DICOM 3 Conformance Statement for IntelePACS - Intelerad

DICOM Version 3Conformance Statement for IntelePACSfor IntelePACS version 3.4.1 and laterOctober 21, 2008Part Number: IPDENCNF-O Issue 001This document contains DICOM conformance statements for applications comprising theIntelePACS Image Management System. These are scalable fault-tolerant systems forstoring, archiving and managing digital radiological information.

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 2Revision Date Author Comments1 May 1, 2003 Robert Cox Initial Revision2 Nov 17, 2003 Kent Tse Added 3 table entries in the SOP classes3 Jul 30, 2004 Jason Bechervaise Updated SOP Class UID tables, updatedPACS version.4 Aug 10, 2004 Kent Tse Updated SOP classes and AcceptablePresentation Contexts tables.5 Feb. 15, 2005 Kent Tse Added new Key Object Selection SOP class forPACS 2-6-1 and above.6 Dec. 12, 2005 Kent Tse and SusanDaoudFull document revision, as applicable toIntelePACS version 3.2.2 and later.7 Feb. 20, 2006 Susan Daoud Added Explicit VR Little Endian TransferSyntax UIDs8 March 12, 2007 Kent Tse and IrenePlokarAdded JPEG Baseline (Process 1) and JPEGExtended (Process 2,4) transfer syntaxes, andupdated JPEG Lossless transfer syntax.9 August 29, 2008 Kent Tse Added Structured Report SOP classes for SCPand SCUIssue 001 October 21, 2008 Marc Paquette Changed document version from 2.6 toIPDENCNF-O Issue 001.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 31 IntroductionThe IntelePACS Image Management System comprises a suite of applications running on a variety ofservers that provide DICOM ® conformant services 1 for both short and long term image storage and retrievalof digital image data. The applications use DICOM as the interface to the external world. An IntelePACSserver accepts DICOM association requests for the purpose of storing images and for query and retrieval ofimages. It also initiates DICOM association requests for the purpose of sending images to an externalapplication entity.IntelePACS provide the following DICOM 3.0 functions:• Verification of DICOM connectivity using the DICOM 3.0 Verification service class SCP.• Short-term storage for images provided using the DICOM 3.0 Storage service class SCP.• Storage commitment services provided using the DICOM 3.0 Storage Commitment SCP.• Patient and Study scheduling information provided using the DICOM 3.0 Modality Worklist service classSCP. 2• Long-term archive for images on magnetic tape supporting both manual systems and automatedlibraries (jukeboxes) using the DICOM 3.0 Storage service class SCP and archive managementsoftware.• Adhoc Retrieval of data from the PACS using the DICOM Query/Retrieve service class SCP. The sameinterface provides access to both the short-term storage and long-term archive.• Automatic routing of incoming images to destinations such as viewing workstations and archive serversusing the DICOM 3.0 Storage service class SCU. The automatic routing is based on rules whoseconditions are drawn from values in the DICOM 3.0 image header.• RIS-triggered automatic prefetching of relevant studies based on radiology orders received from a RISusing the DICOM 3.0 Query/Retrieve and Storage service class SCU.• Acquisition-triggered automatic prefetching of relevant studies to the same destination workstations asdetermined by the automatic routing process using the DICOM 3.0 Query/Retrieve and Storage serviceclass SCUs. IntelePACS provides the ability to prefetch from any PACS that uses the DICOM 3.0Query/Retrieve service class SCP and can authenticate both the IntelePACS SCU and the destinationApplication Entity.1 DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digitalcommunications of medical information.2 Requires interface to Radiology Information System or use of IntelePACS Order Entry Tool.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 42 Abbreviations and AcronymsThe following abbreviations and acronyms appear in this document:AEApplication EntityANSI American National Standards InstituteAPIApplication Programming InterfaceDICOM Digital Imaging and Communications in MedicineDIMSE-C DICOM Message Service Element-CompositeDIMSE-N DICOM Message Service Element-NormalizedIODImage Object DefinitionPDUProtocol Data UnitRISRadiology Information SystemSCPService Class Provider (server)SCUService Class User (client)SOPService Object PairTCP/IP Transmission Control Protocol/Internet ProtocolUIDUnique IdentifierIntelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 53 Implementation ModelIntelePACS DICOM services are installed on several specialized servers providing Application Entitiesspecific to the role of that server. Each IntelePACS server type provides a single Application Entity for alllocally supported DICOM services. Multiple services may be combined on ‘hybrid’ servers in lower volumeimplementations, in which case the combined servers assume multiple Application Entities.Five server types have been identified for the purposes of documenting application data flow: ModalityServer, Master Database/Web Server, Robotics Server, Archive Cache Server and RIS Interface Gateway.3.1 Application Data Flow DiagramApplication data flow diagrams are located with the functional definitions of each application entity.3.2 Functional Definition of Application EntitiesPresented below are the functional definitions of DICOM service supported by Application Entities thatcomprise the IntelePACS Image Management System. Sections for services that have similar functionaldefinitions on other Application Entities refer to those sections of this document to avoid repetitionApplication Entity functions can be combined on ‘hybrid’ servers in implementations with lower data volumesor which require less redundancy in their system design.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 63.2.1 Modality Server AE3.2.1.1 VerificationThe verification service is provided to allow client applications to verify DICOM connectivity to IntelePACSservers. The server performs an association check for the calling Application Entity (client) to a controldatabase based on the calling AE Title and TCP/IP address.The server will respond with either:• Success• Rejecteddepending on the results of the verification process.Possible reasons for rejection are:• Calling AE is unknown to the server• Called AE does not match the server AE• Calling AE does not match associated TCP/IP address for the clientThe verification control database is centrally managed and distributed to all server Application Entities.Therefore, successful verification with one server Application Entity implies successful verification to theentire PACS.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 73.2.1.2 StorageProcessing of a storage request begins with the same verification step using the same criteria described insection 3.2.1.1. The server supports the A-Associate service to negotiate an association including supportedSOP classes and Transfer Syntaxes for the storage request.Possible reasons for rejection (other than verification issues) are:• No supported SOP Classes in association• No Supported Transfer Syntaxes in association• Calling AE is not configured as a Storage SCUThe Storage SCU configuration parameter is established when the calling AE is configured in IntelePACSthrough the InteleBrowser DICOM AE Title configuration Admin Tool.Once the (DIMSE)C-STORE process commences, images are stored temporarily and parsed for IODconformance, in particular that all UIDs and required fields are present. Once successfully stored, the imageis registered in the PACS and becomes available for DICOM Query/Retrieve services, archival, automaticrouting and prefetching tasks. Duplicate images are ‘silently’ dropped by the server.Possible reasons for failed storage are:• Server failed to parse the image DICOM header• One or more required fields are missing from the DICOM header• One or more UID tags are related to other UIDs not present in this image• Local storage is fullIntelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 83.2.1.3 Storage CommitmentThe server will accept a Storage Commitment request that includes a list of SOP Instance UIDs to becommitted. The server checks each SOP Instance UID with two requirements:• The image is registered in the local image database• The image is physically located on the local storage mediumThe server creates a Storage Commitment response and transmits this to the calling AE by establishing aseparate association using the AE Title, TCP/IP address and Port specified in the control database for theStorage Commitment SCU.The server will issue Storage Commitment requests to Foreign Storage SCPs. On receipt of a failure N-ACTION response code, the server will resend the SOP Instances to the Foreign storage SCP.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 93.2.1.4 Query/RetrieveThe server will accept C-FIND and C-MOVE requests from any validated AE. On this type of server, onlydata that are found in local storage and that meet the search criteria of the C-FIND request are included inthe C-FIND response.If the data for a C-MOVE request are found locally, the server then queues the data for asynchronoustransfer to the destination AE. The server will then return an immediate response to the requestercontaining the following information:Successful sub-operations Failed sub-operations Remaining sub-operations Destination entities for C-MOVE requests must be configured as a Storage SCP.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 103.2.1.5 Automatic RoutingThe server schedules each incoming image for automatic routing to destination Storage SCPs. Routingdecisions are made following rule-sets and conditions based on fields in the image DICOM header. Once animage is scheduled for routing to one or more destinations, the server uses the Storage SCU service classto transmit the image.3.2.1.6 Acquisition (DICOM) PrefetchingFor each new study received, the server will initiate rules-based prefetching from a designated PACSarchive. The archive may be the same IntelePACS system or any other PACS that conforms to the DICOM3.0 Query/Retrieve service class, accepts Query/Retrieve associations from the server AE and performs C-MOVE functions to the destination entities specified by the server.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 113.2.2 Master Database/Web Server AE3.2.2.1 VerificationRefer to section 3.2.1.1.3.2.2.2 Store-and-ForwardA Master Database/Web server provides a store-and-forward feature. Images that are sent to this type ofserver will be stored temporarily in local storage but not registered in the PACS. The images are thenforwarded to the appropriate short-term storage device using a DICOM C-STORE.This feature will be deprecated in future releases of IntelePACS.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 123.2.2.3 Query/RetrieveA Master Database/Web does not provide local storage services to the PACS. All C-FIND requests initiate asearch of the local Master Database that contains records of all studies stored in the PACS regardless oftheir current location. This provides a convenient way for the IntelePACS user to query the entire PACSwithout having to know where the data currently reside: short-term storage or long-term archive. It allows thePACS to have a limitless number of storage devices while providing a single DICOM-conformant accesspoint.The server will accept C-FIND and C-MOVE requests from any validated AE. On this type of server, C-MOVE requests are broken into a list of series. For each series, the ‘best’ location is determined throughone of a variety of configurable algorithms based on storage type, e.g. short-term, long-term, (ONLINEAVAILABILITY) and source location relative to destination (SITE AWARENESS).Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 13If the data for a C-MOVE request are found on an available location in the PACS, the server initiates a C-MOVE request to the current ‘best’ location for the data. The server will then return an immediate responseto the requester containing the following information:Successful sub-operations Failed sub-operations Remaining sub-operations Destination entities for C-MOVE requests must be configured as a Storage SCP.3.2.3 Robotics Server AE3.2.3.1 VerificationRefer to section 3.2.1.1.3.2.3.2 Query/RetrieveThe Robotics Server AE supports only retrieve or C-MOVE services. Consequently, all data requests mustgo through a Master Database/Web Server. This type of server should never be queried by foreignApplication Entities.C-MOVE requests are added to a tape retrieval queue for processing by the retrieval applications.3.2.4 Archive Cache Server AE3.2.4.1 VerificationRefer to section 3.2.1.1.3.2.4.2 StorageRefer to section 3.2.1.2.3.2.4.3 Query/RetrieveRefer to section 3.2.1.4.3.2.5 RIS Interface Gateway AE3.2.5.1 VerificationRefer to section 3.2.1.1.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 14Modality WorklistThe RIS Interface Gateway (RIG) provides support for multiple Modality Worklists. Each Modality Worklist isaccessible separately by supplying a different called AE Title to the RIG. The server obtains from the RISorders in a state characterized as ‘Patient Arrived’ for a date range specified in the configuration of the RIG.A worklist database is built for each configured worklist entity and is available to any client using theModality Worklist service class SCU.The server supports worklist queries by the following fields:• Patient Name• Patient ID (MRN)• Accession Number• Modality• Scheduled Procedure Step Start Date• Scheduled Procedure Step Start TimeThe server will optionally supply a Study Instance UID and Station ID in the worklist response.3.3 Sequencing of Real-World ActivitiesThe server cannot determine when it has a complete study or what constitutes a complete study unless theclient application uses the Storage Commitment service. If the server receives an image query while alsoreceiving storage requests, the query response may not include all of the images that are in the study.Automatic routing is performed on an image-by-image basis.Acquisition prefetching is triggered by the arrival at the server of a new study (a study that is not alreadypresent in the short-term archive.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 154 AE SpecificationsThe server processes are invoked once on a single machine. A single Application Entity title is assigned toan IntelePACS server for both SCP and SCU operations.An IntelePACS server provides Standard Conformance to the following DICOM 3.0 SOP Classes as anSCU:TABLE 1. SOP Classes Supported by an IntelePACS Server as an SCUSOP Class NameSOP Class UIDComputed Radiography Image Storage 1.2.840.10008.5.1.4.1.1.1CT Image Storage 1.2.840.10008.5.1.4.1.1.2Ultrasound Multi-Frame Image Storage 1.2.840.10008.5.1.4.1.1.3.1MR Image Storage 1.2.840.10008.5.1.4.1.1.4Nuclear Medicine Image Storage 1.2.840.10008.5.1.4.1.1.20Ultrasound Image Storage 1.2.840.10008.5.1.4.1.1.6.1Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7Multi-frame True Color Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7.4X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.1Positron Emission Tomography Image Storage 1.2.840.10008.5.1.4.1.1.128Standalone PET Curve Storage 1.2.840.10008.5.1.4.1.1.129RT Image Storage 1.2.840.10008.5.1.4.1.1.481.1RT Dose Storage 1.2.840.10008.5.1.4.1.1.481.2RT Structure Storage 1.2.840.10008.5.1.4.1.1.481.3RT Plan Storage 1.2.840.10008.5.1.4.1.1.481.5VL Endoscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.1VL Microscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.2VL Slide-Coordinates Microscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.3VL Photographic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.4Study Root Query/ Retrieve Info Model –FIND 1.2.840.10008.5.1.4.1.2.2.1Study Root Query/ Retrieve Info Model –MOVE 1.2.840.10008.5.1.4.1.2.2.2Key Object Selection 1.2.840.10008.5.1.4.1.1.88.59Digital X-Ray Image Storage – For Presentation 1.2.840.10008.5.1.4.1.1.1.1Digital X-Ray Image Storage – For Processing 1.2.840.10008.5.1.4.1.1.1.1.1Digital Mammography X-Ray Image Storage – ForPresentation1.2.840.10008.5.1.4.1.1.1.2Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 16Digital Mammography X-Ray Image Storage – For Processing 1.2.840.10008.5.1.4.1.1.1.2.1Ultrasound Multi-frame Image Storage (Retired) 1.2.840.10008.5.1.4.1.1.3X-Ray Radiofluoroscopic Image Storage 1.2.840.10008.5.1.4.1.1.12.2Gray Softcopy Pres State Storage 1.2.840.10008.5.1.4.1.1.11.1Basic Text SR 1.2.840.10008.5.1.4.1.1.88.11Enhanced SR 1.2.840.10008.5.1.4.1.1.88.22Comprehensive SR 1.2.840.10008.5.1.4.1.1.88.33Chest CAD SR 1.2.840.10008.5.1.4.1.1.88.65Mammography CAD SR 1.2.840.10008.5.1.4.1.1.88.50OB-GYN Ultrasound Procedure Reports 1.2.840.10008.5.1.4.1.1.88.5000Catheterization Lab SR 1.2.840.10008.5.1.4.1.1.88.40Vascular Ultrasound SR 1.2.840.10008.5.1.4.1.1.88.5100Storage Commitment Push Model 1.2.840.10008.1.20.1An IntelePACS server provides Standard Conformance to the following DICOM 3.0 SOP Classes as anSCP:TABLE 2. SOP Classes Supported an by IntelePACS Server as an SCPSOP Class NameSOP Class UIDVerification SOP Class 1.2.840.10008.1.1Computed Radiography Image Storage 1.2.840.10008.5.1.4.1.1.1CT Image Storage 1.2.840.10008.5.1.4.1.1.2Ultrasound Multi-Frame Image Storage 1.2.840.10008.5.1.4.1.1.3.1MR Image Storage 1.2.840.10008.5.1.4.1.1.4Nuclear Medicine Image Storage 1.2.840.10008.5.1.4.1.1.20Ultrasound Image Storage 1.2.840.10008.5.1.4.1.1.6.1Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7Multi-frame True Color Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7.4X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.1Positron Emission Tomography Image Storage 1.2.840.10008.5.1.4.1.1.128Standalone PET Curve Storage 1.2.840.10008.5.1.4.1.1.129RT Image Storage 1.2.840.10008.5.1.4.1.1.481.1RT Dose Storage 1.2.840.10008.5.1.4.1.1.481.2RT Structure Storage 1.2.840.10008.5.1.4.1.1.481.3RT Plan Storage 1.2.840.10008.5.1.4.1.1.481.5Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 17VL Endoscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.1VL Microscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.2VL Slide-Coordinates Microscopic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.3VL Photographic Image Storage 1.2.840.10008.5.1.4.1.1.77.1.4Patient Root Query/ Retrieve Info Model –FIND 1.2.840.10008.5.1.4.1.2.1.1Patient Root Query/ Retrieve Info Model –MOVE 1.2.840.10008.5.1.4.1.2.1.2Study Root Query/ Retrieve Info Model –FIND 1.2.840.10008.5.1.4.1.2.2.1Study Root Query/ Retrieve Info Model –MOVE 1.2.840.10008.5.1.4.1.2.2.2Storage Commitment Push Model 1.2.840.10008.1.20.1Modality Worklist Information Model - FIND 1.2.840.10008.5.1.4.31Key Object Selection 1.2.840.10008.5.1.4.1.1.88.59Digital X-Ray Image Storage – For Presentation 1.2.840.10008.5.1.4.1.1.1.1Digital X-Ray Image Storage – For Processing 1.2.840.10008.5.1.4.1.1.1.1.1Digital Mammography X-Ray Image Storage – ForPresentation1.2.840.10008.5.1.4.1.1.1.2Digital Mammography X-Ray Image Storage – For Processing 1.2.840.10008.5.1.4.1.1.1.2.1Ultrasound Multi-frame Image Storage (Retired) 1.2.840.10008.5.1.4.1.1.3X-Ray Radiofluoroscopic Image Storage 1.2.840.10008.5.1.4.1.1.12.2Gray Softcopy Pres State Storage 1.2.840.10008.5.1.4.1.1.11.1Basic Text SR 1.2.840.10008.5.1.4.1.1.88.11Enhanced SR 1.2.840.10008.5.1.4.1.1.88.22Comprehensive SR 1.2.840.10008.5.1.4.1.1.88.33Chest CAD SR 1.2.840.10008.5.1.4.1.1.88.65Mammography CAD SR 1.2.840.10008.5.1.4.1.1.88.50OB-GYN Ultrasound Procedure Reports 1.2.840.10008.5.1.4.1.1.88.5000Catheterization Lab SR 1.2.840.10008.5.1.4.1.1.88.40Vascular Ultrasound SR 1.2.840.10008.5.1.4.1.1.88.51004.1 Association Establishment Policies4.1.1 GeneralThe server will attempt to initiate associations in response to C-MOVE requests from other ApplicationEntities. The server will only initiate associations in response to valid C-MOVE requests for images that areknown to the server (stored in its database).The maximum PDU size, which can be transmitted by the server, is fixed at 16KB. The default maximumPDU size, which can be received by the server, is configurable with a default value of 16KB and a maximumvalue of 32KB.