Technical Publication. DICOM Conformance Statement. Trauma 3.0. Document Revision 2. October 5 th, 2010

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Technical Publication DICOM Conformance Statement 3.0 Document Revision 2 October 5 th, 2010 2010 Copyright BrainLAB AG October 6, 2010 Document Revision 1 Page 1 of 23

1 Conformance Statement Overview This is a conformance statement for the BrainLAB software. The main purpose of this software is to intraoperatively receive fluoroscopic images from a C-arm and to make them available for planning and display in navigation. Among the different C-arm types integrated into the software, some are capable of sending the images in DICOM format over a network connection. The DICOM part of the application is Receive DICOM data from other DICOM nodes (e.g. on a C-arm) via the network and load it into the software. Not all of the supported DICOM Storage Classes are convertible to the BrainLAB file format. If the conversion is possible these classes are marked in the column Convertible. SOP Classes User Of Service (SCU) Provider Of Service (SCP) Verification Verification No Yes Transfer X-Ray Angiographic Image Storage No Yes X-Ray Radiofluoroscopic Image Storage No Yes Table 1-1: Network services supported by the navigation application October 5, 2010 Document Revision 2 Page 3 of 23

2 Table Of Contents 1 Conformance Statement Overview 3 2 Table Of Contents 5 3 Introduction 7 3.1 Revision History... 7 3.2 Audience... 7 3.3 Remarks... 7 3.4 Abbreviations... 7 3.5 References... 8 4 Networking 9 4.1 Implementation Model... 9 4.1.1 Application Data Flow Diagram... 9 4.1.2 Functional Definition of Application Entity (AE)... 9 4.1.3 Sequencing Of Real World Activities... 9 4.2 Application Entity Specifications... 10 4.2.1 Dicom service Specification... 10 4.2.1.1 SOP Classes and Transfer Syntaxes... 10 4.2.1.2 Association Policies... 10 4.2.1.2.1 General... 10 4.2.1.2.2 Number of Associations... 10 4.2.1.2.3 Asynchronous Nature... 11 4.2.1.2.4 Implementation Identifying Information... 11 4.2.1.3 Association Initiation Policy... 11 4.2.1.4 Association Acceptance Policy... 11 4.2.1.4.1 Activity Receive... 11 4.3 Network Interfaces... 12 4.3.1 Physical Network Interface... 12 4.3.2 Additional Protocols... 12 4.4 Configuration... 12 4.4.1 AE Title / Presentation Address Mapping... 12 4.4.1.1 Local AE Titles... 12 4.4.1.2 Remote AE Title/Presentation Address Mapping... 12 4.4.2 Parameters... 13 5 Media Interchange 15 6 Support Of Extended Character Sets 17 7 Security Profiles 19 8 Annexes 21 8.1 IOD Contents... 21 8.2 Data Dictionary Of Private Attributes... 21 8.3 Coded Terminology And Templates... 21 8.4 Grayscale Image Consistency... 21 8.5 Standard Extended/Specialized/Private SOP Classes... 21 8.6 Private Transfer Syntaxes... 21 9 Indexes 23 9.1 Index Of Images... 23 9.2 Index Of Tables... 23 October 5, 2010 Document Revision 2 Page 5 of 23

Page 6 of 23 Document Revision 2 October 5, 2010

3 Introduction 3.1 Revision History Document Version Date of Issue Author Description 1 January 19 th, 2010 3.0 - initial 3.2 Audience This document is intended for hospital staff, health system integrators, software designers or implementers. It is assumed that the reader has a working understanding of DICOM. 3.3 Remarks DICOM, by itself, does not guarantee interoperability. However, the Conformance Statement facilitates a first-level validation for interoperability between different applications supporting the same DICOM functionality. The Conformance Statement should be read and understood in conjunction with the DICOM Standard [1]. However, by itself it is not guaranteed to ensure the desired interoperability and a successful interconnectivity. The user should be aware of the following important issues: The comparison of different conformance statements is the first step towards assessing interconnectivity between BrainLAB and non BrainLAB equipment. This Conformance Statement is not intended to replace validation with other DICOM equipment to ensure proper exchange of information. Test procedures should be defined to validate the desired level of connectivity. The DICOM standard will evolve to meet the users future requirements. BrainLAB reserves the right to make changes to its products or to discontinue its delivery. 3.4 Abbreviations There are a variety of terms and abbreviations used in the document that are defined in the DI- COM Standard. Abbreviations and terms are as follows: AE AET IOD ISO PDU SCU SCP SOP DICOM Application Entity Application Entity Title (DICOM) Information Object Definition International Standard Organization DICOM Protocol Data Unit DICOM Service Class User (DICOM client) DICOM Service Class Provider (DICOM server) DICOM Service-Object Pair October 5, 2010 Document Revision 2 Page 7 of 23

3.5 References [1] Digital Imaging and Communications in Medicine (DICOM) 3.0, NEMA PS 3.1-3.18 2004 Page 8 of 23 Document Revision 2 October 5, 2010

4 Networking 4.1 Implementation Model The BrainLAB application uses an implementation of: A Storage SCP that receives DICOM data from other DICOM archives or workstations. 4.1.1 Application Data Flow Diagram The Storage SCP: Load received DICOM data and display it for navigation application Storage SCP DICOM Storage SCU DICOM Standard Interface Figure 4-1: Application Data Flow Diagram 4.1.2 Functional Definition of Application Entity (AE) Some communications and data transfer with remote AE's are accomplished utilizing the DICOM protocol over a network using the TCP/IP protocol stack. Storage SCP: With the start of the DICOM service module within the navigation application, a DICOM Storage SCP is invoked. It accepts any association with a Storage SCU negotiating any of the SOP Classes listed in Table 4-2. 4.1.3 Sequencing Of Real World Activities No sequencing of real world activities is necessary. October 5, 2010 Document Revision 2 Page 9 of 23

4.2 Application Entity Specifications 4.2.1 Dicom service Specification 4.2.1.1 SOP Classes and Transfer Syntaxes The navigation application receives C-ECHO requests in order to test the connection to a remote AE. It provides standard conformance to the following DICOM V3.0 SOP Classes: SOP Class Name SOP Class UID SCU SCP Verification SOP Class 1.2.840.10008.1.1 Yes Yes Table 4-1: Supported Verification SOP Classes The navigation application is able to receive DICOM storage objects. It provides Standard Conformance to the following DICOM V3.0 SOP Classes: SOP Class Name SOP Class UID SCU SCP X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.1 No Yes X-Ray Radiofluoroscopic Image Storage 1.2.840.10008.5.1.4.1.1.12.2 No Yes Table 4-2: Supported Storage SOP Classes The navigation application supports the following transfer syntaxes. In an association negotiation the syntaxes are accepted in the order of appearance in the list. Transfer Syntax Name Transfer Syntax UID SCU SCP Extended Negotiation DICOM Implicit VR Little Endian 1.2.840.10008.1.2 No Yes None DICOM Explicit VR Little Endian 1.2.840.10008.1.2.1 No Yes None DICOM Explicit VR Big Endian 1.2.840.10008.1.2.2 No Yes None JPEG Lossless, Non-Hierarchical, First-Order Prediction (Process 14) 1.2.840.10008.1.2.4.70 No Yes None Table 4-3: Supported Transfer Syntaxes (association negotiation) 4.2.1.2 Association Policies 4.2.1.2.1 General The DICOM standard application context name for DICOM 3.0 is always proposed: Application Context Name 1.2.840.10008.3.1.1.1 4.2.1.2.2 Number of Associations For association acceptance: Maximum number of simultaneous Associations 1 Page 10 of 23 Document Revision 2 October 5, 2010

4.2.1.2.3 Asynchronous Nature The navigation application does not support asynchronous communication (multiple outstanding transactions over a single association). Maximum number of outstanding asynchronous transactions 1 4.2.1.2.4 Implementation Identifying Information The implementation information for this Application Entity is: Implementation Class UID 1.2.276.0.20.1.1.17.3.0.0 Implementation Version Name 4.2.1.3 Association Initiation Policy The navigation application never initiates an association. 4.2.1.4 Association Acceptance Policy 30 The navigation application accepts an association in this case: 1. Receive: When the navigation application accepts an association, it will respond to storage requests. Associations will be rejected, If the Called AE Title does not match the pre-configured AE Title If the application is not in receiving mode. 4.2.1.4.1 Activity Receive 4.2.1.4.1.1 Associated Real-World Activity As DICOM storage instances are received they are saved to the local file system. If the received instance is a duplicate of a previously received instance, the old file will be overwritten with the new one. 4.2.1.4.1.2 Proposed Presentation Contexts Presentation Context Table Abstract Syntax Transfer Syntax Role Ext. Neg All SOP Classes as defined in Table 4-1 and Table 4-2 1 All Transfer Syntaxes as defined in Table 4-3 Table 4-4: Storage SCP Presentation Contexts. SCP SCP SCP None None None 1 Be aware that the Storage SCP accepts more SOP Classes as defined in Table 4-1 and Table 4-2 while association negotiation. But later on it rejects all received messages of a SOP class not mentioned there. October 5, 2010 Document Revision 2 Page 11 of 23

4.2.1.4.1.3 SOP Specific Conformance The navigation application provides standard conformance to the DICOM Verification Service Class and to the DICOM Storage SOP Classes. No extended negotiation is implemented. The navigation application may interrupt the transfer at any point. It then aborts the association immediately. 4.2.1.4.1.4 Presentation Context Acceptance Criterion The navigation application accepts multiple presentation contexts containing the same abstract syntax. 4.2.1.4.1.5 Transfer Syntax Selection Policy The first Transfer Syntax encountered in the configuration file, which matches a Transfer Syntax offered for a given Presentation Context, will be selected as the accepted Transfer Syntax for that Presentation Context. 4.3 Network Interfaces 4.3.1 Physical Network Interface The navigation application supports the DICOM upper layer using TCP/IP. The navigation application is indifferent to the physical medium over which TCP/IP executes. It inherits this from the operating system upon which it executes. 4.3.2 Additional Protocols The usage of DNS and DHCP is possible and is based on the network configuration of the operating system upon which the navigation application executes. 4.4 Configuration All configuration parameters are read out from an application settings file that only may be modified by the BrainLAB support. 4.4.1 AE Title / Presentation Address Mapping 4.4.1.1 Local AE Titles The local AET of the navigation application is configurable: Application Entity Default AE Title Default TCP/IP Port navigation application BRAINLAB_SCP 104 Table 4-5: Local AE Titles. 4.4.1.2 Remote AE Title/Presentation Address Mapping Since the navigation application accepts associations from any DICOM remote node there is no configuration for remote AETs available. Page 12 of 23 Document Revision 2 October 5, 2010

4.4.2 Parameters Parameter Configurable Default Value General Timeout Yes 600 Maximum PDU Size No 28672 SOP Class Support No All supported will always be accepted Transfer Syntax Support No All supported will always be accepted Verbose logging Yes Disabled Table 4-6: Configuration Parameters. October 5, 2010 Document Revision 2 Page 13 of 23

5 Media Interchange The navigation application doesn t support Media Interchange. October 5, 2010 Document Revision 2 Page 15 of 23

6 Support Of Extended Character Sets The navigation application supports the ISO_IR 100 (ISO 8859-1:1987 Latin Alphabet No. 1 supplementary set) October 5, 2010 Document Revision 2 Page 17 of 23

7 Security Profiles No security profiles are supported. October 5, 2010 Document Revision 2 Page 19 of 23

8 Annexes 8.1 IOD Contents None supported. 8.2 Data Dictionary Of Private Attributes None supported. 8.3 Coded Terminology And Templates None supported. 8.4 Grayscale Image Consistency Not supported. 8.5 Standard Extended/Specialized/Private SOP Classes None supported. 8.6 Private Transfer Syntaxes None supported. October 5, 2010 Document Revision 2 Page 21 of 23

9 Indexes 9.1 Index Of Images Figure 4-1: Application Data Flow Diagram... 9 9.2 Index Of Tables Table 1-1: Network services supported by the navigation application... 3 Table 4-1: Supported Verification SOP Classes... 10 Table 4-2: Supported Storage SOP Classes... 10 Table 4-3: Supported Transfer Syntaxes (association negotiation)... 10 Table 4-4: Storage SCP Presentation Contexts.... 11 Table 4-5: Local AE Titles.... 12 Table 4-6: Configuration Parameters.... 13 October 5, 2010 Document Revision 2 Page 23 of 23