PS-2020a / part17

Notice and Disclaimer ...........................................................................................................................................

39​

Foreword ............................................................................................................................................................

41​

1. Scope and Field of Application .............................................................................................................................

43​

2. Normative References .......................................................................................................................................

45​

3. Definitions .......................................................................................................................................................

47​

4. Symbols and Abbreviations .................................................................................................................................

49​

5. Conventions .....................................................................................................................................................

51​

A. Explanation of Patient Orientation (Normative) ........................................................................................................

53​

B. Integration of Modality Worklist and Modality Performed Procedure Step in The Original DICOM Standard (Informative) ........

65​

C. Waveforms (Informative) ....................................................................................................................................

69​

C.1. Domain of Application .................................................................................................................................

69​

C.2. Use Cases ................................................................................................................................................

69​

C.3. Time Synchronization Frame of Reference ......................................................................................................

70​

C.4. Waveform Acquisition Model ........................................................................................................................

70​

C.5. Waveform Information Model ........................................................................................................................

71​

C.6. Harmonization With HL7 ..............................................................................................................................

71​

C.6.1. HL7 Waveform Observation ...................................................................................................................

71​

C.6.2. Channel Definition ...............................................................................................................................

72​

C.6.3. Timing ...............................................................................................................................................

72​

C.6.4. Waveform Data ...................................................................................................................................

73​

C.6.5. Annotation .........................................................................................................................................

73​

C.7. Harmonization With SCP-ECG ......................................................................................................................

73​

D. SR Encoding Example (Informative) .....................................................................................................................

75​

E. Mammography CAD (Informative) ........................................................................................................................

85​

E.1. Mammography CAD SR Content Tree Structure ...............................................................................................

85​

E.2. Mammography CAD SR Observation Context Encoding .....................................................................................

87​

E.3. Mammography CAD SR Examples ................................................................................................................

88​

E.3.1. Example 1: Calcification and Mass Detection With No Findings .....................................................................

88​

E.3.2. Example 2: Calcification and Mass Detection With Findings ..........................................................................

89​

E.3.3. Example 3: Calcification and Mass Detection, Temporal Differencing With Findings ..........................................

99​

E.4. CAD Operating Point .................................................................................................................................

108​

E.5. Mammography CAD SR and For Processing / For Presentation Images ..............................................................

109​

F. Chest CAD (Informative) ...................................................................................................................................

111​

F.1. Chest CAD SR Content Tree Structure ..........................................................................................................

111​

F.2. Chest CAD SR Observation Context Encoding ...............................................................................................

112​

F.3. Chest CAD SR Examples ...........................................................................................................................

113​

F.3.1. Example 1: Lung Nodule Detection With No Findings ................................................................................

113​

F.3.2. Example 2: Lung Nodule Detection With Findings and Anatomy/pathology Interpretation ..................................

114​

F.3.3. Example 3: Lung Nodule Detection, Temporal Differencing With Findings ......................................................

117​

F.3.4. Example 4: Lung Nodule Detection in Chest Radiograph, Spatially Correlated With CT ....................................

119​

G. Explanation of Grouping Criteria For Multi-frame Functional Group IODs (Informative) ..................................................

125​

H. Clinical Trial Identification Workflow Examples (Informative) ....................................................................................

127​

H.1. Example Use-case ...................................................................................................................................

127​

I. Ultrasound Templates (Informative) .....................................................................................................................

129​

I.1. SR Content Tree Structure ..........................................................................................................................

129​

I.2. Procedure Summary ..................................................................................................................................

129​

I.3. Multiple Fetuses ........................................................................................................................................

129​

I.4. Explicitly Specifying Calculation Dependencies ................................................................................................

130​

I.5. Linking Measurements to Images, Coordinates ................................................................................................

130​

I.6. Ob Patterns ..............................................................................................................................................

131​

I.7. Selected Value ..........................................................................................................................................

132​

I.8. OB-GYN Examples ....................................................................................................................................

133​

I.8.1. Example 1: OB-GYN Root with Observation Context ..................................................................................

133​

I.8.2. Example 2: OB-GYN Patient Characteristics and Procedure Summary ...........................................................

135​

I.8.3. Example 3: OB-GYN Multiple Fetus ........................................................................................................

135​

I.8.4. Example 4: Biophysical Profile ...............................................................................................................

136​

I.8.5. Example 5: Biometry Ratios ..................................................................................................................

136​

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DICOM PS3.17 2020a - Explanatory Information​

I.8.6. Example 6: Biometry ............................................................................................................................

137​

I.8.7. Example 7: Amniotic Sac ......................................................................................................................

138​

I.8.8. Example 8: OB-GYN Ovaries

.................................................................................................................

