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MINUTES
DICOM Working Group Twelve
(Ultrasound)
Feb. 4-6, 2014
Univ. of California @ San Diego Conference Room
San Diego, CA
Members Present
Represented by
Agfa HealthCare
GE Healthcare
Philips Healthcare
Siemens Healthcare
Toshiba Med. Res. Inst.
UC San Diego
Ramona Shirley.
Gopi Pattaswamy
Joe Luszcz
Kluiwstra, Jan-Ulco
Kevin O’Donnell
Tom Nelson
Members Absent
Voting Representative
CoreLab Partners
David Clunie
Alternate Representatives, Observers and Others Present:
Kazuya Akaki
Chris Armstrong
Earl Canfield
Royal Chen
Ann Kang
Ruth Knipe (Wed-Thur)
Ernie Lin
Stephen Vastagh
Presiding Officer:
Toshiba Medical Systems
Toshiba America Med. Systems
Philips Healthcare
Toshiba
Philips Healthcare
Siemens Healthcare
Siemens Healthcare
MITA
Joe Luszcz, Chair
1. Opening
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Working Group Twelve (Ultrasound)
of the DICOM Standards Committee
Feb. 4-6, 2014
The Chair called the meeting to order at 09.00 on Feb. 4. Self-introductions followed. The
Agenda was reviewed and approved. The Secretary reviewed the antitrust rules. The Chair
thanked Dr. Nelson for providing the meeting room for this meeting of the Group.
2. Supplement 169-Simplified Adult Echo
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Keeping current SR? After much discussion the Group did not reach a conclusion; it was
proposed to keep the issue open and consider adding some pre-coordinated items to
current SR.
Identified consumers of US SR: Philips Xcelera and QStation, Siemens SYNGO
dynamics, AGFA, Toshiba (in Japan), GE (cart), Merge
K. O’Donnell reported that WG-07
o Approved the concept
o Suggested a new SOP Class to assure that the new template is recognized
extensive technical discussions were conducted over the three days about the specifics
(modifiers, terminology, etc.) of the measurements. The decisions were recorded
concurrently in the DocBook document, by K. O’Donnell.
The measurements not in the core ASE (American Society of Echcardiography) that are
used by various manufacturers were discussed extensively. It was decided to include
them in the Supplement if commonly used. They will be collected from each
manufacturer, anonymized by the Secretary and organized and matched by R. Shirley by
analyzing the clinical content.
ACTION:
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Jan-Ulco will draft a spreadsheet for the collection of the measurements:
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Commonly used measurements not in the ASE list
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ASE measurements that are rarely or never used by customers.
The draft of the Supplement was posted in the meeting folder as <sup169_04EchoSR.docx>. This draft was discussed and the open issues reviewed. In addition the
group discussed, decided:
o Reviewed and resolved some gaps in the semantics defined for the current Core
Set
o Discussed the layout/structure of the tables in the supplement
o Should the new context groups be extensible or non-extensible? Decision: NONExtensible (K O’D)
o Separate containers for pre and post coordinated measurements? Leaning toward
yes.
o No complex equations included in the object. Still an open issue whether to
include simple ratios.
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Working Group Twelve (Ultrasound)
of the DICOM Standards Committee
Feb. 4-6, 2014
o For post-coordinated measurements, add a “other modifiers” code sequence for
characteristics not addressed by standard post-coordinated modifiers (code for
characteristic being augmented, code for augmentation)
o Decided not to create a separate Supplement for user/vendor defined
measurements only, but continue to include it with the Simplified Echo
supplement.
o Make sure all velocity codes say “velocity” and not “flow”
o Will not include Extended Negotiation. It is unlikely that PACS will parse the
stored objects to extract the information needed for extended negotiation
o Discussed that pre-coordinated measurements are a proper subset of TID 300, so a
reader of TID 300 would be able to read the new measurements. Post coordinated
measurements (user and vendor defined) would require a new reader. Both would
require changes to the writers.
o Discussed whether “selectors” of one measurement sample from the set (e.g.,
Min, Max, Preferred, Last) are separate from “derivations” based on all samples
(Mean). It was decided that (One of Derivation OR Selector, one value may be
marked Preferred). Kevin will include this in the Supp for both pre and post
coordinated measurement templates
Next Steps:
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Continue refinement of the ASE core set in DocBook
Collect the measurements that will be additions to the ASE core set and will be postcoordinated (see above)
Aim to complete Public Comment draft by mid-2014
WG-06 suggested new SOP Class. Nevertheless WG-12 considers it still an open issue.
