Use Content Item with Modifier Macro in Acquisition Context Status Assigned Date of Last Update 2020/06/15 Person Assigned David Clunie Submitter Name IDC Submission Date 2020/04/11 Correction Number CP-2045 Log Summary: Use Content Item with Modifier Macro in Acquisition Context Name of Standard PS3.3 Rationale for Correction: Over time, the Content Item usage outside SR in various roles such as worklists and protocols has improved, but these changes (including the use of a level of nesting for modifiers) have not been propagated to Acquisition Context as they should have been. This change allows for additional value types (including DATETIME as well as references to objects including UIDREF, COMPOSITE, IMAGE and WAVEFORM) as well as modifiers. The Content Item macro is also extended to include WAVEFORMS, since there is no reason to allow imags but not waveforms. The Content Item may be applicable to a subset of not only frames, but also segments or waveforms channels. Originally, the Value Type was Type 3 not Type 1, but given the negligible adoption of Acquisition Context, it is appropriate to make it required. [Open Issue: Should we add an observation start datetime?] [Open Issue: Does Acquisition Context need a TCCORD mechanism?] Correction Wording: specifies Attributes for description of the conditions present during data acquisition. This Module shall not contain descriptions of conditions that replace those that are already described in specific Modules or Attributes that are also contained within the IOD that contains this Module. Each Item of the Acquisition Context Sequence (0040,0555) contains one Item of the Concept Name Code Sequence (0040,A043) and one of the mutually-exclusive Observation-value Attributes: Concept Code Sequence (0040,A168), the pair of Numeric Value (0040,A30A) and Measurement Units Code Sequence (0040,08EA), Date (0040,A121), Time (0040,A122), Person Name (0040,A123) or Text Value (0040,A160). If this SOP Instance is a Multi-frame SOP Instance, each Item of the Acquisition Context Sequence (0040,0555) may be configured to describe one frame, all frames, or any specifically enumerated subset set of frames of the Multi-frame SOP Instance. Previously, Referenced Frame Numbers (0040,A136) was used to enumerate which frames were described, but its length was limited, so it has been replaced by Referenced Frame Number (0008,1160). Similarly, applicability to a subset of Segments or Waveform Channels may be specified.

Acquisition Context Module Attributes

Attribute Name	Tag	Type	Attribute Description
Acquisition Context Sequence	(0040,0555)	2	A Sequence of Items that describes the conditions present during the acquisition of the data of the SOP Instance. Zero or more Items shall be included in this Sequence.
>Include
>Value Type	(0040,A040)	3	The type of the value encoded in this Item. TEXT NUMERIC CODE DATE TIME PNAME See .
>Observation DateTime	(0040,A032)	3	The date and time on which this Item was completed. For the purpose of recording measurements or logging events, completion time is defined as the ending time of data acquisition of the measurement, or the ending time of occurrence of the event.
>Concept Name Code Sequence	(0040,A043)	1	A concept that constrains the meaning of (i.e., defines the role of) the Observation Value. The "Name" component of a Name/Value pair. Only a single Item shall be included in this Sequence.
>>Include Table 8.8-1 "Code Sequence Macro Attributes"			No Baseline CID is defined.
>Referenced Frame Number	(0008,1160)	1C	References one or more frames in a Multi-frame SOP Instance. The first frame shall be denoted as frame number one. Required if this SOP Instance is a Multi-frame SOP Instance and the values in this Sequence Item do not apply to all frames, and Referenced Segment Number (0062,000B) is not present.
>Referenced Segment Number	(0062,000B)	1C	Identifies the segments to which the reference applies identified by Segment Number (0062,0004). Required if this SOP Instance is a Segmentation or Surface Segmentation and the values in this Sequence Item do not apply to all segments and Referenced Frame Number (0008,1160) is not present.
>Referenced Waveform Channels	(0040,A0B0)	1C	List of channels in Waveform to which the reference applies. See Required if this SOP Instance is a Waveform that contains multiple Channels and the values in this Sequence Item do not apply to all Waveform Channels.
>Numeric Value	(0040,A30A)	1C	This is the Value component of a Name/Value pair when the Concept implied by Concept Name Code Sequence (0040,A043) is a set of one or more numeric values. Required if the value that Concept Name Code Sequence (0040,A043) requires (implies) is a set of one or more integers or real numbers. Shall not be present otherwise.
>Floating Point Value	(0040,A161)	1C	The floating point representation of Numeric Value (0040,A30A). The same number of values as Numeric Value (0040,A30A) shall be present. Required if Numeric Value (0040,A30A) has insufficient precision to represent the value as a string. May be present otherwise.
>Rational Numerator Value	(0040,A162)	1C	The integer numerator of a rational representation of Numeric Value (0040,A30A). Encoded as a signed integer value. The same number of values as Numeric Value (0040,A30A) shall be present. Required if Numeric Value (0040,A30A) has insufficient precision to represent a rational value as a string. May be present otherwise.
>Rational Denominator Value	(0040,A163)	1C	The integer denominator of a rational representation of Numeric Value (0040,A30A). Encoded as a non-zero unsigned integer value. The same number of values as Numeric Value (0040,A30A) shall be present. Required if Rational Numerator Value (0040,A162) is present.
>Measurement Units Code Sequence	(0040,08EA)	1C	Units of measurement. Only a single Item shall be included in this Sequence. Required if Numeric Value (0040,A30A) is present. Shall not be present otherwise.
>>Include Table 8.8-1 "Code Sequence Macro Attributes"			B.
>Date	(0040,A121)	1C	This is the Value component of a Name/Value pair when the Concept implied by Concept Name Code Sequence (0040,A043) is a date. The purpose or role of the date value could be specified in Concept Name Code Sequence (0040,A043). Required if the value that Concept Name Code Sequence (0040,A043) requires (implies) is a date. Shall not be present otherwise.
>Time	(0040,A122)	1C	This is the Value component of a Name/Value pair when the Concept implied by Concept Name Code Sequence (0040,A043) is a time. The purpose or role of the time value could be specified in Concept Name Code Sequence (0040,A043). Required if the value that Concept Name Code Sequence (0040,A043) requires (implies) is a time. Shall not be present otherwise.
>Person Name	(0040,A123)	1C	This is the Value component of a Name/Value pair when the Concept implied by Concept Name Code Sequence (0040,A043) is a Person Name. The role of the person could be specified in Concept Name Code Sequence (0040,A043). Required if the value that Concept Name Code Sequence (0040,A043) requires (implies) is a person name. Shall not be present otherwise.
>Text Value	(0040,A160)	1C	This is the Value component of a Name/Value pair when the Concept implied by Concept Name Code Sequence (0040,A043) is a Text Observation Value. Required if Date (0040,A121), Time (0040,A122), and Person Name (0040,A123) do not fully describe the concept specified by Concept Name Code Sequence (0040,A043). Shall not be present otherwise.
>Concept Code Sequence	(0040,A168)	1C	This is the Value component of a Name/Value pair when the Concept implied by Concept Name Code Sequence (0040,A043) is a Coded Value. Only a single Item shall be included in this Sequence. Required if Date (0040,A121), Time (0040,A122), Person Name (0040,A123), Text Value (0040,A160), and the pair of Numeric Value (0040,A30A) and Measurement Units Code Sequence (0040,08EA) are not present.
>>Include Table 8.8-1 "Code Sequence Macro Attributes"			No Baseline CID is defined.
Acquisition Context Description	(0040,0556)	3	Free-text description of the image-acquisition context.

A Content Item is a flexible means of encoding attribute identifiers and attribute values using the Code Sequence Macro (see ) for coded terminology defined by a coding scheme. The Content Item provides a name-value pair, i.e., a Concept Name, encoded as a Code Sequence, and a Concept Value. The Concept Value may be encoded by any of a set of generic Attributes, as specified by a Value Type, including text, personal name, numeric, and coded concept (Code Sequence) values. Comparing a Content Item to a native DICOM Data Element, the Concept Name Code Sequence corresponds to the Data Element Tag and Attribute Name, the Value Type to the Value Representation, and the Concept Value to the Data Element Value Field. See . The IMAGE Value Type of this Macro does not include the Type 3 Attributes of the IMAGE Value Type defined in , as they are not required for Acquisition Context or Protocol Context Content Items. Specific uses of the Content Item may invoke the Content Item Macro defined in this Section, the Document Content Macro of , or another similar construct. An invocation of the Content Item Macro may constrain the allowed values of Value Type (0040,A040). The NUMERIC Value Type of this Macro differs from the NUM Value Type defined in , since the encoding of the Concept Value is different. The Value Type uses Enumerated Values so as to assure that non-standard Value Types are not used, and to prevent the nefarious use, for example, of a CONTAINER Value Type in an SR-like manner to create nested content, which is not the intent. Some invocations of this Macro may use the Content Item Modifier Sequence (0040,0441) to achieve a single level of "nesting". That Attribute is not included in this Macro itself, to prevent recursive inclusion. See for the meaning of the Type column in this Macro when applied to Normalized IODs.

