DICOM PS3.17 2025b - Explanatory Information
FFFFF.5 Example of HL7/DICOM Interactions (Current)
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PS3.17 > Sex and Gender Examples (Informative) > Example of HL7/DICOM Interactions

FFFFF.5 Example of HL7/DICOM Interactions

FFFFF.5.1 Mappings Between HL7 and DICOM

The HL7 Implementation Guides have imaging order examples of FHIR, V2, and CDA documents with their gender model encodings. These can be found at:

http://hl7.org/xprod/ig/uv/gender-harmony/informative1/v2dicom_use_case.html

These might be mapped onto the DICOM Patient and Patient Study Module attributes as shown below. These mappings are just illustrative.

FFFFF.5.1.1 Example 01: Imaging Order

The following HL7 v2.9.1 message is an order for a "PET Myocardial Perfusion, Rest and Stress" imaging procedure.

The administrative sex is female based on prior admissions. The patient was given a gender of female at birth in 1978. At admission on July 15, 2022, the patient informed the admitting staff that they now identify as male and are taking hormonal treatment.

The PET imaging procedure uses creatinine reference ranges to determine details of the procedure. Creatinine reference ranges are sex related. Hormonal treatment for gender changes also affects creatinine reference ranges. At this hospital the medical protocol for patients taking hormonal treatment is to use affirmed gender creatinine reference ranges.

The Sex Parameters for Clinical Use category (SPCU) for the current procedure is set as Male-typical, with the comment that due to hormonal treatment Male-typical creatinine reference ranges should be used. The SPCU at birth is also provided in the order for use by equipment that might find that useful (the SPCU at birth is not needed by the PET/CT system but might be needed by subsequent analysis systems.)

Note that the HL7 model does not specify how the effective start and stop datetimes are chosen. That is left to the local policies and procedures. DICOM systems will usually obtain these from the HL7 messages and are unlikely to modify them.

The HL7 OMI message is:

MSH|^~\&|||||20220715142240||OMI^O23|WSA5mY0UBuCGrytRTAFR8UWJ|P|2.9.1
PID|||patientID^^^^MR||Smith^Janet^^^^^B~Smith^John^^^^^N||19780328000000|F
GSP|1|S||76691-5^Gender identity^LN|446151000124109^Identifies as male gender^SCT|20220715010000
GSC|1|S||Male-typical^Male typical parameters^SexParameterForClinicalUse||OBR^4|20220715090000|
    Due to hormonal treatment, use Male-typical Creatinine reference ranges
GSC|2|S||Female-typical^Female typical parameters^SexParameterForClinicalUse|197803280000^20220715090000|
    OBR^4||Sex at Birth
ORC|NW
OBR||||241439007^PET heart study^SCT|||||||||||||||||||||||||||||||||||||||||82800-4^PET+CT Heart W contrast IV^LN
IPC|accessionNum|procedureID|studyInstanceUID|schProcedureStepId|
    PT^Positron emission tomography^DCM|122793^PET Myocardial Perfusion, Rest and Stress^DCM

This message maps to DICOM Modality Worklist content as shown in Table FFFFF.4-1.

Table FFFFF.4-1. Mapping HL7 v2.9.1 OMI to DICOM Modality Worklist

HL7 V2.9.1 OMI field

HL7 Element name

DICOM MWL Attribute Name

Tag

VR

DICOM Value

PID-5

Patient Name

Patient’s Name

(0010,0010)

PN

Smith^Janet^^^

PID-7

Date/Time of Birth

Patient's Birth Date

(0010,0030)

DA

19780328

PID-8

Sex

Patient’s Sex

(0010,0040)

CS

F

GSP-4

Gender Identity

Gender Identity Sequence

(0010,0041)

SQ

n/a

Begin item

GSP-5

SOGI Concept Value

Gender Identity

>Gender Identity Code Sequence

(0010,0044)

SQ

n/a

Begin item

GSP-5-1

n/a

>>Code Value

(0008,0100)

SH

446151000124109

GSP-5-3

n/a

>>Coding Scheme Designator

(0008,0100)

SH

SCT

GSP-5-2

n/a

>>Code Meaning

(0008,0104)

LO

Identifies as male gender

n/a

End item

GSP-6

Validity Period

>Effective Start DateTime

(0040,A034)

DT

20220715010000

n/a

End item

GSC

Sex Parameter for Clinical Use Segment

Sex Parameters for Clinical Use Category Sequence

(0010,0043)

SQ

n/a

Begin item

GSC-4

Sex Parameter for Clinical Use

>Sex Parameters for Clinical Use Category Code Sequence

(0010,0046)

SQ

n/a

Begin item

GSC-4-1

n/a

>>Code Value

(0008,0100)

SH

131231 (HL7 “Male-typical”)

GSC-4-3

n/a

>>Coding Scheme Designator

(0008,0102)

SH

DCM

GSC-4-2

n/a

>>Code Meaning

(0008,0104)

LO

Male-typical

n/a

End item

GSC-8

Comment

>Sex Parameters for Clinical Use Comment

(0010,0042)

LT

Due to hormonal treatment, use Male-typical Creatinine reference ranges

GSC-5-1

Validity Period

>Effective Start DateTime

(0040,A034)

DT

20220715090000

n/a

End item

GSC-4

Sex Parameter for Clinical Use

>Sex Parameters for Clinical Use Category Code Sequence

(0010,0046)

SQ

n/a

Begin item

GSC-4-1

n/a

>>Code Value

(0008,0100)

SH

131230

GSC-4-3

n/a

>>Coding Scheme Designator

(0008,0102)

SH

DCM

GSC-4-2

n/a

>>Code Meaning

(0008,0104)

LO

Female-typical

n/a

End item

GSC-8

Comment

>Sex Parameters for Clinical Use Category Comment

(0010,0042)

LT

Sex at Birth

GSC-5-1

Validity Period

>Effective Start DateTime

(0040,A034)

DT

197803280000

GSC-5-2

Validity Period

>Effective Stop DateTime

(0040,A035)

DT

20220715090000

n/a

End item


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DICOM PS3.17 2025b - Explanatory Information