Journal of Digital Imaging

, Volume 31, Issue 4, pp 568–577 | Cite as

Transforming Dermatologic Imaging for the Digital Era: Metadata and Standards

  • Liam J. CafferyEmail author
  • David Clunie
  • Clara Curiel-Lewandrowski
  • Josep Malvehy
  • H. Peter Soyer
  • Allan C. Halpern


Imaging is increasingly being used in dermatology for documentation, diagnosis, and management of cutaneous disease. The lack of standards for dermatologic imaging is an impediment to clinical uptake. Standardization can occur in image acquisition, terminology, interoperability, and metadata. This paper presents the International Skin Imaging Collaboration position on standardization of metadata for dermatologic imaging. Metadata is essential to ensure that dermatologic images are properly managed and interpreted. There are two standards-based approaches to recording and storing metadata in dermatologic imaging. The first uses standard consumer image file formats, and the second is the file format and metadata model developed for the Digital Imaging and Communication in Medicine (DICOM) standard. DICOM would appear to provide an advantage over using consumer image file formats for metadata as it includes all the patient, study, and technical metadata necessary to use images clinically. Whereas, consumer image file formats only include technical metadata and need to be used in conjunction with another actor—for example, an electronic medical record—to supply the patient and study metadata. The use of DICOM may have some ancillary benefits in dermatologic imaging including leveraging DICOM network and workflow services, interoperability of images and metadata, leveraging existing enterprise imaging infrastructure, greater patient safety, and better compliance to legislative requirements for image retention.


Dermatology Metadata DICOM Standards Enterprise imaging 



The authors acknowledge the contribution of the International Skin Imaging Collaboration: Melanoma Project working group members. We acknowledge David Clunie as co-first author of this manuscript.

Funding Information

Liam Caffery receives funding under a collaborative research agreement between Memorial Sloan Kettering Cancer Center and The University of Queensland. Liam Caffery and H. Peter Soyer are supported in part by the Centre of Research Excellence in Telehealth funded by Australia’s National Health and Medical Research Council (NHMRC APP1061183). Allan Halpern is supported in part by the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Society for Imaging Informatics in Medicine 2018

Authors and Affiliations

  1. 1.Centre for Online Health, Centre for Health Services ResearchThe University of QueenslandBrisbaneAustralia
  2. 2.PixelMed LLCBangorUSA
  3. 3.University of Arizona Cancer Center/Skin Cancer Institute and Division of DermatologyUniversity of ArizonaTucsonUSA
  4. 4.Dermatology Department, Hospital Clinic, IDIBAPS, CIBER de enfermedades rarasUniversity of BarcelonaBarcelonaSpain
  5. 5.Dermatology Research Centre, The University of Queensland Diamantina InstituteThe University of QueenslandBrisbaneAustralia
  6. 6.Dermatology DepartmentPrincess Alexandra HospitalBrisbaneAustralia
  7. 7.Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkUSA

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