PS-2020a / part04

Relative Opacity 0 or 1/n*

Color Image 1

Color Image 2

0 or 1/n*

...

0 or 1/n*

Color Image n

Notes:

1.Blending Mode EQUAL

2.Relative Opacity = 0 if pixel is NOT contributing

3.Relative Opacity = 1/n* if pixel is contributing

4.No restriction on n

5.n* is the number of contributing pixels

Figure N.2.6-3. Equal Blending​

N.3 Behavior of an SCP​

In addition to the behavior for the Storage Service Class specified in Section B.2.2 Behavior of an SCP, the following additional re-​ quirements are specified for the Softcopy Presentation State Storage SOP Classes:​

•​a display device acting as an SCP of these SOP Classes shall make all mandatory presentation Attributes available for application​ tothereferencedimagesatthediscretionofthedisplaydeviceuser,forallImageStorageSOPClassesdefinedintheConformance​ Statement for which the Softcopy Presentation State Storage SOP Class is supported.​

•​a display device that is acting as an SCP of these SOP Classes and that supports compound graphics types shall display the​ graphics described in the Compound Graphic Sequence (0070,0209) and shall not display the Items in the Text Object Sequence​ (0070,0008) and Graphic Object Sequence (0070,0009) that have the same Compound Graphic Instance ID (0070,0226) value.​

Note​

Though it is not required, a display device acting as an SCP of the Blending Softcopy Presentation State Storage SOP Class​ may support the Spatial Registration Storage SOP Class in order to transform one Frame of Reference into another or to​ explicitly identify the relationship between members of two sets of images, and may be able to resample underlying and​ superimposed sets of images that differ from each other in orientation and in-plane and between-plane spatial resolution.​

N.4 Conformance​

In addition to the Conformance Statement requirements for the Storage Service Class specified in Section B.4.3, the following addi-​ tional requirements are specified for the Softcopy Presentation State Storage SOP Classes:​

N.4.1 Conformance Statement for an SCU​

The following issues shall be documented in the Conformance Statement of any implementation claiming conformance to a Softcopy​

Presentation State Storage SOP Class as an SCU:​

- Standard -​

•​For an SCU of a Softcopy Presentation State Storage SOP Class that is creating a SOP Instance of the Class, the manner in which​ presentation related Attributes are derived from a displayed image, operator intervention or defaults, and how they are included in​ the IOD.​

•​For an SCU of a Softcopy Presentation State Storage SOP Class, the Image Storage SOP Classes that are also supported by the​ SCU and may be referenced by instances of the Softcopy Presentation State Storage SOP Class.​

•​ForanSCUofaSoftcopyPresentationStateStorageSOPClasswhetheritsupportstheCompoundGraphicSequence(0070,0209)​ and specifies which compound graphic types can be generated, including additional private defined compound graphic types.​

N.4.2 Conformance Statement for an SCP​

The following issues shall be documented in the Conformance Statement of any implementation claiming conformance to a Softcopy​

Presentation State Storage SOP Class as an SCP:​

•​For an SCP of a Softcopy Presentation State Storage SOP Class that is displaying an image referred to by a SOP Instance of the​ Class, the manner in which presentation related Attributes are used to influence the display of an image.​

•​For an SCP of a Softcopy Presentation State Storage SOP Class, the Image Storage SOP Classes that are also supported by the​ SCP and may be referenced by instances of the Softcopy Presentation State Storage SOP Class.​

•​ForanSCPofaSoftcopyPresentationStateStorageSOPClasswhetheritsupportstheCompoundGraphicSequence(0070,0209)​ and which compound graphic types can be rendered, including additional private defined compound graphic types.​

- Standard -​

OStructuredReportingStorageSOPClasses​ (Normative)​

O.1 Overview​

The Structured Reporting Storage SOP Classes extend the functionality of the Storage Service class (defined in Annex B) to extend​ the SCP behavior and conformance requirements.​

O.2 Structured Reporting Storage SOP Class SCU and SCP Behavior​

O.2.1 Behavior of an SCU​

O.2.1.1 CAD SR SOP Classes​

Rendering Intent concept modifiers in the Mammography CAD SR, Chest CAD SR and Colon CAD SR objects shall be consistent.​ Content items marked "For Presentation" shall not be subordinate to content items marked "Not for Presentation" or "Presentation​ Optional"inthecontenttree.Similarly,contentitemsmarked"PresentationOptional"shallnotbesubordinatetocontentitemsmarked​ "Not for Presentation" in the content tree.​

Content items referenced from another SR object instance, such as a prior Mammography CAD SR, Chest CAD SR or Colon CAD​ SR shall be inserted by-value in the new SR object instance, with appropriate original source observation context. It is necessary to​ updateRenderingIntent,andreferencedcontentitemidentifiersforby-referencerelationships,withincontentitemsparaphrasedfrom​ another source.​

O.2.1.2 Extensible SR SOP Class​

The concept of extensibility implies that a recipient may encounter Content Items, Value Types and Relationship Types that are​ unanticipated and unsupported and hence potentially unrenderable.​

An implementation shall identify in its Conformance Statement which Content Items, Value Types and Relationship Types it creates.​

O.2.2 Behavior of an SCP​

An SCP intending to display or otherwise render a Structured Report shall convey its full meaning in an unambiguous manner, except​ as described in Section O.2.2.2.​

Note​

"Full meaning" includes not just the Content Tree (i.e., the Items of the Content Sequence), but all Attributes of the Data Set​ that are necessary to properly interpret the Structured Report. This includes those Attributes that set the initial Observation​ ContextfortheContentTree,i.e.,thepatient,procedure,andobserveridentifiers,andtheCompletionstatusandVerification​ status of the Structured Report.​

An Icon Image in an IMAGE reference has no meaning, and is not required to be rendered.​

For a device, that is both an SCU and an SCP of these Storage SOP Classes, in addition to the behavior for the Storage Service​ Class specified in Section B.2.2, the following additional requirements are specified for Structured Reporting Storage SOP Classes:​

•​an SCP of this SOP Class shall support Level 2 Conformance as defined in Section B.4.1.​

Note​

ThisrequirementmeansthatallType1,Type2,andType3AttributesdefinedintheInformationObjectDefinitionassociated​ with the SOP Class will be stored and may be accessed.​

- Standard -​

O.2.2.1 CAD SR SOP Classes​

The Mammography CAD SR, Chest CAD SR and Colon CAD SR objects contain data not only for presentation to the clinician, but​ also data solely for use in subsequent mammography CAD analyses.​

TheSCUprovidesrenderingguidelinesvia"RenderingIntent"conceptmodifiersassociatedwith"IndividualImpression/Recommend-​ ation", "Composite Feature" and "Single Image Finding" content items. The full meaning of the SR is provided if all content items​ marked "Presentation Required" are rendered down to the first instance of "Not for Presentation" or "Presentation Optional" for each​ branch of the tree. Use of the SCU's Conformance Statement is recommended if further enhancement of the meaning of the SR can​ be accomplished by rendering some or all of the data marked "Presentation Optional". Data marked "Not for Presentation" should​ not be rendered by the SCP; it is embedded in the SR content tree as input to subsequent CAD analysis work steps.​

The SCP may further interpret whether or not to render a Single Image Finding that has Rendering Intent "Presentation Optional" by​ interpreting the value of the CAD Operating Point content item that is subordinate to the Rendering Intent, if present. If the CAD Op-​ erating Point content item is not present, then rendering of the Single Image Finding may be based on recommendations in the cre-​ ator's DICOM Conformance Statement. For further information on the intended use of CAD Operating Point see Section E.4 “CAD​ Operating Point” in PS3.17.​

O.2.2.2 Extensible SR SOP Class​

The concept of extensibility implies that a recipient may encounter Content Items, Value Types and Relationship Types that are​ unanticipated and unsupported and hence potentially unrenderable.​

An implementation shall identify in its Conformance Statement which Content Items, Value Types and Relationship Types it supports.​

Since it may not be possible to render the entire content in an unambiguous manner because of unrecognized content, an SCP in-​ tending to display or otherwise render an Extensible SR SOP Instance​

•​shall convey a warning in the rendering to indicate that unsupported content is present and that this may affect the meaning of the​ rendering​

•​shall identify in its Conformance Statement its behavior when encountering unsupported content​

O.3 Modification of SR Document Content​

A device that is an SR Storage SOP Class SCU may modify information in a SOP Instance that it has previously sent or received.​ WhenthisSOPInstanceismodifiedandsenttoanSCP,itshallbeassignedanewSOPInstanceUIDifanyofthefollowingconditions​ are met:​

•​addition, removal or update of any Attribute within the SR Document General Module or SR Document Content Module;​

•​modification of the Series Instance UID (0020,000E);​

•​modification of the Study Instance UID (0020,000D).​

O.4 Conformance​

In addition to the Conformance Statement requirements for the Storage Service Class specified in Section B.4.3, the following addi-​ tional requirements are specified for Structured Reporting Storage SOP Classes:​

O.4.1 Conformance Statement for an SCU​

The following shall be documented in the Conformance Statement of any implementation claiming conformance to the Structured​ Reporting Storage SOP Classes as an SCU:​

•​TheImageorothercompositeobjectStorageSOPClassesthatarealsosupportedbytheSCUandmaybereferencedbyinstances​ of Structured Reporting Storage SOP Class.​

•​The range of Value Types and Relationship Types that are supported by the SCU.​

•​The conditions under which a new SOP Instance UID is generated for an existing SR Document.​

- Standard -​

•​If the implementation provides Query/Retrieve of Structured Reporting SOP Instances as an SCU, whether it supports the Optional​ Keys Concept Name Code Sequence or Content Template Sequence.​

Note​

The description of the Value Types and Relationship Types that are supported by the SCU is particularly important for the​ Extensible SR SOP Class.​

O.4.1.1 CAD SR SOP Classes​

ThefollowingshallbedocumentedintheConformanceStatementofanyimplementationclaimingconformancetotheMammography​

CAD SR SOP Class as an SCU:​

•​Which types of detections and/or analyses the device is capable of performing:​

•​From detections listed in Context Group 6014 Mammography Single Image Finding​

•​From analyses listed in Context Group 6043 Types of Mammography CAD Analysis​

The following shall be documented in the Conformance Statement of any implementation claiming conformance to the Chest CAD​ SR SOP Class as an SCU:​

•​Which types of detections and/or analyses the device is capable of performing:​

•​From detections listed in Context ID 6101 Chest Finding or Feature, or Context ID 6102 Chest Finding or Feature Modifier​

•​From analyses listed in Context ID 6137 Types of CAD Analysis​

The following shall be documented in the Conformance Statement of any implementation claiming conformance to the Colon CAD​ SR SOP Class as an SCU:​

•​Which types of detections and/or analyses the device is capable of performing:​

•​From detections listed in Context ID 6201 Colon Finding or Feature​

•​From analyses listed in Context ID 6137 Types of CAD Analysis​

ThefollowingshallbedocumentedintheConformanceStatementofanyimplementationclaimingconformancetotheMammography​ CAD SR, Chest CAD SR or Colon CAD SR SOP Classes as an SCU that creates instances:​

•​Which optional content items are supported​

•​Conditions under which content items are assigned Rendering Intent of "Presentation Optional", and whether a CAD Operating​ Point value will be included with each Single Image Finding that has Rendering Intent of "Presentation Optional"​

