PS3.16

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Foreword

This DICOM Standard was developed according to the procedures of the DICOM Standards Committee.

The DICOM Standard is structured as a multi-part document using the guidelines established in [ISO/IEC Directives, Part 2].

PS3.1 should be used as the base reference for the current parts of this Standard.

1 Scope and Field of Application

This Part of the DICOM Standard specifies the DICOM Content Mapping Resource (DCMR), which defines the Templates and Context Groups used elsewhere in the Standard.

2 Normative References

The following standards contain provisions that, through reference in this text, constitute provisions of this Standard. At the time of publication, the editions indicated were valid. All standards are subject to revision, and parties to agreements based on this Standard are encouraged to investigate the possibilities of applying the most recent editions of the standards indicated below.

2.1 General

[Alderman 1992] Coronary Artery Disease. Alderman EL and Stadius M. 1992. 3. 12. 1189-208. “The angiographic definitions of the bypass angioplasty revascularization investigation”. http://journals.lww.com/coronary-artery/Abstract/1992/12000/The_angiographie_definitions_of_the_Bypass.12.aspx .

[Berry 2012] Berry RB, Brooks R, and Gamaldo CE. 2012. “The AASM Manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.0.”. http://www.aasmnet.org .

[ASTM E 1762-04] ASTM. . Standard Guide for Electronic Authentication of Health Care Information, ASTM International.

[ASTM E 2084-00] ASTM. . Standard Specification for Authentication of Healthcare Information Using Digital Signatures, ASTM International.

[ASTM F 67] ASTM. . Standard Specification for Unalloyed Titanium, for Surgical Implant Applications.

[ASTM F 75] ASTM. . Standard Specification for Cobalt-28 Chromium-6 Molybdenum Alloy Castings and Casting Alloy for Surgical Implants.

[ASTM F 90] ASTM. . Standard Specification for Wrought Cobalt-20Chromium-15Tungsten-10Nickel Alloy for Surgical Implant Applications.

[ASTM F 136] ASTM. . Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications.

[ASTM F 138] ASTM. . Standard Specification for Wrought 18Chromium-14Nickel-2.5Molybdenum Stainless Steel Bar and Wire for Surgical Implants.

[ASTM F 688] ASTM. . Standard Specification for Wrought Cobalt-35Nickel-20Chromium-10Molybdenum Alloy Plate, Sheet, and Foil for Surgical Implants.

[ASTM F 1058] ASTM. . Standard Specification for Wrought 40Cobalt-20Chromium-16Iron-15Nickel-7Molybdenum Alloy Wire, Strip, and Strip Bar for Surgical Implant Applications.

[ASTM F 1295] ASTM. . Standard Specification for Wrought Titanium-6Aluminum-7Niobium Alloy for Surgical Implant Applications.

[AAPM Report 204] American Association of Physicists in Medicine, College Park, Maryland. 2011. Size-Specific Dose Estimates (SSDE) in Pediatric and Adult Body CT Examinations. http://www.aapm.org/pubs/reports/RPT_204.pdf .

[AAPM Report 220] American Association of Physicists in Medicine. September 2014. Report of AAPM Task Group 220 - Use of Water Equivalent Diameter for Calculating Patient Size and Size-Specific Dose Estimates (SSDE) in CT. http://www.aapm.org/pubs/reports/rpt_220.pdf .

[AAPM OR 03] American Association of Physicists in Medicine. 2005. Assessment of Display Performance for Medical Imaging Systems. http://www.aapm.org/pubs/reports/OR_03.pdf .

[DIN 6868-57] Deutsches Institut für Normung. 2001. Image quality assurance in diagnostic X-Ray departments - Acceptance testing for image display devices.

[ETDRS Report Number 10] ETDRS. . Report Number 10, Grading Diabetic Retinopathy from Stereoscopic Color Fundus Photographs- An Extension of the Modified Airlie House Classification. Ophthalmology, May 1991, vol98 (p786-805), Supplement.

[Feuvret] International Journal of Radiation Oncology, Biology, Physics. Feuvret L, Noël G, Mazeron JJ, and Bey P. 2006. 64. 2. 333-342. “Conformity index: a review”. http://dx.doi.org/10.1016/j.ijrobp.2005.09.028 .

[HL7 v3 CMET] HL7. . Version 3 Standard: Common Message Element Types.

[IBSI Features] >arXiv. Zwanenburg A, Leger S, Vallières M, and Löck S. 17 Sep 2018. arXiv:1612.07003v7. “Image biomarker standardisation initiative - Reference manual”. http://arxiv.org/abs/1612.07003 .

[ICRU Report 50] International Commission on Radiation Units and Measurements. 1993. Prescribing, Recording, and Reporting Photon Beam Therapy.

[ICRU Report 62] International Commission on Radiation Units and Measurements. 1999. Prescribing, recording, and reporting photon beam therapy (supplement to ICRU Report 50).

[IEC 60601-2-1] IEC. . Medical Electrical Equipment - Part 2-1: Particular requirements for the basic safety and essential performance of electron accelerators in the range 1 MeV to 50 MeV.

[IEC 60601-2-44] IEC. . Medical Electrical Equipment - Part 2-44: Particular Requirements for the Safety of X-Ray Equipment for Computed Tomography.

[IEC 60601-2-64] IEC. . Medical Electrical Equipment - Part 2-64: Particular requirements for the basic safety and essential performance of light ion beam medical electrical equipment.

[IEC 61217] IEC. 2011. Ed 2.0. Radiotherapy Equipment - Coordinates, Movements and Scales.

[IEC 62563-1] IEC. 2009. Ed 1.0. Medical Electrical Equipment - Medical image display systems - Part 1: Evaluation methods.

[IEC 62985] IEC. 2019. Methods For Calculating Size Specific Dose Estimates (SSDE) For Computed Tomography.

[IHE RAD TF-1] IHE International. IHE Radiology (RAD) Technical Framework, Volume 1 - Integration Profiles. http://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_TF_Vol1.pdf .

[ISO/IEC Directives, Part 2] ISO/IEC. 2016/05. 7.0. Rules for the structure and drafting of International Standards. http://www.iec.ch/members_experts/refdocs/iec/isoiecdir-2%7Bed7.0%7Den.pdf .

[ISO 639] ISO. . Codes for the representation of names of languages.

[ISO 639-1] ISO. 2002. Codes for the representation of names of languages — Part 1: Alpha-2 code.

[ISO 639-2] ISO. 1998. Codes for the representation of names of languages — Part 2: Alpha-3 code.

[ISO 639-3] ISO. 2007. Codes for the representation of names of languages — Part 3: Alpha-3 code for comprehensive coverage of languages.

[ISO 3166] ISO. . Codes for the representation of names of countries.

[ISO 3166-1] ISO. . Codes for the representation of names of countries — Part 1: Country codes.

[ISO 5832-1] ISO. . Implants for surgery – Metallic materials — Part 1: Wrought stainless steel.

[ISO 5832-2] ISO. . Implants for surgery – Metallic materials — Part 2: Unalloyed titanium.

[ISO 5832-3] ISO. . Implants for surgery – Metallic materials — Part 3: Wrought titanium 6-aluminium 4-vanadium alloy.

[ISO 5832-4] ISO. . Implants for surgery – Metallic materials — Part 4: Cobalt-chromium-molybdenum casting alloy.

[ISO 5832-5] ISO. . Implants for surgery – Metallic materials — Part 5: Wrought cobalt-chromium-tungsten-nickel alloy.

[ISO 5832-6] ISO. . Implants for surgery – Metallic materials — Part 6: Wrought cobalt-nickel-chromium-molybdenum alloy.

[ISO 5832-7] ISO. . Implants for surgery – Metallic materials — Part 7: Forgeable and cold-formed cobalt-chromium-nickel-molybdenum-iron alloy.

[ISO 5832-11] ISO. . Implants for surgery – Metallic materials — Part 11: Wrought titanium 6-aluminium 7-niobium alloy.

[ISO 5832-14] ISO. . Implants for surgery – Metallic materials — Part 14: Wrought titanium 15-molybdenum 5-zirconium 3-aluminium alloy.

[ISO 8824-1] ISO. 2015. Information Technology - Abstract Syntax 1 (ASN.1): Specification of Basic Notation.

[ISO 9834-1] ISO. 2012. Information technology - Open Systems Interconnection - Procedures for the operation of OSI Registration Authorities: General procedures and top arcs of the ASN.1 Object Identifier tree.

[ISO 15924] ISO. 2004. Codes for the representation of names of scripts.

[JJ1017] Japan Medical Imaging and Radiological Systems Industries Association (JIRA) and Japanese Association of Healthcare Information Systems Industry (JAHIS). October 5, 2005. 3.0. Guidelines for HIS, RIS, PACS - Modality Data Communication on Scheduling, Billing, and Examination Records. http://www.jira-net.or.jp/commission/system/04_information/files/JJ1017VER3_20051005.doc .

[Kenneweg 2019] J Am Acad Dermatol. Kenneweg KA and et al. 2019. 80. 6. 1564–84. “Developing an international standard for the classification of surface anatomic location for use in clinical practice and epidemiologic research”. doi:10.1016/j.jaad.2018.08.035 http://www.jaad.org/article/S0190-9622(18)32489-7/ .

[NEMA XR 25-2019] National Electrical Manufacturers Association, Rosslyn, Virginia. 2019. Computed Tomography Dose Check Standard. http://www.nema.org/Standards/view/Computed-Tomography-Dose-Check .

[RadLex] RSNA, Chicago. 2006. A Lexicon for Uniform Indexing and Retrieval of Radiology Information Resources. http://www.radlex.org/ .

[RadElement] RSNA, Chicago. Common Data Elements (CDEs) for Radiology. http://radelement.org/ .

[RFC 1766] IETF. March 1995. Tags for the Identification of Languages.

[RFC 3066] IETF. January 2001. Tags for the Identification of Languages.

[RFC 3881] IETF. September 2004. Security Audit and Access Accountability Message - XML Data Definitions for Healthcare Applications.

[RFC 4646] IETF. September 2006. Tags for Identifying Languages.

[RFC 4647] IETF. September 2006. Matching of Language Tags.

[RFC 5646] IETF. September 2009. Tags for Identifying Languages.

[J1086_201210] SAE. Oct 2012. Numbering Metals and Alloys. http://www.sae.org/standards/content/j1086_201210/ .

[Scanlon 1999] Journal of the American College of Cardiology. Scanlon PJ and et al. May 1999. 33. 6. 1756-824. “ACC/AHA guidelines for coronary angiography - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in collaboration with the Society for Cardiac Angiography and Interventions”. doi:10.1016/S0735-1097(99)00126-6 http://www.sciencedirect.com/science/article/pii/S0735109799001266 .

[Seeck 2017] Clinical Neurophysiology. Seeck M and et al. 2017. 128. 10. 2070-7. “The standardized EEG electrode array of the IFCN”. doi:10.1016/j.clinph.2017.06.254 http://www.sciencedirect.com/science/article/pii/S1388245717304832 .

[SMPTE RP133] Society of Motion Picture and Television Engineers (SMPTE). 1991. Specifications for Medical Diagnostic Imaging Test Pattern for Television Monitors and Hard-copy Recording Cameras.

[Stout et al 2013] Molecular Imaging. Stout D, Berr SS, LeBlanc A, Kalen JD, Osborne D, Price J, Schiffer W, Kuntner C, and Wall J. 2013. 12. 7. 1-15. “Guidance for Methods Descriptions Used in Preclinical Imaging Papers”. http://journals.sagepub.com/doi/pdf/10.2310/7290.2013.00055 .

2.2 BI-RADS® Terminology and Nomenclature

A portion of the terminology used within the Mammography CAD SR SOP Class and the Breast Imaging Report and Relevant Patient Information for Breast Imaging Templates is derived from BI-RADS®, a copyrighted lexicon of breast imaging terminology and nomenclature licensed by DICOM from the American College of Radiology.

[BI-RADS®] American College of Radiology, Reston, Virginia. 1998. 3.0. Breast Imaging Reporting and Data System Atlas. http://www.acr.org/Quality-Safety/Resources/BIRADS .

2.3 MQCM 1999 Terminology and Nomenclature

References to MQCM 1999 are made in the description of the Mammography CAD SR SOP Class. In this MQCM 1999 refers to the Mammography Quality Control Manual 1999, available from the American College of Radiology. This document describes a standardized approach to mammographic acquisition standards, patient positioning, and so on. The DICOM Standard does not require Mammography CAD SR SOP Class implementations to adhere to MQCM 1999.

[MQCM] American College of Radiology, Reston, Virginia. 1999. Mammography Quality Control Manual. http://www.acr.org/Education/Education-Catalog/Products/639 .

2.4 MQSA Terminology and Nomenclature

References to MQSA are made in the description of the Mammography CAD SR SOP Class. In this MQSA refers to the Mammography Quality Standards Act final rules. While MQSA is a federal regulation of the United States government, it provides the only widely published standards for mammographic quality and is incorporated in this document for that reason. The DICOM Standard does not require Mammography CAD SR SOP Class implementations to adhere to MQSA.

[MQSA] U.S. Food and Drug Administration, Silver Spring, Maryland. 2002. Mammography Quality Standards Act Regulations. http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/Regulations/ucm110906.htm .

2.5 ACR Position Statement

[ACR Position Statement] American College of Radiology, Reston, Virginia. 2001. Quality Control and Improvement, Safety, Infection Control, and Patient Education. http://www.acr.org/Quality-Safety/Radiology-Safety .

2.6 Chest Radiology and CT

References are made in the description of the Chest CAD SR Templates and Context Groups.

[Fraser and Pare] Fraser, Muller, Colman, and Pare. 1999. 4th. I. xvii-xxxi. Diagnosis of Diseases of the Chest. Terms Used in Chest Radiology.

[Fraser and Pare] Fraser, Muller, Colman, and Pare. 1999. 4th. I. xxxiii-xxxvi. Diagnosis of Diseases of the Chest. Terms for CT of the Lungs.

[ACR CT PE] American College of Radiology, Reston, Virginia. 2001. 109-113. ACR Standards. ACR Standard for the Performance of Computed Tomography for the Detection of Pulmonary Embolism in Adults.

[ACR HR CT] American College of Radiology, Reston, Virginia. 2001. 115-118. ACR Standards. ACR Standard for the Performance of High-Resolution Computed Tomography (HRCT) of the Lungs in Adults.

[ACR Radiography] American College of Radiology, Reston, Virginia. 2001. 95-98. ACR Standards. ACR Standard for the Performance of Pediatric and Adult Chest Radiography.

[ACR Thoracic CT] American College of Radiology, Reston, Virginia. 2001. 103-107. ACR Standards. ACR Standard for the Performance of Pediatric and Adult Thoracic Computed Tomography (CT).

2.7 Response Evaluation Criteria

References to Response Evaluation Criteria are made from the Chest CAD SR Templates and Context Groups

[RECIST] Journal of the National Cancer Institute. Therasse. February 2, 2000. 92. 3. 205-216. “New Guidelines to Evaluate the Response to Treatment in Solid Tumors”. http://www.eortc.be/recist/ .

[WHO] World Health Organization, Geneva. 1979. WHO Handbook for Reporting Results for Cancer Treatment. WHO Offset Publication No. 48. http://whqlibdoc.who.int/publications/9241700483.pdf .

2.8 Myocardial Segmentation

[Cerqueira 2002] Circulation. Cerqueira MD. 2002. 105. 4. 539. “AHA Scientific Statement: Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart”. doi:10.1161/hc0402.102975 Describes 16- and 17-segment models. .

[Voigt 2015] Eur Heart J Cardiovasc Imaging. Voigt JU. 2015. 16. 1. 1-11. “Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging”. doi:10.1093/ehjci/jeu184 Describes 16-, 17-, and 18-segment models. .

2.9 Quantitation of the Left Ventricle

[Schiller 1989] Journal of the American Society of Echocardiography. Schiller. Oct 1989. 2. 5. 358-367. “Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography”.

2.10 Cancer Staging

[AJCC] American Joint Committee on Cancer. 2002. Sixth. AJCC Cancer Staging Handbook: From the AJCC Cancer Staging Manual. Springer-Verlag. 0-387-95270-5.

2.11 Quantitative Arteriography and Ventriculography

[Sheehan, 1986] Circulation. Sheehan FH, Bolson EL, Dodge HT, Mathey DG, Schofer J, and Woo HW. 1986. 74. 2. 293-305. “Advantages and applications of the centerline method for characterizing regional ventricular function”. doi:10.1161/01.CIR.74.2.293

[Slager, 1986] J Am Coll Cardiol.. Slager CJ, Hooghoudt TE, Serruys PW, Schuurbiers JC, Reiber JH, Meester GT, Verdouw PD, and Hugenholtz PG. 1986. 6. 2. 317-26. “Quantitative assessment of regional left ventricular motion using endocardial landmarks”. doi:10.1016/S0735-1097(86)80498-3

[Kennedy, 1970] Am Heart J. Kennedy JW, Trenholme SE, and Kasser IS. 1970. 80. 3. 343. “Left ventricular volume and mass from single-plane cineangiocardiogram. A comparison of anteroposterior and right anterior oblique methods”.

[Dodge, 1960] Am Heart J. Dodge HT, Sandler H, Ballew DW, and Lord JD. 1960. 60. 5. 762. “The use of biplane angiocardiography for the measurement of left ventricular volume in man”. http://www.sciencedirect.com/science/article/pii/0002870360903598 .

[Wynne, 1978] Am J Cardiol. Wynne J, Green LH, Mann T, Levin D, and Grossman W. 1978. 41. 4. 726. “Estimation of left ventricular volumes in man from biplane cineangiograms filmed in oblique projections”.

[Boak, 1977] Cathet Cardiovasc Diagn. Boak, JG, Bove AA, Kreulen T, and Spann JF. 1977. 3. 3. 217-30. “A geometric basis for calculation of right ventricular volume in man”. doi:10.1002/ccd.1810030305

[Ferlinz, 1977] Am Heart J. Ferlinz J. 1977. 94. 1. 87-90. “Measurements of right ventricular volumes in man from single plane cineangiograms. A comparison to the biplane approach”. http://www.sciencedirect.com/science/article/pii/S0002870377803487 .

[Graham, 1973] Circulation. Graham TP, Jarmakani JM, Atwood GF, and Canent RV. 1973. 47. 1. 144-53. “Right ventricular volume determinations in children. Normal values and observations with volume or pressure overload”. doi:10.1161/01.CIR.47.1.144

[Arcilla, 1971] Chest. Arcilla RA, Tsai P, Thilenius O, and Ranniger K. 1971. 60. 5. 446. “Angiographic method for volume estimation of right and left ventricles”. doi:10.1378/chest.60.5.446

2.12 IVUS

[Mintz, 2001] Journal of the American College of Cardiology. Mintz GS. 2001. 37. 5. 1478-1492. “American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS)”. doi:10.1016/S0735-1097(01)01175-5

[Di Mario, 1998] European Heart Journal. Di Mario C. 1998. 19. 2. 207-229. “Clinical Application and Image Interpretation in Intravascular Ultrasound”. doi:10.1053/euhj.1996.0433

[Tobis and Yock] Tobis JM and Yock PC. 1992. Intravascular Ultrasound Imaging. 0443088098.

2.13 C-RADS CT Colonography Reporting and Data System

[Zalis, 2005] Radiology. Zalis ME. 2005. 236. 1. 3-9. “CT Colonography Reporting and Data System: A Consensus Proposal”. doi:10.1148/radiol.2361041926

2.14 Implants

[Eggli, 1998] J Bone Joint Surg Br. Eggli S, Pisan M, and Müller ME. 1998. 80-B. 3. 382-390. “The value of preoperative planning for total hip arthroplasty”. http://www.bjj.boneandjoint.org.uk/content/80-B/3/382 .

2.15 LOINC

[LOINC] Regenstrief Institute, Indianapolis. 2014. Logical Observation Identifier Names and Codes. http://loinc.org/ .

This product includes all or a portion of the LOINC® table, LOINC panels and forms file, LOINC document ontology file, and/or LOINC hierarchies file, or is derived from one or more of the foregoing, subject to a license from Regenstrief Institute, Inc. Your use of the LOINC table, LOINC codes, LOINC panels and forms file, LOINC document ontology file, and LOINC hierarchies file also is subject to this license, a copy of which is available at http://loinc.org/terms-of-use. The current complete LOINC table, LOINC Users' Guide, LOINC panels and forms file, LOINC document ontology file, and LOINC hierarchies file are available for download at http://loinc.org/. The LOINC table and LOINC codes are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. The LOINC panels and forms file, LOINC document ontology file, and LOINC hierarchies file are copyright © 1995-2014, Regenstrief Institute, Inc. All rights reserved.

The LOINC table (in all formats), LOINC panels and forms file, LOINC document ontology file, and LOINC hierarchies are provided "as is." Any express or implied warranties are disclaimed, including, but not limited to, the implied warranties of merchantability and fitness for a particular purpose.

A small portion of the LOINC table may include content (e.g., survey instruments) that is subject to copyrights owned by third parties. Such content has been mapped to LOINC terms under applicable copyright and terms of use. Notice of such third party copyright and license terms would need to be included if such content is included.

2.16 UCUM

[UCUM] Regenstrief Institute, Indianapolis. 2013. Unified Code for Units of Measure. http://unitsofmeasure.org/ .

This product includes all or a portion of the UCUM table, UCUM codes, and UCUM definitions or is derived from it, subject to a license from Regenstrief Institute, Inc. and The UCUM Organization. Your use of the UCUM table, UCUM codes, UCUM definitions also is subject to this license, a copy of which is available at http://unitsofmeasure.org/. The current complete UCUM table, UCUM Specification are available for download at http://unitsofmeasure.org/. The UCUM table and UCUM codes are copyright © 1995-2013, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved.

The UCUM table (in all formats), UCUM definitions, and specification are provided "as is." Any express or implied warranties are disclaimed, including, but not limited to, the implied warranties of merchantability and fitness for a particular purpose.

2.17 Anesthesia Quality Institute Schema

[AQI Schema] Anesthesia Quality Institute, Schaumburg, IL. 2015/07/30. Anesthesia Quality Institute Schema. http://www.aqihq.org/qcdrDataSample/prodFiles/2018%20Files/AQISchDoc/default.html .

Used by permission of the Anesthesia Quality Institute (AQI) (http://www.aqihq.org/), established by the American Society of Anesthesiologists (ASA).

2.18 Point-of-Care Medical Device Nomenclature

Extracts of ISO/IEEE 11073 reprinted by permission of IEEE, 3 Park Avenue, New York, NY 10016-5997 USA. Copyright by IEEE. http://standards.ieee.org/.

Under license from IEEE, the term codes and descriptions of the ISO/IEEE 11073 Nomenclature are available at no cost through the Rosetta Terminology Mapping Management System of the U.S. National Institute of Standards and Technology. http://rtmms.nist.gov/rtmms/index.htm

[ISO/IEEE 11073-10101] ISO/IEEE. 2004. Health informatics - Point-of-care medical device communication - Nomenclature.

[ISO/IEEE 11073-10101a] ISO/IEEE. 2015. Health informatics - Point-of-care medical device communication - Nomenclature Amendment 1: Additional Definitions.

[ISO/IEEE 11073-10102] ISO/IEEE. 2015. . Health informatics - Point-of-care medical device communication - Annotated ECG - Nomenclature.

2.19 SNOMED Clinical Terms

This DICOM Standard incorporates SNOMED CT® International Edition 2021/07/31, used by permission of SNOMED International. SNOMED CT®, was originally created by The College of American Pathologists (CAP). SNOMED International was formerly known as the International Health Terminology Standards Development Organisation (IHTSDO).

The SNOMED CT terms used in this Standard (the SNOMED CT DICOM Subset) are the subject of a licensing agreement between NEMA and SNOMED International that allows the use of this defined subset in DICOM conformant applications without further license or payment of fee. Any use of SNOMED CT beyond the terms published in the DICOM Standard is subject to SNOMED CT licensing rules, which may include a fee. For further information about SNOMED CT licensing, go to http://www.snomed.org/snomed-ct/get-snomed or contact SNOMED International at info@snomed.org.

This DICOM Standard incorporates various veterinary terms from the SNOMED CT VetSCT extension, used by permission of the Veterinary Terminology Services Laboratory (VTSL) (http://vtsl.vetmed.vt.edu/). These terms were previously included in SNOMED CT but have since been inactivated as moved elsewhere.

[SNOMED] SNOMED International. . SNOMED CT Systematized Nomenclature of Medicine - Clinical Terms.

2.20 Prostate Reporting Terminology and Nomenclature

The Prostate Imaging and Report and Data System Version 2 (PI-RADS) is a joint effort of the European Society of Urogenital Radiology, the American College of Radiology and the AdMeTech Foundation.

[PI-RADS] Eur Urol. Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, Margolis, D, Schnall, MD, Shtern, F, Tempany, CM., Thoeny, HC, and Verma, S. 2016/01. 69. 1. 16-40. “PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2”. doi:10.1016/j.eururo.2015.08.052 http://www.europeanurology.com/article/S0302-2838%2815%2900848-9/ .

Note

PI-RADS is also available from the following source:

American College of Radiology: http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/PIRADS/PIRADS%20V2.pdf

[PI-RADS v2.1] Eur Urol. Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, Tempany, CM, Choyke PL, Cornud F, Margolis, D, Thoeny, HC, Verma, S, Barentsz JO, and Weinreb JC. 2019/09. 76. 3. 340–351. “Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2”. doi:10.1016/j.eururo.2019.02.033 http://www.europeanurology.com/article/S0302-2838(19)30180-0/abstract .

[Prostate Eu Concensus] Eur Urol. Dickinson L, Ahmed HU., Allen C, Barentsz JO, Carey B, Futterer JJ, Heijmink SW, Hoskin PJ, Kirkham A, and Padhani AR. 2011. 59. 4. 477-94. “Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting”. doi:10.1016/j.eururo.2010.12.009 http://www.europeanurology.com/article/S0302-2838(10)01187-5/ .

[ESUR Guidelines] Eur Radiol. Barentsz JO, Richenberg J, Clements R, Choyke P, Verma S, Villeirs G, Rouviere O, Logager V, and Fütterer JJ. 2012/04. 22. 4. 746-57. “ESUR prostate MR guidelines 2012”. doi:10.1007/s00330-011-2377-y http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3297750/ .

[Rozenkrantz 2013] Radiology. Rosenkrantz AB, Kim S, Lim RP, Hindman N, Deng FM, Babb JS, and Taneja SS. 2013/11. 269. 2. 482–492. “Prostate cancer localization using multiparametric MR imaging: comparison of Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales”. doi:10.1148/radiol.13122233 http://dx.doi.org/10.1148/radiol.13122233 .

[Kuru 2013] BJU Int. Kuru TH. 2013. 112. 5. 568–577. “Definitions of terms, processes and a minimum dataset for transperineal prostate biopsies: a standardization approach of the Ginsburg Study Group for Enhanced Prostate Diagnostics”. doi:10.1111/bju.12132 http://onlinelibrary.wiley.com/doi/10.1111/bju.12132/full .

2.21 Imaging Agent Administration Concepts

Injector and modality manufacturers use the CiA 425 CANopen standard for communication and synchronization between devices.

[CiA 425 CANopen] CANopen. 30 October 2010. CiA 425 Draft Standard Proposal, Application profile for medical diagnostic add-on modules Part 2: Injector, Version: 2.1.0.

2.22 CAD-RADS™ Terminology and Nomenclature

A portion of the terminology used within the CT/MR Cardiovascular Analysis Report is derived from CAD-RADS™.

[CAD-RADS™] Journal of Cardiovascular Computed Tomography. Cury RC and et al. 2016. 10. 269-81. “CAD-RADS™ Coronary Artery Disease – Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology.”. doi:10.1016/j.jcct.2016.04.005 http://www.journalofcardiovascularct.com/article/S1934-5925(16)30048-X/ .

3 Definitions

For the purposes of this Standard the following definitions apply.

3.1 Codes and Controlled Terminology Definitions

The following definitions are commonly used in this Part of the DICOM Standard:

Baseline Context Group Identifier (BCID)

Identifier that specifies the suggested Context Group for a Code Sequence Attribute.

See Table 5.6-1 “Conventions for Specification of Context Groups” in PS3.3 .

Baseline Template Identifier (BTID)

Identifier that specifies a Template suggested to be used in the creation of a set of Content Items.

Coding Scheme

Dictionary (lexicons) of concepts (terms) with assigned codes and well defined meanings.

Note

Examples of Coding Schemes include SNOMED and LOINC.

Context Group

A set of coded concepts defined by a Mapping Resource forming a set appropriate to use in a particular context.

Context Group Version

Version of a Context Group.

Context ID (CID)

Identifier of a Context Group.

Defined Context Group Identifier (DCID)

Identifier that specifies the Context Group for a Code Sequence Attribute that shall be used.

See Table 5.6-1 “Conventions for Specification of Context Groups” in PS3.3 .

Defined Template Identifier (DTID)

Identifier that specifies a Template that shall be used in the creation of a set of Content Items.

DICOM Content Mapping Resource (DCMR)

A Mapping Resource that defines Templates and Context Groups for use in DICOM IODs.

Extensible Context Group

Context Group that may be extended by a particular application by inclusion of additional concepts.

See Table 5.6-1 “Conventions for Specification of Context Groups” in PS3.3 .

Extensible Template

A Template that may be extended by a particular application by inclusion of additional Content Items beyond those specified in the Template.

Mapping Resource

A resource that defines context-dependent usage constraints (i.e., Value Set or Relationship Type restrictions) for Attributes. A resource that specifies the mapping of the content of an external controlled terminology to the components of a message standard.

Non-Extensible Context Group

Context Group whose defined set of concepts shall not be extended by an application.

See Table 5.6-1 “Conventions for Specification of Context Groups” in PS3.3 .

Non-Extensible Template

A Template that specifies the exact set of Content Items and corresponding Value Sets that shall be used and that shall not be extended by an application.

Relationship Type

The association between two Concepts. Examples: "HAS PROPERTIES", "CONTAINS", "INFERRED FROM".

Root Template

A Template whose first Content Item is a CONTAINER Content Item intended to be encoded in the top level Data Set of a SOP Instance. I.e., the root node of the Content Tree.

Template

A pattern that describes the Content Items, Value Types, Relationship Types and Value Sets that may be used in part of a Structured Report Content Tree, or in other Content Item constructs, such as Acquisition Context or Protocol Context. Analogous to a Module of an Information Object Definition.

Template ID (TID)

Identifier of a Template.

Value Set

The allowed values of a Code Sequence Attribute in a given context. Specified either as one or more individual values or by reference to a Context Group.

3.2 Information Object Definitions

This Part of the Standard makes use of the following terms defined in PS3.3:

Code Sequence Attribute: See Code Sequence Attribute in PS3.3 .

3.3 Contrast Administration Definitions

Imaging Agent

A substance administered to improve the imaging of specific organs, tissues, diseases and physiological functions. Adapted from Wikipedia http://en.wikipedia.org/wiki/Imaging_agent.

Note

Imaging agents include iodinated X-Ray and gadolinium-based MR contrast agents.
Saline flush is not an imaging agent but may be administered in conjunction with imaging agents.
Air used as a negative contrast agent is an imaging agent.

3.4 DICOM Introduction and Overview Definitions

This Part of the Standard makes use of the following terms defined in PS3.1:

Service-Object Pair Class (SOP Class): See Service-Object Pair Class in PS3.1 .

3.5 DICOM Service Class Definitions

This Part of the Standard makes use of the following terms defined in PS3.4:

Service-Object Pair Instance (SOP Instance): See Service-Object Pair Instance in PS3.4 .

3.6 DICOM Data Structures and Encoding

This Part of the Standard makes use of the following terms defined in PS3.5:

Data Set: See Data Set in PS3.5 .

3.7 Radiotherapy

Monitor Units (MU): A unit of radiation output used to quantify a Meterset. See Section C.36.1.1.3 “Meterset” in PS3.3 .

3.8 Structured Report Definitions

This Part of the Standard makes use of the following terms defined in PS3.3:

Content Item: See Content Item in PS3.3 .
Content Tree: See Content Tree in PS3.3 .

4 Symbols and Abbreviations

The following symbols and abbreviations are used in this Part of the Standard.

ACR: American College of Radiology
ASE: American Society of Echocardiography
BCID: Baseline Context Group ID
BTID: Baseline Template ID
CAP: College of American Pathologists
Chest CAD: Computer-Aided Detection and/or Computer-Aided Diagnosis for chest radiography
CNAME: Context Group Name
Colon CAD: Computer-Aided Detection and/or Computer-Aided Diagnosis for colon radiography
CSV: Comma-separated Values
DCID: Defined Context Group ID
DCMR: DICOM Content Mapping Resource
DT: Defined Term
DTID: Defined Template ID
ECID: Enumerated Context Group ID
ETID: Enumerated Template ID
EV: Enumerated Value
FHIR: Fast Healthcare Interoperability Resources
HTML: HyperText Markup Language
IHE: Integrating the Healthcare Enterprise
IHE SVS: IHE Sharing Value Sets
JSON: JavaScript Object Notation
Mammography CAD: Computer-Aided Detection and/or Computer-Aided Diagnosis for Mammography
MPPS: Modality Performed Procedure Step
NEMA: National Electrical Manufacturers Association
OWL: Web Ontology Language
RECIST: Response Evaluation Criteria In Solid Tumors
SNOMED: Systematized Nomenclature of Medicine
TNAME: Template Name
UCUM: Unified Code for Units of Measure
WHO: World Health Organization
XML: eXtensible Markup Language

The following upper-case abbreviations represent specific Attributes:

CM: Code Meaning (0008,0104)
CSD: Coding Scheme Designator (0008,0102)
CSV: Coding Scheme Version (0008,0103)
CV: Code Value (0008,0100) or Long Code Value (0008,0119) or URN Code Value (0008,0120)

5 Conventions

Terms listed in Section 3 are capitalized throughout the document.

6 Form of Template Specifications

Templates are patterns that specify the Concept Names, Requirements, Conditions, Value Types, Value Multiplicity, Value Set restrictions, Relationship Types and other attributes of Content Items for a particular application.

An IOD may specify that particular Standard Templates shall be used or may be used to define or constrain the content of a Content Item construct. A Content Item construct includes a coded concept name and one of several types of coded values. Content Item constructs are used in:

the main Data Set and recursively nested Content Sequences (0040,A730) of the SR Document Content Module
the Acquisition Context Sequence (0040,0555) of the Acquisition Context Module,
the Protocol Context Sequence (0040,0440) and Content Item Modifier Sequence (0040,0441) of the Scheduled Procedure Step Module, Image Acquisition Results Module, and others.
the Specimen Preparation Step Content Item Sequence (0040,0612) of the Specimen Module.

Annex A and Annex C of this Part define Standard Templates.

Note

Standard Extended and Private Templates may be defined by implementers of the Standard. The rules for definition of Standard Extended and Private SR Templates are similar to the rules for definition of Standard Extended and Private SOP Classes. One row of a Template definition table corresponds to one row of a Module table.

Each Standard Template is specified by a Template table in this Part. Each Template table specifies exactly one Template, corresponding to a pattern of content within a Content Item construct.

Each Template table identifies whether the order of Content Items is significant or not significant. SOP Instances whose content is based on a Template where the order is significant shall encode the top level Content Items in the order they are specified in the Template, and the subsidiary Content Items under each parent item in the order they are specified, and so on for each Nesting Level. The significance of the order applies only to the Template itself; subsidiary included Templates may have a different order significance.

Note

Even if a Template specifies that the order is not significant, there may be significance to the order in which Content Items are encoded in a SOP Instance. For example, CONTAINER Content Items with Attribute Continuity of Content (0040,A050) value CONTINUOUS encode Content Items in narrative sequence, and procedure logs encode Content Items in time order.

The Content Items from subsidiary Templates may be intermingled if and only if the parent and subsidiary all specify that the order is not significant. This permits later refactoring into reusable Templates.

The range of concepts and the options that are permitted in a family of SR Documents vary inversely with the level of constraint that is applied by the corresponding SR Template. The more narrow the range of concepts and the more restricted the options permitted by a Template, the more predictable the content of the SR Documents will be.

Note

A very specific Template defines a family of SR Documents that are very similar to each other. They have a narrow range of content options (e.g., high level of constraint of Content Item values; use of CODE or NUM with Enumerated Context Groups) and their content is therefore highly predictable. A very general (e.g., permissive or broad) Template defines a family of SR Documents that may differ considerably from one another. They have a broader range of content options (e.g., low level of constraint of Content Item values; use of TEXT and relatively little restriction of Content Item values) and their content is less predictable.
The degree of interoperability that may be achieved with a family of SR Documents generated from a Template may be determined intentionally and precisely at a desired level by appropriate Template design to achieve the necessary degree of predictability of SR Document contents.

6.1 Template Table Field Definition

SR Templates are described using tables of the following form:

Type:: (Non-) Extensible
Order:: (Non-) Significant
Root:: Yes or No

Table TID <#>. <SR Context Template Name>

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1
2
3

Acquisition Context Templates are described using tables of the following form:

Type:: (Non-) Extensible
Order:: (Non-) Significant

Table TID <#>. <Acquisition Context Template Name>

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1
2
3

Protocol Context Templates are described using tables of the following form:

Type:: (Non-) Extensible
Order:: (Non-) Significant

Table TID <#>. <Protocol Context Template Name>

	NL	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1
2
3

The semantics of the fields (columns) of Template tables are defined by subsections of this Section. A row of a Template table specifies either one Content Item or inclusion of another Template that may specify any number of Content Items (see Section 6.2.3 for definition of Included Templates). Each Template table is named by a title, identified by a TID number and further explained by a description such as explanation of Template contents, purpose and use cases.

The following conventions are defined for the form of references to coded concepts, Context Groups and Templates.

Code Meanings are enclosed in quotation marks (for example "cm"). Code Values and Coding Scheme Designators are not enclosed in quotation marks unless a comma occurs in the string.

References to coded concepts take the following form:

EV or DT (CV, CSD, "CM")

e.g., an Enumerated Value with only CV, CSD, and CM defined is represented as follows: EV (CV, CSD, "CM"), for example EV (76752008, SCT, "Breast").
MemberOf { BCID or DCID (CID) CNAME } MemberOf selects one term from the specified Context Group.

If reference to a specific Coding Scheme version is required, it takes the following form:

EV or DT (CV, CSD [CSV], "CM")

e.g., DT (MA.II.A.5.4A, BI [4.0], "4A - Low suspicion").

