Data consistency - additional image after study is closed

[M1nd0nF1r3]

Dear all!

We have following scenario:

- CR Study was performed and closed
- After study was done, on next day we are making additional exposure
- so new image

Questions:

- should new image will have same STUDY INSTANCE UID?

- does PACS system should accept new image? Should it be attached to
old study, DESPITE that new image(study) date will be DIFFERENT?

- For me it looks like data "corruption". How is that told in DICOM
Standard?

- Should PACS archive additional image as new study once again?

Regards, M1nd0nF1r3

[luigipb]

The Study Date is a study level attribute, so it cannot change across
the study, but in fact it is the date when the study starts, even if
it lasts for more than one day (for example, when it crosses
midnight !), no matter if the study contains images acquired in
different days, just put the first date into every image (of course,
Acquisition Date and Series Date can change across the same study).

So, AFAIK, if the two sets of images really belong to the same study,
there is nothing in DICOM against using the same Study ID, Study
Instance UID and Study Date, even if the acquisition crosses midnight.

In the case of our modalities we decided not to allow to re-open a
study after starting a new one: the reason is that there are very few
cases in which you really need that, and we did not want to complicate
too much the user's interface: in case of misunderstanding, the user
could mistakenly re-open the old study instead of creating a new one,
and this would mean to collapse two different studies into one,
possibly affecting the safety, while instead splitting one study into
two would not affect the safety in any way.

Regards.

Luigi Pampana-Biancheri
luigi....@removethis.esaote.com

[raminder....@gmail.com]

To have a new study_uid or not will depend upon RIS generating a new
order. Typically, a new order generation will result in a new study.
If you are taking images in the same order, they belong to the same
"study", and hence PACS will add those images to the current existing
study with the same UID. Therefore, it is more of a workflow issue. If
you dont want the new images (taken on subsequent days) to go to the
previous study, then generate a new order. A new order will result in
a new study_uid in the Hl-7/DICOM interface (like broker), and then
HIS-verification will fetch a new study_uid in PACS to associate the
images with.

In our PACS, there is also a switch that can be used to "lock" read
studies. What this means is that the PACS wiill reject images if they
come in later, after the study has been dictated.