Merge eFilm Fusion PACS Storage and Distribution Manager

Merge eFilm

Fusion PACS Storage and Distribution Manager

1.4.0 Software Release

DICOM Conformance Statement

February 1, 2005

Revision 2

009-82375-00

Fusion PACSTM Storage and Distribution Manager DICOM Conformance Statement Revision 2

Merge eFilmFebruary 1,

2005

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1 CONFORMANCE STATEMENT OVERVIEW

The FUSION PACS is a self-contained networked computer system used for archiving diagnostic medical images. It allows external systems to send images to it for permanent storage, retrieve information about such images, and retrieve the images themselves. The system conforms to the DICOM standard to allow the sharing of medical information with other digital imaging systems.

To increase processing capabilities, FUSION PACS can be deployed in a cluster of servers that share a common database. Each server in the cluster can be configured to listen for DICOM connections. Interaction by a DICOM Service Class User (SCU) with any server in a cluster will return the same exact results. FUSION PACS can be deployed with load balancing hardware that will allow the cluster of servers to appear as a single IP address and AE Title to DICOM SCUs.

Table 1-1 NETWORK SERVICES

SOP Classes User of Service (SCU) Provider of Service (SCP)

Computed Radiography Image Storage Yes Yes

CT Image Storage Yes Yes

Digital Intra-oral X-Ray Image Storage – For Presentation

Yes Yes

Digital Intra-oral X-Ray Image Storage – For Processing

Yes Yes

Digital Mammography X-Ray Image Storage – For Presentation

Yes Yes

Digital Mammography X-Ray Image Storage – For Processing

Yes Yes

Digital X-Ray Image Storage – For Presentation

Yes Yes

Digital X-Ray Image Storage – For Processing

Yes Yes



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Hardcopy Color Image Storage SOP Class Yes Yes

Hardcopy Grayscale Image Storage SOP Class

Yes Yes

MR Image Storage Yes Yes

Nuclear Medicine Image Storage Yes Yes

Positron Emission Tomography Image Storage

Yes Yes

RT Image Storage Yes Yes

Secondary Capture Image Storage Yes Yes

Ultrasound Image Storage Yes Yes

Ultrasound Image Storage (Retired) Yes Yes

Ultrasound Multi-frame Image Storage Yes Yes

Ultrasound Multi-frame Image Storage (Retired)

Yes Yes

VL Endoscopic Image Storage Yes Yes

VL Microscopic Image Storage Yes Yes

VL Photographic Image Storage Yes Yes

VL Slide-Coordinates Microscopic Image Storage

Yes Yes

X-Ray Angiographic Bi-Plane Image Storage (Retired)

Yes Yes

X-Ray Angiographic Image Storage Yes Yes

X-Ray Radiofluoroscopic Image Storage Yes Yes

Query/Retrieve

Patient Root Query/Retrieve Information Model – FIND

No Yes

Patient Root Query/Retrieve Information Model – MOVE

No Yes

Study Root Query/Retrieve Information Yes Yes



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Model – FIND

Study Root Query/Retrieve Information Model – MOVE

Yes Yes

NOTE: Relational Queries are not supported either as an SCU or SCP.



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2 TABLE OF CONTENTS

1 CONFORMANCE STATEMENT OVERVIEW ................................................................. 2

2 TABLE OF CONTENTS..................................................................................................... 5

3 INTRODUCTION ............................................................................................................... 7 3.1 Revision History..............................................................................................................................7 3.2 Audience .........................................................................................................................................7 3.3 Remarks ..........................................................................................................................................7 3.4 defiNItions, terms and abbreviations...............................................................................................8

4 NETWORKING................................................................................................................ 12 4.1 Implementation Model..................................................................................................................12

Application Data Flow .........................................................................................................................12 Functional Definition of AEs ................................................................................................................15 4.1.3 Sequencing of Real-World Activities ......................................................................................16

4.2 AE Specifications...........................................................................................................................18 4.2.1 STORAGE-SCU Application Entity Specification..................................................................18 4.2.2 QUERY-RETRIEVE-SCP Application Entity Specification....................................................29 4.2.3 STORAGE-SCP Application Entity Specification...................................................................46 4.2.4 FIND-SCU Application Entity Specification ..........................................................................55 4.2.5 MOVE-SCU Application Entity Specification ........................................................................63

4.3 Network Interfaces........................................................................................................................69 4.3.1 Physical Network Interface ....................................................................................................69 4.3.2 Additional Protocols ..............................................................................................................69



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4.4 Configuration................................................................................................................................70 4.4.1 AE Title/Presentation Address Mapping................................................................................70 4.4.2 Parameters .............................................................................................................................71

5 MEDIA INTERCHANGE ................................................................................................. 73

6 SUPPORT OF EXTENDED CHARACTER SETS............................................................ 74

7 SECURITY........................................................................................................................ 74 7.1 Security Profiles.............................................................................................................................74 7.2 Association Level Security .............................................................................................................74 7.3 Application Level Security..................................................................................................................75

8 ANNEXES........................................................................................................................ 76 8.1 IOD Contents................................................................................................................................76

8.1.1 STORAGE-SCP AE Element Use ...........................................................................................76 8.1.2 STORAGE-SCU AE Element modification ............................................................................79 8.1.3 Element modification by Web GUI ........................................................................................80



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3 INTRODUCTION

3.1 REVISION HISTORY

Part Number Document Version

Date Author Description

009-82257-00

1 April 22, 2004 Steve Wranovsky Version for Fusion PACS Image Distribution and Web Serving Module 1.2.7

009-82375-00 1 June 23, 2004 Steve Wranovsky Version for Fusion PACS Distribution and Storage Manager 1.2.8

009-82375-00 2 Feb 1, 2005 Bob Krieger/DAS Edits per DICOM reviewer.

3.2 AUDIENCE

This document is intended for those who need to understand how the Merge eFilm "Fusion PACS Storage and Distribution Manager" product will integrate into their healthcare facility. The document is also useful for those who need to have a detailed understanding of the DICOM features that this product supports. Integration personnel with DICOM knowledge can utilize this document to help them integrate the Merge eFilm "Fusion PACS Storage and Distribution Manager" product with other DICOM products. Having prior DICOM knowledge may be helpful in fully deciphering the information within this document. In fact, integrators are expected to fully understand all the DICOM terminology and how all the tables in this document relate to this product’s functionality and ability to integrate with other DICOM devices that support compatible DICOM features and functions. However, this document strives to give the reader useful definitions so that anyone within the healthcare community that needs to make use of how this product implements DICOM can understand all the DICOM terminology used within.

3.3 REMARKS

The scope of this DICOM Conformance Statement (DCS) is to facilitate communication between the "Fusion PACS Storage and Distribution Manager" product and other DICOM products. The DCS should be read and understood in conjunction with the DICOM Standard. However, DICOM by itself does not



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guarantee interoperability. The (DCS) does, however, facilitate a first-level comparison for interconnectivity and interoperability between different applications supporting compatible DICOM functionality.

This DCS is not supposed to replace validation with other DICOM equipment to ensure proper exchange of intended information. In fact, the user should be aware of the following important issues:

— The comparison of different Conformance Statements is just the first step towards assessing interconnectivity and interoperability between the “Fusion PACS Storage and Distribution Manager” product and other DICOM conformant equipment.

— Test procedures should be defined to validate the desired level of interoperability.

— The successful execution of these test procedures should be the validation of how well a product meets the integration requirements set down by the healthcare facility.

3.4 DEFINITIONS, TERMS AND ABBREVIATIONS

Abstract Syntax: (see Network Association/Negotiation at end of definintions)

AE Application Entity: The externally known name of a DICOM function that resides on a medical imaging device that has implemented DICOM. The AE is used during configuration of one of these devices on a network, normally by a service person, to identify this DICOM device to other DICOM devices on the network. It can also be used by a DICOM function that creates DICOM media, by writing the AE on the media as the creator’s identification.

CR Computed Radiography

CT Computed Tomography

DICOM Digital Imaging and Communications in Medicine: This is the standard that is primarily used in the healthcare environment to describe how devices that want to share medical imaging related information can do it.

IOD Information Object Definition

ISO International Standards Organization: An organization that is internationally recognized as being one of the primary standards



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organizations in the world. ISO oversees that development of many types of world wide standards and is responsible for maintaining and distributing them.

MR Magnetic Resonance

PET Positron Emission Tomography

PDU Protocol Data Unit: An area where the DICOM message is placed before it is sent across the network. There is a requirement to specify the maximum size of this area for receiving DICOM messages over the network from another DICOM device.

Presentation Context: (see Network Association/Negotiation at end of definitions)

RT Radiotherapy

SC Secondary Capture

SCP Service Class Provider: Service Class is the specification of a specific DICOM feature, i.e., Storage Service Class, Print Management Service Class, Study Management Service Class. Within a specific Service Class, there are normally multiple functions specified. For example, one of the functions specified within the Storage Service Class is for storing Computed Tomography (CT) images across the network from one DICOM device to another. Let's take those two DICOM devices that are communicating using DICOM over a network, where one is sending CT images to be received by the other. The one that is receiving the CT Images and storing them is called the Service Class Provider. That device is the provider of the DICOM storage services, i.e., more specifically, it is the SCP for the DICOM CT Image Storage function.

SCU Service Class User: (See SCP for definition of Service Class) This describes the user of a particular DICOM feature/function (please read the full definition of SCP). Let's take that same example (in SCP definition) and now look at it from the point of view of the device sending the CT Images to be stored. That device is considered the user of the storage service, therefore, the SCU for the DICOM CT Image Storage function.



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SOP Class Service-Object Pair Class: This is a specific function for a DICOM feature (please read the full definitions of SCP and SCU). Let's go back to the example used in the definitions of SCP and SCU. We described a device as implementing the DICOM CT Image Storage function as either an SCP or SCU. If the word "function" is replaced with "SOP Class", then we have the complete set of terms that are used to describe DICOM features and functions within this DICOM Conformance Statement and within the DICOM Standard. Therefore, a device that can receive CT images over a network utilizing the DICOM protocol and stores those received CT images in its databases would be called, in DICOM terms: - a CT Image Storage SOP Class - that plays the network role of an SCP - and follows the rules of the Storage Service Class.

SOP Class UID SOP Class Unique Identifier:

This 64-character unique identifier is assigned by the DICOM Standards Committee to uniquely identify the DICOM function implemented within an application. It is used within the DICOM Conformance Statement to insure that everyone understands which specific function is being implemented. It is also used between two DICOM applications on a network to negotiate whether they both support the same functions or not. (SOP Class UIDs can also be assigned by developers of DICOM applications if they want to have a private function defined within their application.)

TCP/IP Transmission Control Protocol/Internet Protocol

Transfer Syntax: (see Network Association/Negotiation at end of definintions)

US Ultrasound

VL Visible Light

VR Value Representation



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Network Association/Negotiation: IMPORTANT [This is important to understand, because of the described terminology in this Conformance Statement. Otherwise, you wouldn’t necessarily need to know it. The terms you need to understand are Abstract Syntax, Transfer Syntax and Presentation Context.]

Two devices that want to connect and communicate with each other over a network using the DICOM protocol must first agree on several things:

- One of the two devices must initiate an association (a connection to the other device) to ask if specific services, information and encoding can be support by the other device. a. Within this request are one or more blocks of information describing something called Presentation Context, which is (are) used to inquire about two (paired) sets of information: 1. Does the other device support a specific SOP Class, which is called an Abstract Syntax in this context. (A SOP Class UID is actually used to pass this information.) 2. And if it does, does it support one or more Transfer Syntaxes, which is (are) the description of how the information is encoded when being sent across the network. DICOM supports many differents ways of encoding information. However, everyone must at least support a required default way of encoding information. So in your Conformance Statement you should at least see the default Transfer Syntax called Implicit VR Little Endian (it will be represented by a Transfer Syntax UID that is in the format of “1.2.840.10008.1.2”). All other Transfer Syntaxes are optional. Normally, only technical personnel need to consider the ramifications of devices supporting the other Transfer Syntaxes. b. The initiator also specifies for each SOP Class whether it wants to play the role of the Service Class User (SCP) or Service Class Provider (SCP). Normally the initiator is the SCU, but not always.

Many other things, like maximum PDU size that the initiator can support and whether it supports any SOP Class optionality (called Extended Negotiation information) are sent to the other device.

- The other device receives the above information and must communicate back those services, information, and encoding it can support. a. All or a subset can be supported. However, nothing can be added to this list. b. The one thing the other device can send, independently of the initiating device, is the maximum PDU size that it can support. - The initiator sends everything in one message. The other device responds with a single message. Unless the other device rejects everything, the two devices have now negotiated how they will work together and should commence doing so.



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4 NETWORKING

4.1 IMPLEMENTATION MODEL

4.1.1 Application Data Flow

The division of FUSION PACS into the separate DICOM Application Entities represents a partitioning of functionality. For the purpose of this document, they are organized in this manner so as to detail their independent logical functionality. By default all of the defined Application Entities have the same AE Title. It is not possible to configure the various Application Entities with different AE Titles.



