In the world of medicine, X-rays, MRIs and others of their kind are used to peer inside our bodies and determine the cause of a patient’s discomfort or ailment. With this medical technology, a consistent standard must be used in order to look at the images and provide them to medical professionals. Luckily, there are several of these standards used within the industry, including DICOM. In this paper, we will discuss the general background of DICOM, including the purpose of the standard, its connectivity levels, its reliability, its level of security, and how it is implemented in the medical profession.
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The Data Interchange Standard for Biomedical Imaging (DICOM) was created to offer an alternative to the Health Level 7 Standard of image communication in terms of providing a file format for the transmission, viewing and sharing of medical images. DICOM, unlike the HL7 standard, provides a “complete specification from top to bottom of the elements required to achieve a practical level of automatic interoperation.” (Bidgood et al. 1997) HL7’s guidelines for electronic document transfer are limited at best; DICOM fills in the blanks and accounts for every contingency possible in the process of exchanging images.
In medical devices, it is required to have a dedicated standard of image communication so that the same image can be viewed and examined among multiple devices by different medical professionals. This allows them to have all the information they need on the spot, and in a manner that they can use to effectively diagnose and address the data they glean from the image. A proper diagnosis can be found and an adequate record keeping system of images can be maintained through DICOM’s consistent and quality standards.
With the help of DICOM, vendors can create interface specifications that will increase network connectivity among their products – this allows medical professionals to more easily use these different products to share and view medical images. The two different groups that DICOM services use are composite and normalized. Composite services make previous ACR-NEMA versions completely compatible. Therefore, you can use products and medical imaging software with that standard with DICOM standard software, and it will still work. (Bidgood et al. 1997)
One of the biggest problems with the HL7 and other standards of imaging is that HL7 “specifies a message model, but provides only a subset of the properties that impact interoperability.” (Bidgood et al. 1997) In short, it does not give all of the solutions for issues of connectivity between devices. DICOM addresses this completely, making it an entirely reliable system.
DICOM is an extremely reliable software standard; DICOM-based software is now “much faster than older bitmap-based software.” It can help reduce analysis time and still give accurate results. (Potter et al. 2007, p. 2) One of the network image management services that DICOM offers is the Storage Commitment Service Class, which “enables an image source to obtain a commitment from an image storage device that images have been stored reliably.” (Bidgood et al. 1997) This means that devices communicate with each other to make sure that the other device has the image securely before stopping their transmission. This ensures that the device will not lose or corrupt the image.
DICOM security mechanisms are used to make sure that images are not retrieved by anyone who is not allowed to, as in when information is sent through the Internet or some non-secure line, where it is vulnerable. All that is required is a simple mechanism to encrypt the data before it is sent through, and electronic signatures are also used in DICOM security to ensure that the image got to the correct recipient. It also keeps a person from altering the information on the image without being noticed by the recipient. (Bidgood et al. 1997)
DICOM standards are mostly used in imaging devices to be used by dermatologists, pathologists, endoscopists and the like. It can be used to exchange images, manage images in databases, maintain an overall high image quality, and much more. Software and programs are used to supplement the DICOM file format and standard, so that all of these imaging devices can communicate with each other effectively, quickly and without error. DICOM based software can be used to “observe and measure structures seen in the CT and MRI three-dimensionally in a way that meets [the needs of physicians].” (Takasaki et al. 2009, p. 53)
DICOM image viewing and processing software is a fantastic standard to use when diagnosing symptoms in sensitive areas such as the brainstem. (Takasaki et al. 2009, p. 56) Due to the fact that so many medical disciplines use DICOM, it is especially vital that all the file formats and DICOM protocols are interchangeable and compatible with each other. Security measures are taken to protect the information, and DICOM systems have been designed for maximum redundancy, communication and reliability. When compared to other standards such as HL7, it provides a much more complete system of image management.
References
Bidgood, Dean, Steven Horii, Fred Prior, and Donald Van Syckle. "Understanding and Using
DICOM, the Data Interchange Standard for Biomedical Imaging." Journal of the American Medical Information Association 4.3 (1997): 199-212. Print.
Potter, K., Green, D. J., Reed, C. J., Woodman, R. J., Watts, G. F., McQuillan, B. M., & ...
Arnolda, L. F. (2007). Carotid intima-medial thickness measured on multiple ultrasound frames: evaluation of a DICOM-based software system. Cardiovascular Ultrasound, 529-38. doi:10.1186/1476-7120-5-29
Takasaki, K., Kumagami, H., Baba, A., Fujiyama, D., & Takahashi, H. (2009). A case with
posterior fossa epidermoid cyst showing audiovestibular symptoms caused by insufficiency of anterior inferior cerebellar artery - usefulness of free DICOM image viewing and processing software. Acta Oto-Laryngologica (Supplement), 12953-56. doi:10.1080/00016480902915681
