DSTU2

This page is part of the FHIR Specification (v0.0.82: (v1.0.2: DSTU 1). 2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

4.18 4.23 Resource ImagingStudy - Content

Imaging Integration Work Group Maturity Level : 2 Compartments : Patient

Manifest of a set Representation of images the content produced in a DICOM imaging study. The A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images may include every image in the study, or it may be an incomplete sample, such as other data) acquired or produced in a list common context. A series is of key images. only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.

4.18.1 4.23.1 Scope and Usage

This resource summarizes a series of images or other instances generated as part of an imaging study, and provides references to where the images are available using WADO-RS . This resource is used mappings of its elements to make information concerning images etc. that DICOM attributes. DICOM attributes are available identified by a 32-bit tag, presented in other clinical contexts such canonical form as diagnostic reports , Care Plans , etc. Also, see the use case description below. two four-digit hexadecimal values within parentheses and separated by a comma, e.g. (0008,103E). The name and value representation (data type) of each attribute can be found in DICOM Part 6 Data Dictionary .

This resources has been specifically designed with The use of the attributes in DICOM contexts in mind. The content is closely based on the definitions context of the equivalent DICOM constructs, and informed by usage patterns already established through DICOM implementation practices, information objects, including XDS-I. It is not, however, necessary to use detailed description of use, can be found in DICOM infrastructure Part 3 Information Object Definitions .

Attributes used in order to use this resource. the DICOM query information models, such as "Number of Instances in Study", can be found in DICOM Part 4 Annex C .

This resource is referenced by DiagnosticReport and ImagingObjectSelection

4.18.2 4.23.2 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
.. ImagingStudy Σ DomainResource A set of images produced in single study (one or more series of references images)
... started Σ 0..1 dateTime When the study was started
... patient Σ 1..1 Reference ( Patient ) Who the images are of
... uid Σ 1..1 oid Formal identifier for the study
... accession Σ 0..1 Identifier Related workflow identifier ("Accession Number")
... identifier Σ 0..* Identifier Other identifiers for the study
... order Σ 0..* Reference ( DiagnosticOrder ) Order(s) that caused this study to be performed
... modalityList Σ 0..* Coding All series modality if actual acquisition modalities
Acquisition Modality Codes ( Extensible )
... referrer Σ 0..1 Reference ( Practitioner ) Referring physician (0008,0090)
... availability Σ 0..1 code ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
InstanceAvailability ( Required )
... url Σ 0..1 uri Retrieve URI
... numberOfSeries Σ 1..1 unsignedInt Number of Study Related Series
... numberOfInstances Σ 1..1 unsignedInt Number of Study Related Instances
... procedure Σ 0..* Reference ( Procedure ) Type of procedure performed
... interpreter Σ 0..1 Reference ( Practitioner ) Who interpreted images
... description Σ 0..1 string Institution-generated description
... series Σ 0..* BackboneElement Each study has one or more series of instances
.... number Σ 0..1 unsignedInt Numeric identifier of this series
.... modality Σ 1..1 Coding The modality of the instances in the series
Acquisition Modality Codes ( Extensible )
.... uid Σ 1..1 oid Formal identifier for this series
.... description Σ 0..1 string A description of the series
.... numberOfInstances Σ 1..1 unsignedInt Number of Series Related Instances
.... availability Σ 0..1 code ONLINE | OFFLINE | NEARLINE | UNAVAILABLE
InstanceAvailability ( Required )
.... url Σ 0..1 uri Location of the referenced instance(s)
.... bodySite Σ 0..1 Coding Body part examined
SNOMED CT Body Structures ( Example )
.... laterality Σ 0..1 Coding Body part laterality
Laterality ( Example )
.... started Σ 0..1 dateTime When the series started
.... instance Σ 0..* BackboneElement A single SOP instance from the series
..... number Σ 0..1 unsignedInt The number of this instance in the series
..... uid Σ 1..1 oid Formal identifier for this instance
..... sopClass Σ 1..1 oid DICOM class type
..... type Σ 0..1 string Type of instance (image etc.)
..... title Σ 0..1 string Description of instance
..... content Σ 0..* Attachment Content of the instance

