WG 12

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WG 12



    American Dental Association

    Chicago, Illinois

    July 11-12, 2005


    Allan G. Farman (WG 22/12.1 Univ. Louisville/ADA Representative to DICOM) Chris Bope (Soredex - TUUSULA Finland)

    Ari Kontkanen (Planmeca USA)

    Tony Bavuso (Progeny)

    Hang Yuan (Progeny)

    Kelly Anderson (Dentrix)

    Filippo Impieri (Kavo/Gendex Des Plaines, IL) Sam Marfatia (Kavo/Gendex Des Plaines, IL) Xavier Carayol (Kodak Imaging Paris, France) Manny Pena (Schick Technologies, Long Island City, NY)

    Andrew Casertano (VA)

    John Goyette (Schick/WG 22/WG 12.1)

    Greg Zeller (Veterans Affairs)

    Don Vu (J. Morita, USA)

    Lance Guffey (Patterson Dental)

    Jason Wendling (Patterson Dental)

    Eriks Blaschka (Sirona Dental)

    Jolanta Majewska (ADSTRA Systems, Toronto, Canada)

    Jim Pearson (AAO)

    Dan Croley (ADA)

    Scott Benjamin (AIM - WG 12.4)

    Steve Jambor


    Paul Bralower, American Dental Association, Chicago, IL

1. Introduction of a new ADA IT Manager Jim Pearon

    2. Paul Bralower update on status of TR 1023. Ballot closes on Thursday, July 14, 2005

    3. Overview of WG 12.1, WG22 and TR1023 on its scope, work items and goals to

    the first time attendees presented by Allan Forman

    4. Minutes approval from February 22-23 delayed to afternoon after a printed copy

    is available

    5. ADA interoperability project overview of the past years and the usage of the CDs

    outside ADA trade show presented by John Goyette

6. Final validation of DICOM images will be done on Friday, July 08, 2005 by

    David Clunie

    ? Timeline for the CD project from last meeting, Feb. 24-25, 2005

    ? Review errors from David’s last validation

    o Max file length is 8 characters; must be rename on FTP site

    o Retired Person Name

    o Review of the DICOM image file

    ? Patient Orientation is not correct in some of the images:

    should be L not P. Dataset in the image doesn’t correspond

    to the actual file. Kelly Anderson (Dentrix) explanation of

    the tag Patient Orientation: L is direction of row and F is

    direction of columns

7. Overview of ADA CD Datasets problems:

    ? Un-enhanced images must be submitted for the CD

    ? Orientation of the image is critical

8. Datasets problems per vendor:


    ? Schick images pixels wrongly inverted

    ? PA Orientation (wrong tooth number)

    ? CEPH image should have Patient Orientation A/F not L/F


    ? PAN was encoded as IO


    ? Image Orientation needs to be corrected


    ? Patient Name tag is different in each image

    ? CEPH Image Pixel Spacing is zero and Patient Orientation should be A/F

    not F/A

    ? Modality wrong for PAN (IO) only in DICOMDIR Hermut Feuerhahn

    to fix this bug


    ? PAN image should have Modality PX not DX

    ? Pixel Spacing on CEPH is wrong

    ? IO image should be labeled 36 FDI and Patient Orientation should be P/F


    ? IO AirTechninques images Pixel Spacing is wrong (24.5)


    ? CEPH images Patient Orientation should be A/F not L/F


    ? Patient Name incorrect; it should be Company and Product Name

    ? Re-label IO patient Laterality, Image Orientation and Tooth Number (L,

    P/F, ###) not (R/F, R, ###): up to the vendor to specify

    ? There is nothing wrong with those images


    ? TOMO/PAN image missing tags L R on the image itself. Allan Farman

    comments on the TOMO image; Sirona will replace the TOMO image

    since WG 22 did not address that issue yet

    ? Sirona IO Bitewing image has wrong region. It should be jaw region and

    only one tooth number instead of nine teeth numbers


    ? Tags should be relabeled

    ? CEPH wrong Patient Orientation

    ? PAN wrong Image Laterality and Patient Orientation


    ? IO Sensor image: Image Laterality is wrong; should not be B

    ? CEPH should be A/F not L/F for Patient Orientation

    ? DenOptix image Modifier Sub Sequence is wrong level

    ? Patient First Name is a different one on each image (Visualix, DenOptix



    9. Missing info describing the way the images are displayed in different software.

    Image dataset is correct and has all the required info.


    Members agreed that all the images will be displayed from the outside-in. The software

    right now does not use the orientation correctly.

For the CD we need to re-label the teeth on some of the pictures as per Allan Farman to

    keep consistency.

10. CD content overview

    ? Any image changes need to be submitted to FTP site; any suggestions to thPower Point Presentation by August 8

    ? Any changes to Logos should be sent to Allan Farman

    ? Checks should be sent to Paul Bralower (ADA) by August 1, 2005

    11. Overview of the Power Point Presentation from last year’s CD presented by Allan Farman. Manufacturer asked to comment and to check if there are any changes to the

    name or missing logos and provide them to Allan Farman.

13. E-mail Attachment Supplement:

    Work item proposal forwarded by Xavier Carayol


    Proposal 1: new ZIP Interchange Profile - Zip DICOM images into one file

    Proposal 2: add to Standards new media type DICOM ZIP

    Memo to be submitted to International Internet Committee to use DCZ extension in order

    for the application be able to open the DICOM image and DICOMDIR automatically.



    st step would be to submit the new DCZ extension.

    The security issues are outside of this scope.

A request for a Work Item has already been written, motioned and passed.

    Any comments on this Work Item are welcomed.

Xavier Carayol will write TR describing all stated in paragraph 13 by October 4th, 2005


    14. VA Dr. Greg Zeller presents Templates:

    1. VA Imaging Status Update to DICOM WG-22

    2. VistA Imaging overview

    3. Annex A and Radiology Core document

    4. Vendor conformance: VA will begin Alpha Testing of DICOM with Q/R

    5. VA/DoD Annex: any feedback welcomed

    6. VA needs the info of when the study was created, when the image is captured

    (Acquisition Date) and when the file is actually created (Content Date)


    Add to Feb. 24-25, 2005 minutes a VA/DoD Joint DICOM Req. document and comments

    for TR1023.

15. John Goyette overview/update of current work item: Dental Viewsets

There is no consistent way to display the viewsets. This is why we need to develop a

    standard method of encoding and exchanging view sets. New IO might be required.

    Hanging Protocols are approved but have limitation. Hanging Protocols are not

    associated with Patient/Study/Series/Image. There is no clear way to handle custom

    orientations and larger number of images. It’s very complex.


    Develop new IOD

    st draft available stTimeline: November 2005 = 1 Group 6 reading (standard committee to approve this) March 2006 Finished September 2005 = 1Dental Viewset Object:

    a. Patient, Study, Series IODs

    b. Frame of reference for the display area

    i. i.e. (0, 0) to (1, 1)

    ii. Physical Dimension (mm)

    c. Sequence of views or view boxes

    i. Special coordinates Upper Left (0.3, 0.3) to Lower Right

    (0.4, 0.06) w/h

    ii. Reference to contained image

    1. Study UID

    2. Series UID

    3. Image UID

    d. Z-Order

    e. Aspect Ratio Deleted



    f. Preferred Acquisition Context

    i. Tooth Numbering

    ii. Order Sequence

    iii. Orientation of the sensor

    iv. (Sensor Size)

    g. Annotation Overlay (Text and Graphics)

    h. Color? Brent/Allan user definable not needed here

    16. VA viewsets discussion:

    a. User search for FMX by Name, Description of viewsets and number of

    images. Store info for retrieval of mounts so they will be displayed the

    same way as the referring Doctor’s view.

    b. FMX will be displayed in the following order, starting top-left going to

    right then bottom across to left and up. This way the images are kept the in

    order of time when the X-Rays where taken

    c. When the viewset is received and rearranged, it will become a Hanging


    d. Viewset is an instance of Hanging Protocol (template) unique to a Patient

    e. Viewset object explains how to display it

    f. Viewset is like a hyperlink to the image

    g. Viewset object does not contain image, it will only contain a list of images

    UIDs. VA sends it in consistent order all of the time

    h. We need to use at higher level. What’s the expected Orientation of the


    i. Scott suggested sending images which are modified (Presentation stage).

