TECHNICAL REPORT. Medical electrical equipment Guidelines for implementation of DICOM in radiotherapy

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TECHNICAL REPORT IEC TR 62266 First edition 2002-03 Medical electrical equipment Guidelines for implementation of DICOM in radiotherapy IEC 2002 Copyright - all rights reserved No part of this publication may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and microfilm, without permission in writing from the publisher. International Electrotechnical Commission, 3, rue de Varembé, PO Box 131, CH-1211 Geneva 20, Switzerland Telephone: +41 22 919 02 11 Telefax: +41 22 919 03 00 E-mail: inmail@iec.ch Web: www.iec.ch Commission Electrotechnique Internationale International Electrotechnical Commission Международная Электротехническая Комиссия PRICE CODE For price, see current catalogue X

2 TR 62266 IEC:2002(E) CONTENTS 1 Introduction to this document...5 2 Introduction to DICOM...5 3 DICOM RT Extension...7 4 DICOM RT Capabilities...8 5 DICOM RT Objects...8 6 A DICOM Example (inc RT Objects)...9 7 The DICOM Conformance Statement (DCS)...9 8 DICOM Storage Media Concept...10 9 DICOM Implementation Guide...10 10 DICOM Testing...11 11 Caution to Users...11 12 Concluding Remarks...12 13 References...12 Annex A XYZ/Company Oncology Systems Ltd An Example DICOM Conformance Statement forxyz/product Treatment System...15 A.1 Introduction...15 A.2 Implementation Model...16 A.3 AE Specifications...18 A.4 Communication Profiles...20 A.5 Extensions/Specialisations/Privatisations...21 A.6 Configuration...21 A.7 Support of Extended Character Sets...22 Annex B Applied RT Plan IOD and Mapping to XYZ/PRODUCT Database Import of RT Plan Prescriptions...23 Annex C C-STORE Response Status Codes...44 Annex D Configurable AE-Specific Attribute Mapping to XYZ/PRODUCT Database...46

TR 62266 IEC:2002(E) 3 INTERNATIONAL ELECTROTECHNICAL COMMISSION MEDICAL ELECTRICAL EQUIPMENT GUIDELINES FOR IMPLEMENTATION OF DICOM IN RADIOTHERAPY FOREWORD 1) The IEC (International Electrotechnical Commission) is a worldwide organization for standardization comprising all national electrotechnical committees (IEC National Committees). The object of the IEC is to promote international co-operation on all questions concerning standardization in the electrical and electronic fields. To this end and in addition to other activities, the IEC publishes International Standards. Their preparation is entrusted to technical committees; any IEC National Committee interested in the subject dealt with may participate in this preparatory work. International, governmental and non-governmental organizations liaising with the IEC also participate in this preparation. The IEC collaborates closely with the International Organization for Standardization (ISO) in accordance with conditions determined by agreement between the two organizations. 2) The formal decisions or agreements of the IEC on technical matters express, as nearly as possible, an international consensus of opinion on the relevant subjects since each technical committee has representation from all interested National Committees. 3) The documents produced have the form of recommendations for international use and are published in the form of standards, technical specifications, technical reports or guides and they are accepted by the National Committees in that sense. 4) In order to promote international unification, IEC National Committees undertake to apply IEC International Standards transparently to the maximum extent possible in their national and regional standards. Any divergence between the IEC Standard and the corresponding national or regional standard shall be clearly indicated in the latter. 5) The IEC provides no marking procedure to indicate its approval and cannot be rendered responsible for any equipment declared to be in conformity with one of its standards. 6) Attention is drawn to the possibility that some of the elements of this technical report may be the subject of patent rights. The IEC shall not be held responsible for identifying any or all such patent rights. The main task of IEC technical committees is to prepare International Standards. However, a technical committee may propose the publication of a technical report when it has collected data of a different kind from that which is normally published as an International Standard, for example "state of the art". Technical reports do not necessarily have to be reviewed until the data they provide are considered to be no longer valid or useful by the maintenance team. IEC 62266, which is a technical report, has been prepared by subcommittee 62C: Equipment for radiotherapy, nuclear medicine and radiation dosimetry, of IEC technical committee 62: Electrical equipment in medical practice. The text of this technical report is based on the following documents: Enquiry draft 62C/309/CDV Report on voting 62C/321/RVC Full information on the voting for the approval of this technical report can be found in the report on voting indicated in the above table. This technical report does not follow the rules for structuring International Standards as given in Part 2 of the ISO/IEC Directives. NOTE This report has been reproduced without significant modification of its original content or drafting.

4 TR 62266 IEC:2002(E) This document, which is purely informative, is not to be regarded as an International Standard. The committee has decided that the contents of this publication will remain unchanged until 2007. At this date, the publication will be reconfirmed; withdrawn; replaced by a revised edition, or amended.

TR 62266 IEC:2002(E) 5 MEDICAL ELECTRICAL EQUIPMENT GUIDELINES FOR IMPLEMENTATION OF DICOM IN RADIOTHERAPY 1 Introduction to this document For a number of years, the International Electrotechnical Commission (IEC) worked on the development of a standard addressing Electronic Data Exchange in Radiotherapy. At about the same time, another group with international representation had been working to extend the DICOM (Digital Imaging and Communication in Medicine) standard initially used for diagnostic images to include images/data used in radiotherapy. Ultimately, a decision was made by the IEC to adopt four DICOM RT objects as an IEC standard which appeared in April 1998 as IEC 61852 Medical Electrical Equipment Digital Imaging and Communication System in Medicine (DICOM) Radiotherapy Objects First Edition. The present document has been developed to introduce and to call attention to the complexity of the DICOM standard with its radiotherapy extension. It also addresses the importance of a complete evaluation of the "DICOM Conformance Statement" prepared by manufacturers, and the need for a qualified individual such as a medical physicist to evaluate the compatibility of pieces of radiotherapy equipment impact in the clinic of electronic data transfer, and the integrity of data exchange. This document gives a brief introduction to DICOM including its extension to Radiotherapy. Parts of this document are derived from the brochure produced by the DICOM WG 7 responsible for producing the RT extension to the DICOM Standard. This document outlines preliminary steps required to implement and test a DICOM interface to a medical application system. The DICOM standard has been published (1a) by the National Electrical Manufacturers Association of America. Based on this standard there are a number of DICOM development tool kits produced by academia and available in the public domain. There are also commercial toolkits produced by a number of vendors. Details of these can be obtained on the Internet. The DICOM newsgroup (1b) on the Internet provides state of the art news on DICOM Standard development, related products, problems etc. Some of the Internet references have links to other companies DICOM-related Web sites which are extremely useful for further information on DICOM related subjects. NOTE This document is an implementation guide. For full normative description of the DICOM standard consult the official standard (1a).