Is it possible to send RSDR and dose report image to PACS

[fwa...@gmail.com]

Dear all,

We've recently got OpenRem up and running at Southampton which is great. I'm in the process of setting up DICOM nodes with Engineers on our equipment. I've been told by Siemens that you can only export one format of dose report. Up until now we have been sending dose reports from our fluoro systems to PACS in an image format which can easily be viewed by anyone with PACS access. If I want to export structured dose reports to OpenRem, PACS cannot process these (it seems, I've contacted our PACS team but not heard anything, I think they're a bit busy at the moment!) which means that there's no dose report for other PACS users to view. I don't know whether anyone else actually looks at them but I don't want to stop anyone from viewing dose information.

Is there anyway to send RSDR to OpenRem and image dose report files to PACS? Is this a 'Siemens thing'? 

Thanks in advance,

Fiona Wall

Principal Clinical Scientist

University Hospital Southampton NHS Foundation Trust

[Ed McDonagh]

Hi Fiona

That's really good to hear that you are making good progress!

I think what you are referring to is a Siemens fluoro systems limitation regarding sending Radiation Dose Structured Reports. I can't remember just now, but it is either:

* If an RDSR is created, it must be sent to the default archive (PACS) in addition to any dose server you wish to send it to, or

* If you are automatically sending an RDSR to a dose server, it has to go to the default archive (PACS) too.

Either way, with older PACS systems that refused to store RDSR objects, they would send a failure message back to the fluoro system and it would look like the archive had failed (when it hadn't, except for the RDSR). So rather than having the radiographers getting archive failed messages all the time, we just had to live with no auto sending of RDSRs to the dose server.

However, with modern PACS systems (or correctly configured PACS systems), they are happy to store RDSRs so this is no longer a problem. When you say 'PACS cannot process these', I hope you are meaning that they just store them silently and you can't access them within the PACS interface. This is the case for our Sectra PACS, and I've previously helped a McKesson engineer add the RDSR config to a cardiology PACS.

Therefore our common practice is to store both the RDSR and the Secondary Capture picture of the dose report to PACS, along with sending the RDSR to the dose server. Other sites do the same but then retrieve the RDSR from PACS.

So it is definitely possible to have both RDSR (that your PACS users most likely won't be able to see) and the picture of text dose report sent to the PACS (that they will), not just one or the other.

I hope this makes sense.

Kind regards

Ed

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[COLE, Jonathan (ROYAL FREE LONDON NHS FOUNDATION TRUST)]

We’ve had a similar problem. Siemens change the (I think) modality set for the series from XA image (dose card) to structured report (RDSR). Our PACS (Carestream) uses the series modality to decide if it will show the images, so the dose card becomes invisible if an RDSR is sent. Carestream more or less refused to fix it on their end.

 

You can, however, get the RDSR to display in the reports window on Carestream PACS, which is our plan for resolving this. It will need some user retraining and it is absurd that Carestream can’t sort it, but it is what it is.

 

Jon

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[stamm...@gmail.com]

Hi, we had the same problem here with our Siemens Artis Systems.

we solved the problem for our needs by sending RDSR and the image to ConquestDICOM (Retriever for our openREM installation). With import and export converters, you can store the RDSR in openREM and PACS and also sent the image to the PACS.

the converters look like:

# Artis
ImportConverter4 = ifequal "%V0008,0016","1.2.840.10008.5.1.4.1.1.12.1"; {set 0008,0060 to "SC"; forward to GEPACS; destroy}

# Converter4 sets the DICOM-Tag: modality type to Secondary Capture (=image) and forwards the object to our GE PACS

ImportConverter5 = ifequal "%V0008,1090","AXIOM-Artis"; {forward to GEPACS; destroy}

# Converter 5 forwards all objects (including RDSR) with station name AXIOM-Artis to PACS

Greetings

Georg