Acquisition Context Templates are described using tables of the following form:Type:(Non-) ExtensibleOrder:(Non-) Significant
<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-) ExtensibleOrder:(Non-) Significant
<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 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.A separate table of the following form may be used to describe individual rows, i.e., Content Items:Content Item Descriptions
Row 1
Rows 2, 3
The first column contains a reference to the row(s) of the Template table using the respective Row Number(s) (see ), e.g., "Row 1" refers to the row identified as the first row of the Template table and "Rows 2, 3" refers to the rows identified as second and third row of the Template table. When referring to multiple rows, the Row Numbers are fully enumerated. The second column contains the description of the referenced row(s).Ranges, such as "Rows 1-3", or other kind of abbreviations are not used.It is not necessary to describe all rows of a Template table in this additional table.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) CNAMEe.g., Defined Context Group Identifier 5000 is represented as follows: DCID (5000) Language.References to Templates take the following form:BTID or DTID (TID) TNAMEe.g., Baseline Template Identifier 1000 is represented as follows: BTID (1000) Quotation.Row NumberEach 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.When templates are amended by adding a new row that is inserted into an existing Template table, i.e., not added after the last row, an alphabetic suffix is appended to the Row Number of the preceding row. E.g., a Row Number of “2a” or “2b” is used to insert the new row between row “2” and “3”.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.Nesting Level (NL)When a parent-child relationship is present between two Content Items, the parent is deemed to be the Source Content Item and the child is deemed to be the Target Content Item; see .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 . 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 ).Relationship with Source Content Item (Parent)Relationship Type and by-value or by-reference constraints, if defined, are specified in this field, as described .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.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 .Acquisition Context and Protocol Context Templates have no Relationship field.
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".
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 for further description of "Included Templates".Concept NameAny constraints on the Concept Name are specified in the Concept Name field as defined or enumerated coded entries, or as baseline or defined Context Group Identifiers. 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.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.
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.
Requirement TypeThe Requirement Type field specifies the requirements on the presence or absence of the Content Item or included Template.There is typically no need to specify Requirement Type separately for SCU and SCP of the SR SOP Classes, because the SCP is required to support the entire content of any SR Document it receives. Therefore, for SR SOP Classes, Requirement Type effectively only applies to the SCU.The following symbols are used:MMandatory. Shall be present. An empty Measured Value Sequence (0040,A300) is not permitted when unknown, only for failures. See .MCMandatory 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 .UUser Option. May or may not be present.UCUser Option Conditional. May not be present. May be present according to the specified condition.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
Requirement Type for Numeric Content Items in Structured Reports 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.This does not apply to the , 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 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 A zero length Measured Value Sequence (0040,A300) is not permitted for any of the reasons listed in , or any other semantically equivalent reasonThe 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.ConditionThe 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). When referring to multiple rows, the Row Numbers have to be fully enumerated, e.g., "Rows 1, 2, 3". When referring to a single row, the singular form is used, e.g., "Row 2".Ranges, such as "Rows 1-3", or other kind of abbreviations, are not used.The following abbreviations are used in the Condition field:XORExclusive OR. One and only one row shall be selected from mutually-exclusive options.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.IFShall be present if the condition is TRUE; may be present otherwise.IFFIf and only if. Shall be present if the condition is TRUE; shall not be present otherwise.Value Set ConstraintAny 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 field 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 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.For the UIDREF Content Item in Row 1 of , the Value Set Constraint column specifies: "Defaults to Value of Device UID (0018,1002) of the ". 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.NUM Units ConstraintAny 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 = DThe constraints on the units apply only when Measured Value Sequence (0040,A300) contains an Item (i.e., a numeric value is present).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.CONTAINER Continuation Flag ConstraintThe 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.The specifies "SEPARATE" and "CONTINUOUS" as the Enumerated Values for Continuity of Content Flag (0040,A050).SCOORD Graphic Type ConstraintConstraints 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}TABLE Row, Column, Units and Coded Content ConstraintsConstraints 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 literallyPermitted 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 referenceIt 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 = 2COLUMN 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 = DTCOLUMN 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 (130520, DCM, "Transformation Matrix")
1
M
NCOLUMNS = 4NROWS= 4CELL VR = FD
Content Item Descriptions
Row 5
The Transformation Matrix is encoded as a 4 by 4 matrix of dimensionless numbers of the form defined in . 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 = 4COLUMN 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 2COLUMN 2 REF = TID 1500 ROW 9 > TID 1501 ROW 6COLUMN 3 REF = TID 1500 ROW 9 > TID 1501 ROW 7COLUMN 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.
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.
Special Conventions for Template TablesMultiple Value Sets Depending on Different ConditionsWhen 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.Target Content Items of RelationshipsWhen 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 inclusion of another Template, see ) 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 Content Item 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 a VM of greater than 1, the specified pattern of Target Content Items applies to all instantiations of the Source Content Item.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.In other words, potential children are not present when there is no parent.Inclusion of TemplatesA 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.Template ParametersA 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 Group Identifers 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 = $parameternameIn 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.Post-coordinated Codes and Has Concept Modifier RelationshipThough 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).Extension of TemplatesAn 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.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.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.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".DCMR Context Group SpecificationsContext 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.Context Group Table Field DefinitionContext 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 XMLKeyword:<Context Group Keyword>FHIR Keyword:dicom-cid-<#>-<Context Group Keyword>Type:(Non-) ExtensibleVersion:<yyyymmdd> or Not versionedUID:1.2.840.10008.6.1.uuuu
<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 titleidentified by a CID numberidentified by a versionidentified by a Keywordidentified by a FHIR Keywordassigned a UID (that is defined in )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.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.See for instance .Special Conventions for Context Group TablesInclude Context GroupThe '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.For example, it is reasonable to have the following definitions for Context Groups:Context ID 1, includes Context IDs 2 and 3Context ID 2, includes Context IDs 4 and 5Context ID 3, includes Context IDs 5 and 6Context ID 4 contains a, b, cContext ID 5 contains e, f, gContext ID 6 contains a, h, iThe contents of Context ID 1 will be a, b, c, e, f, g, h, i.
Include Context Group Macro
Coding Scheme Designator
Code Value
Code Meaning
…
…
…
Include CID nnn
…
…
…
Measurement UnitContext 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 Versionthe 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. 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 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".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).Extension of Context GroupsAn 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 ).Non-extensible Context Groups shall not be modified in an application.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.Coding Schemes lists the Coding Schemes (and their designators) defined for use in DICOM; 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 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".An earlier version of this table was formerly contained in Annex D of .See 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 .The HL7 registration of Coding Schemes is available at .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 .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 .
ACR Index for Radiological Diagnosis Revised, 3rd Edition 1986
ASTM-sigpurpose
1.2.840.10065.1.12
ASTM E 2084
ASTM
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; endorsed by ACC/AHA Guidelines for Coronary Angiography.
BI
BI-RADS
ACR
ACR Breast Imaging Reporting and Data System , 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").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)
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).
International Classification of Diseases for Oncology, 3rd EditionICD-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
, Tags for Identifying Languages, The Internet Society (2005) has been superceded by .
ISO639_1
2.16.840.1.113883.6.99
ISO 639-1
ISO
Two-letter language codesHL7 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
Three-letter language codesHL7 uses "ISO639-2" for the symbolic name, with a hyphen rather than an underscore
ISO3166_1
2.16.1
ISO 3166-1
ISO
alpha-2 Country CodesHL7 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/IEC 8824-1- Information Technology - Abstract Syntax 1 (ASN.1): Specification of Basic Notation, and - 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).
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 (, , , etc.), encoded as decimal strings <partition>:<element>
MDNS
Universal Medical Device (UMD) Nomenclature System
, Tags for the Identification of Languages, Internet Engineering Task ForceHL7 uses "IETF3066" for the symbolic name. has been superseded by , which in turn has been superceded by .
RFC-3881
RFC 3881
IETF
DOC: http://tools.ietf.org/html/rfc3881
, Security Audit and Access Accountability Message - XML Data Definitions for Healthcare ApplicationsA 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
, Tags for Identifying Languages, The Internet Society (2009)The HL7 OID Registry specifies "rfc5646", not "ietf5646", as the Desired Symbolic Name (inconsistent with the pattern used for ). constitutes one part of IETF Best Current Practice BCP 47 Tags for Identifying Languages, which also includes Matching of Language Tags; is not relevant in this context.
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 )
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 )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.
, using the "SNOMED-RT style" Code Values (see )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.
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
UPC
2.16.840.1.113883.6.55
Universal Product Code - Universal Code Council
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
SNOMED CTSNOMED (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 ValuesAll 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."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.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 to allow implementers to process legacy objects from legacy devices and archives.Use of SNOMED Anatomic ConceptsIn 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.ISO_OID and are the standards defined for the generation of object identifiers that are used as DICOM Unique Identifiers (see ), 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 . 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 .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 .Retired Codes and Expected BehaviorAs 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 .Structured Reporting Templates (Normative)This Annex specifies the content of Standard Templates that may be used by DICOM SR IODs.MeasurementThis 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.
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
Measurement ContentThis Template provides a general structure for the content of a numeric measurement, together with evaluations of its normality and/or significance, and the inference source(s) for its value.
Parameters
Parameter Name
Parameter Usage
$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
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
D
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
D
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 . 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).
Measurement PropertiesThis 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.
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:ExtensibleOrder:SignificantRoot:No
Measurement Properties
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
EV (121402, DCM, "Normality")
1
U
D
2
INCLUDE
D
1
U
$RefAuthority = $RefAuthority
3
INCLUDE
D
1
U
$RangeAuthority = $RangeAuthority
4
CODE
EV (121403, DCM, "Level of Significance")
1
U
D
5
NUM
D
1-n
U
6
CODE
EV (121404, DCM, "Selection Status")
1
U
D
Measurement Statistical PropertiesThis 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.
Parameters
Parameter Name
Parameter Usage
$RefAuthority
Bibliographic reference or authority for statistical properties of a reference population
Type:ExtensibleOrder:SignificantRoot:No
Measurement Statistical Properties
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
NUM
D
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
Normal Range PropertiesThis Template provides the normal range of values for a numeric measurement.
Parameters
Parameter Name
Parameter Usage
$RangeAuthority
Bibliographic reference or authority for the normal range of the measurement
Type:ExtensibleOrder:SignificantRoot:No
Normal Range Properties
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
NUM
D
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
RatioThis Template allows for encoding of numeric ratios with explicit numerator and denominator.
The Container Concept Name (with modifiers) is equivalent to the numeric measurement Concept Name of , and uses the same parameter names.Compare to FHIR Ratio DataType
Parameters
Parameter Name
Parameter Usage
$Measurement
Coded term or Context Group for Concept Name ofratio
$ModType
Modifier Name for Concept Name of ratio
$ModValue
Modifier Value for Concept Name of ratio
$NumUnits
Numerator units of measurement
$DenomUnits
Denominator units of 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
Coded term or Context Group for the equation or table from which a measurement was derived or computed
Type:ExtensibleOrder:SignificantRoot:No
Equation or Table
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
D
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.
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.Image or Spatial CoordinatesThis 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.
Parameters
Parameter Name
Parameter Usage
$Purpose
Purpose of Reference for an image used as a source of the measurement
Type:ExtensibleOrder:SignificantRoot:No
Image or Spatial Coordinates
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
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.
Waveform or Temporal CoordinatesThis 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.
Parameters
Parameter Name
Parameter Usage
$Purpose
Purpose of Reference for a waveform used as a source of the measurement
Type:ExtensibleOrder:SignificantRoot:No
Waveform or Temporal Coordinates
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
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.
References to Supporting EvidenceThis 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-ExtensibleOrder:SignificantRoot:No
References to Supporting Evidence
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
IMAGE
B
1-n
U
2
SCOORD
B
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
Previous ReportsThis general Template provides a means to reference previous structured reporting composite object instances.Type:ExtensibleOrder:SignificantRoot:No
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.
Reference LocationThis TID is a subset of the Reference Location Macro. See .Type:ExtensibleOrder:Non-SignificantRoot:No
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
B
2
CODE
EV (128773, DCM, "Reference Geometry")
1
M
B
QuotationUnless 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 quotingwho is doing the quotingthe source of the quotewho is being quoted, and who and what the quote is aboutThis 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 treethat the "observer context" above the invocation of this Template establishes who is doing the quotingthe source of the quote, by the values of the Content Items in this Templatewho is being quoted, and who and what the quote is about, by the observation context that is established at the start of the quoted materialThis 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:ExtensibleOrder:SignificantRoot:No
Quotation
NL
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
D
1
M
Observation ContextSpecifies 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-ExtensibleOrder:SignificantRoot:No
Observation Context
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
HAS OBS CONTEXT
INCLUDE
D
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
D
1
MC
Required if all aspects of procedure context are not inherited.
3
HAS OBS CONTEXT
INCLUDE
D
1
MC
Required if all aspects of observation subject context are not inherited.
Observer ContextThe 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 and shall be included in the order in which the values of Observer Type are specified. Since and both include a single mandatory Content Item as their first Content Item, which observer is being described can be determinedType:Non-ExtensibleOrder:SignificantRoot:No
Observer Context
NL
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
DDefaults to (121006, DCM, "Person")
2
HAS OBS CONTEXT
INCLUDE
D
1
MC
IFF Row 1 value = (121006, DCM, "Person") or Row 1 is absent
3
HAS OBS CONTEXT
INCLUDE
D
1
MC
IFF Row 1 value = (121007, DCM, "Device")
4
HAS OBS CONTEXT
INCLUDE
D
1
U
Person Observer Identifying AttributesThis Template contains identifying (and optionally descriptive) attributes of persons that are observers.Type:ExtensibleOrder:SignificantRoot:No
Person Observer Identifying Attributes
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
3
CODE
EV (121010, DCM, "Person Observer's Role in the Organization")
1
U
B
4
CODE
EV (121011, DCM, "Person Observer's Role in this Procedure")
1
U
B
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.
Device Observer Identifying AttributesThis Template (derived from the ) contains identifying (and optionally descriptive) attributes of devices that are observers.Type:ExtensibleOrder:SignificantRoot:No
Device Observer Identifying Attributes
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
UIDREF
EV (121012, DCM, "Device Observer UID")
1
M
Defaults to Value of Device UID (0018,1002) of the
2
TEXT
EV (121013, DCM, "Device Observer Name")
1
U
Defaults to Value of Station Name (0008,1010) of the
3
TEXT
EV (121014, DCM, "Device Observer Manufacturer")
1
U
Defaults to Value of Manufacturer (0008,0070) of the
4
TEXT
EV (121015, DCM, "Device Observer Model Name")
1
U
Defaults to Value of Manufacturer's Model Name (0008,1090) of the
5
TEXT
EV (121016, DCM, "Device Observer Serial Number")
1
U
Defaults to Value of Device Serial Number (0018,1000) of the
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
B
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 .
10
CONTAINER
EV (121000, DCM, "Unique Device Identifiers")
1-n
U
Defaults to Value of UDI Sequence (0018,100A) of the
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.
Procedure Study ContextThis 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.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-ExtensibleOrder:SignificantRoot:No
Procedure Study Context
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
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
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
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).
Subject ContextThis 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-ExtensibleOrder:SignificantRoot:No
Subject Context
NL
Rel with Parent
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
DDefaults to (121025, DCM, "Patient")
2
INCLUDE
D
1
UC
IFF Row 1 value = (121025, DCM, "Patient") or Row 1 is absent
May be used for human or animal patients
3
INCLUDE
D
1
UC
IFF Row 1 value = (121026, DCM, "Fetus")
May be used for human or animal fetuses
4
INCLUDE
D
1
UC
IFF Row 1 value = (121027, DCM, "Specimen")
5
INCLUDE
D
1
UC
IFF Row 1 value = (121192, DCM, "Device Subject")
Subject Context, PatientIdentifies (and optionally describes) a patient who is the subject.Type:ExtensibleOrder:SignificantRoot:No
Subject Context, Patient
NL
Rel with Parent
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
3
CODE
EV (121030, DCM, "Subject ID")
1
MC
Required if not inherited.
Defaults to Value of Patient ID (0010,0020) of the
4
DATE
EV (121031, DCM, "Subject Birth Date")
1
U
Defaults to Value of Patient's Birth Date (0010,0030) of the
5
CODE
EV (121032, DCM, "Subject Sex")
1
U
Defaults to a code equivalent to Value of Patient's Sex (0010,0040) of the D
5a
CODE
EV (131233, DCM, "Subject Sex Parameters for Clinical Use")
1-n
U
Defaults to a code equivalent to Value of Sex Parameters for Clinical Use Category Sequence (0010,0043) of the D
5b
TEXT
EV (131234, DCM, "Subject Sex Parameters for Clinical Use Category Comment")
1
U
5c
TEXT
EV (131235, DCM, "Subject Sex Parameters for Clinical Use Category Reference")
1-n
U
6
NUM
EV (121033, DCM, "Subject Age")
1
U
Defaults to Value equivalent to Value of Patient's Age (0010,1010) of the UNITS = D
7
CODE
EV (121034, DCM, "Subject Species")
1
MC
Required if not inherited.
DDefaults to Coded Entry Value of Patient Species Code Sequence (0010,2202) of the , or if absent, (337915000, SCT, "Homo sapiens").
