A.35 Structured Report Document Information Object Definitions

A.35 Structured Report Document Information Object Definitions
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A.35.1 Basic Text SR IOD

A.35.1.1 Basic Text SR Information Object Description

The Basic Text Structured Report (SR) IOD is intended for the representation of reports with minimal usage of coded entries (typically used in Document Title and headings) and a hierarchical tree of headings under which may appear text and subheadings. Reference to SOP Instances (e.g., images or waveforms or other SR Documents) is restricted to appear at the level of the leaves of this primarily textual tree. This structure simplifies the encoding of conventional textual reports as SR Documents, as well as their rendering.

A.35.1.2 Basic Text SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Basic Text SR IOD. The Frame of Reference IE, and the IEs at the level of the Image IE in Section A.1.2 are not components of the Basic Text SR IOD. Table A.35.1-1 specifies the Modules of the Basic Text SR IOD.

A.35.1.3 Basic Text SR IOD Module Table

Table A.35.1-1 specifies the Modules of the Basic Text SR IOD.

Table A.35.1-1. Basic Text SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

Note

The Specimen Identification Module was previously included in this IOD but has been retired. See PS3.3-2008.

A.35.1.3.1 Basic Text SR IOD Content Constraints

A.35.1.3.1.1 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
DATETIME
DATE
TIME
UIDREF
PNAME
COMPOSITE
IMAGE
WAVEFORM
CONTAINER

A.35.1.3.1.2 Relationship Constraints

Relationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-8 for Relationship Type definitions.

Note

Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module.

Table A.35.1-2 specifies the relationship constraints of this IOD.

Table A.35.1-2. Relationship Content Constraints for Basic Text SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME, COMPOSITE¹, IMAGE¹, WAVEFORM¹, CONTAINER
CONTAINER	HAS OBS CONTEXT	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME, COMPOSITE¹
CONTAINER, IMAGE¹, WAVEFORM¹, COMPOSITE¹	HAS ACQ CONTEXT	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME
any type	HAS CONCEPT MOD	TEXT, CODE²
TEXT	HAS PROPERTIES	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹
PNAME	HAS PROPERTIES	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME
TEXT	INFERRED FROM	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹

Note

Which SOP Classes the IMAGE, WAVEFORM or COMPOSITE Value Type may refer to, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

A.35.2 Enhanced SR IOD

A.35.2.1 Enhanced SR Information Object Description

The Enhanced Structured Report (SR) IOD is a superset of the Basic Text SR IOD. It is also intended for the representation of reports with minimal usage of coded entries (typically Document Title and headings) and a hierarchical tree of headings under which may appear text and subheadings. In addition, it supports the use of numeric measurements with coded measurement names and units. Reference to SOP Instances (e.g., images or waveforms or SR Documents) is restricted to appear at the level of the leaves of this primarily textual tree. It enhances references to SOP Instances with spatial regions of interest (points, lines, circle, ellipse, etc.) and temporal regions of interest.

A.35.2.2 Enhanced SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Enhanced SR IOD. The Frame of Reference IE, and the IEs at the level of the Image IE in Section A.1.2 are not components of the Enhanced SR IOD. Table A.35.2-1 specifies the Modules of the Enhanced SR IOD.

A.35.2.3 Enhanced SR IOD Module Table

Table A.35.2-1. Enhanced SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

Note

The Specimen Identification Module was previously included in this IOD but has been retired. See PS3.3-2008.

A.35.2.3.1 Enhanced SR IOD Content Constraints

A.35.2.3.1.1 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATETIME
DATE
TIME
UIDREF
PNAME
SCOORD
TCOORD
COMPOSITE
IMAGE
WAVEFORM
CONTAINER

A.35.2.3.1.2 Relationship Constraints

Relationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-8 for Relationship Type definitions.

Note

Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module.

Table A.35.2-2 specifies the relationship constraints of this IOD.

Table A.35.2-2. Relationship Content Constraints for Enhanced SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, SCOORD, TCOORD, COMPOSITE¹, IMAGE¹, WAVEFORM¹, CONTAINER
CONTAINER	HAS OBS CONTEXT	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, COMPOSITE¹
CONTAINER, IMAGE¹, WAVEFORM¹, COMPOSITE¹, NUM	HAS ACQ CONTEXT	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME
any type	HAS CONCEPT MOD	TEXT, CODE²
TEXT, CODE, NUM	HAS PROPERTIES	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹, SCOORD, TCOORD
PNAME	HAS PROPERTIES	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME
TEXT, CODE, NUM	INFERRED FROM	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹, SCOORD, TCOORD
SCOORD	SELECTED FROM	IMAGE¹
TCOORD	SELECTED FROM	SCOORD, IMAGE¹, WAVEFORM¹

Note

Which SOP Classes the IMAGE, WAVEFORM or COMPOSITE Value Type may refer to, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

A.35.3 Comprehensive SR IOD

A.35.3.1 Comprehensive SR Information Object Description

The Comprehensive SR IOD is a superset of the Basic Text SR IOD and the Enhanced SR IOD, which specifies a class of documents, the content of which may include textual and a variety of coded information, numeric measurement values, references to the SOP Instances and spatial or temporal regions of interest within such SOP Instances. Relationships by-reference are enabled between Content Items.

A.35.3.2 Comprehensive SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Comprehensive SR IOD. The IEs at the level of the Image IE in Section A.1.2 are not components of the Comprehensive SR IOD. Table A.35.3-1 specifies the Modules of the Comprehensive SR IOD.

A.35.3.3 Comprehensive SR IOD Module Table

Table A.35.3-1. Comprehensive SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Frame of Reference	Frame of Reference	C.7.4.1	U
Frame of Reference	Synchronization	C.7.4.2	U
Equipment	General Equipment	C.7.5.1	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

Note

The Specimen Identification Module was previously included in this IOD but has been retired. See PS3.3-2008.

A.35.3.3.1 Comprehensive SR IOD Content Constraints

A.35.3.3.1.1 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATETIME
DATE
TIME
UIDREF
PNAME
SCOORD
TCOORD
COMPOSITE
IMAGE
WAVEFORM
CONTAINER

A.35.3.3.1.2 Relationship Constraints

Relationships between content items in the content of this IOD may be conveyed either by-value or by-reference. Table A.35.3-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for Relationship Type definitions.

Table A.35.3-2. Relationship Content Constraints for Comprehensive SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, SCOORD, TCOORD, COMPOSITE¹, IMAGE¹, WAVEFORM¹, CONTAINER (see below).
TEXT, CODE, NUM, CONTAINER	HAS OBS CONTEXT	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, COMPOSITE¹
CONTAINER, IMAGE¹, WAVEFORM¹, COMPOSITE¹, NUM	HAS ACQ CONTEXT	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, CONTAINER.
any type	HAS CONCEPT MOD	TEXT, CODE²
TEXT, CODE, NUM	HAS PROPERTIES	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹, SCOORD, TCOORD, CONTAINER.
PNAME	HAS PROPERTIES	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME
TEXT, CODE, NUM	INFERRED FROM	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹, SCOORD, TCOORD, CONTAINER.
SCOORD	SELECTED FROM	IMAGE¹
TCOORD	SELECTED FROM	SCOORD, IMAGE¹, WAVEFORM¹

Note

Which SOP Classes the IMAGE, WAVEFORM or COMPOSITE Value Type may refer to, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

The HAS CONCEPT MOD and CONTAINS relationships shall not be conveyed by-reference.

Relationships by-reference to ancestor Content Items are forbidden in this IOD to prevent loops.

A.35.4 Key Object Selection Document IOD

A.35.4.1 Key Object Selection Document Information Object Description

The Key Object Selection Document IOD is intended for flagging one or more significant images, waveforms, or other composite SOP Instances.

A.35.4.2 Key Object Selection Document IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Key Object Selection Document IOD. Table A.35.1-1 specifies the Modules of the Key Object Selection Document IOD.

A.35.4.3 Key Object Selection Document IOD Module Table

Table A.35.4-1 specifies the Modules of the Key Object Selection Document IOD.