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Send Im age Function

Query & Retrieve Request Handling Function

Do Verification, Query Request & Response

Handler, and Retrieve Request

Requested Im ages Received and Stored

Verification or Im age Sent Unsolicited

Receive Im age Function

DICOM Standard Interface

Search Database

& Return Matches;

Query Rem ote Database & Handle Matching Response Function

Send Selected Im ages from Perm anent Storage to

Requested Destination Move Selected Im age To Specific Destination

Function

Receive and Store Im ages

Send Im age Function

Association Initiation



Association Acceptance

Association Acceptance

Im ages are

S tored in Database

Request to Send Im ages to rem ote device

via W eb GUI or Routing Request

Initiate Archive Proxy

m ode

Fusion ApplicationEntity

Search Database & Return Matches;

Send Selected Im ages to Requested Destination

Initiate Archive Proxy

m ode (retrieval )


Figure 4.1-1 FUSION PACS DICOM DATA FLOW DIAGRAM

The Application Entities detailed in the Application Data Flow Diagram are all Windows 2000/2003 applications.



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• The QUERY-RETRIEVE-SCP AE can handle incoming query and retrieve requests. It can handle external queries for Patient, Study, and Series data, and also handle Image retrieval requests. The QUERY-RETRIEVE-SCP AE handles retrieval requests by issuing a command to the STORAGE-SCU AE to send the requested Images to the destination specified by the Remote AE. The QUERY-RETRIEVE-SCP AE functions as an SCP for C-FIND and C-MOVE requests.

• The STORAGE-SCU AE can send Composite SOP Instances. It handles requests from the QUERY-RETRIEVE-SCP AE to transmit Images to a specific DICOM destination. The STORAGE-SCU AE functions as a C-STORE SCU.

• The STORAGE-SCP AE can receive incoming DICOM images and add them to the FUSION PACS database. It can respond to external Storage and Verification Requests as a Service Class Provider (SCP) for C-STORE and C-ECHO requests. The STORAGE-SCP AE currently only supports image type Composite SOP Instances.

• The STORAGE-SCU AE can send Composite SOP Instances when requested by a local user from the FUSION PACS Web GUI or based on routing rules configured on the system. The STORAGE-SCU AE can transfer DICOM images to another DICOM Application Entity for permanent storage. FUSION PACS will maintain a record of the DICOM images transferred in this method.

• The FIND-SCU AE queries remote DICOM AEs for study and series information. The FIND-SCU AE can be configured to import study and series information into the FUSION PACS database.

• The MOVE-SCU AE will retrieve DICOM Images when requested by a user or when automatically triggered by a C-MOVE request for an offline study. Images are retrieved from another DICOM Application Entity that is maintaining permanent storage of the DICOM images.



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4.1.2 Functional Definition of AEs

4.1.2.1 Functional Definition of QUERY-RETRIEVE-SCP Application Entity The QUERY-RETRIEVE-SCP AE waits for another application to connect at the presentation address configured for its Application Entity Title. When another application connects, the QUERY-RETRIEVE-SCP AE expects it to be a DICOM application. QUERY-RETRIEVE-SCP AE will accept Associations with Presentation Contexts for SOP Classes of the DICOM Query-Retrieve Service Class, and Verification Service Class. It will handle query and retrieve requests on these Presentation Contexts and respond with data objects with values corresponding to the contents of the FUSION PACS database. For C-MOVE requests, the destination for the image objects is determined from the Destination AE Title contained in the C-MOVE request. When a retrieval request is received, the QUERY-RETRIEVE-SCP AE issues a command to the STORAGE-SCU AE to send the specified images to the C-MOVE Destination AE.

4.1.2.2 Functional Definition of STORAGE-SCU Application Entity The STORAGE-SCU AE can be invoked by the QUERY-RETRIEVE-SCP AE to trigger the transfer of specific images to a remote destination AE. The STORAGE-SCU AE must be correctly configured with the host and port number of any external DICOM AE’s that are to be C-MOVE retrieval destinations. The Presentation Contexts to use are determined from the headers of the DICOM files to be transferred. Some conversion of the DICOM image objects is possible if the original Presentation Context is not supported by the remote destination AE or if compression is preferred.

When configured, the STORAGE-SCU AE is also invoked to permanently store images received by FUSION PACS on another DICOM AE. FUSION PACS supports only a single remote DICOM AE in this mode. This invocation of the STORAGE-SCU AE with this method is an optional configuration and not required for normal operation of FUSION PACS.

4.1.2.3 Functional Definition of STORAGE-SCP Application Entity The STORAGE-SCP AE waits for another application to connect at the presentation address configured for its Application Entity Title. When another application connects, the STORAGE-SCP AE expects it to be a



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DICOM application. The STORAGE-SCP AE will accept Associations with Presentation Contexts for SOP Classes of the Verification and Storage Service Classes. Any images received on such Presentation Contexts will be added to the FUSION PACS database. If the QUERY-RETRIEVE-SCU AE requested the images, the FUSION PACS database will be updated to reflect that the images are now online.

4.1.2.4 Functional Definition of FIND-SCU Application Entity The FIND-SCU AE can be configured to scan the contents of a remote AE. The FIND-SCU AE will issue C-FIND messages to traverse through the contents of the remote AE. It will then import into the FUSION PACS database all of the study and series information contained on the remote AE. The DICOM Studies on the remote AE can then be retrieved by use of the MOVE-SCU Application Entity.

4.1.2.5 Functional Definition of MOVE-SCU Application Entity The MOVE-SCU AE is utilized when FUSION PACS is configured to permanently store images on another DICOM AE. The MOVE-SCU AE will issue retrieve requests to a configured remote AE to transfer images to the FUSION PACS.

4.1.3 Sequencing of Real-World Activities The only sequencing constraint that exists across all the FUSION PACS Application Entities is the fact that a Composite SOP Instance must be received by the STORAGE-SCP AE or imported by the FIND-SCU AE before Query-Retrieve Requests related to this SOP Instance can be successfully handled:



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STORAGE-

SCU AE

Return Information related to SOP Instance

Peer AE Queries for Information related to SOP Instance

Peer AE Requests Retrieval of SOP Instance

Images Sent to Peer AE in Response

Peer Storage SCP AE

Peer Query-Retrieve SCU

AE

QUERY-RETRIEVE-SCP

AE

Notification of Images to be

sent to C-MOVE Destination AE in Response

STORAGE-SCP AE

Peer Storage- SCU AE

Peer AE Sends Composite SOP Instance

Figure 4.1-2 SEQUENCING CONSTRAINTS

Note that the only constraint is for the Composite SOP Instance to be received prior to the other events.



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4.2 AE SPECIFICATIONS

4.2.1 STORAGE-SCU Application Entity Specification

4.2.1.1 SOP Classes The STORAGE-SCU AE provides Standard Conformance to the following DICOM V3.0 SOP Classes:

Table 4.2-1 SOP CLASSES FOR STORAGE-SCU AE

SOP Class Name SOP Class UID SCU SCP

Verification 1.2.840.10008.1.1 Yes No

Computed Radiography Image Storage 1.2.840.10008.5.1.4.1.1.1 Yes No

CT Image Storage 1.2.840.10008.5.1.4.1.1.2 Yes No

Digital X-Ray Image Storage - For Presentation

1.2.840.10008.5.1.4.1.1.1.1 Yes No

Digital X-Ray Image Storage - For Processing

1.2.840.10008.5.1.4.1.1.1.1.1 Yes No

Digital Intra-oral- X-Ray Image Storage – For Presentation

1.2.840.10008.5.1.4.1.1.1.3 Yes No

Digital Intra-oral- X-Ray Image Storage- For Processing

1.2.840.10008.5.1.4.1.1.1.3.1 Yes No

MR Image Storage 1.2.840.10008.5.1.4.1.1.4 Yes No

Ultrasound Multi-frame Image Storage (Retired)

1.2.840.10008.5.1.4.1.1.3 Yes No

Ultrasound Multi-frame Image Storage 1.2.840.10008.5.1.4.1.1.3.1 Yes No

Ultrasound Image Storage (Retired) 1.2.840.10008.5.1.4.1.1.6 Yes No

Ultrasound Image Storage 1.2.840.10008.5.1.4.1.1.6.1 Yes No

Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7 Yes No



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Digital Mammography X-Ray Image Storage - For Presentation

1.2.840.10008.5.1.4.1.1.1.2 Yes No

Digital Mammography X-Ray Image Storage - For Processing

1.2.840.10008.5.1.4.1.1.1.2.1 Yes No

Nuclear Medicine Image Storage 1.2.840.10008.5.1.4.1.1.20 Yes No

X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.1 Yes No

X-Ray Radiofluoroscopic Image Storage 1.2.840.10008.5.1.4.1.1.12.2 Yes No

X-Ray Angiographic Bi-Plane Image Storage (Retired)

1.2.840.10008.5.1.4.1.1.12.3 Yes No

Hardcopy Grayscale Image Storage SOP Class

1.2.840.10008.5.1.1.29 Yes No

Hardcopy Color Image Storage SOP Class 1.2.840.10008.5.1.1.30 Yes No


1.2.840.10008.5.1.4.1.1.128 Yes No

RT Image Storage 1.2.840.10008.5.1.4.1.1.481.1 Yes No

VL Endoscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.1 Yes No

VL Microscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.2 Yes No

VL Slide-Coordinates Microscopic Image Storage

1.2.840.10008.5.1.4.1.1.77.1.3 Yes No

VL Photographic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.4 Yes No

By altering the configuration it is possible to support a subset of these SOP Classes.

4.2.1.2 Association Establishment Policies

4.2.1.2.1 General The STORAGE-SCU AE will form Associations when requested to do so in the following conditions:

• When requested to do so by the QUERY-RETRIEVE-SCP AE. The STORAGE-SCU AE can only request the opening of an Association.



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• When a manual request to move images is created in the FUSION PACS Web GUI.

• When an auto-routing rule has been defined that an incoming or edited image satisfies. This in turn creates a move request.

• When sending to a remote AE for permanent storage.

The DICOM standard Application Context Name for DICOM is always proposed:

Table 4.2-2 DICOM APPLICATION CONTEXT FOR STORAGE-SCU AE

Application Context Name 1.2.840.10008.3.1.1.1

4.2.1.2.2 Number of Associations The STORAGE-SCU AE has two limits on the maximum number of Associations. These limits depend on how the Associations are initiated. For Associations initiated by a C-MOVE request, one association will be created per request. The maximum number of simultaneous C-MOVE Associations is 50 for each server in a FUSION PACS cluster, thus there is a limit of 50 outgoing associations in this case. For Associations initiated by routing requests or by manual requests from the FUSION PACS Web GUI, a maximum of four simultaneous Associations are permitted for each destination AE across the servers in a FUSION PACS cluster.

If the first attempt to open an Association fails for a routing request or manual Web GUI request, the STORAGE-SCU AE will reschedule the task to attempt it again after a configurable time delay. The number of times to reattempt Association establishment is configurable.

Table 4.2-3 NUMBER OF ASSOCIATIONS AS AN ASSOCIATION INITIATOR FOR STORAGE-SCU AE

Maximum number of simultaneous Associations 1 per C-MOVE request , or 4 for each destination AE



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4.2.1.2.3 Asynchronous Nature The STORAGE-SCU AE does not support asynchronous communication (multiple outstanding transactions over a single Association). All Association requests must be completed and acknowledged before a new operation can be initiated.

Table 4.2-4 ASYNCHRONOUS NATURE AS AN SCU FOR STORAGE-SCU AE

Maximum number of outstanding asynchronous transactions 1 (Not Configurable)

4.2.1.2.4 Implementation Identifying Information All FUSION PACS AE’s use the same Implementation Class UID and Implementation Version Name. The Version Name is updated with each new release of the product software, as the different AE versions are never released independently.

Table 4.2-5 DICOM IMPLEMENTATION CLASS AND VERSION FOR STORAGE-SCU AE

Implementation Class UID 1. 2.16.840.1.113669.11.1.3

Implementation Version Name FusionPACS_1.40

4.2.1.3 Association Initiation Policy

4.2.1.3.1 Activity – Send Images Requested by an External Peer AE

4.2.1.3.1.1 Description and Sequencing of Activity The STORAGE-SCU AE will initiate a new Association when the QUERY-RETRIEVE-SCP AE invokes the STORAGE-SCU AE to transmit images. The QUERY-RETRIEVE-SCP AE will issue such a command



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whenever it receives a valid C-MOVE Request. An Association Request is sent to the specified C-MOVE Destination AE and upon successful negotiation of the required Presentation Context, the image transfer is started. In all cases, an attempt will be made to transmit all the indicated images in a single Association, but this may not always be possible. The Association will be released when all the images have been sent. If an error occurs during transmission over an open Association, then the image transfer is halted. The STORAGE-SCU AE will not attempt to independently retry the image export.

