consistent presentation of images - integration profile ellie avraham kodak health imaging ihe...
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Consistent Presentation of Consistent Presentation of Images - Integration ProfileImages - Integration Profile
Ellie AvrahamEllie Avraham
Kodak Health Imaging Kodak Health Imaging
IHE Planning and Technical CommitteesIHE Planning and Technical Committees
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA2
Patient Information
Reconciliation
Unknown patients and unscheduled
orders
Scheduled WorkflowAdmit, order, schedule, acquire images, notify of completed steps
IHE Integration ProfilesIHE Integration Profiles
ConsistentPresentation of
Images
Hardcopy and softcopy
grayscale and presentation state
ConsistentPresentation of
Images
Hardcopy and Softcopy
Image Consistency
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA3
Consistent Presentation of Images Consistent Presentation of Images ObjectivesObjectives
• Consistent distribution of Images across the Consistent distribution of Images across the healthcare enterprise healthcare enterprise
• Consistency among Hardcopy Images Printed on Consistency among Hardcopy Images Printed on different Printers (from different Vendors).different Printers (from different Vendors).
• Consistency among Softcopy Images view on Consistency among Softcopy Images view on different Display devices different Display devices (from different Vendors).(from different Vendors).
• Consistency among Hardcopy and Softcopy Image viewConsistency among Hardcopy and Softcopy Image view
• This IHE Integration Profile is the cost effective This IHE Integration Profile is the cost effective solution to esolution to ensure that image quality is maintained nsure that image quality is maintained across different monitors and film producing across different monitors and film producing devices.devices.
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA4
Consistent Presentation of Consistent Presentation of Images Requires:Images Requires:
• Calibration of the Softcopy Display and the Calibration of the Softcopy Display and the Hardcopy Output Devices using DICOM Hardcopy Output Devices using DICOM Grayscale Standard Display FunctionGrayscale Standard Display Function
• Creating Hardcopy Output Using DICOM Creating Hardcopy Output Using DICOM Basic Print with Presentation LUT SupportBasic Print with Presentation LUT Support
• Saving the Softcopy Display Viewing Saving the Softcopy Display Viewing Parameters using DICOM Grayscale Parameters using DICOM Grayscale Softcopy Presentation StateSoftcopy Presentation State
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22
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April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA5
The Grayscale Image The Grayscale Image Presentation Problems:Presentation Problems:
Device capabilities/ characteristics varyDevice capabilities/ characteristics vary
* Device Luminance range* Display Characteristic Curve:DDL -> Luminance
* Device Display Resolution:
Non-Standard Interpretation of Pixel
value to Output Device Luminance
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA6
• The appearance of grayscale images displayed on different types of softcopy display devices or printed on different types of hardcopy output devices is in general inconsistent and at times may impact clinical perception
The Grayscale Consistency The Grayscale Consistency Problem:Problem:
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA7
• Optimal image viewing parameters (e.g. window/ Optimal image viewing parameters (e.g. window/ level) selected on one device appear different level) selected on one device appear different when displayed on a different devicewhen displayed on a different device
• Device capabilities/ characteristics vary - the same Device capabilities/ characteristics vary - the same number of gray levels cannot be rendered or number of gray levels cannot be rendered or perceived on different devicesperceived on different devices
• Displayed images look different from printed Displayed images look different from printed imagesimages
• ……otherother
The Grayscale Consistency The Grayscale Consistency Problem:Problem:
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA8
Problems of InconsistencyProblems of Inconsistency
mass visible mass invisible
•VOI chosen on one display device
•Rendered on another with different display
•Mass expected to be seen is no longer seen
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA9
Problems of InconsistencyProblems of Inconsistency
0.5
1.5
1.0
3.0
•Not all display levelsare perceivable on alldevices
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA10
Problems of InconsistencyProblems of Inconsistency0.5
1.5
1.0
3.0
•Not all display levelsare perceivable on alldevices
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA11
Problems of InconsistencyProblems of Inconsistency
Digital Modality Laser Printer
•Printed images don’t looklike displayed images
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA12
Causes of InconsistencyCauses of Inconsistency
1.0 .66
•Display devicesvary in the maximumluminance they canproduce
•Display CRT vs. film on a light box is an extreme example
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA13
Standardize Display Systems to Standardize Display Systems to Achieve Grayscale Consistency, Achieve Grayscale Consistency, Hardcopy Output and Softcopy Hardcopy Output and Softcopy
Viewing Devices Have to Be Properly Viewing Devices Have to Be Properly CalibratedCalibrated
The DICOM Standard Defines:The DICOM Standard Defines: A standard curve, the Grayscale A standard curve, the Grayscale
Standard Display Function (GSDF), Standard Display Function (GSDF), against which different types of against which different types of display and hardcopy output display and hardcopy output devices should be calibrateddevices should be calibrated
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April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA14
The GSDF Standard Characteristic The GSDF Standard Characteristic Display Systems CurveDisplay Systems Curve
The The GSDF transformation defines the GSDF transformation defines the mapping of the P-values to the view mapping of the P-values to the view Luminance or optical density value, Luminance or optical density value, and preserving the Human and preserving the Human perceptual response, based on the perceptual response, based on the Human Contrast Sensitivity.Human Contrast Sensitivity.