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 184.1.2 Number of AssociationsThe number of simultaneous associations which will be accepted by an IntelePACS server are limited onlyby the kernel parameters of the underlying TCP/IP implementation. The server will spawn a new process foreach association request that it receives. Therefore, the server can have multiple simultaneous connections,and there is no inherent limitation on the total number of simultaneous associations which the server canmaintain. However, an IntelePACS server will only allow a specified amount of simultaneous associationsper Application Entity. This is established during a configuration step (normally 25).4.1.3 Asynchronous NatureIntelePACS servers support asynchronous operations including C-MOVE operations.4.1.4 Implementation Identifying InformationIntelePACS servers provide an implementation class UID of 1.2.840.114202.5.3 of which 1.2.840.114202 isthe ANSI registered Intelerad Medical Systems UID root.The server will provide an implementation version name of IMSM-m-r-Pp where M-m-r-Pp is theINTELEPACS version.4.2 Association Initiation PolicyThe server attempts to initiate one association in response to each C-MOVE command it receives from anexternal node. The server attempts a single type of association request. The server supports the three C-MOVE SOP classes listed in Table 6. In response to a move request, the server supports the Storage SOPclasses that are listed in Table 1.The server attempts to initiate one C-FIND request for each DICOM prefetching event scheduled by C-STORE activities. The server then attempts one C-MOVE request for each matching prior study obtained inthe previous step for each destination Application Entity.4.2.1 Real-World Activity - Move Request from an External Node4.2.1.1 Associated Real-World Activity - Move Request from an External NodeThe associated Real World activity is a C-MOVE request from an external application. If an applicationsuccessfully establishes an association with an IntelePACS server and makes a valid C-MOVE request thatidentifies one or more images known to the server, the server will insert a C-MOVE request in a moverequest queue to be processed asynchronously. Move requests are checked for duplication before insertionto prevent multiple requests of the same data to the same destination being processed concurrently.On a Master Database/Web Server, C-MOVE requests are processed that identify one or more series thatare known to the entire PACS archive. For each series identified, a C-MOVE requested is initiated by theserver to the current ‘best’ location for that series as determined by the currently configured algorithm.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 194.2.1.2 Proposed Presentation ContextsIn response to a C-MOVE request, the server builds a complete list of series to be moved. The list includesthe SOP class of each series found. The association request will have a single presentation context, whichcontains the abstract syntax that identifies the image class as found in the series list.TABLE 3. Proposed Presentation Contexts for an IntelePACS ServerPresentation Context TableAbstract Syntax Transfer SyntaxName UID Name List UID Listseenoteseenoteseenoteseenoteseenoteseenotesee notesee noteImplicit VR Little Endian TransferSyntaxExplicit VR Little Endian TransferSyntaxRole1.2.840.10008.1.2 SCU None1.2.840.10008.1.2.1 SCU Nonesee note JPEG Baseline (Process 1) 1.2.840.10008.1.2.4.50 SCU Nonesee note JPEG Extended (Process 2,4) 1.2.840.10008.1.2.4.51 SCU Nonesee noteJPEG Lossless, Non-Hierarchical,First-Order Prediction(Process 14 [Selection Value 1])1.2.840.10008.1.2.4.70 SCU Nonesee note JPEG 2000 Lossless Only 1.2.840.10008.1.2.4.90 SCU NoneExtendedNegotiationNote: The Abstract Syntax corresponds to the value found in the database maintained by the each server.More than one presentation context can be offered, each with a different abstract syntax.Note: If the server stored the images in Implicit VR Little Endian Transfer Syntax, some images may havebeen stored by the server with private elements whose encoding scheme is unknown by the server. Theseelements will be transmitted by the server exactly as they were received and they are unaltered upontransmission.Note: If the images are stored in JPEG Baseline or JPEG Extended, they will be transmitted by the server inthe transfer syntax they are stored. There is no conversion from Implicit VR Little Endian or Explicit VR LittleEndian images to JPEG Baseline or JPEG Extended.4.2.1.2.1 SOP Specific Conformance – Move Request from an External NodeAll C-STORE operations are in the context of a C-MOVE request from an external node. The IntelePACSserver sends one C-MOVE response message for each attempted queue insertion.The server does not attempt any extended negotiation. The server does not delete any elements from thefiles it transfers. Therefore the set of optional elements depends entirely on the contents of the files whichwere originally stored on the server.The server may optionally change Photometric Interpretation for out-bound objects to accommodate thoseApplication Entities that cannot support specific interpretations. The server may optionally re-map specificelements to accommodate requirements of the Storage SCP. This is established during a configuration step.The server will attempt a JPEG 2000 Lossless Only transfer syntax to accommodate requirements of theStorage SCP. This is established during a configuration step.