STORAGE-SCU AE

Return Patient, Study, Series, or Image Information

Peer AE Queries for Patient, Study, Series, or Image Information

Peer AE Requests Retrieval of Studies, Series, or Images

Open Association

Peer Storage SCP AE


AE

QUERY-RETRIEVE-SCP

AE



Images Sent to Peer AE in Response

Close Association

Figure 4.2-1 SEQUENCING OF ACTIVITY - SEND IMAGES REQUESTED BY AN EXTERNAL PEER AE

The following sequencing constraints illustrated in Figure 4.2-1 apply to the STORAGE-SCU AE:

1. Peer AE requests retrieval of Study or Series from QUERY-RETRIEVE-SCP AE (C-MOVE-RQ).



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2. QUERY-RETRIEVE-SCP AE signals STORAGE-SCU AE to send the Image Composite SOP Instances indicated in the C-MOVE-RQ to the C-MOVE Destination AE.

3. STORAGE-SCU AE opens a new Association with the indicated C-MOVE Destination AE.

4. STORAGE-SCU AE sends the indicated Composite SOP Instances.

5. STORAGE-SCU AE closes the Association.

6. The Verification Service is only supported as a utility function for Service staff. It is used only as a diagnostic tool.

4.2.1.3.1.2 Proposed Presentation Contexts STORAGE-SCU AE will propose Presentation Contexts as shown in the following table:

Table 4.2-6 PROPOSED PRESENTATION CONTEXTS BY THE STORAGE-SCU AE

Presentation Context Table

Abstract Syntax Transfer Syntax

Name UID Name UID

Role Ext. Neg.

DICOM Implicit VR Little Endian

1.2.840.10008.1.2

DICOM Explicit VR Little Endian

1.2.840.10008.1.2.1

DICOM Explicit VR Big Endian

1.2.840.10008.1.2.2

See Table 4.2-1 See Table 4.2-1

Merge eFilm Private Compressed Transfer Syntax

2.16.840.1.113669.0.1.1

SCU None



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JPEG Process 14 Selection Value 1 Lossless

1.2.840.10008.1.2.4.70

JPEG Process 1 Baseline

1.2.840.10008.1.2.4.50

JPEG Process 2,4 Extended

1.2.840.10008.1.2.4.51

Note: The SOP Classes and Transfer Syntaxes that the STORAGE-SCU AE proposes, as listed above, represent the default behavior. The STORAGE-SCU AE can be configured to propose a subset of these contexts. Also, the default Behavior is to propose one Presentation Context for each Abstract Syntax supported.

The presentation contexts proposed by the STORAGE-SCU can be configured to operate in a number of different ways. First, the compressed transfer syntaxes (JPEG Process 14 Selection Value 1 Lossless, JPEG Process 1 Baseline, and JPEG Process 2,4 Extended) can be disabled or enabled for specific Remote AEs.

Also, with the exception of DICOM Implicit VR Little Endian, each of the transfer syntaxes can be enabled or disabled by SOP Class. Finally, when compression is enabled for a remote AE, the STORAGE-SCU divides the transfer syntaxes between two or three separate presentation contexts. A preferred transfer syntax can be configured for each SOP Class. This transfer syntax is proposed on a dedicated presentation context. Also, two other presentation contexts are always proposed. One presentation context contains all of the enabled compressed transfer syntaxes and one contains all of the uncompressed transfer syntaxes.

The STORAGE-SCU AE will select one of the accepted presentation contexts on which to send images.

4.2.1.3.1.3 SOP Specific Conformance for Verification SOP Class The STORAGE-SCU AE does not support the Verification Service.

4.2.1.3.1.4 SOP Specific Conformance for Storage SOP Classes Composite DICOM SOP Instances are maintained as DICOM Part 10 compliant files by FUSION PACS. The entire set of tags received with the image will be saved in FUSION PACS; this includes all Private and SOP Extended Elements. When a SOP Instance is selected for export from FUSION PACS, its content will be exported as it was originally received except for a few possible exceptions.



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Some of the Patient demographic and Study information elements may have been altered due to edits administered on FUSION PACS. FUSION PACS also removes overlays embedded in the image pixel data, and moves them to the group 0x60xx elements that describe the overlay. Finally, FUSION PACS also modifies images encoded as PALETTE COLOR or RGB images whose pixel data is planar. These images are modified and encoded as non-planar RGB images. The state of the image data due to compression can be altered when the SOP Instance is exported.

The FUSION PACS creates files called Service Logs that can be used to monitor Services’ status and diagnose any problems that may arise. If any error occurs during DICOM communication, appropriate messages are always output to these Service Logs.

The STORAGE-SCU AE will exhibit the following Behavior according to the Status Code value returned in a C-STORE Response from a destination C-STORE SCP:

Table 4.2-7 STORAGE-SCU AE C-STORE RESPONSE STATUS HANDLING BEHAVIOR

Service Status

Further Meaning Error Code Behavior

Success Success 0000 The SCP has successfully stored the exported SOP Instance. A message is sent to the QUERY-RETRIEVE-SCP AE indicating successful export. The QUERY-RETRIEVE-SCP AE will send the appropriate PENDING or SUCCESS Status in the C-MOVE Response.

Success indication message is output to the Service Logs.

No message is posted to the User Interface.

Warning Coercion of Data Elements

B000 Image transmission is considered successful. A message is sent to the QUERY-RETRIEVE-SCP AE indicating successful export. The QUERY-RETRIEVE-SCP AE will send the appropriate PENDING or SUCCESS Status in the C-MOVE Response.

Warning indication message is output to the Service Logs.


Warning Data Set does not match SOP Class




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Warning Elements Discarded




* * Any other status code.

This is treated as a permanent Failure. A message is sent to the QUERY-RETRIEVE-SCP AE indicating an export failure and that the Association is released. The QUERY-RETRIEVE-SCP AE will send an appropriate Status in the C-MOVE Response.

Error indication message is output to the Service Logs.


All Status Codes indicating an error or refusal are treated as a permanent failure. For Associations initiated by the QUERY-RETRIEVE-SCP, the STORAGE-SCU AE never automatically resends images when an error Status Code is returned in a C-STORE response. For specific behavior regarding Status Code values returned in C-MOVE Responses, refer to the Services Supported as an SCP by the QUERY-RETRIEVE-SCP AE.

Table 4.2-8 STORAGE-SCU AE COMMUNICATION FAILURE BEHAVIOR

Exception Behavior

Timeout expiry for an expected DICOM Message Response (DIMSE level timeout).

The Association is aborted using a DICOM A-ABORT and a message is sent to the QUERY-RETRIEVE-SCP AE indicating an export failure. The QUERY-RETRIEVE-SCP AE will send a failure Status in the C-MOVE Response.





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Timeout expiry for an expected DICOM PDU or TCP/IP packet (Low-level timeout).

The Association is aborted using a DICOM A-ABORT and a message is sent to the QUERY-RETRIEVE-SCP AE indicating an export failure. The QUERY-RETRIEVE-SCP AE will send a failure Status in the C-MOVE Response.



Association A-ABORTed by the SCP or the network layers indicate communication loss (i.e., low-level TCP/IP socket closure)

A message is sent to the QUERY-RETRIEVE-SCP AE indicating an export failure. The QUERY-RETRIEVE-SCP AE will send a failure Status in the C-MOVE Response.



4.2.1.3.2 Activity – Send Images for Permanent Storage, Routing Request, or GUI Request

4.2.1.3.2.1 Description and Sequencing of Activity The STORAGE-SCU AE will initiate a new Association when invoked by a user request in the FUSION PACS Web GUI, when fulfilling a routing request, or when configured to transfer to a remote DICOM AE for permanent storage. An Association Request is sent to the specified Destination AE and upon successful negotiation of the required Presentation Context, the image transfer is started. In all cases, an attempt will be made to transmit all the indicated images in a single Association, but this may not always be possible. The Association may be left open after all images are sent in case additional Send Image requests are made. If an error occurs during transmission over an open Association, then the image transfer is halted. In most cases, the STORAGE-SCU AE will retry the image export a configurable number of times. Some internal errors to the STORAGE-SCU result in the transfer failing without a retry.



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STORAGE-SCU AE

Open Association

Peer StorageSCP AE

Request is madeto transfer

Images to PeerStorage SCP AE

Images Sent to Peer AE

Close Association

Figure 4.2-2 SEQUENCING OF ACTIVITY - SEND IMAGES REQUESTED BY AN EXTERNAL PEER AE

The following sequencing constraints illustrated in Figure 4.2-2 apply to the STORAGE-SCU AE:

1. A request is made to transfer images to a Peer AE

2. The FUSION PACS database signals STORAGE-SCU AE to send the image Composite SOP Instances to the Destination AE.

3. STORAGE-SCU AE opens a new Association with the indicated Destination AE.

4. STORAGE-SCU AE sends the indicated Composite SOP Instances.

5. STORAGE-SCU AE closes the Association.

4.2.1.3.2.2 Proposed Presentation Contexts STORAGE-SCU AE will propose Presentation Contexts as shown in Table 4.2-6.



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4.2.1.3.2.3 SOP Specific Conformance for Verification SOP Class The STORAGE-SCU AE does not support the Verification Service.

4.2.1.3.2.4 SOP Specific Conformance for Image SOP Classes Composite DICOM SOP Instances are maintained as DICOM Part 10 compliant files by FUSION PACS. The entire set of tags received with the image will be saved in FUSION PACS; this includes all Private and SOP Extended Elements. When a SOP Instance is selected for export from FUSION PACS, its content will be exported as it was originally received except for a few possible exceptions.

Some of the Patient demographic and Study information elements may have been altered due to changes administered on FUSION PACS. FUSION PACS also removes overlays embedded in the image pixel data, and moves them to the group 0x60xx elements that describe the overlay. Finally, FUSION PACS also modifies images encoded as PALETTE COLOR or RGB images whose pixel data is planar. These images are modified and encoded as non-planar RGB images. The state of the image data due to compression can be altered when the SOP Instance is exported.

The FUSION PACS creates files called Service Logs that can be used to monitor Services’ status and diagnose any problems that may arise. If any error occurs during DICOM communication, appropriate messages are always output to these Service Logs.

See Table 4.2-7 for details on the behavior STORAGE-SCU will exhibit according to the Status Code value returned in a C-STORE Response from a destination C-STORE SCP. For ad-hoc Associations from the Web GUI or for routing requests, the STORAGE-SCU AE will retry sending of images when receiving any failure status code.

See Table 4.2-8 for details on STORAGE-SCU AE communication failures.

4.2.1.4 Association Acceptance Policy The STORAGE-SCU AE does not accept Associations.

4.2.2 QUERY-RETRIEVE-SCP Application Entity Specification

4.2.2.1 SOP Classes The QUERY-RETRIEVE-SCP AE provides Standard Conformance to the following DICOM V3.0 SOP Classes:



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Table 4.2-9 SOP CLASSES FOR QUERY-RETRIEVE-SCP AE


Patient Root Query/Retrieve Information Model - FIND

1.2.840.10008.5.1.4.1.2.1.1 No Yes

Patient Root Query/Retrieve Information Model - MOVE

1.2.840.10008.5.1.4.1.2.1.2 No Yes

Study Root Query/Retrieve Information Model - FIND

1.2.840.10008.5.1.4.1.2.2.1 No Yes


1.2.840.10008.5.1.4.1.2.2.2 No Yes

Note that support for Image Level attributes in the FUSION PACS database is not supported. Image Level queries are not supported for these SOP Classes.

4.2.2.2 Association Policies

4.2.2.2.1 General The QUERY-RETRIEVE-SCP AE will never initiate Associations. It only accepts Association Requests from external DICOM AEs. The QUERY-RETRIEVE-SCP AE will accept Associations for Verification, C-FIND, and C-MOVE requests. In the case of a C-MOVE request, the QUERY-RETRIEVE-SCP AE will issue a command to the STORAGE-SCU AE to initiate an Association with the Destination DICOM AE to send images as specified by the originator of the C-MOVE Request.

The DICOM standard Application Context Name for DICOM 3.0 is always accepted:

Table 4.2-10 DICOM APPLICATION CONTEXT FOR QUERY-RETRIEVE-SCP AE




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4.2.2.2.2 Number of Associations The QUERY-RETRIEVE-SCP AE can support multiple simultaneous Associations. Each time the QUERY-RETRIEVE-SCP AE receives an Association, a child thread will be created to process the Verification, Query, or Retrieval request. The maximum number of child threads, and thus the maximum number of simultaneous Associations that can be processed, is set to 50 Associations for each server in a FUSION PACS cluster.

Table 4.2-11 NUMBER OF SIMULTANEOUS ASSOCIATIONS AS AN ASSOCIATION ACCEPTOR FOR QUERY-RETRIEVE-SCP AE

Maximum number of simultaneous Associations 50 per FUSION PACS server

4.2.2.2.3 Asynchronous Nature The QUERY-RETRIEVE-SCP AE does not support asynchronous communication (multiple outstanding transactions over a single Association). All Association requests must be completed and acknowledged before a new operation can be initiated.

