（92）醫療資訊DICOM 標準推動計畫成果報告

92 DICOM

1

01

03

04

07

.........................................

(1) DICOM.. 07

(2) HIS DICOM................................. 08

(3)............. 09

(4)Free Viewer......... 10

(5)............. 11

DICOM...............

(1) IHE ............ 11

(2)............. 12

(3) DICOM............. 13

(4)............. 13

.........

(1) UID................ 14

(2) DICOM............. 14

(3) DICOM............. 15

(4)DICOM.............. 16

17

18

3

Digital Imaging and Communication MedicineDICOM

5

DICOMDigital Imaging and Communication Medicine

1.

2.

3.

4.

DICOM

6

()

1. DICOM CR(Computed Radiography)DX(Direct X Ray)MR(Magnetic Resonance)CT(Computed Tomography )US(Ultrasound )DICOM DICOM Part 10 DICOM Part 3, Basic Directory Information Object DefinitionDICOM DICOMDIR

2. HIS DICOM IHE DICOM HL7 DICOM

3.

4.

()DICOM

1. IHE

IHE IHE DICOM

7

2.

DICOM Viewer

3. DICOMDICOM Tag viewerDICOM DICOM

DICOM

4. (modality console)(Image acquisition)

()

1. UID DICOM (UID)UID UID UID

2. DICOM

3. DICOM DICOM()

4. DICOM 2 3 DICOM DICOM

8

7 10

8 15 9 5 10 3

11 7

DICOM()-DICOM HL7 IHE E-mail ()

DICOM Part 3 CR (Computed Radiography)DX (Direct X Ray)MR (Magnetic Resonance)CT (Computed Tomography)US (Ultrasound)MG (Mammography)SC (Secondary Capture)VL (Visible light) IO (Intra-oral)RT (Radio Therapy)PET (Positron Emission Tomography)

(1) DICOM

DICOM (Patient)(Study)(Series)(Image) HISPACS

DICOM(Modality Working List) DICOM

DICOM

9

DICOM DICOM DIR()7/25 -DICOM() Minimal Requirement for TAGS for DICOM DIR building Minimal requirement for TAGS for DICOM Display TagsMust Option DICOMDICOMDIR DICOM

DICOMDIR DICOM DICOM Directory DICOMDIRDICOMDIR DICOMDICOMDIR DICOMDIR DICOMDIR READ DICOM DIR

DICOM DIR10/17-

11/7 Minimal Requirement for TAGS for DICOM DIR building Minimal requirement for TAGS for DICOM Display

DICOM DIR Patient LevelTag (0010,1010) Tag(0010,1010

Tag(0010,0030) Tag(0008,0030)Minimal Requirement for TAGS for DICOM DIR building Patient Level Tag(0010,1010 Study LevelTag(0010,1010) DICOM DICOM DIR (2) HIS DICOM

84DICOMHL7

10

DICOMHL7HISRISLISHL7HISHL7HL7Non-HL7Gateway

HL7PACSHL7DICOM(Work List)PACSHL7HIS/RISPACSDICOMDICOM Basic Modality Worklist Service ClassMWLHIS/RIS (3)

DICOM

DICOM (DICOM Storage Network Connection Services)(DICOM Media Storage Services)(FTP, SMTP,HTTP..) DICOM PACS DICOM

DICOM

ACDSee, PhotoShop BMP, GIF

DICOM DICOMDIR

DICOMDIR DICOMDIR

DICOMDIR CD modality DICOMDIR

11

DICOMDIR Viewer DICOMDIRTags PACS Image Viewer DICOMDIR

Credit Valley HospitalAgfa

GE

GE DICOM DICOMDIR DICOMDIR Viewer DICOMDIR DICOM Viewer LargeMin PACS DICOMDIR HL712/11 DICOM imageDICOM MIME DICOMDIR (4) Free DICOM Viewer

Free Viewer ViewerPACS DICOM DICOM

1. Osirishttp://www.expasy.org/www/UIN/html1/projects/osiris/osiris.html

OsirisThe OSIRIS imaging software DICOMDIR

2. PiViewhttp://www.mediface.com

Piview/

100

3. DICOM Eyehttp://www.etiam.com DICOM Eye ETIAMDICOMDIR 21

12

(5)

DICOM DICOM

(1) DICOM Part 15 DICOM

(2) E-Mail DICOM

(3) Web service

()DICOM

(1) IHE

IHE RSNA HIMSS IHEIHE HL7DICOM

IHE Taiwan

13

8 2223 HL7

IHE 11/8

IHE Taiwan IHE () IHE Taiwan IHE (2)

Free Software DICOM DICOM

1. CTNCentral Test Node Mallinckrodt Institute of Radiology RSNA

DICOM

2. DVTDICOM Validation Tool AGFA PHILIPHS

DICOM( License Agreement)DVT DICOM DVT Windows NT/2000

DICOM 3.0(Free-Software)

View DICOM TagsDICOM Storage Service ClassDICOM Query/Retrieve Service Class DICOM Media Storage Service Class ( DICOMDIR )

14

(3) DICOM

DICOM DICOM DICOM DICOM Tag Viewer

(4)

DICOM Part 3 CR (Computed Radiography)DX (Direct X Ray)MR (Magnetic Resonance)CT (Computed Tomography)RT (Radio Therapy)US (Ultrasound)MG (Mammography)VL (Visible light)SC (Secondary Capture) IO (Intra-oral)PET (Positron Emission Tomography)

( modality console )( Image acquisition )

PACS

PACS DICOM(Patient)(Study)(Series)(Image) DICOM Level Tags

15

CRT LCD

Minimal Requirement Size of Some Common Medical Images

Modality (Minimal Requirement)

One Image (bits) One Image (bits)

Nuclear Medicine(NM) 128 * 128 * 8 128 * 128 * 12

Ultrasound (US) 512 * 512 * 6 (24) 512 * 512 * 8 (24)

Computed Tomography (CT) 512 * 512 * 12 512 * 512 * 12

Magnetic Resonance Imaging (MRI) 256 * 256 * 12 256 * 256 * 12

Digital subt. Angiography (DSA) 512 * 512 * 8 1024 * 1024 * 8

Digitized Microscopy 512 * 512 * 8 (24) 512 * 512 * 8 (24)

Digitized X-ray film (14 inches by 14 inches) 2048 * 2048 * 12 2048 * 2048 * 12

Digital Fluoroscopy (DF) 1024 * 1024 * 8 1024 * 1024 * 8

Digital Mammography 2048 * 2048 * 12 4000 * 5000 * 12

Computed Radiography (CR) 2048 * 2048 * 10 2048 * 2048 * 12

* ( ) For color images.

CCD

DICOM JPEG Image Compression, Run Length Encoding Compression, JPEG-LS Image Compression. JPEG 2000 Image Compression

16

. . . .

SMPTE GSDF

()

(1) UID

OID UID UID 8 15 OID (2.16.886.101.20003.20014) OID 0Exp 0228712121 DICOM UID OID OID

OID 0(Exp1)

OID 2.16.886.101.20003.20014.10228712121 OID 1 0 OID

(2) DICOM

DICOM DICOM

17

A. Anthoula P. Anagnostaki, Sotiris Pavlopoulos*,Efthivoulos Kyriakou, and

Dimitris Koutsouris, A novel codification scheme based on the VITAL and DICOM standards for telemedicine applications, IEEE Transactions on Biomedical Engineering, 49(12):1399-1411, 2002.

B. Javier Pereira, Alfonso Castro, Dismer Ronda, Bernardino Arcay,and Alejandro Pazos name, Development of a System for Access to and Exploitation of Medical Images, Proceeding of the 15th IEEE Symposium on Computer-Based Medical Systems (CBMS 2002).

C. Catherine Kim Ly, SoftCopy Display Quality Assurance Program at Texas Children's Hospital, Journal of Digital Imaging Vol. 15, 33-40, 2002.

D. Jose Manuel Vazquez-Naya, Javier Pereira Loureiro, Julian Dorado de la Calle, Jorge Teijeiro Vidal, and Alejandro Pazos Sierra, Necessary Security Mechanisms in a PACS DICOM Access System with Web Technology, Journal of Digital Imaging Vol. 15, 107-111, 2002.

(3) DICOM

DICOM 8/159/5 10/3

DICOM

192 8 15() 6 9 30

- DICOM

292 9 5() 4 30 6 30 - B1

392 10 3() 5 30 6 30

18

2003 DICOM DICOM 11/29 117DICOM QC(92)

DICOM()

192 11 29() 8 30 5 30 - 117 2003 DICOM DICOM

(4) DICOM

DICOM 3.0 DICOM DICOM

DICOM

DICOM DICOM

DICOM DICOM

19

3(1)

(2) DICOM (3)

1.

