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Integrating the Healthcare Enterprise Consistent Presentation of Images

Integrating the Healthcare Enterprise Consistent Presentation of Images. Ellie Avraham Kodak Health Group IHE Planning and Technical Committees. Consistent Presentation of Images Abstract/Scope: The Grayscale Consistency Problem.

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Integrating the Healthcare Enterprise Consistent Presentation of Images

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  1. Integrating the Healthcare EnterpriseConsistent Presentation of Images Ellie Avraham Kodak Health Group IHE Planning andTechnical Committees IHE Interoperability Workshop

  2. Consistent Presentation of Images Abstract/Scope: The Grayscale Consistency Problem • The Visual Appearance of grayscale images displayed on different types of softcopy display devices or printed on different types of hardcopy output devices is in generalinconsistent and may impact the clinical Diagnostics Reading IHE Interoperability Workshop

  3. Problems of Display Inconsistency VOI chosen on one display device Rendered on another with different display Mass expected to be seen is no longer seen mass visible mass invisible Slide Provided by David Clunie IHE Interoperability Workshop

  4. Problems of Inconsistency in Display Luminance range 0.5 1.0 Not all display levelsare perceivable on alldevices 1.5 3.0 Slide Provided by David Clunie IHE Interoperability Workshop

  5. Problems of Inconsistency in Display Luminance range 0.5 1.0 Not all display levelsare perceivable on alldevices 1.5 3.0 Slide Provided by David Clunie IHE Interoperability Workshop

  6. Problems of Hardcopy-Softcopy Inconsistency Digital Modality Laser Printer Printed images don’t looklike displayed images Slide Provided by David Clunie IHE Interoperability Workshop

  7. Causes of Inconsistency Display devicesvary in the maximumluminance they canproduce Display CRT Luminance vs. Film Optical Density on a light box is an extreme example 1.0 .66 Slide Provided by David Clunie IHE Interoperability Workshop

  8. Consistent Presentation of Images Value Proposition 1.Consistent distribution of Images across the healthcareenterprise - Consistency among Hardcopy Images Printed on different Printers - Consistency among Softcopy Images view on different Display devices - Consistency among Hardcopy and Softcopy Image view 2. Maintain and Improve Image Quality - Calibrating the Display/Print Device - Use Presentation State for Display and Presentation (P-Val) LUT for Print. 3. Improve Throughput - Preserve the Display Setup parameters in the Presentation State - Apply the Presentation State automatically before the Images Display The cost effective solution to ensure that image quality is maintained acrossdifferentmonitors and film producing devices IHE Interoperability Workshop

  9. Consistent Presentation of ImagesTransaction Diagram DISPLAY Image Creator Image Display Images Stored Present. State Stored Q /R Presentation Sates Image Archive Image Manager PRINTING Present. State Stored Print Composer Print Server Acquisition Modality Print Request with Presentation LUT • Consistent Appearance of Images: • Display Devices • Printed Output IHE Interoperability Workshop

  10. Consistent Presentation of Images DICOM Standard Used: • Calibration of the Softcopy Display and the Hardcopy Output Devices using DICOM Grayscale Standard Display Function (GSDF) • Creating Hardcopy Output Using DICOM Basic Print with Presentation LUT (P-LUT) Support • Preserving/Using the Softcopy Display Viewing Parameters in the DICOM Grayscale Softcopy Presentation State (GSPS) container Cal Hard Soft IHE Interoperability Workshop

  11. Consistent Presentation of ImagesStandardizing/Calibrating Device The DICOM Standard Defines: A standard curve, the Grayscale Standard Display Function (GSDF), against which different types of display and hardcopy output devices should be calibrated – Adjust their Characteristic Curve to the GSDF curve. Cal Devices Have to Be Properly Calibrated IHE Interoperability Workshop

  12. Cal Standardizing a Display/Print Device to GSDF Curve 100 Standard 10 1 0 50 100 150 200 250 Characteristic Curve 0.1 DDL or P-Values Slide Provided by David Clunie IHE Interoperability Workshop

  13. Consistent Presentation of Images Images Printed, the DICOM Standard Defines: Hard • Basic Print Management with Presentation Look Up Table, for controlling the consistent appearance of preformatted images on printed output IHE Interoperability Workshop

  14. Basic Print Request with Presentation LUT Actors DICOM Presentation LUT N-CREATE Print Print Composer Server DICOM Film Session N-CREATE Print Composer Print Request Print Presentation LUT DICOM Film Box N-CREATE DICOM Image Box N-SET DICOM Film Box N-ACTION DICOM Film Session N-ACTION Print Server Print Status (DICOM N-EVENT-REPORT) Hard Printer Status IHE Interoperability Workshop

  15. Actors: Basic Print Request with Presentation LUT • Print Composer – A system that generates DICOM print requests as a DICOM Print SCU.Print composer has to apply image processing manipulations, and requests to Print server will specify P-Values in the form of a Presentation Look-Up Table (Presentation LUT) or implicitly by Presentation LUT Shape. • Print Server – A system that accepts and processes DICOM print requests as a DICOM Print SCP and performs image rendering on hardcopy media.The system must support pixel rendering to optical density according to the DICOM Grayscale Standard Display Function. Hard IHE Interoperability Workshop

  16. Consistent Presentation of Images Preserving Display Parameters: Soft Grayscale Softcopy Presentation State (GSPS): an object for storing and communicating the parameters that describe how an image or set of images should be displayed. A GSPS object contains references to the images it applies to, and the transformations (grayscale transformations, shutter transformation, image annotation, spatial transformations, and displayed area annotation) that should be applied when the images are presented on a softcopy display, or printed on film. IHE Interoperability Workshop

  17. Area Of Interest Area Of Interest Achieving Consistent Presentation Flip Zoom Annotate Original Image Without Consistent Presentation Window Level Consistent Presentation of Images Referring Physician or Reviewing Radiologist Reporting Radiologist Soft Presentation State Presentation LUT Grayscale Standard IHE Interoperability Workshop

  18. Consistent Presentation of ImagesActors: Grayscale Softcopy Presentation State (GSPS) • Image Acquisition / Evidence Creator • Creates Images with GSPS Objects and Store them on Image Manager/Image Archive • Image Manager /Image Archive • Store and Query & Retrieve Images with GSPS Objects • Image Display • Query & Retrieve Images with GSPS Objects and Apply the GSPS on the Images IHE Interoperability Workshop

  19. Consistent Presentation of Images Print Display Acquire Slide Provided by David Clunie IHE Interoperability Workshop

  20. More information…. • IHE Web site: http://www.ihe.net http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htm • Technical Frameworks • Technical Framework Supplements – Trial Implementation • Non-Technical Brochures : • Calls for Participation • IHE Fact Sheet and FAQ • IHE Integration Profiles: Guidelines for Buyers • IHE Connect-a-thon Results • Vendor Products Integration Statements Questions? IHE Interoperability Workshop

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