Digital Imaging And Communications In Medicine Images Research Articles

A Software Tool for Reading DICOM Directory Files

DICOMDIR directory files are useful in medical software applications because they allow organized access to images and information sets that come from radiological studies that are stored in conformance with the digital imaging and communication in medicine (DICOM) standard. During the medical application software development, specialized programming libraries are commonly used in order to solve the requirements of computation and scientific visualization. However, these libraries do not provide suitable tools for reading DICOMDIR files, making necessary the implementation of a flexible tool for reading these files, which can be also easily integrated into applications under development. To solve this problem, this work introduces an object-oriented design and an open-source implementation for such reading tool. It produces an output data tree containing the information of the DICOM images and their related radiological studies, which can be browsed easily in a structured way through navigation interfaces coupled to it.

Vendor-Neutral Case Input into a Server-based Digital Teaching File System

Although digital teaching files are important to radiology education, there are no current satisfactory solutions for export of Digital Imaging and Communications in Medicine (DICOM) images from picture archiving and communication systems (PACS) in desktop publishing format. A vendor-neutral digital teaching file, the Radiology Interesting Case Server (RadICS), offers an efficient tool for harvesting interesting cases from PACS without requiring modifications of the PACS configurations. Radiologists push imaging studies from PACS to RadICS via the standard DICOM Send process, and the RadICS server automatically converts the DICOM images into the Joint Photographic Experts Group format, a common desktop publishing format. They can then select key images and create an interesting case series at the PACS workstation. RadICS was tested successfully against multiple unmodified commercial PACS. Using RadICS, radiologists are able to harvest and author interesting cases at the point of clinical interpretation with minimal disruption in clinical work flow.

Design of the DICOM-enabled viewing application based on LEADTOOLS V14.5

医学数字图像与通讯(DICOM)图像阅读软件是一个相对独立的软件,它既可以嵌入到医疗影像管理系统(PACS)的影像工作站中,用于DICOM图像的读写、显示和基本的图像处理,也可以单独安装于个人电脑上,方便医生随时随地浏览DICOM图像.LEADTOOLS V14.5是Leadtools公司最新开发的医学软件开发包,在它的基础上开发DICOM图像阅读软件,可以大大缩短开发时间,降低开发成本.我们将从设计原理、编程思路、具体实现等几个方面详细介绍如何应用VC++.NET和LEADTOOLS V14.5,设计DICOM 3.0标准下的DICOM图像阅读软件。

A service based approach for medical image distribution in healthcare Intranets

The Digital Imaging and Communications in Medicine (DICOM) protocol is currently the ubiquitous standard for the communication of medical images and related data within the radiology department. However, seamless image distribution within the healthcare enterprise and especially with research and educational information systems is still hard to achieve, as software developers of such third-party applications have to go through the rather cumbersome task of adapting the DICOM communication model and implementing the DICOM protocol. This paper gives a brief outline of current trends in medical image distribution in the healthcare enterprise, and proposes a new technological approach for distributing DICOM images and related data through commonplace Internet technologies, based on the emerging web services software paradigm. In particular, the paper describes the DICOM Image Management (DIM) web service which acts as a façade for conventional DICOM sources allowing DICOM image data and related information, to be transformed into XML documents encapsulated in SOAP messages, enabling integration at the application level through general purpose standardized web technologies. Implementation issues are discussed and a demonstration of engaging the DIM web service is included.

An Open Source Framework for Modification and Communication of DICOM Objects

A configurable framework has been developed that can receive, modify, and export images in different picture archiving and communication system scenarios. The framework has three main components: a receiver for Digital Imaging and Communications in Medicine (DICOM) objects, a processing pipeline to apply one or more modifications to these objects, and one or more senders to send the processed objects to predefined addresses. The toolbox programming was implemented as an open source project in Java. The processing pipeline uses the concept of configurable plug-ins. One plug-in is user programmable by means of extensible stylesheet language files and allows conversion of DICOM objects to extensible markup language documents or other file types. Input and output channels are the DICOM Storage service, DICOM compact disks-read-only memory (CD-ROMs), and the local file system. The toolbox has been successfully applied to different clinical scenarios, including the correction of DICOM objects from non-Integrating the Healthcare Enterprise (IHE) conform modalities, pseudonaming of DICOM images, and use of the IHE Portable Data for Imaging profile with import and export of CD-ROMs. The toolbox has proved reliability in the clinical routine. Because of the open programming interfaces, the functionality can easily be adapted to future applications.

