Access Everywhere: DICOM in Medical Imaging

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Learn about the DICOM 2013 International Conference & Seminar held in Bangalore, India, focusing on Image Access Everywhere through DICOM Web Services. Discover why DICOM is essential in medical imaging, the history of DICOM standards development, and advancements in web access for DICOM objects. Explore the significance of WADO technology and its evolution over the years. Understand the vital role of DICOM WG10 in standardizing medical imaging protocols. Dive into a brief history of WADO and its progression, emphasizing the importance of web services in facilitating access to DICOM data.

  • Medical Imaging
  • DICOM Standards
  • WADO Technology
  • Image Access
  • Web Services
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  1. THE DICOM 2013 INTERNATIONAL CONFERENCE & SEMINAR March 14-16 Bangalore, India Image Access Everywhere DICOM Web Services also go to PPT tab Insert > Header & Footer to insert title and name of presenter James F Philbin, PhD Johns Hopkins University Co-Director, Center for Biomedical & Imaging Informatics Baltimore, Maryland, USA Co-Chair WG-27; Member WG-06 Co-Authors: Tim Culp, Tim Dawson, Jonathan Whitby

  2. Image Access Everywhere Introduction Web Access for DICOM Objects WADO-URI WADO-WS WADO-RS STore Over the Web Query by IDs for DICOM Objects Putting it all together Image Access Everywhere, James Philbin, PhD 2 14 March 2013

  3. Why Do We Use DICOM? A good standard that continues to evolve Rich, Structured Information Model Compact representation Language independent Widely supported 14 March 2013 Image Access Everywhere, James Philbin, PhD 3

  4. DICOM WG10 NEMA Vienna - March 20, 1999 - WADO Origin: Proposal to DICOM & ISO in 1999 Because no specific Ad Hoc Group on Biomedical Imaging will be set up in ISO / TC215, new works on medical imaging must be done in DICOM (with a Category A Liaison Group between both) More and more it will be important that DICOM makes recommendations on the medical imaging aspects within non pure DICOM protocols DICOM object DICOM world DICOM world non DICOM world *Courtesy of Emmanuel Cordonnier 4

  5. A Brief History WADO(-URI) 1999 - 2003 IHE XDS-I.a WADO-WS 2008-2011 IHE XDS-I.b MINT 2010 2011 v1.0 2011 2013 V2.0 WADO-RS 2011 - 2013 STOW-RS 2011 in progress QIDO-RS 2012 in progress 14 March 2013 Image Access Everywhere, James Philbin, PhD 5

  6. Web Access for (Persistent) DICOM Objects WADO 14 March 2013 Image Access Everywhere, James Philbin, PhD 6

  7. Web Services WADO: Web Access to DICOM (persistent) Objects 1. WADO-URI HTTP Universal Resource Identifier w/ parameters 2. WADO-WS SOAP & WS-* family of specifications 3. WADO-RS RESTful services 14 March 2013 Image Access Everywhere, James Philbin, PhD 7

  8. WADO-URI WADO Using Universal Resource Identifiers 14 March 2013 Image Access Everywhere, James Philbin, PhD 8

  9. WADO-URI HTTP Universal Resource Identifier Parameters Supports DICOM & Rendered images Used in XDS-I.a (deprecated) GET one image at a time 14 March 2013 Image Access Everywhere, James Philbin, PhD 9

  10. Syntax of the WADO HTTP GET method Syntax defined by the RFC2396 (URI) http://<authority><path>?<query> e.g: http://www.hosp.fr/dicom/wado.asp?studyUID=1 Path of the Web Enabled DICOM Server WADO Parameter(s) The Web Access to DICOM Persistent Object standard defines only the <query> 10

  11. WADO-URI Use Cases Embedding images in reports or other documents by URL Browser based viewing of DICOM images for clinical use (one image at a time) 14 March 2013 Image Access Everywhere, James Philbin, PhD 11

