CP-1646 Add repeat flag and reason to RDSR to help with outlier analysis Status Letter Ballot Date of Last Update 2017/01/24 Person Assigned David Clunie Submitter Name David Clunie Submission Date 2016/06/10 Correction Number CP-1646 Log Summary: Add repeat flag and reason to RDSR to help with outlier analysis Name of Standard PS3.16 Rationale for Correction: Repetition of part of a CT study for reasons like patient motion or suboptimal contrast timing have been identified as reasons for radiation dose exposure being higher than usual for a procedure [Chen YA, MacGregor K, Li I, Concepcion L, Deva DP, Dowdell T, et al. Tracking and Resolving CT Dose Metric Outliers Using Root-Cause Analysis. Journal of the American College of Radiology. 2016 Jun;13(6):680–7. Available from .]. Knowledge of this information captured at the time of scanning would potentially reduce the number of outliers that needed to be investigated. It is proposed to add a per-event flag and reason to record this. Correction Wording: <informaltable rules="all" frame="box"> <tr> <td> <para><emphasis role="italic">Amend DICOM PS3.16 as follows (changes to existing text are bold and <emphasis role="bold"><emphasis role="underline" >underlined</emphasis></emphasis> for additions and <emphasis role="bold" ><emphasis role="strikethrough">struckthrough</emphasis></emphasis> for removals):</emphasis></para> </td> </tr> </informaltable> <section label="TID 10013" status="3" xml:id="sect_TID_10013"> <title>CT Irradiation Event Data ...
CT Irradiation Event Data
NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113819, DCM, "CT Acquisition") 1 M
2 > CONTAINS TEXT EV (125203, DCM, "Acquisition Protocol") 1 U
3 > CONTAINS CODE EV (123014, DCM, "Target Region") 1 M D
4 > CONTAINS CODE EV (113820, DCM, "CT Acquisition Type") 1 M D
4b >> CONTAINS CODE EV (113961, DCM, "Reconstruction Algorithm") 1-n U D
5 > CONTAINS CODE EV (G-C32C, SRT, "Procedure Context") 1 U D
6 > CONTAINS UIDREF EV (113769, DCM, "Irradiation Event UID") 1 M
6b > CONTAINS TEXT EV (113605, DCM, "Irradiation Event Label") 1 U
6c >> HAS CONCEPT MOD CODE EV (113606, DCM, "Label Type") 1 MC IF the value of Row 6b is the value of an Attribute in the images. D
6d > CONTAINS TEXT EV (ddd001, DCM, "Is Repeated Acquisition") 1 U D
6e >> HAS CONCEPT MOD CODE EV (ddd002, DCM, "Reason for Repeating Acquisition") 1 M D
7 > CONTAINS CONTAINER EV (113822, DCM, "CT Acquisition Parameters") 1 M
... ... ... ... ... ...
Content Item Descriptions Row 6d, 6e If an acquisition is a repeat because an earlier acquisition was unsatisfactory, this may be recorded along with a coded reason. This is intended to help with subsequent analysis by providing a priori information about why the study might be flagged as an outlier with higher dose exposure values than usual for the type of study.
Reason for Repeating Acquisition Type: Extensible Version: yyyymmdd
Reason for Repeating Acquisition
Coding Scheme Designator Code Value Code Meaning
DCM ddd003 Patient motion
DCM ddd004 Suboptimal contrast timing
Image Quality Finding Type: Extensible Version: 20090402
Image Quality Finding
Coding Scheme Designator Code Value Code Meaning
DCM 111208 Grid artifact(s)
DCM 111209 Positioning
DCM 111210 Motion blur
DCM 111211 Under exposed
DCM 111212 Over exposed
DCM 111213 No image
DCM 111214 Detector artifact(s)
DCM 111215 Artifact(s) other than grid or detector artifact
DCM 111216 Mechanical failure
DCM 111217 Electrical failure
DCM 111218 Software failure
DCM 111219 Inappropriate image processing
DCM 111220 Other failure
DCM 111221 Unknown failure
RADLEX RID11327 Beam-hardening artifact
Rejected for Quality Reasons Type: Extensible Version: 20020904
Rejected for Quality Reasons
Coding Scheme Designator Code Value Code Meaning
DCM 111207 Image artifact(s)
DCM 111208 Grid artifact(s)
DCM 111209 Positioning
DCM 111210 Motion blur
DCM 111211 Under exposed
DCM 111212 Over exposed
DCM 111213 No image
DCM 111214 Detector artifact(s)
DCM 111215 Artifact(s) other than grid or detector artifact
DCM 111216 Mechanical failure
DCM 111217 Electrical failure
DCM 111218 Software failure
DCM 111219 Inappropriate image processing
DCM 111220 Other failure
DCM 111221 Unknown failure
DCM 113026 Double exposure
Yes-No Type: Non-Extensible Version: 20060613
Yes-No
Coding Scheme Designator Code Value Code Meaning SNOMED-CT Concept ID UMLS Concept Unique ID
SRT R-0038D Yes 373066001 C1298907
SRT R-00339 No 373067005 C1298908
SRT R-0038A Undetermined 373068000 C3536725
DICOM Controlled Terminology Definitions (Normative)
DICOM Controlled Terminology Definitions
Code Value Code Meaning Definition Notes
111210 Motion blur Unacceptable image blur resulting from motion of the anatomy of interest during exposure or the inadequately compensated motion of X-Ray source with respect to the image detector during exposure.
ddd001 Is Repeated Acquisition This acquisition of data (e.g., for constructing an image) is a repeat of an earlier acquisition that was for some reason unsatisfactory,
ddd002 Reason for Repeating Acquisition The reason that data (e.g., for constructing an image) was acquired again.
ddd003 Patient motion The acquired data is unsatisfactory because the patient moved.
ddd004 Suboptimal contrast timing The acquired data is unsatisfactory because the contrast timing was not adequate.