2. DICOM

3. DICOM

DICOMDICOM

Minimal Requirement for TAGS for DICOM DIR building

Minimal Requirement for TAGS for DICOM DIR building () ROOT Layer UID ( 2.16.886..) Transfer Syntax: 1.2.840.10008.1.2.1 For Basic Directory FileCharset: ISO_IR192

1. Strict DICOMDIR application profile ! 2. Non strict DICOMDIR part 10 !

Patient Level ( 00041430 directory record type : PATIENT) Tag Name VR VM

00100020 Patient ID LO 1 00100010 Patients Name PN 1 00100040 Patients Sex CS 1 00100030 Patients Birth Date DA 1 00101000 Other Patient IDs() LO 1-n 00100021 Issuer of Patient ID LO 1 00104000 Patient Comments LO 1 00102154 Patients Telephone Number SH 1

Study Level ( 00041430 directory record type : STUDY)

00100020 Patient ID LO 1 00081030 Study Description LO 1 00080050 Accession Number SH 1 00080030 Study Time TM 1 00080020 Study Date DA 1 00080090 Referring Physicians Name PN 1 00101010 Patients Age AS 1

00080061 Modalities in Study CS 1-n 0020000D Study Instance UID UID UI 1 00321033 Requesting Service LO 1 00200010 Study ID ID SH 1 00081080 Admitting Diagnoses Description LO 1-n

Series Level ( 00041430 directory record type :SERIES)

0020000E Series Instance UID UID UI 1 00180015 Body Part Examined CS 1 0008103E Series Description LO 1 00080060 Modality CS 1 00201209 Number of Series Related Instances IS 1 00200011 Series Number IS 1 00080080 Institution Name LO 1 00081050 Performing Physicians Name PN 1-n

Instance Level ( 00041430 directory record type : IMAGE)

00080018 SOP Instance UID SOP UID UI 1 00204000 Image Comments LT 1 00080008 Image Type CS 1-n 00082111 Derivation Description ST 1 00041500 Referenced File ID UID CS 1-8 00041510 Referenced SOP Class UID in File SOP UID UI 1 00041511 Referenced SOP Instance UID in File SOP UID UI 1

00041512 Referenced Transfer Syntax UID in File SOP UID

UI 1 modality ( PART11)

00880200 Icon Image Sequence

SQ 1XA

( 1.2.840.10008.1.2.4.70 )

TAGS Application Profile , type 1, 2 !!

Minimal Requirement for TAGS for DICOM Display

Minimal Requirement for TAGS for DICOM Display

Patient Level ( 00041430 directory record type : PATIENT) M O Option

Tag Name CT MR CR/DX XA/RF US/SC GENERAL

00100020 Patient ID M M M M M M 00100010 Patients Name M M M M M M 00100040 Patients Sex M M M M M M 00100030 Patients Birth Date M M M M M M 00101010 Patients Age M M M M M M 00101000 Other Patient IDs( ) M M M M M M 00100021 Issuer of Patient ID M M M M M M 00104000 Patient Comments O O O O O O 00102154 Patients Telephone Number O O O O O O


00100020 Patient ID M M M M M M 00081030 Study Description M M M M M M 00080050 Accession Number M M M M M M 00080030 Study Time M M M M M M 00080020 Study Date M M M M M M 00101010 Patients Age M M M M M M 00080061 Modalities in Study M M M M M M 00321033 Requesting Service O O O O O O 00200010 Study ID ID O O O O O O

Series Level ( 00041430 directory record type : SERIES)

00180015 Body Part Examined O O O O O O 0008103E Series Description O M O O O O 00080060 Modality M M M M M M 00200011 Series Number O O O O O O 00200060 Laterality O O O O O O


00204000 Image Comments O O O O O O 00082111 Derivation Description O O O O O O

00180050 Slice Thickness O O O O O O

00201041 Slice Location O O O O O O 00180060 KVP O O O O O O 00080033 Content Time O O O O O O 00080032 Acquisition Time O O O O O O 00200013 Instance Number O O O O O O 00281051 Window Width O O O O O O 00281050 Window Center O O O O O O 00280008 Number of Frames O O O O O O 00280009 Frame Increment Pointer O O O O O O 00200020 Patient Orientation O O O O O O 00200037 Image Orientation () O O O O O O 00180080 Repetition Time O O O O O O 00180081 Echo Time O O O O O O 00180082 Inversion Time O O O O O O 00180091 Echo Train Length O O O O O O 00181060 Trigger Time O O O O O O 00181314 Flip Angle O O O O O O 00280010 Rows O O O O O O 00280011 Columns O O O O O O

DICOM -

92 10 17 ()

1. modality file DICOM DIRLossless- check Site 11

2. character set encoding

Big -5 93 UTF-8 character set encoding DICOM CP-252

3. minimal requirement for DICOM Display patient level

study level 4. minimal requirement for DICOM DIR minimal requirement for

DICOM Display 11

5. VPN VPN spare DICOM Communication

DICOM CommunicationVPN

HIS/RISDICOM

HIS/RIS

PACSDICOMDICOM Basic Modality Worklist Service ClassMWLHIS/RIS DICOMHIS/RISPACS

DICOM Basic Modality Worklist Service ClassHIS/RISPACS Integrated Healthcare Enterprise (IHE)

HL7DICOM (1) Modality Worklist Service

DICOM Modality Worklist DICOMWorklistModality

HIS/RISWorklist ServerWorklist ServerModality

IHE HL7 DICOM Service Class HL7 DICOM

HL7 Field DICOM Tag

Broker

HL7 ADT/ORM DICOM Worklist Service Class

HL7 DICOM

[1]Data Types

Data Type

HL7 Field DICOM Tag HL7 DICOM

Mapping DICOM Data Types to HL7 Data Types

DICOM Data Types HL7 Data Types VR Full Name Symbol Full Name

Comments

AE Application Entity ST Character String AS Age String ST Character String AT Attribute Tag SET Set Need a conversion function CS Code String ST Character String DA Date TS Point in Time By omitting the hhmmss.uuuu partDS Decimal String REAL Real Number Need a conversion function DT Date Time TS Point in Time FL Floating Point Single REAL Real Number FD Floating Point Double REAL Real Number IS Integer String INT Integer Number Need a conversion function

Mapping DICOM Data Types to HL7 Data Types

DICOM Data Types HL7 Data Types VR Full Name Symbol Full Name Comments

LO Long String ST Character String LT Long Text ST Character String OB Other Byte String ST Character String Not good enough OW Other Word String ST Character String Nor good enough PN Person Name PN Person Name SH Short String ST Character String SL Signed Long INT Integer Number SQ Sequence of Items LIST Sequence SS Signed Short INT Integer Number ST Short Text ST Character String TM Time ?

UI Unique Identifier (UID) II Instance Identifier

UL Unsigned Long INT Integer Number UN Unknown ST Character String Not good enough US Unsigned Short INT Integer Number UT Unlimited Text ST Character String

[1] PACS and Electronic Health Records, Simona Cohen, Flora Gilboa, Uri Shani

DICOMDIR

DICOMDIR CD modality DICOMDIR DICOMDIR Viewer DICOMDIR Tags PACS Viewer DICOMDIR

DICOMDIR DICOMDIRminimal requirements for building DICOMDIR Tags

(1) DICOMDIR (2) (3) Tags (4)

1. level 2. 3. tags minimal requirement 4.

Viewer Free Viewer

PiView RWCDV DICOMate Osiris DICOMEye

DICOMDIR

OK OK OK OK OK

DICOMDIR level

OK OK OK

OK OK OK

OK




V field O field

Patient Level ( 00041430 directory record type : PATIENT)

Tag Name VR VM A B C D

00100020 Patient ID LO 1 V V V 00100010 Patients Name PN 1 V V V 00100040 Patients Sex CS 1 V V V 00100030 Patients Birth Date DA 1 V V V 00101000 Other Patient IDs() LO 1-n V O 00100021 Issuer of Patient ID LO 1 00104000 Patient Comments LO 1 V V 00102154 Patients Telephone Number SH 1 V V


00100020 Patient ID LO 1 V V V V 00081030 Study Description LO 1 V V V O 00080050 Accession Number SH 1 V V V V 00080030 Study Time TM 1 V V V V 00080020 Study Date DA 1 V V V V 00080090 Referring Physicians Name PN 1 V V V V 00101010 Patients Age AS 1 V V V O

00080061 Modalities in Study CS 1-n 0020000D Study Instance UID UID UI 1 O V V V 00321033 Requesting Service LO 1 V V V 00200010 Study ID ID SH 1 V V V V 00081080 Admitting Diagnoses Description LO 1-n V V V


0020000E Series Instance UID UID UI 1 V V V V 00180015 Body Part Examined CS 1 V O 0008103E Series Description LO 1 O O V O 00080060 Modality CS 1 V V V 00201209 Number of Series Related Instances IS 1 O 00200011 Series Number IS 1 V V V V 00080080 Institution Name LO 1 O V V V 00081050 Performing Physicians Name PN 1-n V


00080018 SOP Instance UID SOP UID UI 1 V V V V 00204000 Image Comments LT 1 V O 00080008 Image Type CS 1-n O V V V 00082111 Derivation Description ST 1 V O 00041500 Referenced File ID UID CS 1-8 00041510 Referenced SOP Class UID in File SOP UID UI 1 00041511 Referenced SOP Instance UID in File SOP UID UI 1




SQ 1XA

( 1.2.840.10008.1.2.4.70 )





V field O field


Tag Name VR VM A B C 00100020 Patient ID LO 1 V V V 00100010 Patients Name PN 1 V V V 00100040 Patients Sex CS 1 V V V 00100030 Patients Birth Date DA 1 V V V 00101000 Other Patient IDs() LO 1-n V 00100021 Issuer of Patient ID LO 1 00104000 Patient Comments LO 1 00102154 Patients Telephone Number SH 1


00100020 Patient ID LO 1 00081030 Study Description LO 1 O O V 00080050 Accession Number SH 1 V O V 00080030 Study Time TM 1 V V V 00080020 Study Date DA 1 V V V 00080090 Referring Physicians Name PN 1 V 00101010 Patients Age AS 1

00080061 Modalities in Study CS 1-n 0020000D Study Instance UID UID UI 1 V V 00321033 Requesting Service LO 1 00200010 Study ID ID SH 1 V V 00081080 Admitting Diagnoses Description LO 1-n


0020000E Series Instance UID UID UI 1 V V V 00180015 Body Part Examined CS 1 V O 0008103E Series Description LO 1 V O 00080060 Modality CS 1 V V V 00201209 Number of Series Related Instances IS 1 00200011 Series Number IS 1 V V V 00080080 Institution Name LO 1 00081050 Performing Physicians Name PN 1-n


00080018 SOP Instance UID SOP UID UI 1 00204000 Image Comments LT 1 00080008 Image Type CS 1-n V V V 00082111 Derivation Description ST 1 00041500 Referenced File ID UID CS 1-8 V V V 00041510 Referenced SOP Class UID in File SOP UID UI 1 V V V 00041511 Referenced SOP Instance UID in File SOP UID UI 1 V V V




SQ 1XA

( 1.2.840.10008.1.2.4.70 )





V field O field


Tag Name VR VM A B C D

00100020 Patient ID LO 1 V V V V 00100010 Patients Name PN 1 V V V V 00100040 Patients Sex CS 1 V V V 00100030 Patients Birth Date DA 1 V V V V 00101000 Other Patient IDs() LO 1-n V 00100021 Issuer of Patient ID LO 1 00104000 Patient Comments LO 1 V 00102154 Patients Telephone Number SH 1 V


00100020 Patient ID LO 1 V V V V 00081030 Study Description LO 1 V V V V 00080050 Accession Number SH 1 V V V V 00080030 Study Time TM 1 V V V V 00080020 Study Date DA 1 V V V V 00080090 Referring Physicians Name PN 1 V V 00101010 Patients Age AS 1 V

00080061 Modalities in Study CS 1-n V 0020000D Study Instance UID UID UI 1 V V V 00321033 Requesting Service LO 1 00200010 Study ID ID SH 1 V V V V 00081080 Admitting Diagnoses Description LO 1-n V


0020000E Series Instance UID UID UI 1 V V V V 00180015 Body Part Examined CS 1 0008103E Series Description LO 1 V V 00080060 Modality CS 1 V V V V 00201209 Number of Series Related Instances IS 1 00200011 Series Number IS 1 V V V V 00080080 Institution Name LO 1 V 00081050 Performing Physicians Name PN 1-n V


00080018 SOP Instance UID SOP UID UI 1 V V 00204000 Image Comments LT 1 V 00080008 Image Type CS 1-n V V 00082111 Derivation Description ST 1 00041500 Referenced File ID UID CS 1-8 V V 00041510 Referenced SOP Class UID in File SOP UID UI 1 V V 00041511 Referenced SOP Instance UID in File SOP UID UI 1 V V




SQ 1XA

( 1.2.840.10008.1.2.4.70 )


HL7 92 12 11 12

HL7 Taiwan

TAMI

DICOM Taiwan FIC

HL7

1. HL7

(1). RQAÎ08/RPAÎ08 (2). RQAÎ08/RPAÎ08

Z segment

2. DICOM image

(1). DICOM MIME DICOMDIR (2). (3). V2.X

1

2

3

4

5

6

7

Digital Imaging and Communications in Medicine (DICOM)8

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Supplement 54: DICOM MIME Type1011

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Prepared by:21

22

DICOM Standards Committee23

1300 N. 17th Street24

Rosslyn, Virginia 22209 USA25

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VERSION: Final Text28

March 10, 200229

Supplement 54: DICOM MIME TypePage i

Table of Contents30

Foreword.................................................................................................................................................................ii311 Supplement Scope and Field of Application........................................................................................... 132Part 11, Body Addendum...................................................................................................................................... 2334 Symbols and abbreviations ..................................................................................................................... 234Annex Y (Normative) - General Purpose MIME Interchange Profile................................................................... 235

Y.1 PROFILE IDENTIFICATION ......................................................................................................... 236Y.2 CLINICAL CONTEXT .................................................................................................................... 337Y.2.1 ROLES AND SERVICE CLASS OPTIONS.................................................................................. 338

Y.2.1.1 File Set Creator ................................................................................................................ 339Y.2.1.2 File Set Reader ................................................................................................................ 340

Y.3 STD-GEN-MIME PROFILE ........................................................................................................... 341Y.3.1 SOP Classes and Transfer Syntaxes................................................................................. 342Y.3.2 Physical Medium and Medium Format ............................................................................... 443Y.3.3 Directory Information in DICOMDIR ................................................................................... 444

Y.3.3.1 Additional Keys ................................................................................................................ 445Part 12, Body Addendum...................................................................................................................................... 5462 References ............................................................................................................................................... 547ANNEX X (Normative) DICOM MIME media ....................................................................................................... 548

X.1 DICOM MAPPING TO MIME FORMATS ............................................................................................... 549X.1.1 DICOM File set............................................................................................................................... 550X.1.2 DICOM file ...................................................................................................................................... 551

X.1.2.1 DICOMDIR ........................................................................................................................ 652X.3 LOGICAL FORMAT ................................................................................................................................. 653

RFC 3240 Digital Imaging and Communications in Medicine (DICOM) Application/dicom MIME Sub-54type Registration (Informative).............................................................................................................................. 755Example 1: Simple DICOM File MIME message (Informative) .....................................................................121456Example 2: DICOM File Set MIME message (Informative) ...........................................................................141657

58

Supplement 54: DICOM MIME TypePage ii

Foreword59

The American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA)60formed a joint committee to develop a standard for Digital Imaging and Communications in Medicine61(DICOM). This DICOM Standard and the corresponding Supplements to the DICOM Standard were62developed according to the NEMA procedures.63

DICOM is developed in liaison with other standardization organizations including CEN TC251 in Europe64and JIRA in Japan, with review also by other organizations including IEEE, HL7 and ANSI in the USA.65

This document is a Supplement to the DICOM Standard. It is an extension to PS 3.11 and 3.12 of the66published DICOM Standard which consists of the following parts:67

PS 3.1 Introduction and Overview68PS 3.2 Conformance69PS 3.3 Information Object Definitions70PS 3.4 Service Class Specifications71PS 3.5 Data Structures and Encoding72PS 3.6 Data Dictionary73PS 3.7 Message Exchange74PS 3.8 Network Communication Support for Message Exchange75PS 3.9 Point-to-Point Communication Support for Message Exchange76PS 3.10 Media Storage and File Format77PS 3.11 Media Storage Application Profiles78PS 3.12 Media Format and Physical Media for Media Interchange79PS 3.13 Print Management Point-to-Point Communication Support80PS 3.14 Grayscale Standard Display Function81PS 3.15 Security Profiles82PS 3.16 Content Mapping Resource83

These parts are related but independent documents.84

This Supplement includes the definition of DICOM MIME Type definition, which enables applications to85exchange DICOM objects with other applications that support communication by e-mail.86

Supplement 54: DICOM MIME TypePage 1

1 Supplement Scope and Field of Application87

This Supplement describes the DICOM MIME Type. MIME (Multipurpose Internet Mail Extension)88describes how to include attached files as parts into internet mail, these may be sent by protocols such89as SMTP (Simple Mail Transfer Protocol).90

