init

extensions/cornerstone-dicom-seg/src/commandsModule.ts

@@ -0,0 +1,379 @@
+import dcmjs from 'dcmjs';
+import { createReportDialogPrompt } from '@ohif/extension-default';
+import { Types } from '@ohif/core';
+import { cache, metaData } from '@cornerstonejs/core';
+import {
+  segmentation as cornerstoneToolsSegmentation,
+  Enums as cornerstoneToolsEnums,
+  utilities,
+} from '@cornerstonejs/tools';
+import { adaptersRT, helpers, adaptersSEG } from '@cornerstonejs/adapters';
+import { classes, DicomMetadataStore } from '@ohif/core';
+
+import vtkImageMarchingSquares from '@kitware/vtk.js/Filters/General/ImageMarchingSquares';
+import vtkDataArray from '@kitware/vtk.js/Common/Core/DataArray';
+import vtkImageData from '@kitware/vtk.js/Common/DataModel/ImageData';
+
+const { segmentation: segmentationUtils } = utilities;
+
+const { datasetToBlob } = dcmjs.data;
+
+const getTargetViewport = ({ viewportId, viewportGridService }) => {
+  const { viewports, activeViewportId } = viewportGridService.getState();
+  const targetViewportId = viewportId || activeViewportId;
+
+  const viewport = viewports.get(targetViewportId);
+
+  return viewport;
+};
+
+const {
+  Cornerstone3D: {
+    Segmentation: { generateSegmentation },
+  },
+} = adaptersSEG;
+
+const {
+  Cornerstone3D: {
+    RTSS: { generateRTSSFromSegmentations },
+  },
+} = adaptersRT;
+
+const { downloadDICOMData } = helpers;
+
+const commandsModule = ({
+  servicesManager,
+  extensionManager,
+}: Types.Extensions.ExtensionParams): Types.Extensions.CommandsModule => {
+  const {
+    segmentationService,
+    uiDialogService,
+    displaySetService,
+    viewportGridService,
+    toolGroupService,
+  } = servicesManager.services as AppTypes.Services;
+
+  const actions = {
+    /**
+     * Loads segmentations for a specified viewport.
+     * The function prepares the viewport for rendering, then loads the segmentation details.
+     * Additionally, if the segmentation has scalar data, it is set for the corresponding label map volume.
+     *
+     * @param {Object} params - Parameters for the function.
+     * @param params.segmentations - Array of segmentations to be loaded.
+     * @param params.viewportId - the target viewport ID.
+     *
+     */
+    loadSegmentationsForViewport: async ({ segmentations, viewportId }) => {
+      // Todo: handle adding more than one segmentation
+      const viewport = getTargetViewport({ viewportId, viewportGridService });
+      const displaySetInstanceUID = viewport.displaySetInstanceUIDs[0];
+
+      const segmentation = segmentations[0];
+      const segmentationId = segmentation.segmentationId;
+      const label = segmentation.config.label;
+      const segments = segmentation.config.segments;
+
+      const displaySet = displaySetService.getDisplaySetByUID(displaySetInstanceUID);
+
+      await segmentationService.createLabelmapForDisplaySet(displaySet, {
+        segmentationId,
+        segments,
+        label,
+      });
+
+      segmentationService.addOrUpdateSegmentation(segmentation);
+
+      await segmentationService.addSegmentationRepresentation(viewport.viewportId, {
+        segmentationId,
+      });
+
+      return segmentationId;
+    },
+    /**
+     * Generates a segmentation from a given segmentation ID.
+     * This function retrieves the associated segmentation and
+     * its referenced volume, extracts label maps from the
+     * segmentation volume, and produces segmentation data
+     * alongside associated metadata.
+     *
+     * @param {Object} params - Parameters for the function.
+     * @param params.segmentationId - ID of the segmentation to be generated.
+     * @param params.options - Optional configuration for the generation process.
+     *
+     * @returns Returns the generated segmentation data.
+     */
+    generateSegmentation: ({ segmentationId, options = {} }) => {
+      const segmentation = cornerstoneToolsSegmentation.state.getSegmentation(segmentationId);
+
+      const { imageIds } = segmentation.representationData.Labelmap;
+
+      const segImages = imageIds.map(imageId => cache.getImage(imageId));
+      const referencedImages = segImages.map(image => cache.getImage(image.referencedImageId));
+
+      const labelmaps2D = [];
+
+      let z = 0;
+
+      for (const segImage of segImages) {
+        const segmentsOnLabelmap = new Set();
+        const pixelData = segImage.getPixelData();
+        const { rows, columns } = segImage;
+
+        // Use a single pass through the pixel data
+        for (let i = 0; i < pixelData.length; i++) {
+          const segment = pixelData[i];
+          if (segment !== 0) {
+            segmentsOnLabelmap.add(segment);
+          }
+        }
+
+        labelmaps2D[z++] = {
+          segmentsOnLabelmap: Array.from(segmentsOnLabelmap),
+          pixelData,
+          rows,
+          columns,
+        };
+      }
+
+      const allSegmentsOnLabelmap = labelmaps2D.map(labelmap => labelmap.segmentsOnLabelmap);
+
+      const labelmap3D = {
+        segmentsOnLabelmap: Array.from(new Set(allSegmentsOnLabelmap.flat())),
+        metadata: [],
+        labelmaps2D,
+      };
+
+      const segmentationInOHIF = segmentationService.getSegmentation(segmentationId);
+      const representations = segmentationService.getRepresentationsForSegmentation(segmentationId);
+
+      Object.entries(segmentationInOHIF.segments).forEach(([segmentIndex, segment]) => {
+        // segmentation service already has a color for each segment
+        if (!segment) {
+          return;
+        }
+
+        const { label } = segment;
+
+        const firstRepresentation = representations[0];
+        const color = segmentationService.getSegmentColor(
+          firstRepresentation.viewportId,
+          segmentationId,
+          segment.segmentIndex
+        );
+
+        const RecommendedDisplayCIELabValue = dcmjs.data.Colors.rgb2DICOMLAB(
+          color.slice(0, 3).map(value => value / 255)
+        ).map(value => Math.round(value));
+
+        const segmentMetadata = {
+          SegmentNumber: segmentIndex.toString(),
+          SegmentLabel: label,
+          SegmentAlgorithmType: segment?.algorithmType || 'MANUAL',
+          SegmentAlgorithmName: segment?.algorithmName || 'OHIF Brush',
+          RecommendedDisplayCIELabValue,
+          SegmentedPropertyCategoryCodeSequence: {
+            CodeValue: 'T-D0050',
+            CodingSchemeDesignator: 'SRT',
+            CodeMeaning: 'Tissue',
+          },
+          SegmentedPropertyTypeCodeSequence: {
+            CodeValue: 'T-D0050',
+            CodingSchemeDesignator: 'SRT',
+            CodeMeaning: 'Tissue',
+          },
+        };
+        labelmap3D.metadata[segmentIndex] = segmentMetadata;
+      });
+
+      const generatedSegmentation = generateSegmentation(
+        referencedImages,
+        labelmap3D,
+        metaData,
+        options
+      );
+
+      return generatedSegmentation;
+    },
+    /**
+     * Downloads a segmentation based on the provided segmentation ID.
+     * This function retrieves the associated segmentation and
+     * uses it to generate the corresponding DICOM dataset, which
+     * is then downloaded with an appropriate filename.
+     *
+     * @param {Object} params - Parameters for the function.
+     * @param params.segmentationId - ID of the segmentation to be downloaded.
+     *
+     */
+    downloadSegmentation: ({ segmentationId }) => {
+      const segmentationInOHIF = segmentationService.getSegmentation(segmentationId);
+      const generatedSegmentation = actions.generateSegmentation({
+        segmentationId,
+      });
+
+      downloadDICOMData(generatedSegmentation.dataset, `${segmentationInOHIF.label}`);
+    },
+    /**
+     * Stores a segmentation based on the provided segmentationId into a specified data source.
+     * The SeriesDescription is derived from user input or defaults to the segmentation label,
+     * and in its absence, defaults to 'Research Derived Series'.
+     *
+     * @param {Object} params - Parameters for the function.
+     * @param params.segmentationId - ID of the segmentation to be stored.
+     * @param params.dataSource - Data source where the generated segmentation will be stored.
+     *
+     * @returns {Object|void} Returns the naturalized report if successfully stored,
+     * otherwise throws an error.
+     */
+    storeSegmentation: async ({ segmentationId, dataSource }) => {
+      const promptResult = await createReportDialogPrompt(uiDialogService, {
+        extensionManager,
+      });
+
+      if (promptResult.action !== 1 && !promptResult.value) {
+        return;
+      }
+
+      const segmentation = segmentationService.getSegmentation(segmentationId);
+
+      if (!segmentation) {
+        throw new Error('No segmentation found');
+      }
+
+      const { label } = segmentation;
+      const SeriesDescription = promptResult.value || label || 'Research Derived Series';
+
+      const generatedData = actions.generateSegmentation({
+        segmentationId,
+        options: {
+          SeriesDescription,
+        },
+      });
+
+      if (!generatedData || !generatedData.dataset) {
+        throw new Error('Error during segmentation generation');
+      }
+
+      const { dataset: naturalizedReport } = generatedData;
+
+      await dataSource.store.dicom(naturalizedReport);
+
+      // The "Mode" route listens for DicomMetadataStore changes
+      // When a new instance is added, it listens and
+      // automatically calls makeDisplaySets
+
+      // add the information for where we stored it to the instance as well
+      naturalizedReport.wadoRoot = dataSource.getConfig().wadoRoot;
+
+      DicomMetadataStore.addInstances([naturalizedReport], true);
+
+      return naturalizedReport;
+    },
+    /**
+     * Converts segmentations into RTSS for download.
+     * This sample function retrieves all segentations and passes to
+     * cornerstone tool adapter to convert to DICOM RTSS format. It then
+     * converts dataset to downloadable blob.
+     *
+     */
+    downloadRTSS: ({ segmentationId }) => {
+      const segmentations = segmentationService.getSegmentation(segmentationId);
+      const vtkUtils = {
+        vtkImageMarchingSquares,
+        vtkDataArray,
+        vtkImageData,
+      };
+
+      const RTSS = generateRTSSFromSegmentations(
+        segmentations,
+        classes.MetadataProvider,
+        DicomMetadataStore,
+        cache,
+        cornerstoneToolsEnums,
+        vtkUtils
+      );
+
+      try {
+        const reportBlob = datasetToBlob(RTSS);
+
+        //Create a URL for the binary.
+        const objectUrl = URL.createObjectURL(reportBlob);
+        window.location.assign(objectUrl);
+      } catch (e) {
+        console.warn(e);
+      }
+    },
+    setBrushSize: ({ value, toolNames }) => {
+      const brushSize = Number(value);
+
+      toolGroupService.getToolGroupIds()?.forEach(toolGroupId => {
+        if (toolNames?.length === 0) {
+          segmentationUtils.setBrushSizeForToolGroup(toolGroupId, brushSize);
+        } else {
+          toolNames?.forEach(toolName => {
+            segmentationUtils.setBrushSizeForToolGroup(toolGroupId, brushSize, toolName);
+          });
+        }
+      });
+    },
+    setThresholdRange: ({
+      value,
+      toolNames = ['ThresholdCircularBrush', 'ThresholdSphereBrush'],
+    }) => {
+      toolGroupService.getToolGroupIds()?.forEach(toolGroupId => {
+        const toolGroup = toolGroupService.getToolGroup(toolGroupId);
+        toolNames?.forEach(toolName => {
+          toolGroup.setToolConfiguration(toolName, {
+            strategySpecificConfiguration: {
+              THRESHOLD: {
+                threshold: value,
+              },
+            },
+          });
+        });
+      });
+    },
+  };
+
+  const definitions = {
+    /**
+     * Obsolete?
+     */
+    loadSegmentationDisplaySetsForViewport: {
+      commandFn: actions.loadSegmentationDisplaySetsForViewport,
+    },
+    /**
+     * Obsolete?
+     */
+    loadSegmentationsForViewport: {
+      commandFn: actions.loadSegmentationsForViewport,
+    },
+
+    generateSegmentation: {
+      commandFn: actions.generateSegmentation,
+    },
+    downloadSegmentation: {
+      commandFn: actions.downloadSegmentation,
+    },
+    storeSegmentation: {
+      commandFn: actions.storeSegmentation,
+    },
+    downloadRTSS: {
+      commandFn: actions.downloadRTSS,
+    },
+    setBrushSize: {
+      commandFn: actions.setBrushSize,
+    },
+    setThresholdRange: {
+      commandFn: actions.setThresholdRange,
+    },
+  };
+
+  return {
+    actions,
+    definitions,
+    defaultContext: 'SEGMENTATION',
+  };
+};
+
+export default commandsModule;

extensions/cornerstone-dicom-seg/src/getHangingProtocolModule.ts

@@ -0,0 +1,101 @@
+import { Types } from '@ohif/core';
+
+const segProtocol: Types.HangingProtocol.Protocol = {
+  id: '@ohif/seg',
+  // Don't store this hanging protocol as it applies to the currently active
+  // display set by default
+  // cacheId: null,
+  name: 'Segmentations',
+  // Just apply this one when specifically listed
+  protocolMatchingRules: [],
+  toolGroupIds: ['default'],
+  // -1 would be used to indicate active only, whereas other values are
+  // the number of required priors referenced - so 0 means active with
+  // 0 or more priors.
+  numberOfPriorsReferenced: 0,
+  // Default viewport is used to define the viewport when
+  // additional viewports are added using the layout tool
+  defaultViewport: {
+    viewportOptions: {
+      viewportType: 'stack',
+      toolGroupId: 'default',
+      allowUnmatchedView: true,
+      syncGroups: [
+        {
+          type: 'hydrateseg',
+          id: 'sameFORId',
+          source: true,
+          target: true,
+          // options: {
+          //   matchingRules: ['sameFOR'],
+          // },
+        },
+      ],
+    },
+    displaySets: [
+      {
+        id: 'segDisplaySetId',
+        matchedDisplaySetsIndex: -1,
+      },
+    ],
+  },
+  displaySetSelectors: {
+    segDisplaySetId: {
+      seriesMatchingRules: [
+        {
+          attribute: 'Modality',
+          constraint: {
+            equals: 'SEG',
+          },
+        },
+      ],
+    },
+  },
+  stages: [
+    {
+      name: 'Segmentations',
+      viewportStructure: {
+        layoutType: 'grid',
+        properties: {
+          rows: 1,
+          columns: 1,
+        },
+      },
+      viewports: [
+        {
+          viewportOptions: {
+            allowUnmatchedView: true,
+            syncGroups: [
+              {
+                type: 'hydrateseg',
+                id: 'sameFORId',
+                source: true,
+                target: true,
+                // options: {
+                //   matchingRules: ['sameFOR'],
+                // },
+              },
+            ],
+          },
+          displaySets: [
+            {
+              id: 'segDisplaySetId',
+            },
+          ],
+        },
+      ],
+    },
+  ],
+};
+
+function getHangingProtocolModule() {
+  return [
+    {
+      name: segProtocol.id,
+      protocol: segProtocol,
+    },
+  ];
+}
+
+export default getHangingProtocolModule;
+export { segProtocol };

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

@@ -0,0 +1,255 @@
+import { utils } from '@ohif/core';
+import { metaData, triggerEvent, eventTarget } from '@cornerstonejs/core';
+import { CONSTANTS, segmentation as cstSegmentation } from '@cornerstonejs/tools';
+import { adaptersSEG, Enums } from '@cornerstonejs/adapters';
+
+import { SOPClassHandlerId } from './id';
+import { dicomlabToRGB } from './utils/dicomlabToRGB';
+
+const sopClassUids = ['1.2.840.10008.5.1.4.1.1.66.4'];
+
+const loadPromises = {};
+
+function _getDisplaySetsFromSeries(
+  instances,
+  servicesManager: AppTypes.ServicesManager,
+  extensionManager
+) {
+  const instance = instances[0];
+
+  const {
+    StudyInstanceUID,
+    SeriesInstanceUID,
+    SOPInstanceUID,
+    SeriesDescription,
+    SeriesNumber,
+    SeriesDate,
+    SOPClassUID,
+    wadoRoot,
+    wadoUri,
+    wadoUriRoot,
+  } = instance;
+
+  const displaySet = {
+    Modality: 'SEG',
+    loading: false,
+    isReconstructable: true, // by default for now since it is a volumetric SEG currently
+    displaySetInstanceUID: utils.guid(),
+    SeriesDescription,
+    SeriesNumber,
+    SeriesDate,
+    SOPInstanceUID,
+    SeriesInstanceUID,
+    StudyInstanceUID,
+    SOPClassHandlerId,
+    SOPClassUID,
+    referencedImages: null,
+    referencedSeriesInstanceUID: null,
+    referencedDisplaySetInstanceUID: null,
+    isDerivedDisplaySet: true,
+    isLoaded: false,
+    isHydrated: false,
+    segments: {},
+    sopClassUids,
+    instance,
+    instances: [instance],
+    wadoRoot,
+    wadoUriRoot,
+    wadoUri,
+    isOverlayDisplaySet: true,
+  };
+
+  const referencedSeriesSequence = instance.ReferencedSeriesSequence;
+
+  if (!referencedSeriesSequence) {
+    console.error('ReferencedSeriesSequence is missing for the SEG');
+    return;
+  }
+
+  const referencedSeries = referencedSeriesSequence[0] || referencedSeriesSequence;
+
+  displaySet.referencedImages = instance.ReferencedSeriesSequence.ReferencedInstanceSequence;
+  displaySet.referencedSeriesInstanceUID = referencedSeries.SeriesInstanceUID;
+  const { displaySetService } = servicesManager.services;
+  const referencedDisplaySets = displaySetService.getDisplaySetsForSeries(
+    displaySet.referencedSeriesInstanceUID
+  );
+
+  const referencedDisplaySet = referencedDisplaySets[0];
+
+  if (!referencedDisplaySet) {
+    // subscribe to display sets added which means at some point it will be available
+    const { unsubscribe } = displaySetService.subscribe(
+      displaySetService.EVENTS.DISPLAY_SETS_ADDED,
+      ({ displaySetsAdded }) => {
+        // here we can also do a little bit of search, since sometimes DICOM SEG
+        // does not contain the referenced display set uid , and we can just
+        // see which of the display sets added is more similar and assign it
+        // to the referencedDisplaySet
+        const addedDisplaySet = displaySetsAdded[0];
+        if (addedDisplaySet.SeriesInstanceUID === displaySet.referencedSeriesInstanceUID) {
+          displaySet.referencedDisplaySetInstanceUID = addedDisplaySet.displaySetInstanceUID;
+          unsubscribe();
+        }
+      }
+    );
+  } else {
+    displaySet.referencedDisplaySetInstanceUID = referencedDisplaySet.displaySetInstanceUID;
+  }
+
+  displaySet.load = async ({ headers }) =>
+    await _load(displaySet, servicesManager, extensionManager, headers);
+
+  return [displaySet];
+}
+
+function _load(
+  segDisplaySet,
+  servicesManager: AppTypes.ServicesManager,
+  extensionManager,
+  headers
+) {
+  const { SOPInstanceUID } = segDisplaySet;
+  const { segmentationService } = servicesManager.services;
+
+  if (
+    (segDisplaySet.loading || segDisplaySet.isLoaded) &&
+    loadPromises[SOPInstanceUID] &&
+    _segmentationExists(segDisplaySet)
+  ) {
+    return loadPromises[SOPInstanceUID];
+  }
+
+  segDisplaySet.loading = true;
+
+  // We don't want to fire multiple loads, so we'll wait for the first to finish
+  // and also return the same promise to any other callers.
+  loadPromises[SOPInstanceUID] = new Promise(async (resolve, reject) => {
+    if (!segDisplaySet.segments || Object.keys(segDisplaySet.segments).length === 0) {
+      try {
+        await _loadSegments({
+          extensionManager,
+          servicesManager,
+          segDisplaySet,
+          headers,
+        });
+      } catch (e) {
+        segDisplaySet.loading = false;
+        return reject(e);
+      }
+    }
+
+    segmentationService
+      .createSegmentationForSEGDisplaySet(segDisplaySet)
+      .then(() => {
+        segDisplaySet.loading = false;
+        resolve();
+      })
+      .catch(error => {
+        segDisplaySet.loading = false;
+        reject(error);
+      });
+  });
+
+  return loadPromises[SOPInstanceUID];
+}
+
+async function _loadSegments({
+  extensionManager,
+  servicesManager,
+  segDisplaySet,
+  headers,
+}: withAppTypes) {
+  const utilityModule = extensionManager.getModuleEntry(
+    '@ohif/extension-cornerstone.utilityModule.common'
+  );
+
+  const { segmentationService, uiNotificationService } = servicesManager.services;
+
+  const { dicomLoaderService } = utilityModule.exports;
+  const arrayBuffer = await dicomLoaderService.findDicomDataPromise(segDisplaySet, null, headers);
+
+  const referencedDisplaySet = servicesManager.services.displaySetService.getDisplaySetByUID(
+    segDisplaySet.referencedDisplaySetInstanceUID
+  );
+
+  if (!referencedDisplaySet) {
+    throw new Error('referencedDisplaySet is missing for SEG');
+  }
+
+  const { instances: images } = referencedDisplaySet;
+  const imageIds = images.map(({ imageId }) => imageId);
+
+  // Todo: what should be defaults here
+  const tolerance = 0.001;
+  const skipOverlapping = true;
+  eventTarget.addEventListener(Enums.Events.SEGMENTATION_LOAD_PROGRESS, evt => {
+    const { percentComplete } = evt.detail;
+    segmentationService._broadcastEvent(segmentationService.EVENTS.SEGMENT_LOADING_COMPLETE, {
+      percentComplete,
+    });
+  });
+
+  const results = await adaptersSEG.Cornerstone3D.Segmentation.generateToolState(
+    imageIds,
+    arrayBuffer,
+    metaData,
+    { skipOverlapping, tolerance, eventTarget, triggerEvent }
+  );
+
+  let usedRecommendedDisplayCIELabValue = true;
+  results.segMetadata.data.forEach((data, i) => {
+    if (i > 0) {
+      data.rgba = data.RecommendedDisplayCIELabValue;
+
+      if (data.rgba) {
+        data.rgba = dicomlabToRGB(data.rgba);
+      } else {
+        usedRecommendedDisplayCIELabValue = false;
+        data.rgba = CONSTANTS.COLOR_LUT[i % CONSTANTS.COLOR_LUT.length];
+      }
+    }
+  });
+
+  if (results.overlappingSegments) {
+    uiNotificationService.show({
+      title: 'Overlapping Segments',
+      message:
+        'Unsupported overlapping segments detected, segmentation rendering results may be incorrect.',
+      type: 'warning',
+    });
+  }
+
+  if (!usedRecommendedDisplayCIELabValue) {
+    // Display a notification about the non-utilization of RecommendedDisplayCIELabValue
+    uiNotificationService.show({
+      title: 'DICOM SEG import',
+      message:
+        'RecommendedDisplayCIELabValue not found for one or more segments. The default color was used instead.',
+      type: 'warning',
+      duration: 5000,
+    });
+  }
+
+  Object.assign(segDisplaySet, results);
+}
+
+function _segmentationExists(segDisplaySet) {
+  return cstSegmentation.state.getSegmentation(segDisplaySet.displaySetInstanceUID);
+}
+
+function getSopClassHandlerModule({ servicesManager, extensionManager }) {
+  const getDisplaySetsFromSeries = instances => {
+    return _getDisplaySetsFromSeries(instances, servicesManager, extensionManager);
+  };
+
+  return [
+    {
+      name: 'dicom-seg',
+      sopClassUids,
+      getDisplaySetsFromSeries,
+    },
+  ];
+}
+
+export default getSopClassHandlerModule;

