Hi,
I am not sure if I am doing something wrong, but I have uploaded some DICOM series (Chest X-rays) to Orthanc that contain overlays after being processed by another CAD software. The overlay circles particular findings on the CR image. But when I open the patient in the Stone Web Viewer, I am able to see the thumbnail for the CXR (#10- 3 below), but the main viewer is unable to show the actual image.
When selecting the CR with an overlay, it just shows some of the DICOM metadata.
Here is a screenshot:
Hello,
Your screenshot corresponds to the rendering of a DICOM-SR file by the Stone Web viewer. Note that this feature is currently only available in the mainline builds, but will soon be part of release 3.0 of the Stone Web viewer.
The Stone Web viewer can currently only display annotations if your DICOM-SR instance complies with the TID1500 “Measurement Report” template (which is notably used by the IHE “AI-Results” profile). I assume that your CAD software doesn’t produce such files.
If you expect further support, you’ll have to provide a (possibly anonymized) DICOM study.
Regards,
Sébastien-
Stone Web viewer is rendering a DICOM SR but that is not what is selected (I believe). It is supposed to be a CR image with Overlay data among the DICOM metadata. Note the “CR Detect Overlay” in the top right corner. So there must be some issue I don’t yet understand.
Opening this same “CR Detect Overlay” instance externally in a DICOM viewer (e.g., Weasis) shows the CR image with the overlay circling the relevant finding.
I am going to spend some more time diagnosing when I am back in office tomorrow morning. Otherwise, happy to provide an anonymized DICOM study to diagnose.
Okay, so as far as I can tell, the issue seems to be with how the CAD files are being index. I don’t actually know if Orthanc is doing anything “wrong” per se. But here’s what I’ve found…
For every one input CR, the CAD software produces three output DICOM instances: two CR and one SR.
All three output instances share a StudyInstanceUID with the input CR, so all four instances belong to the same Study.
The two output CR and output SR share a SeriesInstanceUID with each other, so when they are indexed in Orthanc they are treated as a multi-instance/slice Series. So, trying to view that “series” results in a rendering of the SR file for some reason. But I’m not even sure what the expected behaviour should be in this case.
What do you think?
Also, FWIW, VolView is able to render the CAD instances without issue. It seems like it must be ignoring the SR file which is part of the series and it just shows the two CR files as a two-slice series (though it also doesn’t render the overlay data).
So I guess my main question is: What should the Stone Web Viewer do when a series contains both image and non-image (e.g., SR) instances?
Perhaps the answer is to maintain the existing behaviour and it is a problem with the data.
Hello,
A DICOM series can only contain 1 type of modality. This can be seen by the fact that the tag Modality (0008,0060) is part of the “General Series Module” in the DICOM standard.
Yes, this is a problem with the data. Get in touch with the manufacturer of your CAD software.
Regards,
Sébastien-
@jodogne Thanks for the response. It felt like a data issue to me, but thank you for confirming this. It seemed odd to me that a single Series could be multi-modal but it makes sense that this is non-compliant with the DICOM standard. I am reaching out to the CAD manufacturer to let them know.
Thanks again!