  12. WADO-WS WADO Using WS-* Services 14 March 2013 Image Access Everywhere, James Philbin, PhD 12

  13. WADO-WS SOAP + WS-* (Only HTTP POST) Support DICOM & Rendered images Retrieve DICOM objects (studies, series, instances) referenced by an XDS-I Imaging Document Set Retrieve metadata (XML) for specified instances Either DICOM or Rendered objects Filtered metadata using XPath parameter 14 March 2013 Image Access Everywhere, James Philbin, PhD 13

  14. What is SOAP? Simple Object Access Protocol Invented by Microsoft in 1998 RPC for Client / Server Any transport protocol e.g. HTTP, SMTP, TCP, JMS XML based messages WSDL: Web Services Description Language WS-*: WS-Addressing, WS-Policy, WS-Security, WS-Federation, WS-ReliableMessaging, WS-Coordination, WS-AtomicTransaction, WS-RemotePortlets 14 March 2013 Image Access Everywhere, James Philbin, PhD 14

  15. SOAP Structured XML SOAP envelope <env:Envelope xmlns:env="http://www.w3.org/2003/05/soap- envelope"> <env:Header> <!-- Header information here --> </env:Header> <env:Body> <!-- Body or "Payload" here, Fault if error --> </env:Body> </env:Envelope> 14 March 2013 Image Access Everywhere, James Philbin, PhD 15

  16. WADO-WS Use Cases Accessing images and reports from another clinical application such as an EMR Embedding images in reports or other documents by URL Providing access to anonymized DICOM images for research and teaching. Providing access to images & reports for remote diagnostic workflows using the Web. 14 March 2013 Image Access Everywhere, James Philbin, PhD 16

  17. WADO-RS WADO Using RESTful Services 14 March 2013 Image Access Everywhere, James Philbin, PhD 17

  18. What is REST? Representational State Transfer1 RESTful services follow certain principles Addressable Resources (URI) Uniform, Constrained Interface (HTTP) Representation oriented (content negotiation) Stateless Hypermedia* 1. Coined by Roy Fielding, one of the principal authors of the HTTP, in his PhD thesis. 14 March 2013 Image Access Everywhere, James Philbin, PhD 18

  19. SOAP vs. REST SOAP REST Structured XML SOAP envelope Supports hypermedia, multiple MIME types <env:Envelope xmlns:env="http://www.w3.org/2003/05/soap- envelope"> <env:Header> <!-- Header information here --> </env:Header> <env:Body> <!-- Body or "Payload" here, Fault if error --> </env:Body> </env:Envelope> 14 March 2013 Image Access Everywhere, James Philbin, PhD 19

  20. SOAP vs. REST SOAP REST Structured XML SOAP envelope WSDL Transport agnostic Exception/fault in payload Steep learning curve, tools required Heavy weight; requires significant client and server logic Supports hypermedia, multiple MIME types Manual documentation HTTP specific HTTP error codes Easy to develop, no tools required Lightweight; accessible via JavaScript and the simplest web frameworks 14 March 2013 Image Access Everywhere, James Philbin, PhD 20

  21. WADO-RS Just HTTP 1.1 with Resources, http:{service}/studies/{UID} Multiple objects per study No support for rendered images Metadata can be retrieved separately Headers specify transfer syntax & encodings: DICOM Binary Instances XML Metadata Pixel data for Instances or Frames 14 March 2013 Image Access Everywhere, James Philbin, PhD 21

  22. WADO-RS Formats A set of one or more DICOM objects at a time An XML metadata A set of bulk data as a multi-part response Coming soon?... Normalized metadata 14 March 2013 Image Access Everywhere, James Philbin, PhD 22

  23. WADO-RS API Name Operator Resource RetrieveStudy GET /studies/{StudyInstanceUID} RetrieveSeries GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID} RetrieveInstance GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID} RetrieveFrames GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID}/frames/{FrameList} RetrieveBulkData GET {BulkDataURL} RetrieveMetadata GET /studies/{StudyInstanceUID}/metadata All API are prefixed by {SERVICE}/studies, e.g. http://10.0.0.10:8001/studies, or http://somehost/archive/studies 14 March 2013 Image Access Everywhere, James Philbin, PhD 23

