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

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$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

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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

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$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

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$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