Content Item Macro Attributes Description

Attribute Name	Tag	Type	Attribute Description
Value Type	(0040,A040)	1	The type of the value encoded in this name-value Item. DATE TIME DATETIME PNAME UIDREF TEXT CODE NUMERIC COMPOSITE IMAGE WAVEFORM
Observation DateTime	(0040,A032)	3	The date and time on which this Item was completed. For the purpose of recording measurements or logging events, completion time is defined as the ending time of data acquisition of the measurement, or the ending time of occurrence of the event.
Concept Name Code Sequence	(0040,A043)	1	Coded concept name of this name-value Item. Only a single Item shall be included in this Sequence.
>Include Table 8.8-1 "Code Sequence Macro Attributes"			No Baseline CID is defined.
DateTime	(0040,A120)	1C	DateTime value for this name-value Item. Required if Value Type (0040,A040) is DATETIME.
Date	(0040,A121)	1C	Date value for this name-value Item. Required if Value Type (0040,A040) is DATE.
Time	(0040,A122)	1C	Time value for this name-value Item. Required if Value Type (0040,A040) is TIME.
Person Name	(0040,A123)	1C	Person name value for this name-value Item. Required if Value Type (0040,A040) is PNAME.
UID	(0040,A124)	1C	UID value for this name-value Item. Required if Value Type (0040,A040) is UIDREF.
Text Value	(0040,A160)	1C	Text value for this name-value Item. Required if Value Type (0040,A040) is TEXT.
Concept Code Sequence	(0040,A168)	1C	Coded concept value of this name-value Item. Only a single Item shall be included in this Sequence. Required if Value Type (0040,A040) is CODE.
>Include Table 8.8-1 "Code Sequence Macro Attributes"			No Baseline CID is defined.
Numeric Value	(0040,A30A)	1C	Numeric value for this name-value Item. Only a single value shall be present. Required if Value Type (0040,A040) is NUMERIC.
Floating Point Value	(0040,A161)	1C	The floating point representation of Numeric Value (0040,A30A). The same number of values as Numeric Value (0040,A30A) shall be present. Required if Numeric Value (0040,A30A) has insufficient precision to represent the value as a string. May be present otherwise.
Rational Numerator Value	(0040,A162)	1C	The integer numerator of a rational representation of Numeric Value (0040,A30A). Encoded as a signed integer value. The same number of values as Numeric Value (0040,A30A) shall be present. Required if Numeric Value (0040,A30A) has insufficient precision to represent a rational value as a string. May be present otherwise.
Rational Denominator Value	(0040,A163)	1C	The integer denominator of a rational representation of Numeric Value (0040,A30A). Encoded as a non-zero unsigned integer value. The same number of values as Numeric Value (0040,A30A) shall be present. Required if Rational Numerator Value (0040,A162) is present.
Measurement Units Code Sequence	(0040,08EA)	1C	Units of measurement for a numeric value in this name-value Item. Only a single Item shall be included in this Sequence. Required if Value Type (0040,A040) is NUMERIC.
>Include Table 8.8-1 "Code Sequence Macro Attributes"			B.
Referenced SOP Sequence	(0008,1199)	1C	Composite SOP Instance Reference value for this name-value Item. Only a single Item shall be included in this Sequence. Required if Value Type (0040,A040) is COMPOSITE or IMAGE or WAVEFORM.
>Include Table 10-11 "SOP Instance Reference Macro Attributes"
>Referenced Frame Number	(0008,1160)	1C	Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames, and Referenced Segment Number (0062,000B) is not present.
>Referenced Segment Number	(0062,000B)	1C	Identifies the segments to which the reference applies identified by Segment Number (0062,0004). Required if the Referenced SOP Instance is a Segmentation or Surface Segmentation and the reference does not apply to all segments and Referenced Frame Number (0008,1160) is not present.
>Referenced Waveform Channels	(0040,A0B0)	1C	List of channels in Waveform to which the reference applies. See Required if the Referenced SOP Instance is a Waveform that contains multiple Channels and not all Channels in the Waveform are referenced.

Content Item with Modifiers is a means of describing structured content which needs a Content Item with single optional level of modifiers, i.e. a two-level structure of Content Items. An invocation of the Content Item with Modifiers Macro will usually specify the allowed values using a Protocol Context Template in , which allows a single Nesting Level (see in ). Constraints on the use of this Macro may be specified in , which may be invoked in IODs in .

Content Item with Modifiers Macro Attributes

Attribute Name	Tag	Type	Attribute Description
Include			No Baseline TID is defined.
Content Item Modifier Sequence	(0040,0441)	3	Specifies modifiers for the Content Item. One or more Items are permitted in this Sequence.
>Include			No Baseline TID is defined.

specifies the Attributes that convey a reference to a DICOM Composite Object that is not a DICOM Image or Waveform (such as an SR Document), or to an HL7 Structured Document. If a Softcopy Presentation State is to be applied to an Image, it should be referenced by an Image Reference Macro. Other SR Documents may be referenced by this Macro, but there is no facility to reference individual Content Items within those reports. HL7 Structured Documents include, in particular, those conforming to the Clinical Document Architecture (CDA). See for further details about this type of referenced object.

