R6 Ballot (2nd Draft)

Publish-box (todo)

Imaging Integration icon Work GroupMaturity Level: 4 Trial UseSecurity Category: Patient Compartments: Patient

Detailed Descriptions for the elements in the ImagingStudy resource.

ImagingStudy
Element Id 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.

Short Display A set of images produced in single study (one or more series of references images)
Cardinality 0..*
Type DomainResource
Summary false
ImagingStudy.identifier
Element Id ImagingStudy.identifier
Definition

Identifiers for the ImagingStudy such as DICOM Study Instance UID.

Short Display Identifiers for the whole study
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
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 icon.

Alternate Names StudyInstanceUID
Summary true
Comments

See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID.

ImagingStudy.status
Element Id ImagingStudy.status
Definition

The current state of the ImagingStudy resource. This is not the status of any ServiceRequest or Task resources associated with the ImagingStudy.

Short Display registered | available | cancelled | entered-in-error | unknown
Cardinality 1..1
Terminology Binding Imaging Study Status (Required)
Type code
Is Modifier true (Reason: This element is labeled 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)
Summary true
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 Id ImagingStudy.modality
Definition

A list of all the distinct values of series.modality. This may include both acquisition and non-acquisition modalities.

Short Display All of the distinct values for series' modalities
Cardinality 0..*
Terminology Binding Modality icon (Extensible)
Type CodeableConcept
Alternate Names ModalitiesInStudy
Summary true
ImagingStudy.subject
Element Id ImagingStudy.subject
Definition

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

Short Display Who or what is the subject of the study
Cardinality 1..1
Type Reference(Patient | Device | Group)
Summary true
Comments

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

ImagingStudy.encounter
Element Id ImagingStudy.encounter
Definition

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

Short Display Encounter with which this imaging study is associated
Cardinality 0..1
Type Reference(Encounter)
Summary true
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 Id ImagingStudy.started
Definition

Date and time the study started.

Short Display When the study was started
Cardinality 0..1
Type dateTime
Alternate Names StudyDate; StudyTime
Summary true
ImagingStudy.basedOn
Element Id ImagingStudy.basedOn
Definition

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

Short Display Request fulfilled
Cardinality 0..*
Type Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)
Requirements

To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). If the ImagingStudy is associated with an Accession Number, this field should include a reference to that value in the form:

  • type = ServiceRequest
  • identifier.value = (Accession Number Value)
  • identifier.type = ACSN A reference value pointing to a ServiceRequest resource is allowed but is not required.
Alternate Names AccessionNumber
Summary true
ImagingStudy.partOf
Element Id ImagingStudy.partOf
Definition

A larger event of which this particular ImagingStudy is a component or step. For example, an ImagingStudy as part of a procedure.

Short Display Part of referenced event
Cardinality 0..*
Type Reference(Procedure)
Summary true
Comments

To link an ImagingStudy to an Encounter use encounter.

ImagingStudy.referrer
Element Id ImagingStudy.referrer
Definition

The requesting/referring physician.

Short Display Referring physician
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole)
Alternate Names ReferringPhysiciansName
Summary true
ImagingStudy.endpoint
Element Id 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.connectionType.

Short Display Study access endpoint
Cardinality 0..*
Type Reference(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.

Summary true
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. See Imaging Study Implementation Notes on Endpoints.

ImagingStudy.numberOfSeries
Element Id 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.

Short Display Number of Study Related Series
Cardinality 0..1
Type unsignedInt
Alternate Names NumberOfStudyRelatedSeries
Summary true
ImagingStudy.numberOfInstances
Element Id 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.

Short Display Number of Study Related Instances
Cardinality 0..1
Type unsignedInt
Alternate Names NumberOfStudyRelatedInstances
Summary true
ImagingStudy.procedure
Element Id ImagingStudy.procedure
Definition

This field corresponds to the DICOM Procedure Code Sequence (0008,1032). This is different from the FHIR Procedure resource that may include the ImagingStudy.

Short Display The performed procedure or code
Cardinality 0..*
Terminology Binding ImagingProcedureCode icon:
Type CodeableReference(PlanDefinition | ActivityDefinition)
Summary true
ImagingStudy.location
Element Id ImagingStudy.location
Definition

The principal physical location where the ImagingStudy was performed.

Short Display Where ImagingStudy occurred
Cardinality 0..1
Type Reference(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).

Summary true
ImagingStudy.reason
Element Id ImagingStudy.reason
Definition

Description of clinical condition indicating why the ImagingStudy was requested, and/or Indicates another resource whose existence justifies this Study.

Short Display Why the study was requested / performed
Cardinality 0..*
Terminology Binding Procedure Reason Codes (Example)
Type CodeableReference(Condition | Observation | DiagnosticReport | DocumentReference)
Summary true
ImagingStudy.note
Element Id ImagingStudy.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.