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April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA15
ModalityValues
ofInterest
Polarity Presentation
ImagePresentationDICOM
StandardizedDisplaySystem
Note: The Presentation LUT may be an identity function if, forexample, the Polarity is unchanged and the Values ofInterest transformation outputs P-Values.
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA16
Standardized Display System
LuminanceP-ValuesDisplaySystem
P-Values toDDLs
DDLs
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA17
Printer Calibration Tools Printer Calibration Tools (Densitometer)(Densitometer)
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA18
Display Calibration Tools Display Calibration Tools (Photometer)(Photometer)
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA19
DICOM GSDFDICOM GSDF
.01
.1
1
10
100
1000
0 200 400 600 800 1000
Grayscale Standard Display Function
JND Index
Monitors
Film
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA20
Perceptual LinearizationPerceptual Linearization
.01
.1
1
10
100
1000
0 200 400 600 800 1000
Grayscale Standard Display Function
JND Index
Same number of Just Noticeable Difference == Same perceived contrast
Despite different changein absolute luminance
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA21
Monitor Characteristic CurveMonitor Characteristic Curve
Monitor Characteristic Curve
0.01
0.1
10
100
0 50 100 150 200 250 300Digital Driving Level
Ambient Light
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA22
Standard Display FunctionStandard Display Function
.01
.1
1
10
100
1000
0 200 400 600 800 1000
Grayscale Standard Display Function
JND Index
Monitor’s Capability
Jmax == P-Value of 2n-1
Jmin == P-Value of 0
Minimum Luminance+ Ambient Light
Maximum Luminance+ Ambient Light
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA23
Standardizing a DisplayStandardizing a Display
0.1
1
10
100
0 50 100 150 200 250
DDL or P-Values
Standard
Characteristic Curve
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA24
Standardizing a DisplayStandardizing a Display
Mapping P-Values to Input of Characteristic Curve (DDL’s)
0
50
100
150
200
250
300
0 50 100 150 200 250 300
P-Values
DD
L
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA25
To Achieve Consistent Presentation To Achieve Consistent Presentation of Images, the DICOM Standard of Images, the DICOM Standard
Defines:Defines:
Basic Print Management with Basic Print Management with Presentation Look Up Table, for Presentation Look Up Table, for controlling the consistent appearance controlling the consistent appearance of preformatted images on printed of preformatted images on printed outputoutput
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April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA26
DICOM Grayscale Image DICOM Grayscale Image Transformation ModelTransformation Model
Transformation
VOI LUT(Subtraction)
MaskModality
LUT
Transformation
Annotation
Image
Transformation
Shutter SpatialTransformation
Annotation
Disp. Area
Presentation LUT
Presentation LUT
Transformation
Window/Levelor VOI LUT
Rescale Slope/Interceptor Modality LUT
OriginalImage
DisplayP-Values
Grayscale Transformations
Shutter, Annotation and Spatial Transformations
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA27
Basic Print Management Meta SOP ClassBasic Print Management Meta SOP Class
Print (SCU)Print (SCU) Print (SCP)
Association Negotiation - “Contract Agreement”Association Negotiation - “Contract Agreement”
Agreed set of SOP Classes and Transfer SyntaxesAgreed set of SOP Classes and Transfer Syntaxes( Basic Print Meta SOP Class)( Basic Print Meta SOP Class)
Film SheetFilm Sheet
Basic Print Meta SOP Class consist of four SOP ClassesBasic Print Meta SOP Class consist of four SOP Classes(Film Session, Film Box, Image Box, and Printer)(Film Session, Film Box, Image Box, and Printer)
N-Create (create film sheet, format printer)N-Create (create film sheet, format printer)
N-Set (place images on film sheet)N-Set (place images on film sheet)
N-Action (request to print the film sheet)N-Action (request to print the film sheet)
N-Event-Report (status of the printer)N-Event-Report (status of the printer)
Slide Provided by Don Van Syckle
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA28
Basic Print Request with Presentation Basic Print Request with Presentation LUTLUT
PrintComposer
PrintServer
DICOM Film Session N-CREATE
DICOM Presentation LUT N-CREATE
DICOM Film Box N-CREATE
DICOM Image Box N-SET
DICOM Film Box N-ACTION
DICOM Film Session N-ACTION
Print Status (DICOM N-EVENT-REPORT)
Print Composer
Print Server
Print Request
Printer Status
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA29
Basic Print Request with Presentation Basic Print Request with Presentation LUTLUT
• IHE Transaction - a Print Composer Actor IHE Transaction - a Print Composer Actor issues a DICOM Print request to a Print issues a DICOM Print request to a Print Server Actor. The Print request includes a Server Actor. The Print request includes a Presentation LUT for display consistencyPresentation LUT for display consistency. .