Table 4.2-12 ASYNCHRONOUS NATURE AS A SCP FOR QUERY-RETRIEVE-SCP AE


4.2.2.2.4 Implementation Identifying Information The implementation information for the Application Entity is:

Table 4.2-13 DICOM IMPLEMENTATION CLASS AND VERSION FOR QUERY-RETRIEVE-SCP AE





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All FUSION PACS AE’s use the same Implementation Class UID and Implementation Version Name. The Version Name is updated with each new release of the product software, as the different AE versions are never released independently.

4.2.2.3 Association Initiation Policy The QUERY-RETRIEVE-SCP AE does not initiate Associations.

4.2.2.4 Association Acceptance Policy

4.2.2.4.1 Activity – Handling Query and Retrieval Requests

4.2.2.4.1.1 Description and Sequencing of Activity The QUERY-RETRIEVE-SCP AE accepts Associations only if they have valid Presentation Contexts. If none of the requested Presentation Contexts are accepted, then the Association Request itself is rejected. It can be configured to only accept Associations with certain Application Entity Titles.

If QUERY-RETRIEVE-SCP AE receives a query (C-FIND) request, then the response(s) will be sent over the same Association used to send the C-FIND-Request.

If QUERY-RETRIEVE-SCP AE receives a retrieval (C-MOVE) request, then the responses will be sent over the same Association used to send the C-MOVE-Request. The QUERY-RETRIEVE-SCP AE will notify the STORAGE-SCU to send the requested SOP Instances to the C-MOVE Destination. The STORAGE-SCU AE notifies the QUERY-RETRIEVE-SCP AE of the success or failure of each attempt to send a Composite SOP Instance to the peer C-MOVE Destination AE. The QUERY-RETRIEVE-SCP AE then sends a C-MOVE Response indicating this status after each attempt. Once the STORAGE-SCU AE has finished attempting to transfer all of the requested SOP Instances, the QUERY-RETRIEVE-SCP AE sends a final C-MOVE Response indicating the overall status of the attempted retrieval.



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STORAGE-SCU AE

Return Patient, Study, Series, or Image Information

Peer AE Queries for Patient, Study, Series, or Image Information

Peer AE Requests Retrieval of Studies, Series, or Images

Open Association

Peer C-MOVE Destination AE


AE

QUERY-RETRIEVE-SCP

AE



Image Sent to C-MOVE Destination

Close Association

C-MOVE-RSP sent for each Image Sent

Open Association

Close Association

Repeat …

Open Association

Close Association

Final C-MOVE-RSP sent

Notification of success or failure for

each attempt

Figure 4.2-3 SEQUENCING OF ACTIVITY – HANDLING QUERY AND RETRIEVAL REQUESTS

The following sequencing constraints illustrated in Figure 4.2-2 apply to the QUERY-RETRIEVE-SCP AE for handling queries (C-FIND-Requests):



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1. Peer AE opens an Association with the QUERY-RETRIEVE-SCP AE.

2. Peer AE sends a C-FIND-RQ Message

3. QUERY-RETRIEVE-SCP AE returns a C-FIND-RSP Message to the peer AE with matching information. A C-FIND-RSP is sent for each entity matching the identifier specified in the C-FIND-RQ. A final C-FIND-RSP is sent indicating that the matching is complete.

4. Peer AE closes the Association. Note that the peer AE does not have to close the Association immediately. Further C-FIND or C-MOVE Requests can be sent over the Association before it is closed.

The following sequencing constraints illustrated in Figure 4.2-3 apply to the QUERY-RETRIEVE-SCP AE for handling retrievals (C-MOVE-Requests):

1. Peer AE opens an Association with the QUERY-RETRIEVE-SCP AE.

2. Peer AE sends a C-MOVE-RQ Message

3. QUERY-RETRIEVE-SCP AE notifies the STORAGE-SCU AE to send the Composite SOP Instances to the peer C-MOVE Destination AE as indicated in the C-MOVE-RQ.

4. After attempting to send a SOP Instance, the STORAGE-SCU AE indicates to the QUERY-RETRIEVE-SCP AE whether the transfer succeeded or failed. The QUERY-RETRIEVE-SCP AE then returns a C-MOVE-RSP indicating this success or failure.

5. Once the STORAGE-SCU AE has completed all attempts to transfer the SOP Instances to the C-MOVE Destination AE, or the first failure occurred, the QUERY-RETRIEVE-SCP AE sends a final C-MOVE-RSP indicating the overall success or failure of the retrieval.

6. Peer AE closes the Association. Note that the peer AE does not have to close the Association immediately. Further C-FIND or C-MOVE Requests can be sent over the Association before it is closed.



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The QUERY-RETRIEVE-SCP AE may reject Association attempts as shown in the table below. The Result, Source and Reason/Diag columns represent the values returned in the corresponding fields of an ASSOCIATE-RJ PDU (see PS 3.8, Section 9.3.4). The following abbreviations are used in the Source column:

a. 1 – DICOM UL service-user b. 2 – DICOM UL service-provider (ASCE related function) c. 3 – DICOM UL service-provider (Presentation related function)

Table 4.2-14 ASSOCIATION REJECTION REASONS

Result Source Reason/Diag Explanation

2 – rejected-transient C 2 – local-limit-exceeded The maximum number of simultaneous Associations has been reached. An Association request with the same parameters may succeed at a later time.

1 – rejected-permanent

B 7 – called-AE-title-not-recognized The Association request contained an unrecognized Called AE Title. An Association request with the same parameters will not succeed at a later time unless configuration changes are made. This rejection reason normally occurs when the Association initiator is incorrectly configured and attempts to address the Association acceptor using the wrong AE Title.


A 3 – calling-AE-title-not-recognized The Association request contained an unrecognized Calling AE Title. An Association request with the same



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parameters will not succeed at a later time unless configuration changes are made. This rejection reason normally occurs when the Association acceptor has not been configured to recognize the AE Title of the Association initiator.


B 1 – no-reason-given The Association request could not be parsed. An Association request with the same format will not succeed at a later time.

4.2.2.4.1.2 Accepted Presentation Contexts QUERY-RETRIEVE-SCP AE will accept Presentation Contexts as shown in the following table:

Table 4.2-15 ACCEPTED PRESENTATION CONTEXTS BY THE QUERY-RETRIEVE-SCP AE



Name UID Name UID

Role Ext. Neg.

Verification 1.2.840.10008.1.1 DICOM Implicit VR Little Endian 1.2.840.10008.1.2 SCP None

DICOM Implicit VR Little Endian 1.2.840.10008.1.2 SCP None

DICOM Explicit VR Little Endian 1.2.840.10008.1.2.1 SCP None

Patient Root Q/R Information Model - FIND

1.2.840.10008.5.1.4.1.2.1.1

DICOM Explicit VR Big Endian 1.2.840.10008.1.2.2 SCP None



Patient Root Q/R Information Model - MOVE

1.2.840.10008.5.1.4.1.2.1.2


Study Root Q/R 1.2.840.10008.5.1.4.1.2.2.1 DICOM Implicit VR Little Endian 1.2.840.10008.1.2 SCP None



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DICOM Explicit VR Little Endian 1.2.840.10008.1.2.1 SCP None Information Model - FIND




Study Root Q/R Information Model – MOVE

1.2.840.10008.5.1.4.1.2.2.2


The default Behavior of the QUERY-RETRIEVE-SCP AE supports the Implicit VR Little Endian, Explicit VR Little Endian, and Explicit VR Big Endian Transfer Syntaxes for all Associations.

The QUERY-RETRIEVE-SCP AE can be configured to accept a subset of these Transfer Syntaxes, with the inclusion of Implicit VR Little Endian being mandatory.

If multiple Transfer Syntaxes are proposed per Presentation Context, then only the most preferable Transfer Syntax is accepted. The order of Transfer Syntax preference for the QUERY-RETRIEVE-SCP AE is configurable. The default preference order if multiple Transfer Syntaxes are proposed in a single Presentation Context is: Explicit VR Little Endian, Explicit VR Big Endian, Implicit VR Little Endian (if all these are proposed for a single Presentation Context). This means that if the Implicit VR Little Endian and Explicit VR Little Endian Transfer Syntaxes are proposed in a single Presentation Context, then the accepted Transfer Syntax will be Explicit VR Little Endian. This order of preference is configurable.

These are the default SOP Classes supported. By altering the configuration, it is possible to support a subset of these SOP Classes.

4.2.2.4.1.3 SOP Specific Conformance for Query SOP Classes The QUERY-RETRIEVE-SCP AE supports hierarchical queries and not relational queries. Several attributes are returned by default. These are Instance Availability (0008,0056) and Retrieve AE Title (0008,0054). Retrieve AE Title is returned in all C-FIND-RSP messages and is set to the QUERY-RETRIEVE-SCP AE Title. Instance Availability is returned in all Study and Series Level C-FIND Response messages. (Instance Availability is not returned in Patient Level queries.) Instance Availability is set to “ONLINE” or “NEARLINE”, depending on whether the requested data is stored locally on a cache or is stored on a long-term archive. The long-term archive may be another DICOM AE where images are stored permanently, or it may be tape or optical media device connected to FUSION PACS.



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Query responses always return values from the FUSION PACS database. Exported SOP Instances are always updated with the latest values in the database prior to export. Thus, a change in Patient demographic information will be contained in both the C-FIND Responses and any Composite SOP Instances exported to a C-MOVE Destination AE.

Patient Root Information Model

All required search keys on the Patient, Study and Series levels are supported. Image level keys are not supported.

Study Root Information Model

All the required search keys on the Study and Series levels are supported. Image level keys are not supported.

Table 4.2-16 PATIENT ROOT C-FIND SCP SUPPORTED ELEMENTS

Level Name

Attribute Name

Tag VR Types of Matching

Patient Level

Patient's Name 0010,0010 PN S,*,U

Patient ID 0010,0020 LO S,*,U

Patient's Birth Date 0010,0030 DA S,R,U

Patient’s Birth Time 0010,0032 TM S,R,U

Patient's Sex 0010,0040 CS S,U

Other Patient Ids 0010,1000 LO NONE

Other Patient Names 0010,1001 PN NONE

Patient Comments 0010,4000 LT S,*,U

Number of Patient Related Studies 0020,1200 IS NONE

Number of Patient Related Series 0020,1202 IS NONE

Number of Patient Related Instances 0020,1204 IS NONE

Study Level

Study Date 0008,0020 DA S,R,U



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Study Time 0008,0030 TM R,U

Accession Number 0008,0050 SH S,*,U

Study ID 0020,0010 SH S,*,U

Study Instance UID 0020,000D UI S,U

Modalities in Study 0008,0061 CS S, U

Referring Physician's Name 0008,0090 PN S,*,U

Study Description 0008,1030 LO S,*,U

Name of Physicians Reading Study 0008,1060 PN S,*,U

Admitting Diagnosis Description 0008,1080 LO S,*,U

Patient’s Age 0010,1010 LO S,*,U

Patient’s Size 0010,1020 LO NONE

Patient’s Weight 0010,1030 DS NONE

Occupation 0010,2180 SH S,*,U

Additional Patient History 0010,21B0 LT S,*,U

Other Study Numbers 0020,1070 IS NONE

Number of Study Related Series 0020,1206 IS NONE

Number of Study Related Instances 0020,1208 IS NONE

Interpretation Author 4008,010C PN S,*,U

Institution Name 0008,0080 LO S,*,U

Institutional Department Name 0008,1040 LO S,*,U

Series Level

Modality 0008,0060 CS S,U

Series Number 0020,0011 IS S,*,U

Series Instance UID 0020,000E UI S,U

Series Description 0008,103E LO S,*,U

Body Part Examined 0018,0015 CS S,*,U

Number of Series Related Instances 0020,1209 IS NONE

Protocol Name 0018,1030 LO S,*,U



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View Position 0018,5101 CS S,*,U

Laterality 0020,0060 CS S,*,U

Patient Position 0018,5100 CS S,*,U

Image Level

No Image Level Attributes are supported

Note: Institutional Department Name and Institution Name are DICOM Series level tags. The QUERY-RETRIEVE-SCP AE will respond to Study level queries for these tags with the last value received from this tag from the last image processed for the study.