DICOM network protocols are widely used for applications that:91

involve primary diagnosis and review,92 are used within a tightly integrated imaging department93 are used when there is controlled distribution of images (and other DICOM objects) to other94

departments which also support DICOM protocols.95DICOM network protocols are less frequently used for applications in areas less amenable to tight96integration, such as:97

hospital-to-doctor DICOM object distribution for reviewing or referral purposes98 exchange of DICOM objects for testing purposes99 DICOM object distribution for education, scientific cooperation and contract research100 interpretation by professionals at home (e.g. teleradiology)101

These applications are characterized by:102

greater desire to integrate with consumer desktop applications103 lower expectations of image quality, fidelity, reliability of delivery and conformance104 less centralized control over system setup and configuration105

There has been an increasing demand for the ability to exchange DICOM objects by e-mail.106

The DICOM MIME Type concept covers two levels:107

the DICOM File level, using the Application/dicom MIME Type108 the DICOM File-set level, using the Multipart/mixed MIME Type with some constraints109

(naming, parameters)110Note: No Image/dicom MIME type is proposed, because DICOM objects may also contain other information,111

not only images.112Since this document proposes changes to existing Parts of DICOM the reader should have a working113understanding of the Standard.114

After having introduced the interest of such an extension of DICOM, this document includes a number of115Addenda to existing Parts of DICOM:116

PS 3.11 Addendum Annex XX: General Purpose MIME Interchange Profile117PS 3.12 Addendum Annex XX: DICOM MIME Type118

In addition, it contains the official text of the RFC (Request for Comments) to be submitted to the Internet119Engineering Task Force (IETF) and defining the Application/dicom MIME Type. Once approved this120RFC text will be included as an appendix to Part 12.121

Finally it presents two examples of e-mail messages that can be generated by using DICOM MIME Type.122


Part 11, Body Addendum123

Add the following definitions to Section 4. Symbols and abbreviations.124

4 Symbols and abbreviations125

IETF Internet Engineering Task Force126MIME Multipurpose Internet Mail Extension127RFC Request for Comments128SMTP Simple Mail Transfer Protocol129

Add the following Annex at the end of the document.130

Annex Y (Normative) - General Purpose MIME Interchange Profile131

Y.1 PROFILE IDENTIFICATION132

This Annex defines an Application Profile Class including all defined Media Storage SOP Classes. This133class is intended to be used for the interchange of Composite SOP Instances via e-mail for general134purpose applications.135

Note: This Media Storage Application Profile Class is not intended to replace the more robust DICOM Storage136Service Class.137

Objects from multiple modalities may be included on the same e-mail. A detailed list of the Media Storage138SOP Classes that may be supported is defined in PS 3.4.139

Table Y.1-1140STD-GEN-MIME Profile141

Application Profile Identifier DescriptionGeneral Purpose MIMEInterchange

STD-GEN-MIME Handles interchange of Composite SOP Instances bye-mail.

142

The identifier for this General Purpose MIME Interchange profile shall be STD-GEN-MIME.143

Equipment claiming conformance to this Application Profile shall list the subset of Media Storage SOP144Classes that it supports in its Conformance Statement.145


Note: Since it is not required to support all Media Storage Classes the user should carefully consider the146subset of supported Media Storage SOP Classes in the Conformance Statements of such equipment to147establish effective object interchange.148

Y.2 CLINICAL CONTEXT149

This Application Profile facilitates the interchange of images and related data through e-mail.150

This profile is intended only for general purpose applications. It is not intended as a replacement for151specific Application Profiles that may be defined for a particular clinical context.152

Note: The present Application Profile does not include any specific mechanism regarding privacy. However it is153highly recommended to use secure mechanisms (e.g. S/MIME) when using STD-GEN-MIME Application154Profile over networks that are not otherwise secured.155

156

Y.2.1 ROLES AND SERVICE CLASS OPTIONS157

This Application Profile uses the Media Storage Service Class defined in PS3.4 with the Interchange158Option.159

The Application Entity shall support one or two of the roles of File Set Creator (FSC) and File Set Reader160(FSR), defined in PS 3.10. Because the exchange of e-mail does not involve storage, the role of File Set161Updater (FSU) is not specified.162

Y.2.1.1 File Set Creator163The role of File Set Creator may be used by Application Entities which generate a File Set under this164Interchange Class of Application Profiles.165

File Set Creators may be able to generate the Basic Directory SOP Class in the DICOMDIR file with all the166subsidiary Directory Records related to the Image SOP Classes included in the File Set.167

The Application Entity acting as a File Set Creator generates a File Set under the STD-GEN-MIME168Application Profile.169

Note: A multiple volume (i.e. a logical volume that can cross multiple media) is not supported by this class of170Application profile. Because MIME is a virtual medium and since e-mail mechanisms include some way171of fragmenting MIME parts to be sent through limited size e-mail, there are no needs for multiple volume.172

Y.2.1.2 File Set Reader173The role of File Set Reader shall be used by Application Entities which receive an exchanged File Set174under the Image Interchange Class of Application Profiles.175

File Set Readers may be able to read the DICOMDIR directory file and shall be able to read all the SOP176Instance files defined for this Application Profile, using the Transfer Syntaxes specified in the Conformance177Statement.178

Y.3 STD-GEN-MIME PROFILE179

Y.3.1 SOP Classes and Transfer Syntaxes180This Application Profile is based on the Media Storage Service Class with the Interchange Option (see PS1813.4).182


Table Y.3-1183STD-GEN-MIME SOP Classes and Transfer Syntaxes184

InformationObject Definition

Service Object PairClass UID

Transfer Syntax and UID FSCRequirement

FSRRequirement

Basic Directory 1.2.840.10008.1.3.10 Explicit VR Little EndianUncompressed

1.2.840.10008.1.2.1

Optional Optional

Composite Image& Stand-aloneStorage

Refer to: PS 3.4 forSOPs UID definitions

Defined in ConformanceStatement

Defined inConformanceStatement

Defined inConformanceStatement

185

The SOP Classes and corresponding Transfer Syntax supported by this Application Profile are specified in186the Table Y.3-1. The supported Storage SOP Class(es) and Transfers Syntax(es) shall be listed in the187Conformance Statement using a table of the same form.188

Y.3.2 Physical Medium and Medium Format189The STD-GEN-MIME application profile requires the DICOM MIME medium as defined in PS3.12.190

Y.3.3 Directory Information in DICOMDIR191If the DICOMDIR is included, conformant Application Entities shall include in it the Basic Directory IOD192containing Directory Records at the Patient and the subsidiary Study and Series levels, appropriate to the193SOP Classes in the File Set.194

All DICOM files in the File Set incorporating SOP Instances defined for the specific Application Profile shall195be referenced by Directory Records.196

Note: 1. DICOMDIRs with no directory information are not allowed by this Application Profile.1972. In the DICOMDIR each object may be referenced by a referenced file ID (e.g. 000/000) which198contains multiple values corresponding to a path for physical system, since the MIME organization is flat.199There is no requirement that this path will be used by the receiving application to create file hierarchy.200

There may only be one DICOMDIR file per File Set. The Patient ID at the patient level shall be unique for201each patient directory record in one File Set.202

Y.3.3.1 Additional Keys203No additional keys are specified.204


Part 12, Body Addendum205

Add the following definitions to Section 2. Normative References.206

2 Normative References207

RFC 3240, Digital Imaging and Communications in Medicine (DICOM) - Application/dicom MIME208Sub-type Registration209

210

The concepts MIME, Media Type, MIME Entity, "MIME Part", Content-Type, Multipart/mixed,211Message/partial, Content-Transfer-Encoding, Content-ID and Application/xx are developed212in IETF Multipurpose Internet Mail Extensions, or MIME, described in RFC (Request for Comments)213number 2045, 2046, 2047, 2048 and 2049 (see http://www.imc.org/rfc2045 and ftp://ftp.isi.edu/in-214notes/rfc2045.txt).215

Add the following Annex at the end of the document.216

ANNEX X (Normative) DICOM MIME media217

X.1 DICOM MAPPING TO MIME FORMATS218

X.1.1 DICOM File set219One DICOM File set shall be contained in a MIME Multipart/mixed or Multipart/related Media220Type, called "DICOM File set" MIME Entity.221

Notes: 1. It may be necessary to fragment a message by using the Message/partial Media Type format.2222. A "DICOM File set" MIME Entity may contain MIME Parts other than Application/dicom which223may be ignored by the DICOM application.224

X.1.2 DICOM file225Each generic DICOM file shall be encoded as a MIME Application/dicom Media Type, called "DICOM226File" MIME Part, with the following parameters:227

