PS-2020a / part17

Received, 2. Cassette​ Summary, 3. Number​ of Pieces in Block, 4.​ Staining. This does not​ alwaysworkthisnicely.​ Often one or more of​ fields is empty or​ confusing.​

Note​

This field is​ limited to 64​ characters​

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The example Specimen Preparation Sequence first describes the most recent processing of the slide (staining), then goes back to​ show its provenance. Notice that there is no sampling process for the slide described here; the LIS did not record the step of slicing​ of blocks into slides.​

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NN.7 Specimen Data in Pathology Imaging Workflow Management​

Workflow management in the DICOM imaging environment utilizes the Modality Worklist (MWL) and Modality Performed Procedure​ Step(MPPS)services.Withinthepathologydepartment,theseservicessupportbothhumancontrolledimaging(e.g.,grossspecimen​ photography), as well as automated slide scanning modalities.​

While this section provides an overview of the DICOM services for managing workflow, the reader is referred to the IHE Anatomic​ Pathology Domain Technical Framework for specific use cases and profiles for pathology imaging workflow management.​

NN.7.1 Modality Worklist​

The contents of the Specimen Module may be conveyed in the Scheduled Specimen Sequence of the Modality Worklist query. This​ feature allows an imaging system (Modality Worklist SCU) to query for work items by Container ID. The worklist server (SCP) of the​ laboratory information system can then return all the necessary information for creating a DICOM specimen-related image. This in-​ formation includes patient identity and the complete slide processing history (including stain applied). It may be used for imaging set-​ up and/or inclusion in the Image SOP Instance.​

NN.7.1.1 MWL for Whole Slide Imaging​

In addition to the Specimen Module Attributes, the set up of an automated whole slide scanner requires the acquisition parameters​ such as scan resolution, number of Z-planes, fluorescence wavelengths, etc. A managed set of such parameters is called a Protocol​ (see PS3.3), and the MWL response may contain a Protocol Code to control scanning set up. Additional set-up parameters can be​ passedasContentItemsintheassociatedProtocolContextSequence;thismightbeimportantwhenthereadingpathologistrequests​ a rescan of the slide with slightly different settings.​

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NN.7.2 Modality Performed Procedure Step​

When scanning is initiated, the scanner reports the procedure step in a Modality Performed Procedure Step (MPPS) transaction.​

Upon completion (or cancellation) of an image acquisition, the modality reports the work completed in an update to the MPPS. The​ MPPScanconveyboththeContainerIDandtheimageUIDs,sothattheworkflowmanager(laboratoryinformationsystem)isadvised​ of the image UIDs associated with each imaged specimen.​

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OO Structured Display (Informative)​

OO.1 Structured Display Use Cases​

OO.1.1 Dentistry​

Intra-oralradiographytypicallyinvolvesacquisitionofmultipleimagesofvariouspartsofthedentition.Manydigitalradiographicsystems​ offer customized templates that are used for displaying the images in a study on the screen. These templates may also be referred​ to as mounts or view sets. The Structured Display Object represents a standard method of encoding and exchanging the layout and​ intendeddisplayofStructuredDisplays.Astructureddisplayobjectcreatedinthismannercouldbestoredwithastudyandexchanged​ with images to allow for complete reproduction of the original exam.​

1.​A patient visits a General Dentist where a Full Mouth Series Exam with 18 images is acquired. The dentist observes severe bone​ loss and refers the patient to a Periodontist. The 18 images from the Full Mouth Series along with a Structured Display are copied​ to a DICOM Interchange CD and sent with the patient to see the specialist. The Periodontist uses the CD to open the exam in​ his Dental Radiographic Software and consults via phone with the General Dentist. Both are able to observe the same exam​ showing the images on each user's display using the exact same layout.​

Figure OO-1. Intra-oral Full Mouth Series Structured Display​

2.​A patient requests cosmetic surgery to enhance their facial appearance. The case requires consultation between an orthodontist​ in New York and an oral surgeon in California. The cephalometric series of 2D projections constructed from the volumetric CT​ data that is used for the discussion is arranged by a Structured Display for transfer between the two practitioners.​

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Figure OO-2. Cephalometric Series Structured Display​

3.​AdentalproviderwishestocaptureaseriesofDICOMIOimagesforthepatient’sdentition.Thetoothmorphology,teetharedivided​ into molars, premolars, canines and incisors, and a number of images for each jaw. The anatomic information was captured​ utilizing the triplet of schema. This standard code sequence is based on ISO 3950-2010, Dentistry - Designation system for teeth​ and areas of the oral cavity.​

Every IO image should have anatomic information either through the primary or modifier sequence.​

In most standard cases, images are oriented in structured layouts. These structured displays are useful to be shared between​ providers for reference purposes.​

Table OO.1.1-1 shows structured display standard templates, where Viewset ID is based on the Japanese Society for Oral and​ Maxillofacial Radiology (JSOMR) classification provided by JIRA (Japan Medical Imaging and Radiological Systems Industries​ Association, www.jira-net.or.jp). Expected or typical teeth to be imaged location, region and designation codes are based on ISO​ 3950-2010, Dentistry - Designation system for teeth and areas of the oral cavity. For all the hanging protocols listed in OO.1.1-​ 1, the value to use for Hanging Protocol Creator (0072,0008) is "JSOMR" and the value to use for Hanging Protocol Name​ (0072,0002) does not include "JSOMR" (e.g., "DL-S001A", not "JSOMR DL-S001A").​

Table OO.1.1-1. Hanging Protocol Names for Dental Image Layout based on JSOMR classification​

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