Chest CAD SR IOD Templates 

The templates that comprise the Chest CAD SR IOD are interconnected as in Figure A-9.

Chest CAD SR IOD Template Structure

Figure A-9. Chest CAD SR IOD Template Structure


In Figure A-9, '···' indicates possible recursive application of subordinate templates.

TID 4100 Chest CAD Document Root

This template forms the top of a content tree that allows a chest CAD device to describe the results of detection and analysis of chest evidence. This template, together with its subordinate templates, describes both the results for presentation to radiologists and partial product results for consumption by chest CAD devices in subsequent chest CAD reports.

This template defines a Container that contains an Image Library, the CAD results, and summaries of the detection and analysis algorithms performed. The Image Library contains the Image SOP Class and Instance UIDs, and selected attributes for each image referenced in either the algorithm summaries or chest CAD results.

The atomic CAD results of Single Image Findings and Composite Features are described in the Chest CAD Findings Summary sub-tree.

The Summary of Detections and Summary of Analyses sub-trees gather lists of algorithms attempted, grouped by success/failure status. Algorithms not attempted are not mentioned in these sub-trees. This information forms the basis for understanding why a chest CAD report may produce no (or fewer than anticipated) results. Chest CAD results are constructed bottom-up, starting from Single Image Findings (see TID 4104 “Chest CAD Single Image Finding”), associated as Composite Features (see TID 4102 “Chest CAD Composite Feature”).

See Figure F.1-1 “Top Levels of Chest CAD SR Content Tree” in PS3.17 .

Type:

Non-Extensible

Order:

Significant

Root:

Yes

Table TID 4100. Chest CAD Document Root

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (112000, DCM, "Chest CAD Report")

1

M

Root node

2

>

HAS CONCEPT MOD

INCLUDE

DTID 1204 “Language of Content Item and Descendants”

1

M

3

>

CONTAINS

CONTAINER

EV (111028, DCM, "Image Library")

1

U

4

>>

CONTAINS

INCLUDE

DTID 4020 “CAD Image Library Entry”

1-n

M

$ImageLaterality = DCID 244 "Laterality"

$ImageView = DCID 4010 “DX View”

$ImageViewMod = DCID 4011 “DX View Modifier”

5

>

CONTAINS

INCLUDE

DTID 4101 “Chest CAD Findings Summary”

1

M

6

>

CONTAINS

CODE

EV (111064, DCM, "Summary of Detections")

1

M

DCID 6042 “Status of Results”

7

>>

INFERRED FROM

INCLUDE

DTID 4015 “CAD Detections Performed”

1

MC

Shall be present unless the value of row 6 is (111225, DCM, "Not Attempted")

$DetectionCode = DCID 6101 “Chest Finding Or Feature”, DCID 6102 “Chest Finding Or Feature Modifier”

8

>

CONTAINS

CODE

EV (111065, DCM, "Summary of Analyses")

1

M

DCID 6042 “Status of Results”

9

>>

INFERRED FROM

INCLUDE

DTID 4016 “CAD Analyses Performed”

1

MC

Shall be present unless the value of row 8 is (111225, DCM, "Not Attempted")

$AnalysisCode = DCID 6137 “Types of CAD Analysis”


Content Item Descriptions

Image Library

The "Image Library" section of the Content Tree (TID 4100 “Chest CAD Document Root”, row 3) may include all Image SOP Instances from the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module. If a portion of another instance of a Chest CAD SR IOD is duplicated in the "Chest CAD Findings Summary" section of the Content Tree, the "Image Library" may also include all Image Library Entries referenced from the duplicated portions of the Chest CAD SR.

The Image Library is intended to be used in cases where the acquisition context content items differ from image to image, such as different views and/or laterality in projection X-Ray.

Detections Performed

The "Detections Performed" and "Analyses Performed" sections of the Content Tree (TID 4100 “Chest CAD Document Root”, rows 7 and 9) together shall reference all Image SOP Instances included in the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module.

