Radiology Integration Profile Part 2 IHE-J 2009 Workshop - Changing the Way Healthcare Connects IHE J ( )
PIR Patient Information Reconciliation IRWF Import Reconciliation Workflow SWF Radiology Scheduled Workflow PGP Presentation of Grouped Procedure NM Nuclear Medicine Image CPI Consistent Presentation of Image PWF Post-Processing Processing Workflow MAMMO Mammography Image ED Evidence Documents ARI Access to Radiology Information PDI Portable Data for Imaging XDS-I XDS for Imaging RWF Reporting Workflow FUS Image Fusion KIN Key Image Note ATNA Radiology Option CHG Charge Posting TCE Teaching File & Clinical Clinical Trial Trial Export SINR Simple Image & Numeric Report 2
SWF PIR CPI KIN KIN ARI PWF DICOM SR SINR RWF RWF ED NM MAMMO MAMMO FUS PDI IRWF IRWF XDS-I ATNA PGP PGP CHG TCE 3
Nuclear Medicine Image NM
5
General NM Viewing Suboptimal NM PACS 6
General NM Viewing Suboptimal NM PACS 7
General NM Viewing Suboptimal Click and move mouse down to adjust window level, right to adjust window center 8
Cardiac Viewing Suboptimal If sent as Short axis Images not displayed in a useful format. If sent as screen snapshots (ie, static Secondary Capture) Can t t separately adjust stress and rest images Can t t view gated cine 9
NM Image Transaction Diagram Evidence Creator Image Display Creator Images Stored [18] Storage Commitment [10] Query Images [14] Retrieve Images [16] Image Manager Image Archive Modality Images Stored [8] Storage Commitment [10] Acquisition Modality 10
NM Image Standards Used DICOM NM Image Object DICOM Multiframe Secondary Capture Dynamic Results Collection of Static Results DICOM Secondary Capture Static Results ACC NM Cardiac Display format 11
NM Image Actors Acquisition Modalities NM IOD Evidence Creators NM IOD Result Screen Export Option Image Manager/Archives NM Secondary Capture (SC & MFSC) IOD Image Displays NM Secondary Capture (SC & MFSC) IOD MPR MPR General NM, Cardiac NM General NM Cardiac NM 12
Mammography Image MAMMO
! : CAD MQSA (Mammography Quality Standards Act USA) 14
Modality Archive Workstation CAD For Presentation Image Data For Processing Image Data Mammo CAD Structured Rpt Printer 15
Hanging protocol determined by: View Type (i.e. CC vs. MLO) Specialty View Type (i.e. Spot, Mag) Laterality Patient Orientation R CC L CC R MLO L MLO 16
Hanging based upon series or study descriptions Image order as acquired Image orientation as acquired Stacked series example R CC L CC R MLO L MLO 17
Centered images can create large borders at chestwall Image offset with chestwall side having minimal borders 18
IHE FFDM FFDM 19
Evidence Creator 10. Storage Commitment 43. Store Evidence Documents Image Manager 10. Storage Commitment Image Archive 8. Modality Image Stored Image Display 14. Query Images 16. Retrieve Images 44. Query Evidence Documents 45. Retrieve Evidence Documents Acquisition Modality Print Composer 23. Print Request with Presentation LUT Print Server 20
Acquisition Modality DICOM DICOM 21
Image Display view, laterality, patient orientation, and specialty views 22
Image Display CAD CAD 23
Image Manager Digital Mammography X-RayX Ray SOP SOP CAD CAD SOP 24
Evidence Creator (CAD) CAD SR SOP SOP 25
Print Composers / Print Servers (Requested Image Size) VOI LUTS Presentation LUT 12 bit 26
Translate Rotate Rigid Registration Scale Warp- optional (Deformable Registration) Fuse 28
CT MR. Referring Physician. 29
30
.. 31
: MPR Fusion Side-by by-side 32
Spatial Registration Object PET-CT CT 33
(e.g. CT) (e.g. PET) (optionally). blending factor (0 to 100%) 34
80% 50% 20% 50% 100% 50% 50% 35
Modality CT Modality MR Image Archive Evidence Creator Image Display Store CT Store MR Retrieve CT, MR Register MR to CT Store SRO Fuse CT and MR Store BSPS Retrieve CT, MR, SRO, BSPS Apply T to MR Fuse CT and MR 36
Acquisition Modality Evidence Creator [RAD 8] Modality Images Stored [RAD 57] Blending Presentation States Stored [RAD 56] Spatial Registrations Stored [RAD 10] Storage Commitment [RAD 18] Creator Images Stored [RAD 57] Blending Presentation States Stored [RAD 56] Spatial Registrations Stored [RAD 10] Storage Commitment Image Manager Image Archive Image Display [RAD 14] Query Images [RAD 16] Retrieve Images [RAD 15] Query Presentation States [RAD 17] Retrieve Presentation States [RAD 58] Retrieve Spatial Registrations 37
CT PET Blending State Registration Object CT PET ( ) alignment alignment, Registration object Blending State 38
Blending State Registration Object CT PET Blending state. Blending state.. MPR 39
Portable Data for Imaging PDI
PDI DICOM DICOM 41
PDI [RAD-47] Distribute Imaging Information on Media Display Web Portable Media Creator Image Display Report Reader DICOM Print Composer Media Importer 42
PDI DICOM General Purpose CD-R Web DICOM DICOM 43
PDI CDROM DICOM DICOMDIR Directory of DICOM files DICOM Web INDEX.HTM README.TXT IHE_PDI Directory of web files Web content (optional) Other optional content 44
ISO 9660 Level 1 1 8 8 3 DICOM A-Z 0-9 _ 8 45
DICOM DICOM DIR DICOM DICOM DICOM IHE_PDI 46
Web Web XHTML JPEG GIF GIF INDEX.HTM INDEX.HTM IHE_PDI Web 47
Import Reconciliation Workflow IRWF
IRWF CD CD 49
IRWF 50
Scheduled Import Transaction Diagram DSS/Order Filler Performed Procedure Step Manager Import PS in Progress [RAD-59] Import PS Completed [RAD-60] Import PS in Progress [RAD-59] Import PS Completed [RAD-60] Storage Commitment [RAD-10] Import PS in Progress [RAD-59] Import PS Completed [RAD-60] Query Modality Worklist [RAD-5] Image Manager Importer Image Archive Imported Objects Stored [RAD-61] DICOM Transactions Modality Worklist (MWL) Modality Performed Procedure Step (MPPS) Object Storage Storage Commitment 51
Unscheduled Import Transaction Diagram Performed Procedure Step Manager Import PS in Progress [RAD-59] Import PS Completed [RAD-60] Image Manager Storage Commitment [RAD-10] Import PS in Progress [RAD-59] Import PS Completed [RAD-60] Importer Image Archive Imported Objects Stored [RAD-61] Patient Demographics Supplier Patient Demographics Query [ITI-21] HL7 Transactions Patient Demographics Query (QBP^22) DICOM Transactions Modality Performed Procedure Step (MPPS) Object Storage Storage Commitment 52
Cross-Enterprise Document Sharing for Imaging XDS-I
XDS-I XDS XDS-I I depends on IT Infrastructure Cross-Enterprise Document Sharing (XDS) New Actors Imaging Document Source Imaging Document Consumer (should be grouped with Document Consumer) Same Actors as in XDS Document Consumer Document Registry Document Repository Added extension to support imaging data (images and reports) 54
XDS-I Patient Identity Source Patient Identity Feed Document Registry Query Documents Imaging Document Consumer Document Consumer Imaging Document Source Provide & Register Document Set Document Repository Register Document Set Retrieve Document Retrieve Images Retrieve Presentation States Retrieve Key Image Note Retrieve Evidence Documents WADO Retrieve 55
XDS-I XDS-I I Actors: Imaging Document Consumer at least one Retrieve ( [RAD-55], [RAD-16], [RAD-17], [RAD-27], [RAD-31] [RAD-35]) Imaging Document Source Provide and Register Document Set [RAD-54] WADO Retrieve [RAD-55] Retrieve Images [RAD-16], Retrieve Presentation States [RAD- 17] Retrieve Reports [RAD-27], Retrieve Key Image Note [RAD-31], Retrieve Evidence Documents [RAD-45] XDS Actors Document Repository Provide and Register Document Set [RAD-54] 56
XDS-I: Options Imaging Document Source must support at least one of the following options: Extensive Set of DICOM Instances PDF Report NEW Text Report wrapped in a CDA Document NO Text option NO multipart Text / PDF option 57
WWW.IHE-J.ORG 58