F.3 Chest CAD SR Examples

The following is a simple and non-comprehensive illustration of an encoding of the Chest CAD SR IOD for chest computer aided detection results. For brevity, some mandatory content items are not included, such as several acquisition context content items for the images in the Image Library.

F.3.1 Example 1: Lung Nodule Detection With No Findings

A chest CAD device processes a typical screening chest case, i.e., there is one image and no nodule findings. Chest CAD runs lung nodule detection successfully and finds nothing.

The chest radiograph resembles:

Chest Radiograph as Described in Example 1

Figure F.3-1. Chest Radiograph as Described in Example 1


The content tree structure would resemble:

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1

Chest CAD Report

TID 4100

1.1

Image Library

TID 4100

1.1.1

IMAGE 1

TID 4020

1.1.1.1

Image View

Postero-anterior

TID 4020

1.1.1.2

Study Date

19980101

TID 4020

1.2

CAD Processing and Findings Summary

All algorithms succeeded; without findings

TID 4101

1.3

Summary of Detections

Succeeded

TID 4100

1.3.1

Successful Detections

TID 4015

1.3.1.1

Detection Performed

Nodule

TID 4017

1.3.1.1.1

Algorithm Name

"Lung Nodule Detector"

TID 4019

1.3.1.1.2

Algorithm Version

"V1.3"

TID 4019

1.3.1.1.3

Reference to node 1.1.1

TID 4017

1.4

Summary of Analyses

Not Attempted

TID 4100

F.3.2 Example 2: Lung Nodule Detection With Findings and Anatomy/pathology Interpretation

A chest CAD device processes a screening chest case with one image, and a lung nodule detected. The chest radiograph resembles:

Chest Radiograph as Described in Example 2

Figure F.3-2. Chest Radiograph as Described in Example 2


The content tree structure in this example is complex. Structural illustrations of portions of the content tree are placed within the content tree table to show the relationships of data within the tree. Some content items are duplicated (and shown in boldface) to facilitate use of the diagrams.

Content Tree Root of Example 2 Content Tree

Figure F.3-3. Content Tree Root of Example 2 Content Tree


The content tree structure would resemble:

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1

Chest CAD Report

TID 4100

1.1

Image Library

TID 4100

1.2

CAD Processing and Findings Summary

All algorithms succeeded; with findings

TID 4101

1.3

Summary of Detections

Succeeded

TID 4100

1.4

Summary of Analyses

Not Attempted

TID 4100

Image Library Branch of Example 2 Content Tree

Figure F.3-4. Image Library Branch of Example 2 Content Tree


Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.1

Image Library

TID 4100

1.1.1

IMAGE 1

TID 4020

1.1.1.1

Image View

Postero-anterior

TID 4020

1.1.1.2

Study Date

19990101

TID 4020

CAD Processing and Findings Summary Portion of Example 2 Content Tree

Figure F.3-5. CAD Processing and Findings Summary Portion of Example 2 Content Tree


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 4101

1.2.1

Single Image Finding

Abnormal Opacity

TID 4104

1.2.1.1

Single Image Finding Modifier

Nodule

TID 4104

1.2.1.2

Rendering Intent

Presentation Required:…

TID 4104

1.2.1.3

Algorithm Name

"Lung Nodule Detector"

TID 4019

1.2.1.4

Algorithm Version

"V1.3"

TID 4019

1.2.1.5

Center

POINT

TID 4107

1.2.1.5.1

Reference to Node 1.1.1

TID 4107

1.2.1.6

Outline

POLYLINE

TID 4107

1.2.1.6.1

Reference to Node 1.1.1

TID 4107

1.2.1.7

Diameter

2 cm

TID 1400

1.2.1.7.1

Path

POLYLINE

TID 1400

1.2.1.7.1.1

Reference to Node 1.1.1

TID 1400

Summary of Detections Portion of Example 2 Content Tree

Figure F.3-6. Summary of Detections Portion of Example 2 Content Tree


Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1.3

Summary of Detections

Succeeded

TID 4100

1.3.1

Successful Detections

TID 4015

1.3.1.1

Detection Performed

Nodule

TID 4017

1.3.1.1.1

Algorithm Name

"Lung Nodule Detector"

TID 4019

1.3.1.1.2

Algorithm Version

"V1.3"

TID 4019

1.3.1.1.3

Reference to node 1.1.1

TID 4017

F.3.3 Example 3: Lung Nodule Detection, Temporal Differencing With Findings

The patient in Example 2 returns for another chest radiograph. A more comprehensive chest CAD device processes the current chest radiograph, and analyses are performed that determine some temporally related content items for Composite Features. Portions of the prior chest CAD report (Example 2) are incorporated into this report. In the current chest radiograph the lung nodule has increased in size.

