This article takes a look at DICOM SR and its intended features. While it is does not cover all aspects of this supplement standard, it does look at the pro and cons of its implementation and why it has not been adopted rapidly in clinical use despite it’s intended design.
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Some if the issues around adoption are also a reason why the Imaging group of HL7 (which contains a lot of persons that are actively developing the DICOM standard) has been working on a HL7 v3 CDA specification for an image report. This has the advantage that CDA (as a document) can be easily used/displayed outside of radiology.
DICOM SR (as a structure) is just about as flxible as CDA. CDA is ‘profiled’ using implementation guides. Flexibility v. implementability is indeed an issue.