E.3.3 Example 3: Calcification and Mass Detection, Temporal Differencing with Findings

The patient in Example 2 returns for another mammogram. A more comprehensive mammography CAD device processes the current mammogram; analyses are performed that determine some content items for Overall and Individual Impression/Recommendations. Portions of the prior mammography CAD report (Example 2) are incorporated into this report. In the current mammogram the number of calcifications in the RCC has increased, and the size of the mass in the left breast has increased from 1 to 4 cm 2.

PRIOR
[pic] [pic] [pic] [pic]
CURRENT
[pic] [pic] [pic] [pic]

Figure E.3-16: Mammograms as Described in Example 3

Italicized entries ( xxx ) in the following table denote references to or by-value inclusion of content tree items reused from the prior Mammography CAD SR instance (Example 2).

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1 Mammography CAD Report 4000

While the Image Library contains references to content tree items reused from the prior Mammography CAD SR instance, the images are actually used in the mammography CAD analysis and are therefore not italicized as indicated above.

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.1 Image Library 4000
1.1.1 IMAGE 1 4020
1.1.1.1 Image Laterality Right 4020
1.1.1.2 Image View Cranio-caudal 4020
1.1.1.3 Study Date 20000101 4020
1.1.2 IMAGE 2 4020
1.1.2.1 Image Laterality Left 4020
1.1.2.2 Image View Cranio-caudal 4020
1.1.2.3 Study Date 20000101 4020
1.1.3 IMAGE 3 4020
1.1.3.1 Image Laterality Right 4020
1.1.3.2 Image View Medio-lateral oblique 4020
1.1.3.3 Study Date 20000101 4020
1.1.4 IMAGE 4 4020
1.1.4.1 Image Laterality Left 4020
1.1.4.2 Image View Medio-lateral oblique 4020
1.1.4.3 Study Date 20000101 4020
1.1.5 IMAGE 5 4020
1.1.5.1 Image Laterality Right 4020
1.1.5.2 Image View Cranio-caudal 4020
1.1.5.3 Study Date 19990101 4020
1.1.6 IMAGE 6 4020
1.1.6.1 Image Laterality Left 4020
1.1.6.2 Image View Cranio-caudal 4020
1.1.6.3 Study Date 19990101 4020
1.1.7 IMAGE 7 4020
1.1.7.1 Image Laterality Right 4020
1.1.7.2 Image View Medio-lateral oblique 4020
1.1.7.3 Study Date 19990101 4020
1.1.8 IMAGE 8 4020
1.1.8.1 Image Laterality Left 4020
1.1.8.2 Image View Medio-lateral oblique 4020
1.1.8.3 Study Date 19990101 4020

Current year content:

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.2 CAD Processing and Findings Summary All algorithms succeeded; with findings 4001
1.2.1 Assessment Category 4 – Suspicious abnormality, biopsy should be considered 4002
1.2.2 Recommend Follow-up Interval 0 days 4002
1.2.3 Algorithm Name “Mammogram Analyzer” 4019
1.2.4 Algorithm Version “V1.0 4019
1.2.5 Individual Impression/Recommendation 4003
1.2.5.1 Rendering Intent Presentation Required 4003
1.2.5.2 Differential Diagnosis/Impression Increase in size 4002
1.2.5.3 Impression Description “Worrisome increase in size” 4002
1.2.5.4 Recommended Follow-up Needle localization and biopsy 4002
1.2.5.5 Certainty of impression 84% 4002
1.2.5.6 Algorithm Name “Lesion Analyzer” 4019
1.2.5.7 Algorithm Version “V1.0 4019
1.2.5.8 Composite Feature Mass 4004
1.2.5.8.1 Rendering Intent Presentation Required 4004
1.2.5.8.2 Composite type Target content items are related temporally 4005
1.2.5.8.3 Scope of Feature Feature was detected on multiple images 4005
1.2.5.8.4 Algorithm Name “Temporal Change” 4019
1.2.5.8.5 Algorithm Version “V0.1 4019
1.2.5.8.6 Certainty of Feature 91% 4005
1.2.5.8.7 Probability of Cancer 84% 4005
1.2.5.8.8 Pathology Invasivelobular carcinoma 4005
1.2.5.8.9 Difference in Size 3 cm2 4005
1.2.5.8.9.1 Reference to node 1.2.5.8.13.7.6 4005
1.2.5.8.9.2 Reference to node 1.2.5.8.14.8.6 4005
1.2.5.8.10 Lesion Density High density 4005
1.2.5.8.11 Shape Lobular 4005
1.2.5.8.12 Margins Microlobulated 4005
1.2.5.8.13 Composite Feature Mass 4004
1.2.5.8.13.1 Rendering Intent Presentation Required 4004
1.2.5.8.13.2 Composite type Target content items are related spatially 4005
1.2.5.8.13.3 Scope of Feature Feature was detected on multiple images 4005
1.2.5.8.13.4 Algorithm Name “Mass Maker” 4019
1.2.5.8.13.5 Algorithm Version “V1.9 4019
1.2.5.8.13.6 Single Image Finding Mammography breast density 4006
1.2.5.8.13.6.1 Rendering Intent Presentation Required 4006
1.2.5.8.13.6.2 Algorithm Name “Density Detector” 4019
1.2.5.8.13.6.3 Algorithm Version “V3.7 4019
1.2.5.8.13.6.4 Center POINT 4021
1.2.5.8.13.6.4.1 Reference to node 1.1.2 4021
1.2.5.8.13.6.5 Outline SCOORD 4021
1.2.5.8.13.6.5.1 Reference to node 1.1.2 4021
1.2.5.8.13.7 Single Image Finding Mammography breast density 4006
1.2.5.8.13.7.1 Rendering Intent Presentation Required 4006
1.2.5.8.13.7.2 Algorithm Name “Density Detector” 4019
1.2.5.8.13.7.3 Algorithm Version “V3.7 4019
1.2.5.8.13.7.4 Center POINT 4021
1.2.5.8.13.7.4.1 Reference to node 1.1.4 4021
1.2.5.8.13.7.5 Outline SCOORD 4021
1.2.5.8.13.7.5.1 Reference to node 1.1.4 4021
1.2.5.8.13.7.6 Area of Defined Region 4 cm2 1401
1.2.5.8.13.7.6.1 Area Outline SCOORD 1401
1.2.5.8.13.7.6. 1.1 Reference to node 1.1.4 1401

Included content from prior mammography CAD report (see Example 2, starting with node 1.2.1.2)

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.2.5.8.14 Composite Feature Mass 4004
1.2.5.8.14.1 Rendering Intent Presentation Required 4004
1.2.5.8.14.2 Composite type Target content items are related spatially 4005
1.2.5.8.14.3 Scope of Feature Feature was detected on multiple images 4005
1.2.5.8.14.4 Algorithm Name “Mass Maker” 4019
1.2.5.8.14.5 Algorithm Version “V1.9 4019
1.2.5.8.14.6 [Observation Context content items] 4022
1.2.5.8.14.7 Single Image Finding Mammography breast density 4006
1.2.5.8.14.7.1 Rendering Intent Presentation Required 4006
1.2.5.8.14.7.2 Algorithm Name “Density Detector” 4019
1.2.5.8.14.7.3 Algorithm Version “V3.7 4019
1.2.5.8.14.7.4 Center POINT 4021
1.2.5.8.14.7.4.1 Reference to node 1.1.6 4021
1.2.5.8.14.7.5 Outline SCOORD 4021
1.2.5.8.14.7.5.1 Reference to node 1.1.6 4021
1.2.5.8.14.8 Single Image Finding Mammography breast density 4006
1.2.5.8.14.8.1 Rendering Intent Presentation Required 4006
1.2.5.8.14.8.2 Algorithm Name “Density Detector” 4019
1.2.5.8.14.8.3 Algorithm Version “V3.7 4019
1.2.5.8.14.8.4 Center POINT 4021
1.2.5.8.14.8.4.1 Reference to node 1.1.8 4021
1.2.5.8.14.8.5 Outline SCOORD 4021
1.2.5.8.14.8.5.1 Reference to node 1.1.8 4021
1.2.5.8.14.8.6 Area of Defined Region 1 cm2 1401
1.2.5.8.14.8.6.1 Area Outline SCOORD 1401
1.2.5.8.14.8.6.1.1 Reference to node 1.1.8 1401