Chest radiographs as Described in Example 3

Figure F.3-8. Chest radiographs 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 Chest CAD SR instance (Example 2).

Node

Code Meaning of Concept Name

Code Meaning or Example Value

TID

1

Chest CAD Report

TID 4100

While the Image Library contains references to content tree items reused from the prior Chest CAD SR instance, the images are actually used in the chest 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 4100

1.1.1

IMAGE 1

TID 4020

1.1.1.1

Image View

Postero-anterior

TID 4020

1.1.1.2

Study Date

20000101

TID 4020

1.1.2

IMAGE 2

TID 4020

1.1.2.1

Image View

Postero-anterior

TID 4020

1.1.2.2

Study Date

19990101

TID 4020

The CAD processing and findings consist of one composite feature, comprised of single image findings, one from each year. The temporal relationship allows a quantitative temporal difference to be calculated:

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 4101

1.2.1

Composite Feature

Abnormal Opacity

TID 4102

1.2.1.1

Composite Feature Modifier

Nodule

TID 4102

1.2.1.2

Rendering Intent

Presentation Required: …

TID 4102

1.2.1.3

Algorithm Name

"Nodule Change"

TID 4019

1.2.1.4

Algorithm Version

"V2.3"

TID 4019

1.2.1.5

Composite Type

Target content items are related temporally

TID 4103

1.2.1.6

Scope of Feature

Feature detected on multiple images

TID 4103

1.2.1.7

Certainty of Feature

85%

TID 4103

1.2.1.8

Difference in size

2 cm

TID 4103

1.2.1.8.1

Reference to Node 1.2.1.9.8

TID 4103

1.2.1.8.2

Reference to Node 1.2.1.10.8

TID 4103

1.2.1.9

Single Image Finding

Abnormal Opacity

TID 4104

1.2.1.9.1

Single Image Finding Modifier

Nodule

TID 4104

1.2.1.9.2

Rendering Intent

Presentation Required: …

TID 4104

1.2.1.9.3

Tracking Identifier

"Watchlist #1"

TID 4108

1.2.1.9.4

Algorithm Name

"Lung Nodule Detector"

TID 4019

1.2.1.9.5

Algorithm Version

"V1.3"

TID 4019

1.2.1.9.6

Center

POINT

TID 4107

1.2.1.9.6.1

Reference to Node 1.1.1

TID 4107

1.2.1.9.7

Outline

POLYLINE

TID 4107

1.2.1.9.7.1

Reference to Node 1.1.1

TID 4107

1.2.1.9.8

Diameter

4 cm

TID 1400

1.2.1.9.8.1

Path

POLYLINE

TID 1400

1.2.1.9.8.1.1

Reference to Node 1.1.1

TID 1400

1.2.1.10

Single Image Finding

Abnormal Opacity

TID 4104

1.2.1.10.1

Single Image Finding Modifier

Nodule

TID 4104

1.2.1.10.2

Rendering Intent

Presentation Required: …

TID 4104

1.2.1.10.3

[Observation Context content items]

TID 4022

1.2.1.10.4

Algorithm Name

"Lung Nodule Detector"

TID 4019

1.2.1.10.5

Algorithm Version

"V1.3"

TID 4019

1.2.1.10.6

Center

POINT

TID 4107

1.2.1.10.6.1

Reference to Node 1.1.2

TID 4107

1.2.1.10.7

Outline

POLYLINE

TID 4107

1.2.1.10.7.1

Reference to Node 1.1.2

TID 4107

1.2.1.10.8

Diameter

2 cm

TID 1400

1.2.1.10.8.1

Path

POLYLINE

TID 1400

1.2.1.10.8.1.1

Reference to Node 1.1.2

TID 1400

1.3

Summary of Detections

Succeeded

TID 4100

1.3.1

Successful Detections

TID 4015

1.3.1.1

Detection Performed

Nodule

TID 4017

1.3.1.1.1

Algorithm Name

"Lung Nodule Detector"

TID 4019

1.3.1.1.2

Algorithm Version

"V1.3"

TID 4019

1.3.1.1.3

Reference to node 1.1.1

TID 4017

1.4

Summary of Analyses

Succeeded

TID 4100

1.4.1

Successful Analyses

TID 4016

1.4.1.1

Analysis Performed

"Temporal correlation"

TID 4018

1.4.1.1.1

Algorithm Name

"Nodule Change"

TID 4019

1.4.1.1.2

Algorithm Version

"V2.3"

TID 4019

1.4.1.1.3

Reference to node 1.1.1

TID 4018

1.4.1.1.4

Reference to node 1.1.2

TID 4018

F.3.4 Example 4: Lung Nodule Detection in Chest Radiograph, Spatially Correlated With CT

The patient in Example 3 is called back for CT to confirm the Lung Nodule found in Example 3. The patient undergoes CT of the Thorax and the initial chest radiograph and CT slices are sent to a more comprehensive CAD device for processing. Findings are detected and analyses are performed that correlate findings from the two data sets. Portions of the prior CAD report (Example 3) are incorporated into this report.

