mosaiq 2.50 dicom conformance statementd3a9c288-ca7b-4859...use of trademarks and trade names...

MOSAIQ 2.60

DICOM Conformance Statement

Document ID: LEDDCM0048 (3.0)

Language: English

Publication Date: 2015-05

MOSAIQ DICOM Conformance Statement INTRODUCTION

LEDDCM0048 / 2.0 MOSAIQ 2.60

2015-10-29 MOSAIQ 2.60 DICOM Conformance Statement

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Copyright Statement © 2015 IMPAC Medical Systems, Inc. All rights reserved. Do not make printed or electronic copies of this guide, or parts of it, without written authority from IMPAC Medical Systems, Inc. The information in this guide is for the sole use of IMPAC Medical Systems, Inc. personnel, authorized users and licensees of IMPAC Medical Systems, Inc. products, and no other purpose.

Use of Trademarks and Trade Names Statement The Elekta® trademarks, service marks, logos, and trade names used in this document are the registered and unregistered trademarks and trade names of Elekta AB (publ.), its affiliates, or a third party that has licensed its trademarks and trade names to Elekta AB (publ.) or its affiliates. Do not make copies, show, or use trademarks or trade names without written authority from IMPAC Medical Systems, Inc. an affiliate of Elekta AB (publ.).

Acknowledgement of Other Trademarks and Trade Names Elekta acknowledges the trademarks and trade names of other manufacturers that we use in this document.

Referenced Documents Elekta does not supply all documents referred to in this document in printed forms. Elekta reserves the right to make the decision on which of the documents it supplies in printed form.

Contact Information

Contact Software Support: http://www.elekta.com/healthcare-professionals/products/elekta-services/service-and-support/software-support.html Contact Information: http://www.elekta.com/meta/contact.html

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Table of Contents 1 INTRODUCTION ................................................................................................................................................................... 1

1.1 Purpose ....................................................................................................................................................................................1 1.2 Scope ........................................................................................................................................................................................1 1.3 References ...............................................................................................................................................................................1 1.4 Documentation Conventions ..............................................................................................................................................1 1.5 Definitions, Acronyms and Abbreviations ........................................................................................................................2

2 CONFORMANCE STATEMENT OVERVIEW................................................................................................................ 3 2.1 CONFORMANCE SUMMARY...........................................................................................................................................3

2.1.1 MOSAIQ DICOM Network Service Support ................................................................................................... 3 2.1.2 MOSAIQ DICOM Media Services Support...................................................................................................... 5

3 NETWORKING........................................................................................................................................................................ 6 3.1 IMPLEMENTATION MODEL...........................................................................................................................................6

3.1.1 Application Data Flow.......................................................................................................................................... 7 3.1.2 Sequencing of Real –World Activities ............................................................................................................... 8

3.1.2.1 DICOM Import Workflow .................................................................................................................................. 8 3.1.2.2 DICOM Modality Worklist Workflow ................................................................................................................ 8 3.1.2.3 DICOM Export Workflow ................................................................................................................................... 9 3.1.2.4 DICOM Oncology Workflow Manager for MOSAIQ Data Director Workflow............................................... 10 3.1.2.5 DICOM Archive-Restore Workflow.................................................................................................................. 11

3.2 FUNCTIONAL DEFINITIONS OF AES.........................................................................................................................12 3.2.1 Functional Definition of Storage SCP AE ....................................................................................................... 12 3.2.2 Functional Definition of Storage SCU AE ...................................................................................................... 13 3.2.3 Functional Definition of Q/R SCU AE ............................................................................................................ 13 3.2.4 Functional Definition of Storage SCU/SCP and Storage Commitment SCU AE .................................... 14 3.2.5 Functional Definition of Print SCU AE .......................................................................................................... 15 3.2.6 Functional Definition of Modality Worklist SCP AE ................................................................................... 15

3.3 AE SPECIFICATIONS........................................................................................................................................................15 3.3.1 Storage SCP AE Specification: DICOM Import (DCM) .............................................................................. 15

3.3.1.1 Association Establishment Policies .................................................................................................................... 16 3.3.1.2 Association Initiation Policy .............................................................................................................................. 16 3.3.1.3 Association Acceptance Policy........................................................................................................................... 16 3.3.1.4 Request Verification of Communication ........................................................................................................... 18

3.3.2 Modality Worklist (C-Find Request) SCP AE Specification........................................................................ 19 3.3.2.2 Request Verification of Communication ........................................................................................................... 19

3.3.3 Storage SCU AE Specification: DICOM Export ............................................................................................ 20 3.3.3.1 Association Establishment Policies .................................................................................................................... 20 3.3.3.2 Association Initiation Policy .............................................................................................................................. 21 3.3.3.3 Association Acceptance Policy........................................................................................................................... 21

3.3.4 Q/R SCU AE Specification: Oncology Workflow Manager for MOSAIQ Data Director....................... 23 3.3.4.1 Association Establishment Policies .................................................................................................................... 23 3.3.4.2 Association Initiation Policy .............................................................................................................................. 23 3.3.4.3 Association Acceptance Policy........................................................................................................................... 24

3.3.5 Storage SCU and Q/R SCU AE Specification: Archive and Restore Service ............................................. 26




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3.3.5.1 Association Establishment Policies .................................................................................................................... 26 3.3.5.2 Association Initiation Policy .............................................................................................................................. 27 3.3.5.3 Association Acceptance Policy........................................................................................................................... 27

3.3.6 Print SCU AE Specification ............................................................................................................................... 32 3.3.6.1 Association Establishment Policies .................................................................................................................... 32 3.3.6.2 Association Initiation Policy .............................................................................................................................. 32 3.3.6.3 Association Acceptance Policy........................................................................................................................... 32

3.4 COMMUNICATION PROFILES .....................................................................................................................................33 3.5 SUPPORTED COMMUNICATION STACKS ..............................................................................................................33

3.5.1 TCP/IP Stack........................................................................................................................................................ 33 3.5.1.1 API ..................................................................................................................................................................... 33 3.5.1.2 Physical Media Support ..................................................................................................................................... 33

3.6 EXTENSIONS / SPECIALIZATIONS / PRIVATIZATIONS ......................................................................................33 3.7 STANDARD EXTENDED / SPECIALIZED / PRIVATE SOPS..................................................................................33 3.8 PRIVATE TRANSFER SYNTAXES .................................................................................................................................33 3.9 CONFIGURATION ............................................................................................................................................................33 3.10 APPLICATION ENTITY CONFIGURATION.......................................................................................................33 3.11 AE TITLE / PRESENTATION ADDRESS MAPPING ..........................................................................................34 3.12 CONFIGURABLE PARAMETERS............................................................................................................................34

4 MEDIA INTERCHANGE..................................................................................................................................................... 34 4.1 IMPLEMENTATION MODEL.........................................................................................................................................34 4.2 APPLICATION DATA FLOW .........................................................................................................................................34 4.3 Functional Definition of AEs .............................................................................................................................................35

4.3.1 Functional Definition of Media AE.................................................................................................................. 35

5 SUPPORT OF EXTENDED CHAR ACTER SETS .......................................................................................................... 37 5.1 DICOM SOP Instance Import...........................................................................................................................................37

5.1.1 Single Byte and Single Byte Extended Character Set Support ..................................................................... 37 5.1.2 Multi-Byte Character Set Support .................................................................................................................... 37

5.2 SPECIFIC CONFORMANCE FOR IMAGE TRANSFERS ..........................................................................................37

6 Appendix A .............................................................................................................................................................................. 39 6.1 SPECIFIC CONFORMANCE FOR IMAGE IODs ........................................................................................................39

6.1.1 Image Object Import and Storage .................................................................................................................... 39 6.2 Image IOD Modules ............................................................................................................................................................39 6.3 Common Modules for RT, SC, CR and SC Image IODs...............................................................................................40

6.3.1 Patient Module .................................................................................................................................................... 41 6.3.2 General Study Module ........................................................................................................................................ 41 6.3.3 General Series Module........................................................................................................................................ 41 6.3.4 General Equipment Module .............................................................................................................................. 42 6.3.5 General Image Module ....................................................................................................................................... 43 6.3.6 Image Plane Module ........................................................................................................................................... 43 6.3.7 Image Pixel Module ............................................................................................................................................ 43 6.3.8 SOP Common Module ....................................................................................................................................... 44

6.4 IOD Specific Modules: RT, SC, CR and SC Image IODs ..............................................................................................45 6.4.1 RT Series Module ................................................................................................................................................ 45




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6.4.2 SC Equipment Module ....................................................................................................................................... 45 6.4.3 CR Image Module ............................................................................................................................................... 45 6.4.4 SC Image Module ................................................................................................................................................ 46 6.4.5 RT Image Module ............................................................................................................................................... 46 6.4.6 Curve Module (Retired, but still commonly in use in RT Image) .............................................................. 48 6.4.7 VOI LUT Module ................................................................................................................................................ 49

6.5 Import Process Limitations When Extracting and Storing Image Pixel Data ...........................................................49 6.5.1 Bits Stored less than Bits Allocated, High Bit equal to Bits Stored - 1........................................................ 49 6.5.2 Bits Stored less than Bits Allocated, High Bit not equal to Bits Stored - 1 ................................................. 49

7 Appendix B .............................................................................................................................................................................. 50 7.1 SPECIFIC CONFORMANCE FOR RT PLAN IOD ......................................................................................................50 7.2 RT Plan IOD Modules ........................................................................................................................................................50 7.3 Module Attributes................................................................................................................................................................51

7.3.1 Patient Module .................................................................................................................................................... 51 7.3.2 RT Series Module ................................................................................................................................................ 51 7.3.3 General Equipment Module .............................................................................................................................. 51 7.3.4 RT General Plan Module ................................................................................................................................... 52 7.3.5 RT Prescription Module..................................................................................................................................... 52 7.3.6 RT Tolerance Tables Module ............................................................................................................................ 53 7.3.7 RT Patient Setup Module ................................................................................................................................... 53 7.3.8 RT Fraction Scheme Module............................................................................................................................. 53 7.3.9 RT Beams Module............................................................................................................................................... 54 7.3.10 Approval Module ................................................................................................................................................ 59 7.3.11 SOP Common Module ....................................................................................................................................... 60

8 Appendix C .............................................................................................................................................................................. 61 8.1 SPECIFIC CONFORMANCE FOR RT ION PLAN IMPORT AND EXPORT........................................................61 8.2 RT Ion Plan IOD Modules .................................................................................................................................................61 8.3 Module Attributes................................................................................................................................................................62

8.3.1 Patient Module .................................................................................................................................................... 62 8.3.2 General Study Module ........................................................................................................................................ 62 8.3.3 RT Series Module ................................................................................................................................................ 63 8.3.4 RT General Plan Module ................................................................................................................................... 63 8.3.5 RT Prescription Module..................................................................................................................................... 63 8.3.6 RT Fraction Scheme Module............................................................................................................................. 63 8.3.7 RT Ion Beams Module........................................................................................................................................ 64 8.3.8 SOP Common Module ....................................................................................................................................... 75

9 Appendix D.............................................................................................................................................................................. 76 9.1 SPECIFIC CONFORMANCE FOR RT STRUCTURE SET IMPORT .......................................................................76 9.2 RT Structure Set IOD Modules .........................................................................................................................................76 9.3 Module Attributes................................................................................................................................................................76




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9.3.1 Patient Module .................................................................................................................................................... 77 9.3.2 General Study Module ........................................................................................................................................ 77 9.3.3 RT Series Module ................................................................................................................................................ 77 9.3.4 Structure Set Module .......................................................................................................................................... 77 9.3.5 RT ROI Contour Module ................................................................................................................................... 79 9.3.6 RT ROI Observations Module .......................................................................................................................... 80 9.3.7 SOP Common Module ....................................................................................................................................... 84

10 Appendix E .............................................................................................................................................................................. 85 10.1 SPECIFIC CONFORMANCE FOR RT PLAN EXPORT.......................................................................................85 10.2 RT Plan IOD Modules ..................................................................................................................................................85

10.2.1 ELEKTA Synergy Specific Modules/Elements ............................................................................................... 86 10.2.2 Varian 4D Specific Modules/Elements ............................................................................................................ 86 10.2.3 Siemens DCI Specific Modules/Elements ....................................................................................................... 87

10.3 Module Attributes .........................................................................................................................................................87 10.3.1 Patient Module .................................................................................................................................................... 87 10.3.2 General Study Module ........................................................................................................................................ 87 10.3.3 RT Series Module ................................................................................................................................................ 88 10.3.4 General Equipment Module .............................................................................................................................. 88 10.3.5 RT General Plan Module ................................................................................................................................... 88 10.3.6 RT Prescription Module..................................................................................................................................... 89 10.3.7 RT Tolerance Tables Module ............................................................................................................................ 89 10.3.8 RT Fraction Scheme Module............................................................................................................................. 90 10.3.9 RT Beams Module............................................................................................................................................... 91 10.3.10 Approval Module .............................................................................................................................................. 100 10.3.11 SOP Common Module ..................................................................................................................................... 101

11 Appendix F.............................................................................................................................................................................102 11.1 SPECIFIC CONFORMANCE FOR RT IMAGE EXPORT..................................................................................102 11.2 RT IMAGE IOD Modules..........................................................................................................................................102 11.3 Module Attributes .......................................................................................................................................................102

11.3.1 Patient Module .................................................................................................................................................. 103 11.3.2 General Study Module ...................................................................................................................................... 103 11.3.3 RT Series Module .............................................................................................................................................. 103 11.3.4 Frame of Reference Module ............................................................................................................................ 104 11.3.5 General Equipment Module ............................................................................................................................ 104 11.3.6 General Image Module ..................................................................................................................................... 104 11.3.7 Image Pixel Module .......................................................................................................................................... 104 11.3.8 RT Image Module ............................................................................................................................................. 105 11.3.9 Curve Module (Retired, but still commonly in use in RT Image) ............................................................ 106 11.3.10 SOP Common Module ..................................................................................................................................... 107




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12 Appendix G............................................................................................................................................................................108 12.1 SPECIFIC CONFORMANCE FOR RT BEAMS TREATMENT SUMMARY EX PORT ...............................108 12.2 RT BEAMS Treatment Summary IOD Modules ...................................................................................................108 12.3 Module Attributes .......................................................................................................................................................108

12.3.1 Patient Module .................................................................................................................................................. 108 12.3.2 General Study Module ...................................................................................................................................... 109 12.3.3 RT Series Module .............................................................................................................................................. 109 12.3.4 General Equipment Module ............................................................................................................................ 109 12.3.5 RT General Treatment Record Module ......................................................................................................... 109 12.3.6 RT Treatment Summary Record Module ..................................................................................................... 110 12.3.7 SOP Common Module ..................................................................................................................................... 111

13 Appendix H............................................................................................................................................................................112 13.1 SPECIFIC CONFORMANCE FOR RT BEAMS TREATMENT RECORD EXPORT....................................112 13.2 RT BEAMS Treatment RECORD IOD Modules ...................................................................................................112 13.3 Module Attributes .......................................................................................................................................................113

13.3.1 Patient Module .................................................................................................................................................. 113 13.3.2 General Study Module ...................................................................................................................................... 113 13.3.3 RT Series Module .............................................................................................................................................. 113 13.3.4 General Equipment Module ............................................................................................................................ 113 13.3.5 RT General Treatment Record Module ......................................................................................................... 114 13.3.6 RT Patient Setup Module ................................................................................................................................. 114 13.3.7 RT Treatment Machine Record Module ....................................................................................................... 115 13.3.8 RT Beams Session Record Module ................................................................................................................. 115 13.3.9 RT Treatment Summary Record Module ..................................................................................................... 122 13.3.10 SOP Common Module ..................................................................................................................................... 123

14 Appendix I .............................................................................................................................................................................124 14.1 SPECIFIC CONFORMANCE FOR RT BEAMS TREATMENT RECORD IMPORT....................................124 14.2 RT BEAMS Treatment RECORD IOD Modules ...................................................................................................124 14.3 Module Attributes .......................................................................................................................................................125

14.3.1 Patient Module .................................................................................................................................................. 125 14.3.2 RT Series Module .............................................................................................................................................. 125 14.3.3 RT General Treatment Record Module ......................................................................................................... 125 14.3.4 RT Beams Session Record Module ................................................................................................................. 125 14.3.5 SOP Common Module ..................................................................................................................................... 132

15 Appendix J .............................................................................................................................................................................133 15.1 SPECIFIC CONFORMANCE FOR RT ION BEAMS TREATMENT RECORD IMPORT...........................133 15.2 RT Ion BEAMS Treatment RECORD IOD Modules ............................................................................................133 15.3 Module Attributes .......................................................................................................................................................134

15.3.1 Patient Module .................................................................................................................................................. 134 15.3.2 RT Series Module .............................................................................................................................................. 134 15.3.3 RT General Treatment Record Module ......................................................................................................... 134




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15.3.4 RT Ion Beams Session Record Module.......................................................................................................... 135 15.3.5 SOP Common Module ..................................................................................................................................... 144

16 Appendix K ............................................................................................................................................................................145 16.1 SPECIFIC CONFORMANCE FOR QUERY/RETRIEVE (SCU) INFORMATION MODELS ....................145

17 Appendix L............................................................................................................................................................................146 17.1 SPECIFIC CONFORMANCE FOR RT DOSE IMPORT.....................................................................................146 17.2 RT DOSE IOD MODULES .......................................................................................................................................146 17.3 MODULE ATTRIBUTES ..........................................................................................................................................147

17.3.1 Patient Module .................................................................................................................................................. 147 17.3.2 General Study Module ...................................................................................................................................... 147 17.3.3 RT Series Module .............................................................................................................................................. 148 17.3.4 Frame of Reference Module ............................................................................................................................ 148 17.3.5 General Equipment Module ............................................................................................................................ 148 17.3.6 General Image Module -- Not Supported ..................................................................................................... 149 17.3.7 Image Plane Module ......................................................................................................................................... 149 17.3.8 Image Pixel Module .......................................................................................................................................... 149 17.3.9 Multi-Frame Module ........................................................................................................................................ 150 17.3.10 Overlay Plane Module – Not Supported ....................................................................................................... 150 17.3.11 Multi-Frame Overlay Module – Not Supported .......................................................................................... 150 17.3.12 Modality LUT Module – Not Supported ...................................................................................................... 150 17.3.13 RT Dose Module ............................................................................................................................................... 150 17.3.14 RT DVH Module – Not Supported................................................................................................................ 153 17.3.15 Structure Set Module – Not Supported ......................................................................................................... 153 17.3.16 ROI Contour Module – Not Supported ........................................................................................................ 153 17.3.17 RT Dose ROI Module – Not Supported ........................................................................................................ 153 17.3.18 SOP Common Module ..................................................................................................................................... 153 17.3.19 Single Byte and Single Byte Extended Character Set Support: ................................................................ 154 17.3.20 Multi-Byte Character Set Support:................................................................................................................. 154 17.3.21 Frame Extractor Module – Not Supported ................................................................................................... 155

18 Appendix M ...........................................................................................................................................................................156 18.1 SPECIFIC CONFORMANCE FOR SPATIAL REGISTRATION IMPORT ....................................................156 18.2 SPATIAL REGISTRATION IOD MODULES .......................................................................................................156 18.3 MODULE ATTRIBUTES ..........................................................................................................................................156

18.3.1 Patient Module .................................................................................................................................................. 156 18.3.2 General Study Module ...................................................................................................................................... 157 18.3.3 General Series Module...................................................................................................................................... 157 18.3.4 Spatial Registration Series Module ................................................................................................................. 158 18.3.5 Frame of Reference Module ............................................................................................................................ 158 18.3.6 General Equipment Module ............................................................................................................................ 158




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18.3.7 Spatial Registration Module ............................................................................................................................ 159 18.3.8 Common Instance Reference Module – Not Supported ............................................................................ 160 18.3.9 SOP Common Module ..................................................................................................................................... 160 18.1.1 Single Byte and Single Byte Extended Character Set Support ................................................................... 161 18.1.2 Multi-Byte Character Set Support .................................................................................................................. 161

19 Appendix N............................................................................................................................................................................161 19.1 SPECIFIC CONFORMANCE FOR CT, MR and PET IMAGE IMPORT ........................................................161 19.2 Common Modules for CT, MR and PET Image IOD’s ........................................................................................162

19.2.1 Patient Module .................................................................................................................................................. 162 19.2.2 General Study Module ...................................................................................................................................... 162 19.2.3 General Series Module...................................................................................................................................... 163 19.2.4 General Equipment Module ............................................................................................................................ 164 19.2.5 General Image Module ..................................................................................................................................... 164 19.2.6 Image Plane Module ......................................................................................................................................... 165 19.2.7 Image Pixel Module .......................................................................................................................................... 165 19.2.8 Frame of Reference Module ............................................................................................................................ 165 19.2.9 SOP Common Module ..................................................................................................................................... 166 19.2.10 Single Byte and Single Byte Extended Character Set Support ................................................................... 166 19.2.11 Multi-Byte Character Set Support .................................................................................................................. 166

19.3 CT IMAGE IOD MODULES ....................................................................................................................................167 19.3.1 CT Image Module ............................................................................................................................................. 167 19.3.2 Contrast/bolus Module .................................................................................................................................... 174

19.4 MR IMAGE IOD MODULES ...................................................................................................................................174 19.4.1 MR Image Module ............................................................................................................................................ 175 19.4.2 Contrast/bolus Module .................................................................................................................................... 180

19.5 PET IMAGE IOD MODULES ..................................................................................................................................180 19.5.1 PET Series ........................................................................................................................................................... 181 19.5.2 PET Isotope Module – Not Supported .......................................................................................................... 187 19.5.3 PET Multi-Gated Acquisition Module – Not Supported ........................................................................... 187 19.5.4 NM/PET Patient Orientation Module ........................................................................................................... 188 19.5.5 PET Image Module ........................................................................................................................................... 190

20 Appendix O............................................................................................................................................................................194 20.1 MODALITY WORKLIST MODULES ....................................................................................................................194

20.1.1 Receive Modality Worklist Request (C-Find Request) ............................................................................... 194 20.1.2 Respond Modality Worklist Request (C-Find Response) .......................................................................... 196




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1 INTRODUCTION

1.1 PURPOSE This document is the DICOM Conformance Statement for the DICOM Communication Module (DCM), DICOM Export, DICOM Modality Worklist, and Oncology Workflow Manager for MOSAIQ Data Director in MOSAIQ 2.50. It describes compliance with the DICOM Version 3.0 standard including supported DICOM Services Classes, Information Objects and Communication Protocols. This document has been written in accordance with part PS 3.2 of the DICOM Version 3.0 standard. Familiarity with the DICOM standard is assumed.

This Conformance Statement is intended for use by software developers of DICOM interfaces, customers, and system integrators who wish to connect DICOM equipment with the DICOM Communication Module (DCM), DICOM Export, DICOM Modality Worklist, and Oncology Workflow Manager for MOSAIQ Data Director. This document specifies conformance with the DICOM standard, including limitations and restrictions on conformance. Careful review and comparison of this Conformance Statement with the Conformance Statements of other equipment must be done to determine whether integration will achieve a desired result. This document is essential to integrating DICOM-compliant applications and equipment, but does not guarantee system functionality by itself.

1.2 SCOPE This Conformance Statement covers the DICOM Communication Module (DCM), DICOM Export, DICOM Modality Worklist, and Oncology Workflow Manager for MOSAIQ Data Director in the MOSAIQ 2.50 product release. MOSAIQ is an OIS (Oncology Information System). MOSAIQ provides (but is not limited to) an Image-enabled EMR (Electronic Medical Record) and a TMS (Treatment Management System) with R&V (Record and Verify) capabilities. The DCM and DICOM Export functionality are inherent to MOSAIQ. MOSAIQ with Evaluate also uses DCM. The Oncology Workflow Manager is required to interface MOSAIQ with MOSAIQ Data Director or a 3rd party archive.

1.3 REFERENCES This document references the following documents:

DID TITLE

LED17001 RTPConnect Radiotherapy Treatment Planning Import/Export Interface Specification LEDDCM0045 MOSAIQ DCM 2.50 RT Plan Translation Interface Specification

DICOM Standard

Digital Imaging and Communications in Medicine (DICOM), published by NEMA; further referenced as {DICM}

1.4 DOCUMENTATION CONVENTIONS The following conventions are used throughout this document:

• Menu options and control buttons are indicated by Bold Print. Menu commands that are executed one directly after another are separated by vertical lines. Example: File | Tools | Options.

• Window and dialog box titles and icons are in Arial.

• Window elements (e.g. fields, radio buttons, check boxes, and tabs) and footnotes are in italics.

• Text that you need to type exactly as shown, such as commands or responses, is shaded.

• File names, file paths, databases, and database fields are printed in mixed-case Courier typeface.





• Words or phrases that are specifically defined and could potentially be misunderstood are initially in “quotes”.

• Function keys and booster keys appear in upper case bold print. Example: F2 or CTRL. Multiple keys that you press simultaneously are separated by a plus sign. Example: CTRL + F4.

1.5 DEFINITIONS, ACRONYMS AND ABBREVIATIONS

AE Application Entity, a DICOM application.

AE Title Application Entity Title, the publicly known name of a DICOM AE.

Association One entire communication session between two DICOM AEs. An association is initiated by an SCU. The association may be terminated by either the SCU or SCP.

Asynchronous Window Operations Negotiation

A “window” of opportunity in the association establishment phase, between two DICOM AEs, during which “asynchronous” (non-handshake) operations may be negotiated.

Attribute A unit of data that has a value and is identified by a 4 byte number called a tag.

DICOM file An instance of an IOD that is stored on a physical disk drive or file server. As used by DCM, a DICOM file conforms to the DICOM Version 3.0 standard file format, except it does not contain the file meta information. It consists of attributes with a tag of (0008,0000) and greater.

DICOM message A combination of a DICOM command, request or response and its associated IOD instance.

DICOM Digital Imaging and Communications in Medicine. A standard developed by the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) for the electronic transfer of digital images and associated information.

