Patient and procedure information is provided to the equipment by the DICOM Modality Worklist or manually entered by the operator.

The patient's breast is positioned in the mammography system (e.g., on the breast support or magnification stand) for the initial laterality and view.

Equipment settings like protocols, patient position, laterality, etc., are provided to the equipment by the operator.

Each breast may be imaged one or several times. Subsequent views of the same breast may be performed after repositioning (e.g., mediolateral view following cranial-caudal view).

Each breast is imaged separately, again with repositioning between exposures. A Study may include only a single breast.

Each view may include several acquisitions. For example, both traditional 2D and DBT views may be performed at the same view.

Images may be single frame (e.g., from 2D acquisition) or multi-frame (e.g., from DBT acquisition).

For each X-Ray exposure, dose and other related information is collected and recorded in an Irradiation Event.

The mammography image from each acquisition is typically stored as a separate DICOM Series. While a traditional 2D acquisition generally creates one single-frame DICOM Series, other acquisition types may result in the creation of multiple DICOM series. For example, a DBT acquisition may generate a multi-frame DICOM Series with the projection images, one or more DICOM Series with multi-frame tomosynthesis reconstructions at varying thicknesses and overlaps, and a DICOM Series of a synthesized 2D view generated from the DBT acquisition.

The number of images as part of a Study may vary based on exam type. For example, a screening mammography exam may include two views (mediolateral-oblique and cranial-caudal) of each breast, for a total of four images in four DICOM Series. If the screening exam uses DBT, the Study may include a combination of 2D and DBT images of these same views. A diagnostic mammography exam may only include views of one breast, with the total number varying based on the specifics of the diagnostic exam.

These RDSRs contain information for long-term storage and distribution to dose information management systems and cross-institutional systems such as dose registries, in order to perform relevant dose QA analysis, produce related reports, and support medical regulations.

Each RDSR Instance defines its scope of accumulation which indicates the period of irradiation reported in that RDSR Instance (the Study, the Series, the Performed Procedure Step). Each RDSR Instance includes information of all the Irradiation Events within its scope of accumulation, as well as Accumulated Dose Data within that same scope.

For almost all procedures, there will be an RDSR with the scope that covers all of the Irradiation Events during that procedure.

These RDSRs are stored in a new DICOM Series different from the one where the MG images are stored.

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

Irradiation Events and images are often one to one, but there may be Irradiation Events with no images (e.g., rejected images or aborted acquisitions), and there may be also one Irradiation Event that ultimately results in multiple images (e.g., tomosynthesis, contrast-enhanced, etc.). 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.