1. Introduction

PacsOne is a DICOM 3.0 compliant PACS (Picture Archive and Communication System) application that combines the following components in one machine or one box:

• A DICOM server.
• A PACS server which uses open source MySQL/MariaDB databases.
• A Web server which uses open source Apache 2.x HTTP server and PHP (recursive acronym for "PHP: Hypertext Preprocessor") scripts.
• A optional HL7 interface to receive and send HL7 messages via Minimal Lower Level Transport Protocol (MLP/MLLP/LLTP)

The benefits of PacsOne over the traditional PACS servers are:

• It is free (Basic Edition) or low cost (Premium Edition) since it uses open source MySQL database and Apache web servers.
• It makes the life of a PACS administrator a lot easier since there is only ONE instead of multiple servers or boxes to maintain.
• Users can freely choose their favorite server platform or hardware, whether it is a PC, workstation, fully-fledged server with RAID disk arrays or even a laptop, to install and run PacsOne server software.
• Users can freely choose their favorite operating system software, whether it is Linux, Mac OS X, Windows 2008/2012 Server or Vista/Windows 7/Windows 8/Windows 10.
• Archiving of the PACS database is just as simple as backing up files on a regular server, which makes PacsOne fit seamlessly into the rest of IT infrastructure of the entire organization.  A PACS administrator has the freedom to choose their favorite backup solutions, software and/or archive media.

This implementation of PacsOne server is designed to provide the following features:

• The application serves as a short-term archive for images. It accepts images from external sources and stores them for later retrieval.
• PacsOne uses DICOM as the interface to external conforming clients. The DICOM server accepts DICOM association requests for the purpose of storing images and for image query and retrieve. PacsOne server will initiate DICOM association requests for the purpose of sending images to an external server, querying remote application entities, or printing images to remote Dicom printers. PacsOne server does not respond to any other type of network communication.
• PacsOne uses Apache Web server as the interface for viewing and managing the PACS database, and for reviewing images on-line through a web browser.
• The Premium Edition of PacsOne Server supports Automatic Image Routing Table, where users can define routing entries based on the following criteria:
  

  Field	Description
  Source Application Entity (AE) Title	Images received from the matching Source AE Title will be routed to the destination AE automatically based on the specified Schedule below.
  Key Attribute Tag	Currently, the Patient ID (0010,0020), Referring Physician's Name (0008,0090) and Protocol Name (0018,1030) key tags are supported. Users can define a matching pattern string with wild-card characters including '*' and '?', so that if the received image attribute matches with the specified pattern string, PacsOne Server Premium Edition will automatically route the received image to the destination AE based on the specified Schedule below.
  Destination AE Title	This is the destination AE where the received images will be routed.
  Schedule	Route Immediately (as soon as received), a [From, To] window, or based on a fixed 24-hour clock.
  Auto Purge	Whether or not to purge received images after they have been routed successfully to the destination AE(s).

  
  

• The Premium Edition of PacsOne Server supports querying remote DICOM Modality Worklist (DMWL) SCP applications and displaying the query results through the web user interface.
• The Premium Edition of PacsOne Server supports receiving event notifications sent by remote Detached Study Management SCP applications, as well as querying remote Detached Study Management SCP applications for study related information.
• The Premium Edition of PacsOne Server supports storage of DICOM V3.0 Strucutre Reports (SR), as well as presentation of the Structure Reports through the web user interface.
• The Premium Edition of PacsOne Server supports DICOM Media Storage Services and File Format (PS 3.10) as a File Set Creator (FSC) and File Set Reader (FSR) of the General Purpose CD-R and DVD Interchange Profiles. From the PacsOne web user interface, users can export selected patients/studies in the PacsOne database to a local directory using DICOM standard directory formats (DICOMDIR), which can later be archived into CD-R/RW or DVD-R/RW/RAM for media interchange. Uses can also import external patients/studies from a DICOM Media Storage Service compliant directory or CD/DVD media into the PacsOne database.
• The Premium Edition of PacsOne Server Supports the Automatic Purging Storage Directories feature by allowing the user to define a set of Low-Water and High-Water Marks in terms of disk usage percentage for PacsOne Server archive directories. If Enabled by the user and the disk usage percentage of the archive directories has dropped below the user-defined Low-Water Mark, PacsOne Server Premium Edition will start to purge older studies stored in the archive directories, by the order of the date the studies were received, until the disk usage percentage has risen above the user-defined High-Water Mark. User can also specify optionally a Destination Folder to move aged studies instead of permanently delete the aged studies.
• The Premium Edition of PacsOne Server supports printing both color and grayscale images to Dicom compliant remote printers from the PacsOne Server web user interface.
• The Premium Edition of PacsOne Server supports synchronizing its local database with remote studies stored on external application entities based on user-specified schedule (s). Users can also select whether to synchronize all remote studies or only those recent studies received in the past N days.

2. Implementation Model

PacsOne Server provides for storage, query/retrieval and management of Dicom formatted images and reports. It runs on the following platforms:

• Windows 2008/2012/2016/2019 Server
• Windows Vista/Windows 7/Windows 8/Windows 10
• Linux (Premium Edition)
• Mac OS X (Premium Edition)

as a background process (service) that accepts association requests from external applications. PacsOne server employs a configurable thread pool to service requesting applications. PacsOne server will initiate a DICOM C-STORE association in response to either a C-MOVE request from an external application, user forwarding requests entered from the web user interface, or matches with automatic image routing table entries. PacsOne server is started automatically when Windows starts up, users which have Windows Administrator's privilege can stop and re-start PacsOne server process manually from the "Services" tablet of the Windows Control Panel.

The following parameters of the PacsOne server are configurable by executing the 'SETUP.EXE' program during Installation, or by modifying the Windows Registry values manually under the following key for Windows platforms:

HKEY_LOCAL_MACHINE\\SOFTWARE\\RainbowFish Software\\PacsOne\\${AeTitle}\\

or by modifying the "${AeTitle}.ini" configuration file under the directory where PacsOne Server is installed for Linux/MacOS platforms

After modifying any of the above Registry settings, the PacsOne server needs to be restarted in order for the changes to take effect.

2.1 Application Data Flow Diagram

Figure 1 shows the relationship of PacsOne server to external applications. As noted above, PacsOne server does not initiate any action except in response to requests which are received either via DICOM associations or from the web user interface.

FIGURE 1. PacsOne Server Implementation Model

2.2 Functional Definition of Application Entities

PacsOne server waits for another application to connect to the TCP/IP port number specified when the application is initiated. When a DICOM association request is received, PacsOne server uses a MySQL database table and the following logic to verify the incoming request:

• PacsOne server is permissive when verifying the Called Application Entity Title of the incoming association request. It does not reject an incoming association request based on the specified Called Application Entity Title.
• PaceOne server queries the 'applentity' table to verify if there is a row whose 'title' field matches (case insensitive) with the Calling Application Entity Title of the incoming request.
• If there is a match, PacsOne server then verifies that the matching application entity has access to the MySQL database, by querying the 'allowaccess' field of the 'applentity' table.
• If 'allowaccess' field is Enabled (non-zero), PacsOne server then proceeds to service the incoming association request.
• If 'allowaccess' field is Disabled ('0') or no matching application entity is found for the Calling Application Entity Title, PacsOne server will reject the incoming association request from this application entity.

2.3 Sequencing of Real-World Activities

See the Association Initiation and Acceptance Policy sections below on real-world activities for all SOP classes supported by PacsOne Server.

3. AE Specifications

PacsOne server is started automatically when Windows starts up, or user can manually stop and re-start PacsOne server from the 'Services' tablet of the Windows Control Panel.  PacsOne server uses a configurable thread pool to service all DICOM 3.0 protocol I/O processing.  The number of threads in the thread pool has a default value of 2, and can be configured by modifying the following Registry value for Windows platforms:

HKEY_LOCAL_MACHINE\\SOFTWARE\\RainbowFish Software\\PacsOne\\${AeTitle}\\ThreadPoolSize

ThreadPoolSize = 2

NOTE: Setting a large value for the number of threads in the thread pool does not necessarily increase the overall performance of PacsOne server.  It is recommended to set the size of thread pool to be twice the number of available processors or CPU's in the system. PacsOne server needs to be re-started if the size of thread pool is modified.

3.1 AE PacsOne Server - Specification

PacsOne server provides Standard Conformance to the following DICOM 3.0 SOP Classes as a SCU:

PacsOne server provides Standard Conformance to the following DICOM 3.0 SOP Classes as a SCP:

3.2 Association Establishment Policies

3.2.1 General

The DICOM Application Context Name (ACN) proposed by PacsOne Server is fixed: "1.2.840.10008.3.1.1". The maximum PDU size which can be transmitted by PacsOne server is fixed at 32 Kbytes.  The maximum PDU size which can be received by PacsOne server is up to 32 Kbytes.

3.2.2 Number of Associations

The number of simultaneous associations which can be accepted by PacsOne server are limited only by the kernel parameters of underlying TCP/IP implementation and resource utilization of the computer where PacsOne server is installed. PacsOne server utilizes a thread pool to service each association request that it receives. Therefore, PacsOne server can have multiple simultaneous connections, and there is no inherent limitation on the total number of simultaneous associations which a PacsOne server can maintain.

3.2.3 Asynchronous Nature

PacsOne server does not support asynchronous operations and will not perform asynchronous window negotiation.

3.2.4 Implementation Identifying Information

PacsOne server provides the following implementation class UID:

1.2.826.0.1.3680043.2.737

PacsOne server provides the following implementation version name:

PACSONE01AUG03

3.3 Association Initiation Policy

PacsOne server will attempt to initiate associations in response to user requests from the web user interface to verify DICOM connection status (C-ECHO) to remote Application Entity (AE).

PacsOne server will attempt to initiate associations in response to user requests from the web user interface to query and retrieve (C-FIND) remote Query/Retrieve SCP applications.

PacsOne server will attempt to initiate associations in response to C-MOVE requests from other Application Entities. PacsOne server will only initiate associations in response to valid C-MOVE requests for images that are stored in the MySQL database.

PacsOne server will attempt to initiate associations in response to user selected forwarding requests from the web user interface, where users can select one or more patient(s), study(s) or series to forward (C-STORE) to a remote destination application entity (AE).

The Premium Edition of PacsOne server can also initiate associations to remote destination AE(s) automatically based on the automatic routing table. Users can define entries in the automatic routing table which consist of a source AE title, destination AE title and a schedule, so that the images received from the specified source AE will be automatically forwarded (C-STORE) to one of more destination AE(s) based on the specified schedule, either as soon as received (Immediately) or on a particular 24-hour clock interval., e.g., 7:00 p.m.

PacsOne Server Premium Edition can initiate Modality Worklist - FIND requests to remote Modality Worklist SCP applications, either in response to unsolicited Study Scheduled N-EVENT-REPORT notifications, or by querying the Worklist SCP regularly based on a configurable polling interval. Users can also initiate Modality Worklist - FIND request by clicking on the Get Worklist link from the web user interface.

3.3.1 Real-World Activity - Verification

3.3.1.1 Associated Real-World Activity - Verification

From the PacsOne Server web user interface, users can select the 'Application Entity' Page to display a list of defined application entities (AE). If the TCP port number for an AE is defined, a Ping link will be displayed in the 'Verify Connection' column. Clicking on the Ping link will initiate a C-ECHO request to the TCP port number of the corresponding AE. A confirmation message will be displayed if the C-ECHO request is successfully acknowledged by the remote AE, otherwise a timeout error or any error response from the remote AE will be displayed.

3.3.1.2 Proposed Presentation Contexts - Verification

Table 4 below shows the presentation contexts that are proposed by PacsOne server for verification operations..

3.3.1.3 SOP Specific Conformance Statement - Verification

3.3.2 Real-World Activity - Query/Retrieve

3.3.2.1 Associated Real-World Activity - Query/Retrieve

From the PacsOne Server web user interface, users can select the 'Application Entity' Page to display a list of defined application entities (AE). If the TCP port number for an AE is defined, a Query/Retrieve link will be displayed in the 'Remote Exams' column. Clicking on the Query/Retrieve link will initiate a C-FIND request to the TCP port number of the corresponding AE. Any matching patients and/or studies returned by the remote AE will be displayed, otherwise a timeout error or any error response from the remote AE will be displayed.

3.3.2.2 Proposed Presentation Contexts - Query/Retrieve

Table 5 shows the presentation contexts used by PacsOne server when initiating C-FIND requests to remote Query/Retrieve SCP applications.

3.3.2.3 SOP Specific Conformance Statement - Query/Retrieve

Table 6 below contains the key matching methods supported by PacsOne Server when initiating C-FIND requests to remote Query/Retrieve SCP applications:

Table 7 below indicates which keys are used by the PacsOne server for the Patient Root information model when initiating C-FIND requests to remote Query/Retrieve SCP applications.

3.3.3 Real-World Activity - Move Request From An External Node

3.3.3.1 Associated Real-World Activity - Move Request

The associated Real-World activity is a C-MOVE request received from an external application. If an application successfully establishes an association with the PacsOne server and makes a valid C-MOVE request that identifies one or more images known by the PacsOne server, the PacsOne server will query the 'applentity' MySQL database table to see if a matching entry can be found for the specified destination application entity title.  If a match is found, the PacsOne server will initiate an association with the destination application entity specified in the incoming C-MOVE request.

3.3.3.2 Proposed Presentation Contexts - Move Request

In response to a C-MOVE request, PacsOne server builds a complete list of images to be moved. The list includes the SOP class of each image to be moved. PacsOne server extracts the unique SOP classes from the image lists and proposes a set of presentation contexts that includes one presentation context for each unique SOP class identified in the image list. Thus, the association request may have a single presentation context or multiple presentation contexts. Each presentation context contains the abstract syntax that identifies one image class as found in the image list.

3.3.3.3 Proposed Transfer Syntaxes - Move Request

PacsOne Server Basic Edition only supports Implicit VR Little Endian Transfer Syntax. Some images may have been stored by the PacsOne server with private elements whose encoding scheme is unknown by the PacsOne server. These elements will be transmitted by PacsOne server exactly as they were received (in Implicit VR Little Endian Transfer Syntax), so they should be unaltered upon transmission.

PacsOne Server Premium Edition supports the following additional transfer syntaxes:

When sending images to a remote AE, PacsOne Server will propose the same transfer syntax in which the stored SOP instance is encoded. For example, the encoding transfer syntax is Explicit VR Little-Endian transfer syntax (UID 1.2.840.10008.1.2.1), PacsOne Server will also propose the default Implicit VR Little-Endian transfer syntax (UID 1.2.840.10008.1.2), so that when sending images to applications that do not support the Explicit VR Little-Endian transfer syntax (for example, eFilm), PacsOne Server Premium Edition will translate from the encoding Explicit VR Little-Endian to the Implicit VR Little-Endian transfer syntax.