EMR Electronic Medical Record

import area A directory where DCM stores DICOM files received from other DICOM AEs over a network.

IOD Information Object Definition, a class of data defined in the DICOM standard.

Namer The IMPAC application that imports images into the image management system database.

OIS Oncology Information System

Real-World Activity A command given to a DICOM application by a user or the result of such a command (in the “Real World”).

R&V Record and Verify

MOSAIQ DICOM Conformance Statement CONFORMANCE STATEMENT OVERVIEW




SCP Service Class Provider, a DICOM AE is an SCP when it provides DICOM services (like a server) over a network.

SCU Service Class User, a DICOM AE is an SCU when it requests DICOM services (like a client) over a network.

SOP Service/Object Pair, an actual occurrence of an Information Object and a communication context.

TCP/IP Transmission Control Protocol/Internet Protocol, the suite of network protocols developed and used by DARPA and US DOD.

TMS Treatment Management System

UID Unique Identifier

ViewStation The IMPAC medical image management system product.

2 CONFORMANCE STATEMENT OVERVIEW

2.1 CONFORMANCE SUMMARY

The DICOM Networking and Media Interchange services that are supported by the MOSAIQ software system are outlined in the sections below.

2.1.1 MOSAIQ DICOM NETWORK SERVICE SUPPORT

Note that there are certain DICOM services that are available to the end user in only one specific area of the MOSAIQ application, such as DICOM Print.

There are other DICOM services that have slightly different variants depending on where the functionality is presented to the user or how the functionality is built. An example is DICOM SCU Store, which has end-user access points in multiple MOSAIQ menus. Additional DICOM SCU Store functionality occurs between Sequencer/VMI and a specific matched target Treatment Delivery machine, and also between MOSAIQ and MOSAIQ Data Director in the case of Archive.

MOSAIQ DICOM Conformance Statement




SOP Classes Service Class Provider (SCP)

Service Class User (SCU)

SCU Character Set Support Import

Transfer

CR (Computed Radiography) Image Storage

Yes Yes SBCS Only T

MBCS Conditional P

CT (Computed Tomography) Image Storage

Yes Yes SBCS Only T

MBCS Conditional P

MR (Magnetic Resonance) Image Storage

Yes Yes SBCS Only T

MBCS Conditional P

PET (Positron Emission Tomography) Image Storage

Yes Yes SBCS Only T

MBCS Conditional P

SC (Secondary Capture) Image Storage

YesS YesT SBCS Only T

MBCS Conditional P

RT (Radiotherapy) Image Storage YesS Yes SBCS Only T

MBCS Conditional P

RT (Radiotherapy) Structure Set Storage

YesS Yes SBCS Only T

MBCS Conditional P

RT (Radiotherapy) Plan Storage YesS YesT SBCS Only T

MBCS Conditional P

RT (Radiotherapy) Dose Storage YesS No SBCS Only T

MBCS Conditional P

RT (Radiotherapy) Ion Plan Storage YesS YesT SBCS Only T

MBCS Conditional P

RT (Radiotherapy) Beams Treatment Record Storage


MBCS Conditional P

RT (Radiotherapy) Ion Beams Treatment Record Storage


MBCS Conditional P

Spatial Registration YesS No SBCS Only T

MBCS Conditional P

Verification (Echo) Yes Yes N/A

Storage Commitment

Storage Commitment Push Model YesP Yes N/A

Query/Retrieve

Patient Root Query/Retrieve Information Model - Find

YesP Yes SBCS Only

Patient Root Query/Retrieve Information Model - Move

YesP Yes SBCS Only

MOSAIQ DICOM Conformance Statement




Study Root Query/Retrieve Information Model - Find

YesP Yes SBCS Only

Study Root Query/Retrieve Information Model - Move

YesP Yes SBCS Only

Workflow Management

Unified Worklist Procedure Step YesT YesT SBCS Only

Print Management

Basic Grayscale Print Management No Yes N/A

Basic Color Print Management No Yes N/A

Table 2.1: DICOM SOP Class Support: Network Services

Legend:

S = Due to Treatment Planning or Delivery System data sources - only SBCS objects expected.

T = Treatment Interface: SBCS Only for Import & Treatment based on Conventional and Proton Therapy interface requirements.

P = Defines behavior that applies for generic MOSAIQ DICOM Services (such as DICOM Image Export) and basic DICOM Services for interaction with MOSAIQ Data Director. Note that coercion is configurable for Export of Diagnostic Image Series and consistent for Archive if MBCS Patient Name provided.

2.1.2 MOSAIQ DICOM MEDIA SERVICES SUPPORT There is basic coverage for the DICOM Media Services in the DICOM Export data pathway in MOSAIQ. This is a rudimentary DICOM File Set Creator and Updater (FSC/FSU) implementation with the ability for the end user to select the output format as DICOMDIR with Part 10 or as DICOM Stream files.

Media Services Write Files: File Set Creator (FSC), File Set Updater (FSU)

Read Files: File Set Reader (FSR)

SCU Character Set Support

General Purpose CD-R Yes No MBCS Conditional P

Table 2.2: DICOM SOP Class Support: Media Services

MOSAIQ DICOM Conformance Statement NETWORKING




3 NETWORKING 3.1 IMPLEMENTATION MODEL The three DICOM capabilities work together to receive DICOM data from external systems (DCM), export data in DICOM format to external systems (DICOM Export), and to assist in managing data flow between external systems, including PACS, typically the MOSAIQ Data Director (Oncology Workflow Manager for MOSAIQ Data Director).

• DCM is a 32-bit application designed to operate on Intel x86 based platforms running the Microsoft Windows XP/Windows 7/Vista/Windows 2003/Windows 2008 operating system. Generally, DCM starts automatically on a workstation or server as part of the initialization sequence. Once started, it runs as a background task, usually in a minimized state.

• Oncology Workflow Manager for MOSAIQ Data Director is a 32 bit application designed to operate on Intel x86 based platforms running Windows Server 2008 SP1 or 2008R2 SP1 64-bit / Windows Server 2003 32-bit or 64-bitoperating system. DICOM Export is functionality in the MOSAIQ application.

DCM, DICOM Export, and Oncology Workflow Manager for MOSAIQ Data Director incorporate the MergeCOM-3 implementation of DICOM provided by Merge Technologies, Inc.





3.1.1 APPLICATION DATA FLOW

Storage SCP AE (DCM)

Store Information Objects to Database or

Disk

Remote AE Request Storage of Information

Objects

DICOM Standard Interface

Storage SCU AE (Export)

Request Storage of Information Objects

Remote AE Receives Information Objects

Print SCU AESend Images to Print Remote AE Prints

Images

Q/R SCU AE Query and Retrieve Reference Data

Remote AE Handles Q/R Requests

Storage SCP AE Remote AE Sends Information Objects

Storage SCU AE (Archive/Restore)

Archive Images Remote AE Receives Information Objects

Storage Commitment SCU

AE (Archive/Restore)

Remote AE Handles Storage Commitment


Storage SCP AE (Archive/Restore)

Remote AE Sends Information Objects

Q/R SCU AE (Archive/Restore)

Restore Images

Modality Worklist SCP AE

Scheduled Procedure Database

Modality Worklist Request

Figure 3-1: Application Data Flow: High Level Overview





3.1.2 SEQUENCING OF REAL –WORLD ACTIVITIES

3.1.2.1 DICOM IMPORT WORKFLOW

The relationship of DCM to Real-World Activities is shown below:

Storage SCP AE (DCM)

Store Information Objects to Database or

Disk

Remote AE Request Storage of Information

ObjectsMOSAIQ

Data Store

Remote AE Verification Request


Figure 3-2: Application Data Flow: Storage SCP AE (DCM)

DCM is invoked by the following real world activities.

Request Storage of Information Object:

• When DCM accepts an association request from any remote AE, it processes the Information Objects and stores them either in the database or on disk.

Request Verification of Communication:

• When DCM receives an Echo request from any remote AE, it returns an Echo response.

3.1.2.2 DICOM MODALITY WORKLIST WORKFLOW

The relationship of Modality Worklist to Real-World Activities is shown below:






Modality Worklist SCP Application

Entry

Scheduled Procedure Database

Modality Worklist Request

Verification Request

Figure 3-3: Application Data Flow: Modality Worklist SCP AE

Modality Worklist is invoked by the following real world activities.

Modality Worklist Request:

• When Modality Worklist accepts an association request from a remote AE, it processes the request keys and returns Modality Worklist response(s) with matches found in the Scheduled Procedure database.

Request Verification of Communication:

• When Modality Worklist receives an Echo request from a remote AE, it returns an Echo response.

3.1.2.3 DICOM EXPORT WORKFLOW

The relationship of DICOM Export to Real-World Activities is shown below:

Storage SCU AE (Export)

Request Storage of Information Objects

Remote AE Receives Information Objects

MOSAIQ Data Store


MOSAIQ SEQUENCER

Figure 3-4: Application Data Flow: Storage SCU AE





DICOM Export initiates the association with the Called Application Entity. When DICOM Export is initiated, it either reads the relevant data from the database or is provided the relevant data from the database and processes it in to the appropriate DICOM Information Object for transmission.

DICOM Export is invoked by the following real world activities.

• User selection of DICOM Export (File->Import/Export->DICOM Image Export)

• User workflow in DICOM Treatment Machine Interfaces. Examples include:

o Load Reference Data (Synergy SEQUENCER, Siemens RTT/DCI - by user selection at Treatment dialog, Right Mouse Click)

o Particle Therapy workflow action of Milling Export for a Proton Plan (File->Import/Export->Milling Device)

o Particle Therapy workflow action of PPV Export (D&I dialog, select Rx Site, Right Mouse Click)

3.1.2.4 DICOM ONCOLOGY WORKFLOW MANAGER FOR MOSAIQ DATA DIRECTOR WORKFLOW

The relationship of MOSAIQ Oncology Workflow Manager for MOSAIQ Data Director to Real-World Activities is shown below:

Q/R SCU AE Query and Retrieve Reference Data



MOSAIQ

Storage SCP AE (MOSAIQ or other

SCP)


Figure 3-5: Application Data Flow: Q/R SCU AE

Oncology Workflow Manager for MOSAIQ Data Director DICOM functionality is invoked by the following Real-World Activities:

• Select an “Archive Objects” icon within MOSAIQ • Select a tab within the MOSAIQ Chart workspace containing the Image Browse Widget





The sequence of events to Query, Retrieve or view DICOM objects stored or archived on the MOSAIQ Data Director is illustrated in the steps listed below.

• User defines query parameters. • Query/Retrieve Image Series and/or Instances. • The user can navigate through lists of Image Series or other DICOM objects available as reference data on

MOSAIQ Data Director. • The user can optionally Retrieve (Move) the Image Series or other DICOM objects available as reference

data to another DICOM Storage SCP or 3rd Party PACS system or visualization station.

3.1.2.5 DICOM ARCHIVE-RESTORE WORKFLOW

Archive

The relationship of the MOSAIQ Archive Service to Real-World Activities is shown below:

Storage SCU AE (Archive/Restore)

Archive ImagesRemote AE Receives Information Objects


Storage Commitment SCU AE

(Archive/Restore)


MOSAIQ Data Store

Figure 3-6: Application Data Flow: Storage SCU (Archive)

The sequence of events to Archive DICOM Images (and if applicable referenced DICOM Standard Structure Sets) is illustrated in the steps listed below.

• User Selects Image Series and/or Instances to be Archived. • Check for existence of Image Series and/or Instances in MDD using Storage Commitment Service. • Store Image Series and/or Instances. • Confirm existence of Image Series and/or Instances in MDD using Storage Commitment Service. • Delete Image Series and/or Instances from Data Storage.





Restore

The sequence of events to Restore previously archived DICOM Images (and if applicable referenced DICOM Standard Structure Sets) is illustrated in the steps listed below.


Storage Commitment SCU AE

(Archive/Restore)



Storage SCP AE (Archive/Restore)


Q/R SCU AE (Archive/Restore)

Restore Images

Figure 3-7: Application Data Flow: Storage Commitment SCU and Q/R SCU AE

• User Selects Image Series and/or Instances to be Restored. • Confirm existence of Image Series and/or Instances in MDD using Storage Commitment Service. • Query/Retrieve Image Series and/or Instances. • MOSAIQ Data Director will Store Image Series and/or Instances back to MOSAIQ. • Save Image Series and/or Instances in Data Storage.

3.2 FUNCTIONAL DEFINITIONS OF AES

3.2.1 FUNCTIONAL DEFINITION OF STORAGE SCP AE DCM is a single DICOM AE that is an SCP with a fixed AE Title, IMPAC_DCM_SCP.

DCM will: • Wait for an association request from an SCU AE. • Accept an association for a supported SOP Class. • Receive DICOM messages sent from the SCU AE over the association. • Process each DICOM message and store it either in the database or as a DICOM file on disk. If an error

occurs, DCM aborts the association. • Send appropriate response messages to the SCU AE.





3.2.2 FUNCTIONAL DEFINITION OF STORAGE SCU AE

DICOM Export is performed by more than one DICOM AE which are SCUs.

Each DICOM Export AE has a configurable AE Title

Configuration information can be found in the installation instructions for the various applications, but there are two configuration locations of note.

• A DICOM SCU is used to export DICOM Images (for example CT, MR Image Series) and through

user configuration can also export the referenced RT Structure Sets. This AE typically resides on a MOSAIQ workstation, and the configuration file resides in the MOSAIQ installation directory (ImageArchive.exe.config).

… //ImageArchive.exe.config … <add key="ExportSessionCtrl_AETitle" value="IMS_MOSAIQ_EXP" /> …

• A DICOM SCU used in DICOM Treatment Machine Interfaces for export of DICOM data (RT Plans,

or RT Ion Plans, Image Series, RT Structure Sets, etc). Reference the section above Sequencing of Real-World Activities section (specifically DICOM Export Workflow section). This AE typically resides on the Sequencer box in the MOSAIQ installation and is configured in the IMPAC.ini file.

… //impac.ini … [DICOM_SERVICES] SSCU_AE_Title = MILLING_SCU …

Each DICOM Export AE:

• Creates an association request to a known SCP AE. • Transmits DICOM message to the SCP over the association. If an error occurs, the DICOM Export AE

will abort the association. • Receives appropriate response messages from the SCP AE.

3.2.3 FUNCTIONAL DEFINITION OF Q/R SCU AE

• Oncology Workflow Manager for MOSAIQ Data Director is a single DICOM AE that is an SCU. • For the Query Retrieve workflow, the SCU has a configurable AE Title. • Configuration information can be found in the installation instructions for Oncology Workflow Manager

for MOSAIQ Data Director, and the AE Title is specified using the DICOM Maintenance Utility for the device corresponding to the value named in ImageArchive.exe.config, e.g.

… //ImageArchive.exe.config





… <appSettings> <add key="MDD_QueryDeviceName" value="MOSAIQ Data Director"/> … </appSettings …

The Oncology Workflow Manager for MOSAIQ Data Director AE: • Creates an association request to an SCP AE (typically the MOSAIQ Data Director SCP). • Transmits DICOM message to the SCP over the association. If an error occurs, the Oncology Workflow

Manager for MOSAIQ Data Director AE will abort the association. • Receives appropriate response messages from the SCP AE.

3.2.4 FUNCTIONAL DEFINITION OF STORAGE SCU/SCP AND STORAGE COMMITMENT SCU AE

• The Archive Service is a single DICOM AE that is an SCU. • For the Archive workflow, the DICOM AE has a configurable AE Title. • The installation instructions for the Archive Service have the configuration information. The AE Title is

specified in the application configuration file for the MOSAIQ Archive and Restore service configuration.

The Archive Service AE:

• Creates an association request to an SCP AE (typically the MOSAIQ Data Director SCP). • Transmits DICOM message to the SCP over the association. If an error occurs, the Archive Service AE will

abort the association. • Receives appropriate response messages from the SCP AE. • Performs Storage Commitment request to the SCP over the association. If an error occurs, the Archive

Service AE will abort the association.

Provided the SOP Instance(s) are confirmed to exist on the MOSAIQ Data Director using Storage Commitment, sufficient meta data is retained in MOSAIQ but the binary DICOM SOP Instance streams are deleted from the database.

The Restore Service is a single DICOM AE that serves as both an SCU and an SCP.

• For the Restore workflow, the DICOM AE has a configurable AE Title (the SCU AE title is a shared configuration setting with the Archive SCU).

• Configuration information can be found in the installation instructions for the Archive Service, and the AE Title is specified in the application configuration file for the MOSAIQ Archive and Restore service configuration.

Restore Service AE will:

• Create an association request to a known SCP AE (typically the MOSAIQ Data Director SCP) • Perform Storage Commitment request to the SCP over the association. If an error occurs, the Restore

Service AE will abort the association.





• Provided the SOP Instance(s) are confirmed to exist on MDD using Storage Commitment, a Move Request will be sent to the MDD Query/Retrieve SCP

• Receive appropriate Move response messages from the SCP AE • MDD will transmit DICOM C-STORE message to the Restore Service SCP AE over the association for the

requested SOP Instances. • Restore Service AE will receive messages from the SCU AE and save SOP Instances in MOSAIQ data

storage, restoring access to image data in MOSAIQ

3.2.5 FUNCTIONAL DEFINITION OF PRINT SCU AE The Print SCU AE is a single DICOM AE that allows RT Images to be printed to DICOM Hardcopy.

The Print AE will:

• Create an association request to a Print SCP AE • Transmit DICOM message to the SCP over the association. If an error occurs, the Print SCU AE will abort

the association. • Receive appropriate response messages from the SCP AE

3.2.6 FUNCTIONAL DEFINITION OF MODALITY WORKLIST SCP AE The Modality Worklist SCP will facilitate the communication of information to the requesting modality about Scheduled Procedure Steps.

The Modality Worklist SCP shall support queries against the Worklist Information Model.

• The system shall accept an association with a known SCU AE. • Promiscuous associations will be accepted, but the response will be empty as the calling AE is not

configured. • The system shall return keys to the requesting Modality as specified in Modality Worklist Modules in

Appendix O.

3.3 AE SPECIFICATIONS

3.3.1 STORAGE SCP AE SPECIFICATION: DICOM IMPORT (DCM) DCM provides Standard Conformance to the following DICOM Version 3.0 SOP Classes as an SCP:

SOP Class Name SOP Class UID

CR (Computed Radiography) Image Storage 1.2.840.10008.5.1.4.1.1.1 CT (Computed Tomography) Image Storage 1.2.840.10008.5.1.4.1.1.2 MR (Magnetic Resonance) Image Storage 1.2.840.10008.5.1.4.1.1.4

SC (Secondary Capture) Image Storage 1.2.840.10008.5.1.4.1.1.7 Spatial Registration Storage 1.2.840.10008.5.1.4.1.1.66.1 PET (Positron Emission Tomography) Image Storage 1.2.840.10008.5.1.4.1.1.128

RT (Radiotherapy) Image Storage 1.2.840.10008.5.1.4.1.1.481.1 RT (Radiotherapy) Dose Storage 1.2.840.10008.5.1.4.1.1.481.2 RT (Radiotherapy) Structure Set Storage 1.2.840.10008.5.1.4.1.1.481.3






RT (Radiotherapy) Plan Storage 1.2.840.10008.5.1.4.1.1.481.5 RT (Radiotherapy) Ion Plan Storage 1.2.840.10008.5.1.4.1.1.481.8 Verification (Echo) 1.2.840.10008.1.1

3.3.1.1 ASSOCIATION ESTABLISHMENT POLICIES

3.3.1.1.1 GENERAL

The maximum Protocol Data Unit (PDU) size accepted by DCM is configurable within the range of 1K byte to 32K bytes, with a default size of 28672 bytes in the MOSAIQ build archive MergeCOM configuration file set. Reference SIP4503 for any specific configuration changes to the default MergeCOM files, keeping in mind that local or network MergeCOM configuration files can be customized in the field.

3.3.1.1.2 NUMBER OF ASSOCIATIONS

The maximum number of simultaneous associations supported by DCM as an SCP is configurable with a default of 5. The total number of simultaneous associations may be limited by the resources of the server on which DCM is running.

3.3.1.1.3 ASYNCHRONOUS NATURE

DCM does not support multiple outstanding transactions over an association; it will not perform asynchronous operations window negotiation.

3.3.1.1.4 IMPLEMENTATION IDENTIFYING INFORMATION

Implementation Class UID Implementation Version Name

1.2.840.113854.0.1 MergeCOM3_390IB2

3.3.1.2 ASSOCIATION INITIATION POLICY

DCM will not attempt to initiate an association.

3.3.1.3 ASSOCIATION ACCEPTANCE POLICY

DCM polls the TCP/IP port at specified intervals for association requests from SCUs. DCM only accepts associations pertaining to the specified SOP Classes. Through custom configuration, DCM can be configured to Auto Forward additional SOP Classes to a remote DICOM Storage SCP such as MOSAIQ Data Director. The DICOM instances for the SOP Classes that are Auto Forwarded can be beyond the set of SOP Classes that are supported for inclusion MOSAIQ Data Storage (database and binary storage).

3.3.1.3.1 REQUEST STORAGE OF INFORMATION OBJECT

3.3.1.3.1.1 ASSOCIATED REAL-WORLD ACTIVITY

Once an association has been established, DCM responds to standard DICOM C-STORE requests for those presentation contexts listed below. DCM optionally validates the DICOM messages received for conformance with the related IOD outlined in DICOM Version 3.0 standard {DICM}. The DICOM message is stored either in the database or as a DICOM file within the specified import area. DCM does not modify the content of a DICOM message. A standard C-STORE response is sent to the SCU for each request received by DCM indicating the success or failure of the storage request.





3.3.1.3.1.2 PRESENTATION CONTEXT TABLE

DCM accepts the following SOP Presentation Contexts:

PRESENTATION CONTEXT TABLE Abstract Syntax Transfer Syntax Role Extended

Negotiation Name UID Name List UID List

CR Image Storage

1.2.840.10008.5.1.4.1.1.1 Implicit VR Little Endian Explicit VR Little Endian Explicit VR Big Endian

1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

CT Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

MR Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

SC Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

Spatial Registration Storage

1.2.840.10008.5.1.4.1.1.66.1 Implicit VR Little Endian Explicit VR Little Endian Explicit VR Big Endian

1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

PET Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

RT Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

RT Dose Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

RT Structure Set Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

RT Plan Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

RT Ion Plan Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

3.3.1.3.1.3 SOP SPECIFIC CONFORMANCE

DCM provides Standard Conformance for the DICOM Storage Classes listed above. In the event of a successful C-STORE operation, the DICOM message is stored either in the database or as a DICOM file on disk. Otherwise, DCM returns one of the following status codes to the SCU:





• A700 (Out of Resources) – Indicates that the patient in the Information Object does not match an existing patient in the database, the disk space is insufficient to store the Information Object, or an error occurred while storing the Information Object on disk.

• A780 (Resources not configured) – Indicates that no disk location has been configured to store the Information Object.

• A900 (Data Set does not match SOP Class) – Indicates that the Information Object does not encode an instance of the SOP Class specified. This indicates a problem with the SCU of the Service Class.

• C000 (Cannot understand) – Indicates that DCM cannot parse the Information Object into elements. This indicates a problem with the SCU.

• Reference the section below “SUPPORT OF EXTENDED CHARACTER SETS” for more specifics details around ISO Character Set handling in received SOP Instances.

DCM supports the Standard SOP Classes for CR Image Storage, CT Image Storage, MR Image Storage, SC Image Storage, and RT Image Storage. In the event of a successful C-STORE operation, the DICOM message is stored without modification either in the database or as a DICOM file on disk; refer to Appendix A - SPECIFIC CONFORMANCE FOR IMAGE IODs.

DCM supports the standard SOP Class for:

• RT Plan Storage; refer to Appendix B – SPECIFIC CONFORMANCE FOR RT PLAN IOD. • RT Ion Plan Storage; refer to Appendix C – SPECIFIC CONFORMANCE FOR RT ION PLAN IMPORT

AND EXPORT. • RT Structure Set Storage; refer to Appendix D – SPECIFIC CONFORMANCE FOR RT STRUCTURE SET

IMPORT. • RT Dose Storage, refer to Appendix L – SPECIFIC CONFORMANCE FOR RT DOSE IMPORT. • Spatial Registration Storage, refer to Appendix M – SPECIFIC CONFORMANCE FOR SPATIAL

REGISTRATION IMPORT. • PET Image Storage, refer to Appendix N – SPECIFIC CONFORMANCE FOR PET IMAGE IMPORT

3.3.1.3.2 PRESENTATION CONTEXT ACCEPTANCE CRITERION

DCM supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Context will be rejected.

3.3.1.3.3 TRANSFER SYNTAX SELECTION POLICIES

If DCM is offered a choice of Transfer Syntaxes in a Presentation Context, it applies the following priority to the choice of Transfer Syntax:

• Explicit Little Endian Syntax. • Implicit Little Endian Syntax. • Explicit Big Endian Syntax.

3.3.1.4 REQUEST VERIFICATION OF COMMUNICATION

3.3.1.4.1 ASSOCIATED REAL-WORLD ACTIVITY

DCM responds to echo requests with a DICOM C-Echo response.

3.3.1.4.2 PRESENTATION CONTEXT TABLE

DCM accepts the following Verification Service Presentation Contexts:







Verification Service Class

1.2.840.10008.1.1 Implicit VR Little Endian Explicit VR Little Endian Explicit VR Big Endian

1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

3.3.2 MODALITY WORKLIST (C-FIND REQUEST) SCP AE SPECIFICATION


Once an association has been established, Modality Worklist responds to standard DICOM C-FIND requests for those presentation contexts listed below. A standard C-FIND response is sent to the SCU for each request received. Multiple responses for each request can be sent if multiple matches are found for the given query keys. If no matches are found or if the calling AE is not recognized then an empty response is sent.


Modality Worklist accepts the following SOP Presentation Context:


Negotiation

Name UID Name List UID List

Worklist Information Model- Find

1.2.840.10008.5.1.4.31

Implicit VR Little Endian Explicit VR Little Endian Explicit VR Big Endian

1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None


Modality Worklist provides Standard Conformance for the DICOM Service Class listed above.

3.3.2.1.1.4 PRESENTATION CONTEXT ACCEPTANCE CRITERION

Modality Worklist supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.

3.3.2.1.1.5 TRANSFER SYNTAX SELECTION POLICIES

If Modality Worklist is offered a choice of Transfer Syntaxes in a Presentation Context, it applies the following priority to the choice of Transfer Syntax:

• Explicit Little Endian Syntax.

• Implicit Little Endian Syntax.

• Explicit Big Endian Syntax.

3.3.2.2 REQUEST VERIFICATION OF COMMUNICATION

3.3.2.2.1 ASSOCIATED REAL-WORLD ACTIVITY

Modality Worklist responds to echo requests with a DICOM C-Echo response.





3.3.2.2.2 PRESENTATION CONTEXT TABLE

Modality Worklist accepts the following Verification Service Presentation Contexts:


Negotiation Name UID Name List UID List Verification Service Class


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

3.3.3 STORAGE SCU AE SPECIFICATION: DICOM EXPORT

DICOM Export provides Standard Conformance to the following DICOM Version 3.0 SOP Classes as an SCU:


CT (Computed Tomography) Image Storage 1.2.840.10008.5.1.4.1.1.2

MR Image Storage 1.2.840.10008.5.1.4.1.1.4 SC (Secondary Capture) Image Storage 1.2.840.10008.5.1.4.1.1.7 RT (Radiotherapy) Image Storage 1.2.840.10008.5.1.4.1.1.481.1

RT (Radiotherapy) Structure Set Storage 1.2.840.10008.5.1.4.1.1.481.3 RT (Radiotherapy) Plan Storage 1.2.840.10008.5.1.4.1.1.481.5 RT (Radiotherapy) Ion Plan Storage 1.2.840.10008.5.1.4.1.1.481.8 RT(Radiotherapy) Beams Treatment Record

Storage

1.2.840.10008.5.1.4.1.1.481.4

Verification (Echo) 1.2.840.10008.1.1


3.3.3.1.1 GENERAL

The maximum Protocol Data Unit (PDU) size accepted by DCM is configurable within the range of 1K byte to 32K bytes, with a default size of 28672 bytes in the MOSAIQ build archive MergeCOM configuration file set. This value is field customizable.


Each DICOM Export AE will attempt to open only one association at a time.


DICOM Export does not support multiple outstanding transactions over an association; it will not perform asynchronous operations window negotiation.



1.2.840.113854.0.1 MergeCOM3_390IB2






The DICOM Export AEs will attempt to initiate an association and will propose the above list of SOP classes. The list is configurable and may be curtailed to exclude RT Ion Plan or RT Plan, or to narrow the proposed presentation syntaxes down to Implicit Little Endian to avoid limitations to the size of certain elements inherent in the use of Explicit syntaxes.


The DICOM Export AEs will not accept an association.



DICOM Export constructs RT Image, RT Plan, and RT Ion Plan from data conforming to the MOSAIQ data model which is stored in the MOSAIQ database.

• CT and RT Structure Set are constructed from Level 2 stores of those information objects as obtained from outside MOSAIQ (e.g. from a Virtual Simulator, Treatment Planning System, or CT Modality).

• If an RT Structure Set has been associated with a (MOSAIQ) Rx Site, the RT Plan will include the SOP Instance UID of the RT Structure Set in the Referenced Structure Set Sequence.

• Planar Images which were imported in to MOSAIQ that are selected for export which were not of the RT Image SOP Class will be converted into the RT Image SOP Class, including images that were imported by means other than DICOM. The Siemens DCI interface uses shared infrastructure for DICOM Storage to export the images associated with site and the fields that are sent for treatment.

• In the case of export data flow in the context of a DICOM Treatment Machine Interface - for those systems requiring that the RT Plan, RT Structure Set, and CT share the same Study Instance UID, the RT Plan will have its Study Instance UID coerced to match the Study Instance UID value of the RT Structure Set.


DICOM Export proposes the following SOP Presentation Contexts:


Negotiation


CT Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

MR Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

RT Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None



1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None






Negotiation


RT Plan Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

RT Ion Plan Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

RT Beams Treatment Record Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


DICOM Export provides Standard Conformance for the DICOM Storage Classes listed above. In the event of an unsuccessful C-STORE operation the application returns an error message to the user.

DICOM Export supports the standard SOP Class for:

• RT Plan Storage; refer to Appendix E - SPECIFIC CONFORMANCE FOR RT PLAN EXPORT. • RT Ion Plan Storage; refer to Appendix C - SPECIFIC CONFORMANCE FOR RT ION PLAN IMPORT

AND EXPORT. • RT Image; refer to Appendix F - SPECIFIC CONFORMANCE FOR RT IMAGE EXPORT. • For CT and RT Structure Set, DICOM Export transmits the data as it was received, with the exception of

stripping private elements when forwarding to the ELEKTA Synergy. • RT Beams Treatment Record Storage; refer to Appendix H – SPECIFIC CONFORMANCE FOR RT

BEAMS TREATMENT RECORD EXPORT.


DICOM Export supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.

3.3.3.3.1.4.1 TRANSFER SYNTAX SELECTION POLICIES

DICOM Export will propose only the following transfer syntaxes:


3.3.3.3.2 REQUEST VERIFICATION OF COMMUNICATION


DICOM Export does not attempt a DICOM C-Echo request as part of normal operation.






Using the manual (service personnel only) DICOM Echo tool, one can issue a DICOM C-Echo request which will propose the following Verification Service Presentation Contexts:





1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

3.3.4 Q/R SCU AE SPECIFICATION: ONCOLOGY WORKFLOW MANAGER FOR MOSAIQ DATA DIRECTOR Oncology Workflow Manager for MOSAIQ Data Director provides Standard Conformance to the following DICOM Version 3.0 SOP Classes as an SCU:


Patient Root Query/Retrieve Information Model - Find 1.2.840.10008.5.1.4.1.2.1.1 Patient Root Query/Retrieve Information Model - Move 1.2.840.10008.5.1.4.1.2.1.2

Study Root Query/Retrieve Information Model - Find 1.2.840.10008.5.1.4.1.2.2.1 Study Root Query/Retrieve Information Model - Move 1.2.840.10008.5.1.4.1.2.2.2


3.3.4.1.1 GENERAL



No limit is placed on the number of simultaneous associations opened by Oncology Workflow Manager for MOSAIQ Data Director, but Oncology Workflow Manager for MOSAIQ Data Director will run separate instances of the SCU to support separate users. Each C-FIND or C-MOVE command is issued on a separate association.


Oncology Workflow Manager for MOSAIQ Data Director does not support multiple outstanding transactions over an association; it will not perform asynchronous operations window negotiation. However, separate associations may be opened by Oncology Workflow Manager for MOSAIQ Data Director in response to a User making additional find or move requests while a move request is still outstanding (not finished).



1.2.840.113854.0.1 MergeCOM3_390IB2


Oncology Workflow Manager for MOSAIQ Data Director AE will attempt to initiate an association and will propose the above list of SOP classes.






Oncology Workflow Manager for MOSAIQ Data Director AE will not accept an association.

3.3.4.3.1 QUERY REQUEST: C-FIND


The user initiates a Study Level C-Find by selecting one of several icons or menu items from within MOSAIQ. The MOSAIQ application enforces the previous specification of the patient, so that the Patient Name and Patient ID are always provided with the C-Find request. Once the C-Find request has been issued and a response has been received that contains one or more matching studies, the user can issue a Series Level C-Find by specifying which Study to navigate (the user either expands a table or highlights a row in a GUI). The user may also elect to alter the values within a set of query parameters and issue another Study Level or Series Level query. Oncology Workflow Manager for MOSAIQ Data Director does not issue Instance (IMAGE) Level queries.


Oncology Workflow Manager for MOSAIQ Data Director proposes the following SOP Presentation Contexts:


Negotiation


Patient Root Query/ Retrieve Information Model - Find


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

Study Root Query/ Retrieve Information Model - Find


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


Oncology Workflow Manager for MOSAIQ Data Director provides Standard Conformance for the DICOM Service Classes listed above. Oncology Workflow Manager for MOSAIQ Data Director does not support/create relational queries.

Oncology Workflow Manager for MOSAIQ Data Director supports the standard SOP Class for:

• Patient Root Query/ Retrieve Information Model - Find; refer to Appendix K - SPECIFIC CONFORMANCE FOR QUERY/RETRIEVE (SCU) INFORMATION MODELS.

• Study Root Query/ Retrieve Information Model - Find; refer to Appendix K - SPECIFIC CONFORMANCE FOR QUERY/RETRIEVE (SCU) INFORMATION MODELS.


Oncology Workflow Manager for MOSAIQ Data Director supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.


Oncology Workflow Manager for MOSAIQ Data Director will propose only the following transfer syntaxes:

• Explicit Little Endian Syntax.





• Implicit Little Endian Syntax. • Explicit Big Endian Syntax.

3.3.4.3.2 RETRIEVE REQUEST: C-MOVE


The user initiates a Study or Series Level C-Move by selecting one or more rows within the Oncology Workflow Manager for MOSAIQ Data Director UI, selecting a C-MOVE destination, and clicking the “Send” button. Oncology Workflow Manager for MOSAIQ Data Director does not issue Instance (IMAGE) Level move requests. The C-MOVE is issued asynchronously from the users perspective, and any errors that occur as part of the C-MOVE request or the ensuing C-STORE are presented to the user separately in a log display (shown when the user clicks on the “View Log” button in the Oncology Workflow Manager for MOSAIQ Data Director UI.


Oncology Workflow Manager for MOSAIQ Data Director proposes the following SOP Presentation Contexts:


Negotiation


Patient Root Query/ Retrieve Information Model - Move


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

Study Root Query/ Retrieve Information Model - Move


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


Oncology Workflow Manager for MOSAIQ Data Director provides Standard Conformance for the DICOM Service Classes listed above. Oncology Workflow Manager for MOSAIQ Data Director does not support/create relational move requests.


Oncology Workflow Manager for MOSAIQ Data Director supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.


Oncology Workflow Manager for MOSAIQ Data Director will propose only the following transfer syntaxes:








Oncology Workflow Manager for MOSAIQ Data Director does not attempt a DICOM C-Echo request as part of normal operation.


Using the manual (service personnel only) DICOM Echo tool, one can issue a DICOM C-Echo request which will propose the following Verification Service Presentation Contexts:





1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None

3.3.5 STORAGE SCU AND Q/R SCU AE SPECIFICATION: ARCHIVE AND RESTORE SERVICE The Archive and Restore Services provide Standard Conformance to the following DICOM Version 3.0 SOP Classes as an SCU:


Verification (Echo) 1.2.840.10008.1.1 CT (Computed Tomography) Image Storage 1.2.840.10008.5.1.4.1.1.2

MR Image Storage 1.2.840.10008.5.1.4.1.1.4 RT (Radiotherapy) Image Storage 1.2.840.10008.5.1.4.1.1.481.1 RT (Radiotherapy) Structure Set Storage 1.2.840.10008.5.1.4.1.1.481.3

Patient Root Query/Retrieve Information Model - Find 1.2.840.10008.5.1.4.1.2.1.1 Patient Root Query/Retrieve Information Model - Move 1.2.840.10008.5.1.4.1.2.1.2 Study Root Query/Retrieve Information Model - Find 1.2.840.10008.5.1.4.1.2.2.1

Study Root Query/Retrieve Information Model - Move 1.2.840.10008.5.1.4.1.2.2.2 Storage Commitment Push Model 1.2.840.10008.1.20.1

RT Dose Storage 1.2.840.10008.5.1.4.1.1.481.2 RT Plan Storage 1.2.840.10008.5.1.4.1.1.481.5 Spatial Registration (SRO) Storage 1.2.840.10008.5.1.4.1.1.66.1


3.3.5.1.1 GENERAL



No limit is placed on the number of simultaneous associations opened by the Archive and Restore Services.






The Archive and Restore Services does not support multiple outstanding transactions over an association; it will not perform asynchronous operations window negotiation.



1.2.840.113854.0.1 MergeCOM3_390IB2


The Archive and Restore Service AE(s) will attempt to initiate an association and will propose the above list of SOP classes.


The Archive and Restore Service AE(s) will not accept an association from external SCUs.

3.3.5.3.1 DETERMINE INFORMATION OBJECT EXISTENCE ON PACS (ARCHIVE PATHWAY)


The Archive Service uses Storage Commitment to determine if Information Objects are archived. If the objects do not already reside in MDD the Archive Service will perform DICOM Storage of the objects to MOSAIQ Data Director, and then request Storage Commitment for safekeeping of Information Objects.

The SOP Instance will be deleted from the MOSAIQ local data storage but enough metadata is retained to allow the user to restore the DICOM objects at a later time in full fidelity to the MOSAIQ Database and file storage.


The Archive Service proposes the following SOP Presentation Contexts:


Negotiation Name UID Name List UID List Storage Commitment Push Model

1.2.840.10008.1.20.1

Implicit VR Little Endian

1.2.840.10008.1.2 SCU None

RT Dose Storage

1.2.840.10008.5.1.4.1.1.481.2


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

RT Plan Storage

1.2.840.10008.5.1.4.1.1.481.5


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

Spatial Registration Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


The Archive Service provides Standard Conformance for the DICOM Storage Classes listed above. In the event of an unsuccessful C-STORE operation the application returns an error message to the user available through the user interface and in diagnostic logs.






The Archive Service supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.

3.3.5.3.1.4.1 TRANSFER SYNTAX SELECTION POLICIES The Archive Service will propose only the following transfer syntaxes:




The Archive Service allows the user to select Image Series that will be archived and will perform DICOM Storage of the objects to MOSAIQ Data Director, request Storage Commitment for safekeeping.



The Archive Service proposes the following SOP Presentation Contexts:


Negotiation


CT Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

MR Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

RT Image Storage


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None



1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


The Archive Service provides Standard Conformance for the DICOM Storage Classes listed above. In the event of an unsuccessful C-STORE operation the application returns an error message to the user available through the user interface and in diagnostic logs.

In the case of Archive, if the objects do not already reside in MDD the Archive Service will perform DICOM Storage of the objects to MOSAIQ Data Director, and then request Storage Commitment for safekeeping of Information Objects.






The Archive Service supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.

3.3.5.3.2.4.1 TRANSFER SYNTAX SELECTION POLICIES The Archive Service will propose only the following transfer syntaxes:


3.3.5.3.3 DETERMINE INFORMATION OBJECT EXISTENCE ON PACS (RESTORE PATHWAY)


The Restore Service uses Storage Commitment to determine if Information Objects are archived.



The Restore Service proposes the following SOP Presentation Contexts:


Negotiation


Storage Commitment Push Model

1.2.840.10008.1.20.1

Implicit VR Little Endian

1.2.840.10008.1.2 SCU None


The Restore Service provides Standard Conformance for the DICOM Storage Classes listed above. In the event of an unsuccessful C-STORE operation the application returns an error message to the user available through the user interface and in diagnostic logs.


The Restore Service supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.

3.3.5.3.3.4.1 TRANSFER SYNTAX SELECTION POLICIES The Restore Service will propose only the following transfer syntaxes:






3.3.5.3.4 RESTORE PATHWAY: QUERY/RETRIEVE: C-FIND


The workflow context is that user will use the DICOM Query service to select the Image Series that will be Restored.


The Restore Service AE will propose the following SOP Presentation Contexts:


Negotiation


Patient Root Query/ Retrieve Information Model - Find


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

Study Root Query/ Retrieve Information Model - Find


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


The Restore Service AE provides Standard Conformance for the DICOM Service Classes listed above. Oncology Workflow Manager for MOSAIQ Data Director does not support/create relational queries.

The Restore Service AE supports the standard SOP Class for:

• Patient Root Query/ Retrieve Information Model - Find; refer to Appendix K - SPECIFIC CONFORMANCE FOR QUERY/RETRIEVE (SCU) INFORMATION MODELS.

• Study Root Query/ Retrieve Information Model - Find; refer to Appendix K - SPECIFIC CONFORMANCE FOR QUERY/RETRIEVE (SCU) INFORMATION MODELS.


The Restore Service AE support the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.

3.3.5.3.4.4.1 TRANSFER SYNTAX SELECTION POLICIES The Restore Service AE will propose only the following transfer syntaxes:


3.3.5.3.5 RESTORE PATHWAY: QUERY/RETRIEVE: C-MOVE


The user has initiated a Restore operation, the Image Series will be verified to exist on the MOSAIQ Data Director using Storage Commitment and will be retrieved back to MOSAIQ proper. The C-MOVE is issued asynchronously from the user’s perspective, and any errors that occur as part of the C-MOVE request or the ensuing C-STORE are presented to the user separately in a log display.






The Restore Service AE proposes the following SOP Presentation Contexts:


Negotiation


Patient Root Query/ Retrieve Information Model - Move


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None

Study Root Query/ Retrieve Information Model - Move


1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


The Restore Service AE provides Standard Conformance for the DICOM Service Classes listed above. The Restore Service AE does not support/create relational move requests.


The Restore Service AE supports the Presentation Contexts for the SOP Classes listed in the table above. Any other Presentation Contexts will be rejected.


The Restore Service AE will propose only the following transfer syntaxes:




The Restore Service AE may attempt a DICOM C-Echo request as part of normal operation.


The DICOM C-Echo request will propose the following Verification Service Presentation Contexts:





1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCP None





3.3.6 PRINT SCU AE SPECIFICATION The Print SCU provides Standard Conformance to the following DICOM Version 3.0 SOP Classes as an SCU:


Basic Grayscale Print Management Meta 1.2.840.10008.5.1.1.9 Basic Color Print Management Meta 1.2.840.10008.5.1.1.18


3.3.6.1.1 GENERAL



One simultaneous associations opened by the Print SCU AE.


The Print SCU AE does not support multiple outstanding transactions over an association; it will not perform asynchronous operations window negotiation.



1.2.840.113854.0.1 MergeCOM3_390IB2


The Print SCU AE will attempt to initiate an association and will propose the above list of SOP classes.


The Print SCU AE will not accept an association.

3.3.6.3.1 PRINT REQUEST CREATION


The user is reviewing RT Images in MOSAIQ and chooses the option to print to DICOM network printer.


The Print SCU AE proposes the following SOP Presentation Contexts:


Negotiation


Basic Grayscale Print Management Meta

1.2.840.10008.5.1.1.9 Implicit VR Little Endian Explicit VR Little Endian Explicit VR Big Endian

1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None






Negotiation


Basic Color Print Management Meta

1.2.840.10008.5.1.1.18 Implicit VR Little Endian Explicit VR Little Endian Explicit VR Big Endian

1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2

SCU None


The Print SCU AE provides Standard Conformance for the DICOM Service Classes listed above.


Not applicable


The Print SCU will propose only the following transfer syntaxes:


3.4 COMMUNICATION PROFILES

3.5 SUPPORTED COMMUNICATION STACKS

3.5.1 TCP/IP STACK

3.5.1.1 API

DCM, DICOM Export, and Oncology Workflow Manager for MOSAIQ Data Director use the Windows Sockets API inherent to the Microsoft Windows NT/2000/XP operating system.

3.5.1.2 PHYSICAL MEDIA SUPPORT

All physical media supported by the TCP/IP stack may be used with DCM, DICOM Export, and Oncology Workflow Manager for MOSAIQ Data Director. This includes, but is not limited to, 10-Base-2, 10-Base-T, 100-Base-T, fiber optic and Internet.

3.6 EXTENSIONS / SPECIALIZATIONS / PRIVATIZATIONS

3.7 STANDARD EXTENDED / SPECIALIZED / PRIVATE SOPS None Supported.

3.8 PRIVATE TRANSFER SYNTAXES None Supported.

3.9 CONFIGURATION

3.10 APPLICATION ENTITY CONFIGURATION DCM and DICOM Export both reference the merge.ini file, which is located in the applications directory.

Oncology Workflow Manager for MOSAIQ Data Director would reference the same merge.ini file for the MOSAIQ installation, provided the central MOSAIQ configuration has a co-located MergeCOM configuration.

MOSAIQ DICOM Conformance Statement MEDIA INTERCHANGE




Exceptions could be the use of the MERGE_INI environment variable and/or the case of the MergeCOM located outside of the MOSAIQ installation.

An example of when the entire MergeCOM configuration exists outside of the MOSAIQ installation would be when it is an arbitrary location referenced by a merge.ini located in the %sys% directory (commonly C:\Windows\System32 in Windows XP).

merge.ini Specifies the configurable parameters for DCM, and the names and locations of the other three standard configuration files.

DCM, DICOM Export, and Oncology Workflow Manager for MOSAIQ Data Director reference three standard configuration files. These files specify the parameters for the MergeCOM-3 implementation of DICOM provided by Merge Technologies, Inc. They are as follows:

mergecom.pro Specifies run-time parameters for the MergeCOM-3 implementation. mergecom.app Specifies the services supported by the MergeCOM-3 implementation. mergecom.srv Service definitions for the MergeCOM-3 implementation.

3.11 AE TITLE / PRESENTATION ADDRESS MAPPING • The AE Title for DCM is IMPAC_DCM_SCP • The AE Titles for DICOM Export are configurable using the IMPAC.ini file (see the documentation for the

individual export features) • The AE Title for Oncology Workflow Manager for MOSAIQ Data Director is IMS_MOSAIQ_QRSC

3.12 CONFIGURABLE PARAMETERS None.

4 MEDIA INTERCHANGE 4.1 IMPLEMENTATION MODEL

4.2 APPLICATION DATA FLOW

Offline-Media AE

Export Image Files

Add Image Files

CD-R Storage Medium

Figure 4-1: Application Data Flow: Media AE

• The Offline-Media AE exports image files to a CD-R Storage medium. It is associated with the local real-world activity “Export Image Files” performed upon user request.





• The Offline-Media AE exports image files to a CD-R Storage medium. It is associated with the local real-world activity “Export Image Files” performed upon user request when an existing DICOMDIR is selected.

4.3 FUNCTIONAL DEFINITION OF AES

4.3.1 FUNCTIONAL DEFINITION OF MEDIA AE The can select export of selected Images and Images Series to offline DICOM CD-R medium. The following steps are performed.

Export

• Extracts Image DICOM Information Objects from internal system storage (database or file system) • Creates a DICOMDIR file that represents the contents of the DICOM Information Objects to be persisted

on media • Writes DICOM Information Objects and the DICOMDIR to the CD-R medium

Add

• Reads a DICOMDIR file from disk as indicated by user selection that represents the contents of the DICOM Information Objects to be persisted on media

• Extracts Image DICOM Information Objects from internal system storage (database or file system) • Adds the contents of the DICOM Information Objects to the File-Set in the DICOMDIR file • Updates the DICOMDIR on the CD-R medium.

NOTE: The Media AE can update files that it has created itself.

There is basic coverage for the DICOM Media Services in the Image Export data pathway in MOSAIQ. This is a rudimentary DICOM File Set Creator and Updater (FSC/FSU) implementation with the ability for the end user to select output of a DICOMDIR with Part 10 or DICOM Stream files.

Media Services Write Files: File Set Creator (FSC), File Set Updater (FSU)

Read Files: File Set Reader (FSR)

SCU Character Set Support

Image Record (CT, MR) CD-R Yes No MBCS Conditional P

General Purpose CD-R Yes No MBCS Conditional P

Table 4.1: DICOM SOP Class Support: Media Services

Legend:

S = Due to Treatment Planning or Delivery System data sources - only SBCS objects expected.





T = Treatment Interface: SBCS Only for Import & Treatment based on Conventional and Proton Therapy interface requirements.

P = Defines behavior that applies for generic MOSAIQ DICOM Services (such as DICOM Image Export) and basic DICOM Services for interaction with MOSAIQ Data Director. Note that coercion is configurable for Export of Diagnostic Image Series and consistent for Archive if MBCS Patient Name provided.

MOSAIQ DICOM Conformance Statement SUPPORT OF EXTENDED CHARACTER SETS




5 SUPPORT OF EXTENDED CHARACTER SETS 5.1 DICOM SOP INSTANCE IMPORT

5.1.1 SINGLE BYTE AND SINGLE BYTE EXTENDED CHARACTER SET SUPPORT DICOM SOP Instances received by the DICOM Import SCP AE (DCM) must contain ISO Character Set content in Single Byte and Single Byte Extended Character Sets and have one value only in the Attribute Specific Character Set (0008,0005.)

1. ASCII (ISO-IR 6) IS0 646,

• Latin Alphabet No. 2 (ISO IR 101), • Latin Alphabet No. 3 (ISO IR 109), • Latin Alphabet No. 4 (ISO IR 110), • Cyrillic (ISO IR 144), • Arabic (ISO IR 127), • Greek (ISO IR 126), • Hebrew (ISO IR 138), • Latin Alphabet No. 5 (ISO IR 148), • Thai (ISO IR 166), • Japanese (ISO IR 13)

5.1.2 MULTI-BYTE CHARACTER SET SUPPORT The product supports the following set of ISO Character Set codes, but in MOSAIQ 2.50 the ISO Character Set code support is constrained to the Archive and Restore specific areas of the workflow and for a subset of DICOM Attributes, noted explicitly below.

• ASCII (ISO-IR 6) IS0 646,

• JIS X 0201 Katakana (ISO-IR 13),

• JIS X 0208 Kanji (ISO-IR 87),

• JIS X 0212 Kanji (ISO-IR 159), • JIS-X 0201 Romaji (ISO-IR 14)

• Latin Alphabet No.1 (ISO IR 100) – Supplementary set of ISO 8859

NOTE:

If the Storage SCP AE receives images that contain characters from unsupported character sets, it will respond with “C-STORE-RQ Failure: Refused No Resources” to the C-STORE request.

