C.8.4 Nuclear Medicine Modules

This Section describes Nuclear Medicine Series, Equipment, and Image Modules. These Modules contain Attributes that are specific to the NM Image IOD.

Note: There are some cases where it may be necessary to use several SOP Instances to encode a single NM acquisition. For example, the matrix size must remain constant within a SOP instance. Multiple matrix sizes require multiple SOP instances. Similarly, multiple gated stress levels require separate SOP instances for each stress level. However, a receiving AE is not expected to recombine them.

C.8.4.1 NM Series Module (Retired)

Section C.8.4.1 was defined in a previous version of the DICOM Standard. The Section is now retired.

C.8.4.2 NM Equipment Module (Retired)

Section C.8.4.2 was defined in a previous version of the DICOM Standard. The Section is now retired.

C.8.4.3 NM Image Module (Retired)

Section C.8.4.3 was defined in a previous version of the DICOM Standard. The Section is now retired.

C.8.4.4 NM SPECT Acquisition Image Module (Retired)

Section C.8.4.4 was defined in a previous version of the DICOM Standard. The Section is now retired.

C.8.4.5 NM Multi-gated Acquisition Image Module (Retired)

Section C.8.4.5 was defined in a previous version of the DICOM Standard. The Section is now retired.

C.8.4.6 NM/PET Patient Orientation Module

Table C.8-5 specifies the Attributes that describe the NM/PET Patient Orientation.

Table C.8-5NM/PET PATIENT ORIENTATION MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Patient Orientation Code Sequence (0054,0410) 2 Sequence that describes the orientation of the patient with respect to gravity. See C.8.4.6.1.1 for further explanation. Zero or one item shall be included in this sequence.
>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 19. The Coding Scheme Designator (0008,0102) shall have an Enumerated Value of “99SDM” for historical reasons. Code Meaning (0008,0104) shall be Type 3 for historical reasons.
>Patient Orientation Modifier Code Sequence (0054,0412) 2C Patient Orientation Modifier. Required if needed to fully specify the orientation of the patient with respect to gravity. See C.8.4.6.1.2 for further explanation. Zero or one item shall be included in this sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 20. The Coding Scheme Designator (0008,0102) shall have an Enumerated Value of “99SDM” for historical reasons. Code Meaning (0008,0104) shall be Type 3 for historical reasons.
Patient Gantry Relationship Code Sequence (0054,0414) 2 Sequence which describes the orientation of the patient with respect to the gantry. See Section C.8.4.6.1.3 for further explanation. Zero or one item shall be included in this sequence.
>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 21. The Coding Scheme Designator (0008,0102) shall have an Enumerated Value of “99SDM” for historical reasons. Code Meaning (0008,0104) shall be Type 3 for historical reasons.

C.8.4.6.1 NM/PET Patient Orientation Attribute Descriptions

C.8.4.6.1.1 Patient Orientation Code Sequence

The Patient Orientation Code Sequence (0054,0410) is used to describe the orientation of the patient with respect to gravity, and is independent of the position in the gantry.

C.8.4.6.1.2 Patient Orientation Modifier Code Sequence

The Patient Orientation Modifier Code Sequence (0054,0412) is used to modify or enhance the orientation specified by Patient Orientation Code Sequence (0054,0410).

C.8.4.6.1.3 Patient Gantry Relationship Code Sequence

Patient Gantry Relationship Code Sequence (0054,0414) is used to describe the patient direction within the gantry, such as head-first or feet-first. When imaging the extremities, these directions are related to normal anatomic position.

Example: In normal anatomic position, the fingers point towards the feet.

C.8.4.7 NM Image Pixel Module

Table C.8-6 specifies the Attributes that describe the pixel data of a NM image.

Table C.8-6NM IMAGE PIXEL MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Samples per Pixel (0028,0002) 1 Number of samples (color planes) in this image. The value shall be 1.
Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. See C.8.4.7.1.1 for further explanation.
Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. Enumerated Values: 8, 16.
Bits Stored (0028,0101) 1 Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. The value shall be the same as the value in Bits Allocated (0028,0100).
High Bit (0028,0102) 1 Most significant bit for pixel sample data. Each sample shall have the same high bit. Shall be one less than the value in Bits Stored (0028,0101).
Pixel Spacing (0028,0030) 2 Physical distance in the patient between the center of each pixel, specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing, in mm. See 10.7.1.3 for further explanation of the value order.

C.8.4.7.1 NM Image Pixel Attribute Descriptions

C.8.4.7.1.1 Photometric Interpretation

For NM Images, Photometric Interpretation (0028,0004) shall have one of the following Enumerated Values:

MONOCHROME2

PALETTE COLOR

See C.7.6.3.1.2 for definition of these terms.

C.8.4.8 NM Multi-frame Module

Table C.8-7 specifies the Attributes of a NM Multi-frame Image. This module is always included in a NM SOP instance, even if there is only one frame in the image.

A NM Image object is always a multi-dimensional multi-frame image. The order and organization of the frames within each image is defined by the Frame Increment Pointer (0028,0009). The Frame Increment Pointer (0028,0009) references one or more indexing vectors. An indexing vector is a 1 dimensional array with exactly one element for each frame in the image. The value of the nth element in the indexing vector represents the index for the nth frame, in that dimension. Indices are always numbered starting from 1.

Note: The scheme for encoding a multi-dimensional array of frames into a single image object is as follows. First, the definition of the data element called the Frame Increment Pointer is changed so that it can be multi-valued (i.e. its VM is now 1-n). Each value of the Frame Increment Pointer represents one of the dimensions of the array, with the last value representing the most rapidly changing index.Each value of the Frame Increment Pointer is the tag of a data element which is an indexing vector. An indexing vector is a 1 dimensional array with exactly one element for each frame in the image. The value of the n th element in the indexing vector represents the index for the n th frame, in that dimension. For example, suppose you are encoding a Dynamic image consisting of 2 phases (containing 5 and 2 frames, respectively), from each of two detectors, using one isotope, which gives a total of 14 frames in the image. For a Dynamic image, the Frame Increment Pointer is defined as:Frame Increment Pointer = Energy Window Vector (0054,0010) \ Detector Vector (0054,0020) \ Phase Vector (0054,0030) \ Time Slice Vector (0054,0100)The Pixel Data (7FE0,0010) would contain the frames in the following order:

Frame 1 2 3
Frame Increment Pointer (0028,0009) 1 Contains the Data Element Tags of one or more frame index vectors. See C.8.4.8.1.1 for further specialization.
Energy Window Vector (0054,0010) 1C An array which contains the energy window number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Energy Window Vector (0054,0010). See C.8.4.8.1.2 for specialization.
Number of Energy Windows (0054,0011) 1 Number of energy window groupings. See C.8.4.8.1.2 for specialization.
Detector Vector (0054,0020) 1C An array which contains the detector number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Detector Vector (0054,0020). See C.8.4.8.1.3 for specialization.
Number of Detectors (0054,0021) 1 Number of detectors. See C.8.4.8.1.3 for specialization.
Phase Vector (0054,0030) 1C An array which contains the phase number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Phase Vector (0054,0030). See C.8.4.8.1.4 for specialization.
Number of Phases (0054,0031) 1C Number of phases. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Phase Vector (0054,0030). See C.8.4.8.1.4 for specialization.
Rotation Vector (0054,0050) 1C An array which contains the rotation number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Rotation Vector (0054,0050). See C.8.4.8.1.5 for specialization.
Number of Rotations (0054,0051) 1C Number of rotations. Required if Image Type (0008,0008), Value 3 is TOMO, GATED TOMO, RECON TOMO, or RECON GATED TOMO. See C.8.4.8.1.5 for specialization.
R-R Interval Vector (0054,0060) 1C An array which contains the R-R interval number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for R-R Interval Vector (0054,0060). See C.8.4.8.1.6 for specialization.
Number of R-R Intervals (0054,0061) 1C Number of R-R intervals. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for R-R Interval Vector (0054,0060). See C.8.4.8.1.6 for specialization.
Time Slot Vector (0054,0070) 1C An array which contains the time slot number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Time Slot Vector (0054,0070). See C.8.4.8.1.7 for specialization.
Number of Time Slots (0054,0071) 1C Number of time slots. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Time Slot Vector (0054,0070). See C.8.4.8.1.7 for specialization.
Slice Vector (0054,0080) 1C An array which contains the spatial slice number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Slice Vector (0054,0080). See C.8.4.8.1.8 for specialization.
Number of Slices (0054,0081) 1C Number of slices. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Slice Vector (0054,0080). See C.8.4.8.1.8 for specialization.
Angular View Vector (0054,0090) 1C An array which contains the angular view number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Angular View Vector (0054,0090). See C.8.4.8.1.9 for specialization.
Time Slice Vector (0054,0100) 1C An array which contains the time slice number for each frame. Required if the value of the Frame Increment Pointer (0028,0009) includes the Tag for Time Slice Vector (0054,0100). See C.8.4.8.1.10 for specialization.

Note: Per the rules in PS 3.5, if a data element of Type 1C or 2C is not required, it shall not be included.

C.8.4.8.1 NM Multi-Frame Attribute Descriptions

C.8.4.8.1.1 Frame Increment Pointer

By definition, NM Images are multi-dimensional Multi-frame Images. The value of the Frame Increment Pointer (0028,0009) contains the Tag for one or more frame indexing vectors. This determines the number of dimensions of frame indices in the image, and the order in which these indices vary from one frame to the next, with the last Tag indicating the most rapidly changing index. The Enumerated Values for the Frame Increment Pointer (0028,0009) are determined by the Image Type (0008,0008), Value 3, as shown in Table C.8-8.

Table C.8-8ENUMERATED VALUES FOR FRAME INCREMENT POINTER

Image Type (0008,0008), Value 3 Frame Increment Pointer (0028,0009)
STATIC or WHOLE BODY 0054H 0010H \ 0054H 0020H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020).
DYNAMIC 0054H 0010H \ 0054H 0020H \ 0054H 0030H \ 0054H 0100H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), Phase Vector (0054,0030), Time Slice Vector (0054,0100)
GATED 0054H 0010H \ 0054H 0020H \ 0054H 0060H \ 0054H 0070H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), R-R Interval Vector(0054,0060), Time Slot Vector (0054,0070)
TOMO 0054H 0010H \ 0054H 0020H \ 0054H 0050H \ 0054H 0090H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), Rotation Vector (0054,0050), Angular View Vector (0054,0090)
GATED TOMO 0054H 0010H \ 0054H 0020H \ 0054H 0050H \ 0054H 0060H \ 0054H 0070H \ 0054H 0090H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), Rotation Vector (0054,0050), R-R Interval Vector (0054,0060), Time Slot Vector (0054,0070), Angular View Vector (0054,0090).
RECON TOMO 0054H 0080H Sequencing is by Slice Vector (0054,0080)
RECON GATED TOMO 0054H 0060H \ 0054H 0070H \ 0054H 0080H Sequencing is by R-R Interval Vector (0054,0060), Time Slot Vector (0054,0070), Slice Vector (0054,0080)

C.8.4.8.1.2 Number of Energy Windows and Energy Window Vector

Number of Energy Windows (0054,0011) is the number of distinct energy window groupings acquired in this image. See C.8.4.10.1. When Image Type (0008,0008), Value 3, is RECON TOMO or RECON GATED TOMO, then the Number of Energy Windows (0054,0011) shall be 1.

