The radiation output values provided by the X-Ray irradiating equipment (which are estimated or calculated) can be different from the actual real world radiation output measured by the users. Users such as local medical physicists might perform dose calibration to support reducing this difference and to obtain more accurate dose values.

Encoding of this user dose calibration in RDSR is defined in TID 10002 (Traditional RDSR) and TID 10041 (Enhanced RDSR) and includes a calibration factor which is intended to be multiplied by the radiation output values provided by the X-Ray equipment to obtain the real-world radiation output values.

Dose calibration in RDSR also includes free text describing the calibration protocols, however the definitions of such protocols are outside the scope of the DICOM standard and are not covered in this section.

The radiation output values in the RDSR are exactly as provided by the X-Ray irradiating Equipment, i.e., without the described user calibration being applied. It is the responsibility of the recipients of the RDSR to take this calibration into account as appropriate when interpreting the provided radiation output values.

The interpreter of the RDSR might apply user dose calibration factors to radiation output when performing dose management. Since the relation between the user dose calibration factors in the RDSR and the provided radiation output values can be complex, the user performing the dose calibration is recommended to inform the interpreter of the RDSR of its intended use by specifying the intended dose index and the intended acquisition protocol to which the dose calibration applies. Multiple dose calibrations may be performed under different equipment configurations. It is the responsibility of the RDSR interpreter to properly apply the calibration data based on the calibration date and time, calibration protocols, calibration intentions, etc.

Consider the following use cases: