DICOM Conformance Statement

Transcription

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2 1. CONFORMANCE STATEMENT OVERVIEW A table of Supported Networking DICOM Service (SOP) Classes is provided with roles (User/Provider), organized in 4 categories: Query/Retrieve Workflow Management Print Management Table 1-1 Network Services SOP Classes User of Service (SCU) Provider of Service (SCP) Service Class Computed Radiography Image Digital X-Ray Image For Presentation Digital X-Ray Image For Processing Digital Mammography X-Ray Image For Presentation Digital Mammography X-Ray Image For Processing Digital Intra-oral X-Ray Image For Presentation Digital Intra-oral X-Ray Image For Processing CT Image Enhanced CT Image Ultrasound Multi-frame Image MR Image Enhanced MR Image Page 2 of 74

3 SOP Classes User of Service (SCU) Provider of Service (SCP) MR Spectroscopy Enhanced MR Color Image SOP Class US Image Enhanced US Volume Secondary Capture Image 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 12-lead ECG Waveform General ECG Waveform Ambulatory ECG Waveform Hemodynamic Waveform Cardiac Electrophysiology Waveform Basic Voice Audio Waveform General Audio Waveform Arterial Pulse Waveform Respiratory Waveform Page 3 of 74

4 SOP Classes User of Service (SCU) Provider of Service (SCP) Grayscale Softcopy Presentation State SOP Class Color Softcopy Presentation State SOP Class Pseudo-Color Softcopy Presentation State SOP Class Blending Softcopy Presentation State SOP Class XA/XRF Grayscale Softcopy Presentation State X-Ray Angiographic Image Enhanced XA Image X-Ray Radiofluoroscopic Image Enhanced XRF Image X-Ray 3D Angiographic Image X-Ray 3D Craniofacial Image Breast Tomosynthesis Image Intravascular Optical Coherence Tomography Image For Presentation Intravascular Optical Coherence Tomography Image For Processing Nuclear Medicine Image Page 4 of 74

5 SOP Classes User of Service (SCU) Provider of Service (SCP) Raw Data Spatial Registration Spatial Fiducials Deformable Spatial Registration SOP Class Segmentation SOP Class Surface Segmentation Real World Value Mapping VL Endoscopic Image Video Endoscopic Image VL Microscopic Image Video Microscopic Image VL Slide-Coordinates Microscopic Image VL Photographic Image Video Photographic Image Ophthalmic Photography 8 Bit Image Ophthalmic Photography 16 Bit Image Stereometric Relationship Ophthalmic Tomography Image VL Whole Slide Microscopy Image Positron Emission Tomography Image Page 5 of 74

6 SOP Classes User of Service (SCU) Provider of Service (SCP) Enhanced PET Image Basic Structured Display RT Image RT Dose RT Structure Set RT Beams Treatment Record RT Plan RT Brachy Treatment Record RT Treatment Summary Record RT Beams Delivery Instruction Color Palette Private Medweb Analyze 75 Patient Root Information Model - FIND Patient Root Information Model - MOVE Study Root Information Model - FIND Study Root Information Model - MOVE Patient/Study Information Model - FIND Patient/Study Information Model - MOVE Query/Retrieve Notes, Reports, Measurements Basic Text SR Enhanced SR Comprehensive SR Page 6 of 74

7 SOP Classes User of Service (SCU) Provider of Service (SCP) Procedure Log Mammography CAD SR Key Object Selection Document Chest CAD SR X-Ray Radiation Dose SR Colon CAD SR Implantation Plan SR Document Encapsulated PDF SOP Class Encapsulated CDA SOP Class Lensometry Measurements Autorefraction Measurements Keratometry Measurements Subjective Refraction Measurements Visual Acuity Measurements Spectacle Prescription Report Ophthalmic Axial Measurements Intraocular Lens Calculations Macular Grid Thickness and Volume Report SOP Class Ophthalmic Visual Field Static Perimetry Measurements Generic Implant Template Page 7 of 74

8 SOP Classes User of Service (SCU) Provider of Service (SCP) Implant Assembly Template Implant Template Group Comprehensive SR, and specializations Commitment Push Model SOP Class Detached Results Management Meta SOP Class Detached Results Management SOP Class Detached Interpretation Management SOP Class Modality Worklist Information Model-FIND General Purpose Worklist Information Model - FIND Modality Performed Procedure Step Mitra Report Information Model FIND Workflow Management Page 8 of 74 No No No No No No No Private Worklist Management Print management Basic Film Session SOP Class No Basic Film Box SOP Class No Basic Grayscale Image Box SOP Class Basic Color Image Box SOP Class Basic Grayscale Print Management Meta SOP Class Print Job SOP Class No Basic Annotation Box SOP Class No No No No

9 SOP Classes User of Service (SCU) Provider of Service (SCP) Printer SOP Class No Printer Configuration Retrieval SOP Class Basic Color Print Management Meta SOP Class Presentation LUT SOP Class No Basic Print Image Overlay Box SOP Class Media Creation Management SOP Class UID No No No No Note: Verification SCP (C-Echo) is not included in the table above because it is required for any Acceptor of an Association. The Verification SCU details are covered in the details of the conformance statement. The SOP Classes are categorized as follows: Table A.1-2 UID VALUES UID Value UID NAME Category Commitment Push Model SOP Class Workflow Management Procedural Event Logging SOP Class Workflow Management Substance Administration Logging Workflow Management Modality Performed Procedure Step SOP Class Modality Performed Procedure Step Retrieve SOP Class Modality Performed Procedure Step Notification SOP Class Workflow Management Workflow Management Workflow Management Service Class Basic Film Session SOP Class Print Management Basic Film Box SOP Class Print Management Page 9 of 74

10 UID Value UID NAME Category Basic Grayscale Image Box SOP Class Print Management Basic Color Image Box SOP Class Print Management Basic Grayscale Print Management Meta SOP Class Page 10 of 74 Print Management Print Job SOP Class Print Management Basic Annotation Box SOP Class Print Management Printer SOP Class Print Management Printer Configuration Retrieval SOP Class Basic Color Print Management Meta SOP Class Print Management Print Management Presentation LUT SOP Class Print Management Basic Print Image Overlay Box SOP Class Media Creation Management SOP Class UID Computed Radiography Image Digital X-Ray Image For Presentation Digital X-Ray Image For Processing Digital Mammography X-Ray Image For Presentation Digital Mammography X-Ray Image For Processing Digital Intra-oral X-Ray Image For Presentation Digital Intra-oral X-Ray Image For Processing Print Management Print Management

11 UID Value UID NAME Category CT Image Enhanced CT Image Ultrasound Multi-frame Image Page 11 of MR Image Enhanced MR Image MR Spectroscopy Enhanced MR Color Image SOP Class Ultrasound Image Enhanced US Volume Secondary Capture Image 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 lead ECG Waveform General ECG Waveform Ambulatory ECG Waveform Hemodynamic Waveform Cardiac Electrophysiology Waveform Basic Voice Audio Waveform General Audio Waveform Arterial Pulse Waveform Respiratory Waveform Grayscale Softcopy Presentation State SOP Class Color Softcopy Presentation State SOP Class

12 UID Value UID NAME Category Pseudo-Color Softcopy Presentation State SOP Class Blending Softcopy Presentation State SOP Class XA/XRF Grayscale Softcopy Presentation State Page 12 of X-Ray Angiographic Image Enhanced XA Image X-Ray Radiofluoroscopic Image Enhanced XRF Image X-Ray 3D Angiographic Image X-Ray 3D Craniofacial Image Breast Tomosynthesis Image Intravascular Optical Coherence Tomography Image For Presentation Intravascular Optical Coherence Tomography Image For Processing Nuclear Medicine Image Raw Data Spatial Registration Spatial Fiducials Deformable Spatial Registration SOP Class Segmentation SOP Class Surface Segmentation Real World Value Mapping VL Endoscopic Image Video Endoscopic Image VL Microscopic Image Video Microscopic Image

13 UID Value UID NAME Category VL Slide-Coordinates Microscopic Image VL Photographic Image Video Photographic Image Ophthalmic Photography 8 Bit Image Ophthalmic Photography 16 Bit Image Stereometric Relationship Ophthalmic Tomography Image VL Whole Slide Microscopy Image Lensometry Measurements Autorefraction Measurements Keratometry Measurements Subjective Refraction Measurements Visual Acuity Measurements Spectacle Prescription Report Ophthalmic Axial Measurements Intraocular Lens Calculations Macular Grid Thickness and Volume Report SOP Class Ophthalmic Visual Field Static Perimetry Measurements Basic Text SR Enhanced SR Comprehensive SR Procedure Log Mammography CAD SR Page 13 of 74

14 UID Value UID NAME Category Key Object Selection Document Chest CAD SR X-Ray Radiation Dose SR Colon CAD SR Implantation Plan SR Document Page 14 of Encapsulated PDF SOP Class Encapsulated CDA SOP Class Positron Emission Tomography Image Enhanced PET Image Basic Structured Display RT Image RT Dose RT Structure Set RT Beams Treatment Record RT Plan RT Brachy Treatment Record RT Treatment Summary Record Patient Root Query/Retrieve Information Model FIND Patient Root Query/Retrieve Information Model MOVE Patient Root Query/Retrieve Information Model GET Study Root Query/Retrieve Information Model FIND Study Root Query/Retrieve Information Model MOVE Study Root Query/Retrieve Information Model GET Composite Instance Root Retrieve MOVE Query/Retrieve Query/Retrieve Query/Retrieve Query/Retrieve Query/Retrieve Query/Retrieve Query/Retrieve