5.2 SPECIFIC CONFORMANCE FOR IMAGE TRANSFERS

The table below identifies the key SOP Instance identifying attributes that are in the mix for MDD workflow steps of export and archive for SOP Instances. The additional bullets below indicate the differences between RT Image and Diagnostic Image SOP Class handling.

Export:

MOSAIQ DICOM Conformance Statement SUPPORT OF EXTENDED CHARACTER SETS




• RT Image SOP Instances in the MOSAIQ 2.50 release will not contain MBCS. This adheres strictly to rule to consistently generate SBCS RT Image objects that could be transferred to a Treatment Planning or Delivery System.

• SOP Instances from Diagnostic Image Series in the MOSAIQ 2.50 release will not contain MBCS at time of export by default. However the user will be able to through configuration indicate that coercion should be performed. In this case the Patient Name and Patient ID will be coerced with Patient Name representations from the MOSAIQ database. This includes MBCS or SBCS if they are available.

Archive:

• RT Image SOP Instances in the MOSAIQ 2.50 release will always allow MBCS (if MOSAIQ database contains these Patient Name representations) but only for the Patient Name and Patient ID attributes as highlighted below.

• SOP Instances from Diagnostic Image Series in the MOSAIQ 2.50 release will always allow MBCS (if MOSAIQ database contains these Patient Name representations) but only for the Patient Name and Patient ID attributes as highlighted below.

Attribute Name Tag Type

Series Description (0008,103E) 3

Study Description (0008,1030) 3 Patient Name (0010,0010) 2/R

Patient ID (0010,0020) 2/R

Patient’s Sex (0010,0040) 2

Study ID (0020,0010) 2/R RT Image Label

(3002,0002) 1

Referring Physician's Name (0008,0090) 2 Physician(s) of Record (0008,1048) 3 Operators’ Name

(0008,1070) 2

NOTE:

To foster DICOM connectivity and interoperability, it is highly encouraged that customers do not use Multi-Byte Character Set string content for Patient ID values in MOSAIQ regardless of the user interface capabilities.

MOSAIQ DICOM Conformance Statement Appendix A




6 APPENDIX A 6.1 SPECIFIC CONFORMANCE FOR IMAGE IODS

6.1.1 IMAGE OBJECT IMPORT AND STORAGE DCM supports the Standard SOP Classes for CR Image Storage, CT Image Storage, MR Image Storage, SC Image Storage, PET Image Storage and RT Image Storage. In the event of a successful C-STORE operation, the DICOM message is stored without modification either:

• in the database – for MR image objects, PET image objects, and for CT image objects when Image Type (0008,0008), Value 3 is not LOCALIZER; or

• as a DICOM file on disk – for CR image objects, SC image objects, RT Image objects, and for CT image objects when Image Type (0008,0008), Value 3 is LOCALIZER.

DICOM files created by DCM that contain an image object are processed by the Namer application. Namer performs an import process that extracts information from the DICOM file and stores the digital image and associated information in the database. DCM and Namer work together as an SCP of the Storage Service Class for the following Composite Image IODs: CR, SC, RT Image, and CT when Image Type (0008,0008), Value 3 is LOCALIZER.

All attributes of an image object are stored; none are discarded or modified. This provides Level 2 (Full) conformance as an SCP.

See §6.5 for an important statement regarding import process limitations when extracting and storing image pixel data.

Images stored in the database are accessed by the ViewStation application for display, annotation, etc. Images are stored indefinitely, but may be deleted from the database using ViewStation.

6.2 IMAGE IOD MODULES The following table identifies the modules used when importing an image object into the database. If a module is not listed or is shown with a reference of Not Used then none of its attributes are accessed during import.

Module Name Reference Usage by IOD

CR CT MR SC PET RT Image

Patient §6.3.1 M M M M M M Clinical Trial Subject Not Used U U U U U U

General Study §6.3.2 M M M M M M Patient Study Not Used U U U U U U Clinical Trial Study Not Used U U U U U U

General Series §6.3.3 M M M M M Clinical Trial Series Not Used U U U U U U

CR Series Not Used M PET Series Not Used M PET Isotope Not Used M

PET Multigated Acquisition Not Used C





Module Name Reference Usage by IOD

CR CT MR SC PET RT Image

NM/PET Patient Orientation Not Used M

RT Series § 6.4.1 M Frame Of Reference Not Used M M M U General Equipment §6.3.4 M M M U M M

SC Equipment §6.4.2 M General Image §6.3.5 M M M M M M

Image Plane §6.3.6 M M M Image Pixel §6.3.7 M M M M M M Contrast / Bolus Not Used C C C C

Cine Not Used C Multi-frame Not Used C CR Image §6.43 M

CT Image Not Used M MR Image Not Used M SC Image §6.4.4 M

PET Image M RT Image §6.4.5 M

Approval Not Used U Overlay Plane Not Used U U U U U Curve §6.4.6 U

Modality LUT Not Used U U U VOI LUT §6.4.7 U U U U U U SOP Common §6.3.8 M M M M M M

Refer to {DICM} for a complete definition of the Usage notation, summarized as follows:

M mandatory Module.

C conditional Module.

U user option Module.

6.3 COMMON MODULES FOR RT, SC, CR AND SC IMAGE IODS This section lists the attributes of each module that are used by the import process; attributes that are not accessed during import are not shown. Restrictions on attribute values and usage are also listed. Refer to {DICM} for a complete definition of the Type notation, summarized as follows:

1 The attribute must be included and have a valid value.

1C The attribute must be included under certain conditions. If included, it must have a valid value.

2 The attribute must be included. If the value is unknown, it can be null (empty).

2C The attribute must be included under certain conditions. If included and the value is unknown, it can be





null (empty).

3 The attribute is optional. It may or may not be included in the module. If included, the attribute may or

may not have a null value.

6.3.1 PATIENT MODULE The following table lists the attributes that are used to match the image object with a patient in the database. If the patient in the image object cannot be identified and uniquely matched with an existing patient in the database, the image object is not imported.

Once the patient is identified and matched, the Image Management System uses none of the patient information contained in the image object. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the image object.

Tag Name Type Description

(0010,0010) Patient's Name 2 Patient's full name. The import process may be configured to use this attribute, in addition to Patient ID, to match the image object with a patient in the database. Only the first 40 characters of the last name in this attribute are used.

(0010,0020) Patient ID 2 Primary hospital identification number or code for the patient. The image object is only imported if the Patient ID can be uniquely matched with an existing patient's Primary ID in the database. Only the first 20 characters of this attribute are used.

6.3.2 GENERAL STUDY MODULE


(0008,0020) Study Date 2 Date the Study started. If the value is unknown, the import process defaults to the current date of import.

(0008,0030) Study Time 2 Time the Study started. If the value is unknown, the import process defaults to the current time of import, or optionally midnight.

(0008,1030) Study Description 3 Institution-generated description or classification of the Study. This attribute may be used instead of Image Comments. Only the first 60 characters of this attribute are used. If the attribute is absent or the value is unknown, the import process defaults to blank.

6.3.3 GENERAL SERIES MODULE The Modality attribute in this module is used to identify the source of the image object. In addition to matching the image object with a patient, the image source must be identified. Otherwise the image object is not imported. Identification of the image source also allows the import process to apply image enhancements that are customized for that source. For an RT Image IOD, the Modality attribute in the RT Series Module is used. For an SC Image IOD, the Conversion Type attribute in the SC Equipment Module takes precedence.






(0008,0060) Modality 1 Type of equipment that originally acquired the data used to create the image. It must have the corresponding value for the following Image IODs:

IOD Value CR CR CT CT MR MR PET PT

(0008,103E) Series Description 3 User-provided description of the Series. This attribute may be used instead of Image Comments. Only the first 60 characters of this attribute are used. If the attribute is absent or the value is unknown, the import process defaults to blank.

6.3.4 GENERAL EQUIPMENT MODULE The following table lists the attributes in this module that are used to identify the image source. For an SC Image IOD, the SC Equipment Module takes precedence.


(0008,0070) Manufacturer 2 Manufacturer of the equipment that produced the image. This attribute may be used, in addition to Modality, to identify the image source. This allows the import process to differentiate image objects with the same Modality. Only the first 40 characters of this attribute are used.

(0008,1010) Station Name 3 User-defined name identifying the machine that produced the image. This attribute may be used, in addition to Modality, to identify the image source. This allows the import process to differentiate image objects with the same Modality and Manufacturer.

(0008,1090) Manufacturer's Model Name

3 Manufacturer's model name of the equipment that produced the image. This attribute may be used, in addition to Modality, to identify the image source. This allows the import process to differentiate image objects with the same Modality. Only the first 40 characters of this attribute are used.





6.3.5 GENERAL IMAGE MODULE


(0008,0023) Content Date 2C The date the image pixel data creation started. This attribute may be used instead of Study Date. If the value is unknown, the import process defaults to the current date of import.

(0008,0033) Content Time 2C The time the image pixel data creation started. This attribute may be used instead of Study Time. If the value is unknown, the import process defaults to the current time of import, or optionally midnight.

(0020,4000) Image Comments 3 User-defined comments about the image. Only the first 60 characters of this attribute are used. If the attribute is absent or the value is unknown, the import process defaults to blank.

6.3.6 IMAGE PLANE MODULE


(0018,0050) Slice Thickness 2 Nominal slice thickness, in mm. If the value is unknown, the import process defaults to 0.

(0020,1041) Slice Location 3 Relative position of exposure expressed in mm. If the attribute is absent or the value is unknown, the import process defaults to 0.

(0028,0030) Pixel Spacing 1 Physical distance in the patient between the center of each pixel, in mm. If the row and column spacing values are not equal (pixels are not square), the image appears distorted when displayed and measurements made on the image are inaccurate.

6.3.7 IMAGE PIXEL MODULE

See §6.5 for an important statement regarding import process limitations when extracting and storing image pixel data.


(0028,0002) Samples per Pixel 1 Number of samples (planes) in this image. This attribute is not explicitly used; the value is assumed to be 1. Otherwise the image object is not imported.

(0028,0004) Photometric Interpretation

1 Specifies the intended interpretation of the pixel data. This attribute is not explicitly used; the value is assumed to be MONOCHROME2. Otherwise, if the value is MONOCHROME1, the image is displayed with an inverted grayscale; if the value is anything else, the import process does not properly interpret the image.

(0028,0010) Rows 1 Number of rows in the image. The value must be within the range 16 to 4096. Otherwise the image object is not imported.






(0028,0011) Columns 1 Number of columns in the image. The value must be within the range 16 to 4096. Otherwise the image object is not imported.

(0028,0034) Pixel Aspect Ratio 1C Ratio of the vertical size and horizontal size of the pixels in the image. This attribute is not explicitly used; pixel aspect ratio is assumed to be 1\1. Otherwise the image appears distorted when displayed and measurements made on the image are inaccurate.

(0028,0100) Bits Allocated 1 Number of bits allocated for each pixel sample. The value must be 8 or 16. Otherwise the image object is not imported.

(0028,0101) Bits Stored 1 Number of bits stored for each pixel sample. The value must be within the range 1 to Bits Allocated. Otherwise the import process defaults to Bits Allocated.

(0028,0102) High Bit 1 Most significant bit for pixel sample data. This attribute is not explicitly used; the value is assumed to be Bits Stored - 1. Otherwise the import process does not properly interpret the image.

(0028,0103) Pixel Representation 1 Data representation of the pixel samples. The value must be 1 or 0. A value of 1 indicates that the pixel values are signed, and 0 unsigned.

(7FE0,0010) Pixel Data 1C A data stream of the pixel samples that comprise the image.

6.3.8 SOP COMMON MODULE


(0008,0005) Specific Character Set 1C Character Set that expands or replaces the Basic Graphic Set. This attribute is not explicitly used; all characters in strings are assumed to be from the Default Character Repertoire as defined in {DICM}. Otherwise string comparisons with data from the database may fail, and applications that access the imported character strings may not print or display them correctly.

(0008,0012) Instance Creation Date 3 Date the SOP Instance was created. This attribute may be used instead of Study Date. If the attribute is absent or the value is unknown, the import process defaults to the current date of import.

(0008,0013) Instance Creation Time 3 Time the SOP Instance was created. This attribute may be used instead of Study Time. If the attribute is absent or the value is unknown, the import process defaults to the current time of import, or optionally midnight.





6.4 IOD SPECIFIC MODULES: RT, SC, CR AND SC IMAGE IODS

6.4.1 RT SERIES MODULE The Modality attribute in this module is used to identify the image source for an RT Image IOD.


(0008,0060) Modality 1 Type of equipment that originally acquired the data. The value must be RTIMAGE.

6.4.2 SC EQUIPMENT MODULE The Conversion Type attribute in this module is used to identify the image source for an SC Image IOD.


(0008,0064) Conversion Type 1 Describes the kind of image conversion. The import process only recognizes the following values: DF, DI, DV and WSD

(0018,1016) Secondary Capture Device Manufacturer

3 Manufacturer of the Secondary Capture Device. This attribute may be used, in addition to Conversion Type, to identify the image source. This allows the import process to differentiate image objects with the same Conversion Type. Only the first 40 characters of this attribute are used.

(0018,1018) Secondary Capture Device Manufacturer’s Model Name

3 Manufacturer’s model number of the Secondary Capture Device. This attribute may be used, in addition to Conversion Type, to identify the image source. This allows the import process to differentiate image objects with the same Conversion Type. Only the first 40 characters of this attribute are used.

6.4.3 CR IMAGE MODULE


(0018,1164) Imager Pixel Spacing 3 Physical distance between the center of each pixel in mm. If the row and column spacing values are not equal (pixels are not square), the image appears distorted when displayed and measurements made on the image are inaccurate.





6.4.4 SC IMAGE MODULE


(0018,1012) Date of Secondary Capture

3 The date the Secondary Capture Image was captured. This attribute may be used instead of Study Date. If the attribute is absent or the value is unknown, the import process defaults to the current date of import.

(0018,1014) Time of Secondary Capture

3 The time the Secondary Capture Image was captured. This attribute may be used instead of Study Time. If the attribute is absent or the value is unknown, the import process defaults to the current time of import, or optionally midnight.

6.4.5 RT IMAGE MODULE


(0008,0008) Image Type 1 Image identification characteristics. Only the third value of this attribute is used.

(3002,0002) RT Image Label 1 User-defined label for RT Image. If the RT IMAGE is exported after the RT PLAN has been promoted, this attribute may be used instead of RT Image Name to match the image with a radiotherapy treatment Field ID for the patient in the database. Only the first 5 characters of this attribute are used. If the RT IMAGE is exported first, or the RTPLAN and RT IMAGE are exported to MOSAIQ at the same time, the RT IMAGE will automatically associate with the Fields in MOSAIQ using the beam number in the referenced RT PLAN [see (300C,0006) Referenced Beam Number]. .

(3002,0003) RT Image Name 3 User-defined name for RT Image. If the RT IMAGE is exported after the RT PLAN has been promoted, this attribute is used to match the image with a radiotherapy treatment Field ID for the patient in the database. Only the first 5 characters of this attribute are used. If the attribute is absent or the value is unknown, the import process does not associate the image with a treatment field. If the RT IMAGE is exported first, or the RTPLAN and RT IMAGE are exported to MOSAIQ at the same time, the RT IMAGE will automatically associate with the Fields in MOSAIQ using the beam number in the referenced RT PLAN [see (300C,0006) Referenced Beam Number].

(3002,000C) RT Image Plane 1 Describes whether or not image plane is normal to beam axis. The value must be NORMAL. Otherwise the image object is not imported.






(3002,000D) X-Ray Image Receptor Translation

3 Position in (x,y,z) coordinates of origin of IEC X-RAY IMAGE RECEPTOR System in the IEC GANTRY coordinate system (mm). The x and y values are used to calculate image scaling; the z value is ignored. If the attribute is absent or the values are unknown, the import process defaults to 0,0,0.

(3002,000E) X-Ray Image Receptor Angle

2 Orientation of IEC X-RAY IMAGE RECEPTOR coordinate system with respect to IEC GANTRY coordinate system (degrees). This attribute is used to calculate image scaling. If the value is unknown, the import process defaults to 0.

(3002,0010) RT Image Orientation 2C The direction cosines of the first row and the first column with respect to the IEC X-RAY IMAGE RECEPTOR coordinate system. If the attribute is present and has values other than 1,0,0,0,-1,0, the image object is not imported.

(3002,0011) Image Plane Pixel Spacing

2 Physical distance (in mm) between the center of each image pixel. This attribute is used to calculate image scaling. If the row and column spacing values are not equal (pixels are not square), the image appears distorted when displayed and measurements made on the image are inaccurate. If the values are unknown or not equal, image scaling cannot be calculated.

(3002,0012) RT Image Position 2 The x and y coordinates (in mm) of the upper left hand corner (first pixel transmitted) of the image, in the IEC X-RAY IMAGE RECEPTOR coordinate system. This attribute is used to calculate image scaling. If the values are unknown, image scaling cannot be calculated.

(3002,0020) Radiation Machine Name

2 User-defined name identifying radiation machine used in acquiring or computing image. If the value is unknown, the import process defaults to 'Unknown'.

(3002,0022) Radiation Machine SAD

2 Radiation source to Gantry rotation axis distance of radiation machine used in acquiring or computing image (mm). This attribute is used to calculate image scaling. If the value is unknown, the import process defaults to 0 and image scaling cannot be calculated.

(3002,0024) Radiation Machine SSD 3 Source to patient surface distance (in mm) of radiation machine used in acquiring or computing image. If the attribute is absent or the value is unknown, the import process defaults to 0.

(3002,0026) RT Image SID 2 Distance from radiation machine source to image plane (in mm) along radiation beam axis. This attribute is used to calculate image scaling. If the value is unknown, the import process defaults to 0 and image scaling cannot be calculated.

(300C,0002) Referenced RT Plan Sequence

3 Introduces sequence of one Class/Instance pair describing RT Plan associated with image. Only a single item shall be permitted in this sequence.






(0008,1150) >Referenced SOP Class UID

1C Uniquely identifies the referenced SOP Class. Required if Referenced RT Plan Sequence (300C,0002) is sent.

(0008,1155) >Referenced SOP Instance UID

1C Uniquely identifies the referenced SOP Instance. Required if Referenced RT Plan Sequence (300C,0002) is sent.

(300C,0006) Referenced Beam Number

3 Uniquely identifies the corresponding Nsegment

treatment beam specified by

Beam Number (300A,00C0) within Beam

Sequence in RT Beams Module within the

RT Plan referenced in (300C,0002) Referenced RT Plan

Sequence. If the RTPLAN and RT IMAGE’s are exported to MOSAIQ at the same time, the RT IMAGE’s will automatically associate with this beam number of the referenced RT PLAN when the RTPLAN has been promoted and the Beams become Fields in MOSAIQ. If the RT IMAGE (DRR) is sent separately, after the RT PLAN is promoted, then (3002,0003) RT Image Name or (3002,0002) RT Image Label is used to link to the Field ID in MOSAIQ (only the first 5 characters are used).

6.4.6 CURVE MODULE (RETIRED, BUT STILL COMMONLY IN USE IN RT IMAGE)


(50xx,0005) Curve Dimensions 1 Number of dimensions for these data. The value must be 2. Otherwise the Curve is not imported.

(50xx,0010) Number of Points 1 Number of data points in this Curve. The value must be within the range 1 to 4096. Otherwise the Curve is not imported.

(50xx,0020) Type of Data 1 Type of data in this Curve. The value must be POLY, ROI or LABEL. Otherwise the Curve is not imported.

(50xx,0022) Curve Description 3 User-defined comments about the Curve. (50xx,0030) Axis Units 3 Units of measure for the axes. This attribute is not explicitly

used; the value is assumed to be PIXL\PIXL. Otherwise the import process does not properly interpret the Curve; the Curve will be displayed as if the points in the Curve are in terms of image pixels and the Curve will be exported with the value PIXL\PIXL for this attribute.

(50xx,0103) Data Value Representation

1 Data representation of the Curve data points. The value must be one of the enumerated values 0, 1, 2, 3 or 4.

(50xx,2500) Curve Label 3 A user-defined text string which may be used to label or name this Curve.






(50xx,3000) Curve Data 1 Curve data. The x and y coordinate values of each point in the Curve are rounded to a whole pixel value by the import process and any sub-pixel precision in the original Curve Data is lost. Each x and y coordinate value, after rounding, must be within the range -32768 to 32767. Otherwise the Curve is not imported.

6.4.7 VOI LUT MODULE The Window Center and Window Width attributes in this module are used by the import process to produce the initial image display. The import process assumes no Modality LUT transformation is required (e.g. Rescale Intercept, Rescale Slope) and applies the VOI LUT transformation directly, using Window Center and Window Width to produce the initial display. If a Modality LUT transformation is required, the direct application of the VOI LUT transformation results in incorrect initial image display. Window center/width may be adjusted in the displayed image.


(0028,1050) Window Center 3 Window Center for display. If multiple values are present, only the first value is used. If the attribute is absent or the value is unknown, the import process does not apply the VOI LUT transformation.

(0028,1051) Window Width 1C Window Width for display. If multiple values are present, only the first value is used. If the attribute is absent or the value is unknown, the import process does not apply the VOI LUT transformation.

6.5 IMPORT PROCESS LIMITATIONS WHEN EXTRACTING AND STORING IMAGE PIXEL DATA The import process makes assumptions about certain attribute values that it does not explicitly use, but are nonetheless important for proper interpretation of the image pixel data. All assumptions and restrictions are listed in the tables in the preceding section, and cases that result in a failure to import an image object are described. Assumptions about Pixel Spacing, Photometric Interpretation and Pixel Aspect Ratio may result in incorrect image display, but do not otherwise affect the stored pixel data.

Certain assumptions may result in undesired modification of image pixel data, however, even though the image object is otherwise successfully imported. The following two cases constitute these limitations:

6.5.1 BITS STORED LESS THAN BITS ALLOCATED, HIGH BIT EQUAL TO BITS STORED - 1 In this case, the import process masks off any extra-pixel data (e.g. an overlay encoded in the bits above the High Bit). The stored pixel data has 0 for all such bits, but the original pixel sample values are stored and image display is correct.

6.5.2 BITS STORED LESS THAN BITS ALLOCATED, HIGH BIT NOT EQUAL TO BITS STORED - 1 Since the import process assumes High Bit equal to Bits Stored - 1, this case results in incorrect extraction of the pixel data. As in the case above, data above the assumed High Bit (Bits Stored - 1) is masked off. This data may contain pixel sample as well as extra-pixel data. The effect on image display varies depending on how many bits of the actual pixel sample are lost and whether extra-pixel data is encoded in the least significant bits of each pixel. Regardless, the stored pixel data is an incorrect representation of the original pixel sample and image display is not correct

MOSAIQ DICOM Conformance Statement Appendix B




7 APPENDIX B 7.1 SPECIFIC CONFORMANCE FOR RT PLAN IOD The Radiotherapy Plan Information Object Definition (RT Plan IOD) is used to transfer treatment plans generated by manual entry, a virtual simulation system or a treatment planning system before or during a course of treatment.

RT Plans received by DCM are translated to RTPConnect files that the MOSAIQ application imports. The MOSAIQ application performs an import process that extracts information from the RTPConnect file and stores the information in the database. DCM and the MOSAIQ application work together, acting as an SCP of the Storage Service Class for the RT Plan IOD.

DCM provides Standard Conformance to the standard extended DICOM RT Plan Storage Class at Level 2 (full) as an SCP. However, information stored in the database is accessed by the MOSAIQ application for display, editing, etc. which is equivalent to Level 0 (local). Information may be stored indefinitely or deleted from the database using MOSAIQ.

7.2 RT PLAN IOD MODULES The following table identifies the modules used when translating an RT Plan object to the RTPConnect file and importing the file into the database. A module is shown with a reference of Not Used if none of its attributes are accessed during translation or import.

Module Name Reference Usage

Patient §7.3.1 M

General Study Not Used M Patient Study Not Used U RT Series §7.3.2 M

General Equipment §7.3.3 M RT General Plan §7.3.4 M RT Prescription §7.3.5 U

RT Tolerance Tables §7.3.6 U RT Patient Setup §7.3.7 U RT Fraction Scheme §7.3.8 U

RT Beams §7.3.9 C – Required if RT Fraction Scheme Module exists and Number of Beams is greater than zero for one or more fraction groups.

RT Brachy Application Setups

Not Used C – Required if RT Fraction Scheme Module exists and Number of Brachy Application Setups is greater than zero for one or more fraction groups.

Approval §7.3.10 U Audio Not Used U SOP Common §7.3.11 M


M mandatory Module.







7.3 MODULE ATTRIBUTES This section lists the attributes of each module that are used by the translation and import process; attributes that are not accessed are not shown. Restrictions on attribute values and usage are also listed. Refer to {DICM} for a complete definition of the Type notation, summarized as follows:




3 The attribute is optional. It may or may not be included in the module. If included, the attribute may or may not have a null value.

7.3.1 PATIENT MODULE The following table lists the attributes that are used to match the RT Plan with a patient in the database. If the patient in the RT Plan cannot be identified and uniquely matched with an existing patient in the database, the RT Plan is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the RT Plan. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the RT Plan.


(0010,0010) Patient’s Name 2 Patient’s full legal name. The import process is configured to use the last name in this attribute, in addition to Patient ID, to match the RT Plan with a patient in the database. The first 40 characters of the last name and the first 20 characters of the first name in this attribute are used.

(0010,0020) Patient ID 2 Primary hospital identification number or code for the patient. The RT Plan will only be imported if this attribute and Patient’s Name can be uniquely matched with an existing patient in the database. Only the first 20 characters of this attribute are used.

7.3.2 RT SERIES MODULE


(0008,0060) Modality 1 Type of equipment that originally acquired the data. Enumerated value must be RTPLAN.

7.3.3 GENERAL EQUIPMENT MODULE


(0008,0070) Manufacturer 2 This attribute is translated to RTP_Mfg. Only the first 20 characters of this attribute are used.

(0008,1090) Manufacturer’s Model Name

3 This attribute is translated to RTP_Model. Only the first 20 characters of this attribute are used.

(0018,1020) Software Versions 3 This attribute is translated to RTP_Version. Only the first 10 characters of this attribute are used.





7.3.4 RT GENERAL PLAN MODULE


(0008,1070) Operator’s Name 2 Name of operator creating treatment plan. This attribute is translated to Author_Last_Name (20 characters), Author_First_Name (20 characters) and Author_Minitial (1 character).

(300A,0002) RT Plan Label 1 This attribute is translated to Plan_ID (first 15 characters only). If this attribute consists of numbers, the first 2 digits are translated to Course_ID (1-99).

(300A,0006) RT Plan Date 2 This attribute is translated to Plan_Date (yyyymmdd). (300A,0007) RT Plan Time 2 This attribute is translated to Plan_Time (hhmmss). (300A,0009) Treatment Protocols 3 This attribute is translated to Technique and only the first 20

characters are used.

7.3.5 RT PRESCRIPTION MODULE The following table lists the attributes that are used to create primary and secondary treatment sites for the patient. If Dose Reference Description conflicts with an existing Primary Treatment Site Name or Secondary Treatment Region Name in the database, the dose reference is not imported.


(300A,000E) Prescription Description

3 This attribute is translated to RX_Note. Only the first 60 characters are used.

(300A,0010) Dose Reference Sequence

3 Introduces sequence of Dose References.

(300A,0012) > Dose Reference Number

1C Identification number of the Dose Reference. This attribute is translated to Rx_Site_Name or Region_Name (see description below) if Dose Reference Description does not exist or is NULL.

(300A,0016) > Dose Reference Description

3 This attribute is translated to Rx_Site_Name if Dose Reference Type (300A,0020) is TARGET, or Region_Name if Dose Reference Type is ORGAN_AT_RISK. Only the first 20 characters of this attribute are used.

(300A,001A) > Nominal Prior Dose 3 Dose (in Gy) from prior treatment to this Dose Reference. This attribute is translate to Region Prior Dose (Gy to cGy) and ranges from 1 to 99999 cGy.

(300A,0020) > Dose Reference Type 1C Enumerated values are TARGET or ORGAN_AT_RISK. (300A,0022) > Delivery Warning

Dose 3 The dose which when reached or exceeded should cause

some action to be taken. This attribute is translated to Action Dose (Gy to cGy) and ranges from 1 to 99999 cGy.

(300A,0026) > Target Prescription Dose

3 Prescribed dose to Dose Reference if Dose Reference Type (300A,0020) is TARGET. This attribute is translated to Dose_TTL (Gy to cGy) and ranges from 1 to 99999; and is used in calculating Dose_TX (Gy to cGy), i.e. Dose_Tx is equal to Target Prescription Dose divided by Number of Fractions Planned (300A,0078). It ranges from 1 to 9999 cGy.





7.3.6 RT TOLERANCE TABLES MODULE The following table lists the attributes used to match the RT Plan with an existing Tolerance Table in the database. If the Tolerance Table Label does not match an existing Tolerance Table ID in the database, the attributes in this module are not imported.


(300A,0040) Tolerance Table Sequence

3 Introduces sequence of tolerance tables.

(300A,0043) > Tolerance Table Label 3 Tolerance Table ID. Valid values are 1-9 inclusive and must match an existing ID in the database.

7.3.7 RT PATIENT SETUP MODULE The following table lists the attributes used to match the RT Plan with the Patient Setup information in the database. If the Patient Position does not match a valid enumerated value, the attributes in this module are not imported.


(300A,0180) Patient Setup Sequence 3 Introduces sequence of patient setups (0018,5100) > Patient Position 3 Position of the patient relative to the imaging equipment

space. Valid enumerated values are: • HFP • HFS • HFDR • HFDL • FFP • FFS • FFDR • FFDL

7.3.8 RT FRACTION SCHEME MODULE


(300A,0070) Fraction Group Sequence

1 Introduces sequence of Fraction Groups in current Fraction Scheme. Each Fraction Group is translated to a Prescription Site.

(300A,0078) > Number of Fractions Planned

2 This attribute, together with Target Prescription Dose (300A,0026), is used to calculate Dose_Tx.

(300A,0080) > Number of Beams 1 Number of Beams in current Fraction Group. This attribute is translated to Number of Fields (1-999) for the current Prescription Site.

(300C,0004) > Referenced Beam Sequence

1C Introduces sequence of treatment beams in current Fraction Group. Required if Number of Beams is greater than zero. Each Beam is translated to a Treatment Field within the current Prescription Site.

(300A,0084) >> Beam Dose 3 This attribute is translated to Field Dose (Gy to cGy) and ranges from 0.01 to 9999.99 cGy.






(300A,0086) >> Beam Meterset 3 If the Primary Dosimeter Unit (300A, 00B3) is MU, this attribute is translated to Field_Monitor_Units (0.01-9999.99) if Treatment Delivery Type (300A, 00CE) is TREATMENT; and Wedge_Monitor_Units (0-9999.99) if Wedge Position (300A,0118) is IN and Wedge Type (300A,00D3) is MOTORIZED.

(300C,0006) >> Referenced Beam Number

1C Uniquely identifies Beam specified by Beam Number within Beam Sequence in RT Beams module.

(300C,0050) > Referenced Dose Reference Sequence

3 Introduces sequence of Dose References for the current Fraction Group.

(300C,0051) >> Referenced Dose Reference Number

1C Uniquely identifies Dose Reference specified by Dose Reference Number within Dose Reference Sequence in RT Prescription module.

7.3.9 RT BEAMS MODULE The following table lists the attributes that are used to create a new treatment field for the patient. Beams with a Treatment Delivery Type of TREATMENT are translated to treatment fields, whereas Beams with a Treatment Delivery Type of SETUP are translated to Setup fields. Beams that do not have the Treatment Delivery Type attribute are considered to be TREATMENT beams. If Beam Number conflicts with an existing Treatment Field ID for the patient in the database, the existing treatment field’s revision is incremented and the imported field is imported as the current revision. Otherwise a new treatment field is created. If the Treatment Machine Name does not match an existing Treatment Machine in the database, this attribute is not used and the Treatment Machine for this treatment field is set to blank.


(300A,00B0) Beam Sequence 1 Introduces sequence of treatment beams for current RT Plan. (0008,0070) > Manufacturer 2 This attribute is translated to MLC_Type. If this attribute is

“GE”, set to 1; “PHILIPS” or “ELEKTA”, set to 2; “SCANDATRONICS”, set to 3; “SIEMENS”, set to 4; “VARIAN”, set to 5; “BRAINLAB”, set to 6; “RADIONICS”, set to 7; “LIEBINGER-FISHER”, set to 8; “WELLHOFER”, set to 9; “MITSUBISHI”, set to 10; “MRC”, set to 12; Otherwise, set to 11.

(300A,00B2) > Treatment Machine Name

2 This attribute is translated to Treatment_Machine and only the first 20 characters of this attribute are used. This attribute is used to match with an existing machine in the database so that conversion of treatment geometry attributes from IEC-based coordinate system to machine-based native coordinate system can be performed.






(300A,00B3) > Primary Dosimeter Unit

3 Measurement unit of machine dosimeter. Enumerated values are MU or MINUTE.

(300A,00B4) > Source to Axis Distance

3 Radiation source to Gantry rotation axis distance. This attribute is translated to SAD and ranges from 30.0 to 999.9 centimeters.

(300A,00B6) > Beam Limiting Device Sequence

1 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) sets.

(300A,00B8) >> Beam Limiting Device Type

1 X = symmetric jaw pair in X direction Y = symmetric jaw pair in Y direction ASYMX = asymmetric jaw pair in X direction ASYMY = asymmetric jaw pair in Y direction MLCX = multileaf jaw pair in X direction MLCY = multileaf jaw pair in Y direction

(300A,00BC) >> Number of Leaf/Jaw Pairs

1 Number of leaf (element) or jaw pairs (equal to 1 for standard beam limiting device jaws). This attribute is translated to MLC Leaves (20-100) if Beam Limiting Device Type (300A,00B8) is either MLCX or MLCY.

(300A,00C0) > Beam Number 1 Identification number of the Beam. This attribute is translated to Field_ID if Beam Name (300A,00C2) does not exist or is NULL. Only the first 5 characters of this attribute are used.

(300A,00C2) > Beam Name 3 This attribute is translated to the Field_ID (first 5 characters). (300A,00C3) > Beam Description 3 This attribute is translated to Field_Name (first 20

characters). (300A,00C4) > Beam Type 1 Motion characteristic of Beam. Enumerated values are

STATIC or DYNAMIC. (300A,00C6) > Radiation Type 2 Particle type of Beam. This attribute is translated to Modality.

An enumerated value of PHOTON is translated to Xrays, a value of ELECTRON to Elect, and all other enumerated values are translated to NULL.

(3002,0050) >Primary Fluence Mode Sequence

3 Sequence defining whether the primary fluence of the treatment beam uses a non-standard fluence-shaping. Only a single item is permitted in this sequence.

(3002,0051) >>Primary Fluence Mode

1 STANDARD or NON_STANDARD

(3002,0052) >>Fluence Mode ID 1C Identifier for the specific fluence-shaping mode. Required if Fluence Mode (3002,0051) has value NON_STANDARD. Accept FFF for NON_STANDARD to indicate Flattening Filter Free energy.






(300A,00C7) >High-Dose Technique Type

1C Type of high-dose treatment technique. Defined Terms: NORMAL = Standard treatment TBI = Total Body Irradiation HDR = High Dose Rate Required if treatment technique requires a dose that would normally require overriding of treatment machine safety controls. SRS will be recognized as the designation of Flattening Filter Free energy for Varian treatment machines prior to TrueBeam.

(300A,00CE) > Treatment Delivery Type

3 Beams with Treatment Delivery Type of TREATMENT are translated to treatment fields. If this attribute is missing, the Beam is considered to be a TREATMENT beam. Beams with Treatment Delivery Type of SETUP are translated to Setup fields.

(300A,00C7) > High-Dose Technique Type

1C Type of high-dose treatment technique. Although there are Defined Terms of NORMAL, TBI and HDR in the Standard, the only value acknowledged is “SRS” which is specific to the Varian True Beam interface.

(300A,00D0) > Number of Wedges 1

Number of wedges associated with current Beam. Only a value of 1 is supported.

(300A,00D1) > Wedge Sequence 1C Introduces sequence of treatment wedges. Required if Number of Wedges is non-zero.

(300A,00D3) >> Wedge Type 2C STANDARD = standard (static) wedge DYNAMIC = moving beam limiting device jaw simulating wedge MOTORIZED = single wedge that can be remotely removed from the beam

(300A,00D4) >> Wedge ID 3 This attribute is translated to Wedge and Dynamic_Wedge if Wedge Type (300A,00D3) is MOTORIZED. Only the first 10 characters of this attribute are used.

(300A,00E0) > Number of Compensators

1 Number of Compensators associated with current Beam.

(300A,00E3) > Compensator Sequence

1C Introduces sequence of treatment compensators. Required if Number of Compensators is non-zero.

(300A,00E5) >> Compensator ID 3 This attribute is translated to Compensator if Radiation Type (300A, 00C6) is PHOTON, or eField Def Aperture if Radiation Type is ELECTRON. Only the first 10 characters of this attribute are used.

(300A,00F0) > Number of Blocks 1 Number of shielding blocks associated with Beam. (300A,00F4) > Block Sequence 1C Introduces sequence of blocks associated with Beam.

Required if Number of Blocks is non-zero.






(300A,00F5) >> Block Tray ID 3 This attribute is translated to Block. Only the first 10 characters of this attribute are used.

(300A,0107) > Applicator Sequence 3 Introduces sequence of Applicators. Only a single item shall be permitted in this sequence.

(300A,0108) >> Applicator ID 1C This attribute is translated to eApplicator if Radiation Type (300A, 00C6) is ELECTRON. Only the first 10 characters of this attribute are used.

(300A,00F9) >>Accessory Code 3 An identifier for the accessory intended to be read by a device such as a bar-code reader.

(300A,0109) >>Applicator Type 1 Type of Applicator. Defined Terms: ELECTRON_SQUARE = square electron applicator ELECTRON_RECT = rectangular electron applicator ELECTRON_CIRC = circular electron applicator ELECTRON_SHORT = short electron applicator ELECTRON_OPEN = open (dummy) electron applicator INTRAOPERATIVE = intraoperative (custom) applicator STEREOTACTIC = stereotactic applicator

(300A,010E) > Final Cumulative Meterset Weight

1C Value of Cumulative Meterset Weight (300A, 0134) for final Control Point. This attribute is used to calculate Monitor_Units ( = Cumulative Meterset Weight divided by Final Cumulative Meterset Weight).

(300A,0110) > Number of Control Points

1 This attribute is translated to Total_Control_Points and ranges in value from 1 to 999. If Beam Type (300A,00C4) is STATIC, Total_Control_Points is set to 1.

(300A,0111) > Control Point Sequence

1C Introduces sequence of machine configurations describing treatment beam. Two or more items may be included in this sequence.

(300A,0112) >> Control Point Index 1C Index of current Control Point, starting at 0 for first Control Point. This attribute is translated to Control_Pt_Number and ranges in value from 0 to 999.

(300A,0114) >> Nominal Beam Energy

3 Nominal Beam Energy at control point (MV/MeV). This attribute is translated to Energy and ranges from 0 to 99.99 MeV.

(300A,0115) >> Dose Rate Set 3 This attribute is translated to Doserate (MU/min) and ranges from 1 to 9999.

(300A,0116) >> Wedge Position Sequence

3 Introduces sequence of Wedge positions.

(300A,0118) >>> Wedge Position 1C Position of Wedge at current control point. Enumerated values are IN or OUT.

(300A,011A) >> Beam Limiting Device Position Sequence

1C Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions.






(300A,00B8) >>> Beam Limiting Device Type

1C X = symmetric jaw pair in X direction Y = symmetric jaw pair in Y direction ASYMX = asymmetric jaw pair in X direction ASYMY = asymmetric jaw pair in Y direction MLCX = multileaf jaw pair in X direction MLCY = multileaf jaw pair in Y direction.

(300A,011C) >>> Leaf/Jaw Positions 1C Positions (mm) of beam limiting device leaf or jaw pairs. This attribute is translated to Field_X (00.0-50.0 cm), Field_Y (00.0-50.0 cm), Collimator_X1 (-20.0-25.0 cm), Collimator_X2 (-20.0-25.0 cm), Collimator_Y1 (-20.0-25.0 cm), Collimator_Y2 (-20.0-25.0 cm), and MLC_LPn (-25.00-25.00 cm) depending on Beam Limiting Device Type (300A, 00B8).

(300A,011E) >> Gantry Angle 1C This attribute translates to Arc_Start_Angle, Arc_Stop_Angle and Gantry_Angle, and ranges from –360.0 to 360.0 degrees.

(300A,011F) >> Gantry Rotation Direction

1C Direction of gantry rotation when viewing gantry from isocenter. CW = clockwise CC = counter-clockwise NONE = no rotation. This attribute is translated to Arc_Direction and Gantry_Dir.

(300A,0120) >> Beam Limiting Device Angle

1C This attribute is translated to Collimator_Angle and ranges from –360.0 to 360.0 degrees.

(300A,0121) >> Beam Limiting Device Rotation Direction

1C Direction of beam limiting device rotation when viewing beam limiting device from radiation source. CW = clockwise CC = counter-clockwise NONE = no rotation. This attribute is translated to Collimator_Dir.

(300A,0122) >> Patient Support Angle

1C This attribute is translated to Couch_Angle and ranges from –20.0 to 380.0 degrees.

(300A,0123) >> Patient Support Rotation Direction

1C Direction of patient support rotation when viewing table from above. CW = clockwise CC = counter-clockwise NONE = no rotation. This attribute is translated to Couch_Dir.

(300A,0125) >> Table Top Eccentric Angle

1C This attribute is translated to Couch_Pedestal and ranges from –20.0 to 380.0 degrees.






(300A,0126) >> Table Top Eccentric Rotation Direction

1C Direction of table top eccentric rotation when viewing table from above. CW = clockwise CC = counter-clockwise NONE = no rotation. This attribute is translated to Couch_Ped_Dir.

(300A,0128) >> Table Top Vertical Position

2C Table Top Vertical Position (mm). This attribute is translated to Couch_Vertical and ranges from -999.9 to 999.9 cm.

(300A,0129) >> Table Top Longitudinal Position

2C Table Top Longitudinal Position (mm). This attribute is translated to Couch_Longitudinal and ranges from -999.9 to 999.9 cm.

(300A,012A) >> Table Top Lateral Position

2C Table Top Lateral Position (mm). This attribute is translated to Couch_Lateral and ranges from -999.9 to 999.9 cm.

(300A,0130) >> Source to Surface Distance

3 Source to Patient Surface distance (mm). This attribute is translated to SSD and ranges from 10.0 to 999.9 cm.

(300A,0134) >> Cumulative Meterset Weight

2C Cumulative Weight to current control point. This attribute is used for calculating Monitor_Units ( = Cumulative Meterset Weight divided by Final Cumulative Meterset Weight).

(300C,0050) >> Referenced Dose Reference Sequence

3 Introduces sequence of Dose References for current Beam. Each Dose Reference translates to either a Primary Site (if Dose Reference Type is TARGET) or Secondary Site (if Dose Reference Type is ORGAN_AT_RISK) for the current Beam.

(300A,010C) >>> Cumulative Dose Reference Coefficient

2C Coefficient used to calculate cumulative dose contribution from this Beam to the referenced Dose Reference. This attribute is translated to Reg_Coeff and ranges from 0 to 9.99999.

(300C,0051) >>> Referenced Dose Reference Number

1C Uniquely identifies Dose Reference specified by Dose Reference Number in Dose Reference Sequence in RT Prescription module.

7.3.10 APPROVAL MODULE


(300E,0002) Approval Status 1 Approval status at the time the SOP Instance was created. APPROVED = Reviewer recorded that object met an implied

criterion UNAPPROVED = No review of object has been recorded REJECTED = Reviewer recorded that object failed to meet an

implied criterion (300E,0008) Reviewer’s Name 2C Name of person who reviewed object. Required if Approval

Status (300E, 0002) is APPROVED or REJECTED. This attribute is translated to MD_Approve_LName (20 characters), MD_Approve_FName (20 characters) and MD_Approve_Minitial (1 character).

MOSAIQ DICOM Conformance Statement Appendix C




8 APPENDIX C 8.1 SPECIFIC CONFORMANCE FOR RT ION PLAN IMPORT AND EXPORT The Radiotherapy Ion Plan Information Object Definition (RT Ion Plan IOD) is used to transfer treatment plans generated by manual entry, a virtual simulation system or a treatment planning system before or during a course of treatment.

RT Ion Plans received by DCM are stored directly as DICOM Part 10 files that the MOSAIQ application then imports. The MOSAIQ application performs an import process that extracts information from the DICOM Part 10 file and stores the information in the database. DCM and the MOSAIQ application work together, acting as an SCP of the Storage Service Class for the RT Ion Plan IOD.

DCM provides Standard Conformance to the standard extended DICOM RT Ion Plan Storage Class at Level 2 (full) as an SCP. However, Information stored in the database is accessed by the MOSAIQ application for display, editing, etc. which is equivalent to Level 0 (local). Information may be stored indefinitely or deleted from the database using MOSAIQ.

8.2 RT ION PLAN IOD MODULES The following table identifies the modules used when translating an RT Ion Plan object into the database. A module is shown with a reference of Not Used if none of its attributes are accessed during translation or import.


Patient §8.3.1 M General Study §8.3.2 M Patient Study Not Used U

RT Series §8.3.3 M General Equipment Not Used M

RT General Plan §8.3.4 M RT Prescription §8.3.5 U RT Ion Tolerance Tables

Not Used U

RT Patient Setup Not Used U RT Fraction Scheme §8.3.6 U RT Ion Beams §8.3.7 C – Required if RT Fraction Scheme Module exists and Number of

Beams is greater than zero for one or more fraction groups. RT Brachy Application Setups


Approval Not Used U

Audio Not Used U SOP Common §8.3.8 M






M mandatory Module.








8.3.1 PATIENT MODULE The following table lists the attributes that are used to match the RT Ion Plan with a patient in the database. If the patient in the RT Ion Plan cannot be identified and uniquely matched with an existing patient in the database, the RT Ion Plan is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the RT Ion Plan. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the RT Ion Plan.


(0010,0010) Patient’s Name 2 Patient’s full legal name. The import process is configured to use the last name in this attribute, in addition to Patient ID, to match the RT Ion Plan with a patient in the database. The first 40 characters of the last name and the first 20 characters of the first name in this attribute are used.

(0010,0020) Patient ID 2 Primary hospital identification number or code for the patient. The RT Plan will only be imported if this attribute and Patient’s Name can be uniquely matched with an existing patient in the database. Only the first 20 characters of this attribute are used.



(0008,0020) Study Date 2 YYYYMMDD is parsed and mapped to RTO:Course:Course_Date

(0008,0030) Study Time 2 HHMMSS is parsed and mapped to RTO:Course:Course_Time







(0008,0060) Modality 1 Type of equipment that originally acquired the data. Enumerated value must be RTPLAN.



(0008,1070) Operator’s Name 2 Name of operator creating treatment plan. This attribute is translated to Author_Last_Name (20 characters), Author_First_Name (20 characters) and Author_Minitial (1 character).

(300A,0002) RT Plan Label 1 Mapped to RTO:Plan_Desc:External_Plan_ID. If this attribute contains numbers, the first 2 numeric digits are translated to Course_ID (1-99).

(300A,0006) RT Plan Date 2 This attribute is translated to Plan_Date (yyyymmdd). (300A,0007) RT Plan Time 2 This attribute is translated to Plan_Time (hhmmss). (300A,0009) Treatment Protocols 3 Mapped to RTO:Plan_Desc:Treatment_Protocols

(300A,000A) Plan Intent 3 Mapped to RTO:Plan_Desc:Treatment_Intent. Diverted to a separate storage location if VERIFICATION. Cannot be imported if the value is not one of the Defined Terms.

8.3.5 RT PRESCRIPTION MODULE The following table lists the attributes that are used to create primary and secondary treatment sites for the patient. If Dose Reference Description conflicts with an existing Primary Treatment Site Name or Secondary Treatment Region Name in the database, the dose reference is not imported.



3 User-defined description of treatment prescription.

(300A,0010) Dose Reference Sequence

3 Introduces sequence of Dose References.

(300A,0012) > Dose Reference Number

1C Identification number of the Dose Reference. This attribute is translated to Rx_Site_Name if Dose Reference Description does not exist or is NULL.

(300A,0016) > Dose Reference Description

3 This attribute is translated to Rx_Site_Name if Dose Reference Type (300A,0020) is TARGET, or Region_Name if Dose Reference Type is ORGAN_AT_RISK.




1 Introduces sequence of Fraction Groups in current Fraction Scheme. Only one Fraction Group Sequence Item is supported.






(300A,0080) > Number of Beams 1 Number of Beams in current Fraction Group. This attribute is translated to Number of Fields (1-999) for the current Prescription Site.



(300A,0084) >> Beam Dose 3 This attribute is translated to Field Dose (Gy to cGy) and ranges from 0.01 to 9999.99 cGy.

(300A,0086) >> Beam Meterset 3 If the Primary Dosimeter Unit (300A, 00B3) is MU, this attribute is translated to Field_Monitor_Units (0.01-9999.99)



8.3.7 RT ION BEAMS MODULE The following table lists the attributes that are used to create a new treatment field for the patient. Only Beams with a Treatment Delivery Type of TREATMENT are translated to treatment fields. Beams that do not have the Treatment Delivery Type attribute cannot be imported. If Beam Name conflicts with an existing Treatment Field ID for the patient in the database, the existing treatment field’s revision is incremented and the imported field is imported as the current revision. Otherwise a new treatment field is created. If any of the beams have a Treatment Machine Name that does not match an existing Treatment Machine in the database, the plan cannot be imported.


(300A,00B0) Ion Beam Sequence 1 Introduces sequence of treatment beams for current RTIon Plan.

(300A,00C0) >Beam Number 1 Identification number of the Beam. The value of Beam Number (300A,00C0) shall be unique within the RT Ion Plan in which it is created

(300A,00C2) >Beam Name 1 User-defined name for Beam. (300A,00C3) >Beam Description 3 User-defined description for Beam.

(300A,00C4) >Beam Type 1 Motion characteristic of Beam. Enumerated Values: STATIC = all beam parameters remain unchanged during delivery DYNAMIC = one or more beam parameters changes during delivery

(300A,00C6) >Radiation Type 1 Particle type of Beam. Accepted Defined Terms: PROTON (Import will not proceed if Radiation Type is PHOTON. Export will include Radiation Type PHOTON for beams whose purpose is imaging)






(300A,0308) >Scan Mode 1 The method of beam scanning to be used during treatment. Accepted Defined Terms: NONE = No beam scanning is performed. MODULATED = The beam is scanned between control points to create a modulated lateral fluence distribution across the field.

(300A,00B2) >Treatment Machine Name

2 User-defined name identifying treatment machine to be used for beam delivery.

(300A,00B3) >Primary Dosimeter Unit

1 Measurement unit of machine dosimeter. Enumerated Values: MU = Monitor Unit NP = number of particles

(300A,030A) >Virtual Source-Axis Distances

1 Distance (in mm) from virtual source position to gantry rotation axis or nominal isocenter position (fixed beam-lines) of the equipment to be used for beam delivery. Specified by a numeric pair - the VSAD in the IEC Gantry X direction followed by the VSAD in the IEC Gantry Y direction. The VSAD is commonly used for designing apertures in contrast to the effective source-axis-distance (ESAD) that is commonly used with the inverse square law for calculating the dose decrease with distance

(300A,00E0) >Number of Compensators

1 Number of compensators associated with current Beam.

(300A,02E3) >Total Compensator Tray Water-Equivalent Thickness

3 Water-Equivalent thickness of the compensator tray (in mm) parallel to radiation beam axis.

(300A,02EA) >Ion Range Compensator Sequence

1C Introduces sequence of compensators. Required if Number of Compensators (300A,00E0) is non-zero. The number of items shall be identical to the value of Number of Compensators (300A,00E0).

