DICOM Progress

An overview of the yearly progress of the DICOM standard for the last couple of years


2023


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Sup237
General 32-bit ECG Waveform



This supplement defines a new ECG Waveform SOP Class (based on the existing General ECG SOP Class) with fewer constraints.

This High-Resolution SOP class permits 32 bits per sample. The already available General ECG SOP class can store waveform with 16 bits per sample.

In clinical neurophysiology it is common practice to acquire ECG data together with the routine scalp EEG or in case of a sleep study.

This supplement was voted ready to go out for Letter Ballot review and voting.

This supplement was voted ready as Final Text and will be incorporated into the standard in the next publication (2023c).

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Sup235
High-Throughput JPEG 2000 (HTJ2K) Compression



This supplement adds the HTJ2K Transfer Syntax to Part 5.

HTJ2K speeds-up JPEG 2000 by an order of magnitude at the expense of slightly reduced coding efficiency.

HTJ2K retains JPEG 2000's advanced features, with reduced quality scalability, while being faster and much more efficient than traditional JPEG.

This is achieved by replacing the Part 1 block coder with an innovative block coder for today's vectorized computing architectures.

Detailed information is available at jpeg.org.

This supplement is voted ready as Final Text and will be incorporated in publication 2023e.

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Sup234
DicomWeb Storage Commitment



This supplement adds storage commitment functionality to DICOMweb.

This is an extension to the existing DICOMweb services, mimicking the storage commitment service that is already available using DIMSE.

The storage commitment service is typically used when an image acquisition system wants to free up storage space for new studies and asks an archive system of taking over the storage responsibility for the images previously being sent from the acquisition device to the archive.

A design goal for this supplement is to relatively easy create proxies for Storage Commitment with combinations of DIMSE and DICOMWeb communication.

The DICOMweb variant of Storage Commit extends the DIMSE variant.

In DICOMweb it is possible to provide the study and series context to the referenced instances; this provides more information for finding these instances at the server side.

This supplement is incorporated into the standard as Final Text in the publication 2024a.

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Sup231
Variable Modality LUT Softcopy Presentation State



This supplement defines a new Variable Modality LUT Softcopy Presentation State SOP Class for both grayscale and pseudo-color.

This new SOP class differs from existing SOP classes in that it allows the Modality LUT to be controlled for each image or frame.

This is intended for modalities in which the dynamic range varies between images or frames, resulting in each referenced image having a different Modality LUT.

In DICOM, Presentation States are intended to be a complete specification of the presentation to provide consistent presentation.

An aspect of this is that PS3.4 N.2.1.1 requires the Modality LUT in the image be ignored in the presence of a GSPS object, even if no Modality LUT is explicitly defined in the GSPS. Further, the GSPS only supports one Modality LUT.

This is problematic in cases such as PET or MR, in which the dynamic range of the measured values varies between images.

Without this new SOP Class, the GSPS creator would be forced to render multiple GSPS objects, one for Modality LUT change.

This supplement was voted ready as Final Text and will be incorporated into the standard in the next publication (2023b).

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Sup229
Photoacoustic Imaging



This Supplement introduces a new IOD and a new storage SOP Class for encoding and storing photoacoustic images.

Photoacoustic (PA) imaging enables imaging optical absorption in biological tissues with acoustic resolution.

Contrast is generated through absorption by chromophores that range from intrinsic absorbers such as hemoglobin and melanin to extrinsic agents such as indocyanine green (ICG) or diverse types of nanoparticles.

In principle, excitation at multiple wavelengths allows the modality to discriminate individual chromophores.

Prospective applications in the space of clinical imaging range from classification of breast cancer lesions through screening of sentinel lymph nodes to assessment of inflammation.

Photoacoustic Imaging is in widespread use in preclinical research labs and is currently being translated to clinical applications in first commercial implementations.

Many (but not all) PA implementations integrate active pulse/echo ultrasound in a hybrid imaging system to capitalize on well-established contrast for anatomical information.

The scope of this IOD is to define the a Photoacoustic (PA) images and processed images that may be derived from a combination of these PA images. Complementary images such as pulse/echo ultrasound are represented by their native DICOM IODs.

Albeit fusing PA images with US images for display is the presently most common scenario, the particulars of the fusion are beyond the scope of this IOD, but examples are provided.

PA images represent image output generated by the input of one or more optical excitation wavelengths. PA images may result from excitation by light pulses at one or more wavelengths.

A closely related but out of scope imaging modality is Thermoacoustic imaging (TAI) which uses microwave radiation to excite the tissue (in contrast to light pulses).

This supplement was voted ready as Final Text and will be incorporated into the standard in the next publication (2023c).

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Sup226
Confocal Microscopy



This Supplement to the DICOM Standard introduces two new IODs (Confocal Microscopy IOD, Confocal Microscopy Tiled Pyramidal Image IOD).

These IODs are intended to be applicable to all application of confocal microscopy.

An acquisition context module specific to cutaneous confocal microscopy is defined.

Cutaneous confocal microscopy is a non-invasive imaging technique that allows examination of the skin at resolutions comparable to histology without performing biopsy.

Cutaneous confocal microscopy may be done in-vivo or on ex-vivo tissue.

In-vivo cutaneous reflectance confocal microscopy (RCM) is used for the early diagnosis of a range of cutaneous diseases with an emphasis on melanoma and pigmented lesions.

In-vivo cutaneous RCM is most often used as an adjunct to clinical and dermoscopic imaging of a skin lesion as opposed to a stand-alone imaging technique.

In addition to diagnostic applications, in-vivo cutaneous RCM may be used for the pre-operative mapping of margins of ill-defined tumors, which allows more accurate surgical plan and reduces surgical morbidity.

The cutaneous RCM microscope uses a diode laser as a source of monochromatic and coherent light and scanning and focusing optical lens to penetrate the skin and illuminate a small tissue spot. Reflected light forms an image on a photodetector.

Ex-vivo cutaneous confocal microscopy allows the microscopic examination of freshly excised tissue.

The ex-vivo cutaneous confocal microscopy can work in reflectance mode or fluorescence mode.

When using the fluorescence mode, the entire surgical specimen is dipped in a solution of a fluorescent agent and subsequently rinsed to remove excess of fluorescent agent.

This supplement is voted ready as Final Text and will be incorporated in publication 2023e.

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2022


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Sup230
TLS Security Update 2021



This Supplement adds two new Secure Transport Connection Profiles and retires several others.

The IETF recently updated the Best Current Practice document called BCP-195. The new document no longer allows downgrading to TLS 1.0 or 1.1, which necessitates DICOM retiring Secure Transport Connection Profiles that are based on those protocols.

The new version of BCP-195 is more in line with DICOM's B.10 Non-Downgrading BCP 195 Secure Transport Connection Profile.

In addition, the Japanese government has modified their guidelines for "high-security type" devices, hence the old Extended BCP 195 profile (B.11) is also now out of date, needs to be retired, and a new profile created that reflects the new revisions.

Supplement 230 was voted to be incorporated into the standard as Final Text in publication 2022e.

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Sup227
Elastography SR Template



This supplement to the DICOM Standard introduces an SR section template for Ultrasound Elastography results and a General Ultrasound Report within which it can be used.

Ultrasound elastography is used on tissues including liver, breast, prostate, and tendon. In shear wave elastography (SWE), the ultrasound system measures shear wave speed (SWS) and derives a value for elasticity (in kPa) from that.

Some systems also assess viscosity (which can be correlated to inflammation) by generating a value such as shear wave dispersion slope.

In strain elastography (SE), elasticity/stiffness is assessed qualitatively by comparing the compression of tissue in a target region to that of tissue in a nearby reference region.

This supplement is added into the standard in publication 2022c.

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Sup225
Multi-Fragment Video Transfer



This supplement adds new video transfer syntaxes to remove the restriction that the video cannot be broken up into multiple fragments.

The affected transfer syntaxes are:

  • MPEG2 Main Profile / Main Level Video Compression
  • MPEG2 Main Profile / High Level Video Compression
  • MPEG-4 AVC/H.264 High Profile / Level 4.1 Video Compression
  • MPEG-4 AVC/H.264 High Profile / Level 4.2 Video Compression


A significant motivation for this supplement is the appearance of videos of size larger than 2^32-2 bytes (eg procedure video recordings).

Supplement 225 was voted to be incorporated into the standard as Final Text in publication 2022b.

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Sup223
Archive Inventory



This Supplement introduces a new Repository Query SOP Class to obtain an inventory of a repository system, a composite Inventory IOD that is the equivalent persistent instantiation of such an inventory, an Inventory Creation SOP Class to initiate asynchronous creation of Inventory SOP Instances, and SOP Classes to transfer, query and retrieve Inventory SOP Instances.

There are considerable use cases for these new services:

Porting large DICOM repositories from one image management system (PACS or VNA) to another.

Migration approaches need to operate at large scales, and handle both on-premises and remote (e.g., cloud-based) storage.

Migration often occurs when either the source system or the destination, or both, are in clinical operation, but systems designed and configured to handle the throughput of regular operations might not have capacity for the additional massive input/output requirements of migration.

Healthcare institutions merge previously disparate repositories into an enterprise repository.

Research use cases, including artificial intelligence and machine learning, where bulk access to the archive is desirable, and such uses might leverage some of the same mechanisms developed for migration.

PACS audit and quality control may also utilize some of the standardized functionality developed for migration, such as an archive inventory and metadata to identify the data produced by a particular unit or by a particular modality.

A key requirement for migration (and other use cases) is the ability to have an inventory of all studies, series, and instances from an archive.

This Supplement specifies a new Repository Query SOP Class that includes features supporting a sequential set of queries intended to produce a complete repository inventory. These features include well-defined behavior for queries that reach a system limit for number of responses, and an ability to resume at the next record in a subsequent query.

The current Query Service (DIMSE or equivalent DICOMweb) has limitations on number of responses and the synchronous protocol require the use of a possibly very large number of partial query requests, with undefined behavior when query limits are exceeded.

This Supplement also specifies an Information Object Definition capable of encoding an inventory of all studies, series, and instances in a repository. This is functionally equivalent to a query response that returns an inventory of the entire repository database, or a subset thereof as specified by key attributes.

The Supplement further defines a mechanism to remotely initiate the production of the inventory through a DICOM network service and allow production to proceed asynchronously.

Only inventory of patient-related studies, series and instances is defined. Inventory of non-patient objects is out of scope for this Supplement.

This supplement is not in itself a complete standard for migration.

This supplement is added into the standard in publication 2022c.

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Sup213
2G-RT: Enhanced RT Image



The Supplement addresses imaging within Radiotherapy treatment sessions and acquiring patient positioning information.

The supplement adds three IODs. Two for supporting projection images and one IOD supporting acquisition instructions for images and other artifacts to be used for patient positioning.

The Enhanced RT Image covers the images with a smaller number of frames, where the per-frame functional group macros are populated for all frames.

The Enhanced Continuous RT Image covers images which are continuously acquired, resulting in high number of frames due to a high frame rate. With frame level attributes not being repeated for each frame this image type is more efficiently and sparsely populated.

Both IODs represent projection images of the patient geometry in relation to the treatment device equipment. They may be used to guide the positioning of the patient in respect to the treatment delivery device to ensure delivery of the therapeutic dose to the intended region. They may also be used to verify the position of the patient when acquired prior, during or after the delivery of the therapeutic radiation.