References to Context Groups take the following form:

BCID or DCID (CID) CNAME

e.g., Defined Context Group 5000 is represented as follows: DCID (5000) Language.

References to Templates take the following form:

BTID or DTID (TID) TNAME

e.g., Baseline Template 1000 is represented as follows: BTID (1000) Quotation.

6.1.1 Row Number

Each row of a Template Table is denoted by a row number. The first row is numbered 1 and subsequent rows are numbered in ascending order with increments of 1. This number denotes a row for convenient description as well as reference in conditions.

Note

When templates are amended, temporary assignments of new rows between existing rows may be indicated by an alphabetic suffix, as in "6a" after "6", etc.

The Row Number of a Content Item in a Template may or may not be the same as the ordinal position of the corresponding Sequence Item (representing the Content Item) in a Content Sequence (0040,A730), depending on the number of times the Content Item is repeated.

The Content Item specified in the first row of a Template table may be of any Value Type. Specifically, it is not constrained to be a CONTAINER.

6.1.2 Nesting Level (NL)

The nesting level of Content Items is denoted by ">" symbols, one per level of nesting below the initial Source Content Item (of the Template) in a manner similar to the depiction of nested Sequences of Items in Modules Tables in PS3.3. When it is necessary to specify the Target Content Item(s) of a relationship, they are specified in the row(s) immediately following the corresponding Source Content Item. The Nesting Level of a Target Content Item is one greater than the Nesting Level of the corresponding (parent) Source Content Item. The Content Item specified in row 1 of a Template Table is at the top level (i.e., no ">" symbol is ever present in the NL field for the first Content Item in the table).

Acquisition Context Templates have no Nesting Level field. Protocol Context and UPS Processing Parameter Templates allow a single Nesting Level implemented through the Content Item Modifier Sequence (see PS3.3).

6.1.3 Relationship With Source Content Item (Parent)

Relationship Type and Relationship Mode (i.e., By-value or By-reference) constraints, if defined, are specified in this field, as described Table 6.1.3-1.

Relationship Type and Mode are specified for each row that specifies a target Content Item.

Relationship Type and Mode may also be specified when another Template is included, either "top-down" or "bottom-up" or both (i.e., in the "INCLUDE Template" row of the calling Template, or in all rows of the included Template, or in both places). There shall be no conflict between the Relationship Type and Mode of a row that includes another Template and the Relationship Type and Mode of the rows of the included Template.

Note

SR IODs specify Enumerated Values for Relationship Types. If a Relationship Type other than one of the Defined Terms for Relationship Type (0040,A010) is specified in a Private SOP Class, there is a significant risk to interoperability. Documentation accompanying Templates for Private SOP Classes should define any Relationship-type extensions in the manner that the Standard Relationship Types are defined in PS3.3.

Acquisition Context and Protocol Context Templates have no Relationship field.

Table 6.1.3-1. Syntax of Relationship Constraints

Expression	Definition
RTYPE	Relationship Mode is By-value and Relationship Type is RTYPE. For example, "INFERRED FROM".
R-RTYPE	Relationship Mode is By-reference and Relationship Type is RTYPE. For example, "R-INFERRED FROM".

6.1.4 Value Type (VT)

The Value Type field specifies the SR Value Type of the Content Item or conveys the word "INCLUDE" to indicate that another Template is to be included (substituted for the row). See Section 6.2.3 for further description of "Included Templates".

6.1.5 Concept Name

Any constraints on the Concept Name are specified in the Concept Name field as defined or enumerated coded entries, or as baseline or defined Context Groups. Alternatively, when the VT field is "INCLUDE", the Concept Name field specifies the Template to be included.

The absence of an entry in the Concept Name field means that any code may be used, from any Coding Scheme, including codes from private Coding Schemes.

6.1.6 Value Multiplicity (VM)

The VM field indicates the number of times that either a Content Item of the specified pattern or an included Template may appear in this position. Table 6.1.6-1 specifies the values that are permitted in this field.

Table 6.1.6-1. Permitted Values for VM

Expression	Definition
i (where 'i' represents an integer)	Exactly i occurrences, where i>=1. E.g., when i=1 there shall be one occurrence of the Content Item in this position.
i-j (where 'i' and 'j' represent integers)	From i to j occurrences, where i and j are >=1 and j>i.
i-n (where 'i' and 'n' represent integers)	i or more occurrences, where i>=1.

6.1.7 Requirement Type

The Requirement Type field specifies the requirements on the presence or absence of the Content Item or included Template.

Note

There is typically no need to specify Requirement Type separately for SCU and SCP of the Basic SR SOP Classes, because the SCP is required to support the entire content of any SR Document it receives. Therefore, for Basic SR SOP Classes, Requirement Type effectively only applies to the SCU.

The following symbols are used:

M: Mandatory. Shall be present. An empty Measured Value Sequence (0040,A300) is not permitted when unknown, only for failures. See Section 6.1.7.1.
MC: Mandatory Conditional. Shall be present if the specified condition is satisfied. An empty Measured Value Sequence (0040,A300) is not permitted when unknown, only for failures. See Section 6.1.7.1.
U: User Option. May or may not be present.
UC: User Option Conditional. May not be present. May be present according to the specified condition.

Note

There is an interaction between the VM and the Requirement Type with respect to the number of times that a Content Item (or included Template) may actually be present, as follows:

Req Type	VM	Actual number of occurrences in the Content Tree
M or MC	1	1
M or MC	1-n	1 to n
U or UC	1	0 or 1
U or UC	1-n	0 to n

6.1.7.1 Requirement Type for Numeric Content Items in Structured Reports

Section C.18.1 Numeric Measurement Macro in PS3.3 permits the Measured Value Sequence (0040,A300), which contains the Numeric Value (0040,A30A) and Measurement Units Code Sequence (0040,08EA) to be zero length.

Note

This does not apply to the Section 10.2 Content Item Macro in PS3.3 , which does not permit an empty Measured Value Sequence (0040,A300) nor does it include a Numeric Value Qualifier Code Sequence (0040,A301).

The unknown state shall be distinguished from valid arithmetic or device or algorithm failure related states (in which cases a numeric string that complies with the PS3.5 Value Representation for DS cannot be created).

If the Template Requirement Type is M or MC, then:

A zero length Measured Value Sequence (0040,A300) is permitted for any of the reasons listed in CID 43 “Numeric Value Failure Qualifier”
A zero length Measured Value Sequence (0040,A300) is not permitted for any of the reasons listed in CID 44 “Numeric Value Unknown Qualifier”, or any other semantically equivalent reason

Note

The intent of the foregoing is to discourage an implementer from thwarting the requirements of the Template. Sending meaningless values, such as a value of zero, when zero is not a realistic value, is also not encouraged.

6.1.8 Condition

The Condition field specifies any conditions upon which presence or absence of the Content Item or its values depends. This field specifies any Concept Name(s) or Values upon which there are dependencies.

References in Condition statements to coded concepts or values, whether to select a Content Item to test or to specify a value to test against, are of the form (CV, CSD, "CM"). As is always the case for coded entries, the matching is performed against CV and CSD, irrespective of the string value of CM.

References may also be made to row numbers (e.g., to specify exclusive OR conditions that span multiple rows of a Template table).

The following abbreviations are used:

XOR: Exclusive OR. One and only one row shall be selected from mutually-exclusive options.

Note

For example, if one of rows 1, 2, 3 or 4 may be included, then for row 2, the abbreviation "XOR Rows 1, 3, 4" is specified for the condition.
IF: Shall be present if the condition is TRUE; may be present otherwise.
IFF: If and only if. Shall be present if the condition is TRUE; shall not be present otherwise.

6.1.9 Value Set Constraint

Any constraints on the Value Set for a CODE Content Item are specified in this field as defined or enumerated coded entries, or as baseline or defined Context Groups.

The absence of an entry in the Value Set Constraint field for a CODE Content Item means that any code may be used, from any Coding Scheme, including codes from private Coding Schemes.

The Value Set Constraint column may specify a default value for the Content Item if the Content Item is not present, either as a fixed value, or by reference to another Content Item, or by reference to an Attribute from the Data Set other than within the Content Sequence (0040,A730). For example:

Defaults to (121006, DCM, "Person")
Defaults to Value of Institution Name (0008,0080) of the General Equipment Module

A default value may also be specified to indicate that a Content Item is expected to have a particular value unless there is a reason for it to be different. This is especially true in the case where a Content Item is mandatory and, therefore, must not be absent.

Note

For the UIDREF Content Item in Row 1 of TID 1004 “Device Observer Identifying Attributes”, the Value Set Constraint column specifies: "Defaults to Value of Device UID (0018,1002) of the General Equipment Module". That means, the value of this Content Item should be the same as the value of the referenced Attribute unless there is a reason for it to be different.

6.1.9.1 NUM Units Constraint

Any constraints on units of measurement are specified in the Value Set Constraint field if and only if the Value Type is NUM. The constraints are specified either as defined or enumerated coded entries, or as baseline or defined Context Groups. For example:

UNITS = EV (mm, UCUM, "mm")
UNITS = DCID 7460 “Linear Measurement Unit”

The constraints on the units apply only when Measured Value Sequence (0040,A300) contains an item (i.e., a numeric value is present).

Note

The presence of constraints on the units does not imply that a value is required to be sent, since Measured Value Sequence (0040,A300) is Type 2 and may be zero length if permitted by the Requirement Type for the Content Item in the Template.

The absence of any constraint on units of measurement means that any code for units may be used, from any coding scheme, including codes from private coding schemes.

6.1.9.2 CONTAINER Continuation Flag Constraint

The value of the Continuity of Content Flag (0040,A050) may be specified in the Value Set Constraint field if and only if the Value Type is CONTAINER.

Note

The SR Document Content Module specifies "SEPARATE" and "CONTINUOUS" as the Enumerated Values for Continuity of Content Flag (0040,A050).

6.1.9.3 SCOORD Graphic Type Constraint

Constraints on the value of the Graphic Type(0070,0023) may be specified in the Value Set Constraint field if and only if the Value Type is SCOORD. The constraint may specify a set of allowed values, or a set of disallowed values. For example:

GRAPHIC TYPE = {POINT}
GRAPHIC TYPE = {CIRCLE, ELLIPSE}
GRAPHIC TYPE = not {MULTIPOINT}

6.1.9.4 TABLE Row, Column, Units and Coded Content Constraints

Constraints on various aspects of the TABLE Content Item may be specified in the Value Set Constraint field, including the manner of encoding the tabulated values, either by row, by column, by individual cells, or by reference to other Content Items, by specifying:

Fixed values, minimums and/or maximums for the number of table rows (NROWS) and/or columns (NCOLUMNS)
Defined or enumerated coded entries, or baseline or defined Context Groups for Concept Name Code Sequence (0040,A043) to use in Table Row Definition Sequence (0040,A806) (ROW n) and/or Table Column Definition Sequence (0040,A807) (COLUMN n)
Defined or enumerated coded entries, or baseline or defined Context Groups for Concept Code Sequence (0040,A168) to use in Cell Values Sequence (0040,A808) (ROW n VALUES) and/or (COLUMN n VALUES) and/or (CELL r, c VALUES)
Defined or enumerated coded entries, or baseline or defined Context Groups for Measurement Units Code Sequence (0040,08EA) to use in Table Row Definition Sequence (0040,A806) (ROW n UNITS) and/or Table Column Definition Sequence (0040,A807) (COLUMN n UNITS) and/or Cell Values Sequence (0040,A808) (CELL r, c UNITS)
Permitted VR to use in Selector Attribute VR (0072,0050) for specified rows (ROW n VR) , columns (COLUMN n VR) or cells (CELL r,c VR) , when values are encoded literally
Permitted referenced Content Item target (TID ttt ROW rrr) for specified rows (ROW n REF) , columns (COLUMN n REF) or cells (CELL r,c REF), when values are specified by reference

It is also helpful to provide a detailed description of the form of the table in the corresponding Content Item Description.

Example 1:

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
5		CONTAINS	TABLE	EV (113734, DCM, "X-Ray Tube Current")	1	M		NCOLUMNS = 2 COLUMN 1 = EV (111526, DCM, "DateTime Started") COLUMN 2 = EV (113734, DCM, "X-Ray Tube Current") COLUMN 2 UNITS = EV (mA, UCUM, "mA") COLUMN 1 VR = DT COLUMN 2 VR = FL

Rel with Parent

Concept Name

Req Type

Condition

Value Set Constraint

CONTAINS

TABLE

EV (113734, DCM, "X-Ray Tube Current")

NCOLUMNS = 2

COLUMN 1 = EV (111526, DCM, "DateTime Started")

COLUMN 2 = EV (113734, DCM, "X-Ray Tube Current")

COLUMN 2 UNITS = EV (mA, UCUM, "mA")

COLUMN 1 VR = DT

COLUMN 2 VR = FL

Content Item Descriptions

Row 5

The table of X-Ray Tube Current is encoded as a two-column table, consisting of multiple rows describing corresponding values of datetime and X-Ray tube current. The number of rows is not constrained.

Example 2:

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
5		CONTAINS	TABLE	EV (, , "X-Ray Source Transformation Matrix")	1	M		NCOLUMNS = 4 NROWS= 4 CELL VR = FD

Rel with Parent

Concept Name

Req Type

Condition

Value Set Constraint

CONTAINS

TABLE

EV (, , "X-Ray Source Transformation Matrix")

NCOLUMNS = 4

NROWS= 4

CELL VR = FD

Content Item Descriptions

Row 5

The X-Ray Source Transformation Matrix is encoded as a 4 by 4 matrix of dimensionless numbers of the form defined in Section C.20.2.1.1 Frame of Reference Transformation Matrix in PS3.3 . The table may be encoded as entire rows, entire columns or individual cells of double float numeric values.

Example 3:

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
5		CONTAINS	TABLE	EV (126081, DCM, "RECIST 1.1")	1	M		NCOLUMNS = 4 COLUMN 1 = EV (112039, DCM, "Tracking Identifier") COLUMN 2 = EV (363698007, SCT, "Finding Site") COLUMN 3 = EV (272741003, SCT, "Laterality") COLUMN 4 = EV (103339001, SCT, "Long Axis") COLUMN 4 UNITS = EV (mm, UCUM, "mm") COLUMN 1 REF = TID 1500 ROW 9 > TID 1501 ROW 2 COLUMN 2 REF = TID 1500 ROW 9 > TID 1501 ROW 6 COLUMN 3 REF = TID 1500 ROW 9 > TID 1501 ROW 7 COLUMN 4 REF = TID 1500 ROW 9 > TID 1501 ROW 10 > TID 300 ROW 1

Rel with Parent

Concept Name

Req Type

Condition

Value Set Constraint

CONTAINS

TABLE

EV (126081, DCM, "RECIST 1.1")

NCOLUMNS = 4

COLUMN 1 = EV (112039, DCM, "Tracking Identifier")

COLUMN 2 = EV (363698007, SCT, "Finding Site")

COLUMN 3 = EV (272741003, SCT, "Laterality")

COLUMN 4 = EV (103339001, SCT, "Long Axis")

COLUMN 4 UNITS = EV (mm, UCUM, "mm")

COLUMN 1 REF = TID 1500 ROW 9 > TID 1501 ROW 2

COLUMN 2 REF = TID 1500 ROW 9 > TID 1501 ROW 6

COLUMN 3 REF = TID 1500 ROW 9 > TID 1501 ROW 7

COLUMN 4 REF = TID 1500 ROW 9 > TID 1501 ROW 10 > TID 300 ROW 1

Content Item Descriptions

Row 5

The table of RECIST long axis measurements per target lesion is encoded as a four-column table, consisting of multiple rows describing corresponding values of Tracking Identifier, Finding Site, Laterality and Long Axis in mm by reference to other Content Items. The number of rows is not constrained. The Response Criteria is used as the Concept Name of the table.

Example 4:

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
6	>	CONTAINS	TABLE	EV (111632, DCM, "Anode Target Material")	1	UC	XOR Row 6a	>NCOLUMNS = 2 COLUMN 1 = EV (111526, DCM, "DateTime Started") COLUMN 2 = EV (111632, DCM, "Anode Target Material") COLUMN 2 VALUES = DCID 10016 "Anode Target Material" COLUMN 1 VR = DT COLUMN 2 VR = SQ

Rel with Parent

Concept Name

Req Type

Condition

Value Set Constraint

CONTAINS

TABLE

EV (111632, DCM, "Anode Target Material")

XOR Row 6a

>NCOLUMNS = 2

COLUMN 1 = EV (111526, DCM, "DateTime Started")

COLUMN 2 = EV (111632, DCM, "Anode Target Material")

COLUMN 2 VALUES = DCID 10016 "Anode Target Material"

COLUMN 1 VR = DT

COLUMN 2 VR = SQ

Content Item Descriptions

Row 6

The table of Anode Target Material values is encoded as a two-column table, consisting of multiple rows describing corresponding values of DateTime Started and Anode Target Material Code Values. The number of rows is not constrained. The Anode Target Material is encoded using a code selected from a Defined Context Group.

6.2 Special Conventions for Template Tables

6.2.1 Multiple Value Sets Depending On Different Conditions

When a Content Item may have different value sets, each depending on different conditions, the description of each different case begins in a separate row of the Template Table.

6.2.2 Target Content Items of Relationships

When it is necessary to specify the Target Content Item(s) of a relationship, they are specified in the row(s) immediately following the Source Content Item. The Nesting level of a Target Content Item (or set of Target Content Items specified indirectly via an 'include Template' macro) is one greater than the Nesting Level of the corresponding Source Content Item, as indicated by an increase in the number of ">" characters in the nesting level.

When a Content Item may be the Source of multiple relationships having different Relationship Types and/or different Relationship Modes and/or different patterns of Target Content Item(s), the description of each different case begins in a separate row of the Template Table.

When the Source Content Item of a relationship has VM of greater than 1, the specified pattern of Target Content Items applies to all instantiations of the Source Content Item.

Note

For example, if a Template specifies that the VM of a Source Content Item is 1-n and specifies a By-value relationship to two CODE Content Items with particular value set constraints, then each instantiation of the Source Content Item has a By-value relationship to two CODE Content Items with the specified value constraints.

When a Source Content Item that has a Requirement Type of U, UC or MC is not present (is not instantiated), no Target Content Items of that Source Content Item are present, even if one or more of the Target Content Items is designated with a Requirement Type of M or MC.

Note

In other words, potential children are not present when there is no parent.

6.2.3 Inclusion of Templates

A Template may specify another Template to be included by specifying "INCLUDE" in the Value Type field and the identifier of the included Template in the Concept Name field. All of the rows of the specified Template are in included in the invoking Template, effectively substituting the specified Template for the row where the inclusion is invoked. Whether or not the inclusion is user optional, mandatory or conditional is specified in the Requirement and Condition fields. The number of times the included Template may be repeated is specified in the VM field.

6.2.3.1 Template Parameters

A Template that is included by another Template may include parameters that are replaced by values defined in the invoking Template. Parameters may be used to specify coded concepts or Context Groups in the Concept Name, Condition, or Value Set Constraint fields of a Template.

An included Template that accepts parameters shall be introduced by a table listing those parameters of the form:

Parameter Name	Parameter Usage
...	...
...	...

Parameters are indicated by a name beginning with the character "$".

The invoking Template may specify the value of the parameters in the included Template by name in the Value Set Constraint field of the INCLUDE row. The parameter in the included Template shall be replaced by the specified parameter value. Specification of a parameter value shall be of one of the following forms:

Notation	Definition
$parametername = EV or DT (CV, CSD, "CM")	The parameter passed to the Template is the specified coded term.
$parametername = (CV, CSD, "CM")	The parameter passed to the Template is the specified coded term, used as a parameter in a Condition field of the included Template.
$parametername = BCID or DCID (CID) CNAME	The parameter passed to the Template is the Context Group.
$parametername = MemberOf {BCID or DCID (CID) CNAME}	The parameter passed to the Template is a single coded term from the Context Group in curly braces.

The specification of a parameter value is valid only for the directly included Template. Therefore, it needs to be explicitly respecified in Templates intermediate between the originally specifying Template and the target Template. The intermediate Template may use the same parameter name as used by the Template it invokes; in such a case, the intermediate Template would invoke the subsidiary Template with a specification in the Value Set Constraint field such as:

$parametername = $parametername

Note

In this case, the left hand instance of $parametername is the name in the subsidiary Template, and the right hand instance is the (parametrized) value passed into the current Template.

The invoking Template is not required to specify all parameters of included Templates. If not specified, the value set (term or Context Group) for that parameter is unconstrained. An unconstrained value in a Condition will cause the condition to fail.

6.2.4 Post-coordinated Codes and Has Concept Modifier Relationship

Though it may not be explicitly shown in a particular Template, the use of any coded Concept Name in any Content Item may be defined in a post-coordinated rather than pre-coordinated manner, unless explicitly forbidden by the IOD or the Template.

Accordingly, any such Content Item may have any number of Target Content Items via a "HAS CONCEPT MOD" relationship, even if not explicitly specified in a Template. Each Target Content Item of such a relationship may be more complicated than a single Content Item if the IOD permits (i.e., the post-coordinated concept may potentially be defined by a complex sub-tree).

6.2.5 Extension of Templates

An Extensible Template may be extended in an Application generating SOP Instances to include additional Content Items in its definition. Such Content Items shall not duplicate concepts for which an encoding is defined in the Template. I.e., if a method is provided for the encoding of a concept in the Template, that concept shall not be encoded using a different Content Item in an extension to the Template.

Note

There is no requirement that the included additional Content Items in a Template extension be placed at the end of the Template. The additional Content Items may be included at any semantically appropriate location in the Template, regardless of whether the order of Content Items in the Template is significant.

A Non-extensible Template shall not be modified in an Application by the addition of Content Items to its definition.

Note

The set of Content Items in either an Extensible or a Non-extensible Template may be changed in subsequent editions of the Standard, in accordance with the procedures of the DICOM Standards Committee.

A Non-Extensible Template may include a Template that is Extensible. In invoking such a Template, the content structure of SOP Instances created from the Non-Extensible Template may vary according to the varying content structure allowed by the extension of the included Template.

Note

Specification of such extensible content in a Non-Extensible Template may be desirable if the Template defines, e.g., a fixed top level structure into which a variety of lower level structures may be "plugged".

7 DCMR Context Group Specifications

Context Groups specify Value Set restrictions for Code Value (0008,0100) (or Long Code Value (0008,0119) or URN Code Value (0008,0120)) and Code Meaning (0008,0104) of Code Sequence Attributes for given functional or operational contexts. This Section specifies the semantics of DCMR Context Group Tables.

7.1 Context Group Table Field Definition

Context Groups are described using tables of the following form (optional columns are shown with italic column titles):

Resources:: HTML | FHIR JSON | FHIR XML | IHE SVS XML
Keyword:: <Context Group Keyword>
FHIR Keyword:: dicom-cid-<#>-<Context Group Keyword>
Type:: (Non-) Extensible
Version:: <yyyymmdd> or Not versioned
UID:: 1.2.840.10008.6.1.uuuu

Table CID <#>. <Context Group Name>

Coding Scheme Designator	Coding Scheme Version	Code Value	Code Meaning	<Reference Terminology> Equivalent Value	Units
...	...	...	...	...	...
...	...	...	...	...	...

A row of a Context Group table specifies one coded concept. Each Context Group table is:

named by a title
identified by a CID number
identified by a version
identified by a Keyword
identified by a FHIR Keyword
assigned a UID (that is defined in PS3.6)
linked to various resource files that contain representations of the Context Group (in FHIR JSON, FHIR XML and IHE SVS XML)

The columns of the tables consist of:

Coding Scheme Designator: the value of Coding Scheme Designator (0008,0102)
Code Value: the value of Code Value (0008,0100) or Long Code Value (0008,0119) or URN Code Value (0008,0120)
Coding Meaning: the value of Code Meaning (0008,0104)

In those cases where it is necessary, Coding Scheme Version (the value of Coding Scheme Version (0008,0103)) may also be specified. This column may be absent if Coding Scheme Version is not required for any of the coded concepts in the Context Group.

The value specified in the Code Meaning field is an acceptable value for the specified Code Value, but does not preclude the use of other synonymous text in the same or other language.

Note

Some coding schemes do not specify the equivalent of a Code Meaning.
Capitalization in the Code Meaning is generally not significant, except for abbreviations used in units of measurement prefixes (e.g., "ml" milliliter vs. "Ml" megaliter, or "pV" picovolt vs. "PV" petavolt).

If further description of the concept represented by the code is required in the DCMR (rather than referring to an external coding scheme), it is included in a separate table.

Optional columns may provide an informative mapping from the coded concepts of the Context Group to a reference terminology specified in the column heading. Typical reference terminologies include SNOMED CT and UMLS.

An optional column may provide a normative baseline or defined set of units to use for numeric measurements using the concept, either as a single term (e.g., DT ({ratio}, UCUM, "ratio")), a list of such terms, or a reference to a Context Group (e.g., DCID 7277 "Units of Diffusion Rate Area Over Time").

A Context Group may alternatively be defined by narrative reference to an externally defined coding scheme.

Note

See for instance CID 82 “Measurement Unit”.

7.2 Special Conventions for Context Group Tables

7.2.1 Include Context Group

The 'Include Context Group' macro is a concise mechanism for including (by-reference) all of the rows of a specified Context Group in the invoking Context Group, effectively substituting the specified Context Group for the row where the macro is invoked. If an 'Include Context Group' is specified, it shall be specified in the Concept Name column of a Context Group Table. Table 7.2.1-1 specifies the syntax of the 'Include Context Group macro. Inclusion may be nested, in that included Context Groups may themselves include other Context Groups. This gives rise to the possibility of circular inclusion and multiple inclusion, in which case the Context Group shall consist of the transitive closure of the set of all coded concepts within the included Context Groups.

Note

For example, it is reasonable to have the following definitions for Context Groups:

Context ID 1, includes Context IDs 2 and 3
Context ID 2, includes Context IDs 4 and 5
Context ID 3, includes Context IDs 5 and 6
Context ID 4 contains a, b, c
Context ID 5 contains e, f, g
Context ID 6 contains a, h, i

The contents of Context ID 1 will be a, b, c, e, f, g, h, i.

Table 7.2.1-1. Include Context Group Macro

Coding Scheme Designator	Code Value	Code Meaning
…	…	…
Include CID nnn
…	…	…

7.2.2 Measurement Unit

Context Group 82 is defined to include all units of measurement relevant to DICOM IODs. In the past it was envisaged that an extensible list of pre-coordinated codes would be included in the mapping resource.

DICOM has now adopted the Unified Codes for Units of Measurement (UCUM) standard for all units of measurement. This coding scheme allows for the "construction" of pre-coordinated codes from atomic components.

The specialization of the UCUM standard as it is used in DICOM involves the following rules:

the Coding Scheme Designator is specified as "UCUM"
the version of UCUM from which a code is constructed is not required, as it is not needed to resolve ambiguity in the Code Value or Code Meaning; however, there is no restriction on the version being specified in Coding Scheme Version
the Code Value will be constructed from UCUM and make use of the "case-sensitive" form of UCUM code (e.g., "ml/s")
the Code Meaning for other than UCUM unity may be one of the following:
- the "print" value specified in UCUM (e.g., "mmHg" for Code Value mm[Hg])
- the same string as sent in the Code Value (e.g., "ml/s")
- constructed from the "names" of individual components using the Americanized form of name (e.g., "milliliters/second")
- constructed from the "names" of individual components using the European form of name (e.g., " millilitres /second")
In the case of UCUM unity ("1", or curly braces expression) it is forbidden to use "1" as a Code Meaning. Annex G provides Code Meanings for a Code Value (0008,0100) of 1. A Template or Context Group may constrain the Code Meaning according to the following rules:
- UCUM default unit 1 shall use one of the Code Meaning synonyms specified in Annex G
- ratios of identically dimensioned values may use ({ratio}, UCUM, "ratio")
- unitless numeric scores may use ({M:N}, UCUM, "range: M:N") to specify the minimum and maximum value, for example, ({0:10}, UCUM, "range: 0:10")
- counts using UCUM annotation shall always use the text within the curly braces as the Code Meaning, for example, ({masses}, UCUM, "masses")
- compositions of a curly braces expression with other UCUM values may use a conventional clinical representation, for example, ({H.B.}/min, UCUM, "BPM")

The UCUM standard states that the preferred display values for codes deg (degrees of plane angle) and Cel (degrees Celsius) are "°" and "°C". However, the character ° does not have a representation in the DICOM default character set (ASCII, ISO-IR 6). The Code Meaning specified in this Part therefore uses "deg" and "C". SOP Instances that specify a Specific Character Set that allows the character ° may use Code Meanings "°" and "°C".

Note

Code Meaning "C" formally conflicts with the Code Meaning for Coulomb. In the context of DICOM use, the possibility of confusion to a user based on the display of the Code Meaning is considered remote, as there is little use of Coulomb in imaging, and the context of the displayed item Concept Name would resolve between temperature and electric charge. Automated processing based on the Code Values should not face an issue as the Code Values differ.
The character ° has Unicode code point U+00B0, and is represented as 0xB0 in ISO-IR 100 (Latin-1), ISO-IR 101 (Latin-2), ISO-IR 109 (Latin-3), ISO-IR 110 (Latin-4), ISO-IR 126 (Greek), ISO-IR 138 (Hebrew), and ISO-IR 148 (Latin-5). It is not encodable in ISO-IR 13 (Katakana), ISO-IR 144 (Cyrillic), ISO-IR 127 (Arabic), or ISO-IR 166 (Thai).

7.2.3 Extension of Context Groups

An Application may extend an Extensible Context Group by adding terms for new concepts. Applications may not substitute other terms of the same concept in the Context Group. Applications may not add a term that means "unspecified" or "missing" or "unknown" similar; if such a concept is intended to be permitted then the Standard will include it in the Context Group already. Such extension may be made without a change in Context Group Identifier, but with the specification of Context Group Extensions (see PS3.3).

Non-extensible Context Groups shall not be modified in an Application.

Note

The set of concepts in either an Extensible or a Non-extensible Context Group may be changed in subsequent editions of the Standard, in accordance with the procedures of the DICOM Standards Committee.

8 Coding Schemes

Table 8-1 lists the coding schemes (and their designators) defined for use in DICOM; Table 8-2 lists the HL7v3 coding schemes referenced for use in DICOM. Additionally, any coding scheme may be used that has an entry in the HL7 Registry of Coding Schemes (HL7 v2 Table 0396, or the equivalent online registry), in which case the HL7 Symbolic Name shall be used as the value for the Coding Scheme Designator in DICOM, as long as it does not conflict with an entry Table 8-1 and fits within the Value Representation of the DICOM Coding Scheme Designator (0008,0102) Attribute. As specified in the HL7 v2 Table 0396, local or private coding schemes shall be identified by an alphanumeric identifier beginning with the characters "99".

Note

An earlier version of this table was formerly contained in Annex D of PS3.3.
See Section 8.2 “Coding Scheme Designator and Coding Scheme Version” in PS3.3 for further description.
The Coding Scheme UIDs are provided for reference only; the normative specification of UIDs and their associated meaning is the responsibility of the coding scheme developer and/or HL7.
The current version of HL7 v2 Table 0396 is available at http://www.hl7.org/special/committees/vocab/table_0396/index.cfm.
The HL7 registration of Coding Schemes is available at http://www.hl7.org/oid/index.cfm.
Publication of codes or references to coding schemes within DICOM does not constitute a grant of intellectual property rights to implementers. Use of some Coding Schemes may require a license, or purchase of the relevant coding scheme publication. Implementers should consult the relevant coding scheme publisher; see also Section 2.
The values of Coding Scheme Name (0008,0115), Coding Scheme Responsible Organization (0008,0116) and Coding Scheme Resources Sequence (0008,0109), if available, may be used to fill the corresponding optional Attributes of the Coding Scheme Identification Sequence (0008,0110) in the Section C.12.1 “SOP Common Module” in PS3.3 .