3.3.3.4 SOP Specific Conformance Statement - Move Request

All C-STORE operations are in the context of a C-MOVE request from an external application.  PacsOne server sends one C-MOVE response message for each attempted C-STORE operation.  PacsOne server does not attempt any extended negotiation.  PacsOne server does not delete any elements from the files it transfers. Therefore the set of optional elements depends entirely on the contents of the files which were originally stored on the PacsOne server.

In the event that PacsOne server receives an unsuccessful C-STORE response, PacsOne server will continue sending the remaining images in the requested set.

3.3.4 Real-World Activity - User Forwarding

3.3.4.1 Associated Real-World Activity - User Forwarding

From the PacsOne web user interface, users can select one or more patient(s), study(s) or series while browsing through the list, if the current user has 'Forward' privilege (Premium Edition) or 'Modify' privilege (Basic Edition) enabled, there will be a Forward button displayed below the listed patient, study or series list. Users can click on the Forward button and then select a destination AE title from a drop-down list of application entities currently defined in the 'applentity' table.

3.3.4.2 Proposed Presentation Contexts - User Forwarding

Same as Section 3.3.3.2.

3.3.4.3 Proposed Transfer Syntaxes - User Forwarding

Same as Section 3.3.3.3.

3.3.4.4 SOP Specific Conformance Statement - User Forwarding

Same as Section 3.3.3.4.

3.3.5 Real-World Activity - Automatic Routing (Premium Edition only)

3.3.5.1 Associated Real-World Activity - Automatic Routing

PacsOne Server Premium Edition supports automatic image routing based on entries defined in the Automatic Routing table. When an image is received by PacsOne Server, it will query the Automatic Routing table to see if there is an entry matches with the source application entity (AE) title. If a match is found, then the received image will be forwarded to the destination AE title specified for the matching source AE title, based on the schedule specified for the matching entry. If there are multiple matches (multiple destination AEs defined for the same source AE), then the received image will be forwarded to multiple destination AEs based on the corresponding schedule.

Users can add, delete and modify entries in the Automatic Routing table from the PacsOne Server web user interface, given that the logged-in user has the required 'Modify' privilege enabled.

3.3.5.2 Proposed Presentation Contexts - Automatic Routing

Same as Section 3.3.3.2.

3.3.5.3 Proposed Transfer Syntaxes - Automatic Routing

Same as Section 3.3.3.3.

3.3.5.4 SOP Specific Conformance Statement - Automatic Routing

Same as Section 3.3.3.4.

3.3.6 Real-World Activity - Modality Worklist Management (Premium Edition only)

3.3.6.1 Associated Real-World Activity - Modality Worklist Management

From the PacsOne Server web user interface, users can select the 'Application Entity' Page to display a list of defined application entities (AE). If the TCP port number for an AE is defined and the remote AE has been defined as Modality Worklist SCP ('worklistScp' column set to 'True' in the 'applentity' table), a Get Worklist link will be displayed in the 'Modality Worklist' column. Clicking on the Get Worklist link will initiate a Modality Worklist - FIND request to the TCP port number of the corresponding AE. Any matching result returned by the remote Modality Worklist SCP will be displayed, otherwise a timeout error or any error response from the remote AE will be displayed.

PacsOne Server Premium Edition can also receive unsolicited Study-Scheduled N-EVENT-REPORT notifications. PacsOne Server will then send Modality Worklist - FIND commands to query all configured Modality Worklist SCP application entities for the corresponding study.

PacsOne Server Premium Edition also polls any configured Modality Worklist SCP application entities to update the Worklist table on a regular basis. The default polling interval is 10 minutes, which can be changed by modifying the following Registry value for Windows platforms:

HKEY_LOCAL_MACHINE\\SOFTWARE\\RainbowFish Software\\PacsOne\\${AeTitle}\\WorklistPollInterval\\

WorklistPollInterval = 10

NOTE: Change the polling interval value to zero(0) will disable automatic polling of Modality Worklist SCP applications.

3.3.6.2 Proposed Presentation Contexts - Modality Worklist Management

Table 10 below shows the presentation contexts that are proposed by PacsOne server for Modality Worklist - FIND operations..

3.3.6.3 SOP Specific Conformance Statement - Modality Worklist Management

Table 11 below contains the key matching methods supported by PacsOne Server when initiating Modality Worklist-FIND requests to remote Worklist SCP applications:

Table 12 below indicates which keys are used by the PacsOne Server for the Modality Worklist - FIND requests to remote Modality Worklist SCP applications.

3.3.7 Real-World Activity - Printing (Premium Edition only)

3.3.7.1 Associated Real-World Activity - Printing

After logging into the PacsOne Server web user interface, if the 'Print' privilege has been enabled, the current user can select a list of patients, studies, series or images, and click on the Print button.

The user can then select the destination remote printer, make any appropriate changes to the print parameters, then click on the Print button to send the selected patients, studies, series or images to the printer.

3.3.7.2 Proposed Presentation Contexts - Printing

3.3.7.3 Proposed Transfer Syntaxes - Printing

See Table 13 above.

3.3.7.4 SOP Specific Conformance Statement - Printing

PacsOne Server supports the following required print SOP classes for the Basic Grayscale/Color Management Meta classes:

PacsOne Server supports the following optional print SOP classes for the Basic Grayscale/Color Management Meta classes:

3.3.7.4.1 Conformance for Basic Film Session SOP Class

PacsOne Server supports the following attributes for N-CREATE command of the Basic Film Session SOP class:

PacsOne Server also uses N-DELETE to delete the created Basic Film Sessio SOP instance returned by the remote Print SCP.

3.3.7.4.2 Conformance for SOP Class Basic Film Box

PacsOne Server supports the following attributes for N-CREATE command of the Basic Film Box SOP class:

PacsOne Server also uses N-ACTION to print a complete Basic Film Box SOP instance and N-DELETE to delete the SOP instance after printing is complete.

3.3.7.4.3 Conformance for SOP Class Basic Grayscale Image Box

PacsOne Server supports the following attributes for N-SET command of the Basic Grayscale Image Box SOP class:

3.3.7.4.4 Conformance for SOP Class Printer

PacsOne Server supports the following attributes for N-GET command of the Printer Box SOP class:

3.3.7.4.5 Conformance for Basic Annotation Box SOP Class

PacsOne Server supports the following attributes for N-GET command of the Basic Annotation Box SOP Class:

3.3.8 Real-World Activity - Remote Synchronization (Premium Edition only)

3.3.8.1 Associated Real-World Activity - Remote Synchronization

PacsOne Server Premium Edition supports synchronizing its local database with remote studies stored on external application entities, based on user-specified synchronization schedules for the remote AE.

When adding or modifying an application entity, if the remote AE supports Dicom Query/Retrieve functions as a SCP, i.e., the 'Query/Retrieve SCP' checkbox is selected, users can select whether to enable or disable remote-synchronization for this remote AE, and whether to synchronize with all remote studies or only those recent studies received within the last N days on the remote AE.

Users can add, delete and modify synchronization schedules (up to 24 per remote AE) from the PacsOne Server web user interface, provided that the logged-in user has the required 'Modify' privilege enabled.

3.3.8.2 Proposed Presentation Contexts - Remote Synchronization

Same as Section 3.3.2.2.

3.3.8.3 Proposed Transfer Syntaxes - Remote Synchronization

Same as Section 3.3.2.2.

3.3.8.4 SOP Specific Conformance Statement - Remote Synchronization

Same as Section 3.3.2.3.