    A derived image is to be sent to the other person

    j. VA implementation of DICOM to exchange viewsets based on consistent

    order. This is what VA is using: Modality Tag Attribute Name

     (0008,0020) Study Date

    (0008,0030) Study Time

    (0008, 0023) Content Date

    (0008, 0033) Content Time

    (0008,0060) Modality

    IO - Intra Oral (0008,2218) Anatomic Region Sequence

    (0008,2220) Anatomic Region Modifier Sequence

     Primary Anatomic Structure Sequence


    (0020,0062) Image Laterality

    PX Panoramic (0020, 0020) Patient Orientation

    DX Cephalometric (0008,2218) Anatomic Region Sequence

    (0020,0062) Image Laterality

    XC Visible Light (0020,4000) Image Comments

    Photographic (0008,2218) Anatomic Region Sequence

    Modality Tag Attribute Name

    (0008,2220) > Anatomic Region Modifier Sequence

     Primary Anatomic Structure Sequence


    (0020,0062) Image Laterality

    ES Visible Light (0020,4000) Image Comments


    k. VA/DoD document section 2.6 “Sorting Presentation Constructs” explains

    how the viewsets could be sorted

17. John Goyette will be leading Dental Viewsets Work Item in one team, together

    with Kelly Anderson (Dentrix), Eriks Blaschka (Sirona) to write technical aspects and

    attributes. Second team: Allan G. Farman, Andrew Casertano (VA), Greg Zeller (VA)

    and Scott Benjamin to write USE CASES. Deadline: October 4, 2005.


    Approve minutes from the last meeting. No comments.

    Motion was seconded and passed.

New Item: Multi-Frame of DX images storage specification proposal by Xavier


Defining DX Multi-frame Images objects (e.g. could be used for implants) not currently

    supported by the Standard.

The goal of this proposal is to enable an application to save, in a single DICOM Part 10

    type of file, a set of Digital X-Ray images created during the same tomography

    acquisition process or by a specific post-processing application program in order to

    simplify such image file manipulation.

New DX Object based on existing one Enhanced DX Image Module with added two

    modules. Multi Frame Functional Group Remove some unused Modules. Modify some

    DX Patient Orientation tags to have V, P, M (medial) and D (distal). Since the image is

    3D the anatomical direction is useful.

Working Group 17 attempted to develop n-D standards but it was dropped. A J.Morita

    image has one hundred 2D frames which are put into one 3D image.

Sets of slices will be specified as viewset.

    Pixel Measures Macros contains info about pixel spacing and the slice and thickness.

    DX Frame Content Macro.


    Xavier would like to have a proposal for September meeting to present to DICOM. This

    document will be posted on FTP and any comments are welcome, especially from other

    CT vendors.


    1. Modality: any type

    2. Image Type: it would be useful in this case to differentiate CT 3D image from

    any other

    3. Separate Modality proposal might be rejected by DICOM gurus. John Goyette

    suggested TMJ, TOMO and Sinus slices could be put in a new TAG

    4. Scott Benjamin’s suggestion was to have a separate class since it will be used

    for oral dental

    5. Xavier proposed something very generic and uses a simple Identifier to get

    Modality for this purpose

    6. Steve Jambor proposed to keep it as strictly dental and everyone agreed

    7. Patient Orientation position 2D is not enough which is why 3rd value is

    necessary here

    Action: An initial draft of work item request to be written by Xavier Carayol to get input

    from other manufacturers.

    Proposed completion date: Dec 2005. John Goyette motioned to put this as a work item.

    Motion was seconded and approved.

    Visible Light by Scott Benjamin:

    ADA WG12.4 TR1024. PatientID CD project.

    Feedback welcomed from vendor for the case below:

    1. Select images and click on one button to export and burn them to the CD. The

    tags and image format are not important. The CD will then be used for different purposes

    (e.g. child abduction). Image requires anatomy and patient orientation, also contain x-

    rays, if they are present in DB.

    2. Pre-defined Report generator: It would be some sort of batch file; specialized

    report feature to be added to software.

    TR 1029 talks about different views of the image and with six different attributes the

    image will be described.

    Meeting Adjourned.

     th, 2005 next meeting in Philadelphia. FUTURE MEETINGS Oct 4Submitted by

    Jolanta Majewska (ADSTRA Systems Inc.) Reporting Secretary


__________________________ _________________________

    Allan G. Farman, BDS John Goyette Co-Chair Co-Chair

    Reviewed by Counsel December 21, 2005

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