Ten years of medical imaging standardization and prototypical implementation: the DICOM standard and the OFFIS DICOM toolkit (DCMTK)

In 2003, the DICOM standard celebrated its 10th anniversary. Aside from the standard itself, also OFFIS’ open source DICOM toolkit DCMTK, which has continuously followed the development of DICOM, turns 10 years old. On this occasion, this article looks back at the main standardization efforts in DICOM and illustrates related developments in DCMTK. Considering the development of the DICOM standard, it is possible to distinguish several phases of progress. Within the first phase at the beginning of the 1990s, basic network services for image transfer and retrieval were being introduced. The second phase, in the mid 1990s, was characterized by advances in the specification of a file format and of regulations for media interchange. In the later but partly parallel third phase, DICOM predominantly dealt with the problem of optimizing the workflow within imaging departments. As a result of the fact that it was now possible to exchange images between different systems, efforts concerning image display consistency followed in a fourth phase at the end of the 1990s. In the current fifth phase, security enhancements are being integrated into the standard. In another phase of progress, which took place over a relatively long time period concurrently to the other mentioned phases, DICOM Structured Reporting was developed.