Image formats: Five years after the AAPM standard for digital image interchange

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Abstract
The publication of AAPM Report No. 10 was the first attempt to standardize image formats in the medical imaging community. Since then, three other groups have formed (CART - the Scandinavian collaboration for Computer Assisted Radiation Therapy treatment planning; ACR-NEMA, a collaboration whose purpose is to formulate a standard digital interface to medical imaging equipment; and COST B2 Nuclear Medicine Project a European collaboration whose purpose is to define a format for digital image exchange in Nuclear Medicine). The AAPM format uses key-value pairs in plain text to keep track of all information associated with a particular image. The radiation oncology community in the U.S. has been defining key-value pairs for use with CT, nuclear medicine and magnetic resonance (MR) images. The COST B2 Nuclear Medicine Project has also adopted this format and together with the Australian/New Zealand Society of Nuclear Medicine Technical Standards Sub-Committee which has also adopted this format, has defined an initial set of key-value pairs for Nuclear Medicine images. Additionally, both ACR-NEMA and CART have been defining fields for use with the same types of images. The CART collaboration has introduced a database which is available electronically, but is maintained by a group of individuals. ACR-NEMA operates through committee meetings. The COST B2 Nuclear Medicine Project operates through electronic (and postal where necessary) mail. To insure a consistent set of field names in such rapidly developing arena requires the use of a server rather than a committee. Via a server a person would inquire if a particular field had been defined. If so, the defined name would be returned. If not, the person would be given the opportunity to define the field. The next inquiry would return the previously defined field. As new modalities are added to the imaging repertoire, it would be easier and faster to ensure the consistency and adequacy of the database; e.g., in the present version of its standard, the ACR-NEMA fields are adequate for CT but there are very few fields suitable for describing the parameters associated with nuclear medicine and MR images.

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