Annex A Structured Reporting Templates (Normative)

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

General Templates

TID 300 Measurement

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

TID 300 Parameters

Parameter Name Parameter Usage
$Measurement Coded term or Context Group for Concept Name of measurement
$Units Units of 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 ModifierValue 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

TID 300 MeasurementType: Extensible Order: Significant

NL
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 16 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.

TID 310 Measurement Properties

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

TID 310 Parameters

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

TID 310Measurement PropertiesType: Extensible Order: Significant

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

TID 311 Measurement Statistical Properties

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

TID 311 Parameters

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

TID 311 Measurement Statistical Properties Type: Extensible Order: Significant

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

TID 312 Normal Range Properties

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

TID 312 Parameters

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

TID 312Normal Range PropertiesType: Extensible Order: Significant

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

TID 315 Equation or Table

TID 315 Parameters

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

TID 315 Equation or TableType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE DCID (228) Equation or Table 1 M $Equation
2 > HAS PROPERTIES NUM 1-n U
3 > R-HAS PROPERTIES NUM 1-n U

Content Item Descriptions

Row 2 - The HAS PROPERTIES allows the specification of the numeric values used as input to the equation or table identified in Row 1.

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

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

TID 320 Image or Spatial Coordinates

This Template provides a general structure for inference from an image, either as a whole, or with specific 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.

TID 320 Parameters

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

TID 320 Image or Spatial Coordinates Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 INFERRED FROM IMAGE $Purpose 1 MC XOR Rows 2, 3
2 R-INFERRED FROM IMAGE 1 MC XOR Rows 1, 3
3 INFERRED FROM SCOORD $Purpose 1 MC XOR Rows 1, 2
4 > SELECTED FROM IMAGE 1 MC XOR Row 5
5 > R-SELECTED FROM IMAGE 1 MC XOR Row 4

TID 321 Waveform or Temporal Coordinates

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

TID 321 Parameters

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

TID 321 Waveform or Temporal Coordinates Type: Extensible Order: Significant

NL Relation with Parent Value Type 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

TID 350 References to Supporting Evidence

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

TID 350 REFERENCES TO SUPPORTING EVIDENCE

Type: Non-Extensible Order: Significant

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

Content Item Descriptions

Row 2 Concept Name may be the Root Concept Name (title) of a Structured Report composite object instance.

TID 1000 Quotation

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

This template establishes a mechanism for quoting by specifying:

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

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

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

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

TID 1000 QUOTATION Type: Extensible Order: Significant

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 DTID (1001) "Observation Context" 1 M

TID 1001 Observation Context

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

This includes attributes that specify:

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).

TID 1001 OBSERVATION CONTEXT Type: Non-Extensible Order: Significant

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

TID 1002 Observer Context

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

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

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

TID 1002 OBSERVER CONTEXT Type: Non-Extensible Order: Significant

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 DCID (270) Observer Type Defaults to (121006,DCM, “Person”)
2 HAS OBS CONTEXT INCLUDE DTID (1003) Person observer identifying attributes 1 MC IFF Row 1 value = (121006,DCM, “Person”) or Row 1 is absent
3 HAS OBS CONTEXT INCLUDE DTID (1004) Device observer identifying attributes 1 MC IFF Row 1 value = (121007,DCM, “Device”)

TID 1003 Person Observer Identifying Attributes

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

TID 1003PERSON OBSERVER IDENTIFYING ATTRIBUTESType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 PNAME EV (121008,DCM, “Person Observer Name”) 1 M
2 TEXT EV (121009,DCM, “Person Observer’s Organization Name”) 1 U Defaults to Institution Name (0008,0080) of the General Equipment Module
3 CODE EV (121010,DCM, “Person Observer’s Role in the Organization”) 1 U BCID(7452) Organizational Roles
4 CODE EV (121011,DCM, “Person Observer’s Role in this Procedure”) 1 U BCID(7453) Performing Roles

TID 1004 Device Observer Identifying Attributes

This template (derived from the DICOM General Equipment Module of PS3.3) contains identifying (and optionally descriptive) attributes of devices that are observers.

TID 1004DEVICE OBSERVER IDENTIFYING ATTRIBUTESType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 UIDREF EV (121012,DCM, “Device Observer UID”) 1 M
2 TEXT EV (121013,DCM, “Device Observer Name”) 1 U Defaults to value of Station Name (0008,1010) in General Equipment Module
3 TEXT EV (121014,DCM, “Device Observer Manufacturer”) 1 U Defaults to value of Manufacturer (0008,0070) in General Equipment Module
4 TEXT EV (121015,DCM, “Device Observer Model Name”) 1 U Defaults to value of Manufacturer’s Model Name (0008,1090) in General Equipment Module
5 TEXT EV (121016,DCM, “Device Observer Serial Number”) 1 U Defaults to value of Device Serial Number (0018,1000) in General Equipment Module
6 TEXT EV (121017,DCM, “Device Observer Physical Location during observation”) 1 U
7 CODE EV (113876, DCM, “Device Role in Procedure”) 1-n U BCID (7445) Device Participating Roles

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.

TID 1005 Procedure Context

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

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

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

TID 1005 PROCEDURE CONTEXT Type: Non-Extensible Order: Significant

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 Study Instance UID (0020,000D ) of General Study Module
2 UIDREF EV (121019,DCM, “Procedure Study Component UID”) 1-n U
3 TEXT EV (121020,DCM, “Placer Number”) 1 U
4 > HAS CONCEPT MOD TEXT EV (110190,DCM, “Issuer of Identifier” 1 U See note
5 TEXT EV (121021,DCM, “Filler Number”) 1 U
6 > HAS CONCEPT MOD TEXT EV (110190,DCM, “Issuer of Identifier” 1 U See note
7 TEXT EV(121022,DCM,” Accession Number”) 1 U Defaults to (0008,0050)
8 > HAS CONCEPT MOD TEXT EV (110190,DCM, “Issuer of Identifier” 1 U See note
9 CODE EV(121023,DCM, ”Procedure Code”) 1-n U Defaults to Procedure Code Sequence (0008,1032) of General Study Module

Content Item Descriptions

Rows 4, 6, 8 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 ID identifies an entity within the local namespace or domain, Universal ID is a universal or unique identifier for an entity, and Universal ID Type specifies the standard format of the Universal ID (see HL7 v2 Section 2.A.33).

TID 1006 Subject Context

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

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

TID 1006SUBJECT CONTEXTType: Non-Extensible Order: Significant

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 DCID (271) Observation Subject Class Defaults to (121025, DCM, "Patient”)
2 INCLUDE DTID (1007) Subject Context, Patient 1 UC IFF Row 1 value = (121025,DCM, "Patient") or Row 1 is absent May be used for human or animal patients
3 INCLUDE DTID (1008) Subject Context, Fetus 1 UC IFF Row 1 value = (121026,DCM, "Fetus") May be used for human or animal fetuses
4 INCLUDE DTID (1009) Subject Context, Specimen 1 UC IFF Row 1 value = (121027, DCM, “Specimen”)
5 INCLUDE DTID (1010) Subject Context, Device 1 UC IFF Row 1 value = (121192, DCM, “Device Subject”)

TID 1007 Subject Context, Patient

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

TID 1007 SUBJECT CONTEXT, PATIENT Type: Extensible Order: Significant

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) in Patient Module
3 CODE EV (121030,DCM, "Subject ID”) 1 MC Required if not inherited. Defaults to value of Patient ID (0010,0020) in Patient Module
4 DATE EV (121031,DCM, "Subject Birth Date”) 1 U Defaults to value of Patient’s Birth Date (0010,0030) in Patient Module
5 CODE EV (121032,DCM, "Subject Sex”) 1 U Defaults to value equivalent to Patient’s Sex (0010,0040) in Patient Module DCID (7455) Sex
6 NUM EV (121033,DCM, "Subject Age”) 1 U Defaults to value of Patient’s Age (0010,1010) in Patient Study Module Units DCID (7456) Units of Measure for Age
7 CODE EV (121034,DCM, "Subject Species”) 1 MC Required if not inherited. DCID (7454) Species to define various animals or plants, e.g. veterinary or research. Defaults to (L-85B00, SRT,”homo sapiens”).
8 CODE EV (121035,DCM, “Subject Breed”) 1 U Defaults to value of Patient Breed Code Sequence (0010,2293) in General Patient Module DCID (7480)

TID 1008 Subject Context, Fetus

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

TID 1008 SUBJECT CONTEXT, FETUSType: Extensible Order: Significant

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 For longitudinal tracking of individual fetuses
3 TEXT EV (121030,DCM, "Subject ID”) 1 MC IF row 4 is absent For longitudinal tracking of individual fetuses (human readable value e.g. “A” or “1”)
4 TEXT EV (11951-1,LN, "Fetus ID”) 1 MC IF row 3 is absent For separation of multiple fetuses during this procedure e.g. fetus ‘1” of ‘2” … not for longitudinal comparisons.; ie. the “m” of fetus “m” of “n”
5 NUM EV (11878-6,LN, "Number of Fetuses”) 1 U i.e. the “n” of fetus “m” of “n” Units EV (1,UCUM,”no units”)

TID 1009 Subject Context, Specimen

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

TID 1009 SUBJECT CONTEXT, SPECIMENType: Extensible Order: Significant

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 DTID (1007) "patient subject context" 1 UC IFF the source of the specimen is a human or animal patient
3 TEXT EV (121041,DCM, "Specimen Identifier”) 1 U
4 TEXT EV (111724, DCM, “Issuer of Specimen Identifier”) 1 U See content item descriptions
5 CODE EV (-00254,SRT, "Specimen Type”) 1 U DCID (8103) Anatomic Pathology Specimen Types
6 TEXT EV (111700,DCM, "Specimen Container Identifier”) 1 U

Content Item Descriptions

Row 4 The Issuer of Specimen Identifier shall be formatted in accordance with the HL7 v2 Hierarchic Designator data type (see HL7 v2.6 Section 2.A.33), i.e., [Namespace ID]^[Universal ID^Universal ID Type]

TID 1010 Subject Context, Device

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

TID 1010 SUBJECT CONTEXT, DEVICE Type: Extensible Order: Significant

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

TID 1020 Person Participant

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

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

TID 1020 Parameters

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

TID 1020 PERSON PARTICIPANT Type: Extensible Order: Significant

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 BCID (7452) Organizational Roles

Content Item Descriptions

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

TID 1021 Device Participant

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

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

TID 1021 Parameters

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

TID 1021 DEVICE PARTICIPANT Type: Extensible Order: Significant

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, BCID (7445) Device Participating Roles may be used.
Row 2 This may be used for the name by which the organization manages the device.

TID 1200 Language Designation

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

Notes: 1. For example, the French language could be specified unmodified, or French as written in France or Canada could be distinguished.

2. The language codes specified in CID 5000 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 editions of the Standard.

TID 1200LANGUAGE DESIGNATIONType: Extensible Order: Significant

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

TID 1201 Language of Value

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

Note: The language codes specified in CID 5000 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 editions of the Standard.

TID 1201LANGUAGE OF VALUEType: Non-Extensible Order: Significant

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

TID 1202 Language of Name and Value

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

Note: The language codes specified in CID 5000 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 editions of the Standard.

TID 1202LANGUAGE OF NAME AND VALUEType: Extensible Order: Significant

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

TID 1204 Language of Content Item and Descendants

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

Note: The language codes specified in CID 5000 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 editions of the Standard.

TID 1204LANGUAGE OF CONTENT ITEM AND DESCENDANTSType: Non-Extensible Order: Significant

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

TID 1210 Equivalent Meaning(s) of Concept Name

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

TID 1210EQUIVALENT MEANING(S) OF CONCEPT NAMEType: Non-Extensible Order: Significant

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

TID 1211 Equivalent Meaning(s) of Value

Defines a mechanism for specifying one or more equivalent meanings for the Value of the parent content item.

TID 1211EQUIVALENT MEANING(S) OF VALUEType: Extensible Order: Significant

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

Notes. 1. 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”

2. For example, to specify a concept name and value in both French and English in Canada:

CODE:(T-D0005,SRT,“Anatomical structure”)=(T-04000,SRT,”Breast”)

> Has Concept Mod CODE:(121048,DCM,“Language of name and value”)=(en-CA,RFC3066,”English, Canada”)

> Has Concept Mod CODE: (121050,DCM,“Equivalent meaning of concept name”)=(T-D0005,SRT,“Structure de l’anatomie”)

>> Has Concept Mod CODE: (121047,DCM,“Langue de la valeur”)=(fr-CA,RFC3066,”Français, Canadie”)

> Has Concept Mod CODE: (121051,DCM,“Equivalent meaning of value”)=(T-04000,SRT,”Sein”)

>> Has Concept Mod CODE: (121047,DCM,“Langue de la valeur”)=(fr-CA,RFC3066,”Français, Canadie”)

TID 1350 Negation Modifier, Presence of Finding

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

Notes. 1. For example, negation modifier applied to "sclera" 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”

2. 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.

TID 1350NEGATION MODIFIER, PRESENCE OF FINDINGType: Extensible Order: Significant

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

TID 1400 Linear Measurement Template

TID 1400 LINEAR MEASUREMENTType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM DCID (7470) “Linear Measurements” 1 M UNITS = DCID(7460) “Units of Linear Measurement”
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

Content Item Descriptions

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

TID 1401 Area Measurement Template

TID 1401 AREA MEASUREMENTType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM DCID(7471) “Area Measurements” 1 M Value shall be > 0 UNITS = DCID(7461) “Units of Area Measurement”
2 > INFERRED FROM SCOORD EV (121056,DCM, “Area Outline”) 1 MC IF concept name of Row 1 is (G-A16A,SRT, “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 is (G-A16A, SRT, “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 is (G-A16A, SRT, “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 (G-C036, SRT, “Measurement Method") 1 U DCID (7473) General Area Calculation Methods

Content Item Descriptions

Row 2 “Area Outline” 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.

TID 1402 Volume Measurement Template

TID 1402 VOLUME MEASUREMENTType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM DCID(7472) “Volume Measurements” 1 M Value shall be > 0 UNITS = DCID(7462) “Units of Volume Measurement”
2 > INFERRED FROM SCOORD EV (121057,DCM, “Perimeter Outline”) 1-n UC XOR row 5, 6 GRAPHIC TYPE = not {MULTIPOINT}
3 >> R-SELECTED FROM IMAGE 1 MC XOR Row 4
4 >> SELECTED FROM IMAGE 1 MC XOR Row 3
5 > INFERRED FROM IMAGE EV (121191, DCM, “Referenced Segment”) 1 UC XOR row 2, 6 Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number
6 > R- INFERRED FROM IMAGE 1 UC XOR row 2, 5 Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number
7 > HAS PROPERTIES CODE EV (G-C036, SRT, “Measurement Method") 1 U DCID (7474) General Volume Calculation Methods

Content Item Descriptions

Row 2 “Perimeter Outline” 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.

TID 1404 Numeric Measurement Template

TID 1404 NUMERIC MEASUREMENTType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM No baseline CID 1 M Units = DCID (82) Units of Measurement
2 > INFERRED FROM SCOORD No baseline CID 1-n UC XOR Row 5, 6
3 >> R-SELECTED FROM IMAGE 1 MC XOR Row 4
4 >> SELECTED FROM IMAGE 1 MC XOR Row 3
5 > R-INFERRED FROM IMAGE BCID (7003) Diagnostic Imaging Report Purposes of Reference 1-n UC XOR Row 2,6
6 > INFERRED FROM IMAGE BCID (7003) Diagnostic Imaging Report Purposes of Reference 1-n UC XOR Row 2,5

Content Item Descriptions

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

TID 1406 3D Linear Measurement Template

TID 14063D LINEAR MEASUREMENTType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM DCID (7470) Linear Measurements 1 M UNITS = DCID (7460) Units of Linear Measurement
2 > INFERRED FROM SCOORD3D EV (121055,DCM, “Path”) 1 M GRAPHIC TYPE = {POLYLINE, ELLIPSE, POLYGON}

Content Item Descriptions

Row 2 “Path” Path shall represent the measured path in a reference coordinate space. The Graphic Type (0070,0023) of the Path SCOORD3D shall be: an open POLYLINE with two or more different (x,y,z) triplets (to measure length, diameter, distance, proximity, etc.), an ELLIPSE (to measure circumference) or A closed POLYGON to measure perimeter, where the (x,y,z) triplets are coplanar.

TID 2000 Basic Diagnostic Imaging Report

Basic report template for general diagnostic imaging interpretation reports.

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

TID 2000BASIC DIAGNOSTIC IMAGING REPORTType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER BCID(7000) Diagnostic Imaging Report Document Titles 1 M Root node
2 > HAS CONCEPT MOD CODE EV (121058,DCM,”Procedure reported”) 1-n U
3 > HAS CONCEPT MOD INCLUDE DTID(1204) Language of Content Item and Descendants 1 M
4 > HAS CONCEPT MOD INCLUDE DTID (1210) Equivalent Meaning of Concept Name 1-n U
5 > HAS OBS CONTEXT INCLUDE DTID(1001) Observation Context 1 M
6 > CONTAINS CONTAINER BCID(7001) Diagnostic Imaging Report Headings 1-n U
7 >> HAS OBS CONTEXT INCLUDE DTID(1001) Observation Context 1 U
8 >> INCLUDE DTID (2002) Report Narrative 1 M

No content items other than those defined in Observation Context TID 1001 may be the target of a HAS OBS CONTEXT relationship when TID 2000 is invoked.

TID 2001 Basic Diagnostic Imaging Report Observations

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

TID 2001BASIC DIAGNOSTIC IMAGING REPORT OBSERVATIONSType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 IMAGE BCID(7003) Diagnostic Imaging Report Purposes of Reference 1 MC XOR Rows 2,3,4,5.
2 INCLUDE TID(1400) Linear Measurements 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 TID(1401) Area Measurements 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 TID(1402) Volume Measurements 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 TID (1404) Numeric Measurements 1 MC XOR Rows 1,2,3,4. Shall not be present if the NUM value type is not supported by the IOD.

TID 2002 Report Narrative

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

TID 2002 REPORT NARRATIVE Type: Non-Extensible Order: Non-Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CODE BCID (7002) Diagnostic Imaging Report Elements 1-n U
2 > INFERRED FROM INCLUDE DTID (2001)Basic Diagnostic Imaging Report Observations 1-n U
3 CONTAINS TEXT BCID (7002) Diagnostic Imaging Report Elements 1-n U
4 > INFERRED FROM INCLUDE DTID (2001)Basic Diagnostic Imaging Report Observations 1-n U
5 CONTAINS INCLUDE DTID (2001)Basic Diagnostic Imaging Report Observations 1-n U

TID 2005 Transcribed Diagnostic Imaging Report

Basic report template for general diagnostic imaging interpretation reports produced in a dictation/transcription workflow. SR documents encoded using this template are intended to be transformable to HL7 Clinical Document Architecture format (see PS3.17).

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

Note: See Section on Observation Context Encoding in PS3.3

TID 2005TRANSCRIBED DIAGNOSTIC IMAGING REPORTType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER BCID (7000) Diagnostic Imaging Report Document Titles 1 M
2 > HAS CONCEPT MOD CODE EV (121049, DCM, ”Language of Content Item and Descendants”) 1 M DCID (5000) Language
3 > CONTAINS CONTAINER BCID (7001) Diagnostic Imaging Report Headings 1-n M
4 >> CONTAINS TEXT BCID (7002) Diagnostic Imaging Report Elements 1 U
5 > CONTAINS CONTAINER EV (121180, DCM, “Key Images”) 1-n U
6 >> CONTAINS TEXT EV (113012, DCM, ”Key Object Description”) 1 U
7 >> CONTAINS IMAGE Purpose of Reference is not used 1-n M

Content Item Descriptions

Row 3 CONTAINER Concept Name may be absent.

Row 7 IMAGE Concept Name shall be absent.

TID 2010 Key Object Selection

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

Notes: 1. For instance, when this template is used to identify images rejected for quality reasons, the device or person performing the quality assessment is identified in observation context items (invoked through TID 1002). The reason for rejection can be included both as a code used as a concept modifier for the document title, and as text description.

2. The order of object references may be significant, e.g., when the title concept is "For Conference".

3. Instances referenced in a Key Object Selection Document may be securely referenced by Digital Signature or MAC mechanisms within the SR Document General Module (See PS 3.3).

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

TID 2010KEY OBJECT SELECTIONType: Non-Extensible Order: Non-Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DCID(7010) Key Object Selection Document Titles 1 M Root node
2 > HAS CONCEPT MOD CODE EV (113011, DCM, "Document Title Modifier") 1-n U
3 > HAS CONCEPT MOD CODE EV (113011, DCM, "Document Title Modifier") 1 UC IF Row 1 Concept Name = (113001, DCM, "Rejected for Quality Reasons") or (113010, DCM," Quality Issue") DCID (7011)
4 > HAS CONCEPT MOD CODE EV (113011, DCM, "Document Title Modifier") 1 MC IF Row 1 Concept Name = (113013, DCM, "Best In Set") DCID (7012)
5 > HAS CONCEPT MOD INCLUDE DTID(1204) Language of Content Item and Descendants 1 U
6 > HAS OBS CONTEXT INCLUDE DTID(1002) Observer Context 1-n U
7 > CONTAINS TEXT EV(113012, DCM, ”Key Object Description”) 1 U
8 > CONTAINS IMAGE Purpose of Reference shall not be present 1-n MC At least one of Rows 8, 9 and 10 shall be present
9 > CONTAINS WAVEFORM Purpose of Reference shall not be present 1-n MC At least one of Rows 8, 9 and 10 shall be present
10 > CONTAINS COMPOSITE Purpose of Reference shall not be present 1-n MC At least one of Rows 8, 9 and 10 shall be present

TID 2020 Template for Spectacle Prescription Report Root Template

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

TID 2020 Spectacle Prescription Report Type: Extensible Order: Significant

NL
$Laterality Which eye

TID 2101 Macular Grid Thickness and Volume Measurement Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070,DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M EV (T-AA000, SRT, “Eye”)
3 >> HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality”) 1 M $Laterality
4 > CONTAINS NUM EV (57108-3, LN, “Macular Grid.Center Point Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
5 > CONTAINS NUM EV (57109-1, LN, “Macular Grid.Center Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
6 > CONTAINS NUM EV (57110-9, LN, “Macular Grid.Inner Superior Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
7 > CONTAINS NUM EV (57111-7, LN, “Macular Grid.Inner Nasal Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
8 > CONTAINS NUM EV (57112-5, LN, “Macular Grid.Inner Inferior Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
9 > CONTAINS NUM EV (57113-3, LN, “Macular Grid.Inner Temporal Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
10 > CONTAINS NUM EV (57114-1, LN, “Macular Grid.Outer Superior Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
11 > CONTAINS NUM EV (57115-8, LN, “Macular Grid.Outer Nasal Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
12 > CONTAINS NUM EV (57116-6, LN, “Macular Grid.Outer Inferior Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
13 > CONTAINS NUM EV (57117-4, LN, “Macular Grid.Outer Temporal Subfield Thickness”) 1 M UNITS=EV(um, UCUM, “micrometer”)
14 > CONTAINS NUM EV (57118-2, LN, “Macular Grid.Total Volume”) 1 M UNITS=EV(mm3, UCUM, “mm3”)
15 > CONTAINS NUM EV (111691, DCM, “Number of Images Used for Macular Measurements”) 1 M UNITS = EV ({images}, UCUM, “images”)
16 > CONTAINS NUM EV (111692, DCM, “Number of Samples Used per Image”) 1 M UNITS = EV ({samples},UCUM, “samples”)
17 > CONTAINS NUM EV (111693, DCM, “Analysis Quality Rating”) 1 M UNITS = EV({0:100}, UCUM, “range:0:100”) Value = 0 – 100
18 >> HAS OBS CONTEXT INCLUDE DTID (2102) Quality Rating Identification 1 M
19 > CONTAINS NUM EV (111694, DCM, “Image Set Quality Rating”) 1 M UNITS = EV({0:100}, UCUM, “range:0:100”) Value = 0 – 100
20 >> HAS OBS CONTEXT INCLUDE DTID (2102) Quality Rating Identification 1 M
21 > CONTAINS NUM EV (111029, DCM, “Image Quality Rating”) 1-n U UNITS = EV({0:100}, UCUM, “range:0:100”) Value = 0 – 100
22 >> INFERRED FROM IMAGE No purpose of reference 1 M
23 >> HAS OBS CONTEXT INCLUDE DTID (2102) Quality Rating Identification 1 M
24 > CONTAINS CODE EV (111696, DCM, “Visual Fixation Quality During Acquisition”) 1 U DCID (4220) Visual Fixation Quality During Acquisition
25 >> HAS CONCEPT MOD CODE EV (111697, DCM, “Visual Fixation Quality Problem”) 1-n U DCID (4221) Visual Fixation Quality Problem
26 > CONTAINS CODE EV (111698, DCM, “Ophthalmic Macular Grid Problem”) 1-n U DCID (4222) Ophthalmic Macular Grid Problem
27 > CONTAINS TEXT EV (121106, DCM, “Comments”) 1 U

TID 2102 Quality Rating Identification

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

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

TID 2102QUALITY RATING IDENTIFICATIONType: Non-Extensible Order: Significant

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

PROCEDURE LOG IOD TEMPLATES

TID 3001 Procedure Log

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

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

Notes: 1. The Procedure Log IOD (PS3.3) requires ordering by Observation DateTime; thus log entries of different types (i.e., specified by different Rows in the Template) may appear in any order.2. While this Template is extensible, the Procedure Log IOD forbids Container Content Items subsidiary to the top level Container.

TID 3001 Procedure Log Type: Extensible Order: Non-Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DCID (3400) Procedure Log Titles 1 M
2 > INCLUDE DTID (1002) Observer Context 1-n M
3 > INCLUDE DTID (3601) Procedure Context 1 M
4 > HAS ACQ CONTEXT TEXT EV (121121, DCM, "Room identification") 1 U
5 > HAS ACQ CONTEXT TEXT EV (121122, DCM, "Equipment identification") 1-n U
6 > CONTAINS TEXT DCID (3401) Types of Log Notes 1-n U
7 >> INCLUDE DTID (3010) Log Entry Qualifiers 1 U
8 > CONTAINS CODE EV (121123, DCM, “Patient Status or Event”) 1-n U DCID (3402) Patient Status and Events
9 >> INCLUDE DTID (3010) Log Entry Qualifiers 1 U
10 > CONTAINS PNAME DCID (3404) Staff Actions 1-n U
11 >> INCLUDE DTID (3010) Log Entry Qualifiers 1 U
12 > CONTAINS TEXT DCID (3427) Equipment Events 1-n U Equipment identifier
13 >> INCLUDE DTID (3010) Log Entry Qualifiers 1 U
14 > CONTAINS INCLUDE DTID (3100) Procedure Action 1-n U
15 > CONTAINS INCLUDE DTID (3101) Image Acquisition 1-n U
16 > CONTAINS INCLUDE DTID (3102) Waveform Acquisition 1-n U
17 > CONTAINS INCLUDE DTID (3103) Referenced Object 1-n U
18 > CONTAINS INCLUDE DTID (3104) Consumables 1-n U
19 > CONTAINS INCLUDE DTID (3105) Lesion Identification and Properties 1-n U
20 > CONTAINS INCLUDE DTID (3106) Drugs/Contrast Administered 1-n U
21 > CONTAINS INCLUDE DTID (3107) Device Used 1-n U
22 > CONTAINS INCLUDE DTID (3108) Intervention 1-n U
23 > CONTAINS CODE EV (DD-60002, SRT, “Complication of Procedure”) 1-n U DCID (3413) Adverse Outcomes
24 >> INCLUDE DTID (3010) Log Entry Qualifiers 1 U
25 > CONTAINS INCLUDE DTID (3109) Measurements 1-n U
26 > CONTAINS INCLUDE DTID (3110) Impressions or Findings 1-n U
27 > CONTAINS INCLUDE DTID (3111) Percutaneous Entry 1-n U
28 > CONTAINS INCLUDE DTID (3112) Specimen Obtained 1-n U
29 > CONTAINS INCLUDE DTID (3113) Patient Support 1-n U
30 > CONTAINS INCLUDE DTID (3114) Patient assessment 1-n U
31 > CONTAINS INCLUDE DTID (3115) ECG ST assessment 1-n U

Content Item Descriptions

Row 2 includes TID 1002 Observer Context. TID 1002 shall be used to record the identity of the person responsible for recording the log, as well as all other participants in the procedure, even though these personnel may not technically be "observers" of the Procedure Log. As participants in the procedure, they are potential sources for events and observations recorded in the Log. TID 1002 allows the specification of the person’s role in the organization (e.g., physician, nurse), as well as the role in the procedure (e.g., circulating, performing, etc.).

Row 5 shall be used to record the identity of the major equipment used in the procedure.

Row 6 may be used to record any event not covered by a specific log entry template.

TID 3010 Log Entry Qualifiers

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

TID 3010Log Entry QualifiersType: Extensible Order: Significant

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

Content Item Descriptions

Row 3 Procedure Action ID allows linking recorded events to a particular action, step, or phase of a procedure. See description for TID 3100 Procedure Action.

Row 4 Lesion Identifier is specified as a numeric text string, and allows linking recorded events to the diagnosis or therapy of particular lesion. See description for TID 3105 Lesion Identifier.

TID 3100 Procedure Action

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

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

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

TID 3100Procedure ActionType: Extensible Order: Significant

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

Content Item Descriptions

Row 2 - The value of the Procedure Action ID shall be uniquely associated with the step or action within the context of the Study, and may be used to associate various Procedure Log entries with the step or action.

Row 3 may be used to record the identity of staff roles for the purpose of this Procedure Action, which may differ from their roles in the procedure as a whole.

TID 3101 Image Acquisition

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

TID 3101 Image Acquisition Type: Extensible Order: Significant

NL Relation with Parent Value Type 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 DCID (29) Acquisition Modality Derived from referenced image SOP Instance attribute (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 attribute (0008,0008)
6 > HAS ACQ CONTEXT NUM EV (112011, DCM, “Positioner Primary Angle”) 1 U UNITS = EV (deg, UCUM, “º”)
7 > HAS ACQ CONTEXT NUM EV ( 112012, DCM, “Positioner Secondary Angle”) 1 U UNITS = EV (deg, UCUM, “º”)
8 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

TID 3102 Waveform Acquisition

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

TID 3102Waveform AcquisitionType: Extensible Order: Significant

NL Relation with Parent Value Type 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 DCID (29) Acquisition Modality Derived from referenced waveform SOP Instance attribute (0008,0060)
3 > HAS ACQ CONTEXT NUM EV (121142, DCM, “Acquisition Duration”) 1 U
4 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

TID 3103 Referenced Object

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

TID 3103Referenced ObjectType: Extensible Order: Significant

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

TID 3104 Consumables

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

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

TID 3104ConsumablesType: Extensible Order: Significant

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

TID 3105 Lesion Identification and Properties

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

TID 3105Lesion Identification and PropertiesType: Extensible Order: Significant

NL Relation with Parent Value Type 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 (G-C0E3, SRT, “Finding Site”) 1 M DCID (3604) Arterial lesion locations
3 >> HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical modifier") 1 U DCID (3019) Cardio-vascular Anatomic Location Modifiers
4 > HAS PROPERTIES CODE EV (121153, DCM, “Lesion Risk") 1 U DCID (3418) Lesion Risk
5 > HAS PROPERTIES NUM (R-101BB, SRT, “Lumen Diameter Stenosis”) 1 U UNITS = EV (%, UCUM, "%")
6 >> HAS CONCEPT MOD CODE EV (G-72BB, SRT, “Catheterization Procedure Phase”) 1 M EV (G-7293, SRT, “Baseline Phase”)
7 >> HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 U DCID (3745) Calculation Method
8 > HAS PROPERTIES CODE EV (122109, DCM, "Baseline TIMI Flow") 1 UC IFF Row 2 specifies a coronary artery DCID (3713) TIMI Flow Characteristics
9 > HAS PROPERTIES CODE EV (122131, DCM, "Degree of Thrombus") 1 U DCID (3714) Thrombus
10 > HAS PROPERTIES CODE EV (F-01740, SRT, “Lesion Margin Characteristics”) 1 U DCID (3715) Lesion Margin
11 > HAS PROPERTIES CODE EV (122134, DCM, "Vessel Morphology") 1-n U DCID (3712) Vessel Descriptors
12 > HAS PROPERTIES CODE EV (122132, DCM, "Severity of Calcification") 1 U DCID (3716) Severity
13 > HAS PROPERTIES IMAGE DT (121080, DCM, "Best illustration of finding" 1 U
14 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

Content Item Descriptions

Row 1 Lesion Identifier is specified as a numeric text string in order to facilitate transcoding to DICOM Attribute (0018,3105) Lesion Number and to formats for outcomes registries, such as the ACC National Cardiovascular Data Registry™.

TID 3106 Drugs/Contrast Administered

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

TID 3106 Drugs/Contrast Administered Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE DCID (3409) Administration of Drugs/Contrast 1 M BCID (10) Interventional Drug, or BCID (12) Radiographic Contrast Agent
2 > HAS PROPERTIES TEXT EV (121145, DCM, "Description of Material") 1 U
3 > HAS PROPERTIES CODE EV (G-C340, SRT, "Route of administration") 1 U BCID (11) Route of Administration
4 > HAS PROPERTIES NUM DCID (3410) Numeric Parameters of Drugs/Contrast 1-n U
5 > HAS PROPERTIES PNAME EV (121152, DCM, “Person administering drug/contrast”) 1 U
6 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

TID 3107 Device Used

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

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

TID 3107Device UsedType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE DCID (3422) Device Use Actions 1 M BCID (3429) Catheterization Devices
2 > HAS PROPERTIES CODE EV (121150, DCM, "Device Code") 1-n U Vendor or local bar coded values
3 > HAS PROPERTIES TEXT EV (121145, DCM, "Description of Material") 1 U
4 > HAS PROPERTIES NUM DCID (3423) Numeric Device Characteristics 1-n U
5 > HAS PROPERTIES CODE EV (G-C0E9, SRT, “Procedure site”) 1 U BCID (3630) Cardiovascular Anatomic Locations
6 > HAS CONCEPT MOD CODE EV (G-C0E8, SRT, “Has Intent") 1 U DT (121155, DCM, “Deployment")
7 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

TID 3108 Intervention

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

TID 3108 Intervention Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (122090, DCM, "Intervention Action") 1 M DCID (3412) Intervention Actions and Status
2 > HAS PROPERTIES CODE EV (G-C0E9, SRT, “Procedure site”) 1 M DCID (3604) Arterial Lesion Locations
3 >> HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical modifier") 1 U DCID (3019) Cardio-vascular Anatomic Location Modifiers
4 > HAS PROPERTIES TEXT EV (121154, DCM, "Intervention attempt identifier") 1 M Up to 3 numeric characters
5 > HAS PROPERTIES CODE EV (G-C50A, SRT, "Uses Equipment") 1-n U BCID (3411) Intracoronary Devices
6 >> HAS CONCEPT MOD CODE EV (122111, DCM, "Primary Intervention Device") 1 MC IF Device is Primary for this Lesion DCID (230) Yes-No
7 > HAS PROPERTIES NUM DCID (3425) Intervention Parameters 1-n U
8 > HAS PROPERTIES IMAGE BCID (7003) Diagnostic Imaging Report Purposes of Reference 1 U
9 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

Content Item Descriptions

Row 4 Intervention attempt Identifier is specified as a numeric text string, and shall be treated as the ordinal of the recorded attempted intervention within this procedure (i.e., “1” for the first attempted intervention, “2” for the second, etc.).

TID 3109 Measurements

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

TID 3109MeasurementsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 NUM No BCID 1 U
2 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U
3 > HAS PROPERTIES INCLUDE DTID (310) Measurement Properties 1 U
4 CODE No BCID 1 U
5 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

TID 3110 Impressions or Findings

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

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

TID 3110 Impressions or FindingsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (121071, DCM, "Finding") 1 U BCID (3728) Cath Findings
2 > HAS PROPERTIES CODE EV (G-C197, SRT, "Severity") 1 U DCID (3716) Severity
3 > HAS PROPERTIES CODE EV (G-C0E3, SRT, “Finding Site”) 1 U
4 >> HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical modifier") 1 U DCID (3019) Cardio-vascular Anatomic Location Modifiers
5 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U
6 TEXT BCID (3419) Findings Titles 1 U
7 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

Content Item Descriptions

Row 3 Finding Site has no Baseline Context ID specified. Typically terms would be drawn from coronary segments, other arterial segments, myocardial segments, etc.

TID 3111 Percutaneous Entry

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

TID 3111Percutaneous EntryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (121156, DCM, “Percutaneous Entry Action”) 1 M DCID (3403) Percutaneous Entry
2 > HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality") 1 U DCID (244) Laterality
3 > INCLUDE DTID (3010) Log Entry Qualifiers 1 U

TID 3112 Specimen Obtained

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

TID 3112Specimen ObtainedType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (121123, DCM, “Patient Status or Event”) 1 M DCID (3515) Specimen Collection
2 > HAS ACQ CONTEXT CODE EV (R-00254, SRT, "Specimen Type”) 1 UC IFF specimen is blood sample DCID (3520) Blood Source Type
3 > HAS ACQ CONTEXT CODE EV (G-C0E9, SRT, “Procedure site”) 1 U BCID (3630) Cardiovascular Anatomic locations
4 > HAS PROPERTIES INCLUDE DTID (1009) Subject Context, Specimen 1 U

TID 3113 Patient Support

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

TID 3113 Patient Support Type: Extensible Order: Significant

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

TID 3114 Patient Assessment

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

TID 3114 Patient Assessment Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (121123, DCM, “Patient Status or Event”) 1 M DT (121165, DCM, “Patient Assessment Performed”) or DT (PA-00500, SRT, “Observation of Vital Signs”)
2 > HAS PROPERTIES INCLUDE TID (300) Measurement 1 MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = EV (F-008EC, SRT, "Systolic blood pressure") $Units = DCID (3500) $Method = BCID (3560) Blood Pressure Methods
3 > HAS PROPERTIES INCLUDE TID (300) Measurement 1 MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = EV (F-008ED, SRT, "Diastolic blood pressure") $Units = DCID (3500)
4 > HAS PROPERTIES INCLUDE TID (300) Measurement 1 MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = EV (8867-4, LN, "Heart rate") $Units = EV ("{H.B.}/min", UCUM, "BPM")
5 > HAS PROPERTIES INCLUDE TID (300) Measurement 1 MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = EV (8310-5, LN, "Body temperature") $Units = EV (Cel, UCUM, “°C”)
6 > HAS PROPERTIES INCLUDE TID (300) Measurement 1 MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = DCID (3526) Blood gas saturation $Units = EV (%, UCUM, "%")
7 > HAS PROPERTIES INCLUDE TID (300) Measurement 1 MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = EV (F-043E7, SRT, "Respiration rate") $Units = EV (/min, UCUM, "breaths/min")
8 > HAS PROPERTIES INCLUDE TID (300) Measurement 1-n MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = EV (122195, DCM, "Pulse Strength") $Method = BCID (3442) Peripheral Pulse Methods $TargetSite = BCID (3440) Peripheral Pulse Locations $Units = DT ("{0:4}", UCUM, "range 0:4")
9 > HAS PROPERTIES INCLUDE TID (300) Measurement 1 MC IF Row 1 value = (PA-00500, SRT, “Observation of Vital Signs”) $Measurement = EV (F-009EA, SRT, “Pain Score”) $Units = DT ("{1:10}", UCUM, "range 1:10")
10 > HAS PROPERTIES CODE DT (8884-9, LN, "Cardiac Rhythm") 1 U BCID (3415) Cardiac Rhythms
11 > HAS PROPERTIES CODE DT (9304-7, LN, "Respiration Rhythm") 1 U BCID (3416) Respiration Rhythms
12 > HAS PROPERTIES CODE DT ( F-043E6, SRT, “Respiration Assessment”) 1 U BCID (3448) Airway Assessment
13 > HAS PROPERTIES CODE DT (F-046D8, SRT, “Skin condition") 1-n U BCID (3446) Skin Condition
14 > HAS PROPERTIES CODE DT (F-04317, “Patient mental state assessment”) 1 U No BCID
15 > HAS PROPERTIES TEXT BCID (3441) Patient Assessments 1-n U

Content Item Descriptions

Row 8 Pulse Strength allows the assessment of the patient’s pulse at multiple locations using the Topographical concept modifier. It may also be used for a single pulse strength measurement from an unspecified location, as is typical of vital signs assessments.

Row 16 allows free text description of patient assessments that are not expressible by coded entries of Rows 10 to 14.

TID 3115 ECG ST Assessment

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

TID 3115ECG ST AssessmentType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (121123, DCM, “Patient Status or Event”) 1 M DT (R-41D8B, SRT, “ECG Analysis”)
2 > HAS PROPERTIES NUM DT (122099, DCM, “ST change from baseline”) 1-n M Units = EV(uV, UCUM, “uV”)
3 >> HAS CONCEPT MOD CODE DT (122148, DCM, "Lead ID") 1 M BCID (3001) ECG Leads

QUANTitAtive Ventricular analysis REPORT SR IOD TEMPLATES

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

[pic]

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

TID 3202 Ventricular Analysis Template

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

TID 3202VENTRICULAR ANALYSISType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122292, DCM, "Quantitative Ventriculography Report”) 1 M
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language Of Content Item And Descendants 1 M
3 > HAS OBS CONTEXT INCLUDE DTID (1002) Observer Context 1-n M
4 > CONTAINS INCLUDE DTID (3602) Cardiovascular Patient Characteristics 1 U
5 > CONTAINS CONTAINER EV (122144, DCM, “Quantitative Analysis”) 1-n M
6 >> HAS OBS CONTEXT INCLUDE DTID (1002) Observer Context 1-n U
7 >> HAS OBS CONTEXT TEXT EV (111001, DCM, “Algorithm Name”) 1 M
8 >> HAS OBS CONTEXT TEXT EV (111003, DCM, “Algorithm Version”) 1 M
9 >> HAS OBS CONTEXT TEXT EV (122405, DCM, “Algorithm Manufacturer”) 1 M
10 >> CONTAINS IMAGE EV (121112, DCM, “Source of Measurements”) 1-n M
11 >>> HAS CONCEPT MOD CODE EV (G-A60B), SRT, “Cardiac Phase” 1 M DCID (12233) Cardiac Phase
12 >>> HAS CONCEPT MOD CODE EV (111031, DCM, “Image View”) 1 MC If Biplane Analysis DCID (3466) Plane Identification
13 >> HAS ACQ CONTEXT INCLUDE DTID (3205) Calibration 1-2 U VM = 1: Single plane analysis, VM = 2: Biplane analysis $CalibrationPlane = DCID (3466) Plane Identification
14 >> HAS ACQ CONTEXT INCLUDE DTID (3520) Hemodynamic Clinical Context 1 U
15 >> CONTAINS INCLUDE DTID (3206) VA Main Results 1 M
16 >> CONTAINS INCLUDE DTID (3207) AA Main Results 1 U
17 >> CONTAINS INCLUDE DTID (3208) Frame to Frame Results 1 U
18 >> CONTAINS INCLUDE DTID (3209) Centerline Wall Motion 1-2 U VM = 1: Single plane analysis, VM = 2: Biplane analysis
19 >> CONTAINS INCLUDE DTID (3210) Radial Based Wall Motion 1-2 U VM = 1: Single plane analysis, VM = 2: Biplane analysis
20 >> CONTAINS INCLUDE DTID (3211) Landmark Based Wall Motion 1-2 U VM = 1: Single plane analysis, VM = 2: Biplane analysis

Content Item Descriptions

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

TID 3205 Calibration Template

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

Parameter Name Parameter Usage
$CalibrationPlane XA Imaging plane

TID 3205 CALIBRATION Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122505, DCM, “Calibration”) 1 M
2 > HAS CONCEPT MOD CODE EV (111031, DCM, “Image View”) 1 U $CalibrationPlane
3 > HAS OBS CONTEXT TEXT EV (111001, DCM, “Algorithm Name”) 1 MC If different from Analysis program specified in the invoking template
4 > HAS OBS CONTEXT TEXT EV (111003, DCM, “Algorithm Version”) 1 MC If different from Analysis program specified in the invoking template
5 > HAS OBS CONTEXT TEXT EV (122405, DCM, “Algorithm Manufacturer”) 1 MC If different from Analysis program specified in the invoking template
6 > CONTAINS CODE EV (122422, DCM, “Calibration Method”) 1 M DCID (3452) Calibration Methods
7 > CONTAINS CODE EV (122421, DCM, “Calibration Object”) 1 MC If row 6 value specifies Calibration Object Used DCID (3451) Calibration Object
8 > CONTAINS NUM EV (122423, DCM, “Calibration Object Size”) 1 MC If row 6 value specifies Calibration Object Used DCID (3510) Catheter Size Units
9 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (111026, DCM, “Horizontal Pixel Spacing”) $Unit = DT (mm/{pixel}, UCUM, “mm/pixel”) $ImagePurpose = EV (121112, DCM, “Source of Measurement”)
10 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (111066, DCM, “Vertical Pixel Spacing”) $Unit = DT (mm/{pixel}, UCUM, “mm/pixel”) $ImagePurpose = EV (121112, DCM, “Source of Measurements”)
11 > CONTAINS IMAGE No purpose of reference 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)
Row 9,10 Spacing in the patient body. Point to a single frame containing the image used for calibration if applicable, the actual measurements may be indicated by a SCOORD (see TID 320, row 3)
Row 11 Secondary Capture image with calibration position

TID 3206 VA Main Results Template

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

TID 3206 VA MAIN RESULTS Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DCID (3462) Chamber Identification
3 > CONTAINS CODE EV (122429, DCM, “Volume Method”) 1 M DCID (3453) Cardiac Volume Methods
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 (1, 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 (1, UCUM, “ratio”)
8 > CONTAINS NUM EV (122434, DCM, “Regression Offset ES”) 1 U Unit = DT (ml, UCUM, “ml”)
9 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = DCID (3467) Ejection Fraction $Unit = DT (%, UCUM, “%”)
10 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3468) ED Volume $Unit = DT (ml, UCUM, “ml”)
11 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3469) ES Volume $Unit = DT (ml, UCUM, “ml”)
12 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, “Stroke Volume”) $Unit = DT (ml, UCUM, “ml”)
13 > CONTAINS NUM EV (8867-4, LN, “Heart Rate”) 1 U Unit = DT ({hb}/min, UCUM, “beats/min”)
14 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3468) ED Volume $ModType = EV (121425, DCM, “Index”) $ModValue = DCID (3455) Index Methods $Unit = DT (ml/m2, UCUM, “ml/m^ 2”)
15 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3468) ED Volume $ModType = EV (121425, DCM, “Index”) $ModValue = EV (29463-7. LN, “Patient Weight”) $Unit = DT (ml/kg, UCUM, “ml/kg”)
16 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3469) ES Volume $ModType = EV (121425, DCM, “Index”) $ModValue = DCID (3455) Index Methods $Unit = DT (ml/m2, UCUM, “ml/m^2”)
17 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3469) ES Volume $ModType = EV (121425, DCM, “Index”) $ModValue = EV (29463-7. LN, “Patient Weight”) $Unit = DT (ml/kg, UCUM, “ml/kg”)
18 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, “Stroke Volume”) $ModType = EV (121425, DCM, “Index”) $ModValue = DCID (3455) Index Methods $Unit = DT (ml/m2, UCUM, “ml/m^2”)
19 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, “Stroke Volume”) $ModType = EV (121425, DCM, “Index”) $ModValue = EV (29463-7. LN, “Patient Weight”) $Unit = DT (ml/kg, UCUM, “ml/kg”)
20 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (F-32100, SRT, “Cardiac Output”) $Unit = DT (l/min, UCUM, “l/min”)
21 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (F-32110, SRT, “Cardiac Index”) $ModType = EV (121425, DCM, “Index”) $ModValue = DCID (3455) Index Methods $Unit = DT (l/min/m2, UCUM, “l/min/m^2”)
22 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122445, DCM, “Wall Thickness”) $Unit = DT (mm, UCUM, “mm”)
23 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122446, DCM, “Wall Volume”) $Unit = DT (ml, UCUM, “ml”)
24 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122447, DCM, “Wall Mass”) $Unit = DT (g, UCUM, “gram”)
25 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122447, DCM, “Wall Mass”) $ModType = EV (121425, DCM, “Index”) $ModValue = DCID (3455) Index Methods $Unit = DT (g/m2, UCUM, “gram/m^2”)
26 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122447, DCM, “Wall Mass”) $ModType = EV (121425, DCM, “Index”) $ModValue = EV (29463-7. LN, “Patient Weight”) $Unit = DT (g/kg, UCUM, “gram/kg”)
27 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122448, DCM, “Wall Stress”) $Unit = DT (dyn/cm2, UCUM, “dynes/cm^2”)
28 > CONTAINS IMAGE No purpose of reference 1-n U

Content Item Descriptions

Row 28 Secondary Capture image with ED and/or ES contours

TID 3207 AA Main Results Template

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

TID 3207AA MAIN RESULTSType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DCID (3462) Chamber Identification
3 > CONTAINS CODE EV (122429, DCM, “Volume Method”) 1 M DCID (3453) Cardiac Volume Methods
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 (1, 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 (1, UCUM, “ratio”)
8 > CONTAINS NUM EV (122434, DCM, “Regression Offset ES”) 1 U Unit = DT (ml, UCUM, “ml”)
9 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3468) ED Volume $Unit = DT (ml, UCUM, “ml”)
10 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = DCID (3469) ES Volume $Unit = DT (ml, UCUM, “ml”)
11 > CONTAINS IMAGE No purpose of reference 1-n U

Content Item Descriptions

Row 11 Secondary Capture image with ED and/or ES contours

TID 3208 Frame-to-Frame Results Template

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

TID 3208FRAME-TO-FRAME RESULTType: Extensible Order: Significant

NL
Row 5,6 Includes one measurement for each frame referenced in Row 3.
Row 7 Secondary Capture image with ventricular contours

TID 3209 Centerline Wall Motion Template

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

TID 3209CENTERLINE WALL MOTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (111004, DCM, “Analysis Performed”) 1 M EV (122449, DCM, “Centerline Wall Motion Analysis”)
3 >> HAS CONCEPT MOD CODE EV (122410, DCM, “Contour Realignment”) 1 M DCID (3458) Contour Realignment
4 > CONTAINS INCLUDE DTID (300) Measurement 100 M $Measurement = EV (122450, DCM, “Normalized Chord Length”) $Unit = DT (%, UCUM, “%”)
5 > CONTAINS NUM EV (122411, DCM, “Threshold Value”) 1 M Values shall be 1, 2 or 3 Units = EV ({sd}, UCUM, “Standard Deviations”)
6 > CONTAINS CONTAINER EV (122451, DCM, “Abnormal Region”) 1-6 U
7 >> CONTAINS CODE EV (F-32050, SRT, “Cardiac Wall Motion”) 1 M DCID (3703) Wall Motion
8 >> CONTAINS CODE EV (R-404F0, SRT, “Circumferential Extent”) 1 U DCID (3460) Circumferential Extent
9 >> CONTAINS NUM EV (122452, DCM, “First Chord of Abnormal Region”) 1 M Unit = DT (1, UCUM, “no unit”)
10 >> CONTAINS NUM EV (122453, DCM, “Last Chord of Abnormal Region”) 1 M Unit = DT (1, UCUM, “no unit”)
11 > CONTAINS CONTAINER EV (122417, DCM, “Regional Abnormal Wall Motion ”) 1-4 U
12 >> HAS CONCEPT MOD CODE EV (G-C03E, SRT, “Finding Site”) 1 M DCID (3461) Regional Extent
13 >> CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122459, DCM, “Territory Region Severity”) $ModType = EV (F-32050, SRT, “Cardiac Wall Motion”) $ModValue = DCID (3703) Wall Motion $Unit = DT ({sd}, UCUM, “Standard Deviations”)
14 >> CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122461, DCM, “Opposite Region Severity”) $ModType = EV (F-32050, SRT, “Cardiac Wall Motion”) $ModValue = DCID (3703) Wall Motion $Unit = DT ({sd}, UCUM, “Standard Deviations”)
15 > CONTAINS IMAGE No purpose of reference 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

TID 3210 Radial Based Wall Motion Template

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

TID 3210RADIAL BASED WALL MOTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (111004, DCM, “Analysis Performed”) 1 M EV (122493, DCM, “Radial Based Wall Motion Analysis”)
3 >> HAS CONCEPT MOD CODE EV (122410, DCM, “Contour Realignment”) 1 M DCID (3458) Contour Realignment
4 > CONTAINS CONTAINER EV (121070, DCM, “Findings”) 1-n M
5 >> HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DCID (3718) Myocardial Wall Segments in Projection
6 >> CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122495, DCM, “Regional Contribution to Ejection Fraction”) $Unit = DT (%, UCUM, “%”)
7 >> CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = EV (122496, DCM, “Radial Shortening”) $Unit = DT (%, UCUM, “%”)
8 > CONTAINS IMAGE No purpose of reference 1 U

Content Item Descriptions

Row 6 The CREF values of the 6 regions determined for the radial based wall motion
Row 7 The shortening of the measured radials within the region
Row 8 Secondary Capture image with radial based analysis result

TID 3211 Landmark Based Wall Motion Template

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

TID 3211LANDMARK BASED WALL MOTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (111004, DCM, “Analysis Performed”) 1 M EV (122497, DCM, “Landmark Based Wall Motion Analysis”)
3 >> HAS CONCEPT MOD CODE EV (122410, DCM, “Contour Realignment”) 1 M DCID (3458) Contour Realignment
4 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = EV (122498, DCM, “Slice Contribution to Ejection Fraction”) $Unit = DT (%, UCUM, “%”)
5 > CONTAINS CONTAINER EV (121070, DCM, “Findings”) 5 M
6 >> HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Sites”) 1 M DCID (3718) Myocardial Wall Segments in Projection
7 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122495, DCM, “Regional Contribution to Ejection Fraction”) $Unit = DT (%, UCUM, “%”)
8 > CONTAINS IMAGE No purpose of reference 1 U

Content Item Descriptions

Row 8 Secondary Capture image with Landmark Based Analysis result

QUANTITATIVE ARTERIAL ANALYSIS REPORT SR IOD TEMPLATES

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

[pic]

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

TID 3213 Quantitative Arterial Analysis Template

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

TID 3213 QUANTITATIVE ARTERIAL ANALYSIS Type: Extensible Order: Significant

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 DTID (1204) Language Of Content Item And Descendants 1 M
3 > HAS OBS CONTEXT INCLUDE DTID (1002) Observer Context 1-n M
4 > CONTAINS INCLUDE DTID (3602) Cardiovascular Patient Characteristics 1 U
5 > HAS OBS CONTEXT TEXT EV (111001, DCM, “Algorithm Name”) 1 M
6 > HAS OBS CONTEXT TEXT EV (111003, DCM, “Algorithm Version”) 1 M
7 > HAS OBS CONTEXT TEXT EV (122405, DCM, “Algorithm Manufacturer”) 1 M
8 > CONTAINS INCLUDE DTID (3214) Analyzed Segment 1-n M

Content Item Descriptions

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

TID 3214 Analyzed Segment Template

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

TID 3214ANALYZED SEGMENTType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DCID (3604) Arterial lesion locations
3 > CONTAINS IMAGE EV (121112, DCM, “Source of Measurements”) 1 M
4 > CONTAINS INCLUDE DTID (3205) Calibration 1 M
5 > HAS ACQ CONTEXT INCLUDE DTID (3520) Hemodynamic Clinical Context 1 U
6 > HAS ACQ CONTEXT CODE EV (G-72BB, SRT, “Catheterization Procedure Phase”) 1 U DCID (3651) Hemodynamic Measurement phase
7 > CONTAINS SCOORD EV (122507, DCM, “Left Contour”) 1 M GRAPHIC TYPE = POLYLINE
8 >> R-SELECTED FROM IMAGE 1 M Must reference Row 3
9 > CONTAINS SCOORD EV (122508, DCM, “Right Contour”) 1 M GRAPHIC TYPE = POLYLINE
10 >> R-SELECTED FROM IMAGE 1 M Must reference Row 3
11 > CONTAINS INCLUDE DTID (3219) Segment Values 1 M
12 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation = (R-404FB, SRT, “Minimum”) $Unit = DT (mm, UCUM, “mm”)
13 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation =(G-A437, SRT, “Maximum”) $Unit = DT (mm, UCUM, “mm”)
14 > CONTAINS CONTAINER EV (122509, DCM, “Diameter Graph”) 1 U
15 >> CONTAINS NUM EV (122511, DCM, “Graph Increment”) 1 M Value = 1 Units = DT ({pixels}, UCUM, “pixels”)
16 >> CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Unit = DT (mm, UCUM, “mm”)
17 > CONTAINS NUM EV (122382, DCM, “Site of Luminal Minimum ”) 1 U Units = DT ({pixels}, UCUM, “pixels”)
18 > CONTAINS NUM EV (122516, DCM, “Site of Luminal Maximum”) 1 U Units = DT ({pixels}, UCUM, “pixels”)
19 > CONTAINS INCLUDE DTID (3215) Angiographic Lesion Analysis 1-n U
20 > CONTAINS INCLUDE DTID (3217) Sub-Segmental Data 1-n U
21 > CONTAINS IMAGE No purpose of reference 1 U

Content Item Descriptions

Row 1 Observation DateTime (0040,A032) of container needs to be flagged with the time of the analysis
Row 6 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.
Row 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.
Row 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.

Definition of Left and Right defined by the direction of the blood flow:

[pic]

TID 3215 Angiographic Lesion Analysis Template

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

TID 3215ANGIOGRAPHIC LESION ANALYSISType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
2 > CONTAINS TEXT EV (121151, DCM, “Lesion Identifier”) 1 M
3 >> HAS PROPERTIES CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DCID (3604) Arterial lesion locations
4 >>> HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical modifier”) 1 U DCID (3019) Cardio-vascular Anatomic Location Modifiers
5 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation =(R-404FB, SRT, “Minimum”) $Unit = DT (mm, UCUM, “mm”)
6 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = EV (G-0366, SRT, “Vessel Lumen Cross-Sectional Area”) $Method = DCID (3470) Vessel Lumen Cross-Sectional Area Calculation Methods $Derivation =(R-404FB, SRT, “Minimum”) $Unit = DT (mm2, UCUM, “mm^2”)
7 > CONTAINS CODE EV (122430, DCM, “Reference Method”) 1 M DCID (3465) QA Reference Method
8 > CONTAINS CONTAINER EV (122438, DCM, “Reference Points”) 1 U
9 >> CONTAINS NUM EV (122337, DCM, “Relative Position”) 1-n M $Unit = DT (mm, UCUM, “mm”)
10 >>> HAS PROPERTIES INCLUDE DTID (300) Measurement 1 U $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Unit = DT (mm, UCUM, “mm”)
11 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $TargetSite = (122382, DCM, ”Site of Luminal Minimum”) $Unit = DT (mm, UCUM, “mm”)
12 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (G-0366, SRT, “Vessel Lumen Cross-Sectional Area”) $Derivation = EV (122404, DCM, “Reconstructed”) $TargetSite = (122382, DCM, ”Site of Luminal Minimum”) $Unit = DT (mm2, UCUM, “mm^2”)
13 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation = EV (R-41D2D, SRT, “Calculated”) $TargetSite =EV (122481, DCM, “Contour Start”) $Unit = DT (mm, UCUM, “mm”)
14 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation = EV (R-41D2D, SRT, “Calculated”) $TargetSite = EV (122482, DCM, “Contour End”) $Unit = DT (mm, UCUM, “mm”)
15 > CONTAINS INCLUDE DTID (3218) Position in Arterial Segment 1 M
16 > CONTAINS CONTAINER EV (122517, DCM, “Densitometric Luminal Cross-sectional Area Graph”) 1 U
17 >> CONTAINS NUM EV (122511, DCM, “Graph Increment”) 1 M Value = 1 Units = DT ({pixels}, UCUM, “pixels”)
18 >> CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = EV (G-0366, SRT, ”Vessel Lumen Cross-Sectional Area”) $Unit = (mm2, UCUM, “mm^2”)
19 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (G-0366, SRT, “Vessel Lumen Cross-Sectional Area”) $Derivation = EV (R-41D2D, SRT, “Calculated”) $Method = EV(122474, DCM, “Densitometric method”) $TargetSite =EV (122481, DCM, “Contour Start”) $Unit = (mm2, UCUM, “mm^2”)
20 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (G-0366, SRT, “Vessel Lumen Cross-Sectional Area”) $Derivation = EV (R-41D2D, SRT, “Calculated”) $Method = EV(122474, DCM, “Densitometric method”) $TargetSite = EV (122482, DCM, “Contour End”) $Unit = (mm2, UCUM, “mm^2”)
21 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (R-101BC, SRT, “Lesion Length”) $Unit = DT (mm, UCUM, “mm”)
22 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (R-101BB, SRT, “Lumen Diameter Stenosis”) $Unit = DT (%, UCUM, “%”)
23 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = EV (R-101BA, SRT, “Lumen Area Stenosis”) $Method = DCID (3470) Vessel Lumen Cross-Sectional Area Calculation Methods $Unit = DT (%, UCUM, “%”)
24 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = EV (122372, DCM, “Lumen Volume”) $Method = DCID (3470) Vessel Lumen Cross-Sectional Area Calculation Methods $Unit = DT (mm3, UCUM, “mm^3”)
25 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122542, DCM, “Plaque Area”) $Unit = DT (mm2, UCUM, “mm^2”)
26 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122376, DCM, “Total Plaque Volume”) $Unit = DT (mm3, UCUM, “mm^3”)
27 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122544, DCM, “Diameter Symmetry”) $Unit = DT ({ratio}, UCUM, “ratio”)
28 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122545, DCM, “Area Symmetry”) $Unit = DT ({ratio}, UCUM, “ratio”)
29 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122546, DCM, “Inflow Angle”) $Unit = DT (deg, UCUM, “degrees”)
30 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122547, DCM, “Outflow Angle”) $Unit = DT (deg, UCUM, “degrees”)
31 > CONTAINS INCLUDE DTID (3216) Stenotic Flow Reserve 1 U
32 > CONTAINS IMAGE No purpose of reference 1 U

Content Item Descriptions

Row 8 Set of user defined reference position for method that requires local reference position.
Row 9 Distance of local reference position from an arbitrary landmark.
Row 10 Diameter at a local reference position.
Row 11 The reference diameter for the arterial lesion calculated with the applicable reference method
Row 12 The reference area for the arterial lesion calculated with the applicable reference method
Row 13 The diameter measurement at the start of the reconstruction line in the diameter graph (TID 3214 Row 14)
Row 14 The diameter measurement at the end of the reconstruction line in the diameter graph (TID 3214 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
R0w 20 The cross sectional area measurement at the end of the reconstruction line in the area graph
Row 21 Measured along the midline of the left and right contour
Row 22 The diameter stenosis is calculated as follows: (Reference Luminal Diameter – Minimum Luminal Diameter / Reference Luminal Diameter) * 100%
Row 23 The circular and the densitometric area stenosis are calculated respectively as: (Reference Vessel Lumen Cross-Sectional Area – Minimum Luminal Circular Area / Reference Vessel Lumen Cross-Sectional Area) * 100% (Reference Vessel Lumen Cross-Sectional Area – Minimum Luminal Densitometric Area / Reference Vessel Lumen Cross-Sectional Area) * 100%
Row 24 Estimated lumen volume between proximal border and distal border of lesion (TID 3218, row 1 and 2)
Row 32 Secondary Capture image with obstruction analysis contour

TID 3216 Stenotic Flow Reserve Template

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

TID 3216STENOTIC FLOW RESERVEType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122548, DCM, “Stenotic Flow Reserve”) $Unit = DT ({ratio}, UCUM, “ratio”)
2 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122549, DCM, “Poiseuille Resistance”) $Unit = DT (mm[Hg].s/cm, UCUM, “mmHG.s/cm”)
3 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122550, DCM, “Turbulence Resistance”) $Unit = DT (mm[Hg].s2/cm2, UCUM, “mmHG.s^2/cm^2”)
4 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122555, DCM, “Estimated Normal Flow”) $Unit = DT (ml/s, UCUM, “ml/s”)
5 CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (122551, DCM, “Pressure Drop at SFR”) $Unit = DT (mm[Hg], UCUM, “mmHg”)
6 CONTAINS IMAGE No purpose of reference 1 U

Content Item Descriptions

Row 6 Secondary Capture image with SFR analysis contour

TID 3217 Sub-segmental Data Template

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

TID 3217SUB-SEGMENTAL DATAType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DCID (3604) Arterial lesion locations
3 >> HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical modifier”) 1 U DCID (3019) Cardio-vascular Anatomic Location Modifiers
4 > CONTAINS CODE EV (122554, DCM, “Segmentation Method”) 1 M DCID (3456) Sub-segment Methods
5 > CONTAINS INCLUDE DTID (3219) Segment Values 1 U
6 > CONTAINS INCLUDE DTID (3218) Position in Arterial Segment 1 M
7 > CONTAINS IMAGE No purpose of reference 1 U

Content Item Descriptions

Row 7 Secondary Capture image with obstruction analysis contour

TID 3218 Position in Arterial Segment

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

TID 3218POSITION IN ARTERIAL SEGMENTType: Extensible Order: Significant

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

Content Item Descriptions

Row 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
Row 5,6,7,8 The positions are relative to the measurement locations of the Diameter Graph of TID 3214 row 14.

TID 3219 Segment Values Template

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

TID 3219 SEGMENT VALUES Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (122510, DCM, “Length Luminal Segment”) $Unit = DT (mm, UCUM, “mm”)
2 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation = (R-404FB, SRT, “Minimum”) $Unit = DT (mm, UCUM, “mm”)
3 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation =(G-A437, SRT, “Maximum”) $Unit = DT (mm, UCUM, “mm”)
4 CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation = (R-00317, SRT, “Mean”) $Unit = DT (mm, UCUM, “mm”)
5 CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (G-0364, SRT, “Vessel Luminal Diameter”) $Derivation = (R-10047, SRT, “Standard Deviation”) $Unit = DT (mm, UCUM, “mm”)

Content Item Descriptions

Row 1 Measured along the midline of the left and right contour.

IVUS REPORT TEMPLATES

The templates that comprise the IVUS Report within the Evidence Report IOD are interconnected as shown in Figure A-5.

[pic]

Figure A-5 IVUS Report Template Hierarchy

TID 3250 IVUS Report

The IVUS Report template is the root structure for the representation of IVUS measurements acquired during a catheterization procedure.

TID 3250 IVUS ReportType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (18752-6, LN, “Stress Testing Report”) 1 M
1
Row 17 The Procedure Time Base is the time from which elapsed times are measured. The Study Time (0008,0030) may include the patient prep period, while this Procedure Time Base is typically established when baseline data collection begins.

TID 3303 Stress Test Phase Data

The Stress Test Phase Data template provides a structure for measurements acquired during a single procedure phase.

TID 3303 Stress Test Phase DataType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1

TID 3304 Stress Test Measurement Group

Each instance of the Stress Test Measurement Group represents a group of data elements acquired at approximately the same instant, and conventionally rendered as row in a tabular presentation. It is typically generated during the Stress exam 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.

TID 3304 Stress Test Measurement Group Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1
Row 10 Included Template 3106 allows the recording of test medications other than the Pharmacological Stress Agent identified in Template x3301.
Rows 17, 18 ECG ST elevation/depression is measured in units of mV, but is conventionally reported in units of mm, based on strip recordings with scaling of 100 uV/mm. The display application should render these measurements in units meaningful to the user.
Row 19 Note that the MDC codes for “per lead” measurements specified in CID 3228 are base codes for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row.
Row 20 Note that the MDC code for “QTc interval per lead” specified in CID 3227 is a base code for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row. Note that TID 300 enables the encoding of a non-standard correction algorithm, either as a local code, or as a TEXT Method Citation (see TID 300 row 12).
Row 21 R-R interval used for QT correction algorithm
Row 22 Recommended range for ECG axis measurements is -90° to +270°

TID 3307 NM/PET Perfusion Measurement Group

TID 3307NM/PET Perfusion Measurement GroupType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121070, DCM, “Findings”) 1 M
1

TID 3311 Stress Test Summary

TID 3311Stress Test SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1

TID 3312 Physiological Summary

TID 3312Physiological SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1

TID 3313 Stress ECG Summary

TID 3313Stress ECG SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1
Row 12-13 This Concept and the associated Concept Modifier may be instantiated twice, once for resting state measurements, once for stress.

TID 3317 Stress Imaging Summary

TID 3317Stress Imaging SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1
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 TID 3309 Stress Echo Measurement Group) 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.

TID 3318 Comparison to Prior Stress Exam

This template describes changes in findings from a prior stress exam. Comparison is to only one prior exam, even though the generic concept name for the template uses the plural “exams”.

TID 3318Comparison to Prior Stress ExamType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (111424, DCM, “Comparison to previous exams”) 1 M
1 CONTAINER EV (121076, DCM, "Conclusions") 1 MC IF Completion Flag (0040,A491) = COMPLETE
1 CONTAINER EV (122120, DCM, “Hemodynamics Report”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1002) Observer Context 1-n M
3 > INCLUDE DTID (3601) Procedure Context 1 M
4 > HAS OBS CONTEXT INCLUDE DTID (3602) Cardiovascular Patient Characteristics 1 M
5 > HAS ACQ CONTEXT INCLUDE DTID (3603) Procedure Environmental Characteristics 1 U
6 > CONTAINS INCLUDE DTID (3501) Hemodynamic Measurement Group 1-n M
7 > CONTAINS INCLUDE DTID (3570) "Summary, Hemodynamics" 1 U

TID 3501 Hemodynamics Measurement Group

The Hemodynamic Measurement Group template provides a structure for measurements acquired during a single procedure phase in a cardiac catheterization lab.

TID 3501 Hemodynamics Measurement GroupType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS ACQ CONTEXT CODE EV (G-72BB, SRT, “Catheterization Procedure Phase”) 1 M DCID (3651) Hemodynamic Measurement phase
3 > HAS ACQ CONTEXT INCLUDE DTID (3520) Hemodynamic Clinical Context 1 U
4 > HAS ACQ CONTEXT TEXT EV (121124, DCM, "Procedure Action ID") 1 U
5 > CONTAINS INCLUDE DTID (3510) Vital signs 1-n U
6 > CONTAINS INCLUDE DTID (3504) Arterial Pressure Measurement 1-n U
7 > CONTAINS INCLUDE DTID (3505) Atrial Pressure Measurement 1-n U
8 > CONTAINS INCLUDE DTID (3506) Venous Pressure Measurement 1-n U
9 > CONTAINS INCLUDE DTID (3507) Ventricular Pressure Measurement 1-n U
10 > CONTAINS INCLUDE DTID (3508) Gradient Measurement 1-n U
11 > CONTAINS INCLUDE DTID (3509) Blood Velocity Measurements 1-n U
12 > CONTAINS INCLUDE DTID (3515) Cardiac Output Measurement by Indicator Dilution 1-n U
13 > CONTAINS INCLUDE DTID (3516) Blood lab measurements 1-n U
14 > CONTAINS INCLUDE DTID (3560) Derived Hemodynamic Measurements 1-n U
15 > CONTAINS INCLUDE DTID (3714) ECG Lead Measurements 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 TID 3100.

TID 3504 Arterial Pressure Measurement

The 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.

TID 3504Arterial Pressure MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (P2-36102, SRT, “Arterial pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3606) Arterial source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (8480-6, LN, “Intravascular arterial Systolic pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (8462-4, LN, “Intravascular arterial Diastolic pressure”) $Units = DCID (3500) Pressure Units
5 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (8478-0, LN, “Intravascular arterial mean pressure”) $Units = DCID (3500) Pressure Units
6 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3505 Atrial Pressure Measurement

The 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.

TID 3505Atrial Pressure MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122121, DCM, “Atrial pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3608) Atrial source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (109016, DCM, “A-wave peak pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (109034, DCM, “V-wave peak pressure”) $Units = DCID (3500) Pressure Units
5 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (F 31150, SRT, “Mean blood pressure”) $Units = DCID (3500) Pressure Units
6 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3506 Venous Pressure Measurement

The 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.

TID 3506Venous Pressure Measurement Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (P2-36110, SRT, “Venous pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3607) Venous source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (F 31150, SRT, “Mean blood pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3507 Ventricular Pressure Measurement

The 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.

TID 3507Ventricular Pressure MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122122, DCM, “Ventricular pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3609) Ventricular source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32600, SRT, “Left Ventricle”) or subsite thereof $Measurement = EV (F-03E0D, SRT, “Left Ventricular Systolic blood pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32600, SRT, “Left Ventricle”) or subsite thereof $Measurement = EV (F-03E0E, SRT, “Left Ventricular End Diastolic pressure”) $Units = DCID (3500) Pressure Units
5 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32500, SRT, “Right Ventricle”) or subsite thereof $Measurement = EV (F-03DFE, SRT, “Right Ventricular Systolic blood pressure”) $Units = DCID (3500) Pressure Units
6 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32500, SRT, “Right Ventricle”) or subsite thereof $Measurement = EV (F-03E02, SRT, “Right Ventricular End Diastolic pressure”) $Units = DCID (3500) Pressure Units
7 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32400, SRT, “Common Ventricle”) $Measurement = EV (122194, DCM, “Ventricular Systolic blood pressure”) $Units = DCID (3500) Pressure Units
8 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32400, SRT, “Common Ventricle”) $Measurement = EV (122191, DCM, “Ventricular End Diastolic pressure”) $Units = DCID (3500) Pressure Units
9 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3508 Gradient Measurement

The 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.

TID 3508Gradient MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122123, DCM, “Gradient assessment”) 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 MC XOR with Rows 3 & 4 IFF single location is appropriate $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3610) Gradient Source Locations
3 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 MC XOR with Row 2 IFF a dual location is appropriate $LocationName = EV (121116, DCM, “Proximal Finding Site”) $LocationValue = DCID (3630) Cardiovascular Anatomic Locations
4 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 MC XOR with Row 2 IFF a dual location is appropriate $LocationName = EV (121117, DCM, “Distal Finding Site”) $LocationValue = DCID (3630) Cardiovascular Anatomic Locations
5 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = EV (F-023F7, ”Pressure Gradient”) $Units = DCID (3500) Pressure Units $Derivation = DCID (3627) Measurement Type
6 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

Content Item Descriptions

Row 5, which is used to encode the gradient measurements, uses Template 300 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.

TID 3509 Blood Velocity Measurement

The 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 TID 3560.

TID 3509Blood Velocity MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122124, DCM, “Blood velocity measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E9, SRT, “Procedure site”) $LocationValue = BCID (3606) Arterial source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = DCID (3612) Blood Velocity Measurements $Units = EV (mm/s, UCUM, "mm/s")
4 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3510 Vital Signs

The 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.

TID 3510Vital SignsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (8716-3, LN, “Vital Signs”) 1 M
2 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-008EC, SRT, "Systolic blood pressure") $Units = DCID (3500) $Method = BCID (3560) Blood Pressure Methods
3 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-008ED, SRT, "Diastolic blood pressure") $Units = DCID (3500)
4 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8867-4, LN, "Heart rate") $Units = EV ("{H.B.}/min", UCUM, "BPM")
5 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8310-5, LN, "Body temperature") $Units = EV (Cel, UCUM, “°C”)
6 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = DCID (3526) Blood gas saturation $Units = EV (%, UCUM, "%")
7 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV ( F-043E7, SRT, "Respiration rate") $Units = EV (/min, UCUM, "breaths/min")
8 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122195, DCM, "Pulse Strength") $Units = DT("{0:4}", UCUM, "range 0:4")
9 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-009EA, SRT, “Pain Score”) $Units = DT("{1:10}", UCUM, "range 1:10")
10 > CONTAINS CODE DT (8884-9, LN, "Cardiac Rhythm") 1 U BCID (3415) Cardiac Rhythms
11 > CONTAINS CODE DT (9304-7, LN, "Respiration Rhythm") 1 U BCID (3416) Respiration Rhythms

TID 3515 Cardiac Output Measurement by Indicator Dilution

The 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.

Note: Fick Cardiac Output is encoded in the Derived Hemodynamic Measurements Template 3560.

TID 3515Cardiac Output Measurement by Indicator DilutionType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (P2-34201, SRT, “Cardiac Output measurement”) 1 M
2 > CONTAINS INCLUDE TID (300) Measurement 1 M $Measurement = EV (8737-9, LN, “Cardiac Output by Indicator Dilution”) $Units = EV (l/min, UCUM, ”l/min”) $Method = DCID (3628) Cardiac Output Methods $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 = DCID (3510) Catheter Size Units
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”)

TID 3516 Blood Lab Measurements

The 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.

TID 3516Blood Lab MeasurementsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122125, DCM, ”Blood lab measurements”) 1 M
2 > HAS ACQ CONTEXT CODE EV (R-00254, SRT, "Specimen Type”) 1 M DCID (3520) Blood Source Type
3 > HAS ACQ CONTEXT CODE EV (G-C0E9, SRT, “Procedure site”) 1 M BCID (3630) Cardiovascular Anatomic Locations
4 > INCLUDE DTID (1000) Quotation 1 U
5 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (718-7, LN, “Hemoglobin”) $Units = DT (g/dl, UCUM, "g/dl")
6 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3524) Blood Gas Pressures $Units = DCID (3500)
7 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3525) Blood Gas Content $Units = DT (ml/dl, UCUM, "ml/dl")
8 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3528) Blood pH $Units = EV ([pH], UCUM, "pH")
9 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3526) Blood Gas Saturation $Units = EV (%, UCUM, "%")
10 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3527) Blood Base Excess $Units = DT (meq/dl, UCUM, "meq/dl")
11 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122183, DCM, "Blood temperature") $Units = EV (Cel, UCUM, “°C”)

TID 3520 Hemodynamic Clinical Context

The 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.

TID 3520Hemodynamic Clinical ContextType: Extensible Order: Significant

NL Relation with Parent Value Type 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 BCID (3602) Hemodynamic Patient State
3 > CONTAINS TEXT EV (109054, DCM, ”Patient State”) 1 U
4 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (DD-60002, SRT, “Complication of Procedure”) $ConditionValue = DCID (3413) Adverse Outcomes
5 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (122086, DCM, "Contrast administered") $ConditionValue = BCID (12) Radiographic Contrast Agent
6 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (122083, DCM, "Drug administered") $ConditionValue = BCID (10) Interventional Drug
7 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (109059, DCM, ”Physiological challenges”) $ConditionValue = BCID (3271) Hemodynamic Physiological Challenges
8 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (122138, DCM, "Circulatory Support") $ConditionValue = DCID (3553) Circulatory Support
9 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (P2-2200A, SRT, "Ventilatory assistance") $ConditionValue = DCID (3554) Ventilation
10 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (P2-35000, SRT, "Cardiac Pacing") $ConditionValue = BCID (3555) Pacing
11 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (P0-0000, SRT, "Procedure") $ConditionValue = BCID (3405) Procedure Action Values

TID 3521 Relative Time

The 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.

TID 3521 Parameters

Parameter Name Parameter Usage
$ConditionName Coded term for Concept Name of condition
$ConditionValue Context Group for condition values

TID 3521Relative TimeType: Non-Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE $ConditionName 1 M $ConditionValue
2 > HAS CONCEPT MOD CODE EV (G-D709, SRT, "Relative time") 1 U BCID (3600) Relative times

TID 3530 Hemodynamic Acquisition Context

The Hemodynamic Acquisition Context template is invoked by the various hemodynamic measurement templates.

Parameter Name Parameter Usage
$LocationName Coded term for Concept Name of measurement location
$LocationValue Context Group for appropriate anatomic locations

TID 3530 Hemodynamic Acquisition Context Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 HAS CONCEPT MOD CODE $LocationName 1 M $LocationValue
2 > HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical modifier”) 1 U BCID (3019) Cardiovascular anatomic location modifiers
3 HAS ACQ CONTEXT CODE EV (G-C036, SRT, “Measurement Method ") 1 U BCID (3241) Hemodynamic Measurement Technique
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

TID 3550 Pressure Waveform Measurements

The 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.

TID 3550Pressure Waveform MeasurementsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3611) Pressure Measurements $Units = DCID (3500)
2 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3612) Blood Velocity Measurements $Units = EV (mm/s, UCUM, "mm/s")
3 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3613) Hemodynamic Time Measurements $Units = DT (ms, UCUM, "ms")
4 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32100, SRT, "Cardiac Output") $Units = EV (l/min, UCUM, "l/min")
5 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, "Stroke Volume”) $Units = DT (ml, UCUM, "ml")
6 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (10230-1, LN, "LV Ejection Fraction") $Units = EV (%, UCUM, "%")
7 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8867-4, LN, "Heart rate") $Units = DT ("{H.B.}/min", UCUM, "BPM")
8 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV ( F-043E7, SRT, "Respiration rate") $Units = DT (“/min”, UCUM, "breaths/min")
9 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (109025, DCM, "Max dp/dt") $Units = DT (mm[Hg]/s, UCUM, "mmHg/s")
10 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (109026, DCM, "Max neg dp/dt") $Units = DT (mm[Hg]/s, UCUM, "mmHg/s")
11 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122190, DCM, "Max dp/dt/P") $Units = DT (s-1, UCUM, "/s")
12 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122192, DCM, "Indicator appearance time") $Units = DT (s, UCUM, "s")
13 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122193, DCM, "Maximum pressure acceleration") $Units = DT (mm[Hg]/s2, UCUM, "mmHg/s/s")
14 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3617) Valve Flows $Units = DT (ml/min, UCUM, "ml/min")

TID 3560 Derived Hemodynamic Measurements

The 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.

