DICOM PS3.3 2018e - Information Object Definitions

C.24.2 Encapsulated Document Module

Table C.24-2 defines the Encapsulated Document Attributes.

Table C.24-2. Encapsulated Document Module Attributes

Attribute Name



Attribute Description

Instance Number



A number that identifies this SOP Instance. The value shall be unique within a Series.

Content Date



The date the document content creation was started.

Content Time



The time the document content creation was started.

Acquisition DateTime



The date and time that the original generation of the data in the document started.

Image Laterality



Laterality of the (possibly paired) body part that is the subject of the encapsulated document.

Enumerated Values:








both left and right

If Modality (0008,0060) is M3D, then values for this Attribute shall refer to the intended placement of the created object regardless of how it was generated (see also Section C.35.1 “Manufacturing 3D Model Module”).

Burned In Annotation



Indicates whether or not the encapsulated document contains sufficient burned in annotation to identify the patient and date the data was acquired.

Enumerated Values:



Identification of patient and date as text in an encapsulated document (e.g., in an XML attribute or element) is equivalent to "burned in annotation". A de-identified document may use the value NO.

If Modality (0008,0060) is M3D, the presence of identifying information embossed or engraved on any part of the model shall be indicated by a value of YES.

Recognizable Visual Features



Indicates whether or not the instance contains sufficiently recognizable visual features to allow the instance or a reconstruction from a set of instances to identify the patient.

Enumerated Values:



If this Attribute is absent, then the instance may or may not contain recognizable visual features.

Source Instance Sequence



A Sequence that identifies the set of Instances that were used to derive the encapsulated document.

One or more Items shall be included in this Sequence.

Required if derived from one or more DICOM Instances. May be present otherwise.


Unlike other uses of Source Instance Sequence (0042,0013), such as in the General Reference Module, references to images are permitted in this Module. This Module does not include the Source Image Sequence (0008,2112). The Defined Context Group for Purpose of Reference Code Sequence (0040,A170) includes an appropriate concept.

>Include Table 10-11 “SOP Instance Reference Macro Attributes”

>Purpose of Reference Code Sequence



Describes the purpose for which the reference is made, that is what role the source instances played in the derivation of this encapsulated document

Only a single Item single Item is permitted in this Sequence.

>>Include Table 8.8-1 “Code Sequence Macro Attributes”

DCID 7060 “Encapsulated Document Source Purposes of Reference”.

Document Title



The title of the document.


In the case of a PDF encapsulated document, this may be the value of the "Title" entry in the "Document Information Directory" as encoded in the PDF data.

Concept Name Code Sequence



A coded representation of the document title.

Zero or one Item shall be included in this Sequence.

>Include Table 8.8-1 “Code Sequence Macro Attributes”

For documents with Modality (0008,0060) equal to M3D, CID 7061 “Model Document Titles”.

For all other Encapsulated documents, Baseline CID 7020 “Document Titles”.

Document Class Code Sequence



Additional classifications of the document, beyond the title represented in Concept Name Code Sequence. May be equivalent to HL7 v2.x TXA-2.

One or more Items are permitted in this Sequence.

>Include Table 8.8-1 “Code Sequence Macro Attributes”

No Baseline CID is defined.

Verification Flag



Indicates whether the Encapsulated Document is Verified.

Enumerated Values:


Not attested by a legally accountable person.


Attested to (signed) by a Verifying Observer or Legal Authenticator named in the document, who is accountable for its content.

HL7 Instance Identifier



Instance Identifier of the encapsulated HL7 Structured Document, encoded as a UID (OID or UUID), concatenated with a caret ("^") and Extension value (if Extension is present in Instance Identifier).

Required if encapsulated document is a CDA document.

Predecessor Documents Sequence



References to SOP Instances whose content has been wholly or partially included in this document with or without modification.

One or more Items are permitted in this Sequence.

>Include Table C.17-3 “Hierarchical SOP Instance Reference Macro Attributes”

Defined CID for the Purpose of Reference Code Sequence in the Hierarchical SOP Instance Reference Macro: If Modality (0008,0060) is M3D, CID 7062 “Purpose of Reference to Predecessor 3D Model”; otherwise, CID 7009 “Purpose of Reference to Predecessor Report”.

Identical Documents Sequence



Duplicates of this document, stored with different SOP Instance UIDs.

One or more Items are permitted in this Sequence.

See Section C.17.2.2 for further explanation.

>Include Table C.17-3 “Hierarchical SOP Instance Reference Macro Attributes”

MIME Type of Encapsulated Document



The type of the encapsulated document stream described using the MIME Media Type (see RFC 2046).

List of MIME Types



MIME Types of subcomponents of the encapsulated document.

Required if the encapsulated document incorporates subcomponents with MIME types different than the primary MIME Type of the encapsulated document.


An Encapsulated CDA that includes an embedded JPEG image and an embedded PDF would list "image/jpeg\application/pdf".

Encapsulated Document



Encapsulated Document stream, containing a document encoded according to the MIME Type.


  1. One could distinguish four stages in the creation of the Encapsulated Document Object, identified by the following Attributes:

    1. Measurement and/or data collection, identified by Acquisition DateTime (0008,002A) in the Encapsulated Document Module.

    2. Creation of the original documentation of the data collection, identified by Content Date (0008,0023) and Content Time (0008,0033).

    3. Rendering of the original documentation into the format that will be encapsulated, e.g., a PDF document. The rendering time is not captured by any DICOM Attribute, but may be encoded in the rendering.

    4. Encapsulation of the rendering into a DICOM Object, identified by Instance Creation Date (0008,0012) and Instance Creation Time (0008,0013) in the SOP Common Module.

  2. DICOM does not specify requirements for consistency between DICOM Attribute values and data in the encapsulated document. It is expected that applications will ensure consistency in a manner appropriate to the application. For example, the Patient ID in an encapsulated CDA document may be that of a different institution, which originated the document, and it may be appropriate for the DICOM Attribute value to be different.

C.24.2.1 Attribute Requirements for Encapsulated CDA Document

For an Encapsulated CDA Document, Document Title (0042,0010) shall have the value of the CDA Document Title, if one is present in the encapsulated document.

Concept Name Code Sequence (0040,A043) shall have the value of the CDA Document Type Code, with transcoding as necessary for converting the HL7 CE Data Type to the DICOM Code Sequence Item.

Enumerated Values for MIME Type of Encapsulated Document (0042,0012):


DICOM PS3.3 2018e - Information Object Definitions