138​

I.8.9. Example 9: OB-GYN Follicles ................................................................................................................

140​

I.8.10. Example 10: Pelvis and Uterus .............................................................................................................

141​

J. Handling of Identifying Parameters (Informative) ....................................................................................................

143​

J.1. Purpose of This Annex ...............................................................................................................................

143​

J.2. Integrated Environment ..............................................................................................................................

143​

J.2.1. Modality Conforms to Modality Worklist and MPPS SOP Classes .................................................................

143​

J.2.2. Modality Conforms Only to The Modality Worklist SOP Class ......................................................................

144​

J.2.3. Modality Conforms Only to The MPPS SOP Class .....................................................................................

145​

J.3. Non-integrated Environment ........................................................................................................................

145​

J.4. One MPPS Is Created in Response to Two Or More Requested Procedures .........................................................

146​

J.4.1. Choose Or Create A Value For Study Instance UID and Accession Number ...................................................

146​

J.4.2. Replicate The Image IOD .....................................................................................................................

147​

J.5. MPPS SOP Instance Created by Another System (not the Modality) ....................................................................

148​

J.6. Mapping of Study Instance UIDs to the Study SOP Instance UID ........................................................................

149​

K. Ultrasound Staged Protocol Data Management (Informative) ...................................................................................

151​

K.1. Purpose of this Annex ...............................................................................................................................

151​

K.2. Prerequisites For Support ...........................................................................................................................

151​

K.3. Definition of a Staged Protocol Exam ............................................................................................................

151​

K.4. Attributes Used in Staged Protocol Exams .....................................................................................................

152​

K.5. Guidelines ...............................................................................................................................................

153​

K.5.1. Staged Protocol Exam Identification .......................................................................................................

153​

K.5.2. Stage and View Identification ................................................................................................................

153​

K.5.3. Extra-protocol Image Identification .........................................................................................................

155​

K.5.4. Multiple Images of A Stage-view ...........................................................................................................

156​

K.5.5. Workflow Management of Staged Protocol Images ...................................................................................

156​

K.5.5.1. Uninterrupted Exams - Single MPPS ...............................................................................................

156​

K.5.5.2. Interrupted Exams - Multiple MPPS .................................................................................................

157​

K.5.5.2.2. Scheduled Follow-up Stages ...................................................................................................

158​

L. Hemodynamics Report Structure (Informative) ......................................................................................................

159​

M. Vascular Ultrasound Reports (Informative) ...........................................................................................................

161​

M.1. Vascular Report Structure ..........................................................................................................................

161​

M.2. Vascular Examples ...................................................................................................................................

162​

M.2.1. Example 1: Renal Vessels ...................................................................................................................

162​

M.2.2. Example 2: Carotids Extracranial ..........................................................................................................

163​

N. Echocardiography Procedure Reports (Informative) ...............................................................................................

165​

N.1. Echo Patterns ..........................................................................................................................................

165​

N.2. Measurement Terminology Composition .......................................................................................................

166​

N.3. Illustrative Mapping to ASE Concepts ...........................................................................................................

167​

N.3.1. Aorta ...............................................................................................................................................

167​

N.3.2. Aortic Valve ......................................................................................................................................

167​

N.3.3. Left Ventricle - Linear ..........................................................................................................................

168​

N.3.4. Left Ventricle Volumes and Ejection Fraction ...........................................................................................

170​

N.3.5. Left Ventricle Output ...........................................................................................................................

170​

N.3.6. Left Ventricular Outflow Tract ...............................................................................................................

171​

N.3.7. Left Ventricle Mass .............................................................................................................................

172​

N.3.8. Left Ventricle Miscellaneous

.................................................................................................................

172​

N.3.9. Mitral Valve ......................................................................................................................................

172​

N.3.10. Pulmonary Vein ...............................................................................................................................

174​

N.3.11. Left Atrium / Appendage ....................................................................................................................

175​

N.3.12. Right Ventricle .................................................................................................................................

175​

N.3.13. Pulmonic Valve / Pulmonic Artery ........................................................................................................

176​

N.3.14. Tricuspid Valve ................................................................................................................................

176​

N.3.15. Right Atrium / Inferior Vena Cava ........................................................................................................

177​

N.3.16. Congenital/Pediatric ..........................................................................................................................

178​

N.4. Encoding Examples ..................................................................................................................................

178​

N.4.1. Example 1: Patient Characteristics ........................................................................................................

178​

N.4.2. Example 2: LV Dimensions and Fractional Shortening ...............................................................................

179​

DICOM PS3.17 2020a - Explanatory Information​

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N.4.3. Example 3: Left Atrium / Aortic Root Ratio ...............................................................................................

180​

N.4.4. Example 4: Pressures .........................................................................................................................

180​

N.4.5. Example 5: Cardiac Output ..................................................................................................................

180​

N.4.6. Example 6: Wall Scoring .....................................................................................................................

181​

N.5. IVUS Report ............................................................................................................................................

182​

O. Registration (Informative) .................................................................................................................................

183​

O.1. Spatial Registration and Spatial Fiducials SOP Classes ...................................................................................

183​

O.2. Functional Use Cases ...............................................................................................................................

183​

O.3. System Interaction ....................................................................................................................................

184​

O.4. Overview of Encoding ...............................................................................................................................

185​

O.5. Matrix Registration ...................................................................................................................................

187​

O.6. Spatial Fiducials .......................................................................................................................................

187​

P. Transforms and Mappings (Informative) ...............................................................................................................

189​

Q. Breast Imaging Report (Informative) ...................................................................................................................

193​

Q.1. Breast Imaging Report Content Tree Structure ...............................................................................................

193​

Q.2. Breast Imaging Report Examples ................................................................................................................

195​

Q.2.1. Example 1: Screening Mammogram With Negative Findings ......................................................................

195​

Q.2.2. Example 2: Screening Mammogram With Negative Findings ......................................................................

196​

Q.2.3. Example 3: Diagnostic Mammogram - Unilateral ......................................................................................

198​

Q.2.4. Example 4: Diagnostic Mammogram and Ultrasound - Unilateral .................................................................

201​

R. Configuration Use Cases (Informative) ................................................................................................................

205​

R.1. Install A New Machine ...............................................................................................................................

205​

R.1.1. Configure DHCP ................................................................................................................................

205​

R.1.2. Configure LDAP ................................................................................................................................

206​

R.1.2.1. Pre-configure ..............................................................................................................................

206​

R.1.2.2. Updating Configuration During Installation ........................................................................................

207​

R.1.2.3. Configure Client Then Update Server ..............................................................................................

208​

R.1.3. Distributed Update Propagation ............................................................................................................

209​

R.2. Legacy Compatibility .................................................................................................................................

209​

R.3. Obtain Configuration of Other Devices ..........................................................................................................

210​

R.3.1. Find AE When Given Device Type .........................................................................................................

210​

R.4. Device Start up ........................................................................................................................................

210​

R.5. Shutdown ...............................................................................................................................................

212​

R.5.1. Shutdown .........................................................................................................................................

212​

R.5.2. Online/offline .....................................................................................................................................

212​

R.6. Time Synchronization ................................................................................................................................

212​

R.6.1. High Accuracy Time Synchronization .....................................................................................................

212​

R.6.2. Ordinary Time Synchronization .............................................................................................................

213​

R.6.3. Background ......................................................................................................................................

213​

R.6.3.1. Unsynchronized Time ...................................................................................................................

213​

R.6.3.2. Network Synchronized Time ..........................................................................................................

213​

R.6.3.3. External Clocks ...........................................................................................................................

214​

R.6.4. SNTP Restrictions ..............................................................................................................................

214​

R.6.5. Implementation Considerations .............................................................................................................

215​

S. Legacy Transition For Configuration Management (Informative) ................................................................................

217​

S.1. Legacy Association Requester, Configuration Managed Association Acceptor .......................................................

217​

S.1.1. DHCP Server ....................................................................................................................................

217​

S.1.2. DNS Server ......................................................................................................................................

217​

S.1.3. LDAP Server .....................................................................................................................................

217​

S.2. Managed Association Requester, Legacy Association Acceptor .........................................................................

217​

S.2.1. DHCP Server ....................................................................................................................................

217​

S.2.2. DNS Server ......................................................................................................................................

217​

S.2.3. LDAP Server .....................................................................................................................................

218​

S.3. No DDNS Support ....................................................................................................................................

218​

S.4. Partially Managed Devices .........................................................................................................................

218​

S.5. Adding The First Managed Device to A Legacy Network ...................................................................................

218​

S.5.1. New Servers Required ........................................................................................................................

218​

S.5.2. NTP ................................................................................................................................................

218​

S.5.3. Documenting Managed and Unmanaged Nodes (DHCP, DNS, and LDAP) ....................................................

219​

S.5.3.1. DHCP Documentation ..................................................................................................................

219​

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DICOM PS3.17 2020a - Explanatory Information​

S.5.3.2. DNS Documentation ....................................................................................................................

219​

S.5.3.3. LDAP Documentation ...................................................................................................................

219​

S.5.3.4. Descriptions of Other Devices ........................................................................................................

219​

S.5.4. Description of This Device ...................................................................................................................

219​

S.6. Switching A Node From Unmanaged to Managed in A Mixed Network .................................................................

