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DOI: 10.1148/rg.256055072
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An Open Source Framework for Modification and Communication of DICOM Objects1

Thomas Hackländer, MD, MSc, Jens Martin, MSc and Klaus Kleber, MSc

1 From the Department of Radiology, HELIOS Klinikum Wuppertal, Hospital of the University of Witten-Herdecke, Heusnerstrasse 40, 42283 Wuppertal, Germany (T.H.); and VISUS Technology Transfer, Bochum, Germany (J.M., K.K.). Presented as an infoRAD exhibit at the 2004 RSNA Annual Meeting. Received March 28, 2005; revision requested June 23 and received July 13; accepted July 18. All authors have no financial relationships to disclose.


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  		Figure 1.  Work flow of a PACS. In a PACS environment, images acquired with the modalities are transferred between the archive and workstations in a closed world. Images typically leave the PACS as film prints or as image media in the form of recordable compact disks (CDs), which also allow standardized image import. As additional functions, the DICOM Router allows import, export, and correction of DICOM objects. DVD = digital video disk, PC = personal computer.

 


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  		Figure 2a.  Example of a front end. Screens from the DICOM Router show a front end that is organized into three tab cards. (a) On the first card, the user selects and configures the receiver. (b) On the second card, the configuration file is selected. (c) The third card allows one to select the configuration file for the logger and to start the selected receiver. In addition, a progress bar and a text field for the output of the logging information are shown.

 


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  		Figure 2b.  Example of a front end. Screens from the DICOM Router show a front end that is organized into three tab cards. (a) On the first card, the user selects and configures the receiver. (b) On the second card, the configuration file is selected. (c) The third card allows one to select the configuration file for the logger and to start the selected receiver. In addition, a progress bar and a text field for the output of the logging information are shown.

 


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  		Figure 2c.  Example of a front end. Screens from the DICOM Router show a front end that is organized into three tab cards. (a) On the first card, the user selects and configures the receiver. (b) On the second card, the configuration file is selected. (c) The third card allows one to select the configuration file for the logger and to start the selected receiver. In addition, a progress bar and a text field for the output of the logging information are shown.

 


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  		Figure 3.  Structure of the DICOM Router shown as a layer diagram. Both the receivers and the plug-ins use the dcm4che library for all DICOM communications. The user defines the desired functionality by modifying a configuration file and controls the DICOM Router with a front end.

 


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  		Figure 4.  Configuration of the Tag-ModifyPlugin for correcting the DICOM attributes of the digital subtraction angiographic (DSA) image shown in Figure 5.

 


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  		Figure 5a.  (a) Image sent by a DSA device with partly incorrect DICOM attribute values. (b) The image after correction of the attribute values by the DICOM Router.

 


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  		Figure 5b.  (a) Image sent by a DSA device with partly incorrect DICOM attribute values. (b) The image after correction of the attribute values by the DICOM Router.

 


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  		Figure 6.  Configuration of the DICOM Router for removal of patient identification attributes. Images are send from a workstation or modality to the DICOM Router, which clears any personal data from the images. The PseudonymPlugin, TagModifyPlugin, PrivateRemovePlugin, and UIDModifyPlugin are executed sequentially. Afterward, the modified images are stored in the PACS archive as a copy. SCP = Service Class Provider.

 


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  		Figure 7a.  (a) Original fluoroscopic image from a double-contrast enema examination shows the transverse colon. Regions not exposed by x-rays are represented by dark areas. Not until the image is inverted is the usual x-ray pattern shown (b).

 


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  		Figure 7b.  (a) Original fluoroscopic image from a double-contrast enema examination shows the transverse colon. Regions not exposed by x-rays are represented by dark areas. Not until the image is inverted is the usual x-ray pattern shown (b).

 


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  		Figure 8.  Configuration of the XSLTransformPlugin used to change the photometric interpretation of the image in Figure 7 from MONO-CHROME2 to MONO-CHROME1.

 


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  		Figure 9.  Extract from the XML representation of the image in Figure 7. Every DICOM element is represented by an XML element of the type "elm." The fields of the DICOM element, like the tag, are represented by attributes of the XML element. The child XML element "val" covers the value of the DICOM element; this value is actually given in the "data" attribute.

 


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  		Figure 10.  XSL transformation applied by the XSLTransformPlugin to change the photometric interpretation of the image in Figure 7 from MONOCHROME2 to MONOCHROME1.

 


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  		Figure 11.  Directory tree created by the PortableMediaCreatorPlugin. The example shows the tree after the export of one image of a study with the following specifications: The patient is named Hans Mustermann (a pseudonym) and was born on May 22, 1957. The study was performed on December 30, 2004, at 15:31 on a magnetic resonance (MR) imager. The study and series identifiers (IDs) are 4711 and 3, respectively. The instance number of the image is 54.

 


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  		Figure 12.  Screen from a Web browser shows the Web content of a CD. The Web content was created in the IHE PDI format by the PortableMediaCreator-Plugin.

 


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  		Figure 13.  Use of the DICOM Router as an IHE conform Portable Media Importer actor. The DICOM images are stored on a PDI CD. Because one CD contains images from only one patient, the File Receiver consecutively reads all of the DICOM files from the file system of the CD and sends them to the processing pipeline. Before the images are sent to the archive, four DICOM elements are modified by the TagModifyPlugin. The new values of the elements are given as properties to the plug-in. DVD = digital video disk.

 




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