DICOM and NM Taking the next step Jerold Wallis, MD.

DICOM and NMDICOM and NM

Taking the next stepTaking the next step

Jerold Wallis, MDJerold Wallis, MD

DICOM in Nuclear MedicineDICOM in Nuclear Medicine

SNM DICOM Working Group

SNM DICOM Demo 2001

SNM DICOM Demo 2002

Joint IHE Demo 2003

SNMASNCACCRSNA

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

Achieving Real-World InteroperabilityAchieving Real-World Interoperability

( & What’s in it for NucMed? )( & What’s in it for NucMed? )

IHE slides edited from a presentation byIHE slides edited from a presentation byKevin O’Donnell, Toshiba Corp.Kevin O’Donnell, Toshiba Corp.

Co-chair IHE Planning CommitteeCo-chair IHE Planning Committee

NM ImageNM Image

NM PACS

NM ImageNM Image

NM PACS

NM Image ProblemNM Image Problem

NM PACS

NM Image ProblemNM Image Problem

Click and move mouse down to adjust window level, right to adjust window center

SPECTSPECT

NM PACS

SPECTSPECT

NM PACS

PETPET

NM PACS

NM PACS

CardiacCardiac

Gated CardiacGated Cardiac

NM PACS

Gated CardiacGated Cardiac

NM PACS

Areas for ImprovementAreas for Improvement

• Color image transfersColor image transfers

• Vendor independent Vendor independent labeling of Cardiac labeling of Cardiac SPECT filesSPECT files

• Cardiac DICOMCardiac DICOM– Easy export of staticsEasy export of statics

– Export of gatedExport of gated

• Window level controlsWindow level controls

• Consistency of image Consistency of image presentationpresentation

• Three-plane Three-plane tomographic image tomographic image displaydisplay

• Gated cardiac displayGated cardiac display

• Color tablesColor tables

NM PACS

Past and FuturePast and Future

SNM DICOM Demo 2001

SNM DICOM Demo 2002

Joint IHE Demo 2003SNMASNCACCRSNA

NM PACSNM

NM NM

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

Achieving Real-World InteroperabilityAchieving Real-World Interoperability

What is IHE about?What is IHE about?

IHE is an initiative promoting and supporting IHE is an initiative promoting and supporting the the integrationintegration of of systemssystems in the in the healthcare healthcare enterpriseenterprise..

Goal: Improve the efficiency and effectiveness Goal: Improve the efficiency and effectiveness of clinical practice by:of clinical practice by:Improved Improved Information FlowInformation FlowAdvanced Advanced Multi-System FunctionsMulti-System Functions

How is IHE related to Standards?How is IHE related to Standards?

• Standards provide tools & technologiesStandards provide tools & technologies– HL7 and DICOM provide dictionariesHL7 and DICOM provide dictionaries

• IHE specifies how to apply them to real world IHE specifies how to apply them to real world scenarios & integration problemsscenarios & integration problems

– IHE defines a “phrasebook”IHE defines a “phrasebook”

What Does IHE Do?What Does IHE Do?

• Users and vendors work together to identify and Users and vendors work together to identify and design solutions for integration problemsdesign solutions for integration problems

• Intensive process with Intensive process with annual cyclesannual cycles::– Identify key healthcare workflows and integration problemsIdentify key healthcare workflows and integration problems

– Research & select standards to specify a solutionResearch & select standards to specify a solution

– Write, review and publish IHE Technical FrameworkWrite, review and publish IHE Technical Framework

– Perform cross-testing at “Connectathon”Perform cross-testing at “Connectathon”

– Demonstrations at tradeshows (HIMSS/RSNA)Demonstrations at tradeshows (HIMSS/RSNA)

SNM, Vendor & IHE SNM, Vendor & IHE CooperationCooperation

• Integrate NM into IHE demosIntegrate NM into IHE demos

• Use established IHE “network” to Use established IHE “network” to help distribute and get support for help distribute and get support for all parts of NM DICOM standardall parts of NM DICOM standard

• Work with PACS vendors on Work with PACS vendors on display issues unique to NMdisplay issues unique to NM

Key AreasKey Areas

• General NMGeneral NM

• CardiacCardiac

• PETPET

General NMGeneral NM

• Add support for consistent Add support for consistent presentation of images at NM endpresentation of images at NM end

• Comply with consistent Comply with consistent presentation of images at PACS endpresentation of images at PACS end

• Add support for 3-view Add support for 3-view tomographic imaging on PACStomographic imaging on PACS

CardiacCardiac

• Support DICOM cardiac view Support DICOM cardiac view codescodes

• Support for gated screen DICOM Support for gated screen DICOM output by alloutput by all

• Easy export of DICOM screensEasy export of DICOM screens

3rd party cardiac software authors

Camera vendors systems and databases

PACS systems and databases

Low cost generic viewersOther NM systems

PETPET

• Transmission between NM systems Transmission between NM systems

• PACS displaysPACS displays

• PET-CT displaysPET-CT displays– on NM systemson NM systems

– on PACS systemson PACS systems

What’s Next?What’s Next?

• Commit to concept of anCommit to concept of anIHE NM profileIHE NM profile

• Work toward achieving it for the Work toward achieving it for the October connect-a-thonOctober connect-a-thon

• Continue cooperative efforts within Continue cooperative efforts within the NM communitythe NM community