TID 3560Derived Hemodynamic MeasurementsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122126, DCM, "Derived Hemodynamic Measurements") 1 U
2 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3614) Valve Areas, non-Mitral $Units = EV (cm2, UCUM, "cm2") $Equation = DT (122262, DCM, “Area = Flow / 44.5 * sqrt(Gradient[mmHg])”)
3 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-02320, SRT, "Mitral Valve Area”) $Units = EV (cm2, UCUM, "cm2") $Equation = DT (122263, DCM, “MVA= Flow / 38.0 * sqrt(Gradient[mmHg])”)
4 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3615) Valve Areas $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = DT (cm2/m2, UCUM, "cm2/m2")
5 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3616) Hemodynamic Period Measurements $Units = DT ("s/min", UCUM, "s/min")
6 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3617) Valve Flows $Units = DT (ml/s, UCUM, "ml/s")
7 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32110, SRT, "Cardiac Index”) $Units = DT (l/min/m2, UCUM, "l/min/m2")
8 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3529) Arterial / Venous Content $Units = DT (ml/dl, UCUM, "ml/dl")
9 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3618) Hemodynamic Flows $Units = DT (l/min, UCUM, "l/min")
10 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8736-1, LN, "FICK Cardiac Output”) $Units = DT (l/min, UCUM, "l/min")
11 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8750-2, LN, "FICK Cardiac Index”) $Units = DT (l/min/m2, UCUM, "l/min/m2")
12 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122229, DCM, "Arteriovenous difference”) $Units = DT (ml/dl, UCUM, "ml/dl")
13 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = BCID (3620) Hemodynamic Ratios $Units = DT (1, UCUM, "ratio")
14 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122237, DCM, "Corrected Sinus Node Recovery Time”) $Units = DT (ms, UCUM, "ms")
15 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8861-7, LN, "Left Ventricular Stroke Work”) $Units = DT (gf.m, UCUM, "gf.m")
16 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8862-5, LN, "Right Ventricular Stroke Work”) $Units = DT (gf.m, UCUM, "gf.m")
17 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8863-3, LN, "Left Ventricular Stroke Work Index”) $Units = DT (gf.m/m2, UCUM, "gf.m/m2")
18 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8864-1, LN, "Right Ventricular Stroke Work Index”) $Units = DT (gf.m/m2, UCUM, "gf.m/m2")
19 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122238, DCM, "Max volume normalized to 50mmHg pulse pressure”) $Units = DT (ml, UCUM, "ml")
20 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122239, DCM, "Oxygen Consumption”) $Units = DT (ml/min, UCUM, "ml/min") $Equation = BCID (3664) Oxygen Consumption Equations and Tables
21 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (19217-9, LN, "Oxygen partial pressure at 50% saturation (P50)") $Units = DCID (3500) $Equation = BCID (3666) P50 Equations
22 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (11556-8, LN, "Blood Oxygen partial pressure”) $Units = DCID (3500)
23 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3618) Hemodynamic Flows $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = DT (l/min/m2, UCUM, "l/min/m2")
24 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3619) Hemodynamic Resistance Measurements $Units = BCID (3502) Hemodynamic Resistance Units
25 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3619) Hemodynamic Resistance Measurements $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = BCID (3503) Indexed Hemodynamic Resistance Units
26 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122227, DCM, "Left to Right Flow”) $Units = DT (l/min, UCUM, "l/min")
27 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122228, DCM, "Right to Left Flow”) $Units = DT (l/min, UCUM, "l/min")
28 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, "Stroke Volume”) $Units = DT (ml, UCUM, "ml")
29 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, "Stroke Volume”) $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = DT (ml,/m2 UCUM, "ml/m2")
30 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-042BA, SRT, "Total blood volume”) $Units = DT (l, UCUM, "l")
31 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3667) Framingham Scores $Units = DT (%, UCUM, "%") $Equation = DCID (3668) Framingham Tables

TID 3570 Summary, Hemodynamics

This Template allows the recording of any significant numeric measurements or findings.

TID 3570Summary, HemodynamicsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121111, DCM, "Summary") 1 M
2 > CONTAINS TEXT EV (121111, DCM, "Summary") 1 U
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n U
4 > CONTAINS CODE EV (121071, DCM, "Finding") 1-n U DCID (3640) Hypertension
5 >> INCLUDE DTID (1350) “Negation Modifier, Presence of Finding” 1 U
6 >> HAS PROPERTIES CODE EV (G-C197, SRT, "Severity") 1 U DCID (3716) Severity
7 > CONTAINS CODE DCID (3641) Hemodynamic Assessments 1-n U DCID (3642) Degree Findings
8 >> HAS PROPERTIES CODE EV (G-C0B2, SRT, “Condition”) 1 U EV (R-102B9, SRT, “Large v-wave”)
9 > CONTAINS CODE EV (121071, DCM, “Finding”) 1 U EV (R-102BA, SRT, “Diastolic pressure equalization”)

TID 3601 Procedure Context

The Procedure Context template describes acquisition context for measurements made or events recorded in a procedure.

TID 3601 Procedure ContextType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 HAS ACQ CONTEXT TEXT EV (121065, DCM, "Procedure Description") 1 U Defaults to Study Description (0008,1030) of the General Study Module
2 HAS ACQ CONTEXT CODE EV (G-C0E8, SRT, “Has Intent”) 1 U BCID (3629) Procedure Intent
3 HAS ACQ CONTEXT CODE EV (G-C09C, SRT, “Procedure Priority”) 1 U BCID (3414) Procedure Urgency
4 HAS OBS CONTEXT CODE EV (121023, DCM, ”Procedure Code”) 1-n U Defaults to Procedure Code Sequence (0008,1032) of General Study Module

TID 3602 Cardiovascular Patient Characteristics

This 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 Patient Study Module, are included here as possible targets of by-reference relationships from other content items in the SR tree.

Note: Several of the concepts in this template duplicate concepts in TID 1007 “Subject Context, Patient”. The difference in use is that this template has those concepts as primary observations of the patient, while in TID 1007 the concepts are used to set (or reset) the context for other observations.

TID 3602Cardiovascular Patient CharacteristicsType: Extensible Order: Significant

NL
Row 16 Breast size for interpretation of attenuation in nuclear medicine imaging

TID 3603 Procedure Environmental Characteristics

TID 3603Procedure Environmental CharacteristicsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER 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, “ºC”)
4 > CONTAINS NUM EV (122225, DCM, “Room Barometric pressure”) 1 U UNITS = DT (mbar, UCUM, “millibar”)
ECG REPORT TEMPLATES

TID 3700 ECG Report

The 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.

TID 3700 ECG ReportType: Extensible Order: Significant

NL Relation with Parent Value Type 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 (G-C036, SRT, "Measurement Method") 1 U DCID (3676) Lead Measurement Technique
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 and 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.

TID 3717 ECG Qualitative Analysis

The ECG Qualitative Analysis template allows a free text qualitative interpretation of the analyzed ECG, as well as a structure for a coded analysis.

TID 3717 Qualitative Analysis, ECG Type: Extensible Order: Significant

NL
Row 5-6 Each primary ECG Finding of Row 3 may have multiple supporting coded findings in Row 5, with longer human-readable text strings if necessary in Row 6.

TID 3718 ECG Interpretive Statement (Retired)

This Template is retired. See PS3.16-2009.

TID 3719 Summary, ECG

TID 3719Summary, ECGType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121111, DCM, "Summary") 1 M
2 > CONTAINS TEXT EV (121111, DCM, "Summary") 1 U
3 > CONTAINS CODE DT(18810-2, LN, “ECG overall finding”) 1 U DCID (3677) Summary Codes ECG

CATH LAB CLINICAL REPORT TEMPLATES

The templates that comprise the Cardiac Catheterization Report are interconnected as shown in Figure A-7.

Figure A-7 Cardiac Catheterization Report Template Hierarchy

Note: The figure shows the relationship of templates; it does not show the structural hierarchy of Content Items in the IOD.

TID 3800 Cardiac Catheterization Report Root

The 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.

Notes: 1. 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.2. 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.

TID 3800Cardiac Catheterization Report RootType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (18745-0, LN, "Cardiac Catheterization Report") 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M DCID (3739) Cath Procedure Type
3 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 M
4 > INCLUDE DTID (3601) Procedure Context 1 M
5 > CONTAINS INCLUDE DTID (3802) "Cardiovascular Patient History" 1 U
6 > CONTAINS INCLUDE DTID (3803) "Patient Presentation, Cath" 1 M
7 > CONTAINS INCLUDE DTID (3806) Cath Procedure 1 M
8 > CONTAINS INCLUDE DTID (3810) Cardiac Catheterization Findings 1 M
9 > CONTAINS INCLUDE DTID (3807) Percutaneous Coronary Intervention Procedure 1 U
10 > CONTAINS INCLUDE DTID (3809) Other Interventional Procedures 1-n U
11 > CONTAINS INCLUDE DTID (3820) "Adverse Outcomes, Cath" 1 M
12 > CONTAINS INCLUDE DTID (3824) "Summary, Cath" 1 M
13 > CONTAINS INCLUDE DTID (3828) "Discharge Summary, Cath" 1 U

TID 3802 Cardiovascular Patient History

This 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.

TID 3802Cardiovascular Patient HistoryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121110, DCM, "Patient Presentation") 1 M
2 > CONTAINS TEXT EV (122128, DCM, "Patient Transferred From") 1 U
3 > CONTAINS DATETIME EV (15, NCDR [2.0b], "Admission Date/Time") 1 U
4 > CONTAINS CODE EV (17, NCDR [2.0b], "Admission Status") 1 U DCID (3729) Admission Status
5 > CONTAINS CODE EV (18, NCDR [2.0b], "Insurance Payor Type") 1 U DCID (3730), Insurance Payor
6 > CONTAINS CODE EV (46, NCDR [2.0b], "Congestive Heart Failure Prior to Procedure") 1 U DCID (230) Yes-No
7 > CONTAINS CODE EV (47, NCDR [2.0b], "NYHA Classification") 1 UC IFF Row 6 Value code meaning is <yes> DCID (3736) NYHA Classification
8 > CONTAINS CODE EV (48, NCDR [2.0b], "Noninvasive Testing - Ischemia") 1 U DCID (3737) Non-Invasive Test - Ischemia
9 > CONTAINS CODE EV (49, NCDR [2.0b], "Pre-Cath Angina Type") 1 U DCID (3738) Pre-Cath Angina Type
10 > CONTAINS CODE EV (50, NCDR [2.0b], "Pre-Cath Canadian Classification") 1 U DCID (3719) Canadian Clinical Classification
11 > CONTAINS CODE EV (51, NCDR [2.0b], "Acute Coronary Syndrome Time Period") 1 UC IFF Row 9 Value code meaning is <ACS> DCID (3735) Acute Coronary Syndrome Time Period
12 > CONTAINS CONTAINER EV (121109, DCM, "Indications for Procedure") 1 U
13 >> CONTAINS CODE EV (121071, DCM, "Finding") 1-n U DCID (3727) Indications for Catheterization
14 > CONTAINS NUM EV (10230-1, LN, "LV Ejection Fraction") 1-n U Units = EV (%, UCUM, "%")
15 >> HAS CONCEPT MOD CODE EV (G-C036, SRT, "Measurement method") 1 U DCID (3744) EF Testing Method
16 >> INCLUDE DTID (1000) Quotation 1 U
17 > CONTAINS CODE EV (121069, DCM, “Previous Finding”) 1-n U DCID (3700) Cath Diagnosis
18 > CONTAINS TEXT EV (121110, DCM, "Patient Presentation") 1 U

TID 3806 Cath Procedure

This template describes the patient-related information about this specific clinical encounter (catheterization).

TID 3806Cath ProcedureType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121064, DCM, "Current Procedure Descriptions") 1 M
2 > CONTAINS DATETIME EV (52, NCDR [2.0b], "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 BCID (7453) Performing Roles 1-n U
11 > CONTAINS CODE EV (122129, DCM, "PCI during this procedure") 1 U DCID (230) Yes-No
12 > CONTAINS CONTAINER EV (F-04460, "Medication Given") 1 M
13 >> CONTAINS CODE EV (57, NCDR [2.0b], "Thrombolytics") 1 U DCID (3740) Thrombolytic Administration
14 >> CONTAINS CODE EV (58, NCDR [2.0b], "IIb/IIIa Blockade") 1 U DCID (3741) Medication Administration, Lab Visit
15 >> CONTAINS CODE EV (59, NCDR [2.0b], "Heparin") 1-n U DCID (3742) Medication Administration, PCI
16 >> CONTAINS CODE EV (60, NCDR [2.0b], "Aspirin") 1 U DCID (3741) Medication Administration, Lab Visit
17 >> CONTAINS CODE EV (61, NCDR [2.0b], "Clopidogrel/Ticlopidine") 1 U DCID (3743) Clopidogrel/Ticlopidine Administration
18 >> CONTAINS TEXT EV (122083, DCM, “Drug administered”) 1-n U
19 > CONTAINS CODE EV (122138, DCM, "Circulatory Support") 1-n U DCID (3553) Circulatory Support
20 > CONTAINS CODE EV (74, NCDR [2.0b], "Percutaneous Entry Site") 1 M DCID (3746) Percutaneous Entry Site
21 > CONTAINS CODE EV (75, NCDR [2.0b], "Closure Device") 1 U DCID (3747) Percutaneous Closure

Content Item Descriptions

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.).

TID 3807 Percutaneous Coronary Intervention Procedure

This template describes the various aspects of a coronary intervention.

TID 3807Percutaneous Coronary Intervention ProcedureType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121064, DCM, "Current Procedure Descriptions") 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M DT (122061, DCM, “Percutaneous Coronary Intervention”)
3 > CONTAINS PNAME EV (121114, DCM, "Performing Physician") 1 M
4 > CONTAINS PNAME EV (121088, DCM, "Fellow") 1-n U
5 > CONTAINS PNAME DCID (7452) Organizational Roles 1-n U
6 > CONTAINS CODE EV (G-C09C, SRT, “Procedure Priority”) 1 M DCID (3414) Procedure Urgency
7 > CONTAINS CONTAINER EV (121109, DCM, "Indications for Procedure") 1 U
8 >> CONTAINS CODE EV (121071, DCM, "Finding") 1-n U DCID (3726) Indications for Coronary Intervention
9 >> CONTAINS CODE EV (122172, DCM, "Acute MI Present") 1 U DCID (230) Yes-No
10 >>> HAS PROPERTIES CODE DT (122170, DCM, “Type of Myocardial Infarction”) 1 U DCID (3723) MI Types
11 >>> HAS PROPERTIES DATETIME EV (122173, DCM, "ST Elevation Onset DateTime") 1 U
12 >> CONTAINS TEXT EV (121071, DCM, "Finding") 1-n U
13 > CONTAINS NUM EV (122175, DCM, "Number of lesion interventions attempted") 1 M UNITS = (1, UCUM, "units")
14 > CONTAINS NUM EV (122176, DCM, "Number of lesion interventions successful") 1 M UNITS = (1, UCUM, "units")
15 > CONTAINS CODE EV (122177, DCM, "Procedure Result") 1 M DCID (3749) PCI Procedure Result
16 > CONTAINS TEXT EV (122177, DCM, "Procedure Result") 1 U
17 > CONTAINS INCLUDE DTID (3808) Lesion Intervention Information 1-n M

Content Item Descriptions

Rows 8 and 12 allow the recording of findings as either codes or as text; the same finding shall not be recorded as both.

Similarly, rows 15 and 16 allow the recording of procedure results as either codes or as text, but not as both.

TID 3808 Lesion Intervention Information

TID 3808Lesion Intervention InformationType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122178, DCM, "Lesion Intervention Information") 1 M
2 > CONTAINS INCLUDE DTID (3105) Lesion Identification and Properties 1 M
3 > CONTAINS CODE EV (108, NDR [2.0b, "Previous Dilation") 1 U DCID (3750) Previously Dilated Lesion
4 > CONTAINS CODE EV (103, NDR [2.0b], “Guidewire crossing lesion") 1 U DCID (3752) Guidewire Crossing
5 > CONTAINS CODE EV (G-C50A, SRT, "Uses Equipment") 1-n M DCID (3411) Coronary Intervention Devices
6 >> HAS CONCEPT MOD CODE EV (122111, DCM, "Primary Intervention Device") 1 MC IF Device is Primary for this Lesion DCID (230) Yes-No
7 >> HAS PROPERTIES TEXT EV (121145, DCM, "Description of Material") 1 U
8 >> HAS PROPERTIES NUM DCID (3423) Numeric Device Characteristics 1-n U
9 >> HAS PROPERTIES NUM DCID (3425) Intervention Parameters 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 (R-101BB, SRT, “Lumen Diameter Stenosis”) 1 M UNITS = EV (%, UCUM, "%")
13 >> HAS CONCEPT MOD CODE EV (G-72BB, SRT, “Catheterization Procedure Phase”) 1 M EV (G-7298, SRT, “Post-intervention Phase”)
14 >> HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 U DCID (3745) Calculation Method
15 >> INCLUDE DTID (1000) Quotation 1 U
16 > CONTAINS CODE EV (122110, DCM, "Post- Intervention TIMI Flow") 1 U DCID (3713) TIMI Flow Characteristics
17 > CONTAINS CODE EV (115, NCDR [2.0b], "Dissection in segment observed") 1 U DCID (230) Yes-No
18 > CONTAINS CODE EV (116, NCDR [2.0b], "Acute closure observed") 1 U DCID (230) Yes-No
19 > CONTAINS CODE EV (117, NCDR [2.0b], "Acute closure re-opened") 1 UC IFF Row 18 value is <yes> DCID (230) Yes-No
20 > CONTAINS CODE EV (118, NCDR [2.0b], "Perforation occurred") 1 U DCID (230) Yes-No
21 > CONTAINS IMAGE DT (121080, DCM, "Best illustration of finding" 1 U
22 > CONTAINS TEXT DT (122177, DCM, "Procedure Result") 1 U

TID 3809 Other Interventional Procedures

TID 3809Other Interventional ProceduresType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121064, DCM, "Current Procedure Descriptions") 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M BCID (3406) Non-Coronary Transcatheter Interventions
3 > CONTAINS TEXT EV (121065, DCM, "Procedure Description") 1 U
4 > CONTAINS CODE DT (121065, DCM, "Procedure Description") 1 U No BCID
5 > CONTAINS TEXT DT (122177, DCM, "Procedure Result") 1 U

Content Item Descriptions

Rows 3 and 4 allow the recording of procedure description as either code or as text; the same description shall not be recorded as both.

TID 3810 Cardiac Catheterization Findings

The 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.

TID 3810Cardiac Catheterization FindingsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > CONTAINS INCLUDE DTID (3812) Hemodynamic Findings 1 U
3 > CONTAINS INCLUDE DTID (3817) Coronary Arteriography Findings 1 U
4 > CONTAINS INCLUDE DTID (3814) Left Ventriculography Findings 1 U
5 > CONTAINS INCLUDE DTID (3815) Right Ventriculography Findings 1 U
6 > CONTAINS INCLUDE DTID (3818) Other Cardiographic Findings 1-n U
7 > CONTAINS CODE EV (121071, DCM, "Finding") 1-n U DCID (3700) Cath Diagnosis
8 >> HAS PROPERTIES CODE EV (G-C197, SRT, "Severity") 1 U DCID (3716) Severity
9 > CONTAINS TEXT EV (121071, DCM, "Finding") 1-n U

Content Item Descriptions

Rows 7 and 9 allow the recording of findings as either codes or as text; the same finding shall not be recorded as both.

TID 3812 Hemodynamic Findings

TID 3812Hemodynamic FindingsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M DT (PA-50030, SRT, "Hemodynamic measurements")
3 > CONTAINS CODE EV (121071, DCM, “Finding”) 1-n U DCID (3640) Hypertension
4 >> INCLUDE DTID (1350) “Negation Modifier, Presence of Finding” 1 U
5 >> HAS PROPERTIES CODE EV (G-C197, SRT, "Severity") 1 U DCID (3716) Severity
6 > CONTAINS CODE DCID (3641) Hemodynamic Assessments 1-n U DCID (3642) Degree Findings
7 >> HAS PROPERTIES CODE EV (G-C0B2, SRT, “Condition”) 1 U EV (R-102B9, SRT, “Large v-wave”)
8 > CONTAINS CODE EV (121071, DCM, “Finding”) 1 U EV (R-102BA, SRT, “Diastolic pressure equalization”)
9 > CONTAINS INCLUDE DTID (3819) Common Findings 1-n U $Report = DT (122120, DCM, “Hemodynamics Report”)

Content Item Descriptions

Row 4 (through DTID 3819 Common Findings Template) may be used to encode any significant hemodynamic numeric measurements. For reference, see Templates 3550 Pressure Waveform Measurements, and 3560 Derived Hemodynamic Measurements.

TID 3814 Left Ventriculography Findings

The 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).

TID 3814Left Ventriculography FindingsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M DT (P5-30041, SRT, "Left Ventriculography")
3 > CONTAINS CODE EV ( F-30117, SRT, “Left Ventricular Function - Finding”) 1 M DCID (242) Normal-Abnormal
4 > INCLUDE TID (300) Measurement 1 M $Measurement = EV (10230-1, LN, "LV Ejection Fraction") $Units = EV (%, UCUM, "%") $Method = DCID (3748) Angiographic EF Testing Method $Derivation = DCID (3745) Calculation Method
5 > CONTAINS CODE EV (F-0224E, SRT, "Left Ventricular Cavity Size") 1 U DCID (3705) Chamber Size
6 > CONTAINS CODE EV (F-02225, SRT, "Left Ventricular Contractility") 1 U DCID (3706) Overall Contractility
7 > CONTAINS CODE EV (121071, DCM, "Finding") 1 U EV (D4-31159, SRT, "Ventricular Septal Defect")
8 >> HAS PROPERTIES CODE EV (G-C504, SRT, "Associated Morphology") 1 U DCID (3707) VSD Description
9 > CONTAINS INCLUDE DTID (3816) Ventricular Assessment 1 U
10 > CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 U
11 >> HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DT (T-D0772, SRT, ”Myocardial Wall”)
12 >> CONTAINS CODE EV (LN, 18179-2, "Wall Segment”) 1-n M BCID (3717) Myocardial Wall Segments
13 >>> HAS PROPERTIES CODE EV (F-32050, SRT, ”Cardiac Wall Motion”) 1 M DCID (3703) Wall Motion
14 >>> HAS PROPERTIES CODE EV (G-C504, SRT, "Associated Morphology") 1 U DCID (3704) Myocardium Wall Morphology Findings
15 >>> HAS PROPERTIES NUM DT (G-C1E3, SRT, “Score”) 1 U
16 > CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 U
17 >> HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DT (F-04403, SRT, "Aortic Root")
18 >> CONTAINS CODE EV (121071, DCM, "Finding") 1-n M DCID (3709) Aortic Root Description

TID 3815 Right Ventriculography Findings

The 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.

TID 3815Right Ventriculography FindingsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M DT (P5-3003F, SRT, "Right Ventriculography")
3 > INCLUDE TID (300) Measurement 1 M $Measurement = EV (10231-9, LN, "RV Ejection Fraction")) $Units = EV (%, UCUM, "%") $Method = DCID (3748) Angiographic EF Testing Method $Derivation = DCID (3745) Calculation Method
4 > CONTAINS CODE EV (F-022A1, SRT, "Right Ventricular Cavity Size") 1 U DCID (3705) Chamber Size
5 > CONTAINS CODE EV (F-0227A, "Right Ventricular Contractility") 1 U DCID (3706) Overall Contractility
6 > CONTAINS INCLUDE DTID (3816) Ventricular Assessment 1 U

TID 3816 Ventricular Assessment

TID 3816Ventricular AssessmentType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1-n U
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DCID (3701) Cardiac Valves and Tracts
3 > CONTAINS CODE EV (121071, DCM, "Finding") 1-n M DCID (3711) Valvular Abnormalities
4 >> HAS PROPERTIES CODE EV (G-C197, SRT, "Severity") 1 U DCID (3716) Severity
5 >> HAS PROPERTIES NUM DT (G-C1E3, SRT, “Score”) 1 U
6 CONTAINS INCLUDE DTID (3819) Common Findings 1-n U $Report = DT (122292, DCM, “Quantitative Ventriculography Report”)

TID 3817 Coronary Arteriography Findings

The 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).

TID 3817 Coronary Arteriography FindingsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M BCID (3428) Imaging Procedures
3 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 U BCID (3630) Cardiovascular Anatomic Locations
4 > CONTAINS INCLUDE DTID (3819) Common Findings 1-n M

TID 3819 Common Findings

TID 3819 Parameters

Parameter Name Parameter Usage
$Report Title of composite object (evidence document) referenced

TID 3819 Common FindingsType: Extensible Order: Significant

NL Relation with Parent Value Type 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 No BCID 1 U
4 > INCLUDE DTID (1000) Quotation 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 Section 6.2.4. The source of the measurement may be noted using the Quotation Template in Row 4.

TID 3820 Adverse Outcomes, Cath

TID 3820Adverse Outcomes, CathType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121113, DCM, "Complications") 1 M
2 > CONTAINS CODE EV (DD-60002, SRT, "Complication of Procedure") 1-n U DCID (3755) Cath Complications
3 >> HAS CONCEPT MOD CODE EV (G-D709, SRT, "Relative Time”) 1 U DCID (12102) Temporal Periods Relating to Procedure or Therapy
4 > CONTAINS CODE EV (DD-60002, SRT, "Complication of Procedure") 1-n U DCID (3754) Vascular Complications
5 >> HAS CONCEPT MOD CODE EV (G-D709, SRT, "Relative Time”) 1 U DCID (12102) Temporal Periods Relating to Procedure or Therapy
6 > CONTAINS TEXT EV (DD-60002, SRT, "Complication of Procedure") 1-n U
7 > CONTAINS CODE EV (122179, DCM, "Peri-procedural MI occurred") 1 U DCID (230) Yes-No
8 >> INFERRED FROM NUM EV (122181, DCM, "CK-MB peak") 1 U UNITS = EV ([iU], UCUM, "International unit")
9 >>> HAS PROPERTIES NUM EV (R-0038B, SRT, "Normal Range Upper Limit") 1 M UNITS = EV ([iU], UCUM, "International unit")
10 >> INFERRED FROM NUM EV (122180, DCM, "CK-MB baseline") 1 M UNITS = EV ([iU], UCUM, "International unit")
11 > CONTAINS IMAGE DT (121080, DCM, "Best illustration of finding" 1-n U

Content Item Descriptions

Rows 2, 3 and 4 allow the recording of outcomes as either codes or as text; the same outcome shall not be recorded as both.

TID 3824 Summary, Cath

TID 3824Summary, CathType: Extensible Order: Non-Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121111, DCM, "Summary") 1 M
2 > CONTAINS CODE EV (121071, DCM, "Finding") 1-n U DCID (3728) Cath Findings
3 >> HAS PROPERTIES CODE EV (G-C197, SRT, "Severity") 1 U DCID (3716) Severity
4 > CONTAINS TEXT EV (121111, DCM, "Summary") 1 U
5 > CONTAINS TEXT EV (121075, DCM, "Recommendation") 1-n U

TID 3828 Discharge Summary, Cath

TID 3828Discharge Summary, CathType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121115, DCM, "Discharge Summary") 1 M
2 > CONTAINS DATETIME EV (122163, DCM, "Discharge DateTime") 1 U
3 > CONTAINS CODE EV (122164, DCM, "Coronary Artery Bypass During This Admission") 1 U DCID (230) Yes-No
4 >> HAS PROPERTIES CODE EV (G-C09C, SRT, “Procedure Priority”) 1 U BCID (3414) Procedure Urgency
5 >> HAS PROPERTIES DATETIME EV (122146, DCM, "Procedure DateTime") 1 U
6 > CONTAINS CODE EV (122166, DCM, "Death During This Admission") 1 U DCID (230) Yes-No
7 >> HAS PROPERTIES DATETIME EV (122165, DCM, "Date of Death") 1 U
8 >> HAS PROPERTIES CODE EV (25, NCDR [2.0b], "Primary Cause of Death") 1 U DCID (3733) Primary Cause of Death
9 >> HAS PROPERTIES CODE EV (122167, DCM, “Death During Catheterization") 1 U DCID (230) Yes-No
10 > CONTAINS TEXT EV (121111, DCM, "Summary") 1 U

TID 3829 Problem Properties

TID 3829 Parameters

Parameter Name Parameter Usage
$Problem Coded Value or Context Group for problem
$ModType Modifier Name for Concept Name of problem
$ModValue Modifier Value for Concept Name of problem
$Therapy Coded Value or Context Group for therapy received for problem
$Stage Coded Value or Context Group for problem or disease stage

TID 3829Problem PropertiesType: Extensible Order: Significant

NL
$ProcType Coded Value for class of procedure
$Procedure Coded Value or Context Group for procedure
$ModType Modifier Name for Concept Name of procedure
$ModValue Modifier Value for Concept Name of procedure

TID 3830Procedure PropertiesType: Extensible Order: Significant

NL
$Device Coded Value for type of device

TID 3831Medical Device UseType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122600, DCM, “Cardiovascular Analysis Report”) 1 M
2 > HAS CONCEPT MOD CODE EV(121058, DCM, "Procedure Reported") 1-n M DCID(3820) Non-invasive Vascular Procedures
3 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 M
4 > HAS OBS CONTEXT INCLUDE DTID (1001) Observation Context 1 M
5 > CONTAINS INCLUDE DTID (3602) Cardiovascular Patient Characteristics 1 U
6 > CONTAINS INCLUDE DTID (3802) Patient History, Cardiovascular 1 U
7 > CONTAINS INCLUDE DTID (3901) Procedure Summary 1 U
8 > CONTAINS INCLUDE DTID (3902) Vascular Analysis 1 U $AnalysisPerformed = EV(122605, DCM, "Vascular Morphological Analysis")
9 > CONTAINS INCLUDE DTID (3902) Vascular Analysis 1 U $AnalysisPerformed = EV(122606, DCM, "Vascular Functional Analysis")
10 > CONTAINS INCLUDE DTID (3920) Ventricular Analysis 1 U
11 > CONTAINS INCLUDE DTID (3927) Report Summary 1-n U

TID 3901 Procedure Summary

Contains summaries related to the performed procedures.

TID 3901Procedure SummaryType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV(121064, DCM, "Current Procedure Descriptions") 1 M
2 > CONTAINS TEXT EV(121065, DCM, "Current Procedure Description") 1-n M

TID 3902 Vascular Analysis

Contains either morphological or functional vascular measurement results of an analysis

TID 3902Vascular AnalysisType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV(111004, DCM, "Analysis Performed") 1 M $AnalysisPerformed
3 > CONTAINS INCLUDE DTID (3905) Calcium Scoring Results 1 UC IFF the value of row 2 equals EV(122605, DCM, "Vascular Morphological Analysis")
4 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-40501, SRT, ”Blood Vessel of Head”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12105) Intracranial Cerebral Vessels $AnalysisPerformed = $AnalysisPerformed
5 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-40501, SRT, ”Blood Vessel of Head”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12105) Intracranial Cerebral Vessels $AnalysisPerformed = $AnalysisPerformed
6 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-40501, SRT, ”Blood Vessel of Head” $SectionLaterality = EV (G-A103, SRT, ”Unilateral”) $Anatomy = DCID (12106) Unpaired Intracranial Cerebral Vessels (unilateral) $AnalysisPerformed = $AnalysisPerformed
7 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT(T-45005, SRT, ”Artery of Neck”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12104) Extracranial Arteries $AnalysisPerformed = $AnalysisPerformed
8 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT(T-45005, SRT, ”Artery of Neck”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12104) Extracranial Arteries $AnalysisPerformed = $AnalysisPerformed
9 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT(T-47040, SRT, ”Artery of Lower Extremity ”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12109) Lower Extremity Arteries $AnalysisPerformed = $AnalysisPerformed
10 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT(T-47040, SRT, ”Artery of Lower Extremity ”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12109) Lower Extremity Arteries $AnalysisPerformed = $AnalysisPerformed
11 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-49403, SRT, ”Vein of Lower Extremity”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12110) Lower Extremity Veins $AnalysisPerformed = $AnalysisPerformed
12 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-49403, SRT, ”Vein of Lower Extremity”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12110) Lower Extremity Veins $AnalysisPerformed = $AnalysisPerformed
13 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-47020, SRT, ”Artery of Upper Extremity”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12107) Upper Extremity Arteries $AnalysisPerformed = $AnalysisPerformed
14 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-47020, SRT, ”Artery of Upper Extremity”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12107) Upper Extremity Arteries $AnalysisPerformed = $AnalysisPerformed
15 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-49103, SRT, ”Vein of Upper Extremity”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12108) Upper Extremity Veins $AnalysisPerformed = $AnalysisPerformed
16 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-49103, SRT, ”Vein of Upper Extremity”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12108) Upper Extremity Veins $AnalysisPerformed = $AnalysisPerformed
17 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-71019, SRT, ”Vascular Structure of Kidney”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12115) Renal Vessels $AnalysisPerformed = $AnalysisPerformed
18 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-71019, SRT, ”Vascular Structure of Kidney”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12115) Renal Vessels $AnalysisPerformed = $AnalysisPerformed
19 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-46002, SRT, ”Artery of Abdomen”) $SectionLaterality = EV(G-A101, SRT, ”Left”) $Anatomy = DCID (12111) Abdominal Arteries (lateral) $AnalysisPerformed = $AnalysisPerformed
20 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-46002, SRT, ”Artery of Abdomen”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12111) Abdominal Arteries (lateral) $AnalysisPerformed = $AnalysisPerformed
21 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-46002, SRT, ”Artery of Abdomen”) $SectionLaterality = EV (G-A103, SRT, ”Unilateral”) $Anatomy = DCID (12112) Abdominal Arteries (unilateral) $AnalysisPerformed = $AnalysisPerformed
22 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-487A0, SRT, ”Vein of Abdomen”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12113) Abdominal Veins (lateral) $AnalysisPerformed = $AnalysisPerformed
23 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-487A0, SRT, ”Vein of Abdomen”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12113) Abdominal Veins (lateral) $AnalysisPerformed = $AnalysisPerformed
24 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-487A0, SRT, ”Vein of Abdomen”) $SectionLaterality = EV (G-A103, SRT, ”Unilateral”) $Anatomy = DCID (12114) Abdominal Veins (unilateral) $AnalysisPerformed = $AnalysisPerformed
25 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT (T-44000, SRT, ”Pulmonary Artery Structure”) $SectionLaterality = EV (G-A103, SRT, ”Unilateral”) $Anatomy = DCID (3829) Pulmonary Arteries $AnalysisPerformed = $AnalysisPerformed
26 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT(T-43000, SRT, "Coronary Artery Structure") $Anatomy = DCID(3015) Coronary Arteries $AnalysisPerformed = $AnalysisPerformed
27 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT(T-48400, SRT, "Cardiac Vein Structure") $Anatomy = DCID(3839) Coronary Veins $AnalysisPerformed = $AnalysisPerformed
28 > CONTAINS INCLUDE DTID (3906) Vascular Section Measurements 1-n U $VascularSection = DT(T-48581, SRT, "Pulmonary Venous Structure") $Anatomy = DCID(3840) Pulmonary Veins $AnalysisPerformed = $AnalysisPerformed

TID 3905 Calcium Scoring Results

Contains the calcium scoring results related to plaque findings, vessels or the whole body.

TID 3905Calcium Scoring ResultsType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, "Findings") 1 M
2 > CONTAINS CODE EV(111004, DCM, "Analysis Performed") 1 M EV(122603, DCM, "Calcium Scoring Analysis")
3 > CONTAINS NUM EV(122657, DCM, "Agatston Score Threshold") 1 U Units= DT([hnsf´U], UCUM, "Hounsfield unit")
4 > CONTAINS NUM EV(122658, DCM, "Calcium Mass Threshold") 1 U Units= DT(mg/cm3, UCUM, "mg/cm^3")
5 > CONTAINS NUM EV(122659, DCM, "Calcium Scoring Calibration") 1 U Units= DT(mg/[hnsf´U].cm3), UCUM, "mg/[hnsf´U].cm^3")
6 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement=EV(112058, DCM, "Calcium Score") $Method=EV(112055, DCM, "Agatston Scoring Method") $Units= DT (1, UCUM, "no units")
7 > CONTAINS NUM EV(122660, DCM, "Calcium Volume") 1 U Units= UCUM(mm3, UCUM, "mm^3")
8 > CONTAINS NUM EV(122661, DCM, "Calcium Mass") 1 U Units= UCUM(mg, UCUM, "mg")
9 > CONTAINS NUM EV(F-02A3B, SRT, "Number of Lesions") 1 U Units= DT ({lesions}, UCUM, "lesions")
10 > CONTAINS INCLUDE DTID (3909) Best illustration of findings 1-n U

TID 3906 Vascular Section Measurements

Sections of vascular measurements are section containers of an anatomical region consisting of measurement group containers containing the measurements.

Parameter Name Parameter Usage
$VascularSection The concept name of the region or structure of which the anatomy is part
$SectionLaterality The laterality (if any) of the anatomy in this section heading
$Anatomy The concept name of the vascular anatomy
$AnalysisPerformed The context of the measurements performed during the analysis

TID 3906Vascular Section MeasurementsType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER $VascularSection 1 M
2 > HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality”) 1 MC IFF $SectionLaterality has a value $SectionLaterality
3 > CONTAINS CONTAINER EV (121070, DCM, "Findings") 1-n M
4 >> HAS CONCEPT MOD CODE EV(G-C0E3, SRT, "Finding Site") 1 M $Anatomy
5 >> CONTAINS CODE EV(122686, DCM, “Parent Vessel Finding”) 1-n U DCID(3810) Vascular Morphology
6 >>> INCLUDE DTID (1350) Negation Modifier, Presence of Finding 1 U
7 >> CONTAINS INCLUDE DTID (3905) Calcium Scoring Results 1 UC IF the value of $AnalysisPerformed equals (122605, DCM, "Vascular Morphological Analysis")
8 >> CONTAINS CONTAINER EV (121070, DCM, "Findings") 1-n U
9 >>> HAS CONCEPT MOD CODE EV (125101, DCM, “Vessel Branch”) 1-n UC IF concept value of row 4 is not equal to (T-43000, SRT, "Coronary Artery Structure") DCID (12117) Vessel Branch Modifiers
10 >>> HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical Modifier”) 1 UC IF concept value of row 4 is not equal to (T-43000, SRT, "Coronary Artery Structure") DCID (12116) Vessel Segment Modifiers
11 >>> HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical Modifier”) 1 UC IF concept value of row 4 equals (T-43000, SRT, "Coronary Artery Structure") DCID(3019) Cardiovascular Anatomic Location Modifiers
12 >>> CONTAINS INCLUDE DTID (3907) Vessel Measurements 1 U
13 >>> CONTAINS INCLUDE DTID (3908) Vascular Lesion 1-n UC IF the value of $AnalysisPerformed equals (122605, DCM, "Vascular Morphological Analysis")
14 >>> CONTAINS INCLUDE DTID (3910) Flow Quantification 1 UC IF the value of $AnalysisPerformed equals (122606, DCM, "Vascular Functional Analysis")

Content Item Descriptions

Row 3 This Findings container allows an application to group related vessels or branches
Row 5 The characteristics associated with the parent vessel shall also be reported in the findings Container for the parent vessel. Negative findings (characteristics not present) need not be reported in the parent vessel Container.

TID 3907 Vessel Measurements

Contains measurements made on vessel level.

TID 3907Vessel MeasurementsType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS NUM EV(R-101BB, SRT, “Lumen Diameter Stenosis“) 1 U UNITS=DT(%,UCUM, “%”)
2 CONTAINS NUM EV(R-101BA, SRT, “Lumen Area Stenosis“) 1 U UNITS=DT(%,UCUM, “%”)
3 CONTAINS NUM EV(121206, DCM, ”Distance”) 1-n U UNITS=DT(mm, UCUM, “mm”)
4 > HAS CONCEPT MOD CODE EV(122340, DCM, “Fiducial Feature”) 2 M
5 >> HAS CONCEPT MOD CODE EV(G-C171, SRT, “Laterality”) 1 U DCID(244) Laterality
6 > INCLUDE DTID (320) Image or Spatial Coordinates 1 U
7 CONTAINS NUM EV(G-0364, SRT, "Vessel Lumen Diameter") 1-n U UNITS=DT(mm, UCUM, "mm")
8 > HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 U DCID(3488) Min/Max/Mean
9 > HAS CONCEPT MOD NUM EV(122337, DCM, "Relative Position”) 1 U Units=EV(mm, UCUM, "mm")
10 >> HAS CONCEPT MOD CODE EV(122340, DCM, "Fiducial Feature") 1 M DCID(3837) Fiducial Feature

Content Item Descriptions

Rows 3-5 The distance between two identified fiducial features
Rows 7-10 Measurement of vessel diameter made at a position relative to a fiducial feature
Row 9 A positive value indicates a distance in the direction of flow within the vessel

TID 3908 Vascular Lesion

Specifies properties and the features of a vascular lesion deteced during the analysis. In addition it is possible to reference or include growing of lesions over time by adding references to previous reports or by adding previous examination results.