DICOM router: An open source toolbox for communication and correction of DICOM objects 1

Today, the exchange of medical images and clinical information is well defined by the digital imaging and communications in medicine (DICOM) and Health Level Seven (ie, HL7) standards. The interoperability among information systems is specified by the integration profiles of IHE (Integrating the Healthcare Enterprise). However, older imaging modalities frequently do not correctly support these interfaces and integration profiles, and some use cases are not yet specified by IHE. Therefore, corrections of DICOM objects are necessary to establish conformity. The aim of this project was to develop a toolbox that can automatically perform these recurrent corrections of the DICOM objects. The toolbox is composed of three main components: 1) a receiver to receive DICOM objects, 2) a processing pipeline to correct each object, and 3) one or more senders to forward each corrected object to predefined addressees. The toolbox is implemented under Java as an open source project. The processing pipeline is realized by means of plug ins. One of the plug ins can be programmed by the user via an external eXtensible Stylesheet Language (ie, XSL) file. Using this plug in, DICOM objects can also be converted into eXtensible Markup Language (ie, XML) documents or other data formats. DICOM storage services, DICOM CD-ROMs, and the local file system are defined as input and output channel. The toolbox is used clinically for different application areas. These are the automatic correction of DICOM objects from non-IHE-conforming modalities, the import of DICOM CD-ROMs into the picture archiving and communication system and the pseudo naming of DICOM images. The toolbox has been accepted by users in a clinical setting. Because of the open programming interfaces, the functionality can easily be adapted to future applications.

Advantages of Color B-mode Imaging With Contrast Optimization in Sonography of Low-Contrast Musculoskeletal Lesions and Structures in the Foot and Ankle

The purpose of this study was to evaluate the utility of color B-mode imaging with contrast optimization in evaluating low-contrast lesions of the foot and ankle (Morton neuromas and plantar fasciitis). The sonographic examinations of 49 consecutive patients with a diagnosis of plantar fasciitis or Morton neuroma imaged with both conventional gray scale imaging and color B-mode imaging with contrast optimization (Photopic; Siemens Medical Solutions, Mountain View, CA) were reviewed. In every patient, matched pairs of images obtained with conventional gray and color maps (Photopic) were acquired and stored as DICOM (Digital Imaging and Communications in Medicine) images on a sonographic workstation. Each image was assessed independently by 2 musculoskeletal radiologists trained in musculoskeletal sonography for overall image contrast (lesion to background), conspicuity of regional tissue boundaries, visualization of deep tissue boundaries, and how well the internal characteristics of the structure were visualized. Three-way analysis of variance showed that Photopic imaging resulted in statistically significantly improved overall image contrast, definition of regional soft tissue boundaries, including deep soft tissue boundaries, and depiction of the internal characteristics of the structure being examined. Color imaging with contrast optimization improves overall image contrast and better defines deep soft tissue boundaries and the internal morphologic characteristics of Morton neuromas and the plantar fascia compared with conventional gray scale imaging.

Informatics in Radiology (infoRAD)

A novel mobile system has been developed for use by radiologists in managing Digital Imaging and Communications in Medicine (DICOM) image data. The system consists of a mobile DICOM server (MDS) and personal digital assistants (PDAs), including a Linux PDA with a video graphics array (VGA) display (307,200 pixels, 3.7 inches). The MDS weighs 410 g, has a 60-GB hard disk drive and a built-in wireless local area network (LAN) access point, and supports a DICOM server (Central Test Node). The Linux-based MDS can be accessed with personal computers (PCs) and PDAs by means of a wireless or wired LAN, and client-server communications can be established at any time. DICOM images can be displayed by using any PDA or PC by means of a Web browser. Simultaneous access to the MDS is possible for multiple authenticated users. With most PDAs, image compression is necessary for complete display of DICOM images; however, the VGA screen can display a 512 x 512-pixel DICOM image almost in its entirety. This wireless system allows efficient management of heavy loads of lossless DICOM image data and will be useful for collaborative work by radiologists in education, conferences, and research.

