Studies with mixed/multiple equipment

[Richard Raynor]

Hi,

I've found a few situations where individual studies on our PACS system involve series from different equipment. While this ideally wouldn't happen, I'm trying to work out how OpenREM deals with this and decides which system to associate the series with? Is it the earliest series, most frequent series, most complete series, potluck for whatever it retrieves first?

Thanks in advance,

Richard 

[Ed McDonagh]

Can you give me some details in an example so I can work it through?

Are they the same modality type?

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[Richard Raynor]

Hi Ed,

It's partly hypothetical, partly based on a situation I've encountered. This is for the same modality type. 

From a hypothetical level I am asking how OpenREM would record as series if, all under one accession number, there is an image taken under System A and another from System B. I'm considering a multi-part examination which, for some reason (e.g. equipment malfunction), is split across two different pieces of equipment. 

I happened to find a study which was listed as being performed on a different system on PACS compared to OpenREM. After looking into it, the series contained multiple images for System A and a single image, performed after a short delay, on System B. 

System B does not always record data in a way OpenREM can interpret so that may have impacted this and the exposure details associated with it are not in the OpenREM record. I'm not sure if this is due to the mismatch within the series of the two systems or because of the data within the image itself.  My OpenREM configuration includes a sufficient delay that it should have the full dataset.

We also have one patient pathway which involves planar and OPG imaging. The two exams should be separate but on occasion both are being performed within the same series and so I was getting information for the planar equipment for an OPG which it cannot perform. In this case the OPG system doesn't store DICOM data sufficiently for OpenREM to be reading it so I can understand why I am getting this record for the planar system.

[Ed McDonagh]

There is a general assumption in the DX and MG import code that if a study already exists (because the same study instance UID exists in the database), then this new event is another exposure in the same study and there is no reason to re-import the study level information.

With RDSRs if there are multiple RDSRs (with different SOP Instance UIDs) with the same study instance UID then there is a process to see if the new RDSR contains all the events of the old one or has a different set of events. But I think we are again assuming you wouldn't get RDSRs from two devices within the same study!

So I think that all the events would appear under one device. How does your PACS handle it?

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[Richard Raynor]

Hi Ed,

From the few examples I have they do seem to have the same Study UID. Thankfully these are an oddity rather than a common occurrence but I wanted to look into what was happening and why I was getting odd differences.

I don't have sights of what my PACS system is doing behind the scenes but it appears to be grouping the series and displaying the equipment details for whichever study is most recent. It sounds like OpenREM will be using whichever series it gets first which I presume will depend on the Q/R process and is a bit more detailed than I intend to dig. 

Regards,

Richard