CP-2179 Add Pathology Annotation Codes Status Assigned Date of Last Update 2021/11/14 Person Assigned David Clunie Submitter Name Markus Daniel Herrmann Submission Date 2021/10/17 Correction Number CP-2179 Log Summary: Add Pathology Annotation Codes Name of Standard PS3.16, PS3.17 Rationale for Correction: Additional context groups and concepts are needed for slide microscopy image annotations. Specifically: For Anatomical structure (histology) – using SNOMED-CT body structure or cell structure – possibly for inclusion into CID 7192 "Anatomical Structure Segmentation Property Types". new CID XXXA1 "Tissue Structure" (connective tissue, epithelium, basal membrane, etc.) new CID XXXA2 "Cell Structure" (cell, nucleus, mitochondrium, etc.) ??? reuse or rename Sup 222 CID 8135 "Microscopy Annotation Property Types" (not currently referenced) Morphologically Abnormal Structure (histopathology) – SNOMED-CT finding or morphologic abnormality (but not disorder) – possibly for inclusion into CID 7194 "Morphologically Abnormal Structure Segmentation Property Types". new CID XXXM1 "Epithelial Tumor Structure" (adenocarcinoma, squamous cell carcinoma, adenoma, etc.) new CID XXXM2 Connective Tissue Tumor Structure" (leiomyosarcoma, liposarcoma, chondroma, etc.) Also, add examples in new informative Annex for PS3.17. [Ed.Note: TBD. In examples, is it good practice to include generic type of neaoplasm, and modifier with more specific type, e.g., adenocarcinoma, or should the specific type be illustrated as adenocarcinoma without a modifier (and the recipient expected to have an ontology if they care to recognize that adenocarcinoma are neoplasms..] [Ed.Note: Examples are predicated on separate CP "Add Category of Finding to TID 1500".] [Ed.Note. Examples are predicated on separate CP "Add Anatomy to Microscopy Bulk Simple Annotations".] [Ed.Note: TBD. Is it necessary to explicitly code in SR examples the Associated Topography, ot since this replicates Finding Site, should instead be mentioned tindescription of Finding Site.] [Ed.Note: SNOMED CRS Request ID# for additional concepts in DICOM subset.] Correction Wording:
Amend DICOM PS3.16 as follows:
Anatomical Structure Segmentation Property Types Resources: HTML | FHIR JSON | FHIR XML | IHE SVS XML Type: Extensible Version: 20170914yyymmdd UID: 1.2.840.10008.6.1.1191
Anatomical Structure Segmentation Property Types
Coding Scheme Designator Code Value Code Meaning SNOMED-RT ID UMLS Concept Unique ID
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Morphologically Abnormal Structure Segmentation Property Types Resources: HTML | FHIR JSON | FHIR XML | IHE SVS XML Type: Extensible Version: 20170914yyymmdd UID: 1.2.840.10008.6.1.1193
Morphologically Abnormal Structure Segmentation Property Types
Coding Scheme Designator Code Value Code Meaning SNOMED-RT ID UMLS Concept Unique ID
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Microscopy Annotation Property Types Resources: HTML | FHIR JSON | FHIR XML | IHE SVS XML Type: Extensible Version: 20210712 UID: 1.2.840.10008.6.1.1365
Microscopy Annotation Property Types
Coding Scheme Designator Code Value Code Meaning SNOMED-RT ID UMLS Concept Unique ID
SCT 4421005 Cell T-E0000 C0007634
SCT 84640000 Nucleus T-E0100 C0007610
Add new Context Gropus to DICOM PS3.16 as follows:
Tissue Structure Segmentation Types Resources: HTML | FHIR JSON | FHIR XML | IHE SVS XML Type: Extensible Version: yyyymmdd UID: 1.2.840.10008.6.1.UUUA1
Tissue Structure Segmentation Types
Coding Scheme Designator Code Value Code Meaning SNOMED-RT ID UMLS Concept Unique ID
SCT 21793004 Connective tissue T-1A200 C0009780
Cell Structure Segmentation Types Resources: HTML | FHIR JSON | FHIR XML | IHE SVS XML Type: Extensible Version: yyyymmdd UID: 1.2.840.10008.6.1.UUUA2
Cell Structure Segmentation Types
Coding Scheme Designator Code Value Code Meaning SNOMED-RT ID UMLS Concept Unique ID
SCT 4421005 Cell T-E0000 C0007634
SCT 84640000 Nucleus T-E0100 C0007610
Epithelial Tumor Structure Resources: HTML | FHIR JSON | FHIR XML | IHE SVS XML Type: Extensible Version: yyyymmdd UID: 1.2.840.10008.6.1.UUUM1
Epithelial Tumor Structure
Coding Scheme Designator Code Value Code Meaning SNOMED-RT ID UMLS Concept Unique ID
SCT 35917007 Adenocarcinoma M-81403 C0001418
Connective Tissue Tumor Structure Resources: HTML | FHIR JSON | FHIR XML | IHE SVS XML Type: Extensible Version: yyyymmdd UID: 1.2.840.10008.6.1.UUUM2
Connective Tissue Tumor Structure
Coding Scheme Designator Code Value Code Meaning SNOMED-RT ID UMLS Concept Unique ID
SCT 51549004 Leiomyosarcoma M-88903 C0023269
Add new Informative Annex to DICOM PS3.17 as follows:
Anatomic Pathology Whole Slide Image Annotation (Informative)
Examples of Coding Tumor Morphology and Topography (Primary Site)
In Structured Reports (276214006, SCT, "Finding category") = (49755003, SCT, "Morphologically Abnormal Structure") (121071, DCM, "Finding") = (108369006, SCT, "Neoplasm") (363698007, SCT, "Finding Site") = (39607008, SCT, "Lung") (116676008, SCT, "Associated Morphology") = (35917007, SCT, "Adenocarcinoma") - ??? should we add a Finding Modifier instead to parallel SEG/ANN pattern (116677004, SCT, "Associated Topography") = (39607008, SCT, "Lung") - ??? this is redundant with Finding modifier
In Segmentations Segmented Property Category Code Sequence (0062,0003) = (49755003, SCT, "Morphologically Abnormal Structure") Segmented Property Type Code Sequence (0062,000F) = (108369006, SCT, "Neoplasm") Segmented Property Type Modifier Code Sequence (0062,0011) = (35917007, SCT, "Adenocarcinoma") Primary Anatomic Structure Sequence (0008,2228) = (39607008, SCT, "Lung")
In Bulk Annotations Annotation Property Category Code Sequence (006A,0009) = (49755003, SCT, "Morphologically Abnormal Structure") Annotation Property Type Code Sequence (006A,000A) = (108369006, SCT, "Neoplasm") Annotation Property Type Modifier Code Sequence (006A,000B) = (35917007, SCT, "Adenocarcinoma"), (39607008, SCT, "Lung") Primary Anatomic Structure Sequence (0008,2228) = (39607008, SCT, "Lung")