Composite Object Reference Macro Attributes

Attribute Name	Tag	Type	Attribute Description
Referenced SOP Sequence	(0008,1199)	1	References to Composite Object SOP Class/SOP Instance pairs. Only a single Item shall be included in this Sequence.
>Include Table 10-11 "SOP Instance Reference Macro Attributes"

specifies the Attributes that convey a reference to a DICOM image.

Image Reference Macro Attributes

Attribute Name	Tag	Type	Attribute Description
Include
>Referenced Frame Number	(0008,1160)	1C	Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames, and Referenced Segment Number (0062,000B) is not present.
>Referenced Segment Number	(0062,000B)	1C	Identifies the segments to which the reference applies identified by Segment Number (0062,0004). Required if the Referenced SOP Instance is a Segmentation and the reference does not apply to all segments and Referenced Frame Number (0008,1160) is not present.
>Referenced SOP Sequence	(0008,1199)	3	Reference to a Softcopy Presentation State SOP Class/SOP Instance pair. Only a single Item is permitted in this Sequence.
>>Include Table 10-11 "SOP Instance Reference Macro Attributes"
>Referenced Real World Value Mapping Instance Sequence	(0008,114B)	3	Reference to a Real World Value Mapping SOP Class/SOP Instance pair. Only a single Item is permitted in this Sequence.
>>Include Table 10-11 "SOP Instance Reference Macro Attributes"
>Icon Image Sequence	(0088,0200)	3	This Icon Image is representative of the Image. Only a single Item is permitted in this Sequence. The Icon Image shall be no greater than 128 rows by 128 columns.
>>Include			See

specifies the Attributes that convey a reference to a DICOM waveform.

Waveform Reference Macro Attributes

Attribute Name	Tag	Type	Attribute Description
Include
>Referenced Waveform Channels	(0040,A0B0)	1C	List of channels in Waveform to which the reference applies. See Required if the Referenced SOP Instance is a Waveform that contains multiple Channels and not all Channels in the Waveform are referenced.

Referenced Waveform Channels (0040,A0B0) is a multi-value Attribute that lists the channels referenced. Each channel is specified as a pair of values (M,C), where the first value is the Item number of Waveform Sequence (5400,0100) in the referenced object (i.e., the Multiplex Group Number), and the second value is the Item number of Channel Definition Sequence (003A,0200) (i.e., the Channel Number) within the multiplex group. If the specified channel number is 0, the annotation applies to all channels in the multiplex group. As an example, an annotation that applies to the entire first multiplex group and channels 2 and 3 of the third multiplex group would have Referenced Waveform Channels (0040,A0B0) value 0001 0000 0003 0002 0003 0003.

specifies the Attributes that convey TCOORD Content Items. A TCOORD Content Item shall be the Source Content Item of one or more SELECTED FROM relationships with one or more SCOORD Content Items, one or more IMAGE Content Items, or one or more WAVEFORM Content Items. The same set of temporal coordinates may be selected from more than one single-frame image, or more than one frame of a multi-frame image, or from images and waveforms when the purpose of reference is applicable to multiple objects. For example, the definition of a sampling period at different spatial locations on multiple images and a synchronously acquired waveform. Temporal coordinates may refer to spatial coordinates, which in turn refer to one or more frames or images, for example to indicate a region localized in both time and space.

Temporal Coordinates Macro Attributes

Attribute Name	Tag	Type	Attribute Description
Temporal Range Type	(0040,A130)	1	See for Enumerated Values.
Referenced Sample Positions	(0040,A132)	1C	List of samples within a multiplex group specifying temporal points of the referenced data. Position of first sample is 1. Required if the Referenced SOP Instance is a Waveform and Referenced Time Offsets (0040,A138) and Referenced DateTime (0040,A13A) are not present. May be used only if Referenced Channels (0040,A0B0) refers to channels within a single multiplex group.
Referenced Time Offsets	(0040,A138)	1C	Specifies temporal points for reference by number of seconds after start of data. Required if Referenced Sample Positions (0040,A132) and Referenced DateTime (0040,A13A) are not present.
Referenced DateTime	(0040,A13A)	1C	Specifies temporal points for reference by absolute time. Required if Referenced Sample Positions (0040,A132) and Referenced Time Offsets (0040,A138) are not present.

This Attribute defines the type of temporal extent of the region of interest. A temporal point (or instant of time) may be defined by a waveform sample offset (for a single waveform multiplex group only), time offset, or absolute time. POINT a single temporal point MULTIPOINT multiple temporal points SEGMENT a range between two temporal points MULTISEGMENT multiple segments, each denoted by two temporal points BEGIN a range beginning at one temporal point, and extending beyond the end of the acquired data END a range beginning before the start of the acquired data, and extending to (and including) the identified temporal point