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Re: understanding DICOM workflow

Hello Sebastian,

I write you as the author of Orthanc [1] that you mentioned in your question.

> > What I would like to do: [typical imaging workflow]
> This can indeed be covered by Open Source tools. One well-known Open
> Source DICOM toolkit is DCMTK which is developed in Germany. [...]
> These are the DCMTK tools that specifically deal with your use case:
> - storescu: Send images ("DICOM Storage SCU")
> - storescp: Receive images ("DICOM Storage SCP")
> - wlmscpfs: Worklist server, serves Worklist jobs from file
>   system ("DICOM Modality Worklist SCP").
> The following tools could also be interesting for you:
> - findscu: Worklist client ("DICOM Modality Worklist SCU")
> - movescu/getscu/findscu: Find and download images ("DICOM Q/R SCU")
> - dcmqrscp: Image archive ("DICOM Q/R SCP"), i.e. mini PACS

Technically speaking, Orthanc is built on the top of DCMTK, which is a really wonderful toolkit. I am really grateful to the OFFIS team for publishing DCMTK under as FOSS.

Orthanc is a higher-level software than DCMTK: It can be thought of as the merge of all the DCMTK command-line tools that were mentioned by Michael. Orthanc creates a consistent REST API above these tools. It also provides a Web interface, a binding to database engines (SQLite and PostgreSQL), a plugin SDK to extend the core system, a Web viewer of medical images, Lua scripting, and the support of DICOMweb. Similarly to DCMTK, Orthanc is cross-platform.

> Note that if you need Storage Commitment
> (another DICOM service on top of DICOM Storage) there is no ready-to-use
> Open Source tool in DCMTK.

FYI, this feature is pending in the Orthanc roadmap [2].

> In order to get an idea how the tools work, you might read through a
> tutorial describing their use for PACS communication that I wrote
> some months ago for a research project.

Another such tutorial is available in the Orthanc Book [3]. This tutorial provides an introduction to DICOM through the looking glass of Orthanc.

Coming back to your original question:

> > I didn't figure out whether I can create a worklist.

Orthanc can serve DICOM worklists through its "ModalityWorklists" official plugin [4], in a similar fashion than DCMTK's wlmscpfs. This plugin is available in the Orthanc official distribution, and is installed with the Debian "orthanc" package. The process of creating a worklist is documented is FAQ #37 of DCMTK [5]: The "*.wl" files that result from this process can be served by Orthanc's ModalityWorklits plugin.

> > I suppose I cannot describe the findings using orthanc.

I am not sure to understand your question. There is a "--verbose" flag to Orthanc that will show the content of the C-FIND requests for worklists.

> > I am not sure what DICOM-storage to use for good
> > reliabilty and interoperability.

If you need reliability, use the PostgreSQL plugin for Orthanc: All the DICOM files and the entire Orthanc index will be stored as a PostgreSQL database, that is enterprise-ready with advanced backup possibilities [6].

Thanks to its internal use of DCMTK that is very widespread in the industry, Orthanc provides good DICOM interoperability.

Of course, if you need more information about Orthanc, do not hesitate to get in touch with its community [7].


[1] http://www.orthanc-server.com/
[2] https://trello.com/c/wyVJMJrS
[3] https://orthanc.chu.ulg.ac.be/book/dicom-guide.html
[4] https://bitbucket.org/sjodogne/orthanc/src/default/Plugins/Samples/ModalityWorklists/
[5] http://forum.dcmtk.org/viewtopic.php?f=4&t=84
[6] http://www.orthanc-server.com/static.php?page=postgresql
[7] https://groups.google.com/forum/#!forum/orthanc-users

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