DICOM PS3.16 2024c - Content Mapping Resource

A Structured Reporting Templates (Normative)

This Annex specifies the content of Standard Templates that may be used by DICOM SR IODs.

General Templates 

TID 300 Measurement

This Template provides a general structure for a numeric measurement, together with evaluations of its normality and/or significance, and the inference source(s) for its value. This structure is instantiated by inclusion of this Template with specific contextual parameters from a parent Template.

Table TID 300. Parameters

Parameter Name

Parameter Usage

$Measurement

Coded term or Context Group for Concept Name of measurement

$Units

Measurement Unit

$ModType

Modifier Name for Concept Name of measurement

$ModValue

Modifier Value for Concept Name of measurement

$Method

Value for Measurement Method

$Derivation

Value for Measurement Derivation

$TargetSite

Value(s) for Anatomic Location of measurement

$TargetSiteLaterality

Laterality Value for Anatomic Location of measurement

$TargetSiteMod

Modifier Value for Anatomic Location of measurement

$Equation

Coded term or Context Group for the equation or table from which the measurement was derived or computed

$ImagePurpose

Purpose of Reference for an image used as a source of the measurement

$WavePurpose

Purpose of Reference for a waveform used as a source of the measurement

$RefAuthority

Bibliographic reference or authority for statistical properties of a reference population

$RangeAuthority

Bibliographic reference or authority for the normal range of the measurement

$DerivationParameter

Coded term or Context Group for Concept Name of a derivation parameter

$DerivationParameterUnits

Units of derivation parameter

$PrecoordinatedMeasurementMeaning

Coded value for the precoordinated concept name of measurement


Type:

Extensible

Order:

Significant

Root:

No

Table TID 300. Measurement

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

$Measurement

1

M

UNITS = $Units

2

>

HAS CONCEPT MOD

CODE

$ModType

1-n

U

$ModValue

3

>

HAS CONCEPT MOD

CODE

EV (370129005, SCT, "Measurement Method")

1

U

$Method

4

>

HAS CONCEPT MOD

CODE

EV (121401, DCM, "Derivation")

1

U

$Derivation

5

>

HAS CONCEPT MOD

CODE

EV (363698007, SCT, "Finding Site")

1-n

U

$TargetSite

6

>>

HAS CONCEPT MOD

CODE

EV (272741003, SCT, "Laterality")

1

U

$TargetSiteLaterality

Defaults to DCID 244 “Laterality”

7

>>

HAS CONCEPT MOD

CODE

DT (106233006, SCT, "Topographical modifier")

1

U

$TargetSiteMod

8

>

HAS PROPERTIES

INCLUDE

DTID 310 “Measurement Properties”

1

U

$RefAuthority = $RefAuthority

$RangeAuthority = $RangeAuthority

9

>

INFERRED FROM

NUM

$DerivationParameter

1-n

UC

XOR Row 10

UNITS = $DerivationParameterUnits

10

>

R-INFERRED FROM

NUM

$DerivationParameter

1-n

UC

XOR Row 9

UNITS = $DerivationParameterUnits

11

>

INFERRED FROM

INCLUDE

DTID 315 “Equation or Table”

1

UC

XOR Row 12

$Equation = $Equation

12

>

INFERRED FROM

TEXT

DCID 228 “Equation or Table”

1

UC

XOR Row 11

13

>

INCLUDE

DTID 320 “Image or Spatial Coordinates”

1-n

U

$Purpose = $ImagePurpose

14

>

INCLUDE

DTID 321 “Waveform or Temporal Coordinates”

1-n

U

$Purpose = $WavePurpose

15

>

INCLUDE

DTID 1000 “Quotation”

1

U

16

>

HAS CONCEPT MOD

TEXT

EV (121050, DCM, "Equivalent Meaning of Concept Name")

1

U

16b

>

HAS CONCEPT MOD

CODE

EV (121050, DCM, "Equivalent Meaning of Concept Name")

1

U

$PrecoordinatedMeasurementMeaning

17

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U

18

>

INFERRED FROM

COMPOSITE

EV (126100, DCM, "Real World Value Map used for measurement")

1

U

SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")

19

>

HAS CONCEPT MOD

INCLUDE

DTID 4019 “Algorithm Identification”

1

U


Content Item Descriptions

Rows 2, 3, 4, 5

The HAS CONCEPT MOD items allow the explicit definition of terms for post-coordination of the measurement concept name. Additional post-coordinated modifier terms may be included in a SOP Instance based on this Template, in accordance with section 6.2.4, or as defined by Templates that invoke this Template and explicitly define additional post-coordinated modifiers (e.g., TID 5203).

Row 5

Finding site may be multiple when a region of interest spans multiple anatomical locations and there is not a single pre-coordinated code describing the combination of locations. E.g., when a maligant, inflammatory or traumatic process spans actual or defined anatomical boundaries. There is no requirement that the multiple locations be contiguous.

Rows 9, 10

The INFERRED FROM items allow the specification (by-value or by-reference) of numeric values that were used in the derivation of the numeric measurement of Row 1. The nature of the inference is not explicitly conveyed; it may be implicit in the Concept Names of the measurements. Inference by-reference is valid only in SOP Classes that permit the INFERRED FROM relationship by-reference.

Row 13

Multiple SCOORD Content Items may be necessary to describe the source of the measurement. E.g., the measurement of an angle between two non-intersecting line segments requires two separate POLYLINE SCOORD Content Items with the concept name of (121223, DCM, "Arm of angle") conveyed in $Purpose.

Rows 13, 14

(260753009, SCT, "Source") may be specified for $ImagePurpose or $WavePurpose as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.

Rows 16, 16b

Equivalent Meaning of Concept Name allows the creating application to specify the preferred composed concept name representing the measurement and the associated post-coordinated concept modifiers. The concept modifiers may include those specified in this Template, in a Template that invokes this Template, or at the option of the creating application in accordance with Section 6.2.4. This composed concept name may be rendered by a display application. It may be supplied as text or coded concept or both.

Row 18

Row 18 is a reference to an RWV that describes how measurements were made in units that differ from the stored pixel values in the images referenced in Row 13. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference overrides any reference in an including Template (such as for a Measurement Group).

TID 310 Measurement Properties

This Template provides the properties of a numeric measurement, including evaluations of its normality and/or significance, its relationship to a reference population, and an indication of its selection from a set of measurements.

Table TID 310. Parameters

Parameter Name

Parameter Usage

$RefAuthority

Bibliographic reference or authority for statistical properties of a reference population

$RangeAuthority

Bibliographic reference or authority for the normal range of the measurement


Type:

Extensible

Order:

Significant

Root:

No

Table TID 310. Measurement Properties

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (121402, DCM, "Normality")

1

U

DCID 222 “Normality”

2

INCLUDE

DTID 311 “Measurement Statistical Properties”

1

U

$RefAuthority = $RefAuthority

3

INCLUDE

DTID 312 “Normal Range Properties”

1

U

$RangeAuthority = $RangeAuthority

4

CODE

EV (121403, DCM, "Level of Significance")

1

U

DCID 220 “Significance Level”

5

NUM

DCID 225 “Measurement Uncertainty Concept”

1-n

U

6

CODE

EV (121404, DCM, "Selection Status")

1

U

DCID 224 “Selection Method”


TID 311 Measurement Statistical Properties

This Template provides the statistical properties of a reference population for a numeric measurement, and/or the position of a measurement in such a reference population.

Table TID 311. Parameters

Parameter Name

Parameter Usage

$RefAuthority

Bibliographic reference or authority for statistical properties of a reference population


Type:

Extensible

Order:

Significant

Root:

No

Table TID 311. Measurement Statistical Properties

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

DCID 221 “Measurement Range Concept”

1-n

M

2

TEXT

EV (121405, DCM, "Population description")

1

U

3

TEXT

EV (121406, DCM, "Reference Authority")

1

UC

XOR Row 4

4

CODE

EV (121406, DCM, "Reference Authority")

1

UC

XOR Row 3

$RefAuthority


TID 312 Normal Range Properties

This Template provides the normal range of values for a numeric measurement.

