A. Enhanced CT Image IOD Content Constraints

The General Image Module, Overlay Plane Module and VOI LUT Module shall not be used in a Standard Extended SOP Class of the Enhanced CT Image.

Notes: 1. In order to annotate images, whether during acquisition or subsequently, SOP Instances of the Grayscale Softcopy Presentation State Storage or the Structured Report Storage SOP Classes that reference the image SOP Instance, may be used.

No standard mechanism is provided for inclusion of annotations within the image SOP Instance itself, and implementers are discouraged from using private extensions to circumvent this restriction.

Grayscale Softcopy Presentation State Storage Instances that are generated during acquisition may be referenced from the Image SOP Instance by using the Referenced Grayscale Presentation State Sequence in the Enhanced CT Image Module. See C.8.15.2.

2. The Curve Module was previously include in the list of Modules that shall not be present, but has been retired from DICOM. It is still not permitted to be present. See PS 3.3 2004.

3. 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.