C.8.8.12 RT Patient Setup Module

C.8.8.12 RT Patient Setup Module (Current)
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The RT Patient Setup Module contains information describing the positioning of the patient with respect to the treatment machine, along with any fixation devices used. It also describes the shielding devices applied to the patient. The Module contains a Sequence of patient setup descriptions, each of which may be referenced by one of more beams or brachy application setups.

Table C.8-48. RT Patient Setup Module Attributes

Attribute Name	Tag	Type	Attribute Description
Patient Setup Sequence	(300A,0180)	1	Sequence of patient setup data for current plan. One or more Items shall be included in this Sequence.
>Patient Setup Number	(300A,0182)	1	Identification number of the Patient Setup. The value of Patient Setup Number (300A,0182) shall be unique within the RT Plan in which it is created.
>Patient Setup Label	(300A,0183)	3	The user-defined label for the Patient Setup.
>Patient Position	(0018,5100)	1C	Patient position descriptor relative to the equipment. Required if Patient Additional Position (300A,0184) is not present. See Section C.8.8.12.1.2 for Defined Terms and further explanation.
>Patient Additional Position	(300A,0184)	1C	User-defined additional description of patient position. Required if Patient Position (0018,5100) is not present.
>Patient Treatment Preparation Sequence	(300A,079F)	3	Procedures and devices required to prepare a patient for treatment. Only a single Item is permitted in this Sequence. See Section C.8.8.12.1.3.
>>Include Table C.36.2.3.4-1 “RT Patient Treatment Preparation Macro Attributes”.
>Referenced Setup Image Sequence	(300A,0401)	3	Sequence of setup verification images for this patient setup. One or more Items are permitted in this Sequence. See Section C.8.8.12.1.1
>>Setup Image Comment	(300A,0402)	3	Comment on the Setup Image.
>>Include Table 10-3 “Image SOP Instance Reference Macro Attributes”
>Fixation Device Sequence	(300A,0190)	3	Sequence of Fixation Devices used in Patient Setup. One or more Items are permitted in this Sequence.
>>Fixation Device Type	(300A,0192)	1	Type of Fixation Device used during in Patient Setup. Defined Terms: BITEBLOCK HEADFRAME MASK MOLD CAST HEADREST BREAST_BOARD BODY_FRAME VACUUM_MOLD WHOLE_BODY_POD RECTAL_BALLOON
>>Fixation Device Label	(300A,0194)	2	User-defined label identifier for Fixation Device.
>>Fixation Device Description	(300A,0196)	3	User-defined description of Fixation Device.
>>Fixation Device Position	(300A,0198)	3	Position/Notch number of Fixation Device.
>>Fixation Device Pitch Angle	(300A,0199)	3	The Fixation Device Pitch Angle, i.e., orientation of PITCHED FIXATION DEVICE coordinate system with respect to IEC PATIENT SUPPORT coordinate system (degrees). Pitching is the rotation around IEC PATIENT SUPPORT X-axis.
>>Fixation Device Roll Angle	(300A,019A)	3	The Fixation Device Roll Angle, i.e., orientation of ROLLED FIXATION DEVICE coordinate system with respect to IEC PITCHED FIXATION DEVICE coordinate system (degrees). Rolling is the rotation around IEC PATIENT SUPPORT Y-axis.
>>Accessory Code	(300A,00F9)	3	An identifier for the accessory intended to be read by a device such as a bar-code reader.
>Shielding Device Sequence	(300A,01A0)	3	Sequence of Shielding Devices used in Patient Setup. One or more Items are permitted in this Sequence.
>>Shielding Device Type	(300A,01A2)	1	Type of Shielding Device used in Patient Setup. Defined Terms: GUM EYE GONAD
>>Shielding Device Label	(300A,01A4)	2	User-defined label for Shielding Device.
>>Shielding Device Description	(300A,01A6)	3	User-defined description of Shielding Device.
>>Shielding Device Position	(300A,01A8)	3	Position/Notch number of Shielding Device.
>>Accessory Code	(300A,00F9)	3	An identifier for the accessory intended to be read by a device such as a bar-code reader.
>Setup Technique	(300A,01B0)	3	Setup Technique used in Patient Setup. Defined Terms: ISOCENTRIC FIXED_SSD TBI BREAST_BRIDGE SKIN_APPOSITION
>Setup Technique Description	(300A,01B2)	3	User-defined description of Setup Technique.
>Setup Device Sequence	(300A,01B4)	3	Sequence of devices used for patient alignment in Patient Setup. One or more Items are permitted in this Sequence.
>>Setup Device Type	(300A,01B6)	1	Type of Setup Device used for patient alignment. Defined Terms: LASER_POINTER DISTANCE_METER TABLE_HEIGHT MECHANICAL_PTR ARC
>>Setup Device Label	(300A,01B8)	2	User-defined label for Setup Device used for patient alignment.
>>Setup Device Description	(300A,01BA)	3	User-defined description for Setup Device used for patient alignment.
>>Setup Device Parameter	(300A,01BC)	2	Setup Parameter for Setup Device in appropriate [IEC 61217] coordinate system. Units shall be mm for distances and degrees for angles.
>>Setup Reference Description	(300A,01D0)	3	User-defined description of Setup Reference used for patient alignment.
>>Accessory Code	(300A,00F9)	3	An identifier for the accessory intended to be read by a device such as a bar-code reader.
>Table Top Vertical Setup Displacement	(300A,01D2)	3	Vertical Displacement in IEC TABLE TOP coordinate system (in mm) relative to initial Setup Position, i.e., vertical offset between patient positioning performed using setup and treatment position.
>Table Top Longitudinal Setup Displacement	(300A,01D4)	3	Longitudinal Displacement in IEC TABLE TOP coordinate system (in mm) relative to initial Setup Position, i.e., longitudinal offset between patient positioning performed using setup and treatment position.
>Table Top Lateral Setup Displacement	(300A,01D6)	3	Lateral Displacement in IEC TABLE TOP coordinate system (in mm) relative to initial Setup Position, i.e., lateral offset between patient positioning performed using setup and treatment position.
>Motion Synchronization Sequence	(300A,0410)	3	Sequence of Motion Synchronization. One or more Items are permitted in this Sequence.
>>Respiratory Motion Compensation Technique	(0018,9170)	1	Technique applied to reduce respiratory motion artifacts. Defined Terms: NONE BREATH_HOLD REALTIME image acquisition shorter than respiratory cycle GATING Prospective gating TRACKING prospective through-plane or in-plane motion tracking PHASE_ORDERING prospective phase ordering PHASE_RESCANNING prospective techniques, such as real-time averaging, diminishing variance and motion adaptive gating RETROSPECTIVE retrospective gating CORRECTION retrospective image correction UNKNOWN technique not known
>>Respiratory Signal Source	(0018,9171)	1	Signal source from which respiratory motion is derived. Defined Terms: NONE BELT NASAL_PROBE CO2_SENSOR NAVIGATOR MR navigator and organ edge detection MR_PHASE phase (of center k-space line) ECG baseline demodulation of the ECG SPIROMETER Signal derived from flow sensor EXTERNAL_MARKER Signal determined from external motion surrogate INTERNAL_MARKER Signal determined from internal motion surrogate IMAGE Signal derived from an image UNKNOWN Signal source not known
>>Respiratory Motion Compensation Technique Description	(0018,9185)	3	Description of respiratory motion compensation technique.
>>Respiratory Signal Source ID	(0018,9186)	3	Identifies the device providing the respiratory signal.

C.8.8.12.1 RT Patient Setup Module Attribute Descriptions

C.8.8.12.1.1 Referenced Setup Image Sequence

Images with modality SC or VL serve as visible light photos for visual setup control. Images with modality RTIMAGE serve as reference images on plan level. RT Images present in this Sequence shall not be referenced in the Referenced Reference Image Sequence (300C,0042) of the RT Beams Module.

C.8.8.12.1.2 Patient Position

Defined Terms for Patient Position shall be those specified in Section C.7.3.1.1.2, plus the following:

Defined Terms:

SITTING: In the sitting position, the patient's face is towards the front of the chair

C.8.8.12.1.3 Patient Treatment Preparation Sequence

The Fixation Device Sequence (300A,0190), Shielding Device Sequence (300A,01A0), Setup Technique (300A,01B0), Setup Device Sequence (300A,01B4), and Motion Synchronization Sequence (300A,0410) allow encoding of specific devices and procedures for treatment preparation.

The Patient Treatment Preparation Procedure Sequence (300A,0790) within the Patient Treatment Preparation Sequence (300A,079F) allows generic encoding of the procedures and devices.

Note

Information in the Fixation Device Sequence (300A,0190), Shielding Device Sequence (300A,01A0), Setup Technique (300A,01B0), Setup Device Sequence (300A,01B4), and Motion Synchronization Sequence (300A,0410), if present, need to be consistent with the information in the Patient Treatment Preparation Procedure Sequence (300A,0790), if present.

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