Use a message flow that contains a DICOMInput node and one or
more DICOMOutput nodes
to transfer images to specialists at remote locations.
In locations where radiology skills are limited, it might
be necessary for specialists to receive DICOM images (for diagnosis
or research purposes) from across a healthcare system.
To transfer
these DICOM images, a IBM® Integration Bus message flow that contains
a DICOMInput node is
configured to receive DICOM
images sent by a modality, such as a Computerized Tomography (CT) scanner.
The DICOMInput node extracts
the metadata that is associated with the images. Based on key attributes
in the metadata, for example, the Systematized Nomenclature Of Medicine
(SNOMED) code, the message is routed to one or more DICOMOutput nodes. From the DICOMOutput nodes, the DICOM images are transferred
to DICOM Picture Archiving
Communications Systems (PACS) at the specialist locations.
The
following diagram shows an example.

- A patient in Hospital A has a Computed Radiography (CR) exam.
The DICOM images from
the CR exam are sent to a DICOMInput node in the message
flow.
- By using the DICOMInput node,
the DICOM images are
stored in a file system directory.
- The metadata that is associated with the DICOM images is propagated
into the message flow as a DICOM XML
message.
- From the metadata and other logic in the message flow, the appropriate
expert radiologist is identified as being at Hospital C and the DICOM XML message is sent
to a DICOMOutput node.
- By using the DICOMOutput node,
the pixel data for each DICOM image
is retrieved from the DICOMInput node's
directory.
- The pixel data from each DICOM image
is recombined with the metadata from the DICOM XML message and the
resulting DICOM images
are stored in the PACS at Hospital C.
- A message is also sent from the message flow to the patient's
physician, and includes details of the actions taken.
- The expert radiologist studies the DICOM images and creates
a DICOM Structured Report
(SR), which is sent to a DICOMInput node in the message
flow.
- By using the DICOMInput node,
the DICOM SR is stored
in a file system directory.
- The metadata that is associated with the DICOM SR is propagated into
the message flow as a DICOM XML
message, and forwarded to a DICOMOutput node.
- A message is also sent from the message flow to the patient's
physician, and includes details of the actions taken.
- By using the DICOMOutput node,
the pixel data for the DICOM SR
is retrieved from the DICOMInput node's
directory and recombined with metadata from the DICOM XML message.
- The resulting DICOM SR
is sent to the PACS at Hospital A for the local clinical staff to
review.