(300A,00E4) >>Compensator Number

1 Identification number of the Compensator. The value of Compensator Number (300A,00E4) shall be unique within the Beam in which it is created.

(300A,00E1) >>Material ID 2 User-supplied identifier for material used to manufacture Compensator.

(300A,00E5) >>Compensator ID 3 User-supplied identifier for the compensator. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader. (300A,02E4) >>Isocenter to

Compensator Tray Distance

1C Isocenter to compensator tray attachment edge distance (in mm) for current range compensator. Required if Compensator Mounting Position (300A,02E1) is not DOUBLE_SIDED.






(300A,02E0) >>Compensator Divergence

1 Indicates presence or absence of geometrical divergence of the range compensator. Enumerated Values: PRESENT = the range compensator is shaped according to the beam geometrical divergence. ABSENT = the range compensator is not shaped according to the beam geometrical divergence.

(300A,02E1) >>Compensator Mounting Position

1 Indicates on which side of the Compensator Tray the compensator is mounted. Enumerated Values: PATIENT_SIDE = the Compensator is mounted on the side of the Compensator Tray that is towards the patient. SOURCE_SIDE = the Compensator is mounted on the side of the Compensator Tray that is towards the radiation source. DOUBLE_SIDED = the Compensator has a shaped (i.e. non-flat) surface on both sides of the Compensator Tray.

(300A,00E7) >>Compensator Rows 1 Number of rows in the range compensator.

(300A,00E8) >>Compensator Columns

1 Number of columns in the range compensator.

(300A,00E9) >>Compensator Pixel Spacing

1 Physical distance (in mm) between the center of each pixel projected onto machine isocentric plane. Specified by a numeric pair - adjacent row spacing followed by adjacent column spacing.

(300A,00EA) >>Compensator Position

1 The x and y coordinates of the upper left hand corner (first pixel transmitted) of the range compensator, projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm).

(300A,02E5) >>Compensator Column Offset

1C The offset distance (in mm) applied to the x coordinate of the Compensator Position (300A,00EA) for even numbered rows. Required if the compensator pattern is hexogonal.

(300A,00EC) >>Compensator Physical Thickness Data

1 A data stream of the pixel samples that comprise the range compensator, expressed as physical thickness (in mm), either parallel to radiation beam axis if Compensator Divergence (300A,02E0) equals ABSENT, or divergent according to the beam geometrical divergence if Compensator Divergence (300A,02E0) equals PRESENT. The order of pixels sent is left to right, top to bottom (upper left pixel, followed by the remainder of row 1, followed by the remainder of the rows).






(300A,02E6) >>Isocenter to Compensator Distances

1C A data stream of the pixel samples that comprise the distance from the isocenter to the compensator surface closest to the radiation source (in mm). The order of pixels sent is left to right, top to bottom (upper left pixel, followed by the remainder of row 1, followed by the remainder of the rows). Required if Material ID (300A,00E1) is non-zero length, and Compensator Mounting Position (300A,02E1) is DOUBLE_SIDED.

(300A,02E7) >>Compensator Relative Linear Stopping Power Ratio

3 Compensator Linear Stopping Power Ratio, relative to water, at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Ion Control Point Sequence (300A,03A8).

(300A,02E8) >>Compensator Milling Tool Diameter

3 The diameter (in mm) of the milling tool to be used to create the compensator. The diameter is expressed as the actual physical size and not a projected size at isocenter.

(300A,00F0) >Number of Blocks 1 Number of shielding blocks associated with Beam. (300A,00F3) >Total Block Tray

Water-Equivalent Thickness

3 Water-Equivalent thickness of the block tray (in mm) parallel to radiation beam axis.

(300A,03A6) >Ion Block Sequence 1C Introduces sequence of blocks associated with Beam. Required if Number of Blocks (300A,00F0) is non-zero. The number of items shall be identical to the value of Number of Blocks (300A,00F0).

(300A,00F5) >>Block Tray ID 3 User-supplied identifier for block tray.

(300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar code reader.

(300A,00F7) >>Isocenter to Block Tray Distance

1 Isocenter to downstream edge of block tray (mm). Required if Block Sequence (300A,00F4) is sent.

(300A,00F8) >>Block Type 1 Type of block Enumerated Values: SHIELDING = blocking material is inside contour APERTURE = blocking material is outside contour

(300A,00FA) >>Block Divergence 1 Indicates presence or otherwise of geometrical divergence. Enumerated Values: PRESENT = block edges are shaped for beam divergence ABSENT = block edges are not shaped for beam divergence

(300A,00FB) >>Block Mounting Position

1 Indicates on which side of the Block Tray the block is mounted. Enumerated Values; PATIENT_SIDE = the block is mounted on the side of the Block Tray that is towards the patient. SOURCE_SIDE = the block is mounted on the side of the Block Tray that is towards the radiation source.






(300A,00FC) >>Block Number 1 Identification number of the Block. The value of Block Number (300A,00FC) shall be unique within the Beam in which it is created.

(300A,00FE) >>Block Name 3 User-defined name for block. (300A,00E1) >>Material ID 2 User-supplied identifier for material used to manufacture

Block. (300A,0100) >>Block Thickness 1 Physical thickness of block (in mm) parallel to radiation

beam axis. (300A,0104) >>Block Number of

Points 1 Number of (x,y) pairs defining the block edge.

(300A,0106) >>Block Data 1 A data stream of (x,y) pairs that comprise the block edge. The number of pairs shall be equal to Block Number of Points (300A,0104), and the vertices shall be interpreted as a closed polygon. Coordinates are projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm).

(300A,030C) >Snout Sequence 3 Introduces sequence of Snouts associated with Beam. Only a single item shall be permitted in this sequence.

(300A,030F) >>Snout ID 1 User or machine supplied identifier for Snout. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader. (300A,0312) >Number of Range

Shifters 1 Number of range shifters associated with current beam.

(300A,0314) >Range Shifter Sequence

1C Introduces sequence of range shifters associated with Beam. Required if Number of Range Shifters (300A,0312) is non-zero. The number of items shall be identical to the value of Number of Range Shifters (300A,0312).

(300A,0316) >>Range Shifter Number

1 Identification number of the Range Shifter. The value of Range Shifter Number (300A,0316) shall be unique within the Beam in which it is created.

(300A,0318) >>Range Shifter ID 1 User or machine supplied identifier for Range Shifter.


(300A,0320) >>Range Shifter Type 1 Type of Range Shifter. Defined Terms: ANALOG = Device is variable thickness and is composed of opposing sliding wedges, water column or similar mechanism. BINARY = Device is composed of different thickness materials that can be moved in or out of the beam in various stepped combinations.

(300A,0322) >>Range Shifter Description

3 User defined description of Range Shifter.






(300A,0330) >Number of Lateral Spreading Devices

1 Number of lateral spreading devices associated with current beam.

(300A,0332) >Lateral Spreading Device Sequence

1C Introduces sequence of lateral spreading devices associated with Beam. Required if Number of Lateral Spreading Devices (300A,0330) is non-zero. The number of items shall be identical to the value of Number of Lateral Spreading Devices (300A,0330).

(300A,0334) >>Lateral Spreading Device Number

1 Identification number of the Lateral Spreading Device. The value of Lateral Spreading Device Number (300A,0334) shall be unique within the Beam in which it is created.

(300A,0336) >>Lateral Spreading Device ID

1 User or machine supplied identifier for Lateral Spreading Device.


(300A,0338) >>Lateral Spreading Device Type

1 Type of Lateral Spreading Device. Defined Terms: SCATTERER = metal placed into the beam path to scatter charged particles laterally. MAGNET = nozzle configuration of magnet devices to expand beam laterally.

(300A,033A) >>Lateral Spreading Device Description

3 User-defined description for lateral spreading device.

(300A,0340) >Number of Range Modulators

1 Number of range modulators associated with current beam.

(300A,0342) >Range Modulator Sequence

1C Introduces sequence of range modulators associated with Beam. Required if Number of Range Modulators (300A,0340) is non-zero. The number of items shall be identical to the value of Number of Range Modulators (300A,0340).

(300A,0344) >>Range Modulator Number

1 Identification number of the Range Modulator. The value of Range Modulator Number (300A,0344) shall be unique within the Beam in which it is created.

(300A,0346) >>Range Modulator ID 1 User or machine supplied identifier for Range Modulator. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader.






(300A,0348) >>Range Modulator Type

1 Type of Range Modulator. Defined Terms: FIXED = fixed modulation width and weights using ridge filter or constant speed wheel with constant beam current WHL_FIXEDWEIGHTS = selected wheel/track (Range Modulator ID) is spinning at constant speed. Modulation width is adjusted by switching constant beam current on and off at wheel steps indicated by Range Modulator Gating Values. WHL_MODWEIGHTS = selected wheel/track (Range Modulator ID) is spinning at constant speed. Weight per wheel step is adjusted by modulating beam current according to selected Beam Current Modulation ID (300A,034C). Only one item in the Range Modulator Sequence (300A,0342) can have a Range Modulator Type (300A,0348) of WHL_MODWEIGHTS.

(300A,034A) >>Range Modulator Description

3 User-defined description of Range Modulator.

(300A,034C) >>Beam Current Modulation ID

1C User-supplied identifier for the beam current modulation pattern. Required if Range Modulator Type (300A,0348) is WHL_MODWEIGHTS

(300A,010E) >Final Cumulative Meterset Weight

1C Value of Cumulative Meterset Weight (300A,0134) for final Control Point in Ion Control Point Sequence (300A,03A8). Required if Cumulative Meterset Weight is non-null in Control Points specified within Ion Control Point Sequence.

(300A,0110) >Number of Control Points

1 Number of control points in Beam. Value shall be greater than or equal to 2.

(300A,03A8) >Ion Control Point Sequence

1 Introduces sequence of machine configurations describing Ion treatment beam. The number of items shall be identical to the value of Number of Control Points (300A,0110).

(300A,0112) >>Control Point Index 1 Index of current Control Point, starting at 0 for first Control Point.

(300A,0134) >>Cumulative Meterset Weight

2 Cumulative weight to current control point. Cumulative Meterset Weight for the first item in Control Point Sequence shall always be zero. Cumulative Meterset Weight for the final item in Ion Control Point Sequence shall always be equal to Final Cumulative Meterset Weight.

(300C,0050) >>Referenced Dose Reference Sequence

3 Introduces a sequence of Dose References for current Beam. One or more items may be included in this sequence.

(300C,0051) >>>Referenced Dose Reference Number

1 Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module.

(300A,010C) >>>Cumulative Dose Reference Coefficient

2 Coefficient used to calculate cumulative dose contribution from this Beam to the referenced Dose Reference at the current Control Point.






(300A,0114) >>Nominal Beam Energy

1C Nominal Beam Energy at control point in MeV per nucleon. Defined at nozzle entrance before all Beam Modifiers. Required for first item of Control Point Sequence, or if Nominal Beam Energy changes during Beam, and KVp (0018,0060) is not present.

(300A,035A) >>Meterset Rate 3 Specifies the speed of delivery of the specified dose in units specified by Primary Dosimeter Unit (300A,00B3) per minute.

(300A,0360) >>Range Shifter Settings Sequence

1C Introduces sequence of Range Shifter settings for the current control point. One or more items shall be included in this sequence. Required for first item of Control Point Sequence if Number of Range Shifters (300A,0312) is non-zero, or if Range Shifter Setting (300A,0362) changes during Beam.

(300C,0100) >>>Referenced Range Shifter Number

1 Uniquely references Range Shifter described by Range Shifter Number (300A,0316) in Range Shifter Sequence (300A,0314).

(300A,0362) >>>Range Shifter Setting

1 Machine specific setting attribute for the range shifter. The specific encoding of this value should be documented in a Conformance Statement.

(300A,0364) >>>Isocenter to Range Shifter Distance

3 Isocenter to downstream edge of range shifter (mm) at current control point.

(300A,0366) >>>Range Shifter Water Equivalent Thickness

3 Water equivalent thickness (in mm) of the range shifter at the central axis for the beam energy incident upon the device.

(300A,0370) >>Lateral Spreading Device Settings Sequence

1C Introduces sequence of Lateral Spreading Device settings for the current control point. One or more items shall be included in this sequence. Required for first item of Control Point Sequence if Number of Lateral Spreading Devices (300A,0330) is non-zero, or if Lateral Spreading Device Setting (300A,0372) changes during Beam.

(300C,0102) >>>Referenced Lateral Spreading Device Number

1 Uniquely references Lateral Spreading Device described by Lateral Spreading Device Number (300A,0334) in Lateral Spreading Device Sequence (300A,0332).

(300A,0372) >>>Lateral Spreading Device Setting

1 Machine specific setting attribute for the lateral spreading device. The specific encoding of this value should be documented in a Conformance Statement.

(300A,0380) >>Range Modulator Settings Sequence

1C Introduces sequence of Range Modulator Settings for current control point. One or more items shall be included in this sequence. Required for first item of Control Point Sequence if Number of Range Modulators (300A,0340) is non-zero, or if Range Modulator Setting changes during Beam.

(300C,0104) >>>Referenced Range Modulator Number

1 Uniquely references Range Modulator described by Range Modulator Number (300A,0344) in Range Modulator Sequence (300A,0342).






(300A,0382) >>>Range Modulator Gating Start Value

1C Start position defines the range modulator position at which the beam is switched on. Required if Range Modulator Type (300A,0348) of the range modulator referenced by Referenced Range Modulator Number (300C,0104) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS

(300A,0384) >>>Range Modulator Gating Stop Value

1C Stop position defines the range modulator position at which the beam is switched off. Required if Range Modulator Type (300A,0348) of the range modulator referenced by Referenced Range Modulator Number (300C,0104) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS

(300A,011E) >>Gantry Angle 1C Gantry angle of radiation source, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for first item of Control Point Sequence, or if Gantry Angle changes during Beam.

(300A,011F) >>Gantry Rotation Direction

1C Direction of Gantry Rotation when viewing gantry from isocenter, for segment following Control Point. Required for first item of Control Point Sequence, or if Gantry Rotation Direction changes during Beam. CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,014A) >>Gantry Pitch Angle 2C Gantry Pitch Angle of the radiation source, i.e. the rotation of the IEC GANTRY coordinate system about the X-axis of the IEC GANTRY coordinate system (degrees). Required for first item of Control Point Sequence, or if Gantry Pitch Rotation Angle changes during Beam.

(300A,014C) >>Gantry Pitch Rotation Direction

2C Direction of Gantry Pitch Angle when viewing along the positive X-axis of the IEC GANTRY coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Gantry Pitch Rotation Direction changes during Beam. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0122) >>Patient Support Angle

1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for first item of Control Point Sequence, or if Patient Support Angle changes during Beam.






(300A,0123) >>Patient Support Rotation Direction

1C Direction of Patient Support Rotation when viewing table from above, for segment following Control Point. Required for first item of Control Point Sequence, or if Patient Support Rotation Direction changes during Beam. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0140) >>Table Top Pitch Angle

2C Table Top Pitch Angle, i.e. the rotation of the IEC TABLE TOP coordinate system about the X-axis of the IEC TABLE TOP coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Pitch Angle changes during Beam.

(300A,0142) >>Table Top Pitch Rotation Direction

2C Direction of Table Top Pitch Rotation when viewing the table along the positive X-axis of the IEC TABLE TOP coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Pitch Rotation Direction changes during Beam. See C.8.8.14.8 and C.8.8.25.6.2. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0144) >>Table Top Roll Angle 2C Table Top Roll Angle, i.e. the rotation of the IEC TABLE TOP coordinate system about the Y-axis of the IEC TABLE TOP coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Roll Angle changes during Beam.

(300A,0146) >>Table Top Roll Rotation Direction

2C Direction of Table Top Roll Rotation when viewing the table along the positive Y-axis of the IEC TABLE TOP coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Roll Rotation Direction changes during Beam. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation.

(300A,0128) >>Table Top Vertical Position

2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Vertical Position changes during Beam.

(300A,0129) >>Table Top Longitudinal Position

2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Longitudinal Position changes during Beam.






(300A,012A) >>Table Top Lateral Position

2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Lateral Position changes during Beam.

(300A,0390) >>Scan Spot Tune ID 1C User-supplied or machine code identifier for machine configuration to produce beam spot. This may be the nominal spot size or some other machine specific value. Required if Scan Mode (300A,0308) is MODULATED

(300A,0392) >>Number of Scan Spot Positions

1C Number of spot positions used to specify scanning pattern for current segment beginning at control point. Required if Scan Mode (300A,0308) is MODULATED.

(300A,0394) >>Scan Spot Position Map

1C The x and y coordinates of the scan spots are defined as projected onto the machine isocentric plane in the IEC GANTRY coordinate system (mm). Required if Scan Mode (300A,0308) is MODULATED. Contains 2N values where N is the Nof Scan Spot Positions (300A,0392).

(300A,0396) >>Scan Spot Meterset Weights

1C A data set of meterset weights corresponding to scan spot positions. The order of weights matches the positions in Scan Spot Positions (300A,0394). The sum contained in all meterset weights shall match the difference of the cumulative meterset weight of the current control point to the following control point. Required if Scan Mode (300A,0308) is MODULATED.

(300A,0398) >>Scanning Spot Size 3 The Scanning Spot Size as calculated using the Full Width Half Maximum (FWHM). Specified by a numeric pair - the size measured in air at isocenter in IEC GANTRY X direction followed by the size in the IEC GANTRY Y direction (mm).






(300A,039A) >>Number of Paintings 1C The number of times the scan pattern given by Scan Spot Position Map (300A,0394) and Scan Spot Meterset Weights (300A,0396) shall be applied at the current control point. To obtain the meterset weight per painting, the values in the Scan Spot Meterset Weights (300A,0396) should be divided by the value of this attribute. Required if Scan Mode (300A,0308) is MODULATED.

(300A,030D) >>Snout Position 2C Axial position of the snout (in mm) measured from isocenter to the downstream side of the snout (without consideration of variable length elements such as blocks, MLC and/or compensators). Required for first item in Control Point Sequence, or if Snout Position changes during Beam.



(0008,0005) Specific Character Set 1C Character Set that expands or replaces the Basic Graphic Set. This attribute is not explicitly used; all characters in strings are assumed to be from the Default Character Repertoire as defined in {DICM}.

(0008,0016) SOP Class UID 1 Uniquely identifies the SOP Class, must match “1.2.840.10008.5.1.4.1.1.481.8”

MOSAIQ DICOM Conformance Statement Appendix D




9 APPENDIX D 9.1 SPECIFIC CONFORMANCE FOR RT STRUCTURE SET IMPORT The Radiotherapy Structure Set Information Object Definition (RT Structure Set IOD) is used to transfer contours and references to CT volume data generated by a virtual simulation system or a treatment planning system before or during a course of treatment.

RT Structure Sets received by DCM are stored directly to the MOSAIQ database with a small portion of the data in the Information Object parsed and stored in the database for indexing and reference purposes. The MOSAIQ application provides a User Interface to enable selection and association of a particular RT Structure Set with a MOSAIQ Rx Site.

DCM provides Standard Conformance to the standard DICOM RT Structure Set Class at Level 2 (Full) as an SCP. Information stored in the database is accessed by the MOSAIQ application for display and export only. Information may be stored indefinitely. RT Structure Sets can be deleted from the database if the referenced Image Series is deleted (but cannot be deleted individually) in the MOSAIQ 2.50 product release. This will be supported in a later MOSAIQ release.

9.2 RT STRUCTURE SET IOD MODULES The following table identifies the modules used when storing the file into the database. A module is shown with a reference of Not Used if none of its attributes are accessed during storage.


Patient §9.3.1 M General Study §9.3.2 M Patient Study Not Used U

RT Series §9.3.3 M General Equipment Not Used M

Structure Set §9.3.4 M RT ROI Contour §9.3.5 M RT ROI Observations §9.3.6 M

Approval Not Used U SOP Common §9.3.7 M


M mandatory Module.












9.3.1 PATIENT MODULE The following table lists the attributes that are used to match the RT Structure Set with a patient in the database. If the patient in the RT Structure Set cannot be identified and uniquely matched with an existing patient in the database, the RT Structure Set is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the RT Structure Set. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the RT Structure Set.


(0010,0010) Patient’s Name 2 Patient’s full legal name. The import process is configured to use the last name in this attribute, in addition to Patient ID, to match the RT Structure Set with a patient in the database. The first 40 characters of the last name and the first 20 characters of the first name in this attribute are used.

(0010,0020) Patient ID 2 Primary hospital identification number or code for the patient. The RT Structure Set will only be imported if this attribute and Patient’s Name can be uniquely matched with an existing patient in the database. Only the first 20 characters of this attribute are used.



(0020,000D) Study Instance UID 1 Unique Identifier for the Study.

(0020,0010) Study ID 2 User or equipment generated Study identifier

(0008,1030) Study Description 3 Institution-generated description or classification of the Study (component) performed



(0008,0060) Modality 1 Type of equipment that originally acquired the data. Enumerated value must be RTSTRUCT.

(0020,000E) Series Instance UID 1 Unique Identifier of the Series

(0020,0011) Series Number 2 A number that identifies this Series (0020,103E Series Description 3 User provided description of the Series

9.3.4 STRUCTURE SET MODULE







(3006,0002) Structure Set Label 1 Required for import User Defined label for Structure Set

(3006,0004) Structure Set Name 3 Not required but used if present User Defined name for Structure Set

(3006,0006) Structure Set Description

3 Not required but used if present User Defined description for Structure Set

(0020,0013) Instance Number 3 Not imported A number that identifies this object instance

(3006,0008) Structure Set Date 2 Not required but used if present Date at which Structure Set was last modified

(3006,0009) Structure Set Time 2 Not required but used if present Time at which Structure Set was last modified

(3006,0010) Referenced Frame of Reference Sequence

3 Not required but used if present NOTE: Only 1 value supported in internal storage Introduces sequence of items describing Frames of Reference in which the ROIs are defined. One or more items are permitted in this sequence.

(0020,0052) >Frame of Reference UID

1 Uniquely identifies Frame of Reference within Structure Set

(3006,0012) >RT Referenced Study Sequence

3 Not required but used if present Introduces sequence of studies containing series to be referenced. One or more items are permitted in this sequence.

>>Include ‘SOP Instance Reference Macro’

(3006,0014) >>RT Referenced Series Sequence

1 Introduces sequence of items describing series of images which are used in defining the Structure Set. One or more items shall be included in this sequence. NOTE: Only 1 value supported in internal storage

(0020,000E) >>>Series Instance UID 1 Unique identifier for the series containing the images (3006,0016) >>>Contour Image

Sequence 1 Introduces sequence of items describing images in a given

series used in defining the Structure Set (typically CT or MR images). One or more items shall be included in this sequence.

>>>>Include ‘Image SOP Instance Reference Macro’






(3006,0020) Structure Set ROI Sequence

3 Required for import NOTE: At least one item in this Sequence required. Introduces sequence of ROIs for current Structure Set. One or more items are permitted in this sequence.

(3006,0022) >ROI Number 1 Identification number of the ROI. The value of ROI Number shall be unique within the Structure Set in which it is created.

(3006,0024) >Referenced Frame of Reference UID

1 Uniquely identifies Frame of Reference in which ROI is defined, specified by Frame or Reference UID in Referenced Frame of Reference Sequence.

(3006,0026) >ROI Name 2 Not required for import but used if present User-defined name for ROI.

(3006,0028) >ROI Description 3 Not required for import but used if present User-defined description of ROI.

(3006,002C) >ROI Volume 3 Not required for import but used if present Volume of ROI (cubic cm)

(3006,0036) >ROI Generation Algorithm

2 Not required but used if present Defined Terms Supported:

• AUTOMATIC • SEMIAUTOMATIC • MANUAL

(3006,0038) >ROI Generation Description

3 Not required but used if present User-defined description of technique used to generate ROI

9.3.5 RT ROI CONTOUR MODULE


(3006,0039) ROI Contour Sequence 1 Introduces sequence of Contour Sequences defining ROIs. One or more items shall be included in this sequence.

(3006,0084) >Referenced ROI Number

1 Uniquely identifies the referenced ROI described in the Structure Set ROI Sequence.

(3006,002A) >ROI Display Color 3 Not required but used if present. RGB triplet color representation for ROI, specified using the range 0-255.

(3006,0040) >Contour Sequence 3 Not required but used if present. Introduces sequence of Contours defining an ROI. One or more items are permitted in this sequence.

(3006,0048) >>Contour Number 3 Not required but used if present Identification number of the Contour.






(3006,0016) >>Contour Image Sequence

3 Not imported Introduces sequence of images containing the Contour. One or more items are permitted in this sequence. NOTE: There is also a instance of the Contour Image Sequence (3006,0016) in the Structure Set Module that is required.

>>>Include ‘Image SOP Instance Reference Macro’

(3006,0042) >>Contour Geometric Type

1 Geometric type of contour Enumerated Values Supported: POINT CLOSED_PLANAR

(3006,0046) >>Number of Contour Points

1 Number of points (triplets) in Contour Data

(3006,0050) >>Contour Data 1 Sequence of (x,y,z) triplets defining a contour in the patient based coordinate system.

9.3.6 RT ROI OBSERVATIONS MODULE


(3006,0080) RT ROI Observations Sequence

1 Introduces sequence of observations related to ROIs defined in the ROI Module. One or more items shall be included in this sequence.

(3006.0082) >Observation Number 1 Identification number of the Observation. The value of Observation Number (3006,0082) shall be unique within the RT ROI Observations Sequence (3006,0080).