Table A.35.4-1. Key Object Selection Document IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	Key Object Document Series	C.17.6.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Document	Key Object Document	C.17.6.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

Note

The Specimen Identification Module was previously included in this IOD but has been retired. See PS3.3-2008.

A.35.4.3.1 Key Object Selection Document IOD Content Constraints

A.35.4.3.1.1 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
UIDREF
PNAME
COMPOSITE
IMAGE
WAVEFORM
CONTAINER

A.35.4.3.1.2 Relationship Constraints

Relationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-8 for Relationship Type definitions.

Note

Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module.

Table A.35.4-2 specifies the relationship constraints of this IOD.

Table A.35.4-2. Relationship Content Constraints for Key Object Selection Document IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, IMAGE, WAVEFORM, COMPOSITE
CONTAINER	HAS OBS CONTEXT	TEXT, CODE, UIDREF, PNAME
CONTAINER	HAS CONCEPT MOD	CODE

A.35.4.3.1.3 Template Constraints

The document shall be constructed from TID 2010 “Key Object Selection” invoked at the root node.

A.35.5 Mammography CAD SR IOD

A.35.5.1 Mammography CAD SR Information Object Description

The Mammography CAD SR IOD is used to convey the detection and analysis results of a mammography CAD device. The content may include textual and a variety of coded information, numeric measurement values, references to the SOP Instances, and spatial regions of interest within such SOP Instances. Relationships by-reference are enabled between Content Items.

A.35.5.2 Mammography CAD SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Mammography CAD SR IOD. The Frame of Reference IE, and the IEs at the level of the Image IE in Section A.1.2 are not components of the Mammography CAD SR IOD. Table A.35.5-1 specifies the Modules of the Mammography CAD SR IOD.

A.35.5.3 Mammography CAD SR IOD Module Table

Table A.35.5-1 specifies the Modules of the Mammography CAD SR IOD.

Table A.35.5-1. Mammography CAD SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

Note

The Specimen Identification Module was previously included in this IOD but has been retired. See PS3.3-2008.

A.35.5.3.1 Mammography CAD SR IOD Content Constraints

A.35.5.3.1.1 Template Constraints

The document shall be constructed from TID 4000 “Mammography CAD Document Root” invoked at the root node.
When a content item sub-tree from a prior document is duplicated by-value, its observation context shall be defined by TID 1001 “Observation Context” and its subordinate templates.

Note

All Template and Context Group definitions are located in Annex A “Structured Reporting Templates (Normative)” in PS3.16 and Annex B “DCMR Context Groups (Normative)” in PS3.16, respectively.

A.35.5.3.1.2 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATE
TIME
PNAME
SCOORD
COMPOSITE
IMAGE
CONTAINER

A.35.5.3.1.3 Relationship Constraints

The Mammography CAD SR IOD makes extensive use of by-reference INFERRED FROM, by-reference HAS PROPERTIES and by-reference SELECTED FROM relationships. Other relationships by-reference are forbidden. Table A.35.5-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for Relationship Type definitions.

Table A.35.5-2. Relationship Content Constraints for Mammography CAD SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	CODE, NUM, SCOORD, IMAGE¹, CONTAINER, TEXT, DATE.
TEXT, CODE, NUM, CONTAINER	HAS OBS CONTEXT	TEXT, CODE, NUM, DATE, TIME, PNAME, UIDREF, COMPOSITE¹.
IMAGE	HAS ACQ CONTEXT	TEXT, CODE, DATE, TIME, NUM.
CONTAINER, CODE, NUM, COMPOSITE	HAS CONCEPT MOD	TEXT, CODE².
TEXT, CODE, NUM	HAS PROPERTIES	CONTAINER, TEXT, CODE, NUM, DATE, IMAGE¹, SCOORD, UIDREF.
CODE, NUM	INFERRED FROM	CODE, NUM, SCOORD, CONTAINER, TEXT, IMAGE.
SCOORD	SELECTED FROM	IMAGE¹.

Note

Which SOP Classes the IMAGE or COMPOSITE Value Type may refer to, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

A.35.6 Chest CAD SR IOD

A.35.6.1 Chest CAD SR Information Object Description

The Chest CAD SR IOD is used to convey the detection and analysis results of a chest CAD device. The content may include textual and a variety of coded information, numeric measurement values, references to the SOP Instances, and spatial regions of interest within such SOP Instances. Relationships by-reference are enabled between Content Items.

A.35.6.2 Chest CAD SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Chest CAD SR IOD. The Frame of Reference IE, and the IEs at the level of the Image IE in Section A.1.2 are not components of the Chest CAD SR IOD. Table A.35.6-1 specifies the Modules of the Chest CAD SR IOD.

A.35.6.3 Chest CAD SR IOD Module Table

Table A.35.6-1 specifies the Modules of the Chest CAD SR IOD.

Table A.35.6-1. Chest CAD SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

Note

The Specimen Identification Module was previously included in this IOD but has been retired. See PS3.3-2008.

A.35.6.3.1 Chest CAD SR IOD Content Constraints

A.35.6.3.1.1 Template Constraints

The document shall be constructed from TID 4100 “Chest CAD Document Root” invoked at the root node.
When a content item sub-tree from a prior document is duplicated by-value, its observation context shall be defined by TID 1001 “Observation Context” and its subordinate templates.

Note

All Template and Context Group definitions are located in Annex A “Structured Reporting Templates (Normative)” in PS3.16 and Annex B “DCMR Context Groups (Normative)” in PS3.16, respectively.

A.35.6.3.1.2 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATE
TIME
UIDREF
PNAME
SCOORD
TCOORD
COMPOSITE
IMAGE
WAVEFORM
CONTAINER

A.35.6.3.1.3 Relationship Constraints

The Chest CAD SR IOD makes use of by-reference INFERRED FROM, by-reference SELECTED FROM, and by-reference HAS PROPERTIES relationships. Other relationships by-reference are forbidden. Table A.35.6-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for Relationship Type definitions.

Table A.35.6-2. Relationship Content Constraints for Chest CAD SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	CODE, NUM, IMAGE¹, CONTAINER.
TEXT, CODE, NUM, CONTAINER	HAS OBS CONTEXT	TEXT, CODE, NUM, DATE, TIME, PNAME, UIDREF, COMPOSITE¹.
IMAGE, WAVEFORM	HAS ACQ CONTEXT	TEXT, CODE, DATE, TIME, NUM.
CONTAINER, CODE, COMPOSITE, NUM	HAS CONCEPT MOD	TEXT, CODE².
TEXT, CODE, NUM	HAS PROPERTIES	CONTAINER, TEXT, CODE, NUM, DATE, IMAGE¹, WAVEFORM¹, SCOORD, TCOORD, UIDREF.
CODE, NUM	INFERRED FROM	CODE, NUM, IMAGE¹, WAVEFORM¹, SCOORD, TCOORD, CONTAINER, TEXT.
SCOORD	SELECTED FROM	IMAGE¹.
TCOORD	SELECTED FROM	SCOORD, IMAGE¹, WAVEFORM¹.

Note

Which SOP Classes the IMAGE or COMPOSITE Value Type may refer to, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

A.35.7 Procedure Log IOD

A.35.7.1 Procedure Log Information Object Description

The Procedure Log IOD is intended for the representation of reports or logs of time-stamped events occurring during an extended diagnostic or interventional procedure, typical of the cardiac catheterization lab.

A.35.7.2 Procedure Log IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Procedure Log IOD. Table A.35.7-1 specifies the Modules of the Procedure Log IOD.

Note

Unlike some other SR IODs, the Frame of Reference IE is critical to the synchronized time stamping of events in the Procedure Log IOD and to multi-modality coordination.

A.35.7.3 Procedure Log IOD Module Table

Table A.35.7-1. Procedure Log IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
Study	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Frame of Reference	Synchronization	C.7.4.2	M
Equipment	General Equipment	C.7.5.1	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

A.35.7.3.1 Procedure Log IOD Content Constraints

A.35.7.3.1.1 Template

The document may be constructed from Baseline TID 3001 “Procedure Log” invoked at the root node.

