On-Board Imager 1.

4
DICOM Conformance Statement

P/N KC1406D3CS

March 2008

General Information

Abstract

This document provides information about the DICOM Conformance of the On Board Imager version 1.4 product.. Manufacturer: Varian Medical Systems, Inc. Ltd. 3100 Hansen Way, Bldg. 4A Palo Alto, CA 94304-1030, U.S.A. European Representative: Varian Medical Systems UK Ltd. Gatwick Road, Crawley West Sussex RH10 9RG United Kingdom

Manufacturer and European Representative

Notice

Information in this document is subject to change without notice and does not represent a commitment on the part of Varian. Varian is not liable for errors contained in this document or for incidental or consequential damages in connection with the furnishing or use of this material. This document contains proprietary information protected by copyright. No part of this document may be reproduced, translated, or transmitted without the express written permission of Varian Medical Systems, Inc. Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the requirements specified within this federal regulation. Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the requirements specified ISO 13485 quality systems standards. Varian Medical Systems, Oncology Systems products meet the requirements of Council Directive MDD 93/42/EEC. Varians products and services are specifically designed to include features that help our customers comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The software application uses a secure login process, requiring a user name and password, that supports role-based access. Users are assigned to groups, each with certain access rights, which may include the ability to edit and add data or may limit access to data. When a user adds or modifies data within the database, a record is maintained of the data that was changed, the users ID and the date and time the changes were made. This establishes an audit trail that can be examined by authorized system administrators.

FDA 21 CFR 820 Quality System Regulations (CGMPs) ISO 13485

CE

HIPAA

ii

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DICOM Conformance Statement, KC1406D3CS

General Information

Trademarks

ARIA, VARiS Vision, Eclipse, Varian and VMS are registered trademarks ARIA, VARiS Vision, Eclipse, On-Board Imager are trademarks of Varian Medical Systems, Inc. Microsoft, Windows NT and Windows are registered trademarks of Microsoft Corporation. All other trademarks or registered trademark are the property of their respective owners.

Contacting Support

If you have access to the Varian Intranet, you can download additional Varian internal documents from the PSE Web. To order additional hardcopies of documents, call your local office administrator If you cannot find the required information in this document nor on the PSE Web, please contact the appropriate service listed below. Web PSE Website North America National Technical Support (NTS), telephone support NTS Hardware Support PSE Europe European telephone support Eclipse & CadPlan support ARIA, VARiS Vision & technical support Brachy Help PSE iLab in Switzerland PSE Crawley +41 41-749-8700 [email protected] [email protected] [email protected] [email protected] [email protected] 800-455-3351 http://pse.oscs.varian.com

[email protected] [email protected]

Updates

For updates to this document, please contact PSE Milpitas/PSE Las Vegas/ PSE Crawley/PSE iLab in Switzerland

Copyright 2008 Varian Medical Systems Inc., Oncology Systems All rights reserved. Edited in Switzerland.

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Distribution and Approval List

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Contents

Contents
Contents ............................................................................................................................ v List of Figures................................................................................................................. vii List of Tables .................................................................................................................. vii 1 2 3 Conformance Statement Overview......................................................................... 1 Table of Contents..................................................................................................... 3 Introduction .............................................................................................................. 5
3.1 3.2 3.3 3.4 3.5 Purpose .......................................................................................................................................5 Audience .....................................................................................................................................5 Remarks ......................................................................................................................................5 Definitions, Terms and Abbreviations .........................................................................................6 References ..................................................................................................................................6 Implementation Model.................................................................................................................7 4.1.1 Application Data Flow ..................................................................................................7 4.1.2 Functional Definition of AEs .......................................................................................8 4.1.3 Sequencing of Real World Activities ...........................................................................9 AE Specifications ......................................................................................................................10 4.2.1 OBI Entity Specification .............................................................................................10 Network Interfaces ....................................................................................................................26 Configuration .............................................................................................................................27 4.4.1 AE Title/Presentation Address Mapping....................................................................27 4.4.2 Parameters ................................................................................................................27

Networking................................................................................................................ 7
4.1

4.2 4.3 4.4

5 6 7

Media Interchange.................................................................................................. 29 Support of Character Sets..................................................................................... 30 Security................................................................................................................... 31

7.1 7.2 7.3 Security Profiles ........................................................................................................................31 Association Level Security ........................................................................................................31 7.2.1 OBI Client ..................................................................................................................31 Application Level Security .........................................................................................................31 7.3.1 OBI Application ..........................................................................................................31

Appendix A
A.1

Specialization .................................................................................... 1

A.2 A.3

A.4 A.5 A.6 B.1

IOD Contents ..............................................................................................................................1 A.1.1 Created SOP Instances ...............................................................................................1 A.1.2 Usage of Attributes from received IODs .....................................................................1 Data Dictionary of Private Attributes ...........................................................................................1 Coded Terminology and Templates ............................................................................................1 A.3.1 Context Groups ...........................................................................................................1 A.3.2 Template Specifications ..............................................................................................1 A.3.3 Private Code Definitions ..............................................................................................1 Grayscale Image Consistency ....................................................................................................1 Standard Extended/Specialized/Private SOP Classes ...............................................................1 Private Transfer Syntaxes...........................................................................................................1

Appendix B

IOD Details ......................................................................................... 3

Supported IODs ..........................................................................................................................3

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Contents

B.1.1 B.1.2 B.1.3 B.1.4

Computed Tomography Image A.3.3 ...................................................................... 3 Spatial Registration A.39.3 ...................................................................................... 3 RT Structure Set A.19.3........................................................................................... 4 RT Image A.17.3 ...................................................................................................... 4

Appendix C
C.1

Extended Interface.............................................................................7

RT Plan ...................................................................................................................................... 7

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List of Figures

List of Figures
Figure 4-1 Implementation Model....................................................................................................................... 7 Figure 4-2 Sequence Diagram for CT Set loading ...........................................................................................10