(3006,0084) >Referenced ROI Number

1 Uniquely identifies the referenced ROI described in the Structure Set ROI Sequence (3006,0020).

(3006,0085) >ROI Observation Label

3 Not Imported User-defined label for ROI Observation.

(3006,0088) >ROI Observation Description

3 Not Imported User-defined description for ROI Observation.

(3006,0030) >RT Related ROI Sequence

3 Not Imported

Introduces sequence of significantly related ROIs, e.g. CTVs contained within a PTV. One or more items are permitted in this sequence.

(3006,0084) >>Referenced ROI Number

1 Not Imported

Uniquely identifies the related ROI described in the Structure Set ROI Sequence (3006,0020).






(3006,0033) >>RT ROI Relationship 3 Not Imported Relationship of referenced ROI with respect to referencing ROI. Defined Terms: SAME = ROIs represent the same entity

ENCLOSED = referenced ROI completely encloses referencing ROI

ENCLOSING = referencing ROI completely encloses referenced ROI

(3006,0086) >RT ROI Identification Code Sequence

3 Not Imported Introduces sequence containing Code used to identify ROI. Only a single Item is permitted in this sequence.

>>Include ‘Code Sequence Macro’ Baseline CID 96

(3006,00A0) >Related RT ROI Observations Sequence

3 Not Imported Introduces sequence of related ROI Observations. One or more items are permitted in this sequence.

(3006,0082) >>Observation Number 1 Not Imported Uniquely identifies a related ROI Observation.






(3006,00A4) >RT ROI Interpreted Type

2 Not required but used if present; all Defined Terms supported Type of ROI. Defined Terms: EXTERNAL = external patient contour PTV = Planning Target Volume (as defined in ICRU50) CTV = Clinical Target Volume (as defined in ICRU50) GTV = Gross Tumor Volume (as defined in ICRU50)

TREATED_VOLUME = Treated Volume (as defined in ICRU50)

IRRAD_VOLUME = Irradiated Volume (as defined in ICRU50) BOLUS = patient bolus to be used for external beam therapy AVOIDANCE = region in which dose is to be minimized ORGAN = patient organ MARKER = patient marker or marker on a localizer REGISTRATION = registration ROI

ISOCENTER = treatment isocenter to be used for external beam therapy

CONTRAST_AGENT = volume into which a contrast agent has been injected CAVITY = patient anatomical cavity BRACHY_CHANNEL = brachytherapy channel BRACHY_ACCESSORY = brachytherapy accessory device BRACHY_SRC_APP = brachytherapy source applicator BRACHY_CHNL_SHLD = brachytherapy channel shield SUPPORT = external patient support device FIXATION = external patient fixation or immobilisation device DOSE_REGION = ROI to be used as a dose reference

CONTROL = ROI to be used in control of dose optimization and calculation

(3006,00A6) >ROI Interpreter 2 Not required but used if present Name of person performing the interpretation.

(300A,00E1) >Material ID 3 Not imported User-supplied identifier for ROI material.






(3006,00B0) >ROI Physical Properties Sequence

3 Not imported but warning message is logged if Sequence is absent

Introduces sequence describing physical properties associated with current ROI interpretation. One or more items are permitted in this sequence.

(3006,00B2) >>ROI Physical Property

1 Not Imported

Physical property specified by ROI Physical Property Value (3006,00B4). Defined Terms: REL_MASS_DENSITY = mass density relative to water REL_ELEC_DENSITY = electron density relative to water EFFECTIVE_Z = effective atomic number

EFF_Z_PER_A = ratio of effective atomic number to mass (AMU-1)

REL_STOP_RATIO = linear stopping power ratio relative to water ELEM_FRACTION = elemental composition of the material

(3006,00B6) >>ROI Elemental Composition Sequence

1C Not Imported

The elemental composition of the ROI and the atomic mass fraction of the elements in the ROI. Required if ROI Physical Property (3006,00B2) equals ELEM_FRACTION. One or more items shall be included in this sequence.

(3006,00B7) >>>ROI Elemental Composition Atomic Number

1 Not Imported The atomic number of the element for which the ROI Elemental Composition Sequence (3006,00B6) is sent.

(3006,00B8) >>>ROI Elemental Composition Atomic Mass Fraction

1 Not Imported The fractional weight of the element for which the ROI Elemental Composition Sequence (3006,00B6) is sent.

The sum of all ROI Elemental Composition Atomic Mass Fractions (3006,00B8) sent in the ROI Elemental Composition Sequence (3006,00B6) shall equal 1.0 within acceptable limits of floating point precision.

(3006,00B4) >>ROI Physical Property Value

1 Not Imported User-assigned value for physical property.









(0008,0018) SOP Instance UID 1 Uniquely identifies the SOP Instance. This is utilized to populate the Reference Structure Set Sequence within the RT General Plan Module when an RT Plan is exported by MOSAIQ for use in IGRT utilizing Cone Beam CT.

MOSAIQ DICOM Conformance Statement Appendix E




10 APPENDIX E 10.1 SPECIFIC CONFORMANCE FOR RT PLAN EXPORT The Radiotherapy Plan Information Object Definition (RT Plan IOD) is used to transfer treatment plans to a treatment delivery system (Linear Accelerator or LINAC Control Console). In addition to specification of parameters to be used by the LINAC, the RT PLAN is also commonly used to reference Images and Contours.

Communication between the Treatment Management System (MOSAIQ) and Treatment Delivery System (the LINAC control console) is not fully standardized, but the RT PLAN is commonly used as one of the standardized “building blocks” for this communication.

10.2 RT PLAN IOD MODULES The following table identifies the modules used when creating an RT Plan object. A module is shown with a reference of Not Used if none of its attributes are created/populated.


Patient §10.3.1 M General Study §10.3.2 M

Patient Study Not Used U RT Series §10.3.3 M

General Equipment §10.3.4 M RT General Plan §10.3.5 M RT Prescription §10.3.6 U

RT Tolerance Tables §10.3.7 U RT Patient Setup Not Used U RT Fraction Scheme §10.3.8 U

RT Beams §10.3.9 C – Required if RT Fraction Scheme Module exists and Number of Beams is greater than zero for one or more fraction groups.

RT Brachy Application Setups


Approval §10.3.10 U

Audio Not Used U SOP Common §10.3.11 M


M mandatory Module.







10.2.1 ELEKTA SYNERGY SPECIFIC MODULES/ELEMENTS

ELEKTA Synergy DICOM Private Group

DICOM RT Plan IOD Tag Name Description/Value

(0019,0010) Private Group Creator Name of Vendor who “owns” the private group: ELEKTA (0019,1001) Site ID A non-DICOM integer Identifier for the patient’s Rx Site

10.2.2 VARIAN 4D SPECIFIC MODULES/ELEMENTS Varian 4D DICOM Extended Interface module/Private Group:


(3253,1000) >Extended Interface Data See below (3253,1001) >Extended Interface Length The total length (bytes) of the XML stream contained in the

value of the Extended Interface Data attribute. (3253,1002) >Extended Interface Format ExtendedIF (3249,1000) >Maximum Treatment Time RTO:Field:Treatment_Time

The Extended Interface Data is an XML encoded string, formatted to Varian specifications. The following general requirements apply to the XML encoded string:

• Node names with empty data type attributes are parent XML nodes.

• The XML values are all text (not attributes).

• The data type defines the native type to which the XML text must be converted. The values of the nodes defined in the Extended Interface Data shall be set as follows:

Varian RT Plan Extended Data Interface Node Name Data Type Value

ExtendedVAPlanInterface None >Beams None For each RTO:Site:Field from 1 to RTO:Site:Number_Of_Fields: >>Beam None >>>ReferencedBeamNumber int The sequential number of the RTO:Field in the range of 1 to

RTO:Site:Number_Of_Fields. >>>BeamExtension None >>>>FieldType string If RTO:Field:Delivery_Intent is “SETUP”, then set to

SETUP. Otherwise, set to TREATMENT. >>>>RelatedTreatBeamNumber int The Beam Number of the Treatment Field for which this is

either a PORT, and MV Setup or a KV Setup >>>>Field Order int The sequential number of the RTO:Field in the range of 1 to

RTO:Site:Number_Of_Fields. >>>>GantryRtnExtendedStart Boolean (as

string) false

>>>>GantryRtnExtendedStop Boolean (as string)

false





10.2.3 SIEMENS DCI SPECIFIC MODULES/ELEMENTS Siemens DCI DICOM Private Group


(0037,0010) Private Group Creator Name of Vendor who “owns” the private group: SIEMENS MED OCS PUBLIC RT PLAN ATTRIBUTES

(0037,1000) Private data for Siemens in xml format

10.3 MODULE ATTRIBUTES This section lists the attributes of each module that are used by the translation and export process; attributes that are not exported are not shown. Restrictions on attribute values and usage are also listed. Refer to {DICM} for a complete definition of the Type notation, summarized as follows:





10.3.1 PATIENT MODULE The following table lists the attributes that are used to populate the RT Plan


(0010,0010) Patient’s Name 2 Patient’s full legal name. (0010,0020) Patient ID 2 Primary hospital identification number or code for the

patient. (0010,0030) Patient’s Birth Date 2 Birth date of the patient

(0010,0040) Patient's Sex 2 Sex (Gender) of the named Patient. Enumerated Values: M = male F = female O = other



(0020,000D) Study Instance UID 1 Unique identifier for the Study (0008,0020) Study Date 2 Date the Study started. (0008,0030) Study Time 2 Time the Study started.

(0008,0050) Accession Number 2 A RIS generated number that identifies the order for the Study. MOSAIQ takes the role of the RIS (as an Oncology Information System, OIS).

(0008,0090) Referring Physician's Name

2 Name of the patient's referring physician






(0020,0010) Study ID 2 User or equipment generated Study identifier (0008,1048) Physician(s) of Record 3 Names of the physician(s) who are responsible for overall

patient care at time of Study. (0008,1030) Study Description 3 Institution-generated description or classification of the

Study.



(0008,0060) Modality 1 Type of equipment that originally acquired the data. Enumerated value is RTPLAN.

(0020,000E) Series Instance UID 1 Unique identifier of the Series (0020,0011) Series Number 2 A number that identifies this Series



(0008,0070) Manufacturer 2 Manufacturer of the equipment that produced the composite instances. “IMPAC Medical Systems, Inc.”


3 Manufacturer’s model name of the equipment that produced the composite instances. “MOSAIQ”

(0018,1020) Software Versions 3 Manufacturer’s designation of software version of the equipment that produced the composite instances



(0008,1070) Operator’s Name 2 Name of operator delivering treatment plan.

(300A,0002) RT Plan Label 1 User-defined label for treatment plan. This attribute is translated from Plan_ID

(300A,0003) RT Plan Name 3 User-defined name for treatment plan (300A,0004) RT Plan Description 3 User-defined description for treatment plan

(300A,0006) RT Plan Date 2 Date treatment plan was last modified (in MOSAIQ) (300A,0007) RT Plan Time 2 Time treatment plan was last modified (in MOSAIQ) (300A,0009) Treatment Protocols 3 Planned treatment protocols.

(300A,000A) Plan Intent 3 Intent of the Plan Defined Terms: CURATIVE = curative therapy on patient PALLIATIVE = palliative therapy on patient PROPHYLACTIC = preventative therapy on patient

(300A,000C) RT Plan Geometry 1 Describes whether RT Plan is based on patient or treatment device geometry. See C.8.8.9.1. Defined Terms: PATIENT = RT Structure Set exists TREATMENT_DEVICE = RT Structure Set does not exist






(300C,0060) Referenced Structure Set Sequence

1C Introduces sequence of one Class/Instance pair describing instance of RT Structure Set on which the RT Plan is based. Only a single item shall be permitted in this sequence. Required if RT Plan Geometry (300A,000C) is PATIENT.


1C Uniquely identifies the referenced SOP Class. Required if Referenced Structure Set Sequence (300C,0060) is sent.


1C Uniquely identifies the referenced SOP Instance. Required if Referenced Structure Set Sequence (300C,0060) is sent.

10.3.6 RT PRESCRIPTION MODULE



3 User-defined description of treatment prescription. This attribute is translated from RX_Note.

10.3.7 RT TOLERANCE TABLES MODULE The following table lists the attributes used to match the RT Plan with an existing Tolerance Table in the database. If the Tolerance Table Label does not match an existing Tolerance Table ID in the database, the attributes in this module are not imported.


(300A,0040) Tolerance Table Sequence

3 Introduces sequence of tolerance tables.

(300A,0042) >Tolerance Table Number

1C Identification number of the Tolerance Table. The value of Tolerance Table Number (300A,0042) shall be unique within the RT Plan in which it is created. Required if Tolerance Table Sequence (300A,0040) is sent.

(300A,0043) > Tolerance Table Label 3 User-defined label for Tolerance Table.

(300A,0044) >Gantry Angle Tolerance

3 Maximum permitted difference (in degrees) between planned and delivered Gantry Angle.

(300A,0046) >Beam Limiting Device Angle Tolerance

3 Maximum permitted difference (in degrees) between planned and delivered Beam Limiting Device Angle.

(300A,0048) >Beam Limiting Device Tolerance Sequence

3 Introduces sequence of beam limiting device (collimator) tolerances. One or more items may be included in this sequence.






(300A,00B8) >>RT Beam Limiting Device Type

1C Type of beam limiting device (collimator). Required if Beam Limiting Device Tolerance Sequence (300A,0048) is sent. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction

(300A,004A) >>Beam Limiting Device Position Tolerance

1C Maximum permitted difference (in mm) between planned and delivered leaf (element) or jaw positions for current beam limiting device (collimator). Required if Beam Limiting Device Tolerance Sequence (300A,0048) is sent.

(300A,004C) >Patient Support Angle Tolerance

3 Maximum permitted difference (in degrees) between planned and delivered Patient Support Angle.

(300A,004E) >Table Top Eccentric Angle Tolerance

3 Maximum permitted difference (in degrees) between planned and delivered Table Top Eccentric Angle.

(300A,0051) >Table Top Vertical Position Tolerance

3 Maximum permitted difference (in mm) between planned and delivered Table Top Vertical Position.

(300A,0052) >Table Top Longitudinal Position Tolerance

3 Maximum permitted difference (in mm) between planned and delivered Table Top Longitudinal Position.

(300A,0053) >Table Top Lateral Position Tolerance

3 Maximum permitted difference (in mm) between planned and delivered Table Top Lateral Position.




1 Introduces sequence of Fraction Groups in current Fraction Scheme.

(300A,0071) >Fraction Group Number

1 Identification number of the Fraction Group. The value of Fraction Group Number (300A,0071) shall be unique within the RT Plan in which it is created.

(300A,0078) > Number of Fractions Planned

2 Total number of treatments (Fractions) prescribed for current Fraction Group.

(300A,0080) > Number of Beams 1 Number of Beams in current Fraction Group. If Number of Beams is greater than zero, Number of Brachy Application Setups (300A,00A0) shall equal zero.








(300A,0084) >> Beam Dose 3 Dose (in Gy) at Beam Dose Specification Point (300A,0082) due to current Beam. This attribute is translated from Field Dose and ranges from 0.0001 to 99.9999 Gy.

(300A,0086) >> Beam Meterset 3 Machine setting to be delivered for current Beam, specified in Monitor Units (MU) or minutes as defined by Primary Dosimeter Unit (300A,00B3) (in RT Beams Module) for referenced Beam.



(300A,00A0) >Number of Brachy Application Setups

1 Number of Brachy Application Setups in current Fraction Group. If Number of Brachy Application Setups is greater than zero, Number of Beams (300A,0080) shall equal zero. Always set to zero

10.3.9 RT BEAMS MODULE The following table lists the attributes that are used to create a new treatment field for the patient. Only Beams with a Treatment Delivery Type of TREATMENT are translated to treatment fields. Beams that do not have the Treatment Delivery Type attribute are considered to be TREATMENT beams. If Beam Number conflicts with an existing Treatment Field ID for the patient in the database, the existing treatment field’s revision is incremented and the imported field is imported as the current revision. Otherwise a new treatment field is created. If the Treatment Machine Name does not match an existing Treatment Machine in the database, this attribute is not used and the Treatment Machine for this treatment field is set to blank.


(300A,00B0) Beam Sequence 1 Introduces sequence of treatment beams for current RT Plan. (300A,00C0) >Beam Number 1 Identification number of the Beam. The value of Beam

Number (300A,00C0) shall be unique within the RT Plan in which it is created.

(300A,00C2) >Beam Name 3 User-defined name for Beam.

(300A,00C3) >Beam Description 3 User-defined description for Beam. (300A,00C4) >Beam Type 1 Motion characteristic of Beam. Enumerated Values:

STATIC = All Control Point Sequence (300A,0111) attributes remain unchanged between consecutive pairs of control points with changing Cumulative Meterset Weight (300A,0134). DYNAMIC = One or more Control Point Sequence (300A,0111) attributes change between one or more consecutive pairs of control points with changing Cumulative Meterset Weight (300A,0134).

(300A,00C6) >Radiation Type 2 Particle type of Beam. Defined Terms: PHOTON ELECTRON












1C Type of high-dose treatment technique. Defined Terms: NORMAL = Standard treatment TBI = Total Body Irradiation HDR = High Dose Rate Required if treatment technique requires a dose that would normally require overriding of treatment machine safety controls. SRS will be used as the designation of Flattening Filter Free energy for Varian treatment machines prior to TrueBeam.

(300A,00B2) > Treatment Machine Name

2 User-defined name identifying treatment machine to be used for beam delivery

(0008,0070) > Manufacturer 2 Manufacturer of the equipment to be used for beam delivery.

(300A,00B3) > Primary Dosimeter Unit

3 Measurement unit of machine dosimeter. Enumerated values are MU or MINUTE.

(300C,00A0) >Referenced Tolerance Table Number

3 Uniquely identifies Tolerance Table specified by Tolerance Table Number (300A,0042) within Tolerance Table Sequence in RT Tolerance Tables Module. These tolerances are to be used for verification of treatment machine settings.

(300A,00B4) > Source to Axis Distance

3 Radiation source to Gantry rotation axis distance.

(300A,00B6) > Beam Limiting Device Sequence

1 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) sets.

(300A,00B8) >> Beam Limiting Device Type

1 X = symmetric jaw pair in X direction Y = symmetric jaw pair in Y direction ASYMX = asymmetric jaw pair in X direction ASYMY = asymmetric jaw pair in Y direction MLCX = multileaf jaw pair in X direction MLCY = multileaf jaw pair in Y direction

(300A,00BA) >>Source to Beam Limiting Device Distance

3 Radiation source to beam limiting device (collimator) distance of the equipment that is to be used for beam delivery (mm).

(300A,00BC) >> Number of Leaf/Jaw Pairs

1 Number of leaf (element) or jaw pairs (equal to 1 for standard beam limiting device jaws).






(300A,00BE) >>Leaf Position Boundaries

2C Boundaries of beam limiting device (collimator) leaves (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), i.e. X-axis for MLCY, Y-axis for MLCX. Contains N+1 values, where N is the Number of Leaf/Jaw Pairs (300A,00BC), starting from Leaf (Element) Pair 1. Required if Beam Limiting Device Sequence (300A,00B6) is sent and RT Beam Limiting Device Type (300A,00B8) is MLCX or MLCY.

(300C,0042) >Referenced Reference Image Sequence

3 Introduces sequence of reference images used for validation of current beam. One or more items may be included in this sequence.

(0008,1150) >>Referenced SOP Class UID

1C Uniquely identifies the referenced SOP Class. Required if Referenced Reference Image Sequence (300C,0042) is sent.

(0008,1155) >>Referenced SOP Instance UID

1C Uniquely identifies the referenced SOP Instance. Required if Referenced Reference Image Sequence (300C,0042) is sent.

(300A,00C8) >>Reference Image Number

1C Uniquely identifies Reference Image within Referenced Reference Image Sequence (300A,0042). Required if Referenced Reference Image Sequence (300A,0042) is sent.

(300C,0008) >>Start Cumulative Meterset Weight

3 Cumulative Meterset Weight within current Beam at which image acquisition starts.

(300C,0009) >>End Cumulative Meterset Weight

3 Cumulative Meterset Weight within current Beam at which image acquisition ends.

(300A,00CA) >Planned Verification Image Sequence

3 Introduces sequence of planned verification images to be acquired during current beam. One or more items may be included in this sequence.

(300C,0008) >>Start Cumulative Meterset Weight

3 Cumulative Meterset Weight within current Beam at which image acquisition will start.

(3002,0032) >>Meterset Exposure 3 Meterset duration over which image is to be acquired, specified in Monitor units (MU) or minutes as defined by Primary Dosimeter Unit (300A,00B3).

(300C,0009) >>End Cumulative Meterset Weight

3 Cumulative Meterset Weight within current Beam at which image acquisition will end.

(3002,000C) >>RT Image Plane 3 Describes whether or not image plane is normal to beam axis. Enumerated Values: NORMAL = image plane normal to beam axis NON_NORMAL = image plane non-normal to beam axis

(3002,000E) >>X-Ray Image Receptor Angle

3 X-Ray Image Receptor Angle i.e. orientation of IEC X-RAY IMAGE RECEPTOR coordinate system with respect to IEC GANTRY coordinate system (degrees).

(3002,0010) >>RT Image Orientation

3 The direction cosines of the first row and the first column with respect to the IEC X-RAY IMAGE RECEPTOR coordinate system.






(3002,0012) >>RT Image Position 3 The x and y coordinates (in mm) of the upper left hand corner of the image, in the IEC X-RAY IMAGE RECEPTOR coordinate system. This is the center of the first pixel transmitted.

(3002,0026) >>RT Image SID 3 Radiation machine source to image plane distance (mm). (300A,00CC) >>Imaging Device-

Specific Acquisition Parameters

3 User-specified device-specific parameters that describe how the imager will acquire the image.

(300C,0007) >>Referenced Reference Image Number

3 Uniquely identifies Reference Image to which planned verification image is related, specified by Reference Image Number (300A,00C8) within Referenced Reference Image Sequence (300A,0042).

(300A,00CE) > Treatment Delivery Type

3 Delivery Type of treatment. Defined Terms: TREATMENT = normal patient treatment OPEN_PORTFILM = portal image acquisition with open field TRMT_PORTFILM = portal image acquisition with treatment port CONTINUATION = continuation of interrupted treatment

(300A,00D0) > Number of Wedges 1 Number of wedges associated with current Beam. (300A,00D1) > Wedge Sequence 1C Introduces sequence of treatment wedges. Required if

Number of Wedges is non-zero. (300A,00D2) >>Wedge Number 1C Identification number of the Wedge. The value of Wedge

Number (300A,00D2) shall be unique within the Beam in which it is created. Required if Wedge Sequence (300A,00D1) is sent.

(300A,00D3) >> Wedge Type 2C STANDARD = standard (static) wedge DYNAMIC = moving beam limiting device jaw simulating wedge MOTORIZED = single wedge that can be remotely removed from the beam

(300A,00D4) >> Wedge ID 3 User-supplied identifier for Wedge (300A,00D5) >>Wedge Angle 3 Nominal wedge angle (degrees). Required if Wedge Sequence

(300A,00D1) is sent

(300A,00D8) >>Wedge Orientation 2C Orientation of wedge, i.e. orientation of IEC WEDGE FILTER coordinate system with respect to IEC BEAM LIMITING DEVICE coordinate system (degrees). Required if Wedge Sequence (300A,00D1) is sent

(300A,00DA) >>Source to Wedge Tray Distance

3 Radiation source to wedge tray attachment edge distance (in mm) for current wedge

(300A,00E0) > Number of Compensators

1 Number of Compensators associated with current Beam.






(300A,00E3) > Compensator Sequence

1C Introduces sequence of treatment compensators. Required if Number of Compensators is non-zero.

(300A,00E4) >>Compensator Number

1C Identification number of the Compensator. The value of Compensator Number (300A,00E4) shall be unique within the Beam in which it is created. Required if Number of Compensators (300A,00E0) is non-zero

(300A,00E1) >>Material ID 2C User-supplied identifier for material used to manufacture Compensator. Required if Number of Compensators (300A,00E0) is non-zero.

(300A,00E5) >> Compensator ID 3 User-supplied identifier for compensator. (300A,00E6) >>Source to

Compensator Tray Distance

2C Radiation source to compensator tray attachment edge distance (in mm) for current compensator. Required if Compensator Sequence (300A,00E3) is sent.

(300A,00E7) >>Compensator Rows 1C Number of rows in the compensator. Required if Compensator Sequence (300A,00E3) is sent.

(300A,00E8) >>Compensator Columns

1C Number of columns in the compensator. Required if Compensator Sequence (300A,00E3) is sent.

(300A,00E9) >>Compensator Pixel Spacing

1C Physical distance (in mm) between the center of each pixel projected onto machine isocentric plane. Specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing. Required if Compensator Sequence (300A,00E3) is sent.

(300A,00EA) >>Compensator Position

1C The x and y coordinates of the upper left hand corner (first pixel transmitted) of the compensator, projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm). Required if Compensator Sequence (300A,00E3) is sent.

(300A,00EB) >>Compensator Transmission Data

1C A data stream of the pixel samples which comprise the compensator, expressed as broad-beam transmission values (between 0 and 1) along a ray line passing through the pixel, at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Control Point Sequence (300A,0111). The order of pixels sent is left to right, top to bottom, i.e., the upper left pixel is sent first followed by the remainder of the first row , followed by the first pixel of the 2nd row, then the remainder of the 2nd row and so on) when viewed from the radiation source. Required if Compensator Sequence (300A,00E3) is sent and Material ID (300A,00E1) is zero-length. See C.8.8.14.10. Note: Compensator Transmission Data may not be properly encoded if Explicit-VR transfer syntax is used and the VL of this attribute exceeds 65534 bytes.






(300A,00EC) >>Compensator Thickness Data

1C A data stream of the pixel samples which comprise the compensator, expressed as thicknesses (in mm). The order of pixels sent is left to right, top to bottom, i.e., the upper left pixel is sent first followed by the remainder of the first row , followed by the first pixel of the 2nd row, then the remainder of the 2nd row and so on) when viewed from the radiation source. Required if Compensator Sequence (300A,00E3) is sent and Material ID (300A,00E1) is non-zero length. See C.8.8.14.9 and C.8.8.14.10. Note: Compensator Thickness Data may not be properly encoded if Explicit-VR transfer syntax is used and the VL of this attribute exceeds 65534 bytes.