The Supplement additionally specifies a new IOD to convey parameters instructing devices on how to acquire images or other artifacts used for patient position verification in Radiotherapy treatment delivery sessions.

RT Patient Position Acquisition Instruction contains the definition of the procedures, devices, and related parameters to be used for the assessment and/or verification of the patient position. The technical parameters can be defined on any level of detail as needed by a specific device.

Procedures can be paired to represent related operations like e.g. a paired orthogonal MV and kV image acquisition.

The scope of therapeutic radiation whose position is verified is specified by referencing SOP Instances identifying objects like RT Radiation Set IOD of RT Radiation IODs.

Supplement 213 was voted to be incorporated into the standard as Final Text in publication 2022e.

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Sup209
Revision of DICOM Conformance Statement



This Supplement provides updates to part PS3.2 of the DICOM standard, redefining the content and structure of the DICOM Conformance Statement to better meet the needs of all user groups, for example service, R&D, testing, sales, healthcare provider IT personnel. Comparability is better facilitated for different products' DICOM functionality by providing essential information in tables.

Ambiguities and inconsistencies will be less frequent between different vendor documentations.

Web services and security are additionally addressed in the conformance statement.

A detailed template is provided. Vendors are encouraged to populate this template for their products. Template-based comparison of products is advantageous in many situations.

Supplement 209 was voted to be incorporated into the standard as Final Text in publication 2022e.

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2021


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Sup222
Whole Slide Imaging Annotation



This Supplement to the DICOM Standard specifies a new DICOM Information Object and Storage SOP Class for storing Microscopy Bulk Simple Annotations (points, open polylines, closed polygons and simple geometric shapes without relationships), which is referred to as the Microscopy Bulk Simple Annotations IOD.

Microscopy Bulk Simple Annotations are usually created by machine algorithms from high resolution images of entire tissue sections, e.g., encoded as DICOM Whole Slide Microscopy images.

These annotations are distinct from alternative representations appropriate for different use-cases, such as segmented bit planes (which are encoded in DICOM Segmentation Images), and more tractable size human or machine generated contour-based annotations on selected high-power fields or lower resolution or gross specimen images (which are encoded in DICOM Structured Reports using standard templates like TID 1500).

No new image encoding mechanism is introduced. The annotations are either 2D image relative (frame or Total Pixel Matrix) or in a 3D Frame of Reference that is shared with a Microscopy Image Storage instance.

No new composition mechanism is added. The annotations are basic ("simple") and it is anticipated that in future mechanisms such as the Radiotherapy Conceptual Volume mechanism may be re-used to describe boolean relationships, etc., that reference instances of bulk simple annotations, or embed more complex relationships.

Supplement 222 was voted to be incorporated into the standard as Final Text.

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Sup220
MR Prostate Imaging Structured Report



This supplement to the DICOM standard introduces a DICOM Structured Reporting template for encoding the radiologist's interpretation of a patient's prostate MR imaging study.

The primary purpose of the templates is to support linking of the annotations of findings with the measurements derived from those findings and qualitative evaluations associated with those findings.

In addition, the template provides the means to communicate image-related information that is important to the assessment of prostate MRI (e.g., Prostate Specific Antigen testing history and prostate biopsies).

The main use cases motivating the development of the templates are the following:

  • Interoperability between the radiology workstations used for annotation of prostate MRI and MRI-Ultrasound fusion and targeting workstations used for sampling suspected locations using targeted biopsy approaches;

  • Interoperability with the machine learning tools that automate the process of identifying suspected prostate cancer locations;

  • Collection of structured data to support training of the machine learning tools for automated detection and grading of prostate cancer in MRI;

  • Aggregation of structured MRI interpretation documents across institutions;

  • Integration of structured machine-readable information annotating clinical findings in MRI longitudinally and across radiology, urology and pathology subspecialties.


