Learning Series: RamSoft Gateway Router -'Yes we can do that

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  • *For RamSoft PACS clients

    Gateway Router- System Functions and Features

    'Yes our system can do that'

    Page 1

  • *For RamSoft PACS clients


    Gateway Router Quick Overview

    What is DICOM?

    Setting up a DICOM Connection and its Terminology

    What Data Cleansing Options Are Possible?

    Facility, Issuer of Patient ID, Receive Study Status As

    DICOM Tag Mapping/Morphing

    DICOM File Format Terminology


    Transfer of Data

    TLS versus Replication

    What is PowerCache?

    VPN required or not

    Multi-thread verses single threaded-sending multiple

    Automated Prior Prefetching


    Triggered by HL7

    Product Offerings

    Gateway Router versus Advanced

    Gateway QC versus Viewer

    Page 2

  • Gateway Router Quick Overview

    Designed for routing images

    Flexible with no limits on storage, number of studies or number of modalities

    Robust and flexible that it can work with multiple storage volumes, any number of hard drives, NAS or SAN, and can even store images on a flash drive

    Full-featured online DICOM vendor neutral archive

    Ensures the patient data and study images are stored according to industry standards so they are compatible with any number of disparate RIS and PACS solutions

    Page 3

  • What Is DICOM?

    DICOM stands for Digital Imaging and Communications in Medicine

    It is a standard for handling, storing, printing, and transmitting information in medical imaging

    It includes a file format definition and a network communications protocol

    Page 4

  • Setting Up A DICOM Connection

    RamSoft systems offer installation in both promiscuous and non-promiscuous mode, however installation in non-promiscuous mode is the best practice of choice since it will only communicate with a DICOM station that has explicitly identified as a safe station

    In order to identify a station you will need the AE Title, its IP address, and the port that it uses for DICOM communication

    Page 5

  • *For RamSoft PACS clients

    AE Title

    Application Entity Title

    Uniquely identifies a DICOM Device or program

    The AE Title can be 16 alphanumeric characters or less

    IP Address

    Specifies the internet protocol address for the device

    An IP address identifies a device on a Transmission Control Protocol/Internet Protocol (TCP/IP) network


    Identifies the port for the device's application program that you query, retrieve, receive, and send image files

    A port is a logical connection endpoint that is the means that a program uses to identify a specific program running on a computer on a network (such as TCP/IP).

    DICOMs default port is 104

    Page 6

    DICOM Connection Terminology

  • What Data Cleansing Options Are Possible?a. Facility, Issuer of Patient ID, Receive Study As

    Facility If the facility is filtered, it becomes a

    mandatory field, all studies being received from that station will have that particular facility mapped in the DICOM objects

    For example, when facility is filtered as FACILITYRG1, all studies being received from this station, DICOM tag (0008,0080) for facility will get written as FACILITYRG1.

    Page 7

  • Issuer of Patient ID When receiving DICOM data from facilities using different RIS/HIS numbering

    systems, it is important to segregate Patient IDs from the two facilities

    In this situation, it is likely that the same Patient ID is used to represent different patients in the two facilities

    Entering a value for the Issuer of Patient ID field, will result in DICOM objects that have the Issuer of Patient ID field blank or null to be populated with this value.

    Since this is part of the primary key field in the patient table, this patient will not be merged with a patient with the same Patient ID received from a different facility

    Receive Study As The Receive Study As option determines what status will be assigned to the

    received studies

    Page 8

    What Data Cleansing Options Are Possible?a. Facility, Issuer of Patient ID, Receive Study As

  • What Data Cleansing Options Are Possible?b. DICOM Tag Mapping/Morphing

    This allows individual DICOM tags to be copied, moved, or deleted when DICOM objects are received from a specific station

    Typically, this feature is used to correct images from modalities that are missing or incorrectly populating crucial DICOM tags For example, source tag, StudyID (0020,0010), will get copied

    to destination tag, AccessionNumber (0080, 0050).

