DICOM PS3.17 2021e - Explanatory Information

AAA Implantation Plan SR Document (Informative)

For the implantation of bone mounted implants, information that has been generated during the implantation planning phase is needed in the OR. To convey this information to the OR, a DICOM format for the results of an implantation planning activity referring to implant templates has been introduced. An Implantation Plan SR Document should be utilized by surgeons, navigation devices, and for documentation purposes. The Plan contains relevant intraoperative information concerning the assembly of the implant components, resection lines, registration information, and relevant patient data. Thus, the Implantation Plan SR Document can help to enhance information logistics within the workflow. It does not contain any information about the planned surgical workflow. This information may be addressed by other DICOM Supplements. Nevertheless, this SR document may reference to or may be referenced by objects containing workflow information.

Additionally, once an implantation plan has been generated, it can be used as input for a planning application to facilitate adaption of a plan in cases where this is necessary due to unforeseen situations.

The workflow is considered to be the following:

Some kind of planning application helps the user to perform implantation planning; he can choose the optimal implant for a patient using implant templates from a repository. The user aligns the implant template with patient data with or without the help of the application. (Planning without patient data can be stored in the Implantation Plan SR Document as well.)

Subsequently, an Implantation Plan SR Document Instance will be created that contains the results of the planning. No information of the process itself (previously chosen implant templates, methods, etc.) will be stored. However, an Implantation Plan Document is considered to contain the important parameters to retrace a planning result.

There are two main components an Implantation Plan SR Document consists of (see Figure AAA.1-1). The implant component selection is used to point to a selected implant template in the repository, whereas the assembly is used to describe the composition of the selected implant templates. Figure AAA.2-1 shows how the Implantation Plan SR Document parts make references to the implant templates. Each Implantation Plan SR Document can contain a single implant component selection and several assemblies but it describes only one planning result for one particular patient.

The recipient of the Implantation Plan SR Document can decide whether to read only the "list" of used implants or to go into detail and read the compositions as well. In both cases, he must have access to the repository of the Implant Templates to get detailed information about the implant (such as its geometry).

AAA.1 Implantation Plan SR Document Content Tree Structure

The following structure shows the main content of an Implantation Plan SR Document. As can be seen in Figure AAA.1-1, the Implantation Plan consists mainly of the selected Implant Components and their Assemblies.

Implantation Plan SR Document basic content tree

Figure AAA.1-1. Implantation Plan SR Document basic content tree

DICOM PS3.17 2021e - Explanatory Information