extensions/cornerstone-dicom-seg/src/getToolbarModule.ts

@@ -0,0 +1,57 @@
+export function getToolbarModule({ servicesManager }: withAppTypes) {
+  const { segmentationService, toolbarService, toolGroupService } = servicesManager.services;
+  return [
+    {
+      name: 'evaluate.cornerstone.segmentation',
+      evaluate: ({ viewportId, button, toolNames, disabledText }) => {
+        // Todo: we need to pass in the button section Id since we are kind of
+        // forcing the button to have black background since initially
+        // it is designed for the toolbox not the toolbar on top
+        // we should then branch the buttonSectionId to have different styles
+        const segmentations = segmentationService.getSegmentationRepresentations(viewportId);
+        if (!segmentations?.length) {
+          return {
+            disabled: true,
+            className: '!text-common-bright !bg-black opacity-50',
+            disabledText: disabledText ?? 'No segmentations available',
+          };
+        }
+
+        const toolGroup = toolGroupService.getToolGroupForViewport(viewportId);
+
+        if (!toolGroup) {
+          return {
+            disabled: true,
+            className: '!text-common-bright ohif-disabled',
+            disabledText: disabledText ?? 'Not available on the current viewport',
+          };
+        }
+
+        const toolName = toolbarService.getToolNameForButton(button);
+
+        if (!toolGroup.hasTool(toolName) && !toolNames) {
+          return {
+            disabled: true,
+            className: '!text-common-bright ohif-disabled',
+            disabledText: disabledText ?? 'Not available on the current viewport',
+          };
+        }
+
+        const isPrimaryActive = toolNames
+          ? toolNames.includes(toolGroup.getActivePrimaryMouseButtonTool())
+          : toolGroup.getActivePrimaryMouseButtonTool() === toolName;
+
+        return {
+          disabled: false,
+          className: isPrimaryActive
+            ? '!text-black !bg-primary-light hover:bg-primary-light hover-text-black hover:cursor-pointer'
+            : '!text-common-bright !bg-black hover:bg-primary-light hover:cursor-pointer hover:text-black',
+          // Todo: isActive right now is used for nested buttons where the primary
+          // button needs to be fully rounded (vs partial rounded) when active
+          // otherwise it does not have any other use
+          isActive: isPrimaryActive,
+        };
+      },
+    },
+  ];
+}

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

@@ -0,0 +1,7 @@
+import packageJson from '../package.json';
+
+const id = packageJson.name;
+const SOPClassHandlerName = 'dicom-seg';
+const SOPClassHandlerId = `${id}.sopClassHandlerModule.${SOPClassHandlerName}`;
+
+export { id, SOPClassHandlerId, SOPClassHandlerName };

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

@@ -0,0 +1,56 @@
+import { id } from './id';
+import React from 'react';
+
+import getSopClassHandlerModule from './getSopClassHandlerModule';
+import getHangingProtocolModule from './getHangingProtocolModule';
+import getCommandsModule from './commandsModule';
+import { getToolbarModule } from './getToolbarModule';
+
+const Component = React.lazy(() => {
+  return import(/* webpackPrefetch: true */ './viewports/OHIFCornerstoneSEGViewport');
+});
+
+const OHIFCornerstoneSEGViewport = props => {
+  return (
+    <React.Suspense fallback={<div>Loading...</div>}>
+      <Component {...props} />
+    </React.Suspense>
+  );
+};
+
+/**
+ * You can remove any of the following modules if you don't need them.
+ */
+const extension = {
+  /**
+   * Only required property. Should be a unique value across all extensions.
+   * You ID can be anything you want, but it should be unique.
+   */
+  id,
+  getCommandsModule,
+  getToolbarModule,
+  getViewportModule({ servicesManager, extensionManager, commandsManager }) {
+    const ExtendedOHIFCornerstoneSEGViewport = props => {
+      return (
+        <OHIFCornerstoneSEGViewport
+          servicesManager={servicesManager}
+          extensionManager={extensionManager}
+          commandsManager={commandsManager}
+          {...props}
+        />
+      );
+    };
+
+    return [{ name: 'dicom-seg', component: ExtendedOHIFCornerstoneSEGViewport }];
+  },
+  /**
+   * SopClassHandlerModule should provide a list of sop class handlers that will be
+   * available in OHIF for Modes to consume and use to create displaySets from Series.
+   * Each sop class handler is defined by a { name, sopClassUids, getDisplaySetsFromSeries}.
+   * Examples include the default sop class handler provided by the default extension
+   */
+  getSopClassHandlerModule,
+  getHangingProtocolModule,
+};
+
+export default extension;

extensions/cornerstone-dicom-seg/src/types/segmentation.tsx

@@ -0,0 +1,4 @@
+export enum SegmentationPanelMode {
+  Expanded = 'expanded',
+  Dropdown = 'dropdown',
+}

extensions/cornerstone-dicom-seg/src/utils/dicomlabToRGB.ts

@@ -0,0 +1,14 @@
+import dcmjs from 'dcmjs';
+
+/**
+ * Converts a CIELAB color to an RGB color using the dcmjs library.
+ * @param cielab - The CIELAB color to convert.
+ * @returns The RGB color as an array of three integers between 0 and 255.
+ */
+function dicomlabToRGB(cielab: number[]): number[] {
+  const rgb = dcmjs.data.Colors.dicomlab2RGB(cielab).map(x => Math.round(x * 255));
+
+  return rgb;
+}
+
+export { dicomlabToRGB };

extensions/cornerstone-dicom-seg/src/utils/initSEGToolGroup.ts

@@ -0,0 +1,7 @@
+function createSEGToolGroupAndAddTools(ToolGroupService, customizationService, toolGroupId) {
+  const { tools } = customizationService.get('cornerstone.overlayViewportTools') ?? {};
+
+  return ToolGroupService.createToolGroupAndAddTools(toolGroupId, tools);
+}
+
+export default createSEGToolGroupAndAddTools;

extensions/cornerstone-dicom-seg/src/utils/promptHydrateSEG.ts

@@ -0,0 +1,83 @@
+import { ButtonEnums } from '@ohif/ui';
+
+const RESPONSE = {
+  NO_NEVER: -1,
+  CANCEL: 0,
+  HYDRATE_SEG: 5,
+};
+
+function promptHydrateSEG({
+  servicesManager,
+  segDisplaySet,
+  viewportId,
+  preHydrateCallbacks,
+  hydrateCallback,
+}: withAppTypes) {
+  const { uiViewportDialogService } = servicesManager.services;
+  const extensionManager = servicesManager._extensionManager;
+  const appConfig = extensionManager._appConfig;
+
+  return new Promise(async function (resolve, reject) {
+    const promptResult = appConfig?.disableConfirmationPrompts
+      ? RESPONSE.HYDRATE_SEG
+      : await _askHydrate(uiViewportDialogService, viewportId);
+
+    if (promptResult === RESPONSE.HYDRATE_SEG) {
+      preHydrateCallbacks?.forEach(callback => {
+        callback();
+      });
+
+      window.setTimeout(async () => {
+        const isHydrated = await hydrateCallback({
+          segDisplaySet,
+          viewportId,
+        });
+
+        resolve(isHydrated);
+      }, 0);
+    }
+  });
+}
+
+function _askHydrate(uiViewportDialogService, viewportId) {
+  return new Promise(function (resolve, reject) {
+    const message = 'Do you want to open this Segmentation?';
+    const actions = [
+      {
+        id: 'no-hydrate',
+        type: ButtonEnums.type.secondary,
+        text: 'No',
+        value: RESPONSE.CANCEL,
+      },
+      {
+        id: 'yes-hydrate',
+        type: ButtonEnums.type.primary,
+        text: 'Yes',
+        value: RESPONSE.HYDRATE_SEG,
+      },
+    ];
+    const onSubmit = result => {
+      uiViewportDialogService.hide();
+      resolve(result);
+    };
+
+    uiViewportDialogService.show({
+      viewportId,
+      type: 'info',
+      message,
+      actions,
+      onSubmit,
+      onOutsideClick: () => {
+        uiViewportDialogService.hide();
+        resolve(RESPONSE.CANCEL);
+      },
+      onKeyPress: event => {
+        if (event.key === 'Enter') {
+          onSubmit(RESPONSE.HYDRATE_SEG);
+        }
+      },
+    });
+  });
+}
+
+export default promptHydrateSEG;

extensions/cornerstone-dicom-seg/src/viewports/OHIFCornerstoneSEGViewport.tsx

@@ -0,0 +1,401 @@
+import React, { useCallback, useEffect, useRef, useState } from 'react';
+import { useTranslation } from 'react-i18next';
+import { LoadingIndicatorTotalPercent, useViewportGrid, ViewportActionArrows } from '@ohif/ui';
+import createSEGToolGroupAndAddTools from '../utils/initSEGToolGroup';
+import promptHydrateSEG from '../utils/promptHydrateSEG';
+import _getStatusComponent from './_getStatusComponent';
+import { SegmentationRepresentations } from '@cornerstonejs/tools/enums';
+
+const SEG_TOOLGROUP_BASE_NAME = 'SEGToolGroup';
+
+function OHIFCornerstoneSEGViewport(props: withAppTypes) {
+  const {
+    children,
+    displaySets,
+    viewportOptions,
+    servicesManager,
+    extensionManager,
+    commandsManager,
+  } = props;
+
+  const { t } = useTranslation('SEGViewport');
+  const viewportId = viewportOptions.viewportId;
+
+  const {
+    displaySetService,
+    toolGroupService,
+    segmentationService,
+    customizationService,
+    viewportActionCornersService,
+  } = servicesManager.services;
+
+  const toolGroupId = `${SEG_TOOLGROUP_BASE_NAME}-${viewportId}`;
+
+  // SEG viewport will always have a single display set
+  if (displaySets.length > 1) {
+    throw new Error('SEG viewport should only have a single display set');
+  }
+
+  const segDisplaySet = displaySets[0];
+  const [viewportGrid, viewportGridService] = useViewportGrid();
+
+  // States
+  const [selectedSegment, setSelectedSegment] = useState(1);
+
+  // Hydration means that the SEG is opened and segments are loaded into the
+  // segmentation panel, and SEG is also rendered on any viewport that is in the
+  // same frameOfReferenceUID as the referencedSeriesUID of the SEG. However,
+  // loading basically means SEG loading over network and bit unpacking of the
+  // SEG data.
+  const [isHydrated, setIsHydrated] = useState(segDisplaySet.isHydrated);
+  const [segIsLoading, setSegIsLoading] = useState(!segDisplaySet.isLoaded);
+  const [element, setElement] = useState(null);
+  const [processingProgress, setProcessingProgress] = useState({
+    percentComplete: null,
+    totalSegments: null,
+  });
+
+  // refs
+  const referencedDisplaySetRef = useRef(null);
+
+  const { viewports, activeViewportId } = viewportGrid;
+
+  const referencedDisplaySetInstanceUID = segDisplaySet.referencedDisplaySetInstanceUID;
+  const referencedDisplaySet = displaySetService.getDisplaySetByUID(
+    referencedDisplaySetInstanceUID
+  );
+
+  const referencedDisplaySetMetadata = _getReferencedDisplaySetMetadata(
+    referencedDisplaySet,
+    segDisplaySet
+  );
+
+  referencedDisplaySetRef.current = {
+    displaySet: referencedDisplaySet,
+    metadata: referencedDisplaySetMetadata,
+  };
+  /**
+   * OnElementEnabled callback which is called after the cornerstoneExtension
+   * has enabled the element. Note: we delegate all the image rendering to
+   * cornerstoneExtension, so we don't need to do anything here regarding
+   * the image rendering, element enabling etc.
+   */
+  const onElementEnabled = evt => {
+    setElement(evt.detail.element);
+  };
+
+  const onElementDisabled = () => {
+    setElement(null);
+  };
+
+  const storePresentationState = useCallback(() => {
+    viewportGrid?.viewports.forEach(({ viewportId }) => {
+      commandsManager.runCommand('storePresentation', {
+        viewportId,
+      });
+    });
+  }, [viewportGrid]);
+
+  const getCornerstoneViewport = useCallback(() => {
+    const { component: Component } = extensionManager.getModuleEntry(
+      '@ohif/extension-cornerstone.viewportModule.cornerstone'
+    );
+
+    // Todo: jump to the center of the first segment
+    return (
+      <Component
+        {...props}
+        displaySets={[segDisplaySet]}
+        viewportOptions={{
+          viewportType: viewportOptions.viewportType,
+          toolGroupId: toolGroupId,
+          orientation: viewportOptions.orientation,
+          viewportId: viewportOptions.viewportId,
+          presentationIds: viewportOptions.presentationIds,
+        }}
+        onElementEnabled={evt => {
+          props.onElementEnabled?.(evt);
+          onElementEnabled(evt);
+        }}
+        onElementDisabled={onElementDisabled}
+      ></Component>
+    );
+  }, [viewportId, segDisplaySet, toolGroupId]);
+
+  const onSegmentChange = useCallback(
+    direction => {
+      const segmentationId = segDisplaySet.displaySetInstanceUID;
+      const segmentation = segmentationService.getSegmentation(segmentationId);
+
+      const { segments } = segmentation;
+
+      const numberOfSegments = Object.keys(segments).length;
+
+      let newSelectedSegmentIndex = selectedSegment + direction;
+
+      // Segment 0 is always background
+
+      if (newSelectedSegmentIndex > numberOfSegments - 1) {
+        newSelectedSegmentIndex = 1;
+      } else if (newSelectedSegmentIndex === 0) {
+        newSelectedSegmentIndex = numberOfSegments - 1;
+      }
+
+      segmentationService.jumpToSegmentCenter(segmentationId, newSelectedSegmentIndex, viewportId);
+      setSelectedSegment(newSelectedSegmentIndex);
+    },
+    [selectedSegment]
+  );
+
+  const hydrateSEG = useCallback(() => {
+    // update the previously stored segmentationPresentation with the new viewportId
+    // presentation so that when we put the referencedDisplaySet back in the viewport
+    // it will have the correct segmentation representation hydrated
+    commandsManager.runCommand('updateStoredSegmentationPresentation', {
+      displaySet: segDisplaySet,
+      type: SegmentationRepresentations.Labelmap,
+    });
+
+    // update the previously stored positionPresentation with the new viewportId
+    // presentation so that when we put the referencedDisplaySet back in the viewport
+    // it will be in the correct position zoom and pan
+    commandsManager.runCommand('updateStoredPositionPresentation', {
+      viewportId,
+      displaySetInstanceUID: referencedDisplaySet.displaySetInstanceUID,
+    });
+
+    viewportGridService.setDisplaySetsForViewport({
+      viewportId,
+      displaySetInstanceUIDs: [referencedDisplaySet.displaySetInstanceUID],
+    });
+  }, [commandsManager, viewportId, referencedDisplaySet, segDisplaySet]);
+
+  useEffect(() => {
+    if (segIsLoading) {
+      return;
+    }
+
+    promptHydrateSEG({
+      servicesManager,
+      viewportId,
+      segDisplaySet,
+      preHydrateCallbacks: [storePresentationState],
+      hydrateCallback: hydrateSEG,
+    }).then(isHydrated => {
+      if (isHydrated) {
+        setIsHydrated(true);
+      }
+    });
+  }, [servicesManager, viewportId, segDisplaySet, segIsLoading, hydrateSEG]);
+
+  useEffect(() => {
+    // on new seg display set, remove all segmentations from all viewports
+    segmentationService.clearSegmentationRepresentations(viewportId);
+
+    const { unsubscribe } = segmentationService.subscribe(
+      segmentationService.EVENTS.SEGMENTATION_LOADING_COMPLETE,
+      evt => {
+        if (evt.segDisplaySet.displaySetInstanceUID === segDisplaySet.displaySetInstanceUID) {
+          setSegIsLoading(false);
+        }
+      }
+    );
+
+    return () => {
+      unsubscribe();
+    };
+  }, [segDisplaySet]);
+
+  useEffect(() => {
+    const { unsubscribe } = segmentationService.subscribe(
+      segmentationService.EVENTS.SEGMENT_LOADING_COMPLETE,
+      ({ percentComplete, numSegments }) => {
+        setProcessingProgress({
+          percentComplete,
+          totalSegments: numSegments,
+        });
+      }
+    );
+
+    return () => {
+      unsubscribe();
+    };
+  }, [segDisplaySet]);
+
+  /**
+   Cleanup the SEG viewport when the viewport is destroyed
+   */
+  useEffect(() => {
+    const onDisplaySetsRemovedSubscription = displaySetService.subscribe(
+      displaySetService.EVENTS.DISPLAY_SETS_REMOVED,
+      ({ displaySetInstanceUIDs }) => {
+        const activeViewport = viewports.get(activeViewportId);
+        if (displaySetInstanceUIDs.includes(activeViewport.displaySetInstanceUID)) {
+          viewportGridService.setDisplaySetsForViewport({
+            viewportId: activeViewportId,
+            displaySetInstanceUIDs: [],
+          });
+        }
+      }
+    );
+
+    return () => {
+      onDisplaySetsRemovedSubscription.unsubscribe();
+    };
+  }, []);
+
+  useEffect(() => {
+    let toolGroup = toolGroupService.getToolGroup(toolGroupId);
+
+    if (toolGroup) {
+      return;
+    }
+
+    // keep the already stored segmentationPresentation for this viewport in memory
+    // so that we can restore it after hydrating the SEG
+    commandsManager.runCommand('updateStoredSegmentationPresentation', {
+      displaySet: segDisplaySet,
+      type: SegmentationRepresentations.Labelmap,
+    });
+
+    // always start fresh for this viewport since it is special type of viewport
+    // that should only show one segmentation at a time.
+    segmentationService.clearSegmentationRepresentations(viewportId);
+
+    // This creates a custom tool group which has the lifetime of this view
+    // only, and does NOT interfere with currently displayed segmentations.
+    toolGroup = createSEGToolGroupAndAddTools(toolGroupService, customizationService, toolGroupId);
+
+    return () => {
+      // remove the segmentation representations if seg displayset changed
+      // e.g., another seg displayset is dragged into the viewport
+      segmentationService.clearSegmentationRepresentations(viewportId);
+
+      // Only destroy the viewport specific implementation
+      toolGroupService.destroyToolGroup(toolGroupId);
+    };
+  }, []);
+
+  const onStatusClick = useCallback(async () => {
+    // Before hydrating a SEG and make it added to all viewports in the grid
+    // that share the same frameOfReferenceUID, we need to store the viewport grid
+    // presentation state, so that we can restore it after hydrating the SEG. This is
+    // required if the user has changed the viewport (other viewport than SEG viewport)
+    // presentation state (w/l and invert) and then opens the SEG. If we don't store
+    // the presentation state, the viewport will be reset to the default presentation
+    storePresentationState();
+    hydrateSEG();
+  }, [storePresentationState, hydrateSEG]);
+
+  useEffect(() => {
+    viewportActionCornersService.addComponents([
+      {
+        viewportId,
+        id: 'viewportStatusComponent',
+        component: _getStatusComponent({
+          isHydrated,
+          onStatusClick,
+        }),
+        indexPriority: -100,
+        location: viewportActionCornersService.LOCATIONS.topLeft,
+      },
+      {
+        viewportId,
+        id: 'viewportActionArrowsComponent',
+        component: (
+          <ViewportActionArrows
+            key="actionArrows"
+            onArrowsClick={onSegmentChange}
+            className={
+              viewportId === activeViewportId ? 'visible' : 'invisible group-hover/pane:visible'
+            }
+          ></ViewportActionArrows>
+        ),
+        indexPriority: 0,
+        location: viewportActionCornersService.LOCATIONS.topRight,
+      },
+    ]);
+  }, [
+    activeViewportId,
+    isHydrated,
+    onSegmentChange,
+    onStatusClick,
+    viewportActionCornersService,
+    viewportId,
+  ]);
+
+  // ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
+  let childrenWithProps = null;
+
+  if (
+    !referencedDisplaySetRef.current ||
+    referencedDisplaySet.displaySetInstanceUID !==
+      referencedDisplaySetRef.current.displaySet.displaySetInstanceUID
+  ) {
+    return null;
+  }
+
+  if (children && children.length) {
+    childrenWithProps = children.map((child, index) => {
+      return (
+        child &&
+        React.cloneElement(child, {
+          viewportId,
+          key: index,
+        })
+      );
+    });
+  }
+
+  return (
+    <>
+      <div className="relative flex h-full w-full flex-row overflow-hidden">
+        {segIsLoading && (
+          <LoadingIndicatorTotalPercent
+            className="h-full w-full"
+            totalNumbers={processingProgress.totalSegments}
+            percentComplete={processingProgress.percentComplete}
+            loadingText="Loading SEG..."
+          />
+        )}
+        {getCornerstoneViewport()}
+        {childrenWithProps}
+      </div>
+    </>
+  );
+}
+
+function _getReferencedDisplaySetMetadata(referencedDisplaySet, segDisplaySet) {
+  const { SharedFunctionalGroupsSequence } = segDisplaySet.instance;
+
+  const SharedFunctionalGroup = Array.isArray(SharedFunctionalGroupsSequence)
+    ? SharedFunctionalGroupsSequence[0]
+    : SharedFunctionalGroupsSequence;
+
+  const { PixelMeasuresSequence } = SharedFunctionalGroup;
+
+  const PixelMeasures = Array.isArray(PixelMeasuresSequence)
+    ? PixelMeasuresSequence[0]
+    : PixelMeasuresSequence;
+
+  const { SpacingBetweenSlices, SliceThickness } = PixelMeasures;
+
+  const image0 = referencedDisplaySet.images[0];
+  const referencedDisplaySetMetadata = {
+    PatientID: image0.PatientID,
+    PatientName: image0.PatientName,
+    PatientSex: image0.PatientSex,
+    PatientAge: image0.PatientAge,
+    SliceThickness: image0.SliceThickness || SliceThickness,
+    StudyDate: image0.StudyDate,
+    SeriesDescription: image0.SeriesDescription,
+    SeriesInstanceUID: image0.SeriesInstanceUID,
+    SeriesNumber: image0.SeriesNumber,
+    ManufacturerModelName: image0.ManufacturerModelName,
+    SpacingBetweenSlices: image0.SpacingBetweenSlices || SpacingBetweenSlices,
+  };
+
+  return referencedDisplaySetMetadata;
+}
+
+export default OHIFCornerstoneSEGViewport;

extensions/cornerstone-dicom-seg/src/viewports/_getStatusComponent.tsx

@@ -0,0 +1,62 @@
+import React from 'react';
+import { useTranslation } from 'react-i18next';
+import { Icon, Tooltip } from '@ohif/ui';
+
+export default function _getStatusComponent({ isHydrated, onStatusClick }) {
+  let ToolTipMessage = null;
+  let StatusIcon = null;
+
+  switch (isHydrated) {
+    case true:
+      StatusIcon = () => <Icon name="status-alert" />;
+
+      ToolTipMessage = () => <div>This Segmentation is loaded in the segmentation panel</div>;
+      break;
+    case false:
+      StatusIcon = () => (
+        <Icon
+          className="text-aqua-pale"
+          name="status-untracked"
+        />
+      );
+
+      ToolTipMessage = () => <div>Click LOAD to load segmentation.</div>;
+  }
+
+  const StatusArea = () => {
+    const { t } = useTranslation('Common');
+    const loadStr = t('LOAD');
+
+    return (
+      <div className="flex h-6 cursor-default text-sm leading-6 text-white">
+        <div className="bg-customgray-100 flex min-w-[45px] items-center rounded-l-xl rounded-r p-1">
+          <StatusIcon />
+          <span className="ml-1">SEG</span>
+        </div>
+        {!isHydrated && (
+          <div
+            className="bg-primary-main hover:bg-primary-light ml-1 cursor-pointer rounded px-1.5 hover:text-black"
+            // Using onMouseUp here because onClick is not working when the viewport is not active and is styled with pointer-events:none
+            onMouseUp={onStatusClick}
+          >
+            {loadStr}
+          </div>
+        )}
+      </div>
+    );
+  };
+
+  return (
+    <>
+      {ToolTipMessage && (
+        <Tooltip
+          content={<ToolTipMessage />}
+          position="bottom-left"
+        >
+          <StatusArea />
+        </Tooltip>
+      )}
+      {!ToolTipMessage && <StatusArea />}
+    </>
+  );
+}