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NM Image

NM Image. Chris Lindop, GE Healthcare. NM Image The Problem. Product support is inconsistent DICOM NM object coding techniques very NM full-body display needs misunderstood NM cardiac display needs misunderstood Clinical Analysis Applications results distribution unsupported

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NM Image

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  1. NM Image Chris Lindop, GE Healthcare

  2. NM ImageThe Problem • Product support is inconsistent • DICOM NM object coding techniques very • NM full-body display needs misunderstood • NM cardiac display needs misunderstood • Clinical Analysis Applications results distribution unsupported • Poor communiction during product purchase • NM Users are not adept at getting these requirements accurately included in RFPs • Vendors (especially of general purpose systems) are not adept at accurately representing their support for such features

  3. General NM Viewing Suboptimal NM PACS

  4. General NM Viewing Suboptimal NM PACS

  5. General NM Viewing Suboptimal Click and move mouse down to adjust window level, right to adjust window center

  6. If sent as Short axis Images not displayed in a useful format. If sent as screen snapshots(ie, static Secondary Capture) Can’t separately adjust stress and rest images Can’t view gated cine Cardiac Viewing Suboptimal

  7. NM ImageValue Proposition Use general Radiology Infrastructure to: • Satisfy Basic NM Data Needs • Access to NM Images • Access to usable presentations of NM Images • Access to Clinical Processing Results • Satisfy NM Workflow Needs • Map Cardiac and Multi-phase Studies to SWF • Improved Query

  8. NM Image Abstract / Scope • Content Profile • for users to request • For vendors to claim • No New Actors or Transactions • Additional requirements on existing actors and transactions • Total of 4 options

  9. NM ImageStandards Used • DICOM NM Image Object • DICOM Multiframe Secondary Capture • Dynamic Results • Static Results • DICOM Secondary Capture • Static Results • ACC NM Cardiac Display format

  10. NM ImageTransaction Diagram

  11. NM Image Actors • Acquisition Modalities • Create NM objects as specified (Series, attribute & vector handling) • Include clinical coding in Cardiac studies • Image Manager/Archives • Store/Retrieve NM & Secondary Capture (SC & MFSC) Objects • Support Query on Study Description • Evidence Creators • Create NM objects as specified (Series, attribute & vector handling) • Include process-specific coding in Cardiac studies • Use cardiac codes during processing • Image Displays • Display NM and Secondary Capture (SC & MFSC) Images • Support specified display capabilities • Handles specific NM DICOM attributes

  12. Result Screen Export Option

  13. Result Screen Export Option:Evidence Creators • Render Dynamic Result Screens • Capture Dynamic Results using the following DICOM Objects: • Multi-Frame Secondary Capture • Grayscale Byte • True Color • Render Static Result Screens • Capture the Static Results using either • single frame • Multi-frame (preferred) • Must generate appropriate Secondary Capture objects from any Result Screens rendered.

  14. Image Display • Display NM and Result-Screen Images • Support specified NM essential display capabilities • Additional attribute handling • e.g. Patient State, Image Orientation, Detector Sequence, View Code Sequence

  15. General NM Option Whole body display Cardiac NM Option ACC NM Cardiac display Displays must support at least one of these options! Options: Image Displays

  16. Image Display • Handle multi-frame / multi-vector images • Multiple simultaneous cines • Grayscale and color result screens • Dynamic and static result screens • Original resolution and scaled • Separate adjustment of upper and lower window levels • Apply local color tables to grayscale screens • Add new local color tables to system • Change intensity of grayscale result screens • Display Series Description tag

  17. Image Display • Scale “intelligently” to avoid presenting postage-stamp size NM images • Allow user to select different vectors/framesets of complex multi-frame images • Allow user to separately adjust intensity for different framesets (eg, phases) in the same “image”

  18. A1 A2 A3 A4 A5 A6 A7 A8 A9 … … … … … … … … … … … … … … … … … … … … … … A32 … A1 A2 B1 B2 C1 C1 Display Formats • Grid display • Frames from one image set • Fit display • Frames from multiple image sets

  19. ACC NM Cardiac Display • Generate long axis from short axis images • Display of 2 image sets (Stress and Rest) • Use patient state tags to set display order • Follow ACC guidelines for display • Controls for adjusting stress and rest • Image alignment • Window upper and lower levels.

  20. Short axis ACC NM Display Example • Vertical Long • Horizontal Long

  21. Short ACC NM Display Example Stress Rest Stress Rest • Vertical Stress Rest • Horizontal Stress Rest

  22. MPR Option: Image Displays • Adds Image Display requirements to support Review of SPECT NM Images with Multi-planar reconstruction (MPR) • Transaxial • Sagittal • Coronal

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