DICOM Structure Basics

Gunjan Patel

MS - Medical software,
BE-Biomedical Engineer
PGD-Quality Management
Email: [email protected]
Content
• History
• Introduction
• Why DICOM?
• DICOM Services Class
• Basic Terminology
• Exa.- RIS connection
• Uses of DIOCM

2
History
• 1985-1988 :
• Joint effort between Radiologist and Manufacturers to specify
ACR-NEMA 1.0 and 2.0
– ACR : American College of Radiology
– NEMA : National Electrical Manufacturer Association
• 1993 :
• 9 parts of DICOM (3.0)
• 2007 :
• 18 parts of DICOM - 126 Supplements

• DICOM is developed under joint efforts of

– ACR (American College of Radiology)
– NEMA (National Electrical Manufacturers Assoc.) …… also more than 25
vendors…

DICOM is continuously growing 3

Introduction

• Digital Imaging and COmmunication

in Medicine

 DICOM is not just an image or file

format. It is an all-encompassing data
transfer, storage, and display protocol
built and designed to cover all
functional aspects of digital medical
imaging

4
Why DICOM ?

5
Contin….

6
Contin….

• Need for Digital Image Generation

• More need for Digital Transfer/Archiving (PACS)
• More need for Post-Processing
• More need for Cross-Vendor Compatibility
• Need for Communication via Networks/Media

7
DICOM Services Class

8
9
10
DICOM Terminology
• DICOM File Format
• Information Object Definition (IODs)
• Application Entity Title (AE Title)
• Service Class User/Provider (SCU/SCP)
• Unique IDentifier (UID)
• Transfer Syntax
• Value Representations (VR)

11
DICOM File Format
File
128 Bytes
Preamble
DICOM File (set to 00H by default)
Meta
DICOM Prefix DICM
Information Attribute Name Tag Type
Group Length (0002,0000) 1
File
ONE File Meta Information Version (0002,0001) 1
Meta Media Storage SOP Class UID (0002,0002) 1
DICOM
Eléments Media Storage SOP Instance UID (0002,0003) 1
SOP Transfer Syntax UID (0002,0010) 1

Instance DICOM Implementation Class UID (0002,0012) 1

Implementation Version Name (0002,0013) 3
Data Set Source Application Entity Title (0002,0016) 3
Private Information Creator UID(0002,0100) 3
as sent
Private Information (0002,0102) 1C
during
network Group 0002H elements
transfer
are always encoded in
Explicit VR Little
DICOM File Format (Ref: PS 3.10, Sec.7.1)
Endian

A DICOM Image File is more

than an image stored in a File 12
13
Patient Entity
Rows
Study Entity
General Image Columns
Series Entity
Image Pixel ...
Image Entity ... Pixel Data

IOD Modules Data Elements

Set of Data Elements that
The atomic piece of
are semantically gathered
information in DICOM
- Modules may be general
- Contains the actual
(e.g. General Image)
information
- Modules may be specific
(e.g. CT Image)
14
 “ I am sending a CT Image to you “
A verb A noun
Real world: (an action) (an object)

DICOM: Service IOD

15
 Application Entity Title (AE Title)
• AE is essentially the name of a DICOM device or program
used to uniquely identify it (you cannot have two
identical AEs in your PACS network)
• Even though DICOM does not have strict requirements
for AE naming, AEs are typically labeled with numbers
and uppercase characters only – no spaces, punctuation
signs, or other characters. In fact, it is not uncommon to
see DICOM units that would accept only uppercase
alphanumeric AEs.

16
Application Entity Title (AE Title)

“ Hi Tom , I am John . Can I send you a CT Image?“

Communicator’s
AE Title(s)
Names

An AE Title must be UNIQUE on a given network

17
“ Hi Tom , I am John . Can I send you a CT Image?“

Communication Communication
Initiator Name Recipient Name

Calling AE Title Called AE Title

18
“ I am sending a CT Image to you “

User Provider

SCU SCP
Service Class User Service Class Provider
role role

SCU’s are initiating the actions. Therefore,

they are usually initiating the communication 19
(i.e. the association)
DICOM Storage
• Allows a system to send object data to a remote node.

• Object data may be Images (e.g. CT images), Waveforms,

Mammo CAD, etc.

Modality Remote Node

Image 1.2.840.15.1
Image Send

Response:
Status = SUCCESS
Store Response
Storage (SCU) Storage (SCP)

Other services of DICOM

• Verification
• Query/Retrieve
20
• Modality Worklist
• UIDs are an internal DICOM mechanism to uniquely identify:
Studies, Series, Images, Equipments, SOP Classes, etc…
• A UID is a string of up to 64 Characters including digit numbers (“0” to “9”) and “.”
e.g. SOP Instance UID = 1.2.840.113619.2.65.3.200583648570.2428.1178103577.1

• No Leading zero’s in UID string components are allowed.

1.2.840.115621.4.3.0596632.726 – ill formatted

But a single zero component is OK

1.2.840.115621.2.0.456.632.478 – Format is correct

• This string MUST be UNIQUE around the world. For instance:

• A SOP Instance UID of an image shall never be equal to the SOP Instance UID of
another image
• An Image SOP Instance UID shall never be equal to a Series Instance UID

21
 Transfer Syntax

A transfer syntax is the encoding methodology


used to send data over the network, or the
methodology used to write data to a physical
media
Example:
Two different Transfer Syntaxes to represent the same information

Rx II

The same semantic is conveyed, but using different encoding mechanisms

22
DICOM Transfer Syntaxes (cont’d)

 Big Endian versus Little Endian byte ordering :

DICOM defines two different byte orderings that
affect binary values sent on more than 1 byte
(typically: short integer, long integer, float values).

Example on a 2 byte value: 0x3568

Big Endian versus Little Endian

35 68 68 35
1 Byte 1 Byte 1 Byte 1 Byte

23
DICOM Transfer Syntaxes (cont’d)
 Explicit VR versus Implicit VR
VR stands for Value Representation. It describes the
type and the format of the information sent in a
DICOM Data Element.
For instance, the Patient Date of Birth format is a 8
characters string following the format : YYYYMMDD (e.g.
19980625)

Explicit VR means that the VR is (explicitly) sent in

the DICOM Message.
Implicit VR means that no VR is sent in the message.
Therefore, to know the VR, a product will have to use
its own internal dictionary.
In both cases, the VR used by products for
Standard Elements shall be the same as the one
24
defined in the DICOM Data Dictionary
 Value Representations (VR)

• Clinical data comes in a wide variety of formats.

– Ex. Distances measured in millimeters, time in seconds,
• patient names are typically written in alpha-betic
characters, and so on.
• The DICOM standard defnes 27 basic data types, known
as value representations (VRs),
• which are designed to encapsulate all possible clinical
data types.
• Each VR has its own abbreviated two-letter name, a
defnition of what it represents, a description of what
characters are allowed in its data, and a pre-scribed data
length.

25
A specific VR for each need
DICOM defines a set of 27 VRs identified with two capital
letters. For instance:
• Free Form Text VR: •Fixed Format VR:
• SH: Short String • DA: Date
• TM: Time
• LO: Long String
• DT: DateTime
• ST: Short Text • PN: Person Name
• LT: Long Text
• UT: Unlimited Text
•Other VR:
• Math VR: • OB: Other Byte
• IS: Integer String • OW: Other Word
• OF: Other Float
• DS: Decimal String
• SQ: Sequence
• US: Unsigned Short
• …
• SS: Signed Short
• UL: Unsigned Long
• SL: Signed Long
26
27
28
29
30
DICOM Print Management

A Standard Interface
New Printer to Share Printers

DICOM DICOM Old Printer

Spooler

• DICOM print (Grayscale and/or color) links Printers with

Modalities and Workstations on a standard network

• A lot of flexibility to support all features available on various

vendor’s printers

31
DICOM for Media Interchange

The DICOM
Directory
(a.k.a. DICOMDIR)
The same image
facilitates media
objects as defined for
browsing ALL DICOM
MEDICAL
INFORMATION OBJECTS
Network exchange are
DIRECTORY
usable on physical
media
DICOM File Format

USB CD-ROM 130 mm 90 mm MOD DVD-ROM

Media CD-R MOD (128, 230, -R/+R/
(650 MB, 540, 640 MB, -RW/+RW
1.2, 2.3, 4.1GB) 1.3, 2.3 GB)

DICOM Relies on Broadly Available Media Storage Technology

32
Uses of DIOCM

33
Feedback
and
Query ???

34
“Save Paper, Save Earth, Save US”

Thank you !!!

Email : [email protected]
www.bmeportal.ning.com

35
Referances

• DICOM Cook Book -for Implementations in Modalities

• Digital Imaging and Communication in Medicine (DICOM)-
OS Priyankh
• http://www.mediacy.com/index.aspx?page=IQDICOM_Serv
ice
• http://medical.nema.org/

36