8
CODE
EV (121035, DCM, "Subject Breed")
1
U
Defaults to Coded Entry Value of Patient Breed Code Sequence (0010,2293) of the D
9
CODE
EV (415229000, SCT, "Racial group")
1-n
U
Defaults to Coded Entry Value(s) of Ethnic Group Code Sequence (0010,2161) of the , or if absent, the coded equivalents of the text Values of Ethnic Groups (0010,2162) of the , which is defined as "ethnic group(s) or race(s)", or if absent, the coded equivalent of the text Value of retired Ethnic Group (0010,2160).B
Subject Context, FetusIdentifies (and optionally describes) a fetus who is the subject.Type:ExtensibleOrder:SignificantRoot:No
Subject Context, Fetus
NL
Rel with Parent
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
3
TEXT
EV (121030, DCM, "Subject ID")
1
MC
IF Row 4 is absent
4
TEXT
EV (11951-1, LN, "Fetus ID")
1
MC
IF Row 3 is absent
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
Row 2
For longitudinal tracking of individual fetuses
Row 3
For longitudinal tracking of individual fetuses (human readable value e.g., "A" or "1")
Row 4
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"
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
Subject Context, SpecimenIdentifies (and optionally describes) a specimen that is the subject.Type:ExtensibleOrder:SignificantRoot:No
Subject Context, Specimen
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
UIDREF
EV (121039, DCM, "Specimen UID")
1
U
2
INCLUDE
D
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
5
CODE
EV (371439000, SCT, "Specimen Type")
1
U
D
6
TEXT
EV (111700, DCM, "Specimen Container Identifier")
1
U
Content Item Descriptions
Rows 4, 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]
Subject Context, DeviceIdentifies (and optionally describes) a device that is the subject of observations.Type:ExtensibleOrder:SignificantRoot:No
Subject Context, Device
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
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
Person Observer DescriptionThis Template includes attributes describing the qualifications of the person observer relevant to the content generated by the observer.Type:ExtensibleOrder:Non-SignificantRoot:No
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
D
2
>
HAS PROPERTIES
NUM
EV (C54627, NCIt, "Experience")
1
M
UNITS = EV (a, UCUM, "Year")
Person ParticipantThis 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.
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:ExtensibleOrder:SignificantRoot:No
Person Participant
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
B
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.
Device ParticipantThis 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.
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:ExtensibleOrder:SignificantRoot:No
Device Participant
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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, B may be used.
Row 2
This may be used for the name by which the organization manages the device.
Indications for Procedure
Parameters
Parameter Name
Parameter Usage
$Findings
Coded term or Context Group for Finding.
Type:ExtensibleOrder:SignificantRoot:No
Indications for Procedure
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (18785-6, LN, "Indications for Procedure")
1
U
2
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1-n
U
$Findings
3
>
CONTAINS
TEXT
EV (121071, DCM, "Finding")
1
U
Language DesignationDefines a mechanism for specifying a language, optionally with designation of the country in which that language applies.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 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:ExtensibleOrder:SignificantRoot:No
Language Designation
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
EV (121045, DCM, "Language")
1
M
D
2
>
HAS CONCEPT MOD
CODE
EV (121046, DCM, "Country of Language")
1
U
D
Language of ValueDefines 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.The language codes specified in 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-ExtensibleOrder:SignificantRoot:No
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
D
2
>
HAS CONCEPT MOD
CODE
EV (121046, DCM, "Country of Language")
1
U
D
Language of Name and ValueDefines 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.The language codes specified in 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:ExtensibleOrder:SignificantRoot:No
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
D
2
>
HAS CONCEPT MOD
CODE
EV (121046, DCM, "Country of Language")
1
U
D
Language of Content Item and DescendantsDefines 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.The language codes specified in 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-ExtensibleOrder:SignificantRoot:No
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
D
2
>
HAS CONCEPT MOD
CODE
EV (121046, DCM, "Country of Language")
1
U
D
Equivalent Meaning(s) of Concept NameDefines a mechanism for specifying one or more equivalent meanings for the Concept Name of the parent Content Item.Type:Non-ExtensibleOrder:SignificantRoot:No
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
D
1
U
3
HAS CONCEPT MOD
CODE
EV (121050, DCM, "Equivalent Meaning of Concept Name")
1-n
MC
XOR Row 1
4
>
INCLUDE
D
1
U
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 ), though the equivalent code(s) in the Equivalent Code Sequence (0008,0121) need not be the same as those in TID 1210.Equivalent Meaning(s) of ValueDefines a mechanism for specifying one or more equivalent meanings for the Value of the parent Content Item.Type:ExtensibleOrder:SignificantRoot:No
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
D
1
U
3
HAS CONCEPT MOD
CODE
EV (121051, DCM, "Equivalent Meaning of Value")
1-n
MC
XOR Row 1
4
>
INCLUDE
D
1
U
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 ).Negation Modifier, Presence of FindingConcept Name Modifier for negation of the presence of a finding represented by a post-coordinated concept.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:ExtensibleOrder:SignificantRoot:No
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
D
Linear MeasurementType:ExtensibleOrder:SignificantRoot:No
Linear Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
NUM
D
1
M
UNITS = D
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
D
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) oran 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
Area MeasurementType:ExtensibleOrder:SignificantRoot:No
Area Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
NUM
D
1
M
Value shall be > 0UNITS = D
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
D
8
>
HAS OBS CONTEXT
INCLUDE
D
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.
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
D
8
>
HAS OBS CONTEXT
INCLUDE
D
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
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.
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.
Three Dimensional Linear MeasurementType:ExtensibleOrder:SignificantRoot:No
Three Dimensional Linear Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
NUM
D
1
M
UNITS = D
2
>
INFERRED FROM
SCOORD3D
EV (121055, DCM, "Path")
1
M
GRAPHIC TYPE = {POLYLINE, ELLIPSE, POLYGON}
3
>
HAS OBS CONTEXT
INCLUDE
D
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) ora closed POLYGON to measure perimeter, where the (x,y,z) triplets are coplanar.
Planar ROI Measurements and Qualitative EvaluationsThis 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.
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:ExtensibleOrder:Non-SignificantRoot:No
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
B
4
>
HAS OBS CONTEXT
INCLUDE
D
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, 8b
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")
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 .
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.
Volumetric ROI Measurements and Qualitative EvaluationsThis 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.
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:ExtensibleOrder:Non-SignificantRoot:No
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
B
4
>
HAS OBS CONTEXT
INCLUDE
D
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")
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 .
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.
ROI MeasurementsThis Template encodes measurements for some metric, e.g., density, flow, or concentration.
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
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
D
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).
Measurements Derived From Multiple ROI MeasurementsThis 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.
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:ExtensibleOrder:Non-SignificantRoot:No
Measurements Derived From Multiple ROI Measurements
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).
Measurement ReportThis 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:ExtensibleOrder:Non-SignificantRoot:Yes
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 .
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.
Measurement and Qualitative Evaluation GroupThis 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.
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:ExtensibleOrder:Non-SignificantRoot:No
Measurement and Qualitative Evaluation Group
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
D
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
D
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")
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.
Time Point ContextThis Template describes information about the time point, for example, at which a measurement was obtained.Type:ExtensibleOrder:Non-SignificantRoot:No
Time Point Context
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
B
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
D
Content Item Descriptions
Row 1
Usually the same value as the Clinical Trial Time Point ID (0012,0050) Attribute in the , 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 , 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 , 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).
Image LibraryThe 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:ExtensibleOrder:Non-SignificantRoot:No
Image Library
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
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
D
1
U
4
>>
CONTAINS
INCLUDE
D
1-n
U
Row 3
These Image Library Entry Descriptors apply to all Image Library Entries in this Image Library Group.
Image Library EntryEach 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:ExtensibleOrder:Non-SignificantRoot:No
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
D
1
U
Row 2
These Image Library Entry Descriptors apply to the IMAGE in Row 1 and override descriptors in Row 3 of in case of conflict.
Image Library Entry DescriptorsThis Template contains selected attributes for an image or group of images. The descriptive information may be copied from images or derived.Type:ExtensibleOrder:Non-SignificantRoot:No
Image Library Entry Descriptors
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
HAS ACQ CONTEXT
CODE
EV (121139, DCM, "Modality")
1
U
D
2
HAS ACQ CONTEXT
CODE
EV (123014, DCM, "Target Region")
1
U
D
3
HAS ACQ CONTEXT
CODE
EV (111027, DCM, "Image Laterality")
1
U
D
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
D
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
D
1
MC
IFF Row 1 is present with a value of "CT", "MR" or "PT"
15
HAS ACQ CONTEXT
INCLUDE
D
1
MC
IFF Row 1 is present with a value of "CT"
16
HAS ACQ CONTEXT
INCLUDE
D
1
MC
IFF Row 1 is present with a value of "MR"
17
HAS ACQ CONTEXT
INCLUDE
D
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 .
Image Library Entry Descriptors for Projection RadiographyThis 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:ExtensibleOrder:Non-SignificantRoot:No
Image Library Entry Descriptors for Projection Radiography
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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 .
Row 5
The second component of Imager Pixel Spacing (0018,1164) in the Image IOD. See .
Row 6
The first component of Imager Pixel Spacing (0018,1164) in the Image IOD. See .
Image Library Entry Descriptors for Cross-Sectional ModalitiesThis 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:ExtensibleOrder:Non-SignificantRoot:No
Image Library Entry Descriptors for Cross-Sectional Modalities
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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 and .
Row 2
The first component of Pixel Spacing (0028,0030) in the Image IOD. See and .
Image Library Entry Descriptors for CTThis Template contains selected attributes for a CT image or group of such images. The descriptive information may be copied from images or derived.Type:ExtensibleOrder:Non-SignificantRoot:No
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
D
2
HAS ACQ CONTEXT
CODE
EV (113961, DCM, "Reconstruction Algorithm")
1
U
D
Content Item Descriptions
Row 1
A code derived from the Value of Acquisition Type (0018,9302) in the Image IOD. See .
Row 2
A code derived from the Value of Reconstruction Algorithm (0018,9315) in the Image IOD. See .
Image Library Entry Descriptors for MRThis 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:ExtensibleOrder:Non-SignificantRoot:No
Image Library Entry Descriptors for MR
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
D
4
HAS ACQ CONTEXT
NUM
EV (110852, DCM, "MR signal intensity")
1
U
B
5
HAS ACQ CONTEXT
NUM
EV (130546, DCM, "Cross-sectional scan plane orientation")
1
U
B
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
D
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 .
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.
Image Library Entry Descriptors for PETThis Template contains selected attributes for a PET image or group of such images. The descriptive information may be copied from images or derived.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:ExtensibleOrder:Non-SignificantRoot:No
Image Library Entry Descriptors for PET
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
HAS ACQ CONTEXT
CODE
EV (89457008, SCT, "Radionuclide")
1
U
D
2
HAS ACQ CONTEXT
CODE
EV (349358000, SCT, "Radiopharmaceutical agent")
1
U
D
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
B
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 .
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").
Image Library Entry Descriptors for Prostate Multiparametric MRThis 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.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:ExtensibleOrder:Non-SignificantRoot:No
Image Library Entry Descriptors for Prostate Multiparametric MR
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
D
3
HAS ACQ CONTEXT
NUM
EV (130547, DCM, "Dynamic contrast-enhanced temporal resolution")
1-n
U
UNITS = (s, UCUM, "second")
Generic Blood Lab MeasurementsThe 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.
Parameters
Parameter Name
Parameter Usage
$Measurement
Measurement.
$Units
Measurement units.
Type:ExtensibleOrder:SignificantRoot:No
Generic Blood Lab Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
D
4
>
HAS ACQ CONTEXT
CODE
EV (363704007, SCT, "Procedure site")
1
M
B
5
>
INCLUDE
D
1
U
6
>
CONTAINS
INCLUDE
D
1-n
M
$Measurement = $Measurement$Units = $Units
Imaging Study QualityThis template provides the mechanism to describe image quality both at the study and individual series level, following a specific quality control standard.
Parameters
Parameter Name
Parameter Usage
$ImageQualityControlStandard
Value for Quality Control Standard.
$StudyQualityFindings
Value for Study Quality Findings.
$SeriesQualityFindings
Value for Series Quality Findings.
Type:ExtensibleOrder:SignificantRoot:No
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
D
3
>>
HAS PROPERTIES
CODE
EV (111051, DCM, "Quality Control Standard")
1
M
$ImageQualityControlStandardDefaults to B
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
D
8
>>>
HAS PROPERTIES
CODE
EV (111051, DCM, "Quality Control Standard")
1
M
$ImageQualityControlStandardDefaults to B
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.
Basic Diagnostic Imaging ReportBasic 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-ExtensibleOrder:SignificantRoot:Yes
Basic Diagnostic Imaging Report
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
B
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
D
4
>
HAS CONCEPT MOD
CODE
EV (123014, DCM, "Target Region")
1-n
U
5
>
HAS CONCEPT MOD
INCLUDE
D
1
M
6
>
HAS CONCEPT MOD
INCLUDE
D
1-n
U
7
>
HAS OBS CONTEXT
INCLUDE
D
1
M
8
>
CONTAINS
CONTAINER
B
1-n
U
9
>>
HAS OBS CONTEXT
INCLUDE
D
1
U
10
>>
INCLUDE
D
1
M
No Content Items other than those defined in Observation Context may be the target of a HAS OBS CONTEXT relationship when 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.
Basic Diagnostic Imaging Report ObservationsIndividual numeric or image observations that may be useful for inclusion as individual findings or as the source of inferences in a report.Type:Non-ExtensibleOrder:SignificantRoot:No
Basic Diagnostic Imaging Report Observations
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
IMAGE
B
1
MC
XOR Rows 2, 3, 4, 5.
2
INCLUDE
D
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
D
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
D
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
D
1
MC
XOR Rows 1, 2, 3, 4.Shall not be present if the NUM value type is not supported by the IOD.
Report NarrativeThe 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-ExtensibleOrder:Non-SignificantRoot:No
Report Narrative
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CODE
B
1-n
U
2
>
INFERRED FROM
INCLUDE
D
1-n
U
3
CONTAINS
TEXT
B
1-n
U
4
>
INFERRED FROM
INCLUDE
D
1-n
U
5
CONTAINS
INCLUDE
D
1-n
U
Transcribed Diagnostic Imaging ReportBasic 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 and Annexes in ).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 must be present in the SOP Instance.See .Type:Non-ExtensibleOrder:SignificantRoot:Yes
Transcribed Diagnostic Imaging Report
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
B
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
D
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
D
6
>
CONTAINS
CONTAINER
B
1-n
M
7
>>
CONTAINS
TEXT
B
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.
Imaging Report With Conditional Radiation Exposure and Protection InformationThis 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 , 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-ExtensibleOrder:Non-SignificantRoot:Yes
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
B
1
M
Root node
2
>
HAS CONCEPT MOD
CODE
EV (121058, DCM, "Procedure reported")
1-n
U
3
>
HAS CONCEPT MOD
INCLUDE
D
1
M
4
>
HAS CONCEPT MOD
INCLUDE
D
1-n
U
5
>
HAS OBS CONTEXT
INCLUDE
D
1
M
6
>
CONTAINS
CONTAINER
EV (55111-9, LN, "Current Procedure Descriptions")
1
M
7
>>
INCLUDE
D
1
M
8
>
CONTAINS
CONTAINER
EV (55114-3, LN, "Prior Procedure Descriptions")
1-n
MC
IF relevant prior procedures have been performed.
9
>>
INCLUDE
D
1
M
10
>
CONTAINS
CONTAINER
EV (11329-0, LN, "History")
1
M
11
>>
HAS OBS CONTEXT
INCLUDE
D
1
U
12
>>
INCLUDE
D
1
M
13
>
CONTAINS
CONTAINER
EV (55115-0, LN, "Request")
1
M
14
>>
HAS OBS CONTEXT
INCLUDE
D
1
U
15
>>
INCLUDE
D
1
M
16
>
CONTAINS
CONTAINER
EV (19005-8, LN, "Impressions")
1
M
17
>>
HAS OBS CONTEXT
INCLUDE
D
1
U
18
>>
INCLUDE
D
1
M
19
>
CONTAINS
INCLUDE
D
1
MC
IF the current procedure exposes the patient to ionizing radiation.
20
>
CONTAINS
CONTAINER
B
1-n
U
21
>>
HAS OBS CONTEXT
INCLUDE
D
1
U
22
>>
INCLUDE
D
1
M
No Content Items other than those defined in may be the target of a HAS OBS CONTEXT relationship when is invoked.Content Item Descriptions
Row 2
Even though this information is related to the content of Row 6 in , 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 apply. That means that "Person Observer Name" is the only mandatory Content Item).
Row 20
Each heading (concept code from ) may appear only once, and may not repeat the headings (concept codes) used when instantiating any other rows of this Template.
Imaging Procedure DescriptionContains information related to the procedure.Type:ExtensibleOrder:Non-SignificantRoot:No
Imaging Procedure Description
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
HAS OBS CONTEXT
INCLUDE
D
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
DDD
4
>
HAS CONCEPT MOD
CODE
EV (122142, DCM, "Acquisition Device Type")
1-n
U
D
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 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 in the images to which this report applies.
8
CONTAINS
COMPOSITE
EV (113701, DCM, "X-Ray Radiation Dose Report")
1-n
U
Radiation Exposure and Protection InformationContains 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 and not repeated here.Type:ExtensibleOrder:Non-SignificantRoot:No
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
D
1
U
3
>
CONTAINS
CODE
EV (364320009, SCT, "Pregnancy observable")
1
MC
IF female patient of child-bearing age
D
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 or , and referenced from .
Key Object SelectionThe 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, andoptional identification of the observer (device or person) that created the Key Object Selection.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 ). 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 (see ).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-ExtensibleOrder:Non-SignificantRoot:Yes
Key Object Selection
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
D
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")
D
4
>
HAS CONCEPT MOD
CODE
EV (113011, DCM, "Document Title Modifier")
1
MC
IF Row 1 Concept Name = (113013, DCM, "Best In Set")
D
5
>
HAS CONCEPT MOD
INCLUDE
D
1
U
6
>
HAS OBS CONTEXT
INCLUDE
D
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.
Spectacle Prescription ReportThe 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:ExtensibleOrder:SignificantRoot:Yes
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
D
1
M
4
>
CONTAINS
CONTAINER
EV (111689, DCM, "Left Eye Rx")
1
UC
IF Left Spectacle Lens is prescribed
5
>>
CONTAINS
INCLUDE
D
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
Template for Spectacle Prescription DetailsType:ExtensibleOrder:SignificantRoot:No
Spectacle Prescription Details
NL
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
D
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
D
11
CONTAINS
NUM
EV (415813002, SCT, "Vertex distance")
1
U
UNITS = EV (mm, UCUM, "mm")
Macular Grid Thickness and Volume ReportThe 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:ExtensibleOrder:SignificantRoot:Yes
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
D
1
M
3
>
HAS OBS CONTEXT
INCLUDE
D
1
M
4
>
CONTAINS
INCLUDE
D
1
MC
IF Row 5 is absent.