3.3.9 Real World Activity - Detached Study Management (Premium Edition only)

PacsOne server accepts unsolicited N-EVENT-REPORT notifications sent from Detached Study Management SCP application entities. PacsOne Server will then issue N-GET request back to the remote SCP to get more information for the corresponding study.

Additionally, upon receipt of the Study Scheduled event notification sent from the Detached Study Management SCP, PacsOne Server will initiate a Modality Worklist - FIND request to configured Modality Worklist SCP application entity(s) to query about the corresponding study information contained in the event report.

3.3.9.1 Associated Real World Activity - Detached Study Management

When PacsOne Server receives any Detached Study Management N-EVENT-REPORT notifications sent from a Detached Study Management SCP AE, it will first validate the association request by checking the remote AE title against the internal 'applentity' table. If access is Enabled in the 'applentity' table, the association request will be accepted and the event notification will be processed. Otherwise, the association request will be rejected by PacsOne Server and this event notification will not be processed.

3.3.9.2 Presentation Context Table - Detached Study Management

Table 21 shows the presentation contexts that may be accepted by PacsOne server for Detached Study Management N-EVENT-REPORT notifications.

3.3.9.3 SOP Specific Conformance for SOP Class - Detached Study Management

PacsOne Server supports the following attributes in the N-EVENT-REPORT-RQ notification sent from a Detached Study Management SCP application entity:

PacsOne Server returns one of the following status codes in the N-EVENT-REPORT-RSP sent back to the Detached Study Management SCP:

3.3.9.4 Presentation Context Acceptance Criterion - Detached Study Management

PacsOne server will accept any number of Detached Study Management SOP classes that are listed in Table 21 above, provided that the requesting application is allowed access to the PacsOne server (via the 'applentity' MySQL database table). The PacsOne server defines no limit on the number of presentation contexts accepted. In the event that the PacsOne server runs out of resources when trying to accept multiple presentation contexts, PacsOne server will reject the association request.

PacsOne server does not check for duplicate presentation contexts and will accept duplicate presentation contexts.

3.3.9.5 Transfer Syntax Selection Policies - Detached Study Management

PacsOne Server only supports the Implicit VR Little Endian transfer syntax when accepting Detached Study Management N-EVENT-REPORT requests. Any proposed presentation context which includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endian transfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endian transfer syntax will be rejected.

3.3.10 Real-World Activity - Storage Commitment Push Model (Premium Edition only)

3.3.10.1 Associated Real-World Activity - Storage Commitment Push Model

From the Application Entity page of PacsOne Server, if a remote AE is configured as a Storage Commitment Report SCP and the "Request Storage Commitment Report for Dicom images sent to this SCP" option is enabled for this remote AE, then PacsOne Server will request Dicom Storage Commitment Report(via the N-ACTION-RQ command) for any Dicom SOP instance sent to this remote AE.

3.3.10.2 Proposed Presentation Contexts - Storage Commitment Push Model

Table 24 below shows the presentation contexts that are proposed by PacsOne server for Storage Commitment Push Model requests.

3.3.10.3 SOP Specific Conformance Statement - Storage Commitment Push Model

PacsOne Server supports the following elements for this SOP class as an SCU:

3.3.10.3.1 Storage Commitment Results

After receiving the Dicom Storage Commitment Report request sent from PacsOne Server, the remote AE will respond by sending the Storage Commitment Report for the requested SOP instances in the form of Dicom N-EVENT-REPORT messages back to PacsOne Server. The N-EVENT-REPORT contains the Transaction UID value contained in the initiating N-ACTION-RQ request sent from PacsOne Server. The N-EVENT-REPORT is sent on a separate association from the initiating N-ACTION-RQ request.

PacsOne Server supports the Event Report Information as specified in Table 26 below:

After receiving the Storage Commitment Report (N-EVENT-REPORT) from the remote AE, PacsOne Server will display one of the following status indications for the containing Dicom study of the referenced SOP instances for which the reports have been received:

• Report Initiated - PacsOne Server has initiated the Storage Commitment Report (N-ACTION-RQ) for the SOP instances of this study
• Partially Committed - Storage Commitment Report (N-EVENT-REPORT) has been received for the SOP instances of this study, but not all instances have been committed successfully by the remote AE
• Fully Committed - Storage Commitment Report (N-EVENT-REPORT) has been received for the SOP instances of this study, and all instances have been committed successfully by the remote AE

3.4 Association Acceptance Policy

PacsOne server accepts associations for the purpose of storing images in its MySQL database or for the purpose of performing query/retrieve operations on the images that have been previously stored.

PacsOne server will only accept association requests from applications that have been defined during configuration.  In addition, the PacsOne server will only store images sent by application entities that have been enabled in the 'applentity' MySQL database table.

3.4.1 Real World Activity - Verification

PacsOne server accepts associations from applications that wish to perform a verification (C-ECHO) operation on the PacsOne server.

3.4.1.1 Associated Real World Activity - Verification

The real-world activity associated with the C-ECHO request is that an external application wishes to verify network or server operation without initiating any actual work.

3.4.1.2 Presentation Context Table - Verification

Table 27 shows the presentation contexts that may be accepted by PacsOne server for verification operations..

3.4.1.3 SOP Specific Conformance for SOP Class - Verification

3.4.1.4 Presentation Context Acceptance Criterion - Verification

PacsOne server will accept any number of verification SOP classes that are listed in Table 3 above, provided that the requesting application is allowed access to the PacsOne server (via the 'applentity' MySQL database table). The PacsOne server defines no limit on the number of presentation contexts accepted. In the event that the PacsOne server runs out of resources when trying to accept multiple presentation contexts, PacsOne server will reject the association request.

PacsOne server does not check for duplicate presentation contexts and will accept duplicate presentation contexts.

3.4.1.5 Transfer Syntax Selection Policies - Verification

PacsOne Server only supports the Implicit VR Little Endian transfer syntax when accepting verification requests. Any proposed presentation context which includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endian transfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endian transfer syntax will be rejected.

3.4.2 Real-Word Activity - Storage

PacsOne server accepts associations from applications that wish to store images using the C-STORE command.

3.4.2.1 Associated Real-World Activity - Storage

The associated Real-World activity associated with the C-STORE operation is the storage of the images on the disk of the system upon which the PacsOne server is running. Images are stored by writing the data set of the C-STORE command directly to disk, either with no further header or interpretation ("Native" format), or with the standard file header described in the DICOM 3.0 Part 10 document (DICOM Part 10 format).  The above storage formats are configurable when PacsOne server is installed by running the 'SETUP.EXE' program, they can also be modified later by changing the following Registry value for Windows platforms:

HKEY_LOCAL_MACHINE\\SOFTWARE\\RainbowFish Software\\PacsOne\\${AeTitle}\\StorageFormat\\

StorageFormat= DicomPart10

to either "DicomPart10" or "Native" string values (case insensitive).

After an image is stored to disk, the PacsOne server updates the MySQL database with patient, study, series and image information; this MySQL database is used by the PacsOne server for query/retrieve operations, it is also used by the Apache web server to display patient, study, series, and image information, display stored images through a web browser, and maintain patient/study/series/ image tables for authorized users.

PacsOne server will issue a failure status if it is unable to store the image on disk, if the image does not conform to the IOD of the SOP class under which it was transmitted, or if the PacsOne server is not able to successfully update its MySQL database.

3.4.2.2 Presentation Context Table - Storage

The following Presentation Contexts shown in Table 28 are acceptable to the PacsOne server when receiving images.

3.4.2.3 SOP Specific Conformance for SOP Class - Storage

The PacsOne server implements Level 2 (Full) conformance for the Storage SOP Class.  The raw image files themselves are not modified.

In the event that an image is successfully stored by PacsOne server, it may be accessed by requesting associations with the PacsOne server and performing query/retrieve operations.  PacsOne server can also display stored images to web browser clients through the Apache web server interface.

PacsOne server stores images for an indefinite period.  The stored images, as well as stored patient, study, series and image database records can be deleted from the Apache web server interface by users authorized with UPDATE privilege to the MySQL database.

PacsOne server returns the following status codes in response to a C-STORE request:

In the case of an error of an error storing an image, there is no documented method for recovery.  Trouble-shooting information can be retrieved from the PacsOne server log file.  The directory path for PacsOne server log files is stored in the following Registry value for Windows platforms:

HKEY_LOCAL_MACHINE\\SOFTWARE\\RainbowFish Software\\PacsOne\\${AeTitle}\\LogDirectory

LogDirectory = /var/log/pacsone

3.4.2.4 Presentation Context Acceptance Criterion - Storage

PacsOne server will accept any number of storage SOP classes that are listed in Table 28 above, provided that the requesting application is known to the PacsOne server and has been enabled to store images on the MySQL database (via the 'applentity' MySQL database table).

PacsOne server defines no limit on the number of presentation contexts accepted. In the event that PacsOne server runs out of resources when trying to accept multiple presentation contexts, the PacsOne server will reject the association request.

PacsOne server does not check for duplicate presentation contexts and will accept duplicate presentation contexts in the association request.

3.4.2.5 Transfer Syntax Selection Policies - Storage

PacsOne Server Basic Edition only supports the Implicit VR Little Endian transfer syntax. Any proposed presentation context which includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endian transfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endian transfer syntax will be rejected.

PacsOne Server Premium Edition supports the following additional transfer syntaxes:

When PacsOne Server Premium Edition receives association requests which contain multiple presentation contexts with different transfer syntaxes, PacsOne Server Premium Edition will accept those presentation contexts with supported transfer syntaxes listed above, and reject any presentation context with un-supported transfer syntax. If multiple transfer syntaxes are proposed in a presentation context by the remote C-STORE SCU, and PacsOne Server Premium Edition supports one of more of them, then the first transfer syntax on the list presented will be selected. Users can also define a preferred transfer syntax by defining a named Registry value below:

HKEY_LOCAL_MACHINE\\SOFTWARE\\RainbowFish Software\\PacsOne\\${AeTitle}\\PreferredXferSyntaxRx\\

PreferredXferSyntaxRx = 1.2.840.10008.1.2

If the above named Registry value is defined and it's on the list of transfer syntaxes presented by the remote C-STORE SCU, PacsOne Server Premium Edition will use the specified transfer syntax instead of selecting the first supported transfer syntax from the list presented by the remote AE.

3.4.2.6 Structured Reporting Storage as an SCU and SCP (Premium Edition only)

PacsOne Server Premium Edition provides Standard Conformance to the following DICOM V3.0 Structured Reporting SOP Class as an SCU and SCP.

The following Image Storage SOP Classes may be referenced by instances of Structured Reporting SOP Class.

3.4.3 Real World Activity - Query/Retrieve

PacsOne server accepts associations from applications that wish to perform query (C-FIND) and retrieve (C-MOVE) operations on images that have been previously stored in the MySQL database.

3.4.3.1 Associated Real World Activity - Query/Retrieve

The real-world activity associated with C-FIND and C-MOVE requests are query and retrieval operations initiated by another application. An application other than the PacsOne server queries PacsOne server for patient/study/series/image information that has been previously stored in the MySQL database and can request that the PacsOne server send images to a third application entity.

3.4.3.2 Presentation Context Table - Query/Retrieve

Table 32 shows the presentation contexts that may be accepted by PacsOne server for query operations.

3.4.3.3 SOP Specific Conformance Statement - Query/Retrieve

PacsOne server supports relational queries in addition to hierarchical queries. Table 34 below indicates which keys are supported by the PacsOne server for the Patient Root information model. Table 35 below indicates which keys are supported by the PacsOne server for the Study Root information model.

PacsOne server also supports the Patient/Study Only information model. The keys supported for that model are the same keys found in Table 34 with a level of either "Patient" or "Study".

Table 33 below contains the key matching methods supported by PacsOne Server when processing C-FIND requests from remote Query/Retrieve SCU applications:

Table 34 indicates which keys are supported by the PacsOne server for the Patient Root information model. These tables include all optional and required keys that are supported. Optional keys are supported like required keys.

Table 35 indicates which keys are supported by the PacsOne server for the Study Root information model. These tables include all optional and required keys that are supported. Optional keys are supported like required keys.

PacsOne server supports the three FIND SOP classes listed in Table 3. In response to a C-FIND request, PacsOne server returns the following C-FIND-RSP status codes:

PacsOne server supports the three MOVE SOP classes listed in Table 3. In response to a C-MOVE request, PacsOne server supports the Storage SOP classes that are listed in Table 8 when initiating C-STORE sub-operations.

PacsOne server returns the following status codes in response to a C-MOVE request:

3.4.3.4 Presentation Context Acceptance Criterion - Query/Retrieve

PacsOne server will accept any number of query SOP classes that are listed in Table 3 above, provided that the requesting application is known to the PacsOne server and has been allowed access to the MySQL database (via the 'applentity' MySQL database table). PacsOne server defines no limit on the number of presentation contexts accepted. In the event that PacsOne server runs out of resources when trying to accept multiple presentation contexts, PacsOne server will reject the association request.

PacsOne server does not check for duplicate presentation contexts and will accept duplicate presentation contexts.

3.4.3.5 Transfer Syntax Selection Policies - Query/Retrieve

PacsOne server only supports the Implicit VR Little Endian transfer syntax. Any proposed presentation context which includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endian transfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endian transfer syntax will be rejected.

3.4.4 Real-World Activity - Modality Worklist Management (Premium Edition only)

3.4.4.1 Associated Real-World Activity - Modality Worklist Management

PacsOne server accepts associations from applications that wish to perform Worklist Query (Worklist-FIND) operations on worklist items that have been previously received and stored in the MySQL database.

3.4.4.2 Proposed Presentation Contexts - Modality Worklist Management

Table 38 below shows the presentation contexts that are accepted by PacsOne server for Modality Worklist - FIND requests.

3.4.4.3 SOP Specific Conformance Statement - Modality Worklist Management

Table 39 below contains the key matching methods supported by PacsOne Server when servicing Modality Worklist-FIND requests from remote Worklist SCU applications:

Table 40 below indicates the keys accepted by the PacsOne Server for the Modality Worklist - FIND requests sent from remote Modality Worklist SCU applications.

3.4.4.4 Presentation Context Acceptance Criterion - Modality Worklist Management

PacsOne server will accept any number of query SOP classes that are listed in Table 38 above, provided that the requesting application is known to the PacsOne server and has been allowed access to the MySQL database (via the 'applentity' MySQL database table). PacsOne server defines no limit on the number of presentation contexts accepted. In the event that PacsOne server runs out of resources when trying to accept multiple presentation contexts, PacsOne server will reject the association request.

3.4.4.5 Transfer Syntax Selection Policies - Modality Worklist Management

PacsOne server only supports the Implicit VR Little Endian transfer syntax. Any proposed presentation context which includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endian transfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endian transfer syntax will be rejected.

3.4.5 Real-World Activity - Storage Commitment Push Model (Premium Edition only)

3.4.5.1 Associated Real-World Activity - Storage Commitment Push Model

PacsOne Server stores images that are sent to it from an SCU. The request for storage commitment may then be transmitted to PacsOne Server with a list of references to one or more SOP instances. PacsOne Server will receive and respond to DIMSE N-ACTION of Request Storage Commitment for a set of referenced SOP instances.

3.4.5.2 Proposed Presentation Contexts - Storage Commitment Push Model

Table 41 below shows the presentation contexts that are accepted by PacsOne server for Storage Commitment Push Model requests.

3.4.5.3 SOP Specific Conformance Statement - Storage Commitment Push Model

PacsOne Server supports the following elements for this SOP class as an SCP:

3.4.5.3.1 Storage Commitment Results

After the Storage Commitment Push Model request is received, PacsOne Server will query its database record to determine if the referenced SOP instances exist in its database tables. If so, PacsOne Server will further check to see if the raw image files that correspond to the referenced SOP instances do exist and are valid in the local storage file system.

If PacsOne Server determines that both the database records and raw image files exist and are valid for the referenced SOP instances, PacsOne Server will issue an N-EVENT-REPORT to the SCU including references to the successfully stored SOP Instances contained in the N-ACTION request. Otherwise, PacsOne Server will issue an N-EVENT-REPORT to the SCU including references to the failed SOP Instances contained in the N-ACTION request.

The N-EVENT-REPORT contains the Transaction UID value contained in the initiating N-ACTION request. The N-EVENT-REPORT is sent on a separate association from the N-ACTION request.

PacsOne Server supports the Event Report Information as specified in Table 43 below:

3.4.5.4 Presentation Context Acceptance Criterion - Storage Commitment Push Model

PacsOne server will accept any number of Storage Commitment SOP classes that are listed in Table 41 above, provided that the requesting application is known to the PacsOne server and has been allowed access to the MySQL database (via the 'applentity' MySQL database table). PacsOne server defines no limit on the number of presentation contexts accepted. In the event that PacsOne server runs out of resources when trying to accept multiple presentation contexts, PacsOne server will reject the association request.

3.4.5.5 Transfer Syntax Selection Policies - Storage Commitment Push Model

PacsOne server only supports the Implicit VR Little Endian transfer syntax for the Storage Commitment Push Model SOP class as a SCP. Any proposed presentation context which includes the Implicit VR Little Endian transfer syntax will be accepted with the Implicit VR Little Endian transfer syntax. Any proposed presentation context that does not include the Implicit VR Little Endian transfer syntax will be rejected.

3.5 DICOM Media Storage Services (Premium Edition Only)

3.5.1 Media Storage Application Profiles

TABLE 44. Supported DICOM Media Storage Application Profiles

Description	Identifier
General Purpose CD-R Interchange	STD-GEN-CD
General Purpose Interchange on DVD-RAM Media	STD-GEN-DVD-RAM

3.5.2 Real-World Activities:

PacsOne Server Premium Edition supports the following storage SOP classes when importing from DICOM Media Storage format compliant CD/DVD drives, and exporting patients/studies stored in PacsOne Server database to local DICOM Media Storage formatted directories:

TABLE 45. Supported Storage SOP Classes for DICOM Part 10 Format Import and Export

Storage SOP Class Name	Storage SOP Class UID
Computed Radiography Image Storage	1.2.840.10008.5.1.4.1.1.1
CT Image Storage	1.2.840.10008.5.1.4.1.1.2
Ultrasound Multi-frame Image Storage (retired)	1.2.840.10008.5.1.4.1.1.3
Ultrasound Multi-frame Image Storage	1.2.840.10008.5.1.4.1.1.3.1
MR Image Storage	1.2.840.10008.5.1.4.1.1.4
Nuclear Medicine Image Storage (retired)	1.2.840.10008.5.1.4.1.1.5
Ultrasound Image Storage (retired)	1.2.840.10008.5.1.4.1.1.6
Ultrasound Image Storage	1.2.840.10008.5.1.4.1.1.6.1
Secondary Capture Image Storage	1.2.840.10008.5.1.4.1.1.7
X-Ray Angiographic Image Storage	1.2.840.10008.5.1.4.1.1.12.1
X-Ray Radiofluoroscopic Image Storage	1.2.840.10008.5.1.4.1.1.12.2
X-Ray Angiographic Bi-plane Image Storage (retired)	1.2.840.10008.5.1.4.1.1.12.3
X-Ray 3D Angiographic Image Storage	1.2.840.10008.5.1.4.1.1.13.1.1
X-Ray 3D Craniofacial Image Storage	1.2.840.10008.5.1.4.1.1.13.1.2
Breast Tomosynthesis Image Storage	1.2.840.10008.5.1.4.1.1.13.1.3
Digital X-ray Image Storage - For Presentation	1.2.840.10008.5.1.4.1.1.1.1
Digital X-ray Image Storage - For Processing	1.2.840.10008.5.1.4.1.1.1.1.1
Digital Mammography X-ray Image Storage - For Presentation	1.2.840.10008.5.1.4.1.1.1.2
Digital Mammography X-ray Image Storage - For Processing	1.2.840.10008.5.1.4.1.1.1.2.1
Nuclear Medicine Image Storage	1.2.840.10008.5.1.4.1.1.20
Positron Emission Tomography (PET) Image Storage	1.2.840.10008.5.1.4.1.1.128
RT Image Storage	1.2.840.10008.5.1.4.1.1.481.1
RT Dose Storage	1.2.840.10008.5.1.4.1.1.481.2
RT Structure Set Storage	1.2.840.10008.5.1.4.1.1.481.3
RT Plan Storage	1.2.840.10008.5.1.4.1.1.481.5
VL Endoscopic Image Storage	1.2.840.10008.5.1.4.1.1.77.1.1
VL Microscopic Image Storage	1.2.840.10008.5.1.4.1.1.77.1.2
VL Slide-Coordinates Microscopic Image Storage	1.2.840.10008.5.1.4.1.1.77.1.3
VL Photographic Image Storage	1.2.840.10008.5.1.4.1.1.77.1.4
Video Photographic Image Storage	1.2.840.10008.5.1.4.1.1.77.1.4.1
Ophthalmic Photography 8 Bit Image Storage	1.2.840.10008.5.1.4.1.1.77.1.5.1
Ophthalmic Photography 16 Bit Image Storage	1.2.840.10008.5.1.4.1.1.77.1.5.2
Ophthalmic Tomography Image Storage	1.2.840.10008.5.1.4.1.1.77.1.5.4
Enhanced CT Image Storage	1.2.840.10008.5.1.4.1.1.2.1
Enhanced MR Image Storage	1.2.840.10008.5.1.4.1.1.4.1
MR Spectroscopy Storage	1.2.840.10008.5.1.4.1.1.4.2
Enhanced MR Color Image Storage	1.2.840.10008.5.1.4.1.1.4.3
Raw Data Storage	1.2.840.10008.5.1.4.1.1.66
Segmentation Storage	1.2.840.10008.5.1.4.1.1.66.4
Surface Segmentation Storage	1.2.840.10008.5.1.4.1.1.66.5
Real World Value Mapping Storage	1.2.840.10008.5.1.4.1.1.67
Grayscale Softcopy Presentation State Storage	1.2.840.10008.5.1.4.1.1.11.1
Color Softcopy Presentation State Storage	1.2.840.10008.5.1.4.1.1.11.2
Pseudo-Color Softcopy Presentation State Storage	1.2.840.10008.5.1.4.1.1.11.3
Blending Softcopy Presentation State Storage	1.2.840.10008.5.1.4.1.1.11.4
XA/XRF Grayscale Softcopy Presentation State Storage	1.2.840.10008.5.1.4.1.1.11.5
Video Endoscopic Image Storage	1.2.840.10008.5.1.4.1.1.77.1.1.1
Encapsulated PDF Storage	1.2.840.10008.5.1.4.1.1.104.1
Basic Text Structured Report Storage	1.2.840.10008.5.1.4.1.1.88.11
Enhanced Structured Report Storage	1.2.840.10008.5.1.4.1.1.88.22
Comprehensive Structured Report Storage	1.2.840.10008.5.1.4.1.1.88.33
Comprehensive 3D Structured Report Storage	1.2.840.10008.5.1.4.1.1.88.34
Extensible Structured Report Storage	1.2.840.10008.5.1.4.1.1.88.35
Chest Computer-Aided Detection (CAD) Structured Report Storage	1.2.840.10008.5.1.4.1.1.88.65
X-Ray Radiation Dose Structured Report Storage	1.2.840.10008.5.1.4.1.1.88.67
VL Whole Slide Microscopy Image Storage	1.2.840.10008.5.1.4.1.1.77.1.6
Breast Tomosynthesis Image Storage	1.2.840.10008.5.1.4.1.1.13.1.3
Key Object Selection Document	1.2.840.10008.5.1.4.1.1.88.59

When importing or exporting images of the storage SOP classes listed in Table 45 above, PacsOne Server Premium Edition supports the transfer syntaxes listed in Table 30 in Section 3.4.2.5.

When importing or exporting images of the storage SOP classes listed in TABLE 45 above, PacsOne Server Premium Edition requires or uses the following mandatory Selection Keys/Attributes defined in DICOM PS 3.10 and PS 3.3:

TABLE 46. Mandatory Selection Keys Supported by PacsOne Server Import/Export

Directory Record Type	Selection Key Name	Tag
Patient	Patient Name	(0010,0010)
	Patient ID	(0010,0020)
Study	Study UID	(0020,000D)
	Study ID	(0020,0010)
Series	Modality	(0008,0060)
	Series Number	(0020,0011)
Image	Referenced File ID	(0004,1500)
	Referenced SOP Class UID in File	(0004,1510)
	Referenced SOP Instance UID in File	(0004,1511)
	Referenced Transfer Syntax UID in File	(0004,1512)
	Image Number	(0020,0013)
SR Document	Instance Number	(0020,0013)
	Completion Flag	(0040,A491)
	Verification Flag	(0040,A493)
	Content Date	(0008,0023)
	Content Time	(0008,0033)
	Verification DateTime	(0040,A030)
	Concept Name Code Sequence	(0040,A043)

3.5.2.1 Real-World Activities: Reading Images from CD/DVD Drives

When reading images from CD/DVD media drives, PacsOne Server Premium Edition will play the role of File Set Reader (FSR).

From the PacsOne web user interface, users can import external images stored in CD/DVD media drives by visiting the Tools page from the Main Menu Bar, from which users can select the Import option by entering:

• Either the CD/DVD media drive and the destination storage directory where the images will be imported and raw image files on the media drive will be copied to the destination directory.
• Or a source DICOM storage format compatible directory with or without DICOMDIR directory record, from which the images will be imported into PacsOne Server database but the raw image files are not copied, as the PacsOne Server database records will be linked directly to the source directory.

3.5.2.2 Real-World Activities: Writing Images to Local Directory

When writing images to a local directory using DICOM Media Storage compliant directory formats (DICOMDIR directory record), PacsOne Server Premium Edition will play the role of File Set Creator (FSC).

From the PacsOne web user interface, users can export patients/studies stored in the PacsOne database to a local directory using the DICOM Media Storage formats, by visiting the Tools page from the Main Menu Bar, from which users can select a list of one or more patients/studies, enter a media label for the export, and enter a destination directory to export to. Users will also select the export media types which can be either CD (650 MBytes) or DVD (4.7 GBytes). In case the total size of the selected patients/studies exceeds the storage limit for the selected media type, multiple volumes will be created with the volume number automatically appended to the specified media label.

4. Communication Profiles

4.1 TCP/IP Stack

PacsOne Server provides DICOM V3.0 TCP/IP Network Communication Support as defined in Part 8 of the Standard.

4.1.1 TCP/IP API

PacsOne Server uses the TCP/IP stack from Microsoft Windows, Mac OS X or Linux (Premium Edition only) platforms upon which it executes. It uses a subroutine library that is based on either Windows Socket API (Winsock 2.0) interface on Windows platforms, or the Berkeley socket interface on Linux and Mac OS X platforms (Premium Edition only).

4.1.1.1 Dicom TLS Option

If this option is enabled, PacsOne Server uses the open-source OpenSSL libraries to communicate with other Dicom devices/applications that also support the Dicom TLS option.

4.1.2 Physical Media Support

PacsOne Server exists as a software application that can be compiled and run on various Windows, Mac OS X or Linux (Premium Edition only) platforms. As such, it places no restrictions on the physical network. PacsOne Server has been tested using TCP/IP over Ethernet (10/100/1000 Mbps) as well as wireless LAN (IEEE 802.11x variants).

5. Extensions/Specializations/Privatizations

Not applicable

6. Configuration

PacsOne Server obtains configuration information from a database table which is stored in a relational database. In this implementation, the relational database is the open source MySQL database.

6.1 AE Title/Presentation Address Mapping

A MySQL database table 'applentity' is used to map between AE Titles and Presentation Addresses.  The format of the table is as follows:

Entries in the 'applentity' table can be added, deleted or updated either from a web browser through the Apache web server interface, or directly by executing SQL statements from the localhost where MySQL database server is installed.

6.2 Security Features

PacsOne Server uses the 'applentity' table to control access. The table allows the PacsOne Server to determine which applications are allowed access and where received images should be stored.

6.2.1 Dicom TLS (Transport Layer Security) Security Profiles

If the Dicom TLS option is enabled, PacsOne Server supports the Dicom Basic TLS Secure Transport Connection Profile and the AES TLS Secure Transport Connection Profile as specified in DICOM PS3.15 2018a, Annex B.1 and Annex B.3, respectively.

All cipher suites supported by TLS 1.0, TLS 1.1 and TLS 1.2 are enabled, and the use of TLS 1.2 cipher suites is preferred.