List of Tables
Table 1-1: Network Services .............................................................................................................................. 1 Table 1-2: Media File SOP Classes ................................................................................................................... 1 Table 4-1 Supported SCU/SCP SOP Classes for OBI Entity...........................................................................11 Table 4-2 DICOM Application Context for OBI Client Application Entity..........................................................11 Table 4-3 Number of Associations initiated for OBI Client Application Entity ..................................................12 Table 4-4 Used implementation class UIDs .....................................................................................................12 Table 4-5 Object Categories used by OBI Client Storage SCU Application Entity ..........................................13 Table 4-6 Presentation contexts used by OBI Client Storage SCU Application Entity ....................................13 Table 4-7 OBI Client C-STORE Response Status Handling Behavior ............................................................14 Table 4-8 OBI Client Storage SCU Communication Failure Behavior .............................................................14 Table 4-9 Supported Query/Retrieve Levels for Query/Retrieve SCU.............................................................16 Table 4-10 Proposed Presentation Contexts for OBI Client Q/R SCU Application Entity................................16 Table 4-11 OBI Client C-FIND Response Status Handling Behavior ..............................................................16 Table 4-12 OBI Client Q/R C-FIND SCU Communication Failure Behavior ....................................................17 Table 4-13 Study Root Request Identifier for OBI Client Q/R C-FIND SCU ....................................................17 Table 4-14 OBI Client C-MOVE Response Status Handling Behavior ............................................................18 Table 4-15 OBI Client Q/R C-MOVE SCU Communication Failure Behavior..................................................18 Table 4-16 Study Root Request Identifier for OBI Client Q/R C-MOVE SCU..................................................18 Table 4-17 Supported Operations ....................................................................................................................19 Table 4-18 Beam Setup kv extensions.............................................................................................................22 Table 4-19 Acceptable Presentation Contexts for OBI Client Storage SCP Application Entity and Receive Storage Request .......................................................................................................................................25 Table 4-20 Response Status of OBI Client Storage SCP and Receive Storage Request...............................26 Table 4-21 AE Title Configuration Table ..........................................................................................................27 Table 4-22 Configuration Parameters Table ....................................................................................................28 Table 7-1 Computed Tomography Image IOD Modules Support....................................................................... 3 Table 7-2 Spatial Registration Image IOD Modules Support ............................................................................. 4 Table 7-3 RT Structure Set IOD Modules Support............................................................................................. 4 Table 7-4 RT Image IOD Modules Support........................................................................................................ 5

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List of Tables

Table 7-5 RT Plan Extended Interface .............................................................................................................10

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Conformance Statement Overview

Conformance Statement Overview

The OBI Application is an application that is used to setup a patient for treatment purposes. To support this function the following DICOM services for receiving and sending diagnostic imaging modalities are supported. Table 1-1 lists network services supported by OBI 1.4 SOP Classes Transfer
CT Image Storage Spatial Registration Storage RT Structure Set Storage Yes Yes Yes Yes No Yes No Yes Yes Yes

User of Service (SCU)

Provider of Service (SCP)

RT Image Storage RT Plan Storage Query/Retrieve

Study Root Query/Retrieve Information Model FIND Study Root Query/Retrieve Information Model MOVE

Yes Yes

No No

Table 1-1: Network Services Table 1-2 lists Media File SOP Classes supported for file based export and import. These SOP classes are only supported when the OBI application is in File mode. SOP Classes
CT Image Storage Spatial Registration Storage RT Structure Set Storage

DICOM Media File Export

Yes Yes Yes Yes No

DICOM Media File Import

Yes No Yes Yes Yes

RT Image Storage RT Plan Storage

Table 1-2: Media File SOP Classes

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Conformance Statement Overview

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Table of Contents

Table of Contents
The table of contents, the list of figures and the list of tables are located at the top of the document.

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Table of Contents

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Introduction

3
3.1

Introduction
Purpose
The definition of the DICOM standard for radiotherapy data started in 1994 and has now reached a productive state. Today, DICOM is the primary choice for exchanging data with an open standard protocol for the majority of vendors and institutions. Varian Medical Systems is committed to this notion and supports the full range of radiotherapy objects for their RV system. This Conformance Statement is applicable for

OBI Release 1.4.xx

This release is also known by its product name OBI Advanced Imaging. This document contains definitions which are specific for the OBI product. For definitions which are specific for the Treatment application see 2). Otherwise, all definitions of the Varian Server DICOM conformance statement apply as applicable. This conformance statement is entitled Varian System Server, see 3), for System 8.

3.2

Audience
Marketing and Sales System Integrators of medical equipment Other vendors interfacing using DICOM

3.3

Remarks
The scope of this Conformance Statement is to facilitate communication of the OBI application and other vendors medical equipment. The Conformance Statement should be read and understood in conjunction with the DICOM standard [1]. The DICOM standard in the current version evolved in 1993 with DICOM 3.0. The definition of the DICOM standard for radiotherapy data started in 1994 and has now reached a mature state. Nowadays DICOM is the primary choice for exchanging data with an open standard protocol for the majority of vendors and institutions. Varian Medical Systems is committed to this notion of standard-based cross-vendor interoperability as well as making use of the DICOM protocol among its own products. DICOM, by itself, does not guarantee interoperability. However, the Conformance Statement facilitates a first-level validation for interoperability between different applications supporting the same DICOM functionality. This Conformance Statement is not intended to replace validation with other DICOM equipment to ensure proper exchange of information intended. Because the DICOM standard is subject to ongoing changes, enhancements and improvements, Varian Medical Systems reserves the right to advance their products by making use of upcoming DICOM features.

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Introduction

3.4

Definitions, Terms and Abbreviations

This section provides the definitions of terms, acronyms and abbreviations that are used throughout the document AE DICOM NEMA SCU SCP SOP UID Management System OBI Application Entity Digital Imaging and Communications in Medicine National Electrical Manufacturers Association Service Class User Service Class Provider Service Object Pair Unique Identifier DICOM entity from which OBI retrieves structure set data
Varians On-Board Imager application to provide Image Guided RT features.

3.5

References
1) Digital Imaging and Communications in Medicine (DICOM), Parts 1-16 (2004), National Electrical Manufacturers Association (NEMA Rosslyn, VA, USA Treatment Rel. 6.5 DICOM Conformance Statement (P/N 10001678-01) Varian Medical Systems Inc Palo Alto, CA, USA

2)

3) Varian System Server DICOM Conformance Statement (P/N VA8004D3CS) Varian Medical Systems International AG Baden, Switzerland

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Networking

4
4.1
4.1.1

Networking
Implementation Model
Application Data Flow

Local User requests Query

FIND-SCU OBI Application Entity

Remote Application Entity Receives Query or Retrieve Command

Local User requests Retrieval

MOVE-SCU OBI Application Entity

Remote Application Entity Receives Query or Retrieve Command

Object Imported

STORAGE-SCP OBI Application Entity

Requested Instances sent by remote Application Entity

Local User requests Storage

STORAGE-SCU OBI Application Entity

Remote Application Entity Receives Storage Command

DICOM Standard Interface

Figure 4-1 Implementation Model

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Networking

Conceptually the network services may be modeled as the following separate AEs, though in fact all the AEs share a single (configurable) AE Title: STORAGE-SCP, receives incoming RT images, CT images, RT Plans and Structure Sets. STORAGE-SCU, sends outbound RT images, CT images, Structure Sets and Spatial Registrations. FIND-SCU, which queries remote AEs for lists of studies, series and instances. MOVE-SCU, which retrieves selected studies, series or instances. ECHO-SCU which sends outgoing echo request to Remote Application Entity

4.1.2

Functional Definition of AEs

Note that conceptually the network services may be modeled as the following separate AEs, though in fact all the AEs share a single (configurable) AE Title.

4.1.2.1

OBI Client Storage SCU Application Entity

The Storage SCU Application Entity is invoked when A simple 2D, 2D/2D, marker or 3D/3D matching has been performed and Spatial Registrations or Markers must be sent to the Remote AE. A 3D/3D matching has been performed and the acquired CT set must be sent to the Remote AE Marker Detection has been performed and the markers must be sent to the Remote AE as Structure set linked to the current reference CT image. Each marker is defined as own point set with a single point in it. Marker Match has been performed, the markers are stored as curves in the image object and the image object must be sent to the Remote AE. When the user saves an acquired image through the UI, the image is then sent to the Remote AE. The treatment fraction is closed and all unsaved acquired images and other IODs are sent to the Remote AE.