220​

S.6.1. DHCP and DNS .................................................................................................................................

220​

S.6.2. NTP ................................................................................................................................................

220​

S.6.3. Association Acceptors On This Node .....................................................................................................

220​

S.6.4. Association Requesters On Legacy Nodes ..............................................................................................

220​

S.6.5. Association Requesters On Managed Nodes ...........................................................................................

220​

T. Quantitative Analysis References (Informative) ......................................................................................................

221​

T.1. Definition of Left and Right in the Case of Quantitative Arterial Analysis ...............................................................

221​

T.2. Definition of Diameter Symmetry with Arterial Plaques ......................................................................................

221​

T.3. Wall Motion Regions .................................................................................................................................

222​

T.3.1. Landmark Based Wall Motion Regions ...................................................................................................

222​

T.3.2. Centerline Wall Motion Region ..............................................................................................................

223​

T.3.4. Radial Based Wall Motion Region ..........................................................................................................

225​

T.4. Quantitative Arterial Analysis Reference Method .............................................................................................

225​

T.4.1. Computer Calculated Reference ............................................................................................................

225​

T.4.2. Interpolated Reference ........................................................................................................................

226​

T.4.3. Mean Local Reference ........................................................................................................................

226​

T.5. Positions in Diameter Graphic .....................................................................................................................

226​

U. Ophthalmology Use Cases (Informative) ..............................................................................................................

229​

U.1. Ophthalmic Photography Use Cases ............................................................................................................

229​

U.1.1. Routine N-spot Exam ..........................................................................................................................

229​

U.1.2. Routine N-spot Exam With Exceptions ...................................................................................................

229​

U.1.3. Routine Flourescein Exam ...................................................................................................................

229​

U.1.4. External Examination ..........................................................................................................................

230​

U.1.5. External Examination With Intention .......................................................................................................

230​

U.1.6. External Examination With Drug Application ............................................................................................

230​

U.1.7. Routine Stereo Camera Examination .....................................................................................................

231​

U.1.8. Relative Image Position Definitions ........................................................................................................

231​

U.2. Typical Sequence of Events .......................................................................................................................

232​

U.3. Ophthalmic Tomography Use Cases (Informative) ...........................................................................................

233​

U.3.1. Anterior Chamber Tomography .............................................................................................................

233​

U.3.1.1. Anterior Chamber Exam For Phakic Intraocular Lens Surgery Planning ..................................................

233​

U.3.1.2. Anterior Chamber Angle Exam .......................................................................................................

233​

U.3.1.4. Corneal Exam .............................................................................................................................

234​

U.3.2. Posterior Segment Tomography ............................................................................................................

234​

U.3.2.1. Retinal Nerve Fiber Layer Exam .....................................................................................................

234​

U.3.2.2. Macular Exam ............................................................................................................................

235​

U.3.2.3. Angiographic Exams ....................................................................................................................

235​

U.3.2.4. 3D Reconstruction Exam ..............................................................................................................

236​

U.3.2.5. Transverse Imaging .....................................................................................................................

237​

V. Hanging Protocols (Informative) .........................................................................................................................

241​

V.1. Example Scenario ....................................................................................................................................

241​

V.2. Hanging Protocol Internal Process Model ......................................................................................................

242​

V.3. Chest X-Ray Hanging Protocol Example .......................................................................................................

244​

V.3.1. Hanging Protocol Definition Module .......................................................................................................

244​

V.3.2. Hanging Protocol Environment Module ...................................................................................................

246​

V.3.3. Hanging Protocol Display Module ..........................................................................................................

246​

V.4. Neurosurgery Planning Hanging Protocol Example ..........................................................................................

249​

V.4.1. Hanging Protocol Definition Module .......................................................................................................

250​

V.4.2. Hanging Protocol Environment Module ...................................................................................................

253​

V.4.3. Hanging Protocol Display Module ..........................................................................................................

253​

V.5. Hanging Protocol Query Example ................................................................................................................

272​

V.6. Display Set Patient Orientation Example .......................................................................................................

278​

W. Digital Signatures in Structured Reports Use Cases (Informative) .............................................................................

279​

X. Dictation-based Reporting With Image References (Informative) ...............................................................................

281​

X.1. Basic Data Flows ......................................................................................................................................

281​

DICOM PS3.17 2020a - Explanatory Information​

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X.1.1. Dictation/transcription Reporting ............................................................................................................

281​

X.1.2. Reporting With Image References .........................................................................................................

282​

X.1.3. Reporting With Annotated Images .........................................................................................................

282​

X.2. Transcribed Diagnostic Imaging SR Instance Content ......................................................................................

283​

X.2.1. SR Header Content ............................................................................................................................