    Set the Destination value to 00000000 and check the Delete Source option to remove the source tag without performing any mapping For example, if the NameOfPhysicianReadingStudy tag

    (0080,1060) is entered as source tag, while setting destination value to 00000000 and the Delete Source option has been checked. This will result removing the name in the Reading Physician field making it blank as studies are being received.

    Page 9

  • DICOM Header

    Stores information about the patient's name, the type of scan, image dimensions, etc., as well as all of the image data

    DICOM Tag

    The DICOM standard has a special pair of characters with numbers of 2x4 hexadecimal digits enclosed by parentheses and separated by the comma uniquely identify a specific DICOM field or data

    For example, (0010, 0010) will always be the tag for patients name.

    Page 10

    DICOM File Format Terminology

  • What Data Cleansing Options Are Possible?c. Scripting

    Used to modify the DICOM object being received from the selected station

    Custom scripts are used when modifications of the DICOM objects are more complicated that they couldnt be achieved by simple DICOM tag mapping/morphing

    The Script Editor utilizes Pascal scripts that will conditionally execute a group of statements, depending on the value of an expression

    Page 11

  • What Data Cleansing Options Are Possible?c. Scripting

    For example: To change the priority of all studies to ROUTINE when receiving from a station

    Page 12

    Function DICOM Tag for RequestedProcedurePriority

    DICOM Tag for


    Write tag as this

    This is an example of a simple

    script that will overwrite the value

    for DICOM tags (0032, 000c)

    and (0040, 1003) to LOW and

    ROUTINE respectively for all


  • And What Data Cleansing Options Are Possible?c. Scripting

    For example: To change Comprehensive SR document type from DIAGNOSTIC REPORT to CLINICAL

    Page 13

    FunctionDICOM Tag for SOPClassUID

    Variable SOPCLASS will store the data value found in DICOM tag

    (0008, 0016)

    DICOM Tag for DocumentType

    Write tag as this

    This script will read DICOM tag (0008,

    0016) and store that value to the variable,

    SOPCLASS. If SOPCLASS equals to

    1.2.840.10008., which is

    the UID (Unique Identifier) for

    Comprehensive SR then DICOM tag

    (311b, 1010) will get changed to


  • Transfer Of Dataa. TLS versus Replication

    TLS (Transport Layer Security) Is a protocol that allows two programs to communicate with

    each other in a secure way Provides privacy and data integrity between two communicating

    computer applications When secured by TLS, connections between client and server

    will have one or more of the following properties:Connection is private because symmetric cryptography is used to

    encrypt the data transmitted Identity of the communicating parties can be authenticated using

    public key cryptographyConnection is reliable because each message transmitted includes a

    message integrity check using a message authentication code to prevent undetected loss or alteration of the data during transmission

    Default TLS port for DICOM is 2762

    Page 14

  • Transfer Of Dataa. TLS versus Replication


    Uses a RamSoft proprietary communication protocol

    Is used to send image data directly to a PowerCache or PowerServer without the need for DICOM association or use of the DICOM Service

    Only send and receive services can be used with Replication

    Is preferred for RamSoft to RamSoft communication due to a slight performance boost and ease of use

    Is the mandatory communication protocol for Gateway/Gateway Router to PowerCache communication

    Page 15

  • The Replication Service is the method of choice for file transfer when the PowerServer is located at a remote site, regardless of the presence of a PowerCache

    If the PowerServer and the Gateway/Router are located on the same site, DICOM transfer should still be used

    When using HTTPS Replication, encryption is established using the same SSL Certificate that protects the PowerServer Login Page

    Replication is configured on the Station List and monitored via the Replication Tab in the Communication Log

    URL Formats:

    Page 16

    Station Type Example Format

    PowerServer (HTTPS Connection) https:///powerreader4/webservice/prisapi.dll/bin

    PowerServer (HTTP Connection) http:///powerreader4/webservice/prisapi.dll/bin

    PowerCache :12800

    Transfer Of Dataa. TLS versus Replication

  • What is PowerCache?

    Loading of images is the most costly part of a PACS system in terms of CPU usage, disk I/O, network bandwidth, and time

    Our software addresses this problem by installing a local image cache (Local Cache) with each PowerReader workstation, allowi


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