F.3 CHEST CAD SR EXAMPLES

The following is a simple and non-comprehensive illustration of an encoding of the Chest CAD SR IOD for chest computer aided detection results. For brevity, some mandatory content items are not included, such as several acquisition context content items for the images in the Image Library.

F.3.1 Example 1: Lung Nodule Detection with No Findings

A chest CAD device processes a typical screening chest case, i.e., there is one image and no nodule findings. Chest CAD runs lung nodule detection successfully and finds nothing.

The chest radiograph resembles:

PROJECTION CHEST [pic]

Figure F.3-1: Chest radiograph as Described in Example 1

The content tree structure would resemble:

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1 Chest CAD Report 4100
1.1 Image Library 4100
1.1.1 IMAGE 1 4020
1.1.1.1 Image View Postero-anterior 4020
1.1.1.2 Study Date 19980101 4020
1.2 CAD Processing and Findings Summary All algorithms succeeded; without findings 4101
1.3 Summary of Detections Succeeded 4100
1.3.1 Successful Detections 4015
1.3.1.1 Detection Performed Nodule 4017
1.3.1.1.1 Algorithm Name “Lung Nodule Detector” 4019
1.3.1.1.2 Algorithm Version “V1.3 4019
1.3.1.1.3 Reference to node 1.1.1 4017
1.4 Summary of Analyses Not Attempted 4100

F.3.2 Example 2: Lung Nodule Detection with Findings and Anatomy/Pathology Interpretation

A chest CAD device processes a screening chest case with one image, and a lung nodule detected. The chest radiograph resembles:

PROJECTION CHEST [pic]

Figure F.3-2: Chest radiograph as Described in Example 2

The content tree structure in this example is complex. Structural illustrations of portions of the content tree are placed within the content tree table to show the relationships of data within the tree. Some content items are duplicated (and shown in boldface) to facilitate use of the diagrams.

[pic]

Figure F.3-3: Content Tree Root of Example 2 Content Tree

The content tree structure would resemble:

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1 Chest CAD Report 4100
1.1 Image Library 4100
1.2 CAD Processing and Findings Summary All algorithms succeeded; with findings 4101
1.3 Summary of Detections Succeeded 4100
1.4 Summary of Analyses Not Attempted 4100

[pic]

Figure F.3-4: Image Library Branch of Example 2 Content Tree

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.1 Image Library 4100
1.1.1 IMAGE 1 4020
1.1.1.1 Image View Postero-anterior 4020
1.1.1.2 Study Date 19990101 4020

[pic]

Figure F.3-5: CAD Processing and Findings Summary Portion of Example 2 Content Tree

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.2 CAD Processing and Findings Summary All algorithms succeeded; with findings 4101
1.2.1 Single Image Finding Abnormal Opacity 4104
1.2.1.1 Single Image Finding Modifier Nodule 4104
1.2.1.2 Rendering Intent Presentation Required:… 4104
1.2.1.3 Algorithm Name “Lung Nodule Detector” 4019
1.2.1.4 Algorithm Version “V1.3 4019
1.2.1.5 Center POINT 4107
1.2.1.5.1 Reference to Node 1.1.1 4107
1.2.1.6 Outline POLYLINE 4107
1.2.1.6.1 Reference to Node 1.1.1 4107
1.2.1.7 Diameter 2 cm 1400
1.2.1.7.1 Path POLYLINE 1400
1.2.1.7.1.1 Reference to Node 1.1.1 1400

[pic]

Figure F.3-6: Summary of Detections Portion of Example 2 Content Tree

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.3 Summary of Detections Succeeded 4100
1.3.1 Successful Detections 4015
1.3.1.1 Detection Performed Nodule 4017
1.3.1.1.1 Algorithm Name “Lung Nodule Detector” 4019
1.3.1.1.2 Algorithm Version “V1.3 4019
1.3.1.1.3 Reference to node 1.1.1 4017

F.3.3 Example 3: Lung Nodule Detection, Temporal Differencing with Findings

The patient in Example 2 returns for another chest radiograph. A more comprehensive chest CAD device processes the current chest radiograph, and analyses are performed that determine some temporally related content items for Composite Features. Portions of the prior chest CAD report (Example 2) are incorporated into this report. In the current chest radiograph the lung nodule has increased in size.

PRIOR PROJECTION CHEST [pic]
CURRENT PROJECTION CHEST [pic]

Figure F.3-8: Chest radiographs 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 Chest CAD SR instance (Example 2).

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1 Chest CAD Report 4100

While the Image Library contains references to content tree items reused from the prior Chest CAD SR instance, the images are actually used in the chest 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 4100
1.1.1 IMAGE 1 4020
1.1.1.1 Image View Postero-anterior 4020
1.1.1.2 Study Date 20000101 4020
1.1.2 IMAGE 2 4020
1.1.2.1 Image View Postero-anterior 4020
1.1.2.2 Study Date 19990101 4020

The CAD processing and findings consist of one composite feature, comprised of single image findings, one from each year. The temporal relationship allows a quantitative temporal difference to be calculated:

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.2 CAD Processing and Findings Summary All algorithms succeeded; with findings 4101
1.2.1 Composite Feature Abnormal Opacity 4102
1.2.1.1 Composite Feature Modifier Nodule 4102
1.2.1.2 Rendering Intent Presentation Required: … 4102
1.2.1.3 Algorithm Name “Nodule Change” 4019
1.2.1.4 Algorithm Version “V2.3 4019
1.2.1.5 Composite Type Target content items are related temporally 4103
1.2.1.6 Scope of Feature Feature detected on multiple images 4103
1.2.1.7 Certainty of Feature 85% 4103
1.2.1.8 Difference in size 2 cm 4103
1.2.1.8.1 Reference to Node 1.2.1.9.8 4103
1.2.1.8.2 Reference to Node 1.2.1.10.8 4103
1.2.1.9 Single Image Finding Abnormal Opacity 4104
1.2.1.9.1 Single Image Finding Modifier Nodule 4104
1.2.1.9.2 Rendering Intent Presentation Required: … 4104
1.2.1.9.3 Tracking Identifier “Watchlist #1” 4108
1.2.1.9.4 Algorithm Name “Lung Nodule Detector” 4019
1.2.1.9.5 Algorithm Version “V1.3 4019
1.2.1.9.6 Center POINT 4107
1.2.1.9.6.1 Reference to Node 1.1.1 4107
1.2.1.9.7 Outline POLYLINE 4107
1.2.1.9.7.1 Reference to Node 1.1.1 4107
1.2.1.9.8 Diameter 4 cm 1400
1.2.1.9.8.1 Path POLYLINE 1400
1.2.1.9.8.1.1 Reference to Node 1.1.1 1400
1.2.1.10 Single Image Finding Abnormal Opacity 4104
1.2.1.10.1 Single Image Finding Modifier Nodule 4104
1.2.1.10.2 Rendering Intent Presentation Required: … 4104
1.2.1.10.3 [Observation Context content items] 4022
1.2.1.10.4 Algorithm Name “Lung Nodule Detector” 4019
1.2.1.10.5 Algorithm Version “V1.3 4019
1.2.1.10.6 Center POINT 4107
1.2.1.10.6.1 Reference to Node 1.1.2 4107
1.2.1.10.7 Outline POLYLINE 4107
1.2.1.10.7.1 Reference to Node 1.1.2 4107
1.2.1.10.8 Diameter 2 cm 1400
1.2.1.10.8.1 Path POLYLINE 1400
1.2.1.10.8.1.1 Reference to Node 1.1.2 1400
1.3 Summary of Detections Succeeded 4100
1.3.1 Successful Detections 4015
1.3.1.1 Detection Performed Nodule 4017
1.3.1.1.1 Algorithm Name “Lung Nodule Detector” 4019
1.3.1.1.2 Algorithm Version “V1.3 4019
1.3.1.1.3 Reference to node 1.1.1 4017
1.4 Summary of Analyses Succeeded 4100
1.4.1 Successful Analyses 4016
1.4.1.1 Analysis Performed “Temporal correlation” 4018
1.4.1.1.1 Algorithm Name “Nodule Change” 4019
1.4.1.1.2 Algorithm Version “V2.3 4019
1.4.1.1.3 Reference to node 1.1.1 4018
1.4.1.1.4 Reference to node 1.1.2 4018

F.3.4 Example 4: Lung Nodule Detection in Chest Radiograph, Spatially Correlated with CT

The patient in Example 3 is called back for CT to confirm the Lung Nodule found in Example 3. The patient undergoes CT of the Thorax and the initial chest radiograph and CT slices are sent to a more comprehensive CAD device for processing. Findings are detected and analyses are performed that correlate findings from the two data sets. Portions of the prior CAD report (Example 3) are incorporated into this report.

