FHIR Release 3 (STU) 4

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Imaging Integration Work Group Maturity Level : 3   Trial Use Security Category : Patient Compartments : Patient

Detailed Descriptions for the elements in the ImagingStudy resource.

true Alternate Names Control Type Reference Alternate Names
ImagingStudy
Element Id ImagingStudy
Definition

Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.

Control 1..1 ImagingStudy.uid Definition Formal identifier for the study. Control Cardinality 1..1 0..*
Type oid Alternate Names StudyInstanceUID Summary DomainResource
ImagingStudy.accession ImagingStudy.identifier
Definition 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 . Control 0..1 Type Identifier Alternate Names AccessionNumber Summary Element Id true ImagingStudy.identifier
Definition

Other identifiers Identifiers for the study. ImagingStudy such as DICOM Study Instance UID, and Accession Number.

Note This is a business identifer, identifier, not a resource identifier (see discussion )
Control Cardinality 0..*
Type Identifier
Requirements

If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2 .

Alternate Names StudyID StudyInstanceUID; AccessionNumber
Summary true
Comments

See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.

ImagingStudy.availability ImagingStudy.status
Element Id ImagingStudy.status
Definition

Availability The current state of study (online, offline, or nearline). the ImagingStudy.

Control Cardinality 0..1 1..1
Terminology Binding InstanceAvailability ImagingStudyStatus ( Required )
Type code
Is Modifier InstanceAvailability true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summary true
Comments

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

ImagingStudy.modalityList ImagingStudy.modality
Element Id ImagingStudy.modality
Definition

A list of all the Series.ImageModality series.modality 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).

Control Cardinality 0..*
Terminology Binding Acquisition Modality Codes AcquisitionModality ( Extensible )
Type Coding
Alternate Names ModalitiesInStudy
Summary true
ImagingStudy.patient ImagingStudy.subject
Element Id ImagingStudy.subject
Definition

The patient imaged in subject, typically a patient, of the imaging study.

Control Cardinality 1..1
Type Reference ( Patient | Device | Group )
Summary true
Comments

QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group.

ImagingStudy.context ImagingStudy.encounter
Element Id ImagingStudy.encounter
Definition

The encounter or episode at healthcare event (e.g. a patient and healthcare provider interaction) during which the request this ImagingStudy is initiated. made.

Control Cardinality 0..1
Type Reference ( Encounter | EpisodeOfCare )
Summary true
Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).

ImagingStudy.started
Element Id ImagingStudy.started
Definition

Date and time the study started.

Control Cardinality 0..1
Type dateTime
Alternate Names StudyDate; StudyTime
Summary true
ImagingStudy.basedOn
Element Id ImagingStudy.basedOn
Definition

A list of the diagnostic requests that resulted in this imaging study being performed.

Control Cardinality 0..*
Type Reference ( ReferralRequest | CarePlan | ProcedureRequest ServiceRequest | Appointment | AppointmentResponse | Task )
Requirements

To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).

Summary true
ImagingStudy.referrer
Element Id ImagingStudy.referrer
Definition

The requesting/referring physician.

Control Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole )
Alternate Names ReferringPhysiciansName
Summary true
ImagingStudy.interpreter
Element Id ImagingStudy.interpreter
Definition

Who read the study and interpreted the images or other content.

Control Cardinality 0..*
Type Reference ( Practitioner | PractitionerRole )
Alternate Names Name of Physician(s) Reading Study
Summary true
ImagingStudy.endpoint
Element Id ImagingStudy.endpoint
Definition

The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.type. Endpoint.connectionType.

Control Cardinality 0..*
Type Reference ( Endpoint )
Requirements

Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.

Summary true
Comments

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.

ImagingStudy.numberOfSeries
Element Id ImagingStudy.numberOfSeries
Definition

Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present.

Control Cardinality 0..1
Type unsignedInt
Alternate Names NumberOfStudyRelatedSeries
Summary true
ImagingStudy.numberOfInstances
Element Id ImagingStudy.numberOfInstances
Definition

Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

Control Cardinality 0..1
Type unsignedInt
Alternate Names NumberOfStudyRelatedInstances
Summary true
ImagingStudy.procedureReference
Element Id ImagingStudy.procedureReference
Definition

A reference to the performed Procedure. The procedure which this ImagingStudy was part of.

Control Cardinality 0..* 0..1
Type Reference ( Procedure )
Summary true
ImagingStudy.procedureCode
Element Id ImagingStudy.procedureCode
Definition

The code for the performed procedure type.

Control Cardinality 0..*
Terminology Binding Procedure Codes (SNOMED CT) ( Example ) ImagingProcedureCode :
Type CodeableConcept
Alternate Names ProcedureCodeSequence
Summary true
ImagingStudy.reason ImagingStudy.location
Element Id ImagingStudy.location
Definition

The principal physical location where the ImagingStudy was performed.

Cardinality 0..1
Type Reference ( Location )
Requirements

Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

Summary true
ImagingStudy.reasonCode
Element Id ImagingStudy.reasonCode
Definition

Description of clinical condition indicating why the ImagingStudy was requested.

Control Cardinality 0..1 0..*
Terminology Binding Procedure Reason Codes ( Example )
Type CodeableConcept
Summary true
ImagingStudy.reasonReference
Element Id ImagingStudy.reasonReference
Definition

Indicates another resource whose existence justifies this Study.