Short Display User-defined comments
Cardinality 0..*
Type Annotation
Summary true
ImagingStudy.description
Element Id ImagingStudy.description
Definition

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

Short Display Institution-generated description
Cardinality 0..1
Type string
Alternate Names StudyDescription
Summary true
ImagingStudy.series
Element Id ImagingStudy.series
Definition

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

Short Display Each study has one or more series of instances
Cardinality 0..*
Summary true
ImagingStudy.series.uid
Element Id ImagingStudy.series.uid
Definition

The DICOM Series Instance UID for the series.

Short Display DICOM Series Instance UID for the series
Cardinality 1..1
Type id
Requirements

DICOM Series Instance UID.

Alternate Names SeriesInstanceUID
Summary true
Comments

See DICOM PS3.3 C.7.3 icon.

ImagingStudy.series.number
Element Id ImagingStudy.series.number
Definition

The numeric identifier of this series in the study.

Short Display Numeric identifier of this series
Cardinality 0..1
Type unsignedInt
Alternate Names SeriesNumber
Summary true
ImagingStudy.series.modality
Element Id ImagingStudy.series.modality
Definition

The distinct modality for this series. This may include both acquisition and non-acquisition modalities.

Short Display The modality used for this series
Cardinality 1..1
Terminology Binding Modality icon (Extensible)
Type CodeableConcept
Alternate Names Modality
Summary true
ImagingStudy.series.description
Element Id ImagingStudy.series.description
Definition

A description of the series.

Short Display A short human readable summary of the series
Cardinality 0..1
Type string
Alternate Names SeriesDescription
Summary true
ImagingStudy.series.numberOfInstances
Element Id 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.

Short Display Number of Series Related Instances
Cardinality 0..1
Type unsignedInt
Alternate Names NumberOfSeriesRelatedInstances
Summary true
ImagingStudy.series.endpoint
Element Id 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.connectionType.

Short Display Series access endpoint
Cardinality 0..*
Type Reference(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.

Summary true
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. See Imaging Study Implementation Notes on Endpoints.

ImagingStudy.series.bodySite
Element Id ImagingStudy.series.bodySite
Definition

The anatomic structures examined. See DICOM Part 16 Annex L icon 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.

Short Display Body part examined
Cardinality 0..1
Terminology Binding SNOMED CT Body Structures (Example)
Type CodeableReference(BodyStructure)
Alternate Names BodyPartExamined
Summary true
ImagingStudy.series.laterality
Element Id 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.

Short Display Body part laterality
Cardinality 0..1
Terminology Binding Laterality icon (Example)
Type CodeableConcept
Summary true
ImagingStudy.series.specimen
Element Id ImagingStudy.series.specimen
Definition

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

Short Display Specimen imaged
Cardinality 0..*
Type Reference(Specimen)
Summary true
ImagingStudy.series.started
Element Id ImagingStudy.series.started
Definition

The date and time the series was started.

Short Display When the series started
Cardinality 0..1
Type dateTime
Summary true
ImagingStudy.series.performer
Element Id ImagingStudy.series.performer
Definition

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

Short Display Who performed the series
Cardinality 0..*
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 Names PerformingPhysicianName; OperatorName
Summary true
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 Id ImagingStudy.series.performer.function
Definition

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

Short Display Type of performance
Cardinality 0..1
Terminology Binding ImagingStudy series performer function (Extensible)
Type CodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

Summary true
ImagingStudy.series.performer.actor
Element Id ImagingStudy.series.performer.actor
Definition

Indicates who or what performed the series.

Short Display Who performed the series
Cardinality 1..1
Type Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson | HealthcareService)
Summary true
ImagingStudy.series.instance
Element Id ImagingStudy.series.instance
Definition

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

Short Display A single SOP instance from the series
Cardinality 0..*
Summary false
ImagingStudy.series.instance.uid
Element Id ImagingStudy.series.instance.uid
Definition

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

Short Display DICOM SOP Instance UID
Cardinality 1..1
Type id
Requirements

DICOM SOP Instance UID.

Alternate Names SOPInstanceUID
Summary false
Comments

See DICOM PS3.3 C.12.1 icon.

ImagingStudy.series.instance.sopClass
Element Id ImagingStudy.series.instance.sopClass
Definition

DICOM instance type.

Short Display DICOM class type
Cardinality 1..1
Type oid
Alternate Names SOPClassUID
Summary false
ImagingStudy.series.instance.number
Element Id ImagingStudy.series.instance.number
Definition

The number of instance in the series.

Short Display The number of this instance in the series
Cardinality 0..1
Type unsignedInt
Alternate Names InstanceNumber
Summary false
ImagingStudy.series.instance.title
Element Id ImagingStudy.series.instance.title
Definition

The description of the instance.

Short Display Description of instance
Cardinality 0..1
Type string
Summary false
Comments

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