• TLS_ECDHE_RSA_WITH_AES_256_CBC_SHA384_P256
• TLS_ECDHE_RSA_WITH_AES_256_CBC_SHA384_P384
• TLS_ECDHE_RSA_WITH_AES_128_CBC_SHA256_P256
• TLS_ECDHE_RSA_WITH_AES_128_CBC_SHA256_P384
• TLS_ECDHE_RSA_WITH_AES_256_CBC_SHA_P256
• TLS_ECDHE_RSA_WITH_AES_256_CBC_SHA_P384
• TLS_ECDHE_RSA_WITH_AES_128_CBC_SHA_P256
• TLS_ECDHE_RSA_WITH_AES_128_CBC_SHA_P384
• TLS_DHE_RSA_WITH_AES_256_GCM_SHA384
• TLS_DHE_RSA_WITH_AES_128_GCM_SHA256
• TLS_DHE_RSA_WITH_AES_256_CBC_SHA
• TLS_DHE_RSA_WITH_AES_128_CBC_SHA
• TLS_RSA_WITH_AES_256_GCM_SHA384
• TLS_RSA_WITH_AES_128_GCM_SHA256
• TLS_RSA_WITH_AES_256_CBC_SHA256
• TLS_RSA_WITH_AES_128_CBC_SHA256
• TLS_RSA_WITH_AES_256_CBC_SHA
• TLS_RSA_WITH_AES_128_CBC_SHA
• TLS_ECDHE_ECDSA_WITH_AES_256_GCM_SHA384_P384
• TLS_ECDHE_ECDSA_WITH_AES_128_GCM_SHA256_P256
• TLS_ECDHE_ECDSA_WITH_AES_128_GCM_SHA256_P384
• TLS_ECDHE_ECDSA_WITH_AES_256_CBC_SHA384_P384
• TLS_ECDHE_ECDSA_WITH_AES_128_CBC_SHA256_P256
• TLS_ECDHE_ECDSA_WITH_AES_128_CBC_SHA256_P384
• TLS_ECDHE_ECDSA_WITH_AES_256_CBC_SHA_P256
• TLS_ECDHE_ECDSA_WITH_AES_256_CBC_SHA_P384
• TLS_ECDHE_ECDSA_WITH_AES_128_CBC_SHA_P256
• TLS_ECDHE_ECDSA_WITH_AES_128_CBC_SHA_P384
• TLS_DHE_DSS_WITH_AES_256_CBC_SHA256
• TLS_DHE_DSS_WITH_AES_128_CBC_SHA256
• TLS_DHE_DSS_WITH_AES_256_CBC_SHA
• TLS_DHE_DSS_WITH_AES_128_CBC_SHA
• TLS_RSA_WITH_3DES_EDE_CBC_SHA
• TLS_DHE_DSS_WITH_3DES_EDE_CBC_SHA

6.2.1.1 Inbound Dicom TLS Connections

The TCP port that PacsOne listens to for inbound Dicom TLS connections is configurable by the PacsOne Server Installer when it's initially installed, and it can be modified afterwards via either the Registry setting (Windows platforms) or the .INI configuration file (Linux platforms).

6.2.1.2 Outbound Dicom TLS Connections

PacsOne Server uses a set of private SSL Key and the Certificate to identify itself in the Dicom TLS negotiation with remote peers, which are stored under the following sub-folder where PacsOne Server is installed:

where ${AeTitle} is the AE Title assigned to the current instance of PacsOne Server. This private set of SSL Key/Certificate can be replaced with the official SSL Key/Certificate signed by a public Certificate Authority (CA), if the remote Dicom TLS peers require SSL Certificate Authentication.

6.3 Configurable Parameters

The following parameters may be configured for PacsOne Server:

• Application Entity Title
• Logfile Directory
• TCP/IP Port Number
• Dicom TLS Port Number (if enabled)
• Storage Format

Methods for setting these parameters are detailed in the PacsOne Server Installation Guide included in the PacsOne Server installation package.

6.4 Support of Extended Character Sets

PacsOne Server currently does not support any extended character sets.

7. Web Access to DICOM Persistent Objects (WADO)

WADO specifies a web-based service for accessing and presenting DICOM persistent objects (e.g. images, medical imaging reports). It provides a simple mechanism for accessing a DICOM persistent object from HTML pages or XML documents, through HTTP/HTTPs protocol, using DICOM UIDs (Unique Identifiers). Data may be retrieved either in a presentation-ready form as specified by the requester (e.g. JPEG or GIF) or in a native DICOM format. This standard relates only to DICOM persistent objects (not to other DICOM objects or to non-DICOM objects).

Access to the content of a WADO object is enabled by specifying a "link" pointing to a specific DICOM Persistent Object by means of its URL/URI and specifying its DICOM object Instance UID. The general syntax of the standard respects the URI recommendation IETF RFC2396. It can be expressed as:

<scheme>://<authority><path>?<query>

It is structured following BNF syntax. The first definition of this syntax is:

1. URI-reference = [ absoluteURI | relativeURI ] [ "#" fragment ]
2. absoluteURI = scheme ":" ( hier_part | opaque_part )
3. relativeURI = ( net_path | abs_path | rel_path ) [ "?" query ]
4. hier_part = ( net_path | abs_path ) [ "?" query ]

This definition of the term query shall respect fully the BNF syntax exposed in the IETF RFC2396. Within a query component, the characters ";", "/", "?", ":", "@", "&", "=", "+", ",", and "$" are reserved. It is only a restriction of it for the unique purpose of retrieving DICOM Persistent Objects through Web Access to DICOM Persistent Objects.

Control names and values are escaped. Space characters are replaced by "+", and then reserved characters are escaped as described in IETF RFC2396. Non-alphanumeric characters are replaced by "%HH", a percent sign and two hexadecimal digits representing the ASCII code of the character. Line breaks are represented as "CR LF" pairs (i.e., "%0D%0A"). The control names/values are listed in the order they appear in the document. The name is separated from the value by "=" and name/value pairs are separated from each other by "&".

Syntax of the <query> component

The BNF syntax restriction of parameters for the Web Access to DICOM Persistent Objects service is the following:

1. query = parameter ["&" parameter]
2. parameter = name "=" value
3. name = nchars
4. value = nchars
5. nchars = *nchar
6. nchar = unreserved | escaped

7.1 URL Parameters Required for All DICOM Persistent Objects

7.1.1 Request type - Type of request performed

The parameter name shall be requestType, and the value shall be "WADO".

7.1.2 Unique Identifier of the Series - Series Instance UID

The parameter name shall be seriesUID, and the value shall be encoded as a Unique Identifier (UID) string, as specified in PS 3.5, except that it shall not be padded to an even length with a NULL character.

7.1.3 Unique Identifier of the Object - SOP Instance UID

The parameter name shall be objectUID, and the value shall be encoded as a Unique Identifier (UID) string, as specified in PS 3.5, except that it shall not be padded to an even length with a NULL character.

7.2 URL Parameters Optional for All DICOM Persistent Objects

7.2.1 MIME Type Constraints

MIME type(s) desired by the Web Client for the response from the Server, as defined in the IETF RFC2616.

This parameter is OPTIONAL. If present, the parameter name shall be contentType, and its value can be one of the following:

• application/dicom
• image/jpeg

If the contentType parameter is not present in the request, the response shall contain an image/jpeg MIME type.

7.2.2 AE Title

In case of multi-instance configurations where multiple instances of PacsOne Server are running on the same server, this parameter will be used to identify the particular instance of PacsOne Server in order to access the correct database for the requesting Dicom objects.

This parameter is OPTIONAL. If present, the parameter name shall be aetitle.

7.3 Authentication Methods for Web Access to DICOM Persistent Objects (WADO)

A valid username/password pair is required before the web clients can access the PacsOne Server database, and the System Administrator must have pre-created this username/password before they can be used to login to the PacsOne Server database.

7.3.1 Authentication via HTTP Request Parameters

Authentication information can be supplied via the following URL parameters sent as part of the HTTP request:

• username
• password

http://hostname/pacsone/wado.php?requestType=WADO&seriesUID=1.2.840.113674.514.212.82.300&objectUID=1.2.840.113674.950809132337081.100&contentType=application%2Fdicom&username=wado&password=wado

7.3.2 HTTP Basic Authentication

If authentication information is not supplied via HTTP Request parameters above, PacsOne Server will switch to HTTP Basic Authentication method instead, by presenting a diaglog window prompting for username/password information. Web users can then manually enter such username/password information before they can be authenticated to access the PacsOne Server database.

7.3.3 Pre-Configured Username/Password

Instead of the two HTTP authentication methods above, the System Administrator can pre-configure a designated username/password to be used exclusively for WADO from the Configuration page of the Main Menu.