SCO and CTO Proprietary file conversion to BTO for Mammography in Enterprise Imaging

The exchange of medical images, such as X-rays, MRIs, and CT scans, is integral to patient care and clinical decision-making. As healthcare organizations move towards digital transformation, the need for efficient and standardized file conversion in enterprise imaging has become paramount. Digital mammography produces Full-Field Digital Mammography (FFDM) to create digital breast images. A digital mammography machine captures X-ray images of the breast. It converts them into digital data that can be stored and manipulated electronically, the most commonly used breast cancer screening and diagnostic evaluation method. Two varieties of mammograms are available in the United States: 3D mammograms, also known as digital breast tomosynthesis, digital tomosynthesis, or just tomosynthesis, and 2D digital mammograms.

Digital mammography image

Some vendors store and display mammography exams in proprietary formats, such as Computed Tomography Object (CTO) and Secondary Capture Object (SCO). These proprietary formats cannot be displayed by image viewers, presenting workflow challenges. These file formats require conversion into the standard Breast Tomosynthesis Objects (BTO) format to pull relevant prior studies for the proper diagnosis. Recognizing which proprietary files occur in the workflow and obtaining the right tools for conversion will help streamline the imaging workflows.

What are the Challenges and Considerations with SCO and CTO Proprietary Formats?

In Mammography and data management, several issues surround Secondary Capture Objects (SCO) formatted files:

  1. SCO files pose the challenge of creating archives with unviewable priors, which can complicate the accessibility and interpretation of historical data.
  2. Compliance with the Digital Imaging and Communications in Medicine (DICOM) standard requires converting SCO files to the standard BTO format, introducing an extra step in the transformation process.
  3. Some vendors producing proprietary files don’t offer conversion utilities and keep their file formats undisclosed. As a result, these vendors cannot provide SCO viewers on CDs, adding an extra layer of complexity to data accessibility.
  4. The evolution of modalities now supports a standardized BTO format, offering a more seamless integration of imaging data into modern systems. This means converting SCO/CTO to BTO is required.
  5. Compatibility issues may arise with PACS systems that do not support JPEG lossless compression, emphasizing the need to consider broader system requirements for efficient medical image management.

Computed Tomography Objects (CTO) files represent a proprietary format from one of the modality vendors. In the past, Siemens utilized CT for mammography, and these formats may exist in specific archives. Specific tools or software are necessary to facilitate the conversion from CTO to BTO. While they employ standard BTO, the previous image conversion software should align with the format transition, similar to the process from Hologic SCO to BTO.

What is the BTO standard, and why must proprietary files be converted?

DICOM is the standard for communicating and managing medical imaging information and related data. DICOM is most commonly used for storing and transmitting medical images, enabling the integration of medical imaging devices such as scanners, servers, workstations, printers, network hardware, and PACS (picture archiving and communication systems) from multiple manufacturers. In mammography and breast imaging, DICOM is critical in streamlining workflows, improving the accuracy and efficiency of diagnoses, and enabling better patient care. For mammography, the DICOM-compliant is Breast Tomosynthesis Objects (BTO), the industry standard that supports efficient workflow and interoperability.

Dicom Systems Solutions For Proprietary File Conversion

The Unifier® platform offers a robust solution for managing mammography images, specifically addressing challenges related to proprietary file conversion in SCO and CTO formats. The platform utilizes specialized workflows, allowing users to interoperate between systems seamlessly. With Unifier, users can perform tasks such as retrieving prior images, modifying modality worklists, executing query-retrieve proxies, balancing workloads, converting files, prioritizing studies, and integrating third-party applications.

Key features of the Unifier platform include:

  • Modifying SOP classes and conversion of CTO and SCO proprietary files to BTOs.
  • On-the-fly compression and optimization of network transfers.
  • Prioritization and retrieval of relevant prior studies, regardless of their location.

Contact our enterprise imaging workflow experts for more information on how Unifier can enhance efficiency and productivity in your imaging operations.