TID 3908 Vascular Lesion Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV(F-00585, SRT, "Lesion Finding") 1 M
2 > CONTAINS TEXT EV (121151, DCM, "Lesion Identifier") 1 M
3 > CONTAINS INCLUDE DTID (3909) Best Illustration of Findings 1-n U
4 > CONTAINS TEXT EV(121106, DCM, "Comment") 1-n U
5 > CONTAINS NUM EV(122337, DCM, "Relative Position”) 1 U Units=EV(mm, UCUM, "mm")
6 >> HAS CONCEPT MOD CODE EV(122340, DCM, "Fiducial Feature") 1 M DCID(3837) Fiducial Feature
7 > CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement= EV(G-0364, SRT, "Vessel Lumen Diameter") $Derivation=DCID (3838) Diameter Derivation $FindingSite=DCID(3486) IVUS Measurement Sites $Units=DT(mm, UCUM, "mm")
8 > CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement= EV(G-0366, SRT, "Vessel Lumen Cross-Sectional Area") $Derivation=DCID (3838) Diameter Derivation $FindingSite=DCID(3486) IVUS Measurement Sites $Units=DT(mm2, UCUM, "mm^2")
9 > CONTAINS CODE EV(G-C504, SRT, "Associated Morphology") 1-n M DCID(3810) Vascular Morphology
10 >> INCLUDE DTID(3909) Best Illustration of Findings 1-n U
11 >> HAS PROPERTIES TEXT EV(121106, DCM, "Comment") 1-n U
12 >> INCLUDE DTID(3911) Plaque Properties 1 MC IFF value of row 9 equals (M-01470, SRT, "Plaque")
13 >> INCLUDE DTID(3912) Stenosis Properties 1 MC IFF value of row 9 equals (M-34200, "Stenosis")
14 >> INCLUDE DTID(3913) Aneurysm Properties 1 MC IFF value of row 9 equals (M-32200, SRT, "Aneurysm")
15 >> INCLUDE DTID(3914) Dissection Properties 1 MC IFF value of row 9 equals (D3-81310, SRT, "Arterial Dissection")
16 >> HAS PROPERTIES CODE EV(G-C504, SRT, "Associated Morphology") 1 MC IFF value of row 9 equals (M-520F8, SRT, "Vascular Sclerosis") DCID (3817) Vascular Sclerosis Types
17 >> INCLUDE DTID(3915) Vascular Occlusion Properties 1 MC IFF value of row 9 equals EVM-34000, SRT, "Occlusion")
18 >> INCLUDE DTID(3916) Stent Properties 1 MC IFF value of row 9 equals (A-25500, SRT, "Stent")

Content Item Descriptions

Row Description
Row 5 A positive value indicates a distance in the direction of flow within the vessel For example: An aneurysm with relative position -4 mm from the renal arteries would begin superior to the renal arteries.
Row 7, 8 These rows are associated with the position of the most significant effect of the lesion, i.e. maximum diameter of aneurysm or the minimum diameter of stenosis

TID 3909 Best Illustration of Findings

Specification of images, waveforms, spatial and temporal coordinates used to illustrate findings.

TID 3909Best Illustration of FindingsType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS IMAGE EV (121080, DCM, "Best illustration of finding") 1 U
2 CONTAINS WAVEFORM EV (121080, DCM, "Best illustration of finding") 1 U
3 CONTAINS SCOORD EV (121080, DCM, "Best illustration of finding") 1 U
4 > SELECTED FROM IMAGE no purpose of reference 1 M
5 CONTAINS TCOORD EV (121080, DCM, "Best illustration of finding") 1 U
6 > SELECTED FROM SCOORD no purpose of reference 1 MC XOR row 8, 9
7 >> SELECTED FROM IMAGE no purpose of reference 1 MC must be a multiframe image
8 > SELECTED FROM WAVEFORM no purpose of reference 1 MC XOR row 6, 9
9 > SELECTED FROM IMAGE no purpose of reference 1 MC XOR row 6, 8 must be a multiframe image

TID 3910 Flow Quantification

Contains the flow quantification measurement results

TID 3910 Flow Quantification Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV(111004, DCM, "Analysis Performed") 1 M EV (122604, DCM, "Flow Quantification")
3 > HAS OBS CONTEXT INCLUDE DTID(3929) Cardiovascular Analysis Observation Context 1 U
4 > HAS OBS CONTEXT DATETIME EV(G-D321, SRT, "Start Time") 1 M
5 > HAS OBS CONTEXT DATETIME EV(G-D320, SRT, "Stop Time") 1 M
6 > CONTAINS INCLUDE DTID(3990) 2-Dimensional Measurement Graph 1 U $MeasurementGraph = EV(122667, DCM, "Blood velocity vs. time of cardiac cycle") $X-Concept = EV(122666, DCM, "Time relative to R-wave peak") $Y-Concept = EV(F-0319E, SRT, "Arterial Velocity") $X-AxisUnits= DT(ms, UCUM, "ms") $Y-AxisUnits= DT(cm/s, UCUM, "cm/s")
7 > CONTAINS NUM EV(122642, DCM, "Velocity Encoding Minimum Value") 1 U Units = DT(cm/s, UCUM, "cm/s")
8 > CONTAINS NUM EV(122643, DCM, "Velocity Encoding Maximum Value") 1 U Units = DT(cm/s, UCUM, "cm/s")
9 > CONTAINS CONTAINER EV(125007, DCM, "Measurement Group") 1-n M
10 >> HAS CONCEPT MOD TEXT EV(G-C0E3, SRT, "Finding Site") 1 MC XOR row 11
11 >> HAS CONCEPT MOD CODE EV(G-C0E3, SRT, "Finding Site") 1 MC XOR row 10
12 >> CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122207, DCM, "Blood velocity, peak") $Units = DT(cm/s, UCUM, "cm/s")
13 >> CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122205, DCM, "Blood velocity, mean") $Units = DT(cm/s, UCUM, "cm/s")
14 >> CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(F-39200, SRT, "Blood Flow") $Derivation = EV(R-00317, SRT, "Mean") $Units = DT(ml/s, UCUM, "ml/s"")
15 >> CONTAINS INCLUDE DTID(300) Measurement 1-2 U $Measurement = EV(F-39200, SRT, "Blood Flow") $ModType = EV(G-C048, SRT, “Direction of flow”) $ModValue = DCID(12221) Flow Direction $Units = DT(ml/s, UCUM, "ml/s")
16 >> CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122645, DCM, "Net Forward Volume") $Units = DT(ml, UCUM, "ml")
17 >> CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122645, DCM, "Net Forward Volume") $ModType=EV(121425, DCM, "Index") $ModValue= DT(8277-6, LN, “BSA”) $Units = (ml/m2, UCUM, "ml/m^2")
18 >> CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = EV(G-0366, SRT, "Vessel Lumen Cross-Sectional Area") $Derivation = DCID (3488) Min/Max/Mean $Units = DT(mm2, UCUM, "mm^2")

TID 3911 Plaque Properties

Properties of a plaque finding

TID 3911Plaque PropertiesType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS PROPERTIES NUM EV(122376, DCM, "Total Plaque Volume") 1 U Units=DT(mm3,UCUM,"mm^3")
2 HAS PROPERTIES CODE EV(G-A428, SRT, "Margin") 1 U DCID(3715) Lesion Morphology
3 HAS PROPERTIES CODE EV(M-01000, SRT, "Morphological Abnormal Structure") 1-n M DCID(3802) Plaque Structures
4 HAS PROPERTIES INCLUDE DTID (3905) Calcium Scoring Results 1 U
5 HAS PROPERTIES CODE EV(121071, DCM, "Finding") 1 U DT(R-102DA, SRT, "Contrast Media Seen in Plaque")

TID 3912 Stenosis Properties

Properties of a stenosis finding

TID 3912Stenosis PropertiesType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS PROPERTIES CODE EV(G-C036, SRT, "Measurement method") 1 M DCID(3804) Stenosis Measurement Methods
2 HAS PROPERTIES CODE EV(G-D775, SRT, "Type of Stenosis") 1 U DCID(3805) Stenosis Types
3 HAS PROPERTIES CODE EV(G-C002, SRT, "Associated with") 1 U DCID(3815) Source of Vascular Finding
4 HAS PROPERTIES CODE EV(G-C2FE, SRT, "Shape") 1 U DCID(3806) Stenosis Shapes
5 HAS PROPERTIES INCLUDE DTID(300) Measurement 1-n U $Measurement= EV(G-0364, SRT, "Vessel Lumen Diameter") $Derivation= DCID(3488) Min/Max/Mean $Units=DT(mm, UCUM, "mm")
6 HAS PROPERTIES INCLUDE DTID(300) Measurement 1-n U $Measurement= EV(G-0366, SRT, "Vessel Lumen Cross-Sectional Area") $Derivation= DCID(3488) Min/Max/Mean $Units=DT(mm2,UCUM, "mm^2")
7 HAS PROPERTIES NUM EV(R-101BC, SRT, "Stenotic Lesion Length") 1 U Units=DT(mm, UCUM, "mm")
8 HAS PROPERTIES CODE EV(R-101BC, SRT, "Stenotic Lesion Length") 1 U DCID(3831) Stenosis Length
9 HAS PROPERTIES INCLUDE DTID(300) Measurement 1-n U $Measurement= EV(R-101BA, SRT, "Lumen Area Stenosis") $Derivation= DCID(3488) Min/Max/Mean $Units=DT(%,UCUM, “%")
10 HAS PROPERTIES INCLUDE DTID(300) Measurement 1-n U $Measurement= EV(R-101BB, SRT, "Lumen Diameter stenosis") $Derivation= DCID(3488) Min/Max/Mean $Units=DT(%,UCUM, “%")
11 HAS PROPERTIES CODE EV(R-101BA, SRT, "Lumen Area Stenosis") 1-n U DCID(3832) Stenosis Grade
12 > HAS CONCEPT MOD CODE EV(121401, DCM, "Derivation") 1 M DCID(3488) Min/Max/Mean
13 HAS PROPERTIES CODE EV(R-101BB, SRT, “Lumen Diameter Stenosis“) 1-n U DCID(3832) Stenosis Grade
14 > HAS CONCEPT MOD CODE EV(121401, DCM, "Derivation") 1 M DCID(3488) Min/Max/Mean

TID 3913 Aneurysm Properties

Properties of an aneurysm finding

TID 3913Aneurysm PropertiesType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS PROPERTIES CODE EV(G-C504, SRT, "Associated Morphology") 1-n M DCID (3808) Aneurysm Types
2 HAS PROPERTIES CODE EV(G-C002, SRT, "Associated with") 1 U DCID(3815) Source of Vascular Finding
3 HAS PROPERTIES INCLUDE DTID(3917) Aneurysm Measurements 1 U
4 HAS PROPERTIES CODE EV(G-C504, SRT, "Associated Morphology") 1-n UC IFF value of row 1 equals (M-32206, SRT, "Compound Aneurysm") DCID (3808) Aneurysm Types
5 > HAS PROPERTIES INCLUDE DTID(3917) Aneurysm Measurements 1 U

TID 3914 Arterial Dissection Properties

Properties of a arterial dissection finding

TID 3914Arterial Dissection PropertiesType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS PROPERTIES CODE EV(122387, DCM, "Dissection Classification") 1 M DCID(3492) IVUS Dissection Classification
2 HAS PROPERTIES CODE EV(G-C150, SRT, "Etiology") 1 U DCID(3809) Associated Conditions
3 HAS PROPERTIES NUM EV(G-A22A, SRT, "Length") 1 U Units= DT(mm, UCUM, "mm")
4 HAS PROPERTIES CODE EV(R-102DD, SRT, "Anatomic structure potentially involved in evolution of disease") 1-n U DCID(3827) Vessel Segments

TID 3915 Vascular Occlusion Properties

Properties of vascular occlusion finding

TID 3915 Vascular Occlusion Properties Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS PROPERTIES CODE EV(G-D775, SRT, "Type of Stenosis") 1 M DCID(3805) Stenosis Types
2 HAS PROPERTIES CODE EV(G-C002, SRT, "Associated with") 1 U DCID(3815) Source of Vascular Finding
3 HAS PROPERTIES CODE EV(G-C2FE, SRT, "Shape") 1 U DCID(3806) Stenosis Shapes
4 HAS PROPERTIES INCLUDE DTID(300) Measurement 1 U $Measurement=EV(R-101BC, SRT, "Stenotic Lesion Length") $Method= DCID(3804) Stenosis Measurement Methods $Units=DT(mm, UCUM, "mm")

TID 3916 Stent Properties

Properties of a stent finding

TID 3916Stent PropertiesType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS PROPERTIES CODE EV(155, DCM, "Stent Composition") 1-n M DCID(38014) Stent Composition
2 HAS PROPERTIES NUM EV(R-101AD, SRT, "Vascular Stent Diameter") 1 U Units= DT(mm, UCUM, "mm")
3 HAS PROPERTIES NUM EV(R-101B0, SRT, "Vascular Stent Length") 1 U Units= DT(mm, UCUM, "mm")
4 HAS PROPERTIES CODE EV(121071, DCM, "Finding") 1-n U DCID(3813) Stent Findings
5 > INCLUDE DTID(3912) Stenosis Properties 1 MC IFF value of row 4 equals (M-34200, SRT, "Stenosis")

TID 3917 Aneurysm Measurements

Measurements of aneurysms. TID 300 invoked from this template alllows the measurement to reference an image used as the source of the measurement.

TID 3917Aneurysm MeasurementsType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 INCLUDE DTID(300) Measurement 1 U $Measurement= EV(G-A22A, SRT, "Length") $ModType = EV(G-C093, SRT, ”Extent”) $ModValue = DT(G-A143, SRT, ”Longitudinal” ) $Units=DT(mm, UCUM, "mm")
2 INCLUDE DTID(300) Measurement 1 U $Measurement= EV(G-D705, SRT, "Volume") $Method= DCID(3807) Volume Measurement Methods $Units=DT(mm3, UCUM, "mm^3")
3 INCLUDE DTID(300) Measurement 1 U $Measurement= EV(R-102DB, SRT, "Vessel Lumen Cross-Sectional Area Increase") $Units=DT(%, UCUM, “%")
4 INCLUDE DTID(300) Measurement 1 U $Measurement= EV(R-102DB, SRT, "Vessel Lumen Cross-Sectional Area Increase") $Units=DT(mm2, UCUM, "mm^2")
5 INCLUDE DTID(300) Measurement 1 U $Measurement= EV(R-102DC, SRT, "Vessel Lumen Cross-Sectional Diameter Increase") $Units=DT(%, UCUM, “%")
6 INCLUDE DTID(300) Measurement 1 U $Measurement= EV(R-102DC, SRT, "Vessel Lumen Cross-Sectional Diameter Increase") $Units=DT(mm, UCUM, "mm")

TID 3920 Ventricular Analysis

Contains the ventricular functional measurement results.

TID 3920Ventricular AnalysisType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV(111004, DCM, "Analysis Performed") 1 M EV(122601, DCM, "Ventricular Analysis")
3 > HAS OBS CONTEXT INCLUDE DTID (3929) Cardiovascular Analysis Observation Context 1 U
4 > CONTAINS INCLUDE DTID (3921) Ventricular Measurements 1-n U $Ventricle = EV (T-32600, SRT, "Left Ventricle”)
5 > CONTAINS INCLUDE DTID (3921) Ventricular Measurements 1-n U $Ventricle = EV (T-32500, SRT, "Right Ventricle”)
6 > CONTAINS INCLUDE DTID (3925) Thickening Analysis 1-n U
7 > CONTAINS INCLUDE DTID (3926) Myocardial Perfusion Analysis 1-n U

TID 3921 Ventricular Measurements

Ventricular measurement results related to the volume of a ventricle.

Parameter Name Parameter Usage
$Ventricle Describes if either the left or the right ventricle was examined

TID 3921Ventricular MeasurementsType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV(G-C0E3, SRT, "Finding Site") 1 M $Ventricle
3 > CONTAINS INCLUDE DTID(3922) Absolute Values Of Ventricular Measurements 1 M
4 > CONTAINS INCLUDE DTID(3923) BSA-Normalized Ventricular Measurements 1 U
5 > CONTAINS INCLUDE DTID(3924) Heart Rate-Normalized Ventricular Measurements 1 U

TID 3922 Absolute Values Of Ventricular Measurements

Ventricular measurement results related to the absolute volume of a ventricle.

TID 3922 Absolute Values Of Ventricular Measurements Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV(122608, DCM, "Absolute Values Of Ventricular Measurements") 1 M
2 > CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = DCID(3833) Cardiac Ejection Fraction $ModType = DT(122670, DCM, "Papillary Muscle Included/Excluded") $ModValue = DCID(3821) Papillary Muscle Included/Excluded $Method = DCID(3807) Volume Measurement Methods $Units = DT(%,UCUM,”%")
3 > CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = DCID(3835) Cardiac Volume Measurements $ModType = DT(122670, DCM, "Papillary Muscle Included/Excluded") $ModValue = DCID(3821) Papillary Muscle Included/Excluded $Units = DT(ml, UCUM, "ml")
4 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(F-32100, SRT, "Cardiac Output") $ModType = DT(122670, DCM, "Papillary Muscle Included/Excluded") $ModValue = DCID(3821) Papillary Muscle Included/Excluded $Units = DT(l/min, UCUM, "l/min")
5 > CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = EV(122447, DCM, " Wall Mass") $ModType = DT(122670, DCM, "Papillary Muscle Included/Excluded") $ModValue = DCID(3821) Papillary Muscle Included/Excluded $Units = DT(g, UCUM, "g")
6 >> HAS CONCEPT MOD CODE EV(R-4089A, SRT, "Cardiac Cycle Point") 1 U DCID(12233) Cardiac Cycle Point
7 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122616, DCM, "Peak Ejection Rate") $Units = DT(ml/s, UCUM, "ml/s")
8 > CONTAINS NUM EV(122617, DCM, "Peak Ejection Time") 1 U Units = EV(s, UCUM, "s")
9 >> HAS CONCEPT MOD CODE EV(122611, DCM, “Reference Point”) 1 M EV(F-32011, SRT, "End-Diastolic")
10 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122618, DCM, "Peak Filling Rate") $Units = DT(ml/s, UCUM, "ml/s")
11 > CONTAINS NUM EV(122619, DCM, "Peak Filling Time") 1 U $Units = DT(s, UCUM, ”s”)
12 >> HAS CONCEPT MOD CODE EV(122611, DCM, “Reference Point”) 1 M DT(109070, DCM, "End-Systolic")

TID 3923 BSA-Normalized Ventricular Measurements

Ventricular measurement results normalized based on the Body Surface Area

TID 3923BSA-normalized Ventricular Measurements Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV(122609, DCM, "Normalized values of ventricular measurements") 1 M
2 > HAS CONCEPT MOD CODE EV(121425, DCM, "Index") 1 M DT(8277-6, LN, “Body Surface Area”)
3 > CONTAINS INCLUDE DTID(300) Measurement 1 M $Measurement=EV(8277-6, LN, “Body Surface Area”) $Unit=DT(m2, UCUM, “m^2”)
4 >> INFERRED FROM CODE EV (8278-4, LN, "Body Surface Area Formula") 1 U BCID (3663) Body Surface Area Equations
5 > CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = DCID(3835) Cardiac Volume Measurements $ModType = EV (121425, DCM, “Index”) $ModValue = DT(8277-6, LN, “Body Surface Area”) $Units=DT(ml/m2, UCUM, “ml/m^2")
6 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(F-32110, SRT, "Cardiac Index") $Units=DT(ml/min/m2, UCUM, “(ml/min)/m^2”)
7 > CONTAINS INCLUDE DTID(300) Measurement 1-2 U $Measurement = EV(122447, DCM, "Wall Mass") $ModType = EV (121425, DCM, “Index") $ModValue = DT(8277-6, LN, “Body Surface Area”) $Units=DT(g/m2, UCUM, “g/m^2”)
8 >> HAS CONCEPT MOD CODE DT(122670, DCM, "Papillary Muscle Included/Excluded” 1 U DCID(3821) Papillary Muscle Included/Excluded
9 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122618, DCM, "Peak Filling Rate") $ModType = EV (121425, DCM, “Index”) $ModValue = DT(8277-6, LN, “Body Surface Area”) $Units=DT(ml/s/m2, UCUM, “(ml/s)/m^2”)
10 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(F-32070, SRT, "Peak Cardiac Ejection Fraction") $ModType = EV (121425, DCM, “Index”) $ModValue = DT(8277-6, LN, “Body Surface Area”) $Units=DT(%/m2, UCUM, “%/m^2”)

TID 3924 Heart Rate-Normalized Ventricular Measurements

Ventricular measurement results normalized based on the Heart Rate

TID 3924Heart Rate-Normalized Ventricular Measurements Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV(122609, DCM, "Normalized values of ventricular measurements") 1 M
2 > HAS CONCEPT MOD CODE EV(121425, DCM, "Index" 1 M DT(8867-4, LN, “Heart Rate")
3 > CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = DCID(3835) Cardiac Volume Measurements $ModType = EV (121425, DCM, “Index”) $ModValue = DT(8867-4, LN, “Heart Rate") $Units=DT(ml/{H.B.}/min, UCUM, "ml/BPM”)
4 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(F-32100, SRT, "Cardiac Output") $ModType = EV (121425, DCM, “Index”) $ModValue = DT(8867-4, LN, “Heart Rate") $Units = DT(ml/min/{H.B.}/min, UCUM, ”(ml/min)/ BPM”)
5 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122618, DCM, "Peak Filling Rate") $ModType = EV (121425, DCM, “Index”) $ModValue = DT(8867-4, LN, “Heart Rate") $Units = DT(ml/s/{H.B.}/min, UCUM, “(ml/s)/BPM”)
6 > CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(F-32070, SRT, "Peak Cardiac Ejection Fraction") $ModType = EV (121425, DCM, “Index”) $ModValue = DT(8867-4, LN, “Heart Rate") $Units=DT(%/{H.B.}/min, UCUM, “%/BPM”)

TID 3925 Ventricular Thickening Analysis

Data of a ventricular wall thickening analysis

TID 3925Thickening AnalysisType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV(111004, DCM, "Analysis Performed") 1 M EV (122607, DCM, "Thickening Analysis")
3 > CONTAINS CONTAINER EV (121070, DCM, "Findings") 1-n M
4 >> CONTAINS CODE EV(G-C0E3, SRT, "Finding Site") 1-n MC XOR row 5 DCID(3717) Myocardial Wall Segments
5 >> CONTAINS TEXT EV(G-C0E3, SRT, "Finding Site") 1 MC XOR row 4
6 >> CONTAINS INCLUDE DTID(3909) Best Illustration of Findings 1-n U
7 >> CONTAINS INCLUDE DTID(300) Measurement 1 M $Measurement = EV(122445, DCM, "Wall Thickness") $ModType= EV(R-4089A, SRT, "Cardiac Cycle Point") $ModValue= DT(F-32011, SRT, "End-Diastolic") $Units = DT(mm, UCUM, "mm")
8 >> CONTAINS INCLUDE DTID(300) Measurement 1 M $Measurement = EV(122445, DCM, "Wall Thickness") $ModType= EV(R-4089A, SRT, "Cardiac Cycle Point") $ModValue= DT(109070, DCM, "End-Systolic") $Units = DT(mm, UCUM, "mm")
9 >> CONTAINS INCLUDE DTID(300) Measurement 1 U $Measurement = EV(122624, DCM, "Wall Thickness Ratio end-systolic to end-diastolic") $Units = DT(%, UCUM, “%")
10 >> CONTAINS CODE EV(F-32050, SRT, "Cardiac Wall Motion") 1 U DCID (3703) Wall Motion
11 >> CONTAINS CODE EV(G-C504, SRT, "Associated Morphology") 1 U DCID (3704) Wall Morphology Findings

TID 3926 Myocardial Perfusion Analysis

Myocardial perfusion analysis results.

Perfusion measurements may be performed either for one or more ventricular segments (row 4) or for substructures inside ventricular segments (row 14)

TID 3926Myocardial Perfusion AnalysisType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121070, DCM, "Findings") 1 M
2 > HAS CONCEPT MOD CODE EV(111004, DCM, "Analysis Performed") 1 M EV(122602, DCM, "Myocardial Perfusion Analysis")
3 > CONTAINS CONTAINER EV (121070, DCM, "Findings") 1-n M
4 >> HAS CONCEPT MOD CODE EV(G-C0E3, SRT, "Finding Site") 1-n MC XOR row 6 DCID(3717) Myocardial Wall Segments
5 >>> HAS CONCEPT MOD CODE EV(G-A1F8, SRT, “Topographical Modifier” 1 U DCID(3843) Myocardial Subsegment
6 >> HAS CONCEPT MOD TEXT EV(G-C0E3, SRT, "Finding Site") 1 MC XOR row 4
7 >> HAS ACQ CONTEXT CODE EV(109054, DCM, “Patient State”) 1 U DCID(3101) Cardiac Procedural State Values
8 >> HAS ACQ CONTEXT INCLUDE DTID (3106) Drugs/Contrast Administered 1-n U
9 >> CONTAINS TEXT EV(122627, DCM, "Curve Fit Method") 1 U
10 >> CONTAINS INCLUDE DTID(3909) Best Illustration of Findings 1-n U
11 >> CONTAINS TEXT EV(122628, DCM, "Baseline Result Correction") 1 U
12 >> CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = DCID(3836) Time-based Perfusion Measurements $Units= EV(s, UCUM, "s")
13 >> CONTAINS NUM EV(122640, DCM, "Image Interval") 1 U Units= EV(ms, UCUM, "ms")
14 >> CONTAINS NUM EV(122635, DCM, “MR Perfusion Peak”) 1 U Units=DT(1, UCUM, “No units”)
15 >> CONTAINS NUM EV(122636, DCM, "MR Perfusion Slope") 1 U Units=DT(1, UCUM, “No units”)
16 >> CONTAINS NUM EV(122637, DCM, "MR Perfusion Time Integral") 1 U Units=DT(1, UCUM, “No units”)
17 >> CONTAINS CONTAINER EV(125007, DCM, "Measurement Group") 1-n U
18 >>> CONTAINS INCLUDE DTID(300) Measurement 1-n U $Measurement = DCID(3836) Time-based Perfusion Measurements $Units= EV(s, UCUM, "s")
19 >>> CONTAINS NUM EV(122635, DCM, “MR Perfusion Peak”) 1 U Units=DT(1, UCUM, “No units”)
20 >>> CONTAINS NUM EV(122636, DCM, "MR Perfusion Slope") 1 U Units=DT(1, UCUM, “No units”)
21 >>> CONTAINS NUM EV(122637, DCM, "MR Perfusion Time Integral") 1 U Units=DT(1, UCUM, “No units”)
22 >> CONTAINS CODE EV(122664, DCM, "Late Contrast Enhancement") 1 U DCID(230) Yes-No
23 >>> HAS ACQ CONTEXT NUM EV(122665, DCM, "Time after start of injection of contrast bolus") 1 M Units=DT(s, UCUM, "s")
24 >>> HAS ACQ CONTEXT NUM EV(122668, DCM, "Time interval since detection of contrast bolus") 1 U Units=DT(s, UCUM, "s")

Content Item Descriptions

Row 12 Image Interval is appropriate only for equally time-spaced images

TID 3927 Report Summary

Contains summary elements based on the findings of the report

TID 3927Report SummaryType: Extensible Order: Non-Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER BCID(7001) Diagnostic Imaging Reports Headings 1 M
2 > CONTAINS CODE BCID(7002) Diagnostic Imaging Report Elements 1-n U
3 >> INCLUDE DTID(320) Image or Spatial Coordinates 1-n U
4 >> INCLUDE DTID(321) Waveform or Temporal Coordinates 1-n U
5 > CONTAINS TEXT BCID(7002) Diagnostic Imaging Report Elements 1-n U
6 >> INCLUDE DTID(320) Image or Spatial Coordinates 1-n U
7 >> INCLUDE DTID(321) Waveform or Temporal Coordinates 1-n U

TID 3929 Cardiovascular Analysis Observation Context

Defines the observation context for cardioVascular Functional Analysis

TID 3929Cardiovascular Analysis Observation ContextType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS OBS CONTEXT NUM EV(8867-4, LN, "Heart Rate") 1 U Units= DT ("{H.B.}/min", UCUM, "BPM")
2 HAS OBS CONTEXT CODE EV(8884-9, LN, "Cardiac Rhythm") 1 U DCID(3826) Heart Rhythm
3 HAS OBS CONTEXT NUM EV(F-008EC, SRT, "Systolic Blood Pressure") 1 U Units=DT(mm[Hg], UCUM, “mmHg”)
4 HAS OBS CONTEXT NUM EV(F-008ED, SRT, "Diastolic Blood Pressure") 1 U Units=DT(mm[Hg], UCUM, “mmHg”)
5 HAS OBS CONTEXT CODE EV (F-043E6, SRT, "Respiration Observable") 1 U DCID(3823) Respiratory Status
6 HAS ACQ CONTEXT INCLUDE DTID (3106) Drugs/Contrast Administered 1-n U

TID 3990 2-Dimensional Measurement Graph

Generic template representing arbitrary two-dimensional graphs.

Parameter Name Parameter Usage
$MeasurementGraph Describes what the graph is about
$X-Concept Concept of the X-Axis of the graph
$Y-Concept Concept of the Y-Axis of the graph
$X-AxisUnit Unit of the x-axis data elements
$Y-AxisUnit Unit of the y-axis data elements

TID 39902-Dimensional Measurement GraphType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER $MeasurementGraph 1 M
2 > CONTAINS CODE EV(122698, DCM, "X-Concept") 1 M $X-Concept
3 > CONTAINS CODE EV(122699, DCM, "Y-Concept") 1 M $Y-Concept
4 > CONTAINS CONTAINER no concept name 0-n M
5 >> CONTAINS NUM $X-Concept 1 M UNITS= $X-AxisUnit
6 >> CONTAINS NUM $Y-Concept 1 M UNITS= $Y-AxisUnit
7 > CONTAINS IMAGE $MeasurementGraph 1 U
8 > CONTAINS WAVEFORM $MeasurementGraph 1 U
9 > CONTAINS COMPOSITE $MeasurementGraph 1 U

Content Item Descriptions

Rows 5-6 The X-Concept values shall be monotonically increasing.
Row 7 Secondary Capture Image containing a bitmap representation of the graph
Row 8 Waveform containing a representation of the graph
Row 9 Composite Object containing a rendered representation of the graph

Mammography CAD SR IOD Templates

The templates that comprise the Mammography CAD SR IOD are interconnected as in Figure A-8:

[pic]

Figure A-8: Mammography CAD SR IOD Template Structure

In Figure A-8, ‘ ( ( (’ indicates possible recursive application of subordinate templates.

TID 4000 Mammography CAD Document Root Template

This template forms the top of a content tree that allows a mammography CAD device to describe the results of detection and analysis of Mammographic evidence. This template, together with its subordinate templates, describes both the results for presentation to radiologists and partial product results for consumption by mammography CAD devices in subsequent mammography CAD reports.

This template defines a Container which contains an Image Library, the mammography CAD results, and summaries of the detection and analysis algorithms performed. The Image Library contains the Image SOP Class and Instance UIDs, and selected attributes for each image referenced in either the algorithm summaries or mammography CAD results.

The Summary of Detections and Summary of Analyses sub-trees gather lists of algorithms attempted, grouped by success/failure status. Algorithms not attempted are not mentioned in these sub-trees. This information forms the basis for understanding why a mammography CAD report may produce no (or fewer than anticipated) results. Mammography CAD results are constructed bottom-up, starting from Single Image Findings (see Template 4006), associated as Composite Features (see Template 4004), and from which Individual and Overall Impressions are formed.

See the figure entitled “Top Levels of Mammography CAD SR Content Tree” in the “Mammography CAD SR Content Tree Structure” Annex of PS 3.17.

TID 4000MAMMOGRAPHY CAD DOCUMENT ROOTType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV(111036, DCM, “Mammography CAD Report”) 1 M
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 M
3 > CONTAINS CONTAINER EV(111028, DCM, “Image Library”) 1 M
4 >> CONTAINS INCLUDE DTID (4020) CAD Image Library Entry 1-n M $ImageLaterality = DCID (6022) Side, $ImageView = DCID (4014) View for Mammography, $ImageViewMod = DCID (4015) View Modifier for Mammography
5 > CONTAINS INCLUDE DTID (4001) Mammography CAD Overall Impression / Recommendation” 1 M
6 > CONTAINS CODE EV(111064, DCM, “Summary of Detections”) 1 M DCID (6042) Status of Results
7 >> INFERRED FROM INCLUDE DTID (4015) CAD Detections Performed 1 MC Shall be present unless the value of (111064, DCM, “Summary of Detections”) is (111225, DCM, “Not Attempted”) $DetectionCode = DCID (6014) Mammography Single Image Finding
8 > CONTAINS CODE EV(111065, DCM, “Summary of Analyses”) 1 M DCID (6042) “Status of Results”
9 >> INFERRED FROM INCLUDE DTID (4016) CAD Analyses Performed 1 MC Shall be present unless the value of (111065, DCM, “Summary of Analyses”) is (111225, DCM, “Not Attempted”) $AnalysisCode = DCID (6043) Types of Mammography CAD Analysis

Content Item Descriptions

Image Library The “Image Library” section of the Content Tree (TID 4000, row 3) shall include all Image SOP Instances from the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module. If a portion of another instance of a Mammography CAD SR IOD is duplicated in the “Overall Impression/ Recommendation” section of the Content Tree, the “Image Library” shall also include all Image Library Entries referenced from the duplicated portions of the Mammography CAD SR.
Detections Performed The “Detections Performed” and “Analyses Performed” sections of the Content Tree (TID 4000, rows 6 and 8) together shall reference all Image SOP Instances included in the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module.
Analyses Performed

TID 4001 Mammography CAD Overall Impression/Recommendation Template

This template forms the top of the mammography CAD results sub-tree. The contents of this template describe the overall impression the mammography CAD device had for the mammographic evidence presented and any recommendations that the mammography CAD device made. The details of the overall impression and recommendation are expressed in this instance of the Mammography CAD Impression/Recommendation Body (see TID 4002). The data from which the details are inferred, are expressed in the Mammography CAD Individual Impression/Recommendations (see TID 4003), of which there may be several.

TID 4001MAMMOGRAPHY CAD OVERALL IMPRESSION/RECOMMENDATIONType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111017, DCM, “CAD Processing and Findings Summary”) 1 M DCID (6047) CAD Processing and Findings Summary
2 > HAS PROPERTIES INCLUDE DTID (4002) Mammography CAD Impression/Recommendation Body” 1 U
3 > INFERRED FROM INCLUDE DTID (4003) Mammography CAD Individual Impression/Recommendation 1-n MC Shall be present if 1 or more (111059, DCM, “Single Image Finding”) or (111015, DCM, “Composite Feature”) content items are reported.

Content Item Descriptions

CAD Processing and Findings Summary This code value is used to express if and why the Overall Impression/Recommendation sub-tree is empty. The Summary of Detections and Summary of Analyses sub-trees of the Document Root node contain detail about which (if any) algorithms succeeded or failed. If the code value indicates that there were no findings, then the code value can be used to determine whether mammography CAD processing occurred successfully, without parsing the Summary of Detections and Summary of Analyses sub-trees.
Row 3 There are no constraints regarding the 1-n multiplicity of the inclusion of TID 4003 or its underlying structure, other than the TID 4001 and TID 4003 requirements. Individual Impression/Recommendation containers may be organized, for example per image, per finding or composite feature, or some combination thereof.

TID 4002 Mammography CAD Impression/Recommendation Body Template

The details of an impression and recommendation are expressed in this template. It is applied to both Mammography CAD Overall Impression/Recommendation (TID 4001) and Mammography CAD Individual Impression/Recommendation (TID 4003).

TID 4002MAMMOGRAPHY CAD IMPRESSION/RECOMMENDATION BODYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111005, DCM, “Assessment Category”) 1-n MC At least one of rows 1, 3, 5, 6, 8, 9 shall be present. DCID (6026) Mammography Assessment
2 > HAS CONCEPT MOD CODE EV (G-C171, SRT, ”Laterality”) 1 U DCID (6022) Side
3 CODE EV (111023, DCM, “Differential Diagnosis/ Impression”) 1-n MC At least one of rows 1, 3, 5, 6, 8, 9 shall be present. DCID (6002) Change Since Last Mammogram or Prior Surgery
4 > HAS CONCEPT MOD CODE EV (G-C171, SRT, ”Laterality”) 1 U DCID (6022) Side
5 TEXT EV (111033, DCM, “Impression Description”) 1 MC At least one of rows 1, 3, 5, 6, 8, 9 shall be present.
6 CODE EV (111053, DCM, “Recommended Follow-up”) 1-n MC At least one of rows 1, 3, 5 5, 6, 8, 9 shall be present. DCID (6028) Mammography Recommended Follow-up
7 > HAS CONCEPT MOD CODE EV (G-C171, SRT, ”Laterality”) 1 U DCID (6022) Side
8 NUM EV (111055, DCM, “Recommended Follow-up Interval”) 1 MC At least one of rows 1, 3, 5, 6, 8, 9 shall be present. May be present only if (111054, DCM, “Recommended Follow-up Date”) is not present. UNITS = DCID (6046) Units of Follow-up Interval; Values = Integer ( 0, where 0 = immediate follow-up
9 DATE EV (111054, DCM, “Recommended Follow-up Date”) 1 MC At least one of rows 1, 3, 5, 6, 8, 9 shall be present. May be present only if (111055, DCM, “Recommended Follow-up Interval”) is not present. Shall be later than date of exam
10 NUM EV (111013, DCM, “Certainty of impression”) 1 UC May be present only if (111005, DCM, “Assessment Category”), (111023, DCM, “Differential Diagnosis/Impression”) or (111033, DCM, “Impression Description”) is present. UNITS = EV (%, UCUM, “Percent”) Values = 0 – 100
11 INCLUDE DTID (4019) CAD Algorithm Identification 1-n M
12 NUM DCID (6142) Calculated Value 1-n U
13 > HAS CONCEPT MOD CODE EV (G-C171, SRT, ”Laterality”) 1 U DCID (6022) Side
14 > HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 M DCID (6140) Calculation Methods
15 > INFERRED FROM TEXT EV (112034, DCM, “Calculation Description”) 1 U

Content Item Descriptions

Certainty of Impression The certainty that the device populating the Mammography CAD SR report places on this impression, where 0 equals no certainty and 100 equals certainty.
Impression Description Free-form text describing the overall or an individual impression

TID 4003 Mammography CAD Individual Impression/Recommendation Template

This template collects an individual impression the mammography CAD device had for a lesion, non-lesion object, or correlation of related objects. The details of the impression and recommendation are expressed in the Mammography CAD Impression/Recommendation Body (see TID 4002). The data from which the details are inferred are expressed in the Composite Features (see TID 4004) and/or Single Image Findings (see TID 4006) of which there may be several.

The sub-tree headed by this template is illustrated in PS 3.17 in the Annex on Mammography CAD SR Content Tree Structure.

TID 4003MAMMOGRAPHY CAD INDIVIDUAL IMPRESSION/RECOMMENDATIONType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (111034, DCM, “Individual Impression/ Recommendation”) 1 M
2 > HAS CONCEPT MOD CODE EV (111056, DCM, “Rendering Intent”) 1 M DCID (6034) Intended Use of CAD Output
3 > CONTAINS INCLUDE DTID (4002) Mammography CAD Impression / Recommendation Body 1 U
4 > CONTAINS INCLUDE DTID (4004) Mammography CAD Composite Feature 1-n MC At least one of rows 4, 5 shall be present.
5 > CONTAINS INCLUDE DTID (4006) Mammography CAD Single Image Finding 1-n MC At least one of rows 4, 5 shall be present.

Content Item Descriptions

Rendering Intent This content item constrains the SCP receiving the Mammography CAD SR IOD in its use of the contents of this template and its target content items. Mammography CAD devices may opt to use data marked “Not for Presentation” or “Presentation Optional” as input to subsequent mammography CAD processing steps. Refer to PS 3.4, Annex O Structured Reporting Standard SOP Classes for SCU and SCP Behavior.

TID 4004 Mammography CAD Composite Feature Template

This template collects a composite feature for a lesion, non-lesion object, or correlation of related objects. The details of the composition are expressed in the Mammography CAD Composite Feature Body (see TID 4005). The data from which the details are inferred, are expressed in the Composite Features (see TID 4004) and/or Single Image Findings (see TID 4006), of which there may be several.

A Composite Feature shall be INFERRED FROM any combination of two or more Composite Features or Single Image Findings or mixture thereof.