HOMEWORK/ACTION ITEMS:
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All group members to reach out to McKesson contacts to invite them to participate
KOD (Kevin) to ask WG-06 about multicolumn TIDs
KOD – model simple formula (alternate indexes and ratios)
KOD – velocity
KOD – clean up changes made to date
GP (Gopi) – prepare pros and cons for SOP Class
Diagram of scenarios (new-old)
RK (Ruth) – how can safety be incorporated into stress echo
RS (Ramona) - what is the European description of the measurements
AK - Constrain use of refer/infer SCOORD
JL- structure of augmented information (code pairs)
RK-How do we incorporate stress echo and/or stages?
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Working Group Twelve (Ultrasound)
of the DICOM Standards Committee
Feb. 4-6, 2014
o All: Let Ruth know what measurement support for stress is supported
(Philips, GE)
3. WG-12 Strategic Statement
The Chair asked the Group to review the WG-12 Strategy Statement (in
http://medical.nema.org/dicom/geninfo/Strategy.pdf ) and suggest any additions, revisions,
updates.
Secretary’s note: Revisions should be submitted before the December meeting of the
DICOM Standards Committee, unless earlier revision is warranted.
4. Old Business
At the Chair’s request the Group discussed the following items
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how to promote adoption of Enhanced US Volume object-relevant items:
o issues that may have been discovered during investigation or development of
Enhanced US Volume Storage SOP Class implementations.
o there is no CPT Code for 3D Ultrasound scan-implementation to account for more
skill and time needed for the scan
o RSNA-QIBA -clinical drivers for tumor volume measurement; other drivers
should be cardiologists and surgeons
o Cardiac 3D adopted in open heart surgery
o AIUM ‘Community of Practice Groups’ was mentioned.
ACTION:
Chris Armstrong to prepare rationale for reimbursement and proposal to MITA
reimbursement Committee to make it MITA action. Include initial drive by
clinicians to develop 3D Supplement Standard and the benefits to clinicians, e.g.
no need for separate work stations.
ACTION:
E. Canfield will attend AIUM Annual Meeting. He was asked to explore the
status and possible user participation in reimbursement discussions.
o IHE Profile for US 3D. The IHE cycle was explained. US 3D profile proposal
should be submitted to IHE Radiology Technical Committe by the Fall of 2014 to
be in the Connectathon (if accepted) in Jan. 2016
 an option to profile may be a “projectathon” within the Connectathon.
This can result in certification and can break the chicken-egg problem of
implementation
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It was discussed whether ACC could help write the profile. The
consensus was that no help can be \expected at this time.
another option is a demonstration where engineering has face time with
clinical customers (AIUM, HIMSS Showcase, SIIM
hackthon/showdown.) Tom Nelson suggested just to show how data can
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Working Group Twelve (Ultrasound)
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Feb. 4-6, 2014
be read from all vendiors; this would be an step forward to build customer
demand.
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CPs are there any additional CP’s that need to be submitted
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Update on Sup 156 – Volumetric Imaging Standard Activity (a.k.a. Presentation State Planar MPR: The Chair provided an update on Sup 156 (being developed by WG-11)
Volumetric Presentation State standard.
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CP’s 1235, 1326, 1327, 1328, and 1326 have been approved
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Status of the ASE/ECE (European College of Echcardiography) request that WG-12
submit and begin work on a Strain Reporting work item. (from December 2012)
It was reported that DR. Thomas (Cleveland Clinic continues to inquire about the status.
5. New Business
The Chair asked the Group to identify any emerging needs for new changes to the DICOM
Standard for Ultrasound for which work items should be proposed.
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Working Group Twelve (Ultrasound)
of the DICOM Standards Committee
Feb. 4-6, 2014
ACTION:
each company should review with respective management the interest to develop
standard for strain reporting
6. Next Meetings
Tcons:
2013-03-03
13.00-14.30 USA Eastern Time
In Person:
2014-05-12-13
at SIIM Annual Meeting in Long Beach, CA
6. Adjournment
The meeting recessed daily, at 18.00, and reconvened at 09.00. It was adjourned at 13.00 on
Feb. 6.
Reported by Stephen Vastagh, Secretary
Reviewed by legal counsel:
Clark Silcox
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Working Group Twelve (Ultrasound)
of the DICOM Standards Committee
Feb. 4-6, 2014