4 - Digital Imaging and Communications in Medicine

Abstract

The Digital Imaging and Communications in Medicine (DICOM) standard was established in 1992 to exchange medical images in digital format. It is somewhat complicated by its own specific “lingo”. It is constantly changing to accommodate new imaging technologies and greater integration. Currently, it consists of 18 different sections, dealing with protocol, DICOM formats and specification compliance. DICOM is based on the standard The American Collage of Radiology – The National Electrical Manufacturers Association (ACR-NEMA) and it was released by the ACR to meet the needs of connectivity between imaging equipment. DICOM is affiliated with various American organizations and international standards working in related fields. The original DICOM standard was called ACR-NEMA, referring to these organizations. This standard was first published in 1985, and a second version (2.0) was published in 1998. In order to make clear their ancestral connection with the standard ACR-NEMA, the original version of DICOM has been called DICOM version 3.0. Normally, each year, updated versions of the DICOM standard are published. DICOM history dating back to the 1980s really was driven by users (i.e. ACR). Most manufacturers felt relatively comfortable supporting proprietary standards communication and data exchange, because it restricted their clients to purchasing equipment from the same company or developing custom software to connect to equipment acquisition. The development of a general purpose workstation, such as 3D workstations, was required for supporting a library of all the different types of tapes, floppy drives and other exchange formats. The availability of the ACR-NEMA standard in the 1980s proved to be a double-edged sword. Various manufacturers started to implement it over their own unstandardized network protocol, making the standard extensions as needed. Phillips and Siemens joined and even developed their own version, called Standard Product Interconnect. Early implementations of Picture Archiving and Communication Systems (PACS) and users dealing with systems of that era still have to deal with early ACR-NEMA 2.0 implementation and work with converters, interface boxes, etc., to reach the true level of DICOM.