The first result was the American College of Radiology (ACR)-National Electrical Manufacturers’ Association (NEMA) standard, which specified a point-to-point connection but with the fast growing technological evolutions with respect to computer networking and picture archiving and communication systems (PACS), this point-to-point standard became of limited use. Meanwhile, a major effort was undertaken to redesign the ACR-NEMA standard by taking into account existing standards for networks and current concepts in the handling of information on these networks. The Digital Imaging and Communications in Medicine (DICOM) standard was the result of this exercise and DICOM has now become the most common standard of its kind, compliance to which is much sought after whenever digital systems are specified or purchased.
The DICOM standard is very adaptable and this is the reason which has led to the successful adoption of DICOM by other specialties that generate images for e.g. pathology, endoscopy, dentistry. DICOM has received the international interest from global corporations which are manufacturers of Medical Imaging Equipments.
The European standards organization, the Comitâ Europâen de Normalisation, uses DICOM as the basis for the fully compatible MEDICOM standard. In Japan, the Japanese Industry Association of Radiation Apparatus and the Medical Information Systems Development Center have adopted the portions of DICOM that pertain to exchange of images on removable media and are considering DICOM for future versions of the Medical Image Processing Standard. The DICOM standard is now being maintained and extended by an international, multispecialty committee. DICOM now is most important standard for communication of medical images. The standard is widely available from manufacturers and is rapidly expanding to include non-radiology imaging but the understanding of DICOM by most radiologist’s remains limited.
Radiologist’s are mostly familiar with film images and the film can be viewed anywhere there is a source of light. With DICOM, there is a transition from film images to digital images and the need to communicate, display, and store these images. With film, slight differences in exposure, processing, and viewing would have negligible effect in these areas but in the case of digital imaging, a difference of few bytes can make it impossible to transfer an image from one system to another.
The DICOM standard ‘prescribes a uniform, well-understood set of rules for the communication of digital images.’ The electronic communication system comprises of a set of layers with each layer performing a set of defined functions as per the international standard for communication called the International Standards Organization Open Systems Interconnection (ISO-OSI) Reference Model.
For further reading on DICOM, the following sites can be referred to:
https://www.rsna.org/Technology/DICOM/index.cfm