| DICOM PS3.16 2025b - Content Mapping Resource |
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This Annex specifies the content of Standard Templates that may be used by DICOM SR IODs.
This Template provides a general structure for a numeric measurement, together with evaluations of its normality and/or significance, and the inference source(s) for its value. This structure is instantiated by inclusion of this Template with specific contextual parameters from a parent Template.
Table TID 300. Parameters
Table TID 300. Measurement
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Defaults to DCID 244 “Laterality” |
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EV (126100, DCM, "Real World Value Map used for measurement") |
SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67") |
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The HAS CONCEPT MOD items allow the explicit definition of terms for post-coordination of the measurement concept name. Additional post-coordinated modifier terms may be included in a SOP Instance based on this Template, in accordance with section 6.2.4, or as defined by Templates that invoke this Template and explicitly define additional post-coordinated modifiers (e.g., TID 5203). |
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Finding site may be multiple when a region of interest spans multiple anatomical locations and there is not a single pre-coordinated code describing the combination of locations. E.g., when a maligant, inflammatory or traumatic process spans actual or defined anatomical boundaries. There is no requirement that the multiple locations be contiguous. |
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The INFERRED FROM items allow the specification (by-value or by-reference) of numeric values that were used in the derivation of the numeric measurement of Row 1. The nature of the inference is not explicitly conveyed; it may be implicit in the Concept Names of the measurements. Inference by-reference is valid only in SOP Classes that permit the INFERRED FROM relationship by-reference. |
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Multiple SCOORD Content Items may be necessary to describe the source of the measurement. E.g., the measurement of an angle between two non-intersecting line segments requires two separate POLYLINE SCOORD Content Items with the concept name of (121223, DCM, "Arm of angle") conveyed in $Purpose. |
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(260753009, SCT, "Source") may be specified for $ImagePurpose or $WavePurpose as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item. |
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Equivalent Meaning of Concept Name allows the creating application to specify the preferred composed concept name representing the measurement and the associated post-coordinated concept modifiers. The concept modifiers may include those specified in this Template, in a Template that invokes this Template, or at the option of the creating application in accordance with Section 6.2.4. This composed concept name may be rendered by a display application. It may be supplied as text or coded concept or both. |
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Row 18 is a reference to an RWV that describes how measurements were made in units that differ from the stored pixel values in the images referenced in Row 13. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference overrides any reference in an including Template (such as for a Measurement Group). |
This Template provides the properties of a numeric measurement, including evaluations of its normality and/or significance, its relationship to a reference population, and an indication of its selection from a set of measurements.
This Template provides the statistical properties of a reference population for a numeric measurement, and/or the position of a measurement in such a reference population.
This Template provides the normal range of values for a numeric measurement.
This Template provides a general structure for inference from an image, either as a whole, or with specific 2D or 3D spatial coordinates, as a single included Template in the invoking Template. If allowed by the IOD, the Image Content Item may be included by-reference.
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(260753009, SCT, "Source") may be be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item. |
This Template provides a general structure for referencing a waveform, either as a whole, or with specific temporal coordinates, as a single included Template in the invoking Template. If allowed by the IOD, the Waveform Content Item may be included by-reference.
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(260753009, SCT, "Source") may be be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item. |
This Template provides references to supporting evidence in the form of DICOM composite objects. This includes references to images, spatial coordinates on images, and other composite objects, such as Structured Reports.
This general Template provides a means to reference previous structured reporting composite object instances.
This TID is a subset of the Reference Location Macro. See Section 10.27 “Reference Location Macro” in PS3.3 .
Unless otherwise specified, content in an SR tree is "directly" observed. When material is quoted (from a source that is either a document or something spoken), then it is necessary to specify:
This Template establishes a mechanism for quoting by specifying:
the fact that one is quoting, by the presence of the contents of the Template in the tree
that the "observer context" above the invocation of this Template establishes who is doing the quoting
the source of the quote, by the values of the Content Items in this Template
who is being quoted, and who and what the quote is about, by the observation context that is established at the start of the quoted material
This Template may be invoked recursively, to nest quotes within quotes. In essence, the chain of who is quoting whom can be established by maintaining a "stack" of observer context.
If a dimension of observation context is the same in the quoted material as in the enclosing tree, then the observation context does not need to be respecified (e.g., the quote may be about the same subject or procedure). Typically, the observer context would change (unless one were quoting oneself).
In the case of quoting something that was spoken, the "observer" is the person speaking.
TID 1000 is attached using HAS OBS CONTEXT relationships to the top node of the material that is being quoted. The presence of the Quoted Source concept signals the fact that the material is quoted rather than directly observed.
Specifies attributes of observation context that may be defined, extended or replaced at any location in the SR tree.
This includes attributes that specify:
Establishing context includes two aspects of each dimension: identification and description (e.g., patient name and ID vs. patient's age, height or weight).
Whenever one dimension of context is changed or an attribute is added, all attributes of that dimension of context are "flushed", that is they need to be repeated in their entirety. For example, when the subject is changed from patient (name, id) to fetus (number), then the parameters of the patient are discarded. E.g., the patient's ID does not apply to the fetus.
"Extending" the same class and dimension of observation context isn't feasible, since one cannot "null out" or remove a previously set attribute. Any time a dimension of observation context is "replaced", any attributes that are unspecified remain unspecified (i.e., they are not inherited).
Table TID 1001. Observation Context
The observer (person or device) that created the Content Items to which this context applies.
Whenever this Template is invoked, all previously inherited attributes of Observer Context are discarded and replaced.
