Introduction #
To enable the collection of radiographic data and image quality information a set of DICOM compliant applications have been developed. These applications receive images, structured dose reports and MPPS messages, processing and then sending results to a database for reporting and event notification. These applications are designed to run as a background service on a Windows computer with network access to the DICOM store provider and access to the www.MyXrayDose.com server either directly or via a proxy server. Each installation instance is referred to as a DoseNode.
The application conforms to the requirements of the DICOM standard as a DICOM store-SCP and MPPS SCP and can accept multiple consecutive associations from different Store SCU and MPPS SCU entities.
Figure 1: Overview of DoseNode software component connections.
The MyXrayDose.com destination is specific to the geographical region.
The DoseNode performs a range of function including the following:
- DICOM Store SCP
- DICOM MPPS SCU
- DICOM ECHO
- X-Ray Image Quality Analysis
- Screen Scrape from images of Dose report form some legacy X-ray systems
- DICOM Data Extraction
- Encryption and data transfer to website
Encryption during transfer #
The application is designed to receive medical images, structured dose reports and Modality Performed Procedure Step (MPPS) messages, storing them locally on the client’s computer in the original format until the file is processed. It is the network owner’s responsibility to ensure that access to the local data drive is sufficiently protected to meet their security policy requirements. Once the data is extracted 128 bit AES message level encryption is applied to protect the data from the sending application through to the receiving application on the MyXrayDose server.
Once processed, all local data is deleted from the client’s data directory.
Installation Configurations #
Several configurations of the DoseNode connections to the X-ray Imaging modalities and web service are possible.
A single instance can be installed within an organisation’s network infrastructure, with multiple x-ray systems connecting to the single DoseNode. Alternatively multiple instances can run for the same organisation, each accepting connections from multiple x-ray systems and/or the PACS.
Figure 2: Multiple DoseNodes with connections to multiple x-ray systems.
DoseNode Topology #
The number of DoseNode’s and whether the connection is directly from the Modality or via the PACS is influenced by the capabilities of the imaging modalities and the PACS system. The following table should be used as a guide to the optimal configuration.
|
Modality |
DICOM Images |
RDSR |
MPPS |
Connection Type |
Connections Per DoseNode |
|
CT MG-Tomosynthesis |
One Series per irradiation event minimum. Other series of interest may also be sent |
Required (See note 1) |
Not required |
M |
5 |
|
XA, RF
|
Required |
Preferred |
Only if RDSR not available |
M |
10 |
|
CR, DX, IO, MG, NM, PT, PX |
Required |
Preferred but not required |
Not required |
E |
50 |
Note 1: If RDSR is not available then OCR scrape of dose report is performed .
M = DICOM connect direct to Modality (or to PACS if RDSR available from PACS)
E = Either from PACS (preferred) or from Modality
Modality Abbreviations
- CR Computed Radiography
- CT Computed tomography
- DX Digital Radiography
- IO Intra-oral Radiography
- MG Mammography
- NM Nuclear Medicine
- PT Positron emission tomography (PET)
- PX Panoramic X-Ray
- RF Radio fluoroscopy
- RG Radiographic imaging (conventional film/screen)
- SR SR Document
- XA X-Ray Angiography
- RDSR Radiation Dose Structured Report
- MPPS Modality Performed Procedure Step
DoseNode Computer Requirements #
The DoseNode software will run on either a Virtual Machine or a standalone computer.
|
Component |
Preferred |
Minimum |
|
Operating System
|
Windows 10 Professional 64 Bit OS |
Windows 7, Windows Server 2012, 32 Bit OS |
|
Hardware
|
Quad Core i7 8GB RAM |
A 2GHz processor with 4GB RAM |
|
Disk Storage: |
500 GB SSD, or sufficient disc storage for available for 14 days’ worth of image data. |
100 GB |
|
Networking
|
1 GB/s TCP/IP |
100 MB/s TCP/IP |
DoseNode Computer Configuration Checklist #
|
DoseNode Computer Setup Checklist |
ü |
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BIOS Auto Start after Power Failure (Even if powered via a UPS) |
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Hibernation: CPU Always On |
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Static IP address assigned to computer to allow DICOM communication as per standard connection requirements. |
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Firewall exception created on ports based on configuration settings e.g. Inbound and Outbound Ports 104, 105,11112 enabled for communication with the DICOM compliant imaging modalities within the internal network. Ping, Telnet and DICOM Ping to imaging network on ports performed and confirm communication. |
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Virus protection installed and system scanned: Default AVG. White list service applications as some virus checkers will delete DoseNode applications. |
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Operating system Updated |
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Firewall rule created from Service to website to enable SOAP communication on ports 80 and 443 from local network t Australia au.MyXrayDose.com New Zealand nz.MyXrayDose.com Local system administrator to confirm final rule configuration. |
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Connection information entered into www.MyXrayDose.com website by System administrator. (Data form at end of this document) |
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DoseNode connection entered for external connection to website. Verify connection established for correct customer. Username and password will only work on the original installation (Exclusive to each installation) so cannot be reused on a different computer, or new installation on same computer. |
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Connection details Entered for Proxy Server if required |
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Installation DICOM Client under Windows Operating system #
A windows MSI installer is provided to setup the runtime environment and install the necessary software and libraries.
Running the Installer #
Right click and run the installer MyXrayDose-vXXXX.exe as administrator.
Run as Administrator is required as this installer requires Administrator privileges – for installation and configuration of Windows background services
Click Next
Select Local System account if the services do not require a specific Windows User Account to access installation directory or internet or any proxy servers. If a specific Windows Account is needed the select Use a Specific account and enter details.
Click Next
Click Finish – Another prompt may ask for Administrator privileges, in order to open the MyXrayDose Configuration application
Running the Configuration Utility #
The configuration utility will automatically be launched at the end of the installation process if the Run MyXrayDose check box is left checked during the installation process. It can also be run by locating the MyXrayDoseConfig.exe file in the installation directory and running directly – or via the Start Menu, if that option was left checked during installation.
The following information is required to establish communication between the client application and the web based database.
|
Field |
Usage |
|
Username |
Provided with the installation pack |
|
Password |
Provided with the installation pack. Note 1:The Username and Password are for the application to logon on to the website, and secure the encrypted data transfer connection. They will not provide user access to the web site, and similarly the passwords used to access the user interface and report on the website will not allow the application to access the web services. Note 2: The Username and Password will not work on a different DoseNode computer after the first use as they are specific to each installation. |
|
DICOM Data Directory |
The location where the DICOM images, structured reports and message data will be saved. This should be on the local drive or secure networked drive. Images are stored in the format that they are received. Data stored to this directory will be deleted once processed. Use of a drive other than the system (C:) is recommended so other applications continue to run if the data directory ever fills up to available disc space. |
|
MPPS Receiver’s AE Title |
This is the Application Entity title (AE Title) for this MPPS SCP to allow MMPS-SCU to identify the destination to send MPPS messages if required. Only used for legacy x-ray angiography and fluoroscopy systems that can’t generate Radiation Dose Structured Reports. Suggested name MyXrayDoseMPPS. It is limited to 16 characters length. |
|
DICOM Store Port |
The port should be the standard DICOM Store port used for image storage (Default port 104) |
|
DICOM Receiver’s |
This is the Application Entity title (AE Title) for this Store SCP to allow Store-SCU entities to identify the destination to send images and Radiation Dose Structured Reports to. Suggested name MyXrayDoseNode1. It is limited to 16 characters length. |
|
MPPS Port |
The port should be a different port number to that used for the DICOM Store Port (Default port 11112) |
|
Proxy Address |
Proxy Address if a local proxy server is used for internet access outside of the organisations network. |
|
Proxy Port |
The Port used on the Proxy Server to access the |
|
Proxy Username & Password |
Proxy Username and Password provided by administrator of Proxy Server to allow access through the proxy Server. |
Username & Password #
Important! The User Name and Password provided for the application is only valid for a single installation. If the installer is being re-run a new Username and Password will be required even if the installation is on the same computer.
Connecting to Website #
Use the Main tab on the configuration screen to create a connection to the web site.
Select Server (xx.MyXrayDose.com), enter the Username and Password provided and click Connect. The correct Institution name should load from the website. This confirms the correct identify for this installation and that communication with the website was successful.
Troubleshooting connection Ensure proxy settings are correct on the proxy tab (the program will not use the Windows ‘Internet Options’ proxy)
Click Download Tag Filters and Download Station Filters to retrieve current configuration files for this installation.
Click Save configuration.
Establishing DICOM AE Title and Port Number #
Use the DICOM tab and entre the DICOM AETitle and MMPS AETitle’s for this DICOM Store SCP node. This will be the AETitle that this DICOM instance will be known as to the equipment connecting to this node. A unique AETitle is required for each instance of this application in the case where multiple instances are configured. Leave the default DICOM Data Directory or choose the preferred location. This is where image data is temporarily stored.
Services Tab #
This tab uses the Windows ‘SC’ command to query the state of the MyXrayDose services. The state is intermittently polled, and each service can be individually started/stopped.
Note that following initial installation, the services do not start immediately, but are set to ‘automatic’ to start on system start-up. Should a service crash (due to missing/corrupt configuration or filters file) – the error is logged, and the service will restart following a 1 minute interval. This recovery behaviour can be configured, if desired, in the ‘Services’ Windows Administrator Tool.
Configuring for Use through a Proxy Server #
Where access is through a proxy server is required then activate the Use a proxy to connect to MyXrayDose services check box and enter other details.
Setting up Modality/Store-SCU to Send Images, Structured Reports or MPPS Messages #
The modality or PACS providing the images/DICOM Objects will need to have the DoseNode added as a Store-SCP destination for the images and Dose Structured Report. Vendor documentation required for this.
The DoseNode AETitles, IPAddress and Ports will be needed to configure the connection at the modality.
Any appropriate filtering of data from the PACS system will also need to be applied to restrict data to that from equipment of interest. Advice will be required from your PACS administrator on how to establish a Store-SCP destination and apply any filter conditions to limit sending of data only from appropriate sources.
Testing Network Connections #
Ping #
If the MyXrayDose extraction application has been setup correctly and is discoverable from the Store SCP a network ping and DICOM ping should be possible from both ends of the communication. The ping utility can be used test the IP address is reachable.
Windows Command Prompt:
ping target_name e.g ping 192.168.0.8
If successful a message similar to the following will be received:
Reply from 192.168.0.8: bytes=32 time<1ms TTL=128
If unsuccessful a message similar to the following will be received:
Reply from 192.168.0.8: Destination host unreachable.
If the ping is unsuccessful the source of the DICOM images will be unable to send images to the MyXrayDose application. This is likely to be an issue for the local network administrator to resolve.
Telnet #
The Telnet command is used to test a variety of services for connectivity. This is a good test to use for service or port blocks resulting from a firewall configuration.
To activate Telnet
Search Windows then enter Turn Windows Features On find Telnet Client and check box then exit
Example command prompt TELNET 192.168.0.8 104
Netstat #
You can use NETSTAT.EXE to identify what ports are being used by a particular process. The syntax that we will be using for NETSTAT.EXE is as follows: netstat.exe –a –n –o. The switches we are using provide the following:
-a: listing of all connections and listening ports
-n: display address and port numbers in numerical form
-o: display the owning PID associated with each connection
Command prompt
netstat -a -n –o
If listening on external port then should see:
For IPv4 0.0.0.0 104
For ipV6 [::]: 104
DICOM ECHO #
The MyXrayDose has a DICOM Echo function. Using either the C-ECHO (DICOM ping) function likely to be included in the imaging modality or PACS from which the images are being sent. If this fails the error message will need to be noted and advised for resolution. Failure at this point is most likely due to:
- firewall rule not properly setup
- non-supported image format being sent.
- DICOM StoreSCP (i.e. MXD_DICOMReceiverService) service is not running or is unreachable
An alternative C-ECHO tool such as – the DCMTK utility can be used. This is located in the resources folder after the installer run.
Wireshark #
For advanced troubleshooting install Wireshark www.wireshark.org and set the filter condition to “dicom” to see whether DICOM communication occurring and any imbedded error messages or ip.addr==xx.xx.xx.xxx && ip.addr==yy.yy.yy.yyyy to filter messages between two ip addresses if no DICOM communication.
e.g to filter dicom messages between two ip addresses dicom && ip.addr==192.168.2.101
Uninstalling #
Locate the uninstaller in the application directory and run from. All application source code files will be deleted and the application uninstalled.
DoseNode Installation Record #
|
Installation |
Details |
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Institution |
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Location/Room |
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Department |
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Outlet ID |
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Machine Name |
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Network Card Configuration |
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IP Address (Static) |
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Gateway |
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Mask |
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DNS 1 |
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DNS 2 |
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Application User Credentials |
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Use Local System Account |
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Windows Account |
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Installation Directory |
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Windows Password |
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Application Settings |
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MyXrayDose Username |
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Store AE Title |
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MyXrayDose Password |
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Store Port |
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Server |
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MPPS AETitle |
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DICOM Data Directory |
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MPPS Port |
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Proxy Settings |
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Proxy Address |
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Proxy Username |
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Proxy port |
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Password |
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Connection Test |
ü |
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ü |
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Connection Success |
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Test File sent & received |
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Power Management No Hibernate |
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Station Filter & TagFilter Downloaded |
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Tags Extracted |
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Power management Automatically restart after power failure |
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Proxy Server Test Success |
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XML Uploaded |
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Services Running |
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Log File no errors |
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File received at Website |
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Installation Notes:
Appendix #
Troubleshooting #
|
Symptom |
Possible Cause |
Solution |
|
Services unable to run and Stop and restart every few seconds. |
Missing or invalid configuration file. Missing or invalid security certificate.
|
Reload configuration file from website using Reinstall application using installer. |
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UpLoader won’t upload files from Output directory , but configuration utility able to download XMLStation filters and proxyserver configuration returns “Success” when tested. |
The Service login credentials are incorrect or missing. Run installer again with valid login credentials |
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Message associated with invalid User Credentials.