- id is constructed from the DICOM File ID. The total length is limited to 71 characters (to avoid that228the e-mail application splits the id string). Each component is limited to 8 characters. The delimiter is a229forward slash /. There is never a leading delimiter (i.e. this is not a traditional path from a root230directory).231For example: ROOTDIR/SUBDIR1/MRSCAN/A789FD07/19991024/ST00234/S00003/I00023232


- "name" is constructed from the last DICOM File ID component (that means the file name without233path information) and the extension ".dcm" (except for the DICOMDIR).234For example: I00023.dcm235Note: 1. Email clients typically use this parameter as the default name with which to save the file. If used for236

only one "DICOM File" Part (versus one DICOM File set), the length of this parameter is not restricted237(unlike the id parameter).2382. This name can not be the same as the name inside the DICOMDIR where the file extension is239forbidden.240

241

The other fields of the header of this "DICOM File" MIME Part are respecting the general rules of MIME.242

X.1.2.1 DICOMDIR243One and only one DICOMDIR File may be present in any "DICOM File set" MIME Entity. It is encoded as244the generic "DICOM File" MIME Part, with a DICOM File ID set to DICOMDIR and the id parameter set245to DICOMDIR.246

X.3 LOGICAL FORMAT247

The MIME logical format is used. The Content-Transfer-Encoding shall allow the transfer of binary248information (e.g. typically base64 if the higher level does not allow transfer of binary information).249


Add the following Annex at the end of the PS 3.12.250

ANNEX Y (Informative) RFC 3240 Digital Imaging and Communications in251Medicine (DICOM) Application/dicom MIME Sub-type Registration252

Network Working Group D. Clunie253Request for Comments: 3240 E. Cordonnier254Category: Informational DICOM Committee255 February 2002256

257258

Digital Imaging and Communications in Medicine (DICOM) -259 Application/dicom MIME Sub-type Registration260

261Status of this Memo262

263 This memo provides information for the Internet community. It does264 not specify an Internet standard of any kind. Distribution of this265 memo is unlimited.266

267Copyright Notice268

269 Copyright (C) The Internet Society (2002). All Rights Reserved.270

271Abstract272

273 This document describes the registration of the MIME sub-type274 application/dicom (Digital Imaging and Communications in Medicine).275 The baseline encoding is defined by the DICOM Standards Committee in276 "Digital Imaging and Communications in Medicine".277

2781. DICOM Definition279

280 Digital Imaging and Communications in Medicine (DICOM) specifies281 protocols and formats for the exchange of images, time-based282 waveforms, reports, and associated information for medical283 applications.284

285 Individual DICOM objects (such as images) may be encapulsated in286 files and exchanged by e-mail using the Media Type defined herein.287 In addition, a set of DICOM files may be described by an index file,288 DICOMDIR, which may accompany the files that it references.289

2902. IANA Registration291

292 MIME media type name: Application293

294 MIME subtype name: dicom295

296Required parameters:297


298 "id" is constructed from a DICOM File ID (see DICOM PS3.11). The299 total length is limited to 71 characters. Each component is300 limited to 8 characters. The delimiter is a forward slash "/".301 There is never a leading delimiter (i.e., this is not a302 traditional path from a root directory).303

304 If a DICOMDIR (which provides an index of files) is included, then305 it will refer to other DICOM files in the file set by use of this306 File ID. The File ID is not encoded within each DICOM file. If a307 DICOMDIR is not present, then the "id" parameter may be absent.308 Note that the DICOMDIR will also have a Media Type of309 application/dicom and is distinguished from other files by its ID310 of "DICOMDIR".311

312 For example:313 "ROOTDIR/SUBDIR1/MRSCAN/A789FD07/19991024/ST00234/S00003/I00023"314

315 Each component shall be character strings made of characters from316 a subset of the G0 repertoire of ISO 8859. This subset consists317 of uppercase alphabetic characters, numeric characters and318 underscore. The following characters are permissable:319

320 A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, P, Q, R, S, T, U, V,321 W, X, Y, Z (uppercase)322 1, 2, 3, 4, 5, 6, 7, 8, 9, 0 and _ (underscore)323

324 Optional parameters:325

326 none327

328 Encoding considerations:329

330 The DICOM information is binary, therefore the encoding used shall331 support lossless transfer of binary information. Typically, the332 Content-Transfer-Encoding would be set to "Base64".333

334 Multiple DICOM parts should be included as a Multipart/related335 entity [2387]. Receiving agents shall also support multiple parts336 as a Multipart/mixed entity. When multiple DICOM parts are337 included, one of the parts may be a DICOMDIR, in which case, all338 the files referred to by the DICOMDIR shall also be present. The339 DICOMDIR is not required to be the first Application/dicom part340 encoded in the message, in which case the optional "start"341 parameter should refer to the content-id of the part containing342 the DICOMDIR.343

344 Multiple DICOM Application/dicom parts may be included with other345 types of parts as a Multipart/mixed entity.346

347 Security considerations:348

349 Application/dicom parts contain medical information, including350 individual demographic information. Accordingly, their exchange351 should be restricted to a secure network or within a secure352


wrapper that protects a patient's right to confidentiality353 according to local and national policy. The specific security354 mechanisms are outside the scope of this proposal. Such355 mechanisms as Secured MIME (S/MIME) [2633] or similar might be356 appropriate.357

358 Interoperability considerations:359

360 Because DICOM information is specific to the medical (imaging)361 domain, generic e-mail applications may not be able to interpret362 the information.363

364 The Media Type has been designed in order to allow for365

366 (i) DICOM aware applications to interoperate,367 (ii) generic applications to save the files in a form368 recognizable as DICOM files, that a DICOM application may369 subsequently use.370

371 Published specification:372

373 The Digital Imaging and Communications in Medicine (DICOM)374 Standard is a standard of the DICOM Standards Committee, published375 by the National Electrical Manufacturers Association (NEMA), 1300376 N. 17th Street, Rosslyn, Virginia 22209 USA,377 (http://medical.nema.org).378

379 Applications which use this media:380

381 Biomedical imaging applications.382

383 Additional information:384

385 1. Magic number(s): "DICM" after 128 byte preamble indicates DICOM386 PS 3.10 file387

388 2. File extension(s): ".dcm" is recommended for files saved to389 disk (other than DICOMDIR)390

391 3. Macintosh file type code: Macintosh File Type "DICM" is392 recommended393

394 4. Object Identifiers: none395

396 Person to contact for further information:397

398 1. Name: Howard Clark399 2. E-mail: [email protected]

401 Intended usage:402

403 Common404

405 Interchange of biomedical images.406

407


Author/Change controller:408409

DICOM Standards Committee410411

3. References412413

[DICOM] DICOM Standards Committee, "Digital Imaging and414 Communications in Medicine", 2001.415

416 [2387] Levinson, E., "The MIME Multipart/Related Content-type", RFC417 2387, August 1998.418

419 [2633] Ramsdell, B., "S/MIME Version 3 Message Specification", RFC420 2633, June 1999.421

4224. Authors' Addresses423

424 David Clunie425 RadPharm426 943 Heiden Road427 Bangor PA 18013428 USA429

430 Phone: +1-570-897-7123431 Fax: +1-425-930-0171432 EMail: [email protected]

434435

Emmanuel Cordonnier436 Etiam437 20 rue du Pr J. Pecker438 35000 Rennes439 France440

441 Phone: +33(0)299 14 33 88442 Fax: +33(0)299 14 33 80443 EMail: [email protected]

4455. Full Copyright Statement446

447 Copyright (C) The Internet Society (2002). All Rights Reserved.448

449 This document and translations of it may be copied and furnished to450 others, and derivative works that comment on or otherwise explain it451 or assist in its implementation may be prepared, copied, published452 and distributed, in whole or in part, without restriction of any453 kind, provided that the above copyright notice and this paragraph are454 included on all such copies and derivative works. However, this455 document itself may not be modified in any way, such as by removing456 the copyright notice or references to the Internet Society or other457 Internet organizations, except as needed for the purpose of458 developing Internet standards in which case the procedures for459 copyrights defined in the Internet Standards process must be460 followed, or as required to translate it into languages other than461 English.462


463 The limited permissions granted above are perpetual and will not be464 revoked by the Internet Society or its successors or assigns.465

466 This document and the information contained herein is provided on an467 "AS IS" basis and THE INTERNET SOCIETY AND THE INTERNET ENGINEERING468 TASK FORCE DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING469 BUT NOT LIMITED TO ANY WARRANTY THAT THE USE OF THE INFORMATION470 HEREIN WILL NOT INFRINGE ANY RIGHTS OR ANY IMPLIED WARRANTIES OF471 MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.472

