DICOM SR of clinical data and measurement for breast cancer collections to TCIA

The Data Integration & Imaging Informatics (DI-Cubed) project explored the issue of lack of standardized data capture at the point of data creation, as reflected in the non-image data accompanying various TCIA breast cancer collections. The work addressed the desire for semantic interoperability between various NCI initiatives by aligning on common clinical metadata elements and supporting use cases that connect clinical, imaging, and genomics data. Accordingly, clinical and measurement data was imported into I2B2 and cross-mapped to industry standard concepts for names and values including those derived from BRIDG, CDISC SDTM, DICOM Structured Reporting models and using NCI Thesaurus, SNOMED CT and LOINC controlled terminology.A subset of the standardized data was then exported from I2B2 to CSV and thence converted to DICOM SR according to the the DICOM Breast Imaging Report template  <strong> [1] </strong>, which supports description of patient characteristics, histopathology, receptor status and clinical findings including measurements. The purpose was not to advocate DICOM SR as an appropriate format for interchange or storage of such information for query purposes, but rather to demonstrate that use of standard concepts harmonized across multiple collections could be transformed into an existing standard report representation. The DICOM SR can be stored and used together with the images in repositories such as TCIA and in image viewers that support rendering of DICOM SR content.During the project, various deficiencies in the DICOM Breast Imaging Report template were identified with respect to describing breast MR studies, laterality of findings versus procedures, more recently developed receptor types, and patient characteristics and status. These were addressed via DICOM CP 1838, finalized in Jan 2019, and this subset reflects those changes.DICOM Breast Imaging Report Templates available from: <a href="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_BreastImagingReportTemplates.html">http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_BreastImagingReportTemplates.html</a>

数据集成与成像信息学（DI-Cubed）项目探讨了数据创建阶段标准化数据捕获缺失的问题，这一问题在TCIA乳腺癌数据集中伴随的非图像数据中得以体现。该研究旨在满足各NCI项目间语义互操作性的需求，通过统一临床元数据元素和支持连接临床、成像和基因组数据的用例来实现。因此，临床和测量数据被导入I2B2，并交叉映射到行业标准概念，包括来自BRIDG、CDISC SDTM、DICOM结构化报告模型以及NCI术语表、SNOMED CT和LOINC受控术语的概念。随后，标准化数据的一个子集从I2B2导出为CSV格式，并据此转换为符合DICOM乳腺成像报告模板[1]的DICOM SR格式。该模板支持描述患者特征、组织病理学、受体状态和临床发现，包括测量结果。目的并非倡导DICOM SR作为此类信息查询的适当交换或存储格式，而是展示跨多个集合的标准概念协调后可转化为现有的标准报告表示。DICOM SR可以与图像一起存储和使用，在支持DICOM SR内容渲染的图像查看器中。在项目期间，针对描述乳腺MR研究、发现与程序的左右对比、近期发展的受体类型以及患者特征和状态等方面，识别了DICOM乳腺成像报告模板的多种不足。这些问题通过2019年1月最终确定的DICOM CP 1838得到解决，该子集反映了这些变化。DICOM乳腺成像报告模板可从以下链接获取：[http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_BreastImagingReportTemplates.html](http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_BreastImagingReportTemplates.html)