DICOM PS3.17 2019a - Explanatory Information

E.3.3 Example 3: Calcification and Mass Detection, Temporal Differencing With Findings

The patient in Example 2 returns for another mammogram. A more comprehensive mammography CAD device processes the current mammogram; analyses are performed that determine some content items for Overall and Individual Impression/Recommendations. Portions of the prior mammography CAD report (Example 2) are incorporated into this report. In the current mammogram the number of calcifications in the RCC has increased, and the size of the mass in the left breast has increased from 1 to 4 cm2.

Mammograms as Described in Example 3

Figure E.3-16. Mammograms as Described in Example 3


Italicized entries (xxx) in the following table denote references to or by-value inclusion of content tree items reused from the prior Mammography CAD SR instance (Example 2).

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1

Mammography CAD Report

TID 4000

While the Image Library contains references to content tree items reused from the prior Mammography CAD SR instance, the images are actually used in the mammography CAD analysis and are therefore not italicized as indicated above.

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.1

Image Library

TID 4000

1.1.1

IMAGE 1

TID 4020

1.1.1.1

Image Laterality

Right

TID 4020

1.1.1.2

Image View

Cranio-caudal

TID 4020

1.1.1.3

Study Date

20000101

TID 4020

1.1.2

IMAGE 2

TID 4020

1.1.2.1

Image Laterality

Left

TID 4020

1.1.2.2

Image View

Cranio-caudal

TID 4020

1.1.2.3

Study Date

20000101

TID 4020

1.1.3

IMAGE 3

TID 4020

1.1.3.1

Image Laterality

Right

TID 4020

1.1.3.2

Image View

Medio-lateral oblique

TID 4020

1.1.3.3

Study Date

20000101

TID 4020

1.1.4

IMAGE 4

TID 4020

1.1.4.1

Image Laterality

Left

TID 4020

1.1.4.2

Image View

Medio-lateral oblique

TID 4020

1.1.4.3

Study Date

20000101

TID 4020

1.1.5

IMAGE 5

TID 4020

1.1.5.1

Image Laterality

Right

TID 4020

1.1.5.2

Image View

Cranio-caudal

TID 4020

1.1.5.3

Study Date

19990101

TID 4020

1.1.6

IMAGE 6

TID 4020

1.1.6.1

Image Laterality

Left

TID 4020

1.1.6.2

Image View

Cranio-caudal

TID 4020

1.1.6.3

Study Date

19990101

TID 4020

1.1.7

IMAGE 7

TID 4020

1.1.7.1

Image Laterality

Right

TID 4020

1.1.7.2

Image View

Medio-lateral oblique

TID 4020

1.1.7.3

Study Date

19990101

TID 4020

1.1.8

IMAGE 8

TID 4020

1.1.8.1

Image Laterality

Left

TID 4020

1.1.8.2

Image View

Medio-lateral oblique

TID 4020

1.1.8.3

Study Date

19990101

TID 4020

Current year content:

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.2

CAD Processing and Findings Summary

All algorithms succeeded; with findings

TID 4001

1.2.1

Assessment Category

4 - Suspicious abnormality, biopsy should be considered

TID 4002

1.2.2

Recommend Follow-up Interval

0 days

TID 4002

1.2.3

Algorithm Name

"Mammogram Analyzer"

TID 4019

1.2.4

Algorithm Version

"V1.0"

TID 4019

1.2.5

Individual Impression/Recommendation

TID 4003

1.2.5.1

Rendering Intent

Presentation Required

TID 4003

1.2.5.2

Differential Diagnosis/Impression

Increase in size

TID 4002

1.2.5.3

Impression Description

"Worrisome increase in size"

TID 4002

1.2.5.4

Recommended Follow-up

Needle localization and biopsy

TID 4002

1.2.5.5

Certainty of impression

84%

TID 4002

1.2.5.6

Algorithm Name

"Lesion Analyzer"

TID 4019

1.2.5.7

Algorithm Version

"V1.0"

TID 4019

1.2.5.8

Composite Feature

Mass

TID 4004

1.2.5.8.1

Rendering Intent

Presentation Required

TID 4004

1.2.5.8.2

Composite type

Target content items are related temporally

TID 4005

1.2.5.8.3

Scope of Feature

Feature was detected on multiple images

TID 4005

1.2.5.8.4

Algorithm Name

"Temporal Change"

TID 4019

1.2.5.8.5

Algorithm Version

"V0.1"

TID 4019

1.2.5.8.6

Certainty of Feature

91%

TID 4005

1.2.5.8.7

Probability of Cancer

84%

TID 4005

1.2.5.8.8

Pathology

Invasive lobular carcinoma

TID 4005

1.2.5.8.9

Difference in Size

3 cm2

TID 4005

1.2.5.8.9.1

Reference to node 1.2.5.8.13.7.6

TID 4005

1.2.5.8.9.2

Reference to node 1.2.5.8.14.8.6

TID 4005

1.2.5.8.10

Lesion Density

High density

TID 4005

1.2.5.8.11

Shape

Lobular

TID 4005

1.2.5.8.12

Margins

Microlobulated

TID 4005

1.2.5.8.13

Composite Feature

Mass

TID 4004

1.2.5.8.13.1

Rendering Intent

Presentation Required

TID 4004

1.2.5.8.13.2

Composite type

Target content items are related spatially

TID 4005

1.2.5.8.13.3

Scope of Feature

Feature was detected on multiple images

TID 4005

1.2.5.8.13.4

Algorithm Name

"Mass Maker"

TID 4019

1.2.5.8.13.5

Algorithm Version

"V1.9"

TID 4019

1.2.5.8.13.6

Single Image Finding

Mammography breast density

TID 4006

1.2.5.8.13.6.1

Rendering Intent

Presentation Required

TID 4006

1.2.5.8.13.6.2

Algorithm Name

"Density Detector"

TID 4019

1.2.5.8.13.6.3

Algorithm Version

"V3.7"

TID 4019

1.2.5.8.13.6.4

Center

POINT

TID 4021

1.2.5.8.13.6.4.1

Reference to node 1.1.2

TID 4021

1.2.5.8.13.6.5

Outline

SCOORD

TID 4021

1.2.5.8.13.6.5.1

Reference to node 1.1.2

TID 4021

1.2.5.8.13.7

Single Image Finding

Mammography breast density

TID 4006

1.2.5.8.13.7.1

Rendering Intent

Presentation Required

TID 4006

1.2.5.8.13.7.2

Algorithm Name

"Density Detector"

TID 4019

1.2.5.8.13.7.3

Algorithm Version

"V3.7"

TID 4019

1.2.5.8.13.7.4

Center

POINT

TID 4021

1.2.5.8.13.7.4.1

Reference to node 1.1.4

TID 4021

1.2.5.8.13.7.5

Outline

SCOORD

TID 4021

1.2.5.8.13.7.5.1

Reference to node 1.1.4

TID 4021

1.2.5.8.13.7.6

Area of Defined Region

4 cm2

TID 1401

1.2.5.8.13.7.6.1

Area Outline

SCOORD

TID 1401

1.2.5.8.13.7.6. 1.1

Reference to node 1.1.4

TID 1401

Included content from prior mammography CAD report (see Example 2, starting with node 1.2.1.2)

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.2.5.8.14

Composite Feature

Mass

TID 4004

1.2.5.8.14.1

Rendering Intent

Presentation Required

TID 4004

1.2.5.8.14.2

Composite type

Target content items are related spatially

TID 4005

1.2.5.8.14.3

Scope of Feature

Feature was detected on multiple images

TID 4005

1.2.5.8.14.4

Algorithm Name

"Mass Maker"

TID 4019

1.2.5.8.14.5

Algorithm Version

"V1.9"

TID 4019

1.2.5.8.14.6

[Observation Context content items]

TID 4022

1.2.5.8.14.7

Single Image Finding

Mammography breast density

TID 4006

1.2.5.8.14.7.1

Rendering Intent

Presentation Required

TID 4006

1.2.5.8.14.7.2

Algorithm Name

"Density Detector"

TID 4019

1.2.5.8.14.7.3

Algorithm Version

"V3.7"

TID 4019

1.2.5.8.14.7.4

Center

POINT

TID 4021

1.2.5.8.14.7.4.1

Reference to node 1.1.6

TID 4021

1.2.5.8.14.7.5

Outline

SCOORD

TID 4021

1.2.5.8.14.7.5.1

Reference to node 1.1.6

TID 4021

1.2.5.8.14.8

Single Image Finding

Mammography breast density

TID 4006

1.2.5.8.14.8.1

Rendering Intent

Presentation Required

TID 4006

1.2.5.8.14.8.2

Algorithm Name

"Density Detector"

TID 4019

1.2.5.8.14.8.3

Algorithm Version

"V3.7"

TID 4019

1.2.5.8.14.8.4

Center

POINT

TID 4021

1.2.5.8.14.8.4.1

Reference to node 1.1.8

TID 4021

1.2.5.8.14.8.5

Outline

SCOORD

TID 4021

1.2.5.8.14.8.5.1

Reference to node 1.1.8

TID 4021

1.2.5.8.14.8.6

Area of Defined Region

1 cm2

TID 1401

1.2.5.8.14.8.6.1

Area Outline

SCOORD

TID 1401

1.2.5.8.14.8.6.1.1

Reference to node 1.1.8

TID 1401

More current year content:

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.2.6

Individual Impression/Recommendation

TID 4003

1.2.6.1

Rendering Intent

Not for Presentation

TID 4003

1.2.6.2

Single Image Finding

Mammography breast density

TID 4006

1.2.6.2.1

Rendering Intent

Not for Presentation

TID 4006

1.2.6.2.2

Algorithm Name

"Density Detector"

TID 4019

1.2.6.2.3

Algorithm Version

"V3.7"

TID 4019

1.2.6.2.4

Center

POINT

TID 4021

1.2.6.2.4.1

Reference to node 1.1.2

TID 4021

1.2.6.2.5

Outline

SCOORD

TID 4021

1.2.6.2.5.1

Reference to node 1.1.2

TID 4021

1.2.7

Individual Impression/Recommendation

INDIVIDUAL

TID 4003

1.2.7.1

Rendering Intent

Presentation Required

TID 4003

1.2.7.2

Single Image Finding

Calcification Cluster

TID 4006

1.2.7.2.1

Rendering Intent

Presentation Required

TID 4006

1.2.7.2.2

Algorithm Name

"Calc Cluster Detector"

TID 4019

1.2.7.2.3

Algorithm Version

"V2.4"

TID 4019

1.2.7.2.4

Center

POINT

TID 4021

1.2.7.2.4.1

Reference to node 1.1.3

TID 4021

1.2.7.2.5

Outline

SCOORD

TID 4021

1.2.7.2.5.1

Reference to node 1.1.3

TID 4021

1.2.7.2.6

Number of Calcifications

20

TID 4010

1.2.8

Individual Impression/Recommendation

TID 4003

1.2.8.1

Rendering Intent

Presentation Required

TID 4003

1.2.8.2

Differential Diagnosis/Impression

Increase in number of calcifications

TID 4002

1.2.8.3

Impression Description

"Calcification cluster has increased in size"

TID 4002

1.2.8.4

Recommended Follow-up

Magnification views

TID 4002

1.2.8.5

Certainty of impression

100%

TID 4002

1.2.8.6

Algorithm Name

"Lesion Analyzer"

TID 4019

1.2.8.7

Algorithm Version

"V1.0"

TID 4019

1.2.8.8

Composite Feature

Calcification Cluster

TID 4004

1.2.8.8.1

Rendering Intent

Presentation Required

TID 4004

1.2.8.8.2

Composite type

Target content items are related temporally

TID 4005

1.2.8.8.3

Scope of Feature

Feature was detected on multiple images

TID 4005

1.2.8.8.4

Algorithm Name

"Lesion Analyzer"

TID 4019

1.2.8.8.5

Algorithm Version

"V1.0"

TID 4019

1.2.8.8.6

Certainty of Feature

99%

TID 4005

1.2.8.8.7

Probability of Cancer

54%

TID 4005

1.2.8.8.8

Pathology

Intraductal carcinoma, low grade

TID 4005

1.2.8.8.9

Difference in Number of calcifications

4

TID 4005

1.2.8.8.9.1

Reference to node 1.2.8.8.12.6

TID 4005

1.2.8.8.9.2

Reference to node 1.2.8.8.13.6

TID 4005

1.2.8.8.10

Calcification type

Fine, linear, branching (casting)

TID 4005

1.2.8.8.11

Calcification distribution

Grouped or clustered

TID 4005

1.2.8.8.12

Single Image Finding

Calcification Cluster

TID 4006

1.2.8.8.12.1

Rendering Intent

Presentation Required

TID 4006

1.2.8.8.12.2

Algorithm Name

"Calc Clustering"

TID 4019

1.2.8.8.12.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.12.4

Center

POINT

TID 4021

1.2.8.8.12.4.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.5

Outline

SCOORD

TID 4021

1.2.8.8.12.5.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.6

Number of Calcifications

6

TID 4010

1.2.8.8.12.7

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.12.7.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.12.7.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.12.7.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.12.7.4

Center

POINT

TID 4021

1.2.8.8.12.7.4.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.7.5

Outline

SCOORD

TID 4021

1.2.8.8.12.7.5.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.8

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.12.8.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.12.8.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.12.8.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.12.8.4

Center

POINT

TID 4021

1.2.8.8.12.8.4.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.8.5

Outline

SCOORD

TID 4021

1.2.8.8.12.8.5.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.9

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.12.9.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.12.9.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.12.9.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.12.9.4

Center

POINT

TID 4021

1.2.8.8.12.9.4.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.9.5

Outline

SCOORD

TID 4021

1.2.8.8.12.9.5.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.10

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.12.10.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.12.10.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.12.10.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.12.10.4

Center

POINT

TID 4021

1.2.8.8.12.10.4.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.10.5

Outline

SCOORD

TID 4021

1.2.8.8.12.10.5.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.11

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.12.11.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.12.11.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.12.11.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.12.11.4

Center

POINT

TID 4021

1.2.8.8.12.11.4.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.11.5

Outline

SCOORD

TID 4021

1.2.8.8.12.11.5.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.12

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.12.12.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.12.12.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.12.12.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.12.12.4

Center

POINT

TID 4021

1.2.8.8.12.12.4.1

Reference to node 1.1.1

TID 4021

1.2.8.8.12.12.5

Outline

SCOORD

TID 4021

1.2.8.8.12.12.5.1

Reference to node 1.1.1

TID 4021

Included content from prior mammography CAD report (see Example 2, starting with node 1.2.4.2)

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.2.8.8.13

Single Image Finding

Calcification Cluster

TID 4006

1.2.8.8.13.1

Rendering Intent

Presentation Required

TID 4006

1.2.8.8.13.2

Algorithm Name

"Calc Clustering"

TID 4019

1.2.8.8.13.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.13.4

Center

POINT

TID 4021

1.2.8.8.13.4.1

Reference to node 1.1.5

TID 4021

1.2.8.8.13.5

Outline

SCOORD

TID 4021

1.2.8.8.13.5.1

Reference to node 1.1.5

TID 4021

1.2.8.8.13.6

Number of Calcifications

2

TID 4010

1.2.8.8.13.7

[Observation Context content items]

TID 4022

1.2.8.8.13.8

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.13.8.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.13.8.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.13.8.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.13.8.4

Center

POINT

TID 4021

1.2.8.8.13.8.4.1

Reference to node 1.1.5

TID 4021

1.2.8.8.13.8.5

Outline

SCOORD

TID 4021

1.2.8.8.13.8.5.1

Reference to node 1.1.5

TID 4021

1.2.8.8.13.9

Single Image Finding

Individual Calcification

TID 4006

1.2.8.8.13.9.1

Rendering Intent

Presentation Optional

TID 4006

1.2.8.8.13.9.2

Algorithm Name

"Calc Detector"

TID 4019

1.2.8.8.13.9.3

Algorithm Version

"V2.4"

TID 4019

1.2.8.8.13.9.4

Center

POINT

TID 4021

1.2.8.8.13.9.4.1

Reference to node 1.1.5

TID 4021

1.2.8.8.13.9.4

Outline

SCOORD

TID 4021

1.2.8.8.13.9.4.1

Reference to node 1.1.5

TID 4021

More current year content:

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.3

Summary of Detections

Succeeded

TID 4000

1.3.1

Successful Detections

TID 4015

1.3.1.1

Detection Performed

Mammography breast density

TID 4017

1.3.1.1.1

Algorithm Name

"Density Detector"

TID 4019

1.3.1.1.2

Algorithm Version

"V3.7"

TID 4019

1.3.1.1.3

Reference to node 1.1.1

TID 4017

1.3.1.1.4

Reference to node 1.1.2

TID 4017

1.3.1.1.5

Reference to node 1.1.3

TID 4017

1.3.1.1.6

Reference to node 1.1.4

TID 4017

1.3.1.2

Detection Performed

Individual Calcification

TID 4017

1.3.1.2.1

Algorithm Name

"Calc Detector"

TID 4019

1.3.1.2.2

Algorithm Version

"V2.4"

TID 4019

1.3.1.2.3

Reference to node 1.1.1

TID 4017

1.3.1.2.4

Reference to node 1.1.2

TID 4017

1.3.1.2.5

Reference to node 1.1.3

TID 4017

1.3.1.2.6

Reference to node 1.1.4

TID 4017

1.3.1.3

Detection Performed

Calcification Cluster

TID 4017

1.3.1.3.1

Algorithm Name

"Calc Clustering"

TID 4019

1.3.1.3.2

Algorithm Version

"V2.4"

TID 4019

1.3.1.3.3

Reference to node 1.1.1

TID 4017

1.3.1.4

Detection Performed

Calcification Cluster

TID 4017

1.3.1.4.1

Algorithm Name

"Calc Cluster Detector"

TID 4019

1.3.1.4.2

Algorithm Version

"V2.4"

TID 4019

1.3.1.4.3

Reference to node 1.1.1

TID 4017

1.3.1.4.4

Reference to node 1.1.2

TID 4017

1.3.1.4.5

Reference to node 1.1.3

TID 4017

1.3.1.4.6

Reference to node 1.1.4

TID 4017

1.4

Summary of Analyses

Succeeded

TID 4000

1.4.1

Successful Analyses

TID 4016

1.4.1.1

Analysis Performed

Mass Correlation

TID 4018

1.4.1.1.1

Algorithm Name

"Mass Maker"

TID 4019

1.4.1.1.2

Algorithm Version

"V1.9"

TID 4019

1.4.1.1.3

Reference to node 1.1.2

TID 4018

1.4.1.1.4

Reference to node 1.1.4

TID 4018

1.4.1.2

Analysis Performed

Temporal Correlation

TID 4018

1.4.1.2.1

Algorithm Name

"Temporal Change"

TID 4019

1.4.1.2.2

Algorithm Version

"V0.1"

TID 4019

1.4.1.2.3

Reference to node 1.1.2

TID 4018

1.4.1.2.4

Reference to node 1.1.4

TID 4018

1.4.1.2.5

Reference to node 1.1.6

TID 4018

1.4.1.2.6

Reference to node 1.1.8

TID 4018

1.4.1.3

Analysis Performed

Individual Impression / Recommendation Analysis

TID 4018

1.4.1.3.1

Algorithm Name

"Lesion Analyzer"

TID 4019

1.4.1.3.2

Algorithm Version

"V1.0"

TID 4019

1.4.1.3.3

Reference to node 1.1.2

TID 4018

1.4.1.3.4

Reference to node 1.1.4

TID 4018

1.4.1.3.5

Reference to node 1.1.6

TID 4018

1.4.1.3.6

Reference to node 1.1.8

TID 4018

1.4.1.4

Analysis Performed

Overall Impression / Recommendation Analysis

TID 4018

1.4.1.4.1

Algorithm Name

"Mammogram Analyzer"

TID 4019

1.4.1.4.2

Algorithm Version

"V1.0"

TID 4019

1.4.1.4.3

Reference to node 1.1.2

TID 4018

1.4.1.4.4

Reference to node 1.1.4

TID 4018

1.4.1.4.5

Reference to node 1.1.6

TID 4018

1.4.1.4.6

Reference to node 1.1.8

TID 4018

DICOM PS3.17 2019a - Explanatory Information