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Recent and Future developments of the DICOM standard

Publication date: Mar 06, 2014

Harry Solomon, DICOM chair, discusses some of the new/recent changes to the DICOM standard, inclusive of the publication of DICOM in an XML format, FHIR and RESTful DICOM, as well as Patient Safety issues.

I recently held a video interview with Harry Solomon, who works for GE and has been chair of the ACR/NEMA DICOM committee since the fall of 2013. During the interview, which focused on new and/or future developments in the DICOM standard, three notable topics came up:

DICOM publication in an XML format

"The publication of the DICOM standard in an XML format will prbably have the most visible impact" according to Harry. DICOM has been wordking on this for over 10 years. The idea is that by having the specification in XML developers will be able to access all of the tables, all of the information object definitions, and the vocabulary, and use this in their products.

This would enable thinks like test tools, code generators, documentation generators - there's wide variety of things that they expect to facilitate by creating an XML specification.


"It's the model for what we want to do when accessing DICOM objects", says Harry when asked about FHIR, "as we're developing DICOM webservices we're very much looking at how that would integrate with the FHIR resources. We don't want to reinvent the wheel, so we've already made the decision that any 'general' resources are all going to be FHIR resources, and DICOM will focus on the definition of any 'imaging' resources."

DICOM has been working on webservices (mainly for access to images) for over a decade. Initially WADO (a URL based mechanism), subsequently Webservices, and currently REST. New users with new use cases want to leverage the technology they have - so if mobile devices support REST, DICOM has to create a RESTful protocol to allow for access to imaging objects by such devices.

"At the same time we want to preserve the investment that has been made in imaging systems, and the value of the data that has been collected. So we want to create RESTful services that integrate well with existing production systems." DICOM tries to ensure that the evolutionary trends still maintain the value of any existing images in the radiology department. As such these new protocols are viewed as layers on top of DICOM. There'll be a mixture of the DICOM native protocol and webservices for some of these new use cases.

Radiation dosage monitoring

DICOM also has relationships with the IEC related to the issue of radiation safety. Regulatory agencies have an interest in collecting information related to radiation/patient safety issues. Jointly with the IEC DICOM has created the information stuctures to capture patient radiation dose information, initially for simple X-Rays, for CT, and currently they're working on collecting radiation data for radiopharmaceuticals. This is tricky, because the radiopharmaceutical dose is not produced by the imaging equipment, but by the radiopharmaceutical agent. The dosage has to be collected in a system that's ancilary to the imaging equipment.

Future of DICOM

DICOM will be with us for years to come, and it's my impression that the level of coordination between DICOM and other standards organizations has increased, and I'm sure it will increase, over time. The core value of DICOM (according to the DICOM standardization community) lies in its object definitions, and in the existing clinical information archived according to those definitions. As such new 'transport protocols' like REST can be easily embraced.


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