Educational Course on DICOM-RT


DICOM, the “Digital Imaging and Communications in Medicine” protocol, has now been widely adopted by the manufacturers as the standard for providing interconnectivity between the various equipment used in Radiology and Radiotherapy. However, since DICOM departs somewhat from standard network protocols based on WEB technology, it is rarely mastered by IT people from the hospitals. This leaves the problems of interoperability to the responsibility of the medical physicists in charge of the equipment. The aim of the course was to provide the medical physicist with the necessary qualifications for understanding the DICOM protocol in some detail, especially for its use in Radiotherapy.

Further information and links.


Lecture notes

Selected key statements have been added to the lecture titles by an attending lay person.
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Introduction to networking

Mrs L. Perret
Computer Science Department,
IIUN, University of Neuchâtel

Introduction to networking (250 kB)

Network architecture consists of a stack of layers:

– host to network (physical transfer, e.g. Ethernet);
– internet layer (packet routing, using IP);
– transport layer (rearranging packets, error checking, using TCP);
– application layer (ftp, http, smtp, …).

The basic structure of DICOM

Ch. Parisot
GE Medical Systems, France

The basic structure of DICOM (1’336 kB)

DICOM is an application layer (the “http” for medical images).
Define the required workflow as first step – then consider how to solve this with DICOM.
Don’t ask “Do you support DICOM?” – but “Which service class do you support?”.

– Storage service class (send an image);
– Query service class (ask whether images exist);
– Retrieve service class (ask for images to be sent).
Check conformance statements for matching SC-User vs. SC-Provider.

The DICOM extensions for radiotherapy

M. Neumann
Nucletron B.V., Veenendaal,
The Netherlands

The DICOM extensions for radiotherapy (1’954 kB)

DICOM-RT is not a separate standard – it is an extension, defining 7 new objects:

– RT image
– RT dose
– RT structure set
– RT plan
– RT treatment record (bem session, brachy session, summary).

Beams are defined with a system of “control points”.

The clinical physics aspects behind DICOM-RT

J.-F. Germond
Hospital of La Chaux-de-Fonds

The clinical physics aspects behind DICOM-RT (5’722 kB)

What should the physicist know about DICOM-RT?

– Terminology (learn it);
– Clinic work flow (describe it);
– Interpretation of attributes (map it).

Real time process validation in clinical practice and the role of DICOM-RT

H. Deutschmann
LKS Salzburg, Austria

Real time process validation in clinical practice and the role of DICOM-RT

(Due to the dynamic sequences in this presentation conversion to pdf was not possible)

It is not difficult to define meaningful functionalities which cannot be handled with the present DICOM-RT version – so the standard needs further development.

General perspectives of DICOM

Ch. Parisot
GE Medical Systems, France

General perspectives of DICOM (4’981 kB)

Handle workflow (already works for diagnostic radiology):

– Worklist for device;
– Storage commitment;
– Modality performed procedure step.

Future developments need to be user-driven and vendor-supported.

Radiotherapy perspectives of DICOM

M. Neumann
Nucletron B.V., Veenendaal,
The Netherlands

Radiotherapy perspectives of DICOM (1’013 kB)

Extended query/retrieve (for RT objects).
Handle workflow (in DICOM-RT).
Integration with RT Information Systems.
Incorporate new functionalities (e.g. fluence maps, optimization parameters).