This page is part of the FHIR Specification ~~(v5.0.0: R5 - STU~~ v6.0.0-ballot2: Release 6 Ballot (2nd Draft) (see Ballot Notes ). ~~This is the~~ The current ~~published~~ version ~~in it's permanent home (it will always be available at this URL).~~ is 5.0.0 . For a full list of available versions, see the Directory of published versions

10.6 Resource ImagingSelection - Content

Imaging Integration icon

Work Group

Maturity Level : 1

Trial Use

Security Category : Patient

Compartments : Patient

A selection of DICOM SOP instances and/or frames within a single Study and Series. This might include additional specifics such as an image region, an Observation UID or a Segmentation Number, allowing linkage to an Observation Resource or transferring this information along with the ImagingStudy Resource.

10.6.1 Scope and Usage

This resource is an event resource from a FHIR workflow perspective - see Workflow .

A selection of data from an ImagingStudy. The selection may be:

All DICOM SOP Instances in a single DICOM Series
A set of DICOM SOP Instances within a single DICOM Series
A set of frames within one or more DICOM multiframe image SOP Instances
A set of segments within one or more DICOM segmentation SOP Instances
A set of content items within one or more DICOM Structured Report SOP Instances
...

May also represent regions within the ImagingStudy frame of reference, including:

A 2D region within one or more DICOM image SOP Instances
A 3D region within a DICOM Frame of Reference

Uses for ImagingSelection resources include:

Identifying a specific set of images or frames as the focus of an Observation
Identifying a spatial region or volume as the focus of an Observation
Identifying the set of image coordinates as the focus of a measurement represented by an Observation
Identifying a node in a DICOM Structured Report SOP Instance from which an Observation is derived
Identifying images, frames or presentation states selected as part of shared application context in a context-sharing environment
Identifying a specific set of images, frames or presentation states to be presented

All DICOM SOP Instances referenced in a single ImagingSelection resource shall be part of the same DICOM Series (and therefore also the same DICOM Study). In order to reference SOP Instances in multiple Studies or Series it is necessary to create multiple ImagingSelection resources.

10.6.2 Boundaries and Relationships

~~An Observation~~ The ImagingStudy ~~references~~ resource is used to store details of an entire DICOM Study and associated information.

The ImagingSelection resource is used to ~~specify the~~ reference to a specific set of specific set of ~~DICOM~~ images, frames, waveforms or ~~documents used to make the~~ image regions.

An Observation ~~. By contrast,~~ may be related to a set of images in several ways.

Observation.partOf may reference an ImagingStudy
~~Observation~~ Observation.derivedFrom ~~references~~ may reference an ImagingStudy if when it does not ~~depend on any~~ relate to a specific set of images, frames, waveforms or ~~documents. An~~ image regions
~~Observation~~ Observation.derivedFrom ~~references~~ may reference an ImagingSelection when it directly relates to ~~specify an~~ a specific set of images, frames, waveforms or image ~~region corresponding to the~~ regions
Observation.focus may reference an ImagingSelection when it is a measurement ~~value expressed in~~ of the ~~Observation .~~ set of images, frames, waveforms or image regions described by the ImagingSelection

While an ImagingSelection is restricted to a single DICOM Series, a single Observation references multiple ImagingSelection resources if it relates to multiple Studies and / or Series – for example, to reference multiple images over different cardiac phases or a PET and a CT image.

A DiagnosticReport might directly reference an ImagingSelection that includes one or more Observations derived from ImagingSelection resources.

In contrast with a DocumentReference , an ImagingSelection includes the ability to specify a region within an image, an observation node within a DICOM Structured Reporting (SR) and the ability to specify one or more Endpoint resources for retrieval of the referenced images, frames, waveforms or documents. Additionally, DocumentReference has limited ability to reference multiple images or frames and can only specify the Study, Series and SOP Instance UIDs implicitly via the URL.

DocumentReference might be appropriate for including a rendered DICOM image in cases where the full image context is not important.

10.6.3 References to this Resource

Implements: Event
Resource References: BodyStructure , itself and Observation

Structure

derivedFrom Σ 0..* Reference ( ImagingStudy | DocumentReference ) The imaging study from which the imaging selection is derived endpoint Σ 0..* Reference ( Endpoint ) The network service providing retrieval for the images referenced in the imaging selection

Name	Flags	Card.	Type	Description & Constraints
ImagingSelection	TU		DomainResource	A selection of DICOM SOP instances and/or frames Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
identifier	Σ	0..*	Identifier	Business Identifier for Imaging Selection
status	?! Σ	1..1	code	available \| entered-in-error \| inactive \| unknown Binding: Imaging Selection Status ( Required )
category	Σ	0..*	CodeableConcept	Classifies the imaging selection Binding: KeyObjectSelectionDocumentTitle ( Example )
code	Σ	1..1	CodeableConcept	Imaging Selection purpose text or code Binding: KeyObjectSelectionDocumentTitle ( Example )
subject	Σ	0..1	Reference ( Patient \| Group \| Device \| ~~Location \| Organization \|~~ Procedure \| Practitioner \| Medication \| Substance \| Specimen )	Subject of the selected instances
issued	Σ	0..1	instant	Date / Time when this imaging selection was created
performer	Σ	0..*	BackboneElement	~~Selector~~ Selectors of the instances (human or machine)
function	Σ	0..1	CodeableConcept	Type of performer Binding: ImagingStudy series performer function ( Extensible )
actor	Σ	0..1	Reference ( Practitioner \| PractitionerRole \| Device \| Organization \| CareTeam \| Patient \| RelatedPerson \| HealthcareService )	Author (human or machine)
basedOn	Σ	0..*	Reference ( CarePlan \| ServiceRequest \| Appointment \| AppointmentResponse \| Task )	Associated ~~request~~ requests
~~category~~ derivedFrom	Σ	0..*	~~CodeableConcept~~ Reference ( ImagingStudy \| DocumentReference )	~~Classifies~~ The imaging study from which the imaging selection ~~Binding: KeyObjectSelectionDocumentTitle ( Example )~~ is derived
~~code~~ studyUid	Σ	~~1..1~~ 0..1	~~CodeableConcept~~ id	~~Imaging Selection purpose text or code Binding: KeyObjectSelectionDocumentTitle ( Example )~~ DICOM Study Instance UID
~~studyUid~~ seriesUid	Σ	0..1	id	DICOM ~~Study~~ Series Instance UID
~~seriesUid~~ seriesNumber	Σ	0..1	id unsignedInt	DICOM Series ~~Instance UID~~ Number
~~seriesNumber~~ frameOfReferenceUid	Σ	0..1	~~unsignedInt~~ id	~~DICOM Series Number~~ The Frame of Reference UID for the selected images
~~frameOfReferenceUid~~ bodySite	Σ	~~0..1~~ 0..*	id CodeableReference ( BodyStructure )	~~The Frame of Reference UID for the selected images~~ Body part examined Binding: SNOMED CT Body Structures ( Example )
~~bodySite~~ focus	Σ	~~0..1~~ 0..*	~~CodeableReference~~ Reference ( ~~BodyStructure~~ ImagingSelection )	~~Body part examined~~ Related resources that are the focus for the imaging selection ~~Binding: SNOMED CT Body Structures ( Example )~~
~~focus~~ endpoint	Σ	0..*	Reference ( ~~ImagingSelection~~ Endpoint )	~~Related resource that is the focus~~ The network services providing retrieval for the images referenced in the imaging selection
instance	Σ	0..*	BackboneElement	The selected instances
uid	Σ	1..1	id	DICOM SOP Instance UID
number	Σ	0..1	unsignedInt	DICOM Instance Number
sopClass		0..1	~~Coding~~ oid	DICOM SOP Class UID ~~Binding: sopClass ( Extensible )~~
subset		0..*	string	The selected subset of the SOP Instance
imageRegion2D		0..*	BackboneElement	A specific 2D region in a DICOM image / frame
regionType		1..1	code	point \| polyline \| ~~interpolated~~ multipoint \| circle \| ellipse Binding: Imaging ~~Selection2 D~~ Selection 2D Graphic Type ( Required )
coordinate		1..*	decimal	Specifies the coordinates that define the image region This repeating element order: The values are an ordered set of (x, y) coordinates.
imageRegion3D		0..*	BackboneElement	A specific 3D region in a DICOM frame of reference
regionType		1..1	code	point \| multipoint \| polyline \| polygon \| ellipse \| ellipsoid Binding: Imaging Selection3 D Graphic Type ( Required )
coordinate		1..*	decimal	Specifies the coordinates that define the image region This repeating element order: The values are an ordered set of (x, y, z) coordinates.
Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

XML Template

<ImagingSelection xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <
 <|
   </subject>

 <identifier><!-- 0..* Identifier Business Identifier for Imaging Selection --></identifier>
 <status value="[code]"/><!-- 1..1 available | entered-in-error | inactive | unknown -->
 <category><!-- 0..* CodeableConcept Classifies the imaging selection  --></category>
 <code><!-- 1..1 CodeableConcept Imaging Selection purpose text or code  --></code>
 <subject><!-- 0..1 Reference(Device|Group|Medication|Patient|Practitioner|
   Procedure|Specimen|Substance) Subject of the selected instances --></subject>
 <issued value="[instant]"/><!-- 0..1 Date / Time when this imaging selection was created -->
 <

 <performer>  <!-- 0..* Selectors of the instances (human or machine) -->

  <function><!-- 0..1 CodeableConcept Type of performer --></function>
  <|

  <actor><!-- 0..1 Reference(CareTeam|Device|HealthcareService|Organization|

    Patient|Practitioner|PractitionerRole|RelatedPerson) Author (human or machine) --></actor>
 </performer>
 <basedOn><!-- 0..* Reference(Appointment|AppointmentResponse|CarePlan|
   </basedOn>
 <</category>
 <</code>
 <

   ServiceRequest|Task) Associated requests --></basedOn>
 <derivedFrom><!-- 0..* Reference(DocumentReference|ImagingStudy) The imaging study from which the imaging selection is derived --></derivedFrom>
 <</endpoint>

 <studyUid value="[id]"/><!-- 0..1 DICOM Study Instance UID -->

 <seriesUid value="[id]"/><!-- 0..1 DICOM Series Instance UID -->
 <seriesNumber value="[unsignedInt]"/><!-- 0..1 DICOM Series Number -->
 <frameOfReferenceUid value="[id]"/><!-- 0..1 The Frame of Reference UID for the selected images -->
 <</bodySite>
 <</focus>

 <bodySite><!-- 0..* CodeableReference(BodyStructure) Body part examined --></bodySite>
 <focus><!-- 0..* Reference(ImagingSelection) Related resources that are the focus for the imaging selection --></focus>
 <endpoint><!-- 0..* Reference(Endpoint) The network services providing retrieval for the images referenced in the imaging selection --></endpoint>

 <instance>  <!-- 0..* The selected instances -->
  <uid value="[id]"/><!-- 1..1 DICOM SOP Instance UID -->
  <number value="[unsignedInt]"/><!-- 0..1 DICOM Instance Number -->
  <</sopClass>
  <<a href="imagingselection-definitions.html#ImagingSelection.instance.subset" title="Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance.
       May be one of:
       - A list of frame numbers selected from a multiframe SOP Instance.
       - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance.
       - A list of segment numbers selected from a segmentation SOP Instance.
       - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance." class="dict">
  <<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D" title="Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates.
       If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all frames in the subset list." class="dict">
   <
   <<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D.coordinate" title="The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution.
       The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames." class="dict">

  <sopClass value="[oid]"/><!-- 0..1 DICOM SOP Class UID -->
  <subset value="[string]"/><!-- 0..* The selected subset of the SOP Instance -->
  <imageRegion2D>  <!-- 0..* A specific 2D region in a DICOM image / frame -->
   <regionType value="[code]"/><!-- 1..1 point | polyline | multipoint | circle | ellipse -->
   <coordinate value="[decimal]"/><!-- 1..* Specifies the coordinates that define the image region -->

  </imageRegion2D>
  <
   <
   <
  </imageRegion3D>

 </instance>
 <imageRegion3D>  <!-- 0..* A specific 3D region in a DICOM frame of reference -->
  <regionType value="[code]"/><!-- 1..1 point | multipoint | polyline | polygon | ellipse | ellipsoid -->
  <coordinate value="[decimal]"/><!-- 1..* Specifies the coordinates that define the image region -->
 </imageRegion3D>

</ImagingSelection>

JSON Template

{
  "resourceType" : "ImagingSelection",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "|
   

  "identifier" : [{ Identifier }], // Business Identifier for Imaging Selection
  "status" : "<code>", // R!  available | entered-in-error | inactive | unknown
  "category" : [{ CodeableConcept }], // Classifies the imaging selection 
  "code" : { CodeableConcept }, // R!  Imaging Selection purpose text or code 
  "subject" : { Reference(Device|Group|Medication|Patient|Practitioner|
   Procedure|Specimen|Substance) }, // Subject of the selected instances
  "issued" : "<instant>", // Date / Time when this imaging selection was created
  "

  "performer" : [{ // Selectors of the instances (human or machine)

    "function" : { CodeableConcept }, // Type of performer
    "|

    "actor" : { Reference(CareTeam|Device|HealthcareService|Organization|

    Patient|Practitioner|PractitionerRole|RelatedPerson) } // Author (human or machine)
  }],
  "basedOn" : [{ Reference(Appointment|AppointmentResponse|CarePlan|
   
  "
  "
  "

   ServiceRequest|Task) }], // Associated requests
  "derivedFrom" : [{ Reference(DocumentReference|ImagingStudy) }], // The imaging study from which the imaging selection is derived
  "

  "studyUid" : "<id>", // DICOM Study Instance UID

  "seriesUid" : "<id>", // DICOM Series Instance UID
  "seriesNumber" : "<unsignedInt>", // DICOM Series Number
  "frameOfReferenceUid" : "<id>", // The Frame of Reference UID for the selected images
  "
  "

  "bodySite" : [{ CodeableReference(BodyStructure) }], // Body part examined
  "focus" : [{ Reference(ImagingSelection) }], // Related resources that are the focus for the imaging selection
  "endpoint" : [{ Reference(Endpoint) }], // The network services providing retrieval for the images referenced in the imaging selection

  "instance" : [{ // The selected instances
    "uid" : "<id>", // R!  DICOM SOP Instance UID
    "number" : "<unsignedInt>", // DICOM Instance Number
    "
    "<a href="imagingselection-definitions.html#ImagingSelection.instance.subset" title="Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance.
       May be one of:
       - A list of frame numbers selected from a multiframe SOP Instance.
       - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance.
       - A list of segment numbers selected from a segmentation SOP Instance.
       - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance." class="dict">subset
    "<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D" title="Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates.
       If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all frames in the subset list." class="dict">imageRegion2D
      "
      "<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D.coordinate" title="The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution.
       The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames." class="dict">coordinate
    }],
    "
      "
      "

    "sopClass" : "<oid>", // DICOM SOP Class UID
    "subset" : ["<string>"], // The selected subset of the SOP Instance
    "imageRegion2D" : [{ // A specific 2D region in a DICOM image / frame
      "regionType" : "<code>", // R!  point | polyline | multipoint | circle | ellipse
      "coordinate" : [<decimal>] // R!  Specifies the coordinates that define the image region

    }]
  }],
  "imageRegion3D" : [{ // A specific 3D region in a DICOM frame of reference
    "regionType" : "<code>", // R!  point | multipoint | polyline | polygon | ellipse | ellipsoid
    "coordinate" : [<decimal>] // R!  Specifies the coordinates that define the image region

  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:ImagingSelection;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:
  fhir:
  fhir:|
  

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for Imaging Selection
  fhir:status [ code ] ; # 1..1 available | entered-in-error | inactive | unknown
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Classifies the imaging selection
  fhir:code [ CodeableConcept ] ; # 1..1 Imaging Selection purpose text or code
  fhir:subject [ Reference(Device|Group|Medication|Patient|Practitioner|Procedure|Specimen|Substance) ] ; # 0..1 Subject of the selected instances

  fhir:issued [ instant ] ; # 0..1 Date / Time when this imaging selection was created
  fhir:

  fhir:performer ( [ # 0..* Selectors of the instances (human or machine)

    fhir:function [ CodeableConcept ] ; # 0..1 Type of performer
    fhir:|

    fhir:actor [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|

  PractitionerRole|RelatedPerson) ] ; # 0..1 Author (human or machine)
  ] ... ) ;
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:basedOn  ( [ Reference(Appointment|AppointmentResponse|CarePlan|ServiceRequest|Task) ] ... ) ; # 0..* Associated requests

  fhir:derivedFrom  ( [ Reference(DocumentReference|ImagingStudy) ] ... ) ; # 0..* The imaging study from which the imaging selection is derived
  fhir:

  fhir:studyUid [ id ] ; # 0..1 DICOM Study Instance UID

  fhir:seriesUid [ id ] ; # 0..1 DICOM Series Instance UID
  fhir:seriesNumber [ unsignedInt ] ; # 0..1 DICOM Series Number
  fhir:frameOfReferenceUid [ id ] ; # 0..1 The Frame of Reference UID for the selected images
  fhir:
  fhir:

  fhir:bodySite  ( [ CodeableReference(BodyStructure) ] ... ) ; # 0..* Body part examined
  fhir:focus  ( [ Reference(ImagingSelection) ] ... ) ; # 0..* Related resources that are the focus for the imaging selection
  fhir:endpoint  ( [ Reference(Endpoint) ] ... ) ; # 0..* The network services providing retrieval for the images referenced in the imaging selection

  fhir:instance ( [ # 0..* The selected instances
    fhir:uid [ id ] ; # 1..1 DICOM SOP Instance UID
    fhir:number [ unsignedInt ] ; # 0..1 DICOM Instance Number
    fhir:
    fhir:<a href="imagingselection-definitions.html#ImagingSelection.instance.subset" title="Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance.
       May be one of:
       - A list of frame numbers selected from a multiframe SOP Instance.
       - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance.
       - A list of segment numbers selected from a segmentation SOP Instance.
       - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance." class="dict">subset
    fhir:<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D" title="Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates.
       If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all frames in the subset list." class="dict">imageRegion2D
      fhir:
      fhir:<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D.coordinate" title="The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution.
       The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames." class="dict">coordinate
    ] ... ) ;
    fhir:
      fhir:
      fhir:

    fhir:sopClass [ oid ] ; # 0..1 DICOM SOP Class UID
    fhir:subset  ( [ string ] ... ) ; # 0..* The selected subset of the SOP Instance
    fhir:imageRegion2D ( [ # 0..* A specific 2D region in a DICOM image / frame
      fhir:regionType [ code ] ; # 1..1 point | polyline | multipoint | circle | ellipse
      fhir:coordinate  ( [ decimal ] ... ) ; # 1..* Specifies the coordinates that define the image region

    ] ... ) ;
  ] ... ) ;
  fhir:imageRegion3D ( [ # 0..* A specific 3D region in a DICOM frame of reference
    fhir:regionType [ code ] ; # 1..1 point | multipoint | polyline | polygon | ellipse | ellipsoid
    fhir:coordinate  ( [ decimal ] ... ) ; # 1..* Specifies the coordinates that define the image region
  ] ... ) ;

]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

Structure

Name	Flags	Card.	Type	Description & Constraints
ImagingSelection	TU		DomainResource	A selection of DICOM SOP instances and/or frames Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
identifier	Σ	0..*	Identifier	Business Identifier for Imaging Selection
status	?! Σ	1..1	code	available \| entered-in-error \| inactive \| unknown Binding: Imaging Selection Status ( Required )
category	Σ	0..*	CodeableConcept	Classifies the imaging selection Binding: KeyObjectSelectionDocumentTitle ( Example )
code	Σ	1..1	CodeableConcept	Imaging Selection purpose text or code Binding: KeyObjectSelectionDocumentTitle ( Example )
subject	Σ	0..1	Reference ( Patient \| Group \| Device \| ~~Location \| Organization \|~~ Procedure \| Practitioner \| Medication \| Substance \| Specimen )	Subject of the selected instances
issued	Σ	0..1	instant	Date / Time when this imaging selection was created
performer	Σ	0..*	BackboneElement	~~Selector~~ Selectors of the instances (human or machine)
function	Σ	0..1	CodeableConcept	Type of performer Binding: ImagingStudy series performer function ( Extensible )
actor	Σ	0..1	Reference ( Practitioner \| PractitionerRole \| Device \| Organization \| CareTeam \| Patient \| RelatedPerson \| HealthcareService )	Author (human or machine)
basedOn	Σ	0..*	Reference ( CarePlan \| ServiceRequest \| Appointment \| AppointmentResponse \| Task )	Associated ~~request~~ requests
~~category~~ derivedFrom	Σ	0..*	~~CodeableConcept~~ Reference ( ImagingStudy \| DocumentReference )	~~Classifies~~ The imaging study from which the imaging selection ~~Binding: KeyObjectSelectionDocumentTitle ( Example )~~ is derived
~~code~~ studyUid	Σ	~~1..1~~ 0..1	~~CodeableConcept~~ id	~~Imaging Selection purpose text or code Binding: KeyObjectSelectionDocumentTitle ( Example )~~ DICOM Study Instance UID
~~studyUid~~ seriesUid	Σ	0..1	id	DICOM ~~Study~~ Series Instance UID
~~seriesUid~~ seriesNumber	Σ	0..1	id unsignedInt	DICOM Series ~~Instance UID~~ Number
~~seriesNumber~~ frameOfReferenceUid	Σ	0..1	~~unsignedInt~~ id	~~DICOM Series Number~~ The Frame of Reference UID for the selected images
~~frameOfReferenceUid~~ bodySite	Σ	~~0..1~~ 0..*	id CodeableReference ( BodyStructure )	~~The Frame of Reference UID for the selected images~~ Body part examined Binding: SNOMED CT Body Structures ( Example )
~~bodySite~~ focus	Σ	~~0..1~~ 0..*	~~CodeableReference~~ Reference ( ~~BodyStructure~~ ImagingSelection )	~~Body part examined~~ Related resources that are the focus for the imaging selection ~~Binding: SNOMED CT Body Structures ( Example )~~
~~focus~~ endpoint	Σ	0..*	Reference ( ~~ImagingSelection~~ Endpoint )	~~Related resource that is the focus~~ The network services providing retrieval for the images referenced in the imaging selection
instance	Σ	0..*	BackboneElement	The selected instances
uid	Σ	1..1	id	DICOM SOP Instance UID
number	Σ	0..1	unsignedInt	DICOM Instance Number
sopClass		0..1	~~Coding~~ oid	DICOM SOP Class UID ~~Binding: sopClass ( Extensible )~~
subset		0..*	string	The selected subset of the SOP Instance
imageRegion2D		0..*	BackboneElement	A specific 2D region in a DICOM image / frame
regionType		1..1	code	point \| polyline \| ~~interpolated~~ multipoint \| circle \| ellipse Binding: Imaging ~~Selection2 D~~ Selection 2D Graphic Type ( Required )
coordinate		1..*	decimal	Specifies the coordinates that define the image region This repeating element order: The values are an ordered set of (x, y) coordinates.
imageRegion3D		0..*	BackboneElement	A specific 3D region in a DICOM frame of reference
regionType		1..1	code	point \| multipoint \| polyline \| polygon \| ellipse \| ellipsoid Binding: Imaging Selection3 D Graphic Type ( Required )
coordinate		1..*	decimal	Specifies the coordinates that define the image region This repeating element order: The values are an ordered set of (x, y, z) coordinates.
Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

XML Template

<ImagingSelection xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <
 <|
   </subject>

 <identifier><!-- 0..* Identifier Business Identifier for Imaging Selection --></identifier>
 <status value="[code]"/><!-- 1..1 available | entered-in-error | inactive | unknown -->
 <category><!-- 0..* CodeableConcept Classifies the imaging selection  --></category>
 <code><!-- 1..1 CodeableConcept Imaging Selection purpose text or code  --></code>
 <subject><!-- 0..1 Reference(Device|Group|Medication|Patient|Practitioner|
   Procedure|Specimen|Substance) Subject of the selected instances --></subject>
 <issued value="[instant]"/><!-- 0..1 Date / Time when this imaging selection was created -->
 <

 <performer>  <!-- 0..* Selectors of the instances (human or machine) -->

  <function><!-- 0..1 CodeableConcept Type of performer --></function>
  <|

  <actor><!-- 0..1 Reference(CareTeam|Device|HealthcareService|Organization|

    Patient|Practitioner|PractitionerRole|RelatedPerson) Author (human or machine) --></actor>
 </performer>
 <basedOn><!-- 0..* Reference(Appointment|AppointmentResponse|CarePlan|
   </basedOn>
 <</category>
 <</code>
 <

   ServiceRequest|Task) Associated requests --></basedOn>
 <derivedFrom><!-- 0..* Reference(DocumentReference|ImagingStudy) The imaging study from which the imaging selection is derived --></derivedFrom>
 <</endpoint>

 <studyUid value="[id]"/><!-- 0..1 DICOM Study Instance UID -->

 <seriesUid value="[id]"/><!-- 0..1 DICOM Series Instance UID -->
 <seriesNumber value="[unsignedInt]"/><!-- 0..1 DICOM Series Number -->
 <frameOfReferenceUid value="[id]"/><!-- 0..1 The Frame of Reference UID for the selected images -->
 <</bodySite>
 <</focus>

 <bodySite><!-- 0..* CodeableReference(BodyStructure) Body part examined --></bodySite>
 <focus><!-- 0..* Reference(ImagingSelection) Related resources that are the focus for the imaging selection --></focus>
 <endpoint><!-- 0..* Reference(Endpoint) The network services providing retrieval for the images referenced in the imaging selection --></endpoint>

 <instance>  <!-- 0..* The selected instances -->
  <uid value="[id]"/><!-- 1..1 DICOM SOP Instance UID -->
  <number value="[unsignedInt]"/><!-- 0..1 DICOM Instance Number -->
  <</sopClass>
  <<a href="imagingselection-definitions.html#ImagingSelection.instance.subset" title="Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance.
       May be one of:
       - A list of frame numbers selected from a multiframe SOP Instance.
       - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance.
       - A list of segment numbers selected from a segmentation SOP Instance.
       - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance." class="dict">
  <<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D" title="Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates.
       If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all frames in the subset list." class="dict">
   <
   <<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D.coordinate" title="The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution.
       The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames." class="dict">

  <sopClass value="[oid]"/><!-- 0..1 DICOM SOP Class UID -->
  <subset value="[string]"/><!-- 0..* The selected subset of the SOP Instance -->
  <imageRegion2D>  <!-- 0..* A specific 2D region in a DICOM image / frame -->
   <regionType value="[code]"/><!-- 1..1 point | polyline | multipoint | circle | ellipse -->
   <coordinate value="[decimal]"/><!-- 1..* Specifies the coordinates that define the image region -->

  </imageRegion2D>
  <
   <
   <
  </imageRegion3D>

 </instance>
 <imageRegion3D>  <!-- 0..* A specific 3D region in a DICOM frame of reference -->
  <regionType value="[code]"/><!-- 1..1 point | multipoint | polyline | polygon | ellipse | ellipsoid -->
  <coordinate value="[decimal]"/><!-- 1..* Specifies the coordinates that define the image region -->
 </imageRegion3D>

</ImagingSelection>

JSON Template

{
  "resourceType" : "ImagingSelection",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "|
   

  "identifier" : [{ Identifier }], // Business Identifier for Imaging Selection
  "status" : "<code>", // R!  available | entered-in-error | inactive | unknown
  "category" : [{ CodeableConcept }], // Classifies the imaging selection 
  "code" : { CodeableConcept }, // R!  Imaging Selection purpose text or code 
  "subject" : { Reference(Device|Group|Medication|Patient|Practitioner|
   Procedure|Specimen|Substance) }, // Subject of the selected instances
  "issued" : "<instant>", // Date / Time when this imaging selection was created
  "

  "performer" : [{ // Selectors of the instances (human or machine)

    "function" : { CodeableConcept }, // Type of performer
    "|

    "actor" : { Reference(CareTeam|Device|HealthcareService|Organization|

    Patient|Practitioner|PractitionerRole|RelatedPerson) } // Author (human or machine)
  }],
  "basedOn" : [{ Reference(Appointment|AppointmentResponse|CarePlan|
   
  "
  "
  "

   ServiceRequest|Task) }], // Associated requests
  "derivedFrom" : [{ Reference(DocumentReference|ImagingStudy) }], // The imaging study from which the imaging selection is derived
  "

  "studyUid" : "<id>", // DICOM Study Instance UID

  "seriesUid" : "<id>", // DICOM Series Instance UID
  "seriesNumber" : "<unsignedInt>", // DICOM Series Number
  "frameOfReferenceUid" : "<id>", // The Frame of Reference UID for the selected images
  "
  "

  "bodySite" : [{ CodeableReference(BodyStructure) }], // Body part examined
  "focus" : [{ Reference(ImagingSelection) }], // Related resources that are the focus for the imaging selection
  "endpoint" : [{ Reference(Endpoint) }], // The network services providing retrieval for the images referenced in the imaging selection

  "instance" : [{ // The selected instances
    "uid" : "<id>", // R!  DICOM SOP Instance UID
    "number" : "<unsignedInt>", // DICOM Instance Number
    "
    "<a href="imagingselection-definitions.html#ImagingSelection.instance.subset" title="Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance.
       May be one of:
       - A list of frame numbers selected from a multiframe SOP Instance.
       - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance.
       - A list of segment numbers selected from a segmentation SOP Instance.
       - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance." class="dict">subset
    "<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D" title="Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates.
       If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all frames in the subset list." class="dict">imageRegion2D
      "
      "<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D.coordinate" title="The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution.
       The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames." class="dict">coordinate
    }],
    "
      "
      "

    "sopClass" : "<oid>", // DICOM SOP Class UID
    "subset" : ["<string>"], // The selected subset of the SOP Instance
    "imageRegion2D" : [{ // A specific 2D region in a DICOM image / frame
      "regionType" : "<code>", // R!  point | polyline | multipoint | circle | ellipse
      "coordinate" : [<decimal>] // R!  Specifies the coordinates that define the image region

    }]
  }],
  "imageRegion3D" : [{ // A specific 3D region in a DICOM frame of reference
    "regionType" : "<code>", // R!  point | multipoint | polyline | polygon | ellipse | ellipsoid
    "coordinate" : [<decimal>] // R!  Specifies the coordinates that define the image region

  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:ImagingSelection;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:
  fhir:
  fhir:|
  

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for Imaging Selection
  fhir:status [ code ] ; # 1..1 available | entered-in-error | inactive | unknown
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Classifies the imaging selection
  fhir:code [ CodeableConcept ] ; # 1..1 Imaging Selection purpose text or code
  fhir:subject [ Reference(Device|Group|Medication|Patient|Practitioner|Procedure|Specimen|Substance) ] ; # 0..1 Subject of the selected instances

  fhir:issued [ instant ] ; # 0..1 Date / Time when this imaging selection was created
  fhir:

  fhir:performer ( [ # 0..* Selectors of the instances (human or machine)

    fhir:function [ CodeableConcept ] ; # 0..1 Type of performer
    fhir:|

    fhir:actor [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|

  PractitionerRole|RelatedPerson) ] ; # 0..1 Author (human or machine)
  ] ... ) ;
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:basedOn  ( [ Reference(Appointment|AppointmentResponse|CarePlan|ServiceRequest|Task) ] ... ) ; # 0..* Associated requests

  fhir:derivedFrom  ( [ Reference(DocumentReference|ImagingStudy) ] ... ) ; # 0..* The imaging study from which the imaging selection is derived
  fhir:

  fhir:studyUid [ id ] ; # 0..1 DICOM Study Instance UID

  fhir:seriesUid [ id ] ; # 0..1 DICOM Series Instance UID
  fhir:seriesNumber [ unsignedInt ] ; # 0..1 DICOM Series Number
  fhir:frameOfReferenceUid [ id ] ; # 0..1 The Frame of Reference UID for the selected images
  fhir:
  fhir:

  fhir:bodySite  ( [ CodeableReference(BodyStructure) ] ... ) ; # 0..* Body part examined
  fhir:focus  ( [ Reference(ImagingSelection) ] ... ) ; # 0..* Related resources that are the focus for the imaging selection
  fhir:endpoint  ( [ Reference(Endpoint) ] ... ) ; # 0..* The network services providing retrieval for the images referenced in the imaging selection

  fhir:instance ( [ # 0..* The selected instances
    fhir:uid [ id ] ; # 1..1 DICOM SOP Instance UID
    fhir:number [ unsignedInt ] ; # 0..1 DICOM Instance Number
    fhir:
    fhir:<a href="imagingselection-definitions.html#ImagingSelection.instance.subset" title="Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance.
       May be one of:
       - A list of frame numbers selected from a multiframe SOP Instance.
       - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance.
       - A list of segment numbers selected from a segmentation SOP Instance.
       - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance." class="dict">subset
    fhir:<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D" title="Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates.
       If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all frames in the subset list." class="dict">imageRegion2D
      fhir:
      fhir:<a href="imagingselection-definitions.html#ImagingSelection.instance.imageRegion2D.coordinate" title="The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution.
       The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames." class="dict">coordinate
    ] ... ) ;
    fhir:
      fhir:
      fhir:

    fhir:sopClass [ oid ] ; # 0..1 DICOM SOP Class UID
    fhir:subset  ( [ string ] ... ) ; # 0..* The selected subset of the SOP Instance
    fhir:imageRegion2D ( [ # 0..* A specific 2D region in a DICOM image / frame
      fhir:regionType [ code ] ; # 1..1 point | polyline | multipoint | circle | ellipse
      fhir:coordinate  ( [ decimal ] ... ) ; # 1..* Specifies the coordinates that define the image region

    ] ... ) ;
  ] ... ) ;
  fhir:imageRegion3D ( [ # 0..* A specific 3D region in a DICOM frame of reference
    fhir:regionType [ code ] ; # 1..1 point | multipoint | polyline | polygon | ellipse | ellipsoid
    fhir:coordinate  ( [ decimal ] ... ) ; # 1..* Specifies the coordinates that define the image region
  ] ... ) ;

]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

10.6.4.1 Terminology Bindings

~~ImagingSelection.performer.function~~ ~~ImagingSelection.code~~ ~~ImagingSelection.instance.sopClass http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 Extensible~~

Path	ValueSet	Type	Documentation
ImagingSelection.status	ImagingSelectionStatus	Required	The status of the ImagingSelection.
ImagingSelection.category	~~ImagingStudySeriesPerformerFunction~~ KeyObjectSelectionDocumentTitle	~~Extensible~~ Example	~~Performer function~~ Transitive closure of ~~an agent in an imaging study series~~ CID 7010 KeyObjectSelectionDocumentTitle
~~ImagingSelection.category~~ ImagingSelection.code	KeyObjectSelectionDocumentTitle	Example	Transitive closure of CID 7010 KeyObjectSelectionDocumentTitle
ImagingSelection.performer.function	~~KeyObjectSelectionDocumentTitle~~ ImagingStudySeriesPerformerFunction	~~Example~~ Extensible	~~Transitive closure~~ Performer function of ~~CID 7010 KeyObjectSelectionDocumentTitle~~ an agent in an imaging study series
ImagingSelection.bodySite	SNOMEDCTBodyStructures	Example	This value set includes all codes from SNOMED CT where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
ImagingSelection.instance.imageRegion2D.regionType	ImagingSelection2DGraphicType	Required	The type of 2D coordinates describing a 2D image region.
~~ImagingSelection.instance.imageRegion3D.regionType~~ ImagingSelection.imageRegion3D.regionType	ImagingSelection3DGraphicType	Required	The type of coordinates describing a 3D image region.

Path

ValueSet

Type

Documentation

ImagingSelection.status

ImagingSelectionStatus

Required

The status of the ImagingSelection.

ImagingSelection.category

~~ImagingStudySeriesPerformerFunction~~ KeyObjectSelectionDocumentTitle

~~Extensible~~ Example

~~Performer function~~ Transitive closure of ~~an agent in an imaging study series~~ CID 7010 KeyObjectSelectionDocumentTitle

~~ImagingSelection.category~~ ImagingSelection.code

KeyObjectSelectionDocumentTitle icon

Example

Transitive closure of CID 7010 KeyObjectSelectionDocumentTitle

ImagingSelection.performer.function

~~KeyObjectSelectionDocumentTitle~~ ImagingStudySeriesPerformerFunction

~~Example~~ Extensible

~~Transitive closure~~ Performer function of ~~CID 7010 KeyObjectSelectionDocumentTitle~~ an agent in an imaging study series

ImagingSelection.bodySite

SNOMEDCTBodyStructures

Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).

ImagingSelection.instance.imageRegion2D.regionType

ImagingSelection2DGraphicType

Required

The type of 2D coordinates describing a 2D image region.

~~ImagingSelection.instance.imageRegion3D.regionType~~ ImagingSelection.imageRegion3D.regionType

ImagingSelection3DGraphicType

Required

The type of coordinates describing a 3D image region.

10.6.4.2 10.6.5 Implementation Notes

10.6.4.2.1 10.6.5.1 Imaging Selection Subsets

Some DICOM SOP Instances contain multiple sub-resources, such as frames, segments, etc.

An Imaging Selection resource may specify the subset of these that are included in the selection using the instance.subset element.

The defined types of subsets are:

Frames selected from a multiframe SOP Instance
Referenced Content Item ~~Observation UIDs~~ Identifiers selected from a DICOM SR or other structured document SOP Instance
Segments selected from a segmentation SOP Instance
Regions of interest selected from a radiotherapy structure set SOP Instance

The type of subset is determined by the SOP Class of the parent instance.

Subsets can only reference sub-resources that are already defined within the selected DICOM SOP Instance.

10.6.5.2 Use of ImagingSelection.code and ImagingSelection.category

The code and category element can be used to information relevant for applications that want to identify specific types of ImagingSelection resources.

As code is required and limited to a single value, it holds the primary purpose of the ImagingSelection. Additional applicable values populate the category element.

For example, if an ImagingSelection is used to identify a set of images that make up a volume rendered view, the code could contain a code indicating Volume Rendering - such as RadLex RID35862 - and the category could contain values of the DICOM Image Type (0008,0008) attribute - such as DERVIED and SECONDARY.


  {
    "resource": {
      "resourceType": "ImagingSelection",
      "id": "fa8e0948175f3117a3b8c4be2ff972ec",
      "subject": {
        "reference": "Patient/acb045960122378999c97cd7ca532f8b"
      },
      "code": {
        "coding": [
          {
            "system": "http://radlex.org/",
            "code": "RID12769",
            "display": "volume rendering"
          }
        ]
      },
      "category": [
        {
          "text": "DERIVED"
        },
        {
          "text": "SECONDARY"
        }
      ]
    }
  }

10.6.5 10.6.6 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
based-on	reference	The request associated with an imaging selection	ImagingSelection.basedOn ( Appointment , AppointmentResponse , CarePlan , Task , ServiceRequest )
body-site	token	The body site code associated with the imaging selection	ImagingSelection.bodySite.concept
body-structure	reference	The body structure associated with the imaging selection	ImagingSelection.bodySite.reference
category	token	The imaging selection category	ImagingSelection.category
code	token	The imaging selection ~~status~~ description text or code	~~ImagingSelection.status~~ ImagingSelection.code	22 21 Resources
derived-from	reference	The imaging study from which the imaging selection was derived	ImagingSelection.derivedFrom ( ImagingStudy , DocumentReference )
identifier	token	Identifiers for the imaging selection	ImagingSelection.identifier	65 Resources
issued	date	The date / time the imaging selection was created	ImagingSelection.issued
patient	reference	Who the study is about	ImagingSelection.subject.where(resolve() is Patient) ( Patient )	66 65 Resources
status	token	The status of the imaging selection	ImagingSelection.status
study-uid	token	The DICOM Study Instance UID from which the images were selected	ImagingSelection.studyUid
subject	reference	The subject of the Imaging Selection, such as the associated Patient	ImagingSelection.subject ( Practitioner , Group , Specimen , ~~Organization ,~~ Device , Medication , Patient , Procedure , Substance ~~, Location~~ )