Sup 187 - Preclinical Small Animal Imaging Acquisition Context DICOM Standards Committee - Working Group 30 - Small Animal Imaging

1300 N. 17th Street Suite 1752 Rosslyn VA 22209 USA

2015 NEMA Status: Final Text 2016/02/13 This supplement is prepared pursuant to work item: 2015-05-A This Supplement defines use-cases and templates for storage of information related to acquisition of small animal images during preclinical research. Acquisition Context is a "description of the conditions present during data acquisition" (quoted from the text of PS3.3 Section C.7.6.14 Acquisition Context Module). Traditionally, all attributes that describe an image acquisition are defined as specific Attributes (Data Elements) in a modality-specific IOD. This approach works extremely well when image objects have very specific applications and when the domain from which the descriptive concepts are drawn is well understood and clearly defined. When the visible light image object family was introduced, an alternative and more general mechanism was added to the standard, using lists of coded name-value pairs to specify acquisition content information, rather than depending on SOP-class-specific sets of traditional Attributes. The name-value pairs are encoded in the Acquisition Context Module. Using coded entries has benefits and disadvantages. One of the advantages is the ability to use coding schemes defined by other organizations to define names and value sets for concepts. The "acquisition context" idea was introduced to DICOM by Dean Bidgood and is well described in his article on the subject: Bidgood WD, Bray B, Brown N, Mori AR, Spackman KA, Golichowski A, et al. Image Acquisition Context: Procedure Description Attributes for Clinically Relevant Indexing and Selective Retrieval of Biomedical Images. Journal of the American Medical Informatics Association : JAMIA. 1998 Aug 17;6(1):61–75. available at . Both approaches assume that the Acquisition Context is known prior to encoding the image in DICOM, and that it is known to the device encoding the DICOM image (the modality). In some cases, information about the acquisition that is relevant to the interpretation of the imaging may not be known to the modality. This is particularly the case in small animal preclinical research, where a myriad of factors that affect quantitative analysis need to be recorded, which would be overwhelming if required to be captured at the modality console user interface. Though it would be possible to add this information by post-processing of the acquired images, WG 30 has concluded that it is preferable to encode the Acquisition Context in a separate standalone composite instance. The type of information to be recorded needs to be in a structured form, and many of the concepts are expected to be available in external lexicons. This is particularly the case for descriptions of experimental conditions, animal physiology and animal handling. Accordingly, the DICOM Structured Report (SR) mechanism is a natural choice of encoding. The Acquisition Context Module in the images will remain unpopulated. The Acquisition Context SR instances will usually be in the same Study as the acquired images. This supplement defines a new DICOM SR root template and supporting templates, as well as an IOD and SOP Class specific to that template to facilitate interoperability. Add new DICOM PS3.16 - Content Mapping Resource - Normative References as follows:

AQI Schema Anesthesia Quality Institute, Schaumburg, IL 2015/07/30 Used by permission of the Anesthesia Quality Institute (AQI) (), established by the American Society of Anesthesiologists (ASA).

Add new DICOM PS3.16 - Content Mapping Resource - Coding Schemes as follows:

Coding Schemes

Coding Scheme Designator	Coding Scheme UID	Description
PUBCHEM_CID	1.2.840.10008.2.​16.​9	US National Center for Biotechnology Information (NCBI) PubChem Compound CID. See .

Amend DICOM PS3.16 - Content Mapping Resource - Structured Reporting Templates to add the following:

This root template encodes a description of the conditions present during and related to data acquisition for a single imaging procedure. It is not expected that a single instance be used to describe the entire life of an animal, unless it is sacrificed after a single procedure. Rather, separate instances will be used for separate procedures, though there may be some duplication of common information, such as about the home cage environment. It is expected that an SR instance encoded using this template will be contained in the same Study as other instances created during the procedure, e.g. with a common Study Instance UID. If this is not practical, e.g., due to recording on a separate device without use of a shared Modality Worklist, then commonality of other Study level attributes may be necessary to link procedures (and possibly coerce the Study Instance UID to a common value). Type: Extensible Order: Non-Significant Root: Yes

Preclinical Small Animal Image Acquisition Context

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (127001, DCM, "Preclinical Small Animal Imaging Acquisition Context")	1	M		Root node
2	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 "Language of Content Item and Descendants"	1	M
3	>	HAS OBS CONTEXT	INCLUDE	DTID 1001 "Observation Context"	1	M
5	>	CONTAINS	INCLUDE	D	1	U
6	>	CONTAINS	CONTAINER	EV (127005, DCM, "Animal handling during specified phase")	1-n	U
7	>>	HAS CONCEPT MOD	CODE	EV (127006, DCM, "Phase of animal handling")	1	M		D
8	>>	CONTAINS	DATETIME	EV (111526, DCM, "DateTime Started")	1	U
9	>>	CONTAINS	DATETIME	EV (111527, DCM, "DateTime Ended")	1	U
10	>>	CONTAINS	INCLUDE	D	1	U
11	>>	CONTAINS	INCLUDE	D	1-n	U
12	>>	CONTAINS	INCLUDE	D	1	U
13	>>	CONTAINS	INCLUDE	D	1	U
14	>>	CONTAINS	INCLUDE	D	1	U
15	>	CONTAINS	INCLUDE	D	1	U
16	>	CONTAINS	INCLUDE	D	1	U		$ContainerConcept = EV (10160-0, LN, "History Of Medication Use") $CodeConcept = EV (111516, DCM, "Medication Type") $Route = D
17	>	CONTAINS	INCLUDE	D	1	U		$ContainerConcept = EV (127400, DCM, "Exogenous substance") $CodeConcept = D $CodeValue = D $Route = D $Site = D $TissueOfOrigin = D $TaxonomicRankOfOrigin = DCID 7454 "Animal Taxonomic Rank Values"

Content Item Descriptions Row 3 A single pre-coordinated code describing the general type of imaging procedure can be described using TID 1005 Row 9 Procedure Code (included in TID 1001). For small animal (as opposed to human) imaging, this will likely describe a whole body acquisition in a modality-specific manner and the use of contrast and/or radiopharmaceutical. E.g., whole body FDG PET, or whole body DCE-MRI. May be redundant with (or default to) the value present in the top level data set in Procedure Code Sequence (0008,1032) of the General Study Module. Species and strain identification is not described in TID 1001; rather it is encoded in DICOM Attributes in the top level data set. Row 5 The biosafety conditions are expected to be consistent across all phases of handling, so are not described separately per-phase. Rows 8-9 The period of time during which the phase is defined, i.e., during which the animal was managed in the specified conditions. This may be more important for interpretation for some phases (e.g., transport) than others (e.g., at rest in the home cage), and hence is optional. Rows 10-14 The outline of subordinate templates follows the pattern of categories of Animal Housing, Care, and Physiologic Monitoring information described in . Row 11 Animal feeding is 1-n to allow encoding of dietary supplements and treats in addition to the regular diet. Row 15 A single anesthesia event is normally assumed for a single procedure, though the template included can include multiple pre-, intra- and post-procedure descriptions. Row 16 Used to describe pharmaceuticals administered that are not described elsewhere, in particular, those that are not described as anesthesia medications, and those that are not described in the images (e.g., contrast, radiopharmaceuticals). This includes therapy (such as chemotherapy, immunotherapy) and similar interventions that may be the subject of the research. The value set of $CodeValue is not defined, given the vast range of possible codes and coding schemes for drugs or medicaments that might be used. Nor are value sets for $Classification or $Site defined. Row 17 Used to describe non-pharmaceutical exogenous substances administered, such as cells or other tumor graft, fibrils, viruses, cytokines and toxins that describe the "model" upon which the research is being performed, as distinct from the "therapeutic intervention" (Row 16) that may be the purpose of the research. The Classification parameter is not constrained by any value set.

This template encodes a description of the biosafety conditions applicable to research small animals. Type: Extensible Order: Non-Significant

Biosafety Conditions

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (127010, DCM, "Biosafety conditions")	1	M
2	>	CONTAINS	CODE	EV (F-0061F, SRT, "Biosafety level")	1	U		D
2	>	CONTAINS	CODE	EV (127011, DCM, "Reason for biosafety controls")	1	U		D
4	>	CONTAINS	TEXT	EV (121106, DCM,"Comment")	1	U

Content Item Descriptions Row 4 A brief description of any pertinent or unusual biosafety requirements.

This template encodes a description of housing of animals, e.g., in home cages, holders for imaging, etc., over an interval during which environmental and handling conditions are relatively homogenous. Only "static" parameters of the design and setup are recorded, and "nominal" values for environmental conditions such as humidity and temperature, but not "dynamic" parameters that might vary during one housing interval, and potentially be monitored, such as oxygen or ammonia levels, temperature, humidity, urine or fecal corticosterone levels, etc. Values for product names and codes are expected to be accurate at the time the information is recorded, recognizing that products may evolve over time. Type: Extensible Order: Non-Significant

Animal Housing

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (127120, DCM, "Animal housing")	1	M
2	>	CONTAINS	CODE	EV (127121, DCM, "Animal room type")	1	U		D
2b	>	CONTAINS	TEXT	EV (127122, DCM, "Animal room identifier")	1	U
3	>	CONTAINS	TEXT	EV (127125, DCM, "Housing manufacturer")	1	U
4	>	CONTAINS	TEXT	EV (127126, DCM, "Housing rack product name")	1	U
5	>	CONTAINS	TEXT	EV (127127, DCM, "Housing rack product code")	1	U
6	>	CONTAINS	TEXT	EV (127128, DCM, "Housing unit product name")	1	U
7	>	CONTAINS	TEXT	EV (127129, DCM, "Housing unit product code")	1	U
8	>	CONTAINS	TEXT	EV (127130, DCM, "Housing unit lid product name")	1	U
9	>	CONTAINS	TEXT	EV (127131, DCM, "Housing unit lid product code")	1	U
10	>	CONTAINS	NUM	EV (127140, DCM, "Number of racks per room")	1	U		UNITS = EV ({racks}, UCUM, "racks")
11	>	CONTAINS	NUM	EV (127141, DCM, "Number of housing units per rack")	1	U		UNITS = EV ({housing units}, UCUM, "housing units") or EV ({cages}, UCUM, "cages")
12	>	CONTAINS	TEXT	EV (127142, DCM, "Housing unit location in rack")	1	U
13	>	CONTAINS	NUM	EV (127143, DCM, "Number of animals within same housing unit")	1	U		UNITS = EV ({animals}, UCUM, "animals")
14	>	CONTAINS	CODE	EV (127144, DCM, "Sex of animals within same housing unit")	1	U		D
15	>	CONTAINS	CODE	EV (127145, DCM, "Sex of handler")	1	U		D
16	>	CONTAINS	NUM	EV (127150, DCM, "Total duration in housing")	1	U		UNITS = EV (d, UCUM, "days")
17	>	CONTAINS	NUM	EV (127151, DCM, "Housing change interval")	1	U		UNITS = EV (d, UCUM, "days")
18	>	CONTAINS	NUM	EV (127152, DCM, "Manual handling interval")	1	U		UNITS = EV (h, UCUM, "hours")
19	>	CONTAINS	TEXT	EV (127153, DCM, "Housing unit movement")	1	U
20	>	CONTAINS	NUM	EV (127160, DCM, "Housing unit width")	1	U		UNITS = EV (cm, UCUM, "cm")
21	>	CONTAINS	NUM	EV (127161, DCM, "Housing unit height")	1	U		UNITS = EV (cm, UCUM, "cm")
22	>	CONTAINS	NUM	EV (127162, DCM, "Housing unit length")	1	U		UNITS = EV (cm, UCUM, "cm")
23	>	CONTAINS	CODE	EV (127170, DCM, "Housing individually ventilated")	1	U		D
24	>	CONTAINS	NUM	EV (127172, DCM, "Air changes")	1	U		UNITS = EV (/h, UCUM, "/hour")
25	>	CONTAINS	NUM	EV (C90380, NCIt, "Environmental temperature")	1	U		UNITS = EV (Cel, UCUM, "C")
26	>	CONTAINS	NUM	EV (C90395, NCIt, "Housing humidity")	1	U		UNITS = EV (%, UCUM, "%")
27	>	CONTAINS	CODE	EV (127175, DCM, "Housing unit reuse")	1	U		D
28	>	CONTAINS	CODE	EV (C90366, NCIt, "Bedding material")	1	U		D
29	>	CONTAINS	TEXT	EV (C90366, NCIt, "Bedding material")	1	U
30	>	CONTAINS	TEXT	EV (127180, DCM, "Bedding manufacturer")	1	U
31	>	CONTAINS	TEXT	EV (127181, DCM, "Bedding product name")	1	U
32	>	CONTAINS	TEXT	EV (127182, DCM, "Bedding product code")	1	U
33	>	CONTAINS	NUM	EV (127183, DCM, "Bedding volume")	1	U		UNITS = EV (ml, UCUM, "ml")
34	>	CONTAINS	NUM	EV (127184, DCM, "Bedding mass")	1	U		UNITS = EV (g, UCUM, "g")
34b	>	CONTAINS	NUM	EV (127185, DCM, "Bedding depth")	1	U		UNITS = EV (mm, UCUM, mm")
35	>	CONTAINS	NUM	EV (C90365, NCIt, "Bedding change")	1	U		UNITS = EV (d, UCUM, "days")
36	>	CONTAINS	CODE	EV (127192, DCM, "Enrichment material present")	1	U		D
36b	>	CONTAINS	TEXT	EV (127191, DCM, "Enrichment manufacturer")	1	U
37	>	CONTAINS	TEXT	EV (127190, DCM, "Enrichment material")	1	U
38	>	CONTAINS	CODE	EV (127193, DCM, "Exerciser device present")	1	U		D
39	>	CONTAINS	TEXT	EV (A-17200, SRT, "Exerciser device")	1	U
40	>	CONTAINS	CODE	EV (127195, DCM, "Shelter type")	1	U		D
41	>	CONTAINS	TEXT	EV (127196, DCM, "Shelter manufacturer")	1	U
42	>	CONTAINS	TEXT	EV (127197, DCM, "Shelter product name")	1	U
43	>	CONTAINS	TEXT	EV (127198, DCM, "Shelter product code")	1	U
44	>	CONTAINS	TEXT	EV (121106, DCM,"Comment")	1	U

Content Item Descriptions Row 2 and 2b The type and identifier of the entire room in which, for example, one or more racks of housing units is located, not the housing unit itself. Row 3 The manufacturer is expected to be the same for all housing unit components, rack, bottom and lid. Row 12 The position in the rack is encoded as text since it may be an "identifier" or a description. It is not a set of numeric (e.g., row, column) or coded (e.g., top, bottom or middle) values, since there are too many possible arrangements. Row 13 The number of animals usually applies to a single housing unit, but may also be used to describe the number of animals imaged simultaneously in a multi-animal imaging carrier or support device ("chamber", "holder", etc.). Rows 20-22 These may be internal or external dimensions, and are intended to provide an approximation of the living space and shape available. Rows 25-26 Description of measured or monitored or nominal values of temperature and humidity. The means of maintaining these conditions, if relevant, is described elsewhere (e.g., in the case of peri-procedural temperature control, in ). Rows 28-29 The bedding material may be described as a code or text, or both. The codes do not distinguish between methods of sterilization of the bedding material (e.g., irradiation, autoclaving or other heat treatment), since that is not a relevant factor for image interpretation. The definition of the NCIt concept is "that which comprises the place where a subject sleeps". Row 35 The definition of the NCIt concept is "a replacement of the existing materials that make up the sleeping area of a subject", and is used here to specify the interval between bedding changes. Row 36-37 The presence or absence of enrichment material is coded, but the type is not, and may be described as text, e.g., "facial tissue", "cotton (nesting material)". Row 38-39 The presence or absence of an exercise device is coded, but the type is not, and may be described as text.

This template encodes a description of feeding and watering of animals, over an interval during which conditions are relatively homogenous. No specific time interval during which the diet is applicable is described. Values for product names and codes are expected to be accurate at the time the information is recorded, recognizing that products may evolve over time. Type: Extensible Order: Non-Significant

Animal Feeding

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (PA-00600, SRT, "Feeding")	1	M
2	>	CONTAINS	CODE	EV (C-F5000, SRT, "Animal feed")	1	U		D
3	>	CONTAINS	CODE	EV (127205, DCM, "Feed source")	1	U		D
4	>	CONTAINS	TEXT	EV (127200, DCM, "Feed manufacturer")	1	U
5	>	CONTAINS	TEXT	EV (127201, DCM, "Feed product name")	1	U
6	>	CONTAINS	TEXT	EV (127202, DCM, "Feed product code")	1	U
7	>	CONTAINS	CODE	EV (C0015746, UMLS, "Feeding method")	1	U		D
8	>	CONTAINS	CODE	EV (C-10120, SRT, "Water")	1	U		D
9	>	CONTAINS	CODE	EV (C90486, NCIt, "Water delivery")	1	U		D
10	>	CONTAINS	TEXT	EV (121106, DCM, "Comment")	1	U

This template encodes a description of the anesthesia applied during a procedure (e.g., imaging of research small animals). This template combines selected concepts from the elements, their complex types, and their children: AnesthesiaMethodSet (type AnesthesiaMethodSetType). See and . AirwayManagementSet (type AirwayManagementSetType). See and . MedicationsSet (type MedicationsSetType). See and . Type: Extensible Order: Non-Significant

Anesthesia

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (P1-0512A, SRT, "Administration of anesthesia")	1	M
2	>	CONTAINS	CONTAINER	EV (127300, DCM, "Anesthesia Method Set")	1	M
3	>>	CONTAINS	CONTAINER	EV (127301, DCM, "Anesthesia Method")	1-n	M
4	>>>	CONTAINS	CODE	EV (127302, DCM, "Anesthesia Category")	1	M		D
5	>>>	CONTAINS	TEXT	EV (127303, DCM, "Anesthesia SubCategory")	1	U
6	>>>	CONTAINS	DATETIME	EV (DF-0068E, SRT, "Anesthesia Start Time")	1	U
7	>>>	CONTAINS	DATETIME	EV (DF-0070B, SRT, "Anesthesia Finish Time")	1	U
8	>>>	CONTAINS	CODE	EV (P1-C0012, SRT, "Anesthesia Induction")	1	U		D
9	>>>	CONTAINS	CODE	EV (P1-C001A, SRT, "Anesthesia Maintenance")	1	U		D
10	>>>	CONTAINS	TEXT	121106, DCM, "Comment")	1	U
11	>	CONTAINS	CONTAINER	EV (127310, DCM, "Airway Management Set")	1	M
12	>>	CONTAINS	CONTAINER	EV (P0-0409B, SRT, "Airway Management")	1-n	M
13	>>>	CONTAINS	CODE	EV (127312, DCM, "Airway Management Method")	1	M		D
14	>>>	CONTAINS	CODE	EV (127313, DCM, "Airway Sub-Management Method")	1	M		D
15	>	CONTAINS	CONTAINER	EV (127320, DCM, "Medications Set")	1-n	M
16	>>	CONTAINS	CODE	EV (G-7292, SRT, "Procedure Phase")	1	M		D
17	>>	CONTAINS	INCLUDE	D	1-n	M

Content Item Descriptions Rows 1-3 If this template is used, at least one description of anesthesia method is required. Note that the specific agents used are described separately, as intra-operative medications, per the . Rows 6-7 These correspond to AQI elements that are named "Time" rather than "DateTime", though their value is a DateTime; the DICOM naming convention is used here. Row 9 Only inhalational methods of maintenance are included in this row. Absence of this row implies that the (non-inhalational) induction method is used for maintenance. Row 10 The comment corresponds to AQI element "Anesthesia Notes". Rows 11-13 At least one description of airway management is required. The airway management method also serves as the description of the method of inhalational anesthesia delivery, even if it does not involve "management" of the "airway" per se (e.g., delivery via nose cone). Rows 15-17 In the AQI model, a single AQI MedicationsSet is used in the AQI IntraOp element to describe intra-operative medications. This template allows a more general usage, with one or more Medications Set containers, each of which may be qualified by the phase of the procedure (pre-operative, intra-operative or post-operative). The purpose of the medication (e.g., general anesthetic) is described in the (111516, DCM, "Medication Type") of the included .

This template encodes a description of medications (including but not limited to anesthetic agents) used during a procedure (e.g., anesthesia for imaging of research small animals). This template combines selected concepts from the elements, their complex types, and their children: Medication (type MedicationType). See and . MixtureMedications (type MixtureMedicationType). See and . Type: Extensible Order: Non-Significant

Medications and Mixture Medications

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (F-04460, SRT, "Medication given")	1	M
2	>	CONTAINS	DATETIME	EV (122081, DCM, "Drug start")	1	U
3	>	CONTAINS	DATETIME	EV (122082, DCM, "Drug end")	1	U
4	>	CONTAINS	CODE	EV (G-C340, SRT, "Route of administration")	1	M		D
5	>	CONTAINS	CONTAINER	EV (R-40826, SRT, "Mixture")	1-n	M
6	>>	CONTAINS	CODE	EV (122083, DCM, "Drug administered")	1	MC	XOR Row 7	D
7	>>	CONTAINS	TEXT	EV (122083, DCM, "Drug administered")	1	MC	XOR Row 6
8	>>	CONTAINS	CODE	EV (111516, DCM, "Medication Type")	1	M		D
9	>>	CONTAINS	NUM	EV (G-C0B7, SRT, "Dosage")	1	U		UNITS = DCID 82 "Units of Measurement"
10	>>	CONTAINS	NUM	EV (122093, DCM, "Concentration")	1	U		UNITS = DCID 82 "Units of Measurement"

Content Item Descriptions Row 1 AQI Medication type and element correspond to (F-04460, SRT, "Medication given") (situation). (See TID 3806 Cath Procedure). Rows 2-3 AQI DoseStart and DoseEnd elements correspond to (122081, DCM, "Drug start") and (122082, DCM, "Drug end") respectively. (See CID 3409 Administration of Drugs/Contrast). If the medication is delivered as a bolus, the end time is omitted. Row 4 AQI MedicationRoute corresponds to (G-C340, SRT, "Route of administration"). The existing contains a relevant subset of concepts for the enumerated values of AQI MedicationRouteCodeType. Row 5 The AQI schema allows the Medication type not only to describe medications with a single component, but also to add MixtureMedications children, each of which is encoded following a similar pattern to the contents of Medication, though the start and end time and route of administration are shared. This had been modeled by allowing every medication to have one or more mixture children. For medications that are not a mixture, a single instance of this row defines the medication (even though the mixture container is still used). Rows 6, 7 AQI MedicationName and MixtureMedicationName elements correspond to (122083, DCM, "Drug administered"). (See TID 3806 Cath Procedure). The medication (e.g., anesthesia agent) can be described with a code or text, e.g., (F-61B0A, SRT, "Isoflurane") or "isoflurane". Row 9 Both AQI MedDose (or MixtureMedDose) and DoseUnits (or MixtureDoseUnits) elements are combined in one content item. Units are required to be encoded as UCUM but are not otherwise constrained. Row 10 Both AQI MedConcentration (or MixtureMedConcentration) and MedConcentrationUnit (or MixtureMedConcentrationUnit) elements are combined in one content item. Units are required to be encoded as UCUM but are not otherwise constrained.

This template encodes a description of the heating conditions applied prior to, during or after data acquisition (e.g., during imaging of research small animals). Type: Extensible Order: Non-Significant

Heating Conditions

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (127040, DCM, "Heating conditions")	1	M
2	>	CONTAINS	CODE	EV (G-7292, SRT, "Procedure Phase")	1	U		D
3	>	CONTAINS	CODE	EV (C0018851, UMLS, "Heating")	1	U		D
4	>	CONTAINS	CODE	EV (127210, DCM, "Feedback temperature regulation")	1	U		D
5	>	CONTAINS	CODE	EV (C50304, NCIt, "Temperature sensor device component")	1	U		D
6	>	CONTAINS	NUM	EV (F-021FF, SRT, "Equipment Temperature")	1	U		UNITS = EV (Cel, UCUM, "C")

Content Item Descriptions Row 2 Phase during which the conditions are applicable may be implicit in the context of invocation of this template (e.g., Row 7), or explicitly specified. Row 3 The definition (from MESH) is "The application of heat to raise the temperature of the environment, ambient or local, or systems for accomplishing this effect". Row 6 This is the nominal temperature of the heating device (e.g., heating pad) and/or the set point of the feedback regulation device.

This template encodes a description of the Circadian effects relevant during data acquisition (e.g., during imaging of research small animals). Type: Extensible Order: Non-Significant

Circadian Effects

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (127050, DCM, "Circadian effects")	1	M
2	>	CONTAINS	NUM	EV (127214, DCM, "Total duration of light-dark cycle")	1	U		UNITS = EV (h, UCUM, "hours")
3	>	CONTAINS	NUM	EV (C90419, NCIt, "Light cycle")	1	U		UNITS = EV (%, UCUM, "%")
4	>	CONTAINS	TIME	EV (127215, DCM, "Lights on time of day")	1-n	U

Content Item Descriptions Row 2 Usually 24 hours. Row 3 The definition is "the amount of ambient light/darkness to which a subject is exposed in a period of time"; also mapped to CDISC "the period of light that a subject is exposed to in a period of time, usually expressed as the amount of time in a 24 hour cycle". Row 4 Can only be encoded if the light-dark cycles are aligned to a 24 hour clock. May be multiple if either multiple cycles occur during a 24 hour period, or if the cycle is longer than a 24 hour period and a multiple of 24 hours in duration.

This template encodes a description of the physiological monitoring performed during a period of time during or related to a data acquisition procedure (e.g., imaging of research small animals). Type: Extensible Order: Non-Significant

Physiological Monitoring Performed During Procedure

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (P0-005ED, SRT, "Physiological monitoring")	1	M
2	>	CONTAINS	CODE	EV (P2-31209, SRT, "Electrocardiographic monitoring")	1	U		D
3	>	CONTAINS	CODE	EV (P2-22010, SRT, "Monitoring of respiration")	1	U		D

Content Item Descriptions Row 2 There is no non-surgical procedure non-specific variant of (P2-34122, SRT, "Monitoring of electrocardiogram at surgery"). (P2-31209, SRT, "Continuous electrocardiogram monitoring") is intended for non-procedural (e.g., 24-hour) monitoring. So a more generic code for any kind of monitoring is used.

This template provides detailed information on a research subject's exposure to exogenous substances. It is a specialization of the more general template .

Parameters

Parameter Name	Parameter Usage
$ContainerConcept	Coded term for the concept name of the CONTAINER, identifying it as an exogenous substance.
$CodeConcept	Coded term for the concept name of the CODE, identifying the type of substance.
$CodeValue	Coded term or Context Group for value of the substance.
$Classification	Coded term or Context Group for classification of the substance.
$Route	Coded term or Context Group for the route of administration of the substance.
$Site	Coded term or Context Group for the anatomical site of administration of the substance
$TissueOfOrigin	Coded term or Context Group for the tissue of origin of the substance
$TaxonomicRankOfOrigin	Coded term or Context Group for the taxonomic rank (e.g., species) of origin of the substance

Type: Extensible Order: Significant

Exogenous Substance Administration

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	$ContainerConcept	1	M
2	>	CONTAINS	CODE	$CodeConcept	1-n	M		$CodeValue
3	>>	HAS CONCEPT MOD	CODE	EV (G-C032, SRT, "Classification")	1	U		$Classification
4	>>	HAS OBS CONTEXT	CODE	EV (111534, DCM, "Role of person reporting")	1	U		DCID 7450 "Person Roles"/>
5	>>	HAS PROPERTIES	NUM	EV (111524, DCM, "Age Started")	1	U		UNITS = DCID 7456 "Units of Measure for Age"
6	>>	HAS PROPERTIES	NUM	EV (111525, DCM, "Age Ended")	1	U		UNITS = DCID 7456 "Units of Measure for Age"
7	>>	HAS PROPERTIES	DATETIME	EV (111526, DCM, "DateTime Started")	1	U
8	>>	HAS PROPERTIES	DATETIME	EV (111527, DCM, "DateTime Ended")	1	U
9	>>	HAS PROPERTIES	NUM	EV (G-7290, SRT, "Duration")	1	U		UNITS = D
10	>>	HAS PROPERTIES	CODE	EV (111528, DCM, "Ongoing")	1	U		D
11	>>	HAS PROPERTIES	TEXT	EV (111529, DCM, "Brand Name")	1	U
12	>>	HAS PROPERTIES	NUM	D	1	U		The unit of measure shall be quantity per unit of time
13	>>	HAS PROPERTIES	CODE	D	1	U		D
14	>>	HAS PROPERTIES	CODE	D	1	U		D
15	>>	HAS PROPERTIES	CODE	EV (G-C340, SRT, "Route of administration")	1	U		$Route
16	>>>	HAS PROPERTIES	CODE	EV (G-C581, SRT, "Site of")	1	U		$Site
17	>>>>	HAS CONCEPT MOD	CODE	EV (G-C171, SRT, "Laterality")	1	MC	IF Row 16 has laterality	D
18	>>>	HAS PROPERTIES	SCOORD3D	EV (127450, DCM, "Stereotactic coordinates")	1	U
19	>>>	HAS PROPERTIES	CODE	EV (127451, DCM, "Position reference indicator")	1	U		D
20	>>	HAS PROPERTIES	CODE	EV (127401, DCM, "Tissue of origin")	1	U		$TissueOfOrigin
21	>>	HAS PROPERTIES	CODE	EV (127402, DCM, "Taxonomic rank of origin")	1	U		$TaxonomicRankOfOrigin

Content Item Descriptions Row 3 Classification is inherited from the more general template , and may be supplied as a parameter, but is entirely generic and is not used as an alternative to the more specific information provided in other rows, for example, Rows 19 and 20, tissue and taxonomic rank of origin. Row 11 Brand name may be used for any type of descriptor or identifier. E.g., a particular cell line might have a designated name, such as "MDA-MB-468", which designates a particular human breast cancer cell line.

Amend existing relevant templates in DICOM PS3.16:

This general template provides detailed information on a patient's medication or substance use, or exposure to environmental factors, including type and duration of use or exposure.

Parameters

Parameter Name	Parameter Usage
$ContainerConcept	Coded term for the concept name of the CONTAINER, identifying it as medication, substance, or environmental exposure history.
$CodeConcept	Coded term for the concept name of the CODE, identifying it as medication, substance, or environmental exposure.
$CodeValue	Coded term or Context Group for value of the medication, substance, or environmental exposure.
$Classification	Coded term or Context Group for classification of the medication, substance, or environmental exposure.
$Route	Coded term or Context Group for the route of administration of the medication, substance, or route of environmental exposure.
$Site	Coded term or Context Group for the anatomical site of administration of the medication, substance, or anatomical site of environmental exposure.

Type: Extensible Order: Significant

Medication, Substance, Environmental Exposure

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	$ContainerConcept	1	M
2	>	CONTAINS	CODE	$CodeConcept	1-n	M		$CodeValue
3	>>	HAS CONCEPT MOD	CODE	EV (G-C032, SRT, "Classification")	1	U		$Classification
4	>>	HAS OBS CONTEXT	CODE	EV (111534, DCM, "Role of person reporting")	1	U		DCID 7450 "Person Roles"/>
5	>>	HAS PROPERTIES	NUM	EV (111524, DCM, "Age Started")	1	U		UNITS = EV (a, UCUM, "Year") DCID 7456 "Units of Measure for Age"
6	>>	HAS PROPERTIES	NUM	EV (111525, DCM, "Age Ended")	1	U		UNITS = EV (a, UCUM, "Year") DCID 7456 "Units of Measure for Age"
7	>>	HAS PROPERTIES	DATETIME	EV (111526, DCM, "DateTime Started")	1	U
8	>>	HAS PROPERTIES	DATETIME	EV (111527, DCM, "DateTime Ended")	1	U
9	>>	HAS PROPERTIES	NUM	EV (G-7290, SRT, "Duration")	1	U		UNITS = D
10	>>	HAS PROPERTIES	CODE	EV (111528, DCM, "Ongoing")	1	U		D
11	>>	HAS PROPERTIES	TEXT	EV (111529, DCM, "Brand Name")	1	U
12	>>	HAS PROPERTIES	NUM	D	1	U		The unit of measure shall be quantity per unit of time
13	>>	HAS PROPERTIES	CODE	D	1	U		D
14	>>	HAS PROPERTIES	CODE	D	1	U		D
15	>>	HAS PROPERTIES	CODE	EV (G-C340, SRT, "Route of administration")	1	U		$Route
16	>>>	HAS PROPERTIES	CODE	EV (G-C581, SRT, "Site of")	1	U		$Site
17	>>>>	HAS CONCEPT MOD	CODE	EV (G-C171, SRT, "Laterality")	1	MC	IF Row 16 has laterality	D

Content Item Descriptions Row 3 "Classification" No context group is provided for the value set, but it is recommended that values from a standard external coding scheme, such as SRT or NDC, be used. Classification is mapped in UMLS to (C0008902, UMLS, "Classification"). Its definition is completely generic; i.e., it does not refer to any particular type of classification. Rows 13 & 14 If both of these content items are instantiated, the concept names selected for each should match. For example, use "Relative dose amount" as the concept name for row 13 with "Relative dose frequency" as the concept name for row 14. Row 15 Even though the concept name is route of administration, it is also used for route of exposure in the case of environmental exposure. Rows 16 and 17 This pattern of route with a site and laterality modifier follows that used in TID 10022 Radiopharmaceutical Administration Event Data.

Rename Annex in DICOM PS3.16:

For reference (unchanged), existing relevant templates in DICOM PS3.16:

Type: Extensible Order: Non-Significant

PET Covariates Acquisition Context

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	NUMERIC	(14749-6, LN, "Glucose")	1	U		UNITS = EV (mmol/l, UCUM, "mmol/l")
2	DATE	(109081, DCM, "Glucose Measurement Date")	1	MC	IFF Row 1 is present
3	TIME	(109082, DCM, "Glucose Measurement Time")	1	MC	IFF Row 1 is present

Type: Non-Extensible Version: 20151110

Yes-No Only

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

This context group is intended for use rather than CID 230 "Yes-No" when the value (R-0038A, SRT, "Undetermined") is not permissible.

Type: Non-Extensible Version: 20151110

Present-Absent Only

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	G-A203	Present	52101004	C0150312
SRT	R-4089B	Absent	272519000	C0442733

This context group is intended for use rather than CID 240 "Normal-Abnormal" when the value (R-40271, SRT, "Presence Undetermined") is not permissible.

Type: Extensible Version: 20151110

Biosafety Levels

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	R-41E4D	Biosafety level 1	409600007	C1443934
SRT	R-41E4E	Biosafety level 2	409603009	C1443937
SRT	R-41E4F	Biosafety level 3	409604003	C1443938
SRT	R-41E50	Biosafety level 4	409605002	C1443939

Type: Extensible Version: 20151110

Biosafety Control Reasons

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	F-61E79	Biohazardous material	409595003	C0079021
SRT	C-29000	Carcinogen	88376000	C0007090
SRT	F-00D5F	Patient immunocompromised	370388006	C0085393
UMLS	C0003069	Transgenic animal		C0003069

Type: Extensible Version: 20151110

Sex - Male Female or Both

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	M	Male
DCM	F	Female
DCM	127146	Mixed sex

Type: Extensible Version: 20151110

Animal Room Types

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	127370	Animal housing room
DCM	127371	Preparation room
DCM	127372	Imaging procedure room
SRT	R-305D6	Induction room	414485004	C1532289
SRT	R-305C3	Recovery room	398161000	C0198828
SRT	R-305D3	Isolation room	409688003	C1443994

Only rooms appropriate for animals in the context of in vivo imaging are described (e.g., not necropsy rooms, etc.) (R-305C3, SRT, "Recovery room" (synonym of "postoperative anesthesia care unit ") is reused here even though its parent is "Location within hospital premises (environment)", which is arguably specifically human. The same is true for (R-305D6, SRT, "Induction room") and (R-305D3, SRT, "Isolation room").

Type: Extensible Version: 20151110

Device Reuse

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	127177	Unused
DCM	127178	Reused

Type: Extensible Version: 20151110

Animal Bedding Material

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	127230	Aspen chip bedding
DCM	127231	Aspen shaving bedding
DCM	127232	Corn cob bedding
DCM	127233	Paper-based bedding
DCM	127234	Pine chip bedding
DCM	127235	Pine shaving bedding

Type: Extensible Version: 20151110

Animal Shelter Types

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	R-40775	None	260413007	C0549184
DCM	127220	Igloo
DCM	127221	Red translucent igloo

Type: Extensible Version: 20151110

Animal Feed Types

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	127271	NIH07
DCM	127270	NIH31
DCM	127272	AIN76
DCM	127273	AIN93G
DCM	127274	AIN93M

This context group includes the open source diets described in Barnard DE et al. Open- and Closed-Formula Laboratory Animal Diets and Their Importance to Research. Journal of the American Association for Laboratory Animal Science : JAALAS (2009), 48(6), 709–713. . A more extensive list of NIH-specified diets for small animals (not just mice and rats) can be found at .

Type: Extensible Version: 20151110

Animal Feed Sources

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
UMLS	C1547887	Commercial product
DCM	127390	Locally manufactured product

(C1547887, UMLS, "Commercial product") originates from the HL7 V2.5 Chapter 04 blood products description as an attribute name rather than a value, but in UMLS is not expressly constrained and has as a parent generic semantic type of "Manufactured Object".

Type: Extensible Version: 20151110

Animal Feeding Methods

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
NCIt	C64636	ad libitum		C1879743
UMLS	C0425422	Restricted diet		C0425422
DCM	127391	Food treat
SRT	PA-00620	Gavage	61420007	C0041281

(C0425422, UMLS, "Restricted diet") corresponds to the inactive SNOMED concept of "Dietary restriction NOS"; SNOMED currently does not seem to have an active generic concept of a restricted diet, as opposed to many specific types of restricted diet. In this context, the intent is to convey that the diet is controlled and restricted to finite quantities (e.g., as opposed to ad libitum) without requiring a detailed classification of what components are restricted.

Type: Extensible Version: 20151110

Water Types

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	C-101E9	Tap water	444923006	C2919405
SRT	C-101E8	Distilled water	444883009	C0790233
DCM	127290	Reverse osmosis purified water
DCM	127291	Reverse osmosis purified, HCl acidified water

Type: Extensible Version: 20151110

Anesthesia Category Code Type for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include

Type: Extensible Version: 20151110

Anesthesia Category Code Type from Anesthesia Quality Initiative (AQI)

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	P1-C0010	General anesthesia	50697003	C0002915
SRT	P1-C0B00	Sedation	72641008	C0344106
SRT	P1-C0208	Spinal anesthesia	231249005	C0002928
SRT	P1-C0220	Epidural anesthesia	18946005	C0002913
SRT	P1-C0200	Regional anesthesia	27372005	C0002911
SRT	P1-C0037	Topical local anesthesia	386760001	C0472473
SRT	P1-C0038	Local anesthesia	386761002	C0002921
SRT	P1-0512E	Monitored Anesthesia Care (MAC)	398239001	C1301902

This context group contains SNOMED procedure code equivalents of enumerated string concepts for the element AnesthesiaCategoryCodeType. See .

Type: Extensible Version: 20151110

Anesthesia Induction Code Type for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include
SRT	G-D106	Intraperitoneal route	38239002	C1522583

The intraperitoneal route is added to the AQI value set, since that route is used for small animal imaging.

Type: Extensible Version: 20151110

Anesthesia Induction Code Type from Anesthesia Quality Initiative (AQI)

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	G-D150	By inhalation	112239003	C0205535
SRT	G-D101	Intravenous route	47625008	C1522726
SRT	G-D160	Per rectum	37161004	C1527425
SRT	G-D103	Intramuscular route	78421000	C1556154

This context group contains SNOMED administration route code equivalents of enumerated string concepts for the element AnesthesiaInductionCodeType. See .

Type: Extensible Version: 20151110

Anesthesia Maintenance Code Type for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include

Type: Extensible Version: 20151110

Anesthesia Maintenance Code Type from Anesthesia Quality Initiative (AQI)

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	P1-C0020	Inhalation anesthesia system closed rebreathing primary agent	112987001	C0198795
SRT	P1-C0030	Inhalation anesthesia system closed no rebreathing primary agent	44812007	C0198796

This context group contains SNOMED procedure code equivalents of enumerated string concepts for the element AnesthesiaMaintenanceCodeType. See . The AQI value "circle system" corresponds to (P1-C0020, SRT, "Inhalation anesthesia, machine system, closed, rebreathing of primary agent"). The SNOMED code meaning has been abbreviated to fit within the allowed DICOM Value Representation. The AQI value "non-rebreathing" corresponds to (P1-C0030, SRT, "Inhalation anesthesia, machine system, closed, no rebreathing of primary agent"). The SNOMED code meaning has been abbreviated to fit within the allowed DICOM Value Representation.

Type: Extensible Version: 20151110

Airway Management Method Code Type for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include
DCM	127060	Nose cone

Type: Extensible Version: 20151110

Airway Management Method Code Type from Anesthesia Quality Initiative (AQI)

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	P2-2290D	Controlled Ventilation	243147009	C0419011
SRT	P2-22902	Artificial Respiration	40617009	C0035205
SRT	P2-22500	Oxygen Therapy	57485005	C0184633
SRT	P0-05DE2	Laryngeal Mask Airway (LMA)	424979004	C0396618
SRT	P0-06211	Intubation of respiratory tract	447996002	C3164350
SRT	A-00BA2	Anesthetic face mask	297120004	C0573976
SRT	A-00BA2	Anesthetic face mask	297120004	C0573976
DCM	127061	Nasal cannula		C0179574
SRT	G-D13E	Via tracheostomy	180640008	C0393370

This context group contains SNOMED procedure or physical object or qualifier value code equivalents of enumerated string concepts for the element AirwayManagementMethodCodeType. See . Used by permission of the Anesthesia Quality Institute (AQI) ().

