Release 4B Snapshot #1

This page is part of the FHIR Specification v4.3.0-snapshot1: R4B Snapshot to support the Jan 2022 Connectathon. About the R4B version of FHIR. The current officially released version is 4.3.0. 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 UseSecurity Category: Patient Compartments: Patient

Detailed Descriptions for the elements in the ImagingStudy resource.

ImagingStudy
Element IdImagingStudy
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.

Cardinality0..*
TypeDomainResource
Summaryfalse
ImagingStudy.identifier
Element IdImagingStudy.identifier
Definition

Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number.

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2 .

Alternate NamesStudyInstanceUID; AccessionNumber
Summarytrue
Comments

See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.

ImagingStudy.status
Element IdImagingStudy.status
Definition

The current state of the ImagingStudy.

Cardinality1..1
Terminology BindingImagingStudyStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

ImagingStudy.modality
Element IdImagingStudy.modality
Definition

A list of all the series.modality 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).

Cardinality0..*
Terminology BindingAcquisitionModality (Extensible)
TypeCoding
Alternate NamesModalitiesInStudy
Summarytrue
ImagingStudy.subject
Element IdImagingStudy.subject
Definition

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

Cardinality1..1
TypeReference(Patient | Device | Group)
Summarytrue
Comments

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

ImagingStudy.encounter
Element IdImagingStudy.encounter
Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made.

Cardinality0..1
TypeReference(Encounter)
Summarytrue
Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).

ImagingStudy.started
Element IdImagingStudy.started
Definition

Date and time the study started.

Cardinality0..1
TypedateTime
Alternate NamesStudyDate; StudyTime
Summarytrue
ImagingStudy.basedOn
Element IdImagingStudy.basedOn
Definition

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

Cardinality0..*
TypeReference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)
Requirements

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

Summarytrue
ImagingStudy.referrer
Element IdImagingStudy.referrer
Definition

The requesting/referring physician.

Cardinality0..1
TypeReference(Practitioner | PractitionerRole)
Alternate NamesReferringPhysiciansName
Summarytrue
ImagingStudy.interpreter
Element IdImagingStudy.interpreter
Definition

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

Cardinality0..*
TypeReference(Practitioner | PractitionerRole)
Alternate NamesName of Physician(s) Reading Study
Summarytrue
ImagingStudy.endpoint
Element IdImagingStudy.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.connectionType.

Cardinality0..*
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
Element IdImagingStudy.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.

Cardinality0..1
TypeunsignedInt
Alternate NamesNumberOfStudyRelatedSeries
Summarytrue
ImagingStudy.numberOfInstances
Element IdImagingStudy.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.

Cardinality0..1
TypeunsignedInt
Alternate NamesNumberOfStudyRelatedInstances
Summarytrue
ImagingStudy.procedureReference
Element IdImagingStudy.procedureReference
Definition

The procedure which this ImagingStudy was part of.

Cardinality0..1
TypeReference(Procedure)
Summarytrue
ImagingStudy.procedureCode
Element IdImagingStudy.procedureCode
Definition

The code for the performed procedure type.

Cardinality0..*
Terminology BindingImagingProcedureCode :
TypeCodeableConcept
Alternate NamesProcedureCodeSequence
Summarytrue
ImagingStudy.location
Element IdImagingStudy.location
Definition

The principal physical location where the ImagingStudy was performed.

Cardinality0..1
TypeReference(Location)
Requirements

Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

Summarytrue
ImagingStudy.reasonCode
Element IdImagingStudy.reasonCode
Definition

Description of clinical condition indicating why the ImagingStudy was requested.

Cardinality0..*
Terminology BindingProcedure Reason Codes (Example)
TypeCodeableConcept
Summarytrue
ImagingStudy.reasonReference
Element IdImagingStudy.reasonReference
Definition

Indicates another resource whose existence justifies this Study.

Cardinality0..*
TypeReference(Condition | Observation | Media | DiagnosticReport | DocumentReference)
Summarytrue
ImagingStudy.note
Element IdImagingStudy.note
Definition

Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element.