Table TID 312. Parameters

Parameter Name

Parameter Usage

$RangeAuthority

Bibliographic reference or authority for the normal range of the measurement


Type:

Extensible

Order:

Significant

Root:

No

Table TID 312. Normal Range Properties

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

DCID 223 “Normal Range Value”

1-n

M

2

TEXT

EV (121407, DCM, "Normal Range description")

1

U

3

TEXT

EV (121408, DCM, "Normal Range Authority")

1

UC

XOR Row 4

4

CODE

EV (121408, DCM, "Normal Range Authority")

1

UC

XOR Row 3

$RangeAuthority


TID 315 Equation or Table

Table TID 315. Parameters

Parameter Name

Parameter Usage

$Equation

Coded term or Context Group for the equation or table from which a measurement was derived or computed


Type:

Extensible

Order:

Significant

Root:

No

Table TID 315. Equation or Table

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

DCID 228 “Equation or Table”

1

M

$Equation

2

>

HAS PROPERTIES

NUM

1-n

U

3

>

R-HAS PROPERTIES

NUM

1-n

U


Content Item Descriptions

Row 2

The HAS PROPERTIES allows the specification of the numeric values used as input to the equation or table identified in Row 1.

Row 3

The HAS PROPERTIES allows the specification by-reference of the numeric values used as input to the equation or table. This row is valid only in SOP Classes that permit the HAS PROPERTIES relationship by-reference.

Note

For example, if Row 1 identifies a specific Body Surface Area equation, Rows 2 and 3 can be used to convey (by-value or by-reference) the Patient Height and Patient Weight numeric measurements used in the BSA computation.

TID 320 Image or Spatial Coordinates

This Template provides a general structure for inference from an image, either as a whole, or with specific 2D or 3D spatial coordinates, as a single included Template in the invoking Template. If allowed by the IOD, the Image Content Item may be included by-reference.

Table TID 320. Parameters

Parameter Name

Parameter Usage

$Purpose

Purpose of Reference for an image used as a source of the measurement


Type:

Extensible

Order:

Significant

Root:

No

Table TID 320. Image or Spatial Coordinates

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

INFERRED FROM

IMAGE

$Purpose

1

MC

XOR Rows 2, 3, 6

2

R-INFERRED FROM

IMAGE

1

MC

XOR Rows 1, 3, 6

3

INFERRED FROM

SCOORD

$Purpose

1

MC

XOR Rows 1, 2, 6

4

>

SELECTED FROM

IMAGE

1

MC

XOR Row 5

5

>

R-SELECTED FROM

IMAGE

1

MC

XOR Row 4

6

INFERRED FROM

SCOORD3D

$Purpose

1

MC

XOR Rows 1, 2, 3


Content Item Descriptions

Rows 1, 2, 3, 4, 5, 6

(260753009, SCT, "Source") may be be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.

TID 321 Waveform or Temporal Coordinates

This Template provides a general structure for referencing a waveform, either as a whole, or with specific temporal coordinates, as a single included Template in the invoking Template. If allowed by the IOD, the Waveform Content Item may be included by-reference.

Table TID 321. Parameters

Parameter Name

Parameter Usage

$Purpose

Purpose of Reference for a waveform used as a source of the measurement


Type:

Extensible

Order:

Significant

Root:

No

Table TID 321. Waveform or Temporal Coordinates

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

INFERRED FROM

WAVEFORM

$Purpose

1

MC

XOR Rows 2, 3

2

R-INFERRED FROM

WAVEFORM

1

MC

XOR Rows 1, 3

3

INFERRED FROM

TCOORD

$Purpose

1

MC

XOR Rows 1, 2

4

>

SELECTED FROM

WAVEFORM

1

MC

XOR Row 5

5

>

R-SELECTED FROM

WAVEFORM

1

MC

XOR Row 4


Content Item Descriptions

Rows 1, 2, 3, 4, 5

(260753009, SCT, "Source") may be be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.

TID 350 References to Supporting Evidence

This Template provides references to supporting evidence in the form of DICOM composite objects. This includes references to images, spatial coordinates on images, and other composite objects, such as Structured Reports.

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 350. References to Supporting Evidence

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

IMAGE

BCID 7003 “Diagnostic Imaging Report Purpose of Reference”

1-n

U

2

SCOORD

BCID 7003 “Diagnostic Imaging Report Purpose of Reference”

1-n

U

3

>

SELECTED FROM

IMAGE

1

M

4

COMPOSITE

DT (122073, DCM, "Current procedure evidence")

1-n

U

5

>

HAS CONCEPT MOD

CODE

EV (121144, DCM, "Document Title")

1

U


TID 351 Previous Reports

This general Template provides a means to reference previous structured reporting composite object instances.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 351. Previous Reports

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (111549, DCM, "Previous Reports")

1

M

2

>

CONTAINS

COMPOSITE

1-n

M


Content Item Descriptions

Row 2

Concept Name may be the Root Concept Name (title) of a Structured Report composite object instance.

TID 400 Reference Location

This TID is a subset of the Reference Location Macro. See Section 10.27 “Reference Location Macro” in PS3.3 .

Type:

Extensible

Order:

Non-Significant

Root:

No

Table TID 400. Reference Location

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (128772, DCM, "Reference Basis")

1

M

BCID 1001 “Anatomical Reference Basis”

2

CODE

EV (128773, DCM, "Reference Geometry")

1

M

BCID 1010 “Reference Geometry - Plane”


TID 1000 Quotation

Unless otherwise specified, content in an SR tree is "directly" observed. When material is quoted (from a source that is either a document or something spoken), then it is necessary to specify:

  • the fact that one is quoting

  • who is doing the quoting

  • the source of the quote

  • who is being quoted, and who and what the quote is about

This Template establishes a mechanism for quoting by specifying:

  • the fact that one is quoting, by the presence of the contents of the Template in the tree

  • that the "observer context" above the invocation of this Template establishes who is doing the quoting

  • the source of the quote, by the values of the Content Items in this Template

  • who is being quoted, and who and what the quote is about, by the observation context that is established at the start of the quoted material

This Template may be invoked recursively, to nest quotes within quotes. In essence, the chain of who is quoting whom can be established by maintaining a "stack" of observer context.

If a dimension of observation context is the same in the quoted material as in the enclosing tree, then the observation context does not need to be respecified (e.g., the quote may be about the same subject or procedure). Typically, the observer context would change (unless one were quoting oneself).

In the case of quoting something that was spoken, the "observer" is the person speaking.

TID 1000 is attached using HAS OBS CONTEXT relationships to the top node of the material that is being quoted. The presence of the Quoted Source concept signals the fact that the material is quoted rather than directly observed.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1000. Quotation

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS OBS CONTEXT

CODE

EV (121001, DCM, "Quotation Mode")

1

M

EV (121003, DCM, "Document")

EV (121004, DCM, "Verbal")

2

HAS OBS CONTEXT

COMPOSITE

EV (121002, DCM, "Quoted Source")

1

MC

Required if quoted material source is a DICOM composite object

3

HAS OBS CONTEXT

INCLUDE

DTID 1001 “Observation Context”

1

M


TID 1001 Observation Context

Specifies attributes of observation context that may be defined, extended or replaced at any location in the SR tree.

This includes attributes that specify:

  • who or what the observation is about ("subject context")

  • what procedure the observation is about ("procedure study context")

  • who or what is making the observation ("observer context")

Establishing context includes two aspects of each dimension: identification and description (e.g., patient name and ID vs. patient's age, height or weight).

Whenever one dimension of context is changed or an attribute is added, all attributes of that dimension of context are "flushed", that is they need to be repeated in their entirety. For example, when the subject is changed from patient (name, id) to fetus (number), then the parameters of the patient are discarded. E.g., the patient's ID does not apply to the fetus.

"Extending" the same class and dimension of observation context isn't feasible, since one cannot "null out" or remove a previously set attribute. Any time a dimension of observation context is "replaced", any attributes that are unspecified remain unspecified (i.e., they are not inherited).

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 1001. Observation Context

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS OBS CONTEXT

INCLUDE

DTID 1002 “Observer Context”

1-n

MC

Required if all aspects of observer context are not inherited.

Defaults to the Attributes of the Author Observer Sequence (0040,A078), or the Verifying Observer Sequence (0040,A073) if the Author Observer Sequence is not present

2

HAS OBS CONTEXT

INCLUDE

DTID 1005 “Procedure Study Context”

1

MC

Required if all aspects of procedure context are not inherited.

3

HAS OBS CONTEXT

INCLUDE

DTID 1006 “Subject Context”

1

MC

Required if all aspects of observation subject context are not inherited.


TID 1002 Observer Context

The observer (person or device) that created the Content Items to which this context applies.

Whenever this Template is invoked, all previously inherited attributes of Observer Context are discarded and replaced.

There may be more than one observer, as this Template may be invoked with a VM 1-n, and both person and device observers. In such a case, the Content Items of TID 1003 “Person Observer Identifying Attributes” and TID 1004 “Device Observer Identifying Attributes” shall be included in the order in which the values of Observer Type are specified. Since TID 1003 “Person Observer Identifying Attributes” and TID 1004 “Device Observer Identifying Attributes” both include a single mandatory Content Item as their first Content Item, which observer is being described can be determined

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 1002. Observer Context

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS OBS CONTEXT

CODE

EV (121005, DCM, "Observer Type")

1

MC

IF Observer type is device

DCID 270 “Observer Type”

Defaults to (121006, DCM, "Person")

2

HAS OBS CONTEXT

INCLUDE

DTID 1003 “Person Observer Identifying Attributes”

1

MC

IFF Row 1 value = (121006, DCM, "Person") or Row 1 is absent

3

HAS OBS CONTEXT

INCLUDE

DTID 1004 “Device Observer Identifying Attributes”

1

MC

IFF Row 1 value = (121007, DCM, "Device")

4

HAS OBS CONTEXT

INCLUDE

DTID 1015 “Person Observer Description”

1

U


TID 1003 Person Observer Identifying Attributes

This Template contains identifying (and optionally descriptive) attributes of persons that are observers.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1003. Person Observer Identifying Attributes


Row 5

E.g., "1" or "2", or "A" or "B"; should not recapitulate the role (i.e., should not be "READER1"), since it is used in conjunction with a separate coded concept for the role itself.

TID 1004 Device Observer Identifying Attributes

This Template (derived from the Section C.7.5.1 “General Equipment Module” in PS3.3 ) contains identifying (and optionally descriptive) attributes of devices that are observers.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1004. Device Observer Identifying Attributes

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

UIDREF

EV (121012, DCM, "Device Observer UID")

1

M

Defaults to Value of Device UID (0018,1002) of the General Equipment Module

2

TEXT

EV (121013, DCM, "Device Observer Name")

1

U

Defaults to Value of Station Name (0008,1010) of the General Equipment Module

3

TEXT

EV (121014, DCM, "Device Observer Manufacturer")

1

U

Defaults to Value of Manufacturer (0008,0070) of the General Equipment Module

4

TEXT

EV (121015, DCM, "Device Observer Model Name")

1

U

Defaults to Value of Manufacturer's Model Name (0008,1090) of the General Equipment Module

5

TEXT

EV (121016, DCM, "Device Observer Serial Number")

1

U

Defaults to Value of Device Serial Number (0018,1000) of the General Equipment Module

6

TEXT

EV (121017, DCM, "Device Observer Physical Location During Observation")

1

U

7

CODE

EV (113876, DCM, "Device Role in Procedure")

1-n

U

BCID 7445 “Device Participating Role”

8

TEXT

EV (110119, DCM, "Station AE Title")

1

U

9

UIDREF

EV (121061, DCM, "Device Observer Manufacturer Class UID")

1-n

U

Defaults to Value of Manufacturer's Device Class UID (0018,100B) of the General Equipment Module.

10

CONTAINER

EV (121000, DCM, "Unique Device Identifiers")

1-n

U

Defaults to Value of UDI Sequence (0018,100A) of the General Equipment Module

11

>

CONTAINS

TEXT

EV (74711-3, LN, "Unique Device Identifier")

1

M

12

>

CONTAINS

TEXT

EV (120999, DCM, "Device Description")

1

U


Content Item Descriptions

Row 7

If the device performing the observations has other roles, e.g., as the irradiating device in a dose report, this may be recorded here, if not implicit.

Rows 11, 12

The description can be used to distinguish between multiple UDIs.

TID 1005 Procedure Study Context

This Template contains identifying (and optionally descriptive) attributes of the procedure that is the source of evidence being interpreted.

Whenever this Template is invoked, all previously inherited attributes of Procedure Study Context are discarded and replaced.

Note

If an observed digital image is identified by other than a DICOM UID, a Study Instance UID must be generated for the non-DICOM evidence. The same must be done to document interpretation of hard-copy radiographs generated outside of the scope of the DICOM system.

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 1005. Procedure Study Context

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

UIDREF

EV (121018, DCM, "Procedure Study Instance UID")

1

U

Defaults to Value of Study Instance UID (0020, 000D) of the General Study Module

2

UIDREF

EV (121019, DCM, "Procedure Study Component UID")

1-n

U

3

TEXT

EV (121020, DCM, "Placer Number")

1

U

4

>

HAS CONCEPT MOD

TEXT

EV (110190, DCM, "Issuer of Identifier")

1

U

5

TEXT

EV (121021, DCM, "Filler Number")

1

U

6

>

HAS CONCEPT MOD

TEXT

EV (110190, DCM, "Issuer of Identifier")

1

U

7

TEXT

EV (121022, DCM, "Accession Number")

1

U

Defaults to Value of Accession Number (0008,0050) of the General Study Module

8

>

HAS CONCEPT MOD

TEXT

EV (110190, DCM, "Issuer of Identifier")

1

U

9

CODE

EV (121023, DCM, "Procedure Code")

1-n

U

Defaults to Value of Procedure Code Sequence (0008,1032) of the General Study Module


Content Item Descriptions

Rows 5, 6

The issuer shall be formatted in accordance with the HL7v2 Hierarchic Designator Data Type. That format is [ Namespace ID]^[ Universal ID^ Universal ID Type], where Namespace IDidentifies an entity within the local namespace or domain, Universal IDis a universal or unique identifier for an entity, and Universal ID Typespecifies the standard format of the Universal ID (see HL7 v2 Section 2.A.33).

TID 1006 Subject Context

This Template contains identifying (and optionally descriptive) attributes of the subject of the observation.

Subject context identifies (and optionally) describes the subject of the observation, whether it be a patient (human or animal), a fetus (human or animal), a specimen, or a device.

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 1006. Subject Context

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (121024, DCM, "Subject Class")

1

MC

IF subject is not the Patient

DCID 271 “Observation Subject Class”

Defaults to (121025, DCM, "Patient")

2

INCLUDE

DTID 1007 “Subject Context, Patient”

1

UC

IFF Row 1 value = (121025, DCM, "Patient") or Row 1 is absent

May be used for human or animal patients

3

INCLUDE

DTID 1008 “Subject Context, Fetus”

1

UC

IFF Row 1 value = (121026, DCM, "Fetus")

May be used for human or animal fetuses

4

INCLUDE

DTID 1009 “Subject Context, Specimen”

1

UC

IFF Row 1 value = (121027, DCM, "Specimen")

5

INCLUDE

DTID 1010 “Subject Context, Device”

1

UC

IFF Row 1 value = (121192, DCM, "Device Subject")


TID 1007 Subject Context, Patient

Identifies (and optionally describes) a patient who is the subject.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1007. Subject Context, Patient

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

UIDREF

EV (121028, DCM, "Subject UID")

1

U

E.g., SOP Instance UID of Detached Patient Instance

2

PNAME

EV (121029, DCM, "Subject Name")

1

MC

Required if not inherited.

Defaults to Value of Patient's Name (0010,0010) of the Patient Module

3

CODE

EV (121030, DCM, "Subject ID")

1

MC

Required if not inherited.