15 UID Value UID NAME Category Composite Instance Root Retrieve GET Composite Instance Retrieve Without Bulk Data GET Modality Worklist Information Model FIND General Purpose Worklist Information Model FIND General Purpose Scheduled Procedure Step SOP Class General Purpose Performed Procedure Step SOP Class General Purpose Worklist Management Meta SOP Class Instance Availability Notification SOP Class Unified Procedure Step Push SOP Class Unified Procedure Step Watch SOP Class Unified Procedure Step Pull SOP Class Unified Procedure Step Event SOP Class RT Beams Delivery Instruction RT Conventional Machine Verification Page 15 of 74 Query/Retrieve Query/Retrieve Workflow Management Workflow Management Workflow Management Workflow Management Workflow Management Workflow Management Workflow Management Workflow Management Workflow Management Workflow Management Workflow Management RT Ion Machine Verification Workflow Management General Relevant Patient Information Query Breast Imaging Relevant Patient Information Query Cardiac Relevant Patient Information Query Query/Retrieve Query/Retrieve Query/Retrieve

16 UID Value UID NAME Category Hanging Protocol Hanging Protocol Information Model FIND Hanging Protocol Information Model MOVE Query/Retrieve Query/Retrieve Color Palette Color Palette Information Model FIND Color Palette Information Model MOVE Query/Retrieve Query/Retrieve Color Palette Information Model GET Query/Retrieve Product Characteristics Query Query/Retrieve Substance Approval Query Query/Retrieve Generic Implant Template Generic Implant Template Information Model FIND Generic Implant Template Information Model MOVE Generic Implant Template Information Model GET Page 16 of 74 Query / Retrieve Query / Retrieve Query / Retrieve Implant Assembly Template Implant Assembly Template Information Model FIND Implant Assembly Template Information Model MOVE Implant Assembly Template Information Model GET Query / Retrieve Query / Retrieve Query / Retrieve Implant Template Group Implant Template Group Information Model FIND Implant Template Group Information Model MOVE Implant Template Group Information Model GET Query / Retrieve Query / Retrieve Query / Retrieve

17 UID Value UID NAME Category Private SOP Classes Mitra Report Information Model FIND Workflow Management Medweb Analyze Dcm4che Encapsulated Document Table 1-2 of Supported Media Application Profiles (with roles) is provided, organized in 3 categories: Compact Disk - Recordable Magneto-Optical Disk DVD Media Application Profile Compact Disk - Recordable Table 1-2 Media Services Write Files (FSC or FSU) Read Files (FSR) General Purpose CD-R Option Magneto-Optical Disk DVD General Purpose DVD-ROM Option Page 17 of 74

18 Table Of Contents 1. CONFORMANCE STATEMENT OVERVIEW INTRODUCTION REVISION HISTORY AUDIENCE REMARKS TERMS AND DEFINITIONS BASICS OF DICOM COMMUNICATION ABBREVIATIONS REFERENCES NETWORKING IMPLEMENTATION MODEL Application Data Flow Functional Definition of AE s Functional Definition of Application Entity SCP Functional Definition of Application Entity Modality Worklist SCP Functional Definition of Application Entity Modality Performed Procedure Step SCP Functional Definition of Application Entity DICOM Q/R SCP Functional Definition of Application Commitment SCP Functional Definition of Application Entity Print SCU Functional Definition of Application Entity Detached Management SCP Sequencing of Real World Activities Verification AE SPECIFICATIONS: AE Specification: -SCP, Commitment SCP, Query/Retrieve-SCP and -SCU SOP Classes Association Policies Association Initiation Policy Association Acceptance Policy Modality Worklist Server Application Entity SOP Classes Real-World Activity Results Management Associated Real-World Activity Results Management Print SCU Application Entity Sequencing of Real World Activities Association Establishment Policies NETWORK INTERFACES TCP/IP Stack Physical Network Interface IPv4 and IPv6 Support EXTENSIONS/SPECIALIZATIONS/PRIVATIZATION STANDARD EXTENDED/SPECIALIZED/PRIVATE SOPS Page 18 of 74

19 Mitra s Report Information SOP Class Proposed Presentation Contexts Mitra s Report Information SOP Specific Conformance for Mitra s Report Information SOP Class CONFIGURATION SUPPORT OF EXTENDED CHARACTER SETS MEDIA EXCHANGE IMPLEMENTATION MODEL Application Data Flow Functional Definitions of AE s Sequencing of Real-World Activities MEDIA-FSR Functional Definition of Offline-Media Application Entity Sequencing of Real-World Activities AE SPECIFICATIONS MEDIA-FSR File Meta Information for the Application Entity Real World Activities AUGMENTED AND PRIVATE PROFILES Augmented Profiles Private Profiles File Meta Information for the Application Entity Real-World Activities AUGMENTED AND PRIVATE APPLICATION PROFILES MEDIA CONFIGURATION SECURITY SECURITY PROFILES ASSOCIATION LEVEL SECURITY USER INTERFACE SECURITY Table of Tables Table 1-1 Network Services... 2 Table 1-2 Media Services Table 3-1Acceptable presentation contexts for verification service class Table 3-2 C-Echo Response Status Handling Behavior Table 3-3SOP Classes for -SCP Table 3-4 DICOM APPLICATION CONTEXT Table 3-5 Number of Associations as an association initiator for the -SCU Page 19 of 74

20 Table 3-6 Number of Associations as an association acceptor for -SCP, Commitment SCP, Query/Retrieve-SCP Table 3-7 DICOM Implementation Class And Version For -SCP, Commitment SCP Query/Retrieve-SCP and -SCU Table 3-8 Presentation Contexts Proposed by the Medweb Server Table 3-9 Proposed presentation contexts for storage SOP classes presentation context Table 3-10 Proposed and Accepted Presentation Context Syntaxes Table 3-11 Acceptable Presentation Contexts for Medweb Server Table 3-12 C-STORE Response Status Table 3-13 Acceptable Presentation Contexts for Medweb Server Commitment Table 3-14 Commitment Response Status Table 3-15 Commitment Push Model Request (N-ACTION) Message Table 3-16 Commitment Push Model Event Report (N-EVENT-REPORT) Message. 46 Table 3-17 Acceptable Presentation Contexts for Query Retrieve SOP Classes Table 3-18 Syntax for DICOM Q/R Table 3-19 C-FIND Response Status Table 3-20 Medweb Server Find Request Attributes Table 3-21 Classes for Medweb Modality Worklist Server AE Table 3-22 DICOM application context name for Medweb Modality Worklist Server AE Table 3-23Number of Associations accepted for Medweb Modality Worklist Server AE Table 3-24 Asynchronous Nature as SCP for Medweb Modality Worklist Server AE Table 3-25 DICOM Implementation Class and Version for Medweb Modality Worklist Server AE Table 3-26 Association Rejection Reasons Table 3-27 C-Echo Response Status Handling Behavior Table 3-28Modality Worklist C-FIND SCP Supported Elements Table 3-29 Medweb Modality Worklist Server C-FIND Response Status Page 20 of 74

21 Table 3-30 Medweb Modality Worklist Server Service Communication Failure Behavior Table 3-31 Results Management Presentation Contexts Table 3-32 syntaxes for results management SOP classes Table 3-33 Results Management Status Codes Table 3-34 Detached Results Management Supported Commands and Attributes Table 3-35 Detached Interpretation Management Supported Commands and Attributes Table 3-36 Presentation Contexts Accepted by Modality Performed Procedure Step SCP Table 3-37 Modality Performed Procedure Step SOP Class N-CREATE Attributes Table 3-38 Modality Performed Procedure Step SCP Response Status Table 3-39 Modality Performed Procedure Step SOP Class N-SET Attributes Table 3-40 Modality Performed Procedure Step SCP Response Status Table 3-41Presentation Context Table 3-42 Film Session Attribute Support: Table 3-43 Film Box Attribute Support: Table 3-44 Image Box Attribute Support: Table 3-45 Printer SOP Attribute Support: Table 3-46 The annotation formats supported are: Table 4-1 Mitra s Report Information Table 4-2 Syntax Table 5-1Application Profiles, Activities, and Roles for MEDIA-FSR Table 5-2DICOM Implementation Class and Version for Media Table of Figures Figure 3-1 Application Data Flow Diagram Figure 3-2Real World Activity for Verification Figure 3-3 DICOM Verification Page 21 of 74

22 Figure 3-4 DICOM SCU Figure 3-5 DICOM SCP Figure 3-6 DICOM Commitment SCP Figure 3-7 Query/Retrieve Operation Figure 3-8 Activity Sequence for the Modality Worklist AE Figure 5-1 Implementation Model Page 22 of 74

23 2. Introduction The offers improved scheduling and workflow solutions including online eligibility-confirmation tools to enable faster patient registration and revenue reimbursement. This seamlessly integrated, single database RIS/PACS solution with diagnostic tools, reporting, storage, and direct HL7 messaging engine provides a complete and simple to use turnkey solution with: RIS/PACS single server/database solution Integrated 3D/4D Web-based viewer Multi-modality viewer including digital mammography and echo cardiograms Advanced security and image routing Patented medical image distribution with integrated tools in a Web browser PACS Real time 3D rendering tools provide the opportunity to effortlessly switch between 2D, 3D, and 4D Anywhere, anytime access for administrators, technologists, schedulers and medical transcriptionists Secure Remote Interpretation and Diagnostic Review for radiologists, referring MDs, and peer review Seamless reporting engine for ing preliminary or signed reports in HTML, PDF or plain text Sophisticated HL7 engine and interface is included with every Medweb server Fully Integrated Dictation, Voice Recognition, and Templating Burn patient studies to DVD, CD or USB key Control Worklists Based on User Login RIS Patient contact and identification information is imported into the RIS by swiping a driver s license View worklists for appointment confirmation, arrival status, escort to modality, exam status, order information, exam review, report review and billing status Real time insurance verification and validation is visible at registration by click of single button 2.1. Revision History Version Date Revision Notes V2.4 March 1, 2013 Update of conformance statement to the current template and addition of missing functionality V 2.3 April 23, 2010 Added new SOP Classes, some cleanup and new functionality definition. V2.2 February 27, 2007 New SOP Classes and transfer syntaxes added to the Page 23 of 74

