DICOM
The primary purpose of the standard is to facilitate communication between the software and hardware entities involved in medical imaging, especially those that are created by different manufacturers.
The DICOM standard has been widely adopted by hospitals and the medical software industry, and is sometimes used in smaller-scale applications, such as dentists' and doctors' offices.
[5] DICOM is a standard developed by American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA).
Commercial equipment supporting ACR/NEMA 2.0 was presented at the annual meeting of the Radiological Society of North America (RSNA) in 1990 by these same vendors.
The first large-scale deployment of ACR/NEMA technology was made in 1992 by the US Army and Air Force, as part of the MDIS (Medical Diagnostic Imaging Support)[6] program based at Ft. Detrick, Maryland.
Loral Aerospace and Siemens Medical Systems led a consortium of companies in deploying the first US military PACS (Picture Archiving and Communications System) at all major Army and Air Force medical treatment facilities and teleradiology nodes at a large number of US military clinics.
[7] DICOM has been constantly updated and extended since 1993, with the intent that changes are backward compatible, except in rare cases where the earlier specification was incorrect or ambiguous.
The Integrating the Healthcare Enterprise (IHE) initiative layered on top of DICOM (and HL-7) defines profiles to select features from these standards to implement transactions for specific medical imaging interoperability use cases.
The DICOM storage commitment service is used to confirm that an image has been permanently stored by a device (either on redundant disks or on backup media, e.g. burnt to a CD).
This enables a workstation to find lists of images or other such objects and then retrieve them from a picture archiving and communication system.
Prior to the use of the DICOM modality worklist service, the scanner operator was required to manually enter all the relevant details.
There is a standard calibration (defined in DICOM Part 14) to help ensure consistency between various display devices, including hard copy printout.
), RIS (radiology information systems), VNA (vendor-neutral archives), EMR (electronic medical record) systems, and radiology reporting systems Many fields of medicine have a dedicated Working Group within DICOM,[23] and DICOM is applicable to any field of medicine in which imaging is prevalent, including:, radiology, cardiology, oncology, nuclear medicine, radiotherapy, neurology, orthopedics, obstetrics, gynecology, ophthalmology, dentistry, maxillofacial surgery, dermatology, pathology, clinical trials, veterinary medicine, and medical/clinical photography DICOM have reserved the following TCP and UDP port numbers by the Internet Assigned Numbers Authority (IANA): 104 well-known port for DICOM over Transmission Control Protocol (TCP) or User Datagram Protocol (UDP).
According to a paper presented at an international symposium in 2008, the DICOM standard has problems related to data entry.
[25] DVTk is an Open Source project for testing, validating and diagnosing communication protocols and scenarios in medical environments.
Health Level 7 is a non-profit organization involved in the development of international healthcare informatics interoperability standards.
HL7 and DICOM manage a joint Working Group to harmonize areas where the two standards overlap and address imaging integration in the electronic medical record.
[26][27] Systematized Nomenclature of Medicine (SNOMED) is a systematic, computer-processable collection of medical terms, in human and veterinary medicine, to provide codes, terms, synonyms and definitions which cover anatomy, diseases, findings, procedures, microorganisms, substances, etc.
[29] In December 2023, cybersecurity researcher Sina Yazdanmehr unveiled a critical security issue within the Store service.
This revelation, presented at Black Hat Briefings, demonstrated the potential for malicious actors to manipulate existing series of medical images.
Yazdanmehr's research highlighted the alarming capability of attackers to destroy a series of images or introduce misleading indicators of illness.
[30][31] Ensuring the security of patient data within DICOM is critical, as these files often contain sensitive personal health information (PHI).
De-identification of DICOM refers to the process of removing or anonymizing personal health information (PHI) from medical images to protect patient privacy.
This process is vital for sharing medical data for research, educational purposes, or public health activities while complying with privacy regulations.
Ensuring thorough de-identification is crucial to balance the benefits of data sharing with the obligation to maintain patient confidentiality.
