• Radiology Update: CT/MR Contrast Perfusion profile Wim Corbijn van Willenswaard Chair DICOM WG16 Philips Healthcare
Dec 23, 2015
• Radiology Update:CT/MR Contrast Perfusion profile
Wim Corbijn van Willenswaard
Chair DICOM WG16Philips Healthcare
Introduction
• DICOM has standardized the ENHANCED MR IOD in 2002, followed by CT in 2004 and later for others.
• First IHE profiles for Enhanced IODs were created in 2009.
• Current update has removed major roadblocks for creating the necessary data at modalities, as defined by the profile.
• This will improve the acceptance of Enhanced SOP Classes by industry and users.
Agenda for this session
• Benefits of Enhanced DICOM• Dimension Module Concept
• Contrast Perfusion in CT/MR• Use case• Object Requirements
– Restrictions for Modalities, additional requirements• Display requirements
• Summary• Q&A
Benefits of Enhanced DICOM
• Modern Acquisition Techniques are fully covered. (no longer dependent on private attributes)
• Multi-frame packaging for fast transfer. (reduced number of files to transfer)
• Explicit Dimensions. (this provides context information, guiding (viewing) applications how to order/display the sequence of frames)
• Implementing Enhanced DICOM for one modality will pave the way for all other implementations which have the same structure
DICOM Dimension Module
• Two parts define how to traverse Multi-Volume data correctly:
• The dimension attributes (these play a role in the object dimension, like : time, position, echo, phase, contrast, …….):>Dimension Index Pointer (0020,9165)
• The index values for these attributes:>Dimension Index Values (0020,9157)
See notes
See notes
Temporal order for slice 1
Multi-Phase / Multi-Slice
time
Temporal Position Index
65
43
21
65
43
21
1 2 3
65
43
21
In-stack Position Number (Slice-Index) Frame number 1-6 Frame number 7-12Frame number 13-18
Slice Order for temporal 1
Image frames can be sorted/displayed independent of the frame order
4\1 4\2 4\3
Slice Order for temporal 2
Dimension index values:
Temporal order for slice 5
• IHE Profile PERF
Contrast Perfusion in CT/MR
Contrast Perfusion in CT/MR
• This Integration Profile facilitates the exchange of contrast enhanced images created as a stack of images at different timeslots, in order to demonstrate the uptake of a contrast agent over time
• The exchange of standard attributes for time and position allows for correct and convenient display on standard display systems
• This is a major improvement compared to the older single-frame DICOM image objects (where applications need to depend on proprietary timing attributes) offering improved interoperability
MR Perfusion Imaging
9
time
non perfused stroke area
Sig
nal
delayed perfusion
time-to-peak map
Requirements for creators1. A Volume may not be spread over Enhanced SOP Instances
(a Temporal Position may not be present in multiple objects)
2. Creator provides dimension indices for:• Stack ID• In Stack Position Number• Temporal Position Index
3. Data requirements:Image Type and Frame Type:
• Value 1: ORIGINAL• Value 2: PRIMARY• Value 3: PERFUSION
Functional Requirements for Image Display
1. Provide at least one viewport for display of frames with the same In-Stack Position Number (Slice-index).
(More viewports may be used for displaying images for other In-Stack Position Numbers = simultaneous scrolling)
2. Be able to scroll the images by Temporal Position Index for the same in-stack position (Temporal Position-index = time related movie).
Required display layout
Position = 1 Position = 2 Position = .. Position = n
Time = 1
Time = 2
Time = ..
Time = n
scro
ll
Alternative display layout
Time = 1 Time = 2 Time = .. Time = n
Position = 1
Position = 2
Position = ..
Position = n
Switching Position and Time
scro
ll
Data Requirements for DisplayAttribute Name Tag
Enhanced Contrast/Bolus Module
Contrast/Bolus Agent Sequence (0018,0012)
>Contrast/Bolus Administration Route Sequence (0018,0014)
Frame Type Value 3 (0008,9007)
Frame Content Sequence (0020,9111)
>Temporal Position Index (0020,9128)
>Stack ID (0020,9056)
>InStackPositionNumber (0020,9057)
Time Offset value (0020,930D)
Summary• CT/MR Perfusion Imaging with Contrast profile is updated to be
in line with the modality way of working.
• Series can be stored in more than one object, but a Temporal Position (Volume) is always stored in one object.
• Extra explanation how to use the DIMENSION information.
• Use of the profile will facilitate the display of the more complex acquisitions on standard display systems.
• The other Enhanced Profiles will be updated to the same structure.
• Thank You
Any Questions?