Saturday, February 14, 2015

DICOM's role in the internet world and new release of RZDCX

There's an event held in Israel every year in Hadasa Ein-Karem hospital called IsraPACS. Diego Gicovate is doing a great job organizing it. This year I was invited to say couple of words and decided to ask the question "Where DICOM is going?" What it's role today with all the Internet and cloud technology.

Old lady knitting next to a Renault 4 car
Source: Unknown
(Please contact if you know this picture and or where it came from)

Usually, when I give presentations on DICOM, the introduction, the couple of slides in the beginning,  goes like this: "DICOM is very old, It's very big, It's a bit complicated, but hey, its working!" I have this slide (above) of an old lady sitting outside on a chair and knitting with a Renault 4 in the background. Then I review the parts of the standard, noting that, printed, it probably weighs something like 10 Kilo's and joking that I've read almost all of its 3 - 4 thousand pages. At the end  I show a slide with the poster of Monty Piton's film "The meaning of life" and replace it with the meaning of DICOM and then a slide saying, but hey, 1 standard, 1,000's of vendors 1,000,000's of patients, 1,000,000,000's of images, it can't be so bad, look, its working!

Monday, December 1, 2014

Lovely whether on the first day of RSNA 2014

It's that time of the year. I'm in Chicago again. Luckily, this year the whether is welcoming. We had lovely two days and only this afternoon the temperatures started to drop. Tomorrow its going to be bellow zero and hopefully it will get better during the rest of the week.
RSNA is a great opportunity to meet with colleagues and customers and see what's new and where things are going to. Apart from Big Data which is the number one interest right now, The two hot topics this year seems to be Image Sharing and Dose Recording and Monitoring (which I hope to cover on a future post). On the imaging side, I think the focal point is on Ultrasound technology that brings to the table its best up-side, no radiation damages! So Ultrasound has to evolve to the point where more and more anatomies and pathologies can be imaged with this great device. And it defiantly going that way. We're seeing giant steps in breast ultrasound imaging and many other fields will follow as hardware and software will evolve and mature. There's also the question of price and how it affects this technology. Ultrasound device is by 10's, 100's and 1000's less expensive to purchase and to operate compared with CT and MRI.

Image Sharing. Of course it links directly with big data which will also wait for a future post. As an ex-enterpuneer in this field with XRFiles, I'm always curious to see how the business model is built. One of the issues we had with XRFiles, apart from the misfortunate fact that we failed to raise money on it for various miserable reasons, was that patients don't want to see their images or any other medical data unless they really have to.

Tuesday, November 18, 2014

Do more with DICOMIZER 4.0

After almost a year since the release of DICOMIZER 3.0, today we finally release DICOMIZER 4.0!
DICOMIZER 4.0 Point-of-Care Imaging and Reporting Tool

Behind the completely new graphic design we've streamlined the acquisition process with new features for imaging and reporting.

The new Formatted Report auto-completes patient and study parameters into a new RTF document opened in your favorite document editor. After completing the report save the document and PDF in the case folder to attach it to the study.

Right click on a row in the Modality Worklist or the Query/Retrieve screens to copy the case info to clipboard.

With DICOMIZER 4.0 you can easily attach scanned documents and reports to existing cases. Use the Q/R search to get the case and then right click and select "Add Image/Report as new series".

Read more about DICOMIZER 4.0 on our web-site.

For those of you that are not administrators on their computer you may find the "No Installer" Archive useful. You can run this version without installation. Simply start DICOMIZER.exe from this no-installer zip file.

Saturday, September 27, 2014

Video to DICOM (and back)

This is a story of a lost battle. For many years I refused to add MPEG to DICOM functionality in my DICOM SDK. The explanation I gave to myself and to my customers was that storing video in PACS is a bad idea because video streams are usually very big and nobody ever watches them. From an engineering point of view, the size of the video is not so much a matter of disk space but rather a network headache. The way that the DICOM network protocol works, with all the different levels of timeouts and with no failover mechanisms for PDU’s may cause such huge objects to fail over and over when stored and restored. For the clinical point of view, I consulted with Radiologists friends from whom I learned that the driving force behind keeping most of this stuff is not clinical but rather medico legal. These excuses held for some time but eventually, because I’m an engineer but also a businessman, I changed my mind. After all, the customer is always right, and when more and more customers asked to convert video to DICOM, I realized that winning this battle means loosing customers and that’s not something a businessman should do.