More current year content:

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.2.6 Individual Impression/Recommendation 4003
1.2.6.1 Rendering Intent Not for Presentation 4003
1.2.6.2 Single Image Finding Mammography breast density 4006
1.2.6.2.1 Rendering Intent Not for Presentation 4006
1.2.6.2.2 Algorithm Name “Density Detector” 4019
1.2.6.2.3 Algorithm Version “V3.7 4019
1.2.6.2.4 Center POINT 4021
1.2.6.2.4.1 Reference to node 1.1.2 4021
1.2.6.2.5 Outline SCOORD 4021
1.2.6.2.5.1 Reference to node 1.1.2 4021
1.2.7 Individual Impression/Recommendation INDIVIDUAL 4003
1.2.7.1 Rendering Intent Presentation Required 4003
1.2.7.2 Single Image Finding Calcification Cluster 4006
1.2.7.2.1 Rendering Intent Presentation Required 4006
1.2.7.2.2 Algorithm Name “Calc Cluster Detector” 4019
1.2.7.2.3 Algorithm Version “V2.4 4019
1.2.7.2.4 Center POINT 4021
1.2.7.2.4.1 Reference to node 1.1.3 4021
1.2.7.2.5 Outline SCOORD 4021
1.2.7.2.5.1 Reference to node 1.1.3 4021
1.2.7.2.6 Number of Calcifications 20 4010
1.2.8 Individual Impression/Recommendation 4003
1.2.8.1 Rendering Intent Presentation Required 4003
1.2.8.2 Differential Diagnosis/Impression Increase in number of calcifications 4002
1.2.8.3 Impression Description “Calcification cluster has increased in size” 4002
1.2.8.4 Recommended Follow-up Magnification views 4002
1.2.8.5 Certainty of impression 100% 4002
1.2.8.6 Algorithm Name “Lesion Analyzer” 4019
1.2.8.7 Algorithm Version “V1.0 4019
1.2.8.8 Composite Feature Calcification Cluster 4004
1.2.8.8.1 Rendering Intent Presentation Required 4004
1.2.8.8.2 Composite type Target content items are related temporally 4005
1.2.8.8.3 Scope of Feature Feature was detected on multiple images 4005
1.2.8.8.4 Algorithm Name “Lesion Analyzer” 4019
1.2.8.8.5 Algorithm Version “V1.0 4019
1.2.8.8.6 Certainty of Feature 99% 4005
1.2.8.8.7 Probability of Cancer 54% 4005
1.2.8.8.8 Pathology Intraductal carcinoma, low grade 4005
1.2.8.8.9 Difference in Number of calcifications 4 4005
1.2.8.8.9.1 Reference to node 1.2.8.8.12.6 4005
1.2.8.8.9.2 Reference to node 1.2.8.8.13.6 4005
1.2.8.8.10 Calcification type Fine, linear, branching (casting) 4005
1.2.8.8.11 Calcification distribution Grouped or clustered 4005
1.2.8.8.12 Single Image Finding Calcification Cluster 4006
1.2.8.8.12.1 Rendering Intent Presentation Required 4006
1.2.8.8.12.2 Algorithm Name “Calc Clustering” 4019
1.2.8.8.12.3 Algorithm Version “V2.4 4019
1.2.8.8.12.4 Center POINT 4021
1.2.8.8.12.4.1 Reference to node 1.1.1 4021
1.2.8.8.12.5 Outline SCOORD 4021
1.2.8.8.12.5.1 Reference to node 1.1.1 4021
1.2.8.8.12.6 Number of Calcifications 6 4010
1.2.8.8.12.7 Single Image Finding Individual Calcification 4006
1.2.8.8.12.7.1 Rendering Intent Presentation Optional 4006
1.2.8.8.12.7.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.12.7.3 Algorithm Version “V2.4 4019
1.2.8.8.12.7.4 Center POINT 4021
1.2.8.8.12.7.4.1 Reference to node 1.1.1 4021
1.2.8.8.12.7.5 Outline SCOORD 4021
1.2.8.8.12.7.5.1 Reference to node 1.1.1 4021
1.2.8.8.12.8 Single Image Finding Individual Calcification 4006
1.2.8.8.12.8.1 Rendering Intent Presentation Optional 4006
1.2.8.8.12.8.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.12.8.3 Algorithm Version “V2.4 4019
1.2.8.8.12.8.4 Center POINT 4021
1.2.8.8.12.8.4.1 Reference to node 1.1.1 4021
1.2.8.8.12.8.5 Outline SCOORD 4021
1.2.8.8.12.8.5.1 Reference to node 1.1.1 4021
1.2.8.8.12.9 Single Image Finding Individual Calcification 4006
1.2.8.8.12.9.1 Rendering Intent Presentation Optional 4006
1.2.8.8.12.9.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.12.9.3 Algorithm Version “V2.4 4019
1.2.8.8.12.9.4 Center POINT 4021
1.2.8.8.12.9.4.1 Reference to node 1.1.1 4021
1.2.8.8.12.9.5 Outline SCOORD 4021
1.2.8.8.12.9.5.1 Reference to node 1.1.1 4021
1.2.8.8.12.10 Single Image Finding Individual Calcification 4006
1.2.8.8.12.10.1 Rendering Intent Presentation Optional 4006
1.2.8.8.12.10.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.12.10.3 Algorithm Version “V2.4 4019
1.2.8.8.12.10.4 Center POINT 4021
1.2.8.8.12.10.4.1 Reference to node 1.1.1 4021
1.2.8.8.12.10.5 Outline SCOORD 4021
1.2.8.8.12.10.5.1 Reference to node 1.1.1 4021
1.2.8.8.12.11 Single Image Finding Individual Calcification 4006
1.2.8.8.12.11.1 Rendering Intent Presentation Optional 4006
1.2.8.8.12.11.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.12.11.3 Algorithm Version “V2.4 4019
1.2.8.8.12.11.4 Center POINT 4021
1.2.8.8.12.11.4.1 Reference to node 1.1.1 4021
1.2.8.8.12.11.5 Outline SCOORD 4021
1.2.8.8.12.11.5.1 Reference to node 1.1.1 4021
1.2.8.8.12.12 Single Image Finding Individual Calcification 4006
1.2.8.8.12.12.1 Rendering Intent Presentation Optional 4006
1.2.8.8.12.12.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.12.12.3 Algorithm Version “V2.4 4019
1.2.8.8.12.12.4 Center POINT 4021
1.2.8.8.12.12.4.1 Reference to node 1.1.1 4021
1.2.8.8.12.12.5 Outline SCOORD 4021
1.2.8.8.12.12.5.1 Reference to node 1.1.1 4021

