The DICOM Radiation Dose Structured Report: What It Is and What It Is Not

Although most radiologists and medical physicists have heard of the term “DICOM,” which stands for Digital Imaging and Communications inMedicine,many associate this term onlywith the format used to save radiographic images. However, the DICOM standard actually includes the specifications for communicating many types of medical-related data in an organized manner so that devices from different hardware and software manufacturers can talk to one another [1]. Examples of these different types of data, called nonimage information object definitions (IODs) in DICOMspeak, are treatment plans, waveforms, and structured reports, among others. Over the past few years, there has been an increasing awareness of the importance of the radiation dose used to acquire images with ionizing radiation, and with it there has been an increase in the efforts to optimize the levels of radiation used. For this, it is important to be able to store and analyze data regarding the exposure involved during these acquisitions in a standard format that can be machine read and interpreted. Although exposure information is recorded in the header of each image, this solution is not complete or ideal for various reasons. In the first place, there is no standardmethod to decouple the image itself from the exposure information. Therefore, to access and store the exposure information, it must be accompanied by the image data,