Type: Extensible Version: 20151110

Airway Management Sub-Method Code Type for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include

Type: Extensible Version: 20151110

Airway Management Sub-Method Code Type from Anesthesia Quality Initiative (AQI)

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
UMLS	C2223982	Inverse ratio ventilation		C2223982
SRT	P2-22914	High frequency ventilation	243154003	C0019540
SRT	P2-22933	Transtracheal jet ventilation	448442005	C3164603
SRT	P2-22916	Continuous flow ventilation	243156001	C0419018

This context group contains SNOMED procedure code equivalents of enumerated string concepts for the element AirwayManagementSubMethodCodeType. See .

Type: Extensible Version: 20151110

Medication Type Code Type for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include
DCM	127330	Carrier gas

Type: Extensible Version: 20160212

Medication Type Code Type from Anesthesia Quality Initiative (AQI)

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	C-68000	Adrenergic agent	86308005	C0001637
SRT	C-52500	Aminoglycoside antibiotic	14443002	C0002556
SRT	F-6181F	Analgesic	373265006	C0002771
SRT	F-6196E	Antiarrhythmic	372813008	C0003195
SRT	C-5008C	Antibiotic	255631004	C0003232
SRT	F-6180B	Anticholinergic	373246003	C0242896
SRT	F-6180B	Anticholinergic agent	373246003	C0242896
SRT	F-6199A	Anticoagulant	372862008	C0003280
SRT	R-F1216	Anticonvulsant	255632006	C0003286
SRT	R-F1216	Anticonvulsant	255632006	C0003286
SRT	F-B1810	Antidiuretic hormone	77671006	C1705480
SRT	C-85800	Antiemetic	52017007	C0003297
SRT	F-617EF	Antifungal	373219008	C0003308
SRT	F-618BA	Anti-heparin agent	372708000	C0304941
SRT	F-61969	Antihistamine	372806008	C0003360
SRT	C-81100	Antihypertensive	1182007	C0003364
UMLS	C1579431	Antihypoglycemic		C1579431
SRT	R-F2B23	Barbiturate	372798009	C0004745
SRT	R-F2B1D	Benzodiazepine	372664007	C0005064
SRT	F-619EF	Benzodiazepine antagonist	372906009	C0360298
SRT	F-61814	Beta-blocker	373254001	C0001645
SRT	C-00231	Beta-Lactam antibiotic	373297006	C0026458
SRT	R-005B3	Blood product	410652009	C0456388
SRT	F-616EB	Bronchodilator	372580007	C0006280
SRT	C-14300	Calcium	5540006	C0006675
SRT	F-61878	Calcium channel blocker	373304005	C0006684
SRT	F-618D8	Caloric agent	373530005	C0280082
SRT	C-002B1	Carbapenem antibiotic	396345004	C0006968
SRT	C-0021C	Cephalosporin antibiotic	373262009	C3536856
SRT	F-620E8	Cholinergic agent	421148003	C1720711
SRT	F-618AF	Diuretic	372695000	C0012798
SRT	C-50013	Drug diluent	74626007	C0304221
SRT	F-B2700	Estrogen	41598000	C0014939
SRT	C-84989	Gastrointestinal prokinetic	116532005	C1268865
SRT	F-6186A	General anesthetic	373288007	C0017302
UMLS	C0019593	H2 antagonist		C0019593
SRT	F-618A5	Hemostatic agent	372681003	C0019120
SRT	C-50309	Hypoglycemic	312064005	C0020616
SRT	C-80120	Inotropic agent	111139005	C0304509
SRT	C-0023B	Lincomycin antibiotic	372677003	C0023726
SRT	C-00286	Linezolid antibiotic	387056004	C0663241
SRT	F-6183D	Local anesthetic	373477003	C0002934
SRT	F-6186F	Low Molecular Weight Heparin	373294004	C0019139
SRT	C-00211	Macrolide antibiotic	372480009	C0003240
SRT	C-14800	Magnesium	72717003	C0024467
SRT	F-616FE	Metronidazole antibiotic	372602008	C0025872
SRT	F-6188F	Narcotic (opiate) antagonist	372656001	C0027410
UMLS	C0027409	Narcotic analgesic		C0027409
SRT	C-97302	Nasal decongestant	96329004	C0042398
SRT	F-6180F	NeuroMuscular Blocking (NMB) - depolarizing	373250005	C0027867
SRT	F-61959	NeuroMuscular Blocking (NMB) - non depolarizing	372790002	C0304435
SRT	F-61898	NSAID	372665008	C0003211
SRT	F-61D70	Ocular Lubricant	398828005	C0717951
SRT	F-61E2A	Oxytocic	410937004	C0030094
SRT	C-0021D	Penicillin antibiotic	373270004	C0030842
SRT	F-616E7	Plasma Expander	372578001	C1268852
SRT	C-13500	Potassium	88480006	C0032821
SRT	C-0024C	Quinolone antibiotic	372722000	C1533693
SRT	F-6205D	Respiratory stimulant	418760000	C0282685
SRT	F-61899	Skeletal muscle relaxant	372666009	C0037250
SRT	C-10098	Steroid	116566001	C0038317
SRT	C-00257	Sulfonamide antibiotic	372788003	C0599503
SRT	C-00216	Tetracycline antibiotic	373206009	C1744619
SRT	F-B3000	Thyroid hormone	18220004	C0040135
SRT	C-0024E	Vancomycin antibiotic	372735009	C0042313
SRT	F-619AA	Vasoconstrictor	372881000	C0042397
SRT	F-61957	Vasodilator	372787008	C0042402
SRT	F-BB000	Vitamin	87708000	C0042890

This context group contains SNOMED substance or product code equivalents of enumerated string concepts for the element MedicationTypeCodeType. See and . The AQI value "ABX-Miscellaneous" corresponds to (C-5008C, SRT, "Antibiotic") product, since there is no substance code in SNOMED. The AQI value "Vasopressor" corresponds to (F-619AA, SRT, "Vasoconstrictor"). No equivalent concepts are included for MedicationTypeCodeType values of NonFormulary antibiotic, Dye, Indigo Carmine Red, and Non-Formulary.

Type: Extensible Version: 20151110

Medication for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include
Include
Include
Include
Include
Include
Include

Type: Extensible Version: 20151110

Inhalational Anesthesia Agents for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	C-10520	Carbon dioxide	31811003	C0007012
SRT	C-20830	Chloroform	259153006	C0008238
SRT	F-61AC9	Desflurane	386841003	C0063252
SRT	C-21216	Diethyl ether	259170003	C0014994
SRT	F-61A3F	Enflurane	387176008	C0014277
SRT	F-61AFE	Halothane	387351001	C0018549
SRT	F-61B0A	Isoflurane	387368002	C0022180
SRT	C-6A16A	Methoxyflurane	11136004	C0025688
SRT	C-6A118	Nitrous oxide	111132001	C0028215
SRT	F-61ACA	Sevoflurane	386842005	C0074414

In this context group, SNOMED substance codes are used in preference to product codes, since there is no need to refer to specific products or preparations. SNOMED codes are used in preference to other potential sources of pharmaceutical related codes, such as from the National Drug Code (NDC) directory.

Type: Extensible Version: 20160212

Injectable Anesthesia Agents for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	C-23805	Alphachloralose	277016007	C0008162
SRT	C-6A161	Alphadolone	125707004	C0051481
UMLS	C0051482	Alphaxalone		C0051482
SRT	C-640A0	Azaperone	96229001	C0004477
SRT	R-F2B27	Butabarbital	372901004	C0006464
SRT	R-F6E36	Chloral hydrate	273948005	C0008161
SRT	R-F2B2C	Diazepam	387264003	C0012010
SRT	F-61A26	Droperidol	387146001	C0013136
SRT	F-61A66	Etomidate	387218008	C0015131
UMLS	C0060473	Fluanisone		C0060473
SRT	F-6182F	Ketamine	373464007	C0022614
SRT	F-61848	Methohexital	373488009	C0025668
UMLS	C0025856	Metomidate		C0025856
SRT	F-6183C	Midazolam	373476007	C0026056
SRT	R-F2B1F	Pentobarbital	372703009	C0030883
SRT	F-61B48	Propofol	387423006	C0033487
SRT	C-6A16B	Thiamylal	40342009	C0039855
SRT	F-61BB2	Thiopental	387448009	C0936073
SRT	C-6A190	Tiletamine	96265006	C0242522
SRT	C-6A16E	Tribromoethanol	84386009	C0084847
SRT	C-29020	Urethane (ethyl carbamate)	873008	C0041964
SRT	C-640B0	Xylazine	96230006	C0242544
SRT	C-64090	Zolazepam	96227004	C0917859

In this context group, SNOMED substance codes are used in preference to product codes, since there is no need to refer to specific products or preparations. SNOMED codes are used in preference to other potential sources of pharmaceutical related codes, such as from the National Drug Code (NDC) directory.

Type: Extensible Version: 20151110

Premedication Agents for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	C-62960	Acepromazine	96218000	C0000959
SRT	F-61A7F	Chlorpromazine	387258005	C0008286

Type: Extensible Version: 20151110

Neuromuscular Blocking Agents for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	F-61916	Succinylcholine	372724004	C0038627
SRT	F-61639	Pancuronium	373738000	C0030310

In this context group, SNOMED substance codes are used in preference to product codes, since there is no need to refer to specific products or preparations. SNOMED codes are used in preference to other potential sources of pharmaceutical related codes, such as from the National Drug Code (NDC) directory.

Type: Extensible Version: 20151110

Ancillary Medications for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID

This context group is currently empty since no ancillary medications have been identified for this use case yet.

Type: Extensible Version: 20151110

Carrier Gases for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	C-6A102	Oxygen gas	320917000	C0350411
SRT	C-6A148	Medical air	417696007	C3536832
UMLS	C3846005	Room air		C3846005

In this context group, though SNOMED substance codes are normally used in preference to product codes, in the case of (C-6A102, SRT, "Oxygen gas") there is no corresponding substance that is specifically the gaseous form of oxygen.