PROJECTION CHEST (PRIOR) [pic]
CT SLICES (CURRENT) [pic]Slice 103 [pic]Slice 104 [pic]Slice 105

Figure F.3-9: Chest radiograph and CT slice as described in Example 4

Italicized entries ( xxx ) in the following table denote references to or by-value inclusion of content tree items reused from the prior Chest CAD SR instance (Example 3).

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1 Chest CAD Report 4100
1.1 Language of Content Item and Descendants English 1204
1.2 Image Library 4100
1.3 CAD Processing and Findings Summary All algorithms succeeded; with findings 4101
1.4 Summary of Detections Succeeded 4100
1.5 Summary of Analyses Succeeded 4100

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

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.2 Image Library 4100
1.2.1 IMAGE 1 4020
1.2.1.1 Image View Postero-anterior 4020
1.2.1.2 Study Date 20000101 4020

Most recent examination content:

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.3 CAD Processing and Findings Summary All algorithms succeeded; with findings 4101
1.3.1 Composite Feature Abnormal opacity 4102

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.3.1 Composite Feature Abnormal opacity 4102
1.3.1.1 Composite Feature Modifier Nodule 4102
1.3.1.2 Rendering Intent Presentation Required: … 4102
1.3.1.3 Tracking Identifier “Watchlist #1” 4108
1.3.1.4 Algorithm Name “Chest/CT Correlator” 4019
1.3.1.5 Algorithm Version “V2.1 4019
1.3.1.6 Composite type Target content items are related spatially 4103
1.3.1.7 Scope of Feature Feature detected on images from multiple modalities 4103
1.3.1.8 Diameter 4 cm 1400
1.3.1.8.1 Path 1400
1.3.1.8.1.1 IMAGE 3 [CT slice 104] 1400
1.3.1.9 Volume estimated from single 2D region 3.2 cm3 1402
1.3.1.9.1 Perimeter Outline 1402
1.3.1.9.1.1 IMAGE 3 [CT slice 104] 1402
1.3.1.10 Size Descriptor Small 4105
1.3.1.11 Border Shape Lobulated 4105
1.3.1.12 Location in Chest Mid lobe 4105
1.3.1.13 Laterality Right 4105
1.3.1.14 Composite Feature Abnormal opacity 4102
1.3.1.15 Single Image Finding Abnormal opacity 4104

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.3.1.14 Composite Feature Abnormal opacity 4102
1.3.1.14.1 Composite Feature Modifier Nodule 4102
1.3.1.14.2 Rendering Intent Presentation Required: … 4102
1.3.1.14.3 Tracking Identifier “Nodule #1” 4108
1.3.1.14.4 Algorithm Name “Nodule Builder” 4019
1.3.1.14.5 Algorithm Version “V1.4 4019
1.3.1.14.6 Composite type Target content items are related spatially 4103
1.3.1.14.7 Scope of Feature Feature detected on multiple images 4103
1.3.1.14.8 Diameter 4 cm 1400
1.3.1.14.9 Volume estimated from single 2D region 3.2 cm3 1402
1.3.1.14.10 Single Image Finding Abnormal opacity 4104
1.3.1.14.11 Single Image Finding Abnormal opacity 4104
1.3.1.14.12 Single Image Finding Abnormal opacity 4104

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.3.1.14.10 Single Image Finding Abnormal opacity 4104
1.3.1.14.10.1 Single Image Finding Modifier Nodule 4104
1.3.1.14.10.2 Rendering Intent Presentation Required: … 4104
1.3.1.14.10.3 Tracking Identifier “Detection #1” 4108
1.3.1.14.10.4 Algorithm Name “CT Nodule Detector” 4019
1.3.1.14.10.5 Algorithm Version “V2.5 4019
1.3.1.14.10.6 Center POINT 4107
1.3.1.14.10.6.1 IMAGE 2 [CT slice 103] 4107
1.3.1.14.10.7 Outline POLYLINE 4107
1.3.1.14.10.7.1 IMAGE 2 [CT slice 103] 4107

