C.17.3 SR Document Content Module

This section specifies the Attributes contained in the SR Document Content Module. The Attributes in this Module convey the content of an SR Document.

Table C.17-4SR DOCUMENT CONTENT MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Include Document Content Macro Table C.17-5. with a Value Type (0040,A040) of CONTAINER
Include Document Relationship Macro Table C.17-6.

Table C.17-5DOCUMENT CONTENT MACRO ATTRIBUTES

Attribute Name Tag Type Attribute Description
Value Type (0040,A040) 1 The type of the value encoded in this Content Item. Defined Terms: TEXT NUM CODE DATETIME DATE TIME UIDREF PNAME COMPOSITE IMAGE WAVEFORM SCOORD SCOORD3D TCOORD CONTAINER See C.17.3.2.1 for further explanation.
Concept Name Code Sequence (0040,A043) 1C Code describing the concept represented by this Content Item. Also conveys the value of Document Title and section headings in documents. Only a single Item shall be included in this sequence. Required if Value Type (0040,A040) is TEXT, NUM, CODE, DATETIME, DATE, TIME, UIDREF or PNAME. Required if Value Type (0040,A040) is CONTAINER and a heading is present, or this is the Root Content Item. Note: That is, containers without headings do not require Concept Name Code Sequence Required if Value Type (0040,A040) is COMPOSITE, IMAGE, WAVEFORM, SCOORD, SCOORD3D or TCOORD, and the Purpose of Reference is conveyed in the Concept Name. See C.17.3.2.2 for further explanation.
>Include 'Code Sequence Macro' Table 8.8-1 No Baseline Context ID.
Text Value (0040,A160) 1C This is the value of the Content Item. Required if Value Type (0040,A040) is TEXT. Text data which is unformatted and whose manner of display is implementation dependent. The text value may contain spaces, as well as multiple lines separated by either LF, CR, CR LF or LF CR, but otherwise no format control characters (such as horizontal or vertical tab and form feed) shall be present, even if permitted by the Value Representation of UT. The text shall be interpreted as specified by Specific Character Set (0008,0005) if present in the SOP Common Module. Note: The text may contain single or multi-byte characters and use code extension techniques as described in PS 3.5 if permitted by the values of Specific Character Set (0008,0005).
DateTime (0040,A120) 1C This is the value of the Content Item. Required if Value Type (0040,A040) is DATETIME.
Date (0040,A121) 1C This is the value of the Content Item. Required if Value Type (0040,A040) is DATE.
Time (0040,A122) 1C This is the value of the Content Item. Required if Value Type (0040,A040) is TIME.
Person Name (0040,A123) 1C This is the value of the Content Item. Required if Value Type (0040,A040) is PNAME.
UID (0040,A124) 1C This is the value of the Content Item. Required if Value Type (0040,A040) is UIDREF.
Include 'Numeric Measurement Macro' Table C.18.1-1 if and only if Value Type (0040,A040) is NUM.
Include 'Code Macro' Table C.18.2-1 if and only if Value Type (0040,A040) is CODE.
Include 'Composite Object Reference Macro' Table C.18.3-1 if and only if Value Type (0040,A040) is COMPOSITE.
Include 'Image Reference Macro' Table C.18.4-1 if and only if Value Type (0040,A040) is IMAGE.
Include 'Waveform Reference Macro' Table C.18.5-1 if and only if Value Type (0040,A040) is WAVEFORM.
Include 'Spatial Coordinates Macro' Table C.18.6-1 if and only if Value Type (0040,A040) is SCOORD.
Include ‘3D Spatial Coordinates Macro' Table C.18.9-1 if and only if Value Type (0040,A040) is SCOORD3D.
Include 'Temporal Coordinates Macro' Table C.18.7-1 if and only if Value Type (0040,A040) is TCOORD.
Include 'Container Macro' Table C.18.8-1 if and only if Value Type (0040,A040) is CONTAINER.

Table C.17-6DOCUMENT RELATIONSHIP MACRO ATTRIBUTES

Attribute Name Tag Type Attribute Description
Observation DateTime (0040,A032) 1C The date and time on which this Content Item was completed. For the purpose of recording measurements or logging events, completion time is defined as the time of data acquisition of the measurement, or the time of occurrence of the event. Required if the date and time are different from the Content Date (0008,0023) and Content Time (0008,0033) or the Observation DateTime (0040,A032) defined in higher items. May be present otherwise. Note: When Content Items are copied into successor reports, the Content Date (0008,0023) and Content Time (0008,0033) of the new report are likely to be different than the date and time of the original observation. Therefore this attribute may need to be included in any copied Content Items to satisfy the condition.
Content Sequence (0040,A730) 1C A potentially recursively nested Sequence of Items that conveys content that is the Target of Relationships with the enclosing Source Content Item. One or more Items shall be included in this sequence. Required if the enclosing Content Item has relationships. Notes: 1. If this Attribute is not present then the enclosing Item is a leaf. 2. The order of Items within this Sequence is semantically significant for presentation. See C.17.3.2.4 for further explanation.
>Relationship Type (0040,A010) 1 The type of relationship between the (enclosing) Source Content Item and the Target Content Item. IODs specify additional constraints on Relationships (including lists of Enumerated Values). Defined Terms: CONTAINS HAS PROPERTIES HAS OBS CONTEXT HAS ACQ CONTEXT INFERRED FROM SELECTED FROM HAS CONCEPT MOD See C.17.3.2.4 for further explanation.
>Include Document Relationship Macro Table C.17-6 if the Target Content Item is included by-value in the Source Content Item. The Macro shall not be present if the relationship is by-reference.
>Include Document Content Macro Table C.17-5 if the Target Content Item is included by-value in the Source Content Item. The Macro shall not be present if the relationship is by-reference.
>Referenced Content Item Identifier (0040,DB73) 1C An ordered set of one or more integers that uniquely identifies the Target Content Item of the relationship. The root Content Item is referenced by a single value of 1. Each subsequent integer represents an ordinal position of a Content Item in the Content Sequence (0040,A730) in which it belongs. The Referenced Content Item Identifier is the set of these ordinal positions along the by-value relationship path. The number of values in this Multi-Value Attribute is exactly the number of relationships traversed in the SR content tree plus one. Note: 1. See C.17.3.2.5. 2. Content Items are ordered in a Content Sequence starting from 1 as defined in VR of SQ (See PS 3.5). Required if the Target Content Item is denoted by-reference, i.e. the Document Relationship Macro and Document Content Macro are not included.

C.17.3.1 SR Document Content Tree

The Module consists of a single root Content Item that is the root of the SR Document tree. The root Content Item is of type CONTAINER, and its Content Sequence conveys either directly or indirectly through further nested Content Sequences, all of the other Content Items in the document. This root Content Item shall have a heading in the Concept Name Code Sequence (0040,A043) that conveys the title of the SR Document, i.e. the Document Title.

Figure C.17.3-1 depicts the relationship of SR Documents to Content Items and the relationships of Content Items to other Content Items and to Observation Context.

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Figure C.17.3-1SR Information Model

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Note: Whether or not relationships by-reference are allowed to ancestor Content Items, is specified in the IOD.

Figure C.17.3-2 - Example of an SR Content Tree (Informative)

C.17.3.2 Content Item Attributes

Each Content Item contains:

- name/value pair, consisting of

- a single Concept Name Code Sequence (0040,A043) that is the name of a name/value pair or a heading,

- a value (text, codes, etc.),

- references to images, waveforms or other composite objects, with or without coordinates,

- relationships to other Items, either

- by-value through nested Content Sequences, or

- by-reference.

C.17.3.2.1 Content Item Value Type

The value of the name/value pair is encoded with one of the Value Types defined in Table C.17.3-7 (the choice of which may be constrained by the IOD in which this Module is contained). The Value Type (0040,A040) attribute explicitly conveys the type of Content Item value encoding.

Table C.17.3-7VALUE TYPE DEFINITIONS

Value Type Concept Name Concept Value Description
TEXT Type of text, e.g. "Findings", or name of identifier, e.g. “Lesion ID” Textual expression of the concept Free text, narrative description of unlimited length. May also be used to provide a label or identifier value.
NUM Type of numeric value or measurement, e.g. "BPD" Numeric value and associated Unit of Measurement Numeric value fully qualified by coded representation of the measurement name and unit of measurement.
CODE Type of code, e.g. "Findings" Coded expression of the concept Categorical coded value. Representation of nominal or non-numeric ordinal values.
DATETIME Type of DateTime, e.g. "Date/Time of onset" Concatenated date and time Date and time of occurrence of the type of event denoted by the Concept Name.
DATE Type of Date, e.g. "Birth Date" Calendar date Date of occurrence of the type of event denoted by the Concept Name.
TIME Type of Time, e.g "Start Time" Time of day Time of occurrence of the type of event denoted by the Concept Name.
UIDREF Type of UID, e.g "Study Instance UID" Unique Identifier Unique Identifier (UID) of the entity identified by the Concept Name.
PNAME Role of person, e.g., "Recording Observer" Name of person Person name of the person whose role is described by the Concept Name.
COMPOSITE Purpose of Reference Reference to UIDs of Composite SOP Instances A reference to one Composite SOP Instance which is not an Image or Waveform.
IMAGE Purpose of Reference Reference to UIDs of Image Composite SOP Instances A reference to one Image. IMAGE Content Item may convey a reference to a Softcopy Presentation State associated with the Image.
WAVEFORM Purpose of Reference Reference to UIDs of Waveform Composite SOP Instances A reference to one Waveform.
SCOORD Purpose of Reference Listing of spatial coordinates Spatial coordinates of a geometric region of interest in the DICOM image coordinate system. The IMAGE Content Item from which spatial coordinates are selected is denoted by a SELECTED FROM relationship.
SCOORD3D Purpose of reference Listing of spatial 3D coordinates 3D spatial coordinates (x,y,z) of a geometric region of interest in a Reference Coordinate System.
TCOORD Purpose of Reference Listing of temporal coordinates Temporal Coordinates (i.e. time or event-based coordinates) of a region of interest in the DICOM waveform coordinate system. The WAVEFORM or IMAGE or SCOORD Content Item from which Temporal Coordinates are selected is denoted by a SELECTED FROM relationship.
CONTAINER Document Title or document section heading. Concept Name conveys the Document Title (if the CONTAINER is the Document Root Content Item) or the category of observation. The content of the CONTAINER. The value of a CONTAINER Content Item is the collection of Content Items that it contains. CONTAINER groups Content Items and defines the heading or category of observation that applies to that content. The heading describes the content of the CONTAINER Content Item and may map to a document section heading in a printed or displayed document.

Note: It is recommended that drawings and sketches, sometimes used in reports, be represented byIMAGE Content Items that reference separate SOP Instances (e.g., 8-bit, MONOCHROME2, Secondary Capture, or Multi-frame Single Bit Secondary Capture).

C.17.3.2.2 Concept Name Code Sequence

The Concept Name Code Sequence (0040,A043) conveys the name of the concept whose value is expressed by the value attribute or set of attributes. Depending on the Value Type (0040,A040), the meaning of the Concept Name Code Sequence may reflect specifics of the use of the particular data type (see Table C.17.3-7).

C.17.3.2.3 Continuity of Content

See Section C.18.8.1.1.

C.17.3.2.4 Content Sequence and Relationship Type

The Content Sequence (0040,A730) provides the hierarchical structuring of the Content Tree (see C.17.3.1) by recursively nesting Content Items. A parent (or source) Content Item has an explicit relationship to each child (or target) Content Item, conveyed by the Relationship Type (0040,A010) attribute.

Table C.17.3-8 describes the Relationship Types between Source Content Items and the Target Content Items.

Table C.17.3-8RELATIONSHIP TYPE DEFINITIONS

Relationship Type Description Definition and Example
CONTAINS Contains Source Item contains Target Content Item. E.g.: CONTAINER "History" {CONTAINS: TEXT “mother had breast cancer”, CONTAINS: IMAGE}
HAS OBS CONTEXT Has Observation Context Target Content Items shall convey any specialization of Observation Context needed for unambiguous documentation of the Source Content Item. E.g: CONTAINER "Report" {HAS OBS CONTEXT: PNAME “Recording Observer” = “Smith^John^^Dr^”}
HAS CONCEPT MOD Has Concept Modifier Used to qualify or describe the Concept Name of the Source Content item, such as to create a post-coordinated description of a concept, or to further describe a concept. E.g. CODE "Chest X-Ray" {HAS CONCEPT MOD: CODE "View = PA and Lateral"} E.g. CODE "Breast" {HAS CONCEPT MOD: TEXT "French Translation" = "Sein"} E.g. CODE "2VCXRPALAT" {HAS CONCEPT MOD: TEXT "Further Explanation" = "Chest X-Ray, Two Views, Postero-anterior and Lateral"}
HAS PROPERTIES Has Properties Description of properties of the Source Content Item. E.g: CODE "Mass" {HAS PROPERTIES: CODE “anatomic location”, HAS PROPERTIES: CODE “diameter”, HAS PROPERTIES: CODE “margin”, ...}.
HAS ACQ CONTEXT Has Acquisition Context The Target Content Item describes the conditions present during data acquisition of the Source Content Item. E.g: IMAGE {HAS ACQ CONTEXT: CODE “contrast agent”, HAS ACQ CONTEXT: CODE “position of imaging subject”, ...}.
INFERRED FROM Inferred From Source Content Item conveys a measurement or other inference made from the Target Content Items. Denotes the supporting evidence for a measurement or judgment. E.g: CODE "Malignancy" {INFERRED FROM: CODE "Mass", INFERRED FROM: CODE "Lymphadenopathy",...}. E.g: NUM: "BPD” = “5mm" {INFERRED FROM: SCOORD}.
SELECTED FROM Selected From Source Content Item conveys spatial or temporal coordinates selected from the Target Content Item(s). E.g: SCOORD "POLYLINE1,1 5,10 5,10 1,10 1,1" {SELECTED FROM: IMAGE}. E.g: TCOORD "SEGMENT 60-200mS" {SELECTED FROM: WAVEFORM}.

C.17.3.2.5 Referenced Content Item Identifier

Content Items are identified by their position in the Content Item tree. They have an implicit order as defined by the order of the Sequence Items. When a Content Item is the target of a by-reference relationship, its position is specified in the Referenced Content Item Identifier (0040,DB73) in a Content Sequence Item subsidiary to the source Content Item.

Note: Figure C.17.3-3 illustrates an SR content tree and identifiers associated with each Content Item:

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Figure C.17.3-3 Use of Position as SR Content Item Identifier (Informative)