Efilm: Dicom Conformance Statement September 10/07
Efilm: Dicom Conformance Statement September 10/07
September 10/07
Revision 11
eFilmTM Merge Healthcare
DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
1. INTRODUCTION ................................................................. 4
1.1. Scope and Field of Application ................................................................................... 4
1.2. References and Definitions......................................................................................... 4
1.3. Symbols and Abbreviations ........................................................................................ 4
1.4. Revision Number ........................................................................................................ 5
1.5. Considerations............................................................................................................ 6
2. IMPLEMENTATION MODEL .............................................. 7
2.1. Application Data Flow Diagram .................................................................................. 7
2.2. Functional Definitions of Application Entities.............................................................. 8
2.3. Sequencing of Real World Activities........................................................................... 8
3. APPLICATION ENTITY SPECIFICATIONS ....................... 9
3.1. AE Specifications for eFilm DICOM Services............................................................. 9
3.1.1. Association Establishment Policies ..................................................................... 11
3.1.1.1. General ..................................................................................................................... 11
3.1.1.2. Number of Associations............................................................................................ 11
3.1.1.3. Asynchronous Nature ............................................................................................... 11
3.1.1.4. Implementation Identifying Information..................................................................... 11
3.1.2. Association Initiation Policy.................................................................................. 12
3.1.2.1. Verify Communication with a Remote System ......................................................... 12
3.1.2.1.1. Associated Real World Activity ................................................................................. 12
3.1.2.1.2. Proposed Presentation Contexts.............................................................................. 12
3.1.2.1.3. SOP Specific Conformance Statement for SOP Verification Class.......................... 12
3.1.2.2. Send Images to a Remote System........................................................................... 12
3.1.2.2.1. Associated Real World Activity ................................................................................. 12
3.1.2.2.2. Proposed Presentation Contexts.............................................................................. 13
3.1.2.2.3. SOP Specific Conformance Statement for SOP Image Storage Class.................... 13
3.1.2.3. Query a Remote Database ....................................................................................... 15
3.1.2.3.1. Associated Real World Activity ................................................................................. 15
3.1.2.3.2. Proposed Presentation Contexts.............................................................................. 15
3.1.2.3.3. SOP Specific Conformance Statement for SOP Query Class.................................. 15
3.1.2.4. Retrieve from a Remote System .............................................................................. 17
3.1.2.4.1. Associated Real World Activity ................................................................................. 17
3.1.2.4.2. Proposed Presentation Contexts.............................................................................. 17
3.1.2.4.3. SOP Specific Conformance Statement for SOP Retrieve Class .............................. 17
3.1.2.5. Print to a Remote Laser Imager................................................................................ 17
3.1.2.5.1. Associated Real World Activity ................................................................................. 17
3.1.2.5.2. Proposed Presentation Contexts.............................................................................. 17
3.1.2.5.3. SOP Specific Conformance Statement for SOP Classes Basic Grayscale Print
Management Meta Classes ...................................................................................... 18
3.1.2.5.3.1. Conformance for SOP Class Basic Film Session..................................................... 18
3.1.2.5.3.2. Conformance for SOP Class Basic Film Box ........................................................... 18
3.1.2.5.3.3. Conformance for SOP Class Basic Grayscale Image Box....................................... 19
3.1.2.5.3.4. Conformance for SOP Class Printer......................................................................... 19
3.1.2.5.4. Optional SOP Classes for Basic Grayscale Print Management Meta ...................... 19
3.1.2.6. Retrieve a Modality Worklist from a Remote System ............................................... 20
3.1.2.6.1. Associated Real World Activity ................................................................................. 20
3.1.2.6.2. Proposed Presentation Context................................................................................ 20
3.1.2.6.3. SOP Specific Conformance Statement for the Modality Worklist Management Class
.................................................................................................................................. 20
3.1.2.7. Verify the Committed Storage of Images on a Remote System............................... 21
3.1.3. Association Acceptance Policy ............................................................................ 21
3.1.3.1. Verify Communication with a Remote System ......................................................... 22
3.1.3.1.1. Associated Real World Activity ................................................................................. 22
3.1.3.1.2. Accepted Presentation Contexts .............................................................................. 22
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DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
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eFilmTM Merge Healthcare
DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
1. INTRODUCTION
This document is the DICOM Conformance Statement for the eFilm medical imaging software
application developed by Merge Healthcare. Contained in this statement are detailed
descriptions of how eFilm collaborates with other Medical Imaging devices and applications that
conform to the DICOM 3.0 standard.
The intended user of this document is involved with software design and system integration. It is
understood that this individual is familiar with the concepts and terms used throughout this
document. Readers unfamiliar with the DICOM 3.0 standard should consult the actual
documentation prior to examining this conformance statement.
All necessary references and definitions have been taken from the Digital Imaging and
Communications in Medicine (DICOM) standard, parts 1 through 13 (NEMA PS 3.1-13).
All symbols and abbreviations used herein are described in the Digital Imaging and
Communications in Medicine (DICOM) standard, parts 1 through 13 (NEMAPS 3.1-13).
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Rev 4 May 09/2002 • 3.1. Included support of PET Storage SOP classes as SCU &
SCP
Rev 5 May 17, 2002 • 3.1. Included support for Modality Worklist Management as
SCU
• 3.1.2.6. Included Retrieve a Modality Worklist from a Remote
System as an association initiation policy.
Rev 6 June 14/2002 • 3.1.3.2.3 Included C-STORE response codes
Rev 7 Nov 01/2002 • Changed corporate name to Merge eFilm and included part
number.
Rev 8 Aug 25/2003 • Minor revisions for eFilm 1.9
• Added FSC role for DICOMDIR creation
• Other minor clarifications and additions
Rev 9 Nov 24/2003 Revisions for eFilm v2.0
Revised FSC role in the DICOMDIR creation
Revised C-STORE SCP section
Rev 10 Sep 22/2005 Revisions for company name, and eFilm Workstation 2.1
Added support for RT Image Storage
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DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
1.5. Considerations
• This document on its own should not be interpreted as a guarantee of connectivity between
eFilm and any equipment and/or applications offered by other vendors.
• Integration of eFilm with the equipment and/or applications of different vendors, including
Merge Healthcare, are outside the scope of the DICOM 3.0 standard and product
conformance statements. Integration and interoperability of different equipment/applications
are the sole responsibility of the user.
• In the case of any possible connectivity inferred by a user to exist between eFilm and another
product, the user is responsible for testing and verifying the inferred connectivity.
• Future changes to the DICOM 3.0 standard may require alterations to be made to eFilm.
Merge Healthcare reserves the right to modify the eFilm architecture as needed, in order to
meet changing standards.
• The user should ensure that any existing DICOM equipment also changes with the future
developments of the DICOM standards. Failure to keep pace with any alterations in the
DICOM standards may result in decreased or lost connectivity.
• All trade names mentioned in this document are recognized.
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DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
2. IMPLEMENTATION MODEL
The Implementation Model for the eFilm DICOM services is depicted below:
eFilm W orkstation
Verification C-Echo
Query/
C-FIND
Retrieve
C-M OVE
Request
Application
(eFilm.exe)
Send
C-STORE
Request
N-SET
Print Job N-CREATE
Submittal N-DELETE
N-ACTION
Scan M odule
M odality
C-FIND
Worklist
(eFScan.exe)
C-ECHO
Store IOD DICOM Server
C-STORE
or Query/
C-FIND
Retrieve (efserver.exe)
C-M OVE
DICOM Interface
A number of eFilm’s DICOM services are provided by the eFilm DICOM Server, which runs as a
service (Windows NT/2000/XP Professional). The eFilm DICOM Server starts when the system
is started, and shuts down when the system is turned off. In addition, basic query/retrieve
requests and print job submittals can be made by eFilm directly between SCU and SCP devices
without being routed through the DICOM Server process. This structure means that data
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DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
requests can be accepted at all times when the system is running, regardless of whether or not
the Workstation application is open. In addition, if the DICOM Server should be interrupted or
manually shut down for some reason, queries and print submittals can still be made.
eFilm will retrieve a Modality Worklist from a Remote System only when the eFilmTM ScanTM
module is activated. If the eFilm Scan module is not active, it cannot retrieve a Modality Worklist
from a remote system.
The eFilm DICOM Server supports image reception as well as the processing of query/retrieve
requests.
All communications and image transfer with the remote application is accomplished utilizing the
DICOM protocol over a network using the TCP/IP protocol stack.
SCU SCP
• Verification • Verification
• Storage • Storage
• Query/Retrieve • Query/Retrieve
• Basic Grayscale Print
Management.
• Modality Worklist
Management
Not applicable.
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DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
The eFilm DICOM services provide support for the following DICOM 3.0 SOP Classes as an
SCU:
1
Proposed only if the eFilmTM ScanTM module is activated.
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Part # 009-82078-00 Revision 11
The eFilm DICOM services provide support for the following DICOM 3.0 SOP Classes as an
SCP:
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Part # 009-82078-00 Revision 11
3.1.1.1. General
The DICOM Application Context Name (ACN) that is always proposed by the eFilm DICOM
services is 1.2.840.10008.3.1.1. The services shall offer a maximum PDU size of 16kB (16384
bytes) upon association initiation, and accept maximum PDU sizes up to 16kB (16384 bytes) on
associations initiated by remote applications. There is no limit on the number of Presentation
Context Items that will be proposed.
eFilm can support multiple associations simultaneously, both as an SCP and as an SCU. As an
SCP, the DICOM Server will listen for incoming associations and spawn a new thread to manage
each request. This ability means it is possible for eFilm to receive both images and query/retrieve
requests from multiple SCUs simultaneously. By default, the maximum number of simultaneous
associations is limited to 25. Users may increase this value as needed; however, one should
expect performance to degrade if the maximum number of simultaneous associations is
increased significantly beyond 25.
As an SCU, eFilm DICOM Server can send images to multiple SCPs simultaneously, spawning a
new thread for each destination if the number of sending threads does not exceed 25. For
DICOM print jobs, eFilm establishes associations serially.
eFilm does not support asynchronous operations. All operations will be performed
synchronously.
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The user selects a server from the list of Remote Devices in the Edit->Properties page, and clicks
“Verify”.
The user selects one or more studies from the search dialog and clicks the Send button. A list of
AEs appears, from which the user selects one.
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3.1.2.2.3. SOP Specific Conformance Statement for SOP Image Storage Class
Images stored in the eFilm database that are to be sent to remote systems are converted to
instances of the corresponding SOP Storage class(es). Images are then sent sequentially to the
remote system(s). When sending multiple images to one remote system, a new association is
negotiated for each study. eFilm will propose the transfer syntax of the stored SOP instance, and
the default, Implicit VR, Little Endian (ILE). That is, if the SOP instance is stored using a
compressed syntax, eFilm has the ability to decompress it into the ILE syntax for receivers that
2
Only if the image is already stored in specified syntax, and proposed in addition to ILE.
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Part # 009-82078-00 Revision 11
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Part # 009-82078-00 Revision 11
The user clicks on the Remote exams list in the Search dialogue, selects an AE from the list of
destinations, enters the search criteria, and then clicks Search. “Begins with” searching is used,
allowing partial search criteria to be entered. As some SCPs do not accept wildcard searching in
the Patient ID field and/or do not support the query of the modality key at the Study level, such
options can be enabled/disabled as needed through eFilm’s Edit Properties page.
eFilm supports C-Find response values as defined in DICOM v.3.0 Part 4. All Required (R) and
Unique (U) Study, Series, and Image level keys are supported for the Study Root information
models. In addition, certain Optional (O) keys are supported. For a Study Root Query/Retrieve
the following keys are supported:
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Part # 009-82078-00 Revision 11
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The user selects one or more studies from the Remote Exams list in the Search dialogue, then
clicks either View or Retrieve.
The user selects the desired image(s) by clicking on the lower right-hand square of each image
and then selects DICOM Print from the File menu. He or she selects the appropriate printer,
makes any necessary changes to the printer settings, and then clicks Print.
