DICOM Standards Committee Meeting April 11 2008 Chengdu

DICOM Standards Committee Meeting April 11, 2008 Chengdu, China DICOM Enhanced IODs in Mixed Environments

Enhanced IODs • Released for most modalities – MR – CT – XA/XRF – 3 D XR – PET – US (2002) (2003) (2005) (2007) (2008) (2009? ) (Public Comment done)

Implementation • MR & CT (after 5 years) – some modalities installed; some PACS store • prompted by demonstrations at SIIM & RSNA – display support weak/missing – workstation support largely absent • XA/XRF (after 3 years) – small handful of implementations • 3 D XR (after 1 year) – none

Typical “Mixed Environment” • Some new modalities that support; Some old modalities that don’t • PACS can store; but only minimal display • Maybe 1 -2 Workstations support; Most workstations do not (CAD, 3 D, Viewing, Clinical Packages)

Deployment • No known fully Enhanced sites • Some Mixed Environment Sites • No known significant usage

Adoption: In Theory • To adopt in mixed environment: – New Systems support both (enhanced & basic) – Assoc. Neg. to determine support – Configuration to set preference – Use Enhanced where possible (get benefit) – Provide Basic to older systems; either: • “Down-convert” enhanced to basic, or • Dual-store enhanced & basic throughout pipeline

Problem • Down-conversion: an unsolved problem – basic images need too much tweaking • Dual-store – Wastes bandwidth/storage – Introduces management issues • No support of basic means that: – I have a partly crippled image network/workflow – I can’t provide images to other sites

Result • Lack of technical solutions for mixed environments is obstructing adoption • Essential problems: – All or nothing deployment – No incremental benefit Very poor dynamic

What do we do? Alternatives: • Wait for sites to upgrade all systems – Limited User interest if no immediate benefit – Limited Vendor interest if limited user interest • Devise/promote an intermediate benefit • Devise a better way to support Basic