Chest Radiograph and CT slice as described in Example 4

Figure F.3-9. Chest Radiograph and CT slice as described in Example 4


Italicized entries (xxx) in the following table denote references to or by-value inclusion of content tree items reused from the prior Chest CAD SR instance (Example 3).

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1

Chest CAD Report

TID 4100

1.1

Language of Content Item and Descendants

English

TID 1204

1.2

Image Library

TID 4100

1.3

CAD Processing and Findings Summary

All algorithms succeeded; with findings

TID 4101

1.4

Summary of Detections

Succeeded

TID 4100

1.5

Summary of Analyses

Succeeded

TID 4100

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

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.2

Image Library

TID 4100

1.2.1

IMAGE 1

TID 4020

1.2.1.1

Image View

Postero-anterior

TID 4020

1.2.1.2

Study Date

20000101

TID 4020

Most recent examination content:

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.3

CAD Processing and Findings Summary

All algorithms succeeded; with findings

TID 4101

1.3.1

Composite Feature

Abnormal opacity

TID 4102

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.3.1

Composite Feature

Abnormal opacity

TID 4102

1.3.1.1

Composite Feature Modifier

Nodule

TID 4102

1.3.1.2

Rendering Intent

Presentation Required: …

TID 4102

1.3.1.3

Tracking Identifier

"Watchlist #1"

TID 4108

1.3.1.4

Algorithm Name

"Chest/CT Correlator"

TID 4019

1.3.1.5

Algorithm Version

"V2.1"

TID 4019

1.3.1.6

Composite type

Target content items are related spatially

TID 4103

1.3.1.7

Scope of Feature

Feature detected on images from multiple modalities

TID 4103

1.3.1.8

Diameter

4 cm

TID 1400

1.3.1.8.1

Path

TID 1400

1.3.1.8.1.1

IMAGE 3 [CT slice 104]

TID 1400

1.3.1.9

Volume estimated from single 2D region

3.2 cm3

TID 1402

1.3.1.9.1

Perimeter Outline

TID 1402

1.3.1.9.1.1

IMAGE 3 [CT slice 104]

TID 1402

1.3.1.10

Size Descriptor

Small

TID 4105

1.3.1.11

Border Shape

Lobulated

TID 4105

1.3.1.12

Location in Chest

Mid lobe

TID 4105

1.3.1.13

Laterality

Right

TID 4105

1.3.1.14

Composite Feature

Abnormal opacity

TID 4102

1.3.1.15

Single Image Finding

Abnormal opacity

TID 4104

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.3.1.14

Composite Feature

Abnormal opacity

TID 4102

1.3.1.14.1

Composite Feature Modifier

Nodule

TID 4102

1.3.1.14.2

Rendering Intent

Presentation Required: …

TID 4102

1.3.1.14.3

Tracking Identifier

"Nodule #1"

TID 4108

1.3.1.14.4

Algorithm Name

"Nodule Builder"

TID 4019

1.3.1.14.5

Algorithm Version

"V1.4"

TID 4019

1.3.1.14.6

Composite type

Target content items are related spatially

TID 4103

1.3.1.14.7

Scope of Feature

Feature detected on multiple images

TID 4103

1.3.1.14.8

Diameter

4 cm

TID 1400

1.3.1.14.9

Volume estimated from single 2D region

3.2 cm3

TID 1402

1.3.1.14.10

Single Image Finding

Abnormal opacity

TID 4104

1.3.1.14.11

Single Image Finding

Abnormal opacity

TID 4104

1.3.1.14.12

Single Image Finding

Abnormal opacity

TID 4104

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.3.1.14.10

Single Image Finding

Abnormal opacity

TID 4104

1.3.1.14.10.1

Single Image Finding Modifier

Nodule

TID 4104

1.3.1.14.10.2

Rendering Intent

Presentation Required: …

TID 4104

1.3.1.14.10.3

Tracking Identifier

"Detection #1"

TID 4108

1.3.1.14.10.4

Algorithm Name

"CT Nodule Detector"

TID 4019

1.3.1.14.10.5

Algorithm Version

"V2.5"

TID 4019

1.3.1.14.10.6

Center

POINT

TID 4107

1.3.1.14.10.6.1

IMAGE 2 [CT slice 103]

TID 4107

1.3.1.14.10.7

Outline

POLYLINE

TID 4107

1.3.1.14.10.7.1

IMAGE 2 [CT slice 103]

