DICOM PS3.17 2026d - Explanatory Information

UUUU.3.2.3 Radiography

Radiography describes a wide range of imaging procedures using an X-Ray source and detector. It is the oldest form of X-Ray-based medical imaging, dating back to the earliest images in the age of Roentgen. In general, radiography procedures acquire one to several projection views of patient anatomy, which are typically reviewed without further reconstruction or post-processing. Radiography systems are available in variety of configurations, including fixed or mobile systems, systems with or without integrated detector systems, systems with or without tables, systems with or without wall stands, along with others. While a given system may have a typical imaging focus (e.g., chest X-Ray rooms), radiography systems can be used to image virtually all anatomic regions. Some radiography systems may include additional functionality (e.g., tomosynthesis, dual energy), which require additional hardware and software.

Radiography systems can be broadly characterized in several ways: fixed or mobile, and integrated or non-integrated detector. The configuration will impact both the workflow for system usage, as well as the content available for the creation of an RDSR.

The system generating the RDSR (e.g., X-Ray tube/generator or detector) varies depending on the configuration of the system and level of integration. Generally, fully integrated systems with X-Ray tube, generator, and detector all in communication with one another should be expected to produce the most complete RDSRs with technique information, exposure information, and potentially system geometry information. Non-integrated systems (e.g., independent CR plate/reader and X-Ray tube/generator) generally have no communication between one another, resulting in an RDSR that does not have the same level of information.

Regardless of the configuration and detector type, the general workflow for radiography is as follows:

  1. The study starts

    1. Procedure information, etc., is input by the operator and/or collected from the DICOM Modality Worklist. Depending on the type of detector integration, the information may be put on the generator control side, or on the detector side.

  2. The patient is positioned for the initial view for the study.

  3. During the procedure, X-Ray exposures are performed.

    1. One or several radiography exposures of the patient are performed as separate Irradiation Events.

    2. The patient and/or radiography system are repositioned for each view

  4. During the procedure, images are generated.

    1. The radiography image from each exposure is typically stored as a separate DICOM Series.

    2. Several Series can be performed during the Study. The number of images as part of a Study may vary based on exam type. For example, a two-view chest Study typically includes a PA and lateral view of the chest.

  5. The study ends.

  6. Following the study, one or more RDSR Instances are created from the data collected during the study.

    1. The scope of accumulation of the RDSR indicates the period of irradiation reported in that RDSR instance, e.g., the Study, the Series, etc.

  7. Subsequent dose analysis is performed.

    1. Dose analysis is based on the information of the Irradiation Events contained in the created RDSRs.

    2. Irradiation Events and images are often one to one, but there may be Irradiation Events with no images (e.g., deleted images). For this reason, dose analysis is driven by the Irradiation Events, not by images. See Section UUUU.4.1.4 for the importance to use the Irradiation Event UIDs in the RDSRs.

DICOM PS3.17 2026d - Explanatory Information