doco Documentation for this format

UML Diagram

ImagingStudy ( Resource DomainResource ) Date and Time the study took place started dateTime started : dateTime 0..1 [0..1] Who The patient imaged in the images are of study subject patient : Resource Reference ( [1..1] « Patient ) 1..1 » Formal identifier for the study uid : oid 1..1 [1..1] Accession Number is an identifier related to some aspect of imaging workflow and data management. Usage may vary across different institutions. See for instance [IHE Radiology Technical Framework Volume 1 Appendix A](http://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_TF_Rev13.0_Vol1_FT_2014-07-30.pdf) accessionNo accession : Identifier 0..1 [0..1] Other identifiers for the study identifier : Identifier 0..* [0..*] A list of the diagnostic orders that resulted in this imaging study being performed order : Resource Reference ( [0..*] « DiagnosticOrder ) 0..* » A list of all the Series.ImageModality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19) modality modalityList : code Coding 0..* << [0..*] « Type of acquired image data in the instance (Strength=Extensible) ImagingModality Acquisition Modality >> + » The requesting/referring physician referrer : Resource Reference ( [0..1] « Practitioner ) 0..1 » Availability of study (online, offline or nearline) availability : code 0..1 << [0..1] « Availability of the resource (Strength=Required) InstanceAvailability >> ! » WADO-RS URI resource where Study is available url : uri 0..1 [0..1] Number of Series in Study numberOfSeries : integer unsignedInt 1..1 [1..1] Number of SOP Instances in Study numberOfInstances : integer unsignedInt 1..1 [1..1] Diagnoses etc provided with request clinicalInformation : string 0..1 Type of procedure performed procedure : Coding Reference 0..* [0..*] « Procedure » Who read the study and interpreted the images or other content interpreter : Resource Reference ( [0..1] « Practitioner ) 0..1 » Institution-generated description or classification of the Study (component) performed description : string 0..1 [0..1] Series The number Numeric identifier of this series in the overall sequence study number : integer unsignedInt 0..1 [0..1] The modality of this series sequence modality : code Coding 1..1 << [1..1] « Type of acquired data in the instance (Strength=Extensible) Acquisition Modality >> + » Formal identifier for this series uid : oid 1..1 [1..1] A description of the series description : string 0..1 [0..1] Sequence that contains attributes from the Number of SOP Instances in Series numberOfInstances : integer unsignedInt 1..1 [1..1] Availability of series (online, offline or nearline) availability : code 0..1 << [0..1] « Availability of the resource (Strength=Required) InstanceAvailability >> ! » URI/URL specifying the location of the referenced series using WADO-RS URI where Series is available url : uri 0..1 [0..1] Body part examined. See DICOM Part 16 Annex L for the mapping from DICOM to Snomed CT bodySite : Coding 0..1 << [0..1] « Codes describing anatomical locations. May include laterality. (Strength=Example) SNOMED CT Body Structures ?? » Laterality if body site is paired anatomic structure and laterality is not pre-coordinated in body site code BodySite laterality >> : Coding [0..1] « Codes describing body site laterality (left, right, etc.). (Strength=Example) Laterality ?? » When The date and time the series was started dateTime started : dateTime 0..1 [0..1] Instance The number of this image instance in the series number : integer unsignedInt 0..1 [0..1] Formal identifier for this image or other content uid : oid 1..1 [1..1] DICOM Image instance type sopclass sopClass : oid 1..1 [1..1] Type of instance (image etc) (0004,1430) A human-friendly SOP Class name type : string 0..1 [0..1] Description (0070,0080 | 0040,A043 > 0008,0104 | 0042,0010 | 0008,0008) The description of the instance title : string 0..1 [0..1] Content of the instance or a rendering thereof (e.g. a JPEG of an image, or an XML of a structured report). May be represented for example by inline encoding; by a URL reference to a WADO-RS service that makes the instance available; or to a FHIR Resource (e.g. Media, Document, etc.). Multiple content attachments may be used for alternate representations of the instance content : Attachment [0..*] A single SOP Instance within the series, e.g. an image, or presentation state instance [0..*] Each study has one or more series of images or other content series [0..*]