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 20The server will attempt a JPEG Baseline (Process 1) or JPEG Extended (Process 2,4) if the stored SOP isin this transfer syntax.In the event that the server receives an unsuccessful C-STORE response, the server will continue attemptsto transfer the image set until either all images have been successfully transmitted or the request is timedout. In the event that the transfer syntax is JPEG 2000 Lossless Only or JPEG Lossless, Non-Hierarchical,First-Order Prediction and the server receives an unsuccessful C-STORE response, the server will fallbackto negotiating an Implicit VR Little Endian or Explicit VR Little Endian transfer syntax for the remainder of theseries.In the event that the transfer syntax is JPEG Baseline (Process 1) or JPEG Extended (Process 2,4) and theserver receives an unsuccessful C-STORE response, the server will not fall back to negotiating an ImplicitVR Little Endian or Explicit VR Little Endian transfer syntax.If the data is stored in Implicit VR Little Endian or Explicit VR Little Endian, no conversion will be performedto JPEG Baseline (Process 1) or JPEG Extended (Process 2,4).If a destination is considered insecure (determined during a configuration step) the server will remove thePatient Name from any out-bound objects before transferring them.4.2.2 Real World Activity – DICOM Prefetching4.2.2.1 Associated Real World Activity – DICOM PrefetchingThe IntelePACS server performs Query/Retrieve operations to PACS archives to retrieve prior studies todiagnostic workstations.When a new study is received by a server, a list of prior studies is fetched from the PACS archive using aDICOM C-FIND using the Study Root Information Model. For each prior in this list, a DICOM C-MOVErequest is initiated to the PACS archive for each destination that it has been determined (through rulesbasedlogic) should receive the prior study.4.2.2.2 Proposed Presentation ContextsRefer to section 4.2.1.2.4.2.2.2.1 SOP Specific Conformance – DICOM PrefetchingTable 4 lists elements in the C-FIND request for DICOM Prefetching.TABLE 4. Elements in DICOM Prefetching QueryDescriptionTagPatient Name 0010 0010Patient ID 0010 0020Study Date 0008 0020Accession Number 0008 0050Modality 0008 0060Study Description 0008 1030Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 214.3 Association Acceptance PolicyThe IntelePACS server accepts associations for the purpose of storing images in its database, for thepurpose of performing Query/Retrieve operations on the images that have been previously stored, for thepurpose of providing Storage Commitment services for stored images or for the purpose of providingModality Worklist services.The server will only accept association requests from applications that are defined during configuration. Inaddition, the server will only store images sent by nodes that have been enabled by a configuration step.4.3.1 Real World Activity – Storage4.3.1.1 Associated Real World Activity – StorageThe IntelePACS server accepts associations from nodes that wish to store images using the C-STOREcommand.The associated Real-World activity associated with the C-STORE operation is the storage of the image onthe disk of the system upon which the server is running. Images are stored by writing the data set of the C-STORE command directly to disk. Images headers are modified under the following circumstances:• The server is performing storage of teaching files. In this case, the Patient Name field is replaced by thetext BLANK^NAME.• The server detects a violation of the DICOM standard in a unique identifier, for example a leading zeroin a multi-digit element of a Study, Series or SOP Instance UID. In this case, the server attempts torepair the UID while preserving uniqueness.• The server retrieves RIS information for the current study during a validation step and that informationconflicts with demographics present in the images. In this case, the server will substitute the RIS valuesinto the DICOM elements.• The server is configured to re-map specific DICOM header fields to other fields.• The server is configured to write the calling Application Entity Description into the element InstitutionalDepartment Name (0008 1040).• The server is configured to write its AE Title, the AE Title and Organization of the calling ApplicationEntity (SCU), MD5Sum, Histogram, Largest and Smallest Pixel Value, into private tags.After the image is stored to disk, the server updates an image database with patient, study, series andimage information. This information is used by the server for Query/Retrieve operations.Image database patient, study, series and location information are transferred to one or more central masterdatabases located on Master Database/Web Servers. Series location information consist primarily of theSeries Instance UID for the image set, the Application Entity Title of the C-STORE SCP (the server) and thenumber of images in the series.The server will issue a failure status if it is unable to store the image on disk, if the image does not conformto the IOD of the SOP class under which it was transmitted, or if the server is not able to successfully updateits image database.Duplicate images, those with a SOP Instance UID already stored on the server are accepted and silentlyignored. Images must be explicitly deleted from the server before they can be replaced with altered copies.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 224.3.1.2 Presentation Context TableAny of the Presentation Contexts shown in Table 5 are acceptable to the server for receiving images.TABLE 5. Acceptable Presentation Contexts for an IntelePACS server – StoragePresentation Context TableAbstract SyntaxTransfer SyntaxName UID Name UIDRoleExtendedNegotiationComputedRadiography ImageStorage1.2.840.10008.5.1.4.1.1.1Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneCT Image Storage 1.2.840.10008.5.1.4.1.1.2Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Ultrasound Multi-Frame ImageStorage1.2.840.10008.5.1.4.1.1.3.1Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneMR Image Storage 1.2.840.10008.5.1.4.1.1.4Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Nuclear MedicineImage Storage1.2.840.10008.5.1.4.1.1.20Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Ultrasound ImageStorage1.2.840.10008.5.1.4.1.1.6.1Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Secondary CaptureImage Storage1.2.840.10008.5.1.4.1.1.7Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Multi-frame TrueColor SecondaryCapture ImageStorage1.2.840.10008.5.1.4.1.1.7.4Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneStand-alone OverlayStorage1.2.840.10008.5.1.4.1.1.8Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 23Presentation Context TableAbstract SyntaxTransfer SyntaxName UID Name UIDRoleExtendedNegotiationStand-alone CurveStorageWaveform WVModality StorageX-Ray AngiographicImage StoragePositron EmissionTomography ImageStorageStandalone PETCurve Storage1.2.840.10008.5.1.4.1.1.91.2.840.10008.5.1.4.1.1.9.11.2.840.10008.5.1.4.1.1.12.11.2.840.10008.5.1.4.1.1.1281.2.840.10008.5.1.4.1.1.129RT Image Storage 1.2.840.10008.5.1.4.1.1.481.1RT Dose Storage 1.2.840.10008.5.1.4.1.1.481.2RT StructureStorage1.2.840.10008.5.1.4.1.1.481.3RT Plan Storage 1.2.840.10008.5.1.4.1.1.481.5VL EndoscopicImage Storage1.2.840.10008.5.1.4.1.1.77.1.1Implicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see noteImplicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.2 SCP None1.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.11.2.840.10008.1.2 SCP None1.2.840.10008.1.2.1Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 24Presentation Context TableAbstract SyntaxTransfer SyntaxName UID Name UIDRoleExtendedNegotiationVL MicroscopicImage Storage1.2.840.10008.5.1.4.1.1.77.1.2Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1VL Slide-CoordinatesMicroscopic ImageStorage1.2.840.10008.5.1.4.1.1.77.1.3Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneVL PhotographicImage Storage1.2.840.10008.5.1.4.1.1.77.1.4Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Patient RootQuery/Retrieve InfoModel –FIND1.2.840.10008.5.1.4.1.2.1.1Implicit VR LittleEndian1.2.840.10008.1.2 SCP NonePatient RootQuery/Retrieve InfoModel –MOVE1.2.840.10008.5.1.4.1.2.1.2Implicit VR LittleEndian1.2.840.10008.1.2 SCP NoneStudy RootQuery/Retrieve InfoModel –FIND1.2.840.10008.5.1.4.1.2.2.1Implicit VR LittleEndian1.2.840.10008.1.2 SCP NoneStudy RootQuery/Retrieve InfoModel –MOVE1.2.840.10008.5.1.4.1.2.2.2Implicit VR LittleEndian1.2.840.10008.1.2 SCP NoneStorageCommitment PushModel1.2.840.10008.1.20.1Implicit VR LittleEndian1.2.840.10008.1.2 SCP NoneModality WorklistInformation Model -FIND1.2.840.10008.5.1.4.31Implicit VR LittleEndian1.2.840.10008.1.2 SCP NoneKey ObjectSelection1.2.840.10008.5.1.4.1.1.88.59Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Digital X-Ray ImageStorage – ForPresentation1.2.840.10008.5.1.4.1.1.1.1Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneDigital X-Ray ImageStorage – ForProcessing1.2.840.10008.5.1.4.1.1.1.1.1Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneIntelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 25Presentation Context TableAbstract SyntaxTransfer SyntaxName UID Name UIDRoleExtendedNegotiationDigitalMammography X-Ray Image Storage– For Presentation1.2.840.10008.5.1.4.1.1.1.2Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneDigitalMammography X-Ray Image Storage– For Processing1.2.840.10008.5.1.4.1.1.1.2.1Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneUltrasound MultiframeImageStorage (Retired)1.2.840.10008.5.1.4.1.1.3Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneX-RayRadiofluoroscopicImage Storage1.2.840.10008.5.1.4.1.1.12.2Implicit VR LittleEndian *see noteExplicit VR LittleEndian *see note1.2.840.10008.1.21.2.840.10008.1.2.1SCPNoneGray Softcopy PresState Storage1.2.840.10008.5.1.4.1.1.11.1Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneBasic Text SR 1.2.840.10008.5.1.4.1.1.88.11Explicit VR LittleEndian *see noteImplicit VR LittleEndian *see note1.2.840.10008.1.2.11.2.840.10008.1.2SCPNoneEnhanced SR 1.2.840.10008.5.1.4.1.1.88.22Explicit VR LittleEndian *see noteImplicit VR LittleEndian *see note1.2.840.10008.1.2.11.2.840.10008.1.2SCPNoneComprehensive SR 1.2.840.10008.5.1.4.1.1.88.33Explicit VR LittleEndian *see noteImplicit VR LittleEndian *see note1.2.840.10008.1.2.11.2.840.10008.1.2SCPNoneChest CAD SR 1.2.840.10008.5.1.4.1.1.88.65Explicit VR LittleEndian *see noteImplicit VR LittleEndian *see note1.2.840.10008.1.2.11.2.840.10008.1.2SCPNoneMammography CADSR1.2.840.10008.5.1.4.1.1.88.50Explicit VR LittleEndian *see noteImplicit VR LittleEndian *see note1.2.840.10008.1.2.11.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 26Presentation Context TableAbstract SyntaxTransfer SyntaxName UID Name UIDRoleExtendedNegotiationOB-GYN UltrasoundProcedure Reports1.2.840.10008.5.1.4.1.1.88.5000Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Catheterization LabSR1.2.840.10008.5.1.4.1.1.88.40Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Vascular UltrasoundSR1.2.840.10008.5.1.4.1.1.88.5100Implicit VR LittleEndian *see note1.2.840.10008.1.2SCPNoneExplicit VR LittleEndian *see note1.2.840.10008.1.2.1Note: The IntelePACS server will accept a JPEG Lossless, Non-Hierarchical, First-Order Prediction transfersyntax with UID of 1.2.840.10008.1.2.4.70, a JPEG 2000 Lossless Only with a UID of1.2.840.10008.1.2.4.90 syntax, a JPEG Baseline (Process 1) with a UID of 1.2.840.10008.1.2.4.50 syntax,or a JPEG Extended (Process 2,4) with a UID of 1.2.840.10008.1.2.4.51 syntax to accommodaterequirements of the SCU. This is established during a configuration step.4.3.1.2.1 SOP Specific Conformance - StorageThe server implements Level 2 (Full) conformance for the Storage SOP Class. The following attributes aremodified by converting all characters to upper case before data is stored in the image database. The imagefiles are modified, however a record of all changes is kept.• Patient Name• Patient ID• Accession Number• Study ID• Study Description• Referring Physician Name• Series DescriptionIn the event that an image is successfully stored by the server, it may be accessed by requestingassociations with the server and performing Query/Retrieve operations.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 27The server returns the following status values in response to a C-STORE request:0000H Image successfully storedA700H Refused - out of resources (unable to create local file)A900H Error - data set does not match SOP ClassC000H Error - cannot understandIn the event of a storage error, the server will return one of the follow in the Error Comment field:PARSE ERRORthe server was unable to parse the imageDATABASE MISMATCH the server has stored this UID in a different relationUNKNOWN ERRORany other storage failureIn the case of an error storing an image, there is no documented method for recovery. The onus is on thestorage SCU to retry the operation and/or to report failure of the storage operation.4.3.1.3 Presentation Context Acceptance CriterionThe server will accept any number of storage SOP classes that are listed in Table 5 above, provided that therequesting application is known to the server and has been enabled to store images on the server (via aconfiguration step). The server defines no limit on the number of presentation contexts accepted. In theevent that the server runs out of resources when trying to accept multiple presentation contexts, the serverwill reject the association request.The server does not check for duplicate presentation contexts and will accept duplicate presentationcontexts.4.3.1.4 Transfer Syntax Selection PoliciesThe server supports the Implicit VR Little Endian, Explicit VR Little Endian, JPEG 2000 Lossless Only, JPEGBaseline (Process 1), JPEG Extended (Process 2,4), and JPEG Lossless, Non-Hierarchical, First-OrderPrediction transfer syntax. The presentation context accepted will depend on the order of the proposedpresentation contexts. If there are no matching presentation contexts the association will be rejected. TheJPEG Baseline (Process 1), JPEG Extended (Process 2,4), JPEG Lossless, Non-Hierarchical, First-OrderPrediction, and JPEG 2000 Lossless Only transfer syntax will only be accepted if the SCU allowed thistransfer syntax (this is established during a configuration step).4.3.2 Real World Activity – Query/Retrieve4.3.2.1 Associated Real World Activity – Query/RetrieveThe server accepts associations from nodes that wish to perform query (find) and retrieve (move) operationson images that have been previously stored by the server.The real-world activity associated with C-FIND and C-MOVE requests are the query and retrieval operationsinitiated by another application. An application other than the server queries the server for patient, study,series and image information that has been previously stored by the server and can request that the serversend images to a third application entity.A Master Database/Web server supports only queries for patient, study and series information.