This page is part of the CodeX™ Radiation Therapy (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Change Log

CodeX Radiation Therapy STU 1 Publication Version

These are the changes that were made during ballot reconciliation.

Narrative Changes

• Added description of relationship between the profiles
• Added description of revision or adaptation of prescriptions and plans
• Updated the data elements diagram to reflect changes in the profiles

Profile Additions

• Added Radiotherapy Adverse Event profile based on Vulcan and CTCAE, along with associated ValueSets (FHIR-40654)

Profile Changes

• The relationship between the profiles have been implemented with open, profile-based slicing of the basedOn and replaces fields of the profiles. (FHIR-38231)
• Treatment devices are represented as proper references to [RadiotherapyTreatmentDevice], rather than using an extension. (FHIR-38220 and FHIR-38114)
• Radioactive Seeds are represented with new references to [RadiotherapySeedDevice]
• Device references have been moved out of extensions into the built-in fields with the ServiceRequest and Procedure resources (FHIR-38220 and FHIR-38114)
• A new RadiotherapyDiseaseStatus profile was added based on mCODE’s CancerDiseaseStatus profile with an additional qualifier for disease progression).(FHIR-37922)
• The mCODE DoseDeliveredToVolume extension has been extended with a boolean uniformFractionation flag when incorporated into the RadiotherapyCourseSummary profile. (FHIR-37976)
• The extensions DosePlannedToVolume and DoseDeliveredToVolume were extended in all profiles in which they were used, i.e. RadiotherapyPlannedCourse, RadiotherapyPlannedPhase, RadiotherapyTreatmentPlan, RadiotherapyCourseSummary, RadiotherapyTreatedPhase, and RadiotherapyTreatedPlan, with the following boolean flags.
  • Primary Plan Dose flag, which indicates whether the dose is the primary plan dose in a radiotherapy treatment plan.
  • Point Dose flag, which indicates whether the dose is determined at at a single point.
• An extension with a codeable concept for reason for revision and adaptiation was added to all Plan and Phase profiles. (FHIR-38231)
• An extension with a Reference to DICOM SOP Instance was added to RadiotherapyTreatmentPlan and RadiotherapyTreatedPlan profiles.
• An extension with a boolean for course involves reirradiation was added to the 3 course-level profiles.
• An extension supporting Image Guided Radiotherapy (IGRT) was added everywhere Therapeutic Modality and Technique was present. This is supported by a ValueSet of IGRT modalities and energies.
• Extensions Respiratory Motion Management and Free-Breathing Motion Management Technique were added everywhere Therapeutic Modality and Technique was present. Those are supported by the ValueSets Motion Management and Free Breathing Motion Management Technique.

Valueset Changes

• The Brachytherapy Applicator Types ValueSet has been reworked using new codes requested from SNOMEDCT.
• New SNOMEDCT codes requested by the authors have replaced local codes as they have been issued.

Codesystem Changes

• New SNOMEDCT codes requested by the authors have replaced local codes as they have been issued.

Capability Statement Changes

• Added a server capabilty statement based on XRTS requirements. Included credits for rendering.

Added Data Dictionary

• Add a data dictionary with the same format as the mCODE data dictionary.