While the organization of the templates is not restricted to a specific prostate MRI interpretation protocol, it is primarily designed to support Prostate Imaging - Reporting and Data System (PI-RADS), which is a prostate MRI structured reporting and scoring guidelines developed through an international collaboration of the American College of Radiology (ACR), European Society of Uroradiology (ESUR), and AdMetech Foundation.

Supplement 220 was voted to be incorporated into the standard as Final Text.

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Sup214
Cone-beam CT Radiation Dose SR



This supplement creates a new DICOM SR IOD with the necessary flexibility to address cone-beam CT (CBCT) acquisitions.

CBCT is used in multiple fields (e.g., dentistry, radiotherapy, interventional radiology, image guided surgery), and there are different methodologies for describing the dose associated with each application (typically borrowing from either XA or CT).

However, the underlying data acquisition, reconstruction, and testing parameters for image quality and dose evaluation are similar.

The proposed supplement defines a generic framework for the description of radiation dose amongst the different CBCT applications.

It retains the capability to store legacy dosimetric values (e.g., CTDI, DAP), while allowing for reduced dependence on modality-specific conditions for populating fields.

This generic radiation description is capable of representing acquisition types that already exist in the standard (Angiography, Mammography, CR/DR, CT).

There are two fundamental inclusions in the proposed supplement:



  • Decoupling of irradiation events and dose descriptions (allowing dose-related characteristics to span multiple irradiation events, or breaking irradiation events into smaller time periods). For characteristics that remain constant (e.g., focal spot size), a value can be encoded once for the 90 entire SR. For characteristics that change within irradiation events (e.g., tube current), multiple values can be encoded for improved understanding of dose distributions.

  • Improved geometric description of the system. Describe the spatial relationship of different system components with respect to one another for modeling of spatial distributions of dose.


Radiotherapy treatment dose and radiopharmaceutical dose are out of scope.

Supplement 214 was voted to be incorporated into the standard as Final Text.

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Sup212
XA Protocol



This Supplement defines a pair of storage SOP Classes to distribute defined XA protocols and to record performed XA protocols.

The two storage SOP Classes are:

  • XA Defined Procedure Protocol Storage SOP Class that describes desired values (and/or value ranges) for various parameters, which includes acquisition, reconstruction and storage tasks. Defined Protocols are independent of a specific patient. Defined Protocols are typically specific to a certain acquisition equipment model and/or version (identified by device attributes in the protocol), but model-non-specific protocols are not prohibited.
  • XA Performed Procedure Protocol Storage SOP Class that describes the values actually used in a performed procedure. Performed protocols are patient-specific.


The SOP Classes address details including:

  • patient preparation & positioning
  • equipment characteristics
  • acquisition technique
  • reconstruction technique
  • preliminary image handling such as filtering, enhancement
  • results data storage (auto-sending)


The primary goal is to set up the acquisition (and reconstruction) equipment, not to script the entire behavior of the department, or the angiographic suite. The protocol object supports simple textual instructions relevant to the protocol such as premedication, patient instructions, etc. Formal coding and management of instructions may be handled with other objects and services such as the Contrast Injection SR or the Modality Worklist (MWL).

It is expected that the vast majority of protocol objects will be specific to a certain model and version of acquisition equipment. There is no requirement that an equipment be able to run a protocol from another equipment.

Supplement 212 was voted ready as Final Text. It is incorporated into the standard in the update "2021a".

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Sup160
2G-RT: Patient Setup & Delivery



This Supplement specifies two IODs to support workflow management and patient setup for Radiotherapy treatment delivery sessions. The IODs are designed as part of the 2nd Gen. Radiotherapy object framework.

This Supplement introduces an RT Radiation Set Delivery Instruction IOD, which specifies the RT Radiations to be applied for treatment delivery, the order in which they are applied, and parameters related to the upcoming RT Treatment Session.

