R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Imaging Integration Work GroupMaturity Level: 3 Trial Use Compartments: Patient

Detailed Descriptions for the elements in the ImagingStudy resource.

ImagingStudy
Definition

Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.

Control1..1
ImagingStudy.uid
Definition

Formal identifier for the study.

Control1..1
Typeoid
Alternate NamesStudyInstanceUID
Summarytrue
ImagingStudy.accession
Definition

Accession Number is an identifier related to some aspect of imaging workflow and data management. Usage may vary across different institutions. See for instance IHE Radiology Technical Framework Volume 1 Appendix A .

Control0..1
TypeIdentifier
Alternate NamesAccessionNumber
Summarytrue
ImagingStudy.identifier
Definition

Other identifiers for the study.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Alternate NamesStudyID
Summarytrue
ImagingStudy.availability
Definition

Availability of study (online, offline, or nearline).

Control0..1
Terminology BindingInstanceAvailability (Required)
Typecode
Alternate NamesInstanceAvailability
Summarytrue
ImagingStudy.modalityList
Definition

A list of all the Series.ImageModality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19).

Control0..*
Terminology BindingAcquisition Modality Codes (Extensible)
TypeCoding
Alternate NamesModalitiesInStudy
Summarytrue
ImagingStudy.subject
Definition

The subject, typically a patient, of the imaging study.

Control1..1
TypeReference(Patient | Device | Group)
Summarytrue
Comments

QA phantoms can be recorded with a Device; multiiple subjects 9such as mice) can be recorded with a Group.

ImagingStudy.context
Definition

The encounter or episode at which the request is initiated.

Control0..1
TypeReference(Encounter | EpisodeOfCare)
Summarytrue
ImagingStudy.started
Definition

Date and time the study started.

Control0..1
TypedateTime
Alternate NamesStudyDate; StudyTime
Summarytrue
ImagingStudy.basedOn
Definition

A list of the diagnostic requests that resulted in this imaging study being performed.

Control0..*
TypeReference(CarePlan | ServiceRequest)
Requirements

To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).

Summarytrue
ImagingStudy.referrer
Definition

The requesting/referring physician.

Control0..1
TypeReference(Practitioner)
Alternate NamesReferringPhysiciansName
Summarytrue
ImagingStudy.interpreter
Definition

Who read the study and interpreted the images or other content.

Control0..*
TypeReference(Practitioner)
Alternate NamesName of Physician(s) Reading Study
Summarytrue
ImagingStudy.endpoint
Definition

The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.type.

Control0..*
TypeReference(Endpoint)
Requirements

Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.

Summarytrue
Comments

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.

ImagingStudy.numberOfSeries
Definition

Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present.

Control0..1
TypeunsignedInt
Alternate NamesNumberOfStudyRelatedSeries
Summarytrue
ImagingStudy.numberOfInstances
Definition

Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

Control0..1
TypeunsignedInt
Alternate NamesNumberOfStudyRelatedInstances
Summarytrue
ImagingStudy.procedureReference
Definition

A reference to the performed Procedure.

Control0..*
TypeReference(Procedure)
Summarytrue
ImagingStudy.procedureCode
Definition

The code for the performed procedure type.

Control0..*
Terminology BindingProcedure Codes (SNOMED CT) (Example)
TypeCodeableConcept
Alternate NamesProcedureCodeSequence
Summarytrue
ImagingStudy.reason
Definition

Description of clinical condition indicating why the ImagingStudy was requested.

Control0..1
Terminology BindingProcedure Reason Codes (Example)
TypeCodeableConcept
Summarytrue
ImagingStudy.description
Definition

Institution-generated description or classification of the Study performed.

Control0..1
Typestring
Alternate NamesStudyDescription
Summarytrue
ImagingStudy.series
Definition

Each study has one or more series of images or other content.

Control0..*
Summarytrue
ImagingStudy.series.uid
Definition

Formal identifier for this series.

Control1..1
Typeoid
Alternate NamesSeriesInstanceUID
Summarytrue
ImagingStudy.series.number
Definition

The numeric identifier of this series in the study.

Control0..1
TypeunsignedInt
Alternate NamesSeriesNumber
Summarytrue
ImagingStudy.series.modality
Definition

The modality of this series sequence.

Control1..1
Terminology BindingAcquisition Modality Codes (Extensible)
TypeCoding
Alternate NamesModality
Summarytrue
ImagingStudy.series.description
Definition

A description of the series.

Control0..1
Typestring
Alternate NamesSeriesDescription
Summarytrue
ImagingStudy.series.numberOfInstances
Definition

Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

Control0..1
TypeunsignedInt
Alternate NamesNumberOfSeriesRelatedInstances
Summarytrue
ImagingStudy.series.availability
Definition

Availability of series (online, offline or nearline).

Control0..1
Terminology BindingInstanceAvailability (Required)
Typecode
Alternate NamesInstanceAvailability
Summarytrue
ImagingStudy.series.endpoint
Definition

The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.type.

Control0..*
TypeReference(Endpoint)
Requirements

Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level.

Summarytrue
Comments

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.

ImagingStudy.series.bodySite
Definition

The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality.

Control0..1
Terminology BindingSNOMED CT Body Structures (Example)
TypeCoding
Alternate NamesBodyPartExamined
Summarytrue
ImagingStudy.series.laterality
Definition

The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite.

Control0..1
Terminology BindingLaterality (Example)
TypeCoding
Summarytrue
ImagingStudy.series.specimen
Definition

The specimen imaged, e.g., for whole slide imaging of a biopsy.

Control0..*
TypeReference(Specimen)
Summarytrue
ImagingStudy.series.started
Definition

The date and time the series was started.

Control0..1
TypedateTime
Summarytrue
ImagingStudy.series.performer
Definition

The physician or operator (often the radiology technician) who performed the series.

Control0..*
TypeReference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)
Requirements

The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers.

Alternate NamesPerformingPhysicianName; OperatorName
Summarytrue
Comments

If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images.

ImagingStudy.series.instance
Definition

A single SOP instance within the series, e.g. an image, or presentation state.

Control0..*
ImagingStudy.series.instance.uid
Definition

Formal identifier for this image or other content.

Control1..1
Typeoid
Alternate NamesSOPInstanceUID
ImagingStudy.series.instance.number
Definition

The number of instance in the series.

Control0..1
TypeunsignedInt
Alternate NamesInstanceNumber
ImagingStudy.series.instance.sopClass
Definition

DICOM instance type.

Control1..1
Typeoid
Alternate NamesSOPClassUID
ImagingStudy.series.instance.title
Definition

The description of the instance.

Control0..1
Typestring
Comments

Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc.