Understanding DICOM for Biomedical Engineers

The concept of Digital Imaging is fundamental to biomedical engineering, being a product of the development in the aforementioned field. And, with the advent of the DICOM format, medical devices have undergone a paradigm shift, in terms of technological advancement. For today’s biomedical engineers, the DICOM standard is synonymous with successful image and specific attribute storage, and possesses great promise, with each new iteration of the technologies and systems that use the standard.

For biomedical engineers-to-be, understanding the fundamental concepts of the DICOM standard is necessary, and advised from an early stage of learning. Medical Imaging and Network Training is a brilliant set of training concepts that will help potential BioMed professionals come to grips with the fundamentals of Medical Imaging. To that end, in this article, we will be discussing what DICOM is, as a standard as well as an image format; while explaining the applications of DICOM in terms of practical biomedical engineering.

DICOM: Concept and Fundamental Features

Digital Imaging and Communications in Medicine is basically a standard that is used all over the world to define how storage, transmission and exchange of medical images is performed. The standard is used by medical imaging machines and equipment, to perform the aforementioned functions. Following is some of the medical equipment that uses DICOM:

• X-Ray machines
• Microscopy
• Magnetic Resonance Imaging
• CT scanners
• CR scanning equipment

All of these devices utilize the DICOM format as a standard. While there are some older machines currently being used in some parts of the world, that still don’t use the format; the majority of medical imaging equipment is DICOM-compliant, meaning it is optimized to capture and process DICOM format images.

More than just the imaging devices, any number of DICOM-compliant devices, such as servers, workstations, or any other device that is connected to the network that processes and relays DICOM files, are running on the DICOM protocol, with a network interface that is optimized for the format; rather the standard. All the devices that are connected to the network are referred to as DICOM peers.  

The DICOM format differs from say, .jpg and .png in the way that more than just storing the pixel data; DICOM stores further information which is specific to the singular instance of the format. This data is in the form of attributes, which contain information that is critical to the patient, and the medical case itself. This information needs to be protected, and kept together, not to be separated. An example of this is a CT scan, which contains more than just the image itself. A single DICOM image file coming out of the CT scan will possess several attributes, such as the name, weight, age etc. of the patient.

A single file can contain attributes numbering up to 2,000; all of which can be attached to the file in the fundamental sense. The DICOM data dictionary defines the attributes.

JPEG files have a similar quality, in that they can have embedded tags, which provide a description of the image. DICOM images differ in the sense that they have a lot more detail associated with them, as they are a representation of the medical case in image form, and are meant to compile all the relevant information pertaining to the medical case and the patient within them.

Both two and three-dimensional images can be produced in the DICOM format. This is given that the attribute which has the pixel data stored, possesses said data retained from multiple frames. In simpler terms, a single image can be created from a multi-frame capture, allowing for the creation of 3D images and cine loops.

The DICOM standard expands on the concept, in that it is associated with various other services such as the transport layer protocol. The standard comprises of 20 sections, all of which contain some aspect of the DICOM standard, such as the aforementioned data dictionary. Following are some of the definitions of the sections:

• Image printing into mainstream media (DVDs, MP4 etc.)
• Imaging process worklist management
• Dataset encryption
• Image archival confirmation
• Image review organization
• Saving image manipulation records and annotations

Advantages of DICOM for Modern Biomedical Engineering

There are several integral advantages possessed by the DICOM standard and format that are important for potential biomedical engineers to comprehend.

Singular transactions ensure security

Medical patient records are supposed to be secured at all costs, to both protect the identity of the patient, as well as to prevent unnecessary intervention in the medical procedure pertaining to the said patient. This is a given and is strictly governed. The DICOM format allows for a singular transaction across the network, which will relay both the vital details related to the patient, and the image. Patient safety will also be ensured in this way, since everything will be kept in a single passaged, and relayed in the same way.

Greater device compatibility

In a network consisting of multiple DICOM-compliant devices, there is greater compatibility, and therefore lesser chance of image or data loss through transactions. This increases both the aforementioned patient security, as well as image integrity, as it prevents resizing or compression, which results in corruption of image fidelity.

MINT Training for Biomedical Engineers

Medical Imaging and Network Training instills a deeper understanding of the DICOM standard, and equips biomedical engineer teams to set up stronger, more secure DICOM-compliant networks, while developing more streamlined solutions for their respective healthcare institutions.