Note

This template defines a container (the root) with subsidiary content items, each of which represents a single procedure log entry. There is a defined recording observer (the person responsible for recording the log, generally a technician or nurse). The log entries follow a canonical model of a coded log entry type (the concept name of the content item), the value associated with the concept name as one of the SR Value Types, and optionally a subsidiary free text comment and/or an identifier of the author or device source of the log entry (which may be other than the recording observer).

A.35.7.3.1.2 Observation DateTime

Each Item in Content Sequence (0040,A730) of the SR Document Content Module that is a target of a "CONTAINS" relationship from the root node, i.e., the first level Log Content Items, shall include Observation DateTime (0040,A032) as a Type 1 attribute. This attribute shall represent the DateTime at which the event recorded in the Content Item occurred, not the time at which the Item was recorded.

The first level Procedure Log Content Items in the Content Sequence shall be strictly ordered by monotonically increasing Observation DateTime (0040,A032) values.

Observation DateTime (0040,A032) shall be specified to a precision of one second or finer.

A.35.7.3.1.3 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATETIME
DATE
TIME
UIDREF
PNAME
COMPOSITE
IMAGE
WAVEFORM
CONTAINER

A.35.7.3.1.4 Relationship Constraints

Relationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-8 for Relationship Type definitions.

Note

Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module.
CONTAINERs are not permitted as a target of any relationship.

Table A.35.7-2 specifies the relationship constraints of this IOD.

Table A.35.7-2. Relationship Content Constraints for Procedure Log IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, CODE, NUM, PNAME, COMPOSITE, IMAGE, WAVEFORM
any type	HAS OBS CONTEXT	TEXT, CODE, NUM, DATETIME, UIDREF, PNAME
CONTAINER, IMAGE, WAVEFORM, COMPOSITE	HAS ACQ CONTEXT	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME
any type	HAS CONCEPT MOD	TEXT, CODE
any type (except CONTAINER)	HAS PROPERTIES	TEXT, CODE, NUM, DATETIME, UIDREF, PNAME
TEXT, CODE, NUM	INFERRED FROM	IMAGE, WAVEFORM, COMPOSITE

A.35.8 X-Ray Radiation Dose SR IOD

A.35.8.1 X-Ray Radiation Dose SR Information Object Description

The X-Ray Radiation Dose SR IOD is used to convey the exposure characteristics and dose from X-Rays generated by imaging devices.

Note

Therapeutic dose is reported in the RT Dose IOD.

A.35.8.2 X-Ray Radiation Dose SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the X-Ray Radiation Dose SR IOD. Table A.35.8-1 specifies the Modules of the X-Ray Radiation Dose SR IOD.

A.35.8.3 X-Ray Radiation Dose SR IOD Module Table

Table A.35.8-1. X-Ray Radiation Dose SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Frame of Reference	Synchronization	C.7.4.2	C - shall be present if system time is synchronized to an external reference. May be present otherwise.
Equipment	General Equipment	C.7.5.1	M
Equipment	Enhanced General Equipment	C.7.5.2	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

A.35.8.3.1 X-Ray Radiation Dose SR IOD Content Constraints

A.35.8.3.1.1 Template

The document may be constructed from Baseline TID 10001 “Projection X-Ray Radiation Dose” or Baseline TID 10011 “CT Radiation Dose” invoked at the root node.

Note

This IOD maybe used with other Templates defined for Dose Reporting. Such other Templates maybe specialized for specific modalities or future dose measurement techniques.

A.35.8.3.1.2 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATETIME
UIDREF
PNAME
COMPOSITE
IMAGE
CONTAINER

A.35.8.3.1.3 Relationship Constraints

Relationships between content items in the content of this IOD shall be conveyed by-value. Table A.35.8-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for Relationship Type definitions.

Table A.35.8-2. Relationship Content Constraints for X-Ray Radiation Dose SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, CODE, NUM, DATETIME, UIDREF, PNAME, IMAGE, COMPOSITE, CONTAINER
CONTAINER	HAS OBS CONTEXT	DATETIME, CODE, TEXT, UIDREF, PNAME
TEXT, CODE, NUM	HAS OBS CONTEXT	TEXT, CODE, NUM, DATETIME, UIDREF, PNAME, COMPOSITE
CONTAINER, IMAGE, COMPOSITE	HAS ACQ CONTEXT	TEXT, CODE, NUM, DATETIME, UIDREF, PNAME, CONTAINER.
any type	HAS CONCEPT MOD	TEXT, CODE
TEXT, CODE, NUM	HAS PROPERTIES	TEXT, CODE, NUM, DATETIME, UIDREF, PNAME, IMAGE, COMPOSITE, CONTAINER.
PNAME	HAS PROPERTIES	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME
TEXT, CODE, NUM	INFERRED FROM	TEXT, CODE, NUM, DATETIME, UIDREF, IMAGE, COMPOSITE, CONTAINER.

Note

The SOP Classes to which an IMAGE or COMPOSITE Value Type may refer, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).

A.35.9 Spectacle Prescription Report IOD

A.35.9.1 Spectacle Prescription Report Information Object Description

The Spectacle Prescription Report IOD is used to represent the spectacle prescription for a patient.

A.35.9.2 Spectacle Prescription Report IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Spectacle Prescription Report IOD.

A.35.9.3 Spectacle Prescription Report IOD Module Table

Table A.35.9-1 specifies the Modules of the Spectacle Prescription Report IOD.

Table A.35.9-1. Spectacle Prescription Report IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Equipment	Enhanced General Equipment	C.7.5.2	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

A.35.9.3.1 Spectacle Prescription Report IOD Content Constraints

A.35.9.3.1.1 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
CONTAINER

A.35.9.3.1.2 Relationship Constraints

Relationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-8 for Relationship Type definitions.

Note

Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module.

Table A.35.9-2 specifies the relationship constraints of this IOD.

Table A.35.9-2. Relationship Content Constraints for Spectacle Prescription Report IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	CONTAINER, CODE, NUM, TEXT

A.35.9.3.1.3 Template Constraints

The document shall be constructed from TID 2020 “Spectacle Prescription Report” invoked at the root node.

A.35.10 Colon CAD SR IOD

A.35.10.1 Colon CAD SR Information Object Description

The Colon CAD SR IOD is used to convey the detection and analysis results of a colon CAD device. The content may include textual and a variety of coded information, numeric measurement values, references to the SOP Instances, and spatial regions of interest within such SOP Instances. Relationships by-reference are enabled between Content Items.

A.35.10.2 Colon CAD SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Colon CAD SR IOD. The Frame of Reference IE, and the IEs at the level of the Image IE in Section A.1.2 are not components of the Colon CAD SR IOD. Table A.35.10-1 specifies the Modules of the Colon CAD SR IOD.

A.35.10.3 Colon CAD SR IOD Module Table

Table A.35.10-1 specifies the Modules of the Colon CAD SR IOD.

Table A.35.10-1. Colon CAD SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Equipment	Enhanced General Equipment	C.7.5.2	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

A.35.10.3.1 Colon CAD SR IOD Content Constraints

A.35.10.3.1.1 Template Constraints

The document shall be constructed from TID 4120 “Colon CAD Document Root” invoked at the root node.

Note

All Template and Context Group definitions are located in Annex A “Structured Reporting Templates (Normative)” in PS3.16 and Annex B “DCMR Context Groups (Normative)” in PS3.16, respectively.

A.35.10.3.1.2 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATE
TIME
UIDREF
PNAME
SCOORD
SCOORD3
COMPOSITE
IMAGE
CONTAINER

A.35.10.3.1.3 Relationship Constraints

The Colon CAD SR IOD makes use of by-reference INFERRED FROM and by-reference HAS ACQ CONTEXT relationships. Other relationships by-reference are forbidden. Table A.35.10-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for Relationship Type definitions.