XML Template 


<ImagingStudy xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <started value="[dateTime]"/><!-- 0..1 When the study was started -->
 <patient><!-- 1..1 Reference(Patient) Who the images are of --></patient>
 <uid value="[oid]"/><!-- 1..1 Formal identifier for the study -->
 <accession><!-- 0..1 Identifier Related workflow identifier ("Accession Number") --></accession>
 <identifier><!-- 0..* Identifier Other identifiers for the study --></identifier>
 <order><!-- 0..* Reference(DiagnosticOrder) Order(s) that caused this study to be performed --></order>
 <modalityList><!-- 0..* Coding All series modality if actual acquisition modalities --></modalityList>
 <referrer><!-- 0..1 Reference(Practitioner) Referring physician (0008,0090) --></referrer>
 <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056) -->
 <url value="[uri]"/><!-- 0..1 Retrieve URI -->
 <numberOfSeries value="[unsignedInt]"/><!-- 1..1 Number of Study Related Series -->
 <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Study Related Instances -->
 <procedure><!-- 0..* Reference(Procedure) Type of procedure performed --></procedure>
 <interpreter><!-- 0..1 Reference(Practitioner) Who interpreted images --></interpreter>
 <description value="[string]"/><!-- 0..1 Institution-generated description -->
 <series>  <!-- 0..* Each study has one or more series of instances -->
  <number value="[unsignedInt]"/><!-- 0..1 Numeric identifier of this series -->
  <modality><!-- 1..1 Coding The modality of the instances in the series --></modality>
  <uid value="[oid]"/><!-- 1..1 Formal identifier for this series -->
  <description value="[string]"/><!-- 0..1 A description of the series -->
  <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Series Related Instances -->
  <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE -->
  <url value="[uri]"/><!-- 0..1 Location of the referenced instance(s) -->
  <bodySite><!-- 0..1 Coding Body part examined --></bodySite>
  <laterality><!-- 0..1 Coding Body part laterality --></laterality>
  <started value="[dateTime]"/><!-- 0..1 When the series started -->
  <instance>  <!-- 0..* A single SOP instance from the series -->
   <number value="[unsignedInt]"/><!-- 0..1 The number of this instance in the series -->
   <uid value="[oid]"/><!-- 1..1 Formal identifier for this instance -->
   <sopClass value="[oid]"/><!-- 1..1 DICOM class type -->
   <type value="[string]"/><!-- 0..1 Type of instance (image etc.) -->
   <title value="[string]"/><!-- 0..1 Description of instance -->
   <content><!-- 0..* Attachment Content of the instance --></content>
  </instance>
 </series>
</ImagingStudy>

JSON Template 


{doco
  "resourceType" : "ImagingStudy",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "started" : "<dateTime>", // When the study was started
  "patient" : { Reference(Patient) }, // R!  Who the images are of
  "uid" : "<oid>", // R!  Formal identifier for the study
  "accession" : { Identifier }, // Related workflow identifier ("Accession Number")
  "identifier" : [{ Identifier }], // Other identifiers for the study
  "order" : [{ Reference(DiagnosticOrder) }], // Order(s) that caused this study to be performed
  "modalityList" : [{ Coding }], // All series modality if actual acquisition modalities
  "referrer" : { Reference(Practitioner) }, // Referring physician (0008,0090)
  "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
  "url" : "<uri>", // Retrieve URI
  "numberOfSeries" : "<unsignedInt>", // R!  Number of Study Related Series
  "numberOfInstances" : "<unsignedInt>", // R!  Number of Study Related Instances
  "procedure" : [{ Reference(Procedure) }], // Type of procedure performed
  "interpreter" : { Reference(Practitioner) }, // Who interpreted images
  "description" : "<string>", // Institution-generated description
  "series" : [{ // Each study has one or more series of instances
    "number" : "<unsignedInt>", // Numeric identifier of this series
    "modality" : { Coding }, // R!  The modality of the instances in the series
    "uid" : "<oid>", // R!  Formal identifier for this series
    "description" : "<string>", // A description of the series
    "numberOfInstances" : "<unsignedInt>", // R!  Number of Series Related Instances
    "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE
    "url" : "<uri>", // Location of the referenced instance(s)
    "bodySite" : { Coding }, // Body part examined
    "laterality" : { Coding }, // Body part laterality
    "started" : "<dateTime>", // When the series started
    "instance" : [{ // A single SOP instance from the series
      "number" : "<unsignedInt>", // The number of this instance in the series
      "uid" : "<oid>", // R!  Formal identifier for this instance
      "sopClass" : "<oid>", // R!  DICOM class type
      "type" : "<string>", // Type of instance (image etc.)
      "title" : "<string>", // Description of instance
      "content" : [{ Attachment }] // Content of the instance
    }]
  }]
}

Structure

Name Flags Card. Type Description & Constraints doco
.. ImagingStudy Σ DomainResource A set of images produced in single study (one or more series of references images)
... started Σ 0..1 dateTime When the study was started
... patient Σ 1..1 Reference ( Patient ) Who the images are of
... uid Σ 1..1 oid Formal identifier for the study
... accession Σ 0..1 Identifier Related workflow identifier ("Accession Number")
... identifier Σ 0..* Identifier Other identifiers for the study
... order Σ 0..* Reference ( DiagnosticOrder ) Order(s) that caused this study to be performed
... modalityList Σ 0..* Coding All series modality if actual acquisition modalities
Acquisition Modality Codes ( Extensible )
... referrer Σ 0..1 Reference ( Practitioner ) Referring physician (0008,0090)
... availability Σ 0..1 code ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
InstanceAvailability ( Required )
... url Σ 0..1 uri Retrieve URI
... numberOfSeries Σ 1..1 unsignedInt Number of Study Related Series
... numberOfInstances Σ 1..1 unsignedInt Number of Study Related Instances
... procedure Σ 0..* Reference ( Procedure ) Type of procedure performed
... interpreter Σ 0..1 Reference ( Practitioner ) Who interpreted images
... description Σ 0..1 string Institution-generated description
... series Σ 0..* BackboneElement Each study has one or more series of instances
.... number Σ 0..1 unsignedInt Numeric identifier of this series
.... modality Σ 1..1 Coding The modality of the instances in the series
Acquisition Modality Codes ( Extensible )
.... uid Σ 1..1 oid Formal identifier for this series
.... description Σ 0..1 string A description of the series
.... numberOfInstances Σ 1..1 unsignedInt Number of Series Related Instances
.... availability Σ 0..1 code ONLINE | OFFLINE | NEARLINE | UNAVAILABLE
InstanceAvailability ( Required )
.... url Σ 0..1 uri Location of the referenced instance(s)
.... bodySite Σ 0..1 Coding Body part examined
SNOMED CT Body Structures ( Example )
.... laterality Σ 0..1 Coding Body part laterality
Laterality ( Example )
.... started Σ 0..1 dateTime When the series started
.... instance Σ 0..* BackboneElement A single SOP instance from the series
..... number Σ 0..1 unsignedInt The number of this instance in the series
..... uid Σ 1..1 oid Formal identifier for this instance
..... sopClass Σ 1..1 oid DICOM class type
..... type Σ 0..1 string Type of instance (image etc.)
..... title Σ 0..1 string Description of instance
..... content Σ 0..* Attachment Content of the instance

