JPEG XS, the keystone of the new Digital Imaging and Communications in Medical standard for IP-based video.

08.03.23 02:24 PM By Julie

Using SMPTE 2110-22 and DICOM-RTV to ensure real-time high quality video transmission during the surgery

There is no hospital worthy of the name today, that is not equipped with state-of-the-art audio-visual equipment. In order to guarantee a perfect management of all of this real-time transfer of video, and/or audio, and associated medical metadata between examination rooms, operating theatres and even off-site medical experts, a new DICOM (Digital Imaging and Communications in Medicine) communication service standard has been developed - DICOM-RTV.

Its main objective is to deliver synchronized real-time video feeds to various surgeons during the surgical procedure present in the  operating room (OR). But also the transmission of these real-time video streams beyond the confines of the operating room with a comparable quality of service is targeted .

Moreover, this DICOM-RTV standard allows for true interoperability between the various types of medical equipment that produce/consume the media essences with the reliability and performance so critical in medical applications, regardless whether it involves surgical procedures or establishing an accurate diagnosis.

DICOM is the driving force behind the imaging workflow in hospitals around the world by providing standards to manage the entire chain from the medical image acquisition, the transfer, the processing and the interpretation, down to the final storage. It facilitates the interoperability between OR cameras, scopes, patient monitoring equipment, instrumentation, servers, microphones, video recorders, laptops,…

DICOM Real-Time Video (DICOM-RTV), defines a new IP-based DICOM service for broadcasting real-time video and the corresponding metadata in a fully synchronized way to subscribers (e.g. display monitor), with a quality of service comparable to the one obtained via video cables. Moreover, by allowing the different devices inside the OR to communicate using a standardized way, any potential interoperability issue is eliminated. Last but not least, it guarantees a hassle-free upgrade of the existing SDI-based systems in the OR by a future-proof IP-based one.

DICOM-RTV is based on the SMPTE ST 2110 family of standards, widely used in the professional AV (audio-visual) industries. It uses mainly the communication architecture specified in SMPTE ST 2110-10. As a first step, the current version of DICOM-RTV is focusing on the real-time streaming of uncompressed video. But the standard is now used also with lightly compressed video streams leveraging the new JPEG XS lightweight low latency visually lossless compression standards. 

Using the JPEG XS codec over SMPTE ST 2110-22 allows for direct streaming of one our multiple HD and 4K live feeds from the OR over the hospital’s IP infrastructure (using 1Gb or 10Gb) and over wireless networks such as 60Ghz. JPEG XS enables also to extend these feeds over cloud-based networks with zero latency. Using the JPEG XS codec, the transmission of HD & 4K video over existing ethernet networks is easier and less expensive to implement. This type of CAT5e network infrastructure is already deployed in most hospitals and office buildings and is physically compatible with any equipment following the DICOM standards. 

The new JPEG XS codec manages and transmits more pixels in real time and in lossless quality to anywhere on the hospital campus: all the way from a surgeon’s heads-up camera and display to 4K monitors for viewing by nurses and physicians. That it does so with much lower power consumption, and reduced bandwidth usage provides these medical facilities the added benefit of optimized infrastructure use, without the need to constantly upgrade network requirements. 

By taking advantage of the SMPTE ST 2110, including JPEG XS SMPTE2110-22, DICOM-RTV promises to deliver synchronized and high quality videos, together with their corresponding metadata, in real-time (zero latency) to the physicians (in particular the surgeons) and their assistants, inside the OR.

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