Included content from prior mammography CAD report (see Example 2, starting with node 1.2.4.2)

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.2.8.8.13 Single Image Finding Calcification Cluster 4006
1.2.8.8.13.1 Rendering Intent Presentation Required 4006
1.2.8.8.13.2 Algorithm Name “Calc Clustering” 4019
1.2.8.8.13.3 Algorithm Version “V2.4 4019
1.2.8.8.13.4 Center POINT 4021
1.2.8.8.13.4.1 Reference to node 1.1.5 4021
1.2.8.8.13.5 Outline SCOORD 4021
1.2.8.8.13.5.1 Reference to node 1.1.5 4021
1.2.8.8.13.6 Number of Calcifications 2 4010
1.2.8.8.13.7 [Observation Context content items] 4022
1.2.8.8.13.8 Single Image Finding Individual Calcification 4006
1.2.8.8.13.8.1 Rendering Intent Presentation Optional 4006
1.2.8.8.13.8.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.13.8.3 Algorithm Version “V2.4 4019
1.2.8.8.13.8.4 Center POINT 4021
1.2.8.8.13.8.4.1 Reference to node 1.1.5 4021
1.2.8.8.13.8.5 Outline SCOORD 4021
1.2.8.8.13.8.5.1 Reference to node 1.1.5 4021
1.2.8.8.13.9 Single Image Finding Individual Calcification 4006
1.2.8.8.13.9.1 Rendering Intent Presentation Optional 4006
1.2.8.8.13.9.2 Algorithm Name “Calc Detector” 4019
1.2.8.8.13.9.3 Algorithm Version “V2.4 4019
1.2.8.8.13.9.4 Center POINT 4021
1.2.8.8.13.9.4.1 Reference to node 1.1.5 4021
1.2.8.8.13.9.4 Outline SCOORD 4021
1.2.8.8.13.9.4.1 Reference to node 1.1.5 4021

