June 28-29, 2005IHE Interoperability Workshop 1 Integrating the Healthcare Enterprise Consistent Presentation of Images Integrating the Healthcare Enterprise

June 28-29, 2005 IHE Interoperability Workshop1

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

Consistent Presentation of ImagesConsistent Presentation of Images

Ellie AvrahamEllie AvrahamKodak Health GroupKodak Health Group

IHE Planning andIHE Planning and Technical CommitteesTechnical Committees


The Visual Appearance of grayscale images displayed on different types of softcopy display devices or printed on different types of hardcopy output devices is in general inconsistent and may impact the clinical Diagnostics Reading

Consistent Presentation of Images Consistent Presentation of Images Abstract/Scope: The Grayscale Abstract/Scope: The Grayscale

Consistency ProblemConsistency Problem


Problems of Display InconsistencyProblems of Display Inconsistency

mass visible mass invisible

VOI chosen on one display device

Rendered on another with different display

Mass expected to be seen is no longer seen

Slide Provided by David Clunie


Problems of Inconsistency in Problems of Inconsistency in Display Luminance rangeDisplay Luminance range

0.5

1.5

1.0

3.0

Not all display levelsare perceivable on alldevices



Problems of Inconsistency in Display Problems of Inconsistency in Display Luminance rangeLuminance range

0.5

1.5

1.0

3.0

Not all display levelsare perceivable on alldevices



Problems of Hardcopy-Softcopy InconsistencyProblems of Hardcopy-Softcopy Inconsistency

Digital Modality Laser Printer

Printed images don’t looklike displayed images



Causes of InconsistencyCauses of Inconsistency

1.0 .66

Display devicesvary in the maximumluminance they canproduce

Display CRT Luminance vs. Film Optical Density on a light box is an extreme example



Consistent Presentation of Images Consistent Presentation of Images Value PropositionValue Proposition

1.Consistent distribution of Images across the healthcare enterprise

- Consistency among Hardcopy Images Printed on different Printers

- Consistency among Softcopy Images view on different Display devices

- Consistency among Hardcopy and Softcopy Image view

2. Maintain and Improve Image Quality

- Calibrating the Display/Print Device

- Use Presentation State for Display and Presentation (P-Val) LUT for Print.

3. Improve Throughput

- Preserve the Display Setup parameters in the Presentation State

- Apply the Presentation State automatically before the Images Display

The cost effective solutionto ensure that image quality is maintained across

different monitors and film producing devices


DISPLAY

Image Archive

Image Manager

Image Display

Image Creator

Present.State

Stored

Q /RPresentation

Sates

ImagesStored

Present.State

Stored

AcquisitionModality

PRINTING

Print Server

Print Request withPresentation LUT

Print Composer

• Consistent Appearance of Images:– Display Devices– Printed Output

Consistent Presentation of ImagesConsistent Presentation of ImagesTransaction DiagramTransaction Diagram


Consistent Presentation of Images Consistent Presentation of Images DICOM Standard UsedDICOM Standard Used::Calibration of the Softcopy Display and the Hardcopy Output Devices using DICOM Grayscale Standard Display Function (GSDF)

Creating Hardcopy Output Using DICOM Basic Print with Presentation LUT (P-LUT) Support

Preserving/Using the Softcopy Display Viewing Parameters in the DICOM Grayscale Softcopy Presentation State (GSPS) container

CalCal

HardHard

SoftSoft


Consistent Presentation of ImagesConsistent Presentation of ImagesStandardizing/Calibrating DeviceStandardizing/Calibrating Device

The DICOM Standard Defines: A standard curve, the Grayscale Standard Display

Function (GSDF), against which different types of display and hardcopy output devices should be calibrated – Adjust their Characteristic Curve to the GSDF curve.

CalCal

Devices Have to Be Properly CalibratedDevices Have to Be Properly Calibrated


Standardizing a Display/Print Standardizing a Display/Print Device to GSDF CurveDevice to GSDF Curve


CalCal

0.1

1

10

100

0 50 100 150 200 250

DDL or P-Values

Standard

Characteristic Curve


Consistent Presentation of Images Consistent Presentation of Images Images Printed, the DICOM Standard Images Printed, the DICOM Standard

Defines:Defines:

Basic Print Management with Presentation Look Up Table, for controlling the consistent appearance of preformatted images on printed output

HardHard


Basic Print Request with Presentation LUT Basic Print Request with Presentation LUT ActorsActors

PrintComposer

PrintServer

DICOM Film Session N-CREATE

DICOM Film Box N-CREATE

DICOM Image Box N-SET

DICOM Film Box N-ACTION

DICOM Film Session N-ACTION

Print Status (DICOM N-EVENT-REPORT)

DICOM Presentation LUT N-CREATEDICOM Presentation LUT N-CREATEPrint Composer

Print Server

Print Request

Printer StatusHardHard

Print Presentation LUT


Actors:Actors: Basic Print Request with Basic Print Request with Presentation LUTPresentation LUT

• Print Composer – A system that generates DICOM print requests as a DICOM Print SCU.Print composer has to apply image processing manipulations, and requests to Print server will specify P-Values in the form of a Presentation Look-Up Table (Presentation LUT) or implicitly by Presentation LUT Shape.

• Print Server – A system that accepts and processes DICOM print requests as a DICOM Print SCP and performs image rendering on hardcopy media.The system must support pixel rendering to optical density according to the DICOM Grayscale Standard Display Function.

HardHard


Consistent Presentation of Images Consistent Presentation of Images Preserving Display Parameters:Preserving Display Parameters:

Grayscale Softcopy Presentation State (GSPS): an object for storing and communicating the parameters that describe how an image or set of images should be displayed.

A GSPS object contains references to the images it applies to, and the transformations (grayscale transformations, shutter transformation, image annotation, spatial transformations, and displayed area annotation) that should be applied when the images are presented on a softcopy display, or printed on film.

SoftSoft


Consistent Presentation of ImagesConsistent Presentation of ImagesReporting Radiologist Referring Physician or

Reviewing Radiologist

Presentation StatePresentation LUT

Grayscale Standard

Original Image

Window Level

Flip

Zoom

Area Of

Interest

Annotate

WithoutConsistent Presentation

AchievingConsistent Presentation

Area Of

Interest

SoftSoft


Consistent Presentation of ImagesConsistent Presentation of ImagesActors: Grayscale Softcopy Presentation State (GSPS)Actors: Grayscale Softcopy Presentation State (GSPS)

Image Acquisition / Evidence Creator Creates Images with GSPS Objects and Store them on

Image Manager/Image Archive

Image Manager /Image Archive Store and Query & Retrieve Images with GSPS Objects

Image Display Query & Retrieve Images with GSPS Objects and Apply

the GSPS on the Images


Acquire DisplayPrint

Consistent Presentation of ImagesConsistent Presentation of Images



More information….More information….

IHE Web site: http://www.ihe.nethttp://www.himss.org/IHEhttp://www.rsna.org/IHEhttp://www.acc.org/quality/ihe.htm

Technical Frameworks

Technical Framework Supplements – Trial Implementation

Non-Technical Brochures :

Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results Vendor Products Integration Statements

Questions?

Questions?

Documents

June 28-29, 2005IHE Interoperability Workshop 1 Integrating the Healthcare Enterprise Consistent Presentation of Images Integrating the Healthcare Enterprise