CRIS DICOM Conformance Statement (RIS PD161)

CRIS DICOM Conformance Statement (RIS_PD161) v3.5

CRIS DICOM Conformance Statement (RIS_PD161)

This DICOM conformance statement describes the DICOM functionality of the CRIS Radiological Information System.

Author: Steven Verdon

Version: v3.5

Issue Date: 25th April 2016

Copyright 2014 Healthcare Software Systems. All Rights Reserved

These materials are or comprise restricted and proprietary confidential information of Healthcare Software Systems. Disclosure to or use by the recipient shall not convey any intellectual property rights in these materials. The right to use these materials by the recipient is subject to restrictions and limitations contained in the Provision of Integrated Care Record System and Associated Services Agreement and related agreements.

Confidentiality

All information in this document is provided in confidence for the sole purpose of adjudication of the document and shall not be used for any other purpose and shall not be published or disclosed wholly or in part to any other party without HSS’s prior permission in writing and shall be held in safe custody. These obligations shall not apply to information which is published or becomes known legitimately from some source other than HSS.

Many of the product, service and company names referred to in this document are trademarks or registered trademarks.

They are all hereby acknowledged.

Document Control

Title / CRIS DICOM Conformance Statement
Author / Gary Glover / Steven Verdon / Date: 28/02/2012
File Ref. / RIS_PD161_20910_CRIS_DICOM_Conformance_Statement.doc
Approval Sign-off (For formal issue)
Owner / Role / Signature / Date / Issue
Steven Verdon / Integration Services Manager / 13/04/13
Approver / Role / Signature / Date / Issue
Gary Glover / Software Developer / 13/04/13
Review Panel
Name / Role
Gary Glover / Software Developer
Change History
Issue / Date / Author / Editor / Details of Change
1.0 / 20/06/2006 / Alan Shields / First Draft
2.0 / 25/06/2010 / Gary Glover / MPPS changes
3.0 / 02/03/2011 / Gary Glover / SC Reporting
3.1 / 29/01/2012 / Steven Verdon / Storage details added (6.6)
3.2 / 28/02/2012 / Gary Glover / Data structure for SC Reporting added.
3.3 / 13/04/2013 / Steven Verdon / Document review
3.4 / 01/08/2014 / Steven Verdon / Document review
3.5 / 25/04/2016 / Steven Verdon / Document review

1 Introduction 4

1.1 Intended Audience 4

1.2 Important considerations for the reader 4

2 Acronyms and Abbreviations 5

3 Implementation Model 6

3.1 Overview 6

3.2 Application Data Flow 6

4 AE Specifications 7

4.1 Abstract syntax table 7

4.2 Transfer syntax table 7

4.3 Association Acceptance Policy 8

5 Association initiation policy 9

5.1 General 9

5.2 MPPS Specific Policy 9

6 Description of Functionality 10

6.1 Verification 10

6.2 Modality Work List Information Model 11

6.3 Study Component Management 13

6.4 Modality Performed Procedure Step 13

6.5 Secondary Capture reporting 16

7 Configuration 20

7.1 Modality Worklists 20

7.2 Modality Performed Procedure Step 25

7.3 Report send as Secondary Capture Image 25

1  Introduction

This DICOM conformance statement describes the DICOM functionality of the CRIS Radiological Information System.

CRIS acts as a Service Class Provider in order to supply work lists to a compatible Modality workstation operating as Service Class User.

CRIS now supports the MPPS Dicom service so acts as a Service Class User accepting MPPS messages from appropriate Service Class Providers, i.e. scanning modalities.

CRIS now supports the transmission of reports outbound on the Dicom interface.

This version of the specification applies to CRIS interface release 2.09.10k.

1.1  Intended Audience

This document is intended for system integrators third party suppliers and potential customers, the reader is assumed to be familiar with the DICOM standard.

1.2  Important considerations for the reader

This conformance statement by itself is insufficient to guarantee successful connectivity between CRIS and software/equipment from other vendors. Readers should be aware of the following issues.

·  Integration of software and equipment from different vendors goes beyond the scope of the DICOM 3 standard and DICOM conformance statements. It is the responsibility of the user or user’s agent to assess the application requirements and design a solution that integrates software and equipment from different vendors.

·  CRIS has been tested to ensure that the implementation corresponds with this conformance statement. When attempting to determine the compatibility of equipment from another vendor the first step would be to compare the DICOM conformance statement of the equipment under consideration with this document. If comparison of the two conformance statements suggests that the two systems should be compatible then additional tests should be carried out to ensure that the required functionality and performance if achievable.

·  As the DICOM 3 standard evolves Healthcare Software Systems LTD reserves the right to make changes to the CRIS DICOM functionality. The user or user’s agent should ensure that any equipment connected via DICOM also evolves with the DICOM standard. Failure to do so may result in loss of connectivity.