4.1.2.2

OBI Client FIND SCU, MOVE SCU Application Entity

The Query/Retrieve Application Entity is invoked when The patient is loaded in the 4DITC application, and reference images need to be loaded in OBI Structure Set and/or CT images must be loaded in order to perform a 3D/3D or marker matching.

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4.1.2.3

OBI Client Storage SCP Application Entity

The Storage SCP Application Entity is invoked in order to receive objects requested from a remote Query/Retrieve SCP, such as: Reference Images Structure Sets RT Plan Reference CT image set

4.1.3

Sequencing of Real World Activities

CT images are loaded into the OBI application typically after the user switches to marker matching or 3D/3D matching state. OBI invokes a move command for each CT Image related to the structure set represented by the CT Image Query/Retrieve SCU. This requires the OBI application to provide the CT Image Storage SCP. When a patient is loaded into the OBI application, it loads each reference image by requesting them from the remote AE. When a Marker Matching is performed, the Marker Data (Structure Set) is only stored to the remote AE. When either a Simple 2D, 2D/2D, 3D/3D or marker matching is performed, the Storage SCU entity is invoked and exports the a Spatial Registration to the configured remote AE When loading from or saving to the Remote Application Entity, the ECHO-SCU entity is typically invoked to ensure that the remote AE is alive and responsive. The loading of a CT set is described by the following sequence diagram:

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Networking

User

OBI

Management System

Request CT Load

Structure Set request Structure Set returned

Plan request Plan returned

CT Slice request CT Slice returned

CT Slice request CT Slice returned

DICOM Standard Interface Figure 4-2 Sequence Diagram for CT Set loading

4.2
4.2.1
4.2.1.1

AE Specifications
OBI Entity Specification
SOP Classes
The OBI Entity provides standard conformance to the following DICOM SOP classes.

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Abstract Syntax

Transfer Syntax

Role

Extended Negotiation

Name RT Structure Set Storage

UID 1.2.840.10008.5.1.4.1.1.481.3

Name List DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian

UID List 1.2.840.10008.1.2 1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2 SCU SCP SCP SCU None None None None

Spatial Registration Storage CT Image Storage

1.2.840.10008.5.1.4.1.1.66.1

DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian

1.2.840.10008.5.1.4.1.1.2

1.2.840.10008.1.2 1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2 1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2

SCU SCP SCP SCU SCP SCP SCP SCP SCU

None None None None None None None None None

RT Image Storage

1.2.840.10008.5.1.4.1.1.1

DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian

RT Plan Storage

1.2.840.10008.5.1.4.1.1.5

DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian

Study Root Query/Retriev e information model- FIND Study Root Query/Retriev e information model- MOVE

1.2.840.10008.5.1.4.1.2.2.1

DICOM Implicit VR Little Endian

1.2.840.10008.5.1.4.1.2.2.2

DICOM Implicit VR Little Endian

1.2.840.10008.1.2

SCU

None

Table 4-1 Supported SCU/SCP SOP Classes for OBI Entity

4.2.1.2
4.2.1.2.1

Association Policies
General
The DICOM standard application context name for DICOM 3.0 is always proposed. Application Context Name 1.2.840.10008.3.1.1.1

Table 4-2 DICOM Application Context for OBI Client Application Entity

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4.2.1.2.2

Number of Associations
The OBI Client Application Entity can initiate (by default) up to three associations at a time. This value is configurable. Maximum number of simultaneous Associations no limit

Table 4-3 Number of Associations initiated for OBI Client Application Entity

4.2.1.2.3

Asynchronous Nature
OBI Client Application Entity does not support asynchronous communication.

4.2.1.2.4

Implementation Identifying Information

The following implementation class UIDs are used: Application Entity Echo SCU Storage SCU Storage SCP Query/Retrieve SCU Table 4-4 Used implementation class UIDs Implementation UID 1.2.246.352.70.2.1.1 1.2.246.352.70.2.1.3 1.2.246.352.70.2.1.4 1.2.246.352.70.2.1.5

4.2.1.3

Association Initiation Policy

The OBI Client Application Entity does initiate Associations.

4.2.1.3.1

Activity Store (STORAGE-SCU)

4.2.1.3.1.1 Description and Sequencing of Activities When the user performs a Simple 2D, 2D/2D, marker or 3D/3D matching, the match transformation will be stored as a Spatial Registration IOD. The OBI administration tool can be configured to disable the storage of spatial registrations. When the user performs a marker detection on the reference CT image, the positions of the detected markers will be stored in the Structure Set and linked to the current reference CT image. The OBI administration tool can be configured to disable the storage of the marker data. When the user performs a marker match, the positions of the matched markers will be stored in the acquired image object as curves. The OBI administration tool can be configured to disable the storage of the marker data The Curve Dimensions (5002,0005) will be 2, the Number of Points (5002,0010) will be 1, Type of Data (5000,0020) will be POLY, Axis Units (5000,0030) will be PIXL\PIXL, Axis Labels (5000,0040) will be Marker\Marker and Data Value Representation (5000,0103) will be 3. When the user acquires a verification CT set, each CT Image will be stored. Following isocenters are stored as Points in the Structure Set which is linked to the acquired verification CT set. The values of the RT ROI Interpreted Type (3006,00A4) will be as follows: Initial Laser Isocenter (position before acquisition): INITLASERISO

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Acquisition Isocenter (position during acquisition): ACQISOCENTER Initial Match Isocenter (position after acquisition): INITMATCHISO The OBI administration tool can be configured to disable the storage of CT images and isocenters. The Storage SCU will be invoked and attempts to initiate a new Association. If multiple objects shall be transferred then multiple C-STORE requests will be issued over the Association.

Object Category Structure Set Spatial Registration RT Image CT Image

SOP Class Name RT Structure Set Storage Spatial Registration Storage RT Image Storage CT Image Storage

SOP Class UID 1.2.840.10008.5.1.4.1.1.481.3 1.2.840.10008.5.1.4.1.1.66.1 1.2.840.10008.5.1.4.1.1.1 1.2.840.10008.5.1.4.1.1.2

Table 4-5 Object Categories used by OBI Client Storage SCU Application Entity 4.2.1.3.1.2 Proposed Presentation Contexts OBI Client Storage SCU is capable of proposing the Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Name
Spatial Registration Storage RT Structure Set Storage RT Image Storage CT Image Storage

Transfer Syntax Name

DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian

Role

Ext. Neg.
None

UID
1.2.840.10008.5.1.4.1.1.66.1

UID
1.2.840.10008.1.2 SCU

1.2.840.10008.5.1.4.1.1.481.3 1.2.840.10008.5.1.4.1.1.1 1.2.840.10008.5.1.4.1.1.2

1.2.840.10008.1.2 1.2.840.10008.1.2 1.2.840.10008.1.2

SCU SCU SCU

None None None

Table 4-6 Presentation contexts used by OBI Client Storage SCU Application Entity

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Networking

4.2.1.3.1.3 SOP Specific Conformance for all Storage SOP Classes The behavior of OBI Client Storage SCU upon storage is summarized in table below Service Status Refused Failure Further Meaning Out of Resources Data Set does not match SOP Class Cannot understand Warning Coercion of Data Elements Data Set does not match SOP Class Elements Discarded Success * Success * Error Code A7xx A9xx Cxxx B000 B007 B006 0000 Any other status code. The SCP has successfully stored the SOP Instance. No user feedback is received. Depending on the type of the Error Code it is either handled like a Failure or Warning. However, Error Codes other than listed above in this table should not occur, as they are not defined for C-STORE (see 1), PS 3.4, Table B.2-1). The SCP has successfully stored the SOP Instance. Because a warning status was received Status Comment (0000,0902) is logged . Behavior The user is informed that the C-STORE request has failed. Status Comment (0000,0902) is logged and displayed along with additional error information.

Table 4-7 OBI Client C-STORE Response Status Handling Behavior After sending all SOP Instances, either successfully or not, the Association is released using ARELEASE and the results are presented to the user. Exception Timeout Behavior The Association is released using A-RELEASE and the whole task of sending SOP Instances is aborted. The user is informed about the timeout and available information about it is logged. The whole task of sending SOP Instances is aborted.

Association aborted by the SCP or network layers

Table 4-8 OBI Client Storage SCU Communication Failure Behavior 4.2.1.3.1.4 SOP Specific Conformance for RT Structure Set Storage Detected marker positions will be saved to a new Structure Set. This structure set references the planning CT frame of reference and contains the detected marker positions as they are projected on the planning CT. The modified structure set gets a new UID and the a private referenced structure set sequence (3263,1001) is used to denote the original structure set (with the old UID). This sequence maybe used by the management system to combine the new structure set and the original one to add the markers as detected by OBI. The ROI Contour Sequence (3006, 0040) shall have the following definitions: Contour Geometric type (3006, 0042) = POINT

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Number of Contour Points

(3006, 0046) = 1

The ROI observation module shall have the following definitions: RT ROI Interpreted Type (3006,00A4) = MARKER.

Private tag: Marker Subtype (3271,1000) = MARKER

Marker position may be located between slice positions. Before exporting modified volumetric structures, they get resampled onto the planes of the 3D patient model. The volumetric ROI Contours of an exported RT Structure Set will thus always reference an image slice. All images used to construct the 3D patient model are referenced in Contour Image Sequence (3006,0016) of RT Structure Set Module, even if they do not have any contours defined on them. 4.2.1.3.1.5 SOP Specific Conformance for Spatial Registration Storage The spatial registration of the 2D and 2D/2D Match will be used in the following way: The Registration Sequence (0070,0308) will include all images (the reference images and the acquired verification RT images) and the Frame of Reference UID of the frame of reference of the reference RT images. The frame of reference module of the spatial registration will belong to the frame of reference of the acquired verification RT images. The transformation matrix type will be RIGID.

The spatial registration of the 3D/3D Match will be used in the following way: The Registration Sequence (0070,0308) will include all image slices (the reference CT slices and the acquired verification CT slices) and the Frame of Reference UID of the frame of reference of the reference CT slices. The frame of reference module of the spatial registration will belong to the frame of reference of the acquired verification CT image slices. The transformation matrix type will be RIGID.

The spatial registration of the Marker Match will be used in the following way: The Registration Sequence (0070,0308) will include all image slices (the reference CT slices and the acquired verification RT images) and the Frame of Reference UID of the frame of reference of the reference CT slices. The frame of reference module of the spatial registration will belong to the frame of reference of the acquired verification RT images. The transformation matrix type will be RIGID.

4.2.1.3.2

Activity Query/Retrieve (FIND-SCU, MOVE-SCU)

4.2.1.3.2.1 Description and Sequencing of Activities This function is typically performed by the application after the user switches to marker matching or 3D/3D matching state. At this time an Association is requested. This application supports Query/Retrieve in the SCU role. The table below shows the supported values for the tag Query/Retrieve Level (0008,0052):

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Query/Retrieve Level Composite Object Instance Information

Value in (0008,0052) IMAGE

Table 4-9 Supported Query/Retrieve Levels for Query/Retrieve SCU 4.2.1.3.2.2 Proposed Presentation Contexts Presentation Context Table Abstract Syntax Name
Study Root Query/Retrieve information model FIND Study Root Query/Retrieve information model MOVE

Transfer Syntax Name

DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian

Role

Ext. Neg.
None

UID
1.2.840.10008.5.1.4.1.2. 2.1

UID
1.2.840.10008.1.2 SCU

1.2.840.10008.5.1.4.1.2. 2.2

1.2.840.10008.1.2

SCU

None

Table 4-10 Proposed Presentation Contexts for OBI Client Q/R SCU Application Entity 4.2.1.3.2.3 SOP Specific Conformance for C-FIND SOP Classes The behavior of OBI Client Query/Retrieve SCU when encountering status codes in a C-FIND response is summarized in the table below. Service Status Refused Failure Further Meaning Out of Resources Data Set does not match SOP Class Cannot understand Cancel Matching terminated due to Cancel Request Matching is complete No final Identifier is supplied * Error Code A7xx A9xx Cxxx FE00 Cancel is handled like Failure, i.e. the object is not found and the user is advised. The SCP has completed the match, the user is advised. Handled like failure. Behavior The object is not found, the user is advised.

Success

0000

Any other status code.

Table 4-11 OBI Client C-FIND Response Status Handling Behavior No C-CANCEL-FIND requests are ever issued. Relational-queries are not supported. Specific Character Set is not supported. It is not included in a query and will be ignored when

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present in the response. Exception Timeout Association aborted by the SCP or network layers Behavior The user is informed that the operation (C-FIND or CMOVE) has timed out. When the Association is aborted during a C-MOVE operation the user is informed.

Table 4-12 OBI Client Q/R C-FIND SCU Communication Failure Behavior The table below lists the Attributes supported by the C-FIND SCU. Name Query/Retrieve Level SOP Instance UID Tag (0008,0052) (0008,0018) VR CS UI Type R U

Table 4-13 Study Root Request Identifier for OBI Client Q/R C-FIND SCU The Types of Matching column in the above table should be read as follows: S L U W R Single Value Matching List of UID Matching Universal Matching Wild Card Matching Range Matching

One or more matching types of the above list may be supported per Attribute. 4.2.1.3.2.4 SOP Specific Conformance for C-MOVE SOP Classes The behavior of OBI Client Query/Retrieve SCU when encountering status codes in a C-MOVE response is summarized in the following table. Service Status Refused Further Meaning Out of Resources Unable to calculate number of matches Out of Resources Unable to perform sub-operations Move Destination unknown Failure Identifier does not match SOP Class Unable to Process Cancel Sub-operations terminated due to Cancel Indication Error Code A701 Behavior None of the requested SOP Instances could be retrieved. The user will be informed about the failure.

A702

A801 A900 Cxxx FE00 Cancel is handled like Failure.

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Service Status Warning

Further Meaning Sub-operations complete One or more Failures Sub-operations complete No Failures Sub-operations are continuing *

Error Code B000

Behavior Some or all SOP Instances have not been transmitted successfully. The user is informed. All SOP Instances have successfully been transmitted. Transferring requested SOP Instances is continuing. This message is ignored. Any other status code is handled like Failure.

Success

0000

Pending *

FF00 Any other status code.

Table 4-14 OBI Client C-MOVE Response Status Handling Behavior After having received all requested SOP Instances or when the user aborts the operation the Association is released using A-RELEASE. All events occurring during querying and retrieving SOP Instances are logged. If any log entries are marked with internal category Error they will be shown to the user automatically. No C-CANCEL-MOVE requests are ever issued. Exception Timeout Association aborted by the SCP or network layers Behavior The user is informed that the operation (C-FIND or CMOVE) has timed out. When the Association is aborted during a C-MOVE operation the user is informed.

Table 4-15 OBI Client Q/R C-MOVE SCU Communication Failure Behavior The table below lists the Attributes that will be sent by the C-MOVE SCU. Name Query/Retrieve Level SOP Instance UID Tag (0008,0052) (0008,0018) VR CS UI Type R U

Table 4-16 Study Root Request Identifier for OBI Client Q/R C-MOVE SCU 4.2.1.3.2.5 Supported Operations This application performs only the operations listed in the table below. This table also shows which of the optional key values (see 1)) are used for a request.

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Operation C-FIND C-MOVE C-MOVE C-FIND C-MOVE C-MOVE

Target IOD RT Structure Set RT Structure Set RT Plan RT Image RT Image CT Image

Key value used for Request SOP Instance UID SOP Instance UID SOP Instance UID SOP Instance UID SOP Instance UID SOP Instance UID

Table 4-17 Supported Operations

4.2.1.3.3

Activity Receive Storage Request

4.2.1.3.3.1 Description and Sequencing of Activities Received SOP Instances are received and cached on the filesystem, as well as being passed to the application. 4.2.1.3.3.2 General Preconditions The following precondition for matching shall be fulfilled: In a valid OBI plan every treatment beam shall contain the same couch translation values (vertical, lateral, longitudinal). It is allowed to have different couch rotation values in the plan Tolerances for couch values being interpreted as equal are: absolute 2mm for longitudinal, lateral and vertical axes in space. The plan should contain valid Imaging Device-Specific Acquisition Parameters (300A,00CC) to allow automatic initiation of imaging procedures. However, if no Verification Image Sequence items are present or they do not contain device-specific acquisition parameters as specified above, it is still possible to initiate imaging procedures manually. OBI differentiates between treatment and setup fields. Treatment fields and setup fields (kV and MV) can be used for OBI use cases. OBI supports now the Treatment Delivery Type (300A,00CE) SETUP. This attribute should be the preferred method.

For backwards compatibility, the parameter FieldType in the Extended Interface (3253,1000) can be used to indicate the field type for each beam in the plan as well (please note, that this is a deprecated approach):
<ExtendedVAPlanInterface> <Beams> <Beam> <ReferencedBeamNumber>1</ReferencedBeamNumber> <BeamExtension> <FieldType>SETUP</FieldType> </BeamExtension> </Beam> <Beam> <ReferencedBeamNumber>2</ReferencedBeamNumber>

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<BeamExtension> <FieldType>TREATMENT</FieldType> </BeamExtension> </Beam> </Beams> </ExtendedVAPlanInterface>

Note that the aforementioned interface is only a portion of the entire interface, which is available in Section C.1. If a beam is a setup field and planned verification image sequence contains a single item representing a kV image (see definition below), this beam is referred to as a kV beam in the following. Tag Beam Sequence (300A,00B0) Description T Convention / Interpretation

>Planned Verification Image Sequence (300A,00CA)

Introduces sequence 1 of treatment beams for current RT Plan. One or more items may be included in this sequence. Introduces sequence 3 of planned verification images to be acquired during current beam. One or more items may be included in this sequence. See C.8.8.14.2. User-specified device-specific parameters which describe how the imager will acquire the image. 3

Used to plan RT images (kV or MV) to be acquired with this beam.

>>Imaging Device-Specific Acquisition Parameters (300A,00CC)

This tag is multivalued, values are separated with a backslash character (\). If this tag is missing completely, the planned verification image is interpreted as film. The following values are currently used for portal (MV) imaging: PortImageHighQuality PortImageHighQuality\BeamOff PortImageLowDose PortImageLowDose\BeamOff PortImageIntegrated PortImageContinuous The following values are currently used for kV imaging: KV\<ImageType> Defined terms for ImageType: Image CBCT Examples: KV\Image KV\CBCT For kV beams, this sequence will not be interpreted.

>Beam Limiting Device Sequence (300A,00B6)

Introduces sequence of beam limiting device (jaw or leaf).

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Tag >Number of Wedges (300A,00D0) >Number of Compensators (300A,00E0) >Number of Boli (300A,00ED) >Number of Blocks (300A,00ED) >Control Point Sequence (300A,0111)

Description Number of wedges associated with current Beam. Number of compensators associated with current Beam. Number of boli associated with current Beam. Number of shielding blocks associated with Beam. Introduces sequence of machine configurations describing treatment beam. Two or more items may be included in this sequence. See C.8.8.14.5 and C.8.8.14.6. Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions. Required for first item of Control Point Sequence, or if Beam Limiting Device changes during Beam. One or more items may be included in this sequence. Beam Limiting Device angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for first item of Control Point Sequence, or if Beam Limiting Device Angle changes during Beam.

T 1

Convention / Interpretation For kV beams, this number shall be 0 (no accessories) For kV beams, this number shall be 0 (no accessories)

For kV beams, this number shall be 0 (no accessories) For kV beams, this number shall be 0 (no accessories) For kV beams, this sequences shall always include exactly 2 items.

>>Beam Limiting Device Position Sequence (300A,011A)

1C

For kV beams, this sequence will not be interpreted.

>>Beam Limiting Device Angle (300A,0120)

1C

For kV beams, this number shall be 0.0

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Tag >>Beam Limiting Device Rotation Direction (300A,0121)

Description Direction of Beam Limiting Device Rotation when viewing beam limiting device (collimator) from radiation source, for segment following Control Point. Required for first item of Control Point Sequence, or if Beam Limiting Device Rotation Direction changes during Beam. See C.8.8.14.8. Enumerated Values: CW = clockwise CC = counterclockwise NONE = no rotation Gantry angle of radiation source, i.e.orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for first item of Control Point Sequence, or if Gantry Angle changes during Beam. Direction of Gantry Rotation when viewing gantry from isocenter, for segment following Control Point. Required for first item of Control Point Sequence, or if Gantry Rotation Direction changes during Beam. See C.8.8.14.8. Enumerated Values: CW = clockwise CC = counterclockwise NONE = no rotation

T 1C

Convention / Interpretation For kV beams, this value shall be NONE.

>>Gantry Angle (300A,011E)

1C

For kV beams, this value specifies the orientation of the kV radiation source with respect to IEC FIXED coordinate system. For MV beams, this value specifies the orientation of the MV radiation source (main gantry) with respect to IEC FIXED coordinate system.

>>Gantry Rotation Direction (300A,011F)

1C

For kV beams, this value shall be NONE.

Table 4-18 Beam Setup kv extensions

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When loading reference images in OBI, the (optional) Frame of Reference module in RT Image IODs is ignored. It is always assumed that all reference images of the same plan share a common frame of reference and the internal transformation is computed from the geometric definition of the DICOM RT image module (gantry angle, X-Ray image receptor translation/rotation, etc.). When saving back on board images to the management system, all images acquired for the same plan and session will share the same frame of reference UID, even if the couch position has been adjusted in between (under the assumption that the patient has not moved on the couch significantly). 4.2.1.3.3.3 Preconditions for RT Images RT Images, which are used as reference images (for 2D, 2D/2D and Marker Match), must be scaled and contain all geometrical parameters needed to determine the position of the Image in IEC. They must contain a frame of reference UID and the isocenter position in their frame of reference. The only geometrical parameter, which maybe missing is RT Image Position (3002,0012). If missing, the image is assumed as centered around the z-axis of the Image Receptor system. 4.2.1.3.3.4 Preconditions for 2D Match Besides the General Preconditions, the following condition shall be fulfilled: In a valid OBI plan every treatment beam shall contain the same Isocenter Position (300A, 012C). Tolerance for the same Isocenter Position is that isocenter positions of any pair of beams within the plan shall deviate less than 1.0 mm. The plan shall contain at least one valid setup beam configured as a kV or MV image beam or one valid treatment beam configured as a MV image beam. 4.2.1.3.3.5 Preconditions for 2D/2D Match Besides the General Preconditions, the following condition shall be fulfilled: In a valid OBI plan every treatment beam shall contain no or the same Isocenter Position (300A, 012C). Tolerance for the same Isocenter Position is that isocenter positions of any pair of beams within the plan shall deviate less than 1.0 mm. The plan shall contain two valid setup beams configured as a kV or MV image beam. A delta of 90.0 degrees between the gantry/source angles (300A,011E) of the two beams is recommended for an optimal match. 4.2.1.3.3.6 Preconditions for Marker Match Besides the General Preconditions, the following condition shall be fulfilled: In a valid OBI plan every treatment beam shall contain the same Isocenter Position (300A, 012C). Tolerance for the same Isocenter Position is that isocenter positions of any pair of beams within the plan shall deviate less than 1.0 mm The plan shall contain two valid setup beams configured as a kV or MV image beam. A delta of 90.0 degrees between the gantry/source angles (300A,011E) of the two beams is recommended for an optimal match. To load the slices of the reference CT image OBI loads the plans structure set, which corresponds to the Referenced RT Structure Set (300C,0060), from the Treatment Management System , and subsequently loads all CT slices referenced in the Contour Image Sequence (3006,0016).

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Conditions for CT Slices: All CT slices shall have the same Frame of Reference. The spacing between CT slices positions in z-direction (DICOM Patient coordinate system) may vary, although it is recommended, that they are equal throughout all slices referenced by the Structure Set. The maximal difference in x-direction and in y-direction (DICOM Patient coordinate system) between all CT slices shall be less or equal 0.1 mm.

Conditions for Structure Set (except Structures of Contour Geometric type (3006, 0042) POINT): The contour points within a contour shall be positioned on the same contour plane within a maximal Epsilon of 10-6 mm in z direction (DICOM Patient coordinate system). Structures with contour(s) having contour points that are not positioned on the same contour plane (see point above, i.e. non-transversal structures) are ignored (they are not imported and a corresponding warning message is issued) and the import will continue with the other structures. Contour Geometric Type (3006, 0042) has to be either CLOSED_PLANAR or OPEN_PLANAR for all contours of the structure. Structures with mixed contour types are not supported. Contour Geometric type (3006, 0042) POINT dont need to fulfill the conditions mentioned above. Conditions for Marker Point Structures: The markers shall be in the structure set referenced by the plan. Marker position may be located between slice positions. The ROI Contour Sequence (3006, 0040) shall have the following definitions: o o Contour Geometric type (3006, 0042) = POINT (3006, 0046) = 1

Number of Countour Points

The ROI observation module shall have the following definitions: o o RT ROI Interpreted Type (3006,00A4) = MARKER. Private tag: Marker Subtype (3271,1000) = MARKER

4.2.1.3.3.7 Preconditions for 3D/3D Match Besides the General Preconditions, the following condition shall be fulfilled: In a valid OBI plan every treatment beam shall contain the same Isocenter Position (300A, 012C). Tolerance for the same Isocenter Position is that isocenter positions of any pair of beams within the plan shall deviate less than 1.0 mm. The plan shall contain a valid setup beam.The tag Beam Type (300A,00C4) shall have the value STATIC configured as a CBCT beam. The tag Imaging Device Specific Acquisition Parameters (300A,00CC) shall have the value KV\CBCT. To load the slices of the reference CT image OBI loads the plans structure set, which corresponds to the Referenced RT Structure Set (300C,0060), from the Treatment Management System , and subsequently loads all CT slices referenced in the Contour Image Sequence (3006,0016).

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Conditions for CT Slices: All CT slices shall have the same Frame of Reference. The spacing between CT slices positions in z-direction (DICOM Patient coordinate system) may vary, although it is recommended, that they are equal throughout all slices referenced by the Structure Set. The maximal difference in x-direction and in y-direction (DICOM Patient coordinate system) between all CT slices shall be less or equal 0.1 mm.

Conditions for Structure Set (except Structures of Contour Geometric type (3006, 0042) POINT): The contour points within a contour shall be positioned on the same countour plane within a maximal Epsilon of 10-6 in z direction (DICOM Patient coordinate system). Structures with contour(s) having contour points that are not positioned on the same contour plane (see point above, i.e. non-transversal structures) are ignored (they are not imported and a corresponding warning message is issued) and the import will continue with the other structures. Contour Geometric Type (3006, 0042) has to be either CLOSED_PLANAR or OPEN_PLANAR for all contours of the structure. Structures with mixed contour types are not supported. Contour Geometric type (3006, 0042) POINT dont need to fulfill the conditions mentioned above. 4.2.1.3.3.8 Accepted Presentation Contexts OBI Client Storage SCP Application Entity accepts Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Name All Storage SOP Classes in Table 4-1 UID All Storage SOP Classes in Table 4-1 Name DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian Transfer Syntax UID 1.2.840.10008.1.2 1.2.840.10008.1.2.1 SCP None Role Ext. Neg.

