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4.23 Resource ImagingStudy - Content

This resource maintained by the Imaging Integration Work Group

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.

4.23.1 Scope and Usage

This resource summarizes a series of images or other instances generated as part of an imaging study, and provides references to where the images are available using WADO-RS. This resource is used to make information available concerning images etc. that are referenced in other clinical contexts such as diagnostic reports, Care Plans, etc. Also, see the use case description below.

This resource has been specifically designed with use in DICOM contexts in mind. The content is closely based on the definitions of the equivalent DICOM constructs, and informed by usage patterns already established through DICOM implementation practices, including XDS-I. It is not, however, necessary to use DICOM infrastructure in order to use this resource.

This resource is referenced by DiagnosticReport and Procedure

4.23.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImagingStudy DomainResourceA set of images produced in single study (one or more series of references images)
... started 0..1dateTimeWhen the study was started (0008,0020)+(0008,0030)
... patient 1..1PatientWho the images are of
... uid 1..1oidFormal identifier for the study (0020,000D)
... accession 0..1IdentifierAccession Number (0008,0050)
... identifier 0..*IdentifierOther identifiers for the study (0020,0010)
... order 0..*DiagnosticOrderOrder(s) that caused this study to be performed
... modalityList 0..*codeAll series.modality if actual acquisition modalities
ImagingModality (Required)
... referrer 0..1PractitionerReferring physician (0008,0090)
... availability 0..1codeONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
InstanceAvailability (Required)
... url 0..1uriRetrieve URI (0008,1190)
... numberOfSeries 1..1unsignedIntNumber of Study Related Series (0020,1206)
... numberOfInstances 1..1unsignedIntNumber of Study Related Instances (0020,1208)
... clinicalInformation 0..1stringDiagnoses etc with request (0040,1002)
... procedure 0..*CodingType of procedure performed (0008,1032)
... interpreter 0..1PractitionerWho interpreted images (0008,1060)
... description 0..1stringInstitution-generated description (0008,1030)
... series 0..*ElementEach study has one or more series of instances
.... number 0..1unsignedIntNumeric identifier of this series (0020,0011)
.... modality 1..1codeThe modality of the instances in the series (0008,0060)
Modality (Required)
.... uid 1..1oidFormal identifier for this series (0020,000E)
.... description 0..1stringA description of the series (0008,103E)
.... numberOfInstances 1..1unsignedIntNumber of Series Related Instances (0020,1209)
.... availability 0..1codeONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
InstanceAvailability (Required)
.... url 0..1uriRetrieve URI (0008,1115 > 0008,1190)
.... bodySite 0..1CodingBody part examined (Map from 0018,0015)
BodySite (Example)
.... laterality 0..1CodingBody part laterality
.... dateTime 0..1dateTimeWhen the series started
.... instance 0..*ElementA single instance taken from a patient (image or other)
..... number 0..1unsignedIntThe number of this instance in the series (0020,0013)
..... uid 1..1oidFormal identifier for this instance (0008,0018)
..... sopclass 1..1oidDICOM class type (0008,0016)
..... type 0..1stringType of instance (image etc) (0004,1430)
..... title 0..1stringDescription (0070,0080 | 0040,A043 > 0008,0104 | 0042,0010 | 0008,0008)
..... content 0..*AttachmentContent of the instance