Table 8-1. Coding Schemes

Coding Scheme Designator (0008,0102)	Coding Scheme UID (0008,010C)	Coding Scheme Name (0008,0115)	Coding Scheme Responsible Organization (0008,0116)	Coding Scheme Resources Sequence (0008,0109) Type: URL	Description
ACR	2.16.840.1.113883.6.76	ACR Index	ACR		ACR Index for Radiological Diagnosis Revised, 3^rd Edition 1986
ASTM-sigpurpose	1.2.840.10065.1.12	ASTM E 2084	ASTM		[ASTM E 2084-00] Signature Purpose codes (see Annex A1 of ASTM E 2084), ASTM Subcommittee E 31.20 Data and System Security for Health Information
BARI		BARI			Bypass Angioplasty Revascularization Investigation[Alderman 1992]; endorsed by ACC/AHA Guidelines for Coronary Angiography[Scanlon 1999].
BI		BI-RADS	ACR		ACR Breast Imaging Reporting and Data System [BI-RADS®], Coding Scheme Version (0008,0103) is required; Code Values are section and paragraph identifiers within the publication where the code meaning is defined (e.g., "I.D.1", where I = Breast Imaging Lexicon, D = Special Cases, 1 = Tubular Density, as the Code Value for "Tubular Density"). Note In the HL7 registry, the abbreviation BI is assigned to a different coding scheme, specifically the Beth Israel problem list.
C4	2.16.840.1.113883.6.12	CPT-4	AMA		American Medical Association's Current Procedure Terminology 4 (CPT-4)
C5	2.16.840.1.113883.6.82	CPT-5	AMA		American Medical Association's Current Procedure Terminology 5 (CPT-5)
caDSR	2.16.840.1.113883.3.26.2	Cancer Data Standard Repository	NCI		The Public ID is used as the Code Value. These can be looked up as in the following example (the version is required): http://cdebrowser.nci.nih.gov/CDEBrowser/search?dataElementDetails=9/&cdeId=2178693&version=2.1&PageId=DataElementsGroup
CD2	2.16.840.1.113883.6.13	CDT-2	ADA		American Dental Association's (ADA) Current Dental Terminology 2 (CDT-2)
CTV3	2.16.840.1.113883.6.6	Clinical Terms Version 3	UK NHS		Read Codes
DC	1.2.840.10008.2.16.10	Dublin Core	W3C	DOC: http://dublincore.org/documents/1998/09/dces/ DOC: http://www.ietf.org/rfc/rfc2413.txt	Dublin Code Metadata for Resource Discovery. The Code Value is the Label field, e.g., "Creator" (capitalization significant).
DCM	1.2.840.10008.2.16.4	DICOM Controlled Terminology	DICOM	DOC: http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_D.html OWL: ftp://medical.nema.org/MEDICAL/Dicom/Resources/Ontology/DCM/dcm.owl.zip FHIR: http://dicom.nema.org/resources/ontology/DCM	PS3.16 Content Mapping Resource, Annex D (Note that HL7 also specifies an OID of 2.16.840.1.113883.6.31, but deprecates it in favor of 1.2.840.10008.2.16.4).
DCMUID	1.2.840.10008.2.6.1	DICOM UID Registry	DICOM	DOC: http://dicom.nema.org/medical/dicom/current/output/chtml/part06/chapter_A.html
FMA	2.16.840.1.113883.6.119	FMA	University of Washington, Seattle	DOC: http://sig.biostr.washington.edu/projects/fm/AboutFM.html OWL: http://sig.biostr.washington.edu/share/downloads/fma/release/latest/fma.zip	Digital Anatomist Foundational Model of Anatomy
HPC	2.16.840.1.113883.6.14				Healthcare Financing Administration (HCFA) Common Procedure Coding System (HCPCS)
I10	2.16.840.1.113883.6.3	ICD-10	WHO		International Classification of Diseases revision 10 (ICD-10)
I10C	2.16.840.1.113883.6.90	ICD-10-CM	US DHHS CDC	DOC: http://www.cdc.gov/nchs/icd/icd10cm.htm	International Classification of Diseases, Tenth Revision, Clinical Modification
I10P	2.16.840.1.113883.6.4	ICD-10-PCS	US DHHS CMS	DOC: http://www.cms.gov/Medicare/Coding/ICD10	ICD-10 Procedure Coding System (ICD 10 PCS)
I11	1.2.840.10008.2.16.16	ICD-11	WHO	DOC: http://icd.who.int/browse11/l-m/en	International Classification of Diseases revision 11 (ICD-11)
I9	2.16.840.1.113883.6.42	ICD-9	WHO		International Classification of Diseases revision 9 (ICD-9)
I9C	2.16.840.1.113883.6.2	ICD-9-CM			International Classification of Diseases revision 9, with Clinical Modifications (ICD-9-CM)
ICDO3	2.16.840.1.113883.6.43.1	ICD-O-3	WHO	DOC: http://www.who.int/standards/classifications/other-classifications/international-classification-of-diseases-for-oncology	International Classification of Diseases for Oncology, 3rd Edition Note ICD-O-3 version 3.2 is described at http://www.iacr.com.fr/index.php?option=com_content&view=article&id=149.
IBSI	1.2.840.10008.2.16.13	Image Biomarker Standardisation Initiative		DOC: http://arxiv.org/abs/1612.07003
IETF4646		RFC 4646	IETF	DOC: http://tools.ietf.org/html/rfc4646	[RFC 4646], Tags for Identifying Languages, The Internet Society (2005) [RFC 4646] has been superceded by [RFC 5646].
ISO639_1	2.16.840.1.113883.6.99	ISO 639-1	ISO		[ISO 639-1] Two-letter language codes Note HL7 uses "ISO639-1" for the symbolic name, with a hyphen rather than an underscore
ISO639_2	2.16.840.1.113883.6.100	ISO 639-2	ISO		[ISO 639-2] Three-letter language codes Note HL7 uses "ISO639-2" for the symbolic name, with a hyphen rather than an underscore
ISO3166_1	2.16.1	ISO 3166-1	ISO		[ISO 3166-1] alpha-2 Country Codes Note HL7 uses "ISO3166-1" for the symbolic name, with a hyphen rather than an underscore
ISO5218_1		ISO 5218-1	ISO		Representation of Human Sexes (not used) ISO5218_1, which uses numeric codes, was improperly specified in CID 7455 Sex in earlier editions of the Standard. The alphabetic codes improperly attributed to that coding scheme have been added to the DICOM Controlled Terminology, and thus all references to coding scheme ISO5218_1 should be considered equivalent to coding scheme DCM.
ISO_OID		ISO OID	ISO		[ISO 8824-1] ISO/IEC 8824-1- Information Technology - Abstract Syntax 1 (ASN.1): Specification of Basic Notation, and [ISO 9834-1] - Information technology - Open Systems Interconnection - Procedures for the operation of OSI Registration Authorities: General procedures and top arcs of the ASN.1 Object Identifier tree
ITIS_TSN	1.2.840.10008.2.16.7	ITIS TSN	ITIS	DOC: http://www.itis.gov	A Taxonomic Serial Number (TSN) is a unique, persistent, non-intelligent identifier for a scientific name in the context of the Integrated Taxonomic Information System (ITIS).
LN	2.16.840.1.113883.6.1	LOINC	Regenstrief Institute	DOC: http://loinc.org/ FHIR: http://loinc.org	[LOINC] Logical Observation Identifier Names and Codes
MA	1.2.840.10008.2.16.5	Adult Mouse Anatomy Ontology	The Jackson Laboratory	DOC: http://www.informatics.jax.org/searches/AMA.cgi?id=MA:0002405	Hayamizu TF, Mangan M, Corradi JP, Kadin JA, Ringwald M. The Adult Mouse Anatomical Dictionary: a tool for annotating and integrating data. Genome Biology 2005;6(3):R29. doi:10.1186/gb-2005-6-3-r29. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1088948/
MAYOASRG	1.2.840.10008.2.16.12	Mayo Clinic Non-radiological Images Specific Body Structure Anatomical Surface Region Guide			The numeric code of entries in the Mayo Clinic Non-radiological Images Specific Body Structure Anatomical Surface Region Guide.
MDC	2.16.840.1.113883.6.24				ISO/IEEE 11073 Medical Device Nomenclature, including all its subsections ([ISO/IEEE 11073-10101], [ISO/IEEE 11073-10101a], [ISO/IEEE 11073-10102], etc.), encoded as decimal strings <partition>:<element>
MDNS					Universal Medical Device (UMD) Nomenclature System
MGI	1.2.840.10008.2.16.8	MGI	The Jackson Laboratory	DOC: http://www.informatics.jax.org/mgihome/nomen/	The MGI ID from the Mouse Genome Initiative (MGI) nomenclature.
MSH	2.16.840.1.113883.6.177	MeSH	NLM	DOC: http://www.nlm.nih.gov/mesh/meshhome.html	US National Library of Medicine (NLM) Medical Subject Headings (MeSH)
NBD	2.16.840.1.113883.15.2				NASPE/BPEG Defibrillator Code Bernstein AD, et al."The NASPE/BPEG Defibrillator Code" PACE, 16:1776-1780, 1993
NBG	2.16.840.1.113883.15.3			DOC: http://www.hrsonline.org/Practice-Guidance/Clinical-Guidelines-Documents/2002-The-Revised-NASPE-BPEG-Generic-Code-for-Antibradycardia-AdaptiveRate-and-Multisite-Pacing	NASPE/BPEG Generic Pacemaker Code (2000) Bernstein AD, et al."The Revised NASPE/BPEG Generic Code for antibradycardia, adaptive-rate, and multisite pacing." Pacing Clin Electrophysiol., 25:260-264, 2002 See http://www.hrsonline.org/Practice-Guidance/Clinical-Guidelines-Documents/2002-The-Revised-NASPE-BPEG-Generic-Code-for-Antibradycardia-AdaptiveRate-and-Multisite-Pacing.
NCDR					American College of Cardiology National Cardiovascular Data Registry™ Cath Lab Module Version 1.1, 1997; Version 2.0b, 1999
NCIt	2.16.840.1.113883.3.26.1.1	NCI Thesaurus	NCI	DOC: http://ncit.nci.nih.gov/
NDC	2.16.840.1.113883.6.69	National Drug Code Directory	US FDA	DOC: http://www.fda.gov/Drugs/InformationOnDrugs/ucm142438.htm DOC: http://www.hl7.org/fhir/ndc.html	The Code Value is the 10 digit 3 segment NDC code with "-" between segments included and no asterisk (leading zero placeholder).
NEU	2.16.840.1.113883.6.210	NeuroNames		DOC: http://braininfo.rprc.washington.edu/aboutBrainInfo.aspx#NeuroNames	The numeric brainInfoID is used as the Code Value. See
NICIP	2.16.840.1.113883.2.1.3.2.4.21	NICIP	UK NHS	DOC: http://digital.nhs.uk/article/1108/National-Interim-Clinical-Imaging-Procedure-NICIP-Code-Set	UK National Health Service National Interim Clinical Imaging Procedures (NICIP) Short Code (e.g., "CCHAPC" for CT Thorax abdomen pelvis with contrast)
NPI					HCFA National Provider Identifier
NYUMCCG	1.2.840.10008.2.16.11	New York University Melanoma Clinical Cooperative Group		DOC: http://www.anatomymapper.com/nyu/	The numeric code of entries in the New York University Melanoma Clinical Cooperative Group's numbering system.
PATHLEX	1.3.6.1.4.1.19376.1.8.2.1	PathLex	IHE	DOC: http://www.ihe.net/Technical_Framework/upload/IHE_PAT_Suppl_APSR_Appendix_Value_Sets_2011_03_31.xls DOC: http://purl.bioontology.org/ontology/PATHLEX	The numeric pathLexCode is used as the Code Value.
POS	2.16.840.1.113883.6.50				HCFA Place of Service (POS) Codes for Professional Claims
PUBCHEM_CID	1.2.840.10008.2.16.9	PubChem	NCBI	DOC: http://pubchem.ncbi.nlm.nih.gov/	US National Center for Biotechnology Information (NCBI) PubChem Compound CID.
RADLEX	2.16.840.1.113883.6.256	RadLex	RSNA	DOC: http://www.radlex.org/ FHIR: http://www.radlex.org	[RadLex]
RADELEMENT	1.2.840.10008.2.16.15	RadElement	RSNA	DOC: http://radelement.org/	[RadElement]
RFC3066	2.16.840.1.113883.6.121	RFC 3066	IETF	DOC: http://tools.ietf.org/html/rfc3066	[RFC 3066], Tags for the Identification of Languages, Internet Engineering Task Force Note HL7 uses "IETF3066" for the symbolic name. [RFC 3066] has been superseded by [RFC 4646], which in turn has been superceded by [RFC 5646].
RFC-3881		RFC 3881	IETF	DOC: http://tools.ietf.org/html/rfc3881	[RFC 3881], Security Audit and Access Accountability Message - XML Data Definitions for Healthcare Applications Note A hyphen is used in the Coding Scheme Designator for consistency with historical use in IHE. See IHE ITI TF Vol2a. Section 3.20.7.1.3.
RFC5646	2.16.840.1.113883.6.316	RFC 5646	IETF	DOC: http://tools.ietf.org/html/rfc5646	[RFC 5646], Tags for Identifying Languages, The Internet Society (2009) Note The HL7 OID Registry specifies "rfc5646", not "ietf5646", as the Desired Symbolic Name (inconsistent with the pattern used for [RFC 4646]). [RFC 5646] constitutes one part of IETF Best Current Practice BCP 47 Tags for Identifying Languages, which also includes [RFC 4647] Matching of Language Tags; [RFC 4647] is not relevant in this context.
RO	1.2.840.10008.2.16.14	Radiomics Ontology		DOC: http://bioportal.bioontology.org/ontologies/RO
RRID	1.2.840.10008.2.16.18	RRID	Resource Identification Portal Community	DOC: http://www.rrids.org/	Research Resource Identification
RXNORM	2.16.840.1.113883.6.88	RXNORM	NLM	DOC: http://www.nlm.nih.gov/research/umls/rxnorm/ FHIR: http://www.nlm.nih.gov/research/umls/rxnorm	RxNorm provides normalized names for clinical drugs and links its names to many of the drug vocabularies commonly used in pharmacy management and drug interaction software.
99SDM	2.16.840.1.113883.6.53	SDM	DICOM		SNOMED DICOM Microglossary (Retired) (see Section 8.1)
SCPECG					Standard Communications Protocol for Computer-Assisted Electrocardiography, Draft proposal for ISO Standard, AAMI, Revision 1.3
SNM3	2.16.840.1.113883.6.51	SNOMED V3	SNOMED International	DOC: http://www.snomed.org/	SNOMED International Version 3 (see Section 8.1) Note This coding scheme is deprecated. The use of "SNOMED-RT style" Code Values is no longer authorized by SNOMED except for creation by legacy devices, legacy objects in archives, and receiving systems that need to understand them.
SCT	2.16.840.1.113883.6.96	SNOMED CT	SNOMED International	DOC: http://www.snomed.org/ FHIR: http://snomed.info/sct	[SNOMED], using the CT Code Values
SRT	2.16.840.1.113883.6.96	SNOMED CT	SNOMED International	DOC: http://www.snomed.org/	[SNOMED], using the "SNOMED-RT style" Code Values (see Section 8.1) Note HL7 uses "SNM" for the symbolic name. This coding scheme is deprecated. The use of "SNOMED-RT style" Code Values is no longer authorized by SNOMED except for creation by legacy devices, legacy objects in archives, and receiving systems that need to understand them.
UBERON	1.2.840.10008.2.16.6	UBERON		DOC: http://uberon.org/	The Uberon ID from the Uberon integrated cross-species ontology covering anatomical structures in animals.
UCUM	2.16.840.1.113883.6.8	UCUM	Regenstrief Institute	DOC: http://unitsofmeasure.org/ucum.html FHIR: http://unitsofmeasure.org	[UCUM] Unified Code for Units of Measure
UMLS	2.16.840.1.113883.6.86	UMLS	NLM	DOC: http://www.nlm.nih.gov/research/umls/	UMLS codes as CUIs making up the values in a coding system
UNS	1.2.840.10008.2.16.17	UNS	SAE International		Unified numbering system (UNS) for metals and alloys [J1086_201210]
UPC	2.16.840.1.113883.6.55				Universal Product Code - Universal Code Council

Table 8-2. HL7v3 Coding Schemes

Coding Scheme Designator	Coding Scheme UID	Description
ActCode	2.16.840.1.113883.5.4
ActPriority	2.16.840.1.113883.5.7
AdministrativeGender	2.16.840.1.113883.5.1
mediaType	2.16.840.1.113883.5.79	RFC2046
NullFlavor	2.16.840.1.113883.5.1008
ObservationInterpretation	2.16.840.1.113883.5.83
Confidentiality	2.16.840.1.113883.5.25
ParticipationType	2.16.840.1.113883.5.90

8.1 SNOMED CT

SNOMED (the Systematized Nomenclature of Medicine) Clinical Terms (CT) is the preferred coding system within DICOM for anatomy, clinical findings, procedures, pharmaceutical/biologic products (including contrast agents), and other clinical terms.

SNOMED has had various versions, including SNOMED International (Version 3), which was issued in 1993 and revised through 1998, SNOMED Reference Terminology, the successor to SNOMED 3 that was published between 1999 and 2001, and SNOMED Clinical Terms, which has been the name since 2002. The coding scheme is fully backward-compatible across SNOMED 3, SNOMED-RT, and SNOMED CT. SNOMED CT introduced a solely numeric set of codes (ConceptID) in addition to the former alphanumeric codes (SnomedID), but all SNOMED terminology concepts have both a numeric and an alphanumeric code.

In previous releases of the DICOM Standard, the following Coding Scheme Designators were used for SNOMED codes in DICOM:

"99SDM", denoting the provisional SNOMED DICOM Microglossary
"SNM3", denoting SNOMED International (Version 3)
"SRT", originally denoting SNOMED-RT, but later used to identify SNOMED CT concepts using "SNOMED-RT style" alphanumeric Code Values

All uses of SNOMED CT coded terms in DICOM are now indicated by the Coding Scheme Designator "SCT", identifying them as SNOMED CT numeric Concept IDs as Code Values.

When a Coding Scheme Designator of "99SDM", "SNM3" or "SRT" is encountered by a receiving system, the "SNOMED-RT style" alphanumeric Code Value needs to be mapped to the corresponding concept designated by the SNOMED CT Concept IDs assigned to the same concept.

Note

"SRT" as a coding scheme designator was used only in the DICOM Standard. HL7v2 did not standardize a coding scheme designator for SNOMED-RT.

When interoperating with systems that use SNOMED CT codes, Application Entities may receive and are expected to send Code Sequences with a numeric ConceptID code. It is the responsibility of such Application Entities to convert any alphanumeric SnomedID with Coding Scheme Designator "SRT" used in old DICOM objects and services to the corresponding numeric ConceptID code.

Note

Some non-DICOM systems may use a Coding Scheme Designator of "SNOMED-CT" rather than "SCT" as is used in DICOM.
The SNOMED organization's policy on the use of "antecedent versions", including the continued use of "SNOMED-RT style" alphanumeric Code Values is described at: http://www.snomed.org/news-articles/timetable-for-the-withdrawal-of-legacy-snomed-codes.
Since the SNOMED organization no longer distributes a reference set that includes a mapping of "SNOMED-RT style" SNOMED IDs to SNOMED Concept IDs a complete mapping of those used in DICOM is provided in Annex O to allow implementers to process legacy objects from legacy devices and archives.

8.1.1 Use of SNOMED Anatomic Concepts

In general, DICOM uses the anatomic concepts with the term "structure", rather than with the term "entire". This is an important distinction in SNOMED. "Entire" is a child concept to "structure", has a more restricted meaning, and typically is used in conjunction with treatments (e.g., "excision of entire right kidney"). It is used in distinction to other sibling children of the parent concept that may identify parts of the parent anatomic feature. Since imaging typically targets both the anatomic feature and the area around it, or sometimes just part of the anatomic feature, DICOM usually uses "structure" concepts that are more inclusive than the "entire" concepts.

8.2 ISO_OID

[ISO 8824-1] and [ISO 9834-1] are the standards defined for the generation of object identifiers that are used as DICOM Unique Identifiers (see PS3.5), can also serve as a general mechanism for identifying organizations and objects defined by those organizations.

When the Coding Scheme Designator is ISO_OID, the Code Value shall be the numeric (dot delimited) form of a valid object identifier.

A repository of known existing object identifiers can be found at http://www.oid-info.com/index.htm. For example:

the ISO 9834-1 assigned numeric object identifier for the country France, is "1.0.3166.2.2.1.250" (since ISO 3166 defines a means for maintaining country codes using object identifiers)
the object identifier for the RIPEMD-160 cryptographic hash function is "1.0.10118.3.0.49"
the object identifier for the HL7 V2 table of codes for marital status is "2.16.840.1.113883.12.2"

The re-use of object identifiers for existing concepts that do not have an alternative more appropriate coding scheme compatible with DICOM provides a mechanism to avoid defining new codes. For example, HL7 assigned object identifiers can be found at http://www.hl7.org/oid/index.cfm.

Though the intent of ISO_OID is to define organizational roots for the hierarchical assignment of object identifiers, and not specifically to identify organizations per se, the organizational root values can be construed as identifying the organization. For example, the DICOM Standards Organization itself can be identified by the value "1.2.840.10008". See also CID 5002 “Organization”.

8.3 Retired Codes and Expected Behavior

As this Standard and external coding schemes are maintained, the codes specified as Concept Names, Concept Values and in Conditions may change. The previous codes are considered Retired but implementations may continue to send them and receivers will be expected to be able to continue to recognize the Retired codes, including the Code Value and Coding Scheme Designator, even if the current Standard does not publish them.

A notable example is the change throughout the Standard from using "SNOMED-RT style" Code Values with a Coding Scheme Designator of "SRT", "SNM3" or "99SDM", to the use of SNOMED CT numeric Code Values with a Coding Scheme Designator of "SCT". A mapping of retired to new SNOMED codes is found in Annex O.

A Structured Reporting Templates (Normative)

This Annex specifies the content of Standard Templates that may be used by DICOM SR IODs.

General Templates

TID 300 Measurement

This Template provides a general structure for a numeric measurement, together with evaluations of its normality and/or significance, and the inference source(s) for its value. This structure is instantiated by inclusion of this Template with specific contextual parameters from a parent Template.

Table TID 300. Parameters

Parameter Name	Parameter Usage
$Measurement	Coded term or Context Group for Concept Name of measurement
$Units	Measurement Unit
$ModType	Modifier Name for Concept Name of measurement
$ModValue	Modifier Value for Concept Name of measurement
$Method	Value for Measurement Method
$Derivation	Value for Measurement Derivation
$TargetSite	Value(s) for Anatomic Location of measurement
$TargetSiteLaterality	Laterality Value for Anatomic Location of measurement
$TargetSiteMod	Modifier Value for Anatomic Location of measurement
$Equation	Coded term or Context Group for the equation or table from which the measurement was derived or computed
$ImagePurpose	Purpose of Reference for an image used as a source of the measurement
$WavePurpose	Purpose of Reference for a waveform used as a source of the measurement
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement
$DerivationParameter	Coded term or Context Group for Concept Name of a derivation parameter
$DerivationParameterUnits	Units of derivation parameter
$PrecoordinatedMeasurementMeaning	Coded value for the precoordinated concept name of measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 300. Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			NUM	$Measurement	1	M		UNITS = $Units
2	>	HAS CONCEPT MOD	CODE	$ModType	1-n	U		$ModValue
3	>	HAS CONCEPT MOD	CODE	EV (370129005, SCT, "Measurement Method")	1	U		$Method
4	>	HAS CONCEPT MOD	CODE	EV (121401, DCM, "Derivation")	1	U		$Derivation
5	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1-n	U		$TargetSite
6	>>	HAS CONCEPT MOD	CODE	EV (272741003, SCT, "Laterality")	1	U		$TargetSiteLaterality Defaults to DCID 244 “Laterality”
7	>>	HAS CONCEPT MOD	CODE	DT (106233006, SCT, "Topographical modifier")	1	U		$TargetSiteMod
8	>	HAS PROPERTIES	INCLUDE	DTID 310 “Measurement Properties”	1	U		$RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority
9	>	INFERRED FROM	NUM	$DerivationParameter	1-n	UC	XOR Row 10	UNITS = $DerivationParameterUnits
10	>	R-INFERRED FROM	NUM	$DerivationParameter	1-n	UC	XOR Row 9	UNITS = $DerivationParameterUnits
11	>	INFERRED FROM	INCLUDE	DTID 315 “Equation or Table”	1	UC	XOR Row 12	$Equation = $Equation
12	>	INFERRED FROM	TEXT	DCID 228 “Equation or Table”	1	UC	XOR Row 11
13	>		INCLUDE	DTID 320 “Image or Spatial Coordinates”	1-n	U		$Purpose = $ImagePurpose
14	>		INCLUDE	DTID 321 “Waveform or Temporal Coordinates”	1-n	U		$Purpose = $WavePurpose
15	>		INCLUDE	DTID 1000 “Quotation”	1	U
16	>	HAS CONCEPT MOD	TEXT	EV (121050, DCM, "Equivalent Meaning of Concept Name")	1	U
16b	>	HAS CONCEPT MOD	CODE	EV (121050, DCM, "Equivalent Meaning of Concept Name")	1	U		$PrecoordinatedMeasurementMeaning
17	>	HAS OBS CONTEXT	INCLUDE	DTID 4108 “Tracking Identifier”	1	U
18	>	INFERRED FROM	COMPOSITE	EV (126100, DCM, "Real World Value Map used for measurement")	1	U		SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")
19	>	HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U

Content Item Descriptions

Rows 2, 3, 4, 5	The HAS CONCEPT MOD items allow the explicit definition of terms for post-coordination of the measurement concept name. Additional post-coordinated modifier terms may be included in a SOP Instance based on this Template, in accordance with section 6.2.4, or as defined by Templates that invoke this Template and explicitly define additional post-coordinated modifiers (e.g., TID 5203).
Row 5	Finding site may be multiple when a region of interest spans multiple anatomical locations and there is not a single pre-coordinated code describing the combination of locations. E.g., when a maligant, inflammatory or traumatic process spans actual or defined anatomical boundaries. There is no requirement that the multiple locations be contiguous.
Rows 9, 10	The INFERRED FROM items allow the specification (by-value or by-reference) of numeric values that were used in the derivation of the numeric measurement of Row 1. The nature of the inference is not explicitly conveyed; it may be implicit in the Concept Names of the measurements. Inference by-reference is valid only in SOP Classes that permit the INFERRED FROM relationship by-reference.
Row 13	Multiple SCOORD Content Items may be necessary to describe the source of the measurement. E.g., the measurement of an angle between two non-intersecting line segments requires two separate POLYLINE SCOORD Content Items with the concept name of (121223, DCM, "Arm of angle") conveyed in $Purpose.
Rows 13, 14	(260753009, SCT, "Source") may be specified for $ImagePurpose or $WavePurpose as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.
Rows 16, 16b	Equivalent Meaning of Concept Name allows the creating application to specify the preferred composed concept name representing the measurement and the associated post-coordinated concept modifiers. The concept modifiers may include those specified in this Template, in a Template that invokes this Template, or at the option of the creating application in accordance with Section 6.2.4. This composed concept name may be rendered by a display application. It may be supplied as text or coded concept or both.
Row 18	Row 18 is a reference to an RWV that describes how measurements were made in units that differ from the stored pixel values in the images referenced in Row 13. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference overrides any reference in an including Template (such as for a Measurement Group).

TID 310 Measurement Properties

This Template provides the properties of a numeric measurement, including evaluations of its normality and/or significance, its relationship to a reference population, and an indication of its selection from a set of measurements.

Table TID 310. Parameters

Parameter Name	Parameter Usage
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 310. Measurement Properties

	VT	Concept Name	VM	Req Type	Value Set Constraint
1	CODE	EV (121402, DCM, "Normality")	1	U	DCID 222 “Normality”
2	INCLUDE	DTID 311 “Measurement Statistical Properties”	1	U	$RefAuthority = $RefAuthority
3	INCLUDE	DTID 312 “Normal Range Properties”	1	U	$RangeAuthority = $RangeAuthority
4	CODE	EV (121403, DCM, "Level of Significance")	1	U	DCID 220 “Significance Level”
5	NUM	DCID 225 “Measurement Uncertainty Concept”	1-n	U
6	CODE	EV (121404, DCM, "Selection Status")	1	U	DCID 224 “Selection Method”

TID 311 Measurement Statistical Properties

This Template provides the statistical properties of a reference population for a numeric measurement, and/or the position of a measurement in such a reference population.

Table TID 311. Parameters

Parameter Name	Parameter Usage
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population

Type:: Extensible
Order:: Significant
Root:: No

Table TID 311. Measurement Statistical Properties

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	NUM	DCID 221 “Measurement Range Concept”	1-n	M
2	TEXT	EV (121405, DCM, "Population description")	1	U
3	TEXT	EV (121406, DCM, "Reference Authority")	1	UC	XOR Row 4
4	CODE	EV (121406, DCM, "Reference Authority")	1	UC	XOR Row 3	$RefAuthority

TID 312 Normal Range Properties

This Template provides the normal range of values for a numeric measurement.

Table TID 312. Parameters

Parameter Name	Parameter Usage
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 312. Normal Range Properties

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	NUM	DCID 223 “Normal Range Value”	1-n	M
2	TEXT	EV (121407, DCM, "Normal Range description")	1	U
3	TEXT	EV (121408, DCM, "Normal Range Authority")	1	UC	XOR Row 4
4	CODE	EV (121408, DCM, "Normal Range Authority")	1	UC	XOR Row 3	$RangeAuthority

TID 315 Equation or Table

Table TID 315. Parameters

Parameter Name	Parameter Usage
$Equation	Coded term or Context Group for the equation or table from which a measurement was derived or computed

Type:: Extensible
Order:: Significant
Root:: No

Table TID 315. Equation or Table

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	DCID 228 “Equation or Table”	1	M	$Equation
2	>	HAS PROPERTIES	NUM		1-n	U
3	>	R-HAS PROPERTIES	NUM		1-n	U

Content Item Descriptions

Row 2	The HAS PROPERTIES allows the specification of the numeric values used as input to the equation or table identified in Row 1.
Row 3	The HAS PROPERTIES allows the specification by-reference of the numeric values used as input to the equation or table. This row is valid only in SOP Classes that permit the HAS PROPERTIES relationship by-reference.

Note

For example, if Row 1 identifies a specific Body Surface Area equation, Rows 2 and 3 can be used to convey (by-value or by-reference) the Patient Height and Patient Weight numeric measurements used in the BSA computation.

TID 320 Image or Spatial Coordinates

This Template provides a general structure for inference from an image, either as a whole, or with specific 2D or 3D spatial coordinates, as a single included Template in the invoking Template. If allowed by the IOD, the Image Content Item may be included by-reference.

Table TID 320. Parameters

Parameter Name	Parameter Usage
$Purpose	Purpose of Reference for an image used as a source of the measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 320. Image or Spatial Coordinates

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition
1		INFERRED FROM	IMAGE	$Purpose	1	MC	XOR Rows 2, 3, 6
2		R-INFERRED FROM	IMAGE		1	MC	XOR Rows 1, 3, 6
3		INFERRED FROM	SCOORD	$Purpose	1	MC	XOR Rows 1, 2, 6
4	>	SELECTED FROM	IMAGE		1	MC	XOR Row 5
5	>	R-SELECTED FROM	IMAGE		1	MC	XOR Row 4
6		INFERRED FROM	SCOORD3D	$Purpose	1	MC	XOR Rows 1, 2, 3

Content Item Descriptions

Rows 1, 2, 3, 4, 5, 6

(260753009, SCT, "Source") may be be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.

TID 321 Waveform or Temporal Coordinates

This Template provides a general structure for referencing a waveform, either as a whole, or with specific temporal coordinates, as a single included Template in the invoking Template. If allowed by the IOD, the Waveform Content Item may be included by-reference.

Table TID 321. Parameters

Parameter Name	Parameter Usage
$Purpose	Purpose of Reference for a waveform used as a source of the measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 321. Waveform or Temporal Coordinates

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition
1		INFERRED FROM	WAVEFORM	$Purpose	1	MC	XOR Rows 2, 3
2		R-INFERRED FROM	WAVEFORM		1	MC	XOR Rows 1, 3
3		INFERRED FROM	TCOORD	$Purpose	1	MC	XOR Rows 1, 2
4	>	SELECTED FROM	WAVEFORM		1	MC	XOR Row 5
5	>	R-SELECTED FROM	WAVEFORM		1	MC	XOR Row 4

Content Item Descriptions

Rows 1, 2, 3, 4, 5

(260753009, SCT, "Source") may be be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.

TID 350 References to Supporting Evidence

This Template provides references to supporting evidence in the form of DICOM composite objects. This includes references to images, spatial coordinates on images, and other composite objects, such as Structured Reports.

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 350. References to Supporting Evidence

	NL	Rel with Parent	VT	Concept Name	VM	Req Type
1			IMAGE	BCID 7003 “Diagnostic Imaging Report Purpose of Reference”	1-n	U
2			SCOORD	BCID 7003 “Diagnostic Imaging Report Purpose of Reference”	1-n	U
3	>	SELECTED FROM	IMAGE		1	M
4			COMPOSITE	DT (122073, DCM, "Current procedure evidence")	1-n	U
5	>	HAS CONCEPT MOD	CODE	EV (121144, DCM, "Document Title")	1	U

TID 351 Previous Reports

This general Template provides a means to reference previous structured reporting composite object instances.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 351. Previous Reports

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (111549, DCM, "Previous Reports")	1	M
2	>	CONTAINS	COMPOSITE		1-n	M

Content Item Descriptions

Row 2

Concept Name may be the Root Concept Name (title) of a Structured Report composite object instance.

TID 400 Reference Location

This TID is a subset of the Reference Location Macro. See Section 10.27 “Reference Location Macro” in PS3.3 .

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 400. Reference Location

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	EV (128772, DCM, "Reference Basis")	1	M		BCID 1001 “Anatomical Reference Basis”
2			CODE	EV (128773, DCM, "Reference Geometry")	1	M		BCID 1010 “Reference Geometry - Plane”

TID 1000 Quotation

Unless otherwise specified, content in an SR tree is "directly" observed. When material is quoted (from a source that is either a document or something spoken), then it is necessary to specify:

the fact that one is quoting
who is doing the quoting
the source of the quote
who is being quoted, and who and what the quote is about

This Template establishes a mechanism for quoting by specifying:

the fact that one is quoting, by the presence of the contents of the Template in the tree
that the "observer context" above the invocation of this Template establishes who is doing the quoting
the source of the quote, by the values of the Content Items in this Template
who is being quoted, and who and what the quote is about, by the observation context that is established at the start of the quoted material

This Template may be invoked recursively, to nest quotes within quotes. In essence, the chain of who is quoting whom can be established by maintaining a "stack" of observer context.

If a dimension of observation context is the same in the quoted material as in the enclosing tree, then the observation context does not need to be respecified (e.g., the quote may be about the same subject or procedure). Typically, the observer context would change (unless one were quoting oneself).

In the case of quoting something that was spoken, the "observer" is the person speaking.

TID 1000 is attached using HAS OBS CONTEXT relationships to the top node of the material that is being quoted. The presence of the Quoted Source concept signals the fact that the material is quoted rather than directly observed.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1000. Quotation

	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	HAS OBS CONTEXT	CODE	EV (121001, DCM, "Quotation Mode")	1	M		EV (121003, DCM, "Document") EV (121004, DCM, "Verbal")
2	HAS OBS CONTEXT	COMPOSITE	EV (121002, DCM, "Quoted Source")	1	MC	Required if quoted material source is a DICOM composite object
3	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	M

Rel with Parent

Concept Name

Req Type

Condition

Value Set Constraint

HAS OBS CONTEXT

CODE

EV (121001, DCM, "Quotation Mode")

EV (121003, DCM, "Document")

EV (121004, DCM, "Verbal")

HAS OBS CONTEXT

COMPOSITE

EV (121002, DCM, "Quoted Source")

Required if quoted material source is a DICOM composite object

HAS OBS CONTEXT

INCLUDE

DTID 1001 “Observation Context”

TID 1001 Observation Context

Specifies attributes of observation context that may be defined, extended or replaced at any location in the SR tree.

This includes attributes that specify:

who or what the observation is about ("subject context")
what procedure the observation is about ("procedure study context")
who or what is making the observation ("observer context")

Establishing context includes two aspects of each dimension: identification and description (e.g., patient name and ID vs. patient's age, height or weight).

Whenever one dimension of context is changed or an attribute is added, all attributes of that dimension of context are "flushed", that is they need to be repeated in their entirety. For example, when the subject is changed from patient (name, id) to fetus (number), then the parameters of the patient are discarded. E.g., the patient's ID does not apply to the fetus.

"Extending" the same class and dimension of observation context isn't feasible, since one cannot "null out" or remove a previously set attribute. Any time a dimension of observation context is "replaced", any attributes that are unspecified remain unspecified (i.e., they are not inherited).

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 1001. Observation Context

	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	HAS OBS CONTEXT	INCLUDE	DTID 1002 “Observer Context”	1-n	MC	Required if all aspects of observer context are not inherited.	Defaults to the Attributes of the Author Observer Sequence (0040,A078), or the Verifying Observer Sequence (0040,A073) if the Author Observer Sequence is not present
2	HAS OBS CONTEXT	INCLUDE	DTID 1005 “Procedure Study Context”	1	MC	Required if all aspects of procedure context are not inherited.
3	HAS OBS CONTEXT	INCLUDE	DTID 1006 “Subject Context”	1	MC	Required if all aspects of observation subject context are not inherited.

TID 1002 Observer Context

The observer (person or device) that created the Content Items to which this context applies.

Whenever this Template is invoked, all previously inherited attributes of Observer Context are discarded and replaced.

There may be more than one observer, as this Template may be invoked with a VM 1-n, and both person and device observers. In such a case, the Content Items of TID 1003 “Person Observer Identifying Attributes” and TID 1004 “Device Observer Identifying Attributes” shall be included in the order in which the values of Observer Type are specified. Since TID 1003 “Person Observer Identifying Attributes” and TID 1004 “Device Observer Identifying Attributes” both include a single mandatory Content Item as their first Content Item, which observer is being described can be determined

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 1002. Observer Context

	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	HAS OBS CONTEXT	CODE	EV (121005, DCM, "Observer Type")	1	MC	IF Observer type is device	DCID 270 “Observer Type” Defaults to (121006, DCM, "Person")
2	HAS OBS CONTEXT	INCLUDE	DTID 1003 “Person Observer Identifying Attributes”	1	MC	IFF Row 1 value = (121006, DCM, "Person") or Row 1 is absent
3	HAS OBS CONTEXT	INCLUDE	DTID 1004 “Device Observer Identifying Attributes”	1	MC	IFF Row 1 value = (121007, DCM, "Device")
4	HAS OBS CONTEXT	INCLUDE	DTID 1015 “Person Observer Description”	1	U

TID 1003 Person Observer Identifying Attributes

This Template contains identifying (and optionally descriptive) attributes of persons that are observers.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1003. Person Observer Identifying Attributes

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			PNAME	EV (121008, DCM, "Person Observer Name")	1	M
1a			TEXT	EV (128774, DCM, "Person Observer's Login Name")	1	U
2			TEXT	EV (121009, DCM, "Person Observer's Organization Name")	1	U	Defaults to Value of Institution Name (0008,0080) of the General Equipment Module
3			CODE	EV (121010, DCM, "Person Observer's Role in the Organization")	1	U	BCID 7452 “Organizational Role”
4			CODE	EV (121011, DCM, "Person Observer's Role in this Procedure")	1	U	BCID 7453 “Performing Role”
5	>	HAS CONCEPT MOD	TEXT	EV (128775, DCM, "Identifier within Person Observer's Role")	1	U

Row 5

E.g., "1" or "2", or "A" or "B"; should not recapitulate the role (i.e., should not be "READER1"), since it is used in conjunction with a separate coded concept for the role itself.

TID 1004 Device Observer Identifying Attributes

This Template (derived from the Section C.7.5.1 “General Equipment Module” in PS3.3 ) contains identifying (and optionally descriptive) attributes of devices that are observers.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1004. Device Observer Identifying Attributes

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			UIDREF	EV (121012, DCM, "Device Observer UID")	1	M	Defaults to Value of Device UID (0018,1002) of the General Equipment Module
2			TEXT	EV (121013, DCM, "Device Observer Name")	1	U	Defaults to Value of Station Name (0008,1010) of the General Equipment Module
3			TEXT	EV (121014, DCM, "Device Observer Manufacturer")	1	U	Defaults to Value of Manufacturer (0008,0070) of the General Equipment Module
4			TEXT	EV (121015, DCM, "Device Observer Model Name")	1	U	Defaults to Value of Manufacturer's Model Name (0008,1090) of the General Equipment Module
5			TEXT	EV (121016, DCM, "Device Observer Serial Number")	1	U	Defaults to Value of Device Serial Number (0018,1000) of the General Equipment Module
6			TEXT	EV (121017, DCM, "Device Observer Physical Location During Observation")	1	U
7			CODE	EV (113876, DCM, "Device Role in Procedure")	1-n	U	BCID 7445 “Device Participating Role”
8			TEXT	EV (110119, DCM, "Station AE Title")	1	U
9			UIDREF	EV (121061, DCM, "Device Observer Manufacturer Class UID")	1-n	U	Defaults to Value of Manufacturer's Device Class UID (0018,100B) of the General Equipment Module.
10			CONTAINER	EV (121000, DCM, "Unique Device Identifiers")	1-n	U	Defaults to Value of UDI Sequence (0018,100A) of the General Equipment Module
11	>	CONTAINS	TEXT	EV (74711-3, LN, "Unique Device Identifier")	1	M
12	>	CONTAINS	TEXT	EV (120999, DCM, "Device Description")	1	U

Content Item Descriptions

Row 7	If the device performing the observations has other roles, e.g., as the irradiating device in a dose report, this may be recorded here, if not implicit.
Rows 11, 12	The description can be used to distinguish between multiple UDIs.

TID 1005 Procedure Study Context

This Template contains identifying (and optionally descriptive) attributes of the procedure that is the source of evidence being interpreted.

Whenever this Template is invoked, all previously inherited attributes of Procedure Study Context are discarded and replaced.

Note

If an observed digital image is identified by other than a DICOM UID, a Study Instance UID must be generated for the non-DICOM evidence. The same must be done to document interpretation of hard-copy radiographs generated outside of the scope of the DICOM system.

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 1005. Procedure Study Context

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			UIDREF	EV (121018, DCM, "Procedure Study Instance UID")	1	U	Defaults to Value of Study Instance UID (0020, 000D) of the General Study Module
2			UIDREF	EV (121019, DCM, "Procedure Study Component UID")	1-n	U
3			TEXT	EV (121020, DCM, "Placer Number")	1	U
4	>	HAS CONCEPT MOD	TEXT	EV (110190, DCM, "Issuer of Identifier")	1	U
5			TEXT	EV (121021, DCM, "Filler Number")	1	U
6	>	HAS CONCEPT MOD	TEXT	EV (110190, DCM, "Issuer of Identifier")	1	U
7			TEXT	EV (121022, DCM, "Accession Number")	1	U	Defaults to Value of Accession Number (0008,0050) of the General Study Module
8	>	HAS CONCEPT MOD	TEXT	EV (110190, DCM, "Issuer of Identifier")	1	U
9			CODE	EV (121023, DCM, "Procedure Code")	1-n	U	Defaults to Value of Procedure Code Sequence (0008,1032) of the General Study Module

Content Item Descriptions

Rows 5, 6

The issuer shall be formatted in accordance with the HL7v2 Hierarchic Designator Data Type. That format is [ Namespace ID]^[ Universal ID^ Universal ID Type], where Namespace IDidentifies an entity within the local namespace or domain, Universal IDis a universal or unique identifier for an entity, and Universal ID Typespecifies the standard format of the Universal ID (see HL7 v2 Section 2.A.33).

TID 1006 Subject Context

This Template contains identifying (and optionally descriptive) attributes of the subject of the observation.

Subject context identifies (and optionally) describes the subject of the observation, whether it be a patient (human or animal), a fetus (human or animal), a specimen, or a device.