PrintServer
Print Request withPresentation LUT
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PrintComposer
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA30
Basic Print Request with Presentation Basic Print Request with Presentation LUTLUT
• Print Composer – A system that generates DICOM print Print Composer – A system that generates DICOM print requests as a DICOM Print SCU. requests as a DICOM Print SCU. Print composer has to Print composer has to apply image processing manipulations, and requests to apply image processing manipulations, and requests to Print server will specify P-Values in the form of Print server will specify P-Values in the form of Presentation Look-Up Tables (Presentation LUTs) or Presentation Look-Up Tables (Presentation LUTs) or implicitly by Presentation LUT Shapeimplicitly by Presentation LUT Shape..
• Print Server – A system that accepts and processes Print Server – A system that accepts and processes DICOM print requests as a DICOM Print SCP and DICOM print requests as a DICOM Print SCP and performs image rendering on hardcopy media. performs image rendering on hardcopy media. The The system must support pixel rendering to optical density system must support pixel rendering to optical density according to the DICOM Grayscale Standard Display according to the DICOM Grayscale Standard Display FunctionFunction..
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA31
Basic Print Request with Presentation Basic Print Request with Presentation LUTLUT
• Required transaction for both Print Composer Required transaction for both Print Composer and Print Server Actorsand Print Server Actors
• Print Composer shall be grouped with one of the Print Composer shall be grouped with one of the following:following:– Acquisition Modality ActorAcquisition Modality Actor– Image Manager ActorImage Manager Actor– Image Display ActorImage Display Actor– Image Creator ActorImage Creator Actor
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA32
To Achieve Consistent Presentation To Achieve Consistent Presentation of Images, the DICOM Standard of Images, the DICOM Standard
Defines:Defines: Grayscale Softcopy Presentation State (GSPS), Grayscale Softcopy Presentation State (GSPS),
an object for storing and communicating the an object for storing and communicating the parameters that describe how an image or set of parameters that describe how an image or set of images should be displayed. A GSPS object images should be displayed. A GSPS object contains references to the images it applies to, contains references to the images it applies to, and the transformations (grayscale and the transformations (grayscale transformations, shutter transformation, image transformations, shutter transformation, image annotation, spatial transformations, and annotation, spatial transformations, and displayed area annotation) that should be displayed area annotation) that should be applied when the images are presented on a applied when the images are presented on a softcopy display, or printed on film.softcopy display, or printed on film.
33
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA33
Consistent Presentation of ImagesConsistent Presentation of ImagesReporting Radiologist Referring Physician or
Reviewing Radiologist
Presentation StatePresentation LUT
Grayscale Standard
Original Image
Window Level
Flip
Zoom
Area Of
Interest
Annotate
WithoutConsistent Presentation
AchievingConsistent Presentation
Area Of
Interest
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA34
IEIE ModuleModule UsageUsage
PatientPatient PatientPatient MM
StudyStudy General StudyGeneral Study MM
Patient StudyPatient Study UU
SeriesSeries General SeriesGeneral Series MM
Presentation SeriesPresentation Series MM
EquipmentEquipment General EquipmentGeneral Equipment MM
PresentationPresentation Presentation StatePresentation State MM
Modality LUTModality LUT C - Required if to be appliedC - Required if to be applied
MaskMask C - Required if multi-frame and to be appliedC - Required if multi-frame and to be applied
VOI LUTVOI LUT C - Required if to be appliedC - Required if to be applied
Softcopy Presentation LUTSoftcopy Presentation LUT MM
Graphic AnnotationGraphic Annotation C - Required if to be appliedC - Required if to be applied
Spatial TransformationSpatial Transformation C - Required if rotation, flipping or magnification are to be appliedC - Required if rotation, flipping or magnification are to be applied
Displayed AreaDisplayed Area MM
Display ShutterDisplay Shutter C - Required if to be applied and the Bitmap Display Shutter Module is notC - Required if to be applied and the Bitmap Display Shutter Module is notpresentpresent
Bitmap Display ShutterBitmap Display Shutter C - Required if to be applied and the Display Shutter Module is not presentC - Required if to be applied and the Display Shutter Module is not present
Overlay PlaneOverlay Plane C - Required if to be applied or the BM C - Required if to be applied or the BM Displ. Shutter Module is presentDispl. Shutter Module is present
Overlay/Curve ActivationOverlay/Curve Activation C- Required if image contains curve or overlay which is to be displayedC- Required if image contains curve or overlay which is to be displayed
Graphic LayerGraphic Layer C - Required if Graphic Annotation or Overlays or Curves are to be appliedC - Required if Graphic Annotation or Overlays or Curves are to be applied
SOP CommonSOP Common MM
GSPS Module Table:GSPS Module Table:
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA35
Composite object containing the image display Composite object containing the image display settings parameterssettings parameters
Composite object links to one or more images (Series, Composite object links to one or more images (Series, filters); stored using same Study Instance UID (same filters); stored using same Study Instance UID (same Storage SOP Class!)Storage SOP Class!)
