Unsupported Transfer Syntax Error - How to use a different transfer syntax when routing, receiving or sending DICOM images ?

Each DICOM file in a study is encoded with one of the DICOM encoding scheme that represents its data. The DICOM standard defines following schemes to name some of them. 

• Little-endian Implicit VR

• Big-Endian Explicit VR

• Little-endian Explicit VR

• Run-Length Encoding (RLE)

• Baseline JPEG

• Extended JPEG

• Lossless JPEG

• Lossy JPEG

Whenever you send or receive a study it could be transmitted in one of the above formats across the network. Although all of these schemes are valid, not all PACS systems support for all the transfer syntaxes above.

The most common and most widely supported one being Little-endian Implicit VR is usually a safer choice. However sometimes you can not control in which format the images are being sent to your PACS. If you are receiving images from outside facilities or importing patient images from CD's that were created at another facility, you have little control over the transfer syntax coming into your system. And if your PACS isn't liking a particular transfer syntax you are receiving or sending, you will receive the notorious Unsupported Transfer Syntax Error

AutoPACS DICOM Router has a few ways to address this problem. Let's consider two separate scenarios when sending or receiving images.

A) Receiving images (with a transfer syntax not supported by your PACS system) 

Sending Entity PACS   ->  Your   PACS

If your PACS isn't supporting a particular transfer syntax that you are receiving with, AutoPACS can address this problem. Since all valid DICOM transfer syntaxes we mentioned at the top are accepted by AutoPACS, you will be able to import your studies into AutoPACS with no problems. Once your studies are in AutoPACS, you can send them to your PACS with the supported transfer syntax you would like to use. AutoPACS does the encoding and decoding for you on-the-fly while it is transmitting your studies. So the connection would look like below. 

Sending Entity PACS (JPEG lossless) ->  AutoPACS  -> (Little-endian Implicit VR) Your PACS

B) Sending images (with a transfer syntax not supported by receiving PACS system) 

Your PACS -> Receiving Entity PACS

What if you are trying to send studies from your PACS to another facility and their PACS system is not accepting the transfer syntax, hence resulting in Unsupported Transfer Syntax error? In many cases you may not be able to change the transfer syntax outgoing from your PACS system. Fortunately though for us, this is no different than the receiving scenario above. If you first send your studies to AutoPACS with whatever syntax your PACS is using, you can then use any transfer syntax the receiving side accepts to transmit them to the receiving PACS system. So the connections would look more like.

Your PACS (Little-endian Implicit VR) -> AutoPACS -> (Big-endian Explicit VR)  Receiving Entity PACS

Using a different transfer syntax in AutoPACS:

Both of these scenarios we discussed (sending and receiving) are pretty straight-forward scenarios for AutoPACS to handle. It can actually do better than that and do all of this automatically for you on-the-fly anytime you want to receive or send by using a different transfer syntax using the smart Rule.