Database access methods for medical imaging: DICOM, SQL and HTML

DICOM database functions are employed to locate stored images and to update and retrieve attributes of specific object instances. The Query/Retrieve service class provides a set of consensus schema (the Q/R models) that support a particular view of patient data. This view adequately supports primary reading, i.e., it focuses on organizing images into studies and linking studies to patients, but it does not necessarily support the types of access required for retrieval from a digital file room. As the DICOM standard evolves it is necessary to carefully choose services and models that make sense for the medical imaging and image management marketplace. Should DICOM continue to define it's own proprietary access methods or adopt standard methods? Existing and near-term future standards for database access include: RDA, SQL3 and SQL/CLI. These standards will be evaluated as possible future bases for advanced DICOM database access services.