Analyses Performed

TID 4101 Chest CAD Findings Summary

The contents of this template describe the findings and aggregate features that the chest CAD device detected for the chest evidence presented. This template forms the chest CAD results sub-tree of the Chest CAD Document Root (TID 4100 “Chest CAD Document Root”). The data from which the details are inferred are expressed in the Composite Features (see TID 4102 “Chest CAD Composite Feature”) and/or Single Image Findings (see TID 4104 “Chest CAD Single Image Finding”), of which there may be several.

The sub-tree headed by this template is illustrated in Figure F.1-2 “Example of CAD Processing and Findings Summary Sub-Tree of Chest CAD SR Content Tree” in PS3.17 .

Type:

Non-Extensible

Order:

Significant

Table TID 4101. Chest CAD Findings Summary

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (111017, DCM, "CAD Processing and Findings Summary")

1

M

DCID 6047 “CAD Processing and Findings Summary”

2

>

INFERRED FROM

INCLUDE

DTID 4102 “Chest CAD Composite Feature”

1-n

U

3

>

INFERRED FROM

INCLUDE

DTID 4104 “Chest CAD Single Image Finding”

1-n

U

4

>

HAS PROPERTIES

INCLUDE

DTID 4106 “Response Evaluation”

1-n

U


Content Item Descriptions

CAD Processing and Findings Summary

This code value is used to express if and why the Chest CAD Findings Summary sub-tree is empty. The Summary of Detections and Summary of Analyses sub-trees of the Document Root node contain detail about which (if any) algorithms succeeded or failed.

If the code value indicates that there were no findings, then the code value can be used to determine whether chest CAD processing occurred successfully, without parsing the Summary of Detections and Summary of Analyses sub-trees.

TID 4102 Chest CAD Composite Feature

This template collects a composite feature for a lesion, anatomy, non-lesion object, or correlation of related objects (see TID 4101 “Chest CAD Findings Summary”). The details of the composition are expressed in the Chest CAD Composite Feature Body (see TID 4103 “Chest CAD Composite Feature Body”). The data from which the details are inferred, are expressed in the Composite Features (see TID 4102 “Chest CAD Composite Feature”) and/or Single Image Findings (see TID 4104 “Chest CAD Single Image Finding”), of which there may be several.

A Composite Feature shall be INFERRED FROM any combination of two or more Composite Features or Single Image Findings or mixture thereof.

Type:

Non-Extensible

Order:

Significant

Table TID 4102. Chest CAD Composite Feature

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (111015, DCM, "Composite Feature")

1

M

DCID 6101 “Chest Finding Or Feature”

2

>

HAS CONCEPT MOD

CODE

EV (112023, DCM, "Composite Feature Modifier")

1

U

DCID 6102 “Chest Finding Or Feature Modifier”

3

>

HAS CONCEPT MOD

TEXT

EV (112050, DCM, "Anatomic Identifier")

1

U

4

>

HAS CONCEPT MOD

CODE

EV (112003, DCM, "Associated Chest Component")

1

MC

Shall be present IFF value of row 1 is (112005, DCM, "Radiographic anatomy")

DCID 6100 “Chest Component Categories”

5

>

HAS CONCEPT MOD

CODE

EV (112037, DCM, "Non-lesion Modifier")

1

UC

May be present IFF value of row 1 is (111102, DCM, "Non-lesion")

DCID 6139 “Non-lesion Modifiers”

6

>

HAS CONCEPT MOD

CODE

EV (112038, DCM, "Osseous Modifier")

1

UC

May be present IFF value of row 2 is from DCID 6114 “Osseous Anatomy Finding Or Feature”

DCID 6115 “Osseous Anatomy Modifiers”

7

>

HAS CONCEPT MOD

CODE

EV (111056, DCM, "Rendering Intent")

1

M

DCID 6034 “Intended Use of CAD Output”

8

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U

9

>

HAS OBS CONTEXT

CODE

EV (112016, DCM, "Baseline Category")

1

U

DCID 6145 “Baseline Category”

10

>

HAS OBS CONTEXT

INCLUDE

DTID 4022 “CAD Observation Context”

1

MC

Shall be present IFF this feature is duplicated from a different report than its parent.

11

>

HAS OBS CONTEXT

INCLUDE

DTID 4019 “CAD Algorithm Identification”

1

M

12

>

HAS PROPERTIES

INCLUDE

DTID 4103 “Chest CAD Composite Feature Body”

1

M

13

>

INFERRED FROM

INCLUDE

DTID 4102 “Chest CAD Composite Feature”

1-n

MC

At least two items shall be present: two of row 13, two of row 14, or one of each.

14

>

INFERRED FROM

INCLUDE

DTID 4104 “Chest CAD Single Image Finding”

1-n

MC

At least two items shall be present: two of row 13, two of row 14, or one of each.


Content Item Descriptions

Anatomic Identifier

An identifier of an anatomic feature when a multiplicity of features of that type may be present, such as "Rib 1", "Rib 2" or thoracic vertebrae "T1" or "T2".

Rendering Intent

This content item constrains the SCP receiving the Chest CAD SR IOD in its use of the contents of this template and its target content items. Chest CAD devices may opt to use data marked "Not for Presentation" or "Presentation Optional" as input to subsequent chest CAD processing steps. Refer to Section O.2 “Structured Reporting Storage SOP Class SCU and SCP Behavior” in PS3.4 .

TID 4103 Chest CAD Composite Feature Body

The details of a composite feature are expressed in this template. It is applied to Chest CAD Composite Feature (TID 4102 “Chest CAD Composite Feature”).

Type:

Non-Extensible

Order:

Significant

Table TID 4103. Chest CAD Composite Feature Body

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (111016, DCM, "Composite type")

1

M

DCID 6035 “Composite Feature Relations”

2

CODE

EV (111057, DCM, "Scope of Feature")

1

M

DCID 6036 “Scope of Feature”

3

NUM

EV (111011, DCM, "Certainty of feature")

1

U

UNITS = EV (%, UCUM, "Percent")

Value = 0 - 100

4

INCLUDE

DTID 4107 “Chest CAD Geometry”

1

U

5

INCLUDE

DTID 1400 “Linear Measurement”

1-n

U

6

INCLUDE

DTID 1401 “Area Measurement”

1-n

U

7

INCLUDE

DTID 1402 “Volume Measurement”

1-n

U

8

INCLUDE

DTID 4105 “Chest CAD Descriptors”

1

U

9

NUM

DCID 6133 “Chest Quantitative Temporal Difference Type”

1-n

UC

May be present IFF the value of row 1 is (111153, DCM, "Target content items are related temporally")

10

>

R-INFERRED FROM

NUM

2

U

The referenced numeric values shall have the same Concept Name. Their UNITS shall be the same as row 9

11

CODE

EV (111049, DCM, "Qualitative Difference")

1-n

UC

May be present only if the value of row 1 is (111153, DCM, "Target content items are related temporally")

DCID 6134 “Chest Qualitative Temporal Difference Type”

12

>

HAS PROPERTIES

TEXT

EV (111021, DCM, "Description of Change")

1

U

13

>

R-INFERRED FROM

CODE

2

M

The referenced content items shall have the same Concept Name and their code values shall be from the same context group.


Content Item Descriptions

Certainty of Feature

The certainty of the CAD device that the feature analyzed and classified by the CODE, as specified in the Composite Feature parent template, is in fact that type of feature.

Volume Measurement

If dimensions for a volume are to be stated in terms of length, width, and depth, then one shall use 3 instances of TID (1400) Linear Measurement.

Row 9

Values ≤ 0 are allowed. The two referenced numeric values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature. Given the equation, A - B, the value representing A shall be referenced first.

Qualitative Difference

The two referenced code values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature.

TID 4104 Chest CAD Single Image Finding

This template describes a single image finding for a lesion or other object. The details of the finding are expressed in this template and/or more specific templates.

Type:

Non-Extensible

Order:

Significant

Table TID 4104. Chest CAD Single Image Finding

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (111059, DCM, "Single Image Finding")

1

M

DCID 6101 “Chest Finding Or Feature”

2

>

HAS CONCEPT MOD

CODE

EV (112024, DCM, "Single Image Finding Modifier")

1

U

DCID 6102 “Chest Finding Or Feature Modifier”

3

>

HAS CONCEPT MOD

TEXT

EV (112050, DCM, "Anatomic Identifier")

1

U

4

>

HAS CONCEPT MOD

CODE

EV (112003, DCM, "Associated Chest Component")

1

MC

Shall be present IFF value of row 1 is (112005, DCM, "Radiographic anatomy")

DCID 6100 “Chest Component Categories”

5

>

HAS CONCEPT MOD

CODE

EV (112037, DCM, "Non-lesion Modifier")

1

UC

May be present IFF value of row 1 is (111102, DCM, "Non-lesion")

DCID 6139 “Non-lesion Modifiers”

6

>

HAS CONCEPT MOD

CODE

EV (111056, DCM, "Rendering Intent")

1

M

DCID 6034 “Intended Use of CAD Output”

7

>>

HAS PROPERTIES

NUM

EV (111071, DCM, "CAD Operating Point")

1

UC

IFF value of row 6 is (111151, DCM, "Presentation Optional") and row 1 of TID 4023 “CAD Operating Points” is present for the finding identified in row 1

UNITS = DT ({1:n}, UCUM, "range: 1:n"), where n is the maximum specified in Row 1 of TID 4023 “CAD Operating Points” for the finding identified in row 1. Value is restricted to being an integer

8

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U

9

>

HAS OBS CONTEXT

CODE

EV (112016, DCM, "Baseline Category")

1

U

DCID 6145 “Baseline Category”

10

>

HAS OBS CONTEXT

INCLUDE

DTID 4022 “CAD Observation Context”

1

MC

Shall be present IFF this finding is duplicated from a different report than its parent.

11

>

HAS OBS CONTEXT

INCLUDE

DTID 4019 “CAD Algorithm Identification”

1

M

12

>

HAS PROPERTIES

NUM

EV (111012, DCM, "Certainty of Finding")

1

U

UNITS = EV (%, UCUM, "Percent")

Value = 0 - 100

13

>

HAS PROPERTIES

TEXT

EV (111058, DCM, "Selected Region Description")

1

MC

Shall be present IFF value of row 1 is (111099, DCM, "Selected region")

14

>

HAS PROPERTIES

INCLUDE

DTID 4107 “Chest CAD Geometry”

1

MC

Shall be present unless value of row 1 is (111101, DCM, "Image quality")

15

>

HAS PROPERTIES

INCLUDE

DTID 1400 “Linear Measurement”

1-n

U

16

>

HAS PROPERTIES

INCLUDE

DTID 1401 “Area Measurement”

1-n

U

17

>

HAS PROPERTIES

INCLUDE

DTID 1402 “Volume Measurement”

1-n

U

18

>

HAS PROPERTIES

INCLUDE

DTID 4105 “Chest CAD Descriptors”

1

U

19

>

INFERRED FROM

IMAGE

1

MC

Shall be present IFF value of row 1 is (111101, DCM, "Image quality") and rows 20 and 21 are not present

20

>

R-INFERRED FROM

IMAGE

1

MC

Shall be present IFF value of row 1 is (111101, DCM, "Image quality") and rows 19 and 21 are not present

Shall reference an IMAGE content item in the (111028, DCM, "Image Library")

21

>

INFERRED FROM

SCOORD

EV (111030, DCM, "Image Region")

