is a Standard
for communication of medical imaging
information. Selected highlights of its 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 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.
, X-ray angiography
, and nuclear medicine
protocols added to DICOM, supporting the needs of cardiology
based image exchange via allowed off-line transfer of imaging studies.
The DICOM Standards Committee was reorganized to formally represent all medical specialties that use imaging, not just radiology, including the American College of Cardiology (ACC)
in the imaging department was Standardized as DICOM added the Modality Worklist
information objects were added.
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.
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.
(Computer Aided Detection) SR added for the results of automated image analysis.Media security
2003Multi-frame enhanced image
formats adopted to support the next generation of advanced MR and CT imaging techniques.DVD
media exchange added.
2004WADO (Web-access to DICOM objects)
added to retrieve DICOM images over HTTP connections.Dentistry
joined DICOM.USB and Flash memory
media exchange added.Spatial registration
supported for rigid registrations of imaging datasets.MPEG2
encoding of video data supported.
Structured Reports (RDSR) added for x-ray based
imaging (including angiography, mammography, CR and DR) to support patient safety related data collection.PDF document
encapsulation in DICOM to manage documents associated with imaging studies.
2006Deformable spatial registration
added to handle MR fields, atlases and other deformable cases.
2007Radiation Dose for CT
(RDSR) added to RDSR.
("3-D mammography") added.
2010Whole slide imaging
added to support anatomic pathology imaging (specimen identification added in 2008).Surgical planning
information objects added.
media exchange 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 upcoming HL7 FHIR web services.
2014Radiopharmaceutical Radiation Dose Reporting
added to WADO-RS, allowing web clients to request DICOM images and video be rendered into consumer media formats for simple display, e.g. in EHR portals.Tractography Results
storage added to support applications such as MR DTI
in neurology.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.Wide-Field Ophthalmic Photography
images added.Brachytherapy Delivery Instruction
objects added to support radiotherapy treatment delivery.AVC/H.264 (MPEG4)
video support added.
2016CT Protocol Storage
added for both generic (non-patient-specific) protocols and actual performed protocols.Adult Echo Measurement
SR objects updated/simplified for improved compatibility with cardiac databases and data analytics.HEVC/H.265 (MPEG4)
video support added.
Small Animal Acquisition Context
headers added to support imaging in pre-clinical research.
2017Volumetric and Blending Presentation States
added to manage 3D rendering of image sets and advanced multi-stage blending.NCI AIM to DICOM SR
transcoding defined to facilitate management of image markup for machine learning and other applications.Patient Dose Estimate
reports (P-RDSR) based on RDSR data for individual patients added.Ophthalmic OCT angiography
(OCT-A) imaging added.
20183D Manufacturing - STL
encapsulation added image-based medical 3D-printing workflows.TLS ciphersuites
updated to match current transaction security recommendations.Contrast Injection SR
added to track detailed power injector records for QA and clinical analysis.Multi-Energy CT Image Storage
added to provide Standard encodings of new dual-energy and spectral acquisition techniques for use by image displays and analysis packages.Second Generation RT Prescriptions
provides the basis for a series of upcoming 2nd Generation RT planning and delivery objects.
re-organizes Part 18 to provide a comprehensive view of all DICOM web services in a uniform structure oriented toward web implementers.DICOMweb Thumbnails
service added to provide study/series/image thumbnails to clients such as web apps.Realtime Video Streaming
(DICOM-RTV) added to support streaming medical video and audio over IP networks using the SMPTE ST 2110 protocol family and a profiled DICOM metadata stream.Second Generation C-Arm RT
introduces the RT Radiation Set and representation of C-Arm techniques.