$Laterality = EV (24028007, SCT, "Right")
5
>
CONTAINS
INCLUDE
D
1
MC
IF Row 4 is absent.
$Laterality = EV (7771000, SCT, "Left")
Macular Grid Thickness and Volume MeasurementThis Template encodes the macular grid thickness and volume measurements for a single eye.
Parameters
Parameter Name
Parameter Usage
$Laterality
Which eye
Type:ExtensibleOrder:SignificantRoot:No
Macular Grid Thickness and Volume Measurement
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
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
D
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
D
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
D
1
M
24
>
CONTAINS
CODE
EV (111696, DCM, "Visual Fixation Quality During Acquisition")
1
U
D
25
>>
HAS CONCEPT MOD
CODE
EV (111697, DCM, "Visual Fixation Quality Problem")
1-n
U
D
26
>
CONTAINS
CODE
EV (111698, DCM, "Ophthalmic Macular Grid Problem")
1-n
U
D
27
>
CONTAINS
TEXT
EV (121106, DCM, "Comment")
1
U
Content Item Descriptions
Row 22
No purpose of reference is specified.
Quality Rating IdentificationThis 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-ExtensibleOrder:SignificantRoot:No
Quality Rating Identification
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
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
Ophthalmology Measurements GroupThis Template is a proper subset of , with some optional extensions, and may be processed by a receiving application in the same way. The parameters used in this Template are identical to those parameters as used in . However, this Template is specialized for ophthalmology (finding site "Eye") , and makes mandatory a Content Item for each measuement or finding concept specified in the invoking Template in the Context Groups invoked for the $Measurement parameter ( has no mandatory content).
Parameters
Parameter Name
Parameter Usage
$TargetSiteMod
Value for Anatomic Location of measurement
$Method
Value for Measurement Method
$Measurement
Coded term or Context Group for Concept Name of mandatory measurements
$OptMeasure
Coded term or Context Group for Concept Name of optional measurements
$TableName
Coded term for Concept Name of a table of measurements
Type:ExtensibleOrder:Non-SignificantRoot:No
Ophthalmology Measurements Group
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (125007, DCM, "Measurement Group")
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
D
4
>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
MC
IFF Template is invoked with a non-empty $TargetSiteMod parameter
$TargetSiteMod
5
>
HAS CONCEPT MOD
CODE
EV (370129005, SCT, "Measurement Method")
1
MC
IFF Template is invoked with a non-empty $Method parameter
$Method
6
>
HAS OBS CONTEXT
CODE
EV (418775008, SCT, "Finding Method")
1
MC
IFF measurements made with ROI or sector grid positioned differently from prior analyses
EV (131247, DCM, "Repositioned ROI or grid")
7
>
HAS OBS CONTEXT
INCLUDE
D
1
U
8
>
CONTAINS
INCLUDE
D
1-n
MC
IFF Template is invoked with a non-empty $Measurement parameter (see Content Item Description)
$Measurement = $Measurement
9
>
CONTAINS
INCLUDE
D
1-n
U
$Measurement = $OptMeasure
10
>
CONTAINS
TABLE
$TableName
1
U
11
>
CONTAINS
IMAGE
EV (121112, DCM, "Source of Measurement")
1-n
U
12
>
CONTAINS
NUM
EV (111694, DCM, "Image Set Quality Rating")
1
UC
XOR Row 13
UNITS = EV ({0:100}, UCUM, "range:0:100")Value = 0 - 100
13
>
CONTAINS
CODE
EV (111101, DCM, "Image Quality")
1
UC
XOR Row 12
B
14
>
CONTAINS
IMAGE
EV (130401, DCM, "Visual explanation")
1
U
15
>
CONTAINS
COMPOSITE
EV (130401, DCM, "Visual explanation")
1
U
16
>
CONTAINS
TEXT
EV (121106, DCM, "Comment")
1
U
Content Item Descriptions
Row 8
Mandatory numeric findings of the measurement group.Each Concept specified in the Value Set Constraints (i.e., as specified in the invoking Template $Measurement parameter) shall be encoded in a NUM Content Item. Thus if there are eight concepts in the specified Context Group, eight NUM Content Items in accordance with will be present. Note that the NUM Content Item allows an absent value with an associated reason code per , e.g., (114007, DCM, "Measurement not attempted"). defines an optional capability to specify properties of a measurement via . supports properties such as normality, statistical properties (through subsidiary ), normal ranges (subsidiary ) , level of significance and more. Normality flags are highly useful and commonly provided by implementations.
Row 9
Optional numeric measurements of the measurement group.
Row 10
Optional table of numeric measurements of the measurement group.
Row 11
Reference to the original image(s) , e.g., Ophthalmic Tomography, that provided the data analyzed to produce the measurements in this group.
Rows 12, 13
A numeric (row 12) or categorical (row 13) rating of the quality of the source images for the purpose of producing the measurements in this group.
Rows 14, 15
May be a reference to a Secondary Capture Image (row 14) or Encapsulated PDF (row 15) rendering of the set of measurements and findings encoded in this Measurement Group, and possibly additional data.
Visual Field Key MeasurementsType:ExtensibleOrder:Non-SignificantRoot:Yes
Visual Field Key Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (131240, DCM, "Visual Field Key Measurements")
1
M
2
>
HAS CONCEPT MOD
INCLUDE
D
1
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
U
4
>
HAS OBS CONTEXT
INCLUDE
D
1
U
5
>
CONTAINS
CONTAINER
EV (125007, DCM, "Measurement Group")
1-n
M
6
>>
HAS CONCEPT MOD
CODE
EV (363698007, SCT, "Finding Site")
1
M
EV (81745001, SCT, "Eye")
7
>>>
HAS CONCEPT MOD
CODE
EV (272741003, SCT, "Laterality")
1
M
D
8
>>
HAS CONCEPT MOD
CODE
EV (370129005, SCT, "Measurement Method")
1
M
D
9
>>
HAS ACQ CONTEXT
CODE
EV (246501002, SCT, "Technique")
1
M
D
10
>>
HAS OBS CONTEXT
INCLUDE
D
1
U
11
>>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (131248, DCM, "Visual Field Global Deviation from Normal")
$Units = EV (dB, UCUM, "dB")
12
>>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (131249, DCM, "Visual Field Localized Deviation From Normal")
$Units = EV (dB, UCUM, "dB")
13
>>
CONTAINS
INCLUDE
D
1
U
$Measurement = B
14
>>
CONTAINS
INCLUDE
D
1
MC
IF Row 15 not present
$Measurement = EV (131250, DCM, "Fixation false positive ratio")
$NumUnits = EV ({false positives}, UCUM, "false positives")$DenomUnits = EV ({trials}, UCUM, "trials")
15
>>
CONTAINS
INCLUDE
D
1
MC
IF Row 14 not present
$Measurement = EV (131251, DCM, "Fixation false positive percent")
$Units = EV (%, UCUM, "%")
16
>>
CONTAINS
INCLUDE
D
1
MC
IF Row 17 not present
$Measurement = EV (131252, DCM, "Fixation false negative ratio")
$NumUnits = EV ({false negatives}, UCUM, "false negatives")$DenomUnits = EV ({trials}, UCUM, "trials")
17
>>
CONTAINS
INCLUDE
D
1
MC
IF Row 16 not present
$Measurement = EV (131253, DCM, "Fixation false negative percent")
$Units = EV (%, UCUM, "%")
18
>>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (131254, DCM, "Fixation losses ratio")
$NumUnits = EV ({fixation losses}, UCUM, "fixation losses")$DenomUnits = EV ({trials}, UCUM, "trials")
19
>>
CONTAINS
CODE
EV (111855, DCM, "Glaucoma Hemifield Test Analysis")
1
U
D
20
>>
CONTAINS
COMPOSITE
EV (121112, DCM, "Source of Measurement")
1
U
21
>>
CONTAINS
IMAGE
EV (130401, DCM, "Visual explanation")
1
U
22
>>
CONTAINS
COMPOSITE
EV (130401, DCM, "Visual explanation")
1
U
23
>>
CONTAINS
TEXT
EV (121106, DCM, "Comment")
1
U
Content Item Descriptions
Row 5
For example, the Measurement Group CONTAINER may be instantiated once for each eye, or multiple times for a trend series for a single eye.
Row 20
May be a reference to an Ophthalmic Visual Field Static Perimetry Measurements SOP Instance.
Rows 21, 22
May be a reference to a Secondary Capture Image (row 21) or Encapsulated PDF (row 22) rendering of the set of measurements and findings encoded in this Measurement Group, and possibly additional data.
For example, may be invoked once for each eye, or multiple times for a trend series for a single eye.Applications also use various approaches to identifying different sectors of the retina when measuring the RNFL thickness. The sector definition used is specified by a concept from . Measurements that match the sector names defined by the method may be selected from to be included in the key measurements.Receiving applications are cautioned about comparing or aggregating measurements from measurement groups with different ROI areas or sector methods.
Macular Thickness Key MeasurementsThe macular grid used for the measurements of this template 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 .Type:ExtensibleOrder:Non-SignificantRoot:Yes
Macular Thickness Key Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (131243, DCM, "Macular Thickness Key Measurements")
1
M
2
>
HAS CONCEPT MOD
INCLUDE
D
1
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
U
4
>
HAS OBS CONTEXT
INCLUDE
D
1
M
5
>
CONTAINS
INCLUDE
D
1-n
M
$Measurement = D
Content Item Descriptions
Row 5
For example, may be invoked once for each eye, or multiple times for a trend series for a single eye.
EV (131244, DCM, "Ganglion Cell Key Measurements")
1
M
2
>
HAS CONCEPT MOD
INCLUDE
D
1
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
U
4
>
HAS OBS CONTEXT
INCLUDE
D
1
M
5
>
CONTAINS
INCLUDE
D
1-n
M
$TargetSiteMod= D$Method = D$Measurement = D$OptMeasure = D$TableName = DT (131298, DCM, "Average ganglion cell thickness in posterior pole grid")
Content Item Descriptions
Row 5
For example, may be invoked once for each eye, or multiple times for a trend series for a single eye.Methods to measure the Ganglion Cell thickness vary widely. This template requires the SOP Instance creator application to specify which other cell layers, if any, are measured with the Ganglion Cell Layer proper (using a concept from ).Applications also use various methods to identify different sectors of the retina when measuring the Ganglion Cell thickness. The sector definition used is specified by a concept from . Measurements matching the sector names defined by the method may be selected from . If the sector method uses a rectangular or elliptical ROI, the sector measurements should include both the ROI width and height.If optional measurements using (131298, DCM, "Average ganglion cell thickness in posterior pole grid") are present, the SOP Class of the instance must support the TABLE Content Item Value Type (e.g., the Extensible SR Storage SOP Class).Receiving applications are cautioned about comparing or aggregating measurements from measurement groups with different measurement extents or sector methods.
EV (131245, DCM, "Endothelial Cell Count Key Measurements")
1
M
2
>
HAS CONCEPT MOD
INCLUDE
D
1
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
U
4
>
HAS OBS CONTEXT
INCLUDE
D
1
M
5
>
CONTAINS
INCLUDE
D
1-n
M
$Measurement = D
Content Item Descriptions
Row 5
For example, may be invoked once for each eye, or multiple times for a trend series for a single eye.
Ophthalmic Image ROI MeasurementsType:ExtensibleOrder:Non-SignificantRoot:Yes
Ophthalmic Image ROI Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (131246, DCM, "Ophthalmic Image ROI Measurements")
1
M
2
>
HAS CONCEPT MOD
INCLUDE
D
1
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
U
4
>
HAS OBS CONTEXT
INCLUDE
D
1
U
5
>
CONTAINS
INCLUDE
D
1-n
M
$OptMeasure = D
Content Item Descriptions
Row 5
For example, may be invoked once for each eye, or multiple times for a trend series for a single eye, or multiple times for different classes of measurements.No mandatory key measurements are specified. Creating applications may include any measurements or findings.
Procedure LogThe 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.The Procedure Log IOD () 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:ExtensibleOrder:Non-SignificantRoot:Yes
Procedure Log
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
D
1
M
Root node
2
>
INCLUDE
D
1-n
M
3
>
INCLUDE
D
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
D
1-n
U
7
>>
INCLUDE
D
1
U
8
>
CONTAINS
CODE
EV (121123, DCM, "Patient Status or Event")
1-n
U
D
9
>>
INCLUDE
D
1
U
10
>
CONTAINS
PNAME
D
1-n
U
11
>>
INCLUDE
D
1
U
12
>
CONTAINS
TEXT
D
1-n
U
Equipment identifier
13
>>
INCLUDE
D
1
U
14
>
CONTAINS
INCLUDE
D
1-n
U
15
>
CONTAINS
INCLUDE
D
1-n
U
16
>
CONTAINS
INCLUDE
D
1-n
U
17
>
CONTAINS
INCLUDE
D
1-n
U
18
>
CONTAINS
INCLUDE
D
1-n
U
19
>
CONTAINS
INCLUDE
D
1-n
U
20
>
CONTAINS
INCLUDE
D
1-n
U
21
>
CONTAINS
INCLUDE
D
1-n
U
22
>
CONTAINS
INCLUDE
D
1-n
U
23
>
CONTAINS
CODE
EV (116224001, SCT, "Complication of Procedure")
1-n
U
D
24
>>
INCLUDE
D
1
U
25
>
CONTAINS
INCLUDE
D
1-n
U
26
>
CONTAINS
INCLUDE
D
1-n
U
27
>
CONTAINS
INCLUDE
D
1-n
U
28
>
CONTAINS
INCLUDE
D
1-n
U
29
>
CONTAINS
INCLUDE
D
1-n
U
30
>
CONTAINS
INCLUDE
D
1-n
U
31
>
CONTAINS
INCLUDE
D
1-n
U
Content Item Descriptions
Row 2
Includes , 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. 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.
Log Entry QualifiersThe 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:ExtensibleOrder:SignificantRoot:No
Log Entry Qualifiers
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
INCLUDE
D
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
D
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 .
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 .
Procedure ActionThe 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 ).Type:ExtensibleOrder:SignificantRoot:No
Procedure Action
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
D
1
M
B
2
>
HAS PROPERTIES
TEXT
EV (121124, DCM, "Procedure Action ID")
1
M
3
>
HAS PROPERTIES
PNAME
B
1-n
U
4
>
HAS PROPERTIES
NUM
EV (121128, DCM, "Procedure Action Duration")
1
U
5
>
INCLUDE
D
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.
Image AcquisitionThe Image Acquisition Template allows recording of the essential parameters of a digital image acquired during the procedure.Type:ExtensibleOrder:SignificantRoot:No
Image Acquisition
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
DA code derived from the Value of Modality (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
D
1
U
Waveform AcquisitionThe Waveform Acquisition Template allows recording of the essential parameters of a digital waveform acquired during the procedure.Type:ExtensibleOrder:SignificantRoot:No
Waveform Acquisition
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
WAVEFORM
EV (121143, DCM, "Waveform Acquired")
1
M
2
>
HAS ACQ CONTEXT
CODE
EV (121139, DCM, "Modality")
1
M
DA code derived from the Value of Modality (0008,0060).
3
>
HAS ACQ CONTEXT
NUM
EV (121142, DCM, "Acquisition Duration")
1
U
4
>
INCLUDE
D
1
U
Referenced ObjectThe 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:ExtensibleOrder:SignificantRoot:No
Referenced Object
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
COMPOSITE
B
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
D
1
U
ConsumablesThe 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 or .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:ExtensibleOrder:SignificantRoot:No
Consumables
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
D
1
M
Vendor or local bar coded values
2
>
HAS PROPERTIES
TEXT
D
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
D
1
U
Lesion Identification and PropertiesThe 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 ). 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 ), or by quotation (). Subsequent (e.g., post-intervention) stenosis measurements may be encoded using , with the Lesion Identifier conveyed through its
subsidiary Template.Type:ExtensibleOrder:SignificantRoot:No
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
D
3
>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
D
4
>
HAS PROPERTIES
CODE
EV (121153, DCM, "Lesion Risk")
1
U
D
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
D
8
>
HAS PROPERTIES
CODE
EV (122109, DCM, "Baseline TIMI Flow")
1
UC
IFF Row 2 specifies a coronary artery
D
9
>
HAS PROPERTIES
CODE
EV (122131, DCM, "Degree of Thrombus")
1
U
D
10
>
HAS PROPERTIES
CODE
EV (129737002, SCT, "Lesion Margin Characteristics")
1
U
D
11
>
HAS PROPERTIES
CODE
EV (122134, DCM, "Vessel Morphology")
1-n
U
D
12
>
HAS PROPERTIES
CODE
EV (122132, DCM, "Severity of Calcification")
1
U
D
13
>
HAS PROPERTIES
IMAGE
DT (121080, DCM, "Best illustration of finding")
1
U
14
>
INCLUDE
D
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™.
Drugs/Contrast AdministeredThe 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:ExtensibleOrder:SignificantRoot:No
Drugs/Contrast Administered
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
D
1
M
BorB
2
>
HAS PROPERTIES
TEXT
EV (121145, DCM, "Description of Material")
1
U
3
>
HAS PROPERTIES
CODE
EV (410675002, SCT, "Route of administration")
1
U
B
4
>
HAS PROPERTIES
NUM
D
1-n
U
5
>
HAS PROPERTIES
PNAME
EV (121152, DCM, "Person administering drug/contrast")
1
U
6
>
INCLUDE
D
1
U
Device UsedThe 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 .Type:ExtensibleOrder:SignificantRoot:No
Device Used
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
D
1
M
B
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
D
1-n
U
5
>
HAS PROPERTIES
CODE
EV (363704007, SCT, "Procedure site")
1
U
B
6
>
HAS CONCEPT MOD
CODE
EV (363703001, SCT, "Has Intent")
1
U
DT (121155, DCM, "Deployment")
7
>
INCLUDE
D
1
U
InterventionThe 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:ExtensibleOrder:SignificantRoot:No
Intervention
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
EV (122090, DCM, "Intervention Action")
1
M
D
2
>
HAS PROPERTIES
CODE
EV (363704007, SCT, "Procedure site")
1
M
D
3
>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
D
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
B
6
>>
HAS CONCEPT MOD
CODE
EV (122111, DCM, "Primary Intervention Device")
1
MC
IF Device is Primary for this Lesion
D
7
>
HAS PROPERTIES
NUM
D
1-n
U
8
>
HAS PROPERTIES
IMAGE
B
1
U
9
>
INCLUDE
D
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.).
MeasurementsThe 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 .Type:ExtensibleOrder:SignificantRoot:No
Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
NUM
1
U
2
>
INCLUDE
D
1
U
3
>
HAS PROPERTIES
INCLUDE
D
1
U
4
CODE
1
U
5
>
INCLUDE
D
1
U
Impressions or FindingsThe 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 Template.Type:ExtensibleOrder:SignificantRoot:No
Impressions or Findings
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
EV (121071, DCM, "Finding")
1
U
B
2
>
HAS PROPERTIES
CODE
EV (246112005, SCT, "Severity")
1
U
D
3
>
HAS PROPERTIES
CODE
EV (363698007, SCT, "Finding Site")
1
U
4
>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
D
5
>
INCLUDE
D
1
U
6
TEXT
B
1
U
7
>
INCLUDE
D
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.
Percutaneous EntryThe Percutaneous Entry Template allows recording of the opening or closing of invasive access ports.Type:ExtensibleOrder:SignificantRoot:No
Percutaneous Entry
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
EV (121156, DCM, "Percutaneous Entry Action")
1
M
D
2
>
HAS CONCEPT MOD
CODE
EV (272741003, SCT, "Laterality")
1
U
D
3
>
INCLUDE
D
1
U
Specimen ObtainedThe 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 , or in a separate Structured Report SOP Instance referenced by a log entry using .Type:ExtensibleOrder:SignificantRoot:No
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
D
2
>
HAS ACQ CONTEXT
CODE
EV (371439000, SCT, "Specimen Type")
1
UC
IFF specimen is blood sample
D
3
>
HAS ACQ CONTEXT
CODE
EV (363704007, SCT, "Procedure site")
1
U
B
4
>
HAS PROPERTIES
INCLUDE
D
1
U
Patient SupportThe Patient Support Template allows recording of the use of various support technologies, including oxygen, ventilation, pacing, etc.Type:ExtensibleOrder:SignificantRoot:No
Patient Support
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
D
1
U
D
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
D
1
U
4
CODE
D
1
U
D
5
>
INCLUDE
D
1
U
6
CODE
D
1
U
D
7
>
INCLUDE
D
1
U
8
CODE
D
1
U
D
9
>
INCLUDE
D
1
U
Patient AssessmentThe 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:ExtensibleOrder:SignificantRoot:No
DT (363871006, SCT, "Patient mental state assessment")
1
U
15
>
HAS PROPERTIES
TEXT
B
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, 11, 12, 13, 14.
ECG ST AssessmentThe ECG ST Assessment Template allows recording of the assessment of changes in the patient ECG relative to baseline.Type:ExtensibleOrder:SignificantRoot:No
ECG ST 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 (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
B
The Templates that comprise the Quantitative Ventricular Analysis SR are interconnected as in :Quantitative Ventricular Analysis Report SR IOD Template StructureQuantitative Ventricular Analysis ReportThe Quantitative Ventricular Analysis Report Template provides a CONTAINER with a structure for reporting the result of the ventricular analysis.Type:ExtensibleOrder:SignificantRoot:No
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
D
1
M
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
M
4
>
CONTAINS
INCLUDE
D
1
U
5
>
CONTAINS
CONTAINER
EV (122144, DCM, "Quantitative Analysis")
1-n
M
6
>>
HAS OBS CONTEXT
INCLUDE
D
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
D
12
>>>
HAS CONCEPT MOD
CODE
EV (111031, DCM, "Image View")
1
MC
If Biplane Analysis
D
13
>>
HAS ACQ CONTEXT
INCLUDE
D
1-2
U
VM = 1: Single plane analysis, VM = 2: Biplane analysis
$CalibrationPlane = D
14
>>
HAS ACQ CONTEXT
INCLUDE
D
1
U
15
>>
CONTAINS
INCLUDE
D
1
M
16
>>
CONTAINS
INCLUDE
D
1
U
17
>>
CONTAINS
INCLUDE
D
1
U
18
>>
CONTAINS
INCLUDE
D
1-2
U
VM = 1: Single plane analysis, VM = 2: Biplane analysis
19
>>
CONTAINS
INCLUDE
D
1-2
U
VM = 1: Single plane analysis, VM = 2: Biplane analysis
20
>>
CONTAINS
INCLUDE
D
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
CalibrationThe Calibration Template consists of a CONTAINER, with a structure for reporting of the calibration of images used in the analysis.
Parameters
Parameter Name
Parameter Usage
$CalibrationPlane
XA Imaging plane
Type:ExtensibleOrder:SignificantRoot:No
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
D
7
>
CONTAINS
CODE
EV (122421, DCM, "Calibration Object")
1
MC
If Row 6 value specifies Calibration Object Used
D
8
>
CONTAINS
NUM
EV (122423, DCM, "Calibration Object Size")
1
MC
If Row 6 value specifies Calibration Object Used
D
9
>
CONTAINS
INCLUDE
D
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
D
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 , Row 3)
Row 11
Secondary Capture image with calibration position. No purpose of reference is specified.
VA Main ResultsThe VA Main Results Template consists of a CONTAINER with a structure for reporting the main ventricular analysis measurements.Type:ExtensibleOrder:SignificantRoot:No
Secondary Capture image with ED and/or ES contours. No purpose of reference is specified.
AA Main ResultsThe AA Main Results Template consists of a CONTAINER with a structure for reporting the main atrial analysis measurements.Type:ExtensibleOrder:SignificantRoot:No
AA Main Results
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
M
D
3
>
CONTAINS
CODE
EV (122429, DCM, "Volume Method")
1
M
D
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
D
1
U
$Measurement = D$Units = DT (ml, UCUM, "ml")
10
>
CONTAINS
INCLUDE
D
1
U
$Measurement = D$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.
Frame-to-Frame ResultsThe Frame-to-Frame Result Template consists of a CONTAINER providing measurements derived from the angiographic images on frame-by-frame basis.Type:ExtensibleOrder:SignificantRoot:No
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
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.
Centerline Wall MotionThe Centerline Wall Motion Template consists of a CONTAINER providing measurements of the centerline wall motion.Type:ExtensibleOrder:SignificantRoot:No
Centerline Wall Motion
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 (122449, DCM, "Centerline Wall Motion Analysis")
Values shall be 1, 2 or 3UNITS = 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
D
8
>>
CONTAINS
CODE
EV (255593009, SCT, "Circumferential Extent")
1
U
D
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
D
13
>>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (122459, DCM, "Territory Region Severity")
$ModType = EV (60797005, SCT, "Cardiac Wall Motion")
$ModValue = D$Units = DT ({sd}, UCUM, "Standard Deviations")
14
>>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (122461, DCM, "Opposite Region Severity")
$ModType = EV (60797005, SCT, "Cardiac Wall Motion")
$ModValue = D$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.
Radial Based Wall MotionThe Radial Based Wall Motion Template consists of a CONTAINER providing measurements of the radial based wall motion.Type:ExtensibleOrder:SignificantRoot:No
Radial Based Wall Motion
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 (122493, DCM, "Radial Based Wall Motion Analysis")
3
>>
HAS CONCEPT MOD
CODE
EV (122410, DCM, "Contour Realignment")
1
M
D
4
>
CONTAINS
CONTAINER
EV (59776-5, LN, "Findings")
1-n
M
5
>>
HAS CONCEPT MOD
CODE
EV (363698007, SCT, "Finding Site")
1
M
D
6
>>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (122495, DCM, "Regional Contribution to Ejection Fraction")
$Units = DT (%, UCUM, "%")
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.
Landmark Based Wall MotionThe Landmark Based Wall Motion Template consists of a CONTAINER providing measurements of the landmark based wall motion.Type:ExtensibleOrder:SignificantRoot:No
Landmark Based Wall Motion
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 (122497, DCM, "Landmark Based Wall Motion Analysis")
3
>>
HAS CONCEPT MOD
CODE
EV (122410, DCM, "Contour Realignment")
1
M
D
4
>
CONTAINS
INCLUDE
D
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
D
7
>
CONTAINS
INCLUDE
D
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.
The Templates that comprise the Quantitative Arterial Analysis SR are interconnected as in :Quantitative Arterial Analysis Report SR IOD Template StructureQuantitative Arterial AnalysisThe Quantitative Arterial Analysis Template consists of a CONTAINER with a structure for reporting the result of the quantitative arterial analysis process.Type:ExtensibleOrder:SignificantRoot:No
Quantitative Arterial Analysis
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122291, DCM, "Quantitative Arteriography Report")
1
M
2
>
HAS CONCEPT MOD
INCLUDE
D
1
M
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
M
4
>
CONTAINS
INCLUDE
D
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
D
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
Analyzed SegmentThe Analyzed Segment Template consists of a CONTAINER providing quantitative arterial analysis measurements derived from the angiographic images.Type:ExtensibleOrder:SignificantRoot:No
Analyzed Segment
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
M
D
3
>
CONTAINS
IMAGE
EV (121112, DCM, "Source of Measurement")
1
M
4
>
CONTAINS
INCLUDE
D
1
M
5
>
HAS ACQ CONTEXT
INCLUDE
D
1
U
6
>
HAS ACQ CONTEXT
CODE
EV (129085009, SCT, "Catheterization Procedure Phase")
1
U
D
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
D
1
M
12
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter")
$Derivation = EV (255605001, SCT, "Minimum")
$Units = DT (mm, UCUM, "mm")
13
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter")
$Derivation = EV (56851009, SCT, "Maximum")
$Units = DT (mm, UCUM, "mm")
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 :Direction of Blood FlowAngiographic Lesion AnalysisThe Angiographic Lesion Analysis Template consists of a CONTAINER providing quantitative arterial analysis measurements derived for an obstruction in a total analyzed segment.Type:ExtensibleOrder:SignificantRoot:No
Angiographic Lesion Analysis
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
D
4
>>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
D
5
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (397413000, SCT, "Vessel Luminal Diameter")
$Derivation = EV (255605001, SCT, "Minimum")
$Units = DT (mm, UCUM, "mm")
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 ( Row 14)
Row 14
The diameter measurement at the end of the reconstruction line in the diameter graph ( 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 (, Row 1 and Row 2)
Row 32
Secondary Capture image with obstruction analysis contour. No purpose of reference is specified.
Stenotic Flow ReserveThe Stenotic Flow Reserve Template consists of a CONTAINER providing quantitative arterial analysis measurements derived for an obstruction in a total analyzed segment.Type:ExtensibleOrder:SignificantRoot:No
$Measurement = EV (122555, DCM, "Estimated Normal Flow")
$Units = DT (ml/s, UCUM, "ml/s")
5
CONTAINS
INCLUDE
D
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.
Sub-segmental DataThe Sub-segmental Data Template consists of a CONTAINER providing quantitative arterial analysis measurements derived for a sub-segment in a total analyzed segment.Type:ExtensibleOrder:SignificantRoot:No
Sub-Segmental Data
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
M
D
3
>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
D
4
>
CONTAINS
CODE
EV (122554, DCM, "Segmentation Method")
1
M
D
5
>
CONTAINS
INCLUDE
D
1
U
6
>
CONTAINS
INCLUDE
D
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.
Position in Arterial SegmentThe Position in Arterial Segment Template consists of the position Content Items common for the Angiographic Lesion Analysis and Sub-Segmental Data.Type:ExtensibleOrder:SignificantRoot:No
Position in Arterial Segment
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (122528, DCM, "Position of Proximal Border")
$Units = DT (mm, UCUM, "mm")
2
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (122529, DCM, "Position of Distal Border")
$Units = DT (mm, UCUM, "mm")
3
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (122382, DCM, "Site of Luminal Minimum")
$Units = DT (mm, UCUM, "mm")
4
CONTAINS
INCLUDE
D
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 Row 14 is present
UNITS = DT ({pixels}, UCUM, "pixels")
6
CONTAINS
NUM
EV (122529, DCM, "Position of Distal Border")
1
UC
IFF Row 14 is present
UNITS = DT ({pixels}, UCUM, "pixels")
7
CONTAINS
NUM
EV (122382, DCM, "Site of Luminal Minimum")
1
UC
IFF Row 14 is present
UNITS = DT ({pixels}, UCUM, "pixels")
8
CONTAINS
NUM
EV (122516, DCM, "Site of Luminal Maximum")
1
UC
IFF 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 Row 14.
Segment ValuesThe Segment Values Template consists of Content Items providing quantitative arterial analysis measurements for a total analyzed segment or sub segment.Type:ExtensibleOrder:SignificantRoot:No
Measured along the midline of the left and right contour.
The Templates that comprise the IVUS Report within the Evidence Report IOD are interconnected as shown in .IVUS Report Template HierarchyIVUS ReportThe IVUS Report Template is the root structure for the representation of IVUS measurements acquired during a catheterization procedure.Type:ExtensibleOrder:SignificantRoot:Yes
IVUS Report
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122325, DCM, "IVUS Report")
1
M
Root node
2
>
HAS CONCEPT MOD
INCLUDE
D
1
M
3
>
HAS OBS CONTEXT
INCLUDE
D
1-n
U
4
>
INCLUDE
D
1
U
5
>
CONTAINS
INCLUDE
D
1
U
6
>
CONTAINS
CONTAINER
EV (111028, DCM, "Image Library")
1
U
7
>>
CONTAINS
IMAGE
1-n
U
8
>
CONTAINS
INCLUDE
D
1-n
M
Content Item Descriptions
Row 7
No purpose of reference is specified.
IVUS VesselThe 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:ExtensibleOrder:SignificantRoot:No
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
D
3
>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
D
4
>>
HAS CONCEPT MOD
CODE
EV (272741003, SCT, "Laterality")
1
UC
IFF anatomy has laterality
D
5
>
HAS ACQ CONTEXT
CODE
EV (129085009, SCT, "Catheterization Procedure Phase")
1
U
D
6
>
CONTAINS
CODE
EV (122134, DCM, "Vessel Morphology")
1-n
U
7
>
CONTAINS
INCLUDE
D
1-n
U
8
>
CONTAINS
CODE
EV (115, NCDR [2.0b], "Dissection in segment")
1
U
D
9
>
CONTAINS
INCLUDE
D
1-n
U
IVUS LesionThe IVUS Lesion Template provides a structure for grouping measurements and observations made on a single lesion during an Intravascular Ultrasound Procedure.Type:ExtensibleOrder:SignificantRoot:No
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
D
4
>>>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
D
5
>
HAS ACQ CONTEXT
INCLUDE
D
1-n
U
6
>
CONTAINS
INCLUDE
D
1
MC
One or both of Rows 6 & 7 must be present
7
>
CONTAINS
INCLUDE
D
1
MC
One or both of Rows 6 & 7 must be present
8
>
CONTAINS
INCLUDE
D
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™.Also see .
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.
IVUS MeasurementsThe 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:ExtensibleOrder:SignificantRoot:No
IVUS Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
INCLUDE
D
1-n
U
$Measurement = D$Units = EV (mm, UCUM, "mm")$Derivation = D$TargetSite = B
2
INCLUDE
D
1-n
U
$Measurement = D$Units = EV (mm2, UCUM, "mm2")$Derivation = D$TargetSite = B
3
INCLUDE
D
1-n
U
$Measurement = D$Units = EV (mm, UCUM, "mm")
4
INCLUDE
D
1-n
U
$Measurement = EV (122355, DCM, "Arc of Calcium")
$Units = EV (deg, UCUM, "degrees")$TargetSite = B
5
INCLUDE
D
1
U
$Measurement = EV (408714007, SCT, "Lumen Area Stenosis")
$Units = EV (%, UCUM, "%")
6
INCLUDE
D
1
U
$Measurement = EV (122354, DCM, "Plaque Burden")
$Units = EV (%, UCUM, "%")$TargetSite = B
7
INCLUDE
D
1-n
U
$Measurement = D$Units = EV ({ratio}, UCUM, "ratio")$TargetSite = B
8
INCLUDE
D
1-n
U
9
INCLUDE
D
1
U
$Measurement = EV (122339, DCM, "Stent Volume Obstruction")
$Units = EV (%, UCUM, "%")
IVUS Qualitative AssessmentsThe 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:ExtensibleOrder:SignificantRoot:No
IVUS Qualitative Assessments
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
EV (122133, DCM, "Lesion Morphology")
1-n
U
D
2
CODE
EV (121071, DCM, "Finding")
1-n
U
D
3
>
INCLUDE
D
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
D
6
>
INCLUDE
D
1
U
7
CODE
EV (122391, DCM, "Relative Stenosis Severity")
1
U
D
8
CODE
EV (108, NCDR [2.0b], "Previously Dilated Lesion")
1
U
D
9
CODE
EV (121071, DCM, "Finding")
1
U
EV (122393, DCM, "Restenotic Lesion")
10
>
INCLUDE
D
1
U
11
CODE
EV (111009, DCM, "Calcification Type")
1
U
D
IVUS Volume MeasurementThe IVUS Volume Measurement Template contains information describing an IVUS Volumetric measurementType:ExtensibleOrder:SignificantRoot:No
IVUS Volume Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
INCLUDE
D
1
M
$Measurement = D$Units = EV (mm3, UCUM, "mm3")$TargetSite = B
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
D
Stress Testing ReportThe Stress Testing Report Template is the root structure for the representation of measurements and findings of a stress testing procedure.Type:ExtensibleOrder:SignificantRoot:Yes
Stress Testing Report
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
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
B
3
>
HAS CONCEPT MOD
INCLUDE
D
1
M
4
>
HAS OBS CONTEXT
INCLUDE
D
1-n
M
5
>
CONTAINS
INCLUDE
D
1
U
$Findings = D
8
>
CONTAINS
INCLUDE
D
1
M
9
>
CONTAINS
INCLUDE
D
1
U
10
>
CONTAINS
INCLUDE
D
1
M
11
>
CONTAINS
INCLUDE
D
1-n
M
12
>
CONTAINS
INCLUDE
D
1
U
13
>
CONTAINS
INCLUDE
D
1
U
14
>
CONTAINS
INCLUDE
D
1
U
Stress Test Procedure DescriptionType:ExtensibleOrder:SignificantRoot:No
EV (122700, DCM, "Indications for Pharmacological Stress")
1
MC
IFF Pharmacological Stress used
8
>>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1-n
U
D
9
>
CONTAINS
CODE
DT (363679005, SCT, "Imaging procedure")
1
MC
IFF imaging used in procedure
D
10
>
CONTAINS
CODE
DT (125203, DCM, "Acquisition Protocol")
1
UC
IFF Nuclear imaging
D
11
>
CONTAINS
CODE
DT (125203, DCM, "Acquisition Protocol")
1
UC
IFF PET imaging
D
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
D
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
D
16
>>
HAS CONCEPT MOD
CODE
EV (113744, DCM, "Patient Orientation Modifier")
1
U
D
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.
Stress Test Phase DataThe Stress Test Phase Data Template provides a structure for measurements acquired during a single procedure phase.Type:ExtensibleOrder:SignificantRoot:No
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
B
3
>
HAS ACQ CONTEXT
CODE
EV (128954007, SCT, "Procedure phase")
1
MC
IFF Nuclear Imaging; XOR Row 2
D
4
>
HAS ACQ CONTEXT
TEXT
EV (128954007, SCT, "Procedure phase")
1
U
5
>
CONTAINS
INCLUDE
D
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
D
1-n
U
8
>
CONTAINS
INCLUDE
D
1
MC
IFF Nuclear or PET Imaging
9
>
CONTAINS
INCLUDE
D
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.
Stress Test Measurement GroupEach 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:ExtensibleOrder:SignificantRoot:No
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 = D
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
D
1
U
$Measurement = DT (122706, DCM, "Rating of Perceived Exertion")
$Method = B
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 allows the recording of test medications other than the Pharmacological Stress Agent identified in .
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 are base codes for post-coordination with lead identifiers conveyed in the Target Site modifier in . 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 is a base code for post-coordination with lead identifiers conveyed in the Target Site modifier in . MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row.Note that enables the encoding of a non-standard correction algorithm, either as a local code, or as a TEXT Method Citation (see Row 12).
Row 21
R-R interval used for QT correction algorithm
Row 22
Recommended range for ECG axis measurements is -90° to +270°
$Procedure = DT (35757004, SCT, "Echocardiography for Determining Ventricular Contraction")
Content Item Descriptions
Rows 3, 4, 5, 6, 7, 8, 9, 10
These invocations of do not include an inherited Findings Site concept, for example as in the invocations of from . Echo measurements that do not have the associated Finding Site pre-coordinated in the measurement concept (i.e., the orifice flow measurements of ), 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 . Image Content Items in the Echo Measurement Template shall be included with by-value relationships, not with by-reference relationships.
Stress Test SummaryType:ExtensibleOrder:SignificantRoot:No
$Measurement = EV (122760, DCM, "Stress test score")
$Method = B
22
NUM
DT (429157007, SCT, "Heart rate recovery time")
1
U
UNITS = DT (s, UCUM, "s")
23
CODE
EV (121071, DCM, "Finding")
1-n
U
B
24
CODE
EV (395112001, SCT, "Cardiovascular event risk")
1
U
B
Content Item Descriptions
Row 22
Numerical scoring of a patient's functional capacity shall include the range of the scoring system in the Measurement Unit (see ), and may include a coded identifier for the scoring system in the Method concept modifier of .
$Measurement = EV (164931005, SCT, "ST Elevation")
$Units = DT (mV, UCUM, "mV")$Derivation = EV (56851009, SCT, "Maximum")
$TargetSite = D
5
INCLUDE
D
1-n
U
$Measurement = EV (429622005, SCT, "ST Depression")
$Units = DT (mV, UCUM, "mV")$Derivation = EV (56851009, SCT, "Maximum")
$TargetSite = D
6
INCLUDE
D
1-n
U
$Measurement = EV (428550008, SCT, "T wave alternans")
$Units = DT (uV, UCUM, "uV")$Derivation = EV (56851009, SCT, "Maximum")
$TargetSite = D
7
CODE
EV (365416000, SCT, "ST Segment Finding")
1
U
B
8
>
HAS PROPERTIES
CODE
EV (363698007, SCT, "Finding Site")
1-n
U
B
9
>
HAS PROPERTIES
CODE
EV (116676008, SCT, "Associated Morphology")
1
U
B
10
NUM
DT (122707, DCM, "Number of Ectopic Beats")
1
U
UNITS = EV ({beats}, UCUM, "beats")
11
>
HAS PROPERTIES
CODE
EV (116676008, SCT, "Associated Morphology")
1-n
U
B
12
CODE
DT (8884-9, LN, "Cardiac Rhythm")
1-2
U
B
13
>
HAS CONCEPT MOD
CODE
EV (109054, DCM, "Patient State")
1
M
D
14
CODE
EV (271921002, SCT, "ECG Finding")
1-n
U
B
15
>
HAS CONCEPT MOD
CODE
EV (109054, DCM, "Patient State")
1
U
B
Content Item Descriptions
Rows 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14
Each observation (measurement or finding) may have a specific Observation DateTime (0040,A032) Content Item Attribute to indicate the time in the procedure at which the observation was made (e.g., time of maximum heart rate, or time of occurrence of an arrhythmia).
Rows 12, 13
This Concept and the associated Concept Modifier may be instantiated twice, once for resting state measurements, once for stress.
$Measurement = EV (10230-1, LN, "LV Ejection Fraction")
$ModType = EV (109054, DCM, "Patient State")
$ModValue = D$Units = EV (%, UCUM, "%")
Content Item Descriptions
Row 4
This row may be instantiated twice, once for resting state measurements, once for stress.
Row 15
The LVEF code specified in this row is defined in LOINC with method "imaging". LVEF measurement by ultrasound may also be encoded elsewhere in the Content Tree (e.g., in ) with LOINC code 18043-0, which has method "ultrasound". It is recommended that such findings from the per-phase measurements be summarized here with the generic "LVEF by Imaging" concept code.
Comparison to Prior Stress StudyThis Template describes changes in findings from a prior stress study. Comparison is to only one prior study, even though the generic concept name for the Template uses the plural "studies".Type:ExtensibleOrder:SignificantRoot:No
Comparison to Prior Stress Study
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (111424, DCM, "Comparison to previous studies")
1
M
2
>
CONTAINS
CODE
DT (121058, DCM, "Procedure Reported")
1
U
B
3
>>
HAS PROPERTIES
DATETIME
EV (122146, DCM, "Procedure DateTime")
1
U
4
>>
HAS PROPERTIES
UIDREF
EV (121018, DCM, "Procedure Study Instance UID")
1
U
5
>>
HAS PROPERTIES
COMPOSITE
EV (122075, DCM, "Prior report for current patient")
1-n
U
6
>
CONTAINS
CODE
DT (248243004, SCT, "Exercise tolerance")
1
U
B
7
>
CONTAINS
CODE
DT (251053005, SCT, "Myocardial Perfusion")
1
U
B
8
>>
HAS CONCEPT MOD
CODE
EV (370129005, SCT, "Measurement Method")
1-n
U
B
9
>
CONTAINS
CODE
DT (250909007, SCT, "LV Wall motion")
1-n
U
B
10
>>
HAS CONCEPT MOD
CODE
EV (109054, DCM, "Patient State")
1
M
D
11
>
CONTAINS
CODE
EV (111424, DCM, "Comparison to previous studies")
1
U
B
12
>
CONTAINS
NUM
DT (122768, DCM, "Difference in Ejection Fraction")
1
U
UNITS = EV (%, UCUM, "%")
13
>
CONTAINS
NUM
DT (122769, DCM, "Difference in ED LV Volume")
1
U
UNITS = EV (ml, UCUM, "ml")
14
>
CONTAINS
NUM
DT (122769, DCM, "Difference in ED LV Volume")
1
U
UNITS = EV (ml/m2, UCUM, "ml/m2")
15
>>
HAS CONCEPT MOD
CODE
EV (121425, DCM, "Index")
1
M
DT (8277-6, LN, "BSA")
Conclusions and RecommendationsType:ExtensibleOrder:Non-SignificantRoot:No
Conclusions and Recommendations
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (55110-1, LN, "Conclusions")
1
MC
IF Completion Flag (0040,A491) = COMPLETE
2
>
CONTAINS
TEXT
EV (121077, DCM, "Conclusion")
1
U
3
>
CONTAINS
CODE
EV (271921002, SCT, "ECG Finding")
1
M
D
4
>
CONTAINS
CODE
EV (365853002, SCT, "Imaging Finding")
1
M
D
5
CONTAINER
EV (121074, DCM, "Recommendations")
1
U
6
>
CONTAINS
TEXT
EV (121075, DCM, "Recommendation")
1
U
The Templates that comprise the Hemodynamic Report are interconnected as shown in .Hemodynamic Report Template Hierarchy shows only the use of Templates specific to the Hemodynamic Report; it does not show common structural Templates such as . shows the relationship of Templates; it does not show the structural hierarchy of Content Items in the IOD. See .Hemodynamics ReportThe Hemodynamic Report Template is the root structure for the representation of measurements acquired during a procedure in a cardiac catheterization lab.Type:ExtensibleOrder:SignificantRoot:Yes
Hemodynamics Report
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122120, DCM, "Hemodynamics Report")
1
M
Root node
2
>
HAS OBS CONTEXT
INCLUDE
D
1-n
M
3
>
INCLUDE
D
1
M
4
>
HAS OBS CONTEXT
INCLUDE
D
1
M
5
>
HAS ACQ CONTEXT
INCLUDE
D
1
U
6
>
CONTAINS
INCLUDE
D
1-n
M
7
>
CONTAINS
INCLUDE
D
1
U
Hemodynamics Measurement GroupThe Hemodynamic Measurement Group Template provides a structure for measurements acquired during a single procedure phase in a cardiac catheterization lab.Type:ExtensibleOrder:SignificantRoot:No
Hemodynamics Measurement Group
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 ACQ CONTEXT
CODE
EV (129085009, SCT, "Catheterization Procedure Phase")
1
M
D
3
>
HAS ACQ CONTEXT
INCLUDE
D
1
U
4
>
HAS ACQ CONTEXT
TEXT
EV (121124, DCM, "Procedure Action ID")
1
U
5
>
CONTAINS
INCLUDE
D
1-n
U
6
>
CONTAINS
INCLUDE
D
1-n
U
7
>
CONTAINS
INCLUDE
D
1-n
U
8
>
CONTAINS
INCLUDE
D
1-n
U
9
>
CONTAINS
INCLUDE
D
1-n
U
10
>
CONTAINS
INCLUDE
D
1-n
U
11
>
CONTAINS
INCLUDE
D
1-n
U
12
>
CONTAINS
INCLUDE
D
1-n
U
13
>
CONTAINS
INCLUDE
D
1-n
U
14
>
CONTAINS
INCLUDE
D
1-n
U
15
>
CONTAINS
INCLUDE
D
1-n
U
Content Item Descriptions
Row 4
Procedure Action ID allows linkage between the hemodynamic measurements recorded in this Template and a procedure step or phase recorded in the Procedure Log, e.g., using .
Arterial Pressure MeasurementThe Arterial Pressure Measurement Template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing systolic, diastolic, and mean measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.Type:ExtensibleOrder:SignificantRoot:No
Arterial Pressure Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (73002000, SCT, "Arterial pressure measurements")
1
M
2
>
INCLUDE
D
1
M
$LocationName = EV (363698007, SCT, "Finding Site")
$LocationValue = D
3
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (8480-6, LN, "Intravascular arterial Systolic pressure")
$Units = D
4
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (8462-4, LN, "Intravascular arterial Diastolic pressure")
$Units = D
5
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (8478-0, LN, "Intravascular arterial mean pressure")
$Units = D
6
>
CONTAINS
INCLUDE
D
1-n
U
Atrial Pressure MeasurementThe Atrial Pressure Measurement Template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing a-wave, v-wave, and mean measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.Type:ExtensibleOrder:SignificantRoot:No
Atrial Pressure Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122121, DCM, "Atrial pressure measurements")
1
M
2
>
INCLUDE
D
1
M
$LocationName = EV (363698007, SCT, "Finding Site")
$LocationValue = D
3
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (109016, DCM, "A-wave peak pressure")
$Units = D
4
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (109034, DCM, "V-wave peak pressure")
$Units = D
5
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (6797001, SCT, "Mean blood pressure")
$Units = D
6
>
CONTAINS
INCLUDE
D
1-n
U
Venous Pressure MeasurementThe Venous Pressure Measurement Template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing a mean measurement. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.Type:ExtensibleOrder:SignificantRoot:No
Venous Pressure Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (31724009, SCT, "Venous pressure measurements")
1
M
2
>
INCLUDE
D
1
M
$LocationName = EV (363698007, SCT, "Finding Site")
$LocationValue = D
3
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (6797001, SCT, "Mean blood pressure")
$Units = D
4
>
CONTAINS
INCLUDE
D
1-n
U
Ventricular Pressure MeasurementThe Ventricular Pressure Measurement Template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing systolic and end-diastolic measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.Type:ExtensibleOrder:SignificantRoot:No
Ventricular Pressure Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122122, DCM, "Ventricular pressure measurements")
1
M
2
>
INCLUDE
D
1
M
$LocationName = EV (363698007, SCT, "Finding Site")
$LocationValue = D
3
>
CONTAINS
INCLUDE
D
1
MC
IFF $LocationValue selected in Row 2 = (87878005, SCT, "Left Ventricle") or subsite thereof
$Measurement = EV (276780008, SCT, "Left Ventricular Systolic blood pressure")
$Units = D
4
>
CONTAINS
INCLUDE
D
1
MC
IFF $LocationValue selected in Row 2 = (87878005, SCT, "Left Ventricle") or subsite thereof
$Measurement = EV (276781007, SCT, "Left Ventricular End Diastolic pressure")
$Units = D
5
>
CONTAINS
INCLUDE
D
1
MC
IFF $LocationValue selected in Row 2 = (53085002, SCT, "Right Ventricle") or subsite thereof
$Measurement = EV (276772001, SCT, "Right Ventricular Systolic blood pressure")
$Units = D
6
>
CONTAINS
INCLUDE
D
1
MC
IFF $LocationValue selected in Row 2 = (53085002, SCT, "Right Ventricle") or subsite thereof
$Measurement = EV (276774000, SCT, "Right Ventricular End Diastolic pressure")
$Units = D
$Measurement = EV (122191, DCM, "Ventricular End Diastolic pressure")
$Units = D
9
>
CONTAINS
INCLUDE
D
1-n
U
Gradient MeasurementThe Gradient Measurement Template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing the gradient measurement. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.Type:ExtensibleOrder:SignificantRoot:No
Gradient Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122123, DCM, "Gradient assessment")
1
M
2
>
INCLUDE
D
1
MC
XOR with Rows 3 & 4IFF single location is appropriate
$LocationName = EV (363698007, SCT, "Finding Site")
$LocationValue = D
3
>
INCLUDE
D
1
MC
XOR with Row 2IFF a dual location is appropriate
$LocationName = EV (121116, DCM, "Proximal Finding Site")
$LocationValue = D
4
>
INCLUDE
D
1
MC
XOR with Row 2IFF a dual location is appropriate
$LocationName = EV (121117, DCM, "Distal Finding Site")
$LocationValue = D
5
>
CONTAINS
INCLUDE
D
1-n
M
$Measurement = EV (251081004, SCT, "Pressure Gradient")
$Units = D$Derivation = D
6
>
CONTAINS
INCLUDE
D
1-n
U
Content Item Descriptions
Row 5
Is used to encode the gradient measurements. Uses for the Content Item structure of the measurements. That Template allows an INFERRED FROM relationship to other numeric measurements used in the computation or derivation of the current measurement. In the case of a gradient measurement, the pressure measurements at the distal and proximal locations may thus be explicitly conveyed.
Blood Velocity MeasurementThe Blood Velocity Measurement Template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing primary (not derived) velocity measurements, e.g., from a Doppler catheter. Derived velocity measurements may be recorded using .Type:ExtensibleOrder:SignificantRoot:No
Blood Velocity Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122124, DCM, "Blood velocity measurements")
1
M
2
>
INCLUDE
D
1
M
$LocationName = EV (363704007, SCT, "Procedure site")
$LocationValue = B
3
>
CONTAINS
INCLUDE
D
1-n
M
$Measurement = D$Units = EV (mm/s, UCUM, "mm/s")
4
>
CONTAINS
INCLUDE
D
1-n
U
Vital SignsThe Vital Signs Template consists of a CONTAINER containing the various vital signs measurements. These measurements may be acquired automatically from patient monitoring equipment, or may be entered based on manual measurements.Type:ExtensibleOrder:SignificantRoot:No
Vital Signs
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (8716-3, LN, "Vital Signs")
1
M
2
>
CONTAINS
INCLUDE
D
1
U
$Measurement = EV (271649006, SCT, "Systolic blood pressure")
$Units = D$Method = B
3
>
CONTAINS
INCLUDE
D
1
U
$Measurement = EV (271650006, SCT, "Diastolic blood pressure")
$Units = D
4
>
CONTAINS
INCLUDE
D
1
U
$Measurement = EV (8867-4, LN, "Heart rate")
$Units = EV ({H.B.}/min, UCUM, "BPM")
5
>
CONTAINS
INCLUDE
D
1
U
$Measurement = EV (8310-5, LN, "Body temperature")
$Units = EV (Cel, UCUM, "C")
6
>
CONTAINS
INCLUDE
D
1
U
$Measurement = D$Units = EV (%, UCUM, "%")
7
>
CONTAINS
INCLUDE
D
1
U
$Measurement = EV (86290005, SCT, "Respiration rate")
$Units = EV (/min, UCUM, "breaths/min")
Cardiac Output Measurement by Indicator DilutionThe Cardiac Output Measurement by Indicator Dilution Template consists of a CONTAINER containing the measurement and significant parameters of the technical method. If the measurement is based on a DICOM Hemodynamic Waveform SOP Instance, that object may also be referenced.Fick Cardiac Output is encoded in .Type:ExtensibleOrder:SignificantRoot:No
Cardiac Output Measurement By Indicator Dilution
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (117610000, SCT, "Cardiac Output measurement")
1
M
2
>
CONTAINS
INCLUDE
D
1
M
$Measurement = EV (8737-9, LN, "Cardiac Output by Indicator Dilution")
$Units = EV (l/min, UCUM, "l/min")$Method = D$WavePurpose = DT (121112, DCM, "Source of Measurement")
3
>
HAS ACQ CONTEXT
NUM
EV (122319, DCM, "Catheter Size")
1
MC
IFF Row 2 indicates a thermal method
UNITS = D
4
>
HAS ACQ CONTEXT
NUM
EV (122320, DCM, "Injectate Temperature")
1
MC
IFF Row 2 indicates a thermal method
UNITS = EV (Cel, UCUM, "C")
5
>
HAS ACQ CONTEXT
NUM
EV (122321, DCM, "Injectate Volume")
1
M
UNITS = DT (ml, UCUM, "ml")
6
>
HAS ACQ CONTEXT
NUM
EV (122322, DCM, "Calibration Factor")
1
M
UNITS = DT (1, UCUM, "no units")
Blood Lab MeasurementsThe Blood Lab Measurements Template provides for the recording of measurements made on blood samples obtained during a catheterization procedure. 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.Type:ExtensibleOrder:SignificantRoot:No
$Measurement = EV (122183, DCM, "Blood temperature")
$Units = EV (Cel, UCUM, "C")
Hemodynamic Clinical ContextThe Clinical Context Template allows the recording of information about the patient's clinical state that may affect interpretation of the hemodynamic measurements. This Template includes several coded conditions (e.g., complications, drugs, physiological challenges, etc.), each of which may have a Concept Modifier of "Relative Time". This Modifier indicates the temporal relationship of the hemodynamic measurements to the conditions recorded in this Template. E.g., the Content Item structure:[CONTAINER] "Findings">HAS ACQ CONTEXT "Cath Procedure Phase" "Post-intervention phase">HAS ACQ CONTEXT [CONTAINER] "Clinical Context">>CONTAINS [CODE] "Complication" "Arrhythmia">>>HAS CONCEPT MOD [CODE] "Relative Time" "After">CONTAINS [CONTAINER] "Arterial Measurements"…conveys the semantics that this group of measurements for the post-intervention phase of a cath procedure was made after an occurrence of arrhythmia in the patient.In the absence of a Relative Time modifier, the acquisition context is during the identified event or state.Type:ExtensibleOrder:SignificantRoot:No
Hemodynamic Clinical Context
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122127, DCM, "Clinical Context")
1
M
2
>
CONTAINS
CODE
EV (109054, DCM, "Patient State")
1-n
U
B
3
>
CONTAINS
TEXT
EV (109054, DCM, "Patient State")
1
U
4
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (116224001, SCT, "Complication of Procedure")
$ConditionValue = D
5
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (122086, DCM, "Contrast administered")
$ConditionValue = B
6
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (122083, DCM, "Drug administered")
$ConditionValue = B
7
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (109059, DCM, "Physiological challenges")
$ConditionValue = B
8
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (122138, DCM, "Circulatory Support")
$ConditionValue = D
9
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (266700009, SCT, "Ventilation assistance")
$ConditionValue = D
10
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (18590009, SCT, "Cardiac Pacing")
$ConditionValue = B
11
>
CONTAINS
INCLUDE
D
1-n
U
$ConditionName = EV (71388002, SCT, "Procedure")
$ConditionValue = B
Relative TimeThe Relative Time Template is invoked by 3520 Hemodynamic Acquisition Context Template. It specifies an applicable clinical context condition and the time of the current measurements relative to that condition.
Parameters
Parameter Name
Parameter Usage
$ConditionName
Coded term for Concept Name of condition
$ConditionValue
Context Group for condition values
Type:Non-ExtensibleOrder:SignificantRoot:No
Relative Time
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
$ConditionName
1
M
$ConditionValue
2
>
HAS CONCEPT MOD
CODE
EV (118578006, SCT, "Relative time")
1
U
B
Hemodynamic Acquisition ContextThe Hemodynamic Acquisition Context Template is invoked by the various hemodynamic measurement Templates.
Parameters
Parameter Name
Parameter Usage
$LocationName
Coded term for Concept Name of measurement location
$LocationValue
Context Group for appropriate anatomic locations
Type:ExtensibleOrder:SignificantRoot:No
Hemodynamic Acquisition Context
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
HAS CONCEPT MOD
CODE
$LocationName
1
M
$LocationValue
2
>
HAS CONCEPT MOD
CODE
EV (106233006, SCT, "Topographical modifier")
1
U
B
3
HAS ACQ CONTEXT
CODE
EV (370129005, SCT, "Measurement Method")
1
U
B
4
HAS ACQ CONTEXT
WAVEFORM
DT (121112, DCM, "Source of Measurement")
1
UC
XOR Row 5
5
HAS ACQ CONTEXT
TCOORD
DT (121112, DCM, "Source of Measurement")
1
UC
XOR Row 4
6
>
SELECTED FROM
WAVEFORM
1
M
Pressure Waveform MeasurementsThe Pressure Waveform Measurements Template is invoked by the various hemodynamic measurement Templates for recording general measurements made in conjunction with the specific required measurements for that anatomic location.Type:ExtensibleOrder:SignificantRoot:No
Pressure Waveform Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
INCLUDE
D
1-n
U
$Measurement = D$Units = D
2
CONTAINS
INCLUDE
D
1-n
U
$Measurement = D$Units = EV (mm/s, UCUM, "mm/s")
3
CONTAINS
INCLUDE
D
1-n
U
$Measurement = D$Units = DT (ms, UCUM, "ms")
4
CONTAINS
INCLUDE
D
1
U
$Measurement = EV (82799009, SCT, "Cardiac Output")
$Units = EV (l/min, UCUM, "l/min")
Derived Hemodynamic MeasurementsThe Derived Hemodynamic Measurements Template consists of a CONTAINER containing measurements derived from one or more other measurements. These measurements are associated with a particular procedure phase, but not necessarily with a particular anatomic location.Type:ExtensibleOrder:SignificantRoot:No
Derived Hemodynamic Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122126, DCM, "Derived Hemodynamic Measurements")
$Measurement = D$Units = DT (%, UCUM, "%")$Equation = D
Summary, HemodynamicsThis Template allows the recording of any significant numeric measurements or findings.Type:ExtensibleOrder:SignificantRoot:No
Summary, Hemodynamics
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (55112-7, LN, "Summary")
1
M
2
>
CONTAINS
TEXT
EV (55112-7, LN, "Summary")
1
U
3
>
CONTAINS
INCLUDE
D
1-n
U
4
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1-n
U
D
5
>>
INCLUDE
D
1
U
6
>>
HAS PROPERTIES
CODE
EV (246112005, SCT, "Severity")
1
U
D
7
>
CONTAINS
CODE
D
1-n
U
D
8
>>
HAS PROPERTIES
CODE
EV (260905004, SCT, "Condition")
1
U
EV (414576002, SCT, "Large v-wave")
9
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1
U
EV (413985002, SCT, "Diastolic pressure equalization")
Procedure ContextThe Procedure Context Template describes acquisition context for measurements made or events recorded in a procedure.Type:ExtensibleOrder:SignificantRoot:No
Procedure Context
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
HAS ACQ CONTEXT
TEXT
EV (121065, DCM, "Procedure Description")
1
U
Defaults to Value of Study Description (0008,1030) of the
2
HAS ACQ CONTEXT
CODE
EV (363703001, SCT, "Has Intent")
1
U
B
3
HAS ACQ CONTEXT
CODE
EV (260870009, SCT, "Procedure Priority")
1
U
B
4
HAS OBS CONTEXT
CODE
EV (121023, DCM, "Procedure Code")
1-n
U
Defaults to Value of Procedure Code Sequence (0008,1032) of the
Cardiovascular Patient CharacteristicsThis Template describes the characteristics of the patient that are specific to the current clinical presentation (visit). Patient Characteristic concepts in this Template, which may replicate Attributes in the , are included here as possible targets of by-reference relationships from other Content Items in the SR tree.Several of the concepts in this Template duplicate concepts in . The difference in use is that this Template has those concepts as primary observations of the patient, while in the concepts are used to set (or reset) the context for other observations.Type:ExtensibleOrder:SignificantRoot:No
Cardiovascular Patient Characteristics
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (121118, DCM, "Patient Characteristics")
1
M
2
>
CONTAINS
NUM
EV (121033, DCM, "Subject Age")
1
M
UNITS = D
3
>
CONTAINS
CODE
EV (121032, DCM, "Subject Sex")
1
M
D
4
>
CONTAINS
NUM
EV (8302-2, LN, "Patient Height")
1
M
UNITS = EV (cm, UCUM, "cm")
5
>
CONTAINS
NUM
EV (29463-7, LN, "Patient Weight")
1
M
UNITS = EV (kg, UCUM, "kg")
6
>
CONTAINS
NUM
EV (122221, DCM, "Thorax diameter, sagittal")
1
U
UNITS = EV (cm, UCUM, "cm")
7
>
CONTAINS
NUM
EV (8277-6, LN, "Body Surface Area")
1
MC
IF BSA used for indexed measurements in SOP Instance
UNITS = EV (m2, UCUM, "m2")
8
>>
INFERRED FROM
CODE
EV (8278-4, LN, "Body Surface Area Formula")
1
U
B
9
>
CONTAINS
NUM
EV (60621009, SCT, "Body Mass Index")
1
U
UNITS = EV (kg/m2, UCUM, "kg/m2")
10
>>
INFERRED FROM
CODE
EV (121420, DCM, "Equation")
1
U
DT (122265, DCM, "BMI = Wt/Ht^2")
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 = D
13
>
CONTAINS
NUM
EV (271650006, SCT, "Diastolic Blood Pressure")
1
U
UNITS = D
14
>
CONTAINS
CODE
DT (8884-9, LN, "Cardiac Rhythm")
1
U
B
15
>
CONTAINS
NUM
EV (248366000, SCT, "Chest Circumference")
1
U
UNITS = EV (cm, UCUM, "cm")
16
>
CONTAINS
TEXT
EV (248808008, SCT, "Breast size")
1
U
Bra size as text string
17
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1
U
D
18
>
CONTAINS
CODE
EV (429160000, SCT, "Functional capacity")
1
U
D
19
>
CONTAINS
CODE
EV (429160000, SCT, "Functional capacity")
1
U
D
20
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1-n
U
21
>
CONTAINS
TEXT
EV (55108-5, LN, "Patient Presentation")
1
U
Content Item Descriptions
Rows 11, 12, 13
Cardiac vital signs, for use when the SR SOP Instance does not record vital signs at multiple procedure phases or stages.
Row 16
Breast size for interpretation of attenuation in nuclear medicine imaging
EV (122222, DCM, "Procedure Environmental Characteristics")
1
M
2
>
CONTAINS
NUM
EV (122223, DCM, "Room oxygen concentration")
1
U
UNITS = EV (%, UCUM, "%")
3
>
CONTAINS
NUM
EV (122224, DCM, "Room temperature")
1
U
UNITS = EV (Cel, UCUM, "C")
4
>
CONTAINS
NUM
EV (122225, DCM, "Room Barometric pressure")
1
U
UNITS = DT (mbar, UCUM, "millibar")
ECG ReportThe ECG Report Template is the root structure for the representation of analysis of an ECG waveform, potentially in comparison to a prior ECG waveform analysis. The analyzed waveform may or may not be stored as a DICOM SOP Instance.Type:ExtensibleOrder:SignificantRoot:Yes
ECG Report
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (28010-7, LN, "ECG Report")
1
M
Root node
2
>
HAS CONCEPT MOD
CODE
EV (121058, DCM, "Procedure reported")
1
U
B
3
>
HAS CONCEPT MOD
INCLUDE
D
1
M
4
>
CONTAINS
INCLUDE
D
1-n
M
5
>
CONTAINS
INCLUDE
D
1
U
$Findings = D
8
>
CONTAINS
INCLUDE
D
1
U
9
>
CONTAINS
INCLUDE
D
1
U
10
>
CONTAINS
INCLUDE
D
1
U
11
>
CONTAINS
INCLUDE
D
1
M
12
>
CONTAINS
CONTAINER
EV (122144, DCM, "Quantitative Analysis")
1
M
13
>>
CONTAINS
INCLUDE
D
1
U
14
>>
CONTAINS
INCLUDE
D
1-n
U
One instantiation per reported lead
15
>
CONTAINS
INCLUDE
D
1
U
16
>
CONTAINS
INCLUDE
D
1
U
Clinical Context, ECG (Retired)This Template has been retired (see PS3.16-2009).Prior ECG StudyType:ExtensibleOrder:SignificantRoot:No
Prior ECG Study
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (55114-3, LN, "Prior Procedure Descriptions")
1
M
2
>
CONTAINS
CODE
EV (122140, DCM, "Comparison with Prior Study Done")
1
M
D
3
>
CONTAINS
DATETIME
EV (122146, DCM, "Procedure DateTime")
1
U
4
>
CONTAINS
UIDREF
EV (121018, DCM, "Procedure Study Instance UID")
1
U
5
>
CONTAINS
COMPOSITE
EV (122075, DCM, "Prior report for current patient")
1
U
6
>
CONTAINS
WAVEFORM
EV (121112, DCM, "Source of Measurement")
1
U
Patient Characteristics for ECGType:ExtensibleOrder:SignificantRoot:No
Patient Characteristics for ECG
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (121118, DCM, "Patient Characteristics")
1
M
2
>
CONTAINS
NUM
EV (121033, DCM, "Subject Age")
1
M
UNITS = D
3
>
CONTAINS
CODE
EV (121032, DCM, "Subject Sex")
1
M
D
4
>
CONTAINS
NUM
EV (8302-2, LN, "Patient Height")
1
U
UNITS = EV (cm, UCUM, "cm")
5
>
CONTAINS
NUM
EV (29463-7, LN, "Patient Weight")
1
U
UNITS = EV (kg, UCUM, "kg")
6
>
CONTAINS
NUM
EV (271649006, SCT, "Systolic Blood Pressure")
1
U
UNITS = D
7
>
CONTAINS
NUM
EV (271650006, SCT, "Diastolic Blood Pressure")
1
U
UNITS = D
8
>
CONTAINS
CODE
EV (109054, DCM, "Patient State")
1
U
D
9
>
CONTAINS
CODE
EV (441509002, SCT, "Pacemaker in situ")
1
U
D
10
>
CONTAINS
CODE
EV (443325000, SCT, "ICD in situ")
1
U
D
ECG Waveform InformationThe ECG Waveform Information Template provides reference to, and important parameters of, the analyzed waveform.Type:ExtensibleOrder:SignificantRoot:No
ECG Waveform Information
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (55111-9, LN, "Current Procedure Descriptions")
1
M
2
>
CONTAINS
WAVEFORM
EV (121112, DCM, "Source of Measurement")
1
U
3
>
CONTAINS
CODE
EV (10:11345, MDC, "Lead System")
1
U
D
4
>
CONTAINS
TEXT
EV (122142, DCM, "Acquisition Device Type")
1
U
5
>
CONTAINS
TEXT
EV (121122, DCM, "Equipment Identification")
1
U
6
>
CONTAINS
INCLUDE
D
1
U
Person performing the ECG acquisition
7
>
CONTAINS
TEXT
EV (121121, DCM, "Room Identification")
1
U
8
>
CONTAINS
DATETIME
EV (122146, DCM, "Procedure DateTime")
1
M
9
>
CONTAINS
NUM
D
1-n
U
10
>
CONTAINS
TEXT
D
1-n
U
11
>
CONTAINS
INCLUDE
D
1
U
ECG Global MeasurementsThe ECG Global Measurements Template provides a structure for measurements calculated across the ECG waveform as a whole (multiple leads).As an Extensible Template, applications may include any ECG global measurements, such as angles of the electrical vector of various ECG waves. The recommended vocabulary for such concepts is ISO/IEEE 11073-10102.Type:ExtensibleOrder:SignificantRoot:No
ECG Global Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122158, DCM, "ECG Global Measurements")
1
M
2
>
HAS OBS CONTEXT
INCLUDE
D
1
U
3
>
CONTAINS
NUM
DT (2:16020, MDC, "Atrial Heart Rate")
1
U
UNITS = EV ({H.B.}/min, UCUM, "BPM")
4
>
CONTAINS
NUM
DT (2:16016, MDC, "Ventricular Heart Rate")
1
M
UNITS = EV ({H.B.}/min, UCUM, "BPM")
5
>
CONTAINS
NUM
DT (2:16160, MDC, "QT interval global")
1
M
UNITS = EV (ms, UCUM, "ms")
6
>
CONTAINS
NUM
DT (2:15876, MDC, "QTc interval global")
1
U
UNITS = EV (ms, UCUM, "ms")
7
>>
HAS PROPERTIES
CODE
DT (111001, DCM, "Algorithm Name")
1
U
D
8
>
CONTAINS
NUM
DT (2:15872, MDC, "PR interval global")
1
M
UNITS = EV (ms, UCUM, "ms")
9
>
CONTAINS
NUM
DT (2:16156, MDC, "QRS duration global")
1
M
UNITS = EV (ms, UCUM, "ms")
10
>
CONTAINS
NUM
DT (2:16168, MDC, "RR interval global")
1
M
UNITS = EV (ms, UCUM, "ms")
11
>
CONTAINS
NUM
D
1-n
U
UNITS = EV (ms, UCUM, "ms")
12
>
CONTAINS
NUM
D
1-n
U
UNITS = EV (deg, UCUM, "deg")
13
>
CONTAINS
NUM
DT (2:16032, MDC, "Count of all beats")
1
U
UNITS = EV ({beats}, UCUM, "beats")
14
>
CONTAINS
NUM
DT (122707, DCM, "Number of Ectopic Beats")
1
U
UNITS = EV ({beats}, UCUM, "beats")
15
>>
HAS PROPERTIES
CODE
EV (116676008, SCT, "Associated Morphology")
1-n
U
B
ECG Lead MeasurementsThe ECG Lead Measurements Template provides a structure for measurements calculated on individual ECG leads.As an Extensible Template, applications may include any ECG per lead measurements, such as integrals over time of various ECG wave voltages. The recommended vocabulary for such concepts is ISO/IEEE 11073-10102.Type:ExtensibleOrder:SignificantRoot:No
ECG Lead Measurements
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (122159, DCM, "ECG Lead Measurements")
1
M
2
>
HAS CONCEPT MOD
CODE
EV (122148, DCM, "Lead ID")
1
M
B
3
>
HAS OBS CONTEXT
INCLUDE
D
1
U
4
>
CONTAINS
NUM
D
1-n
U
UNITS = EV (ms, UCUM, "ms")
5
>
CONTAINS
NUM
D
1-n
U
UNITS = EV (mV, UCUM, "mV")
6
>
CONTAINS
CODE
EV (365416000, SCT, "ST Segment Finding")
1
U
D
7
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1-n
U
D
ECG Measurement SourceThe ECG Measurement Source Template provides a structure for identifying the particular cardiac cycle, or beat, in an analyzed ECG waveform used for the measurement group for which this Template provides Observation Context. The cardiac cycle is identified by beat number, and optionally by specific temporal coordinates within a DICOM ECG Waveform SOP Instance.Type:ExtensibleOrder:SignificantRoot:No
ECG Measurement Source
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
TEXT
EV (122149, DCM, "Beat Number")
1
U
Up to three numeric characters
2
CODE
EV (370129005, SCT, "Measurement Method")
1
U
D
3
TCOORD
EV (121112, DCM, "Source of Measurement")
1
U
4
>
SELECTED FROM
WAVEFORM
1
U
Content Item Descriptions
Row 1
Beat Number is specified as a numeric text string, and shall be treated as the ordinal of the beat (cardiac cycle) within the waveform acquisition for this lead that was analyzed for the measurements in this container (i.e., "1" for the first beat, "2" for the second, etc.). If absent, the measurements may have been made by a technique across multiple cycles as specified in Row 2 Measurement Method.
Rows 3, 4
Source of measurement identify the specific channel and time period within a DICOM ECG Waveform SOP Instance that was analyzed for the measurements in this container.
ECG Qualitative AnalysisThe ECG Qualitative Analysis Template allows a free text qualitative interpretation of the analyzed ECG, as well as a structure for a coded analysis.Type:ExtensibleOrder:SignificantRoot:No
Qualitative Analysis, ECG
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (122145, DCM, "Qualitative Analysis")
1
M
2
>
CONTAINS
TEXT
EV (271921002, SCT, "ECG Finding")
1
MC
At least one of Rows 2 and 3 shall be present
3
>
CONTAINS
CODE
EV (271921002, SCT, "ECG Finding")
1-n
MC
At least one of Rows 2 and 3 shall be present
B
4
>>
HAS CONCEPT MOD
TEXT
EV (121051, DCM, "Equivalent Meaning of Value")
1
U
5
>>
INFERRED FROM
CODE
EV (271921002, SCT, "ECG Finding")
1-n
U
6
>>>
HAS CONCEPT MOD
TEXT
EV (121051, DCM, "Equivalent Meaning of Value")
1
U
Content Item Descriptions
Rows 3, 4
ECG Finding provides one or more coded interpretive statements using standard or implementation-specific codes. Each coded finding will include a Code Meaning (0008,0104) using the LO Value Representation (64 characters); longer human-readable text strings for interpretive statements may be conveyed in the Row 4 Equivalent Meaning of Value Content Item.
Rows 5, 6
Each primary ECG Finding of Row 3 may have multiple supporting coded findings in Row 5, with longer human-readable text strings for interpretive statements if necessary in Row 6.
ECG Interpretive Statement (Retired)This Template is retired. See PS3.16-2009.Summary, ECGType:ExtensibleOrder:SignificantRoot:No
Summary, ECG
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (55112-7, LN, "Summary")
1
M
2
>
CONTAINS
TEXT
EV (55112-7, LN, "Summary")
1
U
3
>
CONTAINS
CODE
DT (18810-2, LN, "ECG overall finding")
1
U
D
Waveform AnnotationsThis Root Template encodes a list of annotations for waveform data consisting of measurements or observations added at recording time or later provided either by a human reviewer (such as a cardiologist, neurologist, or technologist) or by an automated analysis algorithm.Type:ExtensibleOrder:Non-SignificantRoot:Yes
Waveform Annotations
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
B
1
M
Root node
2
>
HAS CONCEPT MOD
INCLUDE
D
1
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1
M
4
>
HAS CONCEPT MOD
CODE
EV (130871, DCM, "Procedure annotated")
1-n
U
BB
5
>
HAS OBS CONTEXT
CODE
EV
(1185780006, SCT, "Relative Time")
1
U
D
6
>
CONTAINS
INCLUDE
D
1
U
7
>
CONTAINS
CONTAINER
EV (130870, DCM, "Waveform Annotations")
1
M
8
>>
HAS CONCEPT MOD
INCLUDE
D
1
U
9
>>
CONTAINS
CONTAINER
EV (130872, DCM, "Waveform Annotation Group")
1-n
M
10
>>>
HAS OBS CONTEXT
NUM
EV (130873, DCM, "Waveform Annotation Group Number")
1
M
UNITS = (1, UCUM, "no units")
11
>>>
HAS OBS CONTEXT
TEXT
EV (130874, DCM, "Waveform Annotation Group Label")
1
U
12
>>>
CONTAINS
INCLUDE
D
1-n
U
$AnnotationClassification = EV (130860, DCM, "Pattern Event")
$AnnotationCode = B
13
>>>
CONTAINS
INCLUDE
D
1-n
U
$AnnotationClassification = EV (130861, DCM, "EEG Annotation")
$AnnotationCode = B
14
>>>
CONTAINS
INCLUDE
D
1-n
U
$AnnotationClassification = EV (130862, DCM, "EMG Annotation")
$AnnotationCode = B
15
>>>
CONTAINS
INCLUDE
D
1-n
U
$AnnotationClassification = EV (130863, DCM, "EOG Annotation")
$AnnotationCode = B
16
>>>
CONTAINS
INCLUDE
D
1-n
U
$AnnotationClassification = EV (130864, DCM, "Device-related and Environment-related Event")
$AnnotationCode = B
17
>>>
CONTAINS
INCLUDE
D
1-n
U
$AnnotationClassification = EV (130865, DCM, "Patient Consciousness")
$AnnotationCode = B
18
>>>
CONTAINS
INCLUDE
D
1-n
U
$AnnotationClassification = EV (130866, DCM, "ECG Annotation")
$AnnotationCode = B
19
>>>
CONTAINS
INCLUDE
D
1-n
U
$Measurement = B
20
>>>
CONTAINS
INCLUDE
D
1-n
U
Content Item Descriptions
Row 4
A coded descriptor of the sort of procedure the annotations apply to.
Row 5
Indicates the point in time when the annotations have been made relative to the waveform recording procedure.
Row 6
The Waveform Library provides potentially relevant characteristics of the waveform objects associated with the annotations. There is no requirement to include all, or any, of the waveform objects referenced in the annotations and measurements elsewhere in this template. The template may also include waveform objects that are associated with, but not directly referenced in, the annotations and measurements.The Waveform Library is not replicating the content of the SOP Instance Reference Macro.
Row 10
Defines an identifier for a group of annotations analogously to Annotation Group Number (0040,A180) in , which may be used, for example, for display purposes.The number itself is not semantically significant, no ordering is required.
Row 11
A descriptive label for a group of annotations, e.g., to be used for display purpose.
Waveform Pattern or EventThis Template encodes a Waveform Annotation represented by a coded concept.
Parameters
Parameter Name
Parameter Usage
$AnnotationClassification
A coded term or Context Group for Concept Name of annotation type that determines the value set constraint.
$AnnotationCode
A code or a Context Group with codes representing the observation.
Type:ExtensibleOrder:Non-SignificantRoot:No
Waveform Pattern or Event
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CODE
$AnnotationClassification
1
M
$AnnotationCode
2
>
HAS PROPERTIES
CODE
EV (130875, DCM, "Waveform Annotation Modifier")
1-n
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1
U
4
>
HAS CONCEPT MOD
INCLUDE
D
1
U
5
>
INCLUDE
D
1-n
M
$Purpose = EV (260753009, SCT, "Source")
6
>
HAS PROPERTIES
TEXT
EV (125309, DCM, "Short Label")
1
U
Content Item Descriptions
Row 2
Contains additional qualifiers, if the value in Row 1 does not fully define the annotation. For example, this might be information about the location of an observation or the frequentness of a pattern.
Row 6
This may be used to label the coded annotation when space is limited on the screen or report page.Short Labels are not standardized and may omit details of the annotation; thus, it is not recommended to use them for purposes such as matching.
Waveform MeasurementThis Template encodes a Waveform Annotation expressing a measurement.
Parameters
Parameter Name
Parameter Usage
$Measurement
Coded term or Context Group for Concept Name of measurement.
Type:ExtensibleOrder:Non-SignificantRoot:No
Waveform Measurement
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
NUM
$Measurement
1
M
2
>
HAS PROPERTIES
CODE
EV (130875, DCM, "Waveform Annotation Modifier")
1-n
U
3
>
HAS OBS CONTEXT
INCLUDE
D
1
U
4
>
HAS CONCEPT MOD
INCLUDE
D
1
U
5
>
INCLUDE
D
1-n
M
$Purpose = EV (121112, DCM, "Source of Measurement")
6
>
HAS PROPERTIES
TEXT
EV (125309, DCM, "Short Label")
1
U
Content Item Descriptions
Row 6
This may be used to label the measurement value when space is limited on the screen or report page.Short Labels are not standardized and may omit details of the measurement; thus, it is not recommended to use them for purposes such as matching.
Annotation NoteThis Template defines a Waveform Annotation in the form of a text note.Type:ExtensibleOrder:Non-SignificantRoot:No
Annotation Note
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
TEXT
EV (130876, DCM, "Annotation Note")
1
M
2
>
HAS OBS CONTEXT
INCLUDE
D
1
U
3
>
HAS CONCEPT MOD
INCLUDE
D
1
U
4
>
INCLUDE
D
1-n
M
$Purpose = EV (260753009, SCT, "Source")
5
>
HAS PROPERTIES
TEXT
EV (125309, DCM, "Short Label")
1
U
Content Item Descriptions
Row 5
This may be used to label the text value when space is limited on the screen or report page.Short Labels are not standardized and may omit details of the Annotation Note text; thus, it is not recommended to use them for purposes such as matching.
Waveform LibraryThe Waveform Library contains references to waveform objects and selected attributes describing them that facilitate analysis without having to retrieve the entire set of referenced objects.Type:ExtensibleOrder:Non-SignificantRoot:No
Waveform Library
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (130877, DCM, "Waveform Library")
1
M
2
>
CONTAINS
CONTAINER
EV (130878, DCM, "Waveform Library Group")
1-n
U
3
>>
HAS ACQ CONTEXT
INCLUDE
D
1
U
4
>>
CONTAINS
INCLUDE
D
1-n
U
Content Item Descriptions
Row 3
These Waveform Library Entry Descriptors apply to all Waveform Library Entries in this Waveform Library Group.
Waveform Library EntryEach instance of the Waveform Library Entry Template contains the SOP Class and Instance UIDs, and selected attributes for a waveform that facilitate analysis without having to retrieve the entire set of referenced waveforms.Type:ExtensibleOrder:Non-SignificantRoot:No
Waveform Library Entry
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
WAVEFORM
1
M
2
>
HAS ACQ CONTEXT
INCLUDE
D
1
U
Content Item Descriptions
Row 2
These Waveform Library Entry Descriptors apply to the WAVEFORM in Row 1 and override descriptors in Row 3 of in case of conflict.
Waveform Library Entry DescriptorsThis Template contains selected attributes for a waveform or a group of waveforms. The descriptive information may be copied from the waveforms or derived.Type:ExtensibleOrder:Non-SignificantRoot:No
Waveform Library Entry Descriptors
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
HAS ACQ CONTEXT
CODE
EV (121139, DCM, "Modality")
1
U
D
2
HAS ACQ CONTEXT
DATE
EV (111060, DCM, "Study Date")
1
U
3
HAS ACQ CONTEXT
TIME
EV (111061, DCM, "Study Time")
1
U
4
HAS ACQ CONTEXT
DATE
EV (111018, DCM, "Content Date")
1
U
5
HAS ACQ CONTEXT
TIME
EV (111019, DCM, "Content Time")
1
U
6
HAS ACQ CONTEXT
DATETIME
EV
(130884, DCM, "Acquisition DateTime")
1
U
7
HAS ACQ CONTEXT
UIDREF
EV (130885, DCM, "Synchronization Frame of Reference UID")
1
U
8
CONTAINS
INCLUDE
D
1-n
U
Waveform Library Entry Multiplex Group DescriptorsThis Template contains selected attributes for a waveform multiplex group within a waveform object or a group of waveform objects. The descriptive information may be copied from the waveform objects or derived.Type:ExtensibleOrder:Non-SignificantRoot:No
Waveform Library Entry Multiplex Group Descriptors
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (130879, DCM, "Waveform Library Entry Multiplex Group Descriptors")
1-n
M
2
>
HAS ACQ CONTEXT
NUM
EV (130880, DCM, "Multiplex Group Number")
1
U
UNITS = (1, UCUM, "no units")
3
>
HAS ACQ CONTEXT
UIDREF
EV (130881, DCM, "Multiplex Group UID")
1
U
4
>
HAS ACQ CONTEXT
NUM
EV (130882, DCM, "Sampling Frequency")
1
U
UNITS = (Hz, UCUM, "Hz")
5
>
HAS ACQ CONTEXT
NUM
EV (130883, DCM, "Number of Channels")
1
U
UNITS = EV ({channels}, UCUM, "channels")
The Templates that comprise the Cardiac Catheterization Report are interconnected as shown in .Cardiac Catheterization Report Template Hierarchy shows the relationship of Templates; it does not show the structural hierarchy of Content Items in the IOD.Cardiac Catheterization Report RootThe Cardiac Cath Report provides the overall clinical results of the catheterization procedure and interventions. In many cases, more detailed information is optionally available in other reports (Hemodynamic Measurements, Procedure Log, etc.). That information is collected and summarized here (and referenced when available).When a Discharge Summary section (Row 12) is included, this report Template covers the full set of information required for submission to the ACC NCDR™ (version 2.0) registry.The information required for such a submission must sometimes be reformatted from a single concept in these Templates to two data elements for the registry, or vice versa.This Template is expected to be used with the Basic Text SR or Enhanced SR IOD.3. This Cardiac Cath Report Template is a baseline Template within these SOP Classes that may be replaced; it is therefore in no sense binding for exchange of this type of report. It is solely an example of a possible encoding of the Cardiac Cath Report.Type:ExtensibleOrder:SignificantRoot:Yes
Cardiac Catheterization Report Root
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (18745-0, LN, "Cardiac Catheterization Report")
1
M
Root node
2
>
HAS CONCEPT MOD
CODE
EV (121058, DCM, "Procedure reported")
1
M
B
3
>
HAS CONCEPT MOD
INCLUDE
D
1
M
4
>
INCLUDE
D
1
M
5
>
CONTAINS
INCLUDE
D
1
U
6
>
CONTAINS
INCLUDE
D
1
M
7
>
CONTAINS
INCLUDE
D
1
M
8
>
CONTAINS
INCLUDE
D
1
M
9
>
CONTAINS
INCLUDE
D
1
U
10
>
CONTAINS
INCLUDE
D
1-n
U
11
>
CONTAINS
INCLUDE
D
1
M
12
>
CONTAINS
INCLUDE
D
1
M
13
>
CONTAINS
INCLUDE
D
1
U
Cardiovascular Patient HistoryThis Template contains information about a cardiovascular patient's past medical history that is relevant for the interpretation of the SR document of which it is part. This information is considered to have some degree of "persistence" across different episodes of care.Type:ExtensibleOrder:SignificantRoot:No
Cardiovascular Patient History
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (11329-0, LN, "History")
1
M
2
>
CONTAINS
TEXT
EV (11329-0, LN, "History")
1
U
3
>
CONTAINS
CONTAINER
DT (11450-4, LN, "Problem List")
1
U
4
>>
CONTAINS
TEXT
D
1-n
U
5
>>
CONTAINS
INCLUDE
D
1-n
U
$Problem = D
6
>>
CONTAINS
INCLUDE
D
1
U
$Problem = EV (161445009, SCT, "History of Diabetes mellitus")
$Therapy = D
7
>>
CONTAINS
INCLUDE
D
1
U
$Problem = EV (161501007, SCT, "History of Hypertension")
$Therapy = D
8
>>
CONTAINS
INCLUDE
D
1
U
$Problem = EV (414416008, SCT, "History of Hypercholesterolemia")
$Therapy = D
9
>>
CONTAINS
INCLUDE
D
1
U
$Problem = EV (44808001, SCT, "Arrhythmia")
$Therapy = D
10
>>
CONTAINS
INCLUDE
D
1
U
$Problem = EV (399211009, SCT, "History of Myocardial infarction")
$ModType = DT (122170, DCM, "Type of Myocardial Infarction")
$ModValue = D$Therapy = D
11
>>
CONTAINS
INCLUDE
D
1
U
$Problem = EV (275552000, SCT, "History of Kidney disease")
$Stage = D
12
>
CONTAINS
CONTAINER
DT (29762-2, LN, "Social History")
1
U
13
>>
CONTAINS
TEXT
EV (160476009, SCT, "Social History")
1
U
14
>>
CONTAINS
TEXT
D
1-n
U
15
>>
CONTAINS
CODE
EV (365981007, SCT, "Tobacco Smoking Behavior")
1
U
D
16
>>
CONTAINS
CODE
DT (228366006, SCT, "Drug misuse behavior")
1
U
DT (78267003, SCT, "Cocaine Abuse")
17
>
CONTAINS
CONTAINER
DT (10167-5, LN, "Past Surgical History")
1
U
18
>>
CONTAINS
TEXT
EV (11329-0, LN, "History")
1-n
U
19
>>
CONTAINS
INCLUDE
D
1-n
U
$ProcType = DT (387713003, SCT, "Surgical Procedure")
$Procedure = D
$ProcType = DT (261004008, SCT, "Diagnostic intent")
$Procedure = D
23
>>
CONTAINS
NUM
DT (2086-7, LN, "Cholesterol.in HDL")
1
U
UNITS = EV (mg/dl, UCUM, "mg/dl")
24
>>
CONTAINS
NUM
DT (2089-1, LN, "Cholesterol.in LDL")
1
U
UNITS = EV (mg/dl, UCUM, "mg/dl")
25
>
CONTAINS
CONTAINER
DT (10160-0, LN, "History of Medication Use")
1
U
26
>>
CONTAINS
TEXT
DT (111516, DCM, "Medication Type")
1-n
U
27
>>>
HAS PROPERTIES
CODE
DT (33999-4, LN, "Status")
1
U
D
28
>>
CONTAINS
CODE
DT (111516, DCM, "Medication Type")
1-n
U
29
>>>
HAS PROPERTIES
NUM
DT (260911001, SCT, "Dosage")
1
U
30
>>>
HAS PROPERTIES
CODE
DT (33999-4, LN, "Status")
1
U
D
31
>
CONTAINS
CONTAINER
DT (10157-6, LN, "History of Family Member Diseases")
1
U
32
>>
CONTAINS
TEXT
EV (11329-0, LN, "History")
1-n
U
33
>>
CONTAINS
CODE
EV (416471007, SCT, "Family history of clinical finding")
1-n
U
D
34
>>>
HAS PROPERTIES
CODE
EV (408732007, SCT, "Subject relationship")
1
M
D
35
>
CONTAINS
CONTAINER
DT (46264-8, LN, "History of medical device use")
1
U
36
>>
CONTAINS
TEXT
EV (11329-0, LN, "History")
1
U
37
>>
CONTAINS
INCLUDE
D
1-n
U
$Device = D
Patient Presentation, CathThis Template describes the aspects of the patient that are specific to this clinical presentation (admission).Type:ExtensibleOrder:SignificantRoot:No
Patient Presentation, Cath
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (55108-5, LN, "Patient Presentation")
1
M
2
>
CONTAINS
TEXT
EV (122128, DCM, "Patient Transferred From")
1
U
3
>
CONTAINS
DATETIME
EV (15, NCDR [2.0b], "Admission DateTime")
1
U
4
>
CONTAINS
CODE
EV (17, NCDR [2.0b], "Admission Status")
1
U
D
5
>
CONTAINS
CODE
EV (18, NCDR [2.0b], "Insurance Payor Type")
1
U
D
6
>
CONTAINS
CODE
EV (46, NCDR [2.0b], "Congestive Heart Failure Prior to Procedure")
1
U
D
7
>
CONTAINS
CODE
EV (47, NCDR [2.0b], "NYHA Classification")
1
UC
IFF Row 6 Value code meaning is <yes>
D
8
>
CONTAINS
CODE
EV (48, NCDR [2.0b], "Noninvasive Testing - Ischemia")
1
U
D
9
>
CONTAINS
CODE
EV (49, NCDR [2.0b], "Pre-Cath Angina Type")
1
U
D
10
>
CONTAINS
CODE
EV (50, NCDR [2.0b], "Pre-Cath Canadian Classification")
1
U
D
11
>
CONTAINS
CODE
EV (51, NCDR [2.0b], "Acute Coronary Syndrome Time Period")
1
UC
IFF Row 9 Value code meaning is <ACS>
D
12
>
CONTAINS
INCLUDE
D
1
U
$Findings = D
14
>
CONTAINS
NUM
EV (10230-1, LN, "LV Ejection Fraction")
1-n
U
UNITS = EV (%, UCUM, "%")
15
>>
HAS CONCEPT MOD
CODE
EV (370129005, SCT, "Measurement method")
1
U
D
16
>>
INCLUDE
D
1
U
17
>
CONTAINS
CODE
EV (121069, DCM, "Previous Finding")
1-n
U
D
18
>
CONTAINS
TEXT
EV (55108-5, LN, "Patient Presentation")
1
U
Cath ProcedureThis Template describes the patient-related information about this specific clinical encounter (catheterization).Type:ExtensibleOrder:SignificantRoot:No
Cath Procedure
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (55111-9, LN, "Current Procedure Descriptions")
1
M
2
>
CONTAINS
DATETIME
EV (122146, DCM, "Procedure DateTime")
1
M
3
>
CONTAINS
TEXT
EV (53, NCDR [2.0b], "Procedure Number in this admission")
1
U
Up to three numeric characters
4
>
CONTAINS
TEXT
EV (121065, DCM, "Procedure Description")
1
U
5
>
CONTAINS
COMPOSITE
EV (121120, DCM, "Cath Lab Procedure Log")
1-n
U
6
>
CONTAINS
NUM
EV (55, NCDR [2.0b], "Fluoroscopy Time")
1
U
UNITS = DT (min, UCUM, "min")
7
>
CONTAINS
NUM
EV (122130, DCM, "Dose Area Product")
1
U
UNITS = DT (mGy.cm2, UCUM, "mGy.cm2")
8
>
CONTAINS
PNAME
EV (76, NCDR [2.0b], "Catheterization Operator")
1
M
9
>
CONTAINS
PNAME
EV (121088, DCM, "Fellow")
1-n
U
10
>
CONTAINS
PNAME
B
1-n
U
11
>
CONTAINS
CODE
EV (122129, DCM, "PCI during this procedure")
1
U
D
12
>
CONTAINS
CONTAINER
EV (182833002, SCT, "Medication Given")
1
M
13
>>
CONTAINS
CODE
EV (57, NCDR [2.0b], "Thrombolytics")
1
U
D
14
>>
CONTAINS
CODE
EV (58, NCDR [2.0b], "IIb/IIIa Blockade")
1
U
D
15
>>
CONTAINS
CODE
EV (59, NCDR [2.0b], "Heparin")
1-n
U
D
16
>>
CONTAINS
CODE
EV (60, NCDR [2.0b], "Aspirin")
1
U
D
17
>>
CONTAINS
CODE
EV (61, NCDR [2.0b], "Clopidogrel/Ticlopidine")
1
U
D
18
>>
CONTAINS
TEXT
EV (122083, DCM, "Drug administered")
1-n
U
19
>
CONTAINS
CODE
EV (122138, DCM, "Circulatory Support")
1-n
U
D
20
>
CONTAINS
CODE
EV (74, NCDR [2.0b], "Percutaneous Entry Site")
1
M
D
21
>
CONTAINS
CODE
EV (75, NCDR [2.0b], "Closure Device")
1
U
D
Content Item Descriptions
Row 2
The Concept Name was previously defined as (52, NCDR [2.0b], "Procedure DateTime").
Row 3
Procedure Number (this admission) is specified as a numeric text string, and shall be treated as the ordinal of this catheterization procedure within the admission (i.e., "1" for the first catheterization, "2" for the second, etc.).
Percutaneous Coronary Intervention ProcedureThis Template describes the various aspects of a coronary intervention.Type:ExtensibleOrder:SignificantRoot:No
Percutaneous Coronary Intervention Procedure
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (55111-9, LN, "Current Procedure Descriptions")
EV (122178, DCM, "Lesion Intervention Information")
1
M
2
>
CONTAINS
INCLUDE
D
1
M
3
>
CONTAINS
CODE
EV (108, NDR [2.0b], "Previous Dilation")
1
U
D
4
>
CONTAINS
CODE
EV (103, NDR [2.0b], "Guidewire crossing lesion")
1
U
D
5
>
CONTAINS
CODE
EV (116682006, SCT, "Uses Equipment")
1-n
M
D
6
>>
HAS CONCEPT MOD
CODE
EV (122111, DCM, "Primary Intervention Device")
1
MC
IF Device is Primary for this Lesion
D
7
>>
HAS PROPERTIES
TEXT
EV (121145, DCM, "Description of Material")
1
U
8
>>
HAS PROPERTIES
NUM
D
1-n
U
9
>>
HAS PROPERTIES
NUM
D
1-n
U
10
>>
HAS PROPERTIES
DATETIME
EV (122105, DCM, "DateTime of Intervention")
1
U
11
>>
HAS PROPERTIES
NUM
EV (122106, DCM, "Duration of Intervention")
1
U
UNITS = EV (s, UCUM, "s")
12
>
CONTAINS
NUM
EV (408715008, SCT, "Lumen Diameter Stenosis")
1
M
UNITS = EV (%, UCUM, "%")
13
>>
HAS CONCEPT MOD
CODE
EV (129085009, SCT, "Catheterization Procedure Phase")
1
M
EV (128960007, SCT, "Post-intervention Phase")
14
>>
HAS CONCEPT MOD
CODE
EV (121401, DCM, "Derivation")
1
U
D
15
>>
INCLUDE
D
1
U
16
>
CONTAINS
CODE
EV (122110, DCM, "Post- Intervention TIMI Flow")
1
U
D
17
>
CONTAINS
CODE
EV (115, NCDR [2.0b], "Dissection in segment observed")
1
U
D
18
>
CONTAINS
CODE
EV (116, NCDR [2.0b], "Acute closure observed")
1
U
D
19
>
CONTAINS
CODE
EV (117, NCDR [2.0b], "Acute closure re-opened")
1
UC
IFF Row 18 value is <yes>
D
20
>
CONTAINS
CODE
EV (118, NCDR [2.0b], "Perforation occurred")
1
U
D
21
>
CONTAINS
IMAGE
DT (121080, DCM, "Best illustration of finding")
1
U
22
>
CONTAINS
TEXT
DT (122177, DCM, "Procedure Result")
1
U
Other Interventional ProceduresType:ExtensibleOrder:SignificantRoot:No
Other Interventional Procedures
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINER
EV (55111-9, LN, "Current Procedure Descriptions")
1
M
2
>
HAS CONCEPT MOD
CODE
EV (121058, DCM, "Procedure reported")
1
M
B
3
>
CONTAINS
TEXT
EV (121065, DCM, "Procedure Description")
1
U
4
>
CONTAINS
CODE
DT (121065, DCM, "Procedure Description")
1
U
5
>
CONTAINS
TEXT
DT (122177, DCM, "Procedure Result")
1
U
Content Item Descriptions
Rows 3, 4
Allow the recording of procedure description as either code or as text; the same description shall not be recorded as both.
Cardiac Catheterization FindingsThe Cardiac Catheterization Findings Template provides the structure for the diagnostic findings of the cath procedure, organized into sub-sections based on type of sub-procedure. It also provides for top-level summary findings and diagnoses.Type:ExtensibleOrder:SignificantRoot:No
Cardiac Catheterization Findings
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (59776-5, LN, "Findings")
1
M
2
>
CONTAINS
INCLUDE
D
1
U
3
>
CONTAINS
INCLUDE
D
1
U
4
>
CONTAINS
INCLUDE
D
1
U
5
>
CONTAINS
INCLUDE
D
1
U
6
>
CONTAINS
INCLUDE
D
1-n
U
7
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1-n
U
D
8
>>
HAS PROPERTIES
CODE
EV (246112005, SCT, "Severity")
1
U
D
9
>
CONTAINS
TEXT
EV (121071, DCM, "Finding")
1-n
U
Content Item Descriptions
Rows 7, 9
Allow the recording of findings as either codes or as text; the same finding shall not be recorded as both.
EV (413985002, SCT, "Diastolic pressure equalization")
9
>
CONTAINS
INCLUDE
D
1-n
U
$Report = DT (122120, DCM, "Hemodynamics Report")
Content Item Descriptions
Row 4
(Through ) may be used to encode any significant hemodynamic numeric measurements. For reference, see and .
Left Ventriculography FindingsThe information contained here about the left ventricle is relatively qualitative in nature. It is a high-level summary of the more detailed information that may be contained in an optional Quantitative Ventricular Analysis report. This Template addresses findings about any ventricular septal defect (Row 7), the myocardial wall (Row 11), and about the aortic root (Row 16).Type:ExtensibleOrder:SignificantRoot:No
Left Ventriculography Findings
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (59776-5, LN, "Findings")
1
M
2
>
HAS CONCEPT MOD
CODE
EV (121058, DCM, "Procedure reported")
1
M
DT (265484009, SCT, "Left Ventriculography")
3
>
CONTAINS
CODE
EV (366188009, SCT, "Left Ventricular Function - Finding")
1
M
D
4
>
INCLUDE
D
1
M
$Measurement = EV (10230-1, LN, "LV Ejection Fraction")
$Units = EV (%, UCUM, "%")$Method = D$Derivation = D
5
>
CONTAINS
CODE
EV (250929008, SCT, "Left Ventricular Cavity Size")
1
U
D
6
>
CONTAINS
CODE
EV (250909007, SCT, "Left Ventricular Contractility")
1
U
D
7
>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1
U
EV (30288003, SCT, "Ventricular Septal Defect")
8
>>
HAS PROPERTIES
CODE
EV (116676008, SCT, "Associated Morphology")
1
U
D
9
>
CONTAINS
INCLUDE
D
1
U
10
>
CONTAINS
CONTAINER
EV (59776-5, LN, "Findings")
1
U
11
>>
HAS CONCEPT MOD
CODE
EV (363698007, SCT, "Finding Site")
1
M
DT (272657006, SCT, "Myocardial Wall")
12
>>
CONTAINS
CODE
EV (18179-2, LN, "Wall Segment")
1-n
M
B
13
>>>
HAS PROPERTIES
CODE
EV (60797005, SCT, "Cardiac Wall Motion")
1
M
D
14
>>>
HAS PROPERTIES
CODE
EV (116676008, SCT, "Associated Morphology")
1
U
D
15
>>>
HAS PROPERTIES
NUM
DT (246262008, SCT, "Score")
1
U
16
>
CONTAINS
CONTAINER
EV (59776-5, LN, "Findings")
1
U
17
>>
HAS CONCEPT MOD
CODE
EV (363698007, SCT, "Finding Site")
1
M
DT (364091008, SCT, "Aortic Root")
18
>>
CONTAINS
CODE
EV (121071, DCM, "Finding")
1-n
M
D
Right Ventriculography FindingsThe information contained here about right ventricle is relatively qualitative in nature. It is a high-level summary of the more detailed information that may be contained in an optional Quantitative Ventricular Analysis report.Type:ExtensibleOrder:SignificantRoot:No
Right Ventriculography Findings
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (59776-5, LN, "Findings")
1
M
2
>
HAS CONCEPT MOD
CODE
EV (121058, DCM, "Procedure reported")
1
M
DT (265483003, SCT, "Right Ventriculography")
3
>
INCLUDE
D
1
M
$Measurement = EV (10231-9, LN, "RV Ejection Fraction")
$Units = EV (%, UCUM, "%")$Method = D$Derivation = D
4
>
CONTAINS
CODE
EV (250964004, SCT, "Right Ventricular Cavity Size")
1
U
D
5
>
CONTAINS
CODE
EV (250949004, SCT, "Right Ventricular Contractility")
Coronary Arteriography FindingsThe information contained here about with regards to coronary artery lesions is relatively qualitative in nature. It is a high-level summary of the more detailed information that may be contained in an optional Quantitative Coronary Arteriography report. This Template addresses findings about the individual arteries (Row 4), and about individual lesions (Row 9).Type:ExtensibleOrder:SignificantRoot:No
Other Cardiographic FindingsType:ExtensibleOrder:SignificantRoot:No
Other Cardiographic Findings
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
CONTAINS
CONTAINER
EV (59776-5, LN, "Findings")
1
M
2
>
HAS CONCEPT MOD
CODE
EV (121058, DCM, "Procedure reported")
1
M
B
3
>
HAS CONCEPT MOD
CODE
EV (363698007, SCT, "Finding Site")
1
U
B
4
>
CONTAINS
INCLUDE
D
1-n
M
Common Findings
Parameters
Parameter Name
Parameter Usage
$Report
Title of composite object (evidence document) referenced
Type:ExtensibleOrder:SignificantRoot:No
Common Findings
NL
Rel with Parent
VT
Concept Name
VM
Req Type
Condition
Value Set Constraint
1
TEXT
EV (121071, DCM, "Finding")
1
U
2
IMAGE
DT (121080, DCM, "Best illustration of finding")
1
U
3
NUM
1
U
4
>
INCLUDE
D
1
U
5
COMPOSITE
DT (122073, DCM, "Current procedure evidence")
1
U
6
>
HAS PROPERTIES
CODE
EV (121144, DCM, "Document Title")
1
U
$Report
Content Item Descriptions
Row 3
May be used to encode any significant image- or waveform-based numeric measurements, with post-coordination of the Concept Name using child Content Items (with relationship HAS CONCEPT MOD), as permitted by . The source of the measurement may be noted using the Quotation Template in Row 4.