Defaults to Value of Patient ID (0010,0020) of the Patient Module

4

DATE

EV (121031, DCM, "Subject Birth Date")

1

U

Defaults to Value of Patient's Birth Date (0010,0030) of the Patient Module

5

CODE

EV (121032, DCM, "Subject Sex")

1

U

Defaults to value equivalent to Value of Patient's Sex (0010,0040) of the Patient Module

DCID 7455 “Sex”

6

NUM

EV (121033, DCM, "Subject Age")

1

U

Defaults to value equivalent to Value of Patient's Age (0010,1010) of the Patient Study Module

UNITS = DCID 7456 “Age Unit”

7

CODE

EV (121034, DCM, "Subject Species")

1

MC

Required if not inherited.

DCID 7454 “Animal Taxonomic Rank Value”

Defaults to Value of Patient Species Code Sequence (0010,2202) of the Patient Module, or if absent, (337915000, SCT, "Homo sapiens").

8

CODE

EV (121035, DCM, "Subject Breed")

1

U

Defaults to Value of Patient Breed Code Sequence (0010,2293) of the Patient Module

DCID 7480 “Breed”

9

CODE

EV (415229000, SCT, "Racial group")

1

U

Defaults to Value of Ethnic Group Code Sequence (0010,2161) of the Patient Module, or if absent, the coded equivalent of the text Value of Ethnic Group (0010,2160) of the Patient Module, which is defined as "race or ethnic group".

BCID 6099 “Racial Group”


TID 1008 Subject Context, Fetus

Identifies (and optionally describes) a fetus who is the subject.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1008. Subject Context, Fetus

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

PNAME

EV (121036, DCM, "Mother of fetus")

1

U

Defaults to an observation subject that is a patient prior to replacing the Observation Subject Class with Fetus.

2

UIDREF

EV (121028, DCM, "Subject UID")

1

U

For longitudinal tracking of individual fetuses

3

TEXT

EV (121030, DCM, "Subject ID")

1

MC

IF Row 4 is absent

For longitudinal tracking of individual fetuses (human readable value e.g., "A" or "1")

4

TEXT

EV (11951-1, LN, "Fetus ID")

1

MC

IF Row 3 is absent

For separation of multiple fetuses during this procedure e.g., fetus '1" of '2" … not for longitudinal comparisons.; i.e., the "m" of fetus "m" of "n"

5

NUM

EV (11878-6, LN, "Number of Fetuses by US")

1

U

XOR Row 6

UNITS = EV (1, UCUM, "no units")

6

NUM

EV (55281-0, LN, "Number of Fetuses")

1

UC

XOR Row 5

UNITS = EV (1, UCUM, "no units")


Content Item Descriptions

Rows 5, 6

The "n" of fetus "m" of "n"; either the code for the ultrasound method (Row 5) or for the non-specific method (Row 6) may be used

TID 1009 Subject Context, Specimen

Identifies (and optionally describes) a specimen that is the subject.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1009. Subject Context, Specimen

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

UIDREF

EV (121039, DCM, "Specimen UID")

1

U

2

INCLUDE

DTID 1007 “Subject Context, Patient”

1

UC

IFF the source of the specimen is a human or animal patient

3

TEXT

EV (121041, DCM, "Specimen Identifier")

1

U

4

TEXT

EV (111724, DCM, "Issuer of Specimen Identifier")

1

U

See Content Item descriptions

5

CODE

EV (371439000, SCT, "Specimen Type")

1

U

DCID 8103 “Anatomic Pathology Specimen Type”

6

TEXT

EV (111700, DCM, "Specimen Container Identifier")

1

U


Content Item Descriptions

Rows 5, 6

The Issuer of Specimen Identifier shall be formatted in accordance with the HL7 v2 Hierarchic Designator data type (see HL7 v2.6 Section 2.A.33), i.e., [ Namespace ID]^[ Universal ID^Universal ID Type]

TID 1010 Subject Context, Device

Identifies (and optionally describes) a device that is the subject of observations.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1010. Subject Context, Device


TID 1015 Person Observer Description

This Template includes attributes describing the qualifications of the person observer relevant to the content generated by the observer.

Type:

Extensible

Order:

Non-Significant

Root:

No

Table TID 1015. Person Observer Description

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (128003, DCM, "Reader Specialty")

1

M

DCID 7449 “Reader Specialty”

2

>

HAS PROPERTIES

NUM

EV (C54627, NCIt, "Experience")

1

M

UNITS = EV (a, UCUM, "Year")


TID 1020 Person Participant

This Template describes a person participating in an activity as other than an observer or subject. E.g., for a dose report documenting an irradiating procedure, participants include the person administering the irradiation and the person authorizing the irradiation.

This Template is included with specific contextual parameters from a parent Template.

Table TID 1020. Parameters

Parameter Name

Parameter Usage

$PersonProcedureRole

Coded term or Context Group for the Concept Name that describes the nature of the person's participation in this procedure.


Type:

Extensible

Order:

Significant

Root:

No

Table TID 1020. Person Participant

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

PNAME

EV (113870, DCM, "Person Name")

1

M

2

>

HAS PROPERTIES

CODE

EV (113875, DCM, "Person Role in Procedure")

1

M

$PersonProcedureRole

3

>

HAS PROPERTIES

TEXT

EV (113871, DCM, "Person ID")

1

U

4

>

HAS PROPERTIES

TEXT

EV (113872, DCM, "Person ID Issuer")

1

U

5

>

HAS PROPERTIES

TEXT

EV (113873, DCM, "Organization Name")

1

U

6

>

HAS PROPERTIES

CODE

EV (113874, DCM, "Person Role in Organization")

1

U

BCID 7452 “Organizational Role”


Content Item Descriptions

Row 1

The name of the person participating in the role identified in Row 2.

Row 2

The procedural role played by the person in this procedure.

Row 6

The organizational role played by the person in the organization.

TID 1021 Device Participant

This Template describes a device participating in an activity as other than an observer or subject. E.g., for a dose report documenting an irradiating procedure, participants include the irradiating device.

This Template is included with specific contextual parameters from a parent Template.

Table TID 1021. Parameters

Parameter Name

Parameter Usage

$DeviceProcedureRole

Coded term or Context Group for the Concept Name that describes the nature of the device's participation in this procedure.


Type:

Extensible

Order:

Significant

Root:

No

Table TID 1021. Device Participant

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (113876, DCM, "Device Role in Procedure")

1

M

$DeviceProcedureRole

2

>

HAS PROPERTIES

TEXT

EV (113877, DCM, "Device Name")

1

U

3

>

HAS PROPERTIES

TEXT

EV (113878, DCM, "Device Manufacturer")

1

M

4

>

HAS PROPERTIES

TEXT

EV (113879, DCM, "Device Model Name")

1

M

5

>

HAS PROPERTIES

TEXT

EV (113880, DCM, "Device Serial Number")

1

M

6

>

HAS PROPERTIES

UIDREF

EV (121012, DCM, "Device Observer UID")

1

M


Content Item Descriptions

Row 1

If no Device Procedure Role is provided, BCID 7445 “Device Participating Role” may be used.

Row 2

This may be used for the name by which the organization manages the device.

TID 1200 Language Designation

Defines a mechanism for specifying a language, optionally with designation of the country in which that language applies.

Note

  1. For example, the French language could be specified unmodified, or French as written in France or Canada could be distinguished.

  2. The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous editions of the Standard.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1200. Language Designation

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

EV (121045, DCM, "Language")

1

M

DCID 5000 “Language”

2

>

HAS CONCEPT MOD

CODE

EV (121046, DCM, "Country of Language")

1

U

DCID 5001 “Country”


TID 1201 Language of Value

Defines a mechanism for specifying the language in which the value of the parent Content Item (only) is written. Does not specify the language of the Concept Name of the parent Content Item, nor of any other descendants of the parent Content Item.

Note

The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous editions of the Standard.

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 1201. Language of Value

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS CONCEPT MOD

CODE

EV (121047, DCM, "Language of Value")

1

M

DCID 5000 “Language”

2

>

HAS CONCEPT MOD

CODE

EV (121046, DCM, "Country of Language")

1

U

DCID 5001 “Country”


TID 1202 Language of Name and Value

Defines a mechanism for specifying the language in which the value and the Concept Name of the parent Content Item (only) is written. Does not specify the language of any other descendants of the parent Content Item.

