/or availability of exchanged DICOM data. Service Class User: The role played by a DICOM Application Entity which invokes operations and performs notifications on a specific Association. Service Class Provider: The role played by a DICOM Application Entity which performs operations and invokes notifications on a specific Association. Service Class: A collection of SOP Classes which are related in that they are described together to accomplish a single application. Service-Object Pair (SOP) Class: The union of a specific set of DIMSE Services and one related Information Object Definition (as specified by a Service Class Definition) which completely defines a precise context for communication. Service-Object (SOP) Instance: A concrete occurrence of an Information Object and a communication context. The word Instance is sometimes used to indicate an SOP Instance. This Conformance Statement sometimes uses the abbreviation IOD to indicate an SOP Instance. Presentation Context: A specific SOP Class and a list of Transfer Syntaxes supported by an Application Entity for that SOP Class. ACR: American College of Radiology AE: Application Entity AES: Advanced Encryption Standard AET: Application Entity Title ASCII: American Standard Code for Information Interchange

15 CBC: Cipher Block Chaining DES: Data Encryption Standard DHCP: Dynamic Host Configuration Protocol DICOM: Digital Imaging and Communications in Medicine DIMSE: DICOM Message Service Element DMWL: DICOM Modality Worklist DNS: Domain Name System EDE: Encrypt-Decrypt-Encrypt HIS: Hospital Information System HL7: Health Level 7 Standard IEEE: Institute of Electrical and Electronics Engineers IETF: Internet Engineering Task Force IHE: Integrating the Healthcare Enterprise IOD: Information Object Definition IPv4: Internet Protocol version 4 IPv6: Internet Protocol version 6 JPEG: Joint Photographic Experts Group LDAP: Lightweight Directory Access Protocol MPEG: Motion Picture Experts Group MPPS: Modality Performed Procedure Step MWL: Modality Worklist NEMA: National Electrical Manufacturers Association PACS: Picture Archiving and Communication System PDU: Protocol Data Unit RAID: Redundant Array of Independent Disks RIDS: Retrieve Information for Display RLE: Run Length Encoding RFC: Request For Comment (used by standards issued by the IETF) RSA: Rivest-Shamir-Adleman RSNA: Radiological Society of North America SCP: Service Class Provider : Service Class User SHA: Secure Hash Algorithm SOP: Service Object Pair SSH: Secure Shell SSL: Secure Sockets Layer TCP/IP: Transmission Control Program/Internet Protocol TLS: Transport Layer Security UID: Unique Identifier VM: Value Multiplicity VR: Value Representation WADO: Web Access to DICOM Objects NTT Data, Inc. DICOM Conformance Statement Page 13

16 2.5 References NEMA PS3: Digital Imaging and Communications in Medicine (DICOM) Standard, available free at

17 3 Networking 3.1 Implementation Model for the NTT Data Unified Clinical Archive NTT Data Unified Clinical Archive Stores and Retrieves DICOM instances Application Data Flow Diagram InDex Archive MPPS Request N-CREATE N-SET Order Filler UCA Data Center Send IOD File to Data Center indexxmit InDex Application RAID Queue IOD File to be sent to Data Center Verification Request C-ECHO Modality Write IOD to disk Request C-STORE indexstore DICOM AE Medical Scanner or PACS or Workstation or Modality Enter IOD info into database Commitment Request N-ACTION Database Queue IOD File to forward to other InDex Archive Queue IOD to forward to other DICOM SSCP Commitment Results N-EVENT UCA Data Center Send IOD File to other InDex Archive indexxmit InDex Application indexpush indexforward DICOM AE Request C-STORE DICOM Display or PACS Figure NTT Data Unified Clinical Archive Implementation Model NTT Data, Inc. DICOM Conformance Statement Page 15

18 InDex Archive RAID Verification Request C-ECHO Database Acquire local IOD Files Query Request C-FIND Retrieve Request C-MOVE C-GET Look up in database indexquery DICOM AE DICOM Display Or PACS Request C-STORE Request non-local IOD Files Acquire non-local IOD Files Acquire requested IOD Files DMWL Query C-FIND Modality Worklist Server UCA Data Center Receive IOD Files from Data Center jbreceive InDex Application isowado.php InDex Application WADO Request WADO Client Figure NTT Data Unified Clinical Archive Query/Retrieve Implementation Model A Remote AE (e.g. a modality such as a CT or a workstation) sends one or more IOD Store Requests (usually a Study) to the indexstore AE. The indexstore AE stores the IOD on its local RAID/SAN and adds an entry to its Database for each IOD. This Database is used by the indexquery AE. In the background, the NTT Data Unified Clinical Archive will forward IOD s to one of UCA remote Data Centers where they will be transferred to long term storage for near term retrieval by the indexquery AE. When the indexstore AE receives IOD s it can forward them to other Remote AE s based on configuration parameters using the indexpush AE or indexforward AE. The Remote AE can send Commitment Requests of those IOD s to the indexstore AE. The indexstore AE will wait for the IOD s to arrive at an UCA Data Center before it takes action on

19 the Commit request. The indexstore AE will then send the results of the Commit Request back to the requesting Remote AE. A Modality can send MPPS messages to the indexstore AE, which will forward the messages to an Order Filler. After IOD s have been received and entered into the Database, an AE can send a Query/Retrieve Request to the indexquery AE to examine these IOD s. If the AE requests retrieval of IOD s, the indexquery AE retrieves those IOD s, either locally or from a- UCA Data Center, and sends them to the specified Destination AE in the case of a C-MOVE-RQ or to the requesting AE in the case of a C-GET-RQ using its DICOM Service. The indexquery AE can be configured to send Modality Worklist Queries to a Modality Worklist Server. Any Remote AE can verify the operational readiness and capabilities of either the indexstore AE or the indexquery AE by using their DICOM Verification Services Functional Definitions of Application Entities The NTT Data Unified Clinical Archive has four Application Entities (AE s) which act as a Service Class Provider and User, a Commitment Provider, a Procedure Step SOP Class Provider and User, a Basic Worklist Management Service Class User and a Query/Retrieval Provider indexstore Application Entity The indexstore AE provides the, Commitment, Procedure Step SOP Class and Verification DICOM Services indexpush/indexforward Application Entity The indexpush/indexforward AE use Services to forward IOD s to Remote AE s (e.g. display stations and workstations) based on the configuration information. The indexpush AE does not guarantee delivery; whereas, the indexforward AE does guarantee delivery indexquery Application Entity The indexquery AE provides the Query/Retrieval, Basic Worklist Management and Verification DICOM Services to find Patients, Studies, Series and Instances in the NTT Data Unified Clinical Archive Database and forward the requested IOD s to a Destination AE or the requesting AE using the DICOM Service Sequence of Real World Activities A Commitment Request can be sent on the same Association as the Store Request or later on a separate association. The indexstore AE will not send a Response to a Commitment Request until the requested IOD s are sent to a UCA Data Center. This normally will occur within a few hours but could take an extended period of time depending on configuration. The N-EVENT-REPORT message will be sent back on a new association. A Modality Performed Procedure Step message can be sent on the same Association as a Store Request or on a separate Association. The indexstore AE will forward the MPPS message to an Order Filler. When the indexpush AE forwards IOD s to another Remote AE there is a configurable limit on the number of times it will try sending the IOD s. As a result, there is no guaranteed delivery of these forwarded IOD s. When the indexforward AE forwards IOD s to another Remote AE the delivery is guaranteed. The indexforward AE will periodically retry sending any IOD s until it succeeds. The option of whether to use the indexpush AE or the indexforward AE to forward IOD s is configurable by Destination AE. NTT Data, Inc. DICOM Conformance Statement Page 17

20 A Query/Retrieve Request cannot retrieve a Study until after it has been entered in the Database which occurs sometime after the Originating AE sends the study and the Association is released. The indexquery AE can send Modality Worklist queries to a Modality Worklist Server. A WADO Client can send a request through the isowado.php to the indexquery AE. The indexquery AE will acquire the requested IOD files and the isowado.php will return the requested objects to the WADO Client. 3.2 Application Entity Specifications indexstore Application Entity Specification SOP Classes The indexstore AE provides standard conformance to the DICOM V3.0 SOP Classes listed in Table as an SCP. See DICOM v3.0 PS 3.4 Appendices A, B, F and J for detailed specifications of the Verification,, Procedure Step SOP Class and Commitment Services. Table SOP Classes Supported by the indexstore AE SOP Class Name SOP Class UID SCP Verification No Yes Commitment Push Model No Yes Modality Performed Procedure Step No Yes Computed Radiography Image No Yes Digital X-Ray Image - For Presentation Digital X-Ray Image - For Processing No Yes No Yes Digital Mammography Image - For No Yes Presentation Digital Mammography Image - For No Yes Processing Digital Intra-oral X-Ray Image - For Presentation Digital Intra-oral X-Ray Image - For Processing No Yes No Yes

21 Table SOP Classes Supported by the indexstore AE SOP Class Name SOP Class UID SCP CT Image No Yes Enhanced CT Image Ultrasound Multi-frame Image (Retired) No Yes Ultrasound Multi-frame Image No Yes MR Image No Yes MR Enhanced Image No Yes MR Spectroscopy No Yes Enhanced MR Color Image No Yes Nuclear Medicine Image (Retired) No Yes Ultrasound Image (Retired) No Yes Ultrasound Image No Yes Enhanced US Volume No Yes Secondary Capture Image No Yes Multi-frame Single Bit Secondary Capture Image Multi-frame Grayscale Byte Secondary Capture Image Multi-frame Grayscale Word Secondary Capture Image No Yes No Yes No Yes Multi-frame True Color Secondary Capture No Yes Image Standalone Overlay No Yes Standalone Curve No Yes 12-Lead ECG Waveform No Yes General ECG Waveform No Yes Ambulatory ECG Waveform No Yes Hemodynamic Waveform No Yes Cardiac Electrophysiology Waveform No Yes Basic Voice Audio Waveform No Yes General Audio Waveform No Yes Arterial Pulse Waveform No Yes Respiratory Waveform No Yes Grayscale Softcopy Presentation State No Yes Color Softcopy Presentation State No Yes Pseudo Color Softcopy Presentation State Blending Softcopy Presentation State XA/XRF Grayscale Softcopy Presentation State No Yes No Yes No Yes X-Ray Angiographic Image No Yes NTT Data, Inc. DICOM Conformance Statement Page 19

22 Table SOP Classes Supported by the indexstore AE SOP Class Name SOP Class UID SCP Enhanced XA Image No Yes X-Ray Radiofluoroscopic Image No Yes Enhanced XRF Image No Yes X-Ray Angiographic Bi-plane Image (Retired) No Yes 3D X-Ray Angiographic Image No Yes X Ray 3D Craniofacial Image No Yes Breast Tomosynthesis Image No Yes Intravascular Optical Coherence Tomography Image For Presentation Intravascular Optical Coherence Tomography Image For Processing No Yes No Yes Nuclear Medicine Image No Yes Raw Data No Yes Spatial Registration No Yes Spatial Fiducials No Yes Deformable Spatial Registration No Yes Segmentation No Yes Surface Segmentation No Yes Real World Value Mapping No Yes Surface Scan Mesh No Yes Surface Scan Point Cloud No Yes VL Endoscopic Image No Yes Video Endoscopic Image No Yes VL Microscopic Image No Yes Video Microscopic Image No Yes VL Slide-Coordinates Microscopic Image No Yes VL Photographic Image No Yes

23 Table SOP Classes Supported by the indexstore AE SOP Class Name SOP Class UID SCP Video Photographic Image No Yes Ophthalmic Photography 8 Bit Image Ophthalmic Photography 16 Bit Image No Yes No Yes Stereometric Relationship No Yes Ophthalmic Tomography Image No Yes VL Whole Slide Microscopic Image No Yes Lensometry Measurements No Yes Autorefraction Measurements No Yes Keratometry Measurements No Yes Subjective Refraction Measurements No Yes Visual Acuity Measurements No Yes Spectacle Prescription Report No Yes Ophthalmic Axial Measurements No Yes Intraocular Lens Calculations No Yes Macular Grid Thickness and Volume Report Ophthalmic Visual Field Static Perimetry Measurements No Yes No Yes Ophthalmic Thickness Map No Yes SR Comprehensive Draft (Retired) No Yes Basic Text SR No Yes Enhanced SR No Yes Comprehensive SR No Yes Procedure Log No Yes Mammography CAD SR No Yes Key Object Selection Documentation No Yes Chest CAD SR No Yes X-Ray Radiation Dose SR No Yes Colon CAD SR No Yes Implantation Plan SR No Yes Encapsulated PDF No Yes Encapsulated CDA No Yes Positron Emission Tomography Image No Yes Basic Structured Display No Yes RT Image No Yes RT Dose No Yes RT Structure Set No Yes RT Beams Treatment Record No Yes NTT Data, Inc. DICOM Conformance Statement Page 21

24 Table SOP Classes Supported by the indexstore AE SOP Class Name SOP Class UID SCP RT Plan No Yes RT Brachy Treatment Record No Yes RT Treatment Summary Record No Yes RT Ion Plan No Yes RT Ion Beams Treatment Record No Yes The indexstore AE provides standard conformance to the Private SOP Classes listed in Table as an SCP Table Private SOP Classes Supported by the indexstore AE SOP Class Name SOP Class UID SCP Practice Builder Report Text No Yes Practice Builder Report Dictation No Yes GE Private CT Image No Yes GE Private Display Image No Yes GE Private MR Image No Yes GE Private 3D Model No Yes GE Private Nuclear Medicine No Yes Philips Private Specialized X-Ray Image No Yes Philips Private 3D Presentation State No Yes Philips Private Gyroscan MR Series Data No Yes Siemens Private Syngo CSA Non-Image No Yes

25 Association Policies General The maximum number of Presentation Contexts which can be offered is 128. The maximum PDU length offered/accepted is configurable. The default is bytes. The DICOM standard application context name for DICOM 3.0 is always proposed: Table DICOM Application Context for indexstore AE Application Context Name Number of Associations The indexstore AE supports multiple Associations at one time. The limit is based on the size of the NTT Data Unified Clinical Archive and how many Associations the indexquery AE has opened. This limit is typically 25 on a small NTT Data Unified Clinical Archive Configuration. The indexstore AE is limited to 5 pending Association Requests. Once an Association is negotiated and accepted it is no longer pending and not counted in this limit. Table Number of Association Accepted for indexstore AE Maximum number of simultaneous connections 25 Table Number of Association Initiated by indexstore AE Maximum number of simultaneous connections Asynchronous Nature The indexstore AE does not support asynchronous operations and will not perform asynchronous window negotiation Implementation Identifying Information Table DICOM Implementation Class and Version for indexstore AE Implementation Class UID Implementation Version Name x.x indexstore x.x.x NTT Data, Inc. DICOM Conformance Statement Page 23

26 Association Initiation Policy Commitment Results are Available Description and Sequencing of Activities When all the DICOM Files referenced by a pending Commit Request have been forwarded to a UCA Data Center or found not to exist, a response to the Commit Request is formulated and the indexstore AE attempts to send an N-EVENT-REPORT to the requesting Remote AE on a new association. If it is unable to send the results to the Remote AE, it will periodically retry to initiate the Association. It will give up after 60 days (or some other limit as configured) Proposed Presentation Contexts Table Proposed Presentation Contexts for Commitment SOP Class Abstract Syntax Transfer Syntax Role Ext. Neg. Commitment Push Model Implicit VR Little Endian SCP Explicit VR Little Endian Conformance to Commitment Push Model SOP Class (SCP) Although the indexstore AE is initiating the Association, it uses Role Negotiation to indicate that it is the Provider (SCP) and not the User (). The results of a Commitment Request will always be sent on a separate Association and not on an Association initiated by a Commitment. The Media File Set ID attributes (0008,1150) and (0008,1155) are not supported. The Retrieve AE attribute (0008,0054) is not supported. See Section (Association Acceptance Policy) for the remaining conformance issues.

27 If the indexstore AE is unable to connect to the Originating AE then the indexstore AE will periodically retry to connect to the Originating AE for up to 60 days (a configurable limit). If an error status is given in the N-EVENT-REPORT-RSP, this error will be logged and no attempt will be made to resend the transaction. This is usually caused by an expired Transaction UID. The only Failure Reason (0008,1197) ever given by the indexstore AE is 0112H (No Such Object Instance) which indicates the requested SOP Instance UID was not in the NTT Data Unified Clinical Archive Database and thus never successfully received by the indexstore AE. The recommended action is to resend the IOD with that SOP Instance UID. The indexstore AE does not verify that the SOP class corresponds to the SOP Instance UID (Failure Reason 0119H). A duplicate Transaction UID is reported when the N-ACTION-RQ is sent with an N-ACTION-RSP error status of 0210H (Duplicate Invocation) rather than as failure reason 0131H (Duplicate Transaction UID) Forwarding is Specified for the Originating AE Associated Real World Activity The indexstore AE will initiate an instance of the indexpush AE or indexforward AE to forward the IOD s received from the Originating AE to a Destination AE, as configured. The indexpush AE may be initiated with a retry option based on configuration parameters. If the retry option is present then the indexpush AE will repeatedly try to send the IOD s for the configured number of times (see Section indexpush Application Entity Specifications). If the indexforward AE instead of the indexpush AE is used for forwarding to the given Destination AE, then the indexforward AE will periodically retry sending any IOD until it succeeds, guaranteeing delivery. The IOD s forwarded may be for one or more studies but will be for only one patient. There is no guarantee that the IOD s represent a complete study or that they will be delivered in any particular order Forwarding Modality Performed Procedure Step (MPPS) Requests Associated Real World Activity When the indexstore AE receives an MPPS Request it will attempt to forward the request to an Order Filler. If indexstore AE is unable to forward the MPPS Request, it will periodically retry to initiate the Association. It will give up after 15 days (or some other limit as configured) Proposed Presentation Contexts Table Proposed Presentation Contexts for MPPS SOP Class Abstract Syntax Transfer Syntax Role Ext. Neg. Modality Performed Procedure Step Implicit VR Little Endian Explicit VR Little Endian NTT Data, Inc. DICOM Conformance Statement Page 25

28 Association Acceptance Policy Remote AE Sends a Verification Request Associated Real World Activity A Remote AE sends a Verification Request (C-ECHO-RQ) to the indexstore AE which always responds with a status of zero (0) Accepted Presentation Context Table Acceptable Presentation Contexts for indexstore and Verification Request Abstract Syntax Transfer Syntax Role Ext. Neg. Verification Implicit VR Little Endian SCP Explicit VR Little Endian The indexstore AE will accept any Presentation Context for the Verification SOP Class which proposes Explicit VR Little Endian or Implicit VR Little Endian as a Transfer Syntax. Any other Presentation Contexts for the Verification SOP Class will be rejected. If more than one Presentation Context is accepted, the can choose which Presentation Context to use. The indexstore AE will give preference to JPEG Lossless over JPEG 2000 Lossless for a compressed Transfer Syntax and Explicit VR Little Endian over Implicit VR Little Endian for an uncompressed Transfer Syntax Conformance to Verification SOP Class (SCP) The Verification Service conforms to the DICOM V3.0 Standard. Table Verification Response Status

29 Service Status Further Meaning Error Code Reason Success Success 0 The status in a C-ECHO-RSP is always 0 (success) Remote AE sends an IOD Store Request Associated Real World Activity A Remote AE () sends a DICOM Store Request (C-STORE-RQ) to the indexstore AE for one or more IOD s (e.g. SOP Instances). Usually all the IOD s sent in one Association are for a single study, but this is not a requirement. If the IOD is sent using an accepted encoding (e.g. JPEG Lossless, RLE, etc.) then the IOD will be stored unchanged using that encoding. If the IOD is sent uncompressed then it is compressed using JPEG-LS. The indexstore AE stores the object in a DICOM compatible file which is encapsulated in a non-dicom encryption layer along with non- DICOM MD5 signatures on a local RAID/SAN. A success is reported to the Remote AE if the IOD is successfully stored. The Remote AE can also send Commit Requests on the same Association. After the Remote AE has sent all the IOD s and released the connection, or after an IOD has arrived with a new Patient Name, then the received IOD s are added to the Database on the NTT Data Unified Clinical Archive. A duplicate policy is applied to any IOD which has an SOP Instance UID that already exists in the Database. A configuration parameter determines the duplicate policy and can be set the following ways: 1 If the IOD is a byte-for-byte exact copy of an existing IOD with the same SOP Instance UID then it is discarded. Otherwise the new IOD is added to the Database, replacing all previous IOD s that have the same SOP Instance UID. This is the default. 2 Keeps the first IOD received and discards any subsequent IOD s with the same SOP Instance UID. 3 The new IOD is added to the Database, replacing all previous IOD s that have the same SOP Instance UID. After the IOD s have been added to the Database, they are queued to be copied to a UCA Data Center. The IOD s are sent encrypted and in a manner which guarantees reliable and accurate delivery. This process is non-dicom and beyond the scope of this document. At a UCA Data Center, the IOD s are staged on a RAID/SAN before being copied to permanent storage for remote access by the indexquery AE. Two separate permanent copies of the IOD are made. All copies are encrypted. The NTT Data Unified Clinical Archive can be configured to indicate that any IOD received from a given Remote AE (by AE Title) is to be forwarded to one or more other Remote AE s. In this case the indexstore AE will schedule this delivery. See the Association Initiation section for indexstore and the indexpush/indexforward AE section for further details of this process. The NTT Data Unified Clinical Archive can also be configured to forward IOD s to other NTT Data Unified Clinical Archives at the same site or other sites. In this case the indexstore AE queues the IOD s for forwarding to these remote NTT Data Unified Clinical Archives. This forwarding process send IOD s in an encrypted format and in a manner which guarantees reliable and accurate delivery. This process is non-dicom and beyond the scope of this document Accepted Presentation Contexts The Presentation Contexts listed below represent the supported Presentation Contexts. The default Presentation Contexts may differ and can be configured. NTT Data, Inc. DICOM Conformance Statement Page 27

30 Table Acceptable Presentation Contexts for indexstore and Store Request Abstract Syntax Transfer Syntax Role Ext. SOP Class Name SOP Class UID (See Reference Key in Table ) Neg. Computed Radiography Image L,J2KLL,LE,LI SCP Digital X-Ray Image - For Presentation Digital X-Ray Image - For Processing Digital Mammography Image - For Presentation Digital Mammography Image - For Processing L,J2KLL,LE,LI, L,J2KLL,LE,LI, L,J2KLL,LE,LI, J12, L,J2KLL,LE,LI, Digital Intra-oral X-Ray Image L,J2KLL,LE,LI, For Presentation Digital Intra-oral X-Ray Image L,J2KLL,LE,LI, For Processing CT Image L,J2KLL,LE,LI, J2KLY,J12 SCP SCP SCP SCP SCP SCP SCP Enhanced CT Image LE,LI SCP Ultrasound Multi-frame Image (Retired) L,J2KLL,LE,LI, Ultrasound Multi-frame Image L,J2KLL,LE,LI,,J12 MR Image L,J2KLL,LE,LI, J12,J2KLY SCP SCP SCP MR Enhanced Image L,J2KLL,LE,LI SCP MR Spectroscopy Image LE,LI SCP Enhanced MR Color Image LE,LI SCP Nuclear Medicine Image (Retired) L,J2KLL,LE,LI, Ultrasound Image (Retired) L,J2KLL,LE,LI, SCP SCP

31 Table Acceptable Presentation Contexts for indexstore and Store Request Abstract Syntax Transfer Syntax Role Ext. SOP Class Name SOP Class UID (See Reference Key in Table ) Neg. Ultrasound Image L,J2KLL,LE,LI, NTT Data, Inc. DICOM Conformance Statement Page 29 SCP Enhanced US Volume LE,LI SCP Secondary Capture Image J,L,J2KLL,LE,LI, J12,J2KLY,R Multi-frame Single Bit Secondary Capture Image Multi-frame Grayscale Byte Secondary Capture Image Multi-frame Grayscale Word Secondary Capture Image Multi-frame True Color Secondary Capture Image SCP L,J2KLL,LE,LI,R SCP L,J2KLL,LE,LI, SCP L,J2KLL,LE,LI,R SCP L,J2KLL,LE,LI,R SCP Standalone Overlay LE,LI SCP Standalone Curve LE,LI SCP 12-Lead ECG Waveform LE,LI SCP General ECG Waveform LE,LI SCP Ambulatory ECG Waveform LE,LI SCP Hemodynamic Waveform LE,LI SCP Cardiac Electrophysiology Waveform LE,LI SCP Basic Voice Audio Waveform LE,LI SCP General Audio Waveform LE,LI SCP Arterial Pulse Waveform LE,LI SCP Respiratory Waveform LE,LI SCP Grayscale Softcopy Presentation State Color Softcopy Presentation State Pseudo Color Softcopy Presentation State Blending Softcopy Presentation State XA/XRF Grayscale Softcopy Presentation State LE,LI SCP LE,LI, L,J2KLL,J2KLY SCP LE,LI SCP LE,LI SCP LE,LI SCP X-Ray Angiographic Image L,J2KLL,LE,LI, SCP Enhanced XA Image LE,LI SCP X-Ray Radiofluoroscopic Image L,J2KLL,LE,LI, Enhanced XRF Image LE,LI SCP SCP