473Acknowledgement474

475 Funding for the RFC Editor function is currently provided by the476 Internet Society.477


Example 1: Simple DICOM File MIME message (Informative)478

From: "Dr Smith" 479To: "Dr Johnson" 480Subject: test DICOM Mime Type481Date: Fri, 5 Nov 1999 15:15:35 +0100482MIME-Version: 1.0483Content-Type: Multipart/mixed;484

boundary="----=_NextPart_000_0027_01BF27A0.9BE21980"485486

This is a multi-part message in MIME format.487488

------=_NextPart_000_0027_01BF27A0.9BE21980489Content-Type: text/plain;490

charset="iso-8859-1"491Content-Transfer-Encoding: 7bit492

493Message text: this is a DICOM MIME Type example for DICOM File.494

495------=_NextPart_000_0027_01BF27A0.9BE21980496Content-Type: Application/dicom;497

id="i00023"; name="i00023.dcm"498Content-Transfer-Encoding: base64499

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533


534------=_NextPart_000_0027_01BF27A0.9BE21980--535


Example 2: DICOM File Set MIME message (Informative)536

From: "Dr Johnson" 537To: "Dr Smith" 538Subject: DICOM MIME sub-type file set example539Date: Sat, 9 Mar 2002 16:24:27 +0100540MIME-Version: 1.0541Content-Type: multipart/mixed;542

boundary="----=_NextPart_000_0062_01C1C786.EA262CC0";543start="";544type="text/plain"545

546This is a multi-part message in MIME format.547

548------=_NextPart_000_0062_01C1C786.EA262CC0549Content-Type: text/plain;550

charset="iso-8859-1"551Content-Transfer-Encoding: 7bit552Content-ID: ""553

554This is an example message containing a DICOM file set encoded following the555DICOM MIME sub-type (RFC3240).556

557558

------=_NextPart_000_0062_01C1C786.EA262CC0559Content-Type: text/plain;560

name="header1.txt"561Content-Transfer-Encoding: quoted-printable562Content-Disposition: attachment;563

filename="header1.txt"564Content-ID: ""565Content-Description: Header of the medical message566

567This is the header part of the message, which contains:568- a first text document (letter1)569- a DICOM file set part (dicomfileset1) including an additional =570complementary note571This message was sent by Dr Johnson to Dr Smith.572It relates to the patient: DICOM Nema (M) 01/01/1993573------=_NextPart_000_0062_01C1C786.EA262CC0574Content-Type: multipart/related;575

boundary="----=_NextPart_000_0062_01C1C786.EA262CC1_13487";576start="";577type="application/dicom"578

579------=_NextPart_000_0062_01C1C786.EA262CC1_13487580Content-Type: text/plain;581

name="dicomfileset1note1.txt"582Content-Transfer-Encoding: 7bit583Content-Disposition: attachment;584

filename="dicomfileset1note1.txt"585Content-ID: ""586Content-Description: Note for the images use587

588This is a simple note, for receivers who can not read images.589These images are DICOM 3.0 images and the DICOMDIR index related file.590Please use a DICOM compatible application.591


DICOM is a Standard Mark of Nema (www.nema.org).592------=_NextPart_000_0062_01C1C786.EA262CC1_13487593Content-Type: application/dicom;594

id="DICOMDIR";595name="Dicomdir"596

Content-Transfer-Encoding: base64597Content-Disposition: attachment;598

filename="Dicomdir";599Content-ID: ""600Content-Description: Index of the images (DICOMDIR)601

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623

624------=_NextPart_000_0062_01C1C786.EA262CC1_13487625Content-Type: application/dicom;626

id="SE0001/I0001";627name="I0001.dcm"628


filename="I0001.dcm"631Content-ID: ""632Content-Description: Color image633

634635

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

662------=_NextPart_000_0062_01C1C786.EA262CC1_13487663Content-Type: application/dicom;664

id="SE0001/I0002";665name="I0002.dcm"666


filename="I0002.dcm"669Content-ID: ""670Content-Description: B&W image671

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701

702------=_NextPart_000_0062_01C1C786.EA262CC1_13487--703------=_NextPart_000_0062_01C1C786.EA262CC0--704

705

Free Viewer

XCTMRI

Free ViewerViewer PACS DICOMDICOM

DICOM 3.0(Free-Software)

1. Osirishttp://www.expasy.org/www/UIN/html1/projects/osiris/osiris.html OSIRISThe OSIRIS imaging softwareUniversity Hospital of Geneva 6 PACS

OSIRIS

2. PiViewhttp://www.mediface.com

Piview/

piview

///////////window level: // 100

3. DICOM Eyehttp://www.etiam.com

DICOM Eye ETIAM DICOMDIR 21

View DICOM TagsDICOM Storage Service ClassDICOM Query/Retrieve Service Class DICOM Media Storage Service Class(DICOMDIR)

DicomWorks 1. DICOM 2. DICOMDIR 3. DICOM Tag

http://dicom.online.fr/

FP Image 1.View DICOM Tag http://www.fpimage.com/info.html

JDICOM DICOM Service Class

http://www.tiani.com/JDicom/

Java Application DICOM Service Class AP

DICOMScope

1.DICOM Storage SCU/SCP 2.DICOM Print SCU/SCP 3.Secure Transport Connection Profiles

and Digital Signature Profiles

http://dicom.offis.de/dscope.php.en

1. OFFIS

Java Application for DICOM Viewer

2.

1

(DICOM) 90

(Health Certification Authority, HCA)92 IC

IC

HIPAA

HIPAA (Administrative Procedure) (Physical Safeguards)(Technical Security Services)(Technical Security Mechanisms )

2

PKI

(Confidentiality)(Integrity)(Non-Repudiation)(Authentication)(Access Control)(Auditing Trials)

(Public Key algorithm)

Public Key Infrastructure(Public Key) (Private Key)

PKI

(hash)(Hash Result)

3

(Trust Third Party,TTP)(Certification Authority,CA)

ID

CA

4

DICOM 15(Security Profiles)

DICOM 2000 Part 15 Security Profiles Part 15

DICOM Part 15

(Public Key algorithm)

DICOM Part 15

DICOM Part 15(Secure Use Profile)(Secure Transport Connection Profile) (Digital Signature Profile) (Media Storage Security Profile)(Attribute Confidentiality Profile) DICOM Part 15 DICOM Secure Use Profile () SOP instance status

DICOM DICOM Secure Transport Connection Profile () TLS(Transport Layer Security protocol Vision 1.0 protocol)

ISCL(Integrated Secure Communication Layer,v1.00) DICOM Digital Signature Profile () RSA DIOCM

5

Media Storage Security Profile () DICOM

(data origin authentication) Attribute Confidentiality Profile ()

OSI(Application level) DICOM(Conformance) DICOM Part 15

Part 3 Annex C.12.1.1.3 Digital Signatures MacroDICOM SupplementsSupplement 31(Secure Communication)Supplement 41(Base Digital Signature)Supplement 51(Media Exchange Security)Supplement 55(De-Identification)

() PKI

DICOM

1. TLS

TLS 1.0 1 TLS

1TLS

TLS

RSA

RSA

SHA

DESEDECBC

6

2. ISCL

ISCL 1.00 ISCL 2

2ISCL

ISCL

()(ISO/IEC 9798-2)

MD-5DESDES-MAC(ISO 8730)

DES()

RSA

1. RSA Base RSA Digital Signature Profile

DICOM RSA RSA RSA RIPEMD-160 MD-5 SHA-1 RSA RSARFC2437(PKCS#1)MAC DICOM(04000015) "RIPEMD- 160""MD5" SHA1"(04000110)"X509_1993_SIG"X.509

2. RSA Creator RSA Digital Signature Profile

DICOM SOP

SOP RSA

7

(1) SOP UID

(2) SOP

(3) UID

(4)

(5)

(6)

(7) SR SR

(8)

RSA 3. RSA Authorization RSA Digital Signature Profile

DICOM SOP SOP RSA RSA

(1)SOP UID

(2) UID

(3)()

(4)

(5)

(6) SR SR

(7) DICOM

1. DICOM

DICOM

PKI PKI

8

CA

PKI CA

(PACS) PKI PACS .. DICOM DICOM

CA ( HCA , GCA, MOICA) DICOM

DICOM DICOM

PACSDICOM

DICOM

( DICOM BIT-PRESERVING Digital Signatures Secure Use Profile) DICOM DICOM

(Enveloped Signature) XMLEnveloped Signature(http://www.w3.org/TR/2002/REC-xmldsig-core-20020212/Overview.html )

9

MAC Parameters Sequence Digital Signatures Sequence MAC Parameters Sequence Digital Signatures Sequence( DICOM Part3 Annex C.12.1.1.3 Digital Signatures Macro)

Sequence Sequence Item Item

MAC Parameters Sequence Digital Signatures SequenceMAC Parameters Sequence Items Item Digital Signatures Sequence Item Item (04000005) MAC ID Number MAC Parameters Sequence MAC Parameters Sequence Digital Signatures Sequence Items Item MAC Parameters Sequence

Digital Signatures Sequence

MAC Parameters Sequence



Item 1 Attributes



Item 2 Attributes

Pixel Data

Sequence of Items

Other Header Data

Other Header Data

10

DICOM DICOM DICOM DICOM DICOM

DICOM DICOM

PACS DICOM(Modality) DICOM Storage(DICOM Viewer) DICOM Query/Retrieve

DICOM Server Operations for Storage and Query/Retrieve DICOM

(1) DICOM Storage service Storage Request DICOM Command Object

(DCO) DICOM Data Object(DDO) DCODDO Request Response DCO DCO

11

(2) DICOM

(3)(4)(6)(8)(9)

(5) DICOM Query service Query RequestRequest DCO

DDO Response DCOResponseDDO

(7) DICOM Retrieve service Retrieve RequestRequest DCO

DDO Response DCO Response DDO

DICOM DICOM

12

DICOM Part 15 DICOM

DICOM Part 15 The Basic TLS Secure Transport Connection ProfileDICOM StorageQueryRetrieve

Client Server

SSL or STL connection request Client ------------------------------------------->> Server

Response Certificate of server

Client Server

Data transfer2

Client > Server 1. Exchange the symmetric Key that is encrypted by the public Key in certificate 2. Data transfer is encrypted by the symmetric Key ServerClient

SSL STL Client Client Client Server DICOM storageClient(SCU) DICOM Server (SCP)

Client (SCU)

13

Client ClientDICOM Query/Retrieve ServerDICOMQuery/Retrieve DICOM Query/Retrieve SCU ClientDICOM Query

DICOM Query/Retrieve DICOM Query/Retrieve SCU(Client)DICOM

E-Mail DICOM

DICOMSMTP(E-Mail)HTTP(Web)

E-MailMail DICOM RFC 3240 - Digital Imaging and Communications in Medicine (DICOM) - Application/dicom MIME Sub-type Registrationhttp://www.faqs.org/rfcs/rfc3240.html RFC Mail( DICOM files and DICOM Dir)DICOM Mail

S/MIME(Security / Multipurpose Internet Mail Extensions) http://www.imc.org/ids.html Client--Server S/MIME (1)

(2)

14

1.

()

2. Mail(S/MIME Mail )

3. Mail CA

4. Mail

5. Mail

6. ()

1

2

3()

4(S/MIME )

5

15

mail

S/MIME (MS

Outlookhttp://210.241.69.194/download/security_Email_920908.pdf Mail Mail S/MIME

Mail S/MIME E-Mail

E-Mail E-MailS/MIME DICOM

MailMailMailMailMail

1. (: ttp://islab.csie.thu.edu.tw/case/EHR/)

2. ()

3. (: Patient ID Student instance UIDSeries instance UIDImage instance UID)

16

4. Mail

5. Mail

6. Mail

7. MailDICOM Retrieve

8. MailMail

9. E-Mail

Mail

( Security Proxy ) Security Proxy Proxy

Web service

Mail Web HTTPSWeb HTTPS HTTPS SSL(SSL)Web Server HTTPS Client(Web Client) Client Web Client Server(Web Services)Web SOAP(Simple Object Access Protocol) SOAP HTTP HTTPS XML XMLHL7 V3 XML XML Web

17

XML (Base64 Encoding) XML DICOM XML XML HTTPS SOAPWeb Service

(1) (Browser)(Web Server)

(2) ()

(3) (Patient IDStudent instance UID Series instance UIDImage instance UID) SOAP Client

(4) Browser

(5) SOAP Client(SOAP Server)

(6) SOAP Server XML

(7) SOAP Server XML DICOM Retrieve

(8) SOAP ServerBase64( 1)XML(Browser)

(9) Browser XML DICOM

(10) Web Service

Web SOAP

Client(Browser) SOAP Server

18

Web service

( 1) Base64 Base64 XML Client Server (http://www.microsoft.com/taiwan/msdn/library/2003/Mar-2003/infoset_whitepaper.htm ) XMLWeb Service

IHE

Gateway

/ (HIS)

(RIS)

( Digitizer )

( )

( )

( MRI )

HIS

RIS

Image

Manager

Image

Display

IHE

Modality /Gateway

Image Display

Image Manager

Procedure Scheduled (O) Procedure Update (O)

Modality Worklist Provided (R) Modality PPS in Progress (O) Modality PPS Completed (O)

Modality Image Stored Modality PPS in Progress Modality PPS Completed

Query / Retrieve Images

Order Filler / DSS

Modality / Gateway

Image Display

Image Manager

Procedure Scheduled (O) Procedure Update (O)

Modality Worklist Provided (R) Modality PPS in Progress (O) Modality PPS Completed (O)

Modality Image Stored Modality PPS in Progress Modality PPS Completed

Query / Retrieve Images

Order Filler / DSS

Free Software

DICOM DICOM 1. CTNCentral Test Node Mallinckrodt Institute of Radiology RSNA

DICOM ANSI C SUN Solaris 2.6, Red Hat

Linux 6.2, Windows NT 4.0(ftp://dicomctn.wustl.edu/pub/)

DICOM Service Classes 2. DVTDICOM Validation Tool AGFA PHILIPHS

DICOM( License Agreement)DVT DICOMDVTWindows NT/2000

DVT DICOMScripts(Scripts) DICOM DVT DVT DVT

DICOM Tag Viewer

DICOM(data set)

(data element)(field)(data element tag)(value length)(value field)(value representation)(explicit)

(explicit VR)VR(implicit VR)VR

(DICOM PS 3.5)

(Value Length)

(DICOM PS 3.5)

Tag VR Value Length Value

Group Number

Element Number

VR Reserved Unsigned IntegerData element

values

2 bytes 2 bytes 2bytes 2 bytes 4 bytes

(Value Length) (DICOM PS 3.5)

Tag VR Value Length Value

Group Number

Element Number

VR Unsigned IntegerData element

values

2 bytes 2 bytes 2bytes 2 bytes

VR (DICOM PS 3.5)

Tag Value Length Value

Group

Number

Element

Number Unsigned Integer Data element value

2 bytes 2 bytes 4 bytes

DICOM DICOM DICOMDICOM DICOM )(information entity)

1

(FFFE,E000)(FFFE,E00D)(FFFE,E0DD)(FFFE,E000)(FFFE,E00D)(FFFE,E0DD) 4

(1) 4 00000000H

(2) FFFFFFFFH FFFFFFFFH(FFFE,E000)(FFFE,E00D)(FFFE,E00D) 00000000H

(coded entry data)DICOM IOD(code sequence attribute) .(code sequence)(code scheme)(triplet code)(coding scheme designator), (the code value)(code meaning)(0008,0100)(0008,0102)(0008,0103)(0008,0102)(0008,0102)(0008,0103)(0008,0104) (Channel Source Sequence) (003A,0208) (Channel Sensitivity Units Sequence)(003A,0211)

DICOM (DICOM content

mapping resource) context group( ) (template)Context groupCID(context group identifiers)TID(template identifiers)

DICOM Tag ViewerDICOM

DICOM DICOM

Load DICOM File

DICOM

DICOM

DICOMSQ

(Item) Item DICOM

DICOM Tag Viewer 1.

2. DICOM viewer DICOM DICOM Viewer DICOM DICOM DICOM Viewer DICOM Tag Viewer DICOM DICOM DICOM viewer

modality consoleImage acquisition

Quality controlQuality assuranceISO

-PACS Picture Archiving and Communication System

-DICOM Digital Communication in Medicine[1]serviceDICOM Modality WorkListPACSRIS RIS

Barcode Reader

RIS

FDAQCCTnon-DICOMDICOMDICOM

12

CTDICOMattribute tagImage Acquisition ContextIAC

KVPX-ray Tube CurrentExposure Time

point of study timemeasurement report

attribute tags

Type 1,Type 2 and Type 3 attribute tags []DICOM level 2 Server

vendor specific/proprietary image formatmodality LUTHounsfield UnitHUDICOM or non-DICOMComputed RadiographyCRoptic densityOD( console )window center / window widthVOI value of interest VOI( window center/window width)

Presentation lookup tablelung windowbone window

DICOMPatient levelStudy levelSeries levelImage / instance levelDICOMseries levelinstance level

series mergingseries splittingimage sorting3

standard digital display system? CRTTFT-LCD

luminancecharacteristic curveambient light

( DICOM )( Grayscale monitor)Grayscale Standard Display Function [2]

CIE-labGSDF Grayscale Standard Display FunctionBartens Curve [3]DICOMPhotometerBartens CurveBartens Curvelinear4perceptual5%95%JND: Just Noticeable Differences0-2000 CD/m2 candela per square meterBartens model

4096

25610244096 mapping10 bits 1021 grayscaleslimitation

DICOMformattransmission protocol2-3DICOM( IOD) Presentation StateModality Type: PR[45]

DICOMPRtemplateCR5

DICOM

Digital RadiographyXModality Type: DXVOI LUT modulelookup tabledata elementlookup tableDDLdigital driving levelGamma correctionmid-tonePRX [] Type 1Type 2and Type 3 attribute tagsDICOM

data elementtype 1VR; type 2 NULLtype 3NULLType 2CType 3CC conditional

Reference 1. NEMA Standards Publication PS 3.x, Digital Imaging and Communications in

Medicine (DICOM), National Electrical Manufacturers Association, 2101 L Street, N. W., Washington, D. C. 20037, 1992-2001.

2. NEMA Standards Publication PS 3.14, Digital Imaging and Communications in

Medicine (DICOM), Part 14: Grayscale Standard Display Function, National Electrical Manufacturers Association, 2101 L Street, N. W., Washington, D. C. 20037, 1998-2001.

3. Barten, PGJ, Physical model for the Contrast Sensitivity of the human eye,

Proceedings SPIE 1666, 57-72 (1992). 4. Marco Eichelberga, Jrg Riesmeiera, Klaus Kleberb, Jrg Holsteinb, Herman

Oosterwijkc, Peter Jenschd, Consistency of Softcopy and Hardcopy: Preliminary Experiences with the new DICOM Extensions for Image Display.

5. Eichelberg M, Riesmeier J, Jensch P: Grayscale Softcopy Presentation States a new

DICOM Service for Documenting Image Appearance in a Softcopy Environment, in: P. Rehak, H. Hutten: Medical & Biological Engineering & Computing, Vol. 37, Supplement 2, pp. 1544-1545 (1999).

1

DICOM HiQ, PlusMV-1000DICOMDICOMRadwork QC workstation VOIvalue of interestTagseries merging, splittingDICOM PRINT

2a

2b

(2a, 2b)

3

drap and drop

4Barten

Bartens linearlookup tablepixel dataGSDF

5Presentation State

DICOMSCOPE 3.5.1 [4] OFFIS e.V., D-26121 Oldenburg, GermanyPR.I.O.D.

Introduction to Compression Related Issues in the DICOM Standard

David Heaney, 31-Jan-2001

The DICOM Standard currently supports the following types of image data compression: Run Length Encoding (RLE), JPEG Lossy compression, JPEG Lossless compression, and JPEG-LS compression. JPEG-LS compression can be either lossy or lossless depending on the particular Transfer Syntax specified. In addition to these existing types, a new compression standard is soon to be added to the DICOM Standard, JPEG 2000. This is a wavelet based type of lossy compression. Besides offering better compression ratios in general than JPEG Lossy compression, JPEG 2000 also supports the compression of 16 bit stored per sample image data. This is a big advantage over JPEG Lossy compression that only supports image data with up to 12 bits per sample. For this reason JPEG 2000 will probably be more widely implemented and supported than JPEG Lossy compression.

The Ultrasound Work Group is also considering adding support for some type(s) of MPEG compression to the DICOM Standard. MPEG compression could prove very useful with really long ultrasound clips (such as those acquired for fetal cardio exams) as it should yield better compression ratios than the other lossy mechanisms. WG 12 however is concerned over the proliferation of allowed types of compression. Many archives still do not support JPEG Lossy compression so adding the requirement to support both JPEG 2000 and MPEG may prove unrealistic, especially when MPEG use will be limited to long ultrasound clips where individual image frame quality and consistency of quality is not so important. If the marketplace however demands MPEG support due to the support of MPEG clips by DVD recorders then we may have little choice but to add it.

UID

DICOM Part 3 UID

UID(Org Root)(Suffix)UID=.

UID UID (UID)" . "Exp 2.16.886.101.20025UID " . " UID UID (Character)UID NULL(00E) UID(Character set) ISO646:19901.2.840.10008DICOM UID DICOM UID UID OID OID 2.16.886.101.20003.20014 OID

Exp 2.16.886.101.20003.20014.20006 2.16.886.101.20003.20014.20011

OID OID(2.16.886.101.20003.20014) OIDhttp://www.nhi.gov.tw/02hospital/hospital_7.htm

0Exp 0228712121 DICOM UID OID OID OID 0 (Exp 1) OID 2.16.886.101.20003.20014.10228712121 OID 1 0 OID

A novel codification scheme based on the VITAL and DICOM standards for telemedicine applications

VITALDICOM

Anthoula P. Anagnostaki, Sotiris Pavlopoulos*, Efthivoulos Kyriakou, and Dimitris Koutsouris

()

-- VITAL DICOM Sup. 30

()

(3-lead SpO2)(UML)

I.

A.

[1],[2][3] SIDS

[4]

[5]

[6],[7] 1996 GSM

[8][10]

[11],[12]

1984 IEEE P1073 (MIB)[13][16][17],[18]

RS232

3.2 0.0510 EN ISO 9703-31998 ISO/OSI

(CEN ENV13734 VITAL) [19] VITAL IEEE IEEE 1073

B.

()

TCP/IP3-lead ( NIBP )HR

-- VITALDICOM 30[21][23]

VITAL-[24]European Commission-Directorate General Enterprise(ISIS) VITAL ENV 13 734 DICOM Supplement30 [21][23]

VITAL DICOM /

C . VITAL DICOM Supplement 30

( 1 ) VITAL VITAL ENV 13 734

/

(/ )

ISO 1) (DIM) 2) 3) (MDIB) DIM

VITAL

(CMDISE) ISO/IEC 9595 (CMISE)

DIM (instantiations)

(UI)MDIB

( 2 ) DICOM Supplement 30

DICOM 1 DICOM DICOM Supplement

WG1

HL7 IEEE MIBDICOM

DICOM

II.

A.

(ECG)

VITAL DICOM

B.

CEN(ENV13735) [25]

/

CEN

--

EKG--

()

-- NIBP -

----

()ECG

(LANs)

RS-232 RS-232

ECG 3 SpO2

C .

-- VITAL DICOM

( 1 ) VITAL DIM

(MDS)(VMDs)ECG VMDNIBP VMD SpO2 VMD IEEE 1073[26] IEEE--(MDDL) 1073.1.x[27][29]

VITAL

48

( 2 ) Coad Yourdon

VITAL(UML) [30]UML [31](RAD) UML [32]

UML

1-3 UML 4. 98

1

2

3

4

UMLMDS(VMD)ECG VMDNIBP VMD SpO2 VMDECG VMD HR HR HR ECG ECG NIBP VMDNIBP NIBPSpO2 VMD PR SpO2

ECG III III()()(c-tree)

D.

TCP/IP VITAL IEEE OSI ACSE OSI TCP/IPISO CMOT

(CMDISE)

(PDU)PDUs PDUs PDU PDU

CPU

ISO 8824 1 (ASN.1) ISO 8825(BER) CEN/TC 251/PT35[25] VITALPDUs PDU

E.

DICOM 30

DICOM

DICOM 30

DICOM

5 DICOM

5

III.

A.

/(ECG) [33]

() ( 1 )/ ( 2 )/

(PVSM) Johnson & Johnson CRITIKON DINAMAP PLUS 8700/9700[34] RS-232/(PC)

[35]Windows 98 Intel PC

6.

6

B.

VITAL(GUI) [36]

ECGSpO2NIBP HRPR 3 ECG ECG 12.5 25 50/ ECGPR ECG

PR SpO2PR PR

NIBP

PRPRSpO2SpO2NIBP NIBPNIBP NIBPNIBP NIBP ECGNIBP

C.

TCP/IP [37]

RS-232 (PPP)PPP TCP IP

Borland Delphi 4.0[39],[40]

D.

(DCS)

DCS(CIF) 40 15 25

IV.

CRITICON DINAMAP

Windows 98 PC VITAL DICOM30

( 1 ) ( 2 ) ( 3 )ECGNIBP ( 4 ) PSTN ( 5 )

7 PR

40

7 ID PR

/

DICOM OO

VITAL DICOM

/

V.

(HCMR) [43](FEF) [44]

CEN/TC251/PT-40 (Revision 1.0, 29/11/1999)

ENV 13 735(CEN)

CEN IEEE

[45]

VITAL DICOM(W3C)(XML) XML

CEN TC251 XML

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（92）醫療資訊DICOM 標準推動計畫成果報告

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