  24. WADO-RS Response The response format depends on the Accept header of the request Accept: multipart/related; type=image/dicom+xml Specifies that the response should be DICOM XML metadata Accept: multipart/related; type=application/dicom Specifies that the response should be DICOM Instances encoded in PS3.10 format. Accept: multipart/related; type=application/octet-stream Specifies that the response can include uncompressed bulk or pixel data. Accept: multipart/related; type=image/* Specifies that the response can include be compressed pixel data. Accept: multipart/related; type=video/* Specifies that the response can include video-encoded pixel data. 14 March 2013 Image Access Everywhere, James Philbin, PhD 24

  25. WADO-RS Use Cases Retrieve DICOM (whole studies, entire series, or instances) by UID Retrieve metadata (whole studies, entire series or instances) in one set Retrieve pixel and other bulk data in one message regardless of whether the original study used multi-frame or multiple single- frame instances 14 March 2013 Image Access Everywhere, James Philbin, PhD 25

  26. STOW-RS 14 March 2013 Image Access Everywhere, James Philbin, PhD 26

  27. STOW-RS Capabilities Upload DICOM objects to the server (whole studies, append series / individual instances) Update/replace existing DICOM objects on server 14 March 2013 Image Access Everywhere, James Philbin, PhD 27

  28. STOW API Name Operator Resource StoreInstances POST /studies /studies/{StudyInstanceUID} All API are prefixed by {SERVICE}/studies, e.g. http://10.0.0.10:8001/studies, or http://somehost/archive/studies 14 March 2013 Image Access Everywhere, James Philbin, PhD 28

  29. STOW Formats application/dicom Specifies that the post is DICOM application/dicom+xml Specifies that the post is WADO XML metadata and bulk data 14 March 2013 Image Access Everywhere, James Philbin, PhD 29

  30. STOW Use Cases Viewer adding measurements, GSPS, etc. DICOM routers from modalities to PACS, VNA Securely push studies from outside firewall (e.g. between institutions) Web based QC tools (STOW.v2) 14 March 2013 Image Access Everywhere, James Philbin, PhD 30

  31. QIDO-RS Query by IDs for DICOM Objects 14 March 2013 Image Access Everywhere, James Philbin, PhD 31

  32. QIDO Capabilities Look up DICOM objects based on any meta- data, to get additional meta-data and UIDs Pagination search with offset & limit 14 March 2013 Image Access Everywhere, James Philbin, PhD 32

  33. QIDO API Name Operator Resource SearchForStudy GET /studies SearchForSeries GET /studies/{StudyInstanceUID}/series SearchForInstance GET /studies/{StudyInstanceUID}/instances /studies/{StudyInstanceUID}/series/{SeriesInstanceUID} /instances All API are prefixed by {SERVICE}/studies, e.g. http://10.0.0.10:8001/studies, or http://somehost/archive/studies 14 March 2013 Image Access Everywhere, James Philbin, PhD 33

  34. QIDO Request Parameters {dicomAttribute} = {keyValue} includefield = {dicomAttribute} {dicomAttribute} can be a Tag or Key Word as defined in DICOM PS3.6 or a sequence of the form {dicomSequenceAttribute}.{dicomAttribute} Parameters can be included 0-n times limit = {maxResults} offset = {num of results to skip} 14 March 2013 Image Access Everywhere, James Philbin, PhD 34

  35. QIDO Use Cases Basic study search (patient, date range, type, description) Locate and filter for relevant priors Identify any new studies received 14 March 2013 Image Access Everywhere, James Philbin, PhD 35

  36. Putting It All Together 14 March 2013 Image Access Everywhere, James Philbin, PhD 36

  37. Putting it together Simple URL-based search using QIDO Parse XML or JSON response Launch zero footprint viewer for selected study Download metadata and subset of images Download rest of study in background Upload new evidence / artifacts Upload entire studies 14 March 2013 Image Access Everywhere, James Philbin, PhD 37

  38. Use Case Thin Clients Web Client C-FIND QIDO WADO STOW C-MOVE Proxy Mobile App PACS C-STORE Windows App 14 March 2013 Image Access Everywhere, James Philbin, PhD 38