24 Version Date Revision Notes document. V 2.1 July 1, 1998 Document created and substantially revised from 1995 version 2.2. Audience This document is written for the people that need to understand how Medweb Image Server (Secure DICOM Proxy Webserver) will integrate into their healthcare facility. This includes both those responsible for overall imaging network policy and architecture, as well as integrators who need to have a detailed understanding of the DICOM features of the product. This document contains some basic DICOM definitions so that any reader may understand how this product implements DICOM features. However, integrators are expected to fully understand all the DICOM terminology, how the tables in this document relate to the product s functionality, and how that functionality integrates with other devices that support compatible DICOM features Remarks The scope of this is to facilitate integration between and other DICOM products. The Conformance Statement should be read and understood in conjunction with the DICOM Standard. DICOM by itself does not guarantee interoperability. The Conformance Statement does, however, facilitate a first-level comparison for interoperability between different applications supporting compatible DICOM functionality. This Conformance Statement is not supposed to replace validation with other DICOM equipment to ensure proper exchange of intended information. In fact, the user should be aware of the following important issues: The comparison of different Conformance Statements is just the first step towards assessing interconnectivity and interoperability between the product and other DICOM conformant equipment. Test procedures should be defined and executed to validate the required level of interoperability with specific compatible DICOM equipment, as established by the healthcare facility. has participated in an industry-wide testing program sponsored by Integrating the Healthcare Enterprise (IHE). The IHE Integration Statement for Medweb Image Server (Secure DICOM Proxy Webserver), together with the IHE Technical Framework, may facilitate the process of validation testing. Page 24 of 74

25 2.4. TERMS and Definitions Informal definitions are provided for the following terms used in this Conformance Statement. The DICOM Standard is the authoritative source for formal definitons of these terms. Abstract Syntax the information agreed to be exchanged between applications, generally equivalent to a Service/Object Pair (SOP) Class. Examples : Verification SOP Class, Modality Worklist Information Model Find SOP Class, Computed Radiography Image SOP Class. Application Entity (AE) an end point of a DICOM information exchange, including the DICOM network or media interface software; i.e., the software that sends or receives DICOM information objects or messages. A single device may have multiple Application Entities. Application Entity Title the externally known name of an Application Entity, used to identify a DICOM application to other DICOM applications on the network. Application Context the specification of the type of communication used between Application Entities. Example: DICOM network protocol. Association a network communication channel set up between Application Entities. Attribute a unit of information in an object definition; a data element identified by a tag. The information may be a complex data structure (Sequence), itself composed of lower level data elements. Examples: Patient ID (0010,0020), Accession Number (0008,0050), Photometric Interpretation (0028,0004), Procedure Code Sequence (0008,1032). Information Object Definition (IOD) the specified set of Attributes that comprise a type of data object; does not represent a specific instance of the data object, but rather a class of similar data objects that have the same properties. The Attributes may be specified as Mandatory (Type 1), Required but possibly unknown (Type 2), or Optional (Type 3), and there may be conditions associated with the use of an Attribute (Types 1C and 2C). Examples: MR Image IOD, CT Image IOD, Print Job IOD. Joint Photographic Experts Group (JPEG) a set of standardized image compression techniques, available for use by DICOM applications. Media Application Profile the specification of DICOM information objects and encoding exchanged on removable media (e.g., CDs) Module a set of Attributes within an Information Object Definition that are logically related to each other. Example: Patient Module includes Patient Name, Patient ID, Patient Birth Date, and Patient Sex. Negotiation first phase of Association establishment that allows Application Entities to agree on the types of data to be exchanged and how that data will be encoded. Page 25 of 74

26 Presentation Context the set of DICOM network services used over an Association, as negotiated between Application Entities; includes Abstract Syntaxes and Syntaxes. Protocol Data Unit (PDU) a packet (piece) of a DICOM message sent across the network. Devices must specify the maximum size packet they can receive for DICOM messages. 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 Provider (SCP) role of an Application Entity that provides a DICOM network service; typically, a server that performs operations requested by another Application Entity (Service Class User). Examples: Picture Archiving and Communication System (image storage SCP, and image query/retrieve SCP), Radiology Information System (modality worklist SCP). Service Class User (SCU) role of an Application Entity that uses a DICOM network service; typically, a client. Examples: imaging modality (image storage SCU, and modality worklist SCU), imaging workstation (image query/retrieve SCU) Service/Object Pair (SOP) Class the specification of the network or media transfer (service) of a particular type of data (object); the fundamental unit of DICOM interoperability specification. Examples: Ultrasound Image Service, Basic Grayscale Print Management. Service/Object Pair (SOP) Instance an information object; a specific occurrence of information exchanged in a SOP Class. Examples: a specific x-ray image. Tag a 32-bit identifier for a data element, represented as a pair of four digit hexadecimal numbers, the group and the element. If the group number is odd, the tag is for a private (manufacturer-specific) data element. Examples: (0010,0020) [Patient ID], (07FE,0010) [Pixel Data], (0019,0210) [private data element] Syntax the encoding used for exchange of DICOM information objects and messages. Examples: JPEG compressed (images), little endian explicit value representation. Unique Identifier (UID) a globally unique dotted decimal string that identifies a specific object or a class of objects; an ISO-8824 Object Identifier. Examples: Study Instance UID, SOP Class UID, SOP Instance UID. Value Representation (VR) the format type of an individual DICOM data element, such as text, an integer, a person s name, or a code. DICOM information objects can be transmitted with either explicit identification of the type of each data element (Explicit VR), or without explicit identification (Implicit VR); with Implicit VR, the receiving application must use a DICOM data dictionary to look up the format of each data element. Page 26 of 74

27 2.5. Basics of DICOM Communication This section describes terminology used in this Conformance Statement for the nonspecialist. The key terms used in the Conformance Statement are highlighted in italics below. This section is not a substitute for training about DICOM, and it makes many simplifications about the meanings of DICOM terms. Two Application Entities (devices) that want to communicate with each other over a network using DICOM protocol must first agree on several things during an intial network handshake. One of the two devices must initiate an Association (a connection to the other device), and ask if specific services, information, and encoding can be supported by the other device (Negotiation). DICOM specifes a number of network services and types of information objects, each of which is called an Abstract Syntax for the Negotiation. DICOM also specifes a variety of methods for encoding data, denoted Syntaxes. The Negotiation allows the initiating Application Entity to propose combinations of Abstract Syntax and Syntax to be used on the Association; these combinations are called Presentation Contexts. The receiving Application Entity accepts the Presentation Contexts it supports. For each Presentation Context, the Association Negotiation also allows the devices to agree on Roles which one is the Service Class User (SCU - client) and which is the Service Class Provider (SCP - server). Normally the device initiating the connection is the SCU, i.e., the client system calls the server, but not always. The Association Negotiation finally enables exchange of maximum network packet (PDU) size, security information, and network service options (called Extended Negotiation information). The Application Entities, having negotiated the Association parameters, may now commence exchanging data. Common data exchanges include queries for worklists and lists of stored images, transfer of image objects and analyses (structured reports), and sending images to film printers. Each exchangeable unit of data is formatted by the sender in accordance with the appropriate Information Object Definition, and sent using the negotiated Syntax. There is a Default Syntax that all systems must accept, but it may not be the most efficient for some use cases. Each transfer is explicitly acknowledged by the receiver with a Response Status indicating success, failure, or that query or retrieve operations are still in process. Two Application Entities may also communicate with each other by exchanging media (such as a CD-R). Since there is no Association Negotiation possible, they both use a Media Application Profile that specifies pre-negotiated exchange media format, Abstract Syntax, and Syntax. Page 27 of 74

28 2.6. Abbreviations Abbreviations used within the Conformance Statement: AE Application Entity AET Application Entity Title CAD Computer Aided Detection CDA Clinical Document Architecture CD-R Compact Disk Recordable CSE Customer Service Engineer CR Computed Radiography CT Computed Tomography DHCP Dynamic Host Configuration Protocol DICOM Digital Imaging and Communications in Medicine DIT Directory Information Tree (LDAP) DN Distinguished Name (LDAP) DNS Domain Name System DX Digital X-ray FSC File-Set Creator FSU File-Set Updater FSR File-Set Reader GSDF Grayscale Standard Display Function GSPS Grayscale Softcopy Presentation State HIS Hospital Information System HL7 Health Level 7 Standard IHE Integrating the Healthcare Enterprise IOD Information Object Definition IPv4 Internet Protocol version 4 IPv6 Internet Protocol version 6 ISO International Organization for Standards IO Intra-oral X-ray JPEG Joint Photographic Experts Group LDAP Lightweight Directory Access Protocol LDIF LDAP Data Interchange Format LUT Look-up Table MAR Medication Administration Record MPEG Moving Picture Experts Group MG Mammography (X-ray) MPPS Modality Performed Procedure Step MR Magnetic Resonance Imaging MSPS Modality Scheduled Procedure Step MTU Maximum Transmission Unit (IP) MWL Modality Worklist NM Nuclear Medicine NTP Network Time Protocol Page 28 of 74

29 O Optional (Key Attribute) OP Ophthalmic Photography OSI Open Systems Interconnection PACS Picture Archiving and Communication System PET Positron Emission Tomography PDU Protocol Data Unit R Required (Key Attribute) RDN Relative Distinguished Name (LDAP) RF Radiofluoroscopy RIS Radiology Information System. RT Radiotherapy SC Secondary Capture SCP Service Class Provider SCU Service Class User SOP Service-Object Pair SPS Scheduled Procedure Step SR Structured Reporting TCP/IP Transmission Control Protocol/Internet Protocol U Unique (Key Attribute) UL Upper Layer US Ultrasound VL Visible Light VR Value Representation XA X-ray Angiography 2.7. REFERENCES Referenced documents listed here: NEMA PS3 Medweb Digital Imaging and Communications in Medicine (DICOM) Standard, available free at Administrator Guide Medweb Image Server (Secure DICOM Proxy Webserver) Page 29 of 74

