The scope of WG-35 is the interoperability of interactive streaming and remote device interaction in medical imaging. The Working Group shall address, but is not limited to, the following:

• Data-oriented streaming of medical imaging information, conveyed as DICOM objects or elements thereof, rather than solely as audio/video streams.
• Bidirectional interaction, enabling feedback of derived results (e.g., measurements, annotations, segmentations, overlays) during or immediately after acquisition.
• Definition of realistic interoperability boundaries for remote supervision versus constrained remote control of medical devices.
• Architectural guidance on leveraging existing industry standards and protocols for low-latency interactive exchange, rather than defining medical-specific transport mechanisms.
• Identification of cross-Part implications within the DICOM Standard.

Initial Work Items

Initial work items for WG-35 may include, but are not limited to:

• Development of architectural and terminological frameworks describing interactive streaming and remote device interaction within the DICOM ecosystem.
• Definition of interoperability profiles for representative interactive streaming workflows.
• Clarification of scope, constraints, and assumptions for remote supervision versus remote control scenarios.
• Recommendations on protocol strategy and alignment with existing industry standards.

Roadmap

The WG-35 roadmap will be based on systematic analysis of use cases requiring the interactive, low-latency exchange of imaging data and associated information. In compatibility with DICOM guiding principles, proposed solutions should leverage existing DICOM objects, established information models, and widely adopted industry standards where feasible.

Short-Term Objectives include:

• Establishing and organizing the new Working Group, including recruitment of relevant stakeholders.
• Defining terminology and interoperability boundaries for interactive streaming and remote device interaction.
• Performing a gap analysis of current DICOM capabilities with respect to identified requirements.
• Refining and prioritizing credible, implementable use cases to guide standardization activities.
• Coordinating with related DICOM Working Groups to avoid overlap and ensure consistency.

Challenges and Opportunities

The increasing prevalence of real‑time and near‑real‑time interactive imaging workflows presents both challenges and opportunities for DICOM. These workflows introduce new demands such as low‑latency data delivery, synchronization of multiple concurrent streams, and safe bidirectional interaction with devices—areas where current DICOM mechanisms are not yet fully aligned. At the same time, a coordinated approach to interactive streaming and device interaction can help prevent fragmentation, reduce vendor lock‑in, and provide clearer guidance to implementers, while still allowing innovation and differentiation where appropriate.