1-n

MC

Shall be present IFF value of row 1 is (111101, DCM, "Image quality") and rows 19 and 20 are not present

22

>>

SELECTED FROM

IMAGE

1

MC

XOR row 23

All the row 21 content items in a single invocation of this template shall reference the same IMAGE

23

>>

R-SELECTED FROM

IMAGE

1

MC

XOR row 22

All the row 21 content items in a single invocation of this template shall reference the same IMAGE content item in the (111028, DCM, "Image Library")

24

>

HAS PROPERTIES

INCLUDE

DTID 4014 “CAD Image Quality”

1

MC

Shall be present IFF value of row 1 is (111101, DCM, "Image quality")

$QualityFinding = DCID 6135 “Image Quality Finding”

$QualityStandard = DCID 6136 “Chest Types of Quality Control Standard”


Content Item Descriptions

Anatomic Identifier

An identifier of an anatomic feature when a multiplicity of features of that type may be present, such as "Rib 1", "Rib 2" or thoracic vertebrae "T1" or "T2".

Rendering Intent

This content item constrains the SCP receiving the Chest CAD SR IOD in its use of the contents of this template and its target content items. Chest CAD devices may opt to use data marked "Not for Presentation" or "Presentation Optional" as input to subsequent chest CAD processing steps. Refer to Section O.2 “Structured Reporting Storage SOP Class SCU and SCP Behavior” in PS3.4 .

CAD Operating Point

Additional information to use when Rendering Intent is "Presentation Optional". A CAD Operating Point of zero is not sent, and is encoded as a Rendering Intent of "Presentation Required". See Section O.2 “Structured Reporting Storage SOP Class SCU and SCP Behavior” in PS3.4 and Section E.4 “CAD Operating Point” in PS3.17 .

Certainty of Finding

The certainty of the CAD device that the finding detected and classified by the Single Image Finding CODE specified is in fact that type of finding.

TID 4105 Chest CAD Descriptors

This template provides qualitative detail for a Single Image Finding or Composite Feature. It is applied to Chest CAD Composite Feature (TID 4102 “Chest CAD Composite Feature”) and Chest CAD Single Image Finding (TID 4104 “Chest CAD Single Image Finding”).

Type:

Non-Extensible

Order:

Significant

Table TID 4105. Chest CAD Descriptors

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (112025, DCM, "Size Descriptor")

1

U

DCID 6118 “Size Descriptor”

2

CODE

EV (112026, DCM, "Width Descriptor")

1

U

DCID 6107 “Width Descriptor”

3

CODE

EV (112015, DCM, "Border shape")

1

U

DCID 6119 “Chest Border Shape”

4

CODE

EV (112007, DCM, "Border definition")

1

U

DCID 6120 “Chest Border Definition”

5

CODE

EV (112014, DCM, "Orientation Descriptor")

1

U

DCID 6121 “Chest Orientation Descriptor”

6

CODE

EV (112009, DCM, "Type of Content")

1-n

U

DCID 6122 “Chest Content Descriptor”

7

CODE

EV (112027, DCM, "Opacity Descriptor")

1

U

DCID 6123 “Chest Opacity Descriptor”

8

CODE

EV (112013, DCM, "Location in Chest")

1

U

DCID 6124 “Location in Chest”

9

CODE

EV (G-C171, SRT, "Laterality")

1

U

DCID 244 “Laterality”

10

CODE

EV (112006, DCM, "Distribution Descriptor")

1-n

U

DCID 6128 “Chest Distribution Descriptor”

11

CODE

EV (112028, DCM, "Abnormal Distribution of Anatomic Structure")

1

U

DCID 6108 “Chest Anatomic Structure Abnormal Distribution”

12

CODE

EV (112008, DCM, "Site involvement")

1-n

U

DCID 6129 “Chest Site Involvement”

13

CODE

EV (G-C197, SRT, "Severity")

