A Software Development of DICOM Image Processing Based on QT, VTK

and ITK
SUN Mengmeng, WU Shuicai*
Collage of Life Science and Bioengineering, Beijing University of Technology, Beijing 100124, China
E-mail˖smm_sunmengmeng@163.com

Abstract:To display and process images in different DICOM formats,this article introduces a new method of integrating ITK,
VTK and QT to process the images in DICOM format, and a software was designed based on the three tools . The results indicate
that this software can read and display DICOM images with different suffixes and can process medical images simply.
Key Words:DICOM,Image Processing, ITK, VTK, QT
1 INTRODUCTION scientific research and software development[4].HAO
Weilin[1]have used them to read and display DICOM
As the development of hospital information system and
images. These toolkits do not provide the
picture archiving and communication system,Digital
GUI(Graphical User Interface), which is not
Imaging and Communications in Medicine (DICOM)
convenient for users. WEN Tiexiang[5] have designed
exists as a standard for handling,storing, printing,
a platform using MFC as GUI, but it didn’t support
and transmitting information in medical imaging. The
cross-platform. Qtis a cross-platform graphical user
DICOM files include not only the information of
interface developed by TrollTech in 1991. It provides
images, but also contain a lot of medical information[1].
the application developers all the functions needed by
Due to the complexity of DICOM format, ordinary
building state-of-the-art graphical user interface. Qt is
program can’t read and display images of DICOM
easy to expand, and allows real component
format. How to read and process an image in DICOM
programming. Qt provides a safety type called
format by programming is important for further image
signals/slots to replace the callback, and this makes
processing and image visualization.
cooperation among the various components of work is
Many companies,such as SIEMENS, Philips and GE,
very simple, the user interface development is very
have designed many softwaresspecialized for their
easily. Qt becomes very popular because of its support
medical equipment to display DICOM images. Those
for cross-platform, object-oriented with rich API. This
softwares are not available to public and only support
paper integrate QT, ITK and VTK to develop a
standard format and internal format in theircompanies.
software of image processing with a practical GUI, and
Moreover, some softwares can only read some DICOM
it can read all kinds of DICOM images with different
images with special suffix.For example, Irfanview can
suffixes. The process of development is simple without
only display images with suffix as *.DCM and *.IMA.
underlying development. Our work is a fundamental
Those above-mentioned softwaresabove are developed
step for further image processing.
from bottom using C++ or some other advanced
programming language. The progress is complicated 2 METHODS
and insufficient for encapsulation and further
2.1 Circumstance and tools
processing.
Visualization Toolkit (VTK,www.vtk.org)[2]and We developed the software in Windows7 operating
Insight Segmentation and Registration Toolkit ( ITK, system based onITK, VTK and Qt.
www.itk.org)[3]are the most notable algorithm toolkits 2.2Integrating ITK, VTK and QT in visual studio
aimed to provide an open algorithm library for 2008
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978-1-4673-5887-3/13/$31.00 ©2013 IEEE


2.2.1 Integrate ITK and VTK
ITK and VTK are both work in pipeline, so it’s easy to
integrate them using the type cast files provided by the
library of themselves. The header files we used are
shown as follows:
"itkVTKImageToImageFilter.h"
"itkImageToVTKImageFilter.h".
The flow chart of integrating ITK and VTK is shown
in Fig 1. First, read data using ITK reading function,
second, convert data type supported by ITK to the one
supported by VTK with or without image processing,
and last, display the data using vtkImageViewer in
VTK.
Fig 1. Flow chart of integrating ITK and VTK
2.2.2Integrate VTK and QT
The class used to display 2D image in VTK is
vtkImageViewer2 which encapsulates
objectsincluding vtkRenderWindow, vtkRenderer,
vtkCamera and vtkActor, and the class needn’t to be
initialized.
The widget provided by Qt to connect to VTK is
QVTKWidget, and we can use it by adding the header
file “QVTKWidget.h”. This widget gets Render
Window from vtkImageViewer2 using its function
SetRenderWindow() and encapsulates the
window in the widget supported by Qt.
2.3Interface design
Qt[6] is rich in API, which make the development of
GUI very easy and simple. Qt provides all kinds of
widgets and buttons in Qt Designer. Qt provides a
higher-level interface module called signals/slots.
Signals and slots are used for communication between
objects. The signals and slots mechanism is a central
feature of Qt and probably the part that differs most
from the features provided by other frameworks. A
signal is emitted when a particular event occurs. Qt's
widgets have many predefined signals, but we can
always subclass widgets to add our own signals to
them. A slot is a function that is called in response to a
particular signal. You can connect as many signals as
you want to a single slot, and a signal can be
connected to as many slots as you need. It is even
possible to connect a signal directly to another signal.
This will emit the second signal immediately
whenever the first is emitted. Signals and slots make
up a powerful component programming mechanism as
shown in Fig 2.
Fig 2. Mechanism of signals and slots
the
2.4Read and display DICOM images
2.4.1 Read DICOM files using ITK
In ITK library, the function of reading DICOM files is
provided in GDCM library and we use class named
GDCMImageIO to connect GDCM library[3].
The first thing required to read an image from a file is
to include the header file "itkImageFileReader.h".
VTK Then, the image type should be defined by specifying
the type used to represent pixels and the dimensions of
the image as follows.
typedefunsigned char PixelType;
constunsignedintDimension =2;
typedefitk::Image<PixelType, dimension >ImageType;
Using the image type, it is possible to instantiate the
image reader class. The image type is used as a
template parameter to define how the data will be
represented once it is loaded into memory as follows.
ReaderType::Pointer reader = ReaderType::New();
reader->SetFileName( filename );
Generally, some DICOM images need to be adjusted
through window width and level so that more clearly
human organic structures can be achieved without the
information of environment such as the air. DICOM
header files contain the window width and level

information. After adjusting the image through the
above method, some disturbances of environment can
be removed.
DICOM images store 16-bits per sample (65,535
levels) usually, sothe gray value ranges of DICOM
images should be normalized to 0 to 255 because of
the restrictions of the recognition ability of the human
eyes and the performance of the display device[7].
We used itkIntensityWindowingImageFilter here to
map the gray value to an appropriate boundary before
displaying the image.
2.4.2 Display Image
Class named vtkConnectorType was used to input
image data read by ITK. Coordinated system in ITK is
different from VTK, so we used class vtkImageFlip to
invert Y axis. After that the data was input
vtkImageViewer2.
2.5 DICOM header information
2.5.1 Get DICOM header information
A single DICOM file contains both aheader (which
stores information about the patient's name, the type of
scan, image dimensions), as well as all of the image
data (which can contain information in three
dimensions). The first 794 bytes are used for a
DICOM format header, which describes the image
dimensions and retains other text information about
the scan. The size of this header varies depending on
how much header information is stored. The image
data follows the header information (the header and
the image data are stored in the same file).DICOM
dataset is composed by a series of data elements
according to the label (tag) order from small to large.
Data elements include tag, labelID, length of the value
and the range of the value.
We get the DICOM header information though setting
the function as follows.
GDCMImageIO ->GetMetaDataDictionary();
2.5.2 Display the DICOM header information
The widget in Qt we used to display the header
information is QTableView. We show the information
in three rows: tag, labelID and value.
There are Settings about QTableView as follows:
a.Set the ItemModle.

b.Set the title of each row.
c.Write the information of tag into the first row of
QTableView. The settings of other rows are similar.
d. Set the title and size of QTableView and make the
widget not editable.
2.6 Image processing
The functions we used this part in ITK are shown in
Table 1.
Table 1.Functions in image processing
Module Functions
Median filter itkMedianImageFilter
Curvature filter itkMinMaxCurvatureFlowImageFilter
Edges detection itkCannyEdgeDetectionImageFilter
Image corrosion itkGrayscaleErodeImageFilter
Image dilation itkGrayscaleFunctionDilateImageFilter
2.6.1 Image Smoothing
Image smoothing is helpful for enhancing and
characterizing fundamental image constituents, i.e.,
salient edges, and in the meantime for diminishing
insignificant details. Image smoothing can make
adjacent pixels look more similar[8].
This paper used two smoothing methods, median filter
and a curvature driven image denoisingalgorithm. The
median filter in ITK is itkMedianImageFilter and the
other is itkMinMaxCurvatureFlowImageFilter.
2.6.2 Edge detection
Edge detection is the name for a set of mathematical
methods which aim at identifying points in a digital
image at which the image brightness changes sharply
or, more formally, has discontinuities. The points at
which image brightness changes sharply are typically
organized into a set of curved line segments termed
edges. Edges detection is a fundamental tool in image
processing, machine vision and computer vision,
particularly in the areas of feature detection and
feature extraction. There are a lot of edge detection
kernels, such as Canny, Sobel, Roberts and Prewitt.
This paper takesCanny kernel as an example to
introduce the edge detection. The filter we used in ITK
is itkCannyEdgeDetectionImageFilter.
2.6.3 Image morphology
Image corrosion and dilation is an important basis of
morphological image processing. Corrosion can suffix. They are all CT images. The results are
remove the image noise and certain structure of an shown in Fig 5.
image,and dilation can fill the gap and empty of the
image.
This paper used itkGrayscaleErodeImageFilter for
corrosionand itkGrayscaleFunctionDilateImageFilter
for dilation in ITK.

3EXPERIMENTAL RESULTS
3.1 Interface of the software (a) (b)

The interface of the software is shown in Fig 4 and Fig Fig 5. DICOM images with different suffixes: (a) Image with suffix

5 shows the menu bar of the interface. as *IMA; (b) DICOM image without suffix.

3.3 Display DICOM header information

Original image is shown in Fig 6 and its DICOM

header information is shown in Fig 7.

Fig 3. Interface of the software.

Fig 6.Original image.

(a) (b)

Fig 7.DICOM header information of original image.

3.4 Image smoothing

We used two methods to smooth the original image

(c) (d)
and the results are shown in Fig 8. Median filter can
Fig 4. Menu bar of the interface: (a)File menu; (b)Image process
blur the edge of the image, but the edge can be well
menu; (c)Image smoothing menu; (d)Image information menu.
retained at the same time of denoising by using
3.2 Display DICOM image with different suffixes itkMinMaxCurvatureFlowImageFilter.

We tested two kinds of DICOM formats image: one

image with suffix as *IMA and the other without


 convenient to add further functions.
This software can only show and process 2D images,
so we will add functionsabout 3D images to the
software in the future study. This paper only
fulfillssome simple image processing and this is the
foundationof further processing. We can add image
registration and image segmentation to the software,
(a) (b) which are the hot points at present.
Fig 8. Images after smoothing: (a) Image after median filtering;
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4 CONCLUSION AND EXPECTION

This paper developed a simple software based ITK,
VTK and Qt which can provide a practical and
cross-platform GUI for users. This software can
display and process DICOM images with different
suffixes. The process of development is easy and it’s