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 1006. Subject Context

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	CODE	EV (121024, DCM, "Subject Class")	1	MC	IF subject is not the Patient	DCID 271 “Observation Subject Class” Defaults to (121025, DCM, "Patient")
2	INCLUDE	DTID 1007 “Subject Context, Patient”	1	UC	IFF Row 1 value = (121025, DCM, "Patient") or Row 1 is absent	May be used for human or animal patients
3	INCLUDE	DTID 1008 “Subject Context, Fetus”	1	UC	IFF Row 1 value = (121026, DCM, "Fetus")	May be used for human or animal fetuses
4	INCLUDE	DTID 1009 “Subject Context, Specimen”	1	UC	IFF Row 1 value = (121027, DCM, "Specimen")
5	INCLUDE	DTID 1010 “Subject Context, Device”	1	UC	IFF Row 1 value = (121192, DCM, "Device Subject")

TID 1007 Subject Context, Patient

Identifies (and optionally describes) a patient who is the subject.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1007. Subject Context, Patient

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	UIDREF	EV (121028, DCM, "Subject UID")	1	U		E.g., SOP Instance UID of Detached Patient Instance
2	PNAME	EV (121029, DCM, "Subject Name")	1	MC	Required if not inherited.	Defaults to Value of Patient's Name (0010,0010) of the Patient Module
3	CODE	EV (121030, DCM, "Subject ID")	1	MC	Required if not inherited.	Defaults to Value of Patient ID (0010,0020) of the Patient Module
4	DATE	EV (121031, DCM, "Subject Birth Date")	1	U		Defaults to Value of Patient's Birth Date (0010,0030) of the Patient Module
5	CODE	EV (121032, DCM, "Subject Sex")	1	U		Defaults to value equivalent to Value of Patient's Sex (0010,0040) of the Patient Module DCID 7455 “Sex”
6	NUM	EV (121033, DCM, "Subject Age")	1	U		Defaults to value equivalent to Value of Patient's Age (0010,1010) of the Patient Study Module UNITS = DCID 7456 “Age Unit”
7	CODE	EV (121034, DCM, "Subject Species")	1	MC	Required if not inherited.	DCID 7454 “Animal Taxonomic Rank Value” Defaults to Value of Patient Species Code Sequence (0010,2202) of the Patient Module, or if absent, (337915000, SCT, "Homo sapiens").
8	CODE	EV (121035, DCM, "Subject Breed")	1	U		Defaults to Value of Patient Breed Code Sequence (0010,2293) of the Patient Module DCID 7480 “Breed”
9	CODE	EV (415229000, SCT, "Racial group")	1	U		Defaults to Value of Ethnic Group Code Sequence (0010,2161) of the Patient Module, or if absent, the coded equivalent of the text Value of Ethnic Group (0010,2160) of the Patient Module, which is defined as "race or ethnic group". BCID 6099 “Racial Group”

TID 1008 Subject Context, Fetus

Identifies (and optionally describes) a fetus who is the subject.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1008. Subject Context, Fetus

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	PNAME	EV (121036, DCM, "Mother of fetus")	1	U		Defaults to an observation subject that is a patient prior to replacing the Observation Subject Class with Fetus.
2	UIDREF	EV (121028, DCM, "Subject UID")	1	U		For longitudinal tracking of individual fetuses
3	TEXT	EV (121030, DCM, "Subject ID")	1	MC	IF Row 4 is absent	For longitudinal tracking of individual fetuses (human readable value e.g., "A" or "1")
4	TEXT	EV (11951-1, LN, "Fetus ID")	1	MC	IF Row 3 is absent	For separation of multiple fetuses during this procedure e.g., fetus '1" of '2" … not for longitudinal comparisons.; i.e., the "m" of fetus "m" of "n"
5	NUM	EV (11878-6, LN, "Number of Fetuses by US")	1	U	XOR Row 6	UNITS = EV (1, UCUM, "no units")
6	NUM	EV (55281-0, LN, "Number of Fetuses")	1	UC	XOR Row 5	UNITS = EV (1, UCUM, "no units")

Content Item Descriptions

Rows 5, 6

The "n" of fetus "m" of "n"; either the code for the ultrasound method (Row 5) or for the non-specific method (Row 6) may be used

TID 1009 Subject Context, Specimen

Identifies (and optionally describes) a specimen that is the subject.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1009. Subject Context, Specimen

	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	UIDREF	EV (121039, DCM, "Specimen UID")	1	U
2	INCLUDE	DTID 1007 “Subject Context, Patient”	1	UC	IFF the source of the specimen is a human or animal patient
3	TEXT	EV (121041, DCM, "Specimen Identifier")	1	U
4	TEXT	EV (111724, DCM, "Issuer of Specimen Identifier")	1	U		See Content Item descriptions
5	CODE	EV (371439000, SCT, "Specimen Type")	1	U		DCID 8103 “Anatomic Pathology Specimen Type”
6	TEXT	EV (111700, DCM, "Specimen Container Identifier")	1	U

Content Item Descriptions

Rows 5, 6

The Issuer of Specimen Identifier shall be formatted in accordance with the HL7 v2 Hierarchic Designator data type (see HL7 v2.6 Section 2.A.33), i.e., [ Namespace ID]^[ Universal ID^Universal ID Type]

TID 1010 Subject Context, Device

Identifies (and optionally describes) a device that is the subject of observations.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1010. Subject Context, Device

	VT	Concept Name	VM	Req Type
1	TEXT	EV (121193, DCM, "Device Subject Name")	1	M
2	UIDREF	EV (121198, DCM, "Device Subject UID")	1	U
3	TEXT	EV (121194, DCM, "Device Subject Manufacturer")	1	U
4	TEXT	EV (121195, DCM, "Device Subject Model Name")	1	U
5	TEXT	EV (121196, DCM, "Device Subject Serial Number")	1	U
6	TEXT	EV (121197, DCM, "Device Subject Physical Location during observation")	1	U

TID 1015 Person Observer Description

This Template includes attributes describing the qualifications of the person observer relevant to the content generated by the observer.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1015. Person Observer Description

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	EV (128003, DCM, "Reader Specialty")	1	M		DCID 7449 “Reader Specialty”
2	>	HAS PROPERTIES	NUM	EV (C54627, NCIt, "Experience")	1	M		UNITS = EV (a, UCUM, "Year")

TID 1020 Person Participant

This Template describes a person participating in an activity as other than an observer or subject. E.g., for a dose report documenting an irradiating procedure, participants include the person administering the irradiation and the person authorizing the irradiation.

This Template is included with specific contextual parameters from a parent Template.

Table TID 1020. Parameters

Parameter Name	Parameter Usage
$PersonProcedureRole	Coded term or Context Group for the Concept Name that describes the nature of the person's participation in this procedure.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1020. Person Participant

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			PNAME	EV (113870, DCM, "Person Name")	1	M
2	>	HAS PROPERTIES	CODE	EV (113875, DCM, "Person Role in Procedure")	1	M	$PersonProcedureRole
3	>	HAS PROPERTIES	TEXT	EV (113871, DCM, "Person ID")	1	U
4	>	HAS PROPERTIES	TEXT	EV (113872, DCM, "Person ID Issuer")	1	U
5	>	HAS PROPERTIES	TEXT	EV (113873, DCM, "Organization Name")	1	U
6	>	HAS PROPERTIES	CODE	EV (113874, DCM, "Person Role in Organization")	1	U	BCID 7452 “Organizational Role”

Content Item Descriptions

Row 1	The name of the person participating in the role identified in Row 2.
Row 2	The procedural role played by the person in this procedure.
Row 6	The organizational role played by the person in the organization.

TID 1021 Device Participant

This Template describes a device participating in an activity as other than an observer or subject. E.g., for a dose report documenting an irradiating procedure, participants include the irradiating device.

This Template is included with specific contextual parameters from a parent Template.

Table TID 1021. Parameters

Parameter Name	Parameter Usage
$DeviceProcedureRole	Coded term or Context Group for the Concept Name that describes the nature of the device's participation in this procedure.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1021. Device Participant

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	EV (113876, DCM, "Device Role in Procedure")	1	M	$DeviceProcedureRole
2	>	HAS PROPERTIES	TEXT	EV (113877, DCM, "Device Name")	1	U
3	>	HAS PROPERTIES	TEXT	EV (113878, DCM, "Device Manufacturer")	1	M
4	>	HAS PROPERTIES	TEXT	EV (113879, DCM, "Device Model Name")	1	M
5	>	HAS PROPERTIES	TEXT	EV (113880, DCM, "Device Serial Number")	1	M
6	>	HAS PROPERTIES	UIDREF	EV (121012, DCM, "Device Observer UID")	1	M

Content Item Descriptions

Row 1	If no Device Procedure Role is provided, BCID 7445 “Device Participating Role” may be used.
Row 2	This may be used for the name by which the organization manages the device.

TID 1200 Language Designation

Defines a mechanism for specifying a language, optionally with designation of the country in which that language applies.

Note

For example, the French language could be specified unmodified, or French as written in France or Canada could be distinguished.
The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous releases of the Standard.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1200. Language Designation

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	EV (121045, DCM, "Language")	1	M		DCID 5000 “Language”
2	>	HAS CONCEPT MOD	CODE	EV (121046, DCM, "Country of Language")	1	U		DCID 5001 “Country”

TID 1201 Language of Value

Defines a mechanism for specifying the language in which the value of the parent Content Item (only) is written. Does not specify the language of the Concept Name of the parent Content Item, nor of any other descendants of the parent Content Item.

Note

The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous releases of the Standard.

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 1201. Language of Value

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS CONCEPT MOD	CODE	EV (121047, DCM, "Language of Value")	1	M		DCID 5000 “Language”
2	>	HAS CONCEPT MOD	CODE	EV (121046, DCM, "Country of Language")	1	U		DCID 5001 “Country”

TID 1202 Language of Name and Value

Defines a mechanism for specifying the language in which the value and the Concept Name of the parent Content Item (only) is written. Does not specify the language of any other descendants of the parent Content Item.

Note

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1202. Language of Name and Value

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS CONCEPT MOD	CODE	EV (121048, DCM, "Language of Name and Value")	1	M		DCID 5000 “Language”
2	>	HAS CONCEPT MOD	CODE	EV (121046, DCM, "Country of Language")	1	U		DCID 5001 “Country”

TID 1204 Language of Content Item and Descendants

Defines a mechanism for specifying the language in which the value and the Concept Name of the parent Content Item and any other descendants of the parent Content Item is written.

Note

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 1204. Language of Content Item and Descendants

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS CONCEPT MOD	CODE	EV (121049, DCM, "Language of Content Item and Descendants")	1	M		DCID 5000 “Language”
2	>	HAS CONCEPT MOD	CODE	EV (121046, DCM, "Country of Language")	1	U		DCID 5001 “Country”

TID 1210 Equivalent Meaning(s) of Concept Name

Defines a mechanism for specifying one or more equivalent meanings for the Concept Name of the parent Content Item.

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 1210. Equivalent Meaning(s) of Concept Name

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS CONCEPT MOD	TEXT	EV (121050, DCM, "Equivalent Meaning of Concept Name")	1-n	MC	XOR Row 3	Plain text equivalent of code meaning of the concept name of the Content Item being modified, in the specified language from the specified country, using the default character set or a character set selected from Specified Character Set
2	>		INCLUDE	DTID 1201 “Language of Value”	1	U
3		HAS CONCEPT MOD	CODE	EV (121050, DCM, "Equivalent Meaning of Concept Name")	1-n	MC	XOR Row 1
4	>		INCLUDE	DTID 1201 “Language of Value”	1	U

Note

A coded equivalent meaning for the Concept Name can also be included using the Attribute Equivalent Code Sequence (0008,0121) in the Concept Name Code Sequence (0040,A043) (see Section 8.9 “Equivalent Code Sequence” in PS3.3 ), though the equivalent code(s) in the Equivalent Code Sequence (0008,0121) need not be the same as those in TID 1210.

TID 1211 Equivalent Meaning(s) of Value

Defines a mechanism for specifying one or more equivalent meanings for the Value of the parent Content Item.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1211. Equivalent Meaning(s) of Value

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS CONCEPT MOD	TEXT	EV (121051, DCM, "Equivalent Meaning of Value")	1-n	MC	XOR Row 3	Plain text equivalent of code meaning of the value of the Content Item being modified, in the specified language from the specified country, using the default character set or a character set selected from Specified Character Set
2	>		INCLUDE	DTID 1201 “Language of Value”	1	U
3		HAS CONCEPT MOD	CODE	EV (121051, DCM, "Equivalent Meaning of Value")	1-n	MC	XOR Row 1
4	>		INCLUDE	DTID 1201 “Language of Value”	1	U

Note

For example, to describe a longer, more meaningful equivalent (in the same language) for a procedure code than is defined in a coding scheme:

CODE: (121023, DCM, "Procedure Code") = (50291CC, ICD10PCS, "IMAGING:CNS:CT:SELLA:LOWOSMOLAR:IT, U, E:2PLANE3D")

> HAS CONCEPT MOD TEXT: (121051, DCM, "Equivalent meaning of value") = "imaging study central nervous system of the sella turcica/pituitary gland with low osmolar contrast intrathecal, unenhanced and enhanced, in two planes with 3D reconstructions"
For example, to specify a concept name and value in both French and English in Canada:

CODE:(91723000, SCT, "Anatomical structure") = (76752008, SCT, "Breast")

> HAS CONCEPT MOD CODE: (121048, DCM, "Language of name and value") = (en-CA, RFC5646, "English, Canada")

> HAS CONCEPT MOD CODE: (121050, DCM, "Equivalent meaning of concept name") = (91723000, SCT, Structure de l'anatomie")

>> HAS CONCEPT MOD CODE: (121047, DCM, " Langue de la valeur ") = (fr-CA, RFC5646, " Français, Canadien ")

> HAS CONCEPT MOD CODE: (121051, DCM, "Equivalent meaning of value") = (76752008, SCT, "Sein")

>> HAS CONCEPT MOD CODE: (121047, DCM, " Langue de la valeur ") = (fr-CA, RFC5646, " Français, Candie ")
3. A coded equivalent meaning for the Concept Value of a CODE Content Item can also be included using the Attribute Equivalent Code Sequence (0008,0121) in the Concept Code Sequence (0040, A168) (see Section 8.9 “Equivalent Code Sequence” in PS3.3 ).

TID 1350 Negation Modifier, Presence of Finding

Concept Name Modifier for negation of the presence of a finding represented by a post-coordinated concept.

Note

For example, negation modifier applied to "distention" in the post-coordinated structure:

CODE: "anatomic location" = "bile duct"

> HAS PROPERTY CODE: "morphology" = "distention"

>> HAS CONCEPT MOD CODE: "presence of property" = "absent"

means: "bile duct distention not present"
The presence-negation modifier modifies the entire post-coordinated concept, not just the Source Content Item of the HAS CONCEPT MOD relationship. The entire branch of the tree from the Content Item is included in the post-coordinated structure that is negated.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1350. Negation Modifier, Presence of Finding

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS CONCEPT MOD	CODE	EV (121052, DCM, "Presence of property")	1	M		DCID 240 “Present-Absent”

TID 1400 Linear Measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1400. Linear Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			NUM	DCID 7470 “Linear Measurement”	1	M		UNITS = DCID 7460 “Linear Measurement Unit”
2	>	INFERRED FROM	SCOORD	EV (121055, DCM, "Path")	1	UC	XOR Row 5	GRAPHIC TYPE = {POLYLINE, CIRCLE, ELLIPSE}
3	>>	R-SELECTED FROM	IMAGE		1	MC	XOR Row 4
4	>>	SELECTED FROM	IMAGE		1	MC	XOR Row 3
5	>	INFERRED FROM	SCOORD	EV (121230, DCM, "Path Vertex")	2-n	UC	XOR Row 2	GRAPHIC TYPE = {POINT}
6	>>	R-SELECTED FROM	IMAGE		1	MC	XOR Row 7
7	>>	SELECTED FROM	IMAGE		1	MC	XOR Row 6
8	>	HAS OBS CONTEXT	INCLUDE	DTID 4108 “Tracking Identifier”	1	U

Content Item Descriptions

Row 2	Path shall represent the measured path or a projection of the measured path in the image. The Graphic Type (0070,0023) of the Path SCOORD shall be: an open POLYLINE with two different points (to measure length, diameter, distance, proximity, etc), a CIRCLE or ELLIPSE (to measure circumference) or an open or closed POLYLINE (closed polygon) to measure path length (open) or perimeter (closed).
Row 5	A measured path that traverses two or more images (e.g., the ends of the path are in different cross-sectional plane images) shall be identified by vertices along the path. The Path Vertices shall be ordered by the order of their SCOORD Content Items to identify the measured path. The Graphic Type (0070,0023) of each SCOORD shall be POINT

TID 1401 Area Measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1401. Area Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			NUM	DCID 7471 “Area Measurement”	1	M		Value shall be > 0 UNITS = DCID 7461 “Area Measurement Unit”
2	>	INFERRED FROM	SCOORD	EV (121056, DCM, "Area Outline")	1	MC	IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 5 or 6 not present.	GRAPHIC TYPE = not {MULTIPOINT}
3	>>	R-SELECTED FROM	IMAGE		1	MC	XOR Row 4
4	>>	SELECTED FROM	IMAGE		1	MC	XOR Row 3
5	>	INFERRED FROM	IMAGE	EV (121214, DCM, "Referenced Segmentation Frame")	1	MC	IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 2 or 6 not present.	Reference shall be to a Segmentation Image, with a single value specified in Referenced Frame Number
6	>	R- INFERRED FROM	IMAGE		1	MC	IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 2 or 5 not present.	Reference shall be to a Segmentation Image, with a single value specified in Referenced Frame Number
7	>	HAS PROPERTIES	CODE	EV (370129005, SCT, "Measurement Method")	1	U		DCID 7473 “General Area Calculation Method”
8	>	HAS OBS CONTEXT	INCLUDE	DTID 4108 “Tracking Identifier”	1	U

Content Item Descriptions

Row 2

A Graphic Type of POINT implies that the object is a single pixel and the object's area is the area of the pixel. Otherwise the type shall be a closed POLYLINE (start and end point the same) or a CIRCLE or an ELLIPSE.

Rows 5, 6

Referenced Frame Number (0008,1160) is an Attribute of the IMAGE Content Item.

If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the area of defined (measured) region by pixel values in the referenced frame with value 1. For Segmentation Type value FRACTIONAL, the area is computed by an implementation dependent method.

Frame number shall be specified even if the Segmentation SOP Instance has only a single frame.

Row 8

The values of (112039, DCM, "Tracking Identifier") and (112040, DCM, "Tracking Unique Identifier"), if present, shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 5.

TID 1402 Volume Measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1402. Volume Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			NUM	DCID 7472 “Volume Measurement”	1	M		Value shall be > 0 UNITS = DCID 7462 “Volume Measurement Unit”
2	>	INFERRED FROM	SCOORD	EV (121057, DCM, "Perimeter Outline")	1-n	UC	XOR Rows 5, 6	GRAPHIC TYPE = not {MULTIPOINT}
3	>>	R-SELECTED FROM	IMAGE		1	MC	XOR Row 4
4	>>	SELECTED FROM	IMAGE		1	MC	XOR Row 3
5	>	INFERRED FROM	IMAGE	EV (121191, DCM, "Referenced Segment")	1	UC	XOR Rows 2, 6	Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number
6	>	R- INFERRED FROM	IMAGE		1	UC	XOR Rows 2, 5	Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number
7	>	HAS PROPERTIES	CODE	EV (370129005, SCT, "Measurement Method")	1	U		DCID 7474 “General Volume Calculation Method”
8	>	HAS OBS CONTEXT	INCLUDE	DTID 4108 “Tracking Identifier”	1	U

Content Item Descriptions

Row 2

The two dimensional perimeter of the volume's intersection with or projection into the image. A Graphic Type of POINT implies that the volume's intersection or projection in a plane is a single pixel. A single pixel projection perimeter cannot cause a volume calculation to become 0.

Otherwise the type shall be a closed POLYLINE (start and end point the same) or a CIRCLE or an ELLIPSE.

Rows 5, 6

Referenced Segment Number (0062,000B) is an Attribute of the IMAGE Content Item.

If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the defined (measured) volume by pixel/voxel values in the frames of the referenced segment with value 1. For Segmentation Type value FRACTIONAL, the volume is computed by an implementation dependent method.

Segment number shall be specified even if the Segmentation SOP Instance has only a single segment.

Row 8

TID 1404 Numeric Measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1404. Numeric Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			NUM		1	M		UNITS = DCID 82 “Measurement Unit”
2	>	INFERRED FROM	SCOORD		1-n	UC	XOR Rows 5, 6
3	>>	R-SELECTED FROM	IMAGE		1	MC	XOR Row 4
4	>>	SELECTED FROM	IMAGE		1	MC	XOR Row 3
5	>	R-INFERRED FROM	IMAGE	BCID 7003 “Diagnostic Imaging Report Purpose of Reference”	1-n	UC	XOR Rows 2, 6
6	>	INFERRED FROM	IMAGE	BCID 7003 “Diagnostic Imaging Report Purpose of Reference”	1-n	UC	XOR Rows 2, 5
7	>	HAS OBS CONTEXT	INCLUDE	DTID 4108 “Tracking Identifier”	1	U

Content Item Descriptions

Row 2	The SCOORD may indicate the points or area where the measurement was taken (e.g., a POINT showing the pixel location of a density measurement, or an open POLYLINE of three points showing the calculation of an angle).
Rows 3, 5	Valid only in IODs that permit relationships by-reference.

TID 1406 Three Dimensional Linear Measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1406. Three Dimensional Linear Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			NUM	DCID 7470 “Linear Measurement”	1	M	UNITS = DCID 7460 “Linear Measurement Unit”
2	>	INFERRED FROM	SCOORD3D	EV (121055, DCM, "Path")	1	M	GRAPHIC TYPE = {POLYLINE, ELLIPSE, POLYGON}
3	>	HAS OBS CONTEXT	INCLUDE	DTID 4108 “Tracking Identifier”	1	U

Content Item Descriptions

Row 2

Path shall represent the measured path in a reference coordinate space. The Graphic Type (0070,0023) of the Path SCOORD3D shall be:

an open POLYLINE with two or more different (x,y,z) triplets (to measure length, diameter, distance, proximity, etc.),
an ELLIPSE (to measure circumference) or
a closed POLYGON to measure perimeter, where the (x,y,z) triplets are coplanar.

TID 1410 Planar ROI Measurements and Qualitative Evaluations

This Template provides a general structure to report measurements for some metric, e.g., density, flow, or concentration, and/or qualitative evaluations, over a planar region of interest in an image. The ROI may be specified by an SCOORD on an image, by a Segmentation Image, by an SCOORD3D defining an area relative to a 3D Frame of Reference, or by a reference to an ROI defined in a radiotherapy Structure Set.

Table TID 1410. Parameters

$Measurement	Coded term or Context Group for Concept Name of measurement
$Units	Units for the measurement
$ModType	Modifier Name for Concept Name of measurement
$ModValue	Modifier Value for Concept Name of measurement
$Method	Value for Measurement Method
$Derivation	Value for Measurement Derivation
$TargetSite	Value for Anatomic Location of measurement
$TargetSiteMod	Modifier Value for Anatomic Location of measurement
$Equation	Coded term or Context Group for the equation or table from which the measurement was derived or computed
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement
$DerivationParameter	Coded term or Context Group for Concept Name of a derivation parameter
$DerivationParameterUnits	Units of derivation parameter
$QualType	Evaluations encoded with code or text responses
$QualValue	Value of evaluations encoded with code responses
$QualModType	Modifier Name of evaluations encoded with code or text responses
$QualModValue	Modifier Value of evaluations encoded with code or text responses
$FindingCategory	Category of the finding
$FindingType	Type of the finding
$TrackingID	Value for Tracking Identifier
$TrackingUID	Value for Tracking Unique Identifier

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1410. Planar ROI Measurements and Qualitative Evaluations

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (125007, DCM, "Measurement Group")	1	M
1b	>	HAS OBS CONTEXT	TEXT	EV (C67447, NCIt, "Activity Session")	1	U
2	>	HAS OBS CONTEXT	TEXT	DT (112039, DCM, "Tracking Identifier")	1	U		$TrackingID
3	>	HAS OBS CONTEXT	UIDREF	EV (112040, DCM, "Tracking Unique Identifier")	1	U		$TrackingUID
3a	>	CONTAINS	CODE	EV (276214006, SCT, "Finding category")	1	U		$FindingCategory
3b	>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1	U		$FindingType
3c	>	CONTAINS	CODE	EV (130400, DCM, "Geometric purpose of region")	1	U		BCID 219 “Geometry Graphical Representation”
4	>	HAS OBS CONTEXT	INCLUDE	DTID 1502 “Time Point Context”	1	U
5	>	CONTAINS	SCOORD	EV (111030, DCM, "Image Region")	1	MC	XOR Rows 7, 7b, 8b	GRAPHIC TYPE = not {MULTIPOINT}
6	>>	SELECTED FROM	IMAGE		1	M
7	>	CONTAINS	IMAGE	EV (121214, DCM, "Referenced Segmentation Frame")	1	MC	XOR Rows 5, 7b	Reference shall be to a Segmentation Image, with a single value specified in Referenced Segment Number (0062,000B). For references to tiled Segmentation Images, one or more values shall be specified in Referenced Frame Number (0008,1160), unless all frames in the referenced Segmentation Image are selected and there is only a single Segment, in which case Referenced Frame Number (0008,1160) will be absent. The referenced tiles shall all be in the same plane. For references to non-tiled Segmentation Images, a single value shall be specified in Referenced Frame Number (0008,1160), unless there is only one frame in the referenced Segmentation Image, in which case Referenced Frame Number (0008,1160) will be absent.
7b	>	CONTAINS	SCOORD3D	EV (111030, DCM, "Image Region")	1	MC	XOR Rows 5, 7, 8b	GRAPHIC TYPE = not {MULTIPOINT, POLYLINE or ELLIPSOID}
8	>	CONTAINS	IMAGE	EV (121233, DCM, "Source image for segmentation")	1	MC	IFF Row 7
8b	>	CONTAINS	COMPOSITE	EV (130488, DCM, "Region in Space")	1	MC	XOR Rows 5, 7, 7b	Reference shall be to an Instance of the RT Structure Set Storage SOP Class.
8c	>>	HAS PROPERTIES	TEXT	EV (130489, DCM, "Referenced Region of Interest Identifier")	1	M		Shall be the value of ROI Number (3006,0022) within the single referenced Item of Structure Set ROI Sequence (3006,0020) of the referenced Instance of the RT Structure Set Storage SOP Class.
9	>	CONTAINS	IMAGE	EV (121200, DCM, "Illustration of ROI")	1	U
9b	>	CONTAINS	IMAGE	EV (130401, DCM, "Visual explanation")	1-n	U
10	>	CONTAINS	COMPOSITE	EV (126100, DCM, "Real World Value Map used for measurement")	1	U		SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")
11	>	CONTAINS	INCLUDE	DTID 1419 “ROI Measurements”	1	U		$Measurement = $Measurement $Units = $Units $ModType = $ModType $ModValue = $ModValue $Method = $Method $Derivation = $Derivation $TargetSite = $TargetSite $TargetSiteMod = $TargetSiteMod $Equation = $Equation $RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority $DerivationParameter = $DerivationParameter $DerivationParameterUnits = $DerivationParameterUnits
12	>	CONTAINS	CODE	$QualType	1-n	U		$QualValue
12b	>>	HAS CONCEPT MOD	CODE	$QualModType	1-n	U		$QualModValue
13	>	CONTAINS	TEXT	$QualType	1-n	U

Content Item Descriptions

Row 1b	Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity".
Rows 2, 3	The Tracking Identifier and Tracking Unique Identifier are defined as a text label or unique identifier (respectively) used for tracking a finding or feature, potentially across multiple reporting objects, over time. As such, they are distinct from the Observation UID (0040,A171), which is unique identifier of the specific Content Item and its subsidiary Content Items that constitute an individual observation, and would be different for different observations on different occasions of the same finding or feature. The values of these Content Items shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 7.
Rows 3a, 3b	The category and type of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site). When spatial localization is by reference to a Segmentation, the category and type may correspond to the values of Segmented Property Category Code Sequence (0062,0003) and Segmented Property Type Code Sequence (0062,000F), respectively. See also CID 7150 “Segmentation Property Category”.
Row 5	To describe an infinitely small area, such as the center of a lesion, a Graphic Type of POINT may be used.
Row 6	(260753009, SCT, "Source") may be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.
Row 7	Referenced Frame Number (0008,1160) and Referenced Segment Number (0062,000B) are Attributes of the IMAGE Content Item. If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the area of defined (measured) region of interest by pixel values in the referenced frame with value 1. For Segmentation Type value FRACTIONAL, the area is computed by an implementation dependent method. Referenced Frame Number (0008,1160) may reference multiple frames in the same plane for tiled Segmentation Images (such as segmentations of Whole Slide Microscopy images).
Row 7b	The area may be defined independently of an image by reference to 3D coordinates in any type of DICOM Reference Coordinate System, whether it be patient-relative (Patient Based Coordinate System), volume-relative (including acquired and presentation state volumes), or whole slide relative (Slide Coordinate System).
Row 8	Identifies the source image that was segmented to identify the ROI, and whose properties are described in this container.
Rows 8b, 8c	A reference to a single ROI that defines a planar ROI, within an RT Structure Set.
Row 9	This referenced image may contain a "screen shot" illustrating a rendered version of the ROI.
Row 9b	This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image.
Row 10	The reference to an RWV in Row 10 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden).
Row 11	Measurements may be omitted, for example if it is desired to describe only the location of a finding or to provide categorical information about it.
Rows 12, 12b, 13	Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present.

TID 1411 Volumetric ROI Measurements and Qualitative Evaluations

This Template provides a general structure to report measurements for some metric, e.g., density, flow, or concentration, and/or qualitative evaluations, over a volumetric region of interest in a set of images or a Frame of Reference. The volumetric ROI may be specified by a set of SCOORDs on an image set representing a volume, by a volumetric Segmentation Image, by a volume defined in a Surface Segmentation, by a set of SCOORD3Ds defining a volume relative to a 3D Frame of Reference, or by a reference to an ROI defined in a radiotherapy Structure Set.

Table TID 1411. Parameters

$Measurement	Coded term or Context Group for Concept Name of measurement
$Units	Units for the measurement
$ModType	Modifier Name for Concept Name of measurement
$ModValue	Modifier Value for Concept Name of measurement
$Method	Value for Measurement Method
$Derivation	Value for Measurement Derivation
$TargetSite	Value for Anatomic Location of measurement
$TargetSiteMod	Modifier Value for Anatomic Location of measurement
$Equation	Coded term or Context Group for the equation or table from which the measurement was derived or computed
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement
$DerivationParameter	Coded term or Context Group for Concept Name of a derivation parameter
$DerivationParameterUnits	Units of derivation parameter
$QualType	Evaluations encoded with code or text responses
$QualValue	Value of evaluations encoded with code responses
$QualModType	Modifier Name of evaluations encoded with code or text responses
$QualModValue	Modifier Value of evaluations encoded with code or text responses
$FindingCategory	Category of the finding
$FindingType	Type of the finding
$TrackingID	Value for Tracking Identifier
$TrackingUID	Value for Tracking Unique Identifier

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1411. Volumetric ROI Measurements and Qualitative Evaluations

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (125007, DCM, "Measurement Group")	1	M
1b	>	HAS OBS CONTEXT	TEXT	EV (C67447, NCIt, "Activity Session")	1	U
2	>	HAS OBS CONTEXT	TEXT	DT (112039, DCM, "Tracking Identifier")	1	U		$TrackingID
3	>	HAS OBS CONTEXT	UIDREF	EV (112040, DCM, "Tracking Unique Identifier")	1	U		$TrackingUID
3a	>	CONTAINS	CODE	EV (276214006, SCT, "Finding category")	1	U		$FindingCategory
3b	>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1	U		$FindingType
3c	>	CONTAINS	CODE	EV (130400, DCM, "Geometric purpose of region")	1	U		BCID 219 “Geometry Graphical Representation”
4	>	HAS OBS CONTEXT	INCLUDE	DTID 1502 “Time Point Context”	1	U
5	>	CONTAINS	SCOORD	EV (111030, DCM, "Image Region")	1-n	MC	XOR Rows 7, 10, 12b	GRAPHIC TYPE = not {MULTIPOINT}
6	>>	SELECTED FROM	IMAGE		1	M
7	>	CONTAINS	IMAGE	EV (121191, DCM, "Referenced Segment")	1	MC	XOR Rows 5, 10, 12b	Reference shall be to a Segmentation Image or Surface Segmentation object, with a single value specified in Referenced Segment Number
10	>	CONTAINS	SCOORD3D	EV (121231, DCM, "Volume Surface")	1-n	MC	XOR Rows 5, 7, 12b	If one item, GRAPHIC TYPE = {ELLIPSOID or POINT} If more than one item, GRAPHIC TYPE = {POLYGON or ELLIPSE}
11	>	CONTAINS	IMAGE	EV (121233, DCM, "Source image for segmentation")	1-n	MC	XOR Row 12 and IFF (Row 7 or Row 10)
12	>	CONTAINS	UIDREF	EV (121232, DCM, "Source series for segmentation")	1	MC	XOR Row 11 and IFF (Row 7 or Row 10)
12b	>	CONTAINS	COMPOSITE	EV (130488, DCM, "Region in Space")	1	MC	XOR Rows 5, 7, 10	Reference shall be to an Instance of the RT Structure Set Storage SOP Class.
12c	>>	HAS PROPERTIES	TEXT	EV (130489, DCM, "Referenced Region of Interest Identifier")	1	M		Shall be the value of ROI Number (3006,0022) within the single referenced Item of Structure Set ROI Sequence (3006,0020) of the referenced Instance of the RT Structure Set Storage SOP Class.
13	>	CONTAINS	IMAGE	EV (121200, DCM, "Illustration of ROI")	1-n	U
13b	>	CONTAINS	IMAGE	EV (130401, DCM, "Visual explanation")	1-n	U
14	>	CONTAINS	COMPOSITE	EV (126100, DCM, "Real World Value Map used for measurement")	1	U		SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")
15	>	CONTAINS	INCLUDE	DTID 1419 “ROI Measurements”	1	U		$Measurement = $Measurement $Units = $Units $ModType = $ModType $ModValue = $ModValue $Method = $Method $Derivation = $Derivation $TargetSite = $TargetSite $TargetSiteMod = $TargetSiteMod $Equation = $Equation $RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority $DerivationParameter = $DerivationParameter $DerivationParameterUnits = $DerivationParameterUnits
16	>	CONTAINS	CODE	$QualType	1-n	U		$QualValue
16b	>>	HAS CONCEPT MOD	CODE	$QualModType	1-n	U		$QualModValue
17	>	CONTAINS	TEXT	$QualType	1-n	U

Content Item Descriptions

Row 1b	Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity".
Rows 2, 3	The Tracking Identifier and Tracking Unique Identifier are defined as a text label or unique identifier (respectively) used for tracking a finding or feature, potentially across multiple reporting objects, over time. As such, they are distinct from the Observation UID (0040,A171), which is unique identifier of the specific Content Item and its subsidiary Content Items that constitute an individual observation, and would be different for different observations on different occasions of the same finding or feature. The values of these Content Items shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 7.
Rows 3a, 3b	The type and category of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site). When spatial localization is by reference to a Segmentation, the category and type may correspond to the values of Segmented Property Category Code Sequence (0062,0003) and Segmented Property Type Code Sequence (0062,000F), respectively. See also CID 7150 “Segmentation Property Category”.
Row 5	Even though the coordinates are image-relative, not every image slice within the spatial extent of the ROI is required to be encoded. That is, the ROI may be more coarsely sampled than the image slices, and may be irregularly sampled, and the omission of a contour on a slice does not mean that it is omitted from the ROI. For example, a user may not draw an outline on every slice. However, failure to include every intermediate slice does give rise to this potential ambiguity, and is discouraged.
Rows 5, 7, 10	A single invocation of TID 1411 defines the entire spatial extent defined of a single ROI. A single structure with multiple fragments disconnected in spatial extent needs to be described as separate ROIs, in separate invocations of TID 1411, with different Tracking Identifiers and Tracking Unique Identifiers, but the same Finding.
Rows 5, 10	To describe an infinitely small volume, such as the center of a lesion, a Graphic Type of POINT may be used.
Row 6	(260753009, SCT, "Source") may be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.
Rows 6, 7	Referenced Segment Number (0062,000B) is an Attribute of the IMAGE Content Item, and shall be present with a single value. If the Referenced SOP Instance is a Segmentation Image, it shall have a defined Frame of Reference. If it has Segmentation Type (0062,0001) value BINARY, it identifies the volume of defined (measured) region of interest by voxel values in the referenced segment with value 1. If it has Segmentation Type value FRACTIONAL, the volume is defined by an implementation dependent method. The extent, sampling rate and orientation of the Segmentation are not required to match that of corresponding image slices (if any), identified in Row 11 or referenced from the Segmentation. If the referenced SOP Instance is a Surface Segmentation, the referenced segment shall constitute a finite volume. It identifies the volume of the defined (measured) region of interest by the interior of the finite volume. Segment number shall be specified even if the Segmentation SOP Instance has only a single segment.
Row 10	Either a single item describing a closed volumetric surface, or multiple items describing a set of parallel closed coplanar areas (contours) is specified. The sampling rate and orientation of the contours is not required to match that of any image slices (if any), nor are the in-plane or cross-plane sampling rates required to be regular.
Row 11	Identifies the source images that were segmented to identify the ROI, when, for example a subset of images in a series was used.
Row 12	Identifies the source series of images that were segmented to identify the ROI, when, for example an entire set of images in a series was used.
Rows 12b, 12c	A reference to a single ROI that defines a volumetric ROI, within an RT Structure Set.
Row 13	These referenced images may contain "screen shot" illustrating rendered versions of the ROI.
Row 13b	This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image.
Row 14	The reference to an RWV in Row 14 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden).
Row 15	Measurements may be omitted, for example if it is desired to describe only the location of a finding or to provide categorical information about it.
Rows 16, 16b, 17	Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present.

TID 1419 ROI Measurements

This Template encodes measurements for some metric, e.g., density, flow, or concentration.

Table TID 1419. Parameters

$Measurement	Coded term or Context Group for Concept Name of measurement
$Units	Units for the measurement
$ModType	Modifier Name for Concept Name of measurement
$ModValue	Modifier Value for Concept Name of measurement
$Method	Value for Measurement Method
$Derivation	Value for Measurement Derivation
$TargetSite	Value(s) for Anatomic Location of measurement
$TargetSiteMod	Modifier Value for Anatomic Location of measurement
$Equation	Coded term or Context Group for the equation or table from which the measurement was derived or computed
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement
$DerivationParameter	Coded term or Context Group for Concept Name of a derivation parameter
$DerivationParameterUnits	Units of derivation parameter

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1419. ROI Measurements

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS CONCEPT MOD	CODE	EV (370129005, SCT, "Measurement Method")	1	U		$Method
2		HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1-n	U		$TargetSite
3	>	HAS CONCEPT MOD	CODE	EV (272741003, SCT, "Laterality")	1	U		DCID 244 “Laterality”
4	>	HAS CONCEPT MOD	CODE	DT (106233006, SCT, "Topographical modifier")	1	U		$TargetSiteMod
4b		HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U
5			NUM	$Measurement	1-n	M		UNITS = $Units
6	>	HAS CONCEPT MOD	CODE	$ModType	1-n	U		$ModValue
7	>	HAS CONCEPT MOD	CODE	EV (370129005, SCT, "Measurement Method")	1	U		$Method
8	>	HAS CONCEPT MOD	CODE	EV (121401, DCM, "Derivation")	1	U		$Derivation
9	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1-n	U		$TargetSite
10	>>	HAS CONCEPT MOD	CODE	EV (272741003, SCT, "Laterality")	1	U		DCID 244 “Laterality”
11	>>	HAS CONCEPT MOD	CODE	DT (106233006, SCT, "Topographical modifier")	1	U		$TargetSiteMod
12	>	HAS PROPERTIES	INCLUDE	DTID 310 “Measurement Properties”	1	U		$RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority
13	>	INFERRED FROM	NUM	$DerivationParameter	1-n	UC	XOR Row 14	$DerivationParameterUnits
14	>	R-INFERRED FROM	NUM	$DerivationParameter	1-n	UC	XOR Row 13	$DerivationParameterUnits
14b	>	INFERRED FROM	CODE	$DerivationParameter	1-n	U
14c	>	INFERRED FROM	TEXT	$DerivationParameter	1-n	U
15	>	INFERRED FROM	INCLUDE	DTID 315 “Equation or Table”	1	UC	XOR Row 16	$Equation = $Equation
16	>	INFERRED FROM	TEXT	DCID 228 “Equation or Table”	1	UC	XOR Row 15
17	>		INCLUDE	DTID 1000 “Quotation”	1	U
18	>	HAS CONCEPT MOD	TEXT	EV (121050, DCM, "Equivalent Meaning of Concept Name")	1	U
19	>	CONTAINS	COMPOSITE	EV (126100, DCM, "Real World Value Map used for measurement")	1	U		SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")
20	>	HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U

Content Item Descriptions

Rows 2, 9	Finding site may be multiple when a region of interest spans multiple anatomical locations and there is not a single pre-coordinated code describing the combination of locations. E.g., when a maligant, inflammatory or traumatic process spans actual or defined anatomical boundaries. There is no requirement that the multiple locations be contiguous.
Row 4b	Describes the algorithm that applies to all measurements in Row 5, unless overridden within the individual measurement at Row 20.
Row 5	Specifies the metric for which measurements are reported, e.g., density, flow, or concentration. This metric is computed at each sample point (e.g., pixel or voxel) in an ROI (defined in the invoking Template), but those individual point measurements are not encoded. Instead, just the summary measurements for the ROI are encoded, and the means of computing a single value is defined in Row 8 Derivation (e.g., mean).
Rows 1, 2, 3, 4, 6, 7, 8, 9, 10, 11	The HAS CONCEPT MOD items allow the explicit definition of terms for post-coordination of the measurement concept name. Additional post-coordinated modifier terms may be included in a SOP Instance based on this Template, in accordance with section 6.2.4, or as defined by Templates that invoke this Template and explicitly define additional post-coordinated modifiers.
Rows 13, 14	The INFERRED FROM items allow the specification (by-value or by-reference) of numeric values that were used in the derivation of the numeric measurement of Row 1. The nature of the inference is not explicitly conveyed; it may be implicit in the Concept Names of the measurements. Inference by-reference is valid only in SOP Classes that permit the INFERRED FROM relationship by-reference.
Row 18	Equivalent Meaning of Concept Name allows the creating application to specify the preferred composed concept name representing the measurement and the associated post-coordinated concept modifiers. The concept modifiers may include those specified in this Template, in a Template that invokes this Template, or at the option of the creating application in accordance with section 6.2.4. This composed concept name may be rendered by a display application.
Row 19	The reference to an RWV in Row 19 allows measurements to be made in units that differ from the stored pixel values in the images referenced in the parent Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference overrides any reference in an including Template (such as for a Measurement Group).

TID 1420 Measurements Derived From Multiple ROI Measurements

This Template encodes measurements for some metric, e.g., density, flow, or concentration, which are acquired over some defined sampling (e.g., over successive time slots in a dynamic contrast enhanced acquisition), or of some comparison between different ROIs.

Table TID 1420. Parameters

$Measurement	Coded term or Context Group for Concept Name of measurement
$MeasurementUnits	Units for the measurement
$ModType	Modifier Name for Concept Name of measurement
$ModValue	Modifier Value for Concept Name of measurement
$Method	Value for Measurement Method
$Derivation	Value for Measurement Derivation
$TargetSite	Value for Anatomic Location of measurement
$TargetSiteMod	Modifier Value for Anatomic Location of measurement
$Equation	Coded term or Context Group for the equation or table from which the measurement was derived or computed
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement
$StatisticalRefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$StatisticalRangeAuthority	Bibliographic reference or authority for the normal range of the measurement
$DerivationParameter	Coded term or Context Group for Concept Name of a derivation parameter
$DerivationParameterUnits	Units of derivation parameter

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1420. Measurements Derived From Multiple ROI Measurements

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			NUM	DCID 7465 “Measurement Derived From Multiple ROI Measurements”	1-n	M
1b	>	HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U
2	>	R-INFERRED FROM	INCLUDE	DTID 1410 “Planar ROI Measurements and Qualitative Evaluations”	1-n	MC	XOR Row 3	$Measurement = $Measurement $Units = $MeasurementUnits $ModType = $ModType $ModValue = $ModValue $Method = $Method $Derivation = $Derivation $TargetSite = $TargetSite $TargetSiteMod = $TargetSiteMod $Equation = $Equation $RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority $DerivationParameter = $DerivationParameter $DerivationParameterUnits = $DerivationParameterUnits
3	>	R-INFERRED FROM	INCLUDE	DTID 1411 “Volumetric ROI Measurements and Qualitative Evaluations”	1-n	MC	XOR Row 2	$Measurement = $Measurement $Units = $MeasurementUnits $ModType = $ModType $ModValue = $ModValue $Method = $Method $Derivation = $Derivation $TargetSite = $TargetSite $TargetSiteMod = $TargetSiteMod $Equation = $Equation $RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority $DerivationParameter = $DerivationParameter $DerivationParameterUnits = $DerivationParameterUnits
4	>	HAS PROPERTIES	INCLUDE	DTID 310 “Measurement Properties”	1	U		$RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority

Content Item Descriptions

Row 1	Specifies the type of derived measurement reported, e.g., the mean of the individual ROI mean density values, or a similarity measure of the number of pixels or voxels in the ROIs. Note that the units may be different from the units in the ROI measurements
Row 1b	Describes the algorithm used to produced the derived measurement, as opposed to the referenced measurements from which this measurement was derived.
Rows 2, 3	The measurement values of each ROI that contributes to the derived measurement, e.g., the mean density within an ROI, the number of pixels or voxels in an ROI. These are specified by reference, so as to not have to repeat the ROI information when it contributes to multiple derived measurements (e.g., if both mean and SD of ROI mean density values were specified).

TID 1500 Measurement Report

This Root Template encodes a list of Measurement Groups each containing lists of measurements, together with any derived measurements.

Each Measurement Group is identified by Tracking ID and UIDs.

An image library is available to describe characteristics of the images referenced by the measurements, if any.

Type:: Extensible
Order:: Non-Significant
Root:: Yes

Table TID 1500. Measurement Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	DCID 7021 “Measurement Report Document Title”	1	M		Root node
2	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	U
3	>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	M
4	>	HAS CONCEPT MOD	CODE	EV (121058, DCM, "Procedure reported")	1-n	U		BCID 100 “Quantitative Diagnostic Imaging Procedure”
5	>	CONTAINS	INCLUDE	DTID 1600 “Image Library”	1	U
6	>	CONTAINS	CONTAINER	EV (126010, DCM, "Imaging Measurements")	1	MC	IF Row 10 and 12 are absent
6b	>>	HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U
7	>>	CONTAINS	INCLUDE	DTID 1410 “Planar ROI Measurements and Qualitative Evaluations”	1-n	U		$Measurement = BCID 218 “Quantitative Image Feature” $Units = BCID 7181 “Abstract Multi-dimensional Image Model Component Unit” $Derivation = BCID 7464 “General Region of Interest Measurement Modifier” $Method = BCID 6147 “Response Criteria” $QualModType = BCID 210 “Qualitative Evaluation Modifier Type” $QualModValue = BCID 211 “Qualitative Evaluation Modifier Value”
8	>>	CONTAINS	INCLUDE	DTID 1411 “Volumetric ROI Measurements and Qualitative Evaluations”	1-n	U		$Measurement = BCID 218 “Quantitative Image Feature” $Units = BCID 7181 “Abstract Multi-dimensional Image Model Component Unit” $Derivation = BCID 7464 “General Region of Interest Measurement Modifier” $Method = BCID 6147 “Response Criteria” $QualModType = BCID 210 “Qualitative Evaluation Modifier Type” $QualModValue = BCID 211 “Qualitative Evaluation Modifier Value”
9	>>	CONTAINS	INCLUDE	DTID 1501 “Measurement and Qualitative Evaluation Group”	1-n	U		$Measurement = BCID 218 “Quantitative Image Feature” $ImagePurpose = BCID 7551 “Generic Purpose of Reference to Images and Coordinates in Measurement” $Units = BCID 7181 “Abstract Multi-dimensional Image Model Component Unit” $Derivation = BCID 7464 “General Region of Interest Measurement Modifier” $Method = BCID 6147 “Response Criteria” $QualModType = BCID 210 “Qualitative Evaluation Modifier Type” $QualModValue = BCID 211 “Qualitative Evaluation Modifier Value”
10	>	CONTAINS	CONTAINER	EV (126011, DCM, "Derived Imaging Measurements")	1	MC	IF Row 6 and 12 are absent
10b	>>	HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U
11	>>	CONTAINS	INCLUDE	DTID 1420 “Measurements Derived From Multiple ROI Measurements”	1-n	U
12	>	CONTAINS	CONTAINER	EV (C0034375, UMLS, "Qualitative Evaluations")	1	MC	IF Row 6 and 10 are absent
12b	>>	HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U
13	>>	CONTAINS	CODE		1-n	U
13b	>>>	HAS CONCEPT MOD	CODE	BCID 210 “Qualitative Evaluation Modifier Type”	1-n	U		BCID 211 “Qualitative Evaluation Modifier Value”
14	>>	CONTAINS	TEXT		1-n	U

Content Item Descriptions

Row 5	The Image Library provides potentially relevant characteristics of images associated with the measurements. There is no requirement to include all, or any, of the images referenced in the ROIs and measurements elsewhere in this template. The template may also include images that are associated with, but not directly referenced in, the ROIs and measurements. The Image Library is not replicating the content of the SOP Instance Reference Macro.
Rows 6, 10, 12	The conditions require that at least one of the "heading" containers be present, though any of them may be present but empty.
Row 6b, 10b, 12b	Describes the algorithm that applies to all observations within the container, unless overridden at the group or individual observation level.
Rows 7, 8, 9	The baseline Context Group allows for generic intensity, size, texture and other feature measurements, regardless of the geometry of the ROI (e.g., linear distance can be measured on volumes, or volume can be estimated from a linear distance), and being baseline, do not constrain the invoker from using other appropriate concepts specific to the application. Different measurements of the same real-world lesion made using different types of measurements (different templates) can be correlated by a shared value of Tracking Unique Identifier. See also Section RRR.5 “Measurement Report SR Document Volumetric ROI with RECIST Linear Distance Specified by Coordinates on CT Example” in PS3.17 .
Row 7	Planar ROI measurements are those defined on a single plane by a segmentation reference or planar spatial coordinates.
Row 8	Volumetric ROI measurements are those defined on a volume by raster or surface segmentation references or a set of 2D or 3D spatial coordinates.
Row 9	Generic measurements include those specified on an image as a whole or by unconstrained graphic coordinates. These may be used for such things as whole image scores or quality measures, and for linear distance measurements, such as for RECIST or WHO tumor treatment response criteria evaluation, or angle measurements. A Measurement Group is used to contain one or more individual measurements that are invocations of TID 300, consistent with TIDs 1410 and 1411, which both already have Measurement Group containers as their roots.
Rows 12, 13, 13b, 14	These Content Items allow encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the entire subject of the report rather than specific measurement groups. A single level of coded modifiers may be present, such as to post-coordinate the laterality if the parent concept involves an anatomic part.

TID 1501 Measurement and Qualitative Evaluation Group

This Template groups measurements and/or qualitative evaluations into a Measurement Group.

Each Measurement Group is identified by Tracking ID and UIDs, and may be described as having being made at a particular time point.

Measurement groups may contain various common measurement modifiers that are shared by all measurements in the group, such as method and finding site.

Table TID 1501. Parameters

Parameter Name	Parameter Usage
$Measurement	Coded term or Context Group for Concept Name of measurement
$Units	Measurement Unit
$ModType	Modifier Name for Concept Name of measurement
$ModValue	Modifier Value for Concept Name of measurement
$Method	Value for Measurement Method
$Derivation	Value for Measurement Derivation
$TargetSite	Value(s) for Anatomic Location of measurement
$TargetSiteMod	Modifier Value for Anatomic Location of measurement
$Equation	Coded term or Context Group for the equation or table from which the measurement was derived or computed
$ImagePurpose	Purpose of Reference for an image used as a source of the measurement
$WavePurpose	Purpose of Reference for a waveform used as a source of the measurement
$RefAuthority	Bibliographic reference or authority for statistical properties of a reference population
$RangeAuthority	Bibliographic reference or authority for the normal range of the measurement
$DerivationParameter	Coded term or Context Group for Concept Name of a derivation parameter
$DerivationParameterUnits	Units of derivation parameter
$QualType	Evaluations encoded with code or text responses
$QualValue	Value of evaluations encoded with code responses
$QualModType	Modifier Name of evaluations encoded with code or text responses
$QualModValue	Modifier Value of evaluations encoded with code or text responses
$FindingCategory	Category of the finding
$FindingType	Type of the finding
$TrackingID	Value for Tracking Identifier
$TrackingUID	Value for Tracking Unique Identifier

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1501. Measurement and Qualitative Evaluation Group

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1		CONTAINS	CONTAINER	EV (125007, DCM, "Measurement Group")	1	M
1b	>	HAS OBS CONTEXT	TEXT	EV (C67447, NCIt, "Activity Session")	1	U
2	>	HAS OBS CONTEXT	TEXT	DT (112039, DCM, "Tracking Identifier")	1	U	$TrackingID
3	>	HAS OBS CONTEXT	UIDREF	EV (112040, DCM, "Tracking Unique Identifier")	1	U	$TrackingUID
3a	>	CONTAINS	CODE	EV (276214006, SCT, "Finding category")	1	U	$FindingCategory
3b	>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1	U	$FindingType
4	>	HAS OBS CONTEXT	INCLUDE	DTID 1502 “Time Point Context”	1	U
5	>	HAS CONCEPT MOD	CODE	EV (370129005, SCT, "Measurement Method")	1	U	$Method
6	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1-n	U	$TargetSite
7	>>	HAS CONCEPT MOD	CODE	EV (272741003, SCT, "Laterality")	1	U	DCID 244 “Laterality”
8	>>	HAS CONCEPT MOD	CODE	DT (106233006, SCT, "Topographical modifier")	1	U	$TargetSiteMod
9	>	CONTAINS	COMPOSITE	EV (126100, DCM, "Real World Value Map used for measurement")	1	U	SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67")
9b	>	HAS CONCEPT MOD	INCLUDE	DTID 4019 “Algorithm Identification”	1	U
9c	>	CONTAINS	IMAGE	EV (121200, DCM, "Illustration of ROI")	1	U
9d	>	CONTAINS	IMAGE	EV (130401, DCM, "Visual explanation")	1-n	U
10	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = $Measurement $Units = $Units $ModType = $ModType $ModValue = $ModValue $Method = $Method $Derivation = $Derivation $TargetSite = $TargetSite $TargetSiteMod = $TargetSiteMod $Equation = $Equation $ImagePurpose = $ImagePurpose $WavePurpose = $WavePurpose $RefAuthority = $RefAuthority $RangeAuthority = $RangeAuthority $DerivationParameter = $DerivationParameter $DerivationParameterUnits = $DerivationParameterUnits
10b	>	CONTAINS	IMAGE	$ImagePurpose	1-n	U
10c	>	CONTAINS	SCOORD	$ImagePurpose	1-n	U
10d	>>	SELECTED FROM	IMAGE		1	M
10e	>	CONTAINS	SCOORD3D	$ImagePurpose	1-n	U
10f	>	CONTAINS	WAVEFORM	$WavePurpose	1-n	U
10g	>	CONTAINS	TCOORD	$WavePurpose	1-n	U
10h	>>	SELECTED FROM	WAVEFORM		1	M
11	>	CONTAINS	CODE	$QualType	1-n	U	$QualValue
11b	>>	HAS CONCEPT MOD	CODE	$QualModType	1-n	U	$QualModValue
12	>	CONTAINS	TEXT	$QualType	1-n	U

Content Item Descriptions

Row 1b	Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity".
Rows 2, 3, 10	The included TID 300 contains an optional inclusion of TID 1408 Tracking Identifier as a child of the NUM measurement, which in turns allows for either or both Tracking Identifier and Tracking Unique Identifier Content Items; the intent of Rows 2 and 3 is not to send these Content Items twice, but rather to factor them out into a common location for multiple measurements, and to be consistent with TID 1410 and TID 1411.
Rows 3a, 3b	The category and type of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site).
Row 6	Finding site may be multiple when a region of interest spans multiple anatomical locations and there is not a single pre-coordinated code describing the combination of locations. E.g., when a maligant, inflammatory or traumatic process spans actual or defined anatomical boundaries. There is no requirement that the multiple locations be contiguous.
Row 9	The reference to an RWV in Row 9 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden).
Row 9b	Describes the algorithm that applies to all measurements in TID 300 Row 1, unless overridden within the individual measurement at TID 300 Row 19.
Row 9c	This referenced image may contain a "screen shot" illustrating a rendered version of the ROI.
Row 9d	This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image.
Row 10	(260753009, SCT, "Source") may be specified for $ImagePurpose or $WavePurpose as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item.
Rows 10b, 10c, 10d, 10e, 10f, 10g, 10h	Coordinates, image or waveform references that are the subject of this measurement group instead of, or in addition to, coordinate, image or waveform references associated with measurements in Row 10. Note that if an ROI is defined, other templates may be used, such as TID 1410 Planar ROI Measurements and Qualitative Evaluations.
Rows 11, 11b, 12	Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present.

TID 1502 Time Point Context

This Template describes information about the time point, for example, at which a measurement was obtained.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1502. Time Point Context

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1		HAS OBS CONTEXT	TEXT	EV (126070, DCM, "Subject Time Point Identifier")	1	U
2		HAS OBS CONTEXT	TEXT	EV (126071, DCM, "Protocol Time Point Identifier")	1	U
3		HAS OBS CONTEXT	TEXT	EV (C2348792, UMLS, "Time Point")	1	M
4		HAS OBS CONTEXT	CODE	EV (126072, DCM, "Time Point Type")	1-n	U	BCID 6146 “Time Point Type”
5		HAS OBS CONTEXT	NUM	EV (126073, DCM, "Time Point Order")	1	U	UNITS = EV (1, UCUM, "no units")
6		HAS OBS CONTEXT	NUM	EV (128740, DCM, "Longitudinal Temporal Offset from Event")	1	U	UNITS = DT (d, UCUM, "days")
7	>	HAS CONCEPT MOD	CODE	EV (128741, DCM, "Longitudinal Temporal Event Type")	1	M	DCID 280 “Longitudinal Temporal Event Type”

Content Item Descriptions

Row 1	Usually the same value as the Clinical Trial Time Point ID (0012,0050) Attribute in the Clinical Trial Study Module, though not confined to clinical trial use. May or may not be human readable, and not required to be a DICOM UID.
Row 2	All of the subjects within a treatment protocol that are examined at a particular scheduled time point (e.g., "baseline", "pre-treatment", "first post-treatment") will have the same Protocol Time Point Identifier, but different Subject Time Point Identifiers. However, in different protocols, the Protocol Time Point Identifiers for the same conceptual "time point" will be different. E.g., the "baseline" time point will have different Protocol Time Point Identifiers in different protocols. May or may not be human readable, and not required to be a DICOM UID.
Row 3	Typically a short pre-defined label that has the same scope as Protocol Time Point Identifier (i.e., same conceptual time point within a treatment protocol) but is human-readable and understandable, e.g., "BASELINE" or "TP0", "TP1", etc. Usually the same value as Clinical Trial Time Point Description (0012,0051) Attribute in the Clinical Trial Study Module, though not confined to clinical trial use. The Concept Name is selected as (C2348792, UMLS, "Time Point") (which is (C68568, NCIt, "Time Point"), defined as "a specific point in the time continuum, including those established relative to an event") in order to be compatible with external terminologies.
Row 4	More than one type is permitted, e.g., a time point may be "posttreatment" as well as "unscheduled" or "nadir", etc.
Row 5	The order is expected to be monotonically increasing within a particular scope of usage, but is not required to start at 0 or 1, nor required to increase in increments of 1 or even the same increment (e.g., to allow for retrospective insertion of unscheduled time points). In clinical usage, the Time Point Order would be expected to be temporally increasing, but in a clinical trial may be a randomized reading order rather than a temporal order.
Rows 6, 7	Longitudinal temporal information may be inherited from Longitudinal Temporal Offset from Event (0012,0052) and Longitudinal Temporal Event Type (0012,0053) in the PS3.3 Section C.7.2.3 Clinical Trial Study Module, or may be specified or overridden within this template (e.g., if different measurements in the same SR Instance were measured on different time points).

TID 1600 Image Library

The Image Library contains references to images and selected attributes describing them that facilitate analysis without having to retrieve the entire set of referenced images.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1600. Image Library

	NL	Rel with Parent	VT	Concept Name	VM	Req Type
1			CONTAINER	EV (111028, DCM, "Image Library")	1	M
2	>	CONTAINS	CONTAINER	EV (126200, DCM, "Image Library Group")	1-n	U
3	>>	HAS ACQ CONTEXT	INCLUDE	DTID 1602 “Image Library Entry Descriptors”	1	U
4	>>	CONTAINS	INCLUDE	DTID 1601 “Image Library Entry”	1-n	U

Row 3

These Image Library Entry Descriptors apply to all Image Library Entries in this Image Library Group.

TID 1601 Image Library Entry

Each instance of the Image Library Entry Template contains the Image SOP Class and Instance UIDs, and selected attributes for an image that facilitate analysis without having to retrieve the entire set of referenced images.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1601. Image Library Entry

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			IMAGE		1	M
2	>	HAS ACQ CONTEXT	INCLUDE	DTID 1602 “Image Library Entry Descriptors”	1	U

Row 2

These Image Library Entry Descriptors apply to the IMAGE in Row 1 and override descriptors in Row 3 of Section TID 1600 in case of conflict.

TID 1602 Image Library Entry Descriptors

This Template contains selected attributes for an image or group of images. The descriptive information may be copied from images or derived.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1602. Image Library Entry Descriptors

	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	HAS ACQ CONTEXT	CODE	EV (121139, DCM, "Modality")	1	U		DCID 29 “Acquisition Modality”
2	HAS ACQ CONTEXT	CODE	EV (123014, DCM, "Target Region")	1	U		DCID 4031 “Common Anatomic Region”
3	HAS ACQ CONTEXT	CODE	EV (111027, DCM, "Image Laterality")	1	U		DCID 244 “Laterality”
4	HAS ACQ CONTEXT	DATE	EV (111060, DCM, "Study Date")	1	U
5	HAS ACQ CONTEXT	TIME	EV (111061, DCM, "Study Time")	1	U
6	HAS ACQ CONTEXT	DATE	EV (111018, DCM, "Content Date")	1	U
7	HAS ACQ CONTEXT	TIME	EV (111019, DCM, "Content Time")	1	U
8	HAS ACQ CONTEXT	DATE	EV (126201, DCM, "Acquisition Date")	1	U
9	HAS ACQ CONTEXT	TIME	EV (126202, DCM, "Acquisition Time")	1	U
10	HAS ACQ CONTEXT	UIDREF	EV (112227, DCM, "Frame of Reference UID")	1	U
11	HAS ACQ CONTEXT	NUM	EV (110910, DCM, "Pixel Data Rows")	1	U		UNITS = EV ({pixels}, UCUM, "pixels")
12	HAS ACQ CONTEXT	NUM	EV (110911, DCM, "Pixel Data Columns")	1	U		UNITS = EV ({pixels}, UCUM, "pixels")
13	HAS ACQ CONTEXT	INCLUDE	DTID 1603 “Image Library Entry Descriptors for Projection Radiography”	1	MC	IFF Row 1 is present with a value of "CR", "DX", "IO", "MG, "PX", "RF", "RG" or "XA"
14	HAS ACQ CONTEXT	INCLUDE	DTID 1604 “Image Library Entry Descriptors for Cross-Sectional Modalities”	1	MC	IFF Row 1 is present with a value of "CT", "MR" or "PT"
15	HAS ACQ CONTEXT	INCLUDE	DTID 1605 “Image Library Entry Descriptors for CT”	1	MC	IFF Row 1 is present with a value of "CT"
16	HAS ACQ CONTEXT	INCLUDE	DTID 1606 “Image Library Entry Descriptors for MR”	1	MC	IFF Row 1 is present with a value of "MR"
17	HAS ACQ CONTEXT	INCLUDE	DTID 1607 “Image Library Entry Descriptors for PET”	1	MC	IFF Row 1 is present with a value of "PT"

Content Item Descriptions

Row 2

The value of Anatomic Region Sequence (0008,2218) in the Image IOD, or a code derived from Body Part Examined (0018,0015) using the mapping described in Annex L.

TID 1603 Image Library Entry Descriptors for Projection Radiography

This Template contains selected attributes for a projection radiography image or group of such images. The descriptive information may be copied from images or derived.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1603. Image Library Entry Descriptors for Projection Radiography

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1		HAS ACQ CONTEXT	CODE	EV (111031, DCM, "Image View")	1	U
2	>	HAS CONCEPT MOD	CODE	EV (111032, DCM, "Image View Modifier")	1-n	U
3		HAS ACQ CONTEXT	TEXT	EV (111044, DCM, "Patient Orientation Row")	1	U
4		HAS ACQ CONTEXT	TEXT	EV (111043, DCM, "Patient Orientation Column")	1	U
5		HAS ACQ CONTEXT	NUM	EV (111026, DCM, "Horizontal Pixel Spacing")	1	U	UNITS = EV (mm, UCUM, "millimeter")
6		HAS ACQ CONTEXT	NUM	EV (111066, DCM, "Vertical Pixel Spacing")	1	U	UNITS = EV (mm, UCUM, "millimeter")
7		HAS ACQ CONTEXT	NUM	EV (112011, DCM, "Positioner Primary Angle")	1	U	UNITS = EV (deg, UCUM, "deg")
8		HAS ACQ CONTEXT	NUM	EV (112012, DCM, "Positioner Secondary Angle")	1	U	UNITS = EV (deg, UCUM, "deg")

Content Item Descriptions

Rows 3, 4	First (row) and second (column) components of Patient Orientation (0020,0020) in the Image IOD. See Section C.7.6.1.1.1 “Patient Orientation” in PS3.3 .
Row 5	The second component of Imager Pixel Spacing (0018,1164) in the Image IOD. See Section C.8.11.4 “DX Detector Module” in PS3.3 .
Row 6	The first component of Imager Pixel Spacing (0018,1164) in the Image IOD. See Section C.8.11.4 “DX Detector Module” in PS3.3 .

TID 1604 Image Library Entry Descriptors for Cross-Sectional Modalities

This Template contains selected attributes for a cross-sectional image or group of such images. The descriptive information may be copied from images or derived.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1604. Image Library Entry Descriptors for Cross-Sectional Modalities

	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1	HAS ACQ CONTEXT	NUM	EV (111026, DCM, "Horizontal Pixel Spacing")	1	U	UNITS = EV (mm, UCUM, "millimeter")
2	HAS ACQ CONTEXT	NUM	EV (111066, DCM, "Vertical Pixel Spacing")	1	U	UNITS = EV (mm, UCUM, "millimeter")
3	HAS ACQ CONTEXT	NUM	EV (112226, DCM, "Spacing between slices")	1	U	UNITS = EV (mm, UCUM, "millimeter")
4	HAS ACQ CONTEXT	NUM	EV (112225, DCM, "Slice Thickness")	1	U	UNITS = EV (mm, UCUM, "millimeter")
5	HAS ACQ CONTEXT	NUM	EV (110901, DCM, "Image Position (Patient) X")	1	U	UNITS = EV (mm, UCUM, "millimeter")
6	HAS ACQ CONTEXT	NUM	EV (110902, DCM, "Image Position (Patient) Y")	1	U	UNITS = EV (mm, UCUM, "millimeter")
7	HAS ACQ CONTEXT	NUM	EV (110903, DCM, "Image Position (Patient) Z")	1	U	UNITS = EV (mm, UCUM, "millimeter")
8	HAS ACQ CONTEXT	NUM	EV (110904, DCM, "Image Orientation (Patient) Row X")	1	U	UNITS = EV ({-1:1}, UCUM, "{-1:1}")
9	HAS ACQ CONTEXT	NUM	EV (110905, DCM, "Image Orientation (Patient) Row Y")	1	U	UNITS = EV ({-1:1}, UCUM, "{-1:1}")
10	HAS ACQ CONTEXT	NUM	EV (110906, DCM, "Image Orientation (Patient) Row Z")	1	U	UNITS = EV ({-1:1}, UCUM, "{-1:1}")
11	HAS ACQ CONTEXT	NUM	EV (110907, DCM, "Image Orientation (Patient) Column X")	1	U	UNITS = EV ({-1:1}, UCUM, "{-1:1}")
12	HAS ACQ CONTEXT	NUM	EV (110908, DCM, "Image Orientation (Patient) Column Y")	1	U	UNITS = EV ({-1:1}, UCUM, "{-1:1}")
13	HAS ACQ CONTEXT	NUM	EV (110909, DCM, "Image Orientation (Patient) Column Z")	1	U	UNITS = EV ({-1:1}, UCUM, "{-1:1}")

Content Item Descriptions

Row 1	The second component of Pixel Spacing (0028,0030) in the Image IOD. See Section 10.7.1.1 “Pixel Spacing” in PS3.3 and Section C.7.6.2 “Image Plane Module” in PS3.3 .
Row 2	The first component of Pixel Spacing (0028,0030) in the Image IOD. See Section 10.7.1.1 “Pixel Spacing” in PS3.3 and Section C.7.6.2 “Image Plane Module” in PS3.3 .

TID 1605 Image Library Entry Descriptors for CT

This Template contains selected attributes for a CT image or group of such images. The descriptive information may be copied from images or derived.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1605. Image Library Entry Descriptors for CT

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS ACQ CONTEXT	CODE	EV (113820, DCM, "CT Acquisition Type")	1	U		DCID 10013 “CT Acquisition Type”
2		HAS ACQ CONTEXT	CODE	EV (113961, DCM, "Reconstruction Algorithm")	1	U		DCID 10033 “CT Reconstruction Algorithm”

Content Item Descriptions

Row 1	A code derived from the value of Acquisition Type (0018,9302) in the Image IOD. See Section C.8.15.3.2 “CT Acquisition Type Macro” in PS3.3 .
Row 2	A code derived from the value of Reconstruction Algorithm (0018,9315) in the Image IOD. See Section C.8.15.3.7 “CT Reconstruction Macro” in PS3.3 .

TID 1606 Image Library Entry Descriptors for MR

This Template contains selected attributes for a MR image or group of such images. The descriptive information may be copied from images or derived. Specialized coded Content Items allow more precise description of imaging sequences used for interpretation of multiparametric prostate MRI.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1606. Image Library Entry Descriptors for MR

	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1	HAS ACQ CONTEXT	TEXT	EV (128230, DCM, "Pulse Sequence Name")	1	U
2	HAS ACQ CONTEXT	NUM	EV (130542, DCM, "Magnetic field strength")	1	U	UNITS = (T, UCUM, "Tesla")
3	HAS ACQ CONTEXT	NUM	EV (RID10813, RADLEX, "MR coil")	1-n	U	DCID 6349 “MR Coil Type”
4	HAS ACQ CONTEXT	NUM	EV (110852, DCM, "MR signal intensity")	1	U	BCID 6311 “MR Signal Intensity”
5	HAS ACQ CONTEXT	NUM	EV (130546, DCM, "Cross-sectional scan plane orientation")	1	U	BCID 6312 “Cross-sectional Scan Plane Orientation”
6	HAS ACQ CONTEXT	NUM	EV (113240, DCM, "Source image diffusion b-value")	1-n	U	UNITS = (s/mm2, UCUM, "s/mm2")
7	HAS ACQ CONTEXT	INCLUDE	DTID 1608 “Image Library Entry Descriptors for Prostate Multiparametric MR”	1	U

Content Item Descriptions

Row 1	The value of Pulse Sequence Name (0018,9005) or Sequence Name (0018,0024) in the Image IOD. See Section C.8.13.4 “MR Pulse Sequence Module” in PS3.3 .
Row 6	Multiple values may apply when entry descriptor corresponds to a parametric map such as Apparent Diffusion Coefficient (ADC) map, which utilizes multiple b-values from a Diffusion-Weighted acquisition.

TID 1607 Image Library Entry Descriptors for PET

This Template contains selected attributes for a PET image or group of such images. The descriptive information may be copied from images or derived.

Note

The content of this Template is similar to that in TID 15101 NM/PET Protocol Context, but is in the form of an SR Template rather than a Protocol Context Template, and the Content Items are not nested as modifiers. There is also some similarity to TID 3307 NM/PET Perfusion Measurement Group.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1607. Image Library Entry Descriptors for PET

	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	HAS ACQ CONTEXT	CODE	EV (89457008, SCT, "Radionuclide")	1	U		DCID 4020 “PET Radionuclide”
2	HAS ACQ CONTEXT	CODE	EV (349358000, SCT, "Radiopharmaceutical agent")	1	U		DCID 4021 “PET Radiopharmaceutical”
3	HAS ACQ CONTEXT	NUM	EV (304283002, SCT, "Half-life of radiopharmaceutical")	1	U		UNITS = EV (s, UCUM, "s")
3b	HAS ACQ CONTEXT	TEXT	EV (121022, DCM, "Accession Number")	1	U
4	HAS ACQ CONTEXT	DATETIME	EV (123003, DCM, "Radiopharmaceutical Start DateTime")	1	U
5	HAS ACQ CONTEXT	DATETIME	EV (123004, DCM, "Radiopharmaceutical Stop DateTime")	1	U
6	HAS ACQ CONTEXT	NUM	EV (123005, DCM, "Radiopharmaceutical Volume")	1	U		UNITS = DT (cm3, UCUM, "cm3")
7	HAS ACQ CONTEXT	NUM	EV (123006, DCM, "Radionuclide Total Dose")	1	U		UNITS = DT (Bq, UCUM, "Bq")
8	HAS ACQ CONTEXT	NUM	EV (123007, DCM, "Radiopharmaceutical Specific Activity")	1	U		UNITS = DT (Bq/mol, UCUM, "Bq/mol")
9	HAS ACQ CONTEXT	CODE	EV (410675002, SCT, "Route of Administration")	1	U		BCID 11 “Administration Route”
10	HAS ACQ CONTEXT	NUM	EV (123009, DCM, "Radionuclide Syringe Counts")	1	U		UNITS = DT ({counts}/s, UCUM, "counts/s")
11	HAS ACQ CONTEXT	NUM	EV (123010, DCM, "Radionuclide Residual Syringe Counts")	1	U		UNITS = DT ({counts}/s, UCUM, "counts/s")
12	HAS ACQ CONTEXT	NUM	EV (126203, DCM, "PET Radionuclide Incubation Time")	1	U		UNITS = EV (min, UCUM, "min")
13	HAS ACQ CONTEXT	NUM	EV (14749-6, LN, "Glucose")	1	U		UNITS = EV (mmol/l, UCUM, "mmol/l")
14	HAS ACQ CONTEXT	DATE	EV (127857, DCM, "Glucose Measurement Date")	1	MC	IF Row 13 Glucose is present and does not contain Observation DateTime (0040,A032).
15	HAS ACQ CONTEXT	TIME	EV (127858, DCM, "Glucose Measurement Time")	1	MC	IF Row 13 Glucose is present and does not contain Observation DateTime (0040,A032).

Content Item Descriptions

Row 3	Half-life of radiopharmaceutical	The units for half life are chosen to be seconds, to match the units used for Radionuclide Half Life (0018,1075). See Section C.8.9.2 “PET Isotope Module” in PS3.3 .
Row 14	Glucose Measurement Date	In an earlier edition of the Standard, an incorrect DCM code was used for this concept, which was already assigned as (109081, DCM, "Prospective gating").
Row 15	Glucose Measurement Time	In an earlier edition of the Standard, an incorrect DCM code was used for this concept, which was already assigned as (109082, DCM, "Retrospective gating").

TID 1608 Image Library Entry Descriptors for Prostate Multiparametric MR

This Template includes attributes for image library entries that define the type of the sequence, as needed for PI-RADS interpretation of multiparametric MRI, specify most important sequence-specific attributes, and provide a location for reporting prostate imaging and sequence-specific technical characteristics of the acquisition.

