Digital Imaging and Communications in Medicine (DICOM) is an essential standard in medical imaging, facilitating the interoperability of systems used to produce, display, send, retrieve, and store medical images.
The DICOM standard impacts interactions between all parties in the medical system, from patients and radiologists to teleradiologists. Understanding DICOM can significantly impact your experience with medical imaging. To help everyone understand how the standard works, this guide delves deeper into the DICOM file format, its importance in radiology, and how it is used across different teams.
What is DICOM and How Is It Used?
DICOM, or Digital Imaging and Communications in Medicine, is a standardized protocol used for managing, storing, printing, and transmitting information in medical imaging.
This standard ensures that medical imaging devices from different manufacturers can communicate seamlessly, enabling efficient and accurate transfer of imaging data. In hospitals and clinics worldwide, DICOM is the backbone of medical imaging, crucial for maintaining a smooth and effective workflow.
DICOM applies to images from a variety of medical equipment, from X-ray machines to ultrasound scanners and MRI equipment. All of those images are subject to the DICOM format.
Why DICOM is Important in Radiology
Because there are so many different imaging machines, models, and manufacturers, interoperability is one of the key advantages of DICOM. By ensuring different imaging devices and systems can communicate with each other, DICOM enhances the efficiency of radiology departments.
The format allows for quick and efficient transfer of imaging data, essential for timely diagnosis and treatment. DICOM maintains the integrity and quality of medical images, which is vital for accurate diagnosis and patient care.
The DICOM Standard
The DICOM standard, maintained by the National Electrical Manufacturers Association (NEMA) and the American College of Radiology (ACR), includes a file format definition and a network communications protocol. It is regularly updated to incorporate new technological advances and practices in medical imaging, ensuring it remains relevant and effective.
The format originated in the 1980s, and began to gain more widespread acceptance when the US military adopted the standard in the early 1990s. Today, the DICOM standard has nearly-universal use among the makers of medical equipment.
What is the Image Format in DICOM?
DICOM files use a specific format that includes both the image data and associated metadata. Each DICOM file contains a header with patient information and imaging data, ensuring that all relevant details are stored together. This design makes DICOM compatible with various imaging modalities, including X-rays, MRIs, and CT scans.
What are the Parts of a DICOM File?
A DICOM file consists of several parts:
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Header: Contains metadata such as patient information, study details, and technical parameters of the image.
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Dataset: The actual image data, encoded in a standard format.
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Service-Object Pair (SOP) Classes: Define the types of images and related data that can be included in a DICOM file.
Various DICOM Protocols
For detailed illustrations, refer to the requirements provided in the [NCBI article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC61235/).
Network Image Management
Network Image Management protocols ensure the secure and efficient transfer of images within and between healthcare facilities, maintaining the integrity of the data.
Network Image Interpretation Management
These protocols manage the interpretation and reporting of medical images, facilitating collaboration and communication between radiologists and other healthcare providers.
Network Print Management
Network Print Management protocols allow for the printing of high-quality medical images for physical records or patient use.
Imaging Procedure Management
Imaging Procedure Management protocols manage the scheduling and execution of imaging procedures, ensuring they are performed and documented efficiently.
Exporting and Sharing DICOM Files
DICOM files can be exported and shared using various methods, such as CDs, DVDs, and secure online portals. While there’s no limit to how the images can be exported, it is crucial to maintain patient confidentiality and data integrity during the export and sharing process to comply with healthcare regulations and standards.
To learn a bit more about the sharing and exporting of medical images, join one of our MRI Web Clinics to see a clear demonstration.
DICOM and Other Commonly Used File Formats
DICOM differs from formats like JPEG, PNG, and TIFF that are used for different purposes, such as sharing images with non-medical professionals or for presentations.
Can I Remove Patient Information from DICOM Images?
DICOM anonymization tools can strip patient-identifying information from the files without affecting the image data.
Can I Convert DICOM Images into Other File Formats?
Conversion software or tools can export DICOM files to more common image formats like JPEG or PNG. Any such software needs to be carefully integrated into healthcare workflows.
What is the Difference Between DICOM and JPEG?
DICOM is a comprehensive format that includes both image data and metadata, while JPEG is a simple image format without additional data. JPEGs are far more common in everyday use and can be easily read on nearly any device.
How Different Teams Access DICOM Files
With a unified standard, all parties in the medical process interact with DICOM in different ways.
Patients
Patients typically access their DICOM files through patient portals or physical media (CDs, DVDs). This access allows them to view their medical images and share them with other healthcare providers if necessary.
Radiologists On-Site
Radiologists access DICOM files directly through PACS (Picture Archiving and Communication System) and workstations. This direct access is essential for diagnosis, treatment planning, and interdepartmental consultations. Radiologists and radiology teams may access their DICOM Files via on-site or cloud-based PACS solutions. To learn more about cloud vs on-site pacs, read our article.
Teleradiologists
Teleradiologists access DICOM files via secure remote access to hospital PACS or through specialized teleradiology platforms. This setup enables them to provide diagnostic services from a remote location, often on a 24/7 basis, ensuring timely analysis and reporting. It also allows hospital teams to expand their expertise and obtain outside perspectives when necessary.
Radsource’s MRI Interpretation Services are one such example, allowing existing medical staff to draw on outside expertise.
DICOM and Daily Work
DICOM streamlines the overall workflow in medical imaging by ensuring that images and data are easily accessible and shareable. As such, DICOM reduces delays and improves patient care.
DICOM Drawbacks
DICOM is the accepted standard for medical imaging, but it does contain at least one notable drawback. The format is a technical one, designed to boost interoperability on the technical level, rather than a format intended to make medical diagnosis and the medical workflow easier.
Why Can’t DICOM Files be Viewed Directly on a Personal Computer?
As one example, DICOM files require specialized software to interpret the image data and metadata, which standard image viewers do not support. That makes DICOM great for communication between devices, but not as great for ease of use by medical staff and patients.
DICOM, Radiology, and Modern Imaging Technology
Understanding DICOM is essential for anyone involved in medical imaging. It ensures efficient and accurate handling of medical images, which is crucial for patient care.
By exploring further resources or contacting a professional, readers can deepen their knowledge of DICOM and its applications. As technology advances, DICOM will continue to play a pivotal role in medical imaging and enhancing the quality of care provided to patients.