Down-Scaled 3D Medical Image Transfer System Using Instant Messenger

OBJECTIVE: We have developed an instant messenger system that supports transmitting 3D medical image objects for telediagnostic use. METHODS: We used thresholding and down-scaling technique to build down-scaled 3D object with 80 sliced Digital Imaging and Communication in Medicine(DICOM) images. And, we also construct instant messenger for medical data transfer and general communication. We measured total image size and transmission time which were decreased when applied peer to peer connection using instant messenger for medicine. RESULTS: Our study showed that total DICOM image size was decreased around 1% and transmission time was also decreased by 1.59% when we use proposed system. CONCLUSION: Proposed methods have a potential to be a useful tool in ubiquitous health network system. Also, we expect the synergy effect is increased by developing 3D object technique and security solutions.

Evaluation of the accuracy of volume determination on the orbit and eyeball using MRI

Purpose This study reports a calibration carried out on phantoms simulating the orbit and eyeball to evaluate the accuracy of volumetric determination using MRI DICOM (Digital Imaging and Communication in Medicine) images. Methods Ten tailor-made spherical silicon balls ranging in size from 5 to 14 cm 3 and 10 silicon moulds of orbits from 10 human dried skulls were used to simulate the eyes and orbits, respectively. The CISS (Constructive interference in steady state, TR/TE = 16/8 ms) T2-weighted sequence was taken using a Siemens MRI scanner. The volume of each phantom was computed and compared with the known physical volumes. Results The computed and physical volumes were highly correlated for both eyeball ( r = 0.997) and the orbit ( r = 0.992) phantoms. Coefficients of variation of the computed and physical volumes were low. Consequently, it is possible to apply a calibration value to the computed volume to derive the physical volume with a high level of confidence. Conclusion We conclude that with appropriate calibration, it is viable to use MRI DICOM images to derive the volume of the eyeball and the orbit.

Informatics in Radiology (infoRAD)

It is often necessary for radiologists to use digital images in presentations and conferences. Most imaging modalities produce images in the Digital Imaging and Communications in Medicine (DICOM) format. The image files tend to be large and thus cannot be directly imported into most presentation software, such as Microsoft PowerPoint; the large files also consume storage space. There are many free programs that allow viewing and processing of these files on a personal computer, including conversion to more common file formats such as the Joint Photographic Experts Group (JPEG) format. Free DICOM image viewing and processing software for computers running on the Microsoft Windows operating system has already been evaluated. However, many people use the Macintosh (Apple Computer) platform, and a number of programs are available for these users. The World Wide Web was searched for free DICOM image viewing or processing software that was designed for the Macintosh platform or is written in Java and is therefore platform independent. The features of these programs and their usability were evaluated. There are many free programs for the Macintosh platform that enable viewing and processing of DICOM images.

System Integration and DICOM Image Creation for PET-MR Fusion

This article demonstrates a gateway system for converting image fusion results to digital imaging and communication in medicine (DICOM) objects. For the purpose of standardization and integration, we have followed the guidelines of the Integrated Healthcare Enterprise technical framework and developed a DICOM gateway. The gateway system combines data from hospital information system, image fusion results, and the information generated itself to constitute new DICOM objects. All the mandatory tags defined in standard DICOM object were generated in the gateway system. The gateway system will generate two series of SOP instances of each PET-MR fusion result; SOP (Service Object Pair) one for the reconstructed magnetic resonance (MR) images and the other for position emission tomography (PET) images. The size, resolution, spatial coordinates, and number of frames are the same in both series of SOP instances. Every new generated MR image exactly fits with one of the reconstructed PET images. Those DICOM images are stored to the picture archiving and communication system (PACS) server by means of standard DICOM protocols. When those images are retrieved and viewed by standard DICOM viewing systems, both images can be viewed at the same anatomy location. This system is useful for precise diagnosis and therapy.

Extending PowerPoint with DICOM image support.

