A.6 Sample Documents

The SR sample document encoding includes information on the SR document body tree depth (column 1: SR Tree Depth), nesting level for nested artifacts such as sequences and sequence items (column 2: Nesting), DICOM attribute names (column 3: Attribute), DICOM tag (column 4: Tag), the DICOM attribute value representation (Column 5: VR as specified in PS 3.5), the hexadecimal value of value length (column 6: VL (hex)) and the sample document attribute values (column 7: Value).

A.6.1 DICOM SR “Basic Diagnostic Imaging Report” (TID 2000)

Sample document encoding (refer to section 5.1 for description)

SR Tree Depth Nesting Attribute Tag VR VL (hex) Value
Instance Creation Date (0008,0012) DA 0008 20060827
Instance Creation Time (0008,0013) TM 0006 224157
Instance Creator UID (0008,0014) UI 001c 1.2.276.0.7230010.3.0.3.5.4
SOP Class UID (0008,0016) UI 001e 1.2.840.10008.5.1.4.1.1.88.22
SOP Instance UID (0008,0018) UI 003c 1.2.840.113619.2.62.994044785528.20060823.200608232232322.9
Study Date (0008,0020) DA 0008 20060823
Content Date (0008,0023) DA 0008 20060823
Study Time (0008,0030) TM 0006 222400
Content Time (0008,0033) TM 0006 224352
Accession Number (0008,0050) SH 0008 10523475
Modality (0008,0060) CS 0002 SR
Manufacturer (0008,0070) LO 000a DicomWg20
Referring Physician's Name (0008,0090) PN 0010 Smith^John^^^MD
Procedure Code Sequence (0008,1032) SQ ffffffff
%item  
> Code Value (0008,0100) SH 0006 11123
> Coding Scheme Designator (0008,0102) SH 0008 99WUHID
> Code Meaning (0008,0104) LO 000c X-Ray Study
%enditem  
%endseq
Referenced Performed Procedure Step Sequence (0008,1111) SQ ffffffff
%endseq
Patient's Name (0010,0010) PN 0008 Doe^John
Patient ID (0010,0020) LO 000a 0000680029
Patient's Birth Date (0010,0030) DA 0008 19641128
Patient's Sex (0010,0040) CS 0002 M
Study Instance UID (0020,000d) UI 002e 1.2.840.113619.2.62.994044785528.114289542805
Series Instance UID (0020,000e) UI 0036 1.2.840.113619.2.62.994044785528.20060823223142485052
Study ID (0020,0010) SH 0008 10523475
Series Number (0020,0011) IS 0004 560
Instance Number (0020,0013) IS 0006 07851
1 Value Type (0040,a040) CS 000a CONTAINER
1 Concept Name Code Sequence (0040,a043) SQ ffffffff
1 %item  
1 > Code Value (0008,0100) SH 0008 18782-3
1 > Coding Scheme Designator (0008,0102) SH 0002 LN
1 > Code Meaning (0008,0104) LO 000c X-Ray Report
1 %enditem  
1 %endseq
1 Continuity Of Content (0040,a050) CS 0008 SEPARATE
Verifying Observer Sequence (0040,a073) SQ ffffffff
%item  
> Verifying Organization (0040,a027) LO 001a World University Hospital
> Verification DateTime (0040,a030) DT 000e 20060827141500
> Verifying Observer Name (0040,a075) PN 0012 Blitz^Richard^^^MD
> Verifying Observer Identification Code Sequence (0040,a088) SQ ffffffff
%item  
>> Code Value (0008,0100) SH 0008 08150000
>> Coding Scheme Designator (0008,0102) SH 0008 99WUHID
>> Code Meaning (0008,0104) LO 0016 Verifying Observer ID
%enditem  
%endseq
%enditem  
%endseq
Referenced Request Sequence (0040,a370) SQ ffffffff
%item  
> Accession Number (0008,0050) SH 0008 10523475
> Referenced Study Sequence (0008,1110) SQ ffffffff
%item  
>> Referenced SOP Class UID (0008,1150) UI 001a 1.2.840.10008.5.1.4.1.1.1
>> Referenced SOP Instance UID (0008,1155) UI 003c 1.2.840.113619.2.62.994044785528.20060823.200608232232322.3
%enditem  
%endseq
> Study Instance UID (0020,000d) UI 002e 1.2.840.113619.2.62.994044785528.114289542805
> Requested Procedure Description (0032,1060) LO 0020 CHEST TWO VIEWS, PA AND LATERAL
> Requested Procedure Code Sequence (0032,1064) SQ ffffffff
%item  
>> Code Value (0008,0100) SH 0006 11123
>> Coding Scheme Designator (0008,0102) SH 0008 99WUHID
>> Code Meaning (0008,0104) LO 000c X-Ray Study
%enditem  
%endseq
> Requested Procedure ID (0040,1001) SH 0006 123453
> Reason for the Requested Procedure (0040,1002) LO 0014 Suspected lung tumor
> Placer Order Number/Imaging Service Request (0040,2016) LO 0006 123451
> Filler Order Number/Imaging Service Request (0040,2017) LO 0006 123452
%enditem  
%endseq
Performed Procedure Code Sequence (0040,a372) SQ ffffffff
%item  
> Code Value (0008,0100) SH 0006 11123
> Coding Scheme Designator (0008,0102) SH 0008 99WUHID
> Code Meaning (0008,0104) LO 000c X-Ray Study
%enditem  
%endseq
Current Requested Procedure Evidence Sequence (0040,a375) SQ ffffffff
%item  
> Referenced Series Sequence (0008,1115) SQ ffffffff
%item  
>> Referenced SOP Sequence (0008,1199) SQ ffffffff
%item  
>>> Referenced SOP Class UID (0008,1150) UI 001a 1.2.840.10008.5.1.4.1.1.1
>>> Referenced SOP Instance UID (0008,1155) UI 003c 1.2.840.113619.2.62.994044785528.20060823.200608232232322.3
%enditem  
%item  
>>> Referenced SOP Class UID (0008,1150) UI 001a 1.2.840.10008.5.1.4.1.1.1
>>> Referenced SOP Instance UID (0008,1155) UI 003c 1.2.840.113619.2.62.994044785528.20060823.200608232231422.3
%enditem    
%endseq
>> Series Instance UID (0020,000e) UI 0036 1.2.840.113619.2.62.994044785528.20060823223142485051
%enditem  
%endseq
> Study Instance UID (0020,000d) UI 002e 1.2.840.113619.2.62.994044785528.114289542805
%enditem  
%endseq
Completion Flag (0040,a491) CS 0008 COMPLETE
Verification Flag (0040,a493) CS 0008 VERIFIED
1 Content Sequence (0040,a730) SQ ffffffff
1.1 %item  
1.1 > Relationship Type (0040,a010) CS 0010 HAS CONCEPT MOD
1.1 > Value Type (0040,a040) CS 0004 CODE
1.1 > Concept Name Code Sequence (0040,a043) SQ ffffffff
1.1 %item
1.1 >> Code Value (0008,0100) SH 0006 121049
1.1 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.1 >> Code Meaning (0008,0104) LO 0028 Language of Content Item and Descendants
1.1 %enditem
1.1 %endseq
1.1 > Concept Code Sequence (0040,a168) SQ ffffffff
1.1 %item  
1.1 >> Code Value (0008,0100) SH 0006 en-US
1.1 >> Coding Scheme Designator (0008,0102) SH 0008 ISO639_1
1.1 >> Code Meaning (0008,0104) LO 000e English (U.S.)
1.1 %enditem
1.1 %endseq
1.1 %enditem
1.2 %item
1.2 > Relationship Type (0040,a010) CS 0010 HAS CONCEPT MOD
1.2 > Value Type (0040,a040) CS 0004 TEXT
1.2 > Concept Name Code Sequence (0040,a043) SQ ffffffff
1.2 %item
1.2 >> Code Value (0008,0100) SH 0006 121050
1.2 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.2 >> Code Meaning (0008,0104) LO 0022 Equivalent Meaning of Concept Name
1.2 %enditem
1.2 %endseq
1.2 > Text Value (0040,a160) UT 001c Chest X-Ray, PA and LAT View
1.2 %enditem
1.3 %item
1.3 > Relationship Type (0040,a010) CS 0010 HAS OBS CONTEXT
1.3 > Value Type (0040,a040) CS 0004 CODE
1.3 > Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.3 %item
1.3 >> Code Value (0008,0100) SH 0006 121005
1.3 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.3 >> Code Meaning (0008,0104) LO 000e Observer Type
1.3 %enditem
1.3 %endseq
1.3 > Concept Code Sequence (0040,a168) SQ ffffffff  
1.3 %item
1.3 >> Code Value (0008,0100) SH 0006 121006
1.3 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.3 >> Code Meaning (0008,0104) LO 0006 Person
1.3 %enditem
1.3 %endseq
1.3 %enditem  
1.4 %item
1.4 > Relationship Type (0040,a010) CS 0010 HAS OBS CONTEXT
1.4 > Value Type (0040,a040) CS 0006 PNAME
1.4 > Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.4 %item
1.4 >> Code Value (0008,0100) SH 0006 121008
1.4 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.4 >> Code Meaning (0008,0104) LO 0014 Person Observer Name
1.4 %enditem
1.4 %endseq
1.4 > Person Name (0040,a123) PN 0012 Blitz^Richard^^^MD
1.4 %enditem
1.5 %item
1.5 > Relationship Type (0040,a010) CS 0008 CONTAINS
1.5 > Value Type (0040,a040) CS 000a CONTAINER
1.5 > Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.5 %item
1.5 >> Code Value (0008,0100) SH 0006 121060
1.5 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.5 >> Code Meaning (0008,0104) LO 0008 History
1.5 %enditem
1.5 %endseq
1.5 > Continuity Of Content (0040,a050) CS 0008 SEPARATE
1.5 > Content Sequence (0040,a730) SQ ffffffff  
1.5.1 %item
1.5.1 >> Relationship Type (0040,a010) CS 0008 CONTAINS
1.5.1 >> Value Type (0040,a040) CS 0004 TEXT
1.5.1 >> Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.5.1 %item
1.5.1 >>> Code Value (0008,0100) SH 0006 121060
1.5.1 >>> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.5.1 >>> Code Meaning (0008,0104) LO 0008 History
1.5.1 %enditem
1.5.1 %endseq
1.5.1 >> Text Value (0040,a160) UT 000c Sore throat.
1.5.1 %enditem
1.5 %endseq
1.5 %enditem
1.6 %item
1.6 > Relationship Type (0040,a010) CS 0008 CONTAINS
1.6 > Value Type (0040,a040) CS 000a CONTAINER
1.6 > Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.6 %item
1.6 >> Code Value (0008,0100) SH 0006 121070
1.6 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.6 >> Code Meaning (0008,0104) LO 0008 Findings
1.6 %enditem
1.6 %endseq
1.6 > Continuity Of Content (0040,a050) CS 0008 SEPARATE
1.6 > Content Sequence (0040,a730) SQ ffffffff  
1.6.1 %item
1.6.1 >> Relationship Type (0040,a010) CS 0008 CONTAINS
1.6.1 >> Value Type (0040,a040) CS 0004 TEXT
1.6.1 >> Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.6.1 %item
1.6.1 >>> Code Value (0008,0100) SH 0006 121071
1.6.1 >>> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.6.1 >>> Code Meaning (0008,0104) LO 0008 Finding
1.6.1 %enditem
1.6.1 %endseq
1.6.1 >> Text Value (0040,a160) UT 01ae The cardiomediastinum is within normal limits. The trachea is midline. The previously described opacity at the medial right lung base has cleared. There are no new infiltrates. There is a new round density at the left hilus, superiorly (diameter about 45mm). A CT scan is recommended for further evaluation. The pleural spaces are clear. The visualized musculoskeletal structures and the upper abdomen are stable and unremarkable.
1.6.1 >> Content Sequence (0040,a730) SQ ffffffff  
1.6.1.1 %item
1.6.1.1 >>> Relationship Type (0040,a010) CS 000e INFERRED FROM
1.6.1.1 >>> Observation DateTime (0040,a032) DT 000e 20060823223912
1.6.1.1 >>> Value Type (0040,a040) CS 0004 NUM
1.6.1.1 >>> Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.6.1.1 %item  
1.6.1.1 >>>> Code Value (0008,0100) SH 0008 M-02550
1.6.1.1 >>>> Coding Scheme Designator (0008,0102) SH 0004 SRT
1.6.1.1 >>>> Code Meaning (0008,0104) LO 0008 Diameter
1.6.1.1 %enditem
1.6.1.1 %endseq
1.6.1.1 >>> Measured Value Sequence (0040,a300) SQ ffffffff  
1.6.1.1 %item      
1.6.1.1 >>>> Measurement Units Code Sequence (0040,08ea) SQ ffffffff  
1.6.1.1 %item
1.6.1.1 >>>>> Code Value (0008,0100) SH 0002 mm
1.6.1.1 >>>>> Coding Scheme Designator (0008,0102) SH 0004 UCUM
1.6.1.1 >>>>> Code Meaning (0008,0104) LO 0002 mm
1.6.1.1 %enditem
1.6.1.1 %endseq
1.6.1.1 >>>> Numeric Value (0040,a30a) DS 0002 45
1.6.1.1 %enditem
1.6.1.1 %endseq
1.6.1.1 >>> Content Sequence (0040,a730) SQ ffffffff  
1.6.1.1.1 %item
1.6.1.1.1 >>>> Referenced SOP Sequence (0008,1199) SQ ffffffff  
1.6.1.1.1 %item
1.6.1.1.1 >>>>> Referenced SOP Class UID (0008,1150) UI 001a 1.2.840.10008.5.1.4.1.1.1
1.6.1.1.1 >>>>> Referenced SOP Instance UID (0008,1155) UI 003c 1.2.840.113619.2.62.994044785528.20060823.200608232232322.3
1.6.1.1.1 %enditem
1.6.1.1.1 %endseq
1.6.1.1.1 >>>> Relationship Type (0040,a010) CS 000e INFERRED FROM
1.6.1.1.1 >>>> Value Type (0040,a040) CS 0006 IMAGE
1.6.1.1.1 >>>> Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.6.1.1.1 %item
1.6.1.1.1 >>>>> Code Value (0008,0100) SH 0006 121112
1.6.1.1.1 >>>>> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.6.1.1.1 >>>>> Code Meaning (0008,0104) LO 0016 Source of Measurement
1.6.1.1.1 %enditem
1.6.1.1.1 %endseq
1.6.1.1.1 %enditem
1.6.1.1 %endseq
1.6.1.1 %enditem
1.6.1 %endseq
1.6.1 %enditem
1.6 %endseq
1.6 %enditem
1.7 %item
1.7 > Relationship Type (0040,a010) CS 0008 CONTAINS
1.7 > Value Type (0040,a040) CS 000a CONTAINER
1.7 > Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.7 %item
1.7 >> Code Value (0008,0100) SH 0006 121072
1.7 >> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.7 >> Code Meaning (0008,0104) LO 000c Impressions
1.7 %enditem
1.7 %endseq
1.7 > Continuity Of Content (0040,a050) CS 0008 SEPARATE
1.7 > Content Sequence (0040,a730) SQ ffffffff  
1.7.1 %item
1.7.1 >> Relationship Type (0040,a010) CS 0008 CONTAINS
1.7.1 >> Value Type (0040,a040) CS 0004 TEXT
1.7.1 >> Concept Name Code Sequence (0040,a043) SQ ffffffff  
1.7.1 %item
1.7.1 >>> Code Value (0008,0100) SH 0006 121073
1.7.1 >>> Coding Scheme Designator (0008,0102) SH 0004 DCM
1.7.1 >>> Code Meaning (0008,0104) LO 000a Impression
1.7.1 %enditem
1.7.1 %endseq
1.7.1 >> Text Value (0040,a160) UT 009c No acute cardiopulmonary process. Round density in left superior hilus, further evaluation with CT is recommended as underlying malignancy is not excluded.
1.7.1 %enditem
1.7 %endseq
1.7 %enditem
1 %endseq
A.6.2 Transcoded HL7 CDA Release 2 “Diagnostic Imaging Report”

