Any implementation that claims conformance to this Security Profile shall obey the following rules when creating a Structured Report or Key Object Selection Document that includes Digital Signatures:
When the implementation signs a Structured Report or Key Object Selection Document SOP Instance the Digital Signatures shall be created in accordance with the Structured Report RSA Digital Signature Profile.
In every signed Structured Report or Key Object Selection Document SOP Instance created, all referenced SOP Instances listed in the Referenced SOP Sequence Items of the Current Requested Procedure Evidence Sequence (0040,A375) and Pertinent Other Evidence Sequence (0040,A385) shall include either a Referenced Digital Signature Sequence or a Referenced SOP Instance MAC Sequence. The references may include both.
The implementation claiming conformance shall outline in its conformance statement the conditions under which it will either sign or not sign a Structured Report or Key Object Selection Document.