Table 4-19 Acceptable Presentation Contexts for OBI Client Storage SCP Application Entity and Receive Storage Request 4.2.1.3.3.9 SOP Specific Conformance for all Storage SOP Classes 4.2.1.3.3.9.1 Presentation Context Acceptance Criterion OBI Client Storage SCP will always accept any Presentation Context for the supported SOP Classes with the supported Transfer Syntaxes. More than one proposed Presentation Context will be accepted for the same Abstract Syntax if the Transfer Syntax is supported, whether or not it is the same as another Presentation Context.

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4.2.1.3.3.9.2 Transfer Syntax Selection Policies If offered a choice of Transfer Syntaxes in a Presentation Context, OBI Client Storage SCP will select the first Transfer Syntax that is listed in the Presentation Context. OBI Client Storage SCP will accept duplicate Presentation Contexts, that is, if it is offered multiple Presentation Contexts, each of which offers acceptable Transfer Syntaxes, it will accept all Presentation Contexts, applying the same rule for selecting a Transfer Syntax for each as described above. 4.2.1.3.3.9.3 Response Status OBI Client Storage SCP will behave as described in the Table below when generating the CSTORE response command message. Service Status Refused Further Meaning Out of Resources Out of Resources Failure Invalid object instance Data Set does not match SOP Class Invalid C-STORE request Warning Coercion of Data Elements Data Set does not match SOP Class Elements Discarded Success Error Code A700 A7xx 0117 A9xx C000 B000 B007 B006 0000 Instance successfully stored in temporary file. Image successfully stored in temporary file. Behavior Failed to receive incoming DICOM Stream. Problem is logged on the SCP side.

Table 4-20 Response Status of OBI Client Storage SCP and Receive Storage Request

4.2.1.4

Association Acceptance Policy

The OBI Client Application Entity does accept Associations.

4.3

Network Interfaces
See 3)

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4.4
4.4.1
4.4.1.1

Configuration
AE Title/Presentation Address Mapping
Local AE Titles
The local OBI Client Application Entity uses the AE Title and TCP/IP port number configured via the Daemon configuration option in the OBI Admin tool. Note that conceptually the network services have been modeled as separate AEs, though in fact all the AEs share a single (configurable) AE Title. Application Entity OBI Client Application Entity OBI Client Storage SCU OBI Client Query/Retrieve SCU Table 4-21 AE Title Configuration Table Default AE Title StreamService (configurable) See above See above Default TCP/IP Port 58051 (configurable) See above See above

4.4.1.2
4.4.1.2.1

Remote AE Title/Presentation Address Mapping

OBI Client Storage SCU
For the Storage service class SCU, TCP/IP address, called AE title and port number of the destination are configurable as well as the calling AE title used by OBI.

4.4.1.2.2

OBI Client Query/Retrieve SCU

For the OBI Client Query/Retrieve SCU, TCP/IP address, called AE title and port number of the provider are configurable. The calling AE title of the local application, which is also the Move Destination AE title, is configurable too. The local port is the port of the Storage SCP for receiving the data. The Storage SCP will accept only connection requests from the configured remote AE Title and IP Address.

4.4.2

Parameters
The following table shows DICOM relevant configuration parameters. While some of them may be configured directly via a configuration dialog or a configuration application, other values can only be accessed via the Registry or can not be configured at all. Parameter Configurable (Yes/No) General Parameters Max PDU Receive Size Max PDU Send Size Time-out waiting for a acceptance or rejection response to an Association request or Association Release request (Application Level Timeout) No No Yes Unlimited 32768 Bytes (32kB) 300s Default Value

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Parameter

Configurable (Yes/No)

Default Value

OBI Client Storage SCU Specific Parameters OBI Client Query/Retrieve SCU Specific Parameters Time-out awaiting a Response to a DIMSE Request (Low-Level Timeout) Maximum number of simultaneously initiated Associations Table 4-22 Configuration Parameters Table Yes No 300s 1

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Media Interchange

Media Interchange
OBI Client Application Entity allows importing and exporting DICOM Media Files. Various import and export filters are available in the OBI Client application to read and create DICOM Media Files. This functionality is only available when the OBI Application is operating in file mode. The files fully conform to the Part 10 format. However, the Basic Directory IOD as defined in Media Interchange Application Profiles is not present.

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Support of Character Sets

Support of Character Sets

See Varian System Server DICOM Conformance Statement (3)

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Security

7
7.1 7.2
7.2.1

Security
Security Profiles
No Security Profiles are supported.

Association Level Security

OBI Client
Storage SCU does not support Association Level Security. The Storage SCP instantiated to receive Instances requested by Query/Retrieve SCU checks the following additional values when determining whether to accept Association Open Requests: Called AE Title Calling AE Title IP address of Association Request originator

7.3
7.3.1

Application Level Security

OBI Application
In order to load patient information into the OBI application, the user opens the patient in the 4DITC application, which requires the user identification in the form of a user name and password.

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Appendix A Specialization

Appendix A Specialization
A.1
A.1.1

IOD Contents
Created SOP Instances
IODs created by the OBI Application Entitiy are listed in IOD Details.

A.1.2

Usage of Attributes from received IODs

The OBI Application Entitiy require all Type 1 Attributes to be present.

A.2

Data Dictionary of Private Attributes

The OBI application does not use any private attributes that are not outlined in this document or 3).

A.3
A.3.1

Coded Terminology and Templates

Context Groups
Information will be published in a future version of this document.

A.3.2

Template Specifications
No standard templates are extended and no private templates are used.

A.3.3

Private Code Definitions

There are no private code definitions.

A.4 A.5

Grayscale Image Consistency

Not supported.

Standard Extended/Specialized/Private SOP Classes

Not Used

A.6

Private Transfer Syntaxes

No private Transfer Syntaxes are used.

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Appendix A Specialization

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Appendix B IOD Details

Appendix B IOD Details

B.1 Supported IODs
For better reference with DICOM Standard 1), section titles of the following sub-sections are decorated with section number of DICOM Standard Part 3 where the corresponding IOD Module table can be found.

B.1.1

Computed Tomography Image A.3.3

IE Patient Patient Clinical Trial Subject Study General Study Patient Study Clinical Trial Study Series General Series Clinical Trial Series Frame of Reference Equipment Image Frame of Reference General Equipment General Image Image Plane Image Pixel Contrast/Bolus CT Image Overlay Plane VOI LUT SOP Common Module Reference C.7.1.1 C.7.1.3 C.7.2.1 C.7.2.2 C.7.2.3 C.7.3.1 C.7.3.2 C.7.4.1 C.7.5.1 C.7.6.1 C.7.6.2 C.7.6.3 C.7.6.4 C.8.2.1 C.9.2 C.11.2 C.12.1 Usage M U M U U M U M M M M M C M U U M Not supported Not supported Not supported Not supported Not supported Not supported Presence

Table 7-1 Computed Tomography Image IOD Modules Support

B.1.2

Spatial Registration A.39.3

IE Patient Patient Clinical Trial Subject Study General Study Patient Study Module Reference C.7.1.1 C.7.1.3 C.7.2.1 C.7.2.2 Usage M U M U Not supported Not supported Presence