UML Diagram

ImagingStudy (DomainResource)Date and Time the study started. Timezone Offset From UTCstarted : dateTime 0..1The patient imaged in the studypatient : Reference(Patient) 1..1Formal identifier for the studyuid : oid 1..1Accession Numberaccession : Identifier 0..1Other identifiers for the studyidentifier : Identifier 0..*A list of the diagnostic orders that resulted in this imaging study being performedorder : Reference(DiagnosticOrder) 0..*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)modalityList : code 0..* « Type of acquired image data in the instanceImagingModality »The requesting/referring physicianreferrer : Reference(Practitioner) 0..1Availability of study (online, offline or nearline)availability : code 0..1 « Availability of the resourceInstanceAvailability »WADO-RS resource where Study is availableurl : uri 0..1Number of Series in StudynumberOfSeries : unsignedInt 1..1Number of SOP Instances in StudynumberOfInstances : unsignedInt 1..1Diagnoses etc provided with requestclinicalInformation : string 0..1Type of procedure performedprocedure : Coding 0..*Who read study and interpreted the imagesinterpreter : Reference(Practitioner) 0..1Institution-generated description or classification of the Study performeddescription : string 0..1SeriesThe Numeric identifier of this series in the studynumber : unsignedInt 0..1The modality of this series sequencemodality : code 1..1 « Type of data in the instanceModality »Formal identifier for this seriesuid : oid 1..1A description of the seriesdescription : string 0..1Number of SOP Instances in SeriesnumberOfInstances : unsignedInt 1..1Availability of series (online, offline or nearline)availability : code 0..1 « Availability of the resourceInstanceAvailability »WADO-RS resource where the Series is availableurl : uri 0..1Body part examined. See DICOM Part 16 Annex L for the mapping from DICOM to SnomedbodySite : Coding 0..1 « (Codes describing anatomical locations. May include lateralityBodySite) »Laterality if bodySite is paired anatomic structure and laterality is not pre-coordinated in bodySite code, map from (0020, 0060)laterality : Coding 0..1The date and time when the series was starteddateTime : dateTime 0..1InstanceThe number of this image in the seriesnumber : unsignedInt 0..1Formal identifier for this imageuid : oid 1..1DICOM Image typesopclass : oid 1..1A human-friendly SOP Class nametype : string 0..1The description of the instancetitle : string 0..1Content of the instance or a rendering thereof (e.g., a JPEG of an image, or an XML of a structured report). May be represented by inline encoding, or by a URL reference to a WADO-RS service that makes the instance available. Multiple content attachments may be used for alternate representations of the instancecontent : Attachment 0..*A single SOP Instance within the series, e.g., an image, or presentation stateinstance0..*Each study has one or more series of image instancesseries0..*

XML Template

<ImagingStudy xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <started value="[dateTime]"/><!-- 0..1 When the study was started (0008,0020)+(0008,0030) -->
 <patient><!-- 1..1 Reference(Patient) Who the images are of --></patient>
 <uid value="[oid]"/><!-- 1..1 Formal identifier for the study (0020,000D) -->
 <accession><!-- 0..1 Identifier Accession Number (0008,0050) --></accession>
 <identifier><!-- 0..* Identifier Other identifiers for the study (0020,0010) --></identifier>
 <order><!-- 0..* Reference(DiagnosticOrder) Order(s) that caused this study to be performed --></order>
 <modalityList value="[code]"/><!-- 0..* All series.modality if actual acquisition modalities -->
 <referrer><!-- 0..1 Reference(Practitioner) Referring physician (0008,0090) --></referrer>
 <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056) -->
 <url value="[uri]"/><!-- 0..1 Retrieve URI (0008,1190) -->
 <numberOfSeries value="[unsignedInt]"/><!-- 1..1 Number of Study Related Series (0020,1206) -->
 <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Study Related Instances (0020,1208) -->
 <clinicalInformation value="[string]"/><!-- 0..1 Diagnoses etc with request (0040,1002) -->
 <procedure><!-- 0..* Coding Type of procedure performed (0008,1032) --></procedure>
 <interpreter><!-- 0..1 Reference(Practitioner) Who interpreted images (0008,1060) --></interpreter>
 <description value="[string]"/><!-- 0..1 Institution-generated description (0008,1030) -->
 <series>  <!-- 0..* Each study has one or more series of instances -->
  <number value="[unsignedInt]"/><!-- 0..1 Numeric identifier of this series (0020,0011) -->
  <modality value="[code]"/><!-- 1..1 The modality of the instances in the series (0008,0060) -->
  <uid value="[oid]"/><!-- 1..1 Formal identifier for this series (0020,000E) -->
  <description value="[string]"/><!-- 0..1 A description of the series (0008,103E) -->
  <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Series Related Instances (0020,1209) -->
  <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056) -->
  <url value="[uri]"/><!-- 0..1 Retrieve URI (0008,1115 > 0008,1190) -->
  <bodySite><!-- 0..1 Coding Body part examined (Map from 0018,0015) --></bodySite>
  <laterality><!-- 0..1 Coding Body part laterality --></laterality>
  <dateTime value="[dateTime]"/><!-- 0..1 When the series started -->
  <instance>  <!-- 0..* A single instance taken from a patient (image or other) -->
   <number value="[unsignedInt]"/><!-- 0..1 The number of this instance in the series (0020,0013) -->
   <uid value="[oid]"/><!-- 1..1 Formal identifier for this instance (0008,0018) -->
   <sopclass value="[oid]"/><!-- 1..1 DICOM class type (0008,0016) -->
   <type value="[string]"/><!-- 0..1 Type of instance (image etc) (0004,1430) -->
   <title value="[string]"/><!-- 0..1 Description (0070,0080 | 0040,A043 > 0008,0104 | 0042,0010 | 0008,0008) -->
   <content><!-- 0..* Attachment Content of the instance --></content>
  </instance>
 </series>
</ImagingStudy>

JSON Template

{doco
  "resourceType" : "ImagingStudy",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "started" : "<dateTime>", // When the study was started (0008,0020)+(0008,0030)
  "patient" : { Reference(Patient) }, // R!  Who the images are of
  "uid" : "<oid>", // R!  Formal identifier for the study (0020,000D)
  "accession" : { Identifier }, // Accession Number (0008,0050)
  "identifier" : [{ Identifier }], // Other identifiers for the study (0020,0010)
  "order" : [{ Reference(DiagnosticOrder) }], // Order(s) that caused this study to be performed
  "modalityList" : ["<code>"], // All series.modality if actual acquisition modalities
  "referrer" : { Reference(Practitioner) }, // Referring physician (0008,0090)
  "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
  "url" : "<uri>", // Retrieve URI (0008,1190)
  "numberOfSeries" : "<unsignedInt>", // R!  Number of Study Related Series (0020,1206)
  "numberOfInstances" : "<unsignedInt>", // R!  Number of Study Related Instances (0020,1208)
  "clinicalInformation" : "<string>", // Diagnoses etc with request (0040,1002)
  "procedure" : [{ Coding }], // Type of procedure performed (0008,1032)
  "interpreter" : { Reference(Practitioner) }, // Who interpreted images (0008,1060)
  "description" : "<string>", // Institution-generated description (0008,1030)
  "series" : [{ // Each study has one or more series of instances
    "number" : "<unsignedInt>", // Numeric identifier of this series (0020,0011)
    "modality" : "<code>", // R!  The modality of the instances in the series (0008,0060)
    "uid" : "<oid>", // R!  Formal identifier for this series (0020,000E)
    "description" : "<string>", // A description of the series (0008,103E)
    "numberOfInstances" : "<unsignedInt>", // R!  Number of Series Related Instances (0020,1209)
    "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
    "url" : "<uri>", // Retrieve URI (0008,1115 > 0008,1190)
    "bodySite" : { Coding }, // Body part examined (Map from 0018,0015)
    "laterality" : { Coding }, // Body part laterality
    "dateTime" : "<dateTime>", // When the series started
    "instance" : [{ // A single instance taken from a patient (image or other)
      "number" : "<unsignedInt>", // The number of this instance in the series (0020,0013)
      "uid" : "<oid>", // R!  Formal identifier for this instance (0008,0018)
      "sopclass" : "<oid>", // R!  DICOM class type (0008,0016)
      "type" : "<string>", // Type of instance (image etc) (0004,1430)
      "title" : "<string>", // Description (0070,0080 | 0040,A043 > 0008,0104 | 0042,0010 | 0008,0008)
      "content" : [{ Attachment }] // Content of the instance
    }]
  }]
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImagingStudy DomainResourceA set of images produced in single study (one or more series of references images)
... started 0..1dateTimeWhen the study was started (0008,0020)+(0008,0030)
... patient 1..1PatientWho the images are of
... uid 1..1oidFormal identifier for the study (0020,000D)
... accession 0..1IdentifierAccession Number (0008,0050)
... identifier 0..*IdentifierOther identifiers for the study (0020,0010)
... order 0..*DiagnosticOrderOrder(s) that caused this study to be performed
... modalityList 0..*codeAll series.modality if actual acquisition modalities
ImagingModality (Required)
... referrer 0..1PractitionerReferring physician (0008,0090)
... availability 0..1codeONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
InstanceAvailability (Required)
... url 0..1uriRetrieve URI (0008,1190)
... numberOfSeries 1..1unsignedIntNumber of Study Related Series (0020,1206)
... numberOfInstances 1..1unsignedIntNumber of Study Related Instances (0020,1208)
... clinicalInformation 0..1stringDiagnoses etc with request (0040,1002)
... procedure 0..*CodingType of procedure performed (0008,1032)
... interpreter 0..1PractitionerWho interpreted images (0008,1060)
... description 0..1stringInstitution-generated description (0008,1030)
... series 0..*ElementEach study has one or more series of instances
.... number 0..1unsignedIntNumeric identifier of this series (0020,0011)
.... modality 1..1codeThe modality of the instances in the series (0008,0060)
Modality (Required)
.... uid 1..1oidFormal identifier for this series (0020,000E)
.... description 0..1stringA description of the series (0008,103E)
.... numberOfInstances 1..1unsignedIntNumber of Series Related Instances (0020,1209)
.... availability 0..1codeONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
InstanceAvailability (Required)
.... url 0..1uriRetrieve URI (0008,1115 > 0008,1190)
.... bodySite 0..1CodingBody part examined (Map from 0018,0015)
BodySite (Example)
.... laterality 0..1CodingBody part laterality
.... dateTime 0..1dateTimeWhen the series started
.... instance 0..*ElementA single instance taken from a patient (image or other)
..... number 0..1unsignedIntThe number of this instance in the series (0020,0013)
..... uid 1..1oidFormal identifier for this instance (0008,0018)
..... sopclass 1..1oidDICOM class type (0008,0016)
..... type 0..1stringType of instance (image etc) (0004,1430)
..... title 0..1stringDescription (0070,0080 | 0040,A043 > 0008,0104 | 0042,0010 | 0008,0008)
..... content 0..*AttachmentContent of the instance

UML Diagram

ImagingStudy (DomainResource)Date and Time the study started. Timezone Offset From UTCstarted : dateTime 0..1The patient imaged in the studypatient : Reference(Patient) 1..1Formal identifier for the studyuid : oid 1..1Accession Numberaccession : Identifier 0..1Other identifiers for the studyidentifier : Identifier 0..*A list of the diagnostic orders that resulted in this imaging study being performedorder : Reference(DiagnosticOrder) 0..*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)modalityList : code 0..* « Type of acquired image data in the instanceImagingModality »The requesting/referring physicianreferrer : Reference(Practitioner) 0..1Availability of study (online, offline or nearline)availability : code 0..1 « Availability of the resourceInstanceAvailability »WADO-RS resource where Study is availableurl : uri 0..1Number of Series in StudynumberOfSeries : unsignedInt 1..1Number of SOP Instances in StudynumberOfInstances : unsignedInt 1..1Diagnoses etc provided with requestclinicalInformation : string 0..1Type of procedure performedprocedure : Coding 0..*Who read study and interpreted the imagesinterpreter : Reference(Practitioner) 0..1Institution-generated description or classification of the Study performeddescription : string 0..1SeriesThe Numeric identifier of this series in the studynumber : unsignedInt 0..1The modality of this series sequencemodality : code 1..1 « Type of data in the instanceModality »Formal identifier for this seriesuid : oid 1..1A description of the seriesdescription : string 0..1Number of SOP Instances in SeriesnumberOfInstances : unsignedInt 1..1Availability of series (online, offline or nearline)availability : code 0..1 « Availability of the resourceInstanceAvailability »WADO-RS resource where the Series is availableurl : uri 0..1Body part examined. See DICOM Part 16 Annex L for the mapping from DICOM to SnomedbodySite : Coding 0..1 « (Codes describing anatomical locations. May include lateralityBodySite) »Laterality if bodySite is paired anatomic structure and laterality is not pre-coordinated in bodySite code, map from (0020, 0060)laterality : Coding 0..1The date and time when the series was starteddateTime : dateTime 0..1InstanceThe number of this image in the seriesnumber : unsignedInt 0..1Formal identifier for this imageuid : oid 1..1DICOM Image typesopclass : oid 1..1A human-friendly SOP Class nametype : string 0..1The description of the instancetitle : string 0..1Content of the instance or a rendering thereof (e.g., a JPEG of an image, or an XML of a structured report). May be represented by inline encoding, or by a URL reference to a WADO-RS service that makes the instance available. Multiple content attachments may be used for alternate representations of the instancecontent : Attachment 0..*A single SOP Instance within the series, e.g., an image, or presentation stateinstance0..*Each study has one or more series of image instancesseries0..*

