Examples of use cases / clinical scenarios, as the basis to develop the requirements, include:
Providing access to images and reports from a point-of-service application e.g., EMR.
Following references to significant images used to create an imaging report and displaying those images.
Following references / links to relevant images and imaging reports in email correspondence or clinical reports e.g., clinical summary.
Providing access to anonymized DICOM images and reports for clinical research and teaching purposes.
Providing access to a DICOM encoded imaging report associated with the DICOM IE (patient/study/series/objects) to support remote diagnostic workflows e.g., urgent medical incidents, remote consultation, clinical training, teleradiology/telemedicine applications.
Providing access to summary or selected information from DICOM objects.
Examples of the use cases described in 1 above are:
The EMR displays in JPEG one image with annotations on it (patient and/or technique related), based upon information provided in a report.
The EMR retrieves from a “Manifest” document all the referenced objects in DICOM and launches a DICOM viewer for displaying them (use case addressed by the IHE XDS-I.b profile).
The EMR displays in JPEG one image per series with information describing every series (e.g. series description).
The EMR displays in JPEG all the images of a series with information describing the series as well as every image (e.g. instance number and slice location for scanner images).
The EMR populates in its database for all the instances referred in a manifest (KOS) the relevant information (study ID/UID/AccessionNumber/Description/DateTime, series UID/Modality/Description/DateTime, instance UID/InstanceNumber/SliceLocation).
As an example, the 1c use case is decomposed in the following steps (all the other use cases can be implemented through a similar sequence of basic transactions):
The EMR sends to the DICOM server the list of the objects (“selection”), asking for the object content.
The DICOM server sends back the JPEG images corresponding to the listed objects.
The EMR sends to the DICOM server the “selection” information for obtaining the relevant information about the objects retrieved.
The DICOM server sends back the corresponding information in the form of a “metadata” document, converted in XML.
XX.3.3 Description of the Use Cases
The use cases described above in terms of clinical scenarios correspond to the following technical implementation scenarios. In each case the use is distinguished by the capabilities of the requesting system:
Does it prefer the URI based requests, or the web-services based requests.
Does it have the ability to decode and utilize the DICOM PS 3.10 format or not.
Does it need the metadata describing the image and its acquisition, and/or does it need an image to be displayed.
These then become the following technical use cases.