Standards Update: DICOM continues to evolve

Standards Update:
DICOM continues to evolve

By Herman Oosterwijk, president, OTech Inc.

Many systems developers seem to be getting “DICOM-ed” out these days. As one told me recently, “It is almost impossible to digest any more additions and to implement them in a timely manner.” The same comments are heard from the user community. One radiologist recently asked how he is supposed to keep up with all the new services and additions to the standards. He worries that his group may have to upgrade their equipment to next-generation hardware or software, something that is not always financially or technically possible.

Does DICOM really change as quickly as it seems? Maybe, but that doesn’t mean developers or users must constantly upgrade their systems. Changes to the standard do not affect existing implementations. For example, if you have a CT device that has been exchanging images using DICOM since the early 1990s, the more recent additions to the standard won’t affect that system. However, if a user exchanging scheduling copy from an information system wants to avoid retyping that copy and introducing the potential for spelling errors, then the device may have to be upgraded to support that DICOM service.

The same thinking applies to the new Modality Performed Procedure Step service, which reports back to an information system and a PACS about the performed procedure, conveying details such as the number of images created. In addition, the DICOM Storage Commitment service could be used by a modality to allow the safe deletion of images while preventing accidental deletions.

The question is, do we need to implement all these new services? The answer depends on how the system will be used. Some major customers, such as the U.S. Department of Defense and Department of Veterans Affairs, strongly recommend that all their purchases have the new services. Of course, it is possible to function without these services, but that may require workarounds and investment in people to make up for the lack of functionality. At a recent conference, a panel of PACS system administrators explained their daily duties and chores. It was obvious that the implementation of some of the DICOM services that deal with data integrity, such as the Modality Worklist, would eliminate many of their current job functions.

Additions to the DICOM standard will continue to be generated, and these changes are not just there for the sake of standardization. New image acquisition techniques, such as 3-D MR and intravascular ultrasound, need to be accommodated in the standard to allow for exchanging that information between different vendors’ systems. In addition, new image management services such as the Modality Performed Procedure Step and Interpretation Worklist provide a level playing field for third-party vendors. And the definition of encryption and digital signatures allows systems to comply with some of the upcoming HIPAA requirements.

Changes and new developments are a way of life, and standards are no exception to that.