4.0 Article

DICOM Format and Protocol Standardization-A Core Requirement for Digital Pathology Success

Journal

TOXICOLOGIC PATHOLOGY
Volume 49, Issue 4, Pages 738-749

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/0192623320965893

Keywords

whole slide imaging; virtual microscopy; DICOM; TIFF; image metadata; enterprise imaging; interoperability

Funding

  1. Janssen Pharmaceutica

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The use of digital techniques in toxicologic pathology is expanding, bringing challenges of scalability and interoperability. The DICOM standard, initially known for radiology, has evolved to become widely adopted in medical imaging, although adoption for whole slide imaging has been slow. The incentives for widespread commercially viable clinical use of digital pathology are changing, with DICOM showing feasibility for whole slide imaging and virtual microscopy through connectathons. Adopting DICOM for digital and computational pathology allows for the reuse of enterprise-wide infrastructure and embedded metadata for detached files to remain useful.
As the use of digital techniques in toxicologic pathology expands, challenges of scalability and interoperability come to the fore. Proprietary formats and closed single-vendor platforms prevail but depend on the availability and maintenance of multiformat conversion libraries. Expedient for small deployments, this is not sustainable at an industrial scale. Primarily known as a standard for radiology, the Digital Imaging and Communications in Medicine (DICOM) standard has been evolving to support other specialties since its inception, to become the single ubiquitous standard throughout medical imaging. The adoption of DICOM for whole slide imaging (WSI) has been sluggish. Prospects for widespread commercially viable clinical use of digital pathology change the incentives. Connectathons using DICOM have demonstrated its feasibility for WSI and virtual microscopy. Adoption of DICOM for digital and computational pathology will allow the reuse of enterprise-wide infrastructure for storage, security, and business continuity. The DICOM embedded metadata allows detached files to remain useful. Bright-field and multichannel fluorescence, Z-stacks, cytology, and sparse and fully tiled encoding are supported. External terminologies and standard compression schemes are supported. Color consistency is defined using International Color Consortium profiles. The DICOM files can be dual personality Tagged Image File Format (TIFF) for legacy support. Annotations for computational pathology results can be encoded.

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