Energy Window Vector (0054,0010) is an indexing vector. The value of the nth element of this vector is the energy window number for the nth frame in this image, and shall have a value from 1 to Number of Energy Windows (0054,0011).

C.8.4.8.1.3 Number of Detectors and Detector Vector

Number of Detectors (0054,0021) is the number of separate detectors which differentiate the frames in this image. When Image Type (0008,0008), Value 3, is RECON TOMO or RECON GATED TOMO, then the Number of Detectors (0054,0021) shall be 1.

Note: Number of Detectors (0054,0021) does not necessarily represent the actual number of detectors used during data acquisition.

Example 1: In a TOMO acquisition in which frames from 2 or more detectors are interleaved to form one continuous set of frames, then no distinction is made between frames on the basis of which detector created them. In this case, the Number of Detectors (0054,0021) would be 1.

Example 2: In a WHOLE BODY acquisition in which a single detector acquires anterior and posterior views in two separate passes, the Number of Detectors (0054,0021) would be 2.

Detector Vector (0054,0020) is an indexing vector. The value of the nth element of this vector is the detector number of the nth frame in this image, and shall have a value from 1 to Number of Detectors (0054,0021).

C.8.4.8.1.4 Number of Phases and Phase Vector

Number of Phases (0054,0031) is the number of dynamic phases, independent of the number of Detectors and Isotopes. See Section C.8.4.14 for definition of a phase.

Phase Vector (0054,0030) is an indexing vector. The value of the nth element of this vector is the phase number of the nth frame in this image, and shall have a value from 1 to Number of Phases (0054,0031).

C.8.4.8.1.5 Number of Rotations and Rotation Vector

Number of Rotations (0054,0051) is the number of separate rotations. See Section C.8.4.12 for definition of a rotation. When Image Type (0008,0008), Value 3, is RECON TOMO, GATED TOMO or RECON GATED TOMO, then the Number of Rotations (0054,0051) shall be 1.

Rotation Vector (0054,0050) is an indexing vector. The value of the nth element of this vector is the rotation number of the nth frame in this image, and shall have a value from 1 to Number of Rotations (0054,0051).

C.8.4.8.1.6 Number of R-R Intervals and R-R Interval Vector

Number of R-R Intervals (0054,0061) is the number of ranges of heartbeat durations collected. A gated acquisition may employ one R-R Interval to collect data from normal beats, a second R-R Interval to collect data from ectopic beats, and possibly others. Each R-R Interval accepts beats whose duration is greater than its Low R-R Value (0018,1081) and shorter than its High R-R Value (0018,1082). Beats which do not fall within these ranges may be accepted by another R-R Interval, or may be rejected.

The Number of R-R Intervals (0054,0061) is the total number of such ranges.

R-R Interval Vector (0054,0060) is an indexing vector. The value of the nth element of this vector is the interval number of the nth frame in this image, and shall have a value from 1 to Number of R-R Intervals (0054,0061).

C.8.4.8.1.7 Number of Time Slots and Time Slot Vector

Number of Time Slots (0054,0071) is the number of frames into which each gating event is divided in a gated acquisition. For example, in a cardiac gated acquisition, data from a number of heartbeats are then combined by summing together the first frames from all beats into a summed first frame, all the second frames into a summed second frame, and so on. The result has the same number of frames as the Number of Time Slots in each beat.

Time Slot Vector (0054,0070) is an indexing vector. The value of the nth element of this vector is the time slot number of the nth frame in this image, and shall have a value from 1 to Number of Time Slots (0054,0071).

C.8.4.8.1.8 Number of Slices and Slice Vector

Number of Slices (0054,0081) is the number of slices in each separate volume.

Note: For images with Image Type (0008,0008), Value 3, equal to RECON GATED TOMO this implies that Number of Slices (0054,0081) is the same for all R-R Intervals and Time Slots.

Slice Vector (0054,0080) is an indexing vector. The value of the nth element of this vector is the slice number of the nth frame in this image, and shall have a value from 1 to Number of Slices (0054,0081).

C.8.4.8.1.9 Angular View Vector

Angular View Vector (0054,0090) is an indexing vector. The value of the nth element of this vector is the angular view number of the nth frame in this image. If Image Type (0008,0008), Value 3, is TOMO or GATED TOMO, then the value shall be from 1 to Number of Frames in Rotation (0054,0053).

C.8.4.8.1.10 Time Slice Vector

Time Slice Vector (0054,0100) is an indexing vector. The value of the nth element of this vector is the time slice number of the nth frame in this image, and shall have a value from 1 to Number of Frames in Phase (0054,0033).

C.8.4.9 NM Image Module

Table C.8-9 contains the Attributes that describe Nuclear Medicine Images.