1

U

DCID 6130 “Severity Descriptor”

14

CODE

EV (112010, DCM, "Texture Descriptor")

1

U

DCID 6131 “Chest Texture Descriptor”

15

CODE

EV (112030, DCM, "Calcification Descriptor")

1

U

DCID 6132 “Chest Calcification Descriptor”

16

NUM

DCID 6142 “Calculated Value”

1-n

U

17

>

HAS CONCEPT MOD

CODE

EV (121401, DCM, "Derivation")

1

M

DCID 6140 “Calculation Methods”

18

>

INFERRED FROM

NUM

EV (112032, DCM, "Threshold Attenuation Coefficient")

1

U

UNITS = EV ([hnsf'U], UCUM, "Hounsfield unit")

19

>

INFERRED FROM

TEXT

EV (112034, DCM, "Calculation Description")

1

U

20

NUM

DCID 6141 “Attenuation Coefficient Measurements”

1-n

U

UNITS = EV ([hnsf'U], UCUM, "Hounsfield unit")


TID 4106 Response Evaluation

This template provides a means to report response evaluation to cancer treatment, based on a method such as RECIST or WHO.

Type:

Non-Extensible

Order:

Significant

Table TID 4106. Response Evaluation

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (112020, DCM, "Response Evaluation")

1

M

2

>

HAS OBS CONTEXT

CODE

EV (112021, DCM, "Response Evaluation Method")

1

M

DT (112022, DCM, "RECIST") or

DT (112029, DCM, "WHO")

3

>

CONTAINS

CODE

EV (112048, DCM, "Current Response")

1

U

DCID 6143 “Response Criteria”

4

>

CONTAINS

CODE

EV (112049, DCM, "Best Overall Response")

1

U

DCID 6143 “Response Criteria”

5

>

CONTAINS

NUM

EV (112051, DCM, "Measurement of Response")

1

U

UNITS not specified


TID 4107 Chest CAD Geometry

All geometry template invocations require specification of either the location of the center of the object, the outline, or both. Geometry is a property of single image findings (see TID 4104 “Chest CAD Single Image Finding”) and composite features (see TID 4103 “Chest CAD Composite Feature Body”).

Type:

Non-Extensible

Order:

Significant

Table TID 4107. Chest CAD Geometry

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

SCOORD

EV (111010, DCM, "Center")

1

MC

At least one of rows 1, 4 shall be present.

GRAPHIC TYPE = {POINT}

2

>

SELECTED FROM

IMAGE

1

MC

XOR row 3

3

>

R-SELECTED FROM

IMAGE

1

MC

XOR row 2

Shall reference an IMAGE content item in the (111028, DCM, "Image Library")

4

SCOORD

EV (111041, DCM, "Outline")

1

MC

At least one of rows 1, 4 shall be present.

5

>

SELECTED FROM

IMAGE

1

MC

XOR row 6

Shall reference the same content item as row 2

6

>

R-SELECTED FROM

IMAGE

1

MC

XOR row 5

Shall reference the same content item as row 3


TID 4108 Tracking Identifier

This template provides a means to identify an object for longitudinal tracking, potentially across multiple Structured Reports, over time.

Type:

Non-Extensible

Order:

Significant

Table TID 4108. Tracking Identifier

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

TEXT

EV (112039, DCM, "Tracking Identifier")

1

MC

At least one of row 1 or 2 shall be present.

A string of characters with case being non-significant. Leading and trailing spaces and control characters are forbidden.

2

UIDREF

EV (112040, DCM, "Tracking Unique Identifier")

1

MC

At least one of row 1 or 2 shall be present.


Content Item Descriptions

Tracking Identifier

A human readable identifier for longitudinal tracking, e.g., "Watchlist Nodule 1".

Tracking Unique Identifier

This is distinct from the Observation UID (0040,A171) that may be present in the data set for each content item, which identifies only a specific observation, not an object tracked over time, and each tracked object may have many observations.