Uses regular Storage services (C-STORE); uses Uses regular Storage services (C-STORE); uses Query/Retrieve servicesQuery/Retrieve services
GSPS SOP Instances are immutable: changes require a GSPS SOP Instances are immutable: changes require a new SOP Instance UIDnew SOP Instance UID
Note: generation and specific application of GSPS is Note: generation and specific application of GSPS is outside the scope of DICOM, but not outside the scope outside the scope of DICOM, but not outside the scope of IHE (e.g. Presentation of Grouped Procedures)of IHE (e.g. Presentation of Grouped Procedures)
Grayscale Softcopy Presentation StateGrayscale Softcopy Presentation State::
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA36
Image Creator
Modality PresentationState Stored
9
AcquisitionModality
Creator PresentationState Stored
19
Image Display
QueryPresentation State
15
RetrievePresentation State
17
ImageArchive
GSPS Stored, and Query/Retrieve GSPS Stored, and Query/Retrieve GSPSGSPS
• IHE Transaction - an IHE Transaction - an Acquisition Modality or Image Acquisition Modality or Image Creator Actor sends a DICOM Creator Actor sends a DICOM GSPS C-STORE request to an GSPS C-STORE request to an Image Archive ActorImage Archive Actor
• IHE Transaction - an Image IHE Transaction - an Image Display Actor issues a C-FIND Display Actor issues a C-FIND request to an Image Manager request to an Image Manager ActorActor
• IHE Transaction - an Image IHE Transaction - an Image Display Actor issues a C-Display Actor issues a C-MOVE request to an Image MOVE request to an Image Archive ActorArchive Actor
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA37
Creator Presentation State Creator Presentation State StoredStored
ImageCreator
ImageArchive
C-STORE (Presentation State Stored)
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA38
Query for Grayscale Softcopy Query for Grayscale Softcopy Presentation StatesPresentation States
ImageDisplay
ImageArchive
Query/Retrieve Presentation States (C-FIND/C-MOVE)
Presentation States (C-STORE)
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA39
IHE Year 4: Presentation State IHE Year 4: Presentation State Specific Query Matching and Specific Query Matching and
Return KeysReturn KeysQuery Keys MatchingQuery Keys Matching Query Keys ReturnQuery Keys ReturnAttribute NameAttribute Name TagTag
SCUSCU SCPSCP SCUSCU SCPSCP
Presentation LabelPresentation Label (0070,0080)(0070,0080) OO OO R+R+ R+R+
Presentation DescriptionPresentation Description (0070,0081)(0070,0081) OO OO OO R+R+
Presentation Creation DatePresentation Creation Date (0070,0082)(0070,0082) OO OO R+R+ R+R+
Presentation Creation TimePresentation Creation Time (0070,0083)(0070,0083) OO OO R+R+ R+R+
Presentation Creator’s NamePresentation Creator’s Name (0070,0084)(0070,0084) OO OO R+R+ R+R+
Referenced Series SequenceReferenced Series Sequence (0008,1115)(0008,1115) OO OO R+R+ R+R+
>Series Instance UID>Series Instance UID (0020,000E)(0020,000E) OO OO OO R+R+
>Referenced Image Sequence>Referenced Image Sequence (0008,1140)(0008,1140) OO OO OO R+R+
>>Referenced SOP Class UID>>Referenced SOP Class UID (0008,1150)(0008,1150) OO OO OO R+R+
>>Referenced SOP Instance UID>>Referenced SOP Instance UID (0008,1155)(0008,1155) OO OO OO R+R+
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA40
Acquire DisplayPrint
Consistent Presentation of ImagesConsistent Presentation of Images
Slide Provided by David Clunie
April 8, 2002Year 4 Vendor Workshop
HIMSS / RSNA41
Questions?Questions?
Documents Available On the Web at:Documents Available On the Web at:
www.rsna.org/IHE or www.himss.orgwww.rsna.org/IHE or www.himss.orgwww.rsna.org/IHE or www.himss.orgwww.rsna.org/IHE or www.himss.org