DICOM® is a standard for communication of medical imaging information. Selected highlights of it’s history are shown below:
In the beginning… it was very difficult for anyone other than manufacturers of computed tomography (CT) or magnetic resonance imaging (MRI) devices to decode the images that the machines generated, or to print them.
The American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) joined forces and formed a standards committee to meet the combined needs of radiologists, physicists and equipment vendors.
Their first standard covering point-to-point image communication, ACR-NEMA 300, was released. The specified image transmission used a dedicated 16-bit parallel interface.
The second version of ACR-NEMA 300 was released, gaining increasing acceptance among vendors.
The first demonstration of ACR-NEMA V2.0 occured at Georgetown University in May 1990, and later that year at the annual meeting of the Radiological Society of North America (RSNA).
The first large-scale deployment of ACR/NEMA was by the US Army and Air Force as part of the MDIS (Medical Diagnostic Imaging Support) program at Fort Detrick, Maryland.
The third version of the standard evolved to use local area networks like Ethernet by layering the medical image protocols on top of general networking protocols (TCP/IP). The name was changed to DICOM (Digital Imaging and COmmunications in Medicine), and published as NEMA Standard PS3.
DICOM added formats for ultrasound, X-ray angiography, and nuclear medicine to the Standard, supporting the needs of cardiology imaging. Image exchange via CDs allowed off-line transfer of imaging studies.
The DICOM Standards Committee reorganized to formally represent all medical specialties that use imaging, not just radiology, including the American College of Cardiology (ACC).
Workflow management in the imaging department was standardized as DICOM added the Modality Worklist service.
Radiation therapy information objects were added.
Endoscopy and dermatology became part of the Standard through the addition of Visible Light objects.
Consistent presentation of image annotations across display systems are enabled with the first Presentation State information objects.
Structured data, analytic results and clinical observations made in the imaging environment were standardized with Structured Reporting (SR), extending DICOM beyond just images.
Internet security mechanisms were added through secure communication profiles for the DICOM protocol.
Mammography CAD (Computer Aided Detection) SR added for the results of automated image analysis.
Multi-frame enhanced image formats adopted to support the next generation of advanced MR and CT imaging techniques.
Web-access to DICOM objects (WADO) added to retrieve DICOM images over HTTP connections.
Dentistry and ophthalmology joined DICOM.
Radiation Dose Structured Reports (RDSR) added for x-ray based imaging (including CT) to support patient safety related data collection.
DICOM Encapsulation of PDF added to manage documents associated with imaging studies.
Breast tomosynthesis (“3-D mammography”) added.
Whole slide imaging and specimen identification added to support anatomic pathology imaging.
Surgical planning information objects added.
Second generation RESTful web services defined to retrieve, store and query DICOM images. The suite of web services is re-branded as DICOMweb™, and is aligned with the HL7 FHIR web services.
Imaging report templates using the HL7 Clinical Document Architecture (CDA) added, aligning with requirements for CDA in the U.S. Meaningful Use of Electronic Health Record Systems regulations.
Volumetric Presentation States added to manage 3D rendering of image sets.