There may be more than one observer, as this Template may be invoked with a VM 1-n, and both person and device observers. In such a case, the Content Items of TID 1003 “Person Observer Identifying Attributes” and TID 1004 “Device Observer Identifying Attributes” shall be included in the order in which the values of Observer Type are specified. Since TID 1003 “Person Observer Identifying Attributes” and TID 1004 “Device Observer Identifying Attributes” both include a single mandatory Content Item as their first Content Item, which observer is being described can be determined
Table TID 1002. Observer Context
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Defaults to (121006, DCM, "Person") |
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IFF Row 1 value = (121006, DCM, "Person") or Row 1 is absent |
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IFF Row 1 value = (121007, DCM, "Device") |
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This Template contains identifying (and optionally descriptive) attributes of persons that are observers.
Table TID 1003. Person Observer Identifying Attributes
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Defaults to Value of Institution Name (0008,0080) of the General Equipment Module |
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EV (121010, DCM, "Person Observer's Role in the Organization") |
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EV (121011, DCM, "Person Observer's Role in this Procedure") |
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EV (128775, DCM, "Identifier within Person Observer's Role") |
This Template (derived from the Section C.7.5.1 “General Equipment Module” in PS3.3 ) contains identifying (and optionally descriptive) attributes of devices that are observers.
Table TID 1004. Device Observer Identifying Attributes
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Defaults to Value of Device UID (0018,1002) of the General Equipment Module |
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Defaults to Value of Station Name (0008,1010) of the General Equipment Module |
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Defaults to Value of Manufacturer (0008,0070) of the General Equipment Module |
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Defaults to Value of Manufacturer's Model Name (0008,1090) of the General Equipment Module |
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Defaults to Value of Device Serial Number (0018,1000) of the General Equipment Module |
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EV (121017, DCM, "Device Observer Physical Location During Observation") |
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Defaults to Value of Manufacturer's Device Class UID (0018,100B) of the General Equipment Module. |
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Defaults to Value of UDI Sequence (0018,100A) of the General Equipment Module |
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This Template contains identifying (and optionally descriptive) attributes of the procedure that is the source of evidence being interpreted.
Whenever this Template is invoked, all previously inherited attributes of Procedure Study Context are discarded and replaced.
If an observed digital image is identified by other than a DICOM UID, a Study Instance UID must be generated for the non-DICOM evidence. The same must be done to document interpretation of hard-copy radiographs generated outside of the scope of the DICOM system.
Table TID 1005. Procedure Study Context
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Defaults to Value of Study Instance UID (0020, 000D) of the General Study Module |
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Defaults to Value of Accession Number (0008,0050) of the General Study Module |
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Defaults to Value of Procedure Code Sequence (0008,1032) of the General Study Module |
This Template contains identifying (and optionally descriptive) attributes of the subject of the observation.
Subject context identifies (and optionally) describes the subject of the observation, whether it be a patient (human or animal), a fetus (human or animal), a specimen, or a device.
Table TID 1006. Subject Context
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DCID 271 “Observation Subject Class” Defaults to (121025, DCM, "Patient") |
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IFF Row 1 value = (121025, DCM, "Patient") or Row 1 is absent |
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IFF Row 1 value = (121026, DCM, "Fetus") |
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IFF Row 1 value = (121027, DCM, "Specimen") |
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IFF Row 1 value = (121192, DCM, "Device Subject") |
Identifies (and optionally describes) a patient who is the subject.
Table TID 1007. Subject Context, Patient
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Defaults to Value of Patient's Name (0010,0010) of the Patient Module |
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Defaults to Value of Patient ID (0010,0020) of the Patient Module |
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Defaults to Value of Patient's Birth Date (0010,0030) of the Patient Module |
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Defaults to a code equivalent to Value of Patient's Sex (0010,0040) of the Patient Module |
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Defaults to a code equivalent to Value of Sex Parameters for Clinical Use Category Sequence (0010,0043) of the Patient Study Module |
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EV (131234, DCM, "Subject Sex Parameters for Clinical Use Category Comment") |
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EV (131235, DCM, "Subject Sex Parameters for Clinical Use Category Reference") |
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Defaults to Value equivalent to Value of Patient's Age (0010,1010) of the Patient Study Module UNITS = DCID 7456 “Age Unit” |
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DCID 7454 “Animal Taxonomic Rank Value” Defaults to Coded Entry Value of Patient Species Code Sequence (0010,2202) of the Patient Module, or if absent, (337915000, SCT, "Homo sapiens"). |
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Defaults to Coded Entry Value of Patient Breed Code Sequence (0010,2293) of the Patient Module |
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Defaults to Coded Entry Value(s) of Ethnic Group Code Sequence (0010,2161) of the Patient Module, or if absent, the coded equivalents of the text Values of Ethnic Groups (0010,2162) of the Patient Module, which is defined as "ethnic group(s) or race(s)", or if absent, the coded equivalent of the text Value of retired Ethnic Group (0010,2160). |
Identifies (and optionally describes) a fetus who is the subject.
Table TID 1008. Subject Context, Fetus
Identifies (and optionally describes) a specimen that is the subject.
Identifies (and optionally describes) a device that is the subject of observations.
Table TID 1010. Subject Context, Device
This Template includes attributes describing the qualifications of the person observer relevant to the content generated by the observer.
This Template describes a person participating in an activity as other than an observer or subject. E.g., for a dose report documenting an irradiating procedure, participants include the person administering the irradiation and the person authorizing the irradiation.
This Template is included with specific contextual parameters from a parent Template.
This Template describes a device participating in an activity as other than an observer or subject. E.g., for a dose report documenting an irradiating procedure, participants include the irradiating device.
This Template is included with specific contextual parameters from a parent Template.
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If no Device Procedure Role is provided, BCID 7445 “Device Participating Role” may be used. |
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This may be used for the name by which the organization manages the device. |
Defines a mechanism for specifying a language, optionally with designation of the country in which that language applies.