Note

The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous editions of the Standard.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1202. Language of Name and Value

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS CONCEPT MOD

CODE

EV (121048, DCM, "Language of Name and Value")

1

M

DCID 5000 “Language”

2

>

HAS CONCEPT MOD

CODE

EV (121046, DCM, "Country of Language")

1

U

DCID 5001 “Country”


TID 1204 Language of Content Item and Descendants

Defines a mechanism for specifying the language in which the value and the Concept Name of the parent Content Item and any other descendants of the parent Content Item is written.

Note

The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous editions of the Standard.

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 1204. Language of Content Item and Descendants

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS CONCEPT MOD

CODE

EV (121049, DCM, "Language of Content Item and Descendants")

1

M

DCID 5000 “Language”

2

>

HAS CONCEPT MOD

CODE

EV (121046, DCM, "Country of Language")

1

U

DCID 5001 “Country”


TID 1210 Equivalent Meaning(s) of Concept Name

Defines a mechanism for specifying one or more equivalent meanings for the Concept Name of the parent Content Item.

Type:

Non-Extensible

Order:

Significant

Root:

No

Table TID 1210. Equivalent Meaning(s) of Concept Name

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS CONCEPT MOD

TEXT

EV (121050, DCM, "Equivalent Meaning of Concept Name")

1-n

MC

XOR Row 3

Plain text equivalent of code meaning of the concept name of the Content Item being modified, in the specified language from the specified country, using the default character set or a character set selected from Specified Character Set

2

>

INCLUDE

DTID 1201 “Language of Value”

1

U

3

HAS CONCEPT MOD

CODE

EV (121050, DCM, "Equivalent Meaning of Concept Name")

1-n

MC

XOR Row 1

4

>

INCLUDE

DTID 1201 “Language of Value”

1

U


Note

A coded equivalent meaning for the Concept Name can also be included using the Attribute Equivalent Code Sequence (0008,0121) in the Concept Name Code Sequence (0040,A043) (see Section 8.9 “Equivalent Code Sequence” in PS3.3 ), though the equivalent code(s) in the Equivalent Code Sequence (0008,0121) need not be the same as those in TID 1210.

TID 1211 Equivalent Meaning(s) of Value

Defines a mechanism for specifying one or more equivalent meanings for the Value of the parent Content Item.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1211. Equivalent Meaning(s) of Value

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS CONCEPT MOD

TEXT

EV (121051, DCM, "Equivalent Meaning of Value")

1-n

MC

XOR Row 3

Plain text equivalent of code meaning of the value of the Content Item being modified, in the specified language from the specified country, using the default character set or a character set selected from Specified Character Set

2

>

INCLUDE

DTID 1201 “Language of Value”

1

U

3

HAS CONCEPT MOD

CODE

EV (121051, DCM, "Equivalent Meaning of Value")

1-n

MC

XOR Row 1

4

>

INCLUDE

DTID 1201 “Language of Value”

1

U


Note

  1. For example, to describe a longer, more meaningful equivalent (in the same language) for a procedure code than is defined in a coding scheme:

    CODE: (121023, DCM, "Procedure Code") = (50291CC, ICD10PCS, "IMAGING:CNS:CT:SELLA:LOWOSMOLAR:IT, U, E:2PLANE3D")

    > HAS CONCEPT MOD TEXT: (121051, DCM, "Equivalent meaning of value") = "imaging study central nervous system of the sella turcica/pituitary gland with low osmolar contrast intrathecal, unenhanced and enhanced, in two planes with 3D reconstructions"

  2. For example, to specify a concept name and value in both French and English in Canada:

    CODE:(91723000, SCT, "Anatomical structure") = (76752008, SCT, "Breast")

    > HAS CONCEPT MOD CODE: (121048, DCM, "Language of name and value") = (en-CA, RFC5646, "English, Canada")

    > HAS CONCEPT MOD CODE: (121050, DCM, "Equivalent meaning of concept name") = (91723000, SCT, Structure de l'anatomie")

    >> HAS CONCEPT MOD CODE: (121047, DCM, " Langue de la valeur ") = (fr-CA, RFC5646, " Français, Canadien ")

    > HAS CONCEPT MOD CODE: (121051, DCM, "Equivalent meaning of value") = (76752008, SCT, "Sein")

    >> HAS CONCEPT MOD CODE: (121047, DCM, " Langue de la valeur ") = (fr-CA, RFC5646, " Français, Candie ")

  3. 3. A coded equivalent meaning for the Concept Value of a CODE Content Item can also be included using the Attribute Equivalent Code Sequence (0008,0121) in the Concept Code Sequence (0040, A168) (see Section 8.9 “Equivalent Code Sequence” in PS3.3 ).

TID 1350 Negation Modifier, Presence of Finding

Concept Name Modifier for negation of the presence of a finding represented by a post-coordinated concept.

Note

  1. For example, negation modifier applied to "distention" in the post-coordinated structure:

    CODE: "anatomic location" = "bile duct"

    > HAS PROPERTY CODE: "morphology" = "distention"

    >> HAS CONCEPT MOD CODE: "presence of property" = "absent"

    means: "bile duct distention not present"

  2. The presence-negation modifier modifies the entire post-coordinated concept, not just the Source Content Item of the HAS CONCEPT MOD relationship. The entire branch of the tree from the Content Item is included in the post-coordinated structure that is negated.

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1350. Negation Modifier, Presence of Finding

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS CONCEPT MOD

CODE

EV (121052, DCM, "Presence of property")

1

M

DCID 240 “Present-Absent”


TID 1400 Linear Measurement

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1400. Linear Measurement

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

DCID 7470 “Linear Measurement”

1

M

UNITS = DCID 7460 “Linear Measurement Unit”

2

>

INFERRED FROM

SCOORD

EV (121055, DCM, "Path")

1

UC

XOR Row 5

GRAPHIC TYPE = {POLYLINE, CIRCLE, ELLIPSE}

3

>>

R-SELECTED FROM

IMAGE

1

MC

XOR Row 4

4

>>

SELECTED FROM

IMAGE

1

MC

XOR Row 3

5

>

INFERRED FROM

SCOORD

EV (121230, DCM, "Path Vertex")

2-n

UC

XOR Row 2

GRAPHIC TYPE = {POINT}

6

>>

R-SELECTED FROM

IMAGE

1

MC

XOR Row 7

7

>>

SELECTED FROM

IMAGE

1

MC

XOR Row 6

8

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U


Content Item Descriptions

Row 2

Path shall represent the measured path or a projection of the measured path in the image. The Graphic Type (0070,0023) of the Path SCOORD shall be:

  • an open POLYLINE with two different points (to measure length, diameter, distance, proximity, etc),

  • a CIRCLE or ELLIPSE (to measure circumference) or

  • an open or closed POLYLINE (closed polygon) to measure path length (open) or perimeter (closed).

Row 5

A measured path that traverses two or more images (e.g., the ends of the path are in different cross-sectional plane images) shall be identified by vertices along the path. The Path Vertices shall be ordered by the order of their SCOORD Content Items to identify the measured path. The Graphic Type (0070,0023) of each SCOORD shall be POINT

TID 1401 Area Measurement

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1401. Area Measurement

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

DCID 7471 “Area Measurement”

1

M

Value shall be > 0

UNITS = DCID 7461 “Area Measurement Unit”

2

>

INFERRED FROM

SCOORD

EV (121056, DCM, "Area Outline")

1

MC

IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 5 or 6 not present.

GRAPHIC TYPE = not {MULTIPOINT}

3

>>

R-SELECTED FROM

IMAGE

1

MC

XOR Row 4

4

>>

SELECTED FROM

IMAGE

1

MC

XOR Row 3

5

>

INFERRED FROM

IMAGE

EV (121214, DCM, "Referenced Segmentation Frame")

1

MC

IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 2 or 6 not present.

Reference shall be to a Segmentation Image, with a single value specified in Referenced Frame Number

6

>

R- INFERRED FROM

IMAGE

1

MC

IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 2 or 5 not present.

Reference shall be to a Segmentation Image, with a single value specified in Referenced Frame Number

7

>

HAS PROPERTIES

CODE

EV (370129005, SCT, "Measurement Method")

1

U

DCID 7473 “General Area Calculation Method”

8

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U


Content Item Descriptions

Row 2

A Graphic Type of POINT implies that the object is a single pixel and the object's area is the area of the pixel. Otherwise the type shall be a closed POLYLINE (start and end point the same) or a CIRCLE or an ELLIPSE.