XML Template

<ImagingStudy xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <started value="[dateTime]"/><!-- 0..1 When the study was started (0008,0020)+(0008,0030) -->
 <patient><!-- 1..1 Reference(Patient) Who the images are of --></patient>
 <uid value="[oid]"/><!-- 1..1 Formal identifier for the study (0020,000D) -->
 <accession><!-- 0..1 Identifier Accession Number (0008,0050) --></accession>
 <identifier><!-- 0..* Identifier Other identifiers for the study (0020,0010) --></identifier>
 <order><!-- 0..* Reference(DiagnosticOrder) Order(s) that caused this study to be performed --></order>
 <modalityList value="[code]"/><!-- 0..* All series.modality if actual acquisition modalities -->
 <referrer><!-- 0..1 Reference(Practitioner) Referring physician (0008,0090) --></referrer>
 <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056) -->
 <url value="[uri]"/><!-- 0..1 Retrieve URI (0008,1190) -->
 <numberOfSeries value="[unsignedInt]"/><!-- 1..1 Number of Study Related Series (0020,1206) -->
 <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Study Related Instances (0020,1208) -->
 <clinicalInformation value="[string]"/><!-- 0..1 Diagnoses etc with request (0040,1002) -->
 <procedure><!-- 0..* Coding Type of procedure performed (0008,1032) --></procedure>
 <interpreter><!-- 0..1 Reference(Practitioner) Who interpreted images (0008,1060) --></interpreter>
 <description value="[string]"/><!-- 0..1 Institution-generated description (0008,1030) -->
 <series>  <!-- 0..* Each study has one or more series of instances -->
  <number value="[unsignedInt]"/><!-- 0..1 Numeric identifier of this series (0020,0011) -->
  <modality value="[code]"/><!-- 1..1 The modality of the instances in the series (0008,0060) -->
  <uid value="[oid]"/><!-- 1..1 Formal identifier for this series (0020,000E) -->
  <description value="[string]"/><!-- 0..1 A description of the series (0008,103E) -->
  <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Series Related Instances (0020,1209) -->
  <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056) -->
  <url value="[uri]"/><!-- 0..1 Retrieve URI (0008,1115 > 0008,1190) -->
  <bodySite><!-- 0..1 Coding Body part examined (Map from 0018,0015) --></bodySite>
  <laterality><!-- 0..1 Coding Body part laterality --></laterality>
  <dateTime value="[dateTime]"/><!-- 0..1 When the series started -->
  <instance>  <!-- 0..* A single instance taken from a patient (image or other) -->
   <number value="[unsignedInt]"/><!-- 0..1 The number of this instance in the series (0020,0013) -->
   <uid value="[oid]"/><!-- 1..1 Formal identifier for this instance (0008,0018) -->
   <sopclass value="[oid]"/><!-- 1..1 DICOM class type (0008,0016) -->
   <type value="[string]"/><!-- 0..1 Type of instance (image etc) (0004,1430) -->
   <title value="[string]"/><!-- 0..1 Description (0070,0080 | 0040,A043 > 0008,0104 | 0042,0010 | 0008,0008) -->
   <content><!-- 0..* Attachment Content of the instance --></content>
  </instance>
 </series>
</ImagingStudy>

JSON Template

{doco
  "resourceType" : "ImagingStudy",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "started" : "<dateTime>", // When the study was started (0008,0020)+(0008,0030)
  "patient" : { Reference(Patient) }, // R!  Who the images are of
  "uid" : "<oid>", // R!  Formal identifier for the study (0020,000D)
  "accession" : { Identifier }, // Accession Number (0008,0050)
  "identifier" : [{ Identifier }], // Other identifiers for the study (0020,0010)
  "order" : [{ Reference(DiagnosticOrder) }], // Order(s) that caused this study to be performed
  "modalityList" : ["<code>"], // All series.modality if actual acquisition modalities
  "referrer" : { Reference(Practitioner) }, // Referring physician (0008,0090)
  "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
  "url" : "<uri>", // Retrieve URI (0008,1190)
  "numberOfSeries" : "<unsignedInt>", // R!  Number of Study Related Series (0020,1206)
  "numberOfInstances" : "<unsignedInt>", // R!  Number of Study Related Instances (0020,1208)
  "clinicalInformation" : "<string>", // Diagnoses etc with request (0040,1002)
  "procedure" : [{ Coding }], // Type of procedure performed (0008,1032)
  "interpreter" : { Reference(Practitioner) }, // Who interpreted images (0008,1060)
  "description" : "<string>", // Institution-generated description (0008,1030)
  "series" : [{ // Each study has one or more series of instances
    "number" : "<unsignedInt>", // Numeric identifier of this series (0020,0011)
    "modality" : "<code>", // R!  The modality of the instances in the series (0008,0060)
    "uid" : "<oid>", // R!  Formal identifier for this series (0020,000E)
    "description" : "<string>", // A description of the series (0008,103E)
    "numberOfInstances" : "<unsignedInt>", // R!  Number of Series Related Instances (0020,1209)
    "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
    "url" : "<uri>", // Retrieve URI (0008,1115 > 0008,1190)
    "bodySite" : { Coding }, // Body part examined (Map from 0018,0015)
    "laterality" : { Coding }, // Body part laterality
    "dateTime" : "<dateTime>", // When the series started
    "instance" : [{ // A single instance taken from a patient (image or other)
      "number" : "<unsignedInt>", // The number of this instance in the series (0020,0013)
      "uid" : "<oid>", // R!  Formal identifier for this instance (0008,0018)
      "sopclass" : "<oid>", // R!  DICOM class type (0008,0016)
      "type" : "<string>", // Type of instance (image etc) (0004,1430)
      "title" : "<string>", // Description (0070,0080 | 0040,A043 > 0008,0104 | 0042,0010 | 0008,0008)
      "content" : [{ Attachment }] // Content of the instance
    }]
  }]
}

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON)

4.23.2.1 Terminology Bindings

PathDefinitionTypeReference
ImagingStudy.modalityList Type of acquired image data in the instanceRequiredhttp://hl7.org/fhir/imaging-modality
ImagingStudy.availability
ImagingStudy.series.availability 		Availability of the resourceRequiredhttp://hl7.org/fhir/instance-availability
ImagingStudy.series.modality Type of data in the instanceRequiredhttp://hl7.org/fhir/modality
ImagingStudy.series.bodySite Codes describing anatomical locations. May include lateralityExamplehttp://hl7.org/fhir/vs/body-site

4.23.2.2 Implementation Notes

  • Instances can be images, but they can also be dicom structured documents or other dicom classes
  • Each instance may have a url and an attachment. Both represent the same information, but using different approaches. The URL is a reference to a WADO-RS service that makes the instance available, while the attachment is a reference to a FHIR resource (Media, Composition, etc).
  • This resource follows DICOM practice in using OIDs for elements such as instance type rather than codes.

4.23.2.3 Use Case

The following storyboard illustrates the primary use case for this resource:

An oncologist, Karen, is seeing patients in her clinic, and would like background on the patients she is seeing today. Her first patient of the day, Alex. has arrived. She launches her Electronic Medical Record (EMR) software, and makes a Patient query on Alex using his last name. The EMR software makes a FHIR query on the Patient resource, to provide background demographic information for cover page rendering. The EMR software makes a subsequent FHIR query on the Condition resource, and reports that Alex is suspected to have prostate cancer. With this information, Karen decides to check for two further tests - the results of a Prostate-Specific Antigen (PSA) laboratory test, and of a CT exam performed at the local diagnostic facility. First, a FHIR query is made against the Observation resource to query for the most recent value of PSA (the EMR also queries previous values of PSA for trending). For the CT exam, the EMR software queries on the ImagingStudy resource to retrieve a list of available images with other relevant constraints (such as modality, body region etc.). This returns back the studies available, with relevant meta-data about each study, its series and images. This information will help Karen to select which study would like to review. Using the WADO-RS references provided, the artifacts Karen would like to review can be downloaded and viewed using capable DICOM viewing software.

4.23.3 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
accessiontokenThe accession id for the imageImagingStudy.accession
bodysitetokenBody part examined (Map from 0018,0015)ImagingStudy.series.bodySite
dicom-classtokenDICOM class type (0008,0016)ImagingStudy.series.instance.sopclass
modalitytokenThe modality of the imageImagingStudy.series.modality
orderreferenceThe order for the imageImagingStudy.order
(DiagnosticOrder)
patientreferenceWho the study is aboutImagingStudy.patient
(Patient)
seriestokenThe series id for the imageImagingStudy.series.uid
starteddateWhen the study was startedImagingStudy.started
studytokenThe study id for the imageImagingStudy.uid
uidtokenFormal identifier for this instance (0008,0018)ImagingStudy.series.instance.uid