Add Whole Slide Microscopy Image Flavor of THUMBNAIL and retire LOCALIZER

VL Whole Slide Microscopy Image IOD Modules

IE	Module	Reference	Usage
Patient	Patient		M
	Clinical Trial Subject		U
Study	General Study		M
	Patient Study		U
	Clinical Trial Study		U
Series	General Series		M
	Whole Slide Microscopy Series		M
	Clinical Trial Series		U
Frame of Reference	Frame of Reference		M
Equipment	General Equipment		M
	Enhanced General Equipment		M
Image	General Image		M
	General Reference		U
	Image Pixel		M
	Acquisition Context		M
	Multi-frame Functional Groups		M
	Multi-frame Dimension		M
	Specimen		M
	Whole Slide Microscopy Image		M
	Optical Path		M
	Multi-Resolution Navigation		C - Required if Image Type (0008,0008) Value 3 is LOCALIZER
	Slide Label		C - Required if Image Type (0008,0008) Value 3 is LABEL; may be present otherwise
	SOP Common		M
	Common Instance Reference		M
	Frame Extraction		C - Required if the SOP Instance was created in response to a Frame-Level retrieve request

Whole Slide Microscopy Image Module Attributes

Attribute Name	Tag	Type	Attribute Description
Image Type	(0008,0008)	1	Image identification characteristics. See for specialization.
...
Number of Frames	(0028,0008)	1	Number of frames in a multi-frame image. 1
...
Specimen Label in Image	(0048,0010)	1	Indicates whether the specimen label is captured in the image. YES NO Shall be YES if Image Type (0008,0008) Value 3 is OVERVIEW or LABEL. Shall be NO if Image Type (0008,0008) Value 3 is THUMBNAIL.
Burned In Annotation	(0028,0301)	1	Indicates whether or not image contains sufficient burned in annotation to identify the patient. YES NO If Specimen Label in Image (0048,0010) value is YES, Burned In Annotation (0028,0301) might be NO if the label includes only a specimen identifier and not patient identifying data.
...

Image Type (0008,0008) is specified to be Type 1 with the following constraints: Value 1 shall have a value of ORIGINAL or DERIVED Value 2 shall have a value of PRIMARY Value 3 (Image Flavor) shall have the Defined Terms in .

Whole Slide Microscopy Image Flavors

LOCALIZER	Collected for the purpose of planning or navigating other images; provides frame-level navigational features.
VOLUME	Set of frames that define a regularly sampled volume
LABEL	Purpose of image is to capture the slide label only; non-label area shall not be present; the label is shown in .
OVERVIEW	Purpose of image is to provide an overview of the entire glass slide; shall include at least part of the label, all of the the specimen and the empty space that are shown in . One purpose of the OVERVIEW image is to allow visual quality control to assure that tissue fragments have not been omitted when selecting areas (manually or automatically) to digitize at high resolution. The OVERVIEW image is distinct from the lowest resolution VOLUME image(s) of WSI pyramids, and the THUMBNAIL image, neither of which includes the label.
THUMBNAIL	Purpose of image is to provide an overview of the specimen; shall not include the label.

A Value 3 of LOCALIZER was previously been defined, which triggered the mandatory inclusion of the retired . See PS3.3 202nx. Value 4 (Derived Pixel) shall have the Defined Terms specified in .

Whole Slide Microscopy Image Derived Pixels

NONE	No derivation of pixels (original)
RESAMPLED	Pixels were derived by down sampling a higher resolution image

No additional values shall be present.

specifies the Attributes that describe the Multi-Resolution Navigation Module, used in Whole Slide Microscopy LOCALIZER images.Retired. See PS3.3 202nx.

Multi-Resolution Navigation Module Attributes

Attribute Name	Tag	Type	Attribute Description
Referenced Image Navigation Sequence	(0048,0200)	1	Identification of correspondence between areas of Pixel Data (07FE,0010) and frames of higher resolution images. One or more Items shall be included in this Sequence.
>Include			Referenced Image Instance
>Referenced Frame Number	(0008,1160)	1	Referenced Frame Number within Referenced Image. Only a single value shall be present.
>Top Left Hand Corner of Localizer Area	(0048,0201)	1	Top Left Hand Corner of Localizer image pixel area corresponding to referenced frame, specified as column\row. Column is the horizontal offset and row is the vertical offset.
>Bottom Right Hand Corner of Localizer Area	(0048,0202)	1	Bottom Right Hand Corner of Localizer image pixel area corresponding to referenced frame, specified as column\row. Column is the horizontal offset and row is the vertical offset.
>Pixel Spacing	(0028,0030)	1	Pixel Spacing in Referenced Image, specified as a numeric pair - adjacent row spacing \ adjacent column spacing, in mm.
>Z Offset in Slide Coordinate System	(0040,074A)	1	The Z offset of the referenced frame from the Slide Coordinates System reference plane, in microns
>Samples per Pixel	(0028,0002)	1	The number of samples (color planes) containing information in the referenced image.
>Optical Path Identifier	(0048,0106)	1	Identifies the optical path used in acquiring the referenced Frame by reference to an Item in the Optical Path Sequence (0048,0105) of the current SOP Instance. See .

For reference unchanged, DICOM PS3.3:

Amend DICOM PS3.6 as follows (changes to existing text are bold and underlined for additions and struckthrough for removals):

Registry of DICOM Data Elements

Tag	Name	Keyword	VR	VM
(0048,0200)	Referenced Image Navigation Sequence	Referenced​Image​Navigation​Sequence	SQ	1	RET (202nx)
(0048,0201)	Top Left Hand Corner of Localizer Area	Top​Left​Hand​Corner​Of​Localizer​Area	US	2	RET (202nx)
(0048,0202)	Bottom Right Hand Corner of Localizer Area	Bottom​Right​Hand​Corner​Of​Localizer​Area	US	2	RET (202nx)