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 284.3.2.2 Presentation Context TableTable 6 shows the presentation contexts that may be accepted by an IntelePACS server for queryoperations.TABLE 6. Acceptable Presentation Contexts for Query ClassesPresentation Context TableAbstract SyntaxTransfer SyntaxExtendedRoleName UID Name UIDNegotiationPatient RootQuery/RetrieveInformation Model– FIND1.2.840.10008.5.1.4.1.2.1.1 Implicit VRLittle Endian1.2.840.10008.1.2 SCP NonePatient RootQuery/RetrieveInformation Model–MOVEStudy RootQuery/RetrieveInformation Model– FINDStudy RootQuery/RetrieveInformation Model–MOVEPatient/StudyOnlyQuery/RetrieveInformationModel – FINDPatient/StudyOnlyQuery/ RetrieveInformation Model– MOVE1.2.840.10008.5.1.4.1.2.1.2 Implicit VRLittle Endian1.2.840.10008.5.1.4.1.2.2.1 Implicit VRLittle Endian1.2.840.10008.5.1.4.1.2.2.2 Implicit VRLittle Endian1.2.840.10008.5.1.4.1.2.3.1 Implicit VRLittle Endian1.2.840.10008.5.1.4.1.2.3.3 Implicit VRLittle Endian4.3.2.2.1 SOP Specific Conformance for SOP Class Query/Retrieve1.2.840.10008.1.2 SCP None1.2.840.10008.1.2 SCP None1.2.840.10008.1.2 SCP None1.2.840.10008.1.2 SCP None1.2.840.10008.1.2 SCP NoneTable 7 below indicates which keys are supported by the server for the Patient Root Information Model. Theserver also supports the Study Root and Patient/Study Only Information Models. The keys supported for thePatient/Study Information Model are the same keys found in Table 7 with a level of "Patient" or "Study".Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 29TABLE 7. Keys Supported for Patient Root Information ModelLevel Description Tag TypePatient Patient Name 0010 0010 RPatient Patient ID 0010 0020 UPatient Patient Birth Date 0010 0030 OPatient Patient Birth Time 0010 0032 OPatient Patient Sex 0010 0040 OStudy Study Date 0008 0020 RStudy Study Time 0008 0030 RStudy Accession Number 0008 0050 RStudy Study ID 0020 0010 RStudy Study Instance UID 0020 000D UStudy Referring Physician Name 0008 0090 OStudy Study Description 0008 1030 OStudy Patient's Age 0010 1010 OStudy Patient's Size 0010 1020 OStudy Patient's Weight 0010 1030 OSeries Modality 0008 0060 RSeries Series Number 0020 0011 RSeries Series Instance UID 0020 000E USeries Body Part Examined 0018 0015 OImage Image Number 0020 0013 RImage SOP Instance UID 0008 0018 UImage SOP Class UID 0008 0016 OImage Samples Per Pixel 0028 0002 OImage Rows 0028 0010 OImage Columns 0028 0011 OImage Bits Allocated 0028 0100 OImage Bits Stored 0028 0101 OImage Pixel Representation 0028 0103 OIntelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 30Table 8 indicates which keys are supported by the server for the Study Root Information Model. Thesetables include the optional and required keys that are supported. Optional keys are supported like requiredkeys. The server does not support relational queries.TABLE 8. Keys Supported for Study Root Information ModelLevel Description Tag TypeStudy Study Date 0008 0020 RStudy Study Time 0008 0030 RStudy Accession Number 0008 0050 RStudy Patient Name 0010 0010 RStudy Patient ID 0010 0020 RStudy Study ID 0020 0010 RStudy Study Instance UID 0020 000D UStudy Referring Physician Name 0008 0090 OStudy Study Description 0008 1030 OStudy Patient Birth Date 0010 0030 OStudy Patient Birth Time 0010 0032 OStudy Patient Sex 0010 0040 OStudy Patient's Age 0010 1010 OStudy Patient's Size 0010 1020 OStudy Patient's Weight 0010 1030 OSeries Modality 0008 0060 RSeries Series Number 0020 0011 RSeries Series Instance UID 0020 000E USeries Body Part Examined 0018 0015 OImage Image Number 0020 0013 RImage SOP Instance UID 0008 0018 UImage SOP Class UID 0008 0016 OImage Samples Per Pixel 0028 0002 OImage Rows 0028 0010 OImage Columns 0028 0011 OImage Bits Allocated 0028 0100 OImage Bits Stored 0028 0101 OImage Pixel Representation 0028 0103 OIntelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 314.3.2.3 Presentation Context Acceptance CriterionThe server will accept any number of query SOP classes that are listed in Table 6 above, provided that therequesting application is known to the server and has been enabled to make requests from the server (via aconfiguration step). The server defines no limit on the number of presentation contexts accepted. In theevent that the server runs out of resources when trying to accept multiple presentation contexts, the serverwill reject the association request.The server does not check for duplicate presentation contexts and will accept duplicate presentationcontexts.4.3.2.4 Transfer Syntax Selection PoliciesAn IntelePACS server only supports the Implicit VR Little Endian transfer syntax. Any proposed presentationcontext which includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR LittleEndian transfer syntax. Any proposed presentation context that does not include the Implicit VR LittleEndian transfer syntax will be rejected.4.3.3 Real World Activity – Verification4.3.3.1 Associated Real World Activity - VerificationThe server accepts associations from nodes that wish to perform a verification operation on the server.The real-world activity associated with the C-ECHO request is that an external node wishes to verify networkor server operation without initiating any actual work.4.3.3.2 Presentation Context TableTable 9 shows the presentation contexts that may be accepted by an IntelePACS server for verificationoperationsTABLE 9. Acceptable Presentation Contexts for an IntelePACS server for VerificationPresentation Context TableAbstract SyntaxTransfer SyntaxName UID Name UIDVerification 1.2.840.10008.1.1 Implicit VRLittle EndianRoleExtended1.2.840.10008.1.2 SCP NoneNegotiationIntelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 324.3.3.2.1 SOP Specific Conformance - Verification4.3.3.3 Presentation Context Acceptance CriterionThe server will accept any number of verification SOP classes that are listed in Table 9 above, provided therequesting application is known to the server (via a configuration step). The server defines no limit on thenumber of presentation contexts accepted. In the event that the server runs out of resources when trying toaccept multiple presentation contexts, the server will reject the association request.The server does not check for duplicate presentation contexts and will accept duplicate presentationcontexts.4.3.3.4 Transfer Syntax Selection PoliciesThe server only supports the Implicit VR Little Endian transfer syntax. Any proposed presentation contextwhich includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endiantransfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endiantransfer syntax will be rejected.4.3.4 Real World Activity – Storage Commitment4.3.4.1 Associated Real World Activity - Storage CommitmentThe server accepts a SOP Class UID and list of SOP Instance UIDs for stored images. Each imagerepresented by its SOP Instance UID is verified by the following criteria:• presence of image in local image database• presence of image on local storageA response is formulated based on the results and transmitted to the Storage Commitment SCU through aseparate association using the (DIMSE)N-EVENT-REPORT primitive in an SCU role.4.3.4.2 Presentation Context TableTable 10 shows the presentation contexts that may be accepted by an IntelePACS server for StorageCommitment operations.TABLE 10. Acceptable Presentation Contexts for an IntelePACS server for Storage CommitmentPresentation Context TableAbstract SyntaxTransfer SyntaxName UID Name UIDRoleExtendedNegotiationStorageCommitmentPush1.2.840.10008.1.20.1 Implicit VRLittle Endian1.2.840.10008.1.2 SCP None4.3.4.2.1 SOP Specific Conformance - Storage CommitmentNone.4.3.4.3 Presentation Context Acceptance CriterionThe server will accept Storage Commitment service requests provided the requesting application is knownto the server.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 334.3.4.4 Transfer Syntax Selection PoliciesThe server only supports the Implicit VR Little Endian transfer syntax. Any proposed presentation contextwhich includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endiantransfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endiantransfer syntax will be rejected.4.3.5 Real World Activity – Modality Worklist4.3.5.1 Associated Real World Activity - Modality WorklistThe Modality Worklist Application Entity is configured with one or more modality worklists based oninformation obtained from the RIS. For each configured worklist, the AE builds a list of worklist informationobjects which can be queried through the Modality Worklist Information Model – FIND SOP Class. The clientAE accesses its worklist by supplying the worklist name as the called Application Entity Title (the title of theModality Worklist SCP). In this way, the server can host an unlimited number of separate worklistsaccessible by one or more SCUs.Information is obtained from the RIS for orders in a specific state (Patient Arrived) and for a pre-configuredsliding date/time range based on the Scheduled Procedure Step Date and Time.4.3.5.2 Presentation Context TableTable 11 shows the presentation contexts that may be accepted by an IntelePACS server for ModalityWorklist service requests.TABLE 11. Acceptable Presentation Contexts for an IntelePACS server for Modality WorklistPresentation Context TableAbstract SyntaxTransfer SyntaxExtendedRoleName UID Name UIDNegotiationModalityWorklist –FIND1.2.840.10008.5.1.4.31 Implicit VRLittle Endian1.2.840.10008.1.2 SCP None4.3.5.2.1 SOP Specific Conformance - Modality WorklistTable 12 shows the keys or elements accepted by the server as search criteria:TABLE 12. Keys Supported for Modality Worklist Information Model – FINDDescription Tag TypePatient Name 0010 0010 OPatient ID 0010 0020 OAccession Number 0008 0050 OScheduled Station AE Title 0040 0001 OScheduled Procedure Step StartDate0040 0002 OScheduled Procedure Step StartTime0040 0003 OModality 0008 0060 OIntelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 34Table 13 shows the elements provided in the Modality Worklist Information Model – FIND response:TABLE 13. Elements Available in Modality Worklist Information Model – FINDDescriptionTagAccession Number 0008 0050Referring Physician Name 0008 0090Patient Name 0010 0010Patient ID 0010 0020Patient Birth Date 0010 0030Patient Sex 0010 0040Study Instance UID a0020 000dRequested Procedure Description 0032 1060Requested Procedure Code Sequence 0032 1064> Procedure Code 0008 0100Scheduled Procedure Step Sequence 0040 0100> Modality 0008 0060> Scheduled Station AE Title a 0040 0001> Scheduled Procedure Step Start Date 0040 0002> Scheduled Procedure Step Start Time 0040 0003> Scheduled Procedure Step ID 0040 0009Requested Procedure ID 0040 10014.3.5.3 Presentation Context Acceptance CriterionThe server will accept Modality Worklist service requests from any application when the called ApplicationEntity Title used represents a configured Modality Worklist on the server.4.3.5.4 Transfer Syntax Selection PoliciesThe server only supports the Implicit VR Little Endian transfer syntax. Any proposed presentation contextwhich includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endiantransfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endiantransfer syntax will be rejected.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 355 Communication Profiles5.1 TCP/IP StackThe server provides DICOM V3.0 TCP/IP Network Communication Support as defined in Part 8 of theDICOM Standard.5.1.1 TCP/IP APIThe server uses the TCP/ IP stack from the Unix system upon which it executes. It uses a sub-routine librarythat is based on a Berkeley socket interface.5.1.2 Physical Media SupportThe server exists as software applications that can be compiled on various Unix platforms and utilities thatrequire a Perl interpreter. However, the preferred platform of implementation and the only one for whichoperational versions are routinely supplied is Linux on ix86 (Intel). Implementation places no restrictions onthe physical network. The server has been demonstrated using TCP/IP over Ethernet (Thick Wire, ThinWire, UTP) at speeds of 10, 100 and 1000 MHz.Intelerad confidential — not for distribution

Intelerad DICOM Conformance Statement—for IntelePACS 3.4.1 and later 366 Extensions/Specializations/PrivatizationsThere are currently no extensions, specializations or privatizations.Intelerad confidential — not for distribution