2  Acronyms and Abbreviations

The following acronyms and abbreviations are used in this document

·  DICOM Digital Communications and Imaging in Medicine

·  SCP Service Class Provider

·  SCU Service Class User

·  SOP Service Object Pair

·  UID Unique Identifier

·  AE Application Entity

·  TCP/IP Transmission Control Protocol/Internet Protocol

·  PDU Protocol Data Unit

·  MPPS Modality Performed Procedure Step

·  SC Secondary capture reporting

3  Implementation Model

3.1  Overview

CRIS implements the DICOM Modality Work List Information Model FIND SOP class as an SCP in order to provide work lists to modality workstations. The DICOM Study Component Management SOP class is also implemented as SCP and may optionally be used by workstations to signal completion of work list items, thus triggering subsequent removal from the work list.

3.2  Application Data Flow

The CRIS AE receives DICOM protocol requests over TCP/IP. In order to service these requests connections are made to the CRIS database to look up and update work lists. The CRIS AE is usually co located with the CRIS Database although this is not a requirement.

DICOM

Interface

4  AE Specifications

CRIS contains one Application Entity per TCP/IP listener (the default listener is on port 104, other listeners may be added).

4.1  Abstract syntax table

CRIS accepts associations with the following presentation contexts. Please note that the report query and some storage functionality (shaded) is not supported in this version of CRIS.

Class Name / UID / Role of CRIS
Verification / 1.2.840.10008.1.1 / SCP
Modality Work list Information Model FIND / 1.2.840.10008.5.2.1.4.31 / SCP
Study Component Management / 1.2.840.10008.3.1.2.3.2 / SCP
Modality Performed Procedure Step / 1.2.840.10008.3.1.2.3.3 / SCP
Report Query / 1.2.840.113532.3500.8 / SCP
Computed Radiography Image Storage / 1.2.840.10008.5.1.4.1.1.1 / SCP
CT Image Storage / 1.2.840.10008.5.1.4.1.1.2 / SCP
MR Image Storage / 1.2.840.10008.5.1.4.1.1.4 / SCP
Nuclear Medicine Image Storage / 1.2.840.10008.5.1.4.1.1.20 / SCP
Positron Emission Tomography Image Storage / 1.2.840.10008.5.1.4.1.1.128 / SCP
RT Image Storage / 1.2.840.10008.5.1.4.1.1.481.1 / SCP
Secondary Capture Image Storage / 1.2.840.10008.5.1.4.1.1.7 / SCP
Ultrasound Image Storage / 1.2.840.10008.5.1.4.1.1.6.1 / SCP
Ultrasound Multi Frame Storage / 1.2.840.10008.5.1.4.1.1.3.1 / SCP
Visible Light Endoscopic Image Storage / 1.2.840.10008.5.1.4.1.1.77.1.1 / SCP
Visible Light Microscopic Image Storage / 1.2.840.10008.5.1.4.1.1.77.1.2 / SCP
Visible Light Photographic Image Storage / 1.2.840.10008.5.1.4.1.1.77.1.4 / SCP
X-Ray angiographic Bi-Plane Image Storage / 1.2.840.10008.5.1.4.1.1.12.3 / SCP
X-Ray angiographic Image Storage / 1.2.840.10008.5.1.4.1.1.12.1 / SCP
X-Ray Radiographic Image Storage / 1.2.840.10008.5.1.4.1.1.12.2 / SCP

4.2  Transfer syntax table

Each of the above SOP classes may be transferred using the following transfer syntaxes

Transfer Syntax Name / UID
Explicit VR Big Endian / 1.2.840.10008.1.2.2
Explicit VR Little Endian / 1.2.840.10008.1.2.1
Implicit VR Little Endian / 1.2.840.10008.1.2

4.3  Association Acceptance Policy

4.3.1  General

From the 2.09.10e revision of CRIS, the connection handler on the Dicom interface initially examines the ‘DicomEquipment’ table to ensure a specific modality has been configured. If the modality has not been configured within this table, the association request will be rejected and the connection severed. This functionality applies to all Dicom services, i.e. modality work lists, MPPS and Structured reporting.

Previous CRIS versions use the AE Title of the SCU to determine the work list filter to apply and any per workstation configuration customizations.

4.3.2  Maximum PDU Size

Maximum PDU size is normally not specified; for SCU’s that require this it may be specified per client AE Title.

4.3.3  Number of Associations

The number of concurrent associations supported is limited only by memory and networking capabilities of the operating system and for practical applications should not be an issue.

4.3.4  Implementation Identification Information

The AE Title is configurable for each TCP/IP listener. The default is “CRIS”.