Cardinality 0..*
Type Reference ( Condition | Observation | Media | DiagnosticReport | DocumentReference )
Summary true
ImagingStudy.note
Element Id ImagingStudy.note
Definition

Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element.

Cardinality 0..*
Type Annotation
Summary true
ImagingStudy.description
Element Id ImagingStudy.description
Definition

The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed.

Control Cardinality 0..1
Type string
Alternate Names StudyDescription
Summary true
ImagingStudy.series
Element Id ImagingStudy.series
Definition

Each study has one or more series of images or other content.

Control Cardinality 0..*
Summary true
ImagingStudy.series.uid
Element Id ImagingStudy.series.uid
Definition

Formal identifier The DICOM Series Instance UID for this the series.

Control Cardinality 1..1
Type oid id
Requirements

DICOM Series Instance UID.

Alternate Names SeriesInstanceUID
Summary true
Comments

See DICOM PS3.3 C.7.3 .

ImagingStudy.series.number
Element Id ImagingStudy.series.number
Definition

The numeric identifier of this series in the study.

Control Cardinality 0..1
Type unsignedInt
Alternate Names SeriesNumber
Summary true
ImagingStudy.series.modality
Element Id ImagingStudy.series.modality
Definition

The modality of this series sequence.

Control Cardinality 1..1
Terminology Binding Acquisition Modality Codes AcquisitionModality ( Extensible )
Type Coding
Alternate Names Modality
Summary true
ImagingStudy.series.description
Element Id ImagingStudy.series.description
Definition

A description of the series.

Control Cardinality 0..1
Type string
Alternate Names SeriesDescription
Summary true
ImagingStudy.series.numberOfInstances
Element Id ImagingStudy.series.numberOfInstances
Definition

Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

Control Cardinality 0..1
Type unsignedInt
Alternate Names NumberOfSeriesRelatedInstances
Summary true
ImagingStudy.series.availability ImagingStudy.series.endpoint
Definition Availability of series (online, offline or nearline). Control 0..1 Terminology Binding InstanceAvailability ( Required ) Type code Alternate Names InstanceAvailability Summary Element Id true ImagingStudy.series.endpoint
Definition

The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.type. Endpoint.connectionType.

Control Cardinality 0..*
Type Reference ( Endpoint )
Requirements

Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level.

Summary true
Comments

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.

ImagingStudy.series.bodySite
Element Id ImagingStudy.series.bodySite
Definition

The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality.

Control Cardinality 0..1
Terminology Binding SNOMED CT Body Structures ( Example )
Type Coding
Alternate Names BodyPartExamined
Summary true
ImagingStudy.series.laterality
Element Id ImagingStudy.series.laterality
Definition

The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite.

Control Cardinality 0..1
Terminology Binding Laterality ( Example )
Type Coding
Summary true
ImagingStudy.series.specimen
Element Id ImagingStudy.series.specimen
Definition

The specimen imaged, e.g., for whole slide imaging of a biopsy.

Cardinality 0..*
Type Reference ( Specimen )
Summary true
ImagingStudy.series.started
Element Id ImagingStudy.series.started
Definition

The date and time the series was started.

Control Cardinality 0..1
Type dateTime
Summary true
ImagingStudy.series.performer
Element Id ImagingStudy.series.performer
Definition

The physician or operator (often the radiology technician) Indicates who or what performed the series. series and how they were involved.

Cardinality 0..*
Requirements

The performer is recorded at the series level, since each series in a study may be performed by a different practitioner, performer, at different times, and using different devices. A series may be performed by multiple practitioners. performers.

Alternate Names PerformingPhysicianName; OperatorName
Summary 0..* true
Comments

If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images.

ImagingStudy.series.performer.function
Element Id ImagingStudy.series.performer.function
Definition

Distinguishes the type of involvement of the performer in the series.

Cardinality 0..1
Terminology Binding ImagingStudy series performer function ( Practitioner Extensible )
Type PerformingPhysicianName; OperatorName CodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

Summary true
ImagingStudy.series.performer.actor
Element Id ImagingStudy.series.performer.actor
Definition

Indicates who or what performed the series.

Cardinality 1..1
Type Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson )
Summary true
ImagingStudy.series.instance
Element Id ImagingStudy.series.instance
Definition

A single SOP instance within the series, e.g. an image, or presentation state.

Control Cardinality 0..*
ImagingStudy.series.instance.uid
Element Id ImagingStudy.series.instance.uid
Definition

Formal identifier The DICOM SOP Instance UID for this image or other DICOM content.

Control Cardinality 1..1
Type oid id
Requirements

DICOM SOP Instance UID.

Alternate Names SOPInstanceUID
Comments

See DICOM PS3.3 C.12.1 .

ImagingStudy.series.instance.number ImagingStudy.series.instance.sopClass
Element Id ImagingStudy.series.instance.sopClass
Definition

The number of DICOM instance in the series. type.

Control Cardinality 0..1 1..1
Terminology Binding sopClass :
Type unsignedInt Coding
Alternate Names InstanceNumber SOPClassUID
ImagingStudy.series.instance.sopClass ImagingStudy.series.instance.number
Element Id ImagingStudy.series.instance.number
Definition

DICOM The number of instance type. in the series.

Control Cardinality 1..1 0..1
Type oid unsignedInt
Alternate Names SOPClassUID InstanceNumber
ImagingStudy.series.instance.title
Element Id ImagingStudy.series.instance.title
Definition

The description of the instance.

Control Cardinality 0..1
Type string
Comments

Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc.