Submit Public Comments on DICOM Supplement 226 - Confocal Microscopy

DICOM invites stakeholders to submit comments on Supplement 226: Confocal Microscopy.

Scope and Field of Application
This Supplement to the DICOM Standard introduces three new IODs (Confocal Microscopy Image IOD, Confocal Microscopy Tiled Pyramidal Image IOD, Confocal Microscopy Multi-Frame IOD) and three corresponding SOP Classes for encoding and storing confocal microscopy images.
Confocal microscopy is a non-invasive imaging technique that allows examination of the skin at resolutions comparable to histology without performing biopsy. Confocal microscopy may be done on in-vivo or ex-vivo tissue.
In-vivo reflectance confocal microscopy (RCM) is used for the early diagnosis of a range of cutaneous diseases with an emphasis on melanoma and pigmented lesions. In-vivo RCM is most often used as an adjunct to clinical and dermoscopic imaging of skin lesion as opposed to a stand-alone imaging technique. In addition to diagnostic applications, in-vivo RCM may be used for the pre-operative mapping of margins of ill-defined tumors, which allows more accurate surgical plan and reduces surgical morbidity.
The confocal microscope uses a diode laser as a source of monochromatic and coherent light and scanning and focusing optical lens to penetrate the skin and illuminate a small tissue spot. Reflected light forms an image on a photodetector.
Ex-vivo confocal microscopy allows the microscopic examination of freshly excised tissue. The ex-vivo confocal microscopy can work in reflectance mode or fluorescence mode. When using the fluorescence mode, the entire surgical specimen is dipped in a solution of a fluorescent agent and subsequently rinsed to remove excess of fluorescent agent. In reflectance mode no staining is required.
A confocal microscope imaging study consists of different capture modes outlined in Figure 1. A confocal microscopy imaging study always images a single lesion.



All comments should be submitted as soon as possible but NO LATER than 11:59pm US EST on December 28, 2022.

 Who can comment? All interested persons are invited to comment. Recipients of this solicitation should feel free to forward it to anyone who may be interested in this topic. There is no cost or obligation associated with commenting and DICOM membership is not required to comment. Commenters are requested to include their contact information.
 What will happen to your comments? DICOM Working Group 6 (Base Standard) and DICOM Working Group 19 (Dermatology) will review the comments and discuss their resolution. WG-06 is authorized by the DICOM Standard Committee to decide on the technical merits of the comments.
 Instructions for accessing the documents and submitting comments:
1. Download documents from the website (www.dicomstandard.org/comment)

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FTP server (ftp://medical.nema.org/MEDICAL/Dicom/Supps/PC/) under the file names:
 PDF DOCUMENT – sup226_pc_confocal_microscopy.pdf
 WORD DOCUMENT - sup226_pc_confocal_microscopy.docx
 PPT OVERVIEW - sup226_pc_confocal_microscopy.pptx
(To facilitate the readers’ understanding of this new proposed addition to the DICOM Standard, the authors prepared a PowerPoint presentation which describes the technical issues and use cases.)
2. Submit comment(s): Send your comments to Shayna Knazik (This email address is being protected from spambots. You need JavaScript enabled to view it.) via Word Document or free text within your email. Be sure to include the following information:
 Commenter’s name, affiliation, e-mail address.
 Comment – may be a higher-level statement or a detailed technical comment with tables, illustrations, cut-and-paste from the draft, etc.
 Proposed solution – may be a higher-level statement or a marked-up version or new text, tables, illustrations, etc.
 Line numbers associated with your comment(s).