doco Documentation for this format

UML Diagram

ImagingStudy ( DomainResource ) Date and Time the study started started : dateTime [0..1] The patient imaged in the study patient : Reference [1..1] « Patient » Formal identifier for the study uid : oid [1..1] Accession Number is an identifier related to some aspect of imaging workflow and data management. Usage may vary across different institutions. See for instance [IHE Radiology Technical Framework Volume 1 Appendix A](http://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_TF_Rev13.0_Vol1_FT_2014-07-30.pdf) accession : Identifier [0..1] Other identifiers for the study identifier : Identifier [0..*] A list of the diagnostic orders that resulted in this imaging study being performed order : Reference [0..*] « DiagnosticOrder » A list of all the Series.ImageModality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19) modalityList : Coding [0..*] « Type of acquired data in the instance (Strength=Extensible) Acquisition Modality + » The requesting/referring physician referrer : Reference [0..1] « Practitioner » Availability of study (online, offline or nearline) availability : code [0..1] « Availability of the resource (Strength=Required) InstanceAvailability ! » WADO-RS resource where image Study is available url : uri 0..1 [0..1] Number of Series in Study numberOfSeries : unsignedInt [1..1] Number of SOP Instances in Study numberOfInstances : unsignedInt [1..1] Type of procedure performed procedure : Reference [0..*] « Procedure » Who read the study and interpreted the images or other content interpreter : Reference [0..1] « Practitioner » Institution-generated description or classification of the Study performed description : string [0..1] Series The Numeric identifier of this series in the study number : unsignedInt [0..1] The modality of this series sequence modality : Coding [1..1] « Type of acquired data in the instance (Strength=Extensible) Acquisition Modality + » Formal identifier for this series uid : oid [1..1] A FHIR description of the series description : string [0..1] Number of SOP Instances in Series numberOfInstances : unsignedInt [1..1] Availability of series (online, offline or nearline) availability : code [0..1] « Availability of the resource with content (Strength=Required) InstanceAvailability ! » URI/URL specifying the location of the referenced series using WADO-RS url : uri [0..1] Body part examined. See DICOM Part 16 Annex L for the mapping from DICOM to Snomed CT bodySite : Coding [0..1] « Codes describing anatomical locations. May include laterality. (Strength=Example) SNOMED CT Body Structures ?? » Laterality if body site is paired anatomic structure and laterality is not pre-coordinated in body site code laterality : Coding [0..1] « Codes describing body site laterality (left, right, etc.). (Strength=Example) Laterality ?? » The date and time the series was started started : dateTime [0..1] Instance The number of instance in the series number : unsignedInt [0..1] Formal identifier for this image or other content uid : oid [1..1] DICOM instance type attachment sopClass : oid [1..1] A human-friendly SOP Class name type : string [0..1] The description of the instance title : string [0..1] Content of the instance or a rendering thereof (e.g. a JPEG of an image, or an XML of a structured report). May be represented for example by inline encoding; by a URL reference to a WADO-RS service that makes the instance available; or to a FHIR Resource (e.g. Media, Document, etc.). Multiple content attachments may be used for alternate representations of the instance content ( Any : Attachment ) 0..1 [0..*] A single image taken from a patient SOP Instance within the series, e.g. an image, or presentation state instance 1..* [0..*] Each study has one or more series of image instances images or other content series 0..* [0..*] This resource is referenced by DiagnosticReport and Procedure

XML Template

< <!-- from --> < <</subject> < <</accessionNo> <</identifier> <</order> < <</referrer> < < < < < <</procedure> <</interpreter> < < < < < < < < < <</bodySite> < < < < < < < < <</attachment> 
<ImagingStudy xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <started value="[dateTime]"/><!-- 0..1 When the study was started -->
 <patient><!-- 1..1 Reference(Patient) Who the images are of --></patient>
 <uid value="[oid]"/><!-- 1..1 Formal identifier for the study -->
 <accession><!-- 0..1 Identifier Related workflow identifier ("Accession Number") --></accession>
 <identifier><!-- 0..* Identifier Other identifiers for the study --></identifier>
 <order><!-- 0..* Reference(DiagnosticOrder) Order(s) that caused this study to be performed --></order>
 <modalityList><!-- 0..* Coding All series modality if actual acquisition modalities --></modalityList>
 <referrer><!-- 0..1 Reference(Practitioner) Referring physician (0008,0090) --></referrer>
 <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056) -->
 <url value="[uri]"/><!-- 0..1 Retrieve URI -->
 <numberOfSeries value="[unsignedInt]"/><!-- 1..1 Number of Study Related Series -->
 <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Study Related Instances -->
 <procedure><!-- 0..* Reference(Procedure) Type of procedure performed --></procedure>
 <interpreter><!-- 0..1 Reference(Practitioner) Who interpreted images --></interpreter>
 <description value="[string]"/><!-- 0..1 Institution-generated description -->
 <series>  <!-- 0..* Each study has one or more series of instances -->
  <number value="[unsignedInt]"/><!-- 0..1 Numeric identifier of this series -->
  <modality><!-- 1..1 Coding The modality of the instances in the series --></modality>
  <uid value="[oid]"/><!-- 1..1 Formal identifier for this series -->
  <description value="[string]"/><!-- 0..1 A description of the series -->
  <numberOfInstances value="[unsignedInt]"/><!-- 1..1 Number of Series Related Instances -->
  <availability value="[code]"/><!-- 0..1 ONLINE | OFFLINE | NEARLINE | UNAVAILABLE -->
  <url value="[uri]"/><!-- 0..1 Location of the referenced instance(s) -->
  <bodySite><!-- 0..1 Coding Body part examined --></bodySite>
  <laterality><!-- 0..1 Coding Body part laterality --></laterality>
  <started value="[dateTime]"/><!-- 0..1 When the series started -->
  <instance>  <!-- 0..* A single SOP instance from the series -->
   <number value="[unsignedInt]"/><!-- 0..1 The number of this instance in the series -->
   <uid value="[oid]"/><!-- 1..1 Formal identifier for this instance -->
   <sopClass value="[oid]"/><!-- 1..1 DICOM class type -->
   <type value="[string]"/><!-- 0..1 Type of instance (image etc.) -->
   <title value="[string]"/><!-- 0..1 Description of instance -->
   <content><!-- 0..* Attachment Content of the instance --></content>

  </instance>
 </series>
</ImagingStudy>

JSON Template 


{doco
  "resourceType" : "ImagingStudy",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "started" : "<dateTime>", // When the study was started
  "patient" : { Reference(Patient) }, // R!  Who the images are of
  "uid" : "<oid>", // R!  Formal identifier for the study
  "accession" : { Identifier }, // Related workflow identifier ("Accession Number")
  "identifier" : [{ Identifier }], // Other identifiers for the study
  "order" : [{ Reference(DiagnosticOrder) }], // Order(s) that caused this study to be performed
  "modalityList" : [{ Coding }], // All series modality if actual acquisition modalities
  "referrer" : { Reference(Practitioner) }, // Referring physician (0008,0090)
  "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE (0008,0056)
  "url" : "<uri>", // Retrieve URI
  "numberOfSeries" : "<unsignedInt>", // R!  Number of Study Related Series
  "numberOfInstances" : "<unsignedInt>", // R!  Number of Study Related Instances
  "procedure" : [{ Reference(Procedure) }], // Type of procedure performed
  "interpreter" : { Reference(Practitioner) }, // Who interpreted images
  "description" : "<string>", // Institution-generated description
  "series" : [{ // Each study has one or more series of instances
    "number" : "<unsignedInt>", // Numeric identifier of this series
    "modality" : { Coding }, // R!  The modality of the instances in the series
    "uid" : "<oid>", // R!  Formal identifier for this series
    "description" : "<string>", // A description of the series
    "numberOfInstances" : "<unsignedInt>", // R!  Number of Series Related Instances
    "availability" : "<code>", // ONLINE | OFFLINE | NEARLINE | UNAVAILABLE
    "url" : "<uri>", // Location of the referenced instance(s)
    "bodySite" : { Coding }, // Body part examined
    "laterality" : { Coding }, // Body part laterality
    "started" : "<dateTime>", // When the series started
    "instance" : [{ // A single SOP instance from the series
      "number" : "<unsignedInt>", // The number of this instance in the series
      "uid" : "<oid>", // R!  Formal identifier for this instance
      "sopClass" : "<oid>", // R!  DICOM class type
      "type" : "<string>", // Type of instance (image etc.)
      "title" : "<string>", // Description of instance
      "content" : [{ Attachment }] // Content of the instance
    }]
  }]
}

 

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

4.18.2.1 4.23.2.1 Terminology Bindings

ImagingStudy.modality ImagingStudy.series.modality ImagingStudy.series.bodySite
Path Definition Type Reference
ImagingStudy.modalityList
ImagingStudy.series.modality 		Type of acquired image data in the instance Fixed Extensible http://hl7.org/fhir/imaging-modality Acquisition Modality Codes
ImagingStudy.availability
ImagingStudy.series.availability 		Availability of the resource Fixed Required http://hl7.org/fhir/instance-availability InstanceAvailability
ImagingStudy.series.bodySite Type of data in the instance Codes describing anatomical locations. May include laterality. Fixed Example http://hl7.org/fhir/modality SNOMED CT Body Structures
ImagingStudy.series.laterality Codes describing anatomical locations. May include body site laterality (left, right, etc.). Example http://hl7.org/fhir/vs/body-site Laterality

4.18.2.2 4.23.2.2 Implementation Notes

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

4.18.2.3 4.23.2.3 Use Case

Joe Angina complains of shortness of breath and occasional chest pain to his primary care physician, Dr. Pat Down at Local MultiClinic, who orders a stress echocardiogram; the order is created as a FHIR Order resource to manage the workflow, with a link to a DiagnosticOrder resource with the details of the request. The following storyboard illustrates order is scheduled and assigned to cardiologist Dr. Art Skann, also at Local MultiClinic.

On the primary use case for scheduled day of the exam, Joe arrives at the echo lab to meet with Dr. Skann and have the study done. Dr. Skann’s workstation shows the daily list of Orders, and he follows the link to retrieve the DiagnosticOrder. (He may follow the links through the referenced Patient resource to access Joe’s electronic medical record, but that is not the concern of this resource: storyboard.)

