May 2002 DICOM Seminar in Seoul DICOM and

May 2002 DICOM Seminar in Seoul DICOM and the Web Emmanuel Cordonnier ETIAM emmanuel. cordonnier@etiam. com May 2002 DICOM Seminar in Seoul

DICOM/Internet: strategy • DICOM members (users and vendors) are very aware of the rapid development of the Internet/Web technologies in Healthcare (they are using them largely in their applications and systems) • BUT they decided to go STEP by STEP « to Web » : – The basic Internet standards have been adopted by DICOM from its early stage (IP, JPEG for image compression…) – DICOM is a « domain » standard. It shall focus only on the specific aspects of the « medical imaging » area, and not to define new general purpose standards – DICOM is standardizing COMMUNICATION (including the one with users -Presentation State) but not APPLICATIONS – It must integrate new (general purpose) standards only if they are STABLE (and « open » – e. g. limitations in Snomed or Wavelets compression)

DICOM and Web standards • So short term DICOM strategy is to only standardize the « glue » with Internet/Web when needed: • A DICOM MIME Type (and PC/Mac File type. dcm and DICM) is registered to ensure consistent E-mail and Web -page encapsulation of DICOM Objects. • Perspectives for a DICOM formatted URL consistent with the DICOM unique identification of Objects to allow « HTTP reference » on DICOM Objects. DICOM «object» M «world» creation « Internet » DICOM «object» world encapsulation DICOM «object» M «world» use

DICOM File n File c DICOM File 1 File b DICOMDIR File a DICOM MIME type (RFC 3240 approved by IETF) multipart/related => DICOM File-set Message • DICOM MIME part (application/dicom) for any DICOM « file » (extension. dcm) • First (optional) DICOM MIME for the DICOMDIR « file » • Potential other files • embedded into a multipart/related (or multipart/mixed) MIME part May 2002 DICOM Seminar in Seoul

DICOM MIME Type Example 1 Content-Type: application/ dicom; id="SE 0001/I 0001"; name="I 0001. dcm" Content-Transfer-Encoding: base 64 Content-Disposition: attachment; filename="I 0001. dcm" Content-ID: "" Content-Description: Color image AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAABESUNNAg. AAAFVMBACm. AAAAAg. ABAE 9 CAAAAAQACAAIAVUka. ADEu. Mi 44 NDAu. MTAw. MDgu. NS 4 x. Lj. Qu. MS 4 x. Ljc. AAg. ADAFVJHAAx. Lj. Iu. Mj. Uw. Lj. Eu. NTku. MTIz. Lj. Q 1 Ni 43 ODku. MS 4 x. . . . 3 Ny 619 ew 2 tq 21 tau 1 NSq 5 OTJ 2 dm 03 d 294 u. LG 2 Niz 2 Nix 2 dmz 19 ex 2 Niz 1 NSq 3 t 6+39+/5 ub. P 0 t. Km 09 Oo 2 dm 11 tau 8 f. Hj////+/v 4/v 7+/////v 7++/v 4/Pz 6/f 38////////////////////// May 2002 DICOM Seminar in Seoul

DICOM MIME Type Example 2 Content-Type: multipart/related; boundary="----=_Next. Part_000_0062_01 C 1 C 786. EA 262 CC 1_13487"; start=""; type="application/dicom" ------=_Next. Part_000_0062_01 C 1 C 786. EA 262 CC 1_13487 Content-Type: text/plain; name="dicomfileset 1 note 1. txt". . . ------=_Next. Part_000_0062_01 C 1 C 786. EA 262 CC 1_13487 Content-Type: application/ dicom; id="DICOMDIR"; name="Dicomdir" Content-Transfer-Encoding: base 64 Content-Disposition: attachment; filename="Dicomdir"; Content-ID: "" Content-Description: Index of the images (DICOMDIR) AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. . . MS 4 y. Ljg 0 MC 4 x. MDAw. OC 4 x. Lj. Iu. MQAIAAg. AQ 1 MAACAAEw. BJUw. IAMg. A= ------=_Next. Part_000_0062_01 C 1 C 786. EA 262 CC 1_13487 May 2002 DICOM Seminar in Seoul

DICOM MIME Type Example 2 May 2002 DICOM Seminar in Seoul

DICOM MIME Type Example 2 May 2002 DICOM Seminar in Seoul

Perspective for a « DICOM » URL: needs • DICOM images are increasingly distributed (U. S. or « visible light » images, surgery depts, clinical depts, doctors…) • They are more and more used in conjunction to (textual) clinical information which is often accessed through the Web browser • There is a growing need for referencing DICOM image(s) into hypertext documents May 2002 DICOM Seminar in Seoul

Perspective for a « DICOM » URL: approach • Define the need and potential solution in conjunction with the medical informatics world (ISO TC 215, HL 7, DICOM) • Propose adaptation of the solution for images (DICOM) • Submit it to the Internet world (IETF, W 3 C) ~ late 2003 May 2002 DICOM Seminar in Seoul Non-DICOM document or system DICOM URL / URI DICOM « Entity » (station, server, modality, media) Database

DICOM and XML • XML has been identified as a good standard to be studied by DICOM in the future (~2003+) • All the new DICOM information objects (for example SR) should easily be « converted » into an XML document (but images themselves can’t) • DICOM has decided to wait the stabilization of the XML technologies (schemas…) as well as HL 7 (XML) V 3 to further study its possible impact on DICOM May 2002 DICOM Seminar in Seoul