Table A.35.10-2. Relationship Content Constraints for Colon CAD SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	CODE, NUM, IMAGE¹, CONTAINER, UIDREF, DATE, TIME.
TEXT, CODE, NUM, CONTAINER	HAS OBS CONTEXT	TEXT, CODE, NUM, DATE, TIME, PNAME, UIDREF, COMPOSITE¹.
IMAGE	HAS ACQ CONTEXT	TEXT, CODE, DATE, TIME, NUM, CONTAINER.
CONTAINER, CODE, COMPOSITE, NUM	HAS CONCEPT MOD	TEXT, CODE².
TEXT, CODE, NUM	HAS PROPERTIES	CONTAINER, TEXT, CODE, NUM, DATE, IMAGE¹, SCOORD, SCOORD3D, UIDREF.
CODE, NUM	INFERRED FROM	CODE, NUM, IMAGE¹, SCOORD, SCOORD3D, CONTAINER, TEXT.
SCOORD	SELECTED FROM	IMAGE¹.

Note

Which SOP Classes the IMAGE or COMPOSITE Value Type may refer to, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

A.35.11 Macular Grid Thickness and Volume Report IOD

A.35.11.1 Macular Grid Thickness and Volume Report Information Object Description

The Macular Grid Thickness and Volume Report IOD is used to represent the macular grid thickness and volume values derived from ophthalmic images.

A.35.11.2 Macular Grid Thickness and Volume Report IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Macular Grid Thickness and Volume Report IOD. Table A.35.11-1 specifies the Modules of the Thickness and Macular Volume Report IOD.

A.35.11.3 Macular Grid Thickness and Volume Report IOD Module Table

Table A.35.11-1 specifies the Modules of the Macular Grid Thickness and Volume Report IOD.

Table A.35.11-1. Macular Grid Thickness and Volume Report IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Equipment	Enhanced General Equipment	C.7.5.2	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

A.35.11.3.1 Macular Grid Thickness and Volume Report IOD Content Constraints

A.35.11.3.1.1 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATE
UIDREF
PNAME
IMAGE
CONTAINER

A.35.11.3.1.2 Relationship Constraints

Relationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-8 for Relationship Type definitions.

Note

Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module.

Table A.35.11-2 specifies the relationship constraints of this IOD.

Table A.35.11-2. Relationship Content Constraints for Macular Grid Thickness and Volume Report IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	HAS OBS CONTEXT	CODE, PNAME, TEXT, UIDREF, DATE, NUM
CONTAINER	CONTAINS	CONTAINER, NUM, TEXT, CODE
any type	HAS CONCEPT MOD	CODE
NUM	HAS OBS CONTEXT	TEXT
NUM	INFERRED FROM	IMAGE

A.35.11.3.1.3 Template Constraints

The document shall be constructed from TID 2100 “Macular Grid Thickness and Volume Report” invoked at the root node.

A.35.12 Implantation Plan SR Document IOD

A.35.12.1 Implantation Plan SR Document IOD Description

The Implantation Plan SR Document IOD contains the results of a planning process for an individual patient, wherein specific implant templates are selected and positioned using images of the patient. The Implantation Plan SR Document references the implant templates, the images, and the registration SOP instances that are used in the planning.

A.35.12.2 Implantation Plan SR Document IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Implantation Plan SR Document. The Frame of Reference IE, and the IEs at the level of the Image IE in Section A.1.2 are not components of the Implantation Plan SR Document IOD. Table A.35.12-1 specifies the Modules of the Implantation Plan SR Document IOD.

A.35.12.3 Implantation Plan SR Document IOD Module Table

Table A.35.12-1. Implantation Plan SR Document IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Equipment	General Equipment	C.7.5.1	M
Equipment	Enhanced General Equipment	C.7.5.2	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

A.35.12.3.1 Implantation Plan SR Document IOD Content Constraints

A.35.12.3.1.1 Template Constraints

The document shall be constructed from TID 7000 “Implantation Plan” invoked at the root node.

Note

All Template and Context Group definitions are located in Annex A “Structured Reporting Templates (Normative)” in PS3.16 and Annex B “DCMR Context Groups (Normative)” in PS3.16, respectively.

A.35.12.3.1.2 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATE
UIDREF
PNAME
COMPOSITE
IMAGE
CONTAINER

A.35.12.3.1.3 Relationship Constraints

Relationships between content items in the content of this IOD may be conveyed by-value. Table A.35.12-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for Relationship Type definitions.

