Radiology Participant Workshop, Oct 2004

Nuclear Medicine Image (NM)Nuclear Medicine Image (NM)

Integration ProfileIntegration Profile

Kevin O’Donnell IHE Radiology Technical Committee Member,

Toshiba Medical Systems Company

Radiology Participant Workshop, Oct 2004

NM – Actors and TransactionsNM – Actors and Transactions

Radiology Participant Workshop, Oct 2004

Points of Interest - NMPoints of Interest - NM

Appendix E, Volume 1 (Informative)– New to Nuclear Medicine?– Trouble matching NM to Scheduled Workflow?– Start Here.

– E.2 NM Workflow – What happens in NM procedures– E.3 NM Worklists – How to schedule/model it– E.4 NM Data – What to expect in the DICOM– E.5 NM Display – How it should be presented

– Many subtleties here

Radiology Participant Workshop, Oct 2004

Points of Interest – Points of Interest – Acquisition ModalityAcquisition Modality

Acquisition Modality – Modality Images Stored [8]– Create NM objects as specified

additional attribute & vector handling– e.g. Cardiac context codes, slice spacing, patient

orientation Study & Series UID creation clarification

– e.g. After PPS complete, new images MUST be new series– e.g. Reconstructed images MUST be new series

Radiology Participant Workshop, Oct 2004

Points of Interest –Points of Interest –Image Manager/ArchiveImage Manager/Archive

Image Manager/Archive– Store/Retrieve NM Objects– Store/Retrieve Secondary Capture Objects

Refer to list in the spec.

– “Level 2” storage requirement clarification e.g. keep private tags

– Support for Series Description as Query matching/return key

Radiology Participant Workshop, Oct 2004

Points of Interest – Points of Interest – Evidence CreatorEvidence Creator

Evidence Creator– Creator Images Stored [18]– Ditto. (i.e. See Acquisition Modality)

– Result Screen Export Option

Radiology Participant Workshop, Oct 2004

Result Screen Export Option:Result Screen Export Option:Evidence CreatorsEvidence Creators

Render Dynamic Result Screens– Based on the following DICOM Objects:

Multi-Frame Grayscale Byte Secondary Capture Multi-Frame True Color Secondary Capture

– Creating multiple single frame objects is NOT sufficient. Render Static Result Screens

– Using single frame DICOM Secondary Captures is sufficient– Using Multi-frame to render single or several related static result

screens is recommended provides better image comment/label attributes provides implicit display order displayed by stepping, not cine

Must generate appropriate Secondary Capture objects from any Result Screens created.

Radiology Participant Workshop, Oct 2004

Example Result ScreenExample Result Screen

Radiology Participant Workshop, Oct 2004

Points of Interest – Image DisplayPoints of Interest – Image Display

Image Display– Retrieve Images [16]– Display NM and Result-Screen Images

Note requirement for Color, Greyscale, Static & Dynamic Secondary Capture

– Support specified NM essential display capabilities

– Additional attribute handling e.g. Patient State, Image Orientation, Detector

Sequence, View Code Sequence

– Review Option

Radiology Participant Workshop, Oct 2004

Handle multi-frame / multi-vector images Multiple simultaneous cines Grayscale and color result screens Dynamic and static result screens Original resolution and scaled

Separate adjustment of upper and lower window levels Apply local color tables to grayscale screens Add new local color tables to system Change intensity of grayscale result screens

(recommended) Display Series Description tag …, etc.

Points of Interest – Image DisplayPoints of Interest – Image Display

Radiology Participant Workshop, Oct 2004

Points of Interest – Image DisplayPoints of Interest – Image Display

Scale “intelligently” to avoid presenting postage-stamp size NM images

Allow user to select different vectors/framesets of complex multi-frame images

Allow user to separately adjust intensity for different framesets (eg, phases) in the same “image”

Radiology Participant Workshop, Oct 2004

Display FormatsDisplay Formats Grid display

– Frames from one image set

A1 A2 A3 A4 A5 A6 A7 A8

A9 … … … … … … …

… … … … … … … …

… … … … … … … A32

…

A1 A2 A3 A4 A5 A6 A7 A8

B1 B2 B3 B4 B5 B6 B7 B8

A1 A2 B1 B2

C1 C1

Fit display– Frames from multiple image

sets

Comparison display– Compare frames from multiple

image sets

Radiology Participant Workshop, Oct 2004

Review Option: Image DisplaysReview Option: Image Displays

Adds Image Display requirements to support Review of NM Images– MPR Display– More series at once– Different series types together– Pixel value display

More reason to review Appendix E in detail