Table C.8-9NM IMAGE MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Image Type (0008,0008) 1 Image identification characteristics. See C.8.4.9.1.1 for specialization.
Image ID (0054,0400) 3 User or equipment generated Image identifier.
Lossy Image Compression (0028,2110) 1C Specifies whether an Image has undergone lossy compression. Enumerated Values: 00 = Image has NOT been subjected to lossy compression. 01 = Image has been subjected to lossy compression. See C.7.6.1.1.5 Required if Lossy Compression has been performed on the Image.
Counts Accumulated (0018,0070) 2 Sum of all gamma events for all frames in the image. See C.8.4.9.1.2 for specialization.
Acquisition Termination Condition (0018,0071) 3 Description of how the data collection was stopped. Defined Terms: CNTS = counts DENS = density MANU = manual OVFL = data overflow TIME = time TRIG = physiological trigger See C.8.4.9.1.3 for specialization.
Table Height (0018,1130) 3 The height of the patient table in mm. The range and values of this element are determined by the manufacturer. Should not be included if Image Type (0008,0008), Value 3, is TOMO, GATED TOMO, RECON TOMO or RECON GATED TOMO.
Table Traverse (0018,1131) 3 Location of the patient table (or gantry relative to the table) in mm. The range and values of this element are determined by the manufacturer. Should not be included if Image Type (0008,0008), Value 3, is TOMO, GATED TOMO, RECON TOMO or RECON GATED TOMO.
Actual Frame Duration (0018,1242) 1C Elapsed time for data acquisition in msec. Required if Image Type (0008,0008) Value 3 is: WHOLE BODY or STATIC. See C.8.4.9.1.4 for specialization.
Count Rate (0018,1243) 3 Maximum count rate achieved during the acquisition in counts/sec.
Processing Function (0018,5020) 3 Code or description of processing functions applied to the data.
Corrected Image (0028,0051) 3 One or more values that indicate which, if any, corrections have been applied to the image. Corrections are applied to all frames in the image. Defined Terms: UNIF = flood corrected COR = center of rotation corrected NCO = non-circular orbit corrected DECY = decay corrected ATTN = attenuation corrected SCAT = scatter corrected DTIM = dead time corrected NRGY = energy corrected LIN = linearity corrected MOTN = motion corrected CLN = count loss normalization; Any type of normalization applied to correct for count loss in Time Slots.
Whole Body Technique (0018,1301) 3 The type of scan performed. Used only if Image Type (0008,0008), Value 3, contains the value WHOLE BODY. Enumerated Values: 1PS = one pass 2PS = two pass PCN = patient contour following employed MSP = multiple static frames collected into a whole body frame.
Scan Velocity (0018,1300) 2C The speed of the camera motion over the body in mm/sec. Required if Image Type (0008,0008) Value 3 contains the value WHOLE BODY.
Scan Length (0018,1302) 2C Size of the imaged area in the direction of scanning motion, in mm. Required if Image Type (0008,0008) Value 3 contains the value WHOLE BODY.
Trigger Source or Type (0018,1061) 3 Text indicating trigger source. Defined Term: EKG
Include 'General Anatomy Optional Macro' Table 10-7 No Context ID for the Anatomic Region Sequence is defined.
Referenced Image Real World Value Mapping Sequence (0040,9094) 3 A sequence of real world value mapping items. One or more Items are permitted in this sequence. Each item defines a single mapping and a list of images to which the mapping applies.
>Include Real World Value Mapping Macro Table C.7.6.16-12 Defined Context ID for Measurement Units Code Sequence is 84 “PET Units for Real World Value Mapping”.

Notes: 1. Content Date (0008,0023) and Content Time (0008,0033) are included in the General Image Module, Table C.7-7, whenever the images are temporally related. For this purpose, all NM Images are considered temporally related, so that these elements are included in an NM Image.

2. Referenced Overlay Sequence (0008,1130) and Referenced Curve Sequence (0008,1145) were previously included in this Module as optional Attributes but have been retired. See PS 3.3 2004.

C.8.4.9.1 NM Image Module Attribute Descriptions

C.8.4.9.1.1 Image Type

For NM images, Image Type (0008,0008) Value 3 is specified to be Type 1 and use one of the following Enumerated Values:

STATIC

DYNAMIC

GATED

WHOLE BODY

TOMO

GATED TOMO

RECON TOMO

RECON GATED TOMO

For NM images, Image Type (0008,0008) Value 4 is specified to use one of the following Enumerated Values:

EMISSION

TRANSMISSION

Note: For NM images, Image Type (0008,0008) Value 1 will be ORIGINAL for all raw data and reconstructed images. DERIVED may be appropriate for some other results images.

For NM images, Image Type (0008,0008) Value 2 will be PRIMARY.

C.8.4.9.1.2 Counts Accumulated

Counts Accumulated (0018,0070) is the total of all gamma events accumulated in all frames of this Image. This attribute applies to acquisition data, and often does not apply to processed images (DERIVED, SECONDARY).

C.8.4.9.1.3 Acquisition Termination Condition

Acquisition Termination Condition (0018,0071) is the method of acquisition termination which was actually applied to the data collection. The Defined Terms and definitions are:

CNTS = preset count limit was reached

DENS = preset count density was reached

MANU = acquisition was terminated manually

OVFL = acquisition was terminated automatically by pixel data overflow condition

TIME = preset time limit was reached

TRIG = preset number of physiological triggers was reached

C.8.4.9.1.4 Actual Frame Duration

Actual Frame Duration (0018,1242) is defined as the elapsed time in msec for a single frame of an acquisition. For some types of multi-frame images, Actual Frame Duration (0018,1242) may have a more specialized meaning as defined in the appropriate IOD Module.

C.8.4.10 NM Isotope Module

Table C.8-10 contains Attributes that describe the isotope administered for the acquisition.

Table C.8-10NM ISOTOPE MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Energy Window Information Sequence (0054,0012) 2 Sequence of Items that describe the energy window groups used. Zero or more Items shall be included in this sequence. The number of items shall be equal to Number of Energy Windows (0054,0011). The first item corresponds to frames with value of 1 in the Energy Window Vector (0054,0010), the second item with value 2, etc.
>Energy Window Name (0054,0018) 3 A user defined name which describes this Energy Window.
>Energy Window Range Sequence (0054,0013) 3 Sequence of Items that describes this energy window group. One or more Items are permitted in this Sequence.
>>Energy Window Lower Limit (0054,0014) 3 The lower limit of the energy window in KeV. See C.8.4.10.1.1 for further explanation.
>>Energy Window Upper Limit (0054,0015) 3 The upper limit of the energy window in KeV. See C.8.4.10.1.2 for further explanation.
Radiopharmaceutical Information Sequence (0054,0016) 2 Sequence of Items that describe isotope information. Zero or more Items shall be included in this sequence.
>Radionuclide Code Sequence (0054,0300) 2 Sequence that identifies the radionuclide. Zero or one item shall be included in this sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 18. The Coding Scheme Designator (0008,0102) shall have an Enumerated Value of “99SDM” for historical reasons. Code Meaning (0008,0104) shall be Type 3 for historical reasons.
>Radiopharmaceutical Route (0018,1070) 3 Route of injection.
>Administration Route Code Sequence (0054,0302) 3 Sequence that identifies the administration route for the radiopharmaceutical. Only a single Item is permitted in this sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 11. Code Meaning (0008,0104) shall be Type 3 for historical reasons.
>Radiopharmaceutical Volume (0018,1071) 3 Volume of injection in cubic cm.
>Radiopharmaceutical Start Time (0018,1072) 3 Time of start of injection. See C.8.4.10.1.5 for further explanation.
>Radiopharmaceutical Stop Time (0018,1073) 3 Time of end of injection. See C.8.4.10.1.6 for further explanation.
>Radionuclide Total Dose (0018,1074) 3 Total amount of radionuclide injected. See C.8.4.10.1.7 for further explanation.
>Calibration Data Sequence (0054,0306) 3 Sequence that contains calibration data. One or more Items are permitted in this Sequence.
>>Energy Window Number (0054,0308) 1 The Item number in the Energy Window Information Sequence to which the following calibration data relates. The Items are numbered starting from 1.
>>Syringe Counts (0018,1045) 3 Pre-injection syringe count rate in counts/sec. See C.8.4.10.1.8 for further explanation.
>>Residual Syringe Counts (0054,0017) 3 Post-injection residue syringe count rate in counts/sec. See C.8.4.10.1.9 for further explanation.
>Radiopharmaceutical (0018,0031) 3 Name of the radiopharmaceutical.
>Radiopharmaceutical Code Sequence (0054,0304) 3 Sequence that identifies the radiopharmaceutical. Only a single Item is permitted in this sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 25. Code Meaning (0008,0104) shall be Type 3 for historical reasons.
Intervention Drug Information Sequence (0018,0026) 3 Sequence of Items that describes the intervention drugs used. One or more Items are permitted in this sequence.
>Intervention Drug Name (0018,0034) 3 Name of intervention drug.
>Intervention Drug Code Sequence (0018,0029) 3 Sequence that identifies the intervention drug name. Only a single Item is permitted in this Sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 10. Code Meaning (0008,0104) shall be Type 3 for historical reasons.
>Administration Route Code Sequence (0054,0302) 3 Sequence that identifies the administration route for the intervention drug. Only a single Item is permitted in this sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 11. Code Meaning (0008,0104) shall be Type 3 for historical reasons.
>Intervention Drug Start Time (0018,0035) 3 Time of administration of the intervention drug, using the same time base as for the Acquisition Start Time (0008,0032).
>Intervention Drug Stop Time (0018,0027) 3 Time of completion of administration of the intervention drug, using the same time base as for the Acquisition Start Time (0008,0032).
>Intervention Drug Dose (0018,0028) 3 Intervention drug dose, in mg.

C.8.4.10.1 NM Isotope Module Attribute Descriptions

C.8.4.10.1.1 Energy Window Lower Limit

Energy Window Lower Limit (0054,0014) is the acquisition energy window lower limit in KeV for acceptance of scintillation events into this Isotope.

C.8.4.10.1.2 Energy Window Upper Limit

Energy Window Upper Limit (0054,0015) is the acquisition energy window upper limit in KeV for acceptance of scintillation events into this Isotope.

C.8.4.10.1.3 (Retired)

C.8.4.10.1.4 (Retired)

C.8.4.10.1.5 Radiopharmaceutical Start Time

Radiopharmaceutical Start Time (0018,1072) is the actual time of radiopharmaceutical administration to the patient for imaging purposes, using the same time base as for the Acquisition Start Time (0008,0032).

C.8.4.10.1.6 Radiopharmaceutical Stop Time

Radiopharmaceutical Stop Time (0018,1073) is the actual ending time of radiopharmaceutical administration to the patient for imaging purposes, using the same time base as for the Acquisition Start Time (0008,0032).

C.8.4.10.1.7 Radionuclide Total Dose

Radionuclide Total Dose (0018,1074) is the radiopharmaceutical dose administered to the patient measured in MegaBecquerels (Mbq) at the Radiopharmaceutical Start Time.

C.8.4.10.1.8 Syringe Counts

Syringe Counts (0018,1045) is the pre-injection syringe acquisition count rate measured in counts/sec, corrected to the Acquisition Start Time (0008,0032) if necessary.

C.8.4.10.1.9 Residual Syringe Counts

Residual Syringe Counts (0054,0017) is the syringe acquisition count rate following patient injection, measured in counts/sec, corrected to the Acquisition Start Time (0008,0032) if necessary.

C.8.4.10.1.10 (Retired)

C.8.4.10.1.11 (Retired)

C.8.4.11 NM Detector Module

Table C.8-11 contains IOD Attributes that describe Nuclear Medicine Detectors used to produce an image.