Cardinality0..*
TypeAnnotation
Summarytrue
ImagingStudy.description
Element IdImagingStudy.description
Definition

The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed.

Cardinality0..1
Typestring
Alternate NamesStudyDescription
Summarytrue
ImagingStudy.series
Element IdImagingStudy.series
Definition

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

Cardinality0..*
Summarytrue
ImagingStudy.series.uid
Element IdImagingStudy.series.uid
Definition

The DICOM Series Instance UID for the series.

Cardinality1..1
Typeid
Requirements

DICOM Series Instance UID.

Alternate NamesSeriesInstanceUID
Summarytrue
Comments

See DICOM PS3.3 C.7.3 .

ImagingStudy.series.number
Element IdImagingStudy.series.number
Definition

The numeric identifier of this series in the study.

Cardinality0..1
TypeunsignedInt
Alternate NamesSeriesNumber
Summarytrue
ImagingStudy.series.modality
Element IdImagingStudy.series.modality
Definition

The modality of this series sequence.

Cardinality1..1
Terminology BindingAcquisitionModality (Extensible)
TypeCoding
Alternate NamesModality
Summarytrue
ImagingStudy.series.description
Element IdImagingStudy.series.description
Definition

A description of the series.

Cardinality0..1
Typestring
Alternate NamesSeriesDescription
Summarytrue
ImagingStudy.series.numberOfInstances
Element IdImagingStudy.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.

Cardinality0..1
TypeunsignedInt
Alternate NamesNumberOfSeriesRelatedInstances
Summarytrue
ImagingStudy.series.endpoint
Element IdImagingStudy.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.connectionType.

Cardinality0..*
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
Element IdImagingStudy.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.

Cardinality0..1
Terminology BindingSNOMED CT Body Structures (Example)
TypeCoding
Alternate NamesBodyPartExamined
Summarytrue
ImagingStudy.series.laterality
Element IdImagingStudy.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.

Cardinality0..1
Terminology BindingLaterality (Example)
TypeCoding
Summarytrue
ImagingStudy.series.specimen
Element IdImagingStudy.series.specimen
Definition

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

Cardinality0..*
TypeReference(Specimen)
Summarytrue
ImagingStudy.series.started
Element IdImagingStudy.series.started
Definition

The date and time the series was started.

Cardinality0..1
TypedateTime
Summarytrue
ImagingStudy.series.performer
Element IdImagingStudy.series.performer
Definition

Indicates who or what performed the series and how they were involved.

Cardinality0..*
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.performer.function
Element IdImagingStudy.series.performer.function
Definition

Distinguishes the type of involvement of the performer in the series.

Cardinality0..1
Terminology BindingImagingStudy series performer function (Extensible)
TypeCodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

Summarytrue
ImagingStudy.series.performer.actor
Element IdImagingStudy.series.performer.actor
Definition

Indicates who or what performed the series.

Cardinality1..1
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)
Summarytrue
ImagingStudy.series.instance
Element IdImagingStudy.series.instance
Definition

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

Cardinality0..*
Summaryfalse
ImagingStudy.series.instance.uid
Element IdImagingStudy.series.instance.uid
Definition

The DICOM SOP Instance UID for this image or other DICOM content.

Cardinality1..1
Typeid
Requirements

DICOM SOP Instance UID.

Alternate NamesSOPInstanceUID
Summaryfalse
Comments

See DICOM PS3.3 C.12.1 .

ImagingStudy.series.instance.sopClass
Element IdImagingStudy.series.instance.sopClass
Definition

DICOM instance type.

Cardinality1..1
Terminology BindingsopClass :
TypeCoding
Alternate NamesSOPClassUID
Summaryfalse
ImagingStudy.series.instance.number
Element IdImagingStudy.series.instance.number
Definition

The number of instance in the series.

Cardinality0..1
TypeunsignedInt
Alternate NamesInstanceNumber
Summaryfalse
ImagingStudy.series.instance.title
Element IdImagingStudy.series.instance.title
Definition

The description of the instance.

Cardinality0..1
Typestring
Summaryfalse
Comments

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