Note

A descriptor specific to prostate MRI and PI-RADS is provided to record Prostate DCE temporal resolution. This term follows the conventions used in the PI-RADS guidelines.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 1608. Image Library Entry Descriptors for Prostate Multiparametric MR

	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1	HAS ACQ CONTEXT	TEXT	EV (130544, DCM, "Endorectal coil type")	1	U
2	HAS ACQ CONTEXT	CODE	EV (130545, DCM, "Inflatable endorectal coil fill substance")	1	U	DCID 6350 “Endorectal Coil Fill Substance”
3	HAS ACQ CONTEXT	NUM	EV (130547, DCM, "Dynamic contrast-enhanced temporal resolution")	1-n	U	UNITS = (s, UCUM, "second")

TID 1700 Generic Blood Lab Measurements

The Generic Blood Lab Measurements Template provides for the recording of measurements made on a blood sample that is not specific to a particular clinical application. The type and anatomic source of the blood is recorded as acquisition context. The results from the blood chemistry measurement system are quoted; the measurement names may be pre-coordinated with the type or source of the blood, or generic measurement names may be reported. In the latter case, the full measurement concept name may be effectively post-coordinated using the recorded acquisition context.

Table TID 1700. Parameters

Parameter Name	Parameter Usage
$Measurement	Measurement.
$Units	Measurement units.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1700. Generic Blood Lab Measurements

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (122125, DCM, "Blood lab measurements")	1	M
2	>	HAS ACQ CONTEXT	DATETIME	EV (111469, DCM, "Sampling DateTime")	1	M
3	>	HAS ACQ CONTEXT	CODE	EV (371439000, SCT, "Specimen Type")	1	M	DCID 3520 “Blood Source Type”
4	>	HAS ACQ CONTEXT	CODE	EV (363704007, SCT, "Procedure site")	1	M	BCID 3630 “Cardiovascular Anatomic Location”
5	>		INCLUDE	DTID 1000 “Quotation”	1	U
6	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	M	$Measurement = $Measurement $Units = $Units

TID 1701 Imaging Study Quality

This template provides the mechanism to describe image quality both at the study and individual series level, following a specific quality control standard.

Table TID 1701. Parameters

Parameter Name	Parameter Usage
$ImageQualityControlStandard	Value for Quality Control Standard.
$StudyQualityFindings	Value for Study Quality Findings.
$SeriesQualityFindings	Value for Series Quality Findings.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 1701. Imaging Study Quality

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (130549, DCM, "Imaging Study Quality")	1	M
2	>	CONTAINS	CODE	EV (111050, DCM, "Quality Assessment")	1	M		DCID 6044 “Image Quality Assessment Type”
3	>>	HAS PROPERTIES	CODE	EV (111051, DCM, "Quality Control Standard")	1	M		$ImageQualityControlStandard Defaults to BCID 6326 “Image Quality Control Standard”
4	>	CONTAINS	CODE	EV (111052, DCM, "Quality Finding")	1-n	U		$StudyQualityFindings
5	>	CONTAINS	CONTAINER	EV (130550, DCM, "Imaging Series Quality")	1-n	U
6	>>	CONTAINS	UIDREF	EV (112002, DCM, "Series Instance UID")	1-n	M
7	>>	CONTAINS	CODE	EV (111050, DCM, "Quality Assessment")	1	MC	At least one of Rows 7, 9, 10 shall be present	DCID 6044 “Image Quality Assessment Type”
8	>>>	HAS PROPERTIES	CODE	EV (111051, DCM, "Quality Control Standard")	1	M		$ImageQualityControlStandard Defaults to BCID 6326 “Image Quality Control Standard”
9	>>	CONTAINS	CODE	EV (111052, DCM, "Quality Finding")	1-n	MC	At least one of Rows 7, 9, 10 shall be present	$SeriesQualityFindings
10	>>	CONTAINS	NUM	EV (111029, DCM, "Image Quality Rating")	1-n	MC	At least one of Rows 7, 9, 10 shall be present	UNITS = EV (%, UCUM, "Percent") Value = 0 - 100

Content Item Descriptions

Row 6

Defines the series to which the assessments apply.

TID 2000 Basic Diagnostic Imaging Report

Basic report Template for general diagnostic imaging interpretation reports.

Can only be instantiated at the root node and cannot be included in other Templates.

Type:: Non-Extensible
Order:: Significant
Root:: Yes

Table TID 2000. Basic Diagnostic Imaging Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	BCID 7000 “Diagnostic Imaging Report Document Title”	1	M	Root node
2	>	HAS CONCEPT MOD	CODE	EV (121058, DCM, "Procedure reported")	1-n	U
3	>	HAS CONCEPT MOD	CODE	EV (122142, DCM, "Acquisition Device Type")	1-n	U	DCID 29 “Acquisition Modality”
4	>	HAS CONCEPT MOD	CODE	EV (123014, DCM, "Target Region")	1-n	U
5	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	M
6	>	HAS CONCEPT MOD	INCLUDE	DTID 1210 “Equivalent Meaning(s) of Concept Name”	1-n	U
7	>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	M
8	>	CONTAINS	CONTAINER	BCID 7001 “Diagnostic Imaging Report Heading”	1-n	U
9	>>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	U
10	>>		INCLUDE	DTID 2002 “Report Narrative”	1	M

No Content Items other than those defined in Observation Context TID 1001 “Observation Context” may be the target of a HAS OBS CONTEXT relationship when TID 2000 “Basic Diagnostic Imaging Report” is invoked.

Content Item Descriptions

Rows 2, 3, 4

The content of Rows 2, 3, and 4 shall not be inconsistent with the meaning of the report title of Row 1. If the report title does not include the concepts of the procedure type, modality, or target site (e.g., the generic "Diagnostic Imaging Report"), these rows may provide post-coordination of those concepts. If the report title does include such concepts (e.g., "CT Head Report"), they may be encoded duplicatively to support report categorization and search.

TID 2001 Basic Diagnostic Imaging Report Observations

Individual numeric or image observations that may be useful for inclusion as individual findings or as the source of inferences in a report.

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 2001. Basic Diagnostic Imaging Report Observations

	VT	Concept Name	VM	Req Type	Condition
1	IMAGE	BCID 7003 “Diagnostic Imaging Report Purpose of Reference”	1	MC	XOR Rows 2, 3, 4, 5.
2	INCLUDE	DTID 1400 “Linear Measurement”	1	MC	XOR Rows 1, 3, 4, 5. Shall not be present if the NUM value type is not supported by the IOD.
3	INCLUDE	DTID 1401 “Area Measurement”	1	MC	XOR Rows 1, 2, 4, 5. Shall not be present if the NUM value type is not supported by the IOD.
4	INCLUDE	DTID 1402 “Volume Measurement”	1	MC	XOR Rows 1, 2, 3, 5. Shall not be present if the NUM value type is not supported by the IOD.
5	INCLUDE	DTID 1404 “Numeric Measurement”	1	MC	XOR Rows 1, 2, 3, 4. Shall not be present if the NUM value type is not supported by the IOD.

TID 2002 Report Narrative

The Report Narrative allows recording of text, code, and numeric observations. The order of Content Items in the Template is not significant; the order of Content Items in a SOP Instance may be significant to the narrative flow of the report.

Type:: Non-Extensible
Order:: Non-Significant
Root:: No

Table TID 2002. Report Narrative

	NL	Rel with Parent	VT	Concept Name	VM	Req Type
1		CONTAINS	CODE	BCID 7002 “Diagnostic Imaging Report Element”	1-n	U
2	>	INFERRED FROM	INCLUDE	DTID 2001 “Basic Diagnostic Imaging Report Observations”	1-n	U
3		CONTAINS	TEXT	BCID 7002 “Diagnostic Imaging Report Element”	1-n	U
4	>	INFERRED FROM	INCLUDE	DTID 2001 “Basic Diagnostic Imaging Report Observations”	1-n	U
5		CONTAINS	INCLUDE	DTID 2001 “Basic Diagnostic Imaging Report Observations”	1-n	U

TID 2005 Transcribed Diagnostic Imaging Report

Basic report Template for general diagnostic imaging interpretation reports produced in a dictation/transcription workflow. SR documents encoded using this Template are intended to be transformable to HL7 Clinical Document Architecture format (see Section X.3 “Transcribed Diagnostic Imaging CDA Instance Content” in PS3.17 and Annexes in PS3.20).

This Template can be instantiated only at the root node, and cannot be included in other Templates.

Observation Context shall be inherited from outside the Structured Report Content Tree, and shall not be changed within the Content Tree. To satisfy the requirement that Observer Context is inherited, either or both the Author Observer Sequence (0040,A078) or the Verifying Observer Sequence (0040,A073) from the SR Document General Module must be present in the SOP Instance.

Note

See Section C.17.5 “Observation Context Encoding” in PS3.3 .

Type:: Non-Extensible
Order:: Significant
Root:: Yes

Table TID 2005. Transcribed Diagnostic Imaging Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	BCID 7000 “Diagnostic Imaging Report Document Title”	1	M	Root node
2	>	HAS CONCEPT MOD	CODE	EV (121058, DCM, "Procedure reported")	1-n	U
3	>	HAS CONCEPT MOD	CODE	EV (122142, DCM, "Acquisition Device Type")	1-n	U	DCID 29 “Acquisition Modality”
4	>	HAS CONCEPT MOD	CODE	EV (123014, DCM, "Target Region")	1-n	U
5	>	HAS CONCEPT MOD	CODE	EV (121049, DCM, "Language of Content Item and Descendants")	1	M	DCID 5000 “Language”
6	>	CONTAINS	CONTAINER	BCID 7001 “Diagnostic Imaging Report Heading”	1-n	M
7	>>	CONTAINS	TEXT	BCID 7002 “Diagnostic Imaging Report Element”	1	U
8	>	CONTAINS	CONTAINER	EV (55113-5, LN, "Key Images")	1-n	U
9	>>	CONTAINS	TEXT	EV (113012, DCM, "Key Object Description")	1	U
10	>>	CONTAINS	IMAGE		1-n	M

Content Item Descriptions

Rows 2, 3, 4	The content of Rows 2, 3, and 4 shall not be inconsistent with the meaning of the report title of Row 1. If the report title does not include the concepts of the procedure type, modality, or target site (e.g., the generic "Diagnostic Imaging Report"), these rows may provide post-coordination of those concepts. If the report title does include such concepts (e.g., "CT Head Report"), they may be encoded duplicatively to support report categorization and search.
Row 6	CONTAINER Concept Name may be absent.
Row 10	IMAGE Concept Name shall be absent. Purpose of reference is not specified.

TID 2006 Imaging Report With Conditional Radiation Exposure and Protection Information

This Template is used for general imaging reports for both radiation producing and non-radiation producing modalities.

For radiation producing modalities, radiation exposure and protection information is required, such as to support nationally-specific legal or standard requirements.

It contains mandatory sections, each of which may appear only once in objects instantiated from the Template, including the medical content of the report that comprises relevant medical history data, information on the current request (i.e., clinical question that is expected to be answered by the requested procedure), impressions on the current imaging procedure that has been performed, and radiation exposure and protection information.

This Template is a specialization of TID 2000 “Basic Diagnostic Imaging Report”, in that it uses the same structure of headings and content, but mandates the presence and order of specific headings, and extends the subordinate content with specific Content Items.

Type:: Non-Extensible
Order:: Non-Significant
Root:: Yes

Table TID 2006. Imaging Report With Conditional Radiation Exposure and Protection Information

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	BCID 7000 “Diagnostic Imaging Report Document Title”	1	M		Root node
2	>	HAS CONCEPT MOD	CODE	EV (121058, DCM, "Procedure reported")	1-n	U
3	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	M
4	>	HAS CONCEPT MOD	INCLUDE	DTID 1210 “Equivalent Meaning(s) of Concept Name”	1-n	U
5	>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	M
6	>	CONTAINS	CONTAINER	EV (55111-9, LN, "Current Procedure Descriptions")	1	M
7	>>		INCLUDE	DTID 2007 “Imaging Procedure Description”	1	M
8	>	CONTAINS	CONTAINER	EV (55114-3, LN, "Prior Procedure Descriptions")	1-n	MC	IF relevant prior procedures have been performed.
9	>>		INCLUDE	DTID 2007 “Imaging Procedure Description”	1	M
10	>	CONTAINS	CONTAINER	EV (11329-0, LN, "History")	1	M
11	>>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	U
12	>>		INCLUDE	DTID 2002 “Report Narrative”	1	M
13	>	CONTAINS	CONTAINER	EV (55115-0, LN, "Request")	1	M
14	>>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	U
15	>>		INCLUDE	DTID 2002 “Report Narrative”	1	M
16	>	CONTAINS	CONTAINER	EV (19005-8, LN, "Impressions")	1	M
17	>>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	U
18	>>		INCLUDE	DTID 2002 “Report Narrative”	1	M
19	>	CONTAINS	INCLUDE	DTID 2008 “Radiation Exposure and Protection Information”	1	MC	IF the current procedure exposes the patient to ionizing radiation.
20	>	CONTAINS	CONTAINER	BCID 7001 “Diagnostic Imaging Report Heading”	1-n	U
21	>>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	U
22	>>		INCLUDE	DTID 2002 “Report Narrative”	1	M

No Content Items other than those defined in TID 1001 “Observation Context” may be the target of a HAS OBS CONTEXT relationship when TID 2006 “Imaging Report With Conditional Radiation Exposure and Protection Information” is invoked.

Content Item Descriptions

Row 2

Even though this information is related to the content of Row 6 in TID 2007 “Imaging Procedure Description”, it is present here for consistency with other report Templates.

Rows 5, 6

Information on at least one of the following person observers is mandatory:

1) "Performing Physician"

2) "Performing Technologist".

(For those person observers, requirement types as specified in TID 1003 “Person Observer Identifying Attributes” apply. That means that "Person Observer Name" is the only mandatory Content Item).

Row 20

Each heading (concept code from CID 7001 “Diagnostic Imaging Report Heading”) may appear only once, and may not repeat the headings (concept codes) used when instantiating any other rows of this Template.

TID 2007 Imaging Procedure Description

Contains information related to the procedure.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 2007. Imaging Procedure Description

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1		HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	U
2		CONTAINS	TEXT	EV (123014, DCM, "Target Region")	1	MC	XOR with Row 3
3		CONTAINS	CODE	EV (123014, DCM, "Target Region")	1	MC	XOR with Row 2	DCID 4028 “Craniofacial Anatomic Region” DCID 4030 “CT, MR and PET Anatomy Imaged” DCID 4031 “Common Anatomic Region”
4	>	HAS CONCEPT MOD	CODE	EV (122142, DCM, "Acquisition Device Type")	1-n	U		DCID 29 “Acquisition Modality”
5		CONTAINS	TEXT	EV (121065, DCM, "Procedure Description")	1	M
6		CONTAINS	DATE	EV (111060, DCM, "Study Date")	1	M		Shall be equal to the Study Date (0020,0020) in the General Study Module in the images to which this report applies.
7		CONTAINS	TIME	EV (111061, DCM, "Study Time")	1	U		If present, shall be equal to the Study Time (0020,0030) in the General Study Module in the images to which this report applies.
8		CONTAINS	COMPOSITE	EV (113701, DCM, "X-Ray Radiation Dose Report")	1-n	U

TID 2008 Radiation Exposure and Protection Information

Contains information related to the radiation exposure and protection of the patient, as is required by national legal requirements or standards.

Other information about the current procedure is described in TID 2006 “Imaging Report With Conditional Radiation Exposure and Protection Information” and not repeated here.

Type:: Extensible
Order:: Non-Significant
Root:: No

Table TID 2008. Radiation Exposure and Protection Information

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (73569-6, LN, "Radiation Exposure and Protection Information")	1	M
2	>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	U
3	>	CONTAINS	CODE	EV (364320009, SCT, "Pregnancy observable")	1	MC	IF female patient of child-bearing age	DCID 6096 “Pregnancy Status”
4	>	CONTAINS	TEXT	EV (18785-6, LN, "Indications for Procedure")	1	M
5	>	CONTAINS	PNAME	EV (113850, DCM, "Irradiation Authorizing")	1	M
6	>	CONTAINS	TEXT	EV (113921, DCM, "Radiation Exposure")	1	MC	IFF ionizing radiation is applied in the context of the current procedure
7	>	CONTAINS	TEXT	EV (440252007, SCT, "Administration of radiopharmaceutical")	1	MC	IFF radioactive substance is administered in the context of the current procedure

Content Item Descriptions

Row 5

The clinician responsible for determining that the irradiating procedure was appropriate for the indications.

Row 6

A textual, human-readable description of the radiation exposure is all that is required by this Template (such as is sufficient to comply with, for example, German law). Detailed specification of exposure is out of the scope of this Template. Such information may be given in a separate SR instances such as described in TID 10001 “Projection X-Ray Radiation Dose” or TID 10011 “CT Radiation Dose”, and referenced from TID 2007 “Imaging Procedure Description”.

TID 2010 Key Object Selection

The Key Object Selection Template is intended for flagging one or more significant images, waveforms, or other composite SOP Instances. Key Object Selection contains:

coded document title stating the reason for significance of the referenced objects in the Key Object Selection,
optional free form text comment in an explicitly identified language, and
optional identification of the observer (device or person) that created the Key Object Selection.

Note

For instance, when this Template is used to identify images rejected for quality reasons, the device or person performing the quality assessment is identified in observation context items (invoked through TID 1002 “Observer Context”). The reason for rejection can be included both as a code used as a concept modifier for the document title, and as text description.
The order of object references may be significant, e.g., when the title concept is "For Conference".
Instances referenced in a Key Object Selection Document may be securely referenced by Digital Signature or MAC mechanisms within the SR Document General Module (see PS3.3).

The Template can only be instantiated at the root node and cannot be included in other Templates. The Template is not extensible; that is, no other Content Items may be added to this Template, or the Templates that are included, recursively.

Type:: Non-Extensible
Order:: Non-Significant
Root:: Yes

Table TID 2010. Key Object Selection

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	DCID 7010 “Key Object Selection Document Title”	1	M		Root node
2	>	HAS CONCEPT MOD	CODE	EV (113011, DCM, "Document Title Modifier")	1-n	U
3	>	HAS CONCEPT MOD	CODE	EV (113011, DCM, "Document Title Modifier")	1	UC	IF Row 1 Concept Name = (113001, DCM, "Rejected for Quality Reasons") or (113010, DCM, "Quality Issue")	DCID 7011 “Rejected for Quality Reason”
4	>	HAS CONCEPT MOD	CODE	EV (113011, DCM, "Document Title Modifier")	1	MC	IF Row 1 Concept Name = (113013, DCM, "Best In Set")	DCID 7012 “Best in Set”
5	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	U
6	>	HAS OBS CONTEXT	INCLUDE	DTID 1002 “Observer Context”	1-n	U
7	>	CONTAINS	TEXT	EV (113012, DCM, "Key Object Description")	1	U
8	>	CONTAINS	IMAGE		1-n	MC	At least one of Rows 8, 9 and 10 shall be present
9	>	CONTAINS	WAVEFORM		1-n	MC	At least one of Rows 8, 9 and 10 shall be present
10	>	CONTAINS	COMPOSITE		1-n	MC	At least one of Rows 8, 9 and 10 shall be present

Content Item Descriptions

Rows 8, 9, 10

Purpose of reference shall not be present.

TID 2020 Spectacle Prescription Report

The Spectacle Prescription Report is a structured report used to represent the prescription for a patient. Usually a prescription is for both eyes, but sometimes just one. The Spectacle Prescription Report defines a refractive correction relative to which visual acuity may be measured subjectively, and thus may be referenced by a Visual Acuity Measurements Storage SOP Instance.

Type:: Extensible
Order:: Significant
Root:: Yes

Table TID 2020. Spectacle Prescription Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (111671, DCM, "Spectacle Prescription Report")	1	M		Root node
2	>	CONTAINS	CONTAINER	EV (111688, DCM, "Right Eye Rx")	1	UC	IF Right Spectacle Lens is prescribed
3	>>	CONTAINS	INCLUDE	DTID 2021 “Template for Spectacle Prescription Details”	1	M
4	>	CONTAINS	CONTAINER	EV (111689, DCM, "Left Eye Rx")	1	UC	IF Left Spectacle Lens is prescribed
5	>>	CONTAINS	INCLUDE	DTID 2021 “Template for Spectacle Prescription Details”	1	M
6	>	CONTAINS	NUM	EV (111679, DCM, "Distance Pupillary Distance")	1	U		UNITS = EV (mm, UCUM, "mm")
7	>	CONTAINS	NUM	EV (111680, DCM, "Near Pupillary Distance")	1	U		UNITS = EV (mm, UCUM, "mm")
8	>	CONTAINS	TEXT	EV (121106, DCM, "Comment")	1	U

TID 2021 Template for Spectacle Prescription Details

Type:: Extensible
Order:: Significant
Root:: No

Table TID 2021. Spectacle Prescription Details

	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	CONTAINS	NUM	EV (251795007, SCT, "Sphere")	1	M		UNITS = EV ([diop], UCUM, "diopters")
2	CONTAINS	NUM	EV (251797004, SCT, "Cylinder Power")	1	UC	IF Cylinder is prescribed	UNITS = EV ([diop], UCUM, "diopters")
3	CONTAINS	NUM	EV (251799001, SCT, "Axis")	1	MC	IF Row 2 is present	UNITS = EV (deg, UCUM, "degrees")
4	CONTAINS	NUM	EV (111672, DCM, "Add Near")	1	UC	IF Add Near is prescribed	UNITS = EV ([diop], UCUM, "diopters")
5	CONTAINS	NUM	EV (111673, DCM, "Add Intermediate")	1	UC	IF Add Intermediate is prescribed	UNITS = EV ([diop], UCUM, "diopters")
6	CONTAINS	NUM	EV (111674, DCM, "Add Other")	1	UC	IF Add Other is prescribed	UNITS = EV ([diop], UCUM, "diopters")
7	CONTAINS	NUM	EV (111675, DCM, "Horizontal Prism Power")	1	UC	IF Horizontal Prism is prescribed	UNITS = EV ([p'diop], UCUM, "prism diopters")
8	CONTAINS	CODE	EV (111676, DCM, "Horizontal Prism Base")	1	MC	IF Row 7 is present	DCID 4214 “Ophthalmic Horizontal Direction”
9	CONTAINS	NUM	EV (111677, DCM, "Vertical Prism Power")	1	UC	IF Vertical Prism is prescribed	UNITS = EV ([p'diop], UCUM, "prism diopters")
10	CONTAINS	CODE	EV (111678, DCM, "Vertical Prism Base")	1	MC	IF Row 9 is present	DCID 4215 “Ophthalmic Vertical Direction”
11	CONTAINS	NUM	EV (415813002, SCT, "Vertex distance")	1	U		UNITS = EV (mm, UCUM, "mm")

TID 2100 Macular Grid Thickness and Volume Report

The Macular Grid Thickness and Volume Report is a structured report encoding the macular grid thickness and volume values derived from ophthalmic images, such as ophthalmic OPT images. This may encode measurements of either or both eyes.

The macular grid conveyed by this report is based upon the grid employed by the Early Treatment of Diabetic Retinopathy Study (ETDRS) to measure area and proximity of macular edema to the anatomic center (fovea) of the macula. See ETDRS Report Number 10.

Type:: Extensible
Order:: Significant
Root:: Yes

Table TID 2100. Macular Grid Thickness and Volume Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (111690, DCM, "Macular Grid Thickness and Volume Report")	1	M		Root node
2	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	M
3	>	HAS OBS CONTEXT	INCLUDE	DTID 1001 “Observation Context”	1	M
4	>	CONTAINS	INCLUDE	DTID 2101 “Macular Grid Thickness and Volume Measurement”	1	MC	IF Row 5 is absent.	$Laterality = EV (24028007, SCT, "Right")
5	>	CONTAINS	INCLUDE	DTID 2101 “Macular Grid Thickness and Volume Measurement”	1	MC	IF Row 4 is absent.	$Laterality = EV (7771000, SCT, "Left")

TID 2101 Macular Grid Thickness and Volume Measurement

This Template encodes the macular grid thickness and volume measurements for a single eye.

Table TID 2101. Parameters

Parameter Name	Parameter Usage
$Laterality	Which eye

Type:: Extensible
Order:: Significant
Root:: No

Table TID 2101. Macular Grid Thickness and Volume Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	EV (81745001, SCT, "Eye")
3	>>	HAS CONCEPT MOD	CODE	EV (272741003, SCT, "Laterality")	1	M	$Laterality
4	>	CONTAINS	NUM	EV (57108-3, LN, "Macular Grid.Center Point Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
5	>	CONTAINS	NUM	EV (57109-1, LN, "Macular Grid.Center Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
6	>	CONTAINS	NUM	EV (57110-9, LN, "Macular Grid.Inner Superior Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
7	>	CONTAINS	NUM	EV (57111-7, LN, "Macular Grid.Inner Nasal Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
8	>	CONTAINS	NUM	EV (57112-5, LN, "Macular Grid.Inner Inferior Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
9	>	CONTAINS	NUM	EV (57113-3, LN, "Macular Grid.Inner Temporal Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
10	>	CONTAINS	NUM	EV (57114-1, LN, "Macular Grid.Outer Superior Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
11	>	CONTAINS	NUM	EV (57115-8, LN, "Macular Grid.Outer Nasal Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
12	>	CONTAINS	NUM	EV (57116-6, LN, "Macular Grid.Outer Inferior Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
13	>	CONTAINS	NUM	EV (57117-4, LN, "Macular Grid.Outer Temporal Subfield Thickness")	1	M	UNITS = EV (um, UCUM, "micrometer")
14	>	CONTAINS	NUM	EV (57118-2, LN, "Macular Grid.Total Volume")	1	M	UNITS = EV (mm3, UCUM, "mm3")
15	>	CONTAINS	NUM	EV (111691, DCM, "Number of Images Used for Macular Measurements")	1	M	UNITS = EV ({images}, UCUM, "images")
16	>	CONTAINS	NUM	EV (111692, DCM, "Number of Samples Used per Image")	1	M	UNITS = EV ({samples}, UCUM, "samples")
17	>	CONTAINS	NUM	EV (111693, DCM, "Analysis Quality Rating")	1	M	UNITS = EV ({0:100}, UCUM, "range:0:100") Value = 0 - 100
18	>>	HAS OBS CONTEXT	INCLUDE	DTID 2102 “Quality Rating Identification”	1	M
19	>	CONTAINS	NUM	EV (111694, DCM, "Image Set Quality Rating")	1	M	UNITS = EV ({0:100}, UCUM, "range:0:100") Value = 0 - 100
20	>>	HAS OBS CONTEXT	INCLUDE	DTID 2102 “Quality Rating Identification”	1	M
21	>	CONTAINS	NUM	EV (111029, DCM, "Image Quality Rating")	1-n	U	UNITS = EV ({0:100}, UCUM, "range:0:100") Value = 0 - 100
22	>>	INFERRED FROM	IMAGE		1	M
23	>>	HAS OBS CONTEXT	INCLUDE	DTID 2102 “Quality Rating Identification”	1	M
24	>	CONTAINS	CODE	EV (111696, DCM, "Visual Fixation Quality During Acquisition")	1	U	DCID 4220 “Visual Fixation Quality During Acquisition”
25	>>	HAS CONCEPT MOD	CODE	EV (111697, DCM, "Visual Fixation Quality Problem")	1-n	U	DCID 4221 “Visual Fixation Quality Problem”
26	>	CONTAINS	CODE	EV (111698, DCM, "Ophthalmic Macular Grid Problem")	1-n	U	DCID 4222 “Ophthalmic Macular Grid Problem”
27	>	CONTAINS	TEXT	EV (121106, DCM, "Comment")	1	U

Content Item Descriptions

Row 22

No purpose of reference is specified.

TID 2102 Quality Rating Identification

This Template specifies the algorithm (and parameters) used to create a quality rating for an image or image set.

It is expected that the identified algorithm will create a consistent quality rating when analyzing a given image. If the algorithm allows change to its parameters that would alter the quality rating created, the specific parameters used should be specified.

Type:: Non-Extensible
Order:: Significant
Root:: No

Table TID 2102. Quality Rating Identification

	VT	Concept Name	VM	Req Type
1	TEXT	EV (111001, DCM, "Algorithm Name")	1	M
2	TEXT	EV (111003, DCM, "Algorithm Version")	1	M
3	TEXT	EV (122405, DCM, "Algorithm Manufacturer")	1	M
4	TEXT	EV (111002, DCM, "Algorithm Parameters")	1-n	U

Procedure Log IOD Templates

TID 3001 Procedure Log

The Procedure Log Template is intended for the representation of reports or logs of time-stamped events occurring during an image-guided interventional or other procedure.

This Template does not require a particular ordering of the subsidiary Content Items.

Note

The Procedure Log IOD (PS3.3) requires ordering by Observation DateTime; thus log entries of different types (i.e., specified by different Rows in the Template) may appear in any order.
While this Template is extensible, the Procedure Log IOD forbids Container Content Items subsidiary to the top level Container.

Type:: Extensible
Order:: Non-Significant
Root:: Yes

Table TID 3001. Procedure Log

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	DCID 3400 “Procedure Log Title”	1	M	Root node
2	>		INCLUDE	DTID 1002 “Observer Context”	1-n	M
3	>		INCLUDE	DTID 3601 “Procedure Context”	1	M
4	>	HAS ACQ CONTEXT	TEXT	EV (121121, DCM, "Room identification")	1	U
5	>	HAS ACQ CONTEXT	TEXT	EV (121122, DCM, "Equipment identification")	1-n	U
6	>	CONTAINS	TEXT	DCID 3401 “Log Note Type”	1-n	U
7	>>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
8	>	CONTAINS	CODE	EV (121123, DCM, "Patient Status or Event")	1-n	U	DCID 3402 “Patient Status and Event”
9	>>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
10	>	CONTAINS	PNAME	DCID 3404 “Staff Action”	1-n	U
11	>>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
12	>	CONTAINS	TEXT	DCID 3427 “Equipment Event”	1-n	U	Equipment identifier
13	>>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
14	>	CONTAINS	INCLUDE	DTID 3100 “Procedure Action”	1-n	U
15	>	CONTAINS	INCLUDE	DTID 3101 “Image Acquisition”	1-n	U
16	>	CONTAINS	INCLUDE	DTID 3102 “Waveform Acquisition”	1-n	U
17	>	CONTAINS	INCLUDE	DTID 3103 “Referenced Object”	1-n	U
18	>	CONTAINS	INCLUDE	DTID 3104 “Consumables”	1-n	U
19	>	CONTAINS	INCLUDE	DTID 3105 “Lesion Identification and Properties”	1-n	U
20	>	CONTAINS	INCLUDE	DTID 3106 “Drugs/Contrast Administered”	1-n	U
21	>	CONTAINS	INCLUDE	DTID 3107 “Device Used”	1-n	U
22	>	CONTAINS	INCLUDE	DTID 3108 “Intervention”	1-n	U
23	>	CONTAINS	CODE	EV (116224001, SCT, "Complication of Procedure")	1-n	U	DCID 3413 “Adverse Outcome”
24	>>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
25	>	CONTAINS	INCLUDE	DTID 3109 “Measurements”	1-n	U
26	>	CONTAINS	INCLUDE	DTID 3110 “Impressions or Findings”	1-n	U
27	>	CONTAINS	INCLUDE	DTID 3111 “Percutaneous Entry”	1-n	U
28	>	CONTAINS	INCLUDE	DTID 3112 “Specimen Obtained”	1-n	U
29	>	CONTAINS	INCLUDE	DTID 3113 “Patient Support”	1-n	U
30	>	CONTAINS	INCLUDE	DTID 3114 “Patient Assessment”	1-n	U
31	>	CONTAINS	INCLUDE	DTID 3115 “ECG ST Assessment”	1-n	U

Content Item Descriptions

Row 2	Includes TID 1002 “Observer Context”, which shall be used to record the identity of the person responsible for recording the log, as well as all other participants in the procedure, even though these personnel may not technically be "observers" of the Procedure Log. As participants in the procedure, they are potential sources for events and observations recorded in the Log. TID 1002 “Observer Context” allows the specification of the person's role in the organization (e.g., physician, nurse), as well as the role in the procedure (e.g., circulating, performing, etc.).
Row 5	Shall be used to record the identity of the major equipment used in the procedure.
Row 6	May be used to record any event not covered by a specific log entry Template.

TID 3010 Log Entry Qualifiers

The Log Entry Qualifiers Template provides a common means for adding additional description to a procedure log Content Item. It allows identification of a source for the procedure log entry (other than the recording observer for the log as a whole), a free text comment, a link to a particular Procedure Action item, a link to a particular lesion, or the date/time of recording (if different than the time of the event occurrence recorded in the Observation DateTime of the parent Content Item).

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3010. Log Entry Qualifiers

	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1		INCLUDE	DTID 1000 “Quotation”	1	U
2	HAS PROPERTIES	TEXT	EV (121106, DCM, "Comment")	1	U
3	HAS OBS CONTEXT	TEXT	EV (121124, DCM, "Procedure Action ID")	1-n	U
4	HAS OBS CONTEXT	TEXT	EV (121151, DCM, "Lesion Identifier")	1-n	U	Up to 3 numeric characters
5	HAS OBS CONTEXT	DATETIME	EV (121125, DCM, "DateTime of Recording of Log Entry")	1	U
6	INFERRED FROM	IMAGE		1-n	U
7	INFERRED FROM	WAVEFORM		1-n	U
8	INFERRED FROM	COMPOSITE		1-n	U
9	HAS OBS CONTEXT	CODE	EV (121135, DCM, "Observation DateTime Qualifier")	1	U	DCID 3430 “DateTime Qualifier”

Content Item Descriptions

Row 3	Procedure Action ID allows linking recorded events to a particular action, step, or phase of a procedure. See description for TID 3100 “Procedure Action”.
Row 4	Lesion Identifier is specified as a numeric text string, and allows linking recorded events to the diagnosis or therapy of particular lesion. See description for TID 3105 “Lesion Identification and Properties”.

TID 3100 Procedure Action

The Procedure Action Template is intended for the recording of the beginning or end of procedure steps or action items in a procedure. The level of granularity of the recorded events is not specified, and may vary between institutions, or even be at multiple levels within a single procedure log. There is no requirement for the real-world procedure step or action item recorded with this Template to end before another one begins; there may be overlapping or simultaneous procedure steps or action items.

This log entry Template may be used to record the start or stop of timers.

Other recorded events in the procedure may be linked to a particular step or action item by Procedure Action ID (see TID 3010 “Log Entry Qualifiers”).

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3100. Procedure Action

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	DCID 3421 “Procedure Action”	1	M		BCID 3405 “Procedure Action Value”
2	>	HAS PROPERTIES	TEXT	EV (121124, DCM, "Procedure Action ID")	1	M
3	>	HAS PROPERTIES	PNAME	BCID 7453 “Performing Role”	1-n	U
4	>	HAS PROPERTIES	NUM	EV (121128, DCM, "Procedure Action Duration")	1	U
5	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
6	>	HAS PROPERTIES	UIDREF	EV (121126, DCM, "Performed Procedure Step SOP Instance UID")	1	MC	IFF a Performed Procedure Step SOP Class is used to provide status of the Procedure Step
7	>	HAS PROPERTIES	UIDREF	EV (121127, DCM, "Performed Procedure Step SOP Class UID")	1	MC	IFF a Performed Procedure Step SOP Class is used to provide status of the Procedure Step

Content Item Descriptions

Row 2	The value of the Procedure Action ID shall be uniquely associated with the step or action within the context of the Study, and may be used to associate various Procedure Log entries with the step or action.
Row 3	May be used to record the identity of staff roles for the purpose of this Procedure Action, which may differ from their roles in the procedure as a whole.

TID 3101 Image Acquisition

The Image Acquisition Template allows recording of the essential parameters of a digital image acquired during the procedure.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3101. Image Acquisition

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			IMAGE	EV (121138, DCM, "Image Acquired")	1	M
2	>	HAS ACQ CONTEXT	UIDREF	EV (112002, DCM, "Series Instance UID")	1	M
3	>	HAS ACQ CONTEXT	CODE	EV (121139, DCM, "Modality")	1	M	DCID 29 “Acquisition Modality” Derived from Referenced Image SOP Instance (0008,0060)
4	>	HAS PROPERTIES	NUM	EV (121140, DCM, "Number of Frames")	1	U
5	>	HAS PROPERTIES	TEXT	EV (121141, DCM, "Image Type")	1	U	From Referenced Image SOP Instance (0008,0008)
6	>	HAS ACQ CONTEXT	NUM	EV (112011, DCM, "Positioner Primary Angle")	1	U	UNITS = EV (deg, UCUM, "deg")
7	>	HAS ACQ CONTEXT	NUM	EV (112012, DCM, "Positioner Secondary Angle")	1	U	UNITS = EV (deg, UCUM, "deg")
8	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3102 Waveform Acquisition

The Waveform Acquisition Template allows recording of the essential parameters of a digital waveform acquired during the procedure.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3102. Waveform Acquisition

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			WAVEFORM	EV (121143, DCM, "Waveform Acquired")	1	M
2	>	HAS ACQ CONTEXT	CODE	EV (121139, DCM, "Modality")	1	M	DCID 29 “Acquisition Modality” Derived from Referenced Waveform SOP Instance (0008,0060)
3	>	HAS ACQ CONTEXT	NUM	EV (121142, DCM, "Acquisition Duration")	1	U
4	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3103 Referenced Object

The Referenced Object Template allows reference to measurement or report objects, such as prior medical reports, laboratory results, hemodynamic measurement reports, or quantitative analysis reports.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3103. Referenced Object

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			COMPOSITE	BCID 3407 “Object Reference Purpose”	1	M
2	>	HAS PROPERTIES	CODE	EV (121144, DCM, "Document Title")	1	MC	IFF Row 1 references an SR object	Root node concept of referenced SR object
3	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3104 Consumables

The Consumables Template allows recording of devices (e.g., catheters or stents), drugs, or contrast agents accessed in a procedure. This Content Item is directed towards inventory control and billing. The actual clinical use of the particular consumable is recorded using TID 3106 “Drugs/Contrast Administered” or TID 3107 “Device Used”.

This Template allows recording both consumable retrieval from, and return to, inventory or stock, and disposal of used material. The quantity involved in each recorded transaction may be specified.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3104. Consumables

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	DCID 3408 “Consumable Action”	1	M	Vendor or local bar coded values
2	>	HAS PROPERTIES	TEXT	DCID 3426 “Consumables Parameter”	1-n	U
3	>	HAS PROPERTIES	NUM	EV (121146, DCM, "Quantity of Material")	1	U
4	>	HAS PROPERTIES	CODE	EV (121147, DCM, "Billing Code")	1	U	local billing codes
5	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3105 Lesion Identification and Properties

The Lesion Identification and Properties Template allows recording the identification of each lesion addressed in a procedure. The lesion identifier may be used to relate diagnostic or therapeutic actions with their target lesion (see Row 4 in TID 3010 “Log Entry Qualifiers”). This Content Item may include the initial visually estimated measurements of stenosis or TIMI flow; measured values from a quantitative measurement report may be referenced indirectly (through TID 3103 “Referenced Object”), or by quotation (TID 3109 “Measurements”). Subsequent (e.g., post-intervention) stenosis measurements may be encoded using TID 3109 “Measurements”, with the Lesion Identifier conveyed through its subsidiary TID 3010 “Log Entry Qualifiers” Template.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3105. Lesion Identification and Properties

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			TEXT	EV (121151, DCM, "Lesion Identifier")	1	M		Up to 3 numeric characters
2	>	HAS PROPERTIES	CODE	EV (363698007, SCT, "Finding Site")	1	M		DCID 3604 “Arterial Lesion Location”
3	>>	HAS CONCEPT MOD	CODE	EV (106233006, SCT, "Topographical modifier")	1	U		DCID 3019 “Cardiovascular Anatomic Structure Modifier”
4	>	HAS PROPERTIES	CODE	EV (121153, DCM, "Lesion Risk")	1	U		DCID 3418 “Lesion Risk”
5	>	HAS PROPERTIES	NUM	EV (408715008, SCT, "Lumen Diameter Stenosis")	1	U		UNITS = EV (%, UCUM, "%")
6	>>	HAS CONCEPT MOD	CODE	EV (129085009, SCT, "Catheterization Procedure Phase")	1	M		EV (128955008, SCT, "Baseline Phase")
7	>>	HAS CONCEPT MOD	CODE	EV (121401, DCM, "Derivation")	1	U		DCID 3745 “Calculation Method”
8	>	HAS PROPERTIES	CODE	EV (122109, DCM, "Baseline TIMI Flow")	1	UC	IFF Row 2 specifies a coronary artery	DCID 3713 “TIMI Flow Characteristic”
9	>	HAS PROPERTIES	CODE	EV (122131, DCM, "Degree of Thrombus")	1	U		DCID 3714 “Thrombus”
10	>	HAS PROPERTIES	CODE	EV (129737002, SCT, "Lesion Margin Characteristics")	1	U		DCID 3715 “Lesion Margin”
11	>	HAS PROPERTIES	CODE	EV (122134, DCM, "Vessel Morphology")	1-n	U		DCID 3712 “Vessel Descriptor”
12	>	HAS PROPERTIES	CODE	EV (122132, DCM, "Severity of Calcification")	1	U		DCID 3716 “Severity”
13	>	HAS PROPERTIES	IMAGE	DT (121080, DCM, "Best illustration of finding")	1	U
14	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

Content Item Descriptions

Row 1

Lesion Identifier is specified as a numeric text string in order to facilitate transcoding to DICOM Attribute (0018,3105) Lesion Number and to formats for outcomes registries, such as the ACC National Cardiovascular Data Registry™.

TID 3106 Drugs/Contrast Administered

The Drugs/Contrast Administered Template allows the recording of the start or end of that type of event, together with its parameters. If start and end are represented by a single log entry (e.g., for an injection), the concept name "Drug/contrast administered" shall be used.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3106. Drugs/Contrast Administered

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	DCID 3409 “Drug/Contrast Administration”	1	M	BCID 10 “Interventional Drug” or BCID 12 “Imaging Contrast Agent”
2	>	HAS PROPERTIES	TEXT	EV (121145, DCM, "Description of Material")	1	U
3	>	HAS PROPERTIES	CODE	EV (410675002, SCT, "Route of administration")	1	U	BCID 11 “Administration Route”
4	>	HAS PROPERTIES	NUM	DCID 3410 “Drug/Contrast Numeric Parameter”	1-n	U
5	>	HAS PROPERTIES	PNAME	EV (121152, DCM, "Person administering drug/contrast")	1	U
6	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3107 Device Used

The Device Used Template allows recording of the use of interventional diagnostic and therapeutic devices.

The identification of one device used to deploy another device (e.g., a balloon catheter to deploy a stent) may be described with two entries, with one identified as a deployment device in the Concept Modifier of Row 6 of this Template, and linked by the same Procedure Action ID in the Log Entry Qualifiers of the included TID 3010 “Log Entry Qualifiers”.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3107. Device Used

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	DCID 3422 “Device Use Action”	1	M	BCID 3429 “Catheterization Device”
2	>	HAS PROPERTIES	CODE	EV (121150, DCM, "Device Code")	1-n	U	Vendor or local bar coded values
3	>	HAS PROPERTIES	TEXT	EV (121145, DCM, "Description of Material")	1	U
4	>	HAS PROPERTIES	NUM	DCID 3423 “Numeric Device Characteristic”	1-n	U
5	>	HAS PROPERTIES	CODE	EV (363704007, SCT, "Procedure site")	1	U	BCID 3630 “Cardiovascular Anatomic Location”
6	>	HAS CONCEPT MOD	CODE	EV (363703001, SCT, "Has Intent")	1	U	DT (121155, DCM, "Deployment")
7	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3108 Intervention

The Intervention Template allows recording of interventions, including atherectomy, angioplasty, stent placement, brachytherapy, etc. The record may include reference to an image that documents the intervention.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3108. Intervention

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	EV (122090, DCM, "Intervention Action")	1	M		DCID 3412 “Intervention Action/Status”
2	>	HAS PROPERTIES	CODE	EV (363704007, SCT, "Procedure site")	1	M		DCID 3604 “Arterial Lesion Location”
3	>>	HAS CONCEPT MOD	CODE	EV (106233006, SCT, "Topographical modifier")	1	U		DCID 3019 “Cardiovascular Anatomic Structure Modifier”
4	>	HAS PROPERTIES	TEXT	EV (121154, DCM, "Intervention attempt identifier")	1	M		Up to 3 numeric characters
5	>	HAS PROPERTIES	CODE	EV (116682006, SCT, "Uses Equipment")	1-n	U		BCID 3411 “Intracoronary Device”
6	>>	HAS CONCEPT MOD	CODE	EV (122111, DCM, "Primary Intervention Device")	1	MC	IF Device is Primary for this Lesion	DCID 230 “Yes-No”
7	>	HAS PROPERTIES	NUM	DCID 3425 “Intervention Parameter”	1-n	U
8	>	HAS PROPERTIES	IMAGE	BCID 7003 “Diagnostic Imaging Report Purpose of Reference”	1	U
9	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

Content Item Descriptions

Row 4

Intervention attempt Identifier is specified as a numeric text string, and shall be treated as the ordinal of the recorded attempted intervention within this procedure (i.e., "1" for the first attempted intervention, "2" for the second, etc.).

TID 3109 Measurements

The Measurements Template allows recording of significant measurements, such as vital signs, laboratory results, hemodynamic measurements, or quantitative analysis measurements. These measurements are often quoted from another source, which would be documented in the included TID 3010 “Log Entry Qualifiers”.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3109. Measurements

	NL	Rel with Parent	VT	Concept Name	VM	Req Type
1			NUM		1	U
2	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
3	>	HAS PROPERTIES	INCLUDE	DTID 310 “Measurement Properties”	1	U
4			CODE		1	U
5	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3110 Impressions or Findings

The Impressions or Findings Template allows the recording of unconfirmed (provisional) impressions or findings noted during the procedure. It is not intended to convey the Cath Lab Clinical Report (the formal report from the performing physician), although it may be used (like any Procedure Log entry) for the subsequent construction of the Cath Lab Clinical Report.

A finding that is supported by a specific image frame may reference that image in the INFERRED FROM / IMAGE row of the included TID 3010 “Log Entry Qualifiers” Template.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3110. Impressions or Findings

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	EV (121071, DCM, "Finding")	1	U	BCID 3728 “Cath Finding”
2	>	HAS PROPERTIES	CODE	EV (246112005, SCT, "Severity")	1	U	DCID 3716 “Severity”
3	>	HAS PROPERTIES	CODE	EV (363698007, SCT, "Finding Site")	1	U
4	>>	HAS CONCEPT MOD	CODE	EV (106233006, SCT, "Topographical modifier")	1	U	DCID 3019 “Cardiovascular Anatomic Structure Modifier”
5	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
6			TEXT	BCID 3419 “Finding Title”	1	U
7	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

Content Item Descriptions

Row 3

Finding Site has no Baseline Context ID specified. Typically terms would be drawn from coronary segments, other arterial segments, myocardial segments, etc.

TID 3111 Percutaneous Entry

The Percutaneous Entry Template allows recording of the opening or closing of invasive access ports.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3111. Percutaneous Entry

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	EV (121156, DCM, "Percutaneous Entry Action")	1	M	DCID 3403 “Percutaneous Entry”
2	>	HAS CONCEPT MOD	CODE	EV (272741003, SCT, "Laterality")	1	U	DCID 244 “Laterality”
3	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3112 Specimen Obtained

The Specimen Obtained Template allows recording of obtaining a specimen, and the identifiers for that specimen. This is particularly designed for blood samples that will be analyzed for blood oxygen-related measurements. The analysis of the sample may be recorded in one or more log entries using TID 3109 “Measurements”, or in a separate Structured Report SOP Instance referenced by a log entry using TID 3103 “Referenced Object”.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3112. Specimen Obtained

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	EV (121123, DCM, "Patient Status or Event")	1	M		DCID 3515 “Specimen Collection”
2	>	HAS ACQ CONTEXT	CODE	EV (371439000, SCT, "Specimen Type")	1	UC	IFF specimen is blood sample	DCID 3520 “Blood Source Type”
3	>	HAS ACQ CONTEXT	CODE	EV (363704007, SCT, "Procedure site")	1	U		BCID 3630 “Cardiovascular Anatomic Location”
4	>	HAS PROPERTIES	INCLUDE	DTID 1009 “Subject Context, Specimen”	1	U

TID 3113 Patient Support

The Patient Support Template allows recording of the use of various support technologies, including oxygen, ventilation, pacing, etc.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3113. Patient Support

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	DCID 3530 “Oxygen Administration Action”	1	U		DCID 3531 “Oxygen Administration”
2	>	HAS PROPERTIES	NUM	EV (121160, DCM, "Oxygen Administration Rate")	1	MC	IFF Row 1 Concept is (121161, DCM, "Begin Oxygen Administration")	UNITS = DT (l/min, UCUM, "l/min")
3	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
4			CODE	DCID 3550 “Circulatory Support Action”	1	U		DCID 3553 “Circulatory Support”
5	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
6			CODE	DCID 3551 “Ventilation Action”	1	U		DCID 3554 “Ventilation”
7	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U
8			CODE	DCID 3552 “Pacing Action”	1	U		DCID 3555 “Pacing”
9	>		INCLUDE	DTID 3010 “Log Entry Qualifiers”	1	U

TID 3114 Patient Assessment

The Patient Assessment Template allows recording of the assessment of the patient's cardiovascular, neurological, and/or respiratory condition. A particular use of this Template is for "vital signs", which are a specific subset of mandatory patient assessment measurements.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3114. Patient Assessment

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CODE	EV (121123, DCM, "Patient Status or Event")	1	M		DT (121165, DCM, "Patient Assessment Performed") DT (61746007, SCT, "Observation of Vital Signs")
2	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = EV (271649006, SCT, "Systolic blood pressure") $Units = DCID 3500 “Pressure Unit” $Method = BCID 3560 “Blood Pressure Method”
3	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = EV (271650006, SCT, "Diastolic blood pressure") $Units = DCID 3500 “Pressure Unit”
4	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = EV (8867-4, LN, "Heart rate") $Units = EV ({H.B.}/min, UCUM, "BPM")
5	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = EV (8310-5, LN, "Body temperature") $Units = EV (Cel, UCUM, "C")
6	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = DCID 3526 “Blood Gas Saturation” $Units = EV (%, UCUM, "%")
7	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = EV (86290005, SCT, "Respiration rate") $Units = EV (/min, UCUM, "breaths/min")
8	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1-n	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = EV (122195, DCM, "Pulse Strength") $Method = BCID 3442 “Peripheral Pulse Method” $TargetSite = BCID 3440 “Peripheral Pulse Location” $Units = DT ({0:4}, UCUM, "range 0:4")
9	>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	MC	IF Row 1 value = (61746007, SCT, "Observation of Vital Signs")	$Measurement = EV (225908003, SCT, "Pain Score") $Units = DT ({1:10}, UCUM, "range 1:10")
10	>	HAS PROPERTIES	CODE	DT (8884-9, LN, "Cardiac Rhythm")	1	U		BCID 3415 “Cardiac Rhythm”
11	>	HAS PROPERTIES	CODE	DT (9304-7, LN, "Respiration Rhythm")	1	U		BCID 3416 “Respiration Rhythm”
12	>	HAS PROPERTIES	CODE	DT (364062005, SCT, "Respiration Assessment")	1	U		BCID 3448 “Airway Assessment”
13	>	HAS PROPERTIES	CODE	DT (364528001, SCT, "Skin condition")	1-n	U		BCID 3446 “Skin Condition”
14	>	HAS PROPERTIES	CODE	DT (363871006, SCT, "Patient mental state assessment")	1	U
15	>	HAS PROPERTIES	TEXT	BCID 3441 “Patient Assessment”	1-n	U

Content Item Descriptions

Row 8	Pulse Strength allows the assessment of the patient's pulse at multiple locations using the Topographical concept modifier. It may also be used for a single pulse strength measurement from an unspecified location, as is typical of vital signs assessments.
Row 16	Allows free text description of patient assessments that are not expressible by coded entries of Rows 10 to 14.

TID 3115 ECG ST Assessment

The ECG ST Assessment Template allows recording of the assessment of changes in the patient ECG relative to baseline.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3115. ECG ST Assessment

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	EV (121123, DCM, "Patient Status or Event")	1	M	DT (258181008, SCT, "ECG Analysis")
2	>	HAS PROPERTIES	NUM	DT (122099, DCM, "ST change from baseline")	1-n	M	UNITS = EV (uV, UCUM, "uV")
3	>>	HAS CONCEPT MOD	CODE	DT (122148, DCM, "Lead ID")	1	M	BCID 3001 “ECG Lead”

Quantitative Ventricular Analysis Report SR IOD Templates

The Templates that comprise the Quantitative Ventricular Analysis SR are interconnected as in Figure A-3:

Figure A-3. Quantitative Ventricular Analysis Report SR IOD Template Structure

TID 3202 Quantitative Ventricular Analysis Report

The Quantitative Ventricular Analysis Report Template provides a CONTAINER with a structure for reporting the result of the ventricular analysis.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3202. Quantitative Ventricular Analysis Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (122292, DCM, "Quantitative Ventriculography Report")	1	M
2	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	M
3	>	HAS OBS CONTEXT	INCLUDE	DTID 1002 “Observer Context”	1-n	M
4	>	CONTAINS	INCLUDE	DTID 3602 “Cardiovascular Patient Characteristics”	1	U
5	>	CONTAINS	CONTAINER	EV (122144, DCM, "Quantitative Analysis")	1-n	M
6	>>	HAS OBS CONTEXT	INCLUDE	DTID 1002 “Observer Context”	1-n	U
7	>>	HAS OBS CONTEXT	TEXT	EV (111001, DCM, "Algorithm Name")	1	M
8	>>	HAS OBS CONTEXT	TEXT	EV (111003, DCM, "Algorithm Version")	1	M
9	>>	HAS OBS CONTEXT	TEXT	EV (122405, DCM, "Algorithm Manufacturer")	1	M
10	>>	CONTAINS	IMAGE	EV (121112, DCM, "Source of Measurement")	1-n	M
11	>>>	HAS CONCEPT MOD	CODE	EV (246092007, SCT, "Cardiac Phase")	1	M		DCID 12233 “Cardiac Phase”
12	>>>	HAS CONCEPT MOD	CODE	EV (111031, DCM, "Image View")	1	MC	If Biplane Analysis	DCID 3466 “Plane Identification”
13	>>	HAS ACQ CONTEXT	INCLUDE	DTID 3205 “Calibration”	1-2	U	VM = 1: Single plane analysis, VM = 2: Biplane analysis	$CalibrationPlane = DCID 3466 “Plane Identification”
14	>>	HAS ACQ CONTEXT	INCLUDE	DTID 3520 “Hemodynamic Clinical Context”	1	U
15	>>	CONTAINS	INCLUDE	DTID 3206 “VA Main Results”	1	M
16	>>	CONTAINS	INCLUDE	DTID 3207 “AA Main Results”	1	U
17	>>	CONTAINS	INCLUDE	DTID 3208 “Frame-to-Frame Results”	1	U
18	>>	CONTAINS	INCLUDE	DTID 3209 “Centerline Wall Motion”	1-2	U	VM = 1: Single plane analysis, VM = 2: Biplane analysis
19	>>	CONTAINS	INCLUDE	DTID 3210 “Radial Based Wall Motion”	1-2	U	VM = 1: Single plane analysis, VM = 2: Biplane analysis
20	>>	CONTAINS	INCLUDE	DTID 3211 “Landmark Based Wall Motion”	1-2	U	VM = 1: Single plane analysis, VM = 2: Biplane analysis

Content Item Descriptions

Row 7	Identifies the Ventricular Analysis program
Row 8	Identifies the Ventricular Analysis program version
Row 9	Identifies the Ventricular Analysis program manufacturer
Row 10	Identifies the ES and ED images on which the analysis is based, for frame by frame analysis the analyzed image are specified in the frame by frame results (3208) Template

TID 3205 Calibration

The Calibration Template consists of a CONTAINER, with a structure for reporting of the calibration of images used in the analysis.

Table TID 3205. Parameters

Parameter Name	Parameter Usage
$CalibrationPlane	XA Imaging plane

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3205. Calibration

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (122505, DCM, "Calibration")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (111031, DCM, "Image View")	1	U		$CalibrationPlane
3	>	HAS OBS CONTEXT	TEXT	EV (111001, DCM, "Algorithm Name")	1	MC	IF different from Analysis program specified in the invoking Template
4	>	HAS OBS CONTEXT	TEXT	EV (111003, DCM, "Algorithm Version")	1	MC	IF different from Analysis program specified in the invoking Template
5	>	HAS OBS CONTEXT	TEXT	EV (122405, DCM, "Algorithm Manufacturer")	1	MC	IF different from Analysis program specified in the invoking Template
6	>	CONTAINS	CODE	EV (122422, DCM, "Calibration Method")	1	M		DCID 3452 “Calibration Method”
7	>	CONTAINS	CODE	EV (122421, DCM, "Calibration Object")	1	MC	If Row 6 value specifies Calibration Object Used	DCID 3451 “Calibration Object”
8	>	CONTAINS	NUM	EV (122423, DCM, "Calibration Object Size")	1	MC	If Row 6 value specifies Calibration Object Used	DCID 3510 “Catheter Size Unit”
9	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M		$Measurement = EV (111026, DCM, "Horizontal Pixel Spacing") $Units = DT (mm/{pixel}, UCUM, "mm/pixel") $ImagePurpose = EV (121112, DCM, "Source of Measurement")
10	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M		$Measurement = EV (111066, DCM, "Vertical Pixel Spacing") $Units = DT (mm/{pixel}, UCUM, "mm/pixel") $ImagePurpose = EV (121112, DCM, "Source of Measurement")
11	>	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 3	Identifies the Calibration program
Row 4	Identifies the Calibration program version
Row 5	Identifies the Calibration program manufacturer
Row 7	Besides a Sphere and a Catheter, a Distance can be identified as a Calibration Object. In this case a distance measurement of a known dimension of the object is used to calculate the pixel size.
Row 8	The catheter size units is also used to specify the size of other calibration objects (e.g., sphere)
Rows 9, 10	Spacing in the patient body. Point to a single frame containing the image used for calibration if applicable, the actual measurements may be indicated by a SCOORD (see TID 320 “Image or Spatial Coordinates”, Row 3)
Row 11	Secondary Capture image with calibration position. No purpose of reference is specified.

TID 3206 VA Main Results

The VA Main Results Template consists of a CONTAINER with a structure for reporting the main ventricular analysis measurements.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3206. VA Main Results

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3462 “Chamber Identification”
3	>	CONTAINS	CODE	EV (122429, DCM, "Volume Method")	1	M	DCID 3453 “Cardiac Volume Method”
4	>	CONTAINS	NUM	EV (122435, DCM, "Regression Volume Exponent")	1	U	Unit = DT (1, UCUM, "no units")
5	>	CONTAINS	NUM	EV (122431, DCM, "Regression Slope ED")	1	U	Unit = DT ({ratio}, UCUM, "ratio")
6	>	CONTAINS	NUM	EV (122432, DCM, "Regression Offset ED")	1	U	Unit = DT (ml, UCUM, "ml")
7	>	CONTAINS	NUM	EV (122433, DCM, "Regression Slope ES")	1	U	Unit = DT ({ratio}, UCUM, "ratio")
8	>	CONTAINS	NUM	EV (122434, DCM, "Regression Offset ES")	1	U	Unit = DT (ml, UCUM, "ml")
9	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = DCID 3467 “Ejection Fraction” $Units = DT (%, UCUM, "%")
10	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3468 “ED Volume” $Units = DT (ml, UCUM, "ml")
11	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3469 “ES Volume” $Units = DT (ml, UCUM, "ml")
12	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (90096001, SCT, "Stroke Volume") $Units = DT (ml, UCUM, "ml")
13	>	CONTAINS	NUM	EV (8867-4, LN, "Heart Rate")	1	U	Unit = DT ({H.B.}/min, UCUM, "BPM")
14	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3468 “ED Volume” $ModType = EV (121425, DCM, "Index") $ModValue = DCID 3455 “Index Method” $Units = DT (ml/m2, UCUM, "ml/m2")
15	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3468 “ED Volume” $ModType = EV (121425, DCM, "Index") $ModValue = EV (29463-7, LN, "Patient Weight") $Units = DT (ml/kg, UCUM, "ml/kg")
16	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3469 “ES Volume” $ModType = EV (121425, DCM, "Index") $ModValue = DCID 3455 “Index Method” $Units = DT (ml/m2, UCUM, "ml/m2")
17	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3469 “ES Volume” $ModType = EV (121425, DCM, "Index") $ModValue = EV (29463-7, LN, "Patient Weight") $Units = DT (ml/kg, UCUM, "ml/kg")
18	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (90096001, SCT, "Stroke Volume") $ModType = EV (121425, DCM, "Index") $ModValue = DCID 3455 “Index Method” $Units = DT (ml/m2, UCUM, "ml/m2")
19	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (90096001, SCT, "Stroke Volume") $ModType = EV (121425, DCM, "Index") $ModValue = EV (29463-7, LN, "Patient Weight") $Units = DT (ml/kg, UCUM, "ml/kg")
20	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (82799009, SCT, "Cardiac Output") $Units = DT (l/min, UCUM, "l/min")
21	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (54993008, SCT, "Cardiac Index") $ModType = EV (121425, DCM, "Index") $ModValue = DCID 3455 “Index Method” $Units = DT (l/min/m2, UCUM, "l/min/m2")
22	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122445, DCM, "Wall Thickness") $Units = DT (mm, UCUM, "mm")
23	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122446, DCM, "Wall Volume") $Units = DT (ml, UCUM, "ml")
24	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122447, DCM, "Wall Mass") $Units = DT (g, UCUM, "gram")
25	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122447, DCM, "Wall Mass") $ModType = EV (121425, DCM, "Index") $ModValue = DCID 3455 “Index Method” $Units = DT (g/m2, UCUM, "gram/m2")
26	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122447, DCM, "Wall Mass") $ModType = EV (121425, DCM, "Index") $ModValue = EV (29463-7, LN, "Patient Weight") $Units = DT (g/kg, UCUM, "gram/kg")
27	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122448, DCM, "Wall Stress") $Units = DT (dyn/cm2, UCUM, "dynes/cm2")
28	>	CONTAINS	IMAGE		1-n	U

Content Item Descriptions

Row 28

Secondary Capture image with ED and/or ES contours. No purpose of reference is specified.

TID 3207 AA Main Results

The AA Main Results Template consists of a CONTAINER with a structure for reporting the main atrial analysis measurements.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3207. AA Main Results

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3462 “Chamber Identification”
3	>	CONTAINS	CODE	EV (122429, DCM, "Volume Method")	1	M	DCID 3453 “Cardiac Volume Method”
4	>	CONTAINS	NUM	EV (122435, DCM, "Regression Volume Exponent")	1	U	Unit = DT (1, UCUM, "no units")
5	>	CONTAINS	NUM	EV (122431, DCM, "Regression Slope ED")	1	U	Unit = DT ({ratio}, UCUM, "ratio")
6	>	CONTAINS	NUM	EV (122432, DCM, "Regression Offset ED")	1	U	Unit = DT (ml, UCUM, "ml")
7	>	CONTAINS	NUM	EV (122433, DCM, "Regression Slope ES")	1	U	Unit = DT ({ratio}, UCUM, "ratio")
8	>	CONTAINS	NUM	EV (122434, DCM, "Regression Offset ES")	1	U	Unit = DT (ml, UCUM, "ml")
9	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3468 “ED Volume” $Units = DT (ml, UCUM, "ml")
10	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = DCID 3469 “ES Volume” $Units = DT (ml, UCUM, "ml")
11	>	CONTAINS	IMAGE		1-n	U

Content Item Descriptions

Row 11

Secondary Capture image with ED and/or ES contours. No purpose of reference is specified.

TID 3208 Frame-to-Frame Results

The Frame-to-Frame Result Template consists of a CONTAINER providing measurements derived from the angiographic images on frame-by-frame basis.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3208. Frame-To-Frame Result

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (111004, DCM, "Analysis Performed")	1	M		EV (122499, DCM, "Frame to Frame Analysis")
3	>	CONTAINS	IMAGE	EV (121112, DCM, "Source of Measurement")	1-2	M	VM = 1: Single plane analysis, VM = 2: Biplane analysis
4	>	CONTAINS	CODE	EV (122429, DCM, "Volume Method")	1	M		DCID 3453 “Cardiac Volume Method”
5	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	M		$Measurement = DCID 3471 “Estimated Volume” $TargetSite = DCID 3462 “Chamber Identification” $Units = DT (ml, UCUM, "ml")
6	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U		$Measurement = EV (122445, DCM, "Wall Thickness") $Units = DT (mm, UCUM, "mm")
7	>	CONTAINS	IMAGE		1-n	U

Content Item Descriptions

Row 3	Identifies each frame analyzed, using the multi-valued Referenced Frame Number (0008,1160) Attribute of the IMAGE Content Item.
Rows 5, 6	Includes one measurement for each frame referenced in Row 3.
Row 7	Secondary Capture image with ventricular contours. No purpose of reference is specified.

TID 3209 Centerline Wall Motion

The Centerline Wall Motion Template consists of a CONTAINER providing measurements of the centerline wall motion.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3209. Centerline Wall Motion

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (111004, DCM, "Analysis Performed")	1	M	EV (122449, DCM, "Centerline Wall Motion Analysis")
3	>>	HAS CONCEPT MOD	CODE	EV (122410, DCM, "Contour Realignment")	1	M	DCID 3458 “Contour Realignment”
4	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	100	M	$Measurement = EV (122450, DCM, "Normalized Chord Length") $Units = DT (%, UCUM, "%")
5	>	CONTAINS	NUM	EV (122411, DCM, "Threshold Value")	1	M	Values shall be 1, 2 or 3 UNITS = EV ({sd}, UCUM, "Standard Deviations")
6	>	CONTAINS	CONTAINER	EV (122451, DCM, "Abnormal Region")	1-6	U
7	>>	CONTAINS	CODE	EV (60797005, SCT, "Cardiac Wall Motion")	1	M	DCID 3703 “Wall Motion”
8	>>	CONTAINS	CODE	EV (255593009, SCT, "Circumferential Extent")	1	U	DCID 3460 “Circumferential Extent”
9	>>	CONTAINS	NUM	EV (122452, DCM, "First Chord of Abnormal Region")	1	M	Unit = DT (1, UCUM, "no unit")
10	>>	CONTAINS	NUM	EV (122453, DCM, "Last Chord of Abnormal Region")	1	M	Unit = DT (1, UCUM, "no unit")
11	>	CONTAINS	CONTAINER	EV (122417, DCM, "Regional Abnormal Wall Motion")	1-4	U
12	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3461 “Regional Extent”
13	>>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122459, DCM, "Territory Region Severity") $ModType = EV (60797005, SCT, "Cardiac Wall Motion") $ModValue = DCID 3703 “Wall Motion” $Units = DT ({sd}, UCUM, "Standard Deviations")
14	>>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122461, DCM, "Opposite Region Severity") $ModType = EV (60797005, SCT, "Cardiac Wall Motion") $ModValue = DCID 3703 “Wall Motion” $Units = DT ({sd}, UCUM, "Standard Deviations")
15	>	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 4	Normalized lengths of the chords determined between ED and ES contour. The measurement Template allows the specification of the statistical properties of the normal population and of the chord measurement relative to the population.
Row 8	If the Circumferential Extent is not specified no limitations to the boundaries for regions are assumed.
Row 11	The Regional Abnormal Wall Motion container holds the information on the severity of the decreased or increased wall motion of the 4 predefined regions as described in [Sheehan, 1986].
Row 12	The name of the region with an abnormal ventricular wall motion as described in [Sheehan, 1986].
Row 13	The severity of the wall motion abnormality expressed in Standard Deviations above or below normal in the territory region as described in [Sheehan, 1986].
Row 14	The severity of the wall motion abnormality expressed in Standard Deviations above or below normal in the opposite region as described in [Sheehan, 1986].
Row 15	Secondary Capture image with centerline analysis result. No purpose of reference is specified.

TID 3210 Radial Based Wall Motion

The Radial Based Wall Motion Template consists of a CONTAINER providing measurements of the radial based wall motion.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3210. Radial Based Wall Motion

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (111004, DCM, "Analysis Performed")	1	M	EV (122493, DCM, "Radial Based Wall Motion Analysis")
3	>>	HAS CONCEPT MOD	CODE	EV (122410, DCM, "Contour Realignment")	1	M	DCID 3458 “Contour Realignment”
4	>	CONTAINS	CONTAINER	EV (59776-5, LN, "Findings")	1-n	M
5	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3718 “Myocardial Wall Segments in Projection”
6	>>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122495, DCM, "Regional Contribution to Ejection Fraction") $Units = DT (%, UCUM, "%")
7	>>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = EV (122496, DCM, "Radial Shortening") $Units = DT (%, UCUM, "%")
8	>	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 6	The CREF values of the 6 regions determined for the radial based wall motion
Row 7	The shortening of the measured radials within the region
Row 8	Secondary Capture image with radial based analysis result. No purpose of reference is specified.

TID 3211 Landmark Based Wall Motion

The Landmark Based Wall Motion Template consists of a CONTAINER providing measurements of the landmark based wall motion.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3211. Landmark Based Wall Motion

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (111004, DCM, "Analysis Performed")	1	M	EV (122497, DCM, "Landmark Based Wall Motion Analysis")
3	>>	HAS CONCEPT MOD	CODE	EV (122410, DCM, "Contour Realignment")	1	M	DCID 3458 “Contour Realignment”
4	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	M	$Measurement = EV (122498, DCM, "Slice Contribution to Ejection Fraction") $Units = DT (%, UCUM, "%")
5	>	CONTAINS	CONTAINER	EV (59776-5, LN, "Findings")	5	M
6	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3718 “Myocardial Wall Segments in Projection”
7	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122495, DCM, "Regional Contribution to Ejection Fraction") $Units = DT (%, UCUM, "%")
8	>	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 8

Secondary Capture image with Landmark Based Analysis result. No purpose of reference is specified.

Quantitative Arterial Analysis Report SR IOD Templates

The Templates that comprise the Quantitative Arterial Analysis SR are interconnected as in Figure A-4:

Figure A-4. Quantitative Arterial Analysis Report SR IOD Template Structure

TID 3213 Quantitative Arterial Analysis

The Quantitative Arterial Analysis Template consists of a CONTAINER with a structure for reporting the result of the quantitative arterial analysis process.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3213. Quantitative Arterial Analysis

	NL	Rel with Parent	VT	Concept Name	VM	Req Type
1			CONTAINER	EV (122291, DCM, "Quantitative Arteriography Report")	1	M
2	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	M
3	>	HAS OBS CONTEXT	INCLUDE	DTID 1002 “Observer Context”	1-n	M
4	>	CONTAINS	INCLUDE	DTID 3602 “Cardiovascular Patient Characteristics”	1	U
5	>	HAS OBS CONTEXT	TEXT	EV (111001, DCM, "Algorithm Name")	1	M
6	>	HAS OBS CONTEXT	TEXT	EV (111003, DCM, "Algorithm Version")	1	M
7	>	HAS OBS CONTEXT	TEXT	EV (122405, DCM, "Algorithm Manufacturer")	1	M
8	>	CONTAINS	INCLUDE	DTID 3214 “Analyzed Segment”	1-n	M

Content Item Descriptions

Row 5	Identifies the Arterial Analysis program
Row 6	Identifies the Arterial Analysis program version
Row 7	Identifies the Arterial Analysis program manufacturer

TID 3214 Analyzed Segment

The Analyzed Segment Template consists of a CONTAINER providing quantitative arterial analysis measurements derived from the angiographic images.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3214. Analyzed Segment

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3604 “Arterial Lesion Location”
3	>	CONTAINS	IMAGE	EV (121112, DCM, "Source of Measurement")	1	M
4	>	CONTAINS	INCLUDE	DTID 3205 “Calibration”	1	M
5	>	HAS ACQ CONTEXT	INCLUDE	DTID 3520 “Hemodynamic Clinical Context”	1	U
6	>	HAS ACQ CONTEXT	CODE	EV (129085009, SCT, "Catheterization Procedure Phase")	1	U	DCID 3651 “Hemodynamic Measurement Phase”
7	>	CONTAINS	SCOORD	EV (122507, DCM, "Left Contour")	1	M	GRAPHIC TYPE = {POLYLINE}
8	>>	R-SELECTED FROM	IMAGE		1	M	Must reference Row 3
9	>	CONTAINS	SCOORD	EV (122508, DCM, "Right Contour")	1	M	GRAPHIC TYPE = {POLYLINE}
10	>>	R-SELECTED FROM	IMAGE		1	M	Must reference Row 3
11	>	CONTAINS	INCLUDE	DTID 3219 “Segment Values”	1	M
12	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (255605001, SCT, "Minimum") $Units = DT (mm, UCUM, "mm")
13	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (56851009, SCT, "Maximum") $Units = DT (mm, UCUM, "mm")
14	>	CONTAINS	CONTAINER	EV (122509, DCM, "Diameter Graph")	1	U
15	>>	CONTAINS	NUM	EV (122511, DCM, "Graph Increment")	1	M	Value = 1 UNITS = DT ({pixels}, UCUM, "pixels")
16	>>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Units = DT (mm, UCUM, "mm")
17	>	CONTAINS	NUM	EV (122382, DCM, "Site of Luminal Minimum")	1	U	UNITS = DT ({pixels}, UCUM, "pixels")
18	>	CONTAINS	NUM	EV (122516, DCM, "Site of Luminal Maximum")	1	U	UNITS = DT ({pixels}, UCUM, "pixels")
19	>	CONTAINS	INCLUDE	DTID 3215 “Angiographic Lesion Analysis”	1-n	U
20	>	CONTAINS	INCLUDE	DTID 3217 “Sub-segmental Data”	1-n	U
21	>	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 1	Observation DateTime (0040,A032) of container needs to be flagged with the time of the analysis
Row 7	Numeric coordinates (x,y) identifying the contour points from proximal to distal of left contour. Left is relative to the direction of the blood flow.
Row 9	Numeric coordinates (x,y) identifying the contour points from proximal to distal of right contour. Right is relative to the direction of the blood flow.
Rows 12, 13	Positions are relative to the midpoint between the first left and right contour points and measured along the midline between the left and right contour.
Row 14	The X-axis represents the pixel points of the midline of the vessel from proximal to distal. The points on the midline are not necessarily equidistant.
Row 16	For each point of the midline of the vessel a measurement value for the diameter is calculated.
Rows 17, 18	The positions in the graph are related to the points on the midline of the vessel.
Row 21	Secondary Capture image with Arterial Analysis contour. No purpose of reference is specified.

Definition of Left and Right defined by the direction of the blood flow as in Figure A-4b:

Figure A-4b. Direction of Blood Flow

TID 3215 Angiographic Lesion Analysis

The Angiographic Lesion Analysis Template consists of a CONTAINER providing quantitative arterial analysis measurements derived for an obstruction in a total analyzed segment.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3215. Angiographic Lesion Analysis

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (300577008, SCT, "Lesion Finding")	1	M
2	>	CONTAINS	TEXT	EV (121151, DCM, "Lesion Identifier")	1	M
3	>>	HAS PROPERTIES	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3604 “Arterial Lesion Location”
4	>>>	HAS CONCEPT MOD	CODE	EV (106233006, SCT, "Topographical modifier")	1	U	DCID 3019 “Cardiovascular Anatomic Structure Modifier”
5	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (255605001, SCT, "Minimum") $Units = DT (mm, UCUM, "mm")
6	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = EV (397415007, SCT, "Vessel Lumen Cross-Sectional Area") $Method = DCID 3470 “Vessel Lumen Cross-sectional Area Calculation Method” $Derivation = EV (255605001, SCT, "Minimum") $Units = DT (mm2, UCUM, "mm2")
7	>	CONTAINS	CODE	EV (122430, DCM, "Reference Method")	1	M	DCID 3465 “QA Reference Method”
8	>	CONTAINS	CONTAINER	EV (122438, DCM, "Reference Points")	1	U
9	>>	CONTAINS	NUM	EV (122337, DCM, "Relative Position")	1-n	M	UNITS = DT (mm, UCUM, "mm")
10	>>>	HAS PROPERTIES	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Units = DT (mm, UCUM, "mm")
11	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $TargetSite = (122382, DCM, "Site of Luminal Minimum") $Units = DT (mm, UCUM, "mm")
12	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (397415007, SCT, "Vessel Lumen Cross-Sectional Area") $Derivation = EV (122404, DCM, "Reconstructed") $TargetSite = (122382, DCM, "Site of Luminal Minimum") $Units = DT (mm2, UCUM, "mm2")
13	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (258090004, SCT, "Calculated") $TargetSite = EV (122481, DCM, "Contour Start") $Units = DT (mm, UCUM, "mm")
14	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (258090004, SCT, "Calculated") $TargetSite = EV (122482, DCM, "Contour End") $Units = DT (mm, UCUM, "mm")
15	>	CONTAINS	INCLUDE	DTID 3218 “Position in Arterial Segment”	1	M
16	>	CONTAINS	CONTAINER	EV (122517, DCM, "Densitometric Luminal Cross-sectional Area Graph")	1	U
17	>>	CONTAINS	NUM	EV (122511, DCM, "Graph Increment")	1	M	Value = 1 UNITS = DT ({pixels}, UCUM, "pixels")
18	>>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	M	$Measurement = EV (397415007, SCT, "Vessel Lumen Cross-Sectional Area") $Units = (mm2, UCUM, "mm2")
19	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (397415007, SCT, "Vessel Lumen Cross-Sectional Area") $Derivation = EV (258090004, SCT, "Calculated") $Method = EV (122474, DCM, "Densitometric method") $TargetSite = EV (122481, DCM, "Contour Start") $Units = (mm2, UCUM, "mm2")
20	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (397415007, SCT, "Vessel Lumen Cross-Sectional Area") $Derivation = EV (258090004, SCT, "Calculated") $Method = EV (122474, DCM, "Densitometric method") $TargetSite = EV (122482, DCM, "Contour End") $Units = (mm2, UCUM, "mm2")
21	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (408716009, SCT, "Stenotic Lesion Length") $Units = DT (mm, UCUM, "mm")
22	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (408715008, SCT, "Lumen Diameter Stenosis") $Units = DT (%, UCUM, "%")
23	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = EV (408714007, SCT, "Lumen Area Stenosis") $Method = DCID 3470 “Vessel Lumen Cross-sectional Area Calculation Method” $Units = DT (%, UCUM, "%")
24	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = EV (122372, DCM, "Lumen Volume") $Method = DCID 3470 “Vessel Lumen Cross-sectional Area Calculation Method” $Units = DT (mm3, UCUM, "mm3")
25	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122542, DCM, "Plaque Area") $Units = DT (mm2, UCUM, "mm2")
26	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122376, DCM, "Total Plaque Volume") $Units = DT (mm3, UCUM, "mm3")
27	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122544, DCM, "Diameter Symmetry") $Units = DT ({ratio}, UCUM, "ratio")
28	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122545, DCM, "Area Symmetry") $Units = DT ({ratio}, UCUM, "ratio")
29	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122546, DCM, "Inflow Angle") $Units = DT (deg, UCUM, "deg")
30	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122547, DCM, "Outflow Angle") $Units = DT (deg, UCUM, "deg")
31	>	CONTAINS	INCLUDE	DTID 3216 “Stenotic Flow Reserve”	1	U
32	>	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 8	Set of user defined reference position for method that requires local reference position.
Row 9	Distance of local reference position from an arbitrary landmark.
Row 10	Diameter at a local reference position.
Row 11	The reference diameter for the arterial lesion calculated with the applicable reference method
Row 12	The reference area for the arterial lesion calculated with the applicable reference method
Row 13	The diameter measurement at the start of the reconstruction line in the diameter graph (TID 3214 “Analyzed Segment” Row 14)
Row 14	The diameter measurement at the end of the reconstruction line in the diameter graph (TID 3214 “Analyzed Segment” Row 14)
Row 15	The positions of the lesion, borders of the lesion, etc.
Row 16	The graph with the calculated cross sectional area results based on the densitometric method
Row 18	The cross sectional area measurements calculated based on the densitometric method
Row 19	The cross sectional area measurement at the start of the reconstruction line in the area graph
Row 20	The cross sectional area measurement at the end of the reconstruction line in the area graph
Row 21	Measured along the midline of the left and right contour
Row 22	The diameter stenosis is calculated as follows: (Reference Luminal Diameter - Minimum Luminal Diameter / Reference Luminal Diameter) * 100%
Row 23	The circular and the densitometric area stenosis are calculated respectively as: (Reference Vessel Lumen Cross-Sectional Area - Minimum Luminal Circular Area / Reference Vessel Lumen Cross-Sectional Area) * 100%(Reference Vessel Lumen Cross-Sectional Area - Minimum Luminal Densitometric Area / Reference Vessel Lumen Cross-Sectional Area) * 100%
Row 24	Estimated lumen volume between proximal border and distal border of lesion (TID 3218 “Position in Arterial Segment”, Row 1 and 2)
Row 32	Secondary Capture image with obstruction analysis contour. No purpose of reference is specified.

TID 3216 Stenotic Flow Reserve

The Stenotic Flow Reserve Template consists of a CONTAINER providing quantitative arterial analysis measurements derived for an obstruction in a total analyzed segment.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3216. Stenotic Flow Reserve

	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122548, DCM, "Stenotic Flow Reserve") $Units = DT ({ratio}, UCUM, "ratio")
2	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122549, DCM, "Poiseuille Resistance") $Units = DT (mm[Hg].s/cm, UCUM, "mmHG.s/cm")
3	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122550, DCM, "Turbulence Resistance") $Units = DT (mm[Hg].s2/cm2, UCUM, "mmHG.s2/cm2")
4	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122555, DCM, "Estimated Normal Flow") $Units = DT (ml/s, UCUM, "ml/s")
5	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122551, DCM, "Pressure Drop at SFR") $Units = DT (mm[Hg], UCUM, "mmHg")
6	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 6

Secondary Capture image with SFR analysis contour. No purpose of reference is specified.

TID 3217 Sub-segmental Data

The Sub-segmental Data Template consists of a CONTAINER providing quantitative arterial analysis measurements derived for a sub-segment in a total analyzed segment.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3217. Sub-Segmental Data

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	M	DCID 3604 “Arterial Lesion Location”
3	>>	HAS CONCEPT MOD	CODE	EV (106233006, SCT, "Topographical modifier")	1	U	DCID 3019 “Cardiovascular Anatomic Structure Modifier”
4	>	CONTAINS	CODE	EV (122554, DCM, "Segmentation Method")	1	M	DCID 3456 “Sub-segment Method”
5	>	CONTAINS	INCLUDE	DTID 3219 “Segment Values”	1	U
6	>	CONTAINS	INCLUDE	DTID 3218 “Position in Arterial Segment”	1	M
7	>	CONTAINS	IMAGE		1	U

Content Item Descriptions

Row 7

Secondary Capture image with obstruction analysis contour. No purpose of reference is specified.

TID 3218 Position in Arterial Segment

The Position in Arterial Segment Template consists of the position Content Items common for the Angiographic Lesion Analysis and Sub-Segmental Data.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3218. Position in Arterial Segment

	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M		$Measurement = EV (122528, DCM, "Position of Proximal Border") $Units = DT (mm, UCUM, "mm")
2	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M		$Measurement = EV (122529, DCM, "Position of Distal Border") $Units = DT (mm, UCUM, "mm")
3	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M		$Measurement = EV (122382, DCM, "Site of Luminal Minimum") $Units = DT (mm, UCUM, "mm")
4	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M		$Measurement = EV (122516, DCM, "Site of Luminal Maximum") $Units = DT (mm, UCUM, "mm")
5	CONTAINS	NUM	EV (122528, DCM, "Position of Proximal Border")	1	UC	IFF TID 3214 “Analyzed Segment” Row 14 is present	UNITS = DT ({pixels}, UCUM, "pixels")
6	CONTAINS	NUM	EV (122529, DCM, "Position of Distal Border")	1	UC	IFF TID 3214 “Analyzed Segment” Row 14 is present	UNITS = DT ({pixels}, UCUM, "pixels")
7	CONTAINS	NUM	EV (122382, DCM, "Site of Luminal Minimum")	1	UC	IFF TID 3214 “Analyzed Segment” Row 14 is present	UNITS = DT ({pixels}, UCUM, "pixels")
8	CONTAINS	NUM	EV (122516, DCM, "Site of Luminal Maximum")	1	UC	IFF TID 3214 “Analyzed Segment” Row 14 is present	UNITS = DT ({pixels}, UCUM, "pixels")

Content Item Descriptions

Rows 1, 2, 3, 4	Positions are relative to the midpoint of the first left and right contour points and measured along the midline of the left and right contour
Rows 5, 6, 7, 8	The positions are relative to the measurement locations of the Diameter Graph of TID 3214 “Analyzed Segment” Row 14.

TID 3219 Segment Values

The Segment Values Template consists of Content Items providing quantitative arterial analysis measurements for a total analyzed segment or sub segment.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3219. Segment Values

	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (122510, DCM, "Length Luminal Segment") $Units = DT (mm, UCUM, "mm")
2	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (255605001, SCT, "Minimum") $Units = DT (mm, UCUM, "mm")
3	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (56851009, SCT, "Maximum") $Units = DT (mm, UCUM, "mm")
4	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (373098007, SCT, "Mean") $Units = DT (mm, UCUM, "mm")
5	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter") $Derivation = EV (386136009, SCT, "Standard Deviation") $Units = DT (mm, UCUM, "mm")

Content Item Descriptions

Row 1

Measured along the midline of the left and right contour.

IVUS Report Templates

The Templates that comprise the IVUS Report within the Evidence Report IOD are interconnected as shown in Figure A-5.

Figure A-5. IVUS Report Template Hierarchy

TID 3250 IVUS Report

The IVUS Report Template is the root structure for the representation of IVUS measurements acquired during a catheterization procedure.

Type:: Extensible
Order:: Significant
Root:: Yes

Table TID 3250. IVUS Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (122325, DCM, "IVUS Report")	1	M	Root node
2	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	M
3	>	HAS OBS CONTEXT	INCLUDE	DTID 1002 “Observer Context”	1-n	U
4	>		INCLUDE	DTID 3601 “Procedure Context”	1	U
5	>	CONTAINS	INCLUDE	DTID 3602 “Cardiovascular Patient Characteristics”	1	U
6	>	CONTAINS	CONTAINER	EV (111028, DCM, "Image Library")	1	U
7	>>	CONTAINS	IMAGE		1-n	U
8	>	CONTAINS	INCLUDE	DTID 3251 “IVUS Vessel”	1-n	M

Content Item Descriptions

Row 7

No purpose of reference is specified.

TID 3251 IVUS Vessel

The IVUS Vessel Template provides a structure for grouping one or more lesions analyzed and/or treated during a single phase of a catheterization procedure, according to vessel (or arterial location).

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3251. IVUS Vessel

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	U		DCID 3604 “Arterial Lesion Location”
3	>>	HAS CONCEPT MOD	CODE	EV (106233006, SCT, "Topographical modifier")	1	U		DCID 3019 “Cardiovascular Anatomic Structure Modifier”
4	>>	HAS CONCEPT MOD	CODE	EV (272741003, SCT, "Laterality")	1	UC	IFF anatomy has laterality	DCID 244 “Laterality”
5	>	HAS ACQ CONTEXT	CODE	EV (129085009, SCT, "Catheterization Procedure Phase")	1	U		DCID 3480 “IVUS Procedure Phase”
6	>	CONTAINS	CODE	EV (122134, DCM, "Vessel Morphology")	1-n	U		CID 3712 “Vessel Descriptor”
7	>	CONTAINS	INCLUDE	DTID 3819 “Common Findings”	1-n	U
8	>	CONTAINS	CODE	EV (115, NCDR [2.0b], "Dissection in segment")	1	U		DCID 230 “Yes-No”
9	>	CONTAINS	INCLUDE	DTID 3252 “IVUS Lesion”	1-n	U

TID 3252 IVUS Lesion

The IVUS Lesion Template provides a structure for grouping measurements and observations made on a single lesion during an Intravascular Ultrasound Procedure.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3252. IVUS Lesion

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	EV (300577008, SCT, "Lesion Finding")	1	M
2	>	HAS OBS CONTEXT	TEXT	EV (121151, DCM, "Lesion Identifier")	1	M		Up to 3 numeric characters
3	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1-n	U		DCID 3604 “Arterial Lesion Location”
4	>>>	HAS CONCEPT MOD	CODE	EV (106233006, SCT, "Topographical modifier")	1	U		DCID 3019 “Cardiovascular Anatomic Structure Modifier”
5	>	HAS ACQ CONTEXT	INCLUDE	DTID 3107 “Device Used”	1-n	U
6	>	CONTAINS	INCLUDE	DTID 3253 “IVUS Measurements”	1	MC	One or both of Rows 6 & 7 must be present
7	>	CONTAINS	INCLUDE	DTID 3254 “IVUS Qualitative Assessments”	1	MC	One or both of Rows 6 & 7 must be present
8	>	CONTAINS	INCLUDE	DTID 3819 “Common Findings”	1-n	U

Content Item Descriptions

Row 2	Lesion Identifier is specified as a numeric text string in order to facilitate trans-coding to DICOM Attribute (0018,3105) Lesion Number and to formats for outcomes registries, such as the ACC National Cardiovascular Data Registry™. Note Also see TID 3105 “Lesion Identification and Properties”.
Row 3	Finding site may span multiple segments with the proximal and distal extent specified by separate items. These may not be totally contained with the segment specified at the Vessel level.

TID 3253 IVUS Measurements

The IVUS measurements Template groups together simple distance, area and angle measurements, along with derived measurements that made during an IVUS procedure. Refer to the " ACC Clinical Expert Consensus Document on Standards for Acquisition, measurement and Reporting of Intravascular Ultrasound Studies (IVUS) "for more information.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3253. IVUS Measurements

	VT	Concept Name	VM	Req Type	Value Set Constraint
1	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = DCID 3481 “IVUS Distance Measurement” $Units = EV (mm, UCUM, "mm") $Derivation = DCID 3488 “Min/Max/Mean” $TargetSite = BCID 3486 “Vascular Measurement Site”
2	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = DCID 3482 “IVUS Area Measurement” $Units = EV (mm2, UCUM, "mm2") $Derivation = DCID 3488 “Min/Max/Mean” $TargetSite = BCID 3486 “Vascular Measurement Site”
3	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = DCID 3483 “IVUS Longitudinal Measurement” $Units = EV (mm, UCUM, "mm")
4	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = EV (122355, DCM, "Arc of Calcium") $Units = EV (deg, UCUM, "degrees") $TargetSite = BCID 3486 “Vascular Measurement Site”
5	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (408714007, SCT, "Lumen Area Stenosis") $Units = EV (%, UCUM, "%")
6	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122354, DCM, "Plaque Burden") $Units = EV (%, UCUM, "%") $TargetSite = BCID 3486 “Vascular Measurement Site”
7	INCLUDE	DTID 300 “Measurement”	1-n	U	$Measurement = DCID 3484 “IVUS Index/Ratio” $Units = EV ({ratio}, UCUM, "ratio") $TargetSite = BCID 3486 “Vascular Measurement Site”
8	INCLUDE	DTID 3255 “IVUS Volume Measurement”	1-n	U
9	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (122339, DCM, "Stent Volume Obstruction") $Units = EV (%, UCUM, "%")

TID 3254 IVUS Qualitative Assessments

The IVUS Qualitative Assessments Template groups together the qualitative properties of a lesion that are observed during an IVUS procedure. Refer to the "ACC Clinical Expert Consensus Document on Standards for Acquisition, measurement and Reporting of Intravascular Ultrasound Studies (IVUS) " for more information.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3254. IVUS Qualitative Assessments

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CODE	EV (122133, DCM, "Lesion Morphology")	1-n	U	DCID 3491 “IVUS Lesion Morphology”
2			CODE	EV (121071, DCM, "Finding")	1-n	U	DCID 3494 “IVUS Non Morphological Finding”
3	>		INCLUDE	DTID 1350 “Negation Modifier, Presence of Finding”	1	U
4			CODE	EV (121071, DCM, "Finding")	1	U	EV (710864009, SCT, "Arterial Dissection")
5	>	HAS CONCEPT MOD	CODE	EV (122387, DCM, "Dissection Classification")	1	U	DCID 3492 “Vascular Dissection Classification”
6	>		INCLUDE	DTID 1350 “Negation Modifier, Presence of Finding”	1	U
7			CODE	EV (122391, DCM, "Relative Stenosis Severity")	1	U	DCID 3493 “IVUS Relative Stenosis Severity”
8			CODE	EV (108, NCDR [2.0b], "Previously Dilated Lesion")	1	U	DCID 3750 “Previously Dilated Lesion”
9			CODE	EV (121071, DCM, "Finding")	1	U	EV (122393, DCM, "Restenotic Lesion")
10	>		INCLUDE	DTID 1350 “Negation Modifier, Presence of Finding”	1	U
11			CODE	EV (111009, DCM, "Calcification Type")	1	U	DCID 3489 “Calcium Distribution”

TID 3255 IVUS Volume Measurement

The IVUS Volume Measurement Template contains information describing an IVUS Volumetric measurement

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3255. IVUS Volume Measurement

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			INCLUDE	DTID 300 “Measurement”	1	M	$Measurement = DCID 3485 “IVUS Volume Measurement” $Units = EV (mm3, UCUM, "mm3") $TargetSite = BCID 3487 “Intravascular Volumetric Region”
2	>	HAS PROPERTIES	NUM	EV (122336, DCM, "Vascular Volume measurement length")	1	U	UNITS = DT (mm, UCUM, "mm")
3	>	HAS PROPERTIES	NUM	EV (122337, DCM, "Relative position")	1	U	UNITS = DT (mm, UCUM, "mm")
4	>>	HAS CONCEPT MOD	CODE	EV (122340, DCM, "Fiducial feature")	1	M	DCID 3496 “IVUS Fiducial Point”

Stress Testing Report Templates

TID 3300 Stress Testing Report

The Stress Testing Report Template is the root structure for the representation of measurements and findings of a stress testing procedure.

Type:: Extensible
Order:: Significant
Root:: Yes

Table TID 3300. Stress Testing Report

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	DT (18752-6, LN, "Stress Testing Report")	1	M	Root node
2	>	HAS CONCEPT MOD	CODE	EV (121058, DCM, "Procedure reported")	1	M	BCID 3200 “Stress Test Procedure”
3	>	HAS CONCEPT MOD	INCLUDE	DTID 1204 “Language of Content Item and Descendants”	1	M
4	>	HAS OBS CONTEXT	INCLUDE	DTID 1002 “Observer Context”	1-n	M
5	>	CONTAINS	CONTAINER	EV (18785-6, LN, "Indications for Procedure")	1	U
6	>>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1-n	U	DCID 3201 “Indications for Stress Test”
7	>>	CONTAINS	TEXT	EV (121071, DCM, "Finding")	1	U
8	>	CONTAINS	INCLUDE	DTID 3602 “Cardiovascular Patient Characteristics”	1	M
9	>	CONTAINS	INCLUDE	DTID 3802 “Cardiovascular Patient History”	1	U
10	>	CONTAINS	INCLUDE	DTID 3301 “Stress Test Procedure Description”	1	M
11	>	CONTAINS	INCLUDE	DTID 3303 “Stress Test Phase Data”	1-n	M
12	>	CONTAINS	INCLUDE	DTID 3311 “Stress Test Summary”	1	U
13	>	CONTAINS	INCLUDE	DTID 3318 “Comparison to Prior Stress Study”	1	U
14	>	CONTAINS	INCLUDE	DTID 3320 “Conclusions and Recommendations”	1	U

TID 3301 Stress Test Procedure Description

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3301. Stress Test Procedure Description

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	DT (55111-9, LN, "Current Procedure Descriptions")	1	M
2	>	CONTAINS	CODE	DT (109056, DCM, "Stress Protocol")	1	U		BCID 3261 “Stress Protocol”
3	>	CONTAINS	TEXT	DT (109056, DCM, "Stress Protocol")	1	U
4	>	CONTAINS	CODE	DT (10:11345, MDC, "Lead System")	1	U		BCID 3263 “Electrode Placement Value”
5	>	CONTAINS	CODE	DT (111045004, SCT, "Exerciser Device")	1	U		BCID 3203 “Exerciser Device”
6	>	CONTAINS	CODE	DT (246489000, SCT, "Pharmacological Stress Agent")	1	MC	IFF Pharmacological Stress used	BCID 3204 “Stress Agent”
7	>	CONTAINS	CONTAINER	EV (122700, DCM, "Indications for Pharmacological Stress")	1	MC	IFF Pharmacological Stress used
8	>>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1-n	U		DCID 3205 “Indications for Pharmacological Stress Test”
9	>	CONTAINS	CODE	DT (363679005, SCT, "Imaging procedure")	1	MC	IFF imaging used in procedure	DCID 3206 “Non-invasive Cardiac Imaging Procedure”
10	>	CONTAINS	CODE	DT (125203, DCM, "Acquisition Protocol")	1	UC	IFF Nuclear imaging	DCID 3110 “Nuclear Cardiology Protocol”
11	>	CONTAINS	CODE	DT (125203, DCM, "Acquisition Protocol")	1	UC	IFF PET imaging	DCID 3106 “PET Cardiology Protocol”
12	>	CONTAINS	TEXT	DT (121141, DCM, "Image Type")	1	UC	IFF Nuclear or PET imaging	STATIC, DYNAMIC, or GATED.
13	>	CONTAINS	CODE	DT (RID11248, RADLEX, "Cardiac Gating")	1	U		DCID 3104 “Cardiac Synchronization Technique”
14	>	CONTAINS	CODE	DT (125203, DCM, "Acquisition Protocol")	1	UC	IFF Contrast echocardiography	DT (433231002, SCT, "Contrast echocardiography")
15	>	CONTAINS	CODE	DT (113743, DCM, "Patient Orientation")	1	U		DCID 19 “Patient Orientation”
16	>>	HAS CONCEPT MOD	CODE	EV (113744, DCM, "Patient Orientation Modifier")	1	U		DCID 20 “Patient Orientation Modifier”
17	>	CONTAINS	TEXT	DT (121065, DCM, "Procedure Description")	1	U
18	>	CONTAINS	DATETIME	DT (122701, DCM, "Procedure Time Base")	1	U

Content Item Descriptions

Row 12	Image Type may be copied from the NM Image SOP Instance Attribute Image Type (0008,0008) value 3, or from the PET Image SOP Instance Attribute Series Type (0054,1000).
Row 18	The Procedure Time Base is the time from which elapsed times are measured. The Study Time (0008,0030) may include the patient prep period, while this Procedure Time Base is typically established when baseline data collection begins.

TID 3303 Stress Test Phase Data

The Stress Test Phase Data Template provides a structure for measurements acquired during a single procedure phase.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3303. Stress Test Phase Data

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	DT (59776-5, LN, "Findings")	1	M
2	>	HAS ACQ CONTEXT	CODE	EV (128954007, SCT, "Procedure phase")	1	MC	XOR Row 3	BCID 3207 “Stress Test Procedure Phase”
3	>	HAS ACQ CONTEXT	CODE	EV (128954007, SCT, "Procedure phase")	1	MC	IFF Nuclear Imaging; XOR Row 2	DCID 3101 “Cardiac Procedural State Value”
4	>	HAS ACQ CONTEXT	TEXT	EV (128954007, SCT, "Procedure phase")	1	U
5	>	CONTAINS	INCLUDE	DTID 3301 “Stress Test Procedure Description”	1	MC	IFF protocol changed from initial specification
6	>	HAS ACQ CONTEXT	NUM	EV (109055, DCM, "Protocol Stage")	1	U		UNITS = DT ({stage}, UCUM, "stage")
7	>	CONTAINS	INCLUDE	DTID 3304 “Stress Test Measurement Group”	1-n	U
8	>	CONTAINS	INCLUDE	DTID 3307 “NM/PET Perfusion Measurement Group”	1	MC	IFF Nuclear or PET Imaging
9	>	CONTAINS	INCLUDE	DTID 3309 “Stress Echo Measurement Group”	1	UC	IFF Echocardiography Imaging

Content Item Descriptions

Row 1

The Container shall have a specific Content Item Observation DateTime (0040,A032) Attribute to indicate the time at which the phase began.

TID 3304 Stress Test Measurement Group

Each instance of the Stress Test Measurement Group represents a group of data elements acquired at approximately the same instant, and conventionally rendered as row in a tabular presentation. It is typically generated during the Stress study whenever a time interval elapses (for example, every minute of the phase), when a technician observes data worth capturing, or when measurements exceed a given range.

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3304. Stress Test Measurement Group

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	DT (59776-5, LN, "Findings")	1	M
2	>	CONTAINS	NUM	DT (252131008, SCT, "Time since start of study")	1	M		UNITS = DT (min, UCUM, "min")
3	>	CONTAINS	NUM	DT (122710, DCM, "Time since start of stage")	1	M		UNITS = DT (min, UCUM, "min")
4	>	CONTAINS	NUM	DT (122702, DCM, "Treadmill speed")	1	U		UNITS = DCID 3212 “Treadmill Speed”
5	>	CONTAINS	NUM	DT (122703, DCM, "Treadmill gradient")	1	U		UNITS = EV (%, UCUM, "%")
6	>	CONTAINS	NUM	DT (122704, DCM, "Ergometer power")	1	U		UNITS = EV (W, UCUM, "Watts")
7	>	CONTAINS	NUM	DT (122709, DCM, "Activity workload")	1	U		UNITS = DT ([MET], UCUM, "METS")
8	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U		$Measurement = DT (122706, DCM, "Rating of Perceived Exertion") $Method = BCID 3239 “Perceived Exertion Scale”
9	>	CONTAINS	NUM	DT (122705, DCM, "Pharmacological Stress Agent Dose Rate")	1	MC	IFF Pharmacological Stress used	UNITS = EV (ug/kg/min, UCUM, "ug/kg/min")
10	>	CONTAINS	INCLUDE	DTID 3106 “Drugs/Contrast Administered”	1	U
11	>	CONTAINS	NUM	EV (8867-4, LN, "Heart Rate")	1	U		UNITS = EV ({H.B.}/min, UCUM, "BPM")
12	>	CONTAINS	NUM	EV (271649006, SCT, "Systolic Blood Pressure")	1	U		UNITS = DCID 3500 “Pressure Unit”
13	>	CONTAINS	NUM	EV (271650006, SCT, "Diastolic Blood Pressure")	1	U		UNITS = DCID 3500 “Pressure Unit”
14	>	CONTAINS	NUM	DT (122707, DCM, "Number of Ectopic Beats")	1	U		UNITS = EV ({beats}, UCUM, "beats")
15	>>	HAS PROPERTIES	NUM	DT (260867005, SCT, "Period of collection")	1	M		UNITS = DT (min, UCUM, "min")
16	>>	HAS PROPERTIES	CODE	EV (116676008, SCT, "Associated Morphology")	1-n	U		BCID 3234 “Ectopic Beat Morphology”
17	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U		$Measurement = DT (164931005, SCT, "ST Elevation") $Units = DT (mV, UCUM, "mV") $TargetSite = DCID 3001 “ECG Lead”
18	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U		$Measurement = DT (429622005, SCT, "ST Depression") $Units = DT (mV, UCUM, "mV") $TargetSite = DCID 3001 “ECG Lead”
19	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U		$Measurement = DCID 3228 “ECG Timing Measurement” $Units = DT (ms, UCUM, "ms") $TargetSite = DCID 3001 “ECG Lead”
20	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U		$Measurement = DCID 3227 “QTc Measurement” $Units = DT (ms, UCUM, "ms") $TargetSite = DCID 3001 “ECG Lead” $Equation = DCID 3678 “QT Correction Algorithm”
21	>>	INFERRED FROM	NUM	DT (2:16000, MDC, "RR Interval for QTc")	1	U		UNITS = DT (ms, UCUM, "ms")
22	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1-n	U		$Measurement = DCID 3229 “ECG Axis Measurement” $Units = DT (deg, UCUM, "deg")
23	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U		$Measurement = DCID 3526 “Blood Gas Saturation” $Units = EV (%, UCUM, "%")
24	>	CONTAINS	NUM	DT (122708, DCM, "Double Product")	1	U		UNITS = DT (mm[Hg].{H.B.}/min, UCUM, "mmHg.BPM")
25	>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1-n	U		DCID 3220 “Stress Symptom”
26	>	CONTAINS	CODE	EV (271921002, SCT, "ECG Finding")	1-n	U		DCID 3230 “ECG Finding”
27	>	CONTAINS	TEXT	EV (121106, DCM, "Comment")	1	U

Content Item Descriptions

Row 1	The Container shall have a specific Content Item Observation DateTime (0040,A032) Attribute to indicate the time at which the measurements were made.
Row 10	Included TID 3106 “Drugs/Contrast Administered” allows the recording of test medications other than the Pharmacological Stress Agent identified in TID 3301 “Stress Test Procedure Description”.
Rows 17, 18	ECG ST elevation/depression is measured in units of mV, but is conventionally reported in units of mm, based on strip recordings with scaling of 100 uV/mm. The display application should render these measurements in units meaningful to the user.
Row 19	Note that the MDC codes for "per lead" measurements specified in CID 3228 “ECG Timing Measurement” are base codes for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300 “Measurement”. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row.
Row 20	Note that the MDC code for "QTc interval per lead" specified in CID 3227 “QTc Measurement” is a base code for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300 “Measurement”. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row. Note that TID 300 “Measurement” enables the encoding of a non-standard correction algorithm, either as a local code, or as a TEXT Method Citation (see TID 300 “Measurement” Row 12).
Row 21	R-R interval used for QT correction algorithm
Row 22	Recommended range for ECG axis measurements is -90° to +270°

TID 3307 NM/PET Perfusion Measurement Group

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3307. NM/PET Perfusion Measurement Group

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	DT (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (121058, DCM, "Procedure reported")	1	M	BCID 3108 “NM/PET Procedure”
3	>	CONTAINS	CODE	EV (349358000, SCT, "Radiopharmaceutical agent")	1	M	DCID 3111 “Nuclear Cardiology Radiopharmaceutical”
4	>	CONTAINS	NUM	EV (123006, DCM, "Radionuclide Total Dose")	1	M	DCID 3083 “Radioactivity Unit”
5	>	CONTAINS	DATETIME	EV (123003, DCM, "Radiopharmaceutical Start DateTime")	1	M
6	>	CONTAINS	NUM	DT (122711, DCM, "Exercise duration after stress agent injection")	1	U	UNITS = DT (min, UCUM, "min")
7	>	CONTAINS	DATETIME	EV (122712, DCM, "Imaging Start DateTime")	1	M
8	>	CONTAINS	CODE	EV (122713, DCM, "Attenuation correction")	1	U	BCID 3112 “Attenuation Correction”
9	>>	HAS PROPERTIES	CODE	EV (111001, DCM, "Algorithm Name")	1	U	BCID 3117 “Attenuation Correction Method”
10	>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1-n	U	BCID 3113 “Perfusion Defect Type”
11	>>	HAS PROPERTIES	CODE	EV (363698007, SCT, "Finding Site")	1	M	BCID 3717 “Left Ventricle Myocardial Wall 17 Segment Model”
12	>>	HAS PROPERTIES	CODE	EV (112025, DCM, "Size Descriptor")	1	M	BCID 252 “S-M-L Size Descriptor”
13	>>	HAS PROPERTIES	CODE	EV (246112005, SCT, "Severity")	1	M	BCID 3716 “Severity”
14	>	CONTAINS	CODE	EV (250907009, SCT, "Left Ventricular Function")	1	U	BCID 3119 “LV Function”
15	>>	HAS PROPERTIES	CODE	EV (246112005, SCT, "Severity")	1	U	BCID 3716 “Severity”
16	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (10230-1, LN, "LV Ejection Fraction") $Units = EV (%, UCUM, "%") $Derivation = DT (258090004, SCT, "Calculated")
17	>	CONTAINS	CODE	EV (250924003, SCT, "Left Ventricular Size")	1	U	BCID 3122 “Ventricular Enlargement”
18	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (8821-1, LN, "Left Ventricular ED Volume") $Units = EV (ml, UCUM, "ml")
19	>	CONTAINS	INCLUDE	DTID 300 “Measurement”	1	U	$Measurement = EV (8823-7, LN, "Left Ventricular ES Volume") $Units = EV (ml, UCUM, "ml")
20	>	CONTAINS	INCLUDE	DTID 5204 “Wall Motion Analysis”	1	U	$Procedure = DCID 3108 “NM/PET Procedure”

TID 3309 Stress Echo Measurement Group

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3309. Stress Echo Measurement Group

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Condition	Value Set Constraint
1			CONTAINER	DT (59776-5, LN, "Findings")	1	M
2	>	HAS CONCEPT MOD	CODE	EV (121058, DCM, "Procedure reported")	1	M		DT (40701008, SCT, "Echocardiography")
3	>	CONTAINS	INCLUDE	DTID 5203 “Echo Measurement”	1-n	U		$Measurement = DCID 12200 “Echocardiography Left Ventricle Measurement” $Method = CID 12227 “Echocardiography Measurement Method”
4	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	MC	IF Row 3 measurement concept is in CID 12222 “Orifice Flow Property”	EV (87878005, SCT, "Left Ventricle")
5	>	CONTAINS	INCLUDE	DTID 5203 “Echo Measurement”	1-n	U		$Measurement = DCID 12211 “Echocardiography Aortic Valve Measurement” $Method = CID 12227 “Echocardiography Measurement Method”
6	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	MC	IF Row 5 measurement concept is in CID 12222 “Orifice Flow Property”	EV (34202007, SCT, "Aortic Valve")
7	>	CONTAINS	INCLUDE	DTID 5203 “Echo Measurement”	1-n	U		$Measurement = DCID 12207 “Echocardiography Mitral Valve Measurement” $Method = CID 12227 “Echocardiography Measurement Method”
8	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	MC	IF Row 7 measurement concept is in CID 12222 “Orifice Flow Property”	EV (91134007, SCT, "Mitral Valve")
9	>	CONTAINS	INCLUDE	DTID 5203 “Echo Measurement”	1-n	U		$Measurement = DCID 12208 “Echocardiography Tricuspid Valve Measurement” $Method = CID 12227 “Echocardiography Measurement Method”
10	>>	HAS CONCEPT MOD	CODE	EV (363698007, SCT, "Finding Site")	1	MC	IF Row 9 measurement concept is in CID 12222 “Orifice Flow Property”	EV (46030003, SCT, "Tricuspid Valve")
11	>	CONTAINS	INCLUDE	DTID 5204 “Wall Motion Analysis”	1	U		$Procedure = DT (35757004, SCT, "Echocardiography for Determining Ventricular Contraction")

Content Item Descriptions

Rows 3, 4, 5, 6, 7, 8, 9, 10

These invocations of TID 5203 “Echo Measurement” do not include an inherited Findings Site concept, for example as in the invocations of TID 5203 “Echo Measurement” from TID 5202 “Echo Section”. Echo measurements that do not have the associated Finding Site pre-coordinated in the measurement concept (i.e., the orifice flow measurements of CID 12222 “Orifice Flow Property”), shall have the Finding Site explicitly post-coordinated with a Concept Modifier (Rows 4, 6, 8, and 10).

This Template does not include the concept of an Image Library, for example as used in TID 5200 “Echocardiography Procedure Report”. Image Content Items in the Echo Measurement Template shall be included with by-value relationships, not with by-reference relationships.

TID 3311 Stress Test Summary

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3311. Stress Test Summary

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			CONTAINER	EV (55112-7, LN, "Summary")	1	M
2	>	CONTAINS	TEXT	EV (55112-7, LN, "Summary")	1	U
3	>	CONTAINS	INCLUDE	DTID 3312 “Physiological Summary”	1	U
4	>	CONTAINS	INCLUDE	DTID 3313 “Stress ECG Summary”	1	U
5	>	CONTAINS	INCLUDE	DTID 3317 “Stress Imaging Summary”	1	U
6	>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1	U	EV (300995000, SCT, "Exercise-induced angina")
7	>>		INCLUDE	DTID 1350 “Negation Modifier, Presence of Finding”	1	M
8	>	CONTAINS	CODE	EV (121071, DCM, "Finding")	1-n	U	DCID 3220 “Stress Symptom”
9	>	CONTAINS	TEXT	EV (121071, DCM, "Finding")	1	U
10	>	CONTAINS	CODE	DT (246101005, SCT, "Reason for stopping test")	1	U	DCID 3221 “Stress Test Termination Reason”
11	>	CONTAINS	NUM	DT (122715, DCM, "Pharmacological Stress Agent Dose")	1	U	DT (mg/kg, UCUM, "mg/kg")

Content Item Descriptions

Rows 6, 7

These rows allow an explicit finding of presence or absence of exercise-induced angina through the TID 1350 “Negation Modifier, Presence of Finding” Concept Modifier "Presence of property"

TID 3312 Physiological Summary

Type:: Extensible
Order:: Significant
Root:: No

Table TID 3312. Physiological Summary

	NL	Rel with Parent	VT	Concept Name	VM	Req Type	Value Set Constraint
1			NUM	DT (40443-4, LN, "Resting Heart Rate")	1	M	UNITS = DT ({H.B.}/min, UCUM, "BPM")
2			NUM	EV (271649006, SCT, "Systolic Blood Pressure")	1	M	UNITS = DCID 3500 “Pressure Unit”
3	>	HAS CONCEPT MOD	CODE	EV (109054, DCM, "Patient State")	1	M	DT (128975004, SCT, "Resting State")
4			NUM	EV (271650006, SCT, "Diastolic Blood Pressure")	1	M	UNITS = DCID 3500 “Pressure Unit”
5	>	HAS CONCEPT MOD	CODE	EV (109054, DCM, "Patient State")	1	M	DT (128975004, SCT, "Resting State")
6			NUM	DT (428420003, SCT, "Target HR")	1	M	UNITS = DT ({H.B.}/min, UCUM, "BPM")
7			NUM	DT (428630002, SCT, "Maximum HR Achieved")	1	M	UNITS = DT ({H.B.}/min, UCUM, "BPM")
8			NUM	DT (428630002, SCT, "Maximum HR Achieved")	1	M	UNITS = EV (%, UCUM, "%")
9	>	HAS CONCEPT MOD	CODE	EV (121425, DCM, "Index")	1	M	DT (428420003, SCT, "Target HR")
10			NUM	DT (122716, DCM, "Maximum Power Output Achieved")	1	U	UNITS = DT (W, UCUM, "Watts")
11			NUM	DT (122717, DCM, "Peak activity workload")	1	U	UNITS = DT ([MET], UCUM, "METS")
12			CODE	DT (428531008, SCT, "HR Response")	1	U	DCID 3210 “Speed of Response”
13			NUM	DT (314439003, SCT, "Maximum systolic blood pressure")	1	U	UNITS = DCID 3500 “Pressure Unit”
14			NUM	DT (314452008, SCT, "Maximum diastolic blood pressure")	1	U	UNITS = DCID 3500 “Pressure Unit”
15			CODE	DT (427732000, SCT, "BP Response")	1	U	DCID 3210 “Speed of Response”
16			NUM