This page is part of the FHIR Specification (v0.0.82: DSTU 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

• Content
• Examples
• Formal Definitions
• Mappings
• Profiles

4.18 Resource ImagingStudy - Content

Manifest of a set of images produced in study. The set of images may include every image in the study, or it may be an incomplete sample, such as a list of key images.

4.18.2 Resource Content

This resource is referenced by DiagnosticReport and Procedure

<ImagingStudy xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: extension, modifierExtension, language, text, and contained -->
 <dateTime value="[dateTime]"/><!-- 0..1 When the study was performed -->
 <subject><!-- 1..1 Resource(Patient) Who the images are of --></subject>
 <uid value="[oid]"/><!-- 1..1 Formal identifier for the study (0020,000D) -->
 <accessionNo><!-- 0..1 Identifier Accession Number (0008,0050) --></accessionNo>
 <identifier><!-- 0..* Identifier Other identifiers for the study (0020,0010) --></identifier>
 <order><!-- 0..* Resource(DiagnosticOrder) Order(s) that caused this study to be performed --></order>
 <modality value="[code]"/><!-- 0..* All series.modality if actual acquisition modalities -->
 <referrer><!-- 0..1 Resource(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="[integer]"/><!-- 1..1 Number of Study Related Series (0020,1206) -->
 <numberOfInstances value="[integer]"/><!-- 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 Resource(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="[integer]"/><!-- 0..1 Number of this series in overall sequence (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="[integer]"/><!-- 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>
  <dateTime value="[dateTime]"/><!-- 0..1 When the series started -->
  <instance>  <!-- 1..* A single instance taken from a patient (image or other) -->
   <number value="[integer]"/><!-- 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) -->
   <url value="[uri]"/><!-- 0..1 WADO-RS service where instance is available  (0008,1199 > 0008,1190) -->
   <attachment><!-- 0..1 Resource(Any) A FHIR resource with content for this instance --></attachment>
  </instance>
 </series>
</ImagingStudy>

Alternate definitions: Schema/Schematron, Resource Profile

4.18.2.1 Terminology Bindings

4.18.2.2 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 useing OIDs for elements such as instance type rather than codes.

4.18.2.3 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.

4.18.3 Search Parameters

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