For example, the French language could be specified unmodified, or French as written in France or Canada could be distinguished.
The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous releases of the Standard.
Defines a mechanism for specifying the language in which the value of the parent Content Item (only) is written. Does not specify the language of the Concept Name of the parent Content Item, nor of any other descendants of the parent Content Item.
The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous releases of the Standard.
Defines a mechanism for specifying the language in which the value and the Concept Name of the parent Content Item (only) is written. Does not specify the language of any other descendants of the parent Content Item.
The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous releases of the Standard.
Defines a mechanism for specifying the language in which the value and the Concept Name of the parent Content Item and any other descendants of the parent Content Item is written.
The language codes specified in CID 5000 “Language” optionally allow the encoding of the country of language in the Code Value for the language. Encoding of the country of language in a separate subsidiary Concept Modifier Content Item is allowed for backward compatibility with previous releases of the Standard.
Table TID 1204. Language of Content Item and Descendants
Defines a mechanism for specifying one or more equivalent meanings for the Concept Name of the parent Content Item.
Table TID 1210. Equivalent Meaning(s) of Concept Name
A coded equivalent meaning for the Concept Name can also be included using the Attribute Equivalent Code Sequence (0008,0121) in the Concept Name Code Sequence (0040,A043) (see Section 8.9 “Equivalent Code Sequence” in PS3.3 ), though the equivalent code(s) in the Equivalent Code Sequence (0008,0121) need not be the same as those in TID 1210.
Defines a mechanism for specifying one or more equivalent meanings for the Value of the parent Content Item.
Table TID 1211. Equivalent Meaning(s) of Value
For example, to describe a longer, more meaningful equivalent (in the same language) for a procedure code than is defined in a Coding Scheme:
CODE: (121023, DCM, "Procedure Code") = (50291CC, ICD10PCS, "IMAGING:CNS:CT:SELLA:LOWOSMOLAR:IT, U, E:2PLANE3D")
> HAS CONCEPT MOD TEXT: (121051, DCM, "Equivalent meaning of value") = "imaging study central nervous system of the sella turcica/pituitary gland with low osmolar contrast intrathecal, unenhanced and enhanced, in two planes with 3D reconstructions"
For example, to specify a concept name and value in both French and English in Canada:
CODE:(91723000, SCT, "Anatomical structure") = (76752008, SCT, "Breast")
> HAS CONCEPT MOD CODE: (121048, DCM, "Language of name and value") = (en-CA, RFC5646, "English, Canada")
> HAS CONCEPT MOD CODE: (121050, DCM, "Equivalent meaning of concept name") = (91723000, SCT, Structure de l'anatomie")
>> HAS CONCEPT MOD CODE: (121047, DCM, " Langue de la valeur ") = (fr-CA, RFC5646, " Français, Canadien ")
> HAS CONCEPT MOD CODE: (121051, DCM, "Equivalent meaning of value") = (76752008, SCT, "Sein")
>> HAS CONCEPT MOD CODE: (121047, DCM, " Langue de la valeur ") = (fr-CA, RFC5646, " Français, Candie ")
3. A coded equivalent meaning for the Concept Value of a CODE Content Item can also be included using the Attribute Equivalent Code Sequence (0008,0121) in the Concept Code Sequence (0040, A168) (see Section 8.9 “Equivalent Code Sequence” in PS3.3 ).
Concept Name Modifier for negation of the presence of a finding represented by a post-coordinated concept.
For example, negation modifier applied to "distention" in the post-coordinated structure:
CODE: "anatomic location" = "bile duct"
> HAS PROPERTY CODE: "morphology" = "distention"
The presence-negation modifier modifies the entire post-coordinated concept, not just the Source Content Item of the HAS CONCEPT MOD relationship. The entire branch of the tree from the Content Item is included in the post-coordinated structure that is negated.
Table TID 1401. Area Measurement
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UNITS = DCID 7461 “Area Measurement Unit” |
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IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 5 or 6 not present. |
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IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 2 or 6 not present. |
Reference shall be to a Segmentation Image, with a single value specified in Referenced Frame Number |
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IF concept name of Row 1 = (131184002, SCT, "Area of defined region"), and IFF Row 2 or 5 not present. |
Reference shall be to a Segmentation Image, with a single value specified in Referenced Frame Number |
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A Graphic Type of POINT implies that the object is a single pixel and the object's area is the area of the pixel. Otherwise the type shall be a closed POLYLINE (start and end point the same) or a CIRCLE or an ELLIPSE. |
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Referenced Frame Number (0008,1160) is an Attribute of the IMAGE Content Item. If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the area of defined (measured) region by pixel values in the referenced frame with value 1. For Segmentation Type value FRACTIONAL, the area is computed by an implementation dependent method. Frame number shall be specified even if the Segmentation SOP Instance has only a single frame. |
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The values of (112039, DCM, "Tracking Identifier") and (112040, DCM, "Tracking Unique Identifier"), if present, shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 5. |
Table TID 1402. Volume Measurement
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UNITS = DCID 7462 “Volume Measurement Unit” |
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Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number |
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Reference shall be to a Segmentation Image, with a value specified in Referenced Segment Number |
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The two dimensional perimeter of the volume's intersection with or projection into the image. A Graphic Type of POINT implies that the volume's intersection or projection in a plane is a single pixel. A single pixel projection perimeter cannot cause a volume calculation to become 0. Otherwise the type shall be a closed POLYLINE (start and end point the same) or a CIRCLE or an ELLIPSE. |
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Referenced Segment Number (0062,000B) is an Attribute of the IMAGE Content Item. If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the defined (measured) volume by pixel/voxel values in the frames of the referenced segment with value 1. For Segmentation Type value FRACTIONAL, the volume is computed by an implementation dependent method. Segment number shall be specified even if the Segmentation SOP Instance has only a single segment. |
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The values of (112039, DCM, "Tracking Identifier") and (112040, DCM, "Tracking Unique Identifier"), if present, shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 5. |
This Template provides a general structure to report measurements for some metric, e.g., density, flow, or concentration, and/or qualitative evaluations, over a planar region of interest in an image. The ROI may be specified by an SCOORD on an image, by a Segmentation Image, by an SCOORD3D defining an area relative to a 3D Frame of Reference, or by a reference to an ROI defined in a radiotherapy Structure Set.
Table TID 1410. Parameters
Table TID 1410. Planar ROI Measurements and Qualitative Evaluations
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Reference shall be to a Segmentation Image, with a single value specified in Referenced Segment Number (0062,000B). For references to tiled Segmentation Images, one or more values shall be specified in Referenced Frame Number (0008,1160), unless all frames in the referenced Segmentation Image are selected and there is only a single Segment, in which case Referenced Frame Number (0008,1160) will be absent. The referenced tiles shall all be in the same plane. For references to non-tiled Segmentation Images, a single value shall be specified in Referenced Frame Number (0008,1160), unless there is only one frame in the referenced Segmentation Image, in which case Referenced Frame Number (0008,1160) will be absent. |
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Reference shall be to an Instance of the RT Structure Set Storage SOP Class. |
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EV (130489, DCM, "Referenced Region of Interest Identifier") |
Shall be the value of ROI Number (3006,0022) within the single referenced Item of Structure Set ROI Sequence (3006,0020) of the referenced Instance of the RT Structure Set Storage SOP Class. |
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EV (126100, DCM, "Real World Value Map used for measurement") |
SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67") |
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$TargetSiteMod = $TargetSiteMod $RangeAuthority = $RangeAuthority |
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Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity". |
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The Tracking Identifier and Tracking Unique Identifier are defined as a text label or unique identifier (respectively) used for tracking a finding or feature, potentially across multiple reporting objects, over time. As such, they are distinct from the Observation UID (0040,A171), which is unique identifier of the specific Content Item and its subsidiary Content Items that constitute an individual observation, and would be different for different observations on different occasions of the same finding or feature. The values of these Content Items shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 7. |
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The category and type of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site). When spatial localization is by reference to a Segmentation, the category and type may correspond to the values of Segmented Property Category Code Sequence (0062,0003) and Segmented Property Type Code Sequence (0062,000F), respectively. See also CID 7150 “Segmentation Property Category”. |
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To describe an infinitely small area, such as the center of a lesion, a Graphic Type of POINT may be used. |
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(260753009, SCT, "Source") may be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item. |
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Referenced Frame Number (0008,1160) and Referenced Segment Number (0062,000B) are Attributes of the IMAGE Content Item. If the Referenced Segmentation SOP Instance has Segmentation Type (0062,0001) value BINARY, it identifies the area of defined (measured) region of interest by pixel values in the referenced frame with value 1. For Segmentation Type value FRACTIONAL, the area is computed by an implementation dependent method. Referenced Frame Number (0008,1160) may reference multiple frames in the same plane for tiled Segmentation Images (such as segmentations of Whole Slide Microscopy images). |
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The area may be defined independently of an image by reference to 3D coordinates in any type of DICOM Reference Coordinate System, whether it be patient-relative (Patient Based Coordinate System), volume-relative (including acquired and presentation state volumes), or whole slide relative (Slide Coordinate System). |
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Identifies the source image that was segmented to identify the ROI, and whose properties are described in this container. |
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A reference to a single ROI that defines a planar ROI, within an RT Structure Set. |
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This referenced image may contain a "screen shot" illustrating a rendered version of the ROI. |
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This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image. |
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The reference to an RWV in Row 10 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden). |
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Measurements may be omitted, for example if it is desired to describe only the location of a finding or to provide categorical information about it. |
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Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present. |
This Template provides a general structure to report measurements for some metric, e.g., density, flow, or concentration, and/or qualitative evaluations, over a volumetric region of interest in a set of images or a Frame of Reference. The volumetric ROI may be specified by a set of SCOORDs on an image set representing a volume, by a volumetric Segmentation Image, by a volume defined in a Surface Segmentation, by a set of SCOORD3Ds defining a volume relative to a 3D Frame of Reference, or by a reference to an ROI defined in a radiotherapy Structure Set.
Table TID 1411. Parameters
Table TID 1411. Volumetric ROI Measurements and Qualitative Evaluations
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Reference shall be to a Segmentation Image or Surface Segmentation object, with a single value specified in Referenced Segment Number |
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Reference shall be to an Instance of the RT Structure Set Storage SOP Class. |
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EV (130489, DCM, "Referenced Region of Interest Identifier") |
Shall be the value of ROI Number (3006,0022) within the single referenced Item of Structure Set ROI Sequence (3006,0020) of the referenced Instance of the RT Structure Set Storage SOP Class. |
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EV (126100, DCM, "Real World Value Map used for measurement") |
SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67") |
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$TargetSiteMod = $TargetSiteMod $RangeAuthority = $RangeAuthority |
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Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity". |
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The Tracking Identifier and Tracking Unique Identifier are defined as a text label or unique identifier (respectively) used for tracking a finding or feature, potentially across multiple reporting objects, over time. As such, they are distinct from the Observation UID (0040,A171), which is unique identifier of the specific Content Item and its subsidiary Content Items that constitute an individual observation, and would be different for different observations on different occasions of the same finding or feature. The values of these Content Items shall match the corresponding values of Tracking ID (0062,0020) and Tracking UID (0062,0021), if present, in the corresponding Segment of any Segmentation instance referenced in Row 7. |
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The type and category of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site). When spatial localization is by reference to a Segmentation, the category and type may correspond to the values of Segmented Property Category Code Sequence (0062,0003) and Segmented Property Type Code Sequence (0062,000F), respectively. See also CID 7150 “Segmentation Property Category”. |
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Even though the coordinates are image-relative, not every image slice within the spatial extent of the ROI is required to be encoded. That is, the ROI may be more coarsely sampled than the image slices, and may be irregularly sampled, and the omission of a contour on a slice does not mean that it is omitted from the ROI. For example, a user may not draw an outline on every slice. However, failure to include every intermediate slice does give rise to this potential ambiguity, and is discouraged. |
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A single invocation of TID 1411 defines the entire spatial extent defined of a single ROI. A single structure with multiple fragments disconnected in spatial extent needs to be described as separate ROIs, in separate invocations of TID 1411, with different Tracking Identifiers and Tracking Unique Identifiers, but the same Finding. |
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To describe an infinitely small volume, such as the center of a lesion, a Graphic Type of POINT may be used. |
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(260753009, SCT, "Source") may be used as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item. |
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Referenced Segment Number (0062,000B) is an Attribute of the IMAGE Content Item, and shall be present with a single value. If the Referenced SOP Instance is a Segmentation Image, it shall have a defined Frame of Reference. If it has Segmentation Type (0062,0001) value BINARY, it identifies the volume of defined (measured) region of interest by voxel values in the referenced segment with value 1. If it has Segmentation Type value FRACTIONAL, the volume is defined by an implementation dependent method. The extent, sampling rate and orientation of the Segmentation are not required to match that of corresponding image slices (if any), identified in Row 11 or referenced from the Segmentation. If the referenced SOP Instance is a Surface Segmentation, the referenced segment shall constitute a finite volume. It identifies the volume of the defined (measured) region of interest by the interior of the finite volume. Segment number shall be specified even if the Segmentation SOP Instance has only a single segment. |
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Either a single item describing a closed volumetric surface, or multiple items describing a set of parallel closed coplanar areas (contours) is specified. The sampling rate and orientation of the contours is not required to match that of any image slices (if any), nor are the in-plane or cross-plane sampling rates required to be regular. |
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Identifies the source images that were segmented to identify the ROI, when, for example a subset of images in a series was used. |
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Identifies the source series of images that were segmented to identify the ROI, when, for example an entire set of images in a series was used. |
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A reference to a single ROI that defines a volumetric ROI, within an RT Structure Set. |
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These referenced images may contain "screen shot" illustrating rendered versions of the ROI. |
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This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image. |
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The reference to an RWV in Row 14 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden). |
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Measurements may be omitted, for example if it is desired to describe only the location of a finding or to provide categorical information about it. |
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Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present. |
This Template encodes measurements for some metric, e.g., density, flow, or concentration.
Table TID 1419. Parameters
Table TID 1419. ROI Measurements
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EV (126100, DCM, "Real World Value Map used for measurement") |
SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67") |
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This Template encodes measurements for some metric, e.g., density, flow, or concentration, which are acquired over some defined sampling (e.g., over successive time slots in a dynamic contrast enhanced acquisition), or of some comparison between different ROIs.
Table TID 1420. Parameters
Table TID 1420. Measurements Derived From Multiple ROI Measurements
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DCID 7465 “Measurement Derived From Multiple ROI Measurements” |
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DTID 1410 “Planar ROI Measurements and Qualitative Evaluations” |
$TargetSiteMod = $TargetSiteMod $RangeAuthority = $RangeAuthority |
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DTID 1411 “Volumetric ROI Measurements and Qualitative Evaluations” |
$TargetSiteMod = $TargetSiteMod $RangeAuthority = $RangeAuthority |
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This Root Template encodes a list of Measurement Groups each containing lists of measurements, together with any derived measurements.
Each Measurement Group is identified by Tracking ID and UIDs.
An image library is available to describe characteristics of the images referenced by the measurements, if any.
Table TID 1500. Measurement Report
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The Image Library provides potentially relevant characteristics of images associated with the measurements. There is no requirement to include all, or any, of the images referenced in the ROIs and measurements elsewhere in this template. The template may also include images that are associated with, but not directly referenced in, the ROIs and measurements. The Image Library is not replicating the content of the SOP Instance Reference Macro. |
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The conditions require that at least one of the "heading" containers be present, though any of them may be present but empty. |
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Describes the algorithm that applies to all observations within the container, unless overridden at the group or individual observation level. |
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The baseline Context Group allows for generic intensity, size, texture and other feature measurements, regardless of the geometry of the ROI (e.g., linear distance can be measured on volumes, or volume can be estimated from a linear distance), and being baseline, do not constrain the invoker from using other appropriate concepts specific to the application. Different measurements of the same real-world lesion made using different types of measurements (different templates) can be correlated by a shared value of Tracking Unique Identifier. See also Section RRR.5 “Measurement Report SR Document Volumetric ROI with RECIST Linear Distance Specified by Coordinates on CT Example” in PS3.17 . |
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Planar ROI measurements are those defined on a single plane by a segmentation reference or planar spatial coordinates. |
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Volumetric ROI measurements are those defined on a volume by raster or surface segmentation references or a set of 2D or 3D spatial coordinates. |
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Generic measurements include those specified on an image as a whole or by unconstrained graphic coordinates. These may be used for such things as whole image scores or quality measures, and for linear distance measurements, such as for RECIST or WHO tumor treatment response criteria evaluation, or angle measurements. A Measurement Group is used to contain one or more individual measurements that are invocations of TID 300, consistent with TIDs 1410 and 1411, which both already have Measurement Group containers as their roots. |
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These Content Items allow encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the entire subject of the report rather than specific measurement groups. A single level of coded modifiers may be present, such as to post-coordinate the laterality if the parent concept involves an anatomic part. |
This Template groups measurements and/or qualitative evaluations into a Measurement Group.
Each Measurement Group is identified by Tracking ID and UIDs, and may be described as having being made at a particular time point.
Measurement groups may contain various common measurement modifiers that are shared by all measurements in the group, such as method and finding site.
Table TID 1501. Parameters
Table TID 1501. Measurement and Qualitative Evaluation Group
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EV (126100, DCM, "Real World Value Map used for measurement") |
SOP Class UID shall be Real World Value Mapping Storage ("1.2.840.10008.5.1.4.1.1.67") |
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$TargetSiteMod = $TargetSiteMod $RangeAuthority = $RangeAuthority |
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Identifies the session during which the measurements were made. The NCI Thesaurus definition is "time, period, or term devoted to some activity". |
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The included TID 300 contains an optional inclusion of TID 1408 Tracking Identifier as a child of the NUM measurement, which in turns allows for either or both Tracking Identifier and Tracking Unique Identifier Content Items; the intent of Rows 2 and 3 is not to send these Content Items twice, but rather to factor them out into a common location for multiple measurements, and to be consistent with TID 1410 and TID 1411. |
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The category and type of the finding describe whatever entity (finding or feature) is identified by Rows 2 and 3. E.g., a finding might be a lesion, a tumor, or a reference region (as distinct from its anatomical location, which is encoded in a different Content Item (Finding Site). |
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Finding site may be multiple when a region of interest spans multiple anatomical locations and there is not a single pre-coordinated code describing the combination of locations. E.g., when a maligant, inflammatory or traumatic process spans actual or defined anatomical boundaries. There is no requirement that the multiple locations be contiguous. |
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The reference to an RWV in Row 9 allows measurements to be made in units that differ from the stored pixel values in the images referenced elsewhere in the Template. E.g., for a PET SUVbw measurement, the mapping from activity/concentration units in the referenced image that was used (and which may be reused for measurements in the future) may be encoded in a referenced RWV instance. This reference applies to any measurements in included Templates, unless overridden). |
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Describes the algorithm that applies to all measurements in TID 300 Row 1, unless overridden within the individual measurement at TID 300 Row 19. |
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This referenced image may contain a "screen shot" illustrating a rendered version of the ROI. |
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This referenced image may contain a visual explanation of how an algorithm produces its results, and may be a "screen shot" of the explanation already superimposed on the source image (e.g., a "heat map"), or a parametric map intended to be superimposed on the source image by the receiving application. The type of image and the type of visual explanation is described in the referenced image's own metadata. More than one referenced image may be present, if there is more than one type of visual explanation, or it needs to span more than one single-frame image. |
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(260753009, SCT, "Source") may be specified for $ImagePurpose or $WavePurpose as a generic Concept Name when there is a desire to avoid having an anonymous (unnamed) Content Item. |
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Coordinates, image or waveform references that are the subject of this measurement group instead of, or in addition to, coordinate, image or waveform references associated with measurements in Row 10. Note that if an ROI is defined, other templates may be used, such as TID 1410 Planar ROI Measurements and Qualitative Evaluations. |
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Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present. |
This Template describes information about the time point, for example, at which a measurement was obtained.
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Usually the same value as the Clinical Trial Time Point ID (0012,0050) Attribute in the Clinical Trial Study Module, though not confined to clinical trial use. May or may not be human readable, and not required to be a DICOM UID. |
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All of the subjects within a treatment protocol that are examined at a particular scheduled time point (e.g., "baseline", "pre-treatment", "first post-treatment") will have the same Protocol Time Point Identifier, but different Subject Time Point Identifiers. However, in different protocols, the Protocol Time Point Identifiers for the same conceptual "time point" will be different. E.g., the "baseline" time point will have different Protocol Time Point Identifiers in different protocols. May or may not be human readable, and not required to be a DICOM UID. |
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Typically a short pre-defined label that has the same scope as Protocol Time Point Identifier (i.e., same conceptual time point within a treatment protocol) but is human-readable and understandable, e.g., "BASELINE" or "TP0", "TP1", etc. Usually the same value as Clinical Trial Time Point Description (0012,0051) Attribute in the Clinical Trial Study Module, though not confined to clinical trial use. The Concept Name is selected as (C2348792, UMLS, "Time Point") (which is (C68568, NCIt, "Time Point"), defined as "a specific point in the time continuum, including those established relative to an event") in order to be compatible with external terminologies. |
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More than one type is permitted, e.g., a time point may be "posttreatment" as well as "unscheduled" or "nadir", etc. |
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The order is expected to be monotonically increasing within a particular scope of usage, but is not required to start at 0 or 1, nor required to increase in increments of 1 or even the same increment (e.g., to allow for retrospective insertion of unscheduled time points). In clinical usage, the Time Point Order would be expected to be temporally increasing, but in a clinical trial may be a randomized reading order rather than a temporal order. |
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Longitudinal temporal information may be inherited from Longitudinal Temporal Offset from Event (0012,0052) and Longitudinal Temporal Event Type (0012,0053) in the PS3.3 Section C.7.2.3 Clinical Trial Study Module, or may be specified or overridden within this template (e.g., if different measurements in the same SR Instance were measured on different time points). |
The Image Library contains references to images and selected attributes describing them that facilitate analysis without having to retrieve the entire set of referenced images.
Each instance of the Image Library Entry Template contains the Image SOP Class and Instance UIDs, and selected attributes for an image that facilitate analysis without having to retrieve the entire set of referenced images.
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These Image Library Entry Descriptors apply to the IMAGE in Row 1 and override descriptors in Row 3 of Section TID 1600 in case of conflict. |
This Template contains selected attributes for an image or group of images. The descriptive information may be copied from images or derived.
Table TID 1602. Image Library Entry Descriptors
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DTID 1603 “Image Library Entry Descriptors for Projection Radiography” |
IFF Row 1 is present with a value of "CR", "DX", "IO", "MG, "PX", "RF", "RG" or "XA" |
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DTID 1604 “Image Library Entry Descriptors for Cross-Sectional Modalities” |
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The value of Anatomic Region Sequence (0008,2218) in the Image IOD, or a code derived from Body Part Examined (0018,0015) using the mapping described in Annex L. |
This Template contains selected attributes for a projection radiography image or group of such images. The descriptive information may be copied from images or derived.
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First (row) and second (column) components of Patient Orientation (0020,0020) in the Image IOD. See Section C.7.6.1.1.1 “Patient Orientation” in PS3.3 . |
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The second component of Imager Pixel Spacing (0018,1164) in the Image IOD. See Section C.8.11.4 “DX Detector Module” in PS3.3 . |
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The first component of Imager Pixel Spacing (0018,1164) in the Image IOD. See Section C.8.11.4 “DX Detector Module” in PS3.3 . |
This Template contains selected attributes for a cross-sectional image or group of such images. The descriptive information may be copied from images or derived.
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The second component of Pixel Spacing (0028,0030) in the Image IOD. See Section 10.7.1.1 “Pixel Spacing” in PS3.3 and Section C.7.6.2 “Image Plane Module” in PS3.3 . |
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The first component of Pixel Spacing (0028,0030) in the Image IOD. See Section 10.7.1.1 “Pixel Spacing” in PS3.3 and Section C.7.6.2 “Image Plane Module” in PS3.3 . |
This Template contains selected attributes for a CT image or group of such images. The descriptive information may be copied from images or derived.
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A code derived from the Value of Acquisition Type (0018,9302) in the Image IOD. See Section C.8.15.3.2 “CT Acquisition Type Macro” in PS3.3 . |
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A code derived from the Value of Reconstruction Algorithm (0018,9315) in the Image IOD. See Section C.8.15.3.7 “CT Reconstruction Macro” in PS3.3 . |
This Template contains selected attributes for a MR image or group of such images. The descriptive information may be copied from images or derived. Specialized coded Content Items allow more precise description of imaging sequences used for interpretation of multiparametric prostate MRI.
Table TID 1606. Image Library Entry Descriptors for MR
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The value of Pulse Sequence Name (0018,9005) or Sequence Name (0018,0024) in the Image IOD. See Section C.8.13.4 “MR Pulse Sequence Module” in PS3.3 . |
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Multiple values may apply when entry descriptor corresponds to a parametric map such as Apparent Diffusion Coefficient (ADC) map, which utilizes multiple b-values from a Diffusion-Weighted acquisition. |
This Template contains selected attributes for a PET image or group of such images. The descriptive information may be copied from images or derived.
The content of this Template is similar to that in TID 15101 NM/PET Protocol Context, but is in the form of an SR Template rather than a Protocol Context Template, and the Content Items are not nested as modifiers. There is also some similarity to TID 3307 NM/PET Perfusion Measurement Group.
Table TID 1607. Image Library Entry Descriptors for PET
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The units for half life are chosen to be seconds, to match the units used for Radionuclide Half Life (0018,1075). See Section C.8.9.2 “PET Isotope Module” in PS3.3 . |
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In an earlier edition of the Standard, an incorrect DCM code was used for this concept, which was already assigned as (109081, DCM, "Prospective gating"). |
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In an earlier edition of the Standard, an incorrect DCM code was used for this concept, which was already assigned as (109082, DCM, "Retrospective gating"). |
This Template includes attributes for image library entries that define the type of the sequence, as needed for PI-RADS interpretation of multiparametric MRI, specify most important sequence-specific attributes, and provide a location for reporting prostate imaging and sequence-specific technical characteristics of the acquisition.
A descriptor specific to prostate MRI and PI-RADS is provided to record Prostate DCE temporal resolution. This term follows the conventions used in the PI-RADS guidelines.
Table TID 1608. Image Library Entry Descriptors for Prostate Multiparametric MR
The Generic Blood Lab Measurements Template provides for the recording of measurements made on a blood sample that is not specific to a particular clinical application. The type and anatomic source of the blood is recorded as acquisition context. The results from the blood chemistry measurement system are quoted; the measurement names may be pre-coordinated with the type or source of the blood, or generic measurement names may be reported. In the latter case, the full measurement concept name may be effectively post-coordinated using the recorded acquisition context.
This template provides the mechanism to describe image quality both at the study and individual series level, following a specific quality control standard.
Table TID 1701. Imaging Study Quality
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Defaults to BCID 6326 “Image Quality Control Standard” |
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Defaults to BCID 6326 “Image Quality Control Standard” |
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Basic report Template for general diagnostic imaging interpretation reports.
Can only be instantiated at the root node and cannot be included in other Templates.
No Content Items other than those defined in Observation Context TID 1001 “Observation Context” may be the target of a HAS OBS CONTEXT relationship when TID 2000 “Basic Diagnostic Imaging Report” is invoked.
Individual numeric or image observations that may be useful for inclusion as individual findings or as the source of inferences in a report.
Table TID 2001. Basic Diagnostic Imaging Report Observations
The Report Narrative allows recording of text, code, and numeric observations. The order of Content Items in the Template is not significant; the order of Content Items in a SOP Instance may be significant to the narrative flow of the report.
Basic report Template for general diagnostic imaging interpretation reports produced in a dictation/transcription workflow. SR documents encoded using this Template are intended to be transformable to HL7 Clinical Document Architecture format (see Section X.3 “Transcribed Diagnostic Imaging CDA Instance Content” in PS3.17 and Annexes in PS3.20).
This Template can be instantiated only at the root node, and cannot be included in other Templates.
Observation Context shall be inherited from outside the Structured Report Content Tree, and shall not be changed within the Content Tree. To satisfy the requirement that Observer Context is inherited, either or both the Author Observer Sequence (0040,A078) or the Verifying Observer Sequence (0040,A073) from the SR Document General Module must be present in the SOP Instance.
Table TID 2005. Transcribed Diagnostic Imaging Report
This Template is used for general imaging reports for both radiation producing and non-radiation producing modalities.
For radiation producing modalities, radiation exposure and protection information is required, such as to support nationally-specific legal or standard requirements.
It contains mandatory sections, each of which may appear only once in objects instantiated from the Template, including the medical content of the report that comprises relevant medical history data, information on the current request (i.e., clinical question that is expected to be answered by the requested procedure), impressions on the current imaging procedure that has been performed, and radiation exposure and protection information.
This Template is a specialization of TID 2000 “Basic Diagnostic Imaging Report”, in that it uses the same structure of headings and content, but mandates the presence and order of specific headings, and extends the subordinate content with specific Content Items.
Table TID 2006. Imaging Report With Conditional Radiation Exposure and Protection Information
No Content Items other than those defined in TID 1001 “Observation Context” may be the target of a HAS OBS CONTEXT relationship when TID 2006 “Imaging Report With Conditional Radiation Exposure and Protection Information” is invoked.
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Even though this information is related to the content of Row 6 in TID 2007 “Imaging Procedure Description”, it is present here for consistency with other report Templates. |
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Information on at least one of the following person observers is mandatory: (For those person observers, requirement types as specified in TID 1003 “Person Observer Identifying Attributes” apply. That means that "Person Observer Name" is the only mandatory Content Item). |
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Each heading (concept code from CID 7001 “Diagnostic Imaging Report Heading”) may appear only once, and may not repeat the headings (concept codes) used when instantiating any other rows of this Template. |
Contains information related to the procedure.
Table TID 2007. Imaging Procedure Description
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DCID 4028 “Craniofacial Anatomic Region” |
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Shall be equal to the Study Date (0020,0020) in the General Study Module in the images to which this report applies. |
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If present, shall be equal to the Study Time (0020,0030) in the General Study Module in the images to which this report applies. |
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Contains information related to the radiation exposure and protection of the patient, as is required by national legal requirements or standards.
Other information about the current procedure is described in TID 2006 “Imaging Report With Conditional Radiation Exposure and Protection Information” and not repeated here.
Table TID 2008. Radiation Exposure and Protection Information
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EV (73569-6, LN, "Radiation Exposure and Protection Information") |
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IFF ionizing radiation is applied in the context of the current procedure |
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EV (440252007, SCT, "Administration of radiopharmaceutical") |
IFF radioactive substance is administered in the context of the current procedure |
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The clinician responsible for determining that the irradiating procedure was appropriate for the indications. |
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A textual, human-readable description of the radiation exposure is all that is required by this Template (such as is sufficient to comply with, for example, German law). Detailed specification of exposure is out of the scope of this Template. Such information may be given in a separate SR instances such as described in TID 10001 “Projection X-Ray Radiation Dose” or TID 10011 “CT Radiation Dose”, and referenced from TID 2007 “Imaging Procedure Description”. |
The Key Object Selection Template is intended for flagging one or more significant images, waveforms, or other composite SOP Instances. Key Object Selection contains:
For instance, when this Template is used to identify images rejected for quality reasons, the device or person performing the quality assessment is identified in observation context items (invoked through TID 1002 “Observer Context”). The reason for rejection can be included both as a code used as a concept modifier for the document title, and as text description.
The order of object references may be significant, e.g., when the title concept is "For Conference".
Instances referenced in a Key Object Selection Document may be securely referenced by Digital Signature or MAC mechanisms within the SR Document General Module (see PS3.3).
The Template can only be instantiated at the root node and cannot be included in other Templates. The Template is not extensible; that is, no other Content Items may be added to this Template, or the Templates that are included, recursively.
Table TID 2010. Key Object Selection
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IF Row 1 Concept Name = (113001, DCM, "Rejected for Quality Reasons") or (113010, DCM, "Quality Issue") |
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IF Row 1 Concept Name = (113013, DCM, "Best In Set") |
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The Spectacle Prescription Report is a structured report used to represent the prescription for a patient. Usually a prescription is for both eyes, but sometimes just one. The Spectacle Prescription Report defines a refractive correction relative to which visual acuity may be measured subjectively, and thus may be referenced by a Visual Acuity Measurements Storage SOP Instance.
The Macular Grid Thickness and Volume Report is a structured report encoding the macular grid thickness and volume values derived from ophthalmic images, such as ophthalmic OPT images. This may encode measurements of either or both eyes.
The macular grid conveyed by this report is based upon the grid employed by the Early Treatment of Diabetic Retinopathy Study (ETDRS) to measure area and proximity of macular edema to the anatomic center (fovea) of the macula. See ETDRS Report Number 10.
Table TID 2100. Macular Grid Thickness and Volume Report
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EV (111690, DCM, "Macular Grid Thickness and Volume Report") |
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$Laterality = EV (24028007, SCT, "Right") |
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$Laterality = EV (7771000, SCT, "Left") |
This Template encodes the macular grid thickness and volume measurements for a single eye.
Table TID 2101. Macular Grid Thickness and Volume Measurement
This Template specifies the algorithm (and parameters) used to create a quality rating for an image or image set.
It is expected that the identified algorithm will create a consistent quality rating when analyzing a given image. If the algorithm allows change to its parameters that would alter the quality rating created, the specific parameters used should be specified.
| DICOM PS3.16 2025b - Content Mapping Resource |
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