TID 4004MAMMOGRAPHY CAD COMPOSITE FEATUREType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111015, DCM, “Composite Feature”) 1 M DCID (6016) Mammography Composite Feature
2 > HAS CONCEPT MOD CODE EV (111056, DCM, “Rendering Intent”) 1 M DCID (6034) Intended Use of CAD Output
3 > HAS OBS CONTEXT INCLUDE DTID (4108) Tracking Identifier 1 U
4 > HAS PROPERTIES INCLUDE DTID (4005) Mammography CAD Composite Feature Body 1 M
5 > INFERRED FROM INCLUDE DTID (4004) Mammography CAD Composite Feature 1-n MC At least two items shall be present: two of row 5, two of row 6, or one of each.
6 > INFERRED FROM INCLUDE DTID (4006) Mammography CAD Single Image Finding 1-n MC At least two items shall be present: two of row 5, two of row 6, or one of each.
7 > HAS OBS CONTEXT INCLUDE DTID (4022) CAD Observation Context 1 MC Shall be present only if this feature is incorporated from a different report than its parent.

Content Item Descriptions

Rendering Intent This content item constrains the SCP receiving the Mammography CAD SR IOD in its use of the contents of this template and its target content items. Mammography CAD devices may opt to use data marked “Not for Presentation” or “Presentation Optional” as input to subsequent mammography CAD processing steps. Refer to PS 3.4, Annex O Structured Reporting Standard SOP Classes for SCU and SCP Behavior.
TID 4005 Mammography CAD Composite Feature Body Template

The details of a composite feature are expressed in this template. It is applied to Mammography CAD Composite Feature (TID 4004).

TID 4005MAMMOGRAPHY CAD COMPOSITE FEATURE BODYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111016, DCM, “Composite type”) 1 M DCID (6035) Composite Feature Relations. The value shall be (111155, DCM, “Target content items are related contra-laterally”) if the parent content item has code value (F-01792, SRT, “Focal asymmetric breast tissue”) or (F-01793, SRT, “Asymmetric breast tissue”).
2 CODE EV (111057, DCM, “Scope of Feature”) 1 M DCID (6036) Scope of Feature
3 INCLUDE DTID (4019) CAD Algorithm Identification 1 M
4 NUM EV (111011, DCM, “Certainty of Feature”) 1 U UNITS = (%, UCUM, “Percent”) Value = 0 – 100
5 NUM EV (111047, DCM, “Probability of cancer”) 1 UC May be present only if value of parent is not (111102, DCM, “Non-lesion”) UNITS = (%, UCUM, “Percent”) Value = 0 – 100
6 CODE EV (111042, DCM, “Pathology”) 1-n U BCID (6030) “Mammography Pathology Codes”
7 INCLUDE DTID (1400) Linear Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1400) “Linear Measurement” shall be used.
8 INCLUDE DTID (1401) Area Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1401) “Area Measurement” shall be used.
9 INCLUDE DTID (1402) Volume Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1402) “Volume Measurement” shall be used.
10 INCLUDE DTID (4021) Mammography CAD Geometry 1-n U
11 NUM DCID (6037) Mammography Quantitative Temporal Difference Type 1-n UC May be present only if the value of (111016, DCM, “Composite type”) is (111153, DCM, “Target content items are related temporally”) UNITS = DCID (7460) Units of Linear Measurement, DCID (7461) Units of Area Measurement, DCID (7462) Units of Volume Measurement or DT (1, UCUM, “no units”)
12 > R-INFERRED FROM NUM 2 U The referenced numeric values shall have the same Concept Name. Their UNITS shall be the same as row 11
13 CODE EV (111049, DCM, “Qualitative Difference”) 1-n UC May be present only if the value of (111016, DCM, “Composite type”) is (111153, DCM, “Target content items are related temporally”) DCID (6038) Mammography Qualitative Temporal Difference Type
14 > HAS PROPERTIES TEXT EV (111021, DCM, “Description of Change”) 1 U
15 > R-INFERRED FROM CODE 2 M The referenced code values shall have the same Concept Name and be from the same context group.
16 CODE EV (111048, DCM, “Quadrant location”) 1 U DCID (6020) Quadrant Location
17 CODE EV (111014, DCM, “Clockface or region”) 1 U DCID (6018) Clockface Location or Region
18 CODE EV (111020, DCM, “Depth”) 1 U DCID (6024) Depth
19 CODE EV (111035, DCM, “Lesion Density”) 1 UC May be present only if value of parent is (F-01791, SRT, “Mammographic breast mass”) or (F-01796,SRT,”Mammography breast density”) DCID (6008) Density Modifier
20 CODE EV (M-020F9, SRT, “Shape”) 1 UC May be present only if value of parent is (F-01791, SRT, “Mammographic breast mass”) or (F-01796,SRT,”Mammography breast density”) DCID (6004) Mammography Characteristics of Shape
21 CODE EV (111037, DCM, “Margins”) 1-n UC May be present only if value of parent is (F-01791, SRT, “Mammographic breast mass”) or (F-01796,SRT,”Mammography breast density”) DCID (6006) “Mammography Characteristics of Margin”
22 CODE EV (111009, DCM, “Calcification Type”) 1-n UC May be present only if value of parent is (F-01775,SRT, “Calcification Cluster”) or (F-01776,SRT, “Individual Calcification”) DCID (6010) “Mammography Calcification Types”
23 CODE EV (111008, DCM, “Calcification Distribution”) 1 UC May be present only if value of parent is (F-01775,SRT, “Calcification Cluster”) DCID (6012) “Calcification Distribution Modifier”
24 NUM EV (111038, DCM, “Number of calcifications”) 1 UC May be present only if value of parent is (F-01775,SRT, “Calcification Cluster”) UNITS = EV (1, UCUM, “no units”) Value = Integer 1 – n
25 NUM DCID (6142) Calculated Value 1-n U
26 > HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 M DCID (6140) Calculation Methods
27 > INFERRED FROM TEXT EV (112034, DCM, “Calculation Description”) 1 U

Content Item Descriptions

Certainty of Feature The likelihood that the feature analyzed, and classified by the CODE specified in the Composite Feature parent template, is in fact that type of feature.
Volume Measurement If dimensions for a volume are to be stated in terms of length, width, and depth, then one shall use 3 instances of TID (1400) Linear Measurement.
Row 11 Values ( 0 are allowed. The two referenced numeric values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature. Given the equation, A – B, the value representing A shall be referenced first.
Qualitative Difference The two referenced code values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature.

TID 4006 Mammography CAD Single Image Finding Template

This template describes a single image finding for a lesion or other object. The details of the finding are expressed in this template and/or more specific templates. The details from which a single image Calcification Cluster is inferred may be expressed in a number of Single Image Findings (see TID 4006) of type Individual Calcification.

A Single Image Finding of type Breast Composition may be INFERRED FROM by-reference to a Single Image Finding of type Breast Geometry.

TID 4006MAMMOGRAPHY CAD SINGLE IMAGE FINDINGType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111059, DCM, “Single Image Finding”) 1 M DCID (6014) Mammography Single Image Finding
2 > HAS CONCEPT MOD CODE EV (111056, DCM, “Rendering Intent”) 1 M DCID (6034) Intended Use of CAD Output
3 >> HAS PROPERTIES NUM EV (111071, DCM, “CAD Operating Point”) 1 UC IFF value of row 2 is (111151, DCM, “Presentation Optional”) and row 9 of TID 4017 is present UNITS = DT ({1:n}, UCUM, “range: 1:n”), where n is the maximum specified in Row 9 of TID 4017. Value is restricted to being an integer
4 > HAS OBS CONTEXT INCLUDE DTID (4108) Tracking Identifier 1 U
5 > HAS PROPERTIES INCLUDE DTID (4019) CAD Algorithm Identification 1 M
6 > HAS PROPERTIES NUM EV(111012, DCM, “Certainty of Finding”) 1 U UNITS = EV(%, UCUM, “Percent”) Value = 0 – 100
7 > HAS PROPERTIES NUM EV (111047, DCM, “Probability of cancer”) 1 UC May be present unless value of parent is (F-01710,SRT, “Breast composition”), (111100, DCM, “Breast geometry”), (T-04100, SRT, “Nipple”), (111099, DCM, “Selected region”), (111101, DCM, “Image quality”) or (111102, DCM, “Non-lesion”) UNITS = EV(%, UCUM, “Percent”) Value = 0 – 100
8 > HAS PROPERTIES INCLUDE DTID (4021) Mammography CAD Geometry 1 MC Shall be present unless value of parent is (F-01710,SRT, “Breast composition”), (111100, DCM, “Breast geometry”) or (111101, DCM, “Image quality”)
9 > HAS PROPERTIES INCLUDE DTID (4007) Mammography CAD Breast Composition 1 MC Shall be present only if value of parent is (F-01710,SRT, “Breast composition”)
10 > R-INFERRED FROM CODE 1-n UC May be present only if value of parent is (F-01710,SRT, “Breast composition”) Shall reference a (111059, DCM, “Single Image Finding”) of value: EV (111100, DCM, “Breast geometry”)
11 > HAS PROPERTIES INCLUDE DTID (4008) Mammography CAD Breast Geometry 1 MC Shall be present only if value of parent is (111100, DCM, “Breast geometry”)
12 > HAS PROPERTIES INCLUDE DTID (4009) Mammography CAD Individual Calcification 1 UC May be present only if value of parent is (F-01776,SRT, “Individual Calcification”)
13 > HAS PROPERTIES INCLUDE DTID (4010) Mammography CAD Calcification Cluster 1 UC May be present only if value of parent is (F-01775,SRT, “Calcification Cluster”)
14 > HAS PROPERTIES INCLUDE DTID (4011) Mammography CAD Density 1 UC May be present only if value of parent is (F-01796,SRT,”Mammography breast density”)
15 > HAS PROPERTIES CODE EV (111297,DCM, “Nipple Characteristic”) 1 UC May be present only if value of parent is (T-04100, SRT, “Nipple”) DCID (6039) Nipple Characteristic
16 > HAS PROPERTIES INCLUDE DTID (4012) Mammography CAD Non-Lesion 1 MC Shall be present only if value of parent is (111102, DCM, “Non-lesion”)
17 > HAS PROPERTIES INCLUDE DTID (4013) Mammography CAD Selected Region 1 MC Shall be present only if value of parent is (111099, DCM, “Selected Region”)
18 > R-INFERRED FROM IMAGE 1 MC IF value of parent is (111101, DCM, “Image quality”) and IFF row 19 is not present Shall reference an IMAGE content item in the (111028, DCM, “Image Library”)
19 > HAS PROPERTIES SCOORD EV (111030, DCM, “Image Region”) 1-n MC IF value of parent is (111101, DCM, “Image quality”) and IFF row 18 is not present
20 >> R-SELECTED FROM IMAGE 1 M All the (111030, DCM, “Image Region”) content items in a single invocation of this template shall reference the same IMAGE content item in the (111028, DCM, “Image Library”)
21 > HAS PROPERTIES INCLUDE DTID (4014) CAD Image Quality 1-n MC Shall be present only if value of parent is (111101, DCM, “Image quality”) $QualityFinding = DCID (6041) “Mammography Image Quality Finding”, $QualityStandard = DCID (6045) “Mammography Types of Quality Control Standard”
22 > HAS PROPERTIES NUM DCID (6142) Calculated Value 1-n U
23 >> HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 M DCID (6140) Calculation Methods
24 >> INFERRED FROM TEXT EV (112034, DCM, “Calculation Description”) 1 U
25 > INFERRED FROM INCLUDE DTID (4006) Mammography CAD Single Image Finding 1-n UC May be present only if value of parent is (F-01775,SRT, “Calcification Cluster”) EV (F-01776,SRT, “Individual Calcification”)
26 > HAS OBS CONTEXT INCLUDE DTID (4022) CAD Observation Context 1 MC Shall be present only if this finding is incorporated from a different report than its parent.

Content Item Descriptions

Rendering Intent This content item constrains the SCP receiving the Mammography CAD SR IOD in its use of the contents of this template and its target content items. Mammography CAD devices may opt to use data marked “Not for Presentation” or “Presentation Optional” as input to subsequent mammography CAD processing steps. Refer to PS 3.4, Annex O Structured Reporting Storage SOP Classes for SCU and SCP Behavior.
CAD Operating Point Additional information to use when Rendering Intent is “Presentation Optional”. A CAD Operating Point of zero is not sent, and is encoded as a Rendering Intent of “Presentation Required”. See PS 3.4 section on Structured Reporting Storage SOP Classes for SCU and SCP Behavior and PS 3.17 annex on Mammography.
Single Image Finding A Single Image Finding (whose parent is a Single Image Finding of type Calcification Cluster) allows one level of nesting for the definition of individual calcifications within the cluster. To use this template recursively, this Single Image Finding code value shall be “Individual Calcification”.
Certainty of Finding The likelihood that the finding detected, and classified by the CODE specified in the Single Image Finding parent template, is in fact that type of finding.

TID 4007 Mammography CAD Breast Composition Template

TID 4007MAMMOGRAPHY CAD BREAST COMPOSITIONType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (F-01710,SRT, “Breast composition”) 1 MC At least one of row 1 or 2 shall be present DCID (6000) Overall Breast Composition
2 NUM EV (111046, DCM, “Percent Fibroglandular Tissue”) 1 MC At least one of row 1 or 2 shall be present UNITS = EV (%, UCUM, “Percent”) Value = 0 – 100

Content Item Descriptions

Percent Fibroglandular Tissue Percent of breast area that is mammographically dense, excluding pectoralis muscle.

TID 4008 Mammography CAD Breast Geometry Template

TID 4008MAMMOGRAPHY CAD BREAST GEOMETRYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 SCOORD EV (111007, DCM, “Breast Outline Including Pectoral Muscle Tissue”) 1 M GRAPHIC TYPE = {POLYLINE}
2 > R-SELECTED FROM IMAGE 1 M Shall reference an IMAGE content item in the (111028, DCM, “Image Library”)
3 SCOORD EV (111045, DCM, “Pectoral Muscle Outline”) 1 U GRAPHIC TYPE = {POLYLINE}
4 > R-SELECTED FROM IMAGE 1 M Shall reference the same node as row 2

Content Item Descriptions

Breast Outline Including Pectoral Muscle Tissue [pic] Example Pectoral Muscle Outline [pic] Example

TID 4009 Mammography CAD Individual Calcification Template

This template provides the detail specific to an individual calcification.

TID 4009MAMMOGRAPHY CAD INDIVIDUAL CALCIFICATIONType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111009, DCM, “Calcification Type”) 1-n MC At least one of rows 1, 2, 3 shall be present DCID (6010) Mammography Calcification Types
2 INCLUDE DTID (1400) Linear Measurement 1-n MC At least one of rows 1, 2, 3 shall be present If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1400) Linear Measurement shall be used.
3 INCLUDE DTID (1401) Area Measurement 1-n MC At least one of rows 1, 2, 3 shall be present If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1401) Area Measurement shall be used.
4 INCLUDE DTID (1402) Volume Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1402) Volume Measurement shall be used.

TID 4010 Mammography CAD Calcification Cluster Template

This template provides the detail specific to a calcification cluster.

TID 4010MAMMOGRAPHY CAD CALCIFICATION CLUSTERType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111009, DCM, “Calcification Type”) 1-n MC At least one of rows 1, 2, 3, 4, 5 shall be present DCID (6010) Mammography Calcification Types
2 CODE EV (111008, DCM, “Calcification Distribution”) 1 MC At least one of rows 1, 2, 3, 4, 5 shall be present DCID (6012) Calcification Distribution Modifier
3 NUM EV (111038, DCM, “Number of calcifications”) 1 MC At least one of rows 1, 2, 3, 4, 5 shall be present UNITS = EV (1, UCUM, “no units”) Value = Integer >= 1
4 INCLUDE DTID (1400) Linear Measurement 1-n MC At least one of rows 1, 2, 3, 4, 5 shall be present If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1400) Linear Measurement shall be used.
5 INCLUDE DTID (1401) Area Measurement 1-n MC At least one of rows 1, 2, 3, 4, 5 shall be present If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1401) Area Measurement shall be used.
6 INCLUDE DTID (1402) Volume Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1402) Volume Measurement shall be used.

TID 4011 Mammography CAD Density Template

This template provides the detail specific to a density.

TID 4011MAMMOGRAPHY CAD DENSITYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111035, DCM, “Lesion Density”) 1 MC At least one of rows 1, 2, 3, 4, 5 shall be present DCID (6008) Density Modifier
2 CODE EV (M-020F9, SRT, “Shape”) 1 MC At least one of rows 1, 2, 3, 4, 5 shall be present DCID (6004) Mammography Characteristics of Shape
3 CODE EV (111037, DCM, “Margins”) 1-n MC At least one of rows 1, 2, 3, 4, 5 shall be present DCID (6006) Mammography Characteristics of Margin
4 INCLUDE DTID (1400) Linear Measurement 1-n MC At least one of rows 1, 2, 3, 4, 5 shall be present If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1400) Linear Measurement shall be used.
5 INCLUDE DTID (1401) Area Measurement 1-n MC At least one of rows 1, 2, 3, 4, 5 shall be present If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1401) Area Measurement shall be used.
6 INCLUDE DTID (1402) Volume Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1402) Volume Measurement shall be used.

TID 4012 Mammography CAD Non-Lesion Template

This template provides the detail specific to a finding other than a lesion (see CID 6040).

TID 4012 MAMMOGRAPHY CAD NON-LESION Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111039, DCM, “Object type”) 1 M DCID (6040) Non-Lesion Object Type
2 INCLUDE DTID (1400) Linear Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1400) Linear Measurement shall be used.
3 INCLUDE DTID (1401) Area Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1401) Area Measurement shall be used.
4 INCLUDE DTID (1402) Volume Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1402) Volume Measurement shall be used.

TID 4013 Mammography CAD Selected Region Template

This template provides the detail specific to a selected region. A selected region is any mammography CAD derived arbitrary region of the image, whether within the breast outline or not. This can be use to delineate regions such as the intramammary fold.

TID 4013MAMMOGRAPHY CAD SELECTED REGIONType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 TEXT EV (111058, DCM, “Selected Region Description”) 1 M
2 INCLUDE DTID (1400) Linear Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1400) Linear Measurement shall be used.
3 INCLUDE DTID (1401) Area Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1401) Area Measurement shall be used.
4 INCLUDE DTID (1402) Volume Measurement 1-n U If the measured path is encoded, the SCOORD and its by-reference relationship to the IMAGE in TID (1402) Volume Measurement shall be used.

TID 4014 CAD Image Quality Template

This template provides the detail specific to image quality. It allows the encoding of descriptors of image quality (e.g., CID 6041) for a given image or region of an image. For instance, images with partial motion blur can be identified with the region noted.

Parameter Name Parameter Usage
$QualityFinding Coded term or Context Group for Quality Finding
$QualityStandard Coded term or Context Group for Quality Control Standard

TID 4014 CAD IMAGE QUALITYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV(111052, DCM, “Quality Finding”) 1 M $QualityFinding
2 > HAS PROPERTIES CODE EV(111050, DCM, “Quality Assessment”) 1 U DCID (6044) Types of Image Quality Assessment
3 > HAS PROPERTIES CODE EV(111051, DCM, “Quality Control Standard”) 1 UC Shall be present if row 2 is present. $QualityStandard
4 > HAS PROPERTIES NUM EV(111029, DCM, “Image Quality Rating”) 1 U UNITS = EV({0:100}, UCUM, “range:0:100”) Value = 0 – 100

Content Item Descriptions

Image Quality Rating A numeric value in the range 0 to 100, inclusive, where 0 is worst quality and 100 is best quality.

TID 4015 CAD Detections Performed Template

This template gathers two lists of detection algorithms attempted, grouped by success/failure status. Algorithms not attempted are not mentioned in this sub-tree of the Document Root (e.g., TID 4000). This information forms the basis for understanding why a CAD report may produce no (or fewer than anticipated) detection results.

The sub-tree formed by this template is illustrated in PS 3.17 in the Annex on Mammography CAD SR Content Tree Structure.

Parameter Name Parameter Usage
$DetectionCode Coded term or Context Group for Detection Performed

TID 4015 CAD DETECTIONS PERFORMEDType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV(111063, DCM, “Successful Detections”) 1 MC Shall be present only if value of parent is (111222, DCM, “Succeeded”) or (111223, DCM, “Partially Succeeded”)
2 > CONTAINS INCLUDE DTID (4017) CAD Detection Performed 1-n M $DetectionCode = $DetectionCode
3 CONTAINER EV(111025, DCM, “Failed Detections”) 1 MC Shall be present only if value of parent is (111224, DCM, “Failed”) or (111223, DCM, “Partially Succeeded”)
4 > CONTAINS INCLUDE DTID (4017) CAD Detection Performed 1-n M $DetectionCode = $DetectionCode

TID 4016 CAD Analyses Performed Template

This template gathers two lists of analysis algorithms attempted, grouped by success/failure status. Algorithms not attempted are not mentioned in this sub-tree of the Document Root (e.g., TID 4000). This information forms the basis for understanding why a CAD report may produce no (or fewer than anticipated) analysis results.

The sub-tree formed by this template is illustrated in PS 3.17 in the Annex on Mammography CAD SR Content Tree Structure.

Parameter Name Parameter Usage
$AnalysisCode Coded term or Context Group for Analysis Performed

TID 4016 CAD ANALYSES PERFORMEDType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV(111062, DCM, “Successful Analyses”) 1 MC Shall be present only if value of parent is (111222, DCM, “Succeeded”) or (111223, DCM, “Partially Succeeded”)
2 > CONTAINS INCLUDE DTID (4018) CAD Analysis Performed 1-n M $AnalysisCode=$AnalysisCode
3 CONTAINER EV(111024, DCM, “Failed Analyses”) 1 MC Shall be present only if value of parent is (111224, DCM, “Failed”) or (111223, DCM, “Partially Succeeded”)
4 > CONTAINS INCLUDE DTID (4018) CAD Analysis Performed 1-n M $AnalysisCode=$AnalysisCode

TID 4017 CAD Detection Performed Template

This template fully identifies a detection algorithm and the images and/or image regions on which it operated (see TID 4015).

Parameter Name Parameter Usage
$DetectionCode Coded term or Context Group for Detection Performed

TID 4017 CAD DETECTION PERFORMEDType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV(111022, DCM, “Detection Performed”) 1 M $DetectionCode
2 > HAS PROPERTIES INCLUDE DTID (4019) CAD Algorithm Identification 1 M
3 > HAS PROPERTIES IMAGE 1-n MC At least one of row 3, 4, 5 or 6 shall be present
4 > R-HAS PROPERTIES IMAGE 1-n MC At least one of row 3,4,5 or 6 shall be present Shall reference IMAGE content item(s) in the (111028, DCM, “Image Library”)
5 > HAS PROPERTIES UIDREF EV(112002,DCM,”Series Instance UID”) 1-n MC At least one of row 3,4,5 or 6 shall be present
6 > HAS PROPERTIES SCOORD EV(111030, DCM, “Image Region”) 1-n MC At least one of row 3,4,5 or 6 shall be present
7 >> SELECTED FROM IMAGE 1 MC XOR row 8
8 >> R-SELECTED FROM IMAGE 1 MC XOR row 7 Shall reference an IMAGE content item in the (111028, DCM, “Image Library”)
9 > INCLUDE DTID (4023) CAD Operating Points 1 U

Content Item Descriptions

CAD Algorithm Identification If more than one detection algorithm has the same “Detection Performed” code value (e.g., CID 6014) then the “CAD Algorithm Identification” shall unambiguously distinguish between algorithms.
Rows 3 - 6 Mammography CAD SR: When this template is invoked for the Mammography CAD SR, the Image Library is mandatory, thus only row 4 and/or row 6 shall be present. Chest CAD SR: When this template is invoked for the Chest CAD SR, the Image Library is optional, thus any combination of rows 3, 4, 5 and 6 may be present. Colon CAD SR: When this template is invoked for the Colon CAD SR, the Image Library does not exist, thus rows 3, 5, and/or 6 may be present and row 4 shall not be present.
Rows 7 - 8 Mammography CAD SR: When this template is invoked for the Mammography CAD SR, the Image Library is mandatory, thus only row 8 shall be present. Chest CAD SR: When this template is invoked for the Chest CAD SR, the Image Library is optional, thus row 7 or 8 may be present. Colon CAD SR: When this template is invoked for the Colon CAD SR, the Image Library does not exist, thus only row 7 may be present.

TID 4018 CAD Analysis Performed Template

This template fully identifies an analysis algorithm and the images and/or image regions on which it operated (see TID 4016).

Parameter Name Parameter Usage
$AnalysisCode Coded term or Context Group for Analysis Performed

TID 4018 CAD ANALYSIS PERFORMEDType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV(111004, DCM, “Analysis Performed”) 1 M $AnalysisCode
2 > HAS PROPERTIES INCLUDE DTID (4019) CAD Algorithm Identification 1 M
3 > HAS PROPERTIES IMAGE 1-n MC At least one of row 3, 4, 5 or 6 shall be present
4 > R-HAS PROPERTIES IMAGE 1-n MC At least one of row 3, 4, 5 or 6 shall be present Shall reference IMAGE content item(s) in the (111028, DCM, “Image Library”)
5 > HAS PROPERTIES UIDREF EV(112002,DCM,”Series Instance UID”) 1-n MC At least one of row 3, 4, 5 or 6 shall be present
6 > HAS PROPERTIES SCOORD EV(111030, DCM, “Image Region”) 1-n MC At least one of row 3, 4, 5 or 6 shall be present
7 >> SELECTED FROM IMAGE 1 MC XOR Row 8
8 >> R-SELECTED FROM IMAGE 1 MC XOR Row 7 Shall reference an IMAGE content item in the (111028, DCM, “Image Library”)
9 > INCLUDE DTID (4023) CAD Operating Points 1 U

Content Item Descriptions

CAD Algorithm Identification If more than one analysis algorithm has the same “Analysis Performed” code value (e.g., CID 6043) then the “CAD Algorithm Identification” shall unambiguously distinguish between algorithms.
Rows 3 - 6 Mammography CAD SR: When this template is invoked for the Mammography CAD SR, the Image Library is mandatory, and a total of at least two instances of row 4 or row 6 shall be present. Chest CAD SR: When this template is invoked for the Chest CAD SR, the Image Library is optional, thus any combination of rows 3, 4, 5 and 6 may be present. Colon CAD SR: When this template is invoked for the Colon CAD SR, the Image Library does not exist, thus rows 3, 5 and/or 6 may be present and row 4 shall not be present.
Rows 7 - 8 Mammography CAD SR: When this template is invoked for the Mammography CAD SR, the Image Library is mandatory, thus only row 8 shall be present. Chest CAD SR: When this template is invoked for the Chest CAD SR, the Image Library is optional, thus row 7 or 8 may be present. Colon CAD SR: When this template is invoked for the Colon CAD SR, the Image Library does not exist, thus only row 7 may be present.

TID 4019 CAD Algorithm Identification Template

This template details the algorithm unambiguously. Re-state the software identification from the General Equipment Module of the SR IOD if all algorithms are unambiguously defined by that module.

TID 4019CAD ALGORITHM IDENTIFICATIONType: Non-Extensible Order: Significant

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 (111002, DCM, “Algorithm Parameters”) 1-n U

TID 4020 CAD Image Library Entry Template

Each instance of the Image Library Entry template contains the Image SOP Class and Instance UIDs, and selected attributes for an image. If values for the attributes are not present in the Image SOP Instance, then as many of the attributes as possible should be derived.

Parameter Name Parameter Usage
$ImageLaterality Coded term or Context Group for Image Laterality
$ImageView Coded term or Context Group for Image View
$ImageViewMod Coded term or Context Group for Image View Modifier

TID 4020 CAD IMAGE LIBRARY ENTRYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 IMAGE 1 M
2 > HAS ACQ CONTEXT CODE EV(111027, DCM, “Image Laterality”) 1 MC Shall be present if (0020,0062) is in the Image Instance $ImageLaterality
3 > HAS ACQ CONTEXT CODE EV (111031, DCM, “Image View”) 1 MC Shall be present if (0054,0220) is in the Image Instance $ImageView
4 >> HAS CONCEPT MOD CODE EV (111032, DCM, “Image View Modifier”) 1-n MC Shall be present if (0054,0222) is in the Image Instance $ImageViewMod
5 > HAS ACQ CONTEXT TEXT EV (111044, DCM, “Patient Orientation Row”) 1 MC Shall be present if (0020,0020) is in the Image Instance
6 > HAS ACQ CONTEXT TEXT EV (111043, DCM, “Patient Orientation Column”) 1 MC Shall be present if (0020,0020) is in the Image Instance
7 > HAS ACQ CONTEXT DATE EV (111060, DCM, “Study Date”) 1 MC Shall be present if (0008,0020) is in the Image Instance
8 > HAS ACQ CONTEXT TIME EV (111061, DCM, “Study Time”) 1 MC Shall be present if (0008,0030) is in the Image Instance
9 > HAS ACQ CONTEXT DATE EV (111018, DCM, “Content Date”) 1 MC Shall be present if (0008,0023) is in the Image Instance
10 > HAS ACQ CONTEXT TIME EV (111019, DCM, “Content Time”) 1 MC Shall be present if (0008,0033) is in the Image Instance
11 > HAS ACQ CONTEXT NUM EV (111026, DCM, “Horizontal Pixel Spacing”) 1 MC Shall be present if (0018,1164) or (0028,0030) is in the Image Instance UNITS = EV (um, UCUM, “micrometer”)
12 > HAS ACQ CONTEXT NUM EV (111066, DCM, “Vertical Pixel Spacing”) 1 MC Shall be present if (0018,1164) or (0028,0030) is in the Image Instance UNITS = EV (um, UCUM, “micrometer”)
13 > HAS ACQ CONTEXT NUM EV (112011, DCM, “Positioner Primary Angle”) 1 UC May be present if (0018,1510) is in the Image Instance
14 > HAS ACQ CONTEXT NUM EV (112012, DCM, “Positioner Secondary Angle”) 1 UC May be present if (0018,1511) is in the Image Instance

Content Item Descriptions

Patient Orientation Row First (row) and Second (column) components of Patient Orientation (0020,0020) in the Image IOD. See PS 3, C.7.6.1.1.1.
Patient Orientation Column
Horizontal Imager Pixel Spacing The row (first) component of Imager Pixel Spacing (0018,1164) in the Image IOD. See PS 3, C.8.11.4. Convert the source spacing to micrometers.
Vertical Imager Pixel Spacing The column (second) component of Imager Pixel Spacing (0018,1164) in the Image IOD. See PS 3, C.8.11.4. Convert the source spacing to micrometers.

TID 4021 Mammography CAD Geometry Template

All geometry template invocations require specification of the location of the center of the object. Outline is optional.

TID 4021MAMMOGRAPHY CAD GEOMETRYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 SCOORD EV(111010, DCM, “Center”) 1 M GRAPHIC TYPE = {POINT}
2 > R-SELECTED FROM IMAGE 1 M Shall reference an IMAGE content item in the (111028, DCM, “Image Library”)
3 SCOORD EV(111041, DCM, “Outline”) 1 U
4 > R-SELECTED FROM IMAGE 1 M Shall reference the same content item as row 2
5 SCOORD DCID (6166) CAD Geometry Secondary Graphical Representation 1-n U
6 > R-SELECTED FROM IMAGE 1 M Shall reference the same content item as row 2

TID 4022 CAD Observation Context Template

This template is invoked when a content item, which may be the “root” of a sub-tree, is paraphrased from a prior SR document.

TID 4022 CAD OBSERVATION CONTEXT Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 COMPOSITE EV(111040, DCM, “Original Source”) 1 MC Shall be present if the original source is a DICOM object.
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 M
3 INCLUDE DTID (1001) Observation Context 1 M

TID 4023 CAD Operating Points

This template describes CAD operating points. The description is deliberately left flexible and optional to allow implementation at differing levels of complexity.

TID 4023CAD OPERATING POINTSType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 HAS PROPERTIES NUM EV (111072, DCM, “Maximum CAD Operating Point”) 1 M UNITS = DT ([arb’U], UCUM, “arbitrary unit”) Value is restricted to being an integer
2 HAS PROPERTIES NUM EV (111092, DCM, “Recommended CAD Operating Point”) 1 U UNITS = DT ({0:n}, UCUM, “range: 0:n”), where n is the value specified in row 1 Value is restricted to being an integer
3 HAS PROPERTIES CONTAINER EV (111093,DCM,“CAD Operating Point Table”) 1 U
4 > CONTAINS CODE EV (122698, DCM, "X-Concept") 1 M DCID (6048) CAD Operating Point Axis Label
5 > CONTAINS CODE EV (122699, DCM, "Y-Concept") 1 M DCID (6048) CAD Operating Point Axis Label
6 > CONTAINS NUM EV (111071, DCM, “CAD Operating Point”) 1-n M Number of instances of this row shall equal value of row 1, plus 1. UNITS = DT ({0:n}, UCUM, “range: 0:n”), where n is the value of Row 1. Value is restricted to being an integer that is unique within the invocation of this template.
7 >> HAS PROPERTIES TEXT EV (111081, DCM, “CAD Operating Point Description”) 1 U
8 >> HAS PROPERTIES NUM The value of Row 4 1 U
9 >> HAS PROPERTIES NUM The value of Row 5 1 U

Content Item Descriptions

Maximum CAD Operating Point The maximum possible value of CAD Operating Point for this type of Detection Performed. No CAD Operating Point value recorded in the CAD Processing and Findings Summary sub-tree of the report for this type of Detection Performed shall exceed this value. The report may or may not contain Rendering Intent = “Presentation Optional” detections that are assigned the maximum value.
Recommended CAD Operating Point A number indicating which of the CAD operating points is recommended by the creator of a CAD SR instance as the first operating point to be used when rendering the CAD SR instance contents. Subsequent changes to the displayed operating point are implementation dependent.

CHEST CAD SR IOD TEMPLATES

The templates that comprise the Chest CAD SR IOD are interconnected as in Figure A-9. In Figure A-9, ‘( ( (’ indicates possible recursive application of subordinate templates.

[pic]

Figure A-9: Chest CAD SR IOD Template Structure

TID 4100 Chest CAD Document Root Template

This template forms the top of a content tree that allows a chest CAD device to describe the results of detection and analysis of chest evidence. This template, together with its subordinate templates, describes both the results for presentation to radiologists and partial product results for consumption by chest CAD devices in subsequent chest CAD reports.

This template defines a Container that contains an Image Library, the CAD results, and summaries of the detection and analysis algorithms performed. The Image Library contains the Image SOP Class and Instance UIDs, and selected attributes for each image referenced in either the algorithm summaries or chest CAD results.

The atomic CAD results of Single Image Findings and Composite Features are described in the Chest CAD Findings Summary sub-tree.

The Summary of Detections and Summary of Analyses sub-trees gather lists of algorithms attempted, grouped by success/failure status. Algorithms not attempted are not mentioned in these sub-trees. This information forms the basis for understanding why a chest CAD report may produce no (or fewer than anticipated) results. Chest CAD results are constructed bottom-up, starting from Single Image Findings (see TID 4104), associated as Composite Features (see TID 4102).

See the figure entitled “Top Levels of Chest CAD SR Content Tree” in the “Chest CAD” Annex of PS 3.17.

TID 4100CHEST CAD DOCUMENT ROOTType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (112000, DCM, “Chest CAD Report”) 1 M
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 M
3 > CONTAINS CONTAINER EV (111028, DCM, “Image Library”) 1 U
4 >> CONTAINS INCLUDE DTID (4020) CAD Image Library Entry 1-n M $ImageLaterality = DCID (244) Laterality $ImageView = DCID (4010) DX View $ImageViewMod = DCID (4011) DX View Modifier
5 > CONTAINS INCLUDE DTID (4101) Chest CAD Findings Summary 1 M
6 > CONTAINS CODE EV (111064, DCM, “Summary of Detections”) 1 M DCID (6042) Status of Results
7 >> INFERRED FROM INCLUDE DTID (4015) CAD Detections Performed 1 MC Shall be present unless the value of row 6 is (111225, DCM, “Not Attempted”) $DetectionCode = DCID (6101) Chest Finding or Feature, DCID (6102) Chest Finding or Feature Modifier
8 > CONTAINS CODE EV (111065, DCM, “Summary of Analyses”) 1 M DCID (6042) Status of Results
9 >> INFERRED FROM INCLUDE DTID (4016) CAD Analyses Performed 1 MC Shall be present unless the value of row 8 is (111225, DCM, “Not Attempted”) $AnalysisCode = DCID (6137) Types of CAD Analysis

Content Item Descriptions

Image Library The “Image Library” section of the Content Tree (TID 4100, row 3) may include all Image SOP Instances from the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module. If a portion of another instance of a Chest CAD SR IOD is duplicated in the “Chest CAD Findings Summary” section of the Content Tree, the “Image Library” may also include all Image Library Entries referenced from the duplicated portions of the Chest CAD SR. The Image Library is intended to be used in cases where the acquisition context content items differ from image to image, such as different views and/or laterality in projection X-Ray.
Detections Performed The “Detections Performed” and “Analyses Performed” sections of the Content Tree (TID 4100, rows 7 and 9) together shall reference all Image SOP Instances included in the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module.
Analyses Performed

TID 4101 Chest CAD Findings Summary Template

The contents of this template describe the findings and aggregate features that the chest CAD device detected for the chest evidence presented. This template forms the chest CAD results sub-tree of the Chest CAD Document Root (TID 4100). The data from which the details are inferred are expressed in the Composite Features (see TID 4102) and/or Single Image Findings (see TID 4104), of which there may be several.

The sub-tree headed by this template is illustrated in the figure entitled “Example of CAD Processing and Findings Summary sub-tree of Chest CAD SR Content Tree” in the “Chest CAD” Annex of PS 3.17.

TID 4101CHEST CAD FINDINGS SUMMARYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111017, DCM, “CAD Processing and Findings Summary”) 1 M DCID (6047) CAD Processing and Findings Summary
2 > INFERRED FROM INCLUDE DTID (4102) Chest CAD Composite Feature 1-n U
3 > INFERRED FROM INCLUDE DTID (4104) Chest CAD Single Image Finding 1-n U
4 > HAS PROPERTIES INCLUDE DTID (4106) Response Evaluation 1-n U

Content Item Descriptions

CAD Processing and Findings Summary This code value is used to express if and why the Chest CAD Findings Summary sub-tree is empty. The Summary of Detections and Summary of Analyses sub-trees of the Document Root node contain detail about which (if any) algorithms succeeded or failed. If the code value indicates that there were no findings, then the code value can be used to determine whether chest CAD processing occurred successfully, without parsing the Summary of Detections and Summary of Analyses sub-trees.

TID 4102 Chest CAD Composite Feature Template

This template collects a composite feature for a lesion, anatomy, non-lesion object, or correlation of related objects (see TID 4101). The details of the composition are expressed in the Chest CAD Composite Feature Body (see TID 4103). The data from which the details are inferred, are expressed in the Composite Features (see TID 4102) and/or Single Image Findings (see TID 4104), of which there may be several.

A Composite Feature shall be INFERRED FROM any combination of two or more Composite Features or Single Image Findings or mixture thereof.

TID 4102CHEST CAD COMPOSITE FEATUREType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111015, DCM, “Composite Feature”) 1 M DCID (6101) Chest Finding or Feature
2 > HAS CONCEPT MOD CODE EV (112023, DCM, “Composite Feature Modifier”) 1 U DCID (6102) Chest Finding or Feature Modifier
3 > HAS CONCEPT MOD TEXT EV (112050, DCM, “Anatomic Identifier”) 1 U
4 > HAS CONCEPT MOD CODE EV (112003, DCM, “Associated Chest Component”) 1 MC Shall be present IFF value of row 1 is (112005, DCM, “Radiographic anatomy”) DCID (6100) Chest Component Categories
5 > HAS CONCEPT MOD CODE EV (112037, DCM, “Non-lesion Modifier”) 1 UC May be present IFF value of row 1 is (111102, DCM, ”Non-lesion”) DCID (6139) Non-lesion Modifiers
6 > HAS CONCEPT MOD CODE EV (112038, DCM, “Osseous Modifier”) 1 UC May be present IFF value of row 2 is from DCID (6114) Osseous Anatomy Finding or Feature DCID (6115) Osseous Anatomy Modifiers
7 > HAS CONCEPT MOD CODE EV (111056, DCM, “Rendering Intent”) 1 M DCID (6034) Intended Use of CAD Output
8 > HAS OBS CONTEXT INCLUDE DTID (4108) Tracking Identifier 1 U
9 > HAS OBS CONTEXT CODE EV (112016, DCM, “Baseline Category”) 1 U DCID (6145) Baseline Category
10 > HAS OBS CONTEXT INCLUDE DTID (4022) CAD Observation Context 1 MC Shall be present IFF this feature is duplicated from a different report than its parent.
11 > HAS OBS CONTEXT INCLUDE DTID (4019) CAD Algorithm Identification 1 M
12 > HAS PROPERTIES INCLUDE DTID (4103) Chest CAD Composite Feature Body 1 M
13 > INFERRED FROM INCLUDE DTID (4102) Chest CAD Composite Feature 1-n MC At least two items shall be present: two of row 13, two of row 14, or one of each.
14 > INFERRED FROM INCLUDE DTID (4104) Chest CAD Single Image Finding 1-n MC At least two items shall be present: two of row 13, two of row 14, or one of each.

Content Item Descriptions

Anatomic Identifier An identifier of an anatomic feature when a multiplicity of features of that type may be present, such as “Rib 1”, “Rib 2” or thoracic vertebrae “T1” or “T2”.
Rendering Intent This content item constrains the SCP receiving the Chest CAD SR IOD in its use of the contents of this template and its target content items. Chest CAD devices may opt to use data marked “Not for Presentation” or “Presentation Optional” as input to subsequent chest CAD processing steps. Refer to PS 3.4, Annex O Structured Reporting Standard SOP Classes for SCU and SCP Behavior.

TID 4103 Chest CAD Composite Feature Body Template

The details of a composite feature are expressed in this template. It is applied to Chest CAD Composite Feature (TID 4102).

TID 4103CHEST CAD COMPOSITE FEATURE BODYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111016, DCM, “Composite type”) 1 M DCID (6035) Composite Feature Relations
2 CODE EV (111057, DCM, “Scope of Feature”) 1 M DCID (6036) Scope of Feature
3 NUM EV (111011, DCM, “Certainty of feature”) 1 U UNITS = EV (%, UCUM, “Percent”) Value = 0 – 100
4 INCLUDE DTID (4107) Chest CAD Geometry 1 U
5 INCLUDE DTID (1400) Linear Measurement 1-n U
6 INCLUDE DTID (1401) Area Measurement 1-n U
7 INCLUDE DTID (1402) Volume Measurement 1-n U
8 INCLUDE DTID (4105) Chest CAD Descriptors 1 U
9 NUM DCID (6133) Chest Quantitative Temporal Difference Type 1-n UC May be present IFF the value of row 1 is (111153, DCM, “Target content items are related temporally”)
10 > R-INFERRED FROM NUM 2 U The referenced numeric values shall have the same Concept Name. Their UNITS shall be the same as row 9
11 CODE EV (111049, DCM, “Qualitative Difference”) 1-n UC May be present only if the value of row 1 is (111153, DCM, “Target content items are related temporally”) DCID (6134) Qualitative Temporal Difference Type
12 > HAS PROPERTIES TEXT EV (111021, DCM, “Description of Change”) 1 U
13 > R-INFERRED FROM CODE 2 M The referenced content items shall have the same Concept Name and their code values shall be from the same context group.

Content Item Descriptions

Certainty of Feature The certainty of the CAD device that the feature analyzed and classified by the CODE, as specified in the Composite Feature parent template, is in fact that type of feature.
Volume Measurement If dimensions for a volume are to be stated in terms of length, width, and depth, then one shall use 3 instances of TID (1400) Linear Measurement.
Row 9 Values ( 0 are allowed. The two referenced numeric values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature. Given the equation, A – B, the value representing A shall be referenced first.
Qualitative Difference The two referenced code values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature.

TID 4104 Chest CAD Single Image Finding Template

This template describes a single image finding for a lesion or other object. The details of the finding are expressed in this template and/or more specific templates.

TID 4104CHEST CAD SINGLE IMAGE FINDINGType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111059, DCM, “Single Image Finding”) 1 M DCID (6101) Chest Finding or Feature
2 > HAS CONCEPT MOD CODE EV (112024, DCM, “Single Image Finding Modifier”) 1 U DCID (6102) Chest Finding or Feature Modifier
3 > HAS CONCEPT MOD TEXT EV (112050, DCM, “Anatomic Identifier”) 1 U
4 > HAS CONCEPT MOD CODE EV (112003, DCM, “Associated Chest Component”) 1 MC Shall be present IFF value of row 1 is (112005, DCM, “Radiographic anatomy”) DCID (6100) Chest Component Categories
5 > HAS CONCEPT MOD CODE EV (112037, DCM, “Non-lesion Modifier”) 1 UC May be present IFF value of row 1 is (111102, DCM, ”Non-lesion”) DCID (6139) Non-lesion Modifiers
6 > HAS CONCEPT MOD CODE EV (111056, DCM, “Rendering Intent”) 1 M DCID (6034) Intended Use of CAD Output
7 >> HAS PROPERTIES NUM EV (111071, DCM, “CAD Operating Point”) 1 UC IFF value of row 6 is (111151, DCM, “Presentation Optional”) and row 1 of TID 4023 is present for the finding identified in row 1 UNITS = DT ({1:n}, UCUM, “range: 1:n”), where n is the maximum specified in Row 1 of TID 4023 for the finding identified in row 1. Value is restricted to being an integer
8 > HAS OBS CONTEXT INCLUDE DTID (4108) Tracking Identifier 1 U
9 > HAS OBS CONTEXT CODE EV (112016, DCM, “Baseline Category”) 1 U DCID (6145) Baseline Category
10 > HAS OBS CONTEXT INCLUDE DTID (4022) CAD Observation Context 1 MC Shall be present IFF this finding is duplicated from a different report than its parent.
11 > HAS OBS CONTEXT INCLUDE DTID (4019) CAD Algorithm Identification 1 M
12 > HAS PROPERTIES NUM EV (111012, DCM, “Certainty of Finding”) 1 U UNITS = EV (%, UCUM, “Percent”) Value = 0 – 100
13 > HAS PROPERTIES TEXT EV (111058, DCM, “Selected Region Description”) 1 MC Shall be present IFF value of row 1 is (111099, DCM, “Selected region”)
14 > HAS PROPERTIES INCLUDE DTID (4107) Chest CAD Geometry 1 MC Shall be present unless value of row 1 is (111101, DCM, “Image quality”)
15 > HAS PROPERTIES INCLUDE DTID (1400) Linear Measurement 1-n U
16 > HAS PROPERTIES INCLUDE DTID (1401) Area Measurement 1-n U
17 > HAS PROPERTIES INCLUDE DTID (1402) Volume Measurement 1-n U
18 > HAS PROPERTIES INCLUDE DTID (4105) Chest CAD Descriptors 1 U
19 > INFERRED FROM IMAGE 1 MC Shall be present IFF value of row 1 is (111101, DCM, “Image quality”) and rows 20 and 21 are not present
20 > R-INFERRED FROM IMAGE 1 MC Shall be present IFF value of row 1 is (111101, DCM, “Image quality”) and rows 19 and 21 are not present Shall reference an IMAGE content item in the (111028, DCM, “Image Library”)
21 > INFERRED FROM SCOORD EV (111030, DCM, “Image Region”) 1-n MC Shall be present IFF value of row 1 is (111101, DCM, “Image quality”) and rows 19 and 20 are not present
22 >> SELECTED FROM IMAGE 1 MC XOR row 23 All the row 21 content items in a single invocation of this template shall reference the same IMAGE
23 >> R-SELECTED FROM IMAGE 1 MC XOR row 22 All the row 21 content items in a single invocation of this template shall reference the same IMAGE content item in the (111028, DCM, “Image Library”)
24 > HAS PROPERTIES INCLUDE DTID (4014) CAD Image Quality 1 MC Shall be present IFF value of row 1 is (111101, DCM, “Image quality”) $QualityFinding = DCID (6135) Image Quality Finding $QualityStandard = DCID (6136) Chest Types of Quality Control Standard

Content Item Descriptions

Anatomic Identifier An identifier of an anatomic feature when a multiplicity of features of that type may be present, such as “Rib 1”, “Rib 2” or thoracic vertebrae “T1” or “T2”.
Rendering Intent This content item constrains the SCP receiving the Chest CAD SR IOD in its use of the contents of this template and its target content items. Chest CAD devices may opt to use data marked “Not for Presentation” or “Presentation Optional” as input to subsequent chest CAD processing steps. Refer to PS 3.4 section on Structured Reporting Storage SOP Classes for SCU and SCP Behavior.
CAD Operating Point Additional information to use when Rendering Intent is “Presentation Optional”. A CAD Operating Point of zero is not sent, and is encoded as a Rendering Intent of “Presentation Required”. See PS 3.4 section on Structured Reporting Storage SOP Classes for SCU and SCP Behavior and PS 3.17 annex on Mammography.
Certainty of Finding The certainty of the CAD device that the finding detected and classified by the Single Image Finding CODE specified is in fact that type of finding.

TID 4105 Chest CAD Descriptors

This template provides qualitative detail for a Single Image Finding or Composite Feature. It is applied to Chest CAD Composite Feature (TID 4102) and Chest CAD Single Image Finding (TID 4104).

TID 4105CHEST CAD DESCRIPTORSType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (112025, DCM, “Size Descriptor”) 1 U DCID (6118) Size Descriptor
2 CODE EV (112026, DCM, “Width Descriptor”) 1 U DCID (6107) Width Descriptor
3 CODE EV (112015, DCM, “Border shape”) 1 U DCID (6119) Chest Border Shape
4 CODE EV (112007, DCM, “Border definition”) 1 U DCID (6120) Chest Border Definition
5 CODE EV (112014, DCM, “Orientation Descriptor”) 1 U DCID (6121) Chest Orientation Descriptor
6 CODE EV (112009, DCM, “Type of Content”) 1-n U DCID (6122) Chest Content Descriptor
7 CODE EV (112027, DCM, “Opacity Descriptor”) 1 U DCID (6123) Chest Opacity Descriptor
8 CODE EV (112013, DCM, “Location in Chest”) 1 U DCID (6124) Location in Chest
9 CODE EV (G-C171, SRT, “Laterality”) 1 U DCID (244) Laterality
10 CODE EV (112006, DCM, “Distribution Descriptor”) 1-n U DCID (6128) Chest Distribution Descriptor
11 CODE EV (112028, DCM, “Abnormal Distribution of Anatomic Structure”) 1 U DCID (6108) Chest Anatomic Structure Abnormal Distribution
12 CODE EV (112008, DCM, “Site involvement”) 1-n U DCID (6129) Chest Site Involvement
13 CODE EV (G-C197, SRT, “Severity”) 1 U DCID (6130) Severity Descriptor
14 CODE EV (112010, DCM, “Texture Descriptor”) 1 U DCID (6131) Chest Texture Descriptor
15 CODE EV (112030, DCM, “Calcification Descriptor”) 1 U DCID (6132) Chest Calcification Descriptor
16 NUM DCID (6142) Calculated Value 1-n U
17 > HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 M DCID (6140) Calculation Methods
18 > INFERRED FROM NUM EV (112032, DCM, “Threshold Attenuation Coefficient”) 1 U UNITS = EV ([hnsf’U], UCUM, “Hounsfield unit”)
19 > INFERRED FROM TEXT EV (112034, DCM, “Calculation Description”) 1 U
20 NUM DCID (6141) Attenuation Coefficient Measurements 1-n U UNITS = EV ([hnsf’U], UCUM, “Hounsfield unit”)

TID 4106 Response Evaluation

This template provides a means to report response evaluation to cancer treatment, based on a method such as RECIST or WHO.

TID 4106 RESPONSE EVALUATION Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (112020, DCM, “Response Evaluation”) 1 M
2 > HAS OBS CONTEXT CODE EV (112021, DCM, “Response Evaluation Method”) 1 M DT (112022, DCM “RECIST”) or DT (112029, DCM, “WHO”)
3 > CONTAINS CODE EV (112048, DCM, “Current Response”) 1 U DCID (6143) Response Criteria
4 > CONTAINS CODE EV (112049, DCM, “Best Overall Response”) 1 U DCID (6143) Response Criteria
5 > CONTAINS NUM EV (112051, DCM, “Measurement of Response”) 1 U UNITS not specified

TID 4107 Chest CAD Geometry Template

All geometry template invocations require specification of either the location of the center of the object, the outline, or both. Geometry is a property of single image findings (see TID 4104) and composite features (see TID 4103).

TID 4107CHEST CAD GEOMETRYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 SCOORD EV (111010, DCM, “Center”) 1 MC At least one of rows 1,4 shall be present. GRAPHIC TYPE = {POINT}
2 > SELECTED FROM IMAGE 1 MC XOR row 3
3 > R-SELECTED FROM IMAGE 1 MC XOR row 2 Shall reference an IMAGE content item in the (111028, DCM, “Image Library”)
4 SCOORD EV (111041, DCM, “Outline”) 1 MC At least one of rows 1,4 shall be present.
5 > SELECTED FROM IMAGE 1 MC XOR row 6 Shall reference the same content item as row 2
6 > R-SELECTED FROM IMAGE 1 MC XOR row 5 Shall reference the same content item as row 3

TID 4108 Tracking Identifier

This template provides a means to identify an object for longitudinal tracking, potentially across multiple Structured Reports, over time.

TID 4108TRACKING IDENTIFIERType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 TEXT EV (112039, DCM, “Tracking Identifier”) 1 MC At least one of row 1 or 2 shall be present. A string of characters with case being non-significant. Leading and trailing spaces and control characters are forbidden.
2 UIDREF EV (112040, DCM, “Tracking Unique Identifier”) 1 MC At least one of row 1 or 2 shall be present.

Content Item Descriptions

Tracking Identifier A human readable identifier for longitudinal tracking, e.g., “Watchlist Nodule 1”.

COLON CAD SR IOD TEMPLATES

The templates that comprise the Colon CAD SR IOD are interconnected as in Figure A-9b. In Figure A-9b, ‘( ( (’ indicates possible recursive application of subordinate templates.

[pic]

Figure A-9b: Colon CAD SR IOD Template Structure

TID 4120 Colon CAD Document Root Template

This template forms the top of a content tree that allows a colon CAD device to describe the results of detection and analysis of colon evidence. This template, together with its subordinate templates, describes both the results for presentation to radiologists and partial product results for consumption by colon CAD devices in subsequent colon CAD reports.

This template defines a Container that contains the CAD results and summaries of the detection and analysis algorithms performed.

The atomic CAD results of Single Image Findings and Composite Features are described in the Colon CAD Findings Summary sub-tree.

The Summary of Detections and Summary of Analyses sub-trees gather lists of algorithms attempted, grouped by success/failure status. Algorithms not attempted are not mentioned in these sub-trees. This information forms the basis for understanding why a colon CAD report may produce no (or fewer than anticipated) results. Colon CAD results are constructed bottom-up, starting from Single Image Findings (see TID 4127), associated as Composite Features (see TID 4125).

See the figure entitled “Top Levels of Colon CAD SR Content Tree” in the “Colon CAD” Annex of PS 3.17.

TID 4120COLON CAD DOCUMENT ROOT

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (112220, DCM, “Colon CAD Report”) 1 M
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 M
3 > CONTAINS INCLUDE DTID (4122) CAD Common Image Properties Entry 1-n M
4 > CONTAINS INCLUDE DTID (4121) Colon CAD Findings Summary 1 M
5 > CONTAINS CODE EV (111064, DCM, “Summary of Detections”) 1 M DCID (6042) Status of Results
6 >> INFERRED FROM INCLUDE DTID (4015) CAD Detections Performed 1 MC Shall be present unless the value of row 5 is (111225, DCM, “Not Attempted”) $DetectionCode = DCID (6201) Colon Finding or Feature
7 > CONTAINS CODE EV (111065, DCM, “Summary of Analyses”) 1 M DCID (6042) Status of Results
8 >> INFERRED FROM INCLUDE DTID (4016) CAD Analyses Performed 1 MC Shall be present unless the value of row 7 is (111225, DCM, “Not Attempted”) $AnalysisCode = DCID (6137) Types of CAD Analysis

Content Item Descriptions

Detections Performed The “Detections Performed” and “Analyses Performed” sections of the Content Tree (TID 4120, rows 6 and 8) together shall reference all Image SOP Instances included in the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module.
Analyses Performed

TID 4121 Colon CAD Findings Summary Template

The contents of this template describe the findings and aggregate features that the colon CAD device detected for the colon evidence presented. This template forms the colon CAD results sub-tree of the Colon CAD Document Root (TID 4120). The data from which the details are inferred are expressed in the Composite Features (see TID 4125) and/or Single Image Findings (see TID 4127), of which there may be several.

The sub-tree headed by this template is illustrated in the figure entitled “Example of CAD Processing and Findings Summary sub-tree of Colon CAD SR Content Tree” in the “Colon CAD” Annex of PS 3.17.

TID 4121COLON CAD FINDINGS SUMMARY

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111017, DCM, “CAD Processing and Findings Summary”) 1 M DCID (6047) CAD Processing and Findings Summary
2 > HAS PROPERTIES CODE EV (112222, DCM, “Colon Overall Assessment”) 1 U DCID (6200) Colon Overall Assessment
3 > INFERRED FROM INCLUDE DTID (4125) Colon CAD Composite Feature 1-n U
4 > INFERRED FROM INCLUDE DTID (4127) Colon CAD Single Image Finding 1-n U

Content Item Descriptions

CAD Processing and Findings Summary This code value is used to express if and why the Colon CAD Findings Summary sub-tree is empty. The Summary of Detections and Summary of Analyses sub-trees of the Document Root node contain detail about which (if any) algorithms succeeded or failed. If the code value indicates that there were no findings, then the code value can be used to determine whether colon CAD processing occurred successfully, without parsing the Summary of Detections and Summary of Analyses sub-trees.

TID 4122 CAD Common Image Properties Entry Template

Each instance of the CAD Common Image Properties Entry template contains selected attributes for a set of parallel contiguous equally spaced slices (with identical properties) from which CAD findings are derived.

TID 4122 CAD COMMON IMAGE PROPERTIES ENTRYType: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (112224, DCM, “Image Set Properties”) 1 M
2 > CONTAINS UIDREF EV (112227, DCM, “Frame of Reference UID”) 1 M
3 > CONTAINS UIDREF EV (110180, DCM, “Study Instance UID”) 1 M
4 > CONTAINS DATE EV (111060, DCM, “Study Date”) 1 M Shall be taken from Study Date (0008,0020) in the Image Instances.
5 > CONTAINS TIME EV (111061, DCM, “Study Time”) 1 M Shall be taken from Study Time (0008,0030) in the Image Instances.
6 > CONTAINS CODE EV (121139, DCM, “Modality”) 1 M Shall be taken from Modality (0008,0060) in the Image Instances.
7 > CONTAINS NUM EV (111026, DCM, ”Horizontal Pixel Spacing”) 1 M Shall be taken from value 1 of Pixel Spacing (0028,0030) in the Image Instances. UNITS = EV (mm/{pixel}, UCUM, “millimeters per pixel”)
8 > CONTAINS NUM EV (111066, DCM, ”Vertical Pixel Spacing”) 1 M Shall be taken from value 2 of Pixel Spacing (0028,0030) in the Image Instances. UNITS = EV (mm/{pixel}, UCUM, “millimeters per pixel”)
9 > CONTAINS NUM EV (112225, DCM, “Slice Thickness”) 1 M Shall be taken from Slice Thickness (0018,0050) in the Image Instances. UNITS = EV (mm, UCUM, “millimeter”)
10 > CONTAINS CODE EV (112226, DCM, “Spacing between slices”) 1 M Shall be computed from the Image Position (Patient) (0020,0032) projected onto the normal to the Image Orientation (Patient) (0020,0037); may or may not be the same as the Spacing Between Slices (0018,0088) if present. UNITS = EV (mm, UCUM, “millimeter”)
11 > CONTAINS CODE EV (112228, SRT, “Recumbent Patient Position with respect to gravity”) 1 MC Required if Patient Position (0018,5100) is present in the image instances and has a value. Shall be derived from Patient Position (0018,5100) in the Image Instances. DCID (6206) Recumbent Patient Orientation for Colon CAD

TID 4125 Colon CAD Composite Feature Template

This template collects a composite feature for a lesion, non-lesion object, or correlation of related objects (see TID 4121). The details of the composition are expressed in the Colon CAD Composite Feature Body (see TID 4126). The data from which the details are inferred, are expressed in the Composite Features (see TID 4125) and/or Single Image Findings (see TID 4127), of which there may be several.

TID 4125COLON CAD COMPOSITE FEATURE

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111015, DCM, “Composite Feature”) 1 M DCID (6201) Colon Finding or Feature
2 > HAS CONCEPT MOD CODE EV (112023, DCM, “Composite Feature Modifier”) 1 U DCID (6202) Colon Finding or Feature Modifier
3 > HAS CONCEPT MOD CODE EV (111056, DCM, “Rendering Intent”) 1 M DCID (6034) Intended Use of CAD Output
4 >> HAS PROPERTIES NUM EV (111071, DCM, “CAD Operating Point”) 1 UC IFF value of row 3 is (111151, DCM, “Presentation Optional”) and row 1 of TID 4023 is present for the feature identified in row 1. UNITS = DT ({1:n}, UCUM, “range: 1:n”), where n is the maximum specified in Row 1 of TID 4023 for the feature identified in row 1. Value is restricted to being an integer.
5 > HAS OBS CONTEXT INCLUDE DTID (4108) Tracking Identifier 1 U
6 > HAS OBS CONTEXT INCLUDE DTID (4022) CAD Observation Context 1 MC Shall be present IFF this feature is duplicated from a different report than its parent.
7 > HAS OBS CONTEXT INCLUDE DTID (4019) CAD Algorithm Identification 1 M
8 > HAS PROPERTIES INCLUDE DTID (4126) Colon CAD Composite Feature Body 1 M
9 > INFERRED FROM INCLUDE DTID (4125) Colon CAD Composite Feature 1-n U
10 > INFERRED FROM INCLUDE DTID (4127) Colon CAD Single Image Finding 1-n U

Content Item Descriptions

Rendering Intent This content item constrains the SCP receiving the Colon CAD SR IOD in its use of the contents of this template and its target content items. Colon CAD devices may opt to use data marked “Not for Presentation” or “Presentation Optional” as input to subsequent colon CAD processing steps. Refer to PS 3.4, Annex O Structured Reporting Standard SOP Classes for SCU and SCP Behavior.

TID 4126 Colon CAD Composite Feature Body Template

The details of a composite feature are expressed in this template. It is applied to Colon CAD Composite Feature (TID 4125).

TID 4126COLON CAD COMPOSITE FEATURE BODY

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111016, DCM, “Composite type”) 1 M DCID (6035) Composite Feature Relations
2 CODE EV (111057, DCM, “Scope of Feature”) 1 M DCID (6036) Scope of Feature
3 NUM EV (111011, DCM, “Certainty of feature”) 1 U UNITS = EV (%, UCUM, “Percent”) Value = 0 – 100
4 INCLUDE DTID (4129) Colon CAD Geometry 1 U
5 INCLUDE DTID (4128) Colon CAD Descriptors 1 U
6 NUM DCID (6207) Colon Quantitative Temporal Difference Type 1-n UC May be present IFF the value of row 1 is (111153, DCM, “Target content items are related temporally”)
7 > R-INFERRED FROM NUM 2 U The referenced numeric values shall have the same Concept Name. Their UNITS shall be the same as row 6
8 CODE EV (111049, DCM, “Qualitative Difference”) 1-n UC May be present only if the value of row 1 is (111153, DCM, “Target content items are related temporally”) DCID (6134) Qualitative Temporal Difference Type
9 > HAS PROPERTIES TEXT EV (111021, DCM, “Description of Change”) 1 U
10 > R-INFERRED FROM CODE 2 M The referenced content items shall have the same Concept Name and their code values shall be from the same context group.

Content Item Descriptions

Certainty of Feature The CAD device’s certainty that the feature analyzed and classified by the CODE, as specified in the Composite Feature parent template is, in fact, that type of feature.
Row 6 Values ( 0 are allowed. The two referenced numeric values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature. Given the equation, A – B, the value representing A shall be referenced first.
Qualitative Difference The two referenced code values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature.

TID 4127 Colon CAD Single Image Finding Template

This template describes a single image finding for a lesion or other object. The details of the finding are expressed in this template and/or more specific templates.

TID 4127COLON CAD SINGLE IMAGE FINDING

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (111059, DCM, “Single Image Finding”) 1 M DCID (6201) Colon Finding or Feature
2 > HAS CONCEPT MOD CODE EV (112024, DCM, “Single Image Finding Modifier”) 1 U DCID (6202) Colon Finding or Feature Modifier
3 > HAS CONCEPT MOD CODE EV (111056, DCM, “Rendering Intent”) 1 M DCID (6034) Intended Use of CAD Output
4 >> HAS PROPERTIES NUM EV (111071, DCM, “CAD Operating Point”) 1 UC IFF value of row 3 is (111151, DCM, “Presentation Optional”) and row 1 of TID 4023 is present for the finding identified in row 1 UNITS = DT ({1:n}, UCUM, “range: 1:n”), where n is the maximum specified in Row 1 of TID 4023 for the finding identified in row 1. Value is restricted to being an integer.
5 > HAS OBS CONTEXT INCLUDE DTID (4108) Tracking Identifier 1 U
6 > HAS OBS CONTEXT INCLUDE DTID (4022) CAD Observation Context 1 MC Shall be present IFF this finding is duplicated from a different report than its parent.
7 > HAS OBS CONTEXT INCLUDE DTID (4019) CAD Algorithm Identification 1 M
8 > HAS PROPERTIES NUM EV (111012, DCM, “Certainty of Finding”) 1 U UNITS = EV (%, UCUM, “Percent”) Value = 0 – 100
9 > HAS PROPERTIES TEXT EV (111058, DCM, “Selected Region Description”) 1 MC Shall be present IFF value of row 1 is (111099, DCM, “Selected region”)
10 > HAS PROPERTIES INCLUDE DTID (4129) Colon CAD Geometry 1 MC Shall be present unless value of row 1 is (111101, DCM, “Image quality”)
11 > HAS PROPERTIES INCLUDE DTID (4128) Colon CAD Descriptors 1 U
12 > INFERRED FROM IMAGE 1 MC Shall be present IFF value of row 1 is (111101, DCM, “Image quality”) and row 13 is not present
13 > INFERRED FROM SCOORD EV (111030, DCM, “Image Region”) 1-n MC Shall be present IFF value of row 1 is (111101, DCM, “Image quality”) and row 12 is not present
14 >> SELECTED FROM IMAGE 1 M All the row 13 content items in a single invocation of this template shall reference the same IMAGE
15 > HAS PROPERTIES INCLUDE DTID (4014) CAD Image Quality 1 MC Shall be present IFF value of row 1 is (111101, DCM, “Image quality”) $QualityFinding = DCID (6135) Image Quality Finding $QualityStandard = DCID (6208) Colon Types of Quality Control Standard

Content Item Descriptions

Rendering Intent This content item constrains the SCP receiving the Colon CAD SR IOD in its use of the contents of this template and its target content items. Colon CAD devices may opt to use data marked “Not for Presentation” or “Presentation Optional” as input to subsequent colon CAD processing steps. Refer to PS 3.4 section on Structured Reporting Storage SOP Classes for SCU and SCP Behavior.
CAD Operating Point Additional information to use when Rendering Intent is “Presentational Optional”. A CAD Operating Point of zero is not sent, and is encoded as a Rendering Intent of “Presentation Required”. See PS 3.4 section on Structured Reporting Storage SOP Classes for SCU and SCP Behavior and PS 3.17 annex on Mammography.
Certainty of Finding The certainty of the CAD device that the finding detected and classified by the Single Image Finding CODE specified is in fact that type of finding.

TID 4128 Colon CAD Descriptors

This template provides qualitative detail for a Single Image Finding or Composite Feature. It is applied to Colon CAD Composite Feature (TID 4125) and Colon CAD Single Image Finding (TID 4127).

TID 4128COLON CAD DESCRIPTORS

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CODE EV (G-C504, SRT, “Associated Morphology”) 1-n U DCID (6209) Colon Morphology Descriptor
2 CODE EV (G-C036, SRT, “Finding Site”) 1 U DCID (6210) Location in Intestinal Tract
3 CODE EV (111014, DCM, “Clockface or region”) 1 U DCID (6205) Clockface Location for Colon
4 CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = DCID (6212) Calculated Value for Colon Findings $Derivation = DCID (6140) Calculation Methods $DerivationParameter = EV (112032, DCM, “Threshold Attenuation Coefficient”) $DerivationParameterUnits = EV ([hnsf’U], UCUM, “Hounsfield unit”)
5 INCLUDE DTID (1400) Linear Measurement 1-n U
6 INCLUDE DTID (1401) Area Measurement 1-n U
7 INCLUDE DTID (1402) Volume Measurement 1-n U
8 INCLUDE DTID (1406) 3D Linear Measurement 1-n U
9 NUM DCID (6141) Attenuation Coefficient Measurements 1-n U UNITS = EV ([hnsf’U], UCUM, “Hounsfield unit”)
10 > HAS PROPERTIES CODE EV (112009, DCM, “Type of Content”) 1 U DCID (6211) Colon CAD Material Description

Content Item Descriptions

Row 3 12 o’clock position is the anterior direction of the patient regardless of the positioning with respect to gravity; clockwise is from the point of view of an observer located closer to the anus than the finding being observed.

TID 4129 Colon CAD Geometry Template

All geometry template invocations require specification of either the location of the center of the object, the outline, or both. Geometry is a property of single image findings (see TID 4127) and composite features (see TID 4125).

TID 4129COLON CAD GEOMETRY

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 SCOORD EV (111010, DCM, “Center”) 1 MC At least one of rows 1, 3, 4, 6 or 11 shall be present. GRAPHIC TYPE = {POINT}
2 > SELECTED FROM IMAGE 1 M
3 SCOORD3D EV (111010, DCM, “Center”) 1 MC At least one of rows 1, 3, 4, 6 or 11 shall be present. GRAPHIC TYPE = {POINT}
4 SCOORD EV (111041, DCM, “Outline”) 1 MC At least one of rows 1, 3, 4, 6 or 11 shall be present.
5 > SELECTED FROM IMAGE 1 M
6 SCOORD3D EV (111041, DCM, “Outline”) 1 MC At least one of rows 1, 3, 4, 6 or 11 shall be present.
7 SCOORD DCID (6166) CAD Geometry Secondary Graphical Representation 1-n U
8 > SELECTED FROM IMAGE 1 M
9 SCOORD3D DCID (6166) CAD Geometry Secondary Graphical Representation 1-n U
10 IMAGE EV (112229, DCM, “Identifying Segment”) 1 MC At least one of rows 1, 3, 4, 6 or 11 shall be present. Referenced image shall be a Segmentation and the content item shall include Referenced Segment Number (0062,000B)
BREAST IMAGING REPORT TEMPLATES

The templates that comprise the Breast Imaging Report are interconnected as in Figure A-10:

[pic]Figure A-10: Breast Imaging Report Template Structure

TID 4200 Breast Imaging Report

This template forms the content tree that allows a Breast Imaging Report device to describe the results of a radiologist’s diagnostic interpretation of Breast Imaging (e.g., X-Ray mammography or breast ultrasound) evidence. This template, together with its subordinate templates, describes the results for presentation to clinicians, or for consumption by Breast Imaging Report devices for subsequent Breast Imaging Reports.

This template shall be instantiated at the Root node only.

See the figure entitled “Top Levels of Breast Imaging Report Content Tree” in the “Breast Imaging Report Content Tree Structure” Annex of PS 3.17.

TID 4200 BREAST IMAGING REPORT

Type: Non-Extensible Order: Significant

NL
TID 4202 Breast Imaging Report Narrative

This template contains the narrative text sub-tree of the content tree of a Breast Imaging Report. The narrative summary may be subdivided into sections with section headings.

See the figure entitled “Breast Imaging Report Narrative Content Tree” in the “Breast Imaging Report Content Tree Structure” Annex of PS 3.17.

TID 4202 BREAST IMAGING REPORT NARRATIVE

Type: Non-Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (125000, DCM, “OB-GYN Ultrasound Procedure Report”) 1 M
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 U
3 > HAS OBS CONTEXT INCLUDE DTID (1001) Observation Context 1 M
4 > CONTAINS INCLUDE DTID (5001) Patient Characteristics 1 U
5 > CONTAINS CONTAINER DT (111028, DCM, “Image Library”) 1 U
6 >> CONTAINS IMAGE No purpose of reference 1-n M
7 > CONTAINS INCLUDE DTID (5002) OB-GYN Procedure Summary Section 1 U
8 > CONTAINS INCLUDE DTID (5004) Fetal Biometry Ratio Section 1-n U
9 > CONTAINS INCLUDE DTID (5005) Fetal Biometry Section 1-n U
10 > CONTAINS INCLUDE DTID (5006) Long Bones Section 1-n U
11 > CONTAINS INCLUDE DTID (5007) Fetal Cranium Section 1-n U
12 > CONTAINS INCLUDE DTID (5009) Fetal Biophysical Profile Section 1-n U
13 > CONTAINS INCLUDE DTID (5011) Early Gestation Section 1-n U
14 > CONTAINS INCLUDE DTID (5010) Amniotic Sac Section 1 U
15 > CONTAINS INCLUDE DTID (5015) Pelvis and Uterus Section 1 U
16 > CONTAINS INCLUDE DTID (5012) Ovaries Section 1 U
17 > CONTAINS INCLUDE DTID (5013) Follicles Section 1 U $Laterality = EV (G-A101, SRT, “Left”) $Number = EV (11879-4, LN, “Number of follicles in left ovary”)
18 > CONTAINS INCLUDE DTID (5013) Follicles Section 1 U $Laterality = EV (G-A100, SRT, “Right”) $Number = EV (11880-2, LN, “Number of follicles in right ovary”)
19 > CONTAINS CONTAINER EV (121070, DCM, “Findings”) 1-n U
20 >> HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding SIte”) 1 M EV (T-F6800, SRT, “Embryonic Vascular Structure”)
21 >> CONTAINS INCLUDE DTID (5025) OB-GYN Fetal Vascular Measurement Group 1 M $AnatomyGroup = DCID (12141) Fetal Vasculature
22 > CONTAINS CONTAINER EV (121070, DCM, “Findings”) 1 U
23 >> HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding SIte”) 1 M EV (T-D6007, SRT, “Pelvic Vascular Structure”)
24 >> CONTAINS INCLUDE DTID (5026) OB-GYN Pelvic Vascular Measurement Group 1 M $AnatomyGroup = DCID (12140) Pelvic Vasculature Anatomical Location

TID 5001 OB-GYN Patient Characteristics

Patient Characteristic concepts in this template, which may replicate attributes in the Patient Study Module, are included here as possible targets of by-reference relationships from other content items in the SR tree.

Note: Several of the concepts in this template duplicate concepts in TID 1007 “Subject Context, Patient”. The difference in use is that this template has those concepts as primary observations of the patient, while in TID 1007 the concepts are used to set (or reset) the context for other observations.

TID 5001 OB-GYN PATIENT CHARACTERISTICS Type: Extensible Order: Significant

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 TEXT EV (121106, DCM, “Comment”) 1 U
3 > CONTAINS NUM EV (8302-2, LN, “Patient Height”) 1 U
4 > CONTAINS NUM EV (29463-7, LN, “Patient Weight”) 1 U
5 > CONTAINS NUM EV (11996-6, LN, “Gravida”) 1 U
6 > CONTAINS NUM EV (11977-6, LN, “Para”) 1 U
7 > CONTAINS NUM EV (11612-9, LN, “Aborta”) 1 U
8 > CONTAINS NUM EV (33065-4, LN, “Ectopic Pregnancies”) 1 U

TID 5002 OB-GYN Procedure Summary Section

Observations of the procedure of immediate clinical interest.

TID 5002OB-GYN PROCEDURE SUMMARY SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121111, DCM, “Summary”) 1 M
2 > CONTAINS DATE DCID (12003) OB-GYN Dates 1-n U
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = BCID (12018) OB-GYN Summary
4 > CONTAINS TEXT EV (121106, DCM, “Comment”) 1-n U
5 >> INCLUDE DTID (320) Image or Spatial Coordinates 1-n U
6 > CONTAINS INCLUDE BTID (5003) OB-GYN Fetus Summary 1-n UC No more than 1 inclusion per fetus

TID 5003 OB-GYN Fetus Summary

The Fetus Summary template is a container for summary data of a fetus.

TID 5003OB-GYN PROCEDURE FETUS SUMMARYType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125008, DCM, “Fetus Summary”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > CONTAINS TEXT EV (121106, DCM, “Comment”) 1-n U
4 >> INCLUDE DTID (320) Image or Spatial Coordinates 1 U
5 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = DCID (12019) OB-GYN Fetus Summary $Equation = DCID (12012) OB Equations and Tables

TID 5004 Fetal Biometry Ratio Section

The Fetal Biometry Section Ratio template is a container for common biometric ratios.

TID 5004FETAL BIOMETRY RATIO SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125001, DCM, “Fetal Biometry Ratios”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > CONTAINS NUM DCID (12004) Fetal Biometry Ratios 1-n M
4 >> R-INFERRED FROM NUM 2 U
5 >> HAS PROPERTIES INCLUDE DTID (312) Normal Range Properties 1 U

Content Item Descriptions

Row 3 Numeric ratio related to fetal growth
Row 4 Reference to the numerator and denominator of the ratio.

TID 5005 Fetal Biometry Section

The Fetal Biometry Section template is a container for common biometric groups.

TID 5005FETAL BIOMETRY SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125002, DCM, ”Fetal Biometry”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > CONTAINS INCLUDE DTID (5008) Fetal Biometry Group 1-n M $BiometryType = MemberOf {DCID (12005) Fetal Biometry Measurements}

Content Item Descriptions

Row 3 The group of measurements. Only one group per biometry type.

TID 5006 Fetal Long Bones Section

The Long Bones template is a container for biometric data of long bones.

TID 5006FETAL LONG BONES SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125003, DCM, ”Fetal Long Bones”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > CONTAINS INCLUDE DTID (5008) Fetal Biometry Group 1-n M $BiometryType = MemberOf {DCID (12006) Fetal Long Bones Biometry Measurements}

Content Item Descriptions

Row 3 The group of measurements. Only one group per biometry type.

TID 5007 Fetal Cranium Section

The Fetal Cranium template is a container for groups of biometric data of the fetal cranium.

TID 5007FETAL CRANIUM SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125004, DCM, ”Fetal Cranium”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > CONTAINS INCLUDE DTID (5008) Fetal Biometry Group 1-n M $BiometryType = MemberOf {DCID (12007) Fetal Cranium}

Content Item Descriptions

Row 3 The group of measurements. Only one group per biometry type.

TID 5008 Fetal Biometry Group

The Biometry Group template is container for a biometric value and its associated growth metrics.

TID 5008 Parameters

Parameter Name Parameter Usage
$BiometryType The concept name of the biometry measurement

TID 5008 FETAL BIOMETRY GROUPType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT(125005, DCM, ”Biometry Group”) 1 M
2 > CONTAINS INCLUDE DTID (300) Measurement 1-n MC At least one of row 2 and 3 shall be present $Measurement = $BiometryType $Derivation = DCID (3627) Measurement Type
3 > CONTAINS NUM EV (18185-9, LN, ”Gestational Age”) 1 MC At least one of row 2and 3 shall be present Units= EV (d,UCUM, days)
4 >> INFERRED FROM CODE DCID (228) Equation or Table 1 U DCID (12013) Gestational Age Equations and Tables
5 >> R-INFERRED FROM NUM 1-n U
6 >> HAS PROPERTIES NUM DCID (226) Population Statistical Descriptors 1-n U
7 > CONTAINS NUM DCID (12017) Growth Distribution Rank 1 U
8 >> INFERRED FROM CODE DCID (228) Equation or Table 1 U DCID (12015) Fetal Growth Equations and Tables

Content Item Descriptions

Row 1 Container to segregate biometry data by measurement type
Row 2 The discrete measurements of the biometry type including derived measurements such as mean. One of the measurements may be flagged as selected for derived measurements.
Row 3 The estimated gestational age derived from an equation or table based on the explicitly referenced R-INFERRED FROM content item, selected measurement or mean, in that order of preference.
Row 4 The reference that defines the equation or table of GA derivation
Row 6 The uncertainty/confidence limits of the gestational age
Row 7 Expresses the rank of the selected or mean measurement of row 2 relative to the distribution specified in row 8.
Row 8 This row specifies the CODE reference used to compute the percentile or Z-score.

TID 5009 Fetal Biophysical Profile Section

This template encodes scoring observations for fetal well-being evaluation as described by Manning, Antepartum Fetal Evaluation: Development of a Fetal Biophysical Profile Score, Am. J Obsetet Gynecol, 1980;136:787.

TID 5009FETAL BIOPHYSICAL PROFILE SECTIONType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125006, DCM, ”Biophysical Profile”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > CONTAINS NUM EV (11631-9, LN, “Gross Body Movement”) 1 MC At least one of row 3-7 shall be present Units = DT (“{0:2}”, UCUM, ”range 0:2”)
4 > CONTAINS NUM EV (11632-7, LN, “Fetal Breathing”) 1 MC At least one of row 3-7 shall be present Units = DT (“{0:2}”, UCUM, ”range 0:2”)
5 > CONTAINS NUM EV (11635-0, LN, “Fetal Tone”) 1 MC At least one of row 3-7 shall be present Units = DT (“{0:2}”, UCUM, ”range 0:2”)
6 > CONTAINS NUM EV (11635-5, LN, “Fetal Heart Reactivity”) 1 MC At least one of row 3-7 shall be present Units = DT (“{0:2}”, UCUM, ”range 0:2”)
7 > CONTAINS NUM EV (11630-1, LN, “Amniotic Fluid Volume”) 1 MC At least one of row 3-7 shall be present Units = DT (“{0:2}”, UCUM, ”range 0:2”)
8 > CONTAINS NUM DT (11634-3, LN, “Biophysical Profile Sum Score”) 1 U

Content Item Descriptions

Row 3-7 The numeric profile score of range 0-2
Row 8 The sum of rows 3-7. The range is from 0 to the maximum possible score according the items scored in rows 3-7.

TID 5010 Amniotic Sac Section

This template specifies a container for amniotic sac quadrant diameters and a derived index.

TID 5010AMNIOTIC SAC SECTIONType: Extensible Order: Significant

NL
Row 4 The four amniotic sac quadrant diameters

TID 5011 Early Gestation Section

The Early Gestation Section template is a container for common, first trimester biometric groups.

TID 5011EARLY GESTATION SECTIONType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125009, DCM, “Early Gestation”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > CONTAINS INCLUDE DTID (5008) Fetal Biometry Group 1-n M $BiometryType= Member of {DCID (12009) Early Gestation Biometry Measurements}

TID 5012 Ovaries Section

This template contains metrics of ovary size.

TID 5012OVARIES SECTIONType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DT (T-87000, SRT, ”Ovary”)
3 > CONTAINS INCLUDE DTID (5016) LWH Volume Group 1 U $GroupName = EV (T-87000, SRT, ”Ovary”) $Width =EV (11829-9,LN, ”Left Ovary Width”) $Length =EV (11840-6, LN, ”Left Ovary Length”) $Height =EV (11857-0 , LN,” Left Ovary Height”) $Volume=EV (12164-0, LN, ”Left Ovary Volume”)
4 > CONTAINS INCLUDE DTID (5016) LWH Volume Group 1 U $GroupName = EV (T-87000, SRT, ”Ovary”) $Width = EV (11830-7, LN, ”Right Ovary Width”) $Length = EV (11841-4, LN, ”Right Ovary Length”) $Height = EV (11858-8, LN, ”Right Ovary Height”) $Volume= EV (12165-7, LN, ”Right Ovary Volume”)

TID 5013 Follicles Section

This template contains follicle metrics for left or right ovarian follicles.

TID 5013 Parameters

Parameter Name Parameter Usage
$Laterality Ovary laterality
$Number The number of follicles

TID 5013FOLLICLES SECTIONType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DT (T-87600, SRT, “Ovarian Follicle”)
3 > HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality”) 1 M $Laterality
4 > CONTAINS NUM $Number 1 U
5 > CONTAINS INCLUDE DTID (5014) Follicle Measurement Group 1-n U

TID 5014 Follicle Measurement Group

This template contains metrics for one ovarian follicle.

TID 5014FOLLICLE MEASUREMENT GROUPType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (125007, DCM, “Measurement Group”) 1 M
2 > HAS OBS CONTEXT TEXT EV (125010, DCM, “Identifier”) 1 U Unique among all groups of same laterality
3 > CONTAINS INCLUDE DTID (300) Measurement 1 U $Measurement = EV (G-D705, SRT, “Volume”)
4 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = EV (11793-7, LN, “Follicle Diameter”) $Derivation = DCID (3627) Measurement Type

TID 5015 Pelvis and Uterus Section

This template contains general measurements in the pelvis and uterus.

TID 5015PELVIS AND UTERUS SECTIONType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (125011, DCM, “Pelvis and Uterus”) 1 M
2 > CONTAINS INCLUDE DTID (5016) LWH Volume Group 1 U $GroupName = EV (T-83000, SRT, ”Uterus”) $Width = EV (11865-3,LN,” Uterus Width”) $Length = EV (11842-2, LN,” Uterus Length”) $Height = EV (11859-6, LN,” Uterus Height”) $Volume = EV (33192-6, LN, ”Uterus Volume”)
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = DCID (12011) Ultrasound Pelvis and Uterus $Derivation = DCID (3627) Measurement Type

TID 5016 LWH Volume Group

This template is a container for a group of measurements that assess the size of an anatomical structure using a volume derived from perpendicular diameters.

TID 5016 Parameters

Parameter Name Parameter Usage
$GroupName The name of the volume group
$Volume Concept name of volume measurement
$Length Concept name of length measurement
$Width Concept name of width measurement
$Height Concept name of height measurement

TID 5016LWH VOLUME GROUPType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER $GroupName 1 M
2 > CONTAINS INCLUDE DTID (300) Measurement 1 MC At least one of row 2,3,4,5 shall be present $Measurement = $Volume
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n MC At least one of row 2,3,4,5 shall be present $Measurement = $Length $Derivation = DCID (3627) Measurement Type
4 > CONTAINS INCLUDE DTID (300) Measurement 1-n MC At least one of row 2,3,4,5 shall be present $Measurement = $Width $Derivation = DCID (3627) Measurement Type
5 > CONTAINS INCLUDE DTID (300) Measurement 1-n MC At least one of row 2,3,4,5 shall be present $Measurement = $Height $Derivation = DCID (3627) Measurement Type

TID 5025 OB-GYN Fetal Vascular Ultrasound Measurement Group

This template is an anatomy specific container of OB-GYN fetal vascular measurements.

Parameter Name Parameter Usage
$AnatomyGroup The concept name of the vascular anatomy

TID 5025 OB-GYN FETAL VASCULAR ULTRASOUND MEASUREMENT GROUPType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER $AnatomyGroup 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context, Fetus 1 MC IF this template is invoked more than once to describe more than one fetus
3 > HAS CONCEPT MOD CODE EV (G-C171, SRT “Laterality”) 1 MC IFF anatomy has laterality DCID (244) Laterality
4 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $MeasType = DCID (12119) Vascular Ultrasound Property $Derivation = DCID (3627) Measurement Type

Content Item Descriptions

Anatomy Group Specifies the anatomical context of the observations in the group.

TID 5026 OB-GYN Pelvic Vascular Ultrasound Measurement Group

This template is an anatomy specific container of OB-GYN pelvic vascular measurements.

Parameter Name Parameter Usage
$AnatomyGroup The concept name of the vascular anatomy

TID 5026 OB-GYN PELVIC VASCULAR ULTRASOUND MEASUREMENT GROUPType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER $AnatomyGroup 1 M
2 > HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality”) 1 MC IFF anatomy has laterality DCID (244) Laterality
3 > HAS CONCEPT MOD TEXT (112050, DCM, “Anatomic Identifier”) 1 U
4 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $MeasType = DCID (12119) Vascular Ultrasound Property $Derivation = DCID (3627) Measurement Type
5 >> HAS CONCEPT MOD CODE EV (125105, DCM, “Measurement Orientation”) 1 U DCID (12118) Measurement Orientation
6 >> HAS CONCEPT MOD NUM EV (125106, DCM, “Doppler Angle”) 1 U UNIT = EV (deg, UCUM , ”degrees”)
7 >> HAS CONCEPT MOD NUM EV (125107, DCM, “Sample Volume Depth”) 1 U UNIT = EV (cm, UCUM , ”cm”)

Content Item Descriptions

Row 1 Specifies the anatomical context of the observations in the group.
Row 3 Differentiates between multiple structures such as the two umbilical arteries.

Vascular Ultrasound Report TEMPLATES

TID 5100 Vascular Ultrasound Report

This is the template for the root the content tree for the vascular ultrasound procedure report.

TID 5100VASCULAR ULTRASOUND REPORTType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
CONTAINER EV (125100, DCM, “Vascular Ultrasound Procedure Report”) 1 M
2 > HAS OBS CONTEXT CODE EV (R-40FB8, SRT, “Temporal periods Relating to Procedure”) 1 U DCID (12102) Temporal Periods Relating To Procedure or Therapy
3 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 U
4 > HAS OBS CONTEXT INCLUDE DTID (1001) Observation Context 1 M
5 > CONTAINS INCLUDE DTID (5101) Vascular Patient Characteristics 1 U
6 > CONTAINS CONTAINER EV (111028, DCM, “Image Library”) 1 U
7 >> CONTAINS IMAGE No purpose of reference 1-n M
8 > CONTAINS INCLUDE DTID (5102) Vascular Procedure Summary Section 1 U
9 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-40501, SRT, ”Blood Vessel of Head”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12105) Intracranial Cerebral Vessels
10 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-40501, SRT, ”Blood Vessel of Head”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12105) Intracranial Cerebral Vessels
11 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-40501, SRT, ”Blood Vessel of Head”) $SectionLaterality = EV (G-A103, SRT, ”Unilateral”) $Anatomy = DCID (12106) Intracranial Cerebral Vessels (unilateral)
12 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-45005, SRT, ”Artery of neck”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12104) Extracranial Arteries $AnatomyRatio = DCID (12123) Carotid Ratios
13 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-45005, SRT, ”Artery of neck”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12104) Extracranial Arteries $AnatomyRatio = DCID (12123) Carotid Ratios
14 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-47040, SRT, ”Artery of Lower Extremity”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12109) Lower Extremity Arteries
15 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-47040, SRT, ”Artery of Lower Extremity”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12109) Lower Extremity Arteries
16 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-49403, SRT, ”Vein of Lower Extremity”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12110) Lower Extremity Veins
17 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-49403, SRT, ”Vein of Lower Extremity”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12110) Lower Extremity Veins
18 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-47020, SRT, ”Artery Of Upper Extremity”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12107) Upper Extremity Arteries
19 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-47020, SRT, ”Artery Of Upper Extremity”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12107) Upper Extremity Arteries
20 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-49103, SRT, ”Vein Of Upper Extremity”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12108) Upper Extremity Veins
21 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-49103, SRT, ”Vein Of Upper Extremity”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12108) Upper Extremity Veins
22 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-71019, SRT, ”Vascular Structure Of Kidney”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12115) Renal Vessels $AnatomyRatio = DCID (12124) Renal Ratios
23 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-71019, SRT, ”Vascular Structure Of Kidney”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12115) Renal Vessels $AnatomyRatio = DCID (12124) Renal Ratios
24 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-46002, SRT, ”Artery of Abdomen”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12111) Abdominal Arteries (lateral)
25 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-46002, SRT, ”Artery of Abdomen”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12111) Abdominal Arteries (lateral)
26 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-46002, SRT, ”Artery of Abdomen”) $SectionLaterality = EV (G-A103, SRT, ”Unilateral”) $Anatomy = DCID (12112) Abdominal Arteries (unilateral)
27 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-487A0, SRT, ”Vein of Abdomen”) $SectionLaterality = EV (G-A101, SRT, ”Left”) $Anatomy = DCID (12113) Abdominal Veins (lateral)
28 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-487A0, SRT, ”Vein of Abdomen”) $SectionLaterality = EV (G-A100, SRT, ”Right”) $Anatomy = DCID (12113) Abdominal Veins (lateral)
29 > CONTAINS INCLUDE DTID (5103) Vascular Ultrasound Section 1 U $SectionScope = DT (T-487A0, SRT, ” Vein of Abdomen”) $SectionLaterality = EV (G-A103, SRT, ”Unilateral”) $Anatomy = DCID (12114) Abdominal Veins (unilateral)
30 > CONTAINS INCLUDE DTID (5105) Ultrasound Graft Section 1 U

TID 5101 Vascular Patient Characteristics

Patient Characteristic concepts in this template, which may replicate attributes in the Patient Study Module, are included here as possible targets of by-reference relationships from other content items in the SR tree.

Note: Several of the concepts in this template duplicate concepts in TID 1007 “Subject Context, Patient”. The difference in use is that this template has those concepts as primary observations of the patient, while in TID 1007 the concepts are used to set (or reset) the context for other observations.

TID 5101Vascular Patient CharacteristicsType: Extensible Order: Significant

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 U Units = DCID (7456) Units of Measure for Age
3 > CONTAINS CODE EV (121032, DCM, "Subject Sex”) 1 U DCID (7455) Sex
4 > CONTAINS NUM EV (8867-4, LN, “Heart Rate”) 1 U
5 > CONTAINS NUM EV (F-008EC, SRT, “Systolic Blood Pressure”) 1 U
6 > CONTAINS NUM EV (F-008ED, SRT, "Diastolic Blood Pressure") 1 U

TID 5102 Vascular Procedure Summary Section

Comments and observations of the procedure of immediate clinical interest.

TID 5102VASCULAR PROCEDURE SUMMARY SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121111, DCM, “Summary”) 1 M
2 > TEXT DCID (12101) Vascular Summary 1-n M

TID 5103 Vascular Ultrasound Section

Sections of a vascular ultrasound report are section containers of an anatomic region consisting of measurement group containers that contain the measurements.

Parameter Name Parameter Usage
$SectionScope The concept name of the section heading modifier
$SectionLaterality The laterality (if any) of the anatomy in this section heading
$Anatomy The concept name of the vascular anatomy
$AnatomyRatio The concept name of anatomy-coordinated ratio concepts

TID 5103VASCULAR ULTRASOUND SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M $SectionScope
3 > HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality”) 1 M $SectionLaterality
4 > CONTAINS INCLUDE DTID (5104) Vascular Measurement Group 1-n M $AnatomyGroup = $Anatomy
5 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = $AnatomyRatio

TID 5104 Vascular Ultrasound Measurement Group

This template is an anatomy specific container of measurements.

Parameter Name Parameter Usage
$AnatomyGroup The concept name of the vascular anatomy

TID 5104 VASCULAR ULTRASOUND MEASUREMENT GROUPType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER $AnatomyGroup 1 M
2 > HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical Modifier”) 1 U DCID (12116) Vessel Segment Modifiers
3 > HAS CONCEPT MOD CODE EV (125101, DCM, “Vessel Branch”) 1-n U DCID (12117) Vessel Branch Modifiers
4 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = DCID (12119) Vascular Ultrasound Property $Derivation = DCID (3627) Measurement Type
5 >> HAS CONCEPT MOD CODE EV (R-4089A, SRT, “Cardiac Cycle Point”) 1 U DCID (12233) Cardiac Phase
6 >> HAS CONCEPT MOD CODE EV (R-41FFC, SRT, “Temporal period related to eating”) 1 U DT (G-A491, SRT, "Post-prandial")
7 >> HAS CONCEPT MOD CODE EV (125105, DCM, “Measurement Orientation”) 1 U DCID (12118) Measurement Orientation
8 >> HAS CONCEPT MOD NUM EV (125106, DCM, “Doppler Angle”) 1 U UNIT = EV (deg, UCUM , ”degrees”)
9 >> HAS CONCEPT MOD NUM EV (125107, DCM, “Sample Volume Depth”) 1 U UNIT = EV (cm, UCUM , ”cm”)

Content Item Descriptions

Row 1 Specifies the anatomic context of the observations in the group.
Row 2 Details the anatomical location, e.g. proximal, middle, or distal
Row 3 The particular vessel branch, such as the inferior, medial or lateral
Row 5 Cardiac phase (systolic, diastolic), especially for aorta measurements
Row 6 Eating phase, especially for mesenteric and celiac measurements

TID 5105 Ultrasound Graft Section

This template is a container of measurements on a vascular graft.

TID 5105 ULTRASOUND GRAFT SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121070, DCM, “Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M DT (T-D000F, SRT, “Vascular Graft”)
3 > HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality”) 1 U DCID (244) Laterality
4 > HAS CONCEPT MOD CODE DT (G-D871, SRT, “Proximal anastomosis”) 1 M BCID (12103) Vascular Ultrasound Anatomic Location
5 > HAS CONCEPT MOD CODE DT (G-D872, SRT, “Distal Anastomosis”) 1 M BCID (12103) Vascular Ultrasound Anatomic Location
6 > HAS CONCEPT MOD CODE DT (125102, DCM, “Graft Type”) 1 U No BCID
7 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = DCID (12119) Vascular Ultrasound Property

Content Item Descriptions

Proximal anastomosis The proximal location of the graft
Distal anastomosis The distal location of the graft
Graft type The type of graft, e.g. “in situ”, “prosthetic”, “autogenous”

ECHOCARDIOGRAPHY PROCEDURE REPORT TEMPLATES

TID 5200 Echocardiography Procedure Report

This template forms the top of a content tree that allows an ultrasound device to describe the results of an adult echocardiography imaging procedure. It is instantiated at the root node. It can also be included in other templates that need to incorporate echocardiography findings into another report as quoted evidence.

TID 5200 – Echocardiography Procedure ReportType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (125200, DCM, “Adult Echocardiography Procedure Report”) 1 M
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 U
3 > HAS OBS CONTEXT INCLUDE DTID (1001) Observation Context 1 M
4 > CONTAINS CONTAINER DT (121064, DCM, “Current Procedure Descriptions”) 1 U
5 >> CONTAINS CODE DT (125203, DCM, “Acquisition Protocol”) 1-n M BCID (12001) Ultrasound Protocol Types
6 > CONTAINS INCLUDE DTID (5201) Echocardiography Patient Characteristics 1 U
7 > CONTAINS CONTAINER (111028, DCM, “Image Library”) 1 U
8 >> CONTAINS IMAGE No purpose of reference 1-n M
9 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32600, SRT, “Left Ventricle”) $MeasType = DCID (12200) Echocardiography Left Ventricle
10 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32500, SRT, “Right Ventricle”) $MeasType = DCID (12204) Echocardiography Right Ventricle
11 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32300, SRT, “Left Atrium”) $MeasType = DCID (12205) Echocardiography Left Atrium
12 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32200, SRT, “Right Atrium”) $MeasType = DCID (12206) Echocardiography Right Atrium
13 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35400, SRT, “Aortic Valve”) $MeasType = DCID (12211) Echocardiography Aortic Valve
14 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35300, SRT, “Mitral Valve”) $MeasType = DCID (12207) Echocardiography Mitral Valve
15 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35200, SRT, “Pulmonic Valve”) $MeasType = DCID (12209) Echocardiography Pulmonic Valve
16 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35100, SRT, “Tricuspid Valve”) $MeasType = DCID (12208) Echocardiography Tricuspid Valve
17 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-42000, SRT, “Aorta”) $MeasType= DCID (12212) Echocardiography Aorta
18 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-44000, SRT, “Pulmonary artery”) $MeasType DCID (12210) = Echocardiography Pulmonary Artery
19 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-48600, SRT, “Vena Cava” $MeasType = DCID (12215) Echocardiography Vena Cavae
20 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-48581, SRT, “Pulmonary Venous Structure” $MeasType = DCID (12214) Echocardiography Pulmonary Veins
21 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (P5-30031, SRT, “Cardiac Shunt Study”) $MeasType = DCID (12217) Echocardiography Cardiac Shunt
22 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (D4-30000, SRT, “Congenital Anomaly of Cardiovascular System”) $MeasType = DCID (12218) Echocardiography Congenital
23 > CONTAINS INCLUDE DTID (5204) Wall Motion Analysis 1-n U $Procedure = DT (P5-B3121, SRT, "Echocardiography for Determining Ventricular Contraction")

Content Item Descriptions

Row 23 The wall motion findings of stress stage. There may be multiple Template instances to report wall motion findings of multiple stages.

TID 5201 Echocardiography Patient Characteristics

Patient Characteristic concepts in this template, which may replicate attributes in the Patient Study Module, are included here as possible targets of by-reference relationships from other content items in the SR tree.

Note: Several of the concepts in this template duplicate concepts in TID 1007 “Subject Context, Patient”. The difference in use is that this template has those concepts as primary observations of the patient, while in TID 1007 the concepts are used to set (or reset) the context for other observations.

TID 5201Echocardiography Patient CharacteristicsType: Extensible Order: Significant

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 U Units = DCID (7456) Units of Measure for Age
3 > CONTAINS CODE EV (121032, DCM, "Subject Sex”) 1 U DCID (7455) Sex
4 > CONTAINS NUM EV (8867-4, LN, “Heart Rate”) 1 U
5 > CONTAINS NUM EV (F-008EC, SRT, “Systolic Blood Pressure”) 1 U
6 > CONTAINS NUM EV (F-008ED, SRT, "Diastolic Blood Pressure") 1 U
7 > CONTAINS NUM EV (8277-6, LN, “Body Surface Area”) 1 M
8 >> INFERRED FROM CODE EV (8278-4, LN, "Body Surface Area Formula") 1 U BCID (3663) Body Surface Area Equations

TID 5202 Echo Section

This is a generic section heading Template for any of the anatomical headings. Measurements within a section heading appear as groups (by image mode, acquisition protocol, and/or protocol stage).

Parameter Name Parameter Usage
$SectionSubject The subject modifier of the section heading container
$MeasType The concept name of the measurement

TID 5202ECHO SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, ”Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M $SectionSubject
3 > CONTAINS CONTAINER DT (125007, DCM, “Measurement Group”) 1-n M
4 >> HAS CONCEPT MOD CODE EV (G-0373, SRT,”Image Mode” ) 1 U BCID (12224) Ultrasound Image Modes
5 >> HAS CONCEPT MOD CODE DT (125203,DCM,”Acquisition Protocol”) 1 U
6 >> HAS CONCEPT MOD TEXT DT (125203, DCM, “Acquisition Protocol”) 1 U
7 >> HAS ACQ CONTEXT CODE EV (LN, 18139-6, "Stage") 1 U BCID (12002) Ultrasound Protocol Stage Types
8 >> CONTAINS INCLUDE DTID (5203) Echo Measurement 1-n M $Measurement = $MeasType $Method=CID (12227) Echocardiography Measurement Method

Echo Section Descriptions

Rows 4, 5 Type of measurement group. May be grouped by image mode, or acquisition protocol, or some other user or manufacturer designated classification
Row 7 For measurements acquired in a staged protocol, all measurements in a measurement group are acquired at the identified stage.

TID 5203 Echo Measurement

Parameter Name Parameter Usage
$Measurement Coded term or Context Group for Concept Name of measurement
$Method Value for Measurement Method

TID 5203Echo Measurement Type: Extensible Order: Significant

NL

TID 5204 Wall Motion Analysis

The Wall Motion Analysis Template is used to document wall motion scoring for any imaging modality.

Parameter Name Parameter Usage
$Procedure The imaging procedure used for wall motion analysis.

TID 5204Wall Motion AnalysisType: Extensible Order: Significant

NL
Row 4 Image that graphically depicts the segments and their scores.
Row 5 Text narration accompanying this stage.
Row 6 The composite score computed from the average of the scored segments
Row 7 The type of scoring scheme used to score this exam.
Row 8 A container of all of the individual segment findings for this stage. The container shall be present if the observer makes an assessment, including the assessment of Not Visualized. It shall not be present if no evaluation was made.
Rows 11, 12 Scar/thinning (in Row 12) may accompany akinesis and dyskinesis (in Row 11).
Row 13 A numeric designation for the score. Score ranges vary, typically 0-4 or 0-5. Numeric scores may depend on wall motion findings as well as morphology findings. See the table below for conventional numeric assignment schemes. The UCUM annotation code enables specifying the numeric range, ("{L:N}", UCUM, "scale L:N"), where L and N are the lower and upper ends of the range.

Table 5204-1 Numeric Score Assignment for Segmental Findings

A description of the scoring schemes described in the table below is available in Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography , Journal of the American Society of Echocardiography, Vol 2, No 5 358-367, Oct 1989.

Conventional Numeric Assignment Wall Motion Finding or Morphology Finding
4 Point 5 Point 5 Point with Graded Hypokinesis
-1 (F-32050, SRT, ”Cardiac Wall Motion”) = (R-0030D SRT, “Hyperkinesis”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-0030D, SRT, “Hyperkinesis”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-0030D, SRT, “Hyperkinesis”)
0 (F-32050, SRT, ”Cardiac Wall Motion”) = (122288, DCM , “Not Visualized”) (F-32050, SRT, ”Cardiac Wall Motion”) = (122288, DCM , “Not Visualized”) (F-32050, SRT, ”Cardiac Wall Motion”) = (122288, DCM , “Not Visualized”)
1 (F-32050, SRT, ”Cardiac Wall Motion”) = (R-00344, SRT, “Normal Wall Motion”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-00344, SRT, “Normal Wall Motion”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-00344, SRT, “Normal Wall Motion”)
1.5 (F-32050, SRT, “Cardiac Wall Motion”) = (R-00327, SRT, “Mild Hypokinesis”)
2 (F-32050, SRT, “Cardiac Wall Motion”) = (R-4041B, SRT, “Hypokinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (R-4041B, SRT, “Hypokinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (R-0032F, SRT, “Moderate Hypokinesis”)
2.5 (F-32050, SRT, “Cardiac Wall Motion”) = (R-00370, SRT, “Severe Hypokinesis”)
3 (F-32050, SRT, “Cardiac Wall Motion”) = (F-30004, SRT, “Akinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-30004, SRT, “Akinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-30004, SRT, “Akinesis”)
4 (F-32050, SRT, “Cardiac Wall Motion”) = (F-32052, SRT, “Dyskinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-32052, SRT, “Dyskinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-32052, SRT, “Dyskinesis”)
5 (G-C504, SRT, "Associated Morphology") = (D3-10510, SRT, “Ventricular Aneurysm”) (G-C504, SRT, "Associated Morphology") = (D3-10510, SRT, “Ventricular Aneurysm”)

TID 5220 Pediatric, Fetal and Congenital Cardiac Ultrasound Reports

This template forms the top of a content tree that allows an ultrasound application to describe the results of a Cardiac Ultrasound imaging procedure. It is instantiated at the root node.

TID 5220Pediatric, Fetal and Congenital Cardiac Ultrasound ReportsType: Extensible

NL
Row 7 For Fetal Report, this row will be the patient history of the mother.
Row 8 For Fetal Report, this row will be the Patient Characteristics for the mother.
Row 10 For Fetal Report, this row will be the Summary Section for the mother.

TID 5221 Cardiac Ultrasound Pediatric Echo Measurement Section

TID 5221Cardiac Ultrasound Pediatric Echo Measurement SectionType: Extensible Order: Significant

NL
$SectionSubject The subject modifier of the section heading container
$MeasType The concept name of the measurement

TID 5222Pediatric, Fetal and Congenital Cardiac Ultrasound SectionType: Extensible Order: Significant

NL
$Measurement Coded term or Context Group for Concept Name of measurement
$Method Value for Measurement Method

TID 5223Pediatric, Fetal and Congenital Cardiac Ultrasound MeasurementType: Extensible Order: Significant

NL
Row 2 When this row is available, the row 1 is an index calculation of the object.

TID 5225 Cardiac Ultrasound Fetal Characteristics

Contains a list of Fetus Specific characteristics.

TID 5225Cardiac Ultrasound Fetal CharacteristicsType: Extensible Order: Significant

NL
Row 9 ID given to this Implant Component. Used to reference this specific Component within the Implantation Plan.
Row 10 See description of Component Type Code Sequence (0076,0034) Attribute in Template Assembly Module in PS 3.3
Row 11 Reference to the Template that describes that component. May be the same Implant Template as referenced in row 13. The target of the reference may not be needed or available during implantation. e.g. if the plan is opened in another hospital where those implant templates are not used.
Row 12 This Frame of Reference is the Frame of Reference of the Implant Component (Frame of Reference UID (0020,0052) Attribute in the Generic Implant Template Module in PS 3.3). This may help to find the right registration information (row 43).
Row 13 References the Original Template that was the basis for the Derived Template. May be the same Implant Template as referenced in row 11. The target of the reference may not be needed or available during implantation, e.g., if the plan is opened in another hospital where those implant templates are not used.
Row 14 If there is no Component Connection between sets of Implant Components, one Assembly must be used for each set.
Row 17 The ID of a planned Component that is defined in this document and which is part of this Relation.
Row 18 See description of Mating Feature Set ID (0068,63C0) Attribute in the Generic Implant Template Module in PS 3.3
Row 19 See description of Mating Feature ID (0068,63F0) Attribute in the Generic Implant Template Module in PS 3.3
Row 21 See description of Degree of Freedom ID (0068,6410) Attribute in the Generic Implant Template Module in PS 3.3
Row 22 – 27 Defines the range or exact value that was selected or calculated by the planning application.
Row 31 Defines the calibrated Horizontal Pixel Spacing that was used by the planning application, which may be different from the spacing encoded in the referenced Image SOP Instance.
Row 32 Defines the calibrated Vertical Pixel Spacing that was used by the planning application, which may be different from the spacing encoded in the referenced Image SOP Instance.
Row 33 Any patient data other than Image IEs used for the planning, e.g., Surface Segmentations.
Row 34 Fiducials selected by the user for registration of implant components referenced in the parent content item.
Row 35 User comment about the Fiducial. This may be the reason it was selected, the intended use, the anatomical or non-anatomical structure that the Fiducial represents, or any other intent.
Row 38 All kinds of information in PDF form that are created by a planning application may be referenced here, e.g., drawings.
Row 39 All kinds of images that are created by a planning application should be referenced here, e.g. images that show patient images overlaid with contour information of the Implant Component, or images that show how several implant components may be composed, or merged patient images.
Row 40 References registration objects that contain registration data that is relevant for this Implantation Plan, e.g., registration of Implant Components.
Row 41 Identifies one or more items within the sequence of referenced Frames of Reference (Registration Sequence (0070,0308) in the Spatial Registration Module or Deformable Registration Sequence (0064,0002) in the Deformable Spatial Registration Module in PS 3.3) that are relevant for this Implantation Plan. See Figure A-13.
Row 42 Any patient data created during the planning process that is not referenced in row 39 and 40, e.g., Surface Segmentation Instances created by the planning application.
Row 43 These Fiducials are derived from the Fiducials identified in Row 34.
Row 45 References to any relevant patient data containing IOD instances that were not used in planning or derived from it but belong to the patient model. Might be reports, images, surface segmentations, or other.

[pic]

Figure A-13: References to Registration Objects

TID 7001 Related Implantation Reports

This general template provides a means to reference related Implantation Plan SR Document instances that are not previous Reports. Other Implantations that are planned to be done during the same intervention should be referenced here.

TID 7001RELATED IMPLANTATION REPORTSType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (112365, DCM, ”Related Implantation Reports”) 1 M
2 > CONTAINS COMPOSITE 1-n M

Relevant Patient Information templates

TID 9000 Relevant Patient Information For Breast Imaging

This template collects a patient’s relevant information as it relates to breast imaging. This template, together with its subordinate templates, describes the history of a patient’s reproductive system, hormone medications, past procedures, risk factors, and indicated problems as they relate to breast health.

TID 9000RELEVANT PATIENT INFORMATION FOR BREAST IMAGINGType: Extensible Order: Significant

NL
$ContainerConcept Coded term for the concept name of the CONTAINER, identifying it as medication, substance, or environmental exposure history.
$CodeConcept Coded term for the concept name of the CODE, identifying it as medication, substance, or environmental exposure.
$CodeValue Coded term or Context Group for value of the medication, substance, or environmental exposure.

TID 9002 MEDICATION, SUBSTANCE, ENVIRONMENTAL EXPOSURE Type: Extensible Order: Significant

NL
Rows 13 & 14 If both of these content items are instantiated, the concept names selected for each should match. For example, use “Relative dose amount” as the concept name for row 13 with “Relative dose frequency” as the concept name for row 14.

TID 9003 Previous Procedure

This general template provides detailed information on a patient’s previous procedure, surgery, or treatment.

Parameter Name Parameter Usage
$ProcedureList Coded term or Context Group for value of Previous Procedure
$ProcedureModifier Coded term or Context Group for value of Previous Procedure Modifier
$NumConceptName Coded term or Context Group for the concept name of a numeric property of the Previous Procedure
$LateralityValue Coded term or Context Group for value of Laterality
$ProcedureResult Coded term or Context Group for value of Result of Procedure
$ComplicationValue Coded term or Context Group for value of Complication

TID 9003PREVIOUS PROCEDUREType: Extensible Order: Significant

NL
$ProblemList Coded term or Context Group for value of Indicated Problem
$LateralityValue Coded term or Context Group for value of Laterality
$LocationValue Coded term or Context Group for value of Location

TID 9004INDICATED PROBLEMType: Extensible Order: Significant

NL
$RiskList Coded term or Context Group for value of Risk Factor
$FamilyList Coded term or Context Group for value of Family Member with Risk Factor

TID 9005RISK FACTORType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
2 > CONTAINS DATE DCID (12003) OB-GYN Dates 1-n U
3 >

TID 9007 General Relevant Patient Information

This template collects a patient’s relevant information for general purpose use. This template, together with its subordinate templates, describes the history of a patient’s reproductive system, medications, substance use, environmental exposure, past procedures, risk factors, and indicated problems.

TID 9007GENERAL RELEVANT PATIENT INFORMATIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113701, DCM, “X-Ray Radiation Dose Report”) 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M DT (113704, DCM, “Projection X-Ray”) DT (P5-40010, SRT, “Mammography”)
3 >> HAS CONCEPT MOD CODE EV (G-C0E8, SRT, “Has Intent”) 1 M DCID (3629) Procedure Intent
4 > INCLUDE DTID (1002) Observer Context 1-n M
5 > HAS OBS CONTEXT CODE EV (113705, DCM, “Scope of Accumulation”) 1 M DCID (10000) Scope of Accumulation
6 >> HAS PROPERTIES UIDREF DCID (10001) UID Types 1 M
7 > CONTAINS INCLUDE DTID (10002) Accumulated X-Ray Dose 1 MC IFF Single Plane system $Plane = EV (113622, DCM, ”Single Plane”
8 > CONTAINS INCLUDE DTID (10002) Accumulated X-Ray Dose 1 MC IFF Biplane system $Plane = EV (113620, DCM, ”Plane A”)
9 > CONTAINS INCLUDE DTID (10002) Accumulated X-Ray Dose 1 MC IFF Biplane system $Plane = EV (113621, DCM, ”Plane B”)
10 > CONTAINS INCLUDE DTID (10003) Irradiation Event X-Ray Data 1-n M
11 > CONTAINS TEXT EV (121106, DCM, “Comment”) 1 U
12 > CONTAINS IMAGE EV (121342, DCM, “Dose Image”) 1-n U
13 > CONTAINS INCLUDE DTID (1020) Person Participant 1 U $PersonProcedureRole= EV (113850, DCM, “Irradiation Authorizing”)
14 > CONTAINS CODE EV (113854, DCM, “Source of Dose Information”) 1-n M DCID (10020) Source of Projection X-Ray Dose Information

Content Item Descriptions

Row 4 The observer context may include both a Person Observer identification, as well as the identity of the equipment providing the values for the irradiation event (Device Observer identification), if not inherited.
Row 10 Details of the underlying irradiation events. If Row 6 has a value of “MPPS Content” then a TID 10003 item will be generated for each item in the MPPS Exposure Dose Sequence (0040,030E).
Row 12 The Dose Image references a graphic representation of the radiation dose distribution. This may be a Secondary Capture scan of a dosimetry film.
Row 13 The physician responsible for determining that the irradiating procedure was appropriate for the indications. The value may come from Requesting Physician (0032,1032), Requesting Physician Identification Sequence (0032,1031) or somewhere else based on hospital policies.
Row 14 The primary source of information from which this dose object was constructed.

TID 10002 Accumulated X-Ray Dose

This general template provides detailed information on projection X-Ray dose value accumulations over several irradiation events from the same equipment (typically a study or a performed procedure step).

Parameter Name Parameter Usage
$Plane Coded term identifying to which acquisition plane the encoded information belongs.

TID 10002 ACCUMULATED X-RAY DOSE Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113702, DCM, ”Accumulated X-Ray Dose Data”) 1 M
2 > HAS CONCEPT MOD CODE EV (113764, DCM, “Acquisition Plane” 1 M $Plane
3 > CONTAINS CONTAINER EV (122505, DCM, “Calibration”) 1-n MC IFF Calibration Data is available
4 >> HAS CONCEPT MOD CODE EV (113794, DCM, “Dose Measurement Device”) 1 M DCID (10010) Dose Measurement Devices
5 >> CONTAINS DATETIME EV (113723, DCM, “Calibration Date”) 1 M
6 >> CONTAINS NUM EV (122322, DCM, “Calibration Factor”) 1 M Units = EV (1, UCUM, “no units”)
7 >> CONTAINS NUM EV (113763, DCM, “Calibration Uncertainty”) 1 M Units = EV (%, UCUM, “Percent”)
8 >> CONTAINS TEXT EV (113724, DCM, “Calibration Responsible Party”) 1 M
9 > CONTAINS INCLUDE DTID (10004) Accumulated Projection X-Ray Dose 1 MC XOR row 10, IFF TID (10001) Row 2 = (113704, DCM, “Projection X-Ray”)
10 > CONTAINS INCLUDE DTID (10005) Accumulated Mammography X-Ray Dose 1 MC XOR row 9, IFF TID (10001) Row 2 = (P5-40010, SRT, “Mammography”)
11 > CONTAINS INCLUDE DTID (1021) Device Participant 1 MC Required if the irradiating device is not the recording device and the dose was accumulated on a single device. $DeviceProcedureRole = EV (113859, DCM, “Irradiating Device”)

Content Item Descriptions

Row 5 Date that the calibration of the equipment’s dose indicators was performed
Row 6 Factor by which the measured dose area product total was multiplied to obtain the Dose Area Product Total (Row 10).
Row 7 Value range from 0 to 100 percent. Uncertainty of the ‘actual’ value expressed as +/- of the mean.
Row 8 Identifies Individual or organization responsible for calibration
Row 11 The device which produced the irradiation accumulated in this template. I.e. the X-Ray source. This is not required to be present if the information is the same as that already recorded in the Device Observer Context (TID 1004) encoded via the inclusion of Observer Context (TID 1002) in TID 10001 Row 4, which in turn may be absent if identical to the content in the Enhanced General Equipment Module, or if more than one device produced the accumulated irradiation.

TID 10003 Irradiation Event X-Ray Data

This template conveys the dose and equipment parameters of a single irradiation event.

An irradiation event is the occurrence of radiation being applied to a patient in single continuous time-frame between the start (release) and the stop (cease) of the irradiation. The irradiation event is the “smallest” information entity to be recorded in the realm of Radiation Dose reporting. Individual Irradiation Events are described by a set of accompanying physical parameters that are sufficient to understand the “quality” of irradiation that is being applied. This set of parameters may be different for the various types of equipment that are able to create irradiation events. Any automatic on-off switching of the irradiation source during the event shall not be treated as separate events, rather the event includes the time between start and stop of irradiation as triggered by the user. E.g., a pulsed fluoro X-Ray acquisition shall be treated as a single irradiation event.

As described in Section 6.2.4, measurement concepts may be post-coordinated, even though not explicitly specified in the Template. In particular, post-coordination using modifier concept (121401, DCM, “Derivation”), with modifier values drawn from CID 10009 Measured/Calculated would be appropriate to encode indications of measured or of calculated values.

TID 10003 IRRADIATION EVENT X-RAY DATA Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113706, DCM, ”Irradiation Event X-Ray Data”) 1 M
2 > HAS CONCEPT MOD CODE EV (113764, DCM, “Acquisition Plane” 1 M DCID (10003) Equipment Plane Identification
3 > CONTAINS DATETIME DT (111526, DCM, “DateTime Started”) 1 M
4 > CONTAINS CODE EV (113721, DCM, “Irradiation Event Type”) 1 M DCID (10002) Irradiation Event Types
5 > CONTAINS TEXT EV (125203, DCM, “Acquisition Protocol”) 1 U
6 > CONTAINS CODE EV (T-D0005, SRT, “Anatomical structure”) 1 U
7 >> HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality") 1 UC If anatomy is bi-lateral DCID (244) Laterality
8 > CONTAINS TEXT EV (113780, DCM, “Reference Point Definition”) 1 MC IF Row 13 or Row 14 is present and Row 9 is not present
9 > CONTAINS CODE EV (113780, DCM, “Reference Point Definition”) 1 MC IF Row 13 or Row 14 is present and Row 8 is not present DCID (10025) Radiation Dose Reference Points
10 > CONTAINS UIDREF EV (113769, DCM, “Irradiation Event UID”) 1 M
11 > CONTAINS NUM EV (122130, DCM, “Dose Area Product” 1 MC IFF TID (10001) Row 2 = (113704, DCM, “Projection X-Ray”) Units = EV (Gy.m2, UCUM, "Gy.m2")
12 > CONTAINS NUM EV (111631, DCM, “Average Glandular Dose”) 1 MC IFF TID (10001) Row 2 = (P5-40010, SRT, “Mammography”) Units = EV (dGy, UCUM, “dGy”
13 > CONTAINS NUM EV (113738, DCM, “Dose (RP)”) 1 MC IFF TID (10001) Row 2 = (113704, DCM, “Projection X-Ray”) AND any of the values of TID (10001) Row 14 are not (113858, DCM, “MPPS Content”) Units = EV (Gy, UCUM, “Gy”)
14 > CONTAINS NUM EV (111636, DCM, “Entrance Exposure at RP”) 1 MC IFF TID (10001) Row 2 = (P5-40010, SRT, “Mammography”) Units = EV (mGy, UCUM, “mGy”)
15 > CONTAINS NUM EV (112011, DCM, “Positioner Primary Angle”) 1 UC XOR Row 19 Units = EV (deg, UCUM, “º”)
16 > CONTAINS NUM EV ( 112012, DCM, “Positioner Secondary Angle”) 1 UC XOR Row 19 Units = EV (deg, UCUM, “º”)
17 > CONTAINS NUM EV (113739, DCM, “Positioner Primary End Angle” 1 UC IFF Row 4 value = (113613, DCM, “Rotational Acquisition”) Units = EV (deg, UCUM, “º”)
18 > CONTAINS NUM EV (113740, DCM, “Positioner Secondary End Angle” 1 UC IFF Row 4 value = (113613, DCM, “Rotational Acquisition”) Units = EV (deg, UCUM, “º”)
19 > CONTAINS NUM EV (113770, DCM, “Column Angulation”) 1 UC XOR Rows 15,16 Units = EV (deg, UCUM, “º”)
20 > CONTAINS NUM EV (113790, DCM, “Collimated Field Area” 1 U Units = EV (m2, UCUM, “m^2”)
21 > CONTAINS CONTAINER EV (113771, DCM, “X-Ray Filters”) 1-n U
22 >> CONTAINS CODE EV (113772, DCM, “X-Ray Filter Type”) 1 U DCID (10007) X-Ray Filter Types
23 >> CONTAINS CODE EV (113757, DCM, “X-Ray Filter Material”) 1 U DCID (10006) X-Ray Filter Materials
24 >> CONTAINS NUM EV (113758, DCM, “X-Ray Filter Thickness Minimum”) 1 U Units = EV (mm, UCUM, “mm”)
25 >> CONTAINS NUM EV (113773, DCM, “X-Ray Filter Thickness Maximum”) 1 U Units = EV (mm, UCUM, “mm”)
26 > CONTAINS CODE EV (113732, DCM, “Fluoro Mode”) 1 UC IFF Row 4 value = (P5-06000, SRT, “Fluoroscopy”) DCID (10004) Fluoro Modes
27 > CONTAINS NUM EV (113791, DCM, “Pulse Rate”) 1 MC IFF Row 26 value = (113631, DCM, “Pulsed”) Units = EV ({pulse}/s, UCUM, “pulse/s”)
28 > CONTAINS NUM EV (113768, DCM, “Number of Pulses”) 1 MC IFF Row 26 value = (113631, DCM, “Pulsed”) Units = EV (1, UCUM, “no units”)
29 >> HAS CONCEPT MOD CODE EV (121401, DCM, “Derivation”) 1 MC IFF count of pulses in Row 28 is estimated EV (R-10260, SRT, “Estimated”)
30 > CONTAINS NUM EV (113733, DCM, “KVP”) 1-n U Units = EV (kV, UCUM, “kV”)
31 > CONTAINS NUM EV (113734, DCM, “X-Ray Tube Current”) 1-n U Units = EV (mA, UCUM, “mA”)
32 > CONTAINS NUM EV (113735, DCM, “Exposure Time”) 1 U Units = EV (ms, UCUM, “ms”)
33 > CONTAINS NUM EV (113793, DCM, “Pulse Width”) 1-n U Units = EV (ms, UCUM, “ms”)
34 > CONTAINS NUM EV (113736, DCM, “Exposure”) 1-n U Units = EV (uAs, UCUM, “uAs”)
35 > CONTAINS NUM EV (113766, DCM, “Focal Spot Size”) 1 U Units = EV (mm, UCUM, “mm”)
36 > CONTAINS NUM EV (113742, DCM, “Irradiation Duration”) 1 U Units = EV (s, UCUM, “s”)
37 > CONTAINS NUM EV (113767, DCM, “Average X-Ray Tube Current”) 1 U Units = EV (mA, UCUM, “mA”)
38 > CONTAINS CODE EV (113745, DCM, “Patient Table Relationship”) 1 U DCID (21) Patient Gantry Relationship
39 > CONTAINS CODE EV (113743, DCM, “Patient Orientation”) 1 U DCID (19) Patient Orientation
40 >> HAS CONCEPT MOD CODE EV (113744, DCM, “Patient Orientation Modifier”) 1 M DCID (20) Patient Orientation Modifier
41 > CONTAINS NUM DCID (10008) Dose Related Distance Measurements 1-n U Units = EV (mm, UCUM, “mm”)
42 > CONTAINS NUM EV (113754, DCM, “Table Head Tilt Angle”) 1 U Units = EV (deg, UCUM, “º”)
43 > CONTAINS NUM EV (113755, DCM, “Table Horizontal Rotation Angle”) 1 U Units = EV (deg, UCUM, “º”)
44 > CONTAINS NUM EV (113756, DCM, “Table Cradle Tilt Angle”) 1 U Units = EV (deg, UCUM, “º”)
45 > CONTAINS CODE EV (123014 , DCM, (”Target Region”) 1 M DCID (4031) Common Anatomic Regions
46 > CONTAINS CODE EV (111632, DCM, “Anode Target Material” 1 U DCID (10016) Anode Target Material
47 > CONTAINS NUM EV (111633, DCM, “Compression Thickness”) 1 U Units = (mm, UCUM, “mm”)
48 > CONTAINS NUM EV (111634, DCM, “Half Value Layer”) 1 U Units = (mm, UCUM, “mm”)
49 > CONTAINS CODE EV (111635,DCM, “X-Ray Grid”) 1-n U DCID (10017) X-Ray Grid
50 > CONTAINS INCLUDE DTID (4007) Mammography CAD Breast Composition 1 U
51 > CONTAINS TEXT EV (121106, DCM, “Comment”) 1 U
52 > CONTAINS INCLUDE DTID (1020) Person Participant 1-n U $PersonProcedureRole = EV (113851, DCM, “Irradiation Administering”)
53 > CONTAINS INCLUDE DTID (1021) Device Participant 1 MC Required if the irradiating device is not the recording device. $DeviceProcedureRole = EV (113859, DCM, “Irradiating Device”)
54 > CONTAINS IMAGE EV (113795, DCM, “Acquired Image”) 1-n MC IFF Image Object is created for this irradiation event
55 > CONTAINS NUM EV (113845, DCM, “Exposure Index”) 1 U Units = (1,UCUM, “no units”)
56 > CONTAINS NUM EV (113846, DCM, “Target Exposure Index”) 1 U Units = (1,UCUM, “no units”)
57 > CONTAINS NUM EV (113847, DCM, “Deviation Index”) 1 U Units = (1,UCUM,“no units”)

Content Item Descriptions

Row 3 Provide DateTime the application of X-Ray started. This shall correspond to the start of the first irradiation in the Irradiation Event, which defines the starting point for the calculation of Row 36 “Irradiation Duration”.
Row 8 A text definition of the Reference Point (RP) used for RP-related dose values.
Row 9 A coded definition of the Reference Point (RP) used for RP-related dose values
Row 10 If the image generating entity does not assign a DICOM UID to the irradiation event (e.g., for non-digital imaging equipment), the application generating this report shall assign a UID.
Row 13 Dose applied by this irradiation event, relative to defined reference point.
Row 15 Angle in patient’s “equatorial” plane (LAO to RAO). For dynamically changing angle during the event, the start value shall be provided. Equivalent to (0018,1510) in an image instance.
Row 16 Angle in patient’s “sagittal” plane (CRAN to CAUD). For dynamically changing angle during the event, the start value shall be provided. Equivalent to (0018,1511) in an image instance.
Row 17 In case of motion during irradiation event, Positioner Primary ending angle
Row 18 In case of motion during irradiation event, Positioner Secondary ending angle
Row 19 Column device Angle in equipment based coordinates
Row 20 Collimated area at the receptor plane.
Row 21 If one or more Filter(s) were applied during this irradiation event
Row 28 If a precise count of pulses is not available, an estimated number shall be provided, and the Row 29 Concept Modifier shall indicate “Estimated”
Row 30 KVP value as measured/recorded by system, either as a single mean value, or as multiple values. If multiple values are provided, their number shall match the value in Row 28 “Number of Pulses”.
Row31 Tube current as measured/recorded by system, either as a single mean value, or as multiple values. If multiple values are provided, their number shall match the value in Row 28 “Number of Pulses”.
Row 32 Exposure time as measured/recorded by the system.
Row 33 Pulse width as measured/recorded by the system, either as a single total value, or as multiple values. If multiple values are provided, their number shall match the value in Row 28 “Number of Pulses”.
Row 34 Exposure as measured/recorded by system, either as a single total value, or as multiple values. If multiple values are provided, their number shall match the value in Row 28 “Number of Pulses”. The Exposure will be affected by the shape of the pulse and other factors, and may not be a simple multiplication of tube current and exposure time.
Row 45 The target region is the anatomy exposed.
Row 52 People responsible for the administration of the radiation reported in the irradiation event. May include values which would appear in Performing Physicians’ Name (0008,1050), Performing Physician Identification Sequence (0008,1052), Operators’ Name (0008,1070) and/or Operator Identification Sequence (0008,1072).
Row 53 The device which produced the irradiation in this Irradiation Event. I.e. the X-Ray source. This is not required to be present if the information is the same as that already recorded in the Device Observer Context (TID 1004) encoded via the inclusion of Observer Context (TID 1002) in TID 10001 Row 4, which in turn may be absent if identical to the content in the Enhanced General Equipment Module.
Row 54 Reference to Image instances created during this event, if any. The UID reference(s) provided here shall be the values at the time the images were initially created. (Note that image UIDs may be changed as the images are managed over a long term.)

TID 10004 Accumulated Projection X-Ray Dose

This general template provides detailed information on projection X-Ray dose value accumulations over several irradiation events from the same equipment (typically a study or a performed procedure step).

TID 10004 ACCUMULATED PROJECTION X-RAY DOSE Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM EV (113722, DCM, “Dose Area Product Total”) 1 M Units = EV (Gy.m2, UCUM, “Gy.m2”)
2 NUM EV (113725, DCM, “Dose (RP) Total”) 1 MC IF any of the values of TID (10001) Row 14 are not (113858, DCM, “MPPS Content”). May be present otherwise. Units = EV (Gy, UCUM, “Gy”)
3 NUM EV (113726, DCM, “Fluoro Dose Area Product Total”) 1 MC IFF TID(10003) Row 4 value = (P5-06000, SRT, “Fluoroscopy”) for at least one irradiation event Units = EV (Gy.m2, UCUM, “Gy.m2”)
4 NUM EV (113728, DCM, “Fluoro Dose (RP) Total”) 1 MC IFF TID(10003) Row 4 value = (P5-06000, SRT, “Fluoroscopy”) for at least one irradiation event AND any of the values of TID (10001) Row 14 are not (113858, DCM, “MPPS Content”). Units = EV (Gy, UCUM, “Gy”)
5 NUM EV (113730, DCM, “Total Fluoro Time”) 1 MC IFF TID(10003) Row 4 value = (P5-06000, SRT, “Fluoroscopy”) for at least one irradiation event. Units = EV (s, UCUM, “s”)
6 NUM EV (113727, DCM, “Acquisition Dose Area Product Total”) 1 M Units = EV (Gy.m2, UCUM, “Gy.m2”)
7 NUM EV (113729, DCM, “Acquisition Dose (RP) Total”) 1 MC IF any of the values of TID (10001) Row 14 are not (113858, DCM, “MPPS Content”). May be present otherwise. Units = EV (Gy, UCUM, “Gy”)
8 NUM EV (113855, DCM, “Total Acquisition Time”) 1 M Units = EV (s, UCUM, “s”)
9 NUM EV (113731, DCM, “Total Number of Radiographic Frames”) 1 U Units = EV (1, UCUM, “no units”)
10 CODE EV (113780, DCM, “Reference Point Definition”) 1 MC IF Row 2, Row 4 or Row 7 is present and Row 11 is not present. DCID (10025) Radiation Dose Reference Points
11 TEXT EV (113780, DCM, “Reference Point Definition”) 1 MC IF Row 2, Row 4 or Row 7 is present and Row 10 is not present.

Content Item Descriptions

Row 1 Sum of acquisition and fluoroscopy
Row 2 Sum of acquisition and fluoroscopy, relative to reference point.
Rows 3-5 Fluoroscopic component only
Rows 6-8 Acquisition component only
Row 10 A coded definition of the Reference Point (RP) used for RP-related dose values.
Row 11 A text definition of the Reference Point (RP) used for RP-related dose values.

TID 10005 Accumulated Mammography X-Ray Dose

This modality specific template provides detailed information on mammography X-Ray dose value accumulations over several irradiation events from the same equipment (typically a study or a performed procedure step).

TID 10005 ACCUMULATED MAMMOGRAPHY X-RAY DOSE Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM EV (111637, DCM, “Accumulated Average Glandular Dose”) 1-2 M Units = EV (dGy, UCUM, “dGy”
2 > HAS CONCEPT MOD CODE EV (G-C171, SRT, “Laterality") 1 M DCID (6022) Side

CT RADIATION DOSE SR IOD TEMPLATES

The templates that comprise the CT Radiation Dose SR are interconnect

ted as in Figure A-15

[pic]

Figure A-15: CT Radiation Dose SR IOD Template Structure

TID 10011 CT Radiation Dose

This template defines a container (the root) with subsidiary content items, each of which corresponds to a single CT X-Ray irradiation event entry. There is a defined recording observer (the system or person responsible for recording the log, generally the system). Accumulated values shall be kept for a whole Study or at least a part of a Study, if the Study is divided in the workflow of the examination, or a performed procedure step. Multiple CT Radiation Dose objects may be created for one Study.

TID 10011 CT RADIATION DOSE Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113701, DCM, “X-Ray Radiation Dose Report”) 1 M
2 > HAS CONCEPT MOD CODE EV (121058, DCM, ”Procedure reported”) 1 M EV (P5-08000,SRT, “Computed Tomography X-Ray”)
3 >> HAS CONCEPT MOD CODE EV (G-C0E8, SRT, “Has Intent”) 1 M DCID (3629) Procedure Intent
4 > INCLUDE DTID (1002) Observer Context 1-n M
5 > HAS OBS CONTEXT DATETIME EV (113809, DCM, “Start of X-Ray Irradiation”) 1 M
6 > HAS OBS CONTEXT DATETIME EV (113810, DCM, “End of X-Ray Irradiation”) 1 M
7 > HAS OBS CONTEXT CODE EV (113705, DCM, “Scope of Accumulation”) 1 M DCID (10000) Scope of Accumulation
8 >> HAS PROPERTIES UIDREF DCID (10001) UID Types 1 M
9 > CONTAINS INCLUDE DTID (10012) CT Accumulated Dose Data 1 M
10 > CONTAINS INCLUDE DTID (10013) CT Irradiation Event Data 1-n M
11 > CONTAINS TEXT EV (121106, DCM, “Comment”) 1 U
12 > CONTAINS CODE EV (113854, DCM, “Source of Dose Information”) 1-n M DCID (10021) Source of CT Dose Information
13 > CONTAINS INCLUDE DTID (1020) Person Participant 1 U $PersonProcedureRole = EV (113850, DCM, “Irradiation Authorizing”)

Content Item Descriptions

Row 4 The observer context may include both a Person Observer identification, as well as the identity of the equipment providing the values for the irradiation event (Device Observer identification), if not inherited.
Row 5 Start, Date Time of the first CT Irradiation Event of the accumulation
Row 6 End, Date Time of the last CT Irradiation Event of the accumulation
Row 12 The primary source of information from which this dose object was constructed.
Row 13 The physician responsible for determining that the irradiating procedure was appropriate for the indications. The value may come from Requesting Physician (0032,1032), Requesting Physician Identification Sequence (0032,1031) or somewhere else based on hospital policies.

TID 10012 CT Accumulated Dose Data

This general template provides detailed information on CT X-Ray dose value accumulations over several irradiation events from the same equipment and over the scope of accumulation specified for the report (typically a Study or a Performed Procedure Step).

TID 10012 CT ACCUMULATED DOSE DATA Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113811, DCM, ”CT Accumulated Dose Data”) 1 M
2 > CONTAINS NUM EV (113812, DCM, “Total Number of Irradiation Events”) 1 M Units = EV ({events} UCUM, “events”)
3 > CONTAINS NUM EV (113813, DCM, “CT Dose Length Product Total”) 1 M Units = EV (mGy.cm, UCUM, “mGy.cm”)
4 > CONTAINS NUM EV (113814, DCM, “CT Effective Dose Total”) 1 U Units = EV (mSv, UCUM, “mSv”)
5 >> HAS PROPERTIES TEXT EV (121406,DCM, “Reference Authority”) 1 MC XOR row 6
6 >> HAS PROPERTIES CODE EV (121406,DCM, “Reference Authority”) 1 MC XOR row 5 DCID (10015) CT Dose Reference Authority
7 >> HAS CONCEPT MOD CODE EV (G-C036,SRT, “Measurement Method”) 1 M DCID (10011) Effective Dose Evaluation Method
8 >> HAS PROPERTIES TEXT EV (113815,DCM, “Patient Model”) 1 MC IF the value of row 7 equals (113800, DCM, “DLP to E conversion via MC computation”) or equals (113801, DCM, “CTDIfreeair to E conversion via MC computation”)
9 >> HAS PROPERTIES CONTAINER EV (113816, DCM, “Condition Effective Dose measured”) 1 MC IF the value of row 7 equals (113802, DCM, “DLP to E conversion via measurement”) or equals (113803, DCM, “CTDIfreeair to E conversion via measurement”)
10 >>> CONTAINS TEXT EV (113817,DCM, “Effective Dose Phantom Type”) 1 M
11 >>> CONTAINS TEXT EV (113818, DCM, “Dosimeter Type”) 1 M
12 > CONTAINS TEXT EV (121106, DCM, “Comment”) 1 U
13 > CONTAINS INCLUDE DTID (1021) Device Participant 1 MC Required if the irradiating device is not the recording device and the dose was accumulated on a single device. $DeviceProcedureRole = EV (113859, DCM, “Irradiating Device”)

Content Item Descriptions

Row 2 Total Number of CT irradiation events . A CT irradiation event is one continuous irradiation procedure and is defined through consistent acquisition parameters. In the case of dose modulation the calculations are based on the effective parameters (e.g. the effective mA recorded in the Mean X-Ray Tube Current), and these acquisition parameters are consistent.
Row 3 The Dose Length Product (DLP) is calculated for every irradiation event. The Dose Length Product Total is the sum of the DLP values. The calculation is based on the CTDIvol result of each irradiation event.
Row 4 Effective dose (E, in units of mSv) evaluated as a total over the scope is defined in Row 6 of template TID 10011. Effective dose is defined by the reference in Rows 5 or 6 of this template. It may be calculated from a product of DLP and an ‘Effective Dose Conversion Factor’ (E/DLP). Or it may be calculated from a product of the Mean CTDIfree air and the ratio E/CTDIfree air. The ratios E/DLP or E/CTDIfree air may be evaluated either from computer simulations applying Monte Carlo (MC) sampling techniques or from dosimetric measurements in an anthropomorphic phantom, e.g., the Alderson-Rando phantom.. The specific method used is identified in Rows 7 through 11.
Row 5 - 6 Reference of the base publication defining the Effective Dose, either as a coded value, or a textual bibliographic reference. ICRP Publications shall be referenced using their assigned coded values.
Row 7 Description of the method used for Effective Dose evaluations.
Row 8 Description of the reference-patient mathematical or computational model used when Effective Dose is derived via Monte Carlo simulations of radiation transport in such models. Examples of publications which specify particular reference patient models are NUREG/CR-1159, ORNL/NUREG/TM-367 (1980); NRPB-R186 (1985); GSF-Bericht S-885 (1986); Fill et al., Health Physics Vol. 86 (3): 253-272 (2004).
Row 9 Description of the condition Effective Dose measured
Row 10 Type of Effective Dose phantom used, e.g. Alderson-Rando
Row 11 Type of dosimeter used, e.g. TLD (Thermo Luminescence Dosimeter)
Row 13 The device which produced the irradiation accumulated in this template. I.e. the CT Scanner. This is not required to be present if the information is the same as that already recorded in the Device Observer Context (TID 1004) encoded via the inclusion of Observer Context (TID 1002) in TID 10011 Row 4, which in turn may be absent if identical to the content in the Enhanced General Equipment Module, or if more than one device produced the accumulated irradiation.

TID 10013 CT Irradiation Event Data

This template conveys the dose and equipment parameters of a single irradiation event.

A CT irradiation event is the occurrence of irradiation being applied to a patient in single continuous time-frame between the start (release) and the stop (cease) of the irradiation. Any on-off switching of the radiation source during the event shall not be treated as separate events; rather the event includes the time between start and stop of radiation as triggered by the user, e.g., a single sequence of scanning comprised of multiple slices acquired with successive tube rotations and table increments shall be treated as a single irradiation event. Depending on the examination workflow and the anatomical target region the CT irradiation event data may split into multiple instances of this template for better dose estimation. The irradiation event is the “smallest” information entity to be recorded in the realm of Radiation Dose reporting. Individual Irradiation Events are described by a set of accompanying physical parameters that are sufficient to understand the “quality” of irradiation that is being applied. This set of parameters may be different for the various types of equipment that are able to create irradiation events.

TID 10013 CT IRRADIATION EVENT DATA Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113819, DCM, ”CT Acquisition”) 1 M
2 > CONTAINS TEXT EV (125203, DCM, “Acquisition Protocol”) 1 U
3 > CONTAINS CODE EV (123014 , DCM, ”Target Region”) 1 M DCID (4030) CT and MR Anatomy Imaged
4 > CONTAINS CODE EV (113820, DCM, “CT Acquisition Type”) 1 M DCID (10013) CT Acquisition Types
5 > CONTAINS CODE EV (G-C32C, SRT, “Procedure Context”) 1 U DCID (10014) Contrast Imaging Technique
6 > CONTAINS UIDREF EV (113769, DCM, “Irradiation Event UID”) 1 M
7 > CONTAINS CONTAINER EV (113822, DCM, “CT Acquisition Parameters”) 1 M
8 >> CONTAINS NUM EV (113824, DCM, “Exposure Time”) 1 M Units = EV (s, UCUM, “s”)
9 >> CONTAINS INCLUDE DTID (10014) Scanning Length 1 M
10 >> CONTAINS NUM EV (113826, DCM, “Nominal Single Collimation Width”) 1 M Units = EV (mm, UCUM, “mm”)
11 >> CONTAINS NUM EV (113827, DCM, “Nominal Total Collimation Width”) 1 M Units = EV (mm, UCUM, “mm”)
12 >> CONTAINS NUM EV (113828, DCM, “Pitch Factor”) 1 MC IF row 4 equals (P5-08001, SRT, “Spiral Acquisition”) or equals (113804, DCM, “Sequenced Acquisition”) Units = EV ({ratio}, UCUM, “ratio”)
13 >> CONTAINS NUM EV (113823, DCM, “Number of X-Ray Sources”) 1 M Units = EV ({X-Ray sources}, UCUM, “X-Ray sources”)
14 >> CONTAINS CONTAINER EV (113831, DCM, “CT X-Ray Source Parameters”) 1-n M
15 >>> CONTAINS TEXT EV (113832, DCM, “Identification of the X-Ray Source”) 1 M
16 >>> CONTAINS NUM EV (113733, DCM, “KVP”) 1 M Units = EV (kV, UCUM, “kV”)
17 >>> CONTAINS NUM EV (113833, DCM, “Maximum X-Ray Tube Current”) 1 M Units = EV (mA, UCUM, “mA”)
18 >>> CONTAINS NUM EV (113734, DCM, “X-Ray Tube Current” 1 M Units = EV (mA, UCUM, “mA”)
19 >>> CONTAINS NUM EV (113834, DCM, “Exposure Time per Rotation”) 1 MC IF row 4 does not equal (113805, DCM, “Constant Angle Acquisition”) Units = EV (s, UCUM, “s”)
20 >>> CONTAINS NUM EV (113821, DCM, “X-Ray Filter Aluminum Equivalent”) 1 U Units = EV (mm, UCUM, “mm”)
21 > CONTAINS CONTAINER EV (113829, DCM, “CT Dose”) 1 MC IF row 4 does not equal (113805, DCM, “Constant Angle Acquisition”)
22 >> CONTAINS NUM EV (113830, DCM, “Mean CTDIvol”) 1 M Units = EV (mGy, UCUM, “mGy”)
23 >> CONTAINS CODE EV (113835, DCM, “CTDIw Phantom Type”) 1 M DCID (4052) Phantom Devices
24 >> CONTAINS NUM EV (113836, DCM, “CTDIfreeair Calculation Factor”) 1 U Units = EV (mGy/mAs, UCUM, “mGy/mAs”)
25 >> CONTAINS NUM EV (113837, DCM, “Mean CTDIfreeair”) 1 U Units = EV (mGy, UCUM, “mGy”)
26 >> CONTAINS NUM EV (113838, DCM, “DLP”) 1 M Units = EV (mGy.cm, UCUM, “mGy.cm”)
27 >> CONTAINS NUM EV (113839, DCM, “Effective Dose”) 1 U Units = EV (mSv, UCUM, “mSv”)
28 >>> HAS CONCEPT MOD CODE EV (G-C036, SRT, “Measurement Method“) 1 MC IF row 27 is present DCID (10011) “Effective Dose Evaluation Method”)
29 >>>> HAS PROPERTIES NUM EV (113840, DCM, “Effective Dose Conversion Factor”) 1 MC IF row 28 is present and equals (113800, DCM, “DLP to E conversion via MC computation”) or equals (113802, DCM, “DLP to E conversion via measurement”) Units = EV (mSv/mGy.cm, UCUM, “mSv/mGy.cm”)
30 >> CONTAINS INCLUDE DTID (10015) CT Dose Check Details 1 M
31 > CONTAINS TEXT EV (113842, DCM, “X-Ray Modulation Type”) 1 U
32 > CONTAINS TEXT EV (121106, DCM, “Comment”) 1 U
33 > CONTAINS INCLUDE DTID (1020) Person Participant 1-n U $PersonProcedureRole = EV (113851, DCM, “Irradiation Administering”)
34 > CONTAINS INCLUDE DTID (1021) Device Participant 1 MC Required if the irradiating device is not the recording device. $DeviceProcedureRole = EV (113859, DCM, “Irradiating Device”)

Content Item Descriptions

Row 2 User-defined type of clinical acquisition protocol for creating images or image-derived measurements. May be taken from Protocol Name (0018,1030) or from Performed Procedure Step Description (0040,0254).
Row 3 The target region is the anatomy exposed.
Row 4 Description of the method used during acquisition of this CT irradiation event, may be derived from Acquisition Type (0018,9302).
Row 5 The acquisition was performed with or without contrast medium application.
Row 8 Total time the patient has received X-Ray exposure during the irradiation event.
Row 10 The value of the nominal width (referenced to the location of the isocenter along the z axis) of a single collimated slice in mm.
Row 11 The value of the nominal width (referenced to the location of the isocenter along the z axis) of the nominal total collimation in mm over the area of active X-Ray detection (z-coverage).
Row 12 Pitch Factor: For Spiral Acquisition, the Pitch Factor is the ratio of the Table Feed per Rotation to the Nominal Total Collimation Width. For Sequenced Acquisition, the Pitch Factor is the ratio of the Table Feed per single sequenced scan to the Nominal Total Collimation Width.
Row 14 CT X-Ray source parameters related to the acquisition. For each X-Ray source an item must be present. For multi-energy acquisitions, multiple items may be present for each X-Ray source, each item describing one energy level.
Row 15 Identification of the X-Ray source. Identifies the particular X-Ray source (in a multi-source CT system) for which the set of X-Ray source parameter values is reported.
Row 16 KVP value as measured/recorded by system.
Row 18 Mean tube current as measured/recorded by system.
Row 19 Exposure time as measured/recorded by the system per rotation.
Row 20 Thickness of an equivalent filter constructed from aluminum, in case of multi source CT systems AND if Row 4 is not present
Row 21 CT Dose for one acquisition
Row 22 “Mean CTDIvol” refers to the average value of the CTDIvol applied within this acquisition. CTDIvol is the volume CTDIw, where CTDIw is the weighted computed tomography dose index 100 as defined in IEC 60601-2-44. For Sequenced and Spiral scanning, CTDIvol = CTDIw/Pitch Factor. For Stationary and Free scanning, CTDIvol = CTDIw ( Cumulative Exposure Time/ Exposure Time Per Rotation. According to IEC 60601-2-44 Ed 3 for Constant Angle Acquisition may be calculated as CTDIvol = (CTDIw / Current Time Product (mAs)) x X-Ray Tube Current (mA) x (Nominal Total Collimation Width (mm) / Table Speed (mm/s)). Note: The ratio CTDIw / Current Time Product is evaluated independently of the Constant Angle Acquisition but with the same settings of tube voltage and Total Collimation Width as those of the Constant Angle Acquisition. See also CTDIvol (0018,9345) and Spiral Pitch Factor (0018,9311) in the Enhanced CT Information Object Description (PS 3.3).
Row 23 The type of phantom used for CTDI measurement according to IEC 60601-2-44 (e.g. Head 16 cm diameter PMMA, Body 32 cm diameter PMMA).
Row 24 The CTDIfree air Calculation Factor is the CTDIfree air per mAs, expressed in units of mGy/mAs. The CTDIfree air Calculation Factor may be used in one method calculating Dose. For example, for this acquisition, Effective Dose = Mean X-Ray Tube Current ( Cumulative Exposure Time ( CTDIfree air Calculation Factor ( (Effective Dose/ CTDIfree air).
Row 25 Mean CTDIfree air is the mean CTDI for this acquisition, evaluated free-in-air according to IEC 60601-2-44. Mean CTDIfree air = Mean X-Ray Tube Current ( Cumulative Exposure Time ( CTDIfree air Calculation Factor. The CTDIfree air may be used in one method of calculating Effective Dose.
Row 26 For Spiral scanning, DLP = CTDIvol ( Scanning Length. For Sequenced scanning, DLP = CTDIvol ( Nominal Total Collimation Width ( Cumulative Exposure Time / Exposure Time per Rotation. For Stationary and Free scanning, DLP = CTDIvol ( Nominal Total Collimation Width (according to IEC 60601-2-44).
Row 27 Effective Dose in mSv of the single continuous time-frame of the irradiation computed as described in TID 10012.
Row 29 The Effective Dose Conversion Factor is the ratio of the Effective Dose to the DLP, expressed in units of mSv/mGycm, and it is used as a factor in one method of estimating Effective Dose. Monte Carlo Simulations (or dosimetric measurements in an anthropomorphic phantom, e.g., the Alderson-Rando phantom) may be used as a basis for the evaluation of Effective Dose Conversion Factors.
Row 30 Record of details associated with using the NEMA Dose Check Standard (NEMA XR-25-2010).
Row 31 The type of exposure modulation. May use the value of Exposure Modulation Type (0018,9323) from CT Exposure Macro or from CT Image Module.
Row 33 People responsible for the administration of the radiation reported in the irradiation event. May include values which would appear in Performing Physicians’ Name (0008,1050), Performing Physician Identification Sequence (0008,1052), Operators' Name (0008,1070) and/or Operator Identification Sequence (0008,1072).
Row 34 The device which produced the irradiation in this Irradiation Event. I.e. the CT scanner. This is not required to be present if the information is the same as that already recorded in the Device Observer Context (TID 1004) encoded via the inclusion of Observer Context (TID 1002) in TID 10011 Row 4, which in turn may be absent if identical to the content in the Enhanced General Equipment Module.

TID 10014 Scanning Length

TID 10014Scanning LengthType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 NUM EV (113825, DCM, “Scanning Length”) 1 M Units = EV (mm, UCUM, “mm”)
2 NUM EV (113893, DCM, “Length of Reconstructable Volume”) 1 U Units = EV (mm, UCUM, “mm”)
3 NUM EV (113899, DCM, “Exposed Range”) 1 UC IFF TID 10013 row 4 CT Acquisition Type equals (P5-08001, SRT, “Spiral Acquisition”) Units = EV (mm, UCUM, “mm”)
4 NUM EV (113895, DCM, “Top Z Location of Reconstructable Volume”) 1 U Units = EV (mm, UCUM, “mm”)
5 NUM EV (113896, DCM, “Bottom Z Location of Reconstructable Volume”) 1 U Units = EV (mm, UCUM, “mm”)
6 NUM EV (113897, DCM, “Top Z Location of Scanning Length”) 1 U Units = EV (mm, UCUM, “mm”)
7 NUM EV (113898, DCM, “Bottom Z Location of Scanning Length”) 1 U Units = EV (mm, UCUM, “mm”)
8 UIDREF EV (112227, DCM, “Frame of Reference UID”) 1 MC IF any of Rows 4 through 7 are present. If present, shall be the same UID as in the images reconstructed from this irradiation event.

Content Item Descriptions

Row 1 For Spiral scanning, the scanning length is normally the table travel in mm during the tube loading (see Figure A-16). For Sequenced scanning, the scanning length is the table travel between consecutive scans times the number of scans. For Stationary and Free scanning, the scanning length is the nominal width of the total collimation.
Row 2 The length of the reconstructable volume is the maximum z-range between the outermost edges of the top and bottom slices that can be reconstructed from the acquisition. For Spiral scanning, the length of reconstructable volume is the z-range between the outermost beginning of the first reconstructable slice and the outermost end of the last reconstructable slice (see Figure A-16). For Sequenced scanning, the length of reconstructable volume is the z-range between the outermost beginning of the first slice and the outermost end of the last slice (i.e., including any skip). For Stationary and Free scanning, the length of reconstructable volume is the nominal width of the total collimation.
Row 3 For Spiral scanning, the exposed range is as defined in IEC 60601-2-44 (Ed. 3) 302.115(b) (see Figure A-16). Exposed range is not defined for other modes of scanning.
Rows 4-5 The Top and Bottom Z Locations of the Reconstructable Volume are independent of the slice width of any actual reconstructed slices. They are measured from the edges of the volume, and hence are not equal to the Z locations encoded in the images of any actual reconstructed slices, which are recorded as the center of the slice.
Rows 4-7 These locations are patient (not table or gantry) relative, to allow them to be defined in the Patient Coordinate System and hence related to the Image Position (Patient) in the reconstructed images. They are are also defined in terms of the top (towards the patient’s head), and bottom (towards the patient’s feet) of the corresponding ranges, in order to make them independent of whether the scan starts at the top or the bottom or shuttles back and forth in between (see Figure A-16).

[pic]

Figure A-16 Spiral Acquisition Parameters

TID 10015 CT Dose Check Details

This template records details related to the use of the NEMA Dose Check Standard (NEMA XR-25-2010).

TID 10015 CT DOSE CHECK DETAILS Type: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (113900, DCM, “Dose Check Alert Details”) 1 MC IF the scanning device has implemented dose alerts
2 > CONTAINS CODE EV (113901, DCM, “DLP Alert Value Configured”) 1 M DCID (230) Yes-No
3 > CONTAINS CODE EV (113902, DCM, “CTDIvol Alert Value Configured”) 1 M DCID (230) Yes-No
4 > CONTAINS NUM EV (113903, DCM, “DLP Alert Value”) 1 MC IFF value of Row 2 is (R-0038D,SRT, “Yes”) Units = EV (mGy.cm, UCUM, “mGy.cm”)
5 > CONTAINS NUM EV (113904, DCM, “CTDIvol Alert Value”) 1 MC IFF value of Row 3 is (R-0038D,SRT, “Yes”) Units = EV (mGy, UCUM, “mGy”)
6 > CONTAINS NUM EV(113905, DCM, “Accumulated DLP Forward Estimate”) 1 MC IF Accumulated DLP Forward Estimate (Row 6) exceeds DLP Alert Value (Row 4) Units = EV (mGy.cm, UCUM, “mGy.cm”)
7 > CONTAINS NUM EV (113906, DCM, “Accumulated CTDIvol Forward Estimate”) 1 MC IF Accumulated CTDIvol Forward Estimate (Row 7) exceeds CTDIvol Alert Value (Row 5) Units = EV (mGy, UCUM, “mGy”)
8 > CONTAINS TEXT EV (113907, DCM, “Reason for Proceeding”) 1 UC IFF Accumulated DLP Forward Estimate (Row 6) exceeds DLP Alert Value (Row 4) or Accumulated CTDIvol Forward Estimate (Row 7) exceeds CTDIvol Alert Value (Row 5)
9 > CONTAINS INCLUDE DTID (1020) Person Participant 1 MC IF Accumulated DLP Forward Estimate (Row 6) exceeds DLP Alert Value (Row 4) or Accumulated CTDIvol Forward Estimate (Row 7) exceeds CTDIvol Alert Value (Row 5) $PersonProcedureRole = EV (113850, DCM, “Irradiation Authorizing”)
10 CONTAINER EV (113908, DCM, “Dose Check Notification Details”) 1 MC IF the scanning device has implemented dose notifications
11 > CONTAINS CODE EV (113909, DCM, “DLP Notification Value Configured”) 1 M DCID (230) Yes-No
12 > CONTAINS CODE EV (113910, DCM, “CTDIvol Notification Value Configured”) 1 M DCID (230) Yes-No
13 > CONTAINS NUM EV (113911, DCM, “DLP Notification Value”) 1 MC IFF value of Row 11 is (R-0038D,SRT, “Yes”) Units = EV (mGy.cm, UCUM, “mGy.cm”)
14 > CONTAINS NUM EV (113912, DCM, “CTDIvol Notification Value”) 1 MC IFF value of Row 12 is (R-0038D,SRT, “Yes”) Units = EV (mGy, UCUM, “mGy”)
15 > CONTAINS NUM EV (113913, DCM, “DLP Forward Estimate”) 1 MC IF DLP Forward Estimate (Row 15) exceeds DLP Notification Value (Row 13) Units = EV (mGy.cm, UCUM, “mGy.cm”)
16 > CONTAINS NUM EV (113914, DCM, “CTDIvol Forward Estimate”) 1 MC IF CTDIvol Forward Estimate (Row 16) exceeds CTDIvol Notification Value (Row 14) Units = EV (mGy, UCUM, “mGy”)
17 > CONTAINS TEXT EV (113907, DCM, “Reason for Proceeding”) 1 UC IFF DLP Forward Estimate (Row 15) exceeds DLP Notification Value (Row 13) or CTDIvol Forward Estimate (Row 16) exceeds CTDIvol Notification Value (Row 14)
18 > CONTAINS INCLUDE DTID (1020) Person Participant 1 UC IFF DLP Forward Estimate (Row 15) exceeds DLP Notification Value (Row 13) or CTDIvol Forward Estimate (Row 16) exceeds CTDIvol Notification Value (Row 14) $PersonProcedureRole = EV (113850, DCM, “Irradiation Authorizing”)

Content Item Descriptions

Row 1 Container for Dose Check Alert details.
Row 2 Indicates whether a DLP Alert Value was configured (e.g. by the institution) for the exam to which this irradiation event belongs.
Row 3 Indicates whether a CTDIvol Alert Value was configured (e.g. by the institution) for the exam to which this irradiation event belongs.
Row 4 The configured value applicable to the current exam which would trigger an alert if the accumulated DLP were projected to exceed it.
Row 5 The configured value applicable to the current exam which would trigger an alert if the Accumulated CTDIvol at any given location were projected to exceed it.
Row 6 The value estimated prior to performing this irradiation event of the projected DLP accumulated during this exam, including this irradiation event. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 7 The value estimated prior to performing this irradiation event of the projected CTDIvol accumulated during this exam, including this irradiation event. The value is for the location with the highest estimated accumulation. The actual location is not recorded. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 8 The reason provided by the operator for proceeding with an irradiation event projected to exceed an alert value.
Row 9 Person responsible for authorizing irradiation projected to exceed an alert value.
Row 10 Container for Dose Check Notification details.
Row 11 Indicates whether a DLP Notification Value was configured (e.g. by the institution) for the Protocol Element Group to which this irradiation event corresponds.
Row 12 Indicates whether a CTDIvol Notification Value was configured (e.g. by the institution) for the Protocol Element Group to which this irradiation event corresponds.
Row 13 The configured value applicable to the current irradiation event which would trigger a notification if the DLP were projected to exceed it.
Row 14 The configured value applicable to the current irradiation event which would trigger a notification if the CTDIvol were projected to exceed it.
Row 15 The value estimated prior to performing this irradiation event of the DLP for this irradiation event. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 16 The value estimated prior to performing this irradiation event of the CTDIvol for this irradiation event. The value is for the location with the highest estimated value. The actual location is not recorded. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 17 The reason provided by the operator for proceeding with an irradiation event projected to exceed a notification value.
Row 18 Person responsible for authorizing irradiation projected to exceed a notification value.