30 3. NETWORKING This section contains the networking related services 3.1. Implementation Model The Implementation model consists of three sections: the Application Data Flow Diagram, specifying the relationship between the Application Entities and the external world or Real-World activities, a functional description of each Application Entity, and the sequencing constraints among them Application Data Flow This diagram represents all of the Application Entities present in an implementation, and graphically depicts the relationship of the AE's use of DICOM to Real-World Activities as well as any applicable User interaction. In this illustration, according to Figure 3-1, an occurrence of Remote SCU will request and association to the local SCP. Once the association is established the SCU will store images. The SCP interacts with the local short term and long term storage subsystem and the image is safely stored. Once the storage is complete and the image is inserted into the local database a success message is returned, in case the storage was unsuccessful a failure message is returned. The local shrot and long term storage entities are related via the SCP. A Modality Worklist SCU may initiate an association to the Modality Worklist SCP. Once the association is established the Modality Worklist SCP accesses the local Scheduled Procedure Step database populated by the HL7 subsystem processing order messages. The Modality Worklist SCP matches the scheduled procedure steps to the query keys provided by the Modality Worklist SCU, and the responses containing all the matches are returned. The Modality Performed Procedure SCU may open an association to the Modality Performed Procedure SCP. Once the association is open the SCU may send events and updates related to the modality performed procedure steps. Note that Modality Performed Procedure Steps may be scheduled or unscheduled, also Scheduled Procedure Steps may not be performed at the modality. The Modality Performed Procedure Step SCP will attempt to match the received Modality Performed Procedure Steps to the Scheduled Procedure Step database. The remote DICOM Q/R SCU may initiate an association to perform a query and retrieve operation. Once the association is open the SCU may query the image database for the existence of DICOM studies. The DICOM Q/R SCU will respond to move and get requests for selected DICOM studies. The Commitment SCU may initiate an association. Once the commitment SCP accepts the association the SCU may enquire about the storage state of previously stored SOP instances. The commitment SCP checks if the SOP instances requested are stored in the long term archive and will return storage commitment status for instances requested on a separated association opened using reverse role negotiation. Page 30 of 74

31 A local print request will instruct the Print SCU to establish an association to the Pint SCP. Once the association is established the Print SC will complete all the interactions necessary to print the composed film. Typically, there is a one to one relationship between an AE and an AE Title. Devices may be capable of configuring the relationship between AE and AE Title (e.g. by merging Application Entities to use a single AE Title). This is specified in the configuration section. Local short term storage Standard DICOM Interface Local long term storage SCP Remote SCU Scheduled Procedure Step database Modality Worklist SCP Remote Modality Worklist SCU Modality Performed Procedure step database Modality Performed Procedure Step SCP Remote Modality Performed Procedure step SCU Image Database DICOM Q/R SCP DICOM Q/R SCU commitment resolver Commitment SCP Remote Commitment SCU Print request from client Print SCU Remote Print SCP Detached Management Entity Detached SOP Class management SCP Remote Detached Management SCU Figure 3-1 Application Data Flow Diagram Note: There is no standard definition or guidelines on the number of AE s within a product and what an AE should encompass. Its functionality and scope is purely to the discretion of the vendor and typically depending on the system architecture Functional Definition of AE s This part contains a functional definition for each individual local Application Entity, describing in general terms the functions to be performed by the AE, and the DICOM Page 31 of 74

32 services used to accomplish these functions. In this sense, "DICOM services" refers not only to DICOM Service Classes, but also to lower level DICOM services, such as Association Services Functional Definition of Application Entity SCP The Application Entity, SCP is responsible for processing incoming storage requests. The SCP interacts with the local image database, establishes the Patient and observation context of the incoming DICOM objects using a defined set of information extracted from the IOD header Functional Definition of Application Entity Modality Worklist SCP The Application Entity, Modality Worklist SCP services requests from the Modality Worklist SCUs to populate Patient demographics and ordered procedure information of the headers of the modality generated composite instances. The Modality Worklist SCP will keep Scheduled Procedure Step entries on the worklist till it receives a status change from the RIS indicating the exam that generated the Scheduled Procedure Step is past the state where acquisition of images is allowed. The Modality worklist SCP allows the filtering of Scheduled Procedure Step entries using standard Modality Worklist Query Keys. The exact list of permissible Keys is detailed later in this conformance statement Functional Definition of Application Entity Modality Performed Procedure Step SCP The Application Entity, Modality Performed Procedure Step SCP receives MPPS events from the connected modalities. The Medweb Image Server uses the MPPS events to verify if all composite instances generated by the modalities were transferred to the Medweb Image server. The results of the correlation are accessible to the system administrator for trouble shooting. No additional workflow management actions taken by the server based on MPPS Functional Definition of Application Entity DICOM Q/R SCP The Application Entity, DICOM Q/R SCP receives services connected DICOM Q/R SCUs. The Q/R SCP allows the connected workstations, modalities or other encapsulations of a DICOM Q/R SCU to find and retrieve images from the Medweb Server. The DICOM Q/R SCP supports Patient, Study and Patient/Study information model Q/R operations. The DICOM conformance statement provides details of the supported required and optional keys fro each information model Functional Definition of Application Commitment SCP The Application Entity, Commitment SCP provides information about the safe storage of DICOM Composite instances in the long-term storage subsystem. The Commitment SCP will use reverse role negotiation to establish a connection to the requesting SCU to return the results of the storage commitment Functional Definition of Application Entity Print SCU The Application Entity, Print SCU is used to to service user request for the creation of hard copies of DICOM images stored on the Medweb Image Servers. The Print SCU allow the Page 32 of 74

33 server to connect to configured DICOM Print SCPs and provide hard copy presentation of the images in a particular study Functional Definition of Application Entity Detached Management SCP The Application Entity, Detached Management SCP Provides DICOM services for the management of reports and interpretation. Connected SCUs may provide information about the interpretation status of studies, and may provide interpretation text in a report. These DICOM services are no longer widely implemented, but there are current implementations in the field including the supported private extensions supported by this SCP Sequencing of Real World Activities For sequencing of specific real world activities see the UML sequence diagrams and associated descriptions under each individual AE Specification. This section contains only the interactions that are common to all or most AEs Verification All AEs that accept a DICOM Association are required to support DICOM Verification. Figure 3-2 illustrates the common sequence during the performance of the real world activity. Generic SCP Generic SCU Open Association Send C-ECHO Request Send C-ECHO Response Close Association Figure 3-2Real World Activity for Verification Based on a user request or initialization the SCU may initiate the activity, the SCP receives the indication and the activity is performed as specified. The C-ECHO response may be a success or a failure depending on configuration of the SCP. The sequence diagram does not depict alternate flows Presentation Context Table Verification The table below contains the Verification SOP class presentation contexts that the Medweb Server will accept. Table 3-1Acceptable presentation contexts for verification service class Abstract Syntax Syntax Role Extended Page 33 of 74

34 Name UID Name List UID List Negotiation Verification Implicit VR Little Endian SCP None SOP Specific Conformance for Verification SOP Class The Medweb Server provides standard conformance to the Verification SOP Class and will return one of the following statuses: Table 3-2 C-Echo Response Status Handling Behavior Service Status Further Meaning Error Code Behavior Success Success 0000 The C-ECHO request is accepted Presentation Context Acceptance Criterion - Verification The Medweb Server will always accept a Verification SOP class presentation context as long as the requesting AE is granted the appropriate permissions through the Medweb Server s configuration parameters Syntax Selection Policies - Verification Since there is no dataset defined in this SOP class, only the default transfer syntax applies. Therefore it is the only transfer syntax supported 3.2. AE Specifications: The next section in the is a set of Application Entity Specifications AE Specification: -SCP, Commitment SCP, Query/Retrieve-SCP and -SCU Since the SCPs and SCUs are very closely related it is more efficient to describe them as the activities of the related group SOP Classes The -SCP AE provides Standard Conformance to the following SOP Classes: Notes 1. Table 3-3lists the Network Services Supported as they appear in the DICOM Standard 2. The italicized items represent SOP classes that have been retired but are still supported by the Medweb Server. Table 3-3SOP Classes for -SCP SOP Class Name SOP Class UID SCU SCP Verification Verification Computed Radiography Image Page 34 of 74

35 SOP Class Name SOP Class UID SCU SCP Digital X-Ray Image For Presentation Digital X-Ray Image For Processing Digital Mammography X-Ray Image For Presentation Digital Mammography X-Ray Image For Processing Digital Intra-oral X-Ray Image For Presentation Digital Intra-oral X-Ray Image For Processing CT Image Enhanced CT Image Ultrasound Multi-frame Image MR Image Enhanced MR Image Enhanced MR Color Image MR Spectroscopy Ultrasound Image Enhanced US Volume Secondary Capture Image 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 lead ECG Waveform General ECG Waveform Ambulatory ECG Waveform Hemodynamic Waveform Cardiac Electrophysiology Waveform Basic Voice Audio Waveform General Audio Waveform Arterial Pulse Waveform Respiratory Waveform Grayscale Softcopy Presentation State Color Softcopy Presentation State Pseudo-Color Softcopy Presentation State Blending Softcopy Presentation State XA / XRF Grayscale Softcopy Presentation State X-Ray Angiographic Image Enhanced XA Image X-Ray Radiofluoroscopic Image Enhanced XRF Image X-Ray 3D Angiographic Image X-Ray 3D Craniofacial Image Breast Tomosynthesis Image Nuclear Medicine Image Spatial Registration Spatial Fiducials Deformable Spatial Registration Segmentation Real World Value Mapping Page 35 of 74