Although PowerPoint has become a ubiquitous presentation tool in medical imaging, it does not support the Digital Imaging and Communications in Medicine (DICOM) standard. Users must go through a laborious conversion process that includes guessing the appropriate brightness and contrast to convert 16-bit DICOM images into 8-bit formats. A PowerPoint add-in was developed that incorporates features of a DICOM viewer into a presentation. Users can interactively manipulate large series of 16-bit images in stack mode with scroll, crop, zoom, and window width and level functions, as well as sort through images by location or series. Multiple DICOM image series can be placed on a single slide, and one can interactively scroll through stacks of images during a presentation to demonstrate imaging findings. The problem created by the varying contrast and brightness of different projector systems is overcome by interactively adjusting the image window level during presentations. Bone and lung window views can be shown without having to create separate images. Combining DICOM images into stacks as part of a PowerPoint presentation can result in a more effective and higher-quality presentation of medical images.

Free DICOM image viewing and processing software for your desktop computer: what's available and what it can do for you.

Whether or not a radiology department is "filmless," there is often a need to store images digitally for teaching or presentation purposes. Most computed tomographic and magnetic resonance images are in the Digital Imaging and Communications in Medicine (DICOM) 3 format, which has many advantages; however, these files can be very large and rapidly consume storage space. Converting DICOM files to smaller file formats such as the Joint Photographic Experts Group (JPEG) format can save space and allow insertion of images into presentations created with software such as Microsoft PowerPoint. Some picture archiving and communication systems can convert images from DICOM to other formats; however, many free options are also available. The World Wide Web was searched for free DICOM image viewing or processing software, and programs that were thought to be user-friendly and compatible with the Microsoft Windows operating systems were evaluated. There are many free programs that enable manipulation and processing of DICOM images on a desktop computer, allowing the user to easily window images and convert them to a smaller and more usable format, such as JPEG.

A declarative implementation of the DICOM-3 network protocol

We describe a new design for programs using the Digital Imaging and Communications in Medicine (DICOM) protocol, which we have implemented in a DICOM image storage server and a radiation treatment plan transfer facility for our locally developed radiation treatment planning system, Prism. This design is declarative, representing DICOM as a language for describing messages and sequencing of messages. The coding involved implementing an interpreter for this language. The DICOM protocol specifies messages, message formats, and sequencing. In our design, the specification translates almost directly into computer-readable declarative expressions that closely resemble the relevant tabulated DICOM specifications. The resulting programs are small, simple, and extensible, because most of the details of the DICOM protocol are not coded in the procedural control statements but are in the expressions and state table that the interpreter uses to perform all its functions. This approach provides a way to validate the consistency of a specification and the correctness of the implementation. The same method can be generalized to other such protocols. It may also be used to assist the design of new protocols.

Medical image security in a HIPAA mandated PACS environment

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information.

Digital radiography and film scanners: automating the transition to filmless radiology.

To facilitate the integration of digital radiography (DR) and legacy film/screen technology, we have devised a methodology for film digitization that optimizes workflow and integrates well with the picture archiving and communication system (PACS). This work was performed at Mercy Medical Center (Cedar Rapids, IA) using a film digitizer with built-in Digital Imaging and Communications in Medicine (DICOM) communication. The radiology department at Mercy has one DR system and three separate film/screen systems. The DR system software suite features DICOM Modality Worklist capability to provide complete radiology information system (RIS) integration functionality. This provides for patient demographic information to be automatically downloaded from the RIS worklist to populate the DICOM image header. Likewise, we have taken advantage of the film scanner's DICOM capability to develop software linking it with the hospital RIS. This capability provides a worklist downloading functionality equivalent to that of the DR. Patient demographics can then be rapidly downloaded as each film is digitized. The worklist capability of the scanner is essential in several respects. First, it guarantees that patient demographic information is completely accurate and, therefore, that the digitized x-ray image will be merged with the correct patient file in the PACS. Additionally, high film scanner throughput is achieved, guaranteeing that all inpatient-digitized films are as readily available on the PACS as their DR image counterparts. The digitized images have proven to be of diagnostic quality on the typical 1K by 1K PACS workstation. Also, as patients are admitted to the hospital, prior films from the radiology archive are digitized to form a readily available patient history for in-house physicians. Over time, we are building archival patient histories of soft-copy images that will enable increased availability of patient x-rays to both in-hospital and outside referring physicians, especially as more internet-viewing software becomes available to the out-of-hospital medical community. Finally, the results of this study show that high-throughput RIS integration of film scanning equipment is a key component to making a graceful transition to the filmless hospital as more DR systems are installed.

Distributing digital imaging and communications in medicine data and optimizing access over satellite networks.

To improve radiology access to full uncompressed Digital Imaging and Communications in Medicine (DICOM) data sets, we evaluated satellite access to a DICOM server. Radiologists' home computers were connected by satellite to a Medweb DICOM server (Medweb, San Francisco, CA). A 10.2-kb data set containing a 19-image head computed tomography (CT) scan was transferred using DirecPC (Hughes Electronics Corp, Arlington, VA) at three different times of the day; 6 AM, 3 PM, and 8 PM. The average transfer time for all 19 images from the DICOM server was 4 minutes and 17 seconds (257 seconds). The slowest transfer rate of 670 seconds (121 kbps) was obtained at 8 PM. The best transfer rate of 2 minutes, 54 seconds (467 kbps) was obtained at 6 AM. The full 16-bit DICOM images were viewed with bone, brain, and soft tissue windows. The Medweb plug-in viewer loaded the first image within 30 seconds of selecting the case for satellite transfer. In conclusion, satellite internet transfer of radiology studies is suitable for timely review of full DICOM data sets and can expand the range of teleradiology consultation.

Enhancing availability of the electronic image record for patients and caregivers during follow-up care.

To develop a personal computer (PC)-based software package that allows portability of the electronic imaging record. To create custom software that enhances the transfer of images in two fashions. Firstly, to an end user, whether physician or patient, provide a browser capable of viewing digital images on a conventional personal computer. Second, to provide the ability to transfer the archived Digital Imaging and Communications in Medicine (DICOM) images to other institutional picture archiving and communications systems (PACS) through a transfer engine. Radiologic studies are provided on a CD-ROM. This CD-ROM contains a copy of the browser to view images, a DICOM-based engine to transfer images to the receiving institutional PACS, and copies of all pertinent imaging studies for the particular patient. The host computer system in an Intel based Pentium 90 MHz PC with Microsoft Windows 95 software (Microsoft Inc, Seattle, WA). The system has 48 MB of random access memory, a 3.0 GB hard disk, and a Smart and Friendly CD-R 2006 CD-ROM recorder (Smart and Friendly Inc, Chatsworth, CA). Each CD-ROM disc can hold 640 MB of data. In our experience, this houses anywhere from, based on Table 1, 12 to 30 computed tomography (CT) examinations, 24 to 80 magnetic resonance (MR) examinations, 60 to 128 ultrasound examinations, 32 to 64 computed radiographic examinations, 80 digitized x-rays, or five digitized mammography examinations. We have been able to successfully transfer DICOM images from one DICOM-based PACS to another DICOM-based PACS. This is accomplished by inserting the created CD-ROM onto a CD drive attached to the receiving PACS and running the transfer engine application. Providing copies of radiologic studies performed to the patient is a necessity in every radiology department. Conventionally, film libraries have provided copies to the patient generating issues of cost of loss of film, as well as mailing costs. This software package saves costs and loss of studies, as well as improving patient care by enabling the patient to maintain an archive of their electronic imaging record.

Image acquisition context: procedure description attributes for clinically relevant indexing and selective retrieval of biomedical images.

To support clinically relevant indexing of biomedical images and image-related information based on the attributes of image acquisition procedures and the judgments (observations) expressed by observers in the process of image interpretation. The authors introduce the notion of "image acquisition context," the set of attributes that describe image acquisition procedures, and present a standards-based strategy for utilizing the attributes of image acquisition context as indexing and retrieval keys for digital image libraries. The authors' indexing strategy is based on an interdependent message/terminology architecture that combines the Digital Imaging and Communication in Medicine (DICOM) standard, the SNOMED (Systematized Nomenclature of Human and Veterinary Medicine) vocabulary, and the SNOMED DICOM microglossary. The SNOMED DICOM microglossary provides context-dependent mapping of terminology to DICOM data elements. The capability of embedding standard coded descriptors in DICOM image headers and image-interpretation reports improves the potential for selective retrieval of image-related information. This favorably affects information management in digital libraries.