The Digital X-Ray (DX) Image Information Object Definition specifies an image that has been created by a digital projection radiography imaging device.
Notes: 1. This includes but is not limited to: chest radiography, linear and multi-directional tomography, orthopantomography and skeletal radiography. Acquisition of image data may include but is not limited to: CCD-based sensors, stimulable phosphor imaging plates, amorphous selenium, scintillation based amorphous silicon and secondary capture of film-based images.
2. Specific IODs are defined for intra-oral radiography and mammography that further specialize the DX IOD.
A DX image shall consist of the result of a single X-Ray exposure, in order to ensure that the anatomical and orientation attributes are meaningful for the image, permitting safe annotation, appropriate image processing and appropriate dissemination.
Notes: 1. This requirement specifically deprecates the common film/screen and Computed Radiography practice of making multiple exposures on different areas of a cassette or plate by using lead occlusion between exposures. Such acquisitions could be separated and transformed into multiple DX images during an appropriate quality assurance step by an operator.
2. This requirement does not deprecate the acquisition of multiple paired structures during a single exposure, provided that they can be described by the relevant orientation Attributes. For example, an AP or PA projection of both hands side by side is typically obtained in a single exposure, and can be described by a Patient Orientation (0020,0020) of R\H or L\H since both hands are in the same traditional Anatomical Position. See PS 3.17 annex on Explanation of Patient Orientation.
The DX Image IOD is used in two SOP Classes as defined in PS 3.4 Storage Service Class, a SOP Class for storage of images intended for presentation, and a SOP Class for storage of images intended for further processing before presentation. These are distinguished by their SOP Class UID and by the Enumerated Value of the mandatory Attribute in the DX Series Module, Presentation Intent Type (0008,0068).
The E-R Model in Section A.1.2 depicts those components of the DICOM Information Model that directly reference the DX Image IOD.
Table A.26-1DIGITAL X-RAY IMAGE IOD MODULES
|Clinical Trial Subject||C.7.1.3||U|
|Clinical Trial Study||C.7.2.3||U|
|Clinical Trial Series||C.7.3.2||U|
|Frame of Reference||Frame of Reference||C.7.4.1||U|
|DX Anatomy Imaged||C.8.11.2||M|
|X-Ray Tomo Acquisition||C.8.7.7||U|
|X-Ray Acquisition Dose||C.8.7.8||U|
|Overlay Plane||C.9.2||C - Required if graphic annotation is present - See A.26.4|
|VOI LUT||C.11.2||C - Required if Presentation Intent Type (0008,0068) is FOR PRESENTATION. Shall not be present otherwise. See Note 8.|
|Acquisition Context||C.7.6.14||M – See A.26.5|
Notes: 1. The Overlay Plane requirement is determined by the presence of “graphic annotation”. Graphic annotation includes user or machine drawn graphics or text (such as computer assisted diagnosis) to indicate regions of interest or descriptions. It specifically does not include patient or image identification or technique information that is defined in other Attributes of the IOD..
2. The Device and Intervention Modules are User optional, though it is desirable that, if present, they are stored by an SCP. It is recognized that in some cases the digital image acquisition system will not have a user interface or direct connection that allows acquisition of these parameters, even if device or therapy have been used.
3. The Frame of Reference, X-Ray Collimator, DX Positioning and DX Tomo Acquisition Modules are User optional, though it is desirable that, if present, they are stored by an SCP. It is recognized that in some cases the parameters of the mechanical devices used for collimation, positioning and tomography may not be available to a digital image acquisition system that is not integrated with the X-Ray generation and positioning system.
4. The Histogram Module may contain a single or multiple statistical representations of the pixel data used to derive the VOI LUT Module, or intended to be used to derive or replace the VOI LUT Module. The Histogram Module may contain statistics of a subset of the stored image pixel data (such as from a cropped area or region of interest that is not the full field of view) that are useful for deriving a better VOI LUT than might be derived from the statistics obtained from the entire stored pixel data.
5. The Specimen Identification Module was previously included in this IOD but has been retired, and its functionality replaced by the Specimen Module. See PS 3.3-2008.
6. The VOI LUT Module Attributes and behavior are further specialized in the DX Image Module.
7. The Curve Module was previously included in this IOD but has been retired. See PS 3.3 2004.