Table C.8-11NM DETECTOR MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Detector Information Sequence (0054,0022) 2 Sequence of Items that describe the detectors used. Zero or more Items shall be included in this sequence. The number of items shall be equal to Number of Detectors (0054,0021). The first item corresponds to frames with value of 1 in the Detector Vector (0054,0020), the second item with value 2, etc.
>Collimator/Grid Name (0018,1180) 3 Label describing the collimator used (LEAP, hires, etc.)
>Collimator Type (0018,1181) 2 Collimator type. Defined Terms: PARA = Parallel (default) PINH = Pinhole FANB = Fan-beam CONE = Cone-beam SLNT = Slant hole ASTG = Astigmatic DIVG = Diverging NONE = No collimator UNKN = Unknown
>Field of View Shape (0018,1147) 3 Shape of the field of view of the Nuclear Medicine detector. Defined Terms: RECTANGLE ROUND HEXAGONAL
>Field of View Dimension(s) (0018,1149) 3 Dimensions of the field of view, in mm. If Field of View Shape (0018,1147) is: RECTANGLE: row dimension followed by column. ROUND: diameter. HEXAGONAL: diameter of a circumscribed circle.
>Focal Distance (0018,1182) 2 Focal distance, in mm. A value of 0 means infinite distance for parallel collimation. See C.8.4.11.1.1 for further specialization.
>X Focus Center (0018,1183) 3 Center of focus along a row. See C.8.4.11.1.2 for further explanation.
>Y Focus Center (0018,1184) 3 Center of focus along a column. See C.8.4.11.1.2 for further explanation.
>Zoom Center (0028,0032) 3 The amount of offset from (0,0) applied to each pixel in the image before application of the zoom factor, specified by a numeric pair: row value (delimiter) column value (in mm). See C.8.4.11.1.3 for further explanation.
>Zoom Factor (0028,0031) 3 The amount of magnification applied to each pixel in the image, specified by a numeric pair: row value (delimiter) column value. See C.8.4.11.1.4 for further explanation.
>Center of Rotation Offset (0018,1145) 3 Average center of rotation offset of Nuclear Medicine detector in mm. See C.8.4.11.1.5 for further explanation.
>Gantry/Detector Tilt (0018,1120) 3 Angle of tilt in degrees of the detector. See C.8.4.11.1.6 for further explanation.
>Distance Source to Detector (0018,1110) 2C Distance in mm from transmission source to the detector face. Required if Image Type (0008,0008) Value 4 is TRANSMISSION and Value 3 is not any of: TOMO, GATED TOMO, RECON TOMO or RECON GATED TOMO.
>Start Angle (0054,0200) 3 Position of the detector about the patient for the start of the acquisition, in degrees. Zero degrees is referenced to the origin at the patient's back. Viewing from the patient's feet, angle increases in a counter-clockwise direction (detector normal rotating from the patient's back towards the patient's left side). Should not be included if Image Type (0008,0008), Value 3, is TOMO, GATED TOMO, RECON TOMO or RECON GATED TOMO.
>Radial Position (0018,1142) 3 Radial distance of the detector from the center of rotation, in mm. Should not be included if Image Type (0008,0008), Value 3, is TOMO, GATED TOMO, RECON TOMO or RECON GATED TOMO.
>Image Orientation (Patient) (0020,0037) 2 The direction cosines of the first row and the first column with respect to the patient. See C.7.6.2.1.1 for further explanation.
>Image Position (Patient) (0020,0032) 2 The x, y, and z coordinates of the upper left hand corner (center of the first voxel transmitted) of the image, in mm. See C.7.6.2.1.1 for further explanation.
>View Code Sequence (0054,0220) 3 Sequence that describes the projection of the anatomic region of interest on the image receptor. Only a single Item is permitted in this sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 26 . Code Meaning (0008,0104) shall be Type 3 for historical reasons.
>>View Modifier Code Sequence (0054,0222) 2C View Modifier. Required if needed to fully specify the View. Zero or one Item shall be included in this sequence.
>>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline CID 23. Code Meaning (0008,0104) shall be Type 3 for historical reasons.

C.8.4.11.1 NM Detector Attribute Descriptions

C.8.4.11.1.1 Focal Distance

Focal Distance (0018,1182) for NM Image data is the focal distance, in mm for converging or diverging collimators, measured from the front face of the detector to the focus. Positive values indicate converging and negative values indicate diverging collimators. A value of 0 means infinite distance for parallel collimation.

C.8.4.11.1.2 Focus Center

X Focus Center (0018,1183) and Y Focus Center (0018,1184) for NM Image data is used to define the projection of the focus for a converging or diverging collimator within the un-zoomed Field of View. It is defined in mm for row and column relative to the center of the un-zoomed Field of View.

C.8.4.11.1.3 Zoom Center

Zoom Center (0028,0032) is the offset between the un-zoomed camera field of view and field of view, measured from the center of the un-zoomed camera field of view to the center the of the zoomed field of view. The offset is measured in mm in the un-zoomed camera FOV dimensions. Positive values are to the right and down from the un-zoomed center, as viewed from the image plane. When this attribute is not given, the Zoom Center is assumed to be 0\0.

C.8.4.11.1.4 Zoom Factor

Zoom Factor (0028,0031) is the magnification factor that was used during the acquisition. When this attribute is not given, it is assumed to be 1.0\1.0.

Note: Zoom Factor (0028,0031) is informational only. Pixel Spacing (0028,0030) already takes account of this and any other changes to pixel size.

C.8.4.11.1.5 Center of Rotation Offset

Center of Rotation Offset (0018,1145) is the average amount of offset in mm between the Detector Field of View center and the physical center of rotation of the gantry for circular orbital scans. Positive values indicate the physical center is to the right of the image plane center.

If:

1) Image Type (0008,0008) Value 3 is TOMO or GATED TOMO, and

2) Corrected Image (0028,0051) does not include the value "COR", and

3) Center of Rotation Offset (0018,1145) is non-zero,

then the receiver should assume that Center of Rotation correction has not already been done.

If the Center of Rotation Offset is zero, no correction shall be applied.

C.8.4.11.1.6 Gantry/Detector Tilt

Gantry/Detector Tilt (0018,1120) for NM Image data is the angle in degrees of the detector face relative to the patient's major (Head to Feet) axis (or the table supporting the patient). Positive tilt is towards the patient’s feet.

C.8.4.12 NM TOMO Acquisition Module

This Module applies to a TOMO Multi-frame Image. This module is present when the Image Type (0008,0008) Value 3, is equal to TOMO, GATED TOMO, RECON TOMO, or RECON GATED TOMO. The elements found in this module describe the acquisition of the Image.

Table C.8-12NM TOMO ACQUISITION MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Rotation Information Sequence (0054,0052) 2 Sequence of Items that describe TOMO rotational groups. A new rotation is defined whenever the direction of the detector motion changes, or the Table Traverse (0018,1131) changes. Zero or more Items shall be included in this sequence. The number of items shall be equal to Number of Rotations (0054,0051). If Rotation Vector (0054,0050) is present, the first item corresponds to frames with value of 1 in the Rotation Vector (0054,0050), the second item with value 2, etc.
>Start Angle (0054,0200) 1 Position of the detector about the patient for the start of this rotation, in degrees. Zero degrees is referenced to the origin at the patient's back. Viewing from the patient's feet, angle increases in a counter-clockwise direction (detector normal rotating from the patient's back towards the patient's left side).
>Angular Step (0018,1144) 1 The angular scan arc step between views of the TOMO acquisition, in degrees. See C.8.4.12.1.1 for further explanation.
>Rotation Direction (0018,1140) 1 Direction of rotation of the detector about the patient. See Start Angle (0054,0200) for further explanation of direction. Enumerated Values: CW = clockwise (decreasing angle) CC = counter-clockwise (increasing angle).
>Scan Arc (0018,1143) 1 The effective angular range of the scan data in degrees. The value shall be positive.
>Actual Frame Duration (0018,1242) 1 Nominal acquisition time per angular position, in msec.
>Radial Position (0018,1142) 3 Radial distance of the detector from the center of rotation, in mm. It shall have a single value which is an average value for this rotation, or it shall have one value per angular view.
>Distance Source to Detector (0018,1110) 2C Distance in mm from transmission source to the detector face. Required if Image Type (0008,0008) Value 4 is TRANSMISSION.
>Number of Frames in Rotation (0054,0053) 1 Number of angular views in this rotation.
>Table Traverse (0018,1131) 3 Location of the patient table (or gantry relative to the table) in mm.The range and values of this element are determined by the manufacturer.
>Table Height (0018,1130) 3 The distance in mm of the top of the patient table to the center of rotation. Table height below the center of rotation has a positive value.
Type of Detector Motion (0054,0202) 3 Describes the detector motion during acquisition. Enumerated Values: STEP AND SHOOT = Interrupted motion, acquire only while stationary. CONTINUOUS = Gantry motion and acquisition are simultaneous and continuous. ACQ DURING STEP = Interrupted motion, acquisition is continuous.

C.8.4.12.1 NM TOMO Acquisition Attribute Descriptions

C.8.4.12.1.1 Angular Step

Angular Step (0018,1144) is the nominal frame-to-frame incremental angle for TOMO and GATED TOMO acquisition images, defined in degrees. The Angular Step (0018,1144) shall be a positive number. Summation of Angular Step values is not defined to give accurate Angular Position or Scan Arc values. The Angular Step is the effective angular spacing between resultant frames of the Multi-framed planar image data.

C.8.4.13 NM Multi-gated Acquisition Module

Table C.8-13 contains Attributes that describe a multi-gated acquisition image performed on the patient. This refers to frames acquired while the patient is connected to a gating device.

Table C.8-13NM MULTI-GATED ACQUISITION MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Beat Rejection Flag (0018,1080) 3 Heart beat duration sorting has been applied. Enumerated Values: Y = yes N = no
PVC Rejection (0018,1085) 3 Description of type of arrhythmic beat rejection criteria used.
Skip Beats (0018,1086) 3 Number of beats skipped after a detected arrhythmia
Heart Rate (0018,1088) 3 Average number of heart beats per minute for the collection period for these frames. This shall include all accepted beats as well as rejected beats.
Gated Information Sequence (0054,0062) 2C Sequence of Items that describe R-R intervals. Each gated interval is defined by an upper and lower range of heart beat durations. Required if the Frame Increment Pointer (0028,0009) contains the Tag for R-R Interval Vector (0054,0060). Zero or more Items shall be included in this sequence. The number of items shall be equal to Number of R-R Intervals (0054,0061). The first item corresponds to frames with value of 1 in the R-R Interval Vector (0054,0060), the second item with value 2, etc.
>Trigger Time (0018,1060) 3 Time interval measured in msec from the start of the R-wave to the beginning of the data taking.
>Cardiac Framing Type (0018,1064) 3 Description of type of framing performed. See C.7.6.18.1.1.1 for description and Defined Terms.
>Data Information Sequence (0054,0063) 2 Sequence of Items that describe gating criteria. Zero or more Items shall be included in this sequence. See C.8.4.13.1.1.
>>Frame Time (0018,1063) 1 Nominal time per individual frame in msec.
>>Nominal Interval (0018,1062) 3 Average duration of accepted beats, in msec.
>>Low R-R Value (0018,1081) 3 R-R interval lower limit for beat rejection, in msec
>>High R-R Value (0018,1082) 3 R-R interval upper limit for beat rejection, in msec
>>Intervals Acquired (0018,1083) 3 Number of heartbeats that fall within Low R-R Value (0018,1081) and High R-R Value (0018,1082), and were therefore accepted and contribute gamma events to this R-R Interval.
>>Intervals Rejected (0018,1084) 3 Number of heartbeats that fall outside Low R-R (0018,1081) and High R-R Value (0018,1082), and do not contribute gamma events to this R-R Interval. However, they may contribute gamma events to other R-R Intervals.
>>Time Slot Information Sequence (0054,0072) 2C Sequence of Items that describe Time Slot Information. Required if the Frame Increment Pointer (0028,0009) contains the Tag for Time Slot Vector (0054,0070). Zero or more Items shall be included in this sequence. The number of items shall be equal to Number of Time Slots (0054,0071). The first item corresponds to frames with value of 1 in the Time Slot Vector (0054,0070), the second item with value 2, etc.
>>>Time Slot Time (0054,0073) 3 The total amount of time, in msec, that the acquisition accumulates gamma events into this frame. See C.8.4.13.1.2.

C.8.4.13.1 NM Multi-gated Acquisition Attribute Descriptions

C.8.4.13.1.1 Data Information Sequence

Data Information Sequence (0054,0063) shall contain a single sequence item which applies to the sum of all angular views, except when Image Type (0008,0008) Value 3 is GATED TOMO. In this case it shall have either a single item which applies to the sum of all angular views, or it shall have one item for each angular view.

C.8.4.13.1.2 Time Slot Time

The Time Slot Time (0054,0073) records the effective imaging time of each Time Slot. For example, if some of the accepted beats are shorter than others then the last frames may not receive a contribution from the shorter beats. The Time Slot Time for a Time Slot is the total acquisition time for that Time Slot. It is approximately equal to the Frame Time (0018,1063) multiplied by the number of accepted beats contributing to the Time Slot.

C.8.4.14 NM Phase Module

Table C.8-14 contains Attributes that describe dynamic phases of a dynamic acquisition image performed on the patient. This module is present only when Image Type (0008,0008), Value 3, is equal to DYNAMIC. A phase is defined as a collection of frames in which the acquisition time per frame and the time delay between frames remains constant. A new phase shall be defined whenever there is a change in the time between frames, the acquisition time per frame, or the position of the patient relative to the detector.

Table C.8-14NM PHASE MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Phase Information Sequence (0054,0032) 2C Sequence of Items that describes each dynamic phase. Required if the Frame Increment Pointer (0028,0009) contains the Tag for Phase Vector (0054,0030). Zero or more Items shall be included in this sequence. The number of items shall be equal to Number of Phases (0054,0031). The first item corresponds to frames with value of 1 in the Phase Vector (0054,0030), the second item with value 2, etc.
>Phase Delay (0054,0036) 1 Time paused between the last frame of the previous phase and the first frame of this phase, in msec.
>Actual Frame Duration (0018,1242) 1 Nominal time of acquisition per individual frame, in msec.
>Pause Between Frames (0054,0038) 1 Time paused between each frame of this phase (in msec).
>Number of Frames in Phase (0054,0033) 1 Number of frames in this phase.
>Trigger Vector (0054,0210) 3 An array of trigger times when gating information is acquired simultaneously with the dynamic image data. See Section C.8.4.14.1.1 for further explanation.
>Number of Triggers in Phase (0054,0211) 1C The number of entries in the Trigger Vector (0054,0210) for this phase. Required if Trigger Vector (0054,0210) is present.
>Phase Description (0054,0039) 3 Description of this phase of the Dynamic image. Defined Terms: FLOW WASHOUT UPTAKE EMPTYING EXCRETION

C.8.4.14.1 NM Phase Module Attributes Description

C.8.4.14.1.1 Trigger Vector

Trigger Vector (0054,0210) is an array containing a list of the inter-trigger interval times in milliseconds in the order in which they were acquired, with the first being measured from the start time of the first frame of the image data in the Phase. If this element is used, the start times are required to be the same so that a mathematical correlation can be made between trigger times and frame start times.

C.8.4.15 NM Reconstruction Module

Table C.8-15 contains Attributes that describe Nuclear Medicine reconstructed volumes. Reconstructed volumes are created by applying a transformation (reconstruction) process to the acquired TOMO frames. This module is present only when the Image Type (0008,0008), Value 3, is equal to RECON TOMO or RECON GATED TOMO .

Table C.8-15 NM RECONSTRUCTION MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Spacing Between Slices (0018,0088) 2 Spacing between slices, in mm, measured from center-to-center of each slice along the normal to the first image. The sign of the Spacing Between Slices (0018,0088) determines the direction of stacking. The normal is determined by the cross product of the direction cosines of the first row and first column of the first frame, such that a positive spacing indicates slices are stacked behind the first slice and a negative spacing indicates slices are stacked in front of the first slice. See Image Orientation (0020,0037) in the NM Detector module.
Reconstruction Diameter (0018,1100) 3 Diameter, in mm, of the region from within which the data was used in creating the reconstruction of the image. Data may exist outside this region and portions of the patient may exist outside this region.
Convolution Kernel (0018,1210) 3 A label describing the convolution kernel or algorithm used to reconstruct the data.
Slice Thickness (0018,0050) 2 Nominal slice thickness, in mm.
Slice Location (0020,1041) 3 Relative position of the image plane expressed in mm. See C.7.6.2.1.2 for further explanation.
Slice Progression Direction (0054,0500) 3 Describes the anatomical direction that slices are progressing as the slices are considered in order (as defined by the Slice Vector (0054,0080)). Meaningful only for cardiac images. When View Code Sequence (0054,0220) indicates a short axis view, then Enumerated Values are: APEX_TO_BASE BASE_TO_APEX