Review: Understanding and Using DICOM, the Data Interchange Standard for Biomedical Imaging

The Digital Imaging and Communications in Medicine (DICOM) Standard specifies a non-proprietary data interchange protocol, digital image format, and file structure for biomedical images and image-related information. The fundamental concepts of the DICOM message protocol, services, and information objects are reviewed as background for a detailed discussion of the functionality of DICOM; the innovations and limitations of the Standard; and the impact of various DICOM features on information system users. DICOM addresses five general application areas: (1) network image management, (2) network image interpretation management, (3) network print management, (4) imaging procedure management, (5) off-line storage media management. DICOM is a complete specification of the elements required to achieve a practical level of automatic interoperability between biomedical imaging computer systems--from application layer to bit-stream encoding. The Standard is being extended and expanded in modular fashion to support new applications and incorporate new technology. An interface to other Information Systems provides for shared management of patient, procedure, and results information related to images. A Conformance Statement template enables a knowledgeable user to determine if interoperability between two implementations is possible. Knowledge of DICOM's benefits and realistic understanding of its limitations enable one to use the Standard effectively as the basis for a long term implementation strategy for image management and communications systems.

[1]  Bidgood Wd.  Documenting the information content of images. , 1997 .

[2]  Carl Malamud.  Stacks: Interoperability in Today's Computer Networks , 1991 .

[3]  K Miyasaka,et al.  Clinical experience--16 months of HU-PACS. , 1991, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[4]  D K Benn,et al.  An imaging standard for dentistry. Extension of the radiology DICOM standard. , 1993, Oral surgery, oral medicine, and oral pathology.

[5]  Kent A. Spackman,et al.  Controlled terminology for clinically-relevant indexing and selective retrieval of biomedical images , 1997, International Journal on Digital Libraries.

[6]  Hans M. Mosser,et al.  Clinical routine operation of a filmless radiology department: three years experience , 1995, Medical Imaging.

[7]  V. Rich.  Personal communication , 1989, Nature.

[8]  W. Dean Bidgood,et al.  Documenting the information content of images , 1997, AMIA.

[9]  W D Bidgood,et al.  The SNOMED DICOM microglossary: controlled terminology resource for data interchange in biomedical imaging. , 1998, Methods of information in medicine.

[10]  Suzy Smith,et al.  Lessons learned and two years clinical experience in implementing the Medical Diagnostic Imaging Support (MDIS) System at Madigan Army Medical Center , 1994, Medical Imaging.

[11]  H. K. Huang,et al.  Picture Archiving and Communication Systems (PACS) in Medicine , 1991, NATO ASI Series.

[12]  N. Meyers,et al.  H = W. , 1964, Proceedings of the National Academy of Sciences of the United States of America.

[13]  Kent A. Spackman,et al.  Medical data standards , 1997 .