A user can select images and presentation states and request them to be sent to multiple destinations (up to 3). Each request is forwarded to the job queue and processed individually. When the "Auto-send" option is active, each marked instance or marked set of instances stored in database will be forwarded to the network job queue for a pre-configured auto-send target destination. Which instances will be automatically marked and the destination where the instances are automatically sent to can be configured. The "Auto-send" is triggered by the Close Patient user application.

The Storage AE is invoked by the job control interface that is responsible for processing network archival tasks. The job consists of data describing the instances marked for storage and the destination. An internal daemon process triggered by a job for a specific network destination initiates a C-STORE request to store images. If the process successfully establishes an Association to a remote Application Entity, it will transfer each marked instance one after another via the open Association. Status of the transfer is reported through the job control interface. Only one job will be active at a time. If the C-STORE Response from the remote Application contains a status other than Success or Warning, the Association is aborted and the related Job is switched to a failed state. It can be restarted any time by user interaction or, if configured, by automated retry.

The Storage AE attempts to initiate a new Association in order to issue a C-STORE request. If the job contains multiple images then multiple C-STORE requests will be issued over the same Association.

If the Remote AE is configured as an archive device the Storage AE will, after all images and presentation states have been sent, transmit a single Storage Commitment request (N-ACTION) over the same Association. Upon receiving the N-ACTION response the Storage AE will delay releasing the Association for a configurable amount of time. If no N-EVENT-REPORT is received within this time period the Association will be immediately released (i.e., notification of Storage Commitment success or failure will be received over a separate association). However, the Storage AE is capable of receiving an N-EVENT-REPORT request at any time during an association provided a Presentation Context for the Storage Commitment Push Model has been successfully negotiated (i.e., the N-ACTION is sent at the end of one association and the N-EVENT-REPORT is received during an association initiated for a subsequent send job or during an association initiated by the Remote AE for the specific purpose of sending the N-EVENT-REPORT).

Figure B.4.2-1. Sequencing of Activity - Send Images

A possible sequence of interactions between the Storage AE and an Image Manager (e.g., a storage or archive device supporting the Storage and Storage Commitment SOP Classes as an SCP) is illustrated in Figure B.4.2-1:

EXAMPLE-INTEGRATED-MODALITY is capable of proposing the Presentation Contexts shown in the following table:

Presentation Contexts for X-Ray Radio Fluoroscopic Image Storage or Grayscale Softcopy Presentation State Storage will only be proposed if the Send Job contains instances for these SOP Classes.

A Presentation Context for the Storage Commitment Push Model will only be proposed if the Remote AE is configured as an archive device.

All Image & Presentation State Storage SOP Classes supported by the Storage AE exhibit the same behavior, except where stated, and are described together in this section.

If X-Ray Radio Fluoroscopic Image Storage SOP Instances are included in the Send Job and a corresponding Presentation Context is not accepted then the Association is aborted using AP-ABORT and the send job is marked as failed. The job failure is logged and reported to the user via the job control application.

If Grayscale Softcopy Presentation State Storage SOP Instances are included in the Send Job and a corresponding Presentation Context cannot be negotiated then Grayscale Softcopy Presentation State Storage SOP Instances will not be sent and a warning is logged. Any remaining Image Storage SOP Instances included in the Send Job will be transmitted. Failure to negotiate a Presentation Context for Grayscale Softcopy Presentation State Storage does not in itself cause the Send Job to be marked as failed. The behavior of Storage AE when encountering status codes in a C-STORE response is summarized in the Table below:

The behavior of Storage AE during communication failure is summarized in the Table below:

A failed send job can be restarted by user interaction. The system can be configured to automatically resend failed jobs if a transient status code is received. The delay between resending failed jobs and the number of retries is also configurable.

The contents of X-Ray Radio Fluoroscopic Image Storage SOP Instances created by EXAMPLE-INTEGRATED-MODALITY conform to the DICOM X-Ray Radio Fluoroscopic Image IOD definition and are described in Section B.8.1.

The contents of Grayscale Softcopy Presentation State Storage SOP Instances created by EXAMPLE-INTEGRATED-MODALITY conform to the DICOM Grayscale Softcopy Presentation State IOD and are described in Section B.8.1.

Grayscale Softcopy Presentation State Storage SOP Instances are created upon user request (e.g., explicitly via "Save" or implicitly via "Close Patient") in order to save the most recent visual appearance of an image (e.g., window center/width, shutters, graphic annotations). When saving the visual appearance, a default Presentation Label will be supplied, which the user can change. The user also has the possibility to enter a detailed Presentation Description. If multiple images from the same study are being displayed the request to save the visual appearance will create one or more Presentation States referencing all displayed images. If images from multiple studies are being displayed at least a separate Presentation State will be created for each study.

When displaying an existing image the most recently saved Grayscale Softcopy Presentation State containing references to the image will be automatically applied. The user has the option to select other Presentation States that also reference the image.

Grayscale Softcopy Presentation State Storage SOP Instances created by EXAMPLE-INTEGRATED-MODALITY will only reference instances of X-Ray Radio Fluoroscopic Image Storage SOP Instances.

Graphical annotations and shutters are only stored in Grayscale Softcopy Presentation State objects. Remote AEs that do not support the Grayscale Softcopy Presentation State Storage SOP Class will not have access to graphical annotations or shutters created by EXAMPLE-INTEGRATED-MODALITY.

The Storage AE will accept associations in order to receive responses to a Storage Commitment Request.

Figure B.4.2-2. Sequencing of Activity - Receive Storage Commitment Response

A possible sequence of interactions between the Storage AE and an Image Manager (e.g., a storage or archive device supporting Storage Commitment SOP Classes as an SCP) is illustrated in the Figure above:

The Storage AE may reject association attempts as shown in the Table below. The Result, Source and Reason/Diag columns represent the values returned in the appropriate fields of an ASSOCIATE-RJ PDU (see Section 9.3.4 in PS3.8 ). The contents of the Source column is abbreviated to save space and the meaning of the abbreviations are:

The Storage AE will accept Presentation Contexts as shown in the Table below.

The Storage AE will prefer to select the Explicit VR Little Endian Transfer Syntax if multiple transfer syntaxes are offered. The Storage AE will only accept the SCU role (which must be proposed via SCP/SCU Role Selection Negotiation) within a Presentation Context for the Storage Commitment Push Model SOP Class.

The Storage AE provides standard conformance to the Verification SOP Class as an SCP. If the C-ECHO request was successfully received, a 0000 (Success) status code will be returned in the C-ECHO response. Otherwise, a C000 (Error - Cannot Understand) status code will be returned in the C-ECHO response.

The request for a Worklist Update is initiated by user interaction, i.e., pressing the buttons "Worklist Update"/"Patient Worklist Query" or automatically at specific time intervals, configurable by the user. With "Worklist Update" the automated query mechanism is performed immediately on request, while with "Patient Worklist Query" a dialog to enter search criteria is opened and an interactive query can be performed.

The interactive Patient Worklist Query will display a dialog for entering data as search criteria. When the Query is started on user request, only the data from the dialog will be inserted as matching keys into the query.

With automated worklist queries (including "Worklist Update") the EXAMPLE-INTEGRATED-MODALITY always requests all items for a Scheduled Procedure Step Start Date (actual date), Modality (RF) and Scheduled Station AE Title. Query for the Scheduled Station AE Title is configurable by a Service Engineer.

Upon initiation of the request, the EXAMPLE-INTEGRATED-MODALITY will build an Identifier for the C-FIND request, will initiate an Association to send the request and will wait for Worklist responses. After retrieval of all responses, EXAMPLE-INTEGRATED-MODALITY will access the local database to add or update patient demographic data. To protect the system from overflow, the EXAMPLE-INTEGRATED-MODALITY will limit the number of processed worklist responses to a configurable maximum. During receiving the worklist response items are counted and the query processing is canceled by issuing a C-FIND-CANCEL if the configurable limit of items is reached. The results will be displayed in a separate list, which will be cleared with the next worklist update.

EXAMPLE-INTEGRATED-MODALITY will initiate an Association in order to issue a C-FIND request according to the Modality Worklist Information Model.

Figure B.4.2-3. Sequencing of Activity - Worklist Update

A possible sequence of interactions between the Workflow AE and a Departmental Scheduler (e.g., a device such as a RIS or HIS that supports the Modality Worklist SOP Class as an SCP) is illustrated in the Figure above:

EXAMPLE-INTEGRATED-MODALITY will propose Presentation Contexts as shown in the following table:

The behavior of EXAMPLE-INTEGRATED-MODALITY when encountering status codes in a Modality Worklist C-FIND response is summarized in the Table below. If any other SCP response status than "Success" or "Pending" is received by EXAMPLE­INTEGRATED-MODALITY, a message "query failed" will appear on the user interface.

The behavior of EXAMPLE-INTEGRATED-MODALITY during communication failure is summarized in the Table below.

Acquired images will always use the Study Instance UID specified for the Scheduled Procedure Step (if available). If an acquisition is unscheduled, a Study Instance UID will be generated locally.

The Table below provides a description of the EXAMPLE­INTEGRATED-MODALITY Worklist Request Identifier and specifies the attributes that are copied into the images. Unexpected attributes returned in a C-FIND response are ignored.

Requested return attributes not supported by the SCP are set to have no value. Non-matching responses returned by the SCP due to unsupported optional matching keys are ignored. No attempt is made it filter out possible duplicate entries.

The above table should be read as follows:

The default Query Configuration is set to "Modality" (RF) and "Date" (date of today). Optionally, additional matching for the own AET is configurable.

After Patient registration, the EXAMPLE-INTEGRATED-MODALITY is awaiting the 1st application of X-Ray Dose to the patient. The trigger to create a MPPS SOP Instance is derived from this event. An Association to the configured MPPS SCP system is established immediately and the related MPPS SOP Instance will be created.

A manual update can be performed with the MPPS user interface where is it possible to set the final state of the MPPS to "COMPLETED" or "DISCONTINUED". In the "Discontinued" case the user can also select the discontinuation reason from a list corresponding to CID 9300 “Procedure Discontinuation Reasons”. A MPPS Instance that has been sent with a state of "COMPLETED" or "DISCONTINUED" can no longer be updated.

The EXAMPLE-INTEGRATED-MODALITY will support creation of "unscheduled cases" by allowing MPPS Instances to be communicated for locally registered Patients.

The EXAMPLE-INTEGRATED-MODALITY only supports a 0-to-1 relationship between Scheduled and Performed Procedure Steps.

EXAMPLE-INTEGRATED-MODALITY will initiate an Association to issue an:

Figure B.4.2-4. Sequencing of Activity - Acquire Images

A possible sequence of interactions between the Workflow AE and a Departmental Scheduler (e.g., a device such as a RIS or HIS that supports the MPPS SOP Class as an SCP) is illustrated in Figure B.4.2-4:

EXAMPLE-INTEGRATED-MODALITY will propose Presentation Contexts as shown in the following table:

The behavior of EXAMPLE-INTEGRATED-MODALITY when encountering status codes in an MPPS N-CREATE or N-SET response is summarized in Table B.4.2-26. If any other SCP response status than "Success" or "Warning" is received by EXAMPLE­INTEGRATED-MODALITY, a message "MPPS update failed" will appear on the user interface.

The behavior of EXAMPLE-INTEGRATED-MODALITY during communication failure is summarized in the Table below:

Table B.4.2-28 provides a description of the MPPS N-CREATE and N-SET request identifiers sent by EXAMPLE-INTEGRATED-MODALITY. Empty cells in the N-CREATE and N-SET columns indicate that the attribute is not sent. An "x" indicates that an appropriate value will be sent. A "Zero length" attribute will be sent with zero length.

A user composes images onto film sheets and requests them to be sent to a specific hardcopy device. The user can select the desired film format and number of copies. Each print-job is forwarded to the job queue and processed individually.

The Hardcopy AE is invoked by the job control interface that is responsible for processing network tasks. The job consists of data describing the images and graphics to be printed as well as the requested layout and other parameters. The film sheet is internally processed, converted to a STANDARD/1,1 page and then the page image is sent. If no association to the printer can be established, the print-job is switched to a failed state and the user informed.

Figure B.4.2-5. Sequencing of Activity - Film Images

A typical sequence of DIMSE messages sent over an association between Hardcopy AE and a Printer is illustrated in Figure B.4.2-5:

Status of the print-job is reported through the job control interface. Only one job will be active at a time for each separate hardcopy device. If any Response from the remote Application contains a status other than Success or Warning, the Association is aborted and the related Job is switched to a failed state. It can be restarted any time by user interaction or, if configured, by automated retry.

EXAMPLE-INTEGRATED-MODALITY is capable of proposing the Presentation Contexts shown in the Table below:

The general behavior of Hardcopy AE during communication failure is summarized in the Table below. This behavior is common for all SOP Classes supported by Hardcopy AE.

Hardcopy AE supports the following DIMSE operations and notifications for the Printer SOP Class:

Details of the supported attributes and status handling behavior are described in the following subsections.

Hardcopy AE supports the following DIMSE operations for the Film Session SOP Class:

Details of the supported attributes and status handling behavior are described in the following subsections.

Hardcopy AE supports the following DIMSE operations for the Presentation LUT SOP Class:

Details of the supported attributes and status handling behavior are described in the following subsections.

Hardcopy AE supports the following DIMSE operations for the Presentation LUT SOP Class:

Details of the supported attributes and status handling behavior are described in the following subsections.

Hardcopy AE supports the following DIMSE operations for the Image Box SOP Class:

Details of the supported attributes and status handling behavior are described in the following subsections.