Under the umbrella of IHE XDS-I

XDS-i, Cross-Enterprise Document Sharing for Imaging, is an IHE technical framework for publishing, finding and retrieving imaging documents across a group of affiliated enterprises. The basic concept can be illustrated as below :

Untitled.png.

In a nutshell, there will be a central index system and any hospital who wants to share its images/reports can register the index of the images/reports to the central control unit. Then others who feel interested in relevant images/reports can query and use those data. XDS-I is inherently a distributed architecture. One of the key features is the is that the images remain in the origin PACS Systems and only clinical data including Dicom KOS Objects holding only references and Metadata to distributed Dicom Images will be stored in a Document Repository.

The Publishing/Discovering mechanism guarantees system's scalability. The idea behind the framework is pretty straightforward. Technically, however, one of the difficulties is how to retrieve those image data. DICOM C-Move is not uncommon here but the Dicom C-Move's problem lies in that 1) it is relatively slow due to multiple transactions and DICOM over the WAN. 2) Complexities introduced from copying data between PACS. and 3) DICOM configuration can become unmanageable in a regional setting. As a workaround, http/https based WADO protocol is recommended to use.

The WADO standard specifies a Web-based service for accessing and presenting DICOM persistent objects, such as images and medical imaging reports. It provides a simple mechanism for accessing a DICOM persistent object from HTML pages or XML documents, through HTTP/HTTPS, using DICOM UIDs. Data can be retrieved either in a presentation-ready form as specified by the requestor (e.g., JPEG or GIF) or in a native DICOM format. It was drafted during the last century and has the deep mark of Web1.0 era. It is essentially a static image oriented protocol. However, today's user is more willing to interact with the acquired images to get the desired effects promptly instead of just a simple viewing. In fact, most of the XDS-I products provided in market are not following the WADO at all. WADO is indeed not competent to the new requirements somehow. When you check Simens's syngo via web, you can find they are using a proprietary protocol over http/https to communicate between browser and server.

So does our product.

Here is a simplified concept diagram of our product ,actually a middleware.
architecture.png

In a bigger picture, in term of XDS-I framework,our product will serve the green part which can be seamlessly and almost non-intrusively integrated with any 3rd party PACS (Image source) as illustrated below:

modified.png