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Mammography Image Integration Profile

2. Mammography Image The Problem/Assumptions. What's the big deal?Full Field Digital Mammography (FFDM) is just another modality to PACSMost existing PACS will handle FFDM fine once: the FDA approves the monitor hardware, and workstations have 510K approval for FFDM applications. 3. Mammography

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Mammography Image Integration Profile

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    1. 1 Carolyn Reynolds Hologic, Inc. Vendor co-chair, IHE Mammography Committee Mammography Image Integration Profile

    2. 2 Mammography Image The Problem/Assumptions What’s the big deal? Full Field Digital Mammography (FFDM) is just another modality to PACS Most existing PACS will handle FFDM fine once: the FDA approves the monitor hardware, and workstations have 510K approval for FFDM applications

    3. 3 Mammography Image Not just another modality! What makes it different or challenging: Two types of image data Variances among vendors in image data and attributes Common use of CAD (Computer Aided Detection) Importance of prior study comparisons Image size, orientation, & layout Regional governance such as MQSA (Mammography Quality Standards Act – USA)

    4. 4 Mammography Image Use Case

    5. 5 Hanging Protocol Differences Example Preferred Layout

    6. 6 Generic Image Display Layouts Applied to Mammo Images

    7. 7 Variances in FFDM Vendor Data Detector Size Example

    8. 8 Workstation Tool Enhancements Tissue vs. Air Detection Example

    9. 9 Printing Considerations True Size

    10. 10 Printing Considerations Positioning-minimal borders at chestwall

    11. 11 Mammography Image Integration Value proposition Helps meet desire to have multiple FFDM vendors and use any vendor’s workstation for diagnosis Ensures that FFDM modalities provide adequate information to facilitate downstream applications

    12. 12 Mammography Image Integration Value proposition Ensures systems support required data objects for interoperability Defines image display and printing operations required for effective and efficient diagnoses

    13. 13 Mammography Image Integration Scope Based upon existing actors and transactions Expanded requirements within each transaction

    14. 14 Mammography Image Integration Scope

    15. 15 Mammography Image Expanded Requirements Acquisition Modality Send both for processing and for presentation images with reference that ties them together Additionally required DICOM attributes Detection and indication of tissue vs. air gap Partial View Option (breast is larger than detector) Modified requirements for film digitizers

    16. 16 Mammography Image Expanded Requirements Image Display Hanging protocols based upon view, laterality, patient orientation, and specialty views Maintain a black air gap during window/center operations and inverted pixel data Sizing Same relative size True size 1:1 detector pixels to display pixels

    17. 17 Mammography Image Expanded Requirements Image Display cont’d Measurement calculation requirements Display calibration and grayscale rendering Labeling requirements Mammo CAD Structured Report rendering on “for presentation” images Partial View Option (breast larger than detector)

    18. 18 Mammography Image Expanded Requirements Image Manager Storage and retrieval of For Presentation and For Processing SOP Classes for Digital Mammography X-Ray Storage and retrieval of Mammography CAD Structured Report SOP Class

    19. 19 Mammography Image Expanded Requirements Evidence Creator (CAD) Support for Mammography CAD SR SOP Class and Storage Commitment No specifics on how Evidence Creator obtains mammography images

    20. 20 Mammography Image Expanded Requirements Print Composers/Print Servers True Size printing (Requested Image Size) Justify chestwall and print with 5mm borders or less Render VOI LUTS if present Specify/Support maximum density Specify/Support Presentation LUT Labeling requirements Support for 12 bit pixel depth

    21. 21 Mammography Image Questions???

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