Rows 5, 6

Referenced Frame Number (0008,1160) is an Attribute of the IMAGE Content Item.

If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the area of defined (measured) region by pixel values in the referenced frame with value 1. For Segmentation Type value FRACTIONAL, the area is computed by an implementation dependent method.

Frame number shall be specified even if the Segmentation SOP Instance has only a single frame.

Row 8

The values of (112039, DCM, "Tracking Identifier") and (112040, DCM, "Tracking Unique Identifier"), if present, shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 5.

TID 1402 Volume Measurement

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1402. Volume Measurement

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

DCID 7472 “Volume Measurement”

1

M

Value shall be > 0

UNITS = DCID 7462 “Volume Measurement Unit”

2

>

INFERRED FROM

SCOORD

EV (121057, DCM, "Perimeter Outline")

1-n

UC

XOR Rows 5, 6

GRAPHIC TYPE = not {MULTIPOINT}

3

>>

R-SELECTED FROM

IMAGE

1

MC

XOR Row 4

4

>>

SELECTED FROM

IMAGE

1

MC

XOR Row 3

5

>

INFERRED FROM

IMAGE

EV (121191, DCM, "Referenced Segment")

1

UC

XOR Rows 2, 6

Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number

6

>

R- INFERRED FROM

IMAGE

1

UC

XOR Rows 2, 5

Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number

7

>

HAS PROPERTIES

CODE

EV (370129005, SCT, "Measurement Method")

1

U

DCID 7474 “General Volume Calculation Method”

8

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U


Content Item Descriptions

Row 2

The two dimensional perimeter of the volume's intersection with or projection into the image. A Graphic Type of POINT implies that the volume's intersection or projection in a plane is a single pixel. A single pixel projection perimeter cannot cause a volume calculation to become 0.

Otherwise the type shall be a closed POLYLINE (start and end point the same) or a CIRCLE or an ELLIPSE.

Rows 5, 6

Referenced Segment Number (0062,000B) is an Attribute of the IMAGE Content Item.

If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the defined (measured) volume by pixel/voxel values in the frames of the referenced segment with value 1. For Segmentation Type value FRACTIONAL, the volume is computed by an implementation dependent method.

Segment number shall be specified even if the Segmentation SOP Instance has only a single segment.

Row 8

The values of (112039, DCM, "Tracking Identifier") and (112040, DCM, "Tracking Unique Identifier"), if present, shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 5.

TID 1404 Numeric Measurement

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1404. Numeric Measurement

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

1

M

UNITS = DCID 82 “Measurement Unit”

2

>

INFERRED FROM

SCOORD

1-n

UC

XOR Rows 5, 6

3

>>

R-SELECTED FROM

IMAGE

1

MC

XOR Row 4

4

>>

SELECTED FROM

IMAGE

1

MC

XOR Row 3

5

>

R-INFERRED FROM

IMAGE

BCID 7003 “Diagnostic Imaging Report Purpose of Reference”

1-n

UC

XOR Rows 2, 6

6

>

INFERRED FROM

IMAGE

BCID 7003 “Diagnostic Imaging Report Purpose of Reference”

1-n

UC

XOR Rows 2, 5

7

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U


Content Item Descriptions

Row 2

The SCOORD may indicate the points or area where the measurement was taken (e.g., a POINT showing the pixel location of a density measurement, or an open POLYLINE of three points showing the calculation of an angle).

Rows 3, 5

Valid only in IODs that permit relationships by-reference.

TID 1406 Three Dimensional Linear Measurement

Type:

Extensible

Order:

Significant

Root:

No

Table TID 1406. Three Dimensional Linear Measurement

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

DCID 7470 “Linear Measurement”

1

M

UNITS = DCID 7460 “Linear Measurement Unit”

2

>

INFERRED FROM

SCOORD3D

EV (121055, DCM, "Path")

1

M

GRAPHIC TYPE = {POLYLINE, ELLIPSE, POLYGON}

3

>

HAS OBS CONTEXT

INCLUDE

DTID 4108 “Tracking Identifier”

1

U


Content Item Descriptions

Row 2

Path shall represent the measured path in a reference coordinate space. The Graphic Type (0070,0023) of the Path SCOORD3D shall be:

  • an open POLYLINE with two or more different (x,y,z) triplets (to measure length, diameter, distance, proximity, etc.),

  • an ELLIPSE (to measure circumference) or

  • a closed POLYGON to measure perimeter, where the (x,y,z) triplets are coplanar.

TID 1410 Planar ROI Measurements and Qualitative Evaluations

This Template provides a general structure to report measurements for some metric, e.g., density, flow, or concentration, and/or qualitative evaluations, over a planar region of interest in an image. The ROI may be specified by an SCOORD on an image, by a Segmentation Image, by an SCOORD3D defining an area relative to a 3D Frame of Reference, or by a reference to an ROI defined in a radiotherapy Structure Set.

Table TID 1410. Parameters

$Measurement

Coded term or Context Group for Concept Name of measurement

$Units

Units for the measurement

$ModType

Modifier Name for Concept Name of measurement

$ModValue

Modifier Value for Concept Name of measurement

$Method

Value for Measurement Method

$Derivation

Value for Measurement Derivation

$TargetSite

Value for Anatomic Location of measurement

$TargetSiteMod

Modifier Value for Anatomic Location of measurement

$Equation

Coded term or Context Group for the equation or table from which the measurement was derived or computed

$RefAuthority

Bibliographic reference or authority for statistical properties of a reference population

$RangeAuthority

Bibliographic reference or authority for the normal range of the measurement

$DerivationParameter

Coded term or Context Group for Concept Name of a derivation parameter

$DerivationParameterUnits

Units of derivation parameter

$QualType

Evaluations encoded with code or text responses

$QualValue

Value of evaluations encoded with code responses

$QualModType

Modifier Name of evaluations encoded with code or text responses

$QualModValue

Modifier Value of evaluations encoded with code or text responses

$FindingCategory

Category of the finding

$FindingType

Type of the finding

$TrackingID

Value for Tracking Identifier

$TrackingUID

Value for Tracking Unique Identifier


Type:

Extensible

Order:

Non-Significant

Root:

No

Table TID 1410. Planar ROI Measurements and Qualitative Evaluations

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (125007, DCM, "Measurement Group")

1

M

1b

>

HAS OBS CONTEXT

TEXT

EV (C67447, NCIt, "Activity Session")

1

U

2

>

HAS OBS CONTEXT

TEXT

DT (112039, DCM, "Tracking Identifier")

1

U

$TrackingID

3

>

HAS OBS CONTEXT

UIDREF

EV (112040, DCM, "Tracking Unique Identifier")

1

U

$TrackingUID

3a

>

CONTAINS

CODE

EV (276214006, SCT, "Finding category")

1

U

$FindingCategory

3b

>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1

U

$FindingType

3c

>

CONTAINS

CODE

EV (130400, DCM, "Geometric purpose of region")

1

U

BCID 219 “Geometry Graphical Representation”

4

>

HAS OBS CONTEXT

INCLUDE

DTID 1502 “Time Point Context”

1

U

5

>

CONTAINS

SCOORD

EV (111030, DCM, "Image Region")

1

MC

XOR Rows 7, 7b, 8b

GRAPHIC TYPE = not {MULTIPOINT}

6

>>

SELECTED FROM

IMAGE

1

M

7

>

CONTAINS

IMAGE

EV (121214, DCM, "Referenced Segmentation Frame")

1

MC

XOR Rows 5, 7b

Reference shall be to a Segmentation Image, with a single value specified in Referenced Segment Number (0062,000B).

For references to tiled Segmentation Images, one or more values shall be specified in Referenced Frame Number (0008,1160), unless all frames in the referenced Segmentation Image are selected and there is only a single Segment, in which case Referenced Frame Number (0008,1160) will be absent. The referenced tiles shall all be in the same plane.

For references to non-tiled Segmentation Images, a single value shall be specified in Referenced Frame Number (0008,1160), unless there is only one frame in the referenced Segmentation Image, in which case Referenced Frame Number (0008,1160) will be absent.