More current year content:

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.3 Summary of Detections Succeeded 4000
1.3.1 Successful Detections 4015
1.3.1.1 Detection Performed Mammography breast density 4017
1.3.1.1.1 Algorithm Name “Density Detector” 4019
1.3.1.1.2 Algorithm Version “V3.7 4019
1.3.1.1.3 Reference to node 1.1.1 4017
1.3.1.1.4 Reference to node 1.1.2 4017
1.3.1.1.5 Reference to node 1.1.3 4017
1.3.1.1.6 Reference to node 1.1.4 4017
1.3.1.2 Detection Performed Individual Calcification 4017
1.3.1.2.1 Algorithm Name “Calc Detector” 4019
1.3.1.2.2 Algorithm Version “V2.4 4019
1.3.1.2.3 Reference to node 1.1.1 4017
1.3.1.2.4 Reference to node 1.1.2 4017
1.3.1.2.5 Reference to node 1.1.3 4017
1.3.1.2.6 Reference to node 1.1.4 4017
1.3.1.3 Detection Performed Calcification Cluster 4017
1.3.1.3.1 Algorithm Name “Calc Clustering” 4019
1.3.1.3.2 Algorithm Version “V2.4 4019
1.3.1.3.3 Reference to node 1.1.1 4017
1.3.1.4 Detection Performed Calcification Cluster 4017
1.3.1.4.1 Algorithm Name “Calc Cluster Detector” 4019
1.3.1.4.2 Algorithm Version “V2.4 4019
1.3.1.4.3 Reference to node 1.1.1 4017
1.3.1.4.4 Reference to node 1.1.2 4017
1.3.1.4.5 Reference to node 1.1.3 4017
1.3.1.4.6 Reference to node 1.1.4 4017
1.4 Summary of Analyses Succeeded 4000
1.4.1 Successful Analyses 4016
1.4.1.1 Analysis Performed Mass Correlation 4018
1.4.1.1.1 Algorithm Name “Mass Maker” 4019
1.4.1.1.2 Algorithm Version “V1.9 4019
1.4.1.1.3 Reference to node 1.1.2 4018
1.4.1.1.4 Reference to node 1.1.4 4018
1.4.1.2 Analysis Performed Temporal Correlation 4018
1.4.1.2.1 Algorithm Name “Temporal Change” 4019
1.4.1.2.2 Algorithm Version “V0.1 4019
1.4.1.2.3 Reference to node 1.1.2 4018
1.4.1.2.4 Reference to node 1.1.4 4018
1.4.1.2.5 Reference to node 1.1.6 4018
1.4.1.2.6 Reference to node 1.1.8 4018
1.4.1.3 Analysis Performed Individual Impression / Recommendation Analysis 4018
1.4.1.3.1 Algorithm Name “Lesion Analyzer” 4019
1.4.1.3.2 Algorithm Version “V1.0 4019
1.4.1.3.3 Reference to node 1.1.2 4018
1.4.1.3.4 Reference to node 1.1.4 4018
1.4.1.3.5 Reference to node 1.1.6 4018
1.4.1.3.6 Reference to node 1.1.8 4018
1.4.1.4 Analysis Performed Overall Impression / Recommendation Analysis 4018
1.4.1.4.1 Algorithm Name “Mammogram Analyzer” 4019
1.4.1.4.2 Algorithm Version “V1.0 4019
1.4.1.4.3 Reference to node 1.1.2 4018
1.4.1.4.4 Reference to node 1.1.4 4018
1.4.1.4.5 Reference to node 1.1.6 4018
1.4.1.4.6 Reference to node 1.1.8 4018