Videos were added to DICOM through the mechanism of Transfer Syntax. All together there are currently four (4) video transfer syntaxes for different types of MPEG’s. Here's the list of these transfer syntaxes:
  • MPEG2 Main Profile @ Main Level : "1.2.840.10008."
  • MPEG2 Main Profile @ High Level : "1.2.840.10008."
  • MPEG-4 AVC/H.264 High Profile / Level 4.1 : "1.2.840.10008."
  • MPEG-4 AVC/H.264 BD-compatible High Profile / Level 4.1 : "1.2.840.10008."

If I have to guess, there will probably be more added in the future as new formats of video gain take over. The embedded document option that was taken for PDF would probably be my choice but I admit that I didn’t investigate the reasons that led to the way the standard went and there may have

Wednesday, September 17, 2014

A short one on MPEG to DICOM

This is a quick post referencing our new release of RZDCX that adds the option to convert MPEG to DICOM. I will post a longer article with all the information about MPEG and DICOM, video streams and audio hopefully by the end of this month. Meanwhile, check out this post on our web site and download the latest version of RZDCX DICOM SDK.
Here's a short C++ code snippet that creates a DICOM encapsulated MPEG to start with:

static void CreateVideo(string filename)
    /// Create a DCXOBJ
    IDCXOBJPtr obj(__uuidof(DCXOBJ));

    /// Create an element pointer to place in the object for every tag
    IDCXELMPtr el(__uuidof(DCXELM));

IDCXUIDPtr id(__uuidof(DCXUID));

videoProps.width = 352;
videoProps.Height = 288;
videoProps.PixelAspectRatioX = 4;
videoProps.PixelAspectRatioY = 3;
videoProps.FrameDurationMiliSec; // 40 msec = 25 FPS
videoProps.NumberOfFrames = 1600; // 1600 frames
videoProps.VideoFormat = rzdcxLib::MPEG2_AT_MAIN_LEVEL;
obj->SetVideoStream(filename.c_str(), videoProps);

obj->TransferSyntax = rzdcxLib::TS_MPEG2_MAIN_PROFILE_AT_HIGH_LEVEL;
    /// You don't have to create an element every time, 
    /// just initialize it.
char pn[]="John^Doe";

    el->Value = "123765";

el->Value = id->CreateUID(UID_TYPE_STUDY);

el->Value = id->CreateUID(UID_TYPE_SERIES);
el->Value = id->CreateUID(UID_TYPE_INSTANCE);

el->Value = "1.2.840.10008."; // Video Photographic Image Storage

el->Value = (short)1600;

el->Value = rzdcxLib::FrameTime;

filename += ".dcm";


One last note: You should know your video properties because we don't open or validate the MPEG file. More on "why is it this way" in the longer post soon.

Monday, July 21, 2014

What's new in RZDCX

A new release ( of RZDCX Fast Strike DICOM Toolkit is ready in our downloads page.

The two major feature added in this release is the ability of DCXACC Class that implements the Storage SCP to receive DICOM Objects in memory and the Image property get in DCXOBJ . We've added the in memory accepter feature following a request from one of our customers that wanted to encrypt all Patient Healthcare Information (PHI) on the hard drive. By providing the stored object in memory, the object can be encrypted in memory and then stored encrypted to disk. An example of in memory storage is presented at the end of this post.

In release intermediate release you could only access the last stored object from within OnStoreDone event. In release the object stays in memory until the next request is handled or until the DCXACC object is disposed. Note therefore that if you use this feature and don't take the object you risk it staying in memory for a while.

A quick note: if you're not sure what version are you using, right click the ell and look at the details tab of the file propertoes. The release version is also set in the DICOM File Meta Header tag (0002,0013) - Implementation Version Name (RZDCX_2_0_4_0)  and sent in the association request/response in the same tag - Implementation Version Name.
Another method that we've added following requests from many customers is the "No Exception" GetElement method in DCXOBJ. This method is similar to the old getElementByTag but it doesn't throw an "Element Not Found" exception. Instead if the element is not found it returns null. Depending on your preferences, either one of the methods can be used. If you must have this element or else your software should do something else use the getElementByTag and handle the exception. If on the other hand this element is optional for you, use GetElement.

Wednesday, December 11, 2013

DICOMIZER 3.0.3 Release Notes

The new build of DICOMIZER 3.0.3 is now available on our web site. This build addresses couple of minor issues that were found since the last release.

#155 License is installed only for installed user
#157 Default MWL query with Local AE Title checkbox use wrong AE
#159 Make "Thank you" on the activation end screen clickable

The new DICOMIZER is available for free 30 days evaluation. It was released few weeks ago and we get great feedback on it.

The most notable feature of the DICOMIZER 3.0 is the TWAIN/WIA interface that connects to supporting devices. The user can capture images directly from DICOMIZER and convert them to DICOM files.