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DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
3.1.2.4.3. SOP Specific Conformance Statement for the SOP Classes of the
Basic Grayscale Print Management Meta SOP Class
Below (following page) are the mandatory print SOP classes supported by eFilm for the Basic
Grayscale Management Meta class.
eFilm includes the following N-Create attributes for the Basic Film Session SOP class:
N-Set and N-Action are not used; however, N-Delete is used to delete the complete Basic Film
Session SOP instance hierarchy.
The table below lists the N-Create attributes for the Basic Film Box SOP class, where A means
the attribute is always sent and C means the attribute is only sent when not empty.
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The N-Set is currently unused; however, the N-Action is used to print a complete Basic Film Box
SOP instance and N-Delete is used to delete it after printing.
The following attributes are included in eFilm’s N-Set for the Basic Grayscale Image SOP class.
Again, “A” stands for attributes which are always sent to the printer, while “C” stands for attributes
that are only sent when they contain data.
eFilm uses N-GET for the Printer SOP class to get information from the SCP.
3.1.2.4.4. Optional SOP Classes for Basic Grayscale Print Management Meta
3
Sent only the in case of “expected size” printing.
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DICOM Conformance Statement September 10,2007
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eFilm can query for a Modality Worklist to aid in merging patient demographics into DICOM
images. This prevents the need to enter patient demographics manually. This feature is available
only when the eFilmTM ScanTM module is activated.
eFilm provides standard conformance, a list of supported keys is given in the table below:
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eFilm may fill, none, one or multiple attributes in the query request with a non-empty value. eFilm
may thus request matching on Optional Matching Key Attributes.
All fields listed above are always included in the query request to ask the SCP to return them for
each response. eFilm expects the SCP to return values for all ‘R’ attributes whereas the
attributes marked with ‘O’ may be optionally filled. Therefore eFilm treats these attributes as Type
3 Return Key Attributes.
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DICOM Conformance Statement September 10,2007
Part # 009-82078-00 Revision 11
eFilm will reject association requests from unknown AEs that request an image transfer.
Similarly, most remote systems will reject eFilm’s association requests if the eFilm AE title is not
correctly configured.
eFilm will send an echo response to verification requests made by remote systems.
eFilm will accept all presentation contexts which match those of the preceding table (above). No
specific acceptance and/or prioritization rules are required.
A remote system pushes (i.e., sends) images to eFilm. Upon completion of the transfer, the
images are available locally and can be selected for display.
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The eFilm AE conforms to the SOP’s of the Storage SOP Class at Level 2 (full). No elements are
discarded or coerced by the eFilm AE. In the case of a successful C-STORE operation the object
has successfully been written to disk in the eFilm database. If an image is sent with the same
SOP Instance UID (0008, 0018) as one that already exists on the eFilm AE, the new image will
replace the old image and the database will be updated accordingly.
Lossy JPEG images will be stored in compressed form when received by eFilm and will only be
uncompressed for viewing.
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The eFilm AE responds to a C-STORE request with one of the response codes listed below:
No criterion.
A remote system queries the eFilm database to determine what studies are present on the
system.
Presentation Context Table for Remote Query of the Local eFilm Database
Abstract Syntax Transfer Syntax Role Extended
Name UID Name UID Negotiation
Study Root 1.2.840.10008.5.1.4.1.2.2.1 Implicit VR, 1.2.840.10008.1.2 SCP None
Query Little
Retrieve Endian
Information Explicit VR 1.2.840.10008.1.2.
Model - FIND Little 1
Endian
Explicit VR 1.2.840.10008.1.2.
Big Endian 2
eFilm supports C-Find response values as defined in DICOM v.3.0 Part 4. All Required (R) and
Unique (U) Study, Series, and Image level keys are supported for the Study Root information
models. In addition, certain Optional (O) keys are supported. The following tables outline the
supported keys. Please note that eFilm does not support relational queries.
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eFilm will accept all presentation contexts which match those of the preceding table (above,
preceding page). No specific acceptance and/or prioritization rules are required.
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A remote system retrieves one or more studies from the eFilm system.
Presentation Context Table for Remote Retrieve from the Local eFilm Database
Abstract Syntax Transfer Syntax Role Extended
Name UID Name UID Negotiation
Study Root 1.2.840.10008.5.1.4.1.2.2.2 Implicit 1.2.840.10008.1.2 SCP None
Query Retrieve VR,
Information Little
Model - MOVE Endian
In addition, eFilm implements relational retrieve. In other words, all studies from a single patient
can be retrieved by entering a single patient ID for the Study Root Query/Retrieve Model.
eFilm will only accept requests for retrieval from those systems to which the application has been
properly configured, with respect to Application Entity title, IP address or hostname, and DICOM
port number.
eFilm Workstation conforms to DICOM Media Storage Service and File Format (PS 3.10) and the
Media Storage Application Profiles (PS 3.11) for reading images on CD-Recordable media.
eFilm Workstation, through its supported application profile (above), supports the real world
activities listed below. Please note that some additional flexibility is also available.
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eFilm Workstation assumes the role of FSR when reading the CD-R disk directory. Reading this
directory will display an overview of the patients, studies, and images, organized in one of these
ways:
Type of Query
Type of Query Levels
Study Root Query Study
The user must supply at minimum the data for the Patient Name and Patient ID fields in order to
display correctly the directory information. Reading the DICOMDIR contents is a standard feature
in eFilm Workstation. The following DICOMDIR keys are used for distinguishing between the
objects.
When reading images from a CD-R, eFilm Workstation will assume the role of FSR. DICOM Part
10 Volume image import is standard.
In order for eFilm Workstation to store the images contained on a CD-R correctly, the following
mandatory DICOM image attributes (DICOM Part 10) are required:
eFilm Workstation can only import and read images from the following SOP classes:
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(Presentation)
DX Image Storage (Raw) 1.2.840.10008.5.1.4.1.1.1.1.1
MR Image Storage 1.2.840.10008.5.1.4.1.1.4
US Image Storage (retired) 1.2.840.10008.5.1.4.1.1.6
US Image Storage 1.2.840.10008.5.1.4.1.1.6.1
US Multi-Frame Image Storage 1.2.840.10008.5.1.4.1.1.3
(Retired)
US Multi-Frame Image Storage 1.2.840.10008.5.1.4.1.1.3.1
SC Image Storage 1.2.840.10008.5.1.4.1.1.7
MG Storage (Presentation) 1.2.840.10008.5.1.4.1.1.1.2
MG Storage (Raw) 1.2.840.10008.5.1.4.1.1.1.2.1
NM Image Storage (Retired) 1.2.840.10008.5.1.4.1.1.5
NM Image Storage 1.2.840.10008.5.1.4.1.1.20
XA Image Storage 1.2.840.10008.5.1.4.1.1.12.1
XA Biplane Image 1.2.840.10008.5.1.4.1.1.12.3
Storage(Retired)
RF Image Storage 1.2.840.10008.5.1.4.1.1.12.2
Standard PET Image Storage 1.2.840.10008.5.1.4.1.1.128
RT Image Storage 1.2.840.10008.5.1.4.1.1.481.1
The following transfer syntaxes are supported by eFilm Workstation when importing and reading
CD-R images:
The associated real world activity that initiates export of images for CD-R recording is: The user
selects a study from the Study Manager, and selects “Burn to Media”.
The file set created through the legacy packagers do not conform to the General Purpose CD-R
Image Interchange Profile as a File Set Creator, but notably, they will copy the files from the local
database as-is, rather than converting them to the Explicit VR, Little Endian transfer syntax.
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4. COMMUNICATION PROFILE
The TCP/IP stack supported by eFilm is inherited from the host operating system (Windows
95/98/NT/2000/XP Professional).
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5. EXTENSIONS/SPECIALIZATIONS/PRIVATIZATIONS
Not applicable.
Not applicable.
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6. CONFIGURATION
The local AE title can be configured by authorized personnel. Such personnel may change
configurations through the settings of the Process Manager.
• Local AE Title
• Listening TCP/IP Port (default port is 4006)
• Number of simultaneous connections
• Remote AE
• Remote TCP/IP Port
• Remote IP Address
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