TID 4107

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.3.1.14.11

Single Image Finding

Abnormal opacity

TID 4104

1.3.1.14.11.1

Single Image Finding Modifier

Nodule

TID 4104

1.3.1.14.11.2

Rendering Intent

Presentation Required: …

TID 4104

1.3.1.14.11.3

Tracking Identifier

"Detection #2"

TID 4108

1.3.1.14.11.4

Algorithm Name

"CT Nodule Detector"

TID 4019

1.3.1.14.11.5

Algorithm Version

"V2.5"

TID 4019

1.3.1.14.11.6

Center

POINT

TID 4107

1.3.1.14.11.6.1

IMAGE 3 [CT slice 104]

TID 4107

1.3.1.14.11.7

Outline

POLYLINE

TID 4107

1.3.1.14.11.7.1

IMAGE 3 [CT slice 104]

TID 4107

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.3.1.14.12

Single Image Finding

Abnormal opacity

TID 4104

1.3.1.14.12.1

Single Image Finding Modifier

Nodule

TID 4104

1.3.1.14.12.2

Rendering Intent

Presentation Required: …

TID 4104

1.3.1.14.12.3

Tracking Identifier

"Detection #3"

TID 4108

1.3.1.14.12.4

Algorithm Name

"CT Nodule Detector"

TID 4019

1.3.1.14.12.5

Algorithm Version

"V2.5"

TID 4019

1.3.1.14.12.6

Center

POINT

TID 4107

1.3.1.14.12.6.1

IMAGE 4 [CT slice 105]

TID 4107

1.3.1.14.12.7

Outline

POLYLINE

TID 4107

1.3.1.14.12.7.1

IMAGE 4 [CT slice 105]

TID 4107

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.3.1.15

Single Image Finding

Abnormal opacity

TID 4104

1.3.1.15.1

Single Image Finding Modifier

Nodule

TID 4104

1.3.1.15.2

Rendering Intent

Presentation Required: …

TID 4104

1.3.1.15.3

Tracking Identifier

"Watchlist #1"

TID 4108

1.3.1.15.4

[Observation Context content items]

TID 4022

1.3.1.15.5

Algorithm Name

"Lung Nodule Detector"

TID 4019

1.3.1.15.6

Algorithm Version

"V1.3"

TID 4019

1.3.1.15.7

Center

POINT

TID 4107

1.3.1.15.7.1

Reference to node 1.2.1

TID 4107

1.3.1.15.8

Outline

POLYLINE

TID 4107

1.3.1.15.8.1

Reference to node 1.2.1

TID 4107

1.3.1.15.9

Diameter

4 cm

TID 1400

1.3.1.15.9.1

Path

POLYLINE

TID 1400

1.3.1.15.9.1.1

Reference to Node 1.2.1

TID 1400

Node

Code Meaning of Concept Name

Code Meaning of Example Value

TID

1.4

Summary of Detections

Succeeded

TID 4100

1.4.1

Successful Detections

TID 4015

1.4.1.1

Detection Performed

Nodule

TID 4017

1.4.1.1.1

Algorithm Name

"CT Nodule Detector"

TID 4019

1.4.1.1.2

Algorithm Version

"V2.5"

TID 4019

1.4.1.1.3

IMAGE 2 [CT slice 103]

TID 4017

1.4.1.1.4

IMAGE 3 [CT slice 104]

TID 4017

1.4.1.1.5

IMAGE 4 [CT slice 105]

TID 4017

1.5

Summary of Analyses

Succeeded

TID 4100

1.5.1

Successful Analyses

TID 4016

1.5.1.1

Analysis Performed

"Spatial colocation analysis"

TID 4018

1.5.1.1.1

Algorithm Name

"Chest/CT Correlator"

TID 4019

1.5.1.1.2

Algorithm Version

"V2.1"

TID 4019

1.5.1.1.3

Reference to node 1.2.1

TID 4018

1.5.1.1.4

IMAGE 2 [CT slice 103]

TID 4018

1.5.1.1.5

IMAGE 3 [CT slice 104]

TID 4018

1.5.1.1.6

IMAGE 4 [CT slice 105]

TID 4018

1.5.1.2

Analysis Performed

"Spatial colocation analysis"

TID 4018

1.5.1.2.1

Algorithm Name

"Nodule Builder"

TID 4019

1.5.1.2.2

Algorithm Version

"V1.4"

TID 4019

1.5.1.2.3

IMAGE 2 [CT slice 103]

TID 4018

1.5.1.2.4

IMAGE 3 [CT slice 104]

TID 4018

1.5.1.2.5

IMAGE 4 [CT slice 105]

TID 4018