7b

>

CONTAINS

SCOORD3D

EV (111030, DCM, "Image Region")

1

MC

XOR Rows 5, 7, 8b

GRAPHIC TYPE = not {MULTIPOINT, POLYLINE or ELLIPSOID}

8

>

CONTAINS

IMAGE

EV (121233, DCM, "Source image for segmentation")

1

MC

IFF Row 7

8b

>

CONTAINS

COMPOSITE

EV (130488, DCM, "Region in Space")

1

MC

XOR Rows 5, 7, 7b

Reference shall be to an Instance of the RT Structure Set Storage SOP Class.

8c

>>

HAS PROPERTIES

TEXT

EV (130489, DCM, "Referenced Region of Interest Identifier")

1

M

Shall be the value of ROI Number (3006,0022) within the single referenced Item of Structure Set ROI Sequence (3006,0020) of the referenced Instance of the RT Structure Set Storage SOP Class.

9

>

CONTAINS

IMAGE

EV (121200, DCM, "Illustration of ROI")

1

U

9b

>

CONTAINS

IMAGE

EV (130401, DCM, "Visual explanation")

1-n

U

10

>

CONTAINS

COMPOSITE

EV (126100, DCM, "Real World Value Map used for measurement")

1

U

SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")

11

>

CONTAINS

INCLUDE

DTID 1419 “ROI Measurements”

1

U

$Measurement = $Measurement

$Units = $Units

$ModType = $ModType

$ModValue = $ModValue

$Method = $Method

$Derivation = $Derivation

$TargetSite = $TargetSite

$TargetSiteMod = $TargetSiteMod

$Equation = $Equation

$RefAuthority = $RefAuthority

$RangeAuthority = $RangeAuthority

$DerivationParameter = $DerivationParameter

$DerivationParameterUnits = $DerivationParameterUnits

12

>

CONTAINS

CODE

$QualType

1-n

U

$QualValue

12b

>>

HAS CONCEPT MOD

CODE

$QualModType

1-n

U

$QualModValue

13

>

CONTAINS

TEXT

$QualType

1-n

U


Content Item Descriptions

Row 1b

Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity".

Rows 2, 3

The Tracking Identifier and Tracking Unique Identifier are defined as a text label or unique identifier (respectively) used for tracking a finding or feature, potentially across multiple reporting objects, over time. As such, they are distinct from the Observation UID (0040,A171), which is unique identifier of the specific Content Item and its subsidiary Content Items that constitute an individual observation, and would be different for different observations on different occasions of the same finding or feature. The values of these Content Items shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 7.

Rows 3a, 3b

The category and type of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site). When spatial localization is by reference to a Segmentation, the category and type may correspond to the values of Segmented Property Category Code Sequence (0062,0003) and Segmented Property Type Code Sequence (0062,000F), respectively. See also CID 7150 “Segmentation Property Category”.

Row 5

To describe an infinitely small area, such as the center of a lesion, a Graphic Type of POINT may be used.

Row 6

(260753009, SCT, "Source") may be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.

Row 7

Referenced Frame Number (0008,1160) and Referenced Segment Number (0062,000B) are Attributes of the IMAGE Content Item.

If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the area of defined (measured) region of interest by pixel values in the referenced frame with value 1. For Segmentation Type value FRACTIONAL, the area is computed by an implementation dependent method.

Referenced Frame Number (0008,1160) may reference multiple frames in the same plane for tiled Segmentation Images (such as segmentations of Whole Slide Microscopy images).

Row 7b

The area may be defined independently of an image by reference to 3D coordinates in any type of DICOM Reference Coordinate System, whether it be patient-relative (Patient Based Coordinate System), volume-relative (including acquired and presentation state volumes), or whole slide relative (Slide Coordinate System).

Row 8

Identifies the source image that was segmented to identify the ROI, and whose properties are described in this container.

Rows 8b, 8c

A reference to a single ROI that defines a planar ROI, within an RT Structure Set.

Row 9

This referenced image may contain a "screen shot" illustrating a rendered version of the ROI.

Row 9b

This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image.

Row 10

The reference to an RWV in Row 10 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden).

Row 11

Measurements may be omitted, for example if it is desired to describe only the location of a finding or to provide categorical information about it.

Rows 12, 12b, 13

Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present.

TID 1411 Volumetric ROI Measurements and Qualitative Evaluations

This Template provides a general structure to report measurements for some metric, e.g., density, flow, or concentration, and/or qualitative evaluations, over a volumetric region of interest in a set of images or a Frame of Reference. The volumetric ROI may be specified by a set of SCOORDs on an image set representing a volume, by a volumetric Segmentation Image, by a volume defined in a Surface Segmentation, by a set of SCOORD3Ds defining a volume relative to a 3D Frame of Reference, or by a reference to an ROI defined in a radiotherapy Structure Set.

Table TID 1411. Parameters

$Measurement

Coded term or Context Group for Concept Name of measurement

$Units

Units for the measurement

$ModType

Modifier Name for Concept Name of measurement

$ModValue

Modifier Value for Concept Name of measurement

$Method

Value for Measurement Method

$Derivation

Value for Measurement Derivation

$TargetSite

Value for Anatomic Location of measurement

$TargetSiteMod

Modifier Value for Anatomic Location of measurement

$Equation

Coded term or Context Group for the equation or table from which the measurement was derived or computed

$RefAuthority

Bibliographic reference or authority for statistical properties of a reference population

$RangeAuthority

Bibliographic reference or authority for the normal range of the measurement

$DerivationParameter

Coded term or Context Group for Concept Name of a derivation parameter

$DerivationParameterUnits

Units of derivation parameter

$QualType

Evaluations encoded with code or text responses

$QualValue

Value of evaluations encoded with code responses

$QualModType

Modifier Name of evaluations encoded with code or text responses

$QualModValue

Modifier Value of evaluations encoded with code or text responses

$FindingCategory

Category of the finding

$FindingType

Type of the finding

$TrackingID

Value for Tracking Identifier

$TrackingUID

Value for Tracking Unique Identifier


Type:

Extensible

Order:

Non-Significant

Root:

No

Table TID 1411. Volumetric ROI Measurements and Qualitative Evaluations

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (125007, DCM, "Measurement Group")

1

M

1b

>

HAS OBS CONTEXT

TEXT

EV (C67447, NCIt, "Activity Session")

1

U

2

>

HAS OBS CONTEXT

TEXT

DT (112039, DCM, "Tracking Identifier")

1

U

$TrackingID

3

>

HAS OBS CONTEXT

UIDREF

EV (112040, DCM, "Tracking Unique Identifier")

1

U

$TrackingUID

3a

>

CONTAINS

CODE

EV (276214006, SCT, "Finding category")

1

U

$FindingCategory

3b

>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1

U

$FindingType

3c

>

CONTAINS

CODE

EV (130400, DCM, "Geometric purpose of region")

1

U

BCID 219 “Geometry Graphical Representation”

4

>

HAS OBS CONTEXT

INCLUDE

DTID 1502 “Time Point Context”

1

U

5

>

CONTAINS

SCOORD

EV (111030, DCM, "Image Region")

1-n

MC

XOR Rows 7, 10, 12b

GRAPHIC TYPE = not {MULTIPOINT}

6

>>

SELECTED FROM

IMAGE

1

M

7

>

CONTAINS

IMAGE

EV (121191, DCM, "Referenced Segment")

1

MC

XOR Rows 5, 10, 12b

Reference shall be to a Segmentation Image or Surface Segmentation object, with a single value specified in Referenced Segment Number

10

>

CONTAINS

SCOORD3D

EV (121231, DCM, "Volume Surface")

1-n

MC

XOR Rows 5, 7, 12b

If one item, GRAPHIC TYPE = {ELLIPSOID or POINT}

If more than one item, GRAPHIC TYPE = {POLYGON or ELLIPSE}

11

>

CONTAINS

IMAGE

EV (121233, DCM, "Source image for segmentation")

1-n

MC

XOR Row 12 and IFF (Row 7 or Row 10)

12

>

CONTAINS

UIDREF

EV (121232, DCM, "Source series for segmentation")

1

MC

XOR Row 11 and IFF (Row 7 or Row 10)

12b

>

CONTAINS

COMPOSITE

EV (130488, DCM, "Region in Space")

1

MC

XOR Rows 5, 7, 10

Reference shall be to an Instance of the RT Structure Set Storage SOP Class.

12c

>>

HAS PROPERTIES

TEXT

EV (130489, DCM, "Referenced Region of Interest Identifier")

1

M

Shall be the value of ROI Number (3006,0022) within the single referenced Item of Structure Set ROI Sequence (3006,0020) of the referenced Instance of the RT Structure Set Storage SOP Class.

13

>

CONTAINS

IMAGE

EV (121200, DCM, "Illustration of ROI")

1-n

U

13b

>

CONTAINS

IMAGE

EV (130401, DCM, "Visual explanation")

1-n

U

14

>

CONTAINS

COMPOSITE

EV (126100, DCM, "Real World Value Map used for measurement")

1

U

SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")

15

>

CONTAINS

INCLUDE

DTID 1419 “ROI Measurements”

1

U

$Measurement = $Measurement

$Units = $Units

$ModType = $ModType

$ModValue = $ModValue

$Method = $Method

$Derivation = $Derivation

$TargetSite = $TargetSite

$TargetSiteMod = $TargetSiteMod

$Equation = $Equation

$RefAuthority = $RefAuthority

$RangeAuthority = $RangeAuthority

$DerivationParameter = $DerivationParameter

$DerivationParameterUnits = $DerivationParameterUnits

16

>

CONTAINS

CODE

$QualType

1-n

U

$QualValue

16b

>>

HAS CONCEPT MOD

CODE

$QualModType

1-n

U

$QualModValue

17

>

CONTAINS

TEXT

$QualType

1-n

U


Content Item Descriptions

Row 1b

Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity".

Rows 2, 3

The Tracking Identifier and Tracking Unique Identifier are defined as a text label or unique identifier (respectively) used for tracking a finding or feature, potentially across multiple reporting objects, over time. As such, they are distinct from the Observation UID (0040,A171), which is unique identifier of the specific Content Item and its subsidiary Content Items that constitute an individual observation, and would be different for different observations on different occasions of the same finding or feature. The values of these Content Items shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 7.

Rows 3a, 3b

The type and category of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site). When spatial localization is by reference to a Segmentation, the category and type may correspond to the values of Segmented Property Category Code Sequence (0062,0003) and Segmented Property Type Code Sequence (0062,000F), respectively. See also CID 7150 “Segmentation Property Category”.

Row 5

Even though the coordinates are image-relative, not every image slice within the spatial extent of the ROI is required to be encoded. That is, the ROI may be more coarsely sampled than the image slices, and may be irregularly sampled, and the omission of a contour on a slice does not mean that it is omitted from the ROI. For example, a user may not draw an outline on every slice. However, failure to include every intermediate slice does give rise to this potential ambiguity, and is discouraged.

Rows 5, 7, 10

A single invocation of TID 1411 defines the entire spatial extent defined of a single ROI.

A single structure with multiple fragments disconnected in spatial extent needs to be described as separate ROIs, in separate invocations of TID 1411, with different Tracking Identifiers and Tracking Unique Identifiers, but the same Finding.

Rows 5, 10

To describe an infinitely small volume, such as the center of a lesion, a Graphic Type of POINT may be used.

Row 6

(260753009, SCT, "Source") may be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.

Rows 6, 7

Referenced Segment Number (0062,000B) is an Attribute of the IMAGE Content Item, and shall be present with a single value.

If the Referenced SOP Instance is a Segmentation Image, it shall have a defined Frame of Reference. If it has Segmentation Type (0062,0001) value BINARY, it identifies the volume of defined (measured) region of interest by voxel values in the referenced segment with value 1. If it has Segmentation Type value FRACTIONAL, the volume is defined by an implementation dependent method. The extent, sampling rate and orientation of the Segmentation are not required to match that of corresponding image slices (if any), identified in Row 11 or referenced from the Segmentation.

If the referenced SOP Instance is a Surface Segmentation, the referenced segment shall constitute a finite volume. It identifies the volume of the defined (measured) region of interest by the interior of the finite volume.

Segment number shall be specified even if the Segmentation SOP Instance has only a single segment.

Row 10

Either a single item describing a closed volumetric surface, or multiple items describing a set of parallel closed coplanar areas (contours) is specified.

The sampling rate and orientation of the contours is not required to match that of any image slices (if any), nor are the in-plane or cross-plane sampling rates required to be regular.

Row 11

Identifies the source images that were segmented to identify the ROI, when, for example a subset of images in a series was used.

Row 12

Identifies the source series of images that were segmented to identify the ROI, when, for example an entire set of images in a series was used.

Rows 12b, 12c

A reference to a single ROI that defines a volumetric ROI, within an RT Structure Set.

Row 13

These referenced images may contain "screen shot" illustrating rendered versions of the ROI.

Row 13b

This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image.

Row 14

The reference to an RWV in Row 14 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden).

Row 15

Measurements may be omitted, for example if it is desired to describe only the location of a finding or to provide categorical information about it.

Rows 16, 16b, 17

Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present.

TID 1419 ROI Measurements

This Template encodes measurements for some metric, e.g., density, flow, or concentration.

Table TID 1419. Parameters

$Measurement

Coded term or Context Group for Concept Name of measurement

$Units

Units for the measurement

$ModType

Modifier Name for Concept Name of measurement

$ModValue

Modifier Value for Concept Name of measurement

$Method

Value for Measurement Method

$Derivation

Value for Measurement Derivation

$TargetSite

Value(s) for Anatomic Location of measurement

$TargetSiteMod

Modifier Value for Anatomic Location of measurement

$Equation

Coded term or Context Group for the equation or table from which the measurement was derived or computed

$RefAuthority

Bibliographic reference or authority for statistical properties of a reference population

$RangeAuthority

Bibliographic reference or authority for the normal range of the measurement

$DerivationParameter

Coded term or Context Group for Concept Name of a derivation parameter

$DerivationParameterUnits

Units of derivation parameter


Type:

Extensible

Order:

Non-Significant

Root:

No

Table TID 1419. ROI Measurements

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

HAS CONCEPT MOD

CODE

EV (370129005, SCT, "Measurement Method")

1

U

$Method

2

HAS CONCEPT MOD

CODE

EV (363698007, SCT, "Finding Site")

1-n

U

$TargetSite

3

>

HAS CONCEPT MOD

CODE

EV (272741003, SCT, "Laterality")

1

U

DCID 244 “Laterality”

4

>

HAS CONCEPT MOD

CODE

DT (106233006, SCT, "Topographical modifier")

1

U

$TargetSiteMod

4b

HAS CONCEPT MOD

INCLUDE

DTID 4019 “Algorithm Identification”

1

U

5

NUM

$Measurement

1-n

M

UNITS = $Units

6

>

HAS CONCEPT MOD

CODE

$ModType

1-n

U

$ModValue

7

>

HAS CONCEPT MOD

CODE

EV (370129005, SCT, "Measurement Method")

1

U

$Method

8

>

HAS CONCEPT MOD

CODE

EV (121401, DCM, "Derivation")

1

U

$Derivation

9

>

HAS CONCEPT MOD

CODE

EV (363698007, SCT, "Finding Site")

1-n

U

$TargetSite

10

>>

HAS CONCEPT MOD

CODE

EV (272741003, SCT, "Laterality")

1

U

DCID 244 “Laterality”

11

>>

HAS CONCEPT MOD

CODE

DT (106233006, SCT, "Topographical modifier")

1

U

$TargetSiteMod

12

>

HAS PROPERTIES

INCLUDE

DTID 310 “Measurement Properties”

1

U

$RefAuthority = $RefAuthority

$RangeAuthority = $RangeAuthority

13

>

INFERRED FROM

NUM

$DerivationParameter

1-n

UC

XOR Row 14

$DerivationParameterUnits

14

>

R-INFERRED FROM

NUM

$DerivationParameter

1-n

UC

XOR Row 13

$DerivationParameterUnits

14b

>

INFERRED FROM

CODE

$DerivationParameter