Type: Extensible Version: 20151110

Local Anesthetics for Small Animal Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	F-61A28	Bupivacaine	387150008	C0006400
SRT	C-80477	Lidocaine + Prilocaine	346553009	C0617623
SRT	F-61BD0	Lidocaine	387480006	C0023660

In this context group, SNOMED substance codes are used in preference to product codes, since there is no need to refer to specific products or preparations. SNOMED codes are used in preference to other potential sources of pharmaceutical related codes, such as from the National Drug Code (NDC) directory. For Lidocaine + Prilocaine, since it is a mixture of two substances, the code for the product concept is used. The code for a mixture of unspecified type is used, rather than a more specific code, e.g., for the so-called "Eutectic Mixture of Local Anesthetics (EMLA)", which consists of Lidocaine + Prilocaine. UMLS contains three distinct concepts, (C0059079, UMSL, "EMLA"), (C0617623, UMLS, "Lidocaine/Prilocaine") and (C0950567, UMLS, "Eutectic Lidocaine-Prilocaine").

Type: Extensible Version: 20151110

Phase of Procedure Requiring Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include
Include

Type: Extensible Version: 20151110

Phase of Surgical Procedure Requiring Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	R-413C5	Preoperative	262068006	C0445204
SRT	R-400B2	Intraoperative	277671009	C0456904
SRT	R-413B7	Postoperative	262061000	C0032790

Type: Extensible Version: 20151110

Phase of Imaging Procedure Requiring Anesthesia

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	R-40FB9	Before procedure	307153007	C0585032
SRT	R-40FBA	During procedure	307154001	C0585033
SRT	R-422A4	After procedure	303110006	C0580203

The concepts used in this context group are more general than those for a specific procedure, e.g., surgery, radiotherapy, chemotherapy. In SNOMED, the concepts used in this context group are the parent concepts of the surgically-specific concepts used in . There are no concepts defined specifically for periods related to an imaging procedure so the general concepts suffice (in context).

Type: Extensible Version: 20151110

Phase of Animal Handling

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	127101	In home cage
DCM	127102	During transport
DCM	127103	Staging prior to imaging
DCM	127104	Preparation for imaging
SRT	P1-C0012	Anesthesia induction	241687005	C0473960
SRT	P0-0099A	Imaging procedure	363679005	C0011923
UMLS	C0002908	Anesthesia recovery period		C0002908

Type: Extensible Version: 20151110

Heating Method

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	R-FDB79	Air heating pad	468192005
SRT	A-18041	Electric blanket	79811009	C0336614
SRT	A-2C140	Electric heating pad	27812008	C0181157
DCM	127250	Forced air heater
SRT	A-17454	Forced air warming blanket	420572009	C1719899
DCM	127251	Heated imaging device
DCM	127252	Heated patient support
DCM	127253	Heated water blanket
UMLS	C0181514	Heat lamp		C0181514
SRT	A-2C141	Non-electric heating pad	39790008	C0521200
DCM	127254	Pre-heated pad
DCM	127255	Unheated
SRT	A-17450	Warmer device	71384000	C0184348
SRT	A-17452	Warming blanket	421335007	C0184351

Type: Extensible Version: 20151110

Temperature Sensor Device Component Type for Small Animal Procedures

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	F-00BB8	Rectal temperature	307047009	C0489749
UMLS	C0039810	Thermography		C0039810
DCM	127240	Carrier temperature sensor

(C0039810, UMLS, "Thermography") is a general concept that also encompasses diagnostic uses of thermography, in addition to simple temperature measurement; only the latter meaning is used here, as is implicit from the context of invocation.

Type: Extensible Version: 20151110

Exogenous Substance Types

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	G-C1F9	Graft material	246345001	C0181074
DCM	127460	Tumor Graft
SRT	T-1A080	Fibril	88921000	C0225328
SRT	L-30000	Virus	49872002	C0042776
SRT	F-CB250	Cytokine	75777003	C0079189
SRT	C-00224	Toxin	80917008	C0040549

The specific concept (C22490, NCIt, "Tumor Cell Graft") (UMLS:C1519674) is not used, since grafts may not be cell suspensions, but rather entire tumors, fragments of tumor tissue, etc. Whether the graft is a xenograft or homograft is not specified, and may be encoded elsewhere (e.g., by encoding the species of origin). The non-tumor specific concept (G-C1F9, SRT, "Graft material") may be used when the graft is not a tumor (though strictly speaking, it is a SNOMED attribute rather than substance; UMLS:C0181074 does not make such a distinction).

Type: Extensible Version: 20151110

Exogenous Substance

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
Include
Include
Include
Include
Include

Type: Extensible Version: 20151110

Tumor Graft Histologic Type

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	M-81403	Adenocarcinoma	35917007	C0001418
SRT	M-87303	Amelanotic melanoma	70594002	C0206735
SRT	M-94003	Astrocytoma	38713004	C0004114
NCIt	C2923	Bronchioloalveolar adenocarcinoma		C0007120
SRT	M-80103	Carcinoma	68453008	C0007097
SRT	M-89803	Carcinosarcoma	63264007	C0007140
SRT	M-84403	Cystadenocarcinoma	21008007	C0010631
SRT	M-94403	Glioblastoma	63634009	C0017636
SRT	D0-F0369	Infiltrating ductal carcinoma of breast	408643008	C1134719
SRT	M-80123	Large cell carcinoma	22687000	C0206704
SRT	DC-F4113	Leukemia	93143009	C0023418
SRT	M-87203	Melanoma	2092003	C0025202
SRT	M-90503	Mesothelioma	62064005	C0025500
SRT	M-80453	Mixed small cell carcinoma	21326004	C0334240
SRT	M-80463	Non-small cell carcinoma	128632008	C1266002
SRT	M-91803	Osteosarcoma	21708004	C0029463
SRT	R-FB83F	Renal cell carcinoma	702391001	C0007134
SRT	M-88003	Sarcoma	2424003	C1261473
SRT	M-80413	Small cell carcinoma	74364000	C0262584
SRT	M-80323	Spindle cell carcinoma	65692009	C0205697
SRT	M-80703	Squamous cell carcinoma	28899001	C0007137

Type: Extensible Version: 20151110

Fibrils

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	127851	Human alpha synuclein preformed fibrils
DCM	127852	Mouse alpha synuclein preformed fibrils
DCM	127853	Human Tau preformed fibrils
DCM	127854	Mouse Tau preformed fibrils

Type: Extensible Version: 20151110

Viruses

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	L-30606	Theiler's murine encephalomyelitis virus	42024000	C0206425
SRT	L-35500	Adeno-associated virus group	112381006	C0001417

Type: Extensible Version: 20151110

Cytokines

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	F-CB962	Tumor necrosis factor alpha	39525005	C1456820
SRT	F-C0101	Interferon gamma	420303002	C0021745
SRT	F-CB902	Vascular endothelial growth factor	417324009	C0078058

Type: Extensible Version: 20151110

Toxins

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	F-63750	Lysophosphatidylcholine	54446009	C0024360
UMLS	C0019873	Ethidium Bromide		C0019873
PUBCHEM_CID	4624	6-hydroxydopamine
SRT	F-63390	Lipopolysaccharide	3325005	C0023810

Type: Extensible Version: 20151110

Exogenous Substance Administration Sites

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	T-D2310	Flank	58602004	C0230171
SRT	T-A0100	Brain	12738006	C0006104
SRT	M-8FFFF	Tumor	108369006	C0027651

Since this context group defines the sites, rather than routes of administration, if the exogenous substance is administered into a tumor, the code for the morphologic abnormality (M-8FFFF, SRT, "Tumor") is used, rather than the specific concept for the route (R-F2CD4, SRT, "Intratumor route") (which may also be present as the value for the separately encoded route of administration, if present).

Type: Extensible Version: 20151110

Exogenous Substance Tissue of Origin

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	T-D04AC	Ascitic fluid	409615008	C0003964
SRT	T-D016E	Bone	272673000	C0262950
SRT	T-A0100	Brain	12738006	C0006104
SRT	T-04000	Breast	76752008	C0006141
SRT	T-A0090	Central nervous system	21483005	C0927232
SRT	T-59300	Colon	71854001	C0009368
DCM	127801	Embryonic kidney
SRT	T-71000	Kidney	64033007	C0022646
SRT	T-28000	Lung	39607008	C0024109
SRT	T-C6020	Lymph	38000004	C0024202
SRT	T-D03C2	Lymphatic tissue	181768009	C0024296
SRT	T-C4000	Lymph Node	59441001	C0024204
SRT	DF-00436	Metastasis	128462008	C2939419
SRT	T-87000	Ovary	15497006	C0029939
SRT	D2-80100	Pleural effusion	60046008	C0032227
SRT	T-9200B	Prostate	181422007	C1278980
SRT	D2-F1106	Pulmonary metastasis	94391008	C0153676

Type: Extensible Version: 20151110

Preclinical Small Animal Imaging Procedures

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
LN	46305-9	Whole body CT		C1830206
LN	24725-4	Head CT	303653007	C0202691
LN	46358-8	MRI whole body	426252008	C1830259
LN	24590-2	Brain MRI
LN	44139-4	PET whole body	702767007	C1715409
LN	44138-6	Brain PET	241434002	C0412493
LN	42175-0	Radionuclide scan of whole body	229033006	C1626178
LN	24730-4	Radionuclide brain scan	41440006	C0581582
DCM	127901	SPECT of whole body
LN	39632-5	Brain SPECT		C1543694
DCM	127902	SPECT CT of whole body
SRT	P5-B0008	Ultrasonography of total body	24135002	C0203309

The inconsistent pattern of modality and anatomy in the code meaning is present in the source coding scheme (e.g., "Whole body CT" versus "PET whole body"), and not changed, except where necessary (e.g., (42175-0, LN, "Radionuclide scan of whole body") is actually just "scan of whole body" in the source scheme, which is insufficient, so "radionuclide" has been added). The UMLS codes that map to the SNOMED concepts, when present, are shown, in the cases when UMLS is lacking a mapping between the LOINC and SNOMED codes. E.g., (44138-6, LN, "Brain PET") maps directly to (C1715408, UMLS, "Multisection:Find:Pt:Brain:Doc:Radnuc.PET"), but (P5-0A001, SRT, "PET Brain Study") maps to (C0412493, UMLS, "PET Brain Study"), which is used instead. In general, UMLS does not unify the mappings from LOINC and SNOMED, presumably due to the lexical dissimilarity of the terms (i.e., the LOINC mapping seems to be based on the fully-specified name rather than the long common name).

