Hello c.p.d.,

we just had an interesting discussion about the recent Thread "Data
consistency - additional image after study is closed"
(http://groups.google.com/group/comp....189029036a28f#

or http://preview.tinyurl.com/6kcaju).

The thing that puzzles me is:

A user opens Images / Instances from a previous Study to make, say, a
measurement and adds a new finding ("no change compared with Images take
1 year ago").

If she stores the information as Structured Report, Presentation State
and / or Secondary Capture, where should it show up?

A) In the new study, as the finding / measurement is new? This will bear
the risk, at least for the Secondary Capture, that the Instance / Series
/ Study Date points to "today" instead of the day the state shown in the
Images was current.

B) In the old study, as the Information that was used to create the
instance was taken from there? This bears the Risk that an Artifact is
associated with a "closed study", the thread mentioned above pointed out
that it may not be possible to send this information to Archive, and for
documentation the added Information was not present when the Study was read.

C) Store it in both, so the Information is available in the original
image study and the new study, and it is evident in both that there is
"something" available.

Strictly DICOM speaking, A) seems to me the correct solution, but I
remember having overseen somewhere that the Structured Reports regarding
prior studies shall also be added to the prior study to signalize that a
new study is available that also regards the Instances in this study -
which would be a hint for C). B) may be a solution that users might
expect, but in case of, say, a board review, is it acceptable to have
new Instances in the archived study?

Any information is appreciated; if there is no regulation yet (IHE?
National?), I am also interested in best practices ) .

What is correct now and what is the solution implemented in your sites?

Just curious ) - I would like to learn about your opinions.


Kind regards,



Peter