CP-1845 Add description and example for ROI distance measurements with coordinates Status Jan 2019 Voting Packet Date of Last Update 2018/11/12 Person Assigned David Clunie Submitter Name QIICR Submission Date 2018/07/07 Correction Number CP-1845 Log Summary: Add description and example for ROI distance measurements with coordinates Name of Standard PS3.16, PS3.17 Rationale for Correction: CP 1386 added planar and volumetric ROI measurement examples to PS3.17 and illustrated how to encode related linear distance measurements such as for RECIST or WHO when there were no end points specified, but did not show how to encode linear distance measurements for the same ROIs with explicit end point coordinates. 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 1500" status="3" xml:id="sect_TID_1500"> <title>Measurement Report This Root Template encodes a list of Measurement Groups each containing lists of measurements, together with any derived measurements. Each Measurement Group is identified by Tracking ID and UIDs. An image library is available to describe characteristics of the images referenced by the measurements, if any. Type: Extensible Order: Non-Significant Root: Yes
Measurement Report
NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER D 1 M Root node
2 > HAS CONCEPT MOD INCLUDE D 1 M
3 > HAS OBS CONTEXT INCLUDE D 1 M
4 > HAS CONCEPT MOD CODE EV (121058, DCM, "Procedure reported") 1-n M B
5 > CONTAINS INCLUDE D 1 M
6 > CONTAINS CONTAINER EV (126010, DCM, "Imaging Measurements") 1 C IF row 10 and 12 are absent
7 >> CONTAINS INCLUDE D 1-n U $Measurement = B $Measurement = B $Units = B $Derivation = B $Method = B
8 >> CONTAINS INCLUDE D 1-n U $Measurement = B $Measurement = B $Units = B $Derivation = B $Method = B
9 >> CONTAINS INCLUDE D 1-n U $Measurement = B $Measurement = B $Units = B $Derivation = B $Method = B $ImagePurpose = DT (121112, DCM, "Source of Measurement")
10 > CONTAINS CONTAINER EV (126011, DCM, "Derived Imaging Measurements") 1 C IF row 6 and 12 are absent
11 >> CONTAINS INCLUDE D 1-n U
12 > CONTAINS CONTAINER EV (C0034375, UMLS, "Qualitative Evaluations") 1 C IF row 6 and 10 are absent
13 >> CONTAINS CODE 1-n U
14 >> CONTAINS TEXT 1-n U
Content Item Descriptions Rows 6, 10, 12 The conditions require that at least one of the "heading" containers be present, though any of them may be present but empty. Row 7 Planar ROI measurements are those defined on a single plane by a segmentation reference or planar spatial coordinates. Row 8 Volumetric ROI measurements are those defined on a volume by raster or surface segmentation references or a set of 2D or 3D spatial coordinates. Row 9 Generic measurements include those specified on an image as a whole or by unconstrained graphic coordinates. These may be used for such things as whole image scores or quality measures, and for linear distance meaurements, such as for RECIST or WHO tumor treatment response criteria evaluation. Rows 7, 8, 9 The baseline context groups defined allow for generic intensity, size and texture measurements, regardless of the geometry of the ROI (e.g., linear distance can be measured on volumes, or volume can be estimated from a linear distance), and being baseline, do not constrain the invoker from using other appropriate concepts specific to the application. Different measurements of the same real world lesion made using different types of measurements (different templates) can be correlated by a shared value of Tracking Unique Identifer. See also PS3.17 . Row 9 A Measurement Group is used to contain one or more individual measurements that are invocations of TID 300, consistent with TIDs 1410 and 1411, which both already have Measurement Group containers as their roots. Rows 12, 13, 14 These Content Items allow encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the entire subject of the report rather than specific measurement groups.
Measurement Group ...
Parameters
Parameter Name Parameter Usage
... ...
$ImagePurpose Purpose of Reference for an image used as a source of the measurement
... ...
Measurement Group
NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
...
10 > CONTAINS INCLUDE D 1-n M $Measurement = $Measurement $Units = $Units $ModType = $ModType $ModValue = $ModValue $Method = $Method $Derivation = $Derivation $TargetSite = $TargetSite $TargetSiteMod = $TargetSiteMod $Equation = $Equation $ImagePurpose = $ImagePurpose $RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority $DerivationParameter = $DerivationParameter $DerivationParameterUnits = $DerivationParameterUnits
...
Section headings unchanged (for hyperlinks):
Measurement
Image or Spatial Coordinates
Observation Context
Person Observer Identifying Attributes
Language of Content Item and Descendants
Planar ROI Measurements
Volumetric ROI Measurements
ROI Measurements
Measurements Derived From Multiple ROI Measurements
Image Library
CAD Image Library Entry
Quantitative Diagnostic Imaging Procedures
Response Criteria
Measurement Report Document Titles
Abstract Multi-dimensional Image Model Component Units
General Region of Interest Measurement Modifiers
Texture Measurements
Generic Intensity and Size Measurements
Linear Measurements
General Volume Calculation Methods
Amend DICOM PS3.17 as follows (changes to existing text are bold and underlined for additions and struckthrough for removals):
Measurement Report SR Document for Planar and Volumetric ROI (Informative) ....
Measurement Report SR Document Volumetric ROI on CT Example This CT example describes a set of measurements (volume. long axis and mean attenuation coefficient) made from a single volumetric ROI encoded as a single segment that spans two source CT images, and includes a description of the measurement methods and the finding site, as well as an image library to describe characteristics of the images used, and categorical observations at the measurement group and entire subject level. For a different modality than CT, the choice of measurement for the mean intensity would not be (122713, DCM, "Attenuation Coefficient"). For MR one might use (110852, DCM, "MR signal intensity"), or (110804, DCM, "T1 Weighted MR Signal Intensity"), etc. See also for various appropriate signal intensity types for MR and other modalities. For PET one might use (110821, DCM, "Nuclear Medicine Tomographic Activity"), in which case the specific type of signal would be apparent from the units, e.g., ({SUVbw}g/ml, UCUM, "Standardized Uptake Value body weight") or for activity-concentration, (Bq/ml, UCUM, "Becquerels/milliliter"). See also . Care should be taken when selecting modifiers such as (G-C036, SRT, "Measurement Method") versus (121401, DCM, "Derivation"). The finding site and laterality within the measurement template () are factored out and shared by both measurements. The pattern used for the image library uses , though commonality may be refactored. The long axis of the volumetric ROI is encoded, but the end points of the line segment used to make that measurement are not recorded, since only the volumetric spatial description of TID 1411 is used. For an alternative encoding, see .
Volumetric ROI on CT Example
Node Code Meaning of Concept Name Code Meaning or Example Value TID
1 Oncology Measurement Report
1.1 Language of Content Item and Descendants English
1.2 Observation Context
1.2.1 Person Observer Name Doe^Jane
1.3 Procedure Reported Chest+Abd CT W+WO contr IV
1.4 Image Library
1.4.1 IMAGE - CT image #1
1.4.1.1 Study Date 20030417
1.4.1.2 Study Time 104607
1.4.1.3 Horizontal Pixel Spacing 0.810547 mm
1.4.1.j ... ...
1.4.1.n Pixel Data Columns 512 pixels
1.4.2 IMAGE - CT image #2
1.4.2.j ... ...
1.5 Measurements
1.5.1 Measurement Group
1.5.1.1 Tracking Identifier Object1
1.5.1.2 Tracking Unique Identifier 1.2.276.0.7230010...
1.5.1.3 Referenced Segment IMAGE - Segmentation, Segment #1
1.5.1.4 Source image for segmentation IMAGE - CT image #1
1.5.1.5 Source image for segmentation IMAGE - CT image #2
1.5.1.6 Finding Site Adrenal Gland
1.5.1.6.1 Laterality Right
1.5.1.7 Volume 3267.46 mm3
1.5.1.7.1 Measurement Method Sum of segmented voxel volumes
1.5.1.8 Long Axis 9.21 mm
1.5.1.8.1 Measurement Method RECIST 1.1
1.5.1.9 Attenuation Coefficient 70.978 Hounsfield unit
1.5.1.9.1 Derivation Mean
1.5.1.10 Necrosis Present
1.5.1.11 Hemorrhage Absent
1.6 Qualitative Evaluations
1.6.1 Renal Vein Involvement Absent
Add new Section to DICOM PS3.17 as follows :
Measurement Report SR Document Volumetric ROI with RECIST Linear Distance Specified by Coordinates on CT Example This CT example describes a set of measurements (volume, long axis (RECIST) and mean attenuation coefficient) made from a single volumetric ROI encoded as a single segment, including specification of the end points of the line segment used to make the linear distance measurement. The long axis of the lesion is not encoded as a characteristic of the volumetric ROI, but rather as the end points of a line segment used to make that measurement. The commonality of the Tracking Unique Identifier establishes that they are measurements of the same ROI. If multiple measurements were to be made of the same ROI over time or by different observers, other content items such as those related to Timepoint, Activity Session and Observer may be used. For an alternative encoding, see . The Finding Site information is duplicated in the second measurement template invocation in this example, though it is not require to be.
Volumetric ROI on CT Example
Node Code Meaning of Concept Name Code Meaning or Example Value TID
1 Oncology Measurement Report
... ... ...
1.5 Measurements
1.5.1 Measurement Group
1.5.1.1 Tracking Identifier Object1 (same for both Measurement Groups) -->
1.5.1.2 Tracking Unique Identifier 1.2.276.0.7230010... (same for both Measurement Groups) -->
1.5.1.3 Referenced Segment IMAGE - Segmentation, Segment #1 -->
1.5.1.4 Source image for segmentation IMAGE - CT image #1
1.5.1.5 Source image for segmentation IMAGE - CT image #2
1.5.1.6 Finding Site Adrenal Gland (same for both Measurement Groups)
1.5.1.6.1 Laterality Right (same for both Measurement Groups)
1.5.1.7 Volume 3267.46 mm3
1.5.1.7.1 Measurement Method Sum of segmented voxel volumes
1.5.1.8 Attenuation Coefficient 70.978 Hounsfield unit
1.5.1.8.1 Derivation Mean
1.6.1 Measurement Group
1.6.1.1 Tracking Identifier Object1 (same for both Measurement Groups)
1.6.1.2 Tracking Unique Identifier 1.2.276.0.7230010... (same for both Measurement Groups)
1.6.1.3 Finding Site Adrenal Gland (same for both Measurement Groups)
1.6.1.3.1 Laterality Right (same for both Measurement Groups)
1.6.1.4 Long Axis 9.21 mm
1.6.1.4.1 Measurement Method RECIST 1.1
1.6.1.5 Source of Measurement SCOORD GraphicType POLYLINE with two coordinates, the beginning and end of a line segment
1.6.1.5.1 (none) IMAGE - CT image #1