Type: Extensible Version: 20151110

Position Reference Indicator for Frame of Reference

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
FMA	264776	Bregma		C0934419
FMA	264773	Lambda		C0926407

An FMA code is used for bregma since SNOMED only contains fetal bregma.

Amend existing context groups in DICOM PS3.16 to add additional concepts:

Type: Extensible Version: 20100608 20151110

Route of Administration

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	G-D101	Intravenous route	47625008	C1522726
SRT	G-D102	Intra-arterial route	58100008	C1561451
SRT	G-D103	Intramuscular route	78421000	C1556154
SRT	G-D104	Subcutaneous route	34206005	C1522438
SRT	G-D105	Intracutaneous route	59593002	C1522475
SRT	G-D106	Intraperitoneal route	38239002	C1522583
SRT	G-D107	Intramedullary route	60213007	C1512957
SRT	G-D108	Intrathecal route	72607000	C0677897
SRT	G-D109	Intra-articular route	12130007	C0205528
SRT	G-D111	Intraepithelial route	89947002	C1512943
SRT	G-D112	Topical route	6064005	C1522168
SRT	G-D140	Oral route	26643006	C1527415
SRT	G-D142	Transluminal route	9942002	C0205532
SRT	G-D144	Intraluminal route	37737002	C1522217
SRT	G-D146	Extraluminal route	31638007	C0205534
SRT	G-D150	By inhalation	112239003	C0205535
SRT	G-D160	Per rectum	37161004	C1527425
SRT	G-D164	Vaginal route	16857009	C1522570
SRT	G-D17C	Intracoronary route	372463005	C0595454
SRT	G-D173	Intracardiac route	372460008	C1522207
SRT	R-F2C86	Intraventricular route - cardiac	420287000	C1720462
DCM	127070	Retro-orbital route
SRT	G-D172	Nasal route	46713006	C1522019
SRT	G-D17D	Intradermal route	372464004	C1522475
SRT	R-F2CD4	Intratumor route	447122006	C2960749

For reference (unchanged) and to allow the hypertext links to work, existing relevant context groups in DICOM PS3.16:

Type: Extensible Version: 20141110

Quantitative Diagnostic Imaging Procedures

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	P5-09051	Magnetic resonance imaging guidance	258177008	C0442974
DCM	126020	Multiparametric MRI
DCM	126021	Multiparametric MRI of prostate
DCM	126022	Multiparametric MRI of whole body
SRT	P5-0907F	Dynamic magnetic resonance imaging of knee	433139009	C2315346
SRT	P5-70694	Dynamic magnetic resonance imaging of pelvis	446315002	C2960816
LN	44139-4	PET whole body		C1715409
SRT	P5-080FF	PET/CT FDG imaging of whole body	443271005	C2732676
SRT	P5-08118	PET/CT MET imaging of whole body	443844003	C2732956
RADLEX	RPID96	CT head perfusion with IV contrast
RADLEX	RPID5258	NM head perfusion brain SPECT
RADLEX	RPID5427	NM head perfusion brain PET-CT AV-45

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

Type: Non-Extensible Version: 20030108

Laterality

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	G-A100	Right	24028007	C0205090
SRT	G-A101	Left	7771000	C0205091
SRT	G-A102	Right and left	51440002	C0238767
SRT	G-A103	Unilateral	66459002	C0205092

Type: Extensible Version: 20040112

Quantitative Concepts for Usage, Exposure

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	G-C0B7	Dosage	260911001	C0178602
DCM	111578	Dose frequency
DCM	111579	Rate of exposure
DCM	111580	Volume of use

Type: Extensible Version: 20020904

Units of Follow-up Interval

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
UCUM	d	day
UCUM	wk	week
UCUM	mo	month
UCUM	a	year

Type: Extensible Version: 20050822

Relative Usage, Exposure Amount

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	111575	High
DCM	111576	Medium
DCM	111577	Low
DCM	111587	No known exposure

Type: Extensible Version: 20040112

Relative Frequency of Event Values

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
SRT	R-40377	Continuous	255238004	C0549178
SRT	G-7154	Frequent	70232002	C0332183
SRT	R-40365	Mid-frequency	255218000	C0439604
SRT	G-7155	Infrequent	27789000	C0521114
SRT	R-40B16	As required	225761000	C0558288
SRT	R-4112F	Single event	307486002	C0585347

Type: Extensible Version: 20040112

Qualitative Concepts for Usage, Exposure Amount

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	111581	Relative dose amount
DCM	111582	Relative amount of exposure
DCM	111583	Relative amount of use

Type: Extensible Version: 20040112

Qualitative Concepts for Usage, Exposure Frequency

Coding Scheme Designator	Code Value	Code Meaning	SNOMED-CT Concept ID	UMLS Concept Unique ID
DCM	111584	Relative dose frequency
DCM	111585	Relative frequency of exposure
DCM	111586	Relative frequency of use

This Section contains examples for use cases involving imaging of a single animal in a hybrid PET-CT system. The basic use case involves an animal, which: lives in an individually ventilated home cage with several other animals in the same cage is (briefly) transported (in its home cage) with its cage mates to the imaging facility, without heating, with an appropriate lid is removed from its home/transport cage for preparation for imaging, involving insertion of a tail vein cannula, performed on an electrically heated pad is induced by (a) placement in an induction chamber with more concentrated volatile anesthetic, or (b) intraperitoneal injection of Ketamine mixture is placed in a PET-CT compatible imaging sled/carrier/chamber for imaging (of one animal at a time), with anesthesia with Isoflurane and Oxygen as the carrier gas, and heated with an electric pad regulated by feedback from a rectal probe is removed for recovery in a separate cage The content tree structure (when induction is by a volatile anesthetic) would resemble: Node Code Meaning of Concept Name Code Meaning or Example Value TID 1 Preclinical Small Animal Imaging Acquisition Context 1.1 Language of Content Item and Descendants English TID 1204 1.1.2 Country of Language United States TID 1204 1.2 Person Observer Name Doe^Jane TID 1003 1.3 Procedure Code PET/CT FDG imaging of whole body TID 1005 1.4 Biosafety conditions 1.4.1 Biosafety level Biosafety level 1 1.5 Animal handling during specified phase 1.5.1 Phase of animal handling In home cage 1.5.2 Animal housing 1.5.2.1 Housing manufacturer Acme Inc. 1.5.2.2 Housing rack product name Acmerack IVC Mouse 1.5.2.3 Housing unit product name Acmecage Mouse Pre-Bedded Corn Cob with Enrichment 1.5.2.4 Housing unit product code 12345 1.5.2.5 Housing unit lid product name Acmecage IVC Mouse Single Filter 1.5.2.6 Housing unit lid product code 6789 1.5.2.7 Number of racks per room 4 {racks} 1.5.2.8 Number of housing units per rack 154 {housing units} 1.5.2.9 Housing unit location in rack Row 4 Column 7 1.5.2.10 Number of animals per housing 5 {animals} 1.5.2.11 Sex of animals within housing Female 1.5.2.12 Sex of handler Mixed 1.5.2.13 Total duration in housing 133 days 1.5.2.14 Housing change interval 7 days 1.5.2.15 Manual handling interval 24 hours 1.5.2.16 Housing unit width 23.4 cm 1.5.2.17 Housing unit height 14.0 cm 1.5.2.18 Housing unit length 37.3 cm 1.5.2.19 Housing individually ventilated Yes 1.5.2.20 Air changes 50 /hour 1.5.2.21 Environmental temperature 22 C 1.5.2.22 Housing humidity 50 % 1.5.2.23 Housing unit reuse Unused 1.5.2.24 Bedding material Corn cob bedding 1.5.2.25 Bedding volume 450 ml 1.5.2.26 Enrichment material Acmerichment paper twists 1.5.2.27 Exerciser device Acmewheel 1.5.2.28 Shelter Red translucent igloo 1.5.2.29 Shelter manufacturer Acme Inc. 1.5.2.30 Shelter product name Acmedome 1.6 Animal handling during specified phase 1.6.1 Phase of animal handling During transport 1.6.2 Animal housing 1.6.2.1 Housing manufacturer Acme Inc. 1.6.2.2 Housing unit product name Acmecage Mouse Pre-Bedded Corn Cob with Enrichment 1.6.2.3 Housing unit product code 12345 1.6.2.4 Housing unit lid product name Acmecage Mouse Transport 1.6.2.5 Housing unit lid product code 9872 1.6.2.6 Number of animals per housing 5 {animals} 1.6.2.7 Sex of animals within housing Female 1.6.3 Heating conditions 1.6.3.1 Heating Unheated 1.7 Animal handling during specified phase 1.7.1 Phase of animal handling Staging prior to imaging 1.8 Animal handling during specified phase 1.8.1 Phase of animal handling Preparation for imaging 1.8.2 Animal housing 1.8.2.1 Comment Animal exposed and restrained whilst cannulating tail vein 1.8.3 Heating conditions 1.8.3.1 Heating Electric heating pad 1.8.3.2 Feedback temperature regulation No 1.9 Animal handling during specified phase 1.9.1 Phase of animal handling Anesthesia induction 1.9.2 Animal housing 1.9.2.1 Housing manufacturer Acme Inc 1.9.2.2 Housing unit product name Gas Anesthesia Induction Chamber Mouse 1.9.2.3 Housing unit product code 3487236 1.10 Animal handling during specified phase 1.10.1 Phase of animal handling Imaging procedure 1.10.2 DateTime Started yyyymmddhhss 1.10.3 DateTime Ended yyyymmddhhss 1.10.4 Animal housing 1.10.4.1 Housing manufacturer Acme Inc 1.10.4.2 Housing unit product name Multimodal Mouse Chamber 1.10.5 Heating conditions 1.10.5.1 Heating Electric heating pad 1.10.5.1 Feedback temperature regulation Yes 1.10.5.2 Temperature sensor device component Rectal temperature 1.10.5.3 Equipment Temperature 37 C 1.10.6 Physiological Monitoring 1.10.6.1 Electrocardiographic monitoring Yes 1.10.6.2 Monitoring of respiration No 1.11 Animal handling during specified phase 1.11.1 Phase of animal handling Anesthesia recovery period 1.12 Administration of anesthesia 1.12.1 Anesthesia Method Set 1.12.1.1 Anesthesia Method 1.12.1.1.1 Anesthesia Category General anesthesia 1.12.1.1.2 Anesthesia Start Time yyyymmddhhss 1.12.1.1.3 Anesthesia Finish Time yyyymmddhhss 1.12.1.1.4 Anesthesia Induction By inhalation 1.12.1.1.5 Anesthesia Maintenance Inhalation anesthesia, machine system, closed, no rebreathing of primary agent 1.12.2 Airway Management Set 1.12.2.1 Airway Management 1.12.2.1.1 Airway Management Method Nose cone 1.12.3 Medications Set 1.12.3.1 Procedure Phase During procedure 1.12.3.2 Medication given 1.12.3.2.1 Drug start yyyymmddhhss 1.12.3.2.2 Drug end yyyymmddhhss 1.12.3.2.3 Route of administration By inhalation 1.12.3.2.4 Mixture 1.12.3.2.4.1 Drug administered Isoflurane 1.12.3.2.4.2 Medication Type General anesthetic 1.12.3.2.4.3 Concentration 4 % 1.12.3.2.5 Mixture 1.12.3.2.5.1 Drug administered Oxygen 1.12.3.2.5.2 Medication Type Carrier gas 1.12.3.2.5.3 Concentration 100 % 1.12.3.3 Medication given 1.12.3.3.1 Drug start yyyymmddhhss 1.12.3.3.2 Drug end yyyymmddhhss 1.12.3.3.3 Route of administration By inhalation 1.12.3.3.4 Mixture 1.12.3.3.4.1 Drug administered Isoflurane 1.12.3.3.4.2 Medication Type General anesthetic 1.12.3.3.4.3 Concentration 2 % 1.12.3.3.5 Mixture 1.12.3.3.5.1 Drug administered Oxygen 1.12.3.3.5.2 Medication Type Carrier gas 1.12.3.3.5.3 Concentration 100 % The content tree structure when induction is by intra-peritoneal injection might be different in the following way, in that the housing during the induction phase does not involve a chamber, and the injected agent is specified, as follows: Node Code Meaning of Concept Name Code Meaning or Example Value TID ... ... ... ... 1.9 Animal handling during specified phase 1.9.1 Phase of animal handling Anesthesia induction 1.9.2 Animal housing 1.9.2.1 Comment Animal exposed whilst inducing anesthesia ... ... ... ... 1.12 Administration of anesthesia 1.12.1 Anesthesia Method Set 1.12.1.1 Anesthesia Method 1.12.1.1.1 Anesthesia Category General anesthesia 1.12.1.1.2 Anesthesia Start Time yyyymmddhhss 1.12.1.1.3 Anesthesia Finish Time yyyymmddhhss 1.12.1.1.4 Anesthesia Induction Intraperitoneal route 1.12.1.1.5 Anesthesia Maintenance Inhalation anesthesia, machine system, closed, no rebreathing of primary agent ... ... ... ... 1.12.3 Medications Set 1.12.3.1 Procedure Phase During procedure 1.12.3.2 Medication given 1.12.3.2.1 Drug start yyyymmddhhss 1.12.3.2.2 Route of administration Intraperitoneal route 1.12.3.2.3 Mixture 1.12.3.2.3.1 Drug administered Ketamine 1.12.3.2.3.2 Medication Type General anesthetic 1.12.3.2.3.2 Dosage nn mg 1.12.3.2.4 Mixture 1.12.3.2.4.1 Drug administered Medetomidine 1.12.3.2.4.2 Medication Type General anesthetic 1.12.3.2.4.2 Dosage nn mg ... ... ... ...