Table 4.2-17 STUDY ROOT C-FIND SCP SUPPORTED ELEMENTS

Level Name

Attribute Name

Tag VR Types of Matching

Study Level

Patient's Name 0010,0010 PN S,*,U

Patient ID 0010,0020 LO S,*,U

Patient's Birth Date 0010,0030 DA S,R

Patient’s Birth Time 0010,0032 TM S,R

Patient's Sex 0010,0040 CS S,U

Other Patient Ids 0010,1000 LO NONE

Other Patient Names 0010,1001 PN NONE

Patient Comments 0010,4000 LT S,*,U

Number of Patient Related Studies 0020,1200 IS NONE

Number of Patient Related Series 0020,1202 IS NONE

Number of Patient Related Instances 0020,1204 IS NONE

Study Date 0008,0020 DA S,R,U

Study Time 0008,0030 TM R,U



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Accession Number 0008,0050 SH S,*,U

Study ID 0020,0010 SH S,*,U

Study Instance UID 0020,000D UI S,U

Modalities in Study 0008,0061 CS S, U

Referring Physician's Name 0008,0090 PN S,*,U

Study Description 0008,1030 LO S,*,U

Name of Physicians Reading Study 0008,1060 PN S,*,U

Admitting Diagnosis Description 0008,1080 LO S,*,U

Patient’s Age 0010,1010 AS S,*,U

Patient’s Size 0010,1020 DS NONE

Patient’s Weight 0010,1030 DS NONE

Occupation 0010,2180 SH S,*,U

Additional Patient History 0010,21B0 LT S,*,U

Other Study Numbers 0020,1070 IS NONE

Number of Study Related Series 0020,1206 IS NONE

Number of Study Related Instances 0020,1208 IS NONE

Interpretation Author 4008,010C PN S,*,U

Institution Name 0008,0080 LO S,*,U

Institutional Department Name 0008,1040 LO S,*,U

Series Level

Modality 0008,0060 CS S,U

Series Number 0020,0011 IS S,*,U

Series Instance UID 0020,000E UI S,U

Series Description 0008,103E LO S,*,U

Body Part Examined 0018,0015 CS S,*,U

Number of Series Related Instances 0020,1209 IS NONE

Protocol Name 0018,1030 LO S,*,U

View Position 0018,5101 CS S,*,U



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Laterality 0020,0060 CS S,*,U

Patient Position 0018,5100 CS S,*,U

Image Level

No Image Level Attributes are supported

Note: Institutional Department Name and Institution Name are DICOM Series level tags. The QUERY-RETRIEVE-SCP AE will respond to Study level queries for these tags with the last value received from this tag from the last image processed for the study.

The tables should be read as follows:

Attribute Name: Attributes supported for returned C-FIND Responses.

Tag: Appropriate DICOM tag for this attribute.

VR: Appropriate DICOM VR for this attribute.

Types of Matching: The types of Matching supported by the C-FIND SCP. An ‘S’ indicates the identifier attribute can specify Single Value Matching, an ‘R’ will indicate Range Matching, a ‘*’ will denote wildcard matching, a ‘U’ will indicate universal matching, and an ‘L’ will indicate that UID lists are supported for matching. ‘NONE’ indicates that no matching is supported, but that values for this Element in the database can be returned.

Table 4.2-18 QUERY-RETRIEVE-SCP AE C-FIND RESPONSE STATUS RETURN BEHAVIOR

Service Status

Further Meaning Error Code Behavior

Success Success 0000 Matching is complete. No final identifier is supplied.

Refused Out of Resources

A700 System reached the limit in disk space or memory usage.

Error message is output as an alert to the User Interface, and to the Service Log.



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Identifier does not match SOP Class

A900 The C-FIND query identifier contains invalid Elements or values, or is missing mandatory Elements or values for the specified SOP Class.

Error message is output to the Service Log.

Failed

Unable to process

C001 The C-FIND query identifier is valid for the specified SOP Class but cannot be used to query the database. For example, this can occur if the QUERY-RETRIEVE-SCP AE cannot query the database. It also will be sent if an Image Level query is attempted against the QUERY-RETRIEVE-SCP.


Cancel Matching terminated due to Cancel Request

FE00 The C-FIND SCU sent a Cancel Request. This has been acknowledged and the search for matches has been halted. This is also returned if a maximum number of responses is configured and that number of responses has been reached.

Pending Matches are continuing and current match is supplied.

FF00 Indicates that the search for further matches is continuing. This is returned when each successful match is returned and when further matches are forthcoming. This status code is returned if all Optional keys in the query identifier are actually supported.

4.2.2.4.1.4 SOP Specific Conformance for Retrieval SOP Classes The QUERY-RETRIEVE-SCP AE will convey to the STORAGE-SCU AE that an Association with a DICOM Application Entity named by the external C-MOVE SCU (through a MOVE Destination AE Title) should be established. It will also convey to the STORAGE-SCU AE to perform C-STORE operations on specific images requested by the external C-MOVE SCU. One or more of the Image Storage Presentation Contexts listed in table 4.2-9 will be negotiated.

The QUERY-RETRIEVE-SCP AE does not support lists of UIDs in the C-MOVE Request at the Study and Series Levels.

An initial C-MOVE Response is always sent after confirming that the C-MOVE Request itself can be processed. After this, the QUERY-RETRIEVE-SCP AE will return a response to the C-MOVE SCU after the STORAGE-SCU AE has attempted to send a series of images. This response reports the number of remaining SOP Instances to transfer, and the number transferred having a successful, failed, or warning



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status. If the Composite SOP Instances must be retrieved from long-term archive prior to export, there may be quite a long delay between the first C-MOVE Response and the next one after the attempt to export the first image. The maximum length of time for this delay will depend on the particular type of archive used but typically varies between 3 and 10 minutes.

The QUERY-RETRIEVE-SCP AE has a special mode of operation if the MOVE Destination AE Title is set to “FUSION_PREFETCH”. In this case, the QUERY-RETRIEVE-SCP AE will not convey to the STORAGE-SCU AE to perform C-STORE operations. Instead, it will check if the requested images have to be retrieved from long-term archive. The QUERY-RETRIEVE-SCP AE will queue a restore of the Images from long-term archive, and respond with a status of success to the remote AE. The Images will not be transferred to a remote AE.

Table 4.2-19 QUERY-RETRIEVE-SCP AE C-MOVE RESPONSE STATUS RETURN BEHAVIOR

Service Status Further Meaning Error Code Behavior

Success Sub-operations complete – No Failures

0000 All of the Composite SOP Instances have been successfully sent to the C-MOVE Destination AE.

Warning One or more failures

B000 One or more failures were returned in the C-STORE-RSP message when transferring the Composite SOP Instances to the C-MOVE Destination AE.

Out of Resources – Unable to calculate number of matches

A701 Number of matches cannot be determined due to system failure. Returned if the server’s database is not functioning. Thus, the search for matches to the C-MOVE Request cannot be satisfied.


Out of Resources – Unable to perform sub-operations

A702 C-STORE sub-operations cannot be performed due to failure to access Composite SOP Instances in archive, or failure of a C-STORE Request.


Refused

Move destination unknown

A801 The Destination Application Entity named in the C-MOVE Request is unknown to Query-Retrieve SCP AE.




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Failed Identifier does not match SOP Class

A900 The C-MOVE identifier contains invalid Elements or values, or is missing mandatory Elements or values for the specified SOP Class or retrieval level.


Cancel Matching terminated due to Cancel Request

FE00 The C-MOVE SCU sent a Cancel Request. This has been acknowledged and the export of Composite SOP Instances to the C-MOVE Destination AE has been halted.

Pending Sub-operations are continuing

FF00 A Response with this Status Code is sent every time a Composite SOP Instance has been successfully sent to the C-MOVE Destination AE.

Table 4.2-20 QUERY-RETRIEVE-SCP AE COMMUNICATION FAILURE BEHAVIOR

Exception Behavior

Timeout expiry for an expected DICOM Message Request (DIMSE level timeout), i.e., the QUERY-RETRIEVE-SCP AE is waiting for the next C-FIND or C-MOVE Request on an open Association, but the timer expires.

The Association is aborted by issuing a DICOM A-ABORT.

Timeout expiry for an expected DICOM PDU or TCP/IP packet (Low-level timeout), i.e., the QUERY-RETRIEVE-SCP AE is waiting for the next message PDU, but the timer expires.


Association aborted by the SCU or the network layers indicate communication loss (i.e., low-level TCP/IP socket closure).




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4.2.3 STORAGE-SCP Application Entity Specification

4.2.3.1 SOP Classes The STORAGE-SCP AE provides Standard Conformance to the following DICOM V3.0 SOP Classes:

Table 4.2-21 SOP CLASSES FOR STORAGE-SCP AE


Verification 1.2.840.10008.1.1 No Yes

Computed Radiography Image Storage 1.2.840.10008.5.1.4.1.1.1 No Yes

CT Image Storage 1.2.840.10008.5.1.4.1.1.2 No Yes

Digital X-Ray Image Storage - For Presentation 1.2.840.10008.5.1.4.1.1.1.1 No Yes

Digital X–Ray Image Storage - For Processing 1.2.840.10008.5.1.4.1.1.1.1.1 No Yes

Digital Intra-oral X-Ray Image Storage –For Presentation

1.2.840.10008.5.1.4.1.1.1.3 No Yes

Digital Intra-oral X-Ray Image Storage – For Processing

1.2.840.10008.5.1.4.1.1.1.3.1 No Yes

MR Image Storage 1.2.840.10008.5.1.4.1.1.4 No Yes

Ultrasound Multi-frame Image Storage (Retired) 1.2.840.10008.5.1.4.1.1.3 No Yes

Ultrasound Multi-frame Image Storage 1.2.840.10008.5.1.4.1.1.3.1 No Yes

Ultrasound Image Storage (Retired) 1.2.840.10008.5.1.4.1.1.6 No Yes

Ultrasound Image Storage 1.2.840.10008.5.1.4.1.1.6.1 No Yes

Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7 No Yes


1.2.840.10008.5.1.4.1.1.1.2 No Yes

Digital Mammography X-Ray Image Storage - For Processing

1.2.840.10008.5.1.4.1.1.1.2.1 No Yes

Nuclear Medicine Image Storage 1.2.840.10008.5.1.4.1.1.20 No Yes

X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.1 No Yes



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X-Ray Radiofluoroscopic Image Storage 1.2.840.10008.5.1.4.1.1.12.2 No Yes

X-Ray Radiofluoroscopic Bi-Plane Image Storage (Retired)

1.2.840.10008.5.1.4.1.1.12.3 No Yes

Hardcopy Grayscale Image Storage SOP Class 1.2.840.10008.5.1.1.29 No Yes

Hardcopy Color Image Storage SOP Class 1.2.840.10008.5.1.1.30 No Yes

Positron Emission Tomography Image Storage 1.2.840.10008.5.1.4.1.1.128 No Yes

RT Image Storage 1.2.840.10008.5.1.4.1.1.481.1 No Yes

VL Endoscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.1 No Yes

VL Microscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.2 No Yes

VL Slide-Coordinates Microscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.3 No Yes

VL Photographic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.4 No Yes

These are the default SOP Classes supported. By altering the configuration, it is possible to support a subset of these SOP Classes.

4.2.3.2 Association Policies

4.2.3.2.1 General The STORAGE-SCP AE can only accept Association Requests. The STORAGE-SCP AE will accept Association Requests for the Verification and Storage Services.

The DICOM standard Application Context Name for DICOM 3.0 is always accepted and proposed:

Table 4.2-22 DICOM APPLICATION CONTEXT FOR STORAGE-SCP AE


4.2.3.2.2 Number of Associations The STORAGE-SCP AE can support multiple simultaneous Associations. Each time the STORAGE-SCP AE receives an Association, a child thread will be created to process the Verification or Storage request.



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The maximum number of child threads, and thus the maximum number of simultaneous Associations that can be processed, is set to 50 Associations for each server in a FUSION PACS cluster.

Table 4.2-23 NUMBER OF SIMULTANEOUS ASSOCIATIONS AS AN SCP FOR STORAGE-SCP AE

Maximum number of simultaneous Associations requested by peer AEs 50 per FUSION PACS server (Not Configurable)

4.2.3.2.3 Asynchronous Nature The STORAGE-SCP AE does not support asynchronous communication (multiple outstanding transactions over a single Association).

Table 4.2-24 ASYNCHRONOUS NATURE AS AN ASSOCIATION ACCEPTOR FOR STORAGE-SCP AE


4.2.3.2.4 Implementation Identifying Information The implementation information for this Application Entity is:

Table 4.2-25 DICOM IMPLEMENTATION CLASS AND VERSION FOR STORAGE-SCP AE



All FUSION PACS AE’s use the same Implementation Class UID and Implementation Version Name. The Version Name is updated with each new release of the product software, as the different AE versions are never released independently.

4.2.3.3 Association Initiation Policy The STORAGE-SCP AE does not initiate any Associations.



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4.2.3.4 Association Acceptance Policy

4.2.3.4.1 Activity – Receive Images

4.2.3.4.1.1 Description and Sequencing of Activity The STORAGE-SCP AE accepts Associations only if they have valid Presentation Contexts. If none of the requested Presentation Contexts are accepted, then the Association Request itself is rejected. It can be configured to only accept Associations with certain hosts using TCP/IP address and Application Entity Titles.

