DICOM Standard in Healthcare: Introduction and Services

DICOM i.e. Digital Imaging & communications in Medicine standard has been developed by National Electrical Manufacturers Association for handling imaging data. It is one of the most widely deployed healthcare messaging standards in the world specifies a digital imaging format, data interchange protocol etc. To communicate between systems this standard includes the application protocol that uses TCP/IP as a transport protocol.

dicom healthcare

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It enables the integration of various medical devices such as servers, workstations, network hardware, PACS etc varies from manufacturers to manufacturers.  In our previous articles, we explain Hospital information system, Medical Robots, Artificial intelligence benefits, cloud computing, Virtual reality, Telemedicine, laboratory information system etc in detail. In this article, we explain DICOM in healthcare introduction, services etc in detail.

DICOM Standard [Brief Description]:

With the advancement of technology in medicine, it is now possible to have a paperless hospital & filmless radiology department. For dealing with the medical images like MRIs, X-rays etc Dicom protocol is used. For ease of use, we recommended some points which you should know from the beginning before using it. Let’s go through its some basic facts explained below:

  • Extension: The extension used for Dicom files are .dcm, it contains both image & patient data. The image data is created by the radiology medical imaging devices and the patient data comes from the EMR/EHR/HIS systems.
  • Protocol architecture: The Dicom protocol architecture looks like this:  Network ⇒ TCP/IP ⇒ DICOM ULP for TCP/IP ⇒ UL Service boundary ⇒ DICOM Message Exchange ⇒ Medical Imaging Application.
  • Dicom Ports: This protocol is a binary upper-level protocol over TCP/IP. To process DICOM data, transmit, search/query, print, share display medical images, well-known ports used by DICOM are 104,2761,2762,11112. It is also used to write reports for the radiologist & transmit the patient data from the radiology archival systems to the workstation.

DICOM Services:

In the medical imaging field, Dicom standard specifies various image related services which prove to be an asset for healthcare providers. This standard describes & specifies services at the protocol level i.e. which kind of information must be exchanged for each service & at the semantic level i.e. what each service has been designed.

Each Dicom service requires the following entities explained below for communication.

  • SCP (Service Class Provider): From the network communication point of view this is a server, specifies that the DICOM node providing the DICOM service itself. An example of DICOM SCP is the PACS server which provides storage services to DICOM clients.
  • SCU (Service Class User): From the network communication point of view this is a client, specifies that the DICOM node using the DICOM service. An example of SCU’s is workstations or modalities which use the storage services provided by a PACS server in order to send DICOM images to PACS server’s archive.

Basic DICOM services:

DICOM consist of lots of services which includes transmission of data over a specified network. Have a look at its services.

(i) Query & Retrieve:

This DICOM service allows workstations to find lists of images or other objects & retrieve them from PACS ( picture archiving & communication system). The user is allowed to send queries to the query provider & provider will answer with a list of identifiers.

(i) Data Storage:

This DICOM service will confirm that an image has been permanently stored either on backup media or on redundant disks. For deleting any image, service class user, a modality etc will take the confirmation from the service class provider & make sure that it is safe to delete the images locally or not.

(iii) Transferring Data:

Before exchanging data it is necessary to have knowledge of devices because DICOM standard allows a number of different possibilities to describe data. The main aspect of the DICOM communication between devices is the way they identify each other. A device can be identified by its IP address, the port & the application entity title usually abbreviated as AE title. If you want to connect two DICOM devices then firstly identifies these three characterising data of devices. To enter the another device data, the user interface is used which may be password protected depend upon the device.

(iv) Modality worklist:

This service describes imaging procedures that have been scheduled for performance by an image acquisition device.  Worklist includes procedure order (referring physician), the subject of the procedure (Patient ID, age, sex, name) & type of procedure (procedure code, equipment type) etc. To show the details of the image data, image acquisition device such as CT scanner queries a service provider to get the information. For example,if one device is a DICOM MW (Modality Worklist) Provider & other is  DICOM MW (Modality Worklist) user then this device may query the first one & obtain the result in form of list of requests.

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