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The DICOM (Digital Imaging and Communications in Medicine) Standard was originally developed by a joint committee of the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) to "facilitate the open exchange of information between digital imaging computer systems in medical environments".
Since its initial completion in 1993, the standard has taken hold. More and more products are advertising DICOM conformance, and more customers are requiring it. DICOM has also been incorporated as part of a developing European standard by CEN, as a Japanese standard by JIRA, and is increasingly becoming an International Standard.
DICOM Version 3.0 is composed of several hundreds of pages over sixteen separate parts. Each part of the standard focuses on a different aspect of the DICOM protocol:
Part 1 of the standard gives an overview of the standard. Since this part was approved before most of the other parts were completed, it is already somewhat outdated and can be confusing.
Part 2 describes DICOM conformance and how to write a conformance statement. A conformance statement is important because it allows a network administrator to plan or coordinate a network of DICOM applications. For an application to claim DICOM conformance, it must have an accurate conformance statement.
Parts 3 and 4 define the types of services and information that can be exchanged using DICOM.
Parts 5 and 6 describe how commands and data shall be encoded so that decoding devices can interpret them.
Part 7 describes the structure of the DICOM commands, that along with related data, make up a DICOM message. This part also describes the association negotiation process, whereby two DICOM applications mutually agree upon the services they will perform over the network.
Part 8 describes how the DICOM messages are exchanged over the network using two prominent transport layer protocols; TCP/IP and OSI. This is termed the DICOM Upper Layer Protocol (DICOM UL).
Part 9 is rarely of interest, as it describes how DICOM messages shall be exchanged using the ‘old’ 50-pin point-to-point connection originally specified in the predecessor to DICOM (ACR/NEMA Version 2). This part has been retired from the DICOM standard.
Part 10 describes the DICOM model for the storage of medical imaging information on removable media. It specifies the contents of a DICOM File Set, the format of a DICOM File and the policies associated with the maintenance of a DICOM Media Storage Directory (DICOMDIR) structure.
Part 11 specifies Media Storage Application Profiles that standardizes a number of choices related to a specific clinical need (modality or application). This includes the specification of a specific physical medium and media format (e.g. CD-ROM, 3.5” high-density floppy, ...), as well as the types of information (objects) that can be stored within the DICOM File Set. Part 11 also includes useful templates to provide guidance in authoring media application conformance statements.
Part 12 details the characteristics of various physical medium and media formats that are referenced by the Media Storage Application Profiles of Part 11.
While parts 11 and 12 of DICOM are expected to evolve along with the introduction of new clinical procedures and the advancement of storage media and file system technology, Part 10 should remain quite stable since it specifies file formats organization independent of medical application or storage technology.
Part 13 details a point to point protocol for doing print management services. This part has been retired from the DICOM standard.
Part 14 specifies a standardized display function for display of grayscale images.
Part 15 specifies Security Profiles to which implementations may claim conformance. Profiles are defined for secure network transfers and secure media.
Part 16 specifies the DICOM Content Mapping Resource (DCMR) which defines the templates and context groups used elsewhere in the standard.
Part 17 consolidates informative information previously contained in other parts of the standard. It is composed of several annexes describing the use of the standard.
Part 18 specifies a web-based service for accessing and presenting DICOM persistent objects (e.g. images, medical imaging reports).
As a user of this toolkit, you should have access to the DICOM Standard. Merge DICOM Toolkit takes care of most of the details of DICOM for you. However, the standard is the final word. You will probably find Parts 2 to 6 most useful. The DICOM Standard can be ordered from:
NEMA, 1300 N. 17th Street, Suite 1847, Rosslyn, VA 22209, USA
or downloaded from http://medical.nema.org.
The DICOM Standard is typically published every other year. Each version includes approved changes since the last publishing.
Please note: The DICOM Standard is evolving so rapidly, that additions to the Standard are published as supplements. If you find that this document references a part of the Standard and you cannot find what you are looking for in that part, you probably need to get the proper supplement from NEMA. Other additions to the Standard (e.g., new image objects or documents) will also be published as supplements. NEMA also makes all supplements to the standard freely available on their ftp server.
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