An oncologist, Karen, The Order/DiagnosticOrder has been transcoded to a DICOM Modality Worklist Scheduled Procedure Step, and in the echo lab the equipment has downloaded the Modality Worklist. The study is seeing patients performed, and the acquired images and sonographer’s preliminary measurements are stored in her clinic, the Local MultiClinic Picture Archiving and would like background Communication System (PACS). The PACS creates an ImagingStudy resource for each study it manages.

Dr. Skann interprets the study on a PACS workstation, and he selects two key image frames to be included in the patients she diagnostic report; this selection is seeing today. Her first patient of stored back to the day, Alex. has arrived. She launches her Electronic Medical Record (EMR) software, and makes PACS as a Patient query on Alex using his last name. The EMR software DICOM Key Object Selection with the title "For Report Attachment", and the PACS makes it available (transcodes it) as a FHIR query on ImagingObjectSelection resource. Dr. Skann dictates the Patient resource, to provide background demographic information report using a structured data entry report writing program, including a recommendation for cover page rendering. a cardiac catheterization procedure, and signs it. The EMR software makes report writing program formats the report as a subsequent FHIR query on CDA document, retrieves the Condition ImagingObjectSelection resource, and reports that Alex is suspected to have prostate cancer. With this information, Karen decides to check for two further tests - inserts the results of a Prostate-Specific Antigen (PSA) laboratory test, referenced key images into the report.

Dr. Down meets again with Joe, and they review the results of a CT exam performed at the local diagnostic facility. First, stress test. Joe has a FHIR query is made against question about the Observation resource findings that the key images in the report do not show, so Dr. Down uses the Local MultiClinic EMR to query the PACS for the most recent value of PSA (the EMR also queries previous values of PSA full ImagingStudy resource, and uses the references there to open an image display for trending). For the CT exam, full study. Joe agrees to proceed to catheterization, and Dr. Down sends a referral to the EMR software queries on Ginormous University Hospital cath department, and triggers the ImagingStudy resource PACS to retrieve share the echo study through the Metropolitan Health Information Exchange.

The PACS creates a list manifest of available the study as an ImagingObjectSelection resource, which includes all the images with other relevant constraints (such but excludes the sonographer’s preliminary measurements (which as modality, body region etc.). This returns back a matter of policy are not shared outside the studies available, Local MultiClinic). The manifest is published to the Metro HIE. (In accordance with relevant meta-data about each study, its series and images. This information will help Karen IHE XDS-I, the images themselves are not directly published to select which the HIE, but available for on-demand retrieval from the PACS.)

At Ginormous Hospital, Dr. Cora Plummer receives the cath referral, and looks up the study would like to review. Using in the WADO-RS references provided, Metro HIE registry. She retrieves the artifacts Karen would like to review can be downloaded study manifest ImagingObjectSelection, and viewed using capable DICOM viewing software. uses it to access the shared images, which she uses to prepare for the cath procedure.

4.18.3 4.23.3 Search Parameters

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

Name Type Description Paths
_id token The logical resource id associated with the resource (must be supported by all servers) _language token The language of the resource accession token The accession id identifier for the image study ImagingStudy.accessionNo ImagingStudy.accession
bodysite token Body part examined (Map from 0018,0015) The body site studied ImagingStudy.series.bodySite
date dicom-class date uri The date type of the study was done was taken instance ImagingStudy.dateTime ImagingStudy.series.instance.sopClass
dicom-class modality token DICOM class type (0008,0016) The modality of the series ImagingStudy.series.instance.sopclass ImagingStudy.series.modality
modality order token reference The modality of order for the image ImagingStudy.series.modality ImagingStudy.order
( DiagnosticOrder )
series patient token reference The series id for Who the image study is about ImagingStudy.series.uid ImagingStudy.patient
( Patient )
size series number uri The size identifier of the image in MB - may include > or < in the value series of images ImagingStudy.series.uid
study started token date The study id for When the image study was started ImagingStudy.uid ImagingStudy.started
subject study reference uri Who the The study is about identifier for the image ImagingStudy.subject ( Patient ) ImagingStudy.uid
uid token uri Formal identifier for this The instance (0008,0018) unique identifier ImagingStudy.series.instance.uid
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