Table A.35.12-2. Relationship Content Constraints for Implantation Plan SR Document IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, CODE, NUM, UIDREF, COMPOSITE¹, IMAGE¹, CONTAINER
CONTAINER	HAS OBS CONTEXT	TEXT, CODE, NUM, DATE, UIDREF, PNAME, COMPOSITE¹
any type	HAS CONCEPT MOD	TEXT, CODE²
TEXT, CODE, NUM, IMAGE, UIDREF, COMPOSITE	HAS PROPERTIES	TEXT, CODE, NUM, UIDREF, IMAGE¹, COMPOSITE¹

Note

Which SOP Classes the IMAGE or COMPOSITE Value Type may refer to is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example, to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

A.35.13 Comprehensive 3D SR IOD

A.35.13.1 Comprehensive 3D SR Information Object Description

The Comprehensive 3D SR IOD is a superset of the Comprehensive SR IOD, which specifies a class of documents, the content of which may include textual and a variety of coded information, numeric measurement values, references to the SOP Instances and 2D or 3D spatial or temporal regions of interest within such SOP Instances. Relationships by-reference are enabled between Content Items.

A.35.13.2 Comprehensive 3D SR IOD Entity-Relationship Model

The E-R Model in Section A.1.2 applies to the Comprehensive 3D SR IOD. The IEs at the level of the Image IE in Section A.1.2 are not components of the Comprehensive 3D SR IOD. Table A.35.13-1 specifies the Modules of the Comprehensive 3D SR IOD.

A.35.13.3 Comprehensive 3D SR IOD Module Table

Table A.35.13-1. Comprehensive 3D SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
Patient	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
Series	Clinical Trial Series	C.7.3.2	U
Frame of Reference	Frame of Reference	C.7.4.1	U
Frame of Reference	Synchronization	C.7.4.2	U
Equipment	General Equipment	C.7.5.1	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

A.35.13.3.1 Comprehensive 3D SR IOD Content Constraints

A.35.13.3.1.1 Value Type

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):

Enumerated Values:

TEXT
CODE
NUM
DATETIME
DATE
TIME
UIDREF
PNAME
SCOORD
SCOORD3
TCOORD
COMPOSITE
IMAGE
WAVEFORM
CONTAINER

A.35.13.3.1.2 Relationship Constraints

Relationships between content items in the content of this IOD may be conveyed either by-value or by-reference. Table A.35.13-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for Relationship Type definitions.

Table A.35.13-2. Relationship Content Constraints for Comprehensive 3D SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, SCOORD, SCOORD3D, TCOORD, COMPOSITE¹, IMAGE¹, WAVEFORM¹, CONTAINER (see below).
TEXT, CODE, NUM, CONTAINER	HAS OBS CONTEXT	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, COMPOSITE¹
CONTAINER, IMAGE¹, WAVEFORM¹, COMPOSITE¹, NUM	HAS ACQ CONTEXT	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, CONTAINER.
any type	HAS CONCEPT MOD	TEXT, CODE²
TEXT, CODE, NUM	HAS PROPERTIES	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹, SCOORD, SCOORD3D, TCOORD, CONTAINER.
PNAME	HAS PROPERTIES	TEXT, CODE, DATETIME, DATE, TIME, UIDREF, PNAME
TEXT, CODE, NUM	INFERRED FROM	TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME, IMAGE¹, WAVEFORM¹, COMPOSITE¹, SCOORD, SCOORD3D, TCOORD, CONTAINER.
SCOORD	SELECTED FROM	IMAGE¹
TCOORD	SELECTED FROM	SCOORD, SCOORD3D, IMAGE¹, WAVEFORM¹

Note

Which SOP Classes the IMAGE, WAVEFORM or COMPOSITE Value Type may refer to, is documented in the Conformance Statement for an application (see PS3.2 and PS3.4).
The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.
SCOORD3D has no children, since its coordinates are patient rather than image-relative.

The HAS CONCEPT MOD and CONTAINS relationships shall not be conveyed by-reference.

Relationships by-reference to ancestor Content Items are forbidden in this IOD to prevent loops.

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