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

Description

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 [1], 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.

1. DICOM Breast Imaging Report Templates. Available from: http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_BreastImagingReportTemplates.html