DICOM is now widely, accepted and used as a standard for exchange of medical images acquired e.g. during cardiac catheterization. To be able to store and display images together with waveforms (ECG, pressure) recorded simultaneously, a new supplement to the DICOM standard has been proposed for storage and exchange of waveforms. The next step is the definition of how DICOM-waveforms capabilities should be implemented in the cathlab environment. To obtain this goal, under the supervision of the ESC Committee on Digital Imaging, a Media Storage Application Profile, as described in DICOM Part II, is defined. It contains a detailed description of how the time synchronization should be accomplished. For this, a two-step approach is proposed. Possible solutions are tested in cooperation with the hemodynamic and X-ray system vendors.
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