DICOM PS3.3 2019c - Information Object Definitions
C.8.8.6.3 Representing Inner and Outer Contours on an Image

When a single ROI describes an excluded inner volume, this can be encoded with a single contour, using a "keyhole" technique. In this method, an arbitrarily narrow channel is used to connect the outer contour to the inner contour, so that it is drawn as a single contour. An example of such a structure is shown in Figure C.8.8.6-1

Points in space lying along the path defined by the contour are considered to be inside the ROI.

Example of ROI with excluded inner volume

Figure C.8.8.6-1. Example of ROI with excluded inner volume


DICOM PS3.3 2019c - Information Object Definitions