5  Association initiation policy

5.1  General

CRIS acts only as an SCP and as such does not initiate associations.

5.2  MPPS Specific Policy

Even though MPPS specific associations are not initiated by CRIS, there are monitored for inactivity. A scenario could exist where a number of modalities have created associations but have not initiated any MPPS messages. In this case, CRIS will monitor this inactivity and close the association after a preconfigured delay. The delay is default to 5 minutes.

6  Description of Functionality

6.1  Verification

The verification service allows a workstation to verify connectivity with the CRIS DICOM service. Upon receipt of a C-ECHO request CRIS will respond with an Echo response.

6.2  Modality Work List Information Model

CRIS provides work list services to connected modality work stations. The work lists are generated using a pre defined query configured for each individual work station.

Upon receipt of a C-FIND request, the configuration values for the specific AE Title are looked up and a suitable database query is executed in order to build the work list.

CRIS events and examinations are selected for inclusion in the work list based upon the following.

1. Radiographer details and examination start time have not been added to the exam (this data is normally added post processing)
2. The event is attended
3. The event is either for today, or (prior to nine am) yesterday.
4. Neither the event nor exam has been deleted.

Additional filtering can be configured on a per workstation basis in order to select certain modalities etc. Optionally filtering can be performed based upon the data supplied in the incoming query.

CRIS will send a response message containing DICOM objects with the relevant data for each work list entry. When all work list entries have been sent a terminating response with no data is sent.

CRIS will populate the response DICOM object as per the following table. Only attributes that are requested in the original C-FIND request will be populated. To accommodate work stations that require attributes not normally provided by CRIS the system may be configured to provide additional data on a per work station basis. Any attributes requested that are neither specified here or in the per AE Title configuration will be populated with the values received in the original C-FIND request.

Attribute / Tag / Type / Note
Study Date / 0008,0020 / DA / Date of the examination
Study Time / 0008,0030 / TM / Booked Time of the examination
Accession Number / 0008,0050 / SH / Accession number
Modality / 0008,0060 / CS / Modality, this is populated with the value that Cris received in the original C-FIND request
Referring Physicians Name / 0008,0090 / PN / Name of the referring doctor
Code Value / 0008,0100 / SH / Examination procedure code
Study Description / 0008,1030 / LO / Description of the procedure
Name of physicians reading study / 0008,1060 / PN / Identifier code for the intended radiologist populated in the surname part of the field
Patients Name / 0010,0010 / PN / Patient Name
Patient ID / 0010,0020 / LO / Patient Identifier
Patients Birth Date / 0010,0030 / DA / Patients Date of Birth
Patients Sex / 0010,0040 / CS / Patient Sex
Patients Age / 0010,1010 / AS / Patients AGE
Ethnic Group / 0010,2160 / SH / Patients ethnic origin
Study Instance UID / 0020,000D / UI / This is populated with the examination key from CRIS, if a site identifier code has been configured a universally unique identifier is generated of the form
1.2.826.0.1.2112370.siteID.examKey
Requesting Physician / 0032,1032 / PN / Referring clinicians name populated in the surname part of the field
Requesting Service / 0032,1033 / LO / Referral source
Requested Procedure Description / 0032,1060 / LO / Description of the procedure
Requested Procedure Code Sequence / 0032,1064 / SQ / Sequence
Patients institutional residence / 0038,0400 / LO / Referring ward/location
Scheduled station AE title / 0040,0001 / AE / Returns the value supplied by the calling workstation in the request
Scheduled Procedure Step Start Date / 0040,0002 / DA / Date of the examination
Scheduled Procedure Step Start Time / 0040,0003 / TM / Booked Time of the examination
Scheduled Procedure Step Description / 0040,0007 / LO / Procedure description
Scheduled Procedure Step Sequence / 0040,0100 / SQ / Sequence

6.3  Study Component Management

Study component management allows a work station to communicate completion of an examination to CRIS so as to update the work list. The SCU should send an N-CREATE request with a DICOM object containing the following attributes.

Attribute / Tag / Type / Note
Referenced Study Instance / 0008,1110 / SQ
>Referenced SOP Instance UID / 0008,1155 / UI / CRIS will use the value of this attribute to identify the work list entry that has been completed.

6.4  Modality Performed Procedure Step

6.4.1  Validation

The validation is performed when the association is first established. The AE Title is verified against a value stored within the ‘Dicom Equipment’ configuration table. If this verification fails, no association is established.

6.4.2  Message Sequence

The modality first sends CRIS an ‘N-CREATE’ message with a status of ‘IN PROGRESS’.

The Dicom object sent to CRIS contains various pieces of information, some of which CRIS needs to store.

The main piece of data is the ‘accession number’. With this number the required exam and associated event can be found. The table below shows all the attributes stored to CRIS.