•​RecommendationsfortheconditionsunderwhichcontentitemswithRenderingIntentof"PresentationOptional"shouldberendered,​ based on CAD Operating Point or otherwise​

•​Conditions under which content items are assigned Rendering Intent of "Not for Presentation"​

O.4.1.2 Ultrasound SR SOP Classes​

The following shall be documented in the Conformance Statement of any SR creator implementation claiming conformance to the​ Simplified Adult Echo SR SOP Class as an SCU:​

•​A list of all the measurement codes from CID 12300 “Core Echo Measurements” supported by the device for use in TID 5301 “Pre-​ coordinated Echo Measurement”.​

•​AlistofinitialmeasurementcodessupportedbythedeviceforuseinRow1or2ofTID5302“Post-coordinatedEchoMeasurement”.​

•​Optionally, a table of the TID 5302 post-coordinated modifer values associated with each measurement code.​

- Standard -​

•​A list of any extension codes added to CID 12301 “Measurement Selection Reasons”, CID 12304 “Echo Measured Properties”,​ CID12305“BasicEchoAnatomicSites”,CID12307“CardiacPhasesandTimePoints”,CID12227“EchocardiographyMeasurement​ Method”.​

O.4.2 Conformance Statement for an SCP​

The following shall be documented in the Conformance Statement of any implementation claiming conformance to the Structured​ Reporting Storage SOP Class as an SCP:​

•​For an SCP of a Structured Reporting Storage SOP Class that is displaying or otherwise rendering the structured report contained​ in a SOP Instance of the Class, the general form in which the structured report related Attributes are rendered.​

•​For an SCP of a Structured Reporting Storage SOP Class, the Image or other composite object Storage SOP Classes that are also​ supported by the SCP and may be referenced by instances of the Structured Reporting Storage SOP Class, and whether or not​ they will be displayed or otherwise rendered.​

•​For an SCP of a Structured Reporting Storage SOP Class that is displaying or otherwise rendering an image or other composite​ object referred to by a SOP Instance of the Class, the manner in which the structured report related Attributes (such as spatial co-​ ordinates and referenced presentation states) are used to influence the display of the image or object.​

•​If the implementation supports Query/Retrieve of Structured Reporting SOP Instances as an SCP, whether it supports the Optional​ Keys Concept Name Code Sequence or Content Template Sequence.​

O.4.2.1 CAD SR SOP Classes​

ThefollowingshallbedocumentedintheConformanceStatementofanyimplementationclaimingconformancetotheMammography​ CAD SR, Chest CAD SR or Colon CAD SR SOP Classes as an SCP:​

•​Conditions under which the SCP will render content items with Rendering Intent concept modifier set to "Presentation Optional"​

O.4.2.2 Extensible SR SOP Class​

The following shall be documented in the Conformance Statement of any implementation claiming conformance to the Extensible SR​

SOP Class as an SCP:​

•​The behavior and warnings generated when encountering unsupported Content Items, Value Types and Relationship Types​

- Standard -​

P Application Event Logging Service Class​ (Normative)​

P.1 Overview​

P.1.1 Scope​

TheApplicationEventLoggingServiceClassdefinesanapplication-levelclass-of-servicethatfacilitatesthenetworktransferofEvent​ Log Records to be logged or recorded in a central location.​

The Application Event Logging Service Class addresses the class of application specific logs (e.g., procedural event logs) that are​ managed by a medical application. The Application Event Logging Service Class does not specify the means of accessing the central​ logs.​

Note​

This Service Class does not address system security or audit logs that are managed by general system logging applications​ and may use non-DICOM protocols (e.g., SYSLOG).​

P.1.2 Service Definition​

Two peer DICOM AEs implement a SOP Class of the Application Event Logging Service Class with one serving in the SCU role and​ one serving in the SCP role. SOP Classes of the Application Event Logging Service Class are implemented using the DIMSE-N N-​ ACTION service as defined in PS3.7.​

The N-ACTION service conveys the following semantics:​

•​TheSCUnotifiesthe SCPthataneventhasoccurredthatthe SCPshouldrecordin alog.The ActionInformation of theN-ACTION-​ RQ contains the information about the event.​

•​The SCP responds with a confirmation of the status of the recording action.​

The association negotiation procedure is used to negotiate the supported SOP Classes. PS3.7 specifies the association procedure.​ The Application Event Logging Service Class does not support extended negotiation.​

The release of an association shall not have any effect on the contents of the log managed by the SCP.​

P.2 Procedural Event Logging SOP Class Definition​

The Procedural Event Logging SOP Class allows SCUs to report to an SCP the events that are to be recorded in a Procedure Log​ SOP Instance, as described in PS3.3. This allows multiple devices participating in a Study to cooperatively construct a log of events​ that occur during that Study.​

The multiple procedural events reported through this SOP Class are related by Patient ID, Study Instance UID, Study ID, and/or​ Performed Location. The mechanism by which multiple devices obtain these shared identifiers is not defined by this SOP Class.​

Note​

The Modality Worklist or UPS SOP Classes may be used for this purpose. For simple devices that cannot support worklist​ SOP Classes, the SCP may be able to use Performed Location, or the SCU AE Title, to relate the use of the device to a​ particular procedure.​

TheSCPmayalsoprovideforrecordingeventsforwhichtheSCUdoesnotprovideidentifiersformatching.Themechanismbywhich​ the SCP determines the association of such an unidentified event with the log for a specific procedure is not defined by this SOP​ Class.​

- Standard -​

Page 258​ DICOM PS3.4 2020a - Service Class Specifications​

Note​

The network address and/or AE Title of the SCU may be used to identify the device as a participant in a particular procedure.​

P.2.1 DIMSE Service Group​

The DIMSE-N Services applicable to the Procedural Event Logging SOP Class are shown in Table P.2-1.​

Table P.2-1. DIMSE Service Group Applicable to Procedural Event Logging​

P.2.2 Operation​

The DICOM AEs that claim conformance to this SOP Class as an SCU shall invoke the N-ACTION request. The DICOM AEs that​ claim conformance to this SOP Class as an SCP shall support the N-ACTION request.​

P.2.2.1 Action Information​

The DICOM AEs that claim conformance to this SOP Class as an SCU and/or an SCP shall support the Action Type and Action In-​ formation in the N-ACTION-RQ as specified in Table P.2-2.​

Table P.2-2. Procedural Event Logging Action Information​

P.2.2.1.1 Study Matching Attributes​

The SCU may provide Patient ID (0010,0020), Study Instance UID (0020,000D), Study ID (0020,0010), and/or Performed Location​ (0040,0243) Attributes to allow the SCP to match the N-ACTION with a Study for which a procedure log is being created.​

P.2.2.1.2 Synchronization Frame of Reference UID​

The Synchronization Frame of Reference UID (0020,0200) Attribute identifies the temporal frame of reference for the Observation​ DateTime (0040,A032) Attributes in the Procedural Event record. If the Observation DateTime Attribute Values are not synchronized​ in an identifiable Frame of Reference, the Attribute shall be zero length.​

- Standard -​

P.2.2.1.3 Constraints on Attributes of the SR Document Content Module​

The Procedural Event record shall be conveyed in a (top level) Content Item, and subsidiary Content Items, as specified by the SR​ Document Content Module definition in PS3.3.​

The top level and subsidiary Content Items shall be constructed in accordance with the Procedure Log IOD Content Constraints of​ PS3.3.​

Note​

1.​These constraints specify use of BTID 3001 Procedure Log defined in PS3.16, and specific particular use of the Obser-​ vation DateTime (0040,A032) Attributes.​

2.​TID 3001 requires the explicit identification of the Observer Context of the top level CONTAINER through TID 1002.​

3.​There may be multiple events (subsidiary Content Items) included in a single N-ACTION-RQ message.​

P.2.2.2 Service Class User Behavior​

The SCU shall request logging of events that occur during a Study, using the N-ACTION request primitive.​

The SCU shall receive N-ACTION responses. The actions taken upon a response status of Failure, or upon non-response of the​ SCP, are implementation dependent.​

P.2.2.3 Service Class Provider Behavior​

TheSCPshallmanagethecreationofSOPInstancesoftheProcedureLogStorageService.Itshallreceive,viatheN-ACTIONrequest​ primitive, requests for logging of events that occur during a Study. The SCP shall (consonant with application dependent constraints)​ incorporate those event records into a Procedure Log SOP Instance for the specified Study.​

TheSCPshallreturn,viatheN-ACTIONresponseprimitive,theN-ACTIONResponseStatusCodeapplicabletotheassociatedaction​ request.​

P.2.2.4 Status Codes​

Table P.2-3 defines the specific status code values that might be returned in a N-ACTION response. See PS3.7 for additional general​ response status codes.​

Table P.2-3. Response Status​

P.2.2.5 Action Reply​

With any response status indicating Success or Warning, the identifiers of the study into which the event has been logged shall be​ returned in the N-ACTION-RSP Action Reply as specified in Table P.2-4.​

- Standard -​

Page 260​ DICOM PS3.4 2020a - Service Class Specifications​

Table P.2-4. Procedural Event Logging Action Reply​

P.2.3 Procedural Event Logging SOP Class UID​

The Procedural Event Logging SOP Class shall be uniquely identified by the Procedural Event Logging SOP Class UID, which shall​ have the value "1.2.840.10008.1.40".​

P.2.4 Procedural Event Logging Instance Identification​

The well-known UID of the Procedural Event Logging SOP Instance shall have the value "1.2.840.10008.1.40.1".​

P.2.5 Conformance Requirements​

The DICOM AE's Conformance Statement shall be formatted as defined in PS3.2.​

P.2.5.1 SCU Conformance​

The SCU shall document in its Conformance Statement the behavior and actions that cause the SCU to generate an N-ACTION​ primitive (Procedural Event Notification). It shall specify the Template used for constructing the Event Information, and the Coding​ Schemes used for coded entries in the Event Information.​

The SCU shall document the identifiers it sends for matching purposes, and how it obtains those Attributes (e.g., through a Modality​ Worklist query, manual entry, etc.).​

The SCU shall document the behavior and actions performed when a success, warning, or failure status is received.​

The SCU shall document the mechanisms used for establishing time synchronization and specifying the Synchronization Frame of​ Reference UID.​

P.2.5.2 SCP Conformance​

The SCP shall document in its Conformance Statement how it uses the identifiers it receives for matching the N-ACTION (Procedural​ Event Notification) to a specific procedure.​

The SCP shall document the behavior and actions that cause the SCP to generate a success, warning, or failure status for a received​

N-ACTION.​

TheSCPshalldocumentthebehaviorandactionsthatcausetheSCPtogenerateaProcedureLogSOPInstanceincludingthereceived​

Event Information.​

The SCP shall document how it assigns the value of the Observation Datetime (0040,A032) Attribute when the SCU-provided Syn-​ chronization Frame of Reference UID is absent, or differs from that of the SCP.​

P.3 Substance Administration Logging SOP Class Definition​

The Substance Administration Logging SOP Class allows an SCU to report to an SCP the events that are to be recorded in a patient's​ Medication Administration Record (MAR) or similar log, whose definition is outside the scope of the Standard. This allows devices​ with DICOM protocol interfaces to report administration of diagnostic agents (including contrast) and therapeutic drugs, and implant-​ ation of devices.​

The Substance Administration reported through this SOP Class is related to the MAR by Patient ID or Admission ID. The mechanism​ by which the SCU obtains this identifier is not defined by this SOP Class.​

- Standard -​