fix(SR): When loading DICOM SR, only one measurement is shown with no way to show others (#3228)

* fix: Make the cornerstone sR viewport show all measurements

* PR fixes

* PR fixes

* Add a DICOM SR hanging protocol

* Duplicate the hanging protocol for seg as well

* PR requested change

* PR requested changes

* PR fixes plus merge update fixes

* PR fixes and integration test fix

* PR - documentation

extensions/cornerstone-dicom-seg/src/getSopClassHandlerModule.js

@@ -53,6 +53,7 @@ function _getDisplaySetsFromSeries(
     segments: {},
     sopClassUids,
     instance,
+    instances: [instance],
     wadoRoot,
     wadoUriRoot,
     wadoUri,

extensions/cornerstone-dicom-seg/src/index.tsx

@@ -3,7 +3,7 @@ import React from 'react';
 
 import { Types } from '@ohif/core';
 
-import getSopClassHandlerModule from './getSopClassHandlerModule';
+import getSopClassHandlerModule, { protocols } from './getSopClassHandlerModule';
 import PanelSegmentation from './panels/PanelSegmentation';
 import getHangingProtocolModule from './getHangingProtocolModule';
 
@@ -37,7 +37,7 @@ const extension = {
    * iconName, iconLabel, label, component} object. Example of a panel module
    * is the StudyBrowserPanel that is provided by the default extension in OHIF.
    */
-  getPanelModule: ({ servicesManager, commandsManager, extensionManager }): Types.Panel[] => {
+  getPanelModule: ({ servicesManager, commandsManager, extensionManager }: Types.Extensions.ExtensionParams): Types.Panel[] => {
     const wrappedPanelSegmentation = () => {
       return (
         <PanelSegmentation
@@ -58,6 +58,7 @@ const extension = {
       },
     ];
   },
+
   getViewportModule({ servicesManager, extensionManager }) {
     const ExtendedOHIFCornerstoneSEGViewport = props => {
       return (
@@ -85,3 +86,7 @@ const extension = {
 };
 
 export default extension;
+
+// Export the protocols separately to allow for extending it at compile time
+// in other modules
+export { protocols };

extensions/cornerstone-dicom-sr/package.json

@@ -46,7 +46,7 @@
     "@babel/runtime": "^7.20.13",
     "classnames": "^2.3.2",
     "@cornerstonejs/adapters": "^0.6.0",
-    "@cornerstonejs/core": "^0.40.0",
+    "@cornerstonejs/core": "^0.42.2",
-    "@cornerstonejs/tools": "^0.60.1"
+    "@cornerstonejs/tools": "^0.61.11"
   }
 }

extensions/cornerstone-dicom-sr/src/commandsModule.js

@@ -1,6 +1,6 @@
 import { metaData, utilities } from '@cornerstonejs/core';
 
-import OHIF from '@ohif/core';
+import OHIF, { DicomMetadataStore } from '@ohif/core';
 import dcmjs from 'dcmjs';
 import { adaptersSR } from '@cornerstonejs/adapters';
 
@@ -41,7 +41,6 @@ const _generateReport = (
   if (typeof dataset.SpecificCharacterSet === 'undefined') {
     dataset.SpecificCharacterSet = 'ISO_IR 192';
   }
-
   return dataset;
 };
 
@@ -104,7 +103,18 @@ const commandsModule = ({}) => {
           additionalFindingTypes,
           options
         );
-        const { StudyInstanceUID } = naturalizedReport;
+
+        const { StudyInstanceUID, ContentSequence } = naturalizedReport;
+        // The content sequence has 5 or more elements, of which
+        // the `[4]` element contains the annotation data, so this is
+        // checking that there is some annotation data present.
+        if (!ContentSequence?.[4].ContentSequence?.length) {
+          console.log(
+            'naturalizedReport missing imaging content',
+            naturalizedReport
+          );
+          throw new Error('Invalid report, no content');
+        }
 
         await dataSource.store.dicom(naturalizedReport);
 
@@ -112,6 +122,11 @@ const commandsModule = ({}) => {
           dataSource.deleteStudyMetadataPromise(StudyInstanceUID);
         }
 
+        // The "Mode" route listens for DicomMetadataStore changes
+        // When a new instance is added, it listens and
+        // automatically calls makeDisplaySets
+        DicomMetadataStore.addInstances([naturalizedReport], true);
+
         return naturalizedReport;
       } catch (error) {
         console.warn(error);

extensions/cornerstone-dicom-sr/src/getSopClassHandlerModule.ts

@@ -1,12 +1,15 @@
 import { SOPClassHandlerName, SOPClassHandlerId } from './id';
-import { utils, classes } from '@ohif/core';
+import { utils, classes, DisplaySetService, Types } from '@ohif/core';
 import addMeasurement from './utils/addMeasurement';
 import isRehydratable from './utils/isRehydratable';
 import { adaptersSR } from '@cornerstonejs/adapters';
 
+type InstanceMetadata = Types.InstanceMetadata;
+
 const { CodeScheme: Cornerstone3DCodeScheme } = adaptersSR.Cornerstone3D;
 
 const { ImageSet, MetadataProvider: metadataProvider } = classes;
+
 // TODO ->
 // Add SR thumbnail
 // Make viewport
@@ -22,6 +25,17 @@ const sopClassUids = [
 const CORNERSTONE_3D_TOOLS_SOURCE_NAME = 'Cornerstone3DTools';
 const CORNERSTONE_3D_TOOLS_SOURCE_VERSION = '0.1';
 
+const validateSameStudyUID = (uid: string, instances): void => {
+  instances.forEach(it => {
+    if (it.StudyInstanceUID !== uid) {
+      console.warn('Not all instances have the same UID', uid, it);
+      throw new Error(
+        `Instances ${it.SOPInstanceUID} does not belong to ${uid}`
+      );
+    }
+  });
+};
+
 const CodeNameCodeSequenceValues = {
   ImagingMeasurementReport: '126000',
   ImageLibrary: '111028',
@@ -50,15 +64,38 @@ const RELATIONSHIP_TYPE = {
 
 const CORNERSTONE_FREETEXT_CODE_VALUE = 'CORNERSTONEFREETEXT';
 
+/**
+ * Adds instances to the DICOM SR series, rather than creating a new
+ * series, so that as SR's are saved, they append to the series, and the
+ * key image display set gets updated as well, containing just the new series.
+ * @param instances is a list of instances from THIS series that are not
+ *     in this DICOM SR Display Set already.
+ */
+function addInstances(
+  instances: InstanceMetadata[],
+  displaySetService: DisplaySetService
+) {
+  this.instances.push(...instances);
+  utils.sortStudyInstances(this.instances);
+  // The last instance is the newest one, so is the one most interesting.
+  // Eventually, the SR viewer should have the ability to choose which SR
+  // gets loaded, and to navigate among them.
+  this.instance = this.instances[this.instances.length - 1];
+  this.isLoaded = false;
+  if (this.keyImageDisplaySet) {
+    this.load();
+    this.keyImageDisplaySet.updateInstances();
+    displaySetService.setDisplaySetMetadataInvalidated(
+      this.keyImageDisplaySet.displaySetInstanceUID
+    );
+  }
+  return this;
+}
+
 /**
  * DICOM SR SOP Class Handler
  * For all referenced images in the TID 1500/300 sections, add an image to the
- * display (this is TODO - it is not the actual behaviour below unfortunately)
+ * display.
- *
- * This will only display and rehydrate the latest DICOM SR in the given series
- * It would be possible to add the ability to view older series rehydrations
- * in the future.
- *
  * @param instances is a set of instances all from the same series
  * @param servicesManager is the services that can be used for creating
  * @returns The list of display sets created for the given instances object
@@ -74,6 +111,9 @@ function _getDisplaySetsFromSeries(
   }
 
   utils.sortStudyInstances(instances);
+  // The last instance is the newest one, so is the one most interesting.
+  // Eventually, the SR viewer should have the ability to choose which SR
+  // gets loaded, and to navigate among them.
   const instance = instances[instances.length - 1];
 
   const {
@@ -86,11 +126,12 @@ function _getDisplaySetsFromSeries(
     ConceptNameCodeSequence,
     SOPClassUID,
   } = instance;
+  validateSameStudyUID(instance.StudyInstanceUID, instances);
 
   if (
     !ConceptNameCodeSequence ||
     ConceptNameCodeSequence.CodeValue !==
-    CodeNameCodeSequenceValues.ImagingMeasurementReport
+      CodeNameCodeSequenceValues.ImagingMeasurementReport
   ) {
     console.log(
       'Only support Imaging Measurement Report SRs (TID1500) for this renderer.'
@@ -111,14 +152,13 @@ function _getDisplaySetsFromSeries(
     SOPClassHandlerId,
     SOPClassUID,
     instances,
-    // Others is a historical value used for instances which is deprecated and will be removed
-    others: instances,
     referencedImages: null,
     measurements: null,
     isDerivedDisplaySet: true,
     isLoaded: false,
     sopClassUids,
     instance,
+    addInstances,
   };
 
   displaySet.load = () => _load(displaySet, servicesManager, extensionManager);
@@ -327,7 +367,7 @@ function _getMeasurements(ImagingMeasurementReportContentSequence) {
     trackingUniqueIdentifier => {
       const mergedContentSequence =
         mergedContentSequencesByTrackingUniqueIdentifiers[
-        trackingUniqueIdentifier
+          trackingUniqueIdentifier
         ];
 
       const measurement = _processMeasurement(mergedContentSequence);
@@ -367,7 +407,7 @@ function _getMergedContentSequencesByTrackingUniqueIdentifiers(
 
     if (
       mergedContentSequencesByTrackingUniqueIdentifiers[
-      trackingUniqueIdentifier
+        trackingUniqueIdentifier
       ] === undefined
     ) {
       // Add the full ContentSequence
@@ -473,18 +513,18 @@ function _processNonGeometricallyDefinedMeasurement(mergedContentSequence) {
       CodeNameCodeSequenceValues.TrackingIdentifier
   );
 
-  const Finding = mergedContentSequence.find(
+  const finding = mergedContentSequence.find(
     item =>
       item.ConceptNameCodeSequence.CodeValue ===
       CodeNameCodeSequenceValues.Finding
   );
 
-  const FindingSites = mergedContentSequence.filter(
+  const findingSites = mergedContentSequence.filter(
     item =>
       item.ConceptNameCodeSequence.CodingSchemeDesignator ===
-      CodingSchemeDesignators.SRT &&
+        CodingSchemeDesignators.SRT &&
       item.ConceptNameCodeSequence.CodeValue ===
-      CodeNameCodeSequenceValues.FindingSite
+        CodeNameCodeSequenceValues.FindingSite
   );
 
   const measurement = {
@@ -496,28 +536,28 @@ function _processNonGeometricallyDefinedMeasurement(mergedContentSequence) {
   };
 
   if (
-    Finding &&
+    finding &&
     CodingSchemeDesignators.CornerstoneCodeSchemes.includes(
-      Finding.ConceptCodeSequence.CodingSchemeDesignator
+      finding.ConceptCodeSequence.CodingSchemeDesignator
     ) &&
-    Finding.ConceptCodeSequence.CodeValue ===
+    finding.ConceptCodeSequence.CodeValue ===
-    CodeNameCodeSequenceValues.CornerstoneFreeText
+      CodeNameCodeSequenceValues.CornerstoneFreeText
   ) {
     measurement.labels.push({
       label: CORNERSTONE_FREETEXT_CODE_VALUE,
-      value: Finding.ConceptCodeSequence.CodeMeaning,
+      value: finding.ConceptCodeSequence.CodeMeaning,
     });
   }
 
   // TODO -> Eventually hopefully support SNOMED or some proper code library, just free text for now.
-  if (FindingSites.length) {
+  if (findingSites.length) {
-    const cornerstoneFreeTextFindingSite = FindingSites.find(
+    const cornerstoneFreeTextFindingSite = findingSites.find(
       FindingSite =>
         CodingSchemeDesignators.CornerstoneCodeSchemes.includes(
           FindingSite.ConceptCodeSequence.CodingSchemeDesignator
         ) &&
         FindingSite.ConceptCodeSequence.CodeValue ===
-        CodeNameCodeSequenceValues.CornerstoneFreeText
+          CodeNameCodeSequenceValues.CornerstoneFreeText
     );
 
     if (cornerstoneFreeTextFindingSite) {
@@ -633,17 +673,16 @@ function _getReferencedImagesList(ImagingMeasurementReportContentSequence) {
 
   _getSequenceAsArray(ImageLibraryGroup.ContentSequence).forEach(item => {
     const { ReferencedSOPSequence } = item;
+    if (!ReferencedSOPSequence) return;
+    for (const ref of _getSequenceAsArray(ReferencedSOPSequence)) {
+      if (ref.ReferencedSOPClassUID) {
+        const { ReferencedSOPClassUID, ReferencedSOPInstanceUID } = ref;
 
-    if (item.hasOwnProperty('ReferencedSOPClassUID')) {
+        referencedImages.push({
-      const {
+          ReferencedSOPClassUID,
-        ReferencedSOPClassUID,
+          ReferencedSOPInstanceUID,
-        ReferencedSOPInstanceUID,
+        });
-      } = ReferencedSOPSequence;
+      }
-
-      referencedImages.push({
-        ReferencedSOPClassUID,
-        ReferencedSOPInstanceUID,
-      });
     }
   });
 
@@ -651,6 +690,7 @@ function _getReferencedImagesList(ImagingMeasurementReportContentSequence) {
 }
 
 function _getSequenceAsArray(sequence) {
+  if (!sequence) return [];
   return Array.isArray(sequence) ? sequence : [sequence];
 }
 

extensions/cornerstone-dicom-sr/src/index.tsx

@@ -9,6 +9,7 @@ import preRegistration from './init';
 import { id } from './id.js';
 import toolNames from './tools/toolNames';
 import hydrateStructuredReport from './utils/hydrateStructuredReport';
+import createReferencedImageDisplaySet from './utils/createReferencedImageDisplaySet';
 
 const Component = React.lazy(() => {
   return import(
@@ -57,8 +58,6 @@ const dicomSRExtension = {
   },
   getCommandsModule,
   getSopClassHandlerModule,
-  getHangingProtocolModule,
-
   // Include dynmically computed values such as toolNames not known till instantiation
   getUtilityModule({ servicesManager }) {
     return [
@@ -75,4 +74,4 @@ const dicomSRExtension = {
 export default dicomSRExtension;
 
 // Put static exports here so they can be type checked
-export { hydrateStructuredReport, srProtocol };
+export { hydrateStructuredReport, createReferencedImageDisplaySet, srProtocol };

extensions/cornerstone-dicom-sr/src/onModeEnter.js

@@ -4,7 +4,7 @@ export default function onModeEnter({ servicesManager }) {
   const { displaySetService } = servicesManager.services;
   const displaySetCache = displaySetService.getDisplaySetCache();
 
-  const srDisplaySets = displaySetCache.filter(
+  const srDisplaySets = [...displaySetCache.values()].filter(
     ds => ds.SOPClassHandlerId === SOPClassHandlerId
   );
 

extensions/cornerstone-dicom-sr/src/utils/createReferencedImageDisplaySet.ts

@@ -0,0 +1,89 @@
+import { DisplaySetService, classes } from '@ohif/core';
+
+const ImageSet = classes.ImageSet;
+
+const findInstance = (measurement, displaySetService: DisplaySetService) => {
+  const {
+    displaySetInstanceUID,
+    ReferencedSOPInstanceUID: sopUid,
+  } = measurement;
+  const referencedDisplaySet = displaySetService.getDisplaySetByUID(
+    displaySetInstanceUID
+  );
+  if (!referencedDisplaySet.images) return;
+  return referencedDisplaySet.images.find(it => it.SOPInstanceUID === sopUid);
+};
+
+/** Finds references to display sets inside the measurements
+ * contained within the provided display set.
+ * @return an array of instances referenced.
+ */
+const findReferencedInstances = (
+  displaySetService: DisplaySetService,
+  displaySet
+) => {
+  const instances = [];
+  const instanceById = {};
+  for (const measurement of displaySet.measurements) {
+    const { imageId } = measurement;
+    if (!imageId) continue;
+    if (instanceById[imageId]) continue;
+
+    const instance = findInstance(measurement, displaySetService);
+    if (!instance) {
+      console.log('Measurement', measurement, 'had no instances found');
+      continue;
+    }
+
+    instanceById[imageId] = instance;
+    instances.push(instance);
+  }
+  return instances;
+};
+
+/**
+ * Creates a new display set containing a single image instance for each
+ * referenced image.
+ *
+ * @param displaySetService
+ * @param displaySet - containing measurements referencing images.
+ * @returns A new (registered/active) display set containing the referenced images
+ */
+const createReferencedImageDisplaySet = (displaySetService, displaySet) => {
+  const instances = findReferencedInstances(displaySetService, displaySet);
+  // This will be a  member function of the created image set
+  const updateInstances = function() {
+    this.images.splice(
+      0,
+      this.images.length,
+      ...findReferencedInstances(displaySetService, displaySet)
+    );
+    this.numImageFrames = this.images.length;
+  };
+
+  const imageSet = new ImageSet(instances);
+  const instance = instances[0];
+  imageSet.setAttributes({
+    displaySetInstanceUID: imageSet.uid, // create a local alias for the imageSet UID
+    SeriesDate: instance.SeriesDate,
+    SeriesTime: instance.SeriesTime,
+    SeriesInstanceUID: imageSet.uid,
+    StudyInstanceUID: instance.StudyInstanceUID,
+    SeriesNumber: instance.SeriesNumber || 0,
+    SOPClassUID: instance.SOPClassUID,
+    SeriesDescription: `${displaySet.SeriesDescription} KO ${displaySet.instance.SeriesNumber}`,
+    Modality: 'KO',
+    isMultiFrame: false,
+    numImageFrames: instances.length,
+    SOPClassHandlerId: `@ohif/extension-default.sopClassHandlerModule.stack`,
+    isReconstructable: false,
+    madeInClient: true,
+    updateInstances,
+  });
+
+  displaySetService.addDisplaySets(imageSet);
+
+  return imageSet;
+};
+
+export default createReferencedImageDisplaySet;

extensions/cornerstone-dicom-sr/src/viewports/OHIFCornerstoneSRViewport.tsx

@@ -15,6 +15,7 @@ import {
   ViewportActionBar,
 } from '@ohif/ui';
 import hydrateStructuredReport from '../utils/hydrateStructuredReport';
+import createReferencedImageDisplaySet from '../utils/createReferencedImageDisplaySet';
 
 const { formatDate } = utils;
 
@@ -59,7 +60,6 @@ function OHIFCornerstoneSRViewport(props) {
     referencedDisplaySetMetadata,
     setReferencedDisplaySetMetadata,
   ] = useState(null);
-  const [isHydrated, setIsHydrated] = useState(srDisplaySet.isHydrated);
   const [element, setElement] = useState(null);
   const { viewports, activeViewportIndex } = viewportGrid;
 
@@ -89,9 +89,9 @@ function OHIFCornerstoneSRViewport(props) {
         { servicesManager, extensionManager },
         displaySetInstanceUID
       );
-      const displaySets = displaySetService.getDisplaySetsForSeries(
+      const displaySets = srDisplaySet.keyImageDisplaySet
-        SeriesInstanceUIDs[0]
+        ? [srDisplaySet.keyImageDisplaySet]
-      );
+        : displaySetService.getDisplaySetsForSeries(SeriesInstanceUIDs[0]);
       if (displaySets.length) {
         viewportGridService.setDisplaySetsForViewports([
           {
@@ -293,8 +293,6 @@ function OHIFCornerstoneSRViewport(props) {
     if (!srDisplaySet.isLoaded) {
       srDisplaySet.load();
     }
-    setIsHydrated(srDisplaySet.isHydrated);
-
     const numMeasurements = srDisplaySet.measurements.length;
     setMeasurementCount(numMeasurements);
   }, [srDisplaySet]);
@@ -382,6 +380,7 @@ function OHIFCornerstoneSRViewport(props) {
           label: viewportLabel,
           useAltStyling: true,
           studyDate: formatDate(StudyDate),
+          currentSeries: SeriesNumber,
           seriesDescription: SeriesDescription || '',
           patientInformation: {
             patientName: PatientName
@@ -424,6 +423,7 @@ OHIFCornerstoneSRViewport.propTypes = {
   viewportIndex: PropTypes.number.isRequired,
   dataSource: PropTypes.object,
   children: PropTypes.node,
+  viewportLabel: PropTypes.string,
   customProps: PropTypes.object,
   viewportOptions: PropTypes.object,
   viewportLabel: PropTypes.string,
@@ -440,14 +440,18 @@ async function _getViewportReferencedDisplaySetData(
   measurementSelected,
   displaySetService
 ) {
-  const { measurements } = displaySet;
+  if (!displaySet.keyImageDisplaySet) {
-  const measurement = measurements[measurementSelected];
+    // Create a new display set, and preserve a reference to it here,
+    // so that it can be re-displayed and shown inside the SR viewport.
+    // This is only for ease of redisplay - the display set is stored in the
+    // usual manner in the display set service.
+    displaySet.keyImageDisplaySet = createReferencedImageDisplaySet(
+      displaySetService,
+      displaySet
+    );
+  }
 
-  const { displaySetInstanceUID } = measurement;
+  const referencedDisplaySet = displaySet.keyImageDisplaySet;
-
-  const referencedDisplaySet = displaySetService.getDisplaySetByUID(
-    displaySetInstanceUID
-  );
 
   const image0 = referencedDisplaySet.images[0];
   const referencedDisplaySetMetadata = {

extensions/cornerstone/package.json

@@ -49,9 +49,9 @@
   "dependencies": {
     "@babel/runtime": "^7.20.13",
     "@cornerstonejs/adapters": "^0.6.0",
-    "@cornerstonejs/core": "^0.40.0",
+    "@cornerstonejs/core": "^0.42.2",
     "@cornerstonejs/streaming-image-volume-loader": "^0.16.0",
-    "@cornerstonejs/tools": "^0.60.1",
+    "@cornerstonejs/tools": "^0.61.11",
     "@kitware/vtk.js": "26.5.6",
     "html2canvas": "^1.4.1",
     "lodash.debounce": "4.0.8",

extensions/cornerstone/src/Viewport/OHIFCornerstoneViewport.tsx

@@ -550,6 +550,7 @@ function _checkForCachedJumpToMeasurementEvents(
   const displaysUIDs = displaySets.map(
     displaySet => displaySet.displaySetInstanceUID
   );
+  if (!displaysUIDs?.length) return;
 
   const measurementIdToJumpTo = measurementService.getJumpToMeasurement(
     viewportIndex
@@ -561,7 +562,7 @@ function _checkForCachedJumpToMeasurementEvents(
       measurementIdToJumpTo
     );
 
-    if (displaysUIDs.includes(measurement.displaySetInstanceUID)) {
+    if (displaysUIDs.includes(measurement?.displaySetInstanceUID)) {
       _jumpToMeasurement(
         measurement,
         elementRef,

extensions/cornerstone/src/index.tsx

@@ -93,7 +93,7 @@ const cornerstoneExtension: Types.Extensions.Extension = {
       return (
         <OHIFCornerstoneViewport
           {...props}
-          ToolbarService={toolbarService}
+          toolbarService={toolbarService}
           servicesManager={servicesManager}
           commandsManager={commandsManager}
         />

extensions/cornerstone/src/services/CornerstoneCacheService/CornerstoneCacheService.ts

@@ -1,5 +1,10 @@
 import { ServicesManager, Types } from '@ohif/core';
-import { cache as cs3DCache, Enums, volumeLoader } from '@cornerstonejs/core';
+import {
+  cache as cs3DCache,
+  Enums,
+  volumeLoader,
+  utilities as utils,
+} from '@cornerstonejs/core';
 
 import getCornerstoneViewportType from '../../utils/getCornerstoneViewportType';
 import {
@@ -11,14 +16,14 @@ const VOLUME_LOADER_SCHEME = 'cornerstoneStreamingImageVolume';
 
 class CornerstoneCacheService {
   static REGISTRATION = {
-    name: 'cornerstoneCacheService',
+      name: 'cornerstoneCacheService',
-    altName: 'CornerstoneCacheService',
+      altName: 'CornerstoneCacheService',
     create: ({
       servicesManager,
     }: Types.Extensions.ExtensionParams): CornerstoneCacheService => {
       return new CornerstoneCacheService(servicesManager);
-    },
+      },
-  };
+    };
 
   stackImageIds: Map<string, string[]> = new Map();
   volumeImageIds: Map<string, string[]> = new Map();
@@ -91,7 +96,10 @@ class CornerstoneCacheService {
     displaySetService
   ) {
     if (viewportData.viewportType === Enums.ViewportType.STACK) {
-      throw new Error('Invalidation of StackViewport is not supported yet');
+      return this._getCornerstoneStackImageIds(
+        displaySetService.getDisplaySetByUID(invalidatedDisplaySetInstanceUID),
+        dataSource
+      );
     }
 
     // Todo: grab the volume and get the id from the viewport itself

extensions/cornerstone/src/services/ViewportService/Viewport.ts

@@ -203,6 +203,10 @@ class ViewportInfo {
       orientation = getCornerstoneOrientation(viewportOptionsEntry.orientation);
     }
 
+    if (!toolGroupId) {
+      toolGroupId = DEFAULT_TOOLGROUP_ID;
+    }
+
     this.setViewportOptions({
       ...viewportOptionsEntry,
       viewportId: this.viewportId,
@@ -228,7 +232,8 @@ class ViewportInfo {
   }
 
   public getSyncGroups(): SyncGroup[] {
-    return this.viewportOptions.syncGroups || [];
+    this.viewportOptions.syncGroups ||= [];
+    return this.viewportOptions.syncGroups;
   }
 
   public getDisplaySetOptions(): Array<DisplaySetOptions> {

extensions/default/src/utils/findSRWithSameSeriesDescription.ts

@@ -40,7 +40,7 @@ export default function findSRWithSameSeriesDescription(
       SeriesTime,
       SeriesNumber,
       Modality,
-      InstanceNumber: sameSeries.others.length + 1,
+      InstanceNumber: sameSeries.instances.length + 1,
     };
   }
 

extensions/dicom-pdf/src/getSopClassHandlerModule.js

@@ -50,7 +50,7 @@ const _getDisplaySetsFromSeries = (
       referencedImages: null,
       measurements: null,
       pdfUrl,
-      others: [instance],
+      instances: [instance],
       thumbnailSrc: dataSource.retrieve.directURL({
         instance,
         defaultPath: '/thumbnail',

extensions/dicom-video/src/getSopClassHandlerModule.js

@@ -70,7 +70,7 @@ const _getDisplaySetsFromSeries = (
           singlepart: 'video',
           tag: 'PixelData',
         }),
-        others: [instance],
+        instances: [instance],
         thumbnailSrc: dataSource.retrieve.directURL({
           instance,
           defaultPath: '/thumbnail',

extensions/measurement-tracking/package.json

@@ -32,8 +32,8 @@
   "peerDependencies": {
     "@ohif/core": "^3.0.0",
     "classnames": "^2.3.2",
-    "@cornerstonejs/core": "^0.40.0",
+    "@cornerstonejs/core": "^0.42.2",
-    "@cornerstonejs/tools": "^0.60.1",
+    "@cornerstonejs/tools": "^0.61.11",
     "@ohif/extension-cornerstone-dicom-sr": "^3.0.0",
     "dcmjs": "^0.29.5",
     "lodash.debounce": "^4.17.21",

platform/core/src/classes/MetadataProvider.js

@@ -441,6 +441,7 @@ class MetadataProvider {
   }
 
   getUIDsFromImageID(imageId) {
+    if (!imageId) throw new Error('MetadataProvider::Empty imageId');
     // TODO: adding csiv here is not really correct. Probably need to use
     // metadataProvider.addImageIdToUIDs(imageId, {
     //   StudyInstanceUID,

platform/core/src/services/DisplaySetService/DisplaySetService.ts

@@ -1,31 +1,40 @@
+import { InstanceMetadata } from '../../types';
 import { PubSubService } from '../_shared/pubSubServiceInterface';
 import EVENTS from './EVENTS';
 
-const displaySetCache = [];
+export type DisplaySet = {
-
+  displaySetInstanceUID: string;
-/**
+  instances: InstanceMetadata[];
- * Find an instance in a list of instances, comparing by SOP instance UID
+  StudyInstanceUID: string;
- */
+  SeriesInstanceUID?: string;
-const findInSet = (instance, list) => {
+  numImages?: number;
-  if (!list) return false;
-  for (const elem of list) {
-    if (!elem) continue;
-    if (elem === instance) return true;
-    if (elem.SOPInstanceUID === instance.SOPInstanceUID) return true;
-  }
-  return false;
 };
 
+const displaySetCache = new Map<string, DisplaySet>();
+
 /**
- * Find an instance in a display set
+ * Filters the instances set by instances not in
- * @returns true if found
+ * display sets.  Done in O(n) time.
  */
-const findInstance = (instance, displaySets) => {
+const filterInstances = (
-  for (const displayset of displaySets) {
+  instances: InstanceMetadata[],
-    if (findInSet(instance, displayset.images)) return true;
+  displaySets: DisplaySet[]
-    if (findInSet(instance, displayset.others)) return true;
+): InstanceMetadata[] => {
-  }
+  const dsInstancesSOP = new Set();
-  return false;
+  displaySets.forEach(ds => {
+    const dsInstances = ds.instances;
+    if (!dsInstances) {
+      console.warn('No instances in', ds);
+    } else {
+      dsInstances.forEach(instance =>
+        dsInstancesSOP.add(instance.SOPInstanceUID)
+      );
+    }
+  });
+
+  return instances.filter(
+    instance => !dsInstancesSOP.has(instance.SOPInstanceUID)
+  );
 };
 
 export default class DisplaySetService extends PubSubService {
@@ -38,6 +47,13 @@ export default class DisplaySetService extends PubSubService {
   };
 
   public activeDisplaySets = [];
+
+  protected activeDisplaySetsMap = new Map<string, DisplaySet>();
+
+  // Record if the active display sets changed - used to group change events so
+  // that fewer events need to be fired when creating multiple display sets
+  protected activeDisplaySetsChanged = false;
+
   constructor() {
     super(EVENTS);
   }
@@ -46,64 +62,85 @@ export default class DisplaySetService extends PubSubService {
     this.extensionManager = extensionManager;
     this.SOPClassHandlerIds = SOPClassHandlerIds;
     this.activeDisplaySets = [];
+    this.activeDisplaySetsMap.clear();
   }
 
-  _addDisplaySetsToCache(displaySets) {
+  _addDisplaySetsToCache(displaySets: DisplaySet[]) {
     displaySets.forEach(displaySet => {
-      displaySetCache.push(displaySet);
+      displaySetCache.set(displaySet.displaySetInstanceUID, displaySet);
     });
   }
 
-  _addActiveDisplaySets(displaySets) {
+  _addActiveDisplaySets(displaySets: DisplaySet[]) {
-    const activeDisplaySets = this.activeDisplaySets;
+    const { activeDisplaySets, activeDisplaySetsMap } = this;
 
     displaySets.forEach(displaySet => {
-      // This test makes adding display sets an N^2 operation, so it might
+      if (!activeDisplaySetsMap.has(displaySet.displaySetInstanceUID)) {
-      // become important to do this in an efficient manner for large
+        this.activeDisplaySetsChanged = true;
-      // numbers of display sets.
-      if (!activeDisplaySets.includes(displaySet)) {
         activeDisplaySets.push(displaySet);
+        activeDisplaySetsMap.set(displaySet.displayInstanceUID, displaySet);
       }
     });
   }
 
-  getDisplaySetCache() {
+  /**
+   * Adds new display sets directly, as specified.
+   * Use this function when the display sets are created externally directly
+   * rather than using the default sop class handlers to create display sets.
+   */
+  public addDisplaySets(...displaySets: DisplaySet[]): string[] {
+    this._addDisplaySetsToCache(displaySets);
+    this._addActiveDisplaySets(displaySets);
+
+    // The activeDisplaySetsChanged flag is only seen if we add display sets
+    // so, don't broadcast the change if all the display sets were pre-existing.
+    this.activeDisplaySetsChanged = false;
+    this._broadcastEvent(EVENTS.DISPLAY_SETS_ADDED, {
+      displaySetsAdded: displaySets,
+      options: { madeInClient: displaySets[0].madeInClient },
+    });
+    return displaySets;
+  }
+
+  public getDisplaySetCache(): Map<string, DisplaySet> {
     return displaySetCache;
   }
 
-  getMostRecentDisplaySet() {
+  public getMostRecentDisplaySet(): DisplaySet {
     return this.activeDisplaySets[this.activeDisplaySets.length - 1];
   }
 
-  getActiveDisplaySets() {
+  public getActiveDisplaySets(): DisplaySet[] {
     return this.activeDisplaySets;
   }
 
-  getDisplaySetsForSeries = SeriesInstanceUID => {
+  public getDisplaySetsForSeries = (
-    return displaySetCache.filter(
+    seriesInstanceUID: string
-      displaySet => displaySet.SeriesInstanceUID === SeriesInstanceUID
+  ): DisplaySet[] => {
+    return [...displaySetCache.values()].filter(
+      displaySet => displaySet.SeriesInstanceUID === seriesInstanceUID
     );
   };
 
-  getDisplaySetForSOPInstanceUID(
+  public getDisplaySetForSOPInstanceUID(
-    SOPInstanceUID,
+    sopInstanceUID: string,
-    SeriesInstanceUID,
+    seriesInstanceUID: string,
-    frameNumber
+    frameNumber?: number
-  ) {
+  ): DisplaySet {
-    const displaySets = SeriesInstanceUID
+    const displaySets = seriesInstanceUID
-      ? this.getDisplaySetsForSeries(SeriesInstanceUID)
+      ? this.getDisplaySetsForSeries(seriesInstanceUID)
-      : this.getDisplaySetCache();
+      : [...this.getDisplaySetCache().values()];
 
     const displaySet = displaySets.find(ds => {
       return (
-        ds.images && ds.images.some(i => i.SOPInstanceUID === SOPInstanceUID)
+        ds.images && ds.images.some(i => i.SOPInstanceUID === sopInstanceUID)
       );
     });
 
     return displaySet;
   }
 
-  setDisplaySetMetadataInvalidated(displaySetInstanceUID) {
+  public setDisplaySetMetadataInvalidated(displaySetInstanceUID: string): void {
     const displaySet = this.getDisplaySetByUID(displaySetInstanceUID);
 
     if (!displaySet) {
@@ -117,19 +154,17 @@ export default class DisplaySetService extends PubSubService {
     );
   }
 
-  deleteDisplaySet(displaySetInstanceUID) {
+  public deleteDisplaySet(displaySetInstanceUID) {
-    const { activeDisplaySets } = this;
+    if (!displaySetInstanceUID) return;
-
+    const { activeDisplaySets, activeDisplaySetsMap } = this;
-    const displaySetCacheIndex = displaySetCache.findIndex(
-      ds => ds.displaySetInstanceUID === displaySetInstanceUID
-    );
 
     const activeDisplaySetsIndex = activeDisplaySets.findIndex(
       ds => ds.displaySetInstanceUID === displaySetInstanceUID
     );
 
-    displaySetCache.splice(displaySetCacheIndex, 1);
+    displaySetCache.delete(displaySetInstanceUID);
     activeDisplaySets.splice(activeDisplaySetsIndex, 1);
+    activeDisplaySetsMap.delete(displaySetInstanceUID);
 
     this._broadcastEvent(EVENTS.DISPLAY_SETS_CHANGED, this.activeDisplaySets);
     this._broadcastEvent(EVENTS.DISPLAY_SETS_REMOVED, {
@@ -141,10 +176,8 @@ export default class DisplaySetService extends PubSubService {
    * @param {string} displaySetInstanceUID
    * @returns {object} displaySet
    */
-  getDisplaySetByUID = displaySetInstanceUid =>
+  public getDisplaySetByUID = (displaySetInstanceUid: string): DisplaySet =>
-    displaySetCache.find(
+    displaySetCache.get(displaySetInstanceUid);
-      displaySet => displaySet.displaySetInstanceUID === displaySetInstanceUid
-    );
 
   /**
    *
@@ -167,7 +200,7 @@ export default class DisplaySetService extends PubSubService {
     }
 
     // If array of instances => One instance.
-    let displaySetsAdded = [];
+    const displaySetsAdded = [];
 
     if (batch) {
       for (let i = 0; i < input.length; i++) {
@@ -177,12 +210,12 @@ export default class DisplaySetService extends PubSubService {
           settings
         );
 
-        displaySetsAdded = [...displaySetsAdded, displaySets];
+        displaySetsAdded.push(...displaySets);
       }
     } else {
       const displaySets = this.makeDisplaySetForInstances(input, settings);
 
-      displaySetsAdded = displaySets;
+      displaySetsAdded.push(...displaySets);
     }
 
     const options = {};
@@ -191,10 +224,13 @@ export default class DisplaySetService extends PubSubService {
       options.madeInClient = true;
     }
 
-    // TODO: This is tricky. How do we know we're not resetting to the same/existing DSs?
+    if (this.activeDisplaySetsChanged) {
-    // TODO: This is likely run anytime we touch DicomMetadataStore. How do we prevent unnecessary broadcasts?
+      this.activeDisplaySetsChanged = false;
-    if (displaySetsAdded && displaySetsAdded.length) {
       this._broadcastEvent(EVENTS.DISPLAY_SETS_CHANGED, this.activeDisplaySets);
+    }
+    if (displaySetsAdded?.length) {
+      // The response from displaySetsAdded will only contain newly added
+      // display sets.
       this._broadcastEvent(EVENTS.DISPLAY_SETS_ADDED, {
         displaySetsAdded,
         options,
@@ -210,22 +246,45 @@ export default class DisplaySetService extends PubSubService {
    * the mode specific onModeExit is called before this method and should
    * store the active display sets and the cached data.
    */
-  onModeExit() {
+  public onModeExit(): void {
-    this.getDisplaySetCache().length = 0;
+    this.getDisplaySetCache().clear();
     this.activeDisplaySets.length = 0;
+    this.activeDisplaySetsMap.clear();
   }
 
-  makeDisplaySetForInstances(instancesSrc, settings) {
+  /**
-    let instances = instancesSrc;
+   * Creates new display sets for the instances contained in instancesSrc
+   * according to the sop class handlers registered.
+   * This is idempotent in that calling it a second time with the
+   * same set of instances will not result in new display sets added.
+   * However, the response for the subsequent call will be empty as the data
+   * is already present.
+   * Calling it with some new instances and some existing instances will
+   * result in the new instances being added to existing display sets if
+   * they support the addInstances call, OR to new instances otherwise.
+   * Only the new instances are returned - the others are updated.
+   *
+   * @param instancesSrc are instances to add
+   * @param settings are settings to add
+   * @returns Array of the display sets added.
+   */
+  public makeDisplaySetForInstances(
+    instancesSrc: InstanceMetadata[],
+    settings
+  ): DisplaySet[] {
+    // Some of the sop class handlers take a direct reference to instances
+    // so make sure it gets copied here so that they have their own ref
+    let instances = [...instancesSrc];
     const instance = instances[0];
 
     const existingDisplaySets =
       this.getDisplaySetsForSeries(instance.SeriesInstanceUID) || [];
 
     const SOPClassHandlerIds = this.SOPClassHandlerIds;
-    let allDisplaySets;
+    const allDisplaySets = [];
 
-    for (let i = 0; i < SOPClassHandlerIds.length; i++) {
+    // Iterate over the sop class handlers while there are still instances to add
+    for (let i = 0; i < SOPClassHandlerIds.length && instances.length; i++) {
       const SOPClassHandlerId = SOPClassHandlerIds[i];
       const handler = this.extensionManager.getModuleEntry(SOPClassHandlerId);
 
@@ -236,34 +295,81 @@ export default class DisplaySetService extends PubSubService {
         );
 
         if (displaySets.length) {
-          this._addActiveDisplaySets(displaySets);
+          // This case occurs when there are already display sets, so remove
-        } else {
+          // any instances in existing display sets.
-          displaySets = handler.getDisplaySetsFromSeries(instances);
+          instances = filterInstances(instances, displaySets);
+          // See if an existing display set can add this instance to it,
+          // for example, if it is a new image to be added to the existing set
+          for (const ds of displaySets) {
+            const addedDs = ds.addInstances?.(instances, this);
+            if (addedDs) {
+              this.activeDisplaySetsChanged = true;
+              instances = filterInstances(instances, [addedDs]);
+              this._addActiveDisplaySets([addedDs]);
+              this.setDisplaySetMetadataInvalidated(
+                addedDs.displaySetInstanceUID
+              );
+            }
+            // This means that all instances already existed or got added to
+            // existing display sets, and had an invalidated event fired
+            if (!instances.length) return allDisplaySets;
+          }
 
-          if (!displaySets || !displaySets.length) continue;
+          if (!instances.length) {
-
+            // Everything is already added - this is just an update caused
-          // applying hp-defined viewport settings to the displaysets
+            // by something else
-          displaySets.forEach(ds => {
+            this._addActiveDisplaySets(displaySets);
-            Object.keys(settings).forEach(key => {
+            return allDisplaySets;
-              ds[key] = settings[key];
+          }
-            });
-          });
-
-          this._addDisplaySetsToCache(displaySets);
-          this._addActiveDisplaySets(displaySets);
-
-          instances = instances.filter(
-            instance => !findInstance(instance, displaySets)
-          );
         }
 
-        allDisplaySets = allDisplaySets
+        // The instances array still contains some instances, so try
-          ? [...allDisplaySets, ...displaySets]
+        // creating additional display sets using the sop class handler
-          : displaySets;
+        displaySets = handler.getDisplaySetsFromSeries(instances);
 
-        if (!instances.length) return allDisplaySets;
+        if (!displaySets || !displaySets.length) continue;
+
+        // applying hp-defined viewport settings to the displaysets
+        displaySets.forEach(ds => {
+          Object.keys(settings).forEach(key => {
+            ds[key] = settings[key];
+          });
+        });
+
+        this._addDisplaySetsToCache(displaySets);
+        this._addActiveDisplaySets(displaySets);
+
+        // It is possible that this SOP class handler handled some instances
+        // but there may need to be other instances handled by other handlers,
+        // so remove the handled instances
+        instances = filterInstances(instances, displaySets);
+
+        allDisplaySets.push(...displaySets);
       }
     }
     return allDisplaySets;
   }
+
+  /**
+   * Iterates over displaysets and invokes comparator for each element.
+   * It returns a list of items that has being succeed by comparator method.
+   *
+   * @param comparator - method to be used on the validation
+   * @returns list of displaysets
+   */
+  public getDisplaySetsBy(comparator: (DisplaySet) => boolean): DisplaySet[] {
+    const result = [];
+
+    if (typeof comparator !== 'function') {
+      throw new Error(`The comparator ${comparator} was not a function`);
+    }
+
+    this.getActiveDisplaySets().forEach(displaySet => {
+      if (comparator(displaySet)) {
+        result.push(displaySet);
+      }
+    });
+
+    return result;
+  }
 }

platform/core/src/services/HangingProtocolService/HPMatcher.js

@@ -32,7 +32,7 @@ const match = (
   // Allow for matching against current or prior specifically
   const prior = options?.studies?.[1];
   const current = options?.studies?.[0];
-  const instance = (metadataInstance.images || metadataInstance.others)?.[0];
+  const instance = metadataInstance.instances?.[0];
   const fromSrc = {
     prior,
     current,

platform/core/src/types/index.ts

@@ -2,6 +2,7 @@ import * as Extensions from '../extensions/ExtensionManager';
 import * as HangingProtocol from './HangingProtocol';
 import Services from './Services';
 import Hotkey from '../classes/Hotkey';
+import { DisplaySet } from '../services/DisplaySetService/DisplaySetService';
 
 export * from '../services/CustomizationService/types';
 // Separate out some generic types
@@ -16,4 +17,4 @@ export * from './IPubSub';
  * Export the types used within the various services and managers, but
  * not the services/managers themselves, which are exported at the top level.
  */
-export { Extensions, HangingProtocol, Services, Hotkey };
+export { Extensions, HangingProtocol, Services, Hotkey, DisplaySet };

platform/viewer/cypress/integration/measurement-tracking/OHIFMeasurementPanel.spec.js

@@ -59,7 +59,9 @@ describe('OHIF Measurement Panel', function() {
     cy.get('@viewportInfoTopRight').should('contains.text', '(14/');
 
     // Click on first measurement item
-    cy.get('[data-cy="measurement-item"]').click();
+    cy.get('[data-cy="measurement-item"]')
+      .eq(0)
+      .click();
 
     cy.get('@viewportInfoTopRight').should('contains.text', '(1/');
     cy.get('@viewportInfoTopRight').should('not.contains.text', '(14/');

yarn.lock

@@ -1451,6 +1451,14 @@
     detect-gpu "^4.0.45"
     lodash.clonedeep "4.5.0"
 
+"@cornerstonejs/core@^0.42.2":
+  version "0.42.2"
+  resolved "https://registry.yarnpkg.com/@cornerstonejs/core/-/core-0.42.2.tgz#be69adbfd7b63718316a4f18fa55ca473506cee5"
+  integrity sha512-sLRqCOzR8cxBtQel9fltRti/rQRiYs1Wgx/CaYRPXlWID9Gj9os4j2PJHa70OiMIp4shMsF3jyVW7BPK0t6ZJQ==
+  dependencies:
+    detect-gpu "^4.0.45"
+    lodash.clonedeep "4.5.0"
+
 "@cornerstonejs/streaming-image-volume-loader@^0.16.0":
   version "0.16.0"
   resolved "https://registry.npmjs.org/@cornerstonejs/streaming-image-volume-loader/-/streaming-image-volume-loader-0.16.0.tgz#513f868c285963fd2f2dbf54ed7840a2dc05e33a"
@@ -1459,12 +1467,12 @@
     "@cornerstonejs/core" "^0.40.0"
     cornerstone-wado-image-loader "^4.10.2"
 
-"@cornerstonejs/tools@^0.60.1":
+"@cornerstonejs/tools@^0.61.11":
-  version "0.60.1"
+  version "0.61.11"
-  resolved "https://registry.npmjs.org/@cornerstonejs/tools/-/tools-0.60.1.tgz#88cf32fe79c7fb714a99c1a63c25822233a4d231"
+  resolved "https://registry.yarnpkg.com/@cornerstonejs/tools/-/tools-0.61.11.tgz#dacd85967cd6ab22c27dd44c10b14664863631f9"
-  integrity sha512-0GsxN8INh8/1/uKH4pU1ZT8XLNn4Xi2GJug9CQBT6plfnppru//+P+xl+LEQbYVpsydD1iYoWzLe8ykPuIeQCA==
+  integrity sha512-TCUde2gmuyiyd0EXhoT4DhDZBHYy82MOiekGQe+IG24um3a7GNGJ7jOKBk7fVFxJCTAI2Cb6XI8K79h6BhuWdg==
   dependencies:
-    "@cornerstonejs/core" "^0.40.0"
+    "@cornerstonejs/core" "^0.42.2"
     lodash.clonedeep "4.5.0"
     lodash.get "^4.4.2"