<?xml version="1.0" encoding="UTF-8"?>

<?xml-stylesheet type="text/xsl" href="CDA-DIR.xsl"?>

<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"; xsi:schemaLocation="urn:hl7-org:v3 CDA.xsd">

<realmCode code="UV"/>

<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>

<templateId root="2.16.840.1.113883.10.20.6"/>

<id root="1.2.840.113619.2.62.994044785528.12" extension="20060828170821659"/>

<code code="18748-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnostic Imaging Report"/>

<!-- from DICOM TID 1210 "Equivalent Meaning(s) of Concept Name" (Concept Modifier to DICOM SR document report title) -->

<title>Chest X-Ray, PA and LAT View</title>

<!-- /from TID 1210 -->

<effectiveTime value="20060828170821"/>

<!-- CDA DIR effective time usually will be different from SR study date and SR content date and time-->

<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>

<languageCode code="en-US"/>

<recordTarget>

<patientRole>

<id root="1.2.840.113619.2.62.994044785528.10" extension="0000680029"/>

<!-- Unique identifier for root: {root}.10 = patient ID list added based on organizational policy (not present in SR sample document because root is not specified by DICOM. DICOM Patient ID (0010,0020) value inserted into extension -->

<addr nullFlavor="NI"/>

<telecom nullFlavor="NI"/>

<patient>

<name>

<given>John</given>

<family>Doe</family>

</name>

<administrativeGenderCode codeSystem="2.16.840.1.113883.5.1" code="M"/>

<birthTime value="19641128"/>

</patient>

</patientRole>

</recordTarget>

<author>

<time value="20060823224352"/>

<assignedAuthor>

<id extension="121008" root="2.16.840.1.113883.19.5"/>

<addr nullFlavor="NI"/>

<telecom nullFlavor="NI"/>

<assignedPerson>

<name>

<given>Richard</given>

<family>Blitz</family>

<suffix>MD</suffix>

</name>

</assignedPerson>

</assignedAuthor>

</author>

<custodian>

<!-- custodian values have been added based on organizational policy (in this case they are not mapped from the SR sample document)-->

<assignedCustodian>

<representedCustodianOrganization>

<id root="2.16.840.1.113883.19.5"/>

<name>World University Hospital</name>

<telecom nullFlavor="NI"/>

<addr nullFlavor="NI"/>

</representedCustodianOrganization>

</assignedCustodian>

</custodian>

<!-- legal authenticator present in sample, document is VERIFIED -->

<legalAuthenticator>

<time value="20060827141500"/>

<!-- verification date time (0040,A030)-->

<signatureCode code="S"/>

<assignedEntity>

<id extension="08150000" root="1.2.840.113619.2.62.994044785528.33"/>

<addr nullFlavor="NI"/>

<telecom nullFlavor="NI"/>

<assignedPerson>

<name>

<given>Richard</given>

<family>Blitz</family>

<suffix>MD</suffix>

</name>

</assignedPerson>

</assignedEntity>

</legalAuthenticator>

<!-- Mapped from Referring physicians name (0008,0090) SR sample document -->

<participant typeCode="REF">

<associatedEntity classCode="PROV">

<id nullFlavor="NI"/>

<addr nullFlavor="NI"/>

<telecom nullFlavor="NI"/>

<associatedPerson>

<name>

<given>John</given>

<family>Smith</family>

<suffix>MD</suffix>

</name>

</associatedPerson>

</associatedEntity>

</participant>

<inFulfillmentOf>

<order>

<id extension="10523475" root="1.2.840.113619.2.62.994044785528.27"/>

<!-- {root}.27 of accession number added based on organizational policy (not present in SR sample document because root is not specified by DICOM). Accession number value used in extension -->

<id extension="123452" root="1.2.840.113619.2.62.994044785528.28"/>

<!-- {root}.28 of filler order number added based on organizational policy (not present in SR sample document because root is not specified by DICOM). Filler number value used in extension -->

<id extension="123451" root="1.2.840.113619.2.62.994044785528.29"/>

<!-- {root}.29 of placer order number added based on organizational policy (not present in SR sample document because root is not specified by DICOM). Placer number value used in extension -->

</order>

</inFulfillmentOf>

<documentationOf>

<serviceEvent classCode="ACT">

<id root="1.2.840.113619.2.62.994044785528.114289542805"/>

<!-- study instance UID -->

<code nullFlavor="NI"/>

<effectiveTime value="20060823222400"/>

</serviceEvent>

</documentationOf>

<!-- transformation of a DICOM SR -->

<relatedDocument typeCode="XFRM">

<parentDocument>

<id root="1.2.840.113619.2.62.994044785528.20060823.200608232232322.9"/>

<!-- SOP Instance UID (0008,0018) of SR sample document-->

</parentDocument>

</relatedDocument>

<component>

<structuredBody>

<component>

<!--

**********************************************************************

DICOM Object Catalog Section

**********************************************************************

-->

<section classCode="DOCSECT" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.1.1"/>

<code code="121181" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="DICOM Object Catalog"/>

<entry>

<!--

**********************************************************************

Study

**********************************************************************

-->

<act classCode="ACT" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.2.6"/>

<id root="1.2.840.113619.2.62.994044785528.114289542805"/>

<code code="113014" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Study"/>

<!--

*****************************************************************

Series (Parent SR Document)

*****************************************************************

-->

<entryRelationship typeCode="COMP">

<act classCode="ACT" moodCode="EVN">

<id root="1.2.840.113619.2.62.994044785528.20060823222132232023"/>

<code code="113015" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Series">

<qualifier>

<name code="121139" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Modality"> </name>

<value code="CR" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="SR Document"> </value>

</qualifier>

</code>

<!--

*****************************************************************

SopInstance UID

*****************************************************************

-->

<!-- Reference to SR Document -->

<entryRelationship typeCode="COMP">

<observation classCode="DGIMG" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.2.8"/>

<id root="1.2.840.113619.2.62.994044785528.20060823.200608242334312.3"/>

<code code="1.2.840.10008.5.1.4.1.1.88.22" codeSystem="1.2.840.10008.2.6.1" codeSystemName="DCMUID" displayName="Enhanced SR"> </code>

<text mediaType="application/dicom">

<reference value="http://www.example.org/wado?requestType=WADO&amp;studyUID=1.2.840.113619.2.62.994044785528.114289542805&amp;seriesUID=1.2.840.113619.2.62.994044785528.20060823222132232023&amp;objectUID=1.2.840.113619.2.62.994044785528.20060823.200608232232322.9&amp;contentType=application/dicom"/>;

<!--reference to image 1 (PA) -->

</text>

<effectiveTime value="20060823223232"/>

</observation>

</entryRelationship>

</act>

</entryRelationship>

<!--

*****************************************************************

Series (CR Images)

*****************************************************************

-->

<entryRelationship typeCode="COMP">

<act classCode="ACT" moodCode="EVN">

<id root="1.2.840.113619.2.62.994044785528.20060823223142485051"/>

<code code="113015" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Series">

<qualifier>

<name code="121139" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Modality"> </name>

<value code="CR" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Computed Radiography"> </value>

</qualifier>

</code>

<!--

*****************************************************************

SopInstance UID

*****************************************************************

-->

<!-- 2 References (chest PA and LAT) -->

<entryRelationship typeCode="COMP">

<observation classCode="DGIMG" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.2.8"/>

<id root="1.2.840.113619.2.62.994044785528.20060823.200608232232322.3"/>

<code code="1.2.840.10008.5.1.4.1.1.1" codeSystem="1.2.840.10008.2.6.1" codeSystemName="DCMUID" displayName="Computed Radiography Image Storage"> </code>

<text mediaType="application/dicom">

<reference value="http://www.example.org/wado?requestType=WADO&amp;studyUID=1.2.840.113619.2.62.994044785528.114289542805&amp;seriesUID=1.2.840.113619.2.62.994044785528.20060823223142485051&amp;objectUID=1.2.840.113619.2.62.994044785528.20060823.200608232232322.3&amp;contentType=application/dicom"/>;

<!--reference to image 1 (PA) -->

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<effectiveTime value="20060823223232"/>

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<observation classCode="DGIMG" moodCode="EVN">

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<id root="1.2.840.113619.2.62.994044785528.20060823.200608232231422.3"/>

<code code="1.2.840.10008.5.1.4.1.1.1" codeSystem="1.2.840.10008.2.6.1" codeSystemName="DCMUID" displayName="Computed Radiography Image Storage"> </code>

<text mediaType="application/dicom">

<reference value="http://www.example.org/wado?requestType=WADO&amp;studyUID=1.2.840.113619.2.62.994044785528.114289542805&amp;seriesUID=1.2.840.113619.2.62.994044785528.20060823223142485051&amp;objectUID=1.2.840.113619.2.62.994044785528.20060823.200608232231422.3&amp;contentType=application/dicom"/>;

<!--reference to image 2 (LAT) -->

</text>

<effectiveTime value="20060823223142"/>

</observation>

</entryRelationship>

</act>

</entryRelationship>

</act>

</entry>

</section>

<!--

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End of DICOM Object Catalog Section

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-->

</component>

<component>

<!--

**********************************************************************

Reason for study Section

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The original DICOM SR document that is mapped does not contain a "Indications for Procedure" section. The attribute value "Reason for the Requested Procedure" (0040,1002) within the Referenced Request Sequence (0040,A370) of the SR header has been mapped under the assumption that the header attribute value has been displayed to and included by the legal authenticator.

-->

<section>

<code code="121109" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Indications for Procedure"/>

<title>Indications for Procedure</title>

<text>Suspected lung tumor</text>

</section>

<!--

**********************************************************************

Reason for study Section

**********************************************************************

-->

</component>

<component>

<!--

**********************************************************************

History Section

**********************************************************************

-->

<section>

<code code="121060" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="History"/>

<title>History</title>

<text>

<paragraph>

<caption>History</caption>

<content ID="Fndng1">Sore throat.</content>

</paragraph>

</text>

<entry>

<!-- History report element (TEXT) -->

<observation classCode="OBS" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.2.12"/>

<code code="121060" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="History"/> <value xsi:type="ED">

<reference value="#Fndng1"/>

</value>

</observation>

</entry>

</section>

<!--

**********************************************************************

End of History Section

**********************************************************************

-->

</component>

<component>

<!--

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Findings Section

**********************************************************************

-->

<section>

<templateId root="2.16.840.1.113883.10.20.6.1.2"/>

<code code="121070" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Findings"/>

<title>Findings</title>

<text>

<paragraph>

<caption>Finding</caption>

<content ID="Fndng2">The cardiomediastinum is within normal limits. The

trachea is midline. The previously described opacity at the medial

right lung base has cleared. There are no new infiltrates. There is

a new round density at the left hilus, superiorly (diameter about

45mm). A CT scan is recommended for further evaluation. The pleural

spaces are clear. The visualized musculoskeletal structures and the

upper abdomen are stable and unremarkable.</content>

</paragraph>

<paragraph>

<caption>Diameter</caption>

<content ID="Diam2">45mm</content>

</paragraph>

<paragraph>

<caption>Source of Measurement</caption>

<content ID="SrceOfMeas2">

<linkHtml href="http://www.example.org/wado?requestType=WADO&amp;studyUID=1.2.840.113619.2.62.994044785528.114289542805&amp;seriesUID=1.2.840.113619.2.62.994044785528.20060823223142485051&amp;objectUID=1.2.840.113619.2.62.994044785528.20060823.200608232232322.3&amp;contentType=application/dicom">Chest_PA </linkHtml>