Peer StorageSCU AE

STORAGE-SCPAE

Peer AE Opens Association

Peer AE sends Composite SOP Instances

Peer AE Closes Association

Figure 4.2-4 SEQUENCING OF ACTIVITY – RECEIVE IMAGES

The following sequencing constraints illustrated in Figure 4.2-4 apply to the STORAGE-SCP AE for handling Storage Requests over the original Association:

1. Peer AE opens an Association with the STORAGE-SCP AE.

2. Peer AE sends zero or more Composite SOP Instances.



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3. Peer AE closes the Association.

The STORAGE-SCP AE has a configurable timeout value for the maximum amount of time that it will wait on an open Association for a new request from a peer AE.

The STORAGE-SCP AE may reject Association attempts as shown in the Table below. The Result, Source and Reason/Diag columns represent the values returned in the corresponding fields of an ASSOCIATE-RJ PDU (see PS 3.8, Section 9.3.4). The following abbreviations are used in the Source column:

a. 1 – DICOM UL service-user b. 2 – DICOM UL service-provider (ASCE related function)

c. 3 – DICOM UL service-provider (Presentation related function)

Table 4.2-26 ASSOCIATION REJECTION REASONS

Result Source Reason/Diag Explanation

2 – rejected-transient c 2 – local-limit-exceeded The maximum number of simultaneous Associations has been reached. An Association request with the same parameters may succeed at a later time.


b 7 – called-AE-title-not-recognized The Association request contained an unrecognized Called AE Title. An Association request with the same parameters will not succeed at a later time unless configuration changes are made. This rejection reason normally occurs when the Association initiator is incorrectly configured and attempts to address the Association acceptor using the wrong AE Title.



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a 3 – calling-AE-title-not-recognized The Association request contained an unrecognized Calling AE Title. An Association request with the same parameters will not succeed at a later time unless configuration changes are made. This rejection reason normally occurs when the Association acceptor has not been configured to recognize the AE Title of the Association initiator.


b 1 – no-reason-given The Association request could not be parsed. An Association request with the same format will not succeed at a later time.

4.2.3.4.1.2 Accepted Presentation Contexts The default Behavior of the STORAGE-SCP AE supports the JPEG Process 14 Selection Value 1 Lossless, JPEG Process 1 Baseline, JPEG Process 2,4 Extended, Implicit VR Little Endian, Explicit VR Little Endian, and Explicit VR Big Endian Transfer Syntaxes for all Associations. In addition, a private Merge eFilm transfer syntax is supported for all Associations.

The STORAGE-SCP AE can be configured to accept a subset of these Transfer Syntaxes, with the inclusion of Implicit VR Little Endian being mandatory.

If multiple Transfer Syntaxes are proposed per Presentation Context, then only the most preferable Transfer Syntax is accepted. The order of Transfer Syntax preference for the STORAGE-SCP AE is configurable. The default preference order if multiple Transfer Syntaxes are proposed in a single Presentation Context is: Merge eFilm Private Compressed, JPEG Process 14 Selection Value 1 Lossless, JPEG Process 1 Baseline, JPEG Process 2,4 Extended, Explicit VR Little Endian, Explicit VR Big Endian, Implicit VR Little Endian (if all of these are proposed for a single Presentation Context). This means that if the Implicit VR Little Endian and Explicit VR Little Endian Transfer Syntaxes are proposed in a single Presentation Context, then the accepted Transfer Syntax will be Explicit VR Little Endian. This order of preference is configurable.

Any of the Presentation Contexts shown in the following table are acceptable to the STORAGE-SCP AE for receiving images.



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Table 4.2-27 ACCEPTED PRESENTATION CONTEXTS BY STORAGE-SCP AE



Name UID Name UID

Role Ext. Neg.

Merge eFilm Private Compressed Transfer Syntax

2.16.840.1.113669.0.1.1

DICOM Explicit VR Little Endian 1.2.840.10008.1.2.1

DICOM Explicit VR Big Endian 1.2.840.10008.1.2.2

DICOM Implicit VR Little Endian 1.2.840.10008.1.2

JPEG Process 14 Selection Value 1 Lossless

1.2.840.10008.1.2.4.70

JPEG Process 1 Baseline 1.2.840.10008.1.2.4.50

See Table 4.2-21 See Table 4.2-21

JPEG Process 2,4 Extended 1.2.840.10008.1.2.4.51

SCP None

4.2.3.4.1.3 SOP Specific Conformance for Verification SOP Class The STORAGE-SCP AE provides standard conformance to the Verification SOP Class as an SCP.

4.2.3.4.1.4 SOP Specific Conformance for Storage SOP Classes The associated Activity with the Storage service is the storage of medical image data received over the network onto a designated hard disk. The STORAGE-SCP AE will return a failure status if it is unable to store the images onto the hard disk.

The STORAGE-SCP AE does not have any dependencies on the number of Associations used to send images to it. Images belonging to more than one Study or Series can be sent over single or multiple Associations. Images belonging to a single Study or Series can also be sent over different Associations. There is no limit on either the number of SOP Instances or the maximum amount of total SOP Instance data that can be transferred over a single Association.

The STORAGE-SCP AE retains the original DICOM data in DICOM Part 10 compliant file format. The STORAGE-SCP AE is Level 2 (Full) conformant as a Storage SCP. In addition, all Private and SOP Class Extended Elements are maintained in the DICOM format files. In addition to saving all Elements in files, a



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subset of the Elements is stored in the FUSION PACS database to support query and retrieval requests. This also allows updating of Patient, Study, and Series information by user input, or demographic and Study related messages. Refer to the Annex for the list of Elements that are checked and/or processed upon receiving a Composite SOP Instance.

The STORAGE-SCP AE will modify Composite SOP Instances which have Overlay Data encoded in their pixel data. When initially processed by the STORAGE-SCP AE, the Overlay Data is removed from the pixel data and placed into the Overlay Data tag (60xx,3000), where 0x60xx is the group containing the Overlay. The Overlay Bit Position (60xx,0102) and Overlay Bits Allocated (60xx,0100) tags are modified to reflect the new encoding of the Overlay.

The STORAGE-SCP AE will also modify Composite SOP Instances encoded with a photometric interpretation of Palette Color. The photometric interpretation of these Images is changed to RGB. The Palette Color related tags are stored in private attributes and the pixel data is modified.

The STORAGE-SCP AE will modify Composite SOP Instances encoded with a Photometric Interpretation of RGB and a value for Planar Configuration of 1. The Pixel Data of the Composite SOP Instances will be modified to be non-Planar, and the Planar Configuration will be changed to 0.

The behavior for handling duplicate SOP Instances is configurable. The default behavior is to perform a binary comparison against the original SOP Instance received. If the images are equivalent (the header and image portion of the DICOM image are identical), the new image is discarded. If the images are different, the SOP Instance is stored in a folder for later examination by service personnel. Storing of duplicate SOP Instances that are different is configurable and can be disabled.

For the purposes of image display, the system supports the following photometric interpretations: MONOCHROME1, MONOCHROME2, and RGB.

Display of information conveyed using the DICOM Curve Module is not supported. Graphic overlay data sent either embedded in the unused image pixel data bits or in the separate Overlay Data Element is also not supported for display.

Some processing of DICOM SOP Instances is decoupled from the receipt of the Images. It is possible that a C-STORE SCU may receive a success status. However, the DICOM SOP Instance is not inserted into the FUSION PACS database. These images are stored by FUSION PACS for later processing by manual intervention.

Table 4.2-28 STORAGE-SCP AE C-STORE RESPONSE STATUS RETURN REASONS



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Service Status

Further Meaning Error Code Reason

Success Success 0000 The Composite SOP Instance was successfully received, verified, and stored in the system database.

Refused Out of Resources

A700

Indicates that there was not enough disk space to store the image.

Error message is output to the Service Log. The SOP Instance will not be saved.

Data Set does not match SOP Class

A900 Indicates that the Data Set does not encode a valid instance of the SOP Class specified. This status is returned if the DICOM Object stream can be successfully parsed but does not contain values for one or more mandatory Elements of the SOP Class. The STORAGE-SCP AE does not perform a comprehensive check, as it only checks a subset of required Elements. In addition, if the SOP Class is for a given image type , but the SOP Instance does not contain values necessary for its display, then this status is returned.


Error

Processing Failure

0110 Indicates that the STORAGE-SCP AE could not process the Data Set.


NOTE: If a failure condition does occur when handling an Association, then all images previously received over the Association are maintained in the FUSION PACS database. No previously received images are discarded. Even if an image is successfully received but an error occurs transmitting the C-STORE Response, this final image is maintained rather than discarded. If the loss of an Association is detected, then the Association is closed.

NOTE: Some processing of DICOM SOP Instances is decoupled from the receipt of the images. It is possible that a C-STORE SCU may receive a Success status, but the DICOM SOP Instance cannot be processed. In this case, the SOP Instance is not inserted into the FUSION PACS database. However, the Instance is stored for future processing.



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The Behavior of the STORAGE-SCP AE during communication failure is summarized in the following table:

Table 4.2-29 STORAGE-SCP AE STORAGE SERVICE COMMUNICATION FAILURE REASONS

Exception Reason

Timeout expiry for an expected DICOM Message Request (DIMSE level timeout),i.e., . the STORAGE-SCP AE is waiting for the next C-STORE Request on an open Association, but the timer expires.


Error message is output to the Service Log. If some Composite SOP Instances have already been successfully received, then they are maintained in the database. They are not automatically discarded because of a later failure.

Timeout expiry for an expected DICOM PDU or TCP/IP packet (Low-level timeout), i.e., the STORAGE-SCP AE is waiting for the next C-STORE Data Set PDU, but the timer expires.


Error message is output to the Service Log. If a C-STORE Data Set has not been fully received, then the data already received is discarded. If some Composite SOP Instances have already been successfully received over the Association, then they are maintained in the database.

Association was aborted by the SCU or the network layers indicate communication loss (i.e., low-level TCP/IP socket closure).

Error message is output to the Service Log. If some Composite SOP Instances have already been successfully received, then they are maintained in the database. They are not automatically discarded because of a later failure.

4.2.4 FIND-SCU Application Entity Specification

4.2.4.1 SOP Classes The FIND-SCU AE provides Standard Conformance to the following DICOM V3.0 SOP Class(es):

Table 4.2-30 SOP CLASSES SUPPORTED BY FIND-SCU AE



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Study Root Query/Retrieve Information Model – FIND

1.2.840.10008.5.1.4.1.2.2.1 Yes No


4.2.4.2.1 General The FIND-SCU AE initiates but never accepts associations. Use of the FIND-SCU AE by FUSION PACS is configurable. It is used when a peer AE is configured as permanent storage for FUSION PACS. The FIND-SCU AE can be used to determine the pre-existing contents of the peer AE and import those contents into the FUSION PACS database. The FIND-SCU AE is also used in situations to synchronize the contents of the FUSION PACS database with the contents of the peer AE. The FIND-SCU AE can be used to discover new studies that may have been sent to the peer AE, but were not sent to FUSION PACS.


Table 4.2-31 DICOM APPLICATION CONTEXT FOR FIND-SCU AE


4.2.4.2.2 Number of Associations Table 4.2-32

Number of Associations as an SCU for FIND-SCU AE

Maximum number of simultaneous associations 2

The FIND-SCU AE supports a maximum of two simultaneous associations querying a remote archive at one time.



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4.2.4.2.3 Asynchronous Nature The FIND-SCU AE does not support asynchronous communication (multiple outstanding transactions over a single Association). All Association requests must be completed and acknowledged before a new operation can be initiated.

Table 4.2-33 ASYNCHRONOUS NATURE AS AN SCU FOR FIND-SCU AE


4.2.4.2.4 Implementation Identifying Information Table 4.2-34

DICOM Implementation Class and Version for FIND-SCU AE



All FUSION PACS AEs use the same Implementation Class UID and Implementation Version Name. The Version Name is updated with each new release of the product software, as the different AE versions are never released independently.

4.2.4.3 Association Initiation Policy When enabled, the FIND-SCU AE automatically attempts to initiate new associations. The FIND-SCU AE performs recursive queries for lower query levels in the hierarchy on the same association. The FIND-SCU AE is configured to run at set intervals as it queries. The delay between associations is configurable.

4.2.4.3.1 Activity – Query Remote AE

4.2.4.3.1.1 Description and Sequencing of Activities On configured intervals, the FIND-SCU AE will make a single attempt to query the remote AE. If the query fails, the FIND-SCU AE will delay a configured interval and then retry the query.



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FIND-SCUAE

Peer FIND-SCPAE

FIND-SCU AE Opens Association

Query Request for Study Information

FIND-SCU AE Closes Association

Figure 4.2-5 Sequencing of Activity – Query Studies

The following sequencing constraints illustrated in Figure 4.2-5 apply to the FIND-SCU AE for querying for Study information:

1. The FIND-SCU AE opens an Association with the Peer AE.

2. The FIND-SCU AE sends zero or more C-FIND-RQ messages to Peer AE for Study, Series and Image information.

3. The FIND-SCU AE closes the Association.

The FIND-SCU AE will perform one Study level query over the open Association. For each study result received, it will then perform Series (and if necessary, Image level) queries to determine the contents of the remote AE. Once complete, the Association will be closed.