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Appendix B IOD Details

IE

Module Clinical Trial Study

Reference C.7.2.3 C.7.3.1 C.7.3.2 C.20.1 C.7.4.1 C.7.5.1 C.20.2 C.12.2 C.12.1

Usage U M U M M M M M M

Presence Not supported

Series

General Series Clinical Trial Series Spatial Registration Series

Not supported

Frame of Reference Equipment Spatial Registration

Frame of Reference General Equipment Spatial Registration Common Instance Reference SOP Common

Table 7-2 Spatial Registration Image IOD Modules Support

B.1.3

RT Structure Set A.19.3

IE Patient Patient Clinical Trial Subject Study General Study Patient Study Clinical Trial Study Series RT Series Clinical Trial Series Equipment Structure Set General Equipment Structure Set ROI Contour RT ROI Observations Approval SOP Common Table 7-3 RT Structure Set IOD Modules Support Module Reference C.7.1.1 C.7.1.3 C.7.2.1 C.7.2.2 C.7.2.3 C.8.8.1 C.7.3.2 C.7.5.1 C.8.8.5 C.8.8.6 C.8.8.8 C.8.8.16 C.12.1 Usage M U M U U M U M M M M U M Not supported Not supported Not supported Not supported Not supported Presence

B.1.4

RT Image A.17.3
IE Patient Patient Clinical Trial Subject Module Reference C.7.1.1 C.7.1.3 Usage M U Not supported Presence

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IE Study

Module General Study Patient Study Clinical Trial Study

Reference C.7.2.1 C.7.2.2 C.7.2.3 C.8.8.1 C.7.3.2 C.7.4.1 C.7.5.1 C.7.6.1 C.7.6.3 C.7.6.4 C.7.6.5 C.7.6.6 C.8.8.2 C.11.1 C.11.2 C.8.8.16 C.10.2 C.12.1 N/A

Usage M U U M U M M M M C C C M U U U U M U

Presence

Not supported Not supported

Series

RT Series Clinical Trial Series

Not supported

Frame of Reference Equipment Image

Frame of Reference General Equipment General Image Image Pixel Contrast/Bolus Cine Multi Frame RT Image Modality LUT VOI LUT Approval Curve (Retired) SOP Common

Not supported Not supported Not supported

Extended Interface

Extended Interface

Private

Table 7-4 RT Image IOD Modules Support

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Appendix C Extended Interface

Appendix C Extended Interface

The following IODs have private Attributes containing an XML data structure for transporting structured non-DICOM data: RT Plan CR/CT/MR/SC/RT Image The following sections specify Attributes containing the XML data and describe the structure of the XML data.

C.1

RT Plan
Node Name Min occurs 0 0 0 1 1 Max occurs 1 1 Unbounded 1 1 int Beam identifier Additional items provided from Vision to expand the features of RT Beams. string int TREATMENT or SETUP Relation from the image beams to the treatment and/or setup beams. Order in which the fields are shown When true, gantry angle position is in the extended range, which means it has an over travel (a Gantry can move most typical 400' and not only 360'). When true, gantry angle position is in the extended range, which means it has an over travel (a Gantry can move most typical 400' and not only 360'). MUSubtraction defines whether some MUs have to be subtracted from the related treatment beam to take images in the before phase and/or after phase. Data Type Node Description

ExtendedVAPlanInterface > Beams >> Beam >>> ReferencedBeamNumber >>> BeamExtension

>>>> FieldType >>>> RelatedTreatBeamNumber

1 0

1 1

>>>> FieldOrder >>>> GantryRtnExtendedStart

1 0

1 1

int int

>>>> GantryRtnExtendedStop

int

>>>> MUSubtraction

int

>>>> FieldSetupPhotos

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DICOM Conformance Statement, KC1406D3CS

Appendix - 7 of 10

Appendix C Extended Interface

Node Name >>>>> FieldSetupPhoto >>>>>> SetupPhotoNumber

Min occurs 0 1

Max occurs 2 1

Data Type

Node Description Two setup photos max

int

Increasing number of setup photos. The value has to start from 1 and up. The format of the pixel information. Supported values are 'JPG' and 'BMP' Pixel information of the photo in the corresponding format. Photo has been modified. PhotoModified may have true or false

>>>>>> SetupPhotoFormat

string

>>>>>> SetupPhotoPicture

hex binary

>>>>>> PhotoModified

string

>>> CustomAddOns >>>> CustomAddOn >>>>> CustomAddOnType

0 0 1

1 4 1 string Three Add On Type to choose from: BLOCK COMPENSATOR TRAY Codes for accessory which may be custom made or factory made (in that case the internal code in equal the custom code.) Reference to the identification number of the Block or Compensator. In case the CustomAddOn is a tray, it gets reported back through this node string User-supplied identifier for tray. Max length is 16 characters. The distance from source to slot. This information is needed to distinguish the slot

>>>>> CustomCode

int

>>>>> ReferencedAddOnNumber

int

>>>>> TraySpecification

>>>>>> TrayID

>>>>>> SourceTrayDistance

int

> ToleranceTables >> ToleranceTable

0 0

1 Unbounded Additional items provided from Vision to expand the features of Tolerance Tables with AutoSetup capabilities int Refers to the tolerance

>>> ReferencedToleranceTableNumber

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DICOM Conformance Statement, KC1406D3CS

Appendix C Extended Interface

Node Name

Min occurs

Max occurs

Data Type

Node Description table in RT Tolerance Table module

>>> ToleranceTableExtension >>>> GantryRtnSetup

1 0

1 1 string Setup attributes may have following type: Automatic Manual Remote

>>>> CollRtnSetup >>>> CollXSetup >>>> CollYSetup >>>> PatientSupportAngleSetup >>>> CouchLngSetup >>>> CouchVrtSetup >>>> CouchLatSetup >>>> TableTopEccentricAngleSetup > DoseReferences >> DoseReference >>> ReferencedDoseReferenceNumber

0 0 0 0 0 0 0 0 0 0 1

1 1 1 1 1 1 1 1 1 Unbounded 1

string string string string string string string string

int

Reference to the identification number of the Dose Reference (300A,0012) in the RT Prescription module which is a representation of our reference point Additional items provided from Vision to expand the features of reference points.

>>> DoseReferenceExtension

>>>> DailyDoseLimit >>>> SessionDoseLimit >>>> Breakpoints >>>>> Breakpoint

0 0 0 0

1 1 1 Unbounded

decimal decimal

Unit is [Gy] Unit is [Gy]

Breakpoint extensions, since DICOM has just one DeliveryWarningDose without a description this is needed. decimal Unit is [Gy]

>>>>>> BreakpointDose

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DICOM Conformance Statement, KC1406D3CS

Appendix - 9 of 10

Appendix C Extended Interface

Node Name >>>>>> BreakpointWarning

Min occurs 1

Max occurs 1

Data Type string

Node Description Text which describes the breakpoint. Max length is 254 characters

Table 7-5 RT Plan Extended Interface

10 of 10 - Appendix

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DICOM Conformance Statement, KC1406D3CS