</content>

</paragraph>

</text>

<entry>

<observation classCode="OBS" moodCode="EVN">

<!-- Text Observation -->

<templateId root="2.16.840.1.113883.10.20.6.2.12"/>

<code code="121071" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Finding"/>

<value xsi:type="ED">

<reference value="#Fndng2"/>

</value>

<!-- inferred from measurement -->

<entryRelationship typeCode="SPRT">

<observation classCode="OBS" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.2.14"/>

<code code="246120007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" displayName="Nodule size">

<originalText>

<reference value="#Diam2"/>

</originalText>

</code>

<!-- no DICOM attribute <statusCode code="completed"/> -->

<effectiveTime value="20060823223912"/>

<value xsi:type="PQ" value="45" unit="mm"/>

<!-- inferred from image -->

<entryRelationship typeCode="SUBJ">

<observation classCode="DGIMG" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.2.8"/>

<!-- (0008,1155) Referenced SOP Instance UID-->

<id root="1.2.840.113619.2.62.994044785528.20060823.200608232232322.3"/>

<!-- (0008,1150) Referenced SOP Class UID -->

<code code="1.2.840.10008.5.1.4.1.1.1" codeSystem="1.2.840.10008.2.6.1" codeSystemName="DCMUID" displayName="Computed Radiography Image Storage"> </code>

<text mediaType="application/dicom">

<!--reference to CR DICOM image (PA view) -->

<reference value="http://www.example.org/wado?requestType=WADO&amp;studyUID=1.2.840.113619.2.62.994044785528.114289542805&amp;seriesUID=1.2.840.113619.2.62.994044785528.20060823223142485051&amp;objectUID=1.2.840.113619.2.62.994044785528.20060823.200608232232322.3&amp;contentType=application/dicom"/>;

</text>

<effectiveTime value="20060823223232"/>

<!-- Purpose of Reference -->

<entryRelationship typeCode="RSON">

<observation classCode="OBS" moodCode="EVN">

<templateId root="2.16.840.1.113883.10.20.6.2.9"/>

<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>

<value xsi:type="CD" code="121112" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Source of Measurement">

<originalText>

<reference value="#SrceOfMeas2"/>

</originalText>

</value>

</observation>

</entryRelationship>

</observation>

</entryRelationship>

</observation>

</entryRelationship>

</observation>

</entry>

</section>

<!--

**********************************************************************

End of Findings Section

**********************************************************************

-->

</component>

<component>

<!--

**********************************************************************

Impressions Section

**********************************************************************

-->

<section>

<code code="121072" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Impressions"/>

<title>Impressions</title>

<text>

<paragraph>

<caption>Impression</caption>

<content ID="Fndng3">No acute cardiopulmonary process. Round density in

left superior hilus, further evaluation with CT is recommended as

underlying malignancy is not excluded.</content>

</paragraph>

</text>

<entry>

<!-- Impression report element (TEXT) -->

<observation classCode="OBS" moodCode="EVN">

<!-- Text Observation -->

<templateId root="2.16.840.1.113883.10.20.6.2.12"/>

<code code="121073" codeSystem="1.2.840.10008.2.16.4" codeSystemName="DCM" displayName="Impression"/>

<value xsi:type="ED">

<reference value="#Fndng3"/>

</value>

</observation>

</entry>

</section>

<!--

**********************************************************************

End of Impressions Section

**********************************************************************

-->

</component>

</structuredBody>

</component>

</ClinicalDocument>