This Supplement introduces an RT Treatment Preparation IOD to specify setup devices, setup procedures and parameters related to the setup of the patient prior to the delivery of therapeutic radiation.

The 1st Gen. RT Plan IOD contained a Patient Setup Module with a similar content. However, this content may change between the treatment sessions, while most of the content of the RT Plan, defining the treatment parameters, remains the same.

This caused unnecessary proliferation of RT Plan SOP Instances, and compromised fraction counting within a series of dosimetrically uniform treatments. Therefore, the 2nd Gen. RT Radiation Set and RT Radiation IODs use a separate IOD for this purpose.

Supplement 160 was voted as Final Text and will be incorporated into the standard with the 2021d publication.

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2020


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Sup221
Dermoscopy



This Supplement to the DICOM Standard introduces a new IOD and a new storage SOP Class for encoding and storing dermoscopic images.

Dermoscopy is a diagnostic technique that enables visualization of the morphological structures of the skin. Dermoscopy (also known as dermatoscopy and epiluminescence microscopy) is a non-invasive, in vivo skin examination that has demonstrated to be an important aid in the early recognition of malignant melanoma and other skin tumors. Dermoscopy is also used for non-skin cancer disease conditions (e.g., inflammatory disease).

A dermoscope is hand-held device that consists of magnifier and light source. Emitted light can be polarized light or non-polarized. Dermoscopic examination can be by direct contact with skin or noncontact. Dermoscopy using non-polarized light require direct contact between the skin and the device.

For direct contact dermoscopy an immersion medium is placed on the skin surface and a glass plate on the dermoscope is placed directly against the skin. Non-contact dermoscopy does not require the dermoscope to be in contact with the skin surface.

Three techniques are used in dermoscopy: polarized non-contact dermoscopy, polarized contact dermoscopy, and non-polarized contact dermoscopy.

Supplement 221 was voted ready as Final Text. It is incorporated into the standard in the update "2020e".

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Sup217
Neurophysiology Waveform



This Supplement introduces SOP Classes for storage of neurophysiology waveforms by adding the related neurophysiology IODs and the necessary neurophysiology waveform context groups.

This Supplement adds the following SOP Classes:

  • To store routine electroencephalography (EEG) data recording the electrical activity of the brain collected on the skull surface using electrode positions of the international 10/10 or 10/20 localization scheme.
  • To store electromyography (EMG) data recording the electrical activity of skeletal muscles.
  • To store electrooculography (EOG) data collected near the eyes recording eye movement.
  • To store electroencephalography (EEG) data acquired during a polysomnography (PSG) study.
  • To store respiratory data recorded using more than a single channel.
  • To store information about a patient's position continuously.


Supplement 217 was voted into Final Text and to become part of the standard.

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Sup208
Encapsulated Additional Models 3D Manufacturing



Supplement 208 extends the DICOM Standard to better address medical 3D manufacturing and uses of Virtual Reality, Augmented Reality, and Mixed Reality.

These extensions fall in three areas:

  • Support for a new 3D model type: Object File (OBJ)
  • Identification of models for assembly into a larger object
  • Capturing a preferred color for manufacturing or display of a model OBJ Encapsulation


The supplement incorporates not just Object Files (OBJ), and also any supporting Material Library Files (MTL) and texture map files (JPG or PNG) on which an OBJ may rely.

As with Encapsulated STL, the new Encapsulated OBJ, Encapsulated MTL and texture image IODs allow 3D manufacturing models to be exchanged between various types of equipment using DICOM messages. This adds the ability to store, query and retrieve complete OBJ models as DICOM Instances.

Updates are addressed by storing new instances, with reference back to earlier instances in a manner similar to the IOD for STL encapsulation.

This supplement was voted to be ready as final text. It is now being incorporated into the standard.

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Sup199
RT Radiation Records



The SOP Classes in this document are defined to record how a Radio Therapy treatment was performed.

The following IODs are introduces:

  • RT Radiation Record Set Storage
  • RT Radiation Salvage Record Storage
  • Tomotherapeutic Radiation Record Storage
  • C-Arm Photon Electron Radiation Record Storage
  • Robotic-Arm Radiation Record Storage


This comprises acquired machine values, measured dose values, overrides, etc.

In addition, recording of a manual implementation of a radiation is covered.

This supplement is based on the real-world model and specifications defined in supplement 147. References, definitions etc. not present in this supplement can be found in supplement 147. Additional information is found in Supplement 175 and 176.

Supplement 199 was voted into Final Text and to become part of the standard.

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Sup176
2nd Gen. Other non C-Arm RT Treatment



The scope of this supplement is the introduction of new RT Radiation IODs for non-C-Arm treatment devices.

This supplement adds support for instances of the following RT devices:

  • Tomotherapeutic Radiation
  • Robotic Radiation Storage


This supplement was voted to be ready as final text. It is now being incorporated into the standard.

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2019


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Sup203
Thumbnail Service over DICOMweb



This supplement adds thumbnail handling to web services in part 18 of the DICOM standard.

This supplement defines Thumbnail resources on the WADO-RS Study, Series, Instance, and Frame resources in the DICOM RESTful web services standard. These resources provide representative images that reflect the content of the parent resources. The origin server determines the pixel content of the Thumbnail.

The primary use cases are Thumbnails for image viewers, or EMR/EHRs, e.g., as referenced from HL7 FHIR Imaging Study resources.

This resource allows a web client to retrieve a representative image without having to retrieve a full study structure.

This supplement was voted as Final Text. It will be part of the next edition of the standard.

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Sup202
Realtime Video



This supplement adds realtime video handling to the DICOM standard.

It describes several new DICOM IODs and associated transfer syntaxes for the transport of real-time video, and/or audio, and associated medical data. These are referred to collectively as DICOM Real-Time Video (DICOM-RTV).

The supplement defines an new IP-based DICOM Service for the broadcasting of real-time video to subscribers with a quality of service which is compatible with the communication inside the operating room (OR).

Professional video (e.g., TV studios) equipment providers and users have defined in SMPTE (ST 2110 family of standards). ST 2110-10 uses a multicast model rather than a peer-to-peer communication model. DICOM-RTV builds upon ST 2110.

DICOM-RTV restricts real-time communication to uncompressed video.

This supplement was voted as Final Text. It will be part of the next edition of the standard.

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Sup183
Webservices Redocumentation



This supplement re-documents PS3.18 Web Services. The goals of this re-documentation are:

  • Factor out text that is common to multiple services and in doing so 1) ensure uniformity and 2) make clearer and concise for readers.
  • Use a uniform format and style for documenting DICOM web services, making it easier to navigate and more efficient for readers implementing multiple services
  • Bring the Standard into conformance with current Web Standards, especially [RFC7230 - 7234], and [RFC3986 - 3987].
  • Use the Augmented Backus-Naur Form (ABNF) defined in [RFC5234] and [RFC7405] to specify the syntax of request and response messages.
  • Use consistent terminology throughout the Standard.
  • Use a consistent format for documenting services and transactions.
The most important aspect of the re-documentation is that technical requirements of PS3.18 should not be changed. Errors, ambiguities, and underspecified aspects of the current PS3.18 have been corrected through the CP process prior to the finalization of this supplement.

This supplement was voted as Final Text and will be part of the next edition of the standard.

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Sup175
2nd Gen. C-Arm RT Treatment



This Supplement introduces the RT Radiation Set and representation of the C-Arm techniques.

An RT Radiation Set IOD defines a Radiotherapy Treatment Fraction as a collection of instances of RT Radiation IODs.

Further this supplement adds support for C-Arm Photon-Electron Radiation instances.

RT Radiation IODs represent different treatment modalities.

This supplement was voted as Final Text and will be part of the next edition of the standard.

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