283​

X.2.2. Transcribed Text Data Format ..............................................................................................................

283​

X.2.3. Image Reference Format .....................................................................................................................

284​

X.3. Transcribed Diagnostic Imaging CDA Instance Content ....................................................................................

284​

X.3.1. CDA Header Content ..........................................................................................................................

285​

X.3.2. Transcribed Text Content ....................................................................................................................

285​

X.3.3. Image References ..............................................................................................................................

285​

X.3.4. Icons ...............................................................................................................................................

286​

X.3.5. Structured Entries ..............................................................................................................................

286​

X.4.3. Using The WADO Reference For DICOM Network Protocol Retrievals ..........................................................

289​

X.4. Simultaneous SR and CDA Instance Creation ................................................................................................

290​

X.4.1. Equivalence ......................................................................................................................................

290​

X.4.2. Document Cross-reference ..................................................................................................................

290​

Y. VOI LUT Functions (Informative) ........................................................................................................................

291​

Z. X-Ray Isocenter Reference Transformations (Informative) .......................................................................................

293​

Z.1. Introduction .............................................................................................................................................

293​

Z.2. Positioner Coordinate System Transformations ...............................................................................................

293​

Z.3. Table Coordinate System Transformations .....................................................................................................

293​

AA. Radiation Dose Reporting Use Cases (Informative) ..............................................................................................

295​

AA.1. Purpose of This Annex ............................................................................................................................

295​

AA.2. Definitions .............................................................................................................................................

295​

AA.3. Use Cases ............................................................................................................................................

295​

AA.3.1. Basic Dose Reporting .......................................................................................................................

295​

AA.3.2. Dose Reporting For Non-digital Imaging ...............................................................................................

296​

AA.3.3. Dose Reporting Post-processing .........................................................................................................

297​

AA.3.4. Dose Reporting Workflow Management ................................................................................................

297​

BB. Printing (Informative) .....................................................................................................................................

299​

BB.1. Example of Print Management SCU Session (Informative) ..............................................................................

299​

BB.1.1. Simple Example ...............................................................................................................................

299​

BB.1.2. Advanced Example (Retired) ..............................................................................................................

300​

CC. Storage Commitment (Informative) ...................................................................................................................

301​

CC.1. Storage Commitment Examples (Informative) ..............................................................................................

301​

CC.1.1. Push Model Example ........................................................................................................................

301​

CC.1.2. Pull Model Example (Retired) .............................................................................................................

301​

CC.1.3. Remote Storage of Data by The SCP ...................................................................................................

301​

CC.1.4. Storage Commitment in Conjunction With Use of Storage Media ...............................................................

302​

DD. Worklists (Informative) ...................................................................................................................................

305​

DD.1. Examples For The Usage of The Modality Worklist (Informative) ......................................................................

305​

DD.2. General Purpose Worklist Example (Informative) (Retired) ..............................................................................

305​

EE. Relevant Patient Information Query (Informative) .................................................................................................

307​

EE.1. Relevant Patient Information Query Example (Informative) ..............................................................................

307​

FF. CT/MR Cardiovascular Analysis Report Templates (Informative) .............................................................................

315​

FF.2. Template Structure ..................................................................................................................................

316​

FF.3. Report Example ......................................................................................................................................

318​

GG. JPIP Referenced Pixel Data Transfer Syntax Negotiation (Informative) ....................................................................

321​

HH. Segmentation Encoding Example (Informative) ...................................................................................................

323​

II. Use of Product Characteristics Attributes in Composite SOP Instances (Informative) .....................................................

325​

II.1. Contrast/bolus Module ...............................................................................................................................

325​

II.2. Enhanced Contrast/bolus Module .................................................................................................................

326​

II.3. Device Module .........................................................................................................................................

328​

II.4. Intervention Module ...................................................................................................................................

328​

JJ. Surface Mesh Representation (Informative) .........................................................................................................

331​

JJ.1. Multi-Dimensional Vectors .........................................................................................................................

331​

JJ.2. Encoding Examples .................................................................................................................................

331​

KK. Use Cases For The Composite Instance Root Retrieval Classes (Informative) ...........................................................

333​

KK.1. Clinical Review ......................................................................................................................................

333​

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DICOM PS3.17 2020a - Explanatory Information​

KK.1.1. Retrieval Based On Report References ................................................................................................

333​

KK.1.2. Selective Retrieval Without References to Specific Slices .........................................................................

333​

KK.2. Local Use - "Relevant Priors" ....................................................................................................................

333​

KK.2.1. Anatomic Sub-region ........................................................................................................................

333​

KK.2.2. Worklists ........................................................................................................................................

333​

KK.3. Attribute Based Retrieval ..........................................................................................................................

333​

KK.4. CAD & Data Mining Applications ................................................................................................................

333​

KK.5. Independent WADO Server ......................................................................................................................

334​

LL. Example SCU Use of The Composite Instance Root Retrieval Classes (Informative) ...................................................

335​

LL.1. Retrieval of Entire Composite Instances .......................................................................................................

335​

LL.2. Retrieval of Selected Frame Composite Instances From Multi-frame Objects .......................................................

335​

LL.3. Retrieval of Selected Frame Composite Instances From MPEG-2, MPEG-4 AVC/H.264 or HEVC/H.265 Video ..........

335​

MM. Considerations For Applications Creating New Images From Multi-frame Images ......................................................

337​

MM.1. Scope .................................................................................................................................................

337​

MM.2. Frame Extraction Issues .........................................................................................................................

337​

MM.2.1. Number of Frames ..........................................................................................................................

337​

MM.2.2. Start and End Times ........................................................................................................................

337​

MM.2.3. Time Interval versus Frame Increment Vector .......................................................................................

337​

MM.2.4. MPEG-2, MPEG-4 AVC/H.264 or HEVC/H.265 .....................................................................................

337​

MM.2.5. JPEG 2000 Part 2 Multi-Component Transform .....................................................................................

337​

MM.2.6. Functional Groups For Enhanced CT, MR, etc. .....................................................................................

337​

MM.2.7. Nuclear Medicine Images

.................................................................................................................

338​

MM.2.8. A "Single Frame" Multi-frame Image ...................................................................................................

338​

MM.3. Frame Numbers ....................................................................................................................................

338​

MM.4. Consistency .........................................................................................................................................

338​

MM.5. Time Synchronization .............................................................................................................................

338​

MM.6. Audio ..................................................................................................................................................

338​

MM.7. Private Attributes ...................................................................................................................................

338​

NN. Specimen Identification and Management ..........................................................................................................

339​

NN.1. Pathology Workflow ................................................................................................................................

339​

NN.2. Basic Concepts and Definitions

.................................................................................................................

339​

NN.2.1. Specimen .......................................................................................................................................

339​

NN.2.2. Containers .....................................................................................................................................

340​

NN.3. Specimen Module ..................................................................................................................................

340​

NN.3.1. Scope ...........................................................................................................................................

340​

NN.3.2. Relationship With The Laboratory Information System .............................................................................

341​

NN.3.3. Case Level Information and The Accession Number ...............................................................................

341​

NN.3.4. Laboratory Workflows and Specimen Types ..........................................................................................

341​

NN.3.5. Relationship Between Specimens and Containers ..................................................................................

342​

NN.3.6. Relationship Between Specimens and Images .......................................................................................

343​

NN.4. Specimen Identification Examples .............................................................................................................

344​

NN.4.1. One Specimen Per Container .............................................................................................................

344​

NN.4.2. Multiple Items From Same Block .........................................................................................................

344​

NN.4.3. Items From Different Parts in The Same Block .......................................................................................

345​

NN.4.4. Items From Different Parts On The Same Slide ......................................................................................

345​

NN.4.5. Tissue Micro Array ...........................................................................................................................

346​

NN.5. Structure of The Specimen Module ............................................................................................................

346​

NN.6. Examples of Specimen Module Use ...........................................................................................................

347​

NN.6.1. Gross Specimen ..............................................................................................................................

347​

NN.6.2. Slide .............................................................................................................................................

349​

NN.7. Specimen Data in Pathology Imaging Workflow Management ..........................................................................

354​

NN.7.1. Modality Worklist .............................................................................................................................

354​

NN.7.1.1. MWL for Whole Slide Imaging ......................................................................................................

354​

NN.7.2. Modality Performed Procedure Step ....................................................................................................

355​

OO. Structured Display (Informative) ......................................................................................................................

357​

OO.1. Structured Display Use Cases ..................................................................................................................

357​

OO.1.1. Dentistry ........................................................................................................................................

357​

OO.1.2. Ophthalmology ...............................................................................................................................

379​

OO.1.3. Cardiology .....................................................................................................................................

381​

OO.1.4. Radiology ......................................................................................................................................

382​

DICOM PS3.17 2020a - Explanatory Information​

Page 9​

PP. 3D Ultrasound Volumes (Informative) ................................................................................................................

383​

PP.1. Purpose of This Annex ............................................................................................................................

383​

PP.2. 3D Ultrasound Clinical Use Cases ..............................................................................................................

383​

PP.2.1. Use Cases ......................................................................................................................................

383​

PP.2.2. Hierarchy of Use Cases .....................................................................................................................

384​

PP.3. 3D Ultrasound Solutions in DICOM ............................................................................................................

385​

PP.3.1. 3D Volume Data sets ........................................................................................................................

385​

PP.3.2. 2D Derived Images ...........................................................................................................................

386​

PP.3.3. Physiological Waveforms Associated With 3D Volume Data sets ...............................................................

386​

PP.3.4. Workflow Considerations ...................................................................................................................

387​

QQ. Enhanced US Data Type Blending Examples (Informative) ...................................................................................

389​

QQ.1. Enhanced US Volume Use of the Blending and Display Pipeline ......................................................................

389​

QQ.1.1. Example 1 - Grayscale P-Values Output ..............................................................................................

390​

QQ.1.2. Example 2 - Grayscale-only Color Output .............................................................................................

390​

QQ.1.3. Example 3 - Color Tissue (Pseudo-color) Mapping .................................................................................

391​

QQ.1.4. Example 4 - Fixed Proportion Additive Grayscale Tissue and Color Flow ....................................................

392​

QQ.1.5. Example 5 - Threshold Based On Flow_velocity .....................................................................................

393​

QQ.1.6. Example 6 - Threshold Based On Flow_velocity and Flow_variance W/2d Color Mapping ...............................

394​

QQ.1.7. Example 7 - Color Tissue / Velocity / Variance Mapping - Blending Considers Both Data Paths .......................

395​

RR. Ophthalmic Refractive Reports Use Cases (Informative) .......................................................................................

397​

RR.1. Introduction ...........................................................................................................................................

397​

RR.2. Reference Tables For Equivalent Visual Acuity Notations ...............................................................................

398​

RR.2.1. Background ....................................................................................................................................

398​

RR.2.2. Notations .......................................................................................................................................

398​

RR.2.3. Use of The Lookup Table ..................................................................................................................

399​

RR.2.4. Traditional Charts ............................................................................................................................

399​

RR.2.5. ETDRS Charts ................................................................................................................................

402​

SS. Colon CAD (Informative) .................................................................................................................................

407​

SS.1. Colon CAD SR Content Tree Structure .......................................................................................................

407​

SS.2. Colon CAD SR Observation Context Encoding .............................................................................................

407​

SS.3. Colon CAD SR Examples .........................................................................................................................

408​

SS.3.1. Example 1: Colon Polyp Detection With No Findings ...............................................................................

408​

SS.3.2. Example 2: Colon Polyp Detection With Findings ....................................................................................

409​

SS.3.3. Example 3: Colon Polyp Detection, Temporal Differencing With Findings .....................................................

412​

TT. Stress Testing Report Template (Informative) ......................................................................................................

417​

UU. Macular Grid Thickness and Volume Report Use Cases (Informative) ......................................................................

419​

UU.1. Introduction ...........................................................................................................................................

419​

UU.2. Use of B-scan Images .............................................................................................................................

419​

UU.3. Use of Tissue Measurements ...................................................................................................................

419​

UU.4. Axial Measurements ...............................................................................................................................

420​

UU.5. En Face Measurements ...........................................................................................................................

420​

UU.6. Interpretation of OPT ..............................................................................................................................

422​

VV. Pediatric, Fetal and Congenital Cardiac Ultrasound Reports (Informative) .................................................................

423​

VV.1. Content Structure ...................................................................................................................................

423​

VV.2. Pediatric, Fetal and Congenital Cardiac Ultrasound Patterns ...........................................................................

423​

VV.3. Measurement Terminology Composition ......................................................................................................

424​

WW. Audit Messages (Informative) .........................................................................................................................

425​

WW.1. Message Example ................................................................................................................................

425​

WW.2. Workflow Example ................................................................................................................................

426​

XX. Use Cases for Application Hosting ....................................................................................................................

429​

XX.1. Agent-Specific Post Processing .................................................................................................................

429​

XX.2. Support For Multi-site Collaborative Research ..............................................................................................

429​

XX.3. Screening Applications ............................................................................................................................

429​

XX.4. Modality-Specific Post Processing ..............................................................................................................

430​

XX.5. Measurement/Evidence Document Creation .................................................................................................

430​

XX.6. CAD Rendering ......................................................................................................................................

430​

YY. Compound and Combined Graphic Objects in Presentation States (Informative) ........................................................

431​

YY.1. An Example of The Compound Graphic 'axis' ...............................................................................................

431​

YY.2. An Example of Distance Line Defined As A Combined Graphic Object ...............................................................

433​

ZZ. Implant Template Description ...........................................................................................................................

435​

Page 10​

DICOM PS3.17 2020a - Explanatory Information​

ZZ.1. Implant Mating .......................................................................................................................................

435​

ZZ.1.1. Mating Features ...............................................................................................................................

435​

ZZ.1.2. Mating Feature ID .............................................................................................................................

435​

ZZ.1.3. Mating Feature Sets ..........................................................................................................................

435​

ZZ.1.4. Degrees of Freedom .........................................................................................................................

436​

ZZ.1.5. Implant Assembly Templates ..............................................................................................................

436​

ZZ.2. Planning Landmarks ................................................................................................................................

437​

ZZ.3. Implant Registration and Mating Example ....................................................................................................

437​

ZZ.3.1. Degrees of Freedom .........................................................................................................................

439​

ZZ.4. Encoding Example ..................................................................................................................................

440​

ZZ.5. Implant Template Versions and Derivation ...................................................................................................

444​

AAA. Implantation Plan SR Document (Informative) ...................................................................................................

447​

AAA.1. Implantation Plan SR Document Content Tree Structure ...............................................................................

447​

AAA.2. Relationship Between Implant Template and Implantation Plan ......................................................................

448​

AAA.3. Implantation Plan SR Document Total Hip Replacement Example ..................................................................

448​

AAA.4. Implantation Plan SR Document Dental Drilling Template Example .................................................................

451​

BBB. Unified Procedure Step in Radiotherapy (Informative) .........................................................................................

455​

BBB.1. Purpose of this Annex ...........................................................................................................................

455​

BBB.2. Use Case Actors ..................................................................................................................................

455​

BBB.3. Use Cases ..........................................................................................................................................

456​

BBB.3.1. Treatment Delivery Normal Flow - Internal Verification ...........................................................................

456​

BBB.3.1.1. Message Sequencing ...............................................................................................................

456​

BBB.3.1.2. Transactions and Message Flow .................................................................................................

456​

BBB.3.2. Treatment Delivery Normal Flow - External Verification ..........................................................................

459​

BBB.3.2.1. Message Sequencing ...............................................................................................................

459​

BBB.3.2.2. Transactions and Message Flow .................................................................................................

459​

BBB.3.3. Treatment-delivery With External Verification - Override Or Additional Info Required ....................................

462​

BBB.3.3.1. Message Sequencing ...............................................................................................................

462​

BBB.3.3.2. Transactions and Message Flow .................................................................................................

463​

BBB.3.4. Treatment-delivery With External Verification - Machine Adjustment Required ............................................

464​

BBB.3.4.1. Message Sequencing ...............................................................................................................

464​

BBB.3.4.2. Transactions and Message Flow .................................................................................................

465​

CCC. Ophthalmic Axial Measurements and Intraocular Lens Calculations Use Cases (Informative) .....................................

467​

CCC.1. Axial Measurements .............................................................................................................................

467​

CCC.2. Intraocular Lens Calculations Introduction .................................................................................................

467​

CCC.3. Output of An Ultrasound A-scan Device ....................................................................................................

469​

CCC.4. Output of An Optical A-scan Device .........................................................................................................

470​

CCC.5. IOL Calculation Results Example ............................................................................................................

470​

DDD. Visual Field Static Perimetry Use Cases (Informative) ........................................................................................

473​

DDD.1. Introduction .........................................................................................................................................

473​

DDD.2. Use Cases ..........................................................................................................................................

473​

DDD.2.1. Evaluation For Glaucoma ................................................................................................................

474​

DDD.2.2. Neurological Disease .....................................................................................................................

476​

DDD.2.3. Diffuse and Local Defect

.................................................................................................................

477​

DDD.2.3.1. Diffuse Defect ........................................................................................................................

477​

DDD.2.4.2. Local Defect ...........................................................................................................................

478​

EEE. Intravascular OCT Image (Informative) ............................................................................................................

481​

EEE.1. Purpose of This Annex ..........................................................................................................................

481​

EEE.2. IVOCT For Processing Parameters ..........................................................................................................

481​

EEE.2.1. Z Offset Correction .........................................................................................................................

481​

EEE.2.2. Refractive Index Correction ..............................................................................................................

481​

EEE.2.3. Polar-Cartesian Conversion .............................................................................................................

482​

EEE.3. Intravascular Longitudinal Image .............................................................................................................

482​

FFF. Enhanced XA/XRF Encoding Examples (Informative) ..........................................................................................

485​

FFF.1. General Concepts of X-Ray Angiography ...................................................................................................

485​

FFF.1.1. Time Relationships .........................................................................................................................

485​

FFF.1.1.1. Time Relationships of A Multi-frame Image ....................................................................................

485​

FFF.1.1.2. Time Relationships of One Frame ...............................................................................................

485​

FFF.1.2. Acquisition Geometry ......................................................................................................................

486​

FFF.1.2.1. Patient Description ...................................................................................................................

487​