4.2.4.3.1.2 Proposed Presentation Contexts

Table 4.2-35 Proposed Presentation Contexts for the FIND-SCU AE



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Abstract Syntax Transfer Syntax Role

Name UID Name UID

Extended

Negotiation

Implicit VR Little Endian

1.2.840.10008.1.2

Explicit VR Little Endian

1.2.840.10008.1.2.1

Study Root Query/Retrieve Information Model – FIND

1.2.840.10008.5.1.4.1.2.2.1

Explicit VR Big Endian

1.2.840.10008.1.2.2

SCU None

The FIND-SCU AE will propose one Presentation Context with all of the supported Transfer Syntaxes.

4.2.4.3.1.2.1 Extended Negotiation No extended negotiation is performed.

In particular, relational queries are not supported.

4.2.4.3.1.3 SOP Specific Conformance for C-FIND SOP Classes The FIND-SCU AE provides standard conformance to the supported C-FIND SOP Class. Only a single information model, Study Root, is supported.

The FIND-SCU AE is used to systematically query the contents of a DICOM Query Retrieve SCP system and import the contents into the FUSION PACS database. It can be configured to wait between each Study level query to the remote system and to query specific time intervals to limit the results returned and reduce load on the remote AE.

All queries are initiated at the highest level of the information model (the STUDY level), and then for each response received, recursively repeated at the next lower levels (the SERIES and then IMAGE levels), in order to completely elucidate the “tree” of instances available on the remote AE. Note that if the tag “Series Related Instances” is returned at the SERIES Level, FIND-SCU will not query at the IMAGE level.

A CANCEL request will be issued if the FIND-SCU AE is shut down in the middle of conducting a query.

Unexpected attributes returned in a C-FIND response (those not requested) are ignored. Requested return attributes not returned by the SCP are ignored. Non-matching responses returned by the SCP due to



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unsupported (hopefully optional) matching keys are not filtered locally by the FIND-SCU AE and thus will still be presented in the browser. No attempt is made to filter out duplicate responses.

Table 4.2-36 STUDY ROOT REQUEST IDENTIFIER FOR FIND-SCU AE

Name Tag Types of

Matching

Study Level

Patient's Name 0010,0010 NONE

Patient ID 0010,0020 NONE

Patient's Birth Date 0010,0030 NONE

Patient’s Birth Time 0010,0032 NONE

Patient's Sex 0010,0040 NONE

Study Date 0008,0020 S,R

Study Time 0008,0030 NONE

Accession Number 0008,0050 NONE

Study ID 0020,0010 NONE

Study Instance UID 0020,000D UNIQUE

Referring Physician's Name 0008,0090 NONE

Study Description 0008,1030 NONE

Patient’s Age 0010,1010 NONE

Patient’s Size 0010,1020 NONE

Patient’s Weight 0010,1030 NONE

Other Patient Ids 0010,1000 NONE

Other Patient Names 0010,1001 NONE

Patient Comments 0010,4000 NONE

Modalities in Study 0008,0061 NONE

Name of Physicians Reading Study 0008,1060 NONE



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Admitting Diagnosis Description 0008,1080 NONE

Occupation 0010,2180 NONE

Additional Patient History 0010,21B0 NONE

Other Study Numbers 0020,1070 NONE

Interpretation Author 4008,010C NONE

Series Level

Modality 0008,0060 NONE

Series Number 0020,0011 NONE

Series Instance UID 0020,000E UNIQUE

Series Description 0008,103E NONE

Body Part Examined 0018,0015 NONE

Number of Series Related Instances 0020,1209 NONE

Protocol Name 0018,1030 NONE

View Position 0018,5101 NONE

Laterality 0020,0060 NONE

Patient Position 0018,5100 NONE

Image Level

Instance Number 0020,0013 NONE

SOP Instance UID 0008,0018 UNIQUE

Types of Matching:

The types of Matching supported by the C-FIND SCU. An "S" indicates the identifier attribute uses Single Value Matching, an “R” indicates Range Matching, a “*” indicates wildcard matching, a ‘U’ indicates Universal Matching, and an ‘L’ indicates that UID lists are sent. “NONE” indicates that no matching is supported, but that values for this Element are requested to be returned (i.e., universal matching), and “UNIQUE” indicates that this is the Unique Key for that query level, in which case either Universal Matching or Single Value Matching will be used, depending on the query level.

The FIND-SCU AE will behave as described in Table 4.2-37 in response to the status returned in the C-FIND response command message(s).



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Table 4.2-37 RESPONSE STATUS FOR FIND-SCU AND QUERY REMOTE AE REQUEST

Service Status

Further Meaning Status Codes

Behavior

Refused Out of Resources A700 Query is terminated and rescheduled

Error Identifier does not match SOP Class

A900 Query is terminated and rescheduled

Unable to process Cxxx Query is terminated and rescheduled

Cancel Matching terminated due to Cancel request

FE00 Query is terminated and rescheduled

Success Matching is complete - No final Identifier is supplied

0000 Current query is terminated; remaining queries continue

Matches are continuing - Current Match is supplied and any Optional Keys were supported in the same manner as Required Keys

FF00 Identifier used to trigger recursive lower level queries in FUSION PACS database

Pending

Matches are continuing - Warning that one or more Optional Keys were not supported for existence and/or matching for this Identifier

FF01 Identifier used to trigger recursive lower level queries in FUSION PACS database.



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4.2.4.4 Association Acceptance Policy The FIND-SCU AE does not accept associations.

4.2.5 MOVE-SCU Application Entity Specification

4.2.5.1 SOP Classes The MOVE-SCU AE provide Standard Conformance to the following DICOM V3.0 SOP Class(es):

Table 4.2-38 SOP CLASSES SUPPORTED BY MOVE-SCU AE



1.2.840.10008.5.1.4.1.2.2.2 Yes No


4.2.5.2.1 General The MOVE-SCU AE initiates but never accepts associations. Use of the MOVE-SCU AE by FUSION PACS is configurable. It is used when a peer AE is configured as permanent storage for FUSION PACS. The MOVE-SCU AE is used to retrieve series from the peer AE that are offline on the FUSION PACS.


Table 4.2-39 DICOM APPLICATION CONTEXT FOR MOVE-SCU AE




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4.2.5.2.2 Number of Associations The MOVE-SCU AE may initiate multiple simultaneous associations. It will initiate a maximum of 8 associations per server in a FUSION PACS cluster. It will initiate 1 association to a given remote AE for each server in a FUSION PACS cluster, up to a maximum of 4 associations to a given remote AE.

Table 4.2-40 NUMBER OF ASSOCIATIONS AS AN SCU FOR MOVE-SCU AE

Maximum number of simultaneous associations 8 (Configurable) per server in a FUSION PACS cluster

4.2.5.2.3 Asynchronous Nature The MOVE-SCU AE does not support asynchronous communication (multiple outstanding transactions over a single Association). All Association requests must be completed and acknowledged before a new operation can be initiated.

Table 4.2-41 ASYNCHRONOUS NATURE AS AN SCU FOR MOVE-SCU AE


4.2.5.2.4 Implementation Identifying Information Table 4.2-42

DICOM IMPLEMENTATION CLASS AND VERSION FOR MOVE-SCU



All FUSION PACS AEs use the same Implementation Class UID and Implementation Version Name. The Version Name is updated with each new release of the product software, as the different AE versions are never released independently.



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4.2.5.3 Association Initiation Policy The MOVE-SCU AE attempts to initiate a new association when a user performs the retrieve action from the user interface when FUSION PACS has a remote DICOM AE configured as its long-term archive.

4.2.5.3.1 Activity – Retrieve From Remote AE

4.2.5.3.1.1 Description and Sequencing of Activities The MOVE-SCU AE will initiate a new Association when a retrieval request is made on the FUSION PACS for an offline study and a remote AE is configured as permanent storage for the FUSION PACS. If the move fails, the MOVE-SCU AE will delay a configured interval and then retry the move.

MOVE-SCUAE

Peer MOVE-SCPAE

MOVE-SCU AE Opens Association

Move Series

MOVE-SCU AE Closes Association

Figure 4.2-6 Sequencing of Activity – Retrieve from Remote AE

The following sequencing constraints illustrated in Figure 4.2-6 apply to the MOVE-SCU AE for moving a Series:

1. MOVE-SCU AE opens an Association with the Peer AE.

2. MOVE-SCU sends C-MOVE-RQ to move a specific Series to FUSION PACS.



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3. MOVE-SCU AE closes the Association.

The MOVE-SCU AE will perform one Series level move over the open Association. It will wait for a Success status to be returned before closing the association.

4.2.5.3.1.2 Proposed Presentation Contexts

Table 4.2-43 PROPOSED PRESENTATION CONTEXTS FOR MOVE-SCU AND RETRIEVE FROM REMOTE AE



Name UID Name UID

Role Extended

Negotiation

Implicit VR Little Endian

1.2.840.10008.1.2

Explicit VR Little Endian

1.2.840.10008.1.2.1


1.2.840.10008.5.1.4.1.2.2.2

Explicit VR Big Endian 1.2.840.10008.1.2.2

SCU None

The MOVE-SCU AE will propose a single Presentation Context with each of the supported Transfer Syntaxes.

4.2.5.3.1.2.1 Extended Negotiation No extended negotiation is performed.

In particular, relational retrievals are not supported.

4.2.5.3.1.3 SOP Specific Conformance for C-MOVE SOP Classes The MOVE-SCU AE provides standard conformance to the supported C-MOVE SOP Class. The MOVE-SCU AE is only activated when another DICOM Application Entity is configured as the permanent archive for FUSION PACS.



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Only a single information model, Study Root, is supported. Retrievals will be performed at the SERIES level only.

No CANCEL requests are ever issued.

The retrieval is performed from the AE configured as the permanent archive for FUSION PACS. The instances are retrieved to the current application’s local database by specifying the destination as the AE Title of the STORAGE-SCP AE of the local application. This implies that the remote C-MOVE SCP must be preconfigured to determine the presentation address corresponding to the STORAGE-SCP AE.

Table 4.2-44 STUDY ROOT REQUEST IDENTIFIER FOR MOVE-SCU

Name Tag Unique,

Matching or Return Key

STUDY level

Study Instance UID (0020,000D) U

SERIES level

Series Instance UID (0020,000E) U

The MOVE-SCU AE will behave as described in the Table below in response to the status returned in the C-MOVE response command message(s).

Table 4.2-45 RESPONSE STATUS FOR MOVE-SCU AND RETRIEVE FROM REMOTE AE REQUEST

Service Status

Further Meaning Status Codes

Related Fields Behavior

Refused Out of Resources - Unable to calculate number of matches

A701 (0000,0902) Retrieval is terminated and rescheduled.

Out of Resources - Unable to perform sub-operations

A702 (0000,1020) (0000,1021) (0000,1022) (0000,1023)

Retrieval is terminated and rescheduled.



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Move Destination unknown

A801 (0000,0902) Retrieval is terminated and rescheduled.

Failed Identifier does not match SOP Class

A900 (0000,0901) (0000,0902)


Unable to process Cxxx (0000,0901) (0000,0902)


Cancel Sub-operations terminated due to Cancel Indication

FE00 (0000,1020) (0000,1021) (0000,1022) (0000,1023)

Retrieval is terminated (should never occur, since cancels never issued)

Warning Sub-operations Complete - One or more Failures

B000 (0000,1020) (0000,1022) (0000,1023)


Success Sub-operations Complete - No Failures

0000 (0000,1020) (0000,1021) (0000,1022) (0000,1023)

Retrieval is terminated

Pending Sub-operations are continuing

FF00 (0000,1020) (0000,1021) (0000,1022) (0000,1023)

Retrieval continues

Since the C-MOVE operation is dependent upon completion of C-STORE sub-operations that are occurring on a separate association, the question of failure of operations on the other association(s) must be considered.

The MOVE-SCU AE completely ignores whatever activities are taking place in relation to the STORAGE-SCP AE that is receiving the retrieved instances. Once the C-MOVE has been initiated, it runs to completion (or failure) as described in the C-MOVE response command message(s). There is no attempt by MOVE-SCU to confirm that instances actually have been successfully received or locally stored.

Whether or not completely or partially successful retrievals are made available in the local database to the user is purely dependent upon the success or failure of the C-STORE sub-operations, not on any explicit action by the MOVE-SCU AE.



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Whether or not the remote AE attempts to retry any failed C-STORE sub-operations is beyond the control of the MOVE-SCU AE.

If the association on which the C-MOVE was issued is aborted for any reason, whether or not the C-STORE sub-operations continue is dependent upon the remote AE. The local STORAGE-SCP AE will continue to accept associations and storage operations regardless.

4.2.5.4 Association Acceptance Policy The MOVE-SCU AE does not accept associations.

4.3 NETWORK INTERFACES

4.3.1 Physical Network Interface The FUSION PACS supports a single network interface. One of the following physical network interfaces will be available depending on installed hardware options:

Table 4.3-1 SUPPORTED PHYSICAL NETWORK INTERFACES

Ethernet 1000baseT

Ethernet 100baseT

Ethernet 10baseT

4.3.2 Additional Protocols FUSION PACS conforms to the System Management Profile listed in Table 4.3-2. All requested transactions for the listed profiles and actors are supported. It does not support any optional transactions.

Table 4.3-2 SUPPORTED SYSTEM MANAGEMENT PROFILES



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Profile Name Actor Protocols Used Optional Transactions Security Support

Network Address Management

DNS Client DNS N/A

4.3.2.1 DNS DNS can be used for address resolution. If DHCP is not in use or the DHCP server does not return any DNS server addresses, the identity of a DNS server can be configured via the Service/Installation Tool. If a DNS server is not in use, local mapping between hostname and IP address can be manually configured via the Service/Installation Tool.

4.4 CONFIGURATION

4.4.1 AE Title/Presentation Address Mapping

4.4.1.1 Local AE Titles The mapping from AE Title to TCP/IP addresses and ports is configurable and set at the time of installation by Installation Personnel.

Table 4.4-1 DEFAULT APPLICATION ENTITY CHARACTERISTICS

Application Entity Role Default AE Title Default TCP/IP Port

STORAGE-SCU SCU FUSION None

FIND-SCU SCU FUSION None

MOVE-SCU SCU FUSION None

STORAGE-SCP SCP FUSION 104

QUERY-RETRIEVE-SCP SCP FUSION 104

All Application Entities are configured through a single AE Title.



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4.4.1.2 Remote AE Title/Presentation Address Mapping The mapping of external AE Titles to TCP/IP addresses and ports is configurable and can be set at the time of installation by Installation Personnel. This mapping is necessary for resolving the IP address and port of C-MOVE Destination Application Entities and must be correctly configured for the QUERY-RETRIEVE-SCP AE to correctly function as a C-MOVE SCP.

When enabled, FUSION PACS will also auto-enter a configuration for remote AEs connecting. It will enter the IP Address and AE Title of the remote system, and enter port 4006 as a default listen port.

Use of compressed transfer syntaxes can also be enabled or disabled by device. This will enabled or disable the use of compression by the STORAGE-SCU AE when transferring to devices.

4.4.2 Parameters Table 4.4-2

CONFIGURATION PARAMETERS

Parameter Configurable Default Value

General Parameters

Maximum PDU Size the AE can receive Yes 64kbytes

Maximum PDU Size the AE can send No Unlimited

Time-out waiting for response to TCP/IP connect() request. (Low-level timeout)

Yes 60 s

Time-out waiting for A-ASSOCIATE RQ PDU on open TCP/IP connection. (ARTIM timeout)

Yes 60 s

Time-out waiting for acceptance or rejection response to an Association Open Request. (Application Level timeout)

Yes 60s

Time-out waiting for acceptance of a TCP/IP message over the network. (Low-level timeout)

Yes 60 s

Time-out for waiting for data between TCP/IP packets. (Low-level timeout)

Yes 60 s

The Windows NT TCP/IP socket buffer size is set to 131,072 bytes in order to improve image data throughput performance.

Yes 131,072 bytes



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STORAGE-SCU AE Parameters

Maximum number of simultaneous Associations. No 4 to a given AE title for auto-routing requests, 50 for C-MOVE requests from remote AEs

STORAGE-SCU AE time-out waiting for a Response to a C-STORE-RQ. (DIMSE timeout)

No 5 minutes

STORAGE-SCU AE number of times a failed send job to a C-MOVE Destination is automatically retried.

Yes 12 when transferred via auto-routing or long-term storage, 0 when requested via a C-MOVE

Modification of SOP Instance UID when Lossy Compressing Images.

Yes Creation of new SOP Instance UIDs for images Lossy Compressed on export can be enabled or disabled from the FUSION PACS Web GUI.

STORAGE-SCP AE Parameters



Maximum number of simultaneous Associations

(Can be configured to be a maximum total number or a maximum per external SCU AE)

No 50 (for each server in a FUSION PACS cluster)

STORAGE-SCP AE time-out waiting on an open Association for the next Request message (C-STORE-RQ, Association Close Request. etc.) (DIMSE timeout)

No 5 minutes

STORAGE-SCP AE maximum number of simultaneous Associations

No 50 (for each server in a FUSION PACS cluster)

Permanent archival of SOP Instances sent by a peer AE to the STORAGE-SCP AE in response to a retrieval request from QUERY-RETRIEVE AE.

No TRUE



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Permanent archival of SOP Instances sent unsolicited by a peer AE to the STORAGE-SCP AE, i.e., not in response to a retrieval request from QUERY-RETRIEVE AE.

Yes TRUE

(FUSION PACS can be configured to run without permanent archival)

QUERY-RETRIEVE-SCP AE Parameters



Maximum number of simultaneous Associations No 50 (for each server in a FUSION PACS cluster)

QUERY-RETRIEVE-SCP AE time-out waiting on an open Association for the next message (C-FIND-RQ, C-MOVE-RQ, Association Close Request., etc.) (DIMSE timeout)

Yes 5 minutes

FIND-SCU AE Parameters



Maximum number of simultaneous Associations No 8 (for each server in a FUSION PACS cluster)

MOVE-SCU AE Parameters



Maximum number of simultaneous Associations No 1

5 MEDIA INTERCHANGE

FUSION PACS does not support Media Storage.



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6 SUPPORT OF EXTENDED CHARACTER SETS

All FUSION PACS DICOM applications support the following:

ISO_IR 100 (ISO 8859-1:1987 Latin Alphabet No. 1 supplementary set)

As well as supporting this Extended Character Set for DICOM messaging, the Query-Server system database and user interface can support the expected display of this character set.

7 SECURITY

7.1 SECURITY PROFILES

The FUSION PACS does not support any Security Profiles.

7.2 ASSOCIATION LEVEL SECURITY

The QUERY-RETRIEVE-SCP AE and the STORAGE-SCP AE can both be configured to check the following DICOM values when determining whether to accept Association Open Requests:

Calling AE Title

Called AE Title

Application Context

The SCP AEs can be configured to accept Association Requests from only a limited list of Calling AE Titles. All SCPs share the same list. The SCP AEs can be configured to check that the Association requestor specifies the correct Called AE Title for the SCP.

In addition, the IP address of the requestor can be checked. The SCP AEs can be constrained to only accept Association Requests from a configured list of IP addresses and AE titles. All SCPs share the same list.



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7.3 APPLICATION LEVEL SECURITY

The FUSION PACS Web GUI requires a username and password to access. Specific users must have rights in order to invoke the STORAGE-SCU AE in order to transfer DICOM Storage Instances to a Remote AE.

Maintenance of the DICOM Device configuration also requires authorization for a specific user to access.



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8 ANNEXES

8.1 IOD CONTENTS

8.1.1 STORAGE-SCP AE Element Use The following Elements of Composite SOP Instances received by the STORAGE-SCP AE are either stored to the permanent FUSION PACS database or are of particular importance in the received images.

SOP Instances conforming to the following Composite Image SOP Classes are fully supported for display on the system workstations.

Table 8.1-1 SUPPORTED COMPOSITE IMAGE SOP CLASSES FOR DISPLAY

Computed Radiography Image Storage CT Image Storage Digital X-Ray Image Storage - For Presentation

Digital Intra-oral X-Ray Image Storage - For Presentation

MR Image Storage Ultrasound Multi-frame Image Storage (Retired) Ultrasound Multi-frame Image Storage

Ultrasound Image Storage (Retired)

Ultrasound Image Storage

Secondary Capture Image Storage


Nuclear Medicine Image Storage X-Ray Angiographic Image Storage

X-Ray Radiofluoroscopic Image Storage



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Table 8.1-2 SIGNIFICANT ELEMENTS IN RECEIVED COMPOSITE SOP INSTANCES

Module Attribute Name Tag ID Type Significance

Patient’s Name (0010,0010) Opt Value is saved in database in ^ delimited format. All components of the Patient’s Name are stored in the FUSION PACS database. The total length of the field is a maximum of 64 characters.

Names will be parsed correctly if they are in the format of ‘lname^fname’ or ‘lname, fname’. If space separation is used (i.e., ‘lname fname’), then the entire name will be treated as the last name. Additional ^ delimiters will be added to the end of the name until five delimiters are present.

Patient

Patient’s Sex (0010,0040) Opt Value is saved in the database.

Study Instance UID

(0020,000D) Mand Must be provided.

Value is saved to database.

Study Date (0008,0020) Opt If the date is not in the proper DICOM format, today’s date will be applied to this value.

Value is saved to database.

Referring Physician’s Name

(0008,0090) Opt Value is saved to database.

Accession Number


General Study

Study Description


General Series

Modality (0008,0060) Opt Value is saved to database and can be up to 16 characters in length.



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Series Description

(0008,103E) Opt Value is saved to database.

Body Part Examined


Photometric Interpretation

(0028,0004) Cond The following photometric interpretations are supported for image display purposes:

MONOCHROME1, MONOCHROME2, RGB

Images with a value of PALETTE COLOR will be converted to RGB format.

Required if SOP Instance is an Image.

Planar Configuration

(0028,0006) Cond Images with Planar Configuration set to 1 will have their pixel data modified and their Planar Configuration set to 0.

Red Palette Color Lookup Table Descriptor

(0028,1101) Cond Tag removed and stored in private attribute when Photometric Interpretation is set to PALETTE COLOR.

Green Palette Color Lookup Table Descriptor


Blue Palette Color Lookup Table Descriptor


Red Palette Color Lookup Table Data


Image Pixel

Green Palette Color Lookup Table Data




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Blue Palette Color Lookup Table Data


Pixel Data (7fe0,0010) Mand Pixel data is modified when Photometric Interpretation is PALETTE COLOR, when Overlay is embedded in pixel data, or when Planar Configuration is set to 1.

Overlay Bits Allocated

(6000,0100) Cond Will be modified if Overlay is embedded in pixel data. Set to 1 after overlay is moved to Overlay Data tag from Pixel Data tag.

Overlay Bit Position

(6000,0102) Cond Will be modified if Overlay is embedded in pixel data. Set to 0 after overlay is moved to Overlay Data tag from Pixel Data Tag.

Overlay Plane

Module (see Note 1)

Overlay Data (6000,3000) Cond Overlay data will be moved to this tag if embedded in the pixel data.

SOP Common

SOP Instance UID

(0008,0018) Mand Must be provided. If a duplicate SOP Instance UID is received, the system will store the duplicate for later investigation. The system will assign a new UID if the received image data is lossy compressed.

8.1.2 STORAGE-SCU AE Element modification The following table contains a list of all Elements that can have a value modified by the STORAGE-SCU at the time of export using the Storage Service, depending on the capabilities of the receiver:

Table 8.1-3 SIGNIFICANT ELEMENTS IN EXPORTED COMPOSITE SOP INSTANCES

Module Attribute Name Tag ID Value

SOP Common

SOP Instance UID (0008,0018) System assigns a new UID if the image data is lossy compressed by the STORAGE-SCU AE at the time of export. Generation of the new UID is configurable.



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Source Image Sequence

(0008,2112) Sequence added to reference the original DICOM image when lossy compressing a SOP Instance. Only added when generation of new SOP Instance UIDs on lossy compression is enabled.

>Referenced SOP Class UID

(0008,1150) The SOP Class UID of the original image is placed here. Only added when generation of new SOP Instance UIDs on lossy compression is enabled.

>Referenced SOP Instance UID

(0008,1155) The SOP Instance UID of the original image is placed here. Only added when generation of new SOP Instance UIDs on lossy compression is enabled.

Image Type (0008,0008) First two values of this tag changed to “DERIVED\SECONDARY” when image is lossy compressed.

Lossy Image Compression

(0028,2110) Enumerated value set to “01” if lossy compression occurs on export.

Lossy Image Compression Ratio

(0028,2112) Set to the compression ratio image has been lossy compressed at when exported

General Image

Derivation Description

(0008,2111) Text description of the type of lossy compression done on the image placed in this field.

8.1.3 Element modification by Web GUI The following table contains a list of all Elements that can have a value modified by the FUSION PACS Web GUI by authorized users.

Table 8.1-3 SIGNIFICANT ELEMENTS EDITED BY FUSION PACS WEB GUI

Module Attribute Name Tag ID Type Significance

Patient ‘sName (0010,0010) Opt Value can be edited. Patient

Patient ID (0010,0020) Opt Value can be edited.



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Patient’s Birth Date

(0010,0030) Opt Value can be edited.

Patient’s Sex (0010,0040) Opt Value can be edited.

Accession Number


Study Date (0008,0020) Opt Value can be edited.

Study Time (0008,0030) Op Value can be edited.

Referring Physician’s Name


General Study

Study Description


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