Only the exogenous substance information is included in this example and content describing animal handling, anesthesia information, etc. is excluded for clarity. Indeed, given the optionality of the other content, it would be possible to create an Acquisition Context SR instance that describes only the exogenous substance information and nothing else. The content tree structure would resemble: Node Code Meaning of Concept Name Code Meaning or Example Value TID 1 Preclinical Small Animal Imaging Acquisition Context 1.1 Language of Content Item and Descendants English TID 1204 1.1.2 Country of Language United States TID 1204 1.2 Person Observer Name Doe^Jane TID 1003 ... ... ... ... 1.n Exogenous substance 1.n.1 Tumor Graft Adenocarcinoma 1.n.2 Age Started 6 week CID 7456 "Units of Measure for Age" 1.n.3 DateTime Started yyyymmddhhss 1.n.4 Brand name MDA-MB-468 1.n.5 Dosage 10E6 {cells} 1.n.6 Relative dose frequency Single event 1.n.7 Route of Administration Subcutaneous route 1.n.7.1 Site of Flank 1.n.7.1.1 Laterality Left 1.n.8 Tissue of origin Breast 1.n.9 Taxonomic rank of origin homo sapiens CID 7454 "Animal Taxonomic Rank Values"

Stout et al 2013 Stout D Berr SS LeBlanc A Kalen JD Osborne D Price J Schiffer W Kuntner C Wall J 2013 12 7 1-15 David et al 2013a David JM Chatziioannou AF Taschereau R Wang H Stout DB 2013 63 5 386–91 David et al 2013b David JM Knowles S Lamkin DM Stout DB 2013 52 6 738–44 Rosenbaum et al 2009 Rosenbaum MD 2009 48 6 763–73 Fueger et al 2006 Fueger BJ 2006 47 6 999–1006 Dandekar et al 2007 Dandekar M 2007 48 4 602–7 10.2967/jnumed.106.036608 Lee et al 2005 Lee KH 2005 46 9 1531–36 Balcombe et al 2004 Balcombe JP 2004 43 6 42–51 Van der Meer et al 2004 Van der Meer E 2004 38 4 376–83 Tabata et al 1998 Tabata H 1998 32 2 143–48 10.1258/002367798780599983

Amend DICOM PS3.3 - Information Object Definitions - Section 3 - Definitions, to add definition of Acquisition Context. For the purposes of this Standard the following definitions apply. Acquisition Context A description of the conditions present during data acquisition.

Amend DICOM PS3.3 - Information Object Definitions - Annex A - Composite Information Object Definitions (Normative), to add Acquisition Context IOD Modules to A.1.4 Overview of the Composite IOD Module Content. Amend DICOM PS3.3 - Information Object Definitions - Annex A - Composite Information Object Definitions (Normative) as follows, to add a new Acquisition Context Structured Report IOD:

The Acquisition Context SR IOD is used to represent the description of the conditions present during data acquisition of other data that is stored separately (such as images).

The E-R Model in Section A.1.2 applies to the Acquisition Context SR IOD.

specifies the Modules of the Acquisition Context SR IOD.

Acquisition Context SR IOD Modules

IE	Module	Reference	Usage
Patient	Patient	C.7.1.1	M
	Clinical Trial Subject	C.7.1.3	U
Study	General Study	C.7.2.1	M
	Patient Study	C.7.2.2	U
	Clinical Trial Study	C.7.2.3	U
Series	SR Document Series	C.17.1	M
	Clinical Trial Series	C.7.3.2	U
Frame of Reference	Synchronization	C.7.4.2	C - Required if time synchronization was applied
Equipment	General Equipment	C.7.5.1	M
	Enhanced General Equipment	C.7.5.2	M
Document	SR Document General	C.17.2	M
	SR Document Content	C.17.3	M
	SOP Common	C.12.1	M

Value Type (0040,A040) in Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions): TEXT CODE NUM DATETIME DATE TIME UIDREF PNAME SCOORD3D CONTAINER

Relationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-8 for Relationship Type definitions. Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module. specifies the relationship constraints of this IOD.

Relationship Content Constraints for Acquisition Context SR IOD

Source Value Type	Relationship Type (Enumerated Values)	Target Value Type
CONTAINER	CONTAINS	CODE, CONTAINER, DATETIME, NUM, PNAME, TEXT, TIME, UIDREF
CONTAINER	HAS OBS CONTEXT	CODE, DATE, DATETIME, NUM, PNAME, TEXT, TIME, UIDREF
CODE	HAS OBS CONTEXT	CODE
any type	HAS CONCEPT MOD	CODE, TEXT1
CODE	HAS PROPERTIES	CODE, DATETIME, NUM, SCOORD3D, TEXT

The HAS CONCEPT MOD relationship is used to modify the meaning of the Concept Name of a Source Content Item, for example to provide a more descriptive explanation, a different language translation, or to define a post-coordinated concept.

The document may be constructed from Baseline invoked at the root node. This IOD maybe used with other Templates defined for Acquisition Context.

Amend DICOM PS3.4 - Service Class Specifications - Annex B - Storage Service Class (Normative) as follows:

...

Standard and Related General SOP Classes

SOP Class Name	Related General SOP Class Name
...	...
Radiopharmaceutical Radiation Dose SR	Enhanced SR
	Comprehensive SR
	Comprehensive 3D SR
	Extensible SR
Acquisition Context SR	Enhanced SR (see note)
	Comprehensive SR (see note)
	Comprehensive 3D SR
	Extensible SR
...	...

The Acquisition Context SR may be encoded as Enhanced or Comprehensive only if it does not contain stereotactic coordinates (SCOORD3D).

...

Standard SOP Classes

SOP Class Name	SOP Class UID	IOD Specification (defined in PS3.3)
...	...	...
Acquisition Context SR Storage	1.2.840.10008.5.​1.​4.​1.​1.​88.​71	Acquisition Context SR IOD
...	...	...

The requirements of Annex O apply to the following SOP Classes: ... Acquisition Context SR

Amend DICOM PS3.4 - Service Class Specifications - Annex I - Media Storage Service Class (Normative) as follows:

...

Media Storage Standard SOP Classes

SOP Class Name	SOP Class UID	IOD Specification (defined in PS3.3)
...	...	...
Acquisition Context SR Storage	1.2.840.10008.5.​1.​4.​1.​1.​88.​71	Acquisition Context SR IOD
...	...	...

The requirements of Annex O apply to the following SOP Classes: ... Acquisition Context SR

Amend DICOM PS3.6 - Data Dictionary - Annex A - Registry of DICOM Unique Identifiers (UIDs) as follows:

UID Values

UID Value	UID NAME	UID TYPE	Part
...	...	...	...
1.2.840.10008.5.​1.​4.​1.​1.​88.​71	Acquisition Context SR Storage	SOP Class	PS3.4
...	...	...	...
1.2.840.10008.2.​16.​9	PubChem Compound CID	Coding Scheme	PS3.16

Amend DICOM PS3.6 - Data Dictionary - Annex A - Add new Context Group UIDs as follows:

Amend DICOM PS3.2 - Conformance - Annex A - DICOM Conformance Statement Template (Normative) as follows:

UID Values

UID Value	UID Name	Category
...	...	...
1.2.840.10008.5.​1.​4.​1.​1.​88.​71	Acquisition Context SR Storage SOP Class	Transfer
...	...	...