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.3.1.14.11 Single Image Finding Abnormal opacity 4104
1.3.1.14.11.1 Single Image Finding Modifier Nodule 4104
1.3.1.14.11.2 Rendering Intent Presentation Required: … 4104
1.3.1.14.11.3 Tracking Identifier “Detection #2” 4108
1.3.1.14.11.4 Algorithm Name “CT Nodule Detector” 4019
1.3.1.14.11.5 Algorithm Version “V2.5 4019
1.3.1.14.11.6 Center POINT 4107
1.3.1.14.11.6.1 IMAGE 3 [CT slice 104] 4107
1.3.1.14.11.7 Outline POLYLINE 4107
1.3.1.14.11.7.1 IMAGE 3 [CT slice 104] 4107

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.3.1.14.12 Single Image Finding Abnormal opacity 4104
1.3.1.14.12.1 Single Image Finding Modifier Nodule 4104
1.3.1.14.12.2 Rendering Intent Presentation Required: … 4104
1.3.1.14.12.3 Tracking Identifier “Detection #3” 4108
1.3.1.14.12.4 Algorithm Name “CT Nodule Detector” 4019
1.3.1.14.12.5 Algorithm Version “V2.5 4019
1.3.1.14.12.6 Center POINT 4107
1.3.1.14.12.6.1 IMAGE 4 [CT slice 105] 4107
1.3.1.14.12.7 Outline POLYLINE 4107
1.3.1.14.12.7.1 IMAGE 4 [CT slice 105] 4107

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.3.1.15 Single Image Finding Abnormal opacity 4104
1.3.1.15.1 Single Image Finding Modifier Nodule 4104
1.3.1.15.2 Rendering Intent Presentation Required: … 4104
1.3.1.15.3 Tracking Identifier “Watchlist #1” 4108
1.3.1.15.4 [Observation Context content items] 4022
1.3.1.15.5 Algorithm Name “Lung Nodule Detector” 4019
1.3.1.15.6 Algorithm Version “V1.3 4019
1.3.1.15.7 Center POINT 4107
1.3.1.15.7.1 Reference to node 1.2.1 4107
1.3.1.15.8 Outline POLYLINE 4107
1.3.1.15.8.1 Reference to node 1.2.1 4107
1.3.1.15.9 Diameter 4 cm 1400
1.3.1.15.9.1 Path POLYLINE 1400
1.3.1.15.9.1.1 Reference to Node 1.2.1 1400

Node Code Meaning of Concept Name Code Meaning of Example Value TID
1.4 Summary of Detections Succeeded 4100
1.4.1 Successful Detections 4015
1.4.1.1 Detection Performed Nodule 4017
1.4.1.1.1 Algorithm Name “CT Nodule Detector” 4019
1.4.1.1.2 Algorithm Version “V2.5 4019
1.4.1.1.3 IMAGE 2 [CT slice 103] 4017
1.4.1.1.4 IMAGE 3 [CT slice 104] 4017
1.4.1.1.5 IMAGE 4 [CT slice 105] 4017
1.5 Summary of Analyses Succeeded 4100
1.5.1 Successful Analyses 4016
1.5.1.1 Analysis Performed “Spatial colocation analysis” 4018
1.5.1.1.1 Algorithm Name “Chest/CT Correlator” 4019
1.5.1.1.2 Algorithm Version “V2.1 4019
1.5.1.1.3 Reference to node 1.2.1 4018
1.5.1.1.4 IMAGE 2 [CT slice 103] 4018
1.5.1.1.5 IMAGE 3 [CT slice 104] 4018
1.5.1.1.6 IMAGE 4 [CT slice 105] 4018
1.5.1.2 Analysis Performed “Spatial colocation analysis” 4018
1.5.1.2.1 Algorithm Name “Nodule Builder” 4019
1.5.1.2.2 Algorithm Version “V1.4 4019
1.5.1.2.3 IMAGE 2 [CT slice 103] 4018
1.5.1.2.4 IMAGE 3 [CT slice 104] 4018
1.5.1.2.5 IMAGE 4 [CT slice 105] 4018