  39. Use Case Remote Access Client QIDO WADO STOW Proxy Site 1 C-FIND QIDO WADO STOW C-MOVE Proxy PACS C-STORE Site 2 14 March 2013 Image Access Everywhere, James Philbin, PhD 39

  40. Use Case Cloud Sharing Teaching File Referring Portal Client Patient Portal QIDO WADO STOW Cache Client 14 March 2013 Image Access Everywhere, James Philbin, PhD 40

  41. Other Use Cases: 1. Physician referrals 2. ED transfer 3. Cloud Storage 4. Viewer Worklist 5. Integration with FHIR / HL7 RESTful services 14 March 2013 Image Access Everywhere, James Philbin, PhD 41

  42. Author Contacts James F Philbin james.philbin@jhmi.edu 5801 Smith Ave. Baltimore, MD 21209, USA Tim Culp timothy.culp@harris.com Tim Dawson tdawson@vitalimages.com Jonathan Whitby jwhitby@vitalimages.com Thank you for your attention ! 14 March 2013 Image Access Everywhere, James Philbin, PhD 43

  43. Backup Slides 14 March 2013 Image Access Everywhere, James Philbin, PhD 44

  44. DICOM & RESTful Services WADO-RS Web Access to DICOM Objects by RESTful Services Supplement 161 Final Text STOW STore DICOM Over the Web Supplement 163 Public Comment QIDO Query Interface to DICOM Objects Supplement 166 Work In Progress NADO Notification for Availability of DICOM Objects Future under discussion Other: Normalized study level XML and JSON

  45. Security DICOM doesn t define security mechanism Typical HTTP security mechanisms Basic (over SSL) Digest Client certificate Kerberos Windows NT LAN Manager IHE-IUA: Internet User Authentication for HTTP profiles Likely to be OAuth 2.0 14 March 2013 Image Access Everywhere, James Philbin, PhD 46

  46. WADO-RS Additional Use Cases Study Launch 1. Retrieve Metadata (one request) 2. Determine images to display 3. Retrieve initial image(s) 4. Retrieve remaining images (e.g. by series) 14 March 2013 Image Access Everywhere, James Philbin, PhD 47

  47. WADO-RS API Name Operator Resource RetrieveStudy GET /studies/{StudyInstanceUID} RetrieveSeries GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID} RetrieveInstance GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID} RetrieveFrames GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID}/frames/{FrameList} /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID}/frames?calculated= RetrieveBulkData GET /studies/{StudyInstanceUID}/bulkdata/{BulkDataID}? offset={Offset}&length={Length} RetrieveMetadata GET /studies/{StudyInstanceUID}/metadata 14 March 2013 Image Access Everywhere, James Philbin, PhD 48

  48. WADO-RS API Name Operator Resource RetrieveStudy GET /studies/{StudyInstanceUID} RetrieveSeries GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID} RetrieveInstance GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID} RetrieveFrames GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID}/frames/{FrameList} /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID}/frames?calculated= RetrieveBulkData GET /studies/{StudyInstanceUID}/bulkdata/{BulkDataID}? offset={Offset}&length={Length} RetrieveMetadata GET /studies/{StudyInstanceUID}/metadata 14 March 2013 Image Access Everywhere, James Philbin, PhD 49

  49. WADO-RS API Name Operator Resource RetrieveStudy GET /studies/{StudyInstanceUID} RetrieveSeries GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID} RetrieveInstance GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID} RetrieveFrames GET /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID}/frames/{FrameList} /studies/{StudyInstanceUID}/series/{SeriesInstanceUID}/ instances/{SOPInstanceUID}/frames?calculated= RetrieveBulkData GET /studies/{StudyInstanceUID}/bulkdata/{BulkDataID}? offset={Offset}&length={Length} RetrieveMetadata GET /studies/{StudyInstanceUID}/metadata 14 March 2013 Image Access Everywhere, James Philbin, PhD 50

  50. Retrieve Types Study Series Instance Rendered Yes Yes WADO-URI No No Yes Yes Yes Yes WADO-WS Yes Yes Yes WADO-RS No 14 March 2013 Image Access Everywhere, James Philbin, PhD 51

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