The Frame of Reference UID (0020,0052) shall be used to uniquely identify a frame of reference for a series. Each series shall have a single Frame of Reference UID. However, multiple Series within a Study may share a Frame of Reference UID. All images in a Series that share the same Frame of Reference UID shall be spatially related to each other.
Notes: 1. Previous versions of this Standard defined a Data Element "Location", which has been retired. Frame of Reference UID provides a completely unambiguous identification of the image location reference used to indicate position.
2. A common Frame of Reference UID may be used to spatially relate localizer images with a set of transverse images. However, in some cases (eg. multiple localizer images being related to a single set of transverse images) a common Frame of Reference UID may not be sufficient. The Referenced Image Sequence (0008,1140) provides an unambiguous method for relating localizer images.
The Position Reference Indicator (0020,1040) specifies the part of the imaging target that was used as a reference point associated with a specific Frame of Reference UID. The Position Reference Indicator may or may not coincide with the origin of the fixed frame of reference related to the Frame of Reference UID.
For a Patient-related Frame of Reference, this is an anatomical reference point such as the iliac crest, orbital-medial, sternal notch, symphysis pubis, xiphoid, lower coastal margin, or external auditory meatus, or a fiducial marker placed on the patient. The patient-based coordinate system is described in C.22.214.171.124.1.
For a slide-related Frame of Reference, this is the slide corner as specified in C.126.96.36.199 and shall be identified in this attribute with the value “SLIDE_CORNER”. The slide-based coordinate system is described in C.188.8.131.52.
The Position Reference Indicator shall be used only for annotation purposes and is not intended to be used as a mathematical spatial reference.
Note: The Position Reference Indicator may be sent zero length when it has no meaning, for example, when the Frame of Reference Module is required to relate mammographic images of the breast acquired without releasing breast compression, but where there is no meaningful anatomical reference point as such.