(300A,02E2) >>Source to Compensator Distance

1C A data stream of the pixel samples which comprise the distance from the radiation source to the compensator surface closest to the radiation source (in mm). The order of pixels sent is left to right, top to bottom (upper left pixel, followed by the remainder of row 1, followed by the remainder of the columns). Required if Compensator Sequence (300A,00E3) is sent, Material ID (300A,00E1) is non-zero length, and Compensator Mounting Position (300A,02E1) is DOUBLE_SIDED. See C.8.8.14.9.

(300A,00ED) >Number of Boli 1 Number of boli associated with current Beam. Always zero

(300A,00F0) > Number of Blocks 1 Number of shielding blocks associated with Beam. (300A,00F4) > Block Sequence 1C Introduces sequence of blocks associated with Beam.

Required if Number of Blocks is non-zero. (300A,00F5) >> Block Tray ID 3 User-supplied identifier for block tray (300A,00F6) >>Source to Block Tray

Distance 2C Radiation Source to attachment edge of block tray assembly

(mm). Required if Block Sequence (300A,00F4) is sent.

(300A,00F8) >>Block Type 1C Type of block. Required if Block Sequence (300A,00F4) is sent. See C.8.8.14.4. Enumerated Values: SHIELDING = blocking material is inside contour APERTURE = blocking material is outside contour

(300A,00FA) >>Block Divergence 2C Indicates presence or otherwise of geometrical divergence. Required if Block Sequence (300A,00F4) is sent. Enumerated Values: PRESENT = block edges are shaped for beam divergence ABSENT = block edges are not shaped for beam divergence

(300A,00FC) >>Block Number 1C Identification number of the Block. The value of Block Number (300A,00FC) shall be unique within the Beam in which it is created. Required if Block Sequence (300A,00F4) is sent

(300A,00FE) >>Block Name 3 User-defined name for block






(300A,00E1) >>Material ID 2C User-supplied identifier for material used to manufacture Block. Required if Block Sequence (300A,00F4) is sent.

(300A,0100) >>Block Thickness 2C Physical thickness of block (in mm) parallel to radiation beam axis. Required if Block Sequence (300A,00F4) is sent and Material ID (300A,00E1) is non-zero length. See C.8.8.14.4.

(300A,0102) >>Block Transmission 2C Transmission through the block (between 0 and 1) at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Control Point Sequence (300A,0111). Required if Block Sequence (300A,00F4) is sent and Material ID (300A,00E1) is zero length.

(300A,0104) >>Block Number of Points

2C Number of (x,y) pairs defining the block edge. Required if Block Sequence (300A,00F4) is sent.

(300A,0106) >>Block Data 2C A data stream of (x,y) pairs which comprise the block edge. The number of pairs shall be equal to Block Number of Points (300A,0104), and the vertices shall be interpreted as a closed polygon. Coordinates are projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm). Required if Block Sequence (300A,00F4) is sent

(300A,0107) > Applicator Sequence 3 Introduces sequence of Applicators. Only a single item shall be permitted in this sequence.

(300A,0108) >> Applicator ID 1C User or machine supplied identifier for Applicator. Required if Applicator Sequence (300A,0107) is sent.

(300A,0109) >>Applicator Type 1C Type of Applicator. Required if Applicator Sequence (300A,0107) is sent. Defined Terms: ELECTRON_SQUARE = square electron applicator ELECTRON_RECT = rectangular electron applicator ELECTRON_CIRC = circular electron applicator ELECTRON_SHORT = short electron applicator ELECTRON_OPEN = open (dummy) electron applicator INTRAOPERATIVE = intraoperative (custom) applicator STEREOTACTIC = stereotactic applicator

(300A,010E) > Final Cumulative Meterset Weight

1C Value of Cumulative Meterset Weight (300A, 0134) for final Control Point. This attribute is used to calculate Monitor_Units ( = Cumulative Meterset Weight divided by Final Cumulative Meterset Weight).

(300A,0110) > Number of Control Points

1 Number of control points in Beam.

(300A,0111) > Control Point Sequence

1C Introduces sequence of machine configurations describing treatment beam. Two or more items may be included in this sequence.






(300A,0112) >> Control Point Index 1C Index of current Control Point, starting at 0 for first Control Point.

(300A,0134) >> Cumulative Meterset Weight

2C Cumulative weight to current control point. Cumulative Meterset Weight for the first item in Control Point Sequence shall always be zero. Cumulative Meterset Weight for the final item in Control Point Sequence shall always be equal to Final Cumulative Meterset Weight. Required if Control Point Sequence (300A,0111) is sent

(300A,0114) >> Nominal Beam Energy

3 Nominal Beam Energy at control point (MV/MeV).

(300A,0115) >> Dose Rate Set 3 Dose Rate to be set on treatment machine for segment beginning at current control point (e.g. MU/min).

(300A,0116) >> Wedge Position Sequence

3 Introduces sequence of Wedge positions.

(300C,00C0) >>>Referenced Wedge Number

1C Uniquely references Wedge described by Wedge Number (300A,00D2) in Wedge Sequence (300A,00D1). Required if Wedge Position Sequence (300A,0116) is sent

(300A,0118) >>> Wedge Position 1C Position of Wedge at current control point. Enumerated values are IN or OUT.

(300A,011A) >> Beam Limiting Device Position Sequence

1C Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions.

(300A,00B8) >>> RT Beam Limiting Device Type

1C Type of beam limiting device (collimator). The value of this attribute shall correspond to RT Beam Limiting Device Type (300A,00B8) defined in an item of Beam Limiting Device Sequence (300A,00B6). Required if Beam Limiting Device Position Sequence (300A,011A) is sent. X = symmetric jaw pair in X direction Y = symmetric jaw pair in Y direction ASYMX = asymmetric jaw pair in X direction ASYMY = asymmetric jaw pair in Y direction MLCX = multileaf jaw pair in X direction MLCY = multileaf jaw pair in Y direction.

(300A,011C) >>> Leaf/Jaw Positions 1C Positions of beam limiting device (collimator) leaf (element) or jaw pairs (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), e.g. X-axis for MLCX, Y-axis for MLCY. Contains 2N values, where N is the Number of Leaf/Jaw Pairs (300A,00BC) in Beam Limiting Device Sequence (300A,00B6). Values shall be listed in IEC leaf (element) subscript order 101, 102, ... 1N, 201, 202, ... 2N.






(300A,011E) >> Gantry Angle 1C Gantry angle of radiation source, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for first item of Control Point Sequence, or if Gantry Angle changes during Beam

(300A,011F) >> Gantry Rotation Direction

1C Direction of gantry rotation when viewing gantry from isocenter. CW = clockwise CC = counter-clockwise NONE = no rotation.

(300A,0120) >> Beam Limiting Device Angle

1C Beam Limiting Device angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for first item of Control Point Sequence, or if Beam Limiting Device Angle changes during Beam.

(300A,0121) >> Beam Limiting Device Rotation Direction

1C Direction of beam limiting device rotation when viewing beam limiting device from radiation source. , for segment following Control Point. Required for first item of Control Point Sequence, or if Beam Limiting Device Rotation Direction changes during Beam. CW = clockwise CC = counter-clockwise NONE = no rotation. This attribute is translated to Collimator_Dir.

(300A,0122) >> Patient Support Angle

1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for first item of Control Point Sequence, or if Patient Support Angle changes during Beam. a.k.a Couch Angle

(300A,0123) >> Patient Support Rotation Direction

1C Direction of patient support rotation when viewing table from above. CW = clockwise CC = counter-clockwise NONE = no rotation.

(300A,0125) >> Table Top Eccentric Angle

1C Table Top (non-isocentric) angle, i.e. orientation of IEC TABLE TOP ECCENTRIC coordinate system with respect to IEC PATIENT SUPPORT coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Eccentric Angle changes during Beam.






(300A,0126) >> Table Top Eccentric Rotation Direction

1C Direction of Table Top Eccentric Rotation when viewing table from above, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Eccentric Rotation Direction changes during Beam Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0128) >> Table Top Vertical Position

2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Vertical Position changes during Beam.

(300A,0129) >> Table Top Longitudinal Position

2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Longitudinal Position changes during Beam.

(300A,012A) >> Table Top Lateral Position

2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Lateral Position changes during Beam.

(300A,012C) >>Isocenter Position 2C Isocenter coordinates (x,y,z) in the patient based coordinate system (mm). Required for first item of Segment Control Point Sequence, or if Segment Isocenter Position changes during Beam.

(300A,0130) >> Source to Surface Distance

3 Source to Patient Surface distance (mm).

10.3.10 APPROVAL MODULE


(300E,0002) Approval Status 1 Approval status at the time the SOP Instance was created. APPROVED = Reviewer recorded that object met an implied criterion UNAPPROVED = No review of object has been recorded REJECTED = Reviewer recorded that object failed to meet an implied criterion

(300E,0004) Review Date 2C Date on which object was reviewed. Required if Approval Status (300E,0002) is APPROVED or REJECTED.

(300E,0005) Review Time 2C Time at which object was reviewed. Required if Approval Status (300E,0002) is APPROVED or REJECTED.






(300E,0008) Reviewer’s Name 2C Name of person who reviewed object. Required if Approval Status (300E, 0002) is APPROVED or REJECTED.



(0008,0016) SOP Class UID 1 Uniquely identifies the SOP Class.

(0008,0018) SOP Instance UID 1 Uniquely identifies the SOP Instance.

MOSAIQ DICOM Conformance Statement Appendix F




11 APPENDIX F 11.1 SPECIFIC CONFORMANCE FOR RT IMAGE EXPORT The Radiotherapy Image Information Object Definition (RT Image IOD) is used to transfer reference images (DRRs) to a treatment delivery system (Linear Accelerator or LINAC Control Console).

Communication between the Treatment Management System (MOSAIQ) and Treatment Delivery System (the LINAC control console) is not fully standardized, but the RT Image is commonly used as one of the standardized “building blocks” for this communication.

11.2 RT IMAGE IOD MODULES The following table identifies the modules used when creating an RT Image object. A module is shown with a reference of Not Used if none of its attributes are created/populated.


Patient §11.3.1 M

Clinical Trial Subject Not Used U General Study §11.3.2 M

Patient Study Not Used U Clinical Trial Study Not Used U RT Series §11.3.3 M

Clinical Trial Series Not Used U Frame of Reference §11.3.4 U General Equipment §11.3.5 M

General Image §11.3.6 M Image Pixel §11.3.7 M Contrast/bolus Not Used C-Required if contrast media was used in this image.

Cine Not Used C - Required if multi-frame image is a cine image. Multi-Frame Not Used C - Required if pixel data is multi-frame data.

RT Image §11.3.8 M Modality LUT Not Used U VOI LUT Not Used U

Approval Not Used U Curve §11.3.9 U Audio Not Used U

SOP Common §11.3.10 M

11.3 MODULE ATTRIBUTES This section lists the attributes of each module that are used by the translation and export process; attributes that are not exported are not shown. Restrictions on attribute values and usage are also listed. Refer to {DICM} for a complete definition of the Type notation, summarized as follows:









11.3.1 PATIENT MODULE The following table lists the attributes that are used to populate the RT Image













Study.



(0008,0060) Modality 1 Type of equipment that originally acquired the data. Enumerated value is RTIMAGE.






11.3.4 FRAME OF REFERENCE MODULE


(0020,0052) Frame of Reference UID

1 Uniquely identifies the frame of reference for a Series.

(0020,1040) Position Reference Indicator

2 Part of the patient's anatomy used as a reference









(0020,0013) Instance Number 2 A number that identifies this image. (0020,0020) Patient Orientation 2C Patient direction of the rows and columns of the image.

Required if image does not require Image Orientation (Patient) (0020,0037) and Image Position (Patient) (0020,0032)



(0008,0008) Image Type 3 Image identification characteristics (0020,4000) Image Comments 3 User-defined comments about the image. Only the first 60

characters of this attribute are used. If the attribute is absent or the value is unknown, the import process defaults to blank.



(0028,0002) Samples per Pixel 1 Number of samples (planes) in this image. Always set to 1


1 Specifies the intended interpretation of the pixel data. Always set to MONOCHROME2.

(0028,0010) Rows 1 Number of rows in the image. (0028,0011) Columns 1 Number of columns in the image.






(0028,0100) Bits Allocated 1 Number of bits allocated for each pixel sample. The value will be 8 or 16.

(0028,0101) Bits Stored 1 Number of bits stored for each pixel sample. The value will be equal to Bits Allocated (0028,0100)

(0028,0102) High Bit 1 Most significant bit for pixel sample data. The value will be Bits Stored - 1.


(7FE0,0010) Pixel Data 1 A data stream of the pixel samples that comprise the image.

11.3.8 RT IMAGE MODULE


(0008,0008) Image Type 1 Image identification characteristics. This attribute uses the Defined Terms for Value 3: DRR = digitally reconstructed radiograph PORTAL = digital portal image or portal film image SIMULATOR = conventional simulator image RADIOGRAPH = radiographic image BLANK = image pixels set to background value FLUENCE = fluence map

(0008,0064) Conversion Type 2 Describes the kind of image conversion. The value will be WSD

(3002,0002) RT Image Label 1 User-defined label for RT Image. (3002,0003) RT Image Name 3 User-defined name for RT Image. (3002,000C) RT Image Plane 1 Describes whether or not image plane is normal to beam axis.

The value will be NORMAL. (3002,000D) X-Ray Image Receptor

Translation 3 Position in (x,y,z) coordinates of origin of IEC X-RAY

IMAGE RECEPTOR System in the IEC GANTRY coordinate system (mm).

(3002,000E) X-Ray Image Receptor Angle

2 Orientation of IEC X-RAY IMAGE RECEPTOR coordinate system with respect to IEC GANTRY coordinate system (degrees).

(3002,0010) RT Image Orientation 2C The direction cosines of the first row and the first column with respect to the IEC X-RAY IMAGE RECEPTOR coordinate system.

(3002,0011) Image Plane Pixel Spacing

2 Physical distance (in mm) between the center of each image pixel.

(3002,0012) RT Image Position 2 The x and y coordinates (in mm) of the upper left hand corner (first pixel transmitted) of the image, in the IEC X-RAY IMAGE RECEPTOR coordinate system.






(3002,0020) Radiation Machine Name

2 User-defined name identifying radiation machine used in acquiring or computing image.

(300A,00B3) Primary Dosimeter Unit

2 Measurement unit of machine dosimeter. Enumerated Values: MU = Monitor Unit MINUTE = minute

(3002,0022) Radiation Machine SAD

2 Radiation source to Gantry rotation axis distance of radiation machine used in acquiring or computing image (mm).

(3002,0024) Radiation Machine SSD 3 Source to patient surface distance (in mm) of radiation machine used in acquiring or computing image.

(3002,0026) RT Image SID 2 Distance from radiation machine source to image plane (in mm) along radiation beam axis.


3 Introduces sequence of one Class/Instance pair describing RT Plan associated with image. Only a single item shall be permitted in this sequence.


1C Uniquely identifies the referenced SOP Class. Required if Referenced RT Plan Sequence (300C,0002) is sent



(300A,011E) Gantry Angle 3 Treatment machine gantry angle, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees).

(300A,0120) Beam Limiting Device Angle

3 Treatment machine beam limiting device (collimator) angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees).

(300A,0122) Patient Support Angle 3 Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees).

11.3.9 CURVE MODULE (RETIRED, BUT STILL COMMONLY IN USE IN RT IMAGE)


(50xx,0005) Curve Dimensions 1 Number of dimensions for these data

(50xx,0010) Number of Points 1 Number of data points in this Curve

(50xx,0020) Type of Data 1 Type of data in this curve. (50xx,0103) Data Value

Representation 1 Data representation of the curve data

points. Value will be zero, meaning unsigned 2 byte data.

(50xx,3000) Curve Data 1 Curve data.

(50xx,0022) Curve Description 3 User-defined comments about the Curve

(50xx,0030) Axis Units 3 Units of measure for the axes. Value will be PIXL\PIXL






(50xx,2500) Curve Label 3 A user defined text string which may be used to label or name this curve.



(0008,0016) SOP Class UID 1 Uniquely identifies the SOP Class. (0008,0018) SOP Instance UID 1 Uniquely identifies the SOP Instance.

MOSAIQ DICOM Conformance Statement Appendix G




12 APPENDIX G 12.1 SPECIFIC CONFORMANCE FOR RT BEAMS TREATMENT SUMMARY EXPORT The Radiotherapy Beams Treatment Summary Information Object Definition (RT Beams Treatment Summary IOD) is used to provide a summary of the dose delivered on specific beams to a treatment delivery system (Linear Accelerator or LINAC Control Console).

Communication between the Treatment Management System (MOSAIQ) and Treatment Delivery System (the LINAC control console) is not fully standardized, but the RT Beams Treatment Summary can be used as one of the standardized “building blocks” for this communication.

12.2 RT BEAMS TREATMENT SUMMARY IOD MODULES The following table identifies the modules used when creating an RT Beams Treatment Summary object. A module is shown with a reference of Not Used if none of its attributes are created/populated.


Patient §12.3.1 M Clinical Trial Subject Not Used U

General Study §12.3.2 M Patient Study Not Used U

Clinical Trial Study Not Used U RT Series §12.3.3 M Clinical Trial Series Not Used U

General Equipment §12.3.4 M RT General Treatment Record

§12.3.5 M

RT Treatment Summary Record

§12.3.6 M


12.3 MODULE ATTRIBUTES

12.3.1 PATIENT MODULE The following table lists the attributes that are used to populate the RT Beams Treatment Summary IOD


(0010,0010) Patient’s Name 2 Patient’s full legal name.

(0010,0020) Patient ID 2 Primary hospital identification number or code for the patient.

(0010,0030) Patient’s Birth Date 2 Birth date of the patient















Study.











12.3.5 RT GENERAL TREATMENT RECORD MODULE


(0020,0013) Instance Number 1 Instance number identifying this particular instance of the object.






(3008,0250) Treatment Date 2 Date when current fraction was delivered, or Date last fraction was delivered in case of RT Treatment Summary Record IOD. See Note.

(3008,0251) Treatment Time 2 Time when current fraction was delivered (begun), or Time last fraction was delivered (begun) in case of RT Treatment Summary Record IOD. See Note.


2 A sequence which provides reference to a RT Plan SOP Class/Instance pair. Only a single Item shall be permitted in this Sequence.





(3008,0030) Referenced Treatment Record Sequence

3 A sequence which provides reference to RT Treatment Record SOP Class/Instance pairs to which the current RT Treatment Record is significantly related. The sequence may contain one or more items.


1C Uniquely identifies the referenced SOP Class. Required if Referenced Treatment Record Sequence (3008,0030) is sent.


1C Uniquely identifies the referenced SOP Instance. Required if Referenced Treatment Record Sequence (3008,0030) is sent.

12.3.6 RT TREATMENT SUMMARY RECORD MODULE


(3008,0200) Current Treatment Status

1 Status of the Treatment at the time the Treatment Summary was created. Enumerated Values: NOT_STARTED, ON_TREATMENT, ON_BREAK, SUSPENDED, STOPPED, COMPLETED.

(3008,0202) Treatment Status Comment

3 Comment on current treatment status.

(3008,0054) First Treatment Date 2 Date of delivery of the first treatment.

(3008,0056) Most Recent Treatment Date

2 Date of delivery of the most recent administration.

(3008,0220) Fraction Group Summary Sequence

3 Introduces sequence describing current state of planned vs. delivered fraction groups. The sequence may contain one or more items.

(300C,0022) >Referenced Fraction Group Number

3 References Fraction Group Number (300A,0071) in Fraction Group Sequence (300A,0070) in the referenced RT Plan.

(3008,0224) >Fraction Group Type 2C Indicates type of fraction group. Required if Fraction Group Summary Sequence (3008,0220) is sent. Enumerated Values: EXTERNAL_BEAM, BRACHY.

(300A,0078) >Number of Fractions Planned

2C Number of fractions planned for this fraction group. Required if Fraction Group Summary Sequence (3008,0220) is sent.






(3008,005A) >Number of Fractions Delivered

2C Number of fractions delivered as of Treatment Summary Report. Required if Fraction Group Summary Sequence (3008,0220) is sent.

(3008,0240) >Fraction Status Summary Sequence

3 Introduces sequence describing status of fractions in Fraction Group. The sequence may contain one or more items.

(3008,0223) >>Referenced Fraction Number

1C Identifies fraction. Required if Fraction Status Summary Sequence (3008,0240) is sent.

(3008,0250) >>Treatment Date 2C Date when fraction was delivered. Required if Fraction Status Summary Sequence (3008,0240) is sent.

(3008,0251) >>Treatment Time 2C Time when fraction was delivered. Required if Fraction Status Summary Sequence (3008,0240) is sent.

(3008,002A) >>Treatment Termination Status

2C Conditions under which treatment was terminated. Required if Fraction Status Summary Sequence (3008,0240) is sent. Enumerated Values: NORMAL = treatment terminated normally OPERATOR = operator terminated treatment MACHINE = machine terminated treatment for other than NORMAL condition UNKNOWN = status at termination unknown




MOSAIQ DICOM Conformance Statement Appendix H




13 APPENDIX H 13.1 SPECIFIC CONFORMANCE FOR RT BEAMS TREATMENT RECORD EXPORT The Radiotherapy Beams Treatment Record Information Object Definition (RT Beams Treatment Record IOD) is used to provide information regarding the dose delivered on specific beams to a treatment delivery system (Linear Accelerator or LINAC Control Console).

Communication between the Treatment Management System (MOSAIQ) and Treatment Delivery System (the LINAC control console) is not fully standardized, but the RT Beams Treatment Record can be used as one of the standardized “building blocks” for this communication.

13.2 RT BEAMS TREATMENT RECORD IOD MODULES The following table identifies the modules used when creating an RT Beams Treatment Record object. A module is shown with a reference of Not Used if none of its attributes are created/populated.





General Equipment §13.3.4 M RT General Treatment Record

§13.3.5 M

RT Patient Setup §13.3.6 U

RT Treatment Machine Record

§13.3.7 M

Measured Dose Reference Record

Not Used U

Calculated Dose Reference Record

Not Used U

RT Beams Session Record

§13.3.8 M


§13.3.9 M







13.3.1 PATIENT MODULE The following table lists the attributes that are used to populate the RT Beams Treatment Summary IOD







(0020,000D) Study Instance UID 1 Unique identifier for the Study (0008,0020) Study Date 2 Date the Study started.

(0008,0030) Study Time 2 Time the Study started. (0008,0050) Accession Number 2 A RIS generated number that identifies the order for the

Study. MOSAIQ takes the role of the RIS (as an Oncology Information System, OIS).




patient care at time of Study.

(0008,1030) Study Description 3 Institution-generated description or classification of the Study.


















(0020,0013) Instance Number 1 Instance number identifying this particular instance of the object.









(3008,0030) Referenced Treatment Record Sequence

3 A sequence which provides reference to RT Treatment Record SOP Class/Instance pairs to which the current RT Treatment Record is significantly related. The sequence may contain one or more items.


1C Uniquely identifies the referenced SOP Class. Required if Referenced Treatment Record Sequence (3008,0030) is sent.


1C Uniquely identifies the referenced SOP Instance. Required if Referenced Treatment Record Sequence (3008,0030) is sent.

13.3.6 RT PATIENT SETUP MODULE


(300A,0180) Patient Setup Sequence 1 Introduces sequence of patient setup data for current plan. One or more items may be included in this sequence.

(300A,0182) >Patient Setup Number 1 Identification number of the Patient Setup. The value of Patient Setup Number (300A,0182) shall be unique within the RT Plan in which it is created.






(0018,5100) >Patient Position 1C Not Imported Patient position descriptor relative to the equipment. Required for images where Patient Orientation Code Sequence (0054,0410) is not present and whose SOP Class is one of the following: CT ("1.2.840.10008.5.1.4.1.1.2") or MR ("1.2.840.10008.5.1.4.1.1.4") or Enhanced CT ("1.2.840.10008.5.1.4.1.1.2.1") or Enhanced MR Image ("1.2.840.10008.5.1.4.1.1.4.1") or Enhanced Color MR Image ("1.2.840.10008.5.1.4.1.1.4.3") or MR Spectroscopy ("1.2.840.10008.5.1.4.1.1.4.2") Storage SOP Classes. May be present for other SOP Classes if Patient Orientation Code Sequence (0054,0410) is not present.

13.3.7 RT TREATMENT MACHINE RECORD MODULE


(300A,0206) Treatment Machine Sequence

1 Introduces sequence describing treatment machine used for treatment delivery. Only a single Item shall be permitted in this Sequence.

(300A,00B2) >Treatment Machine Name

2 User-defined name identifying treatment machine used for treatment delivery.

(0008,0070) >Manufacturer 2 Manufacturer of the equipment used for treatment delivery. (0008,0080) >Institution Name 2 Institution where the equipment is located that was used for

treatment delivery. (0008,1090) >Manufacturer's Model

Name 2 Manufacturer's model name of the equipment used for

treatment delivery. (0018,1000) >Device Serial Number 2 Manufacturer's serial number of the equipment used for

treatment delivery.

13.3.8 RT BEAMS SESSION RECORD MODULE


(0008,1070) Operator Name 2 Name of operator administering treatment session. (300C,0022) Referenced Fraction

Group Number 3 Identifier of Fraction Group within referenced RT Plan.

(300A,0078) Number of Fractions Planned

2 Total number of treatments (Fractions) planned for current Fraction Group.



(3008,0020) Treatment Session Beam Sequence

1 Introduces sequence of Beams administered during treatment session. The sequence may contain one or more items.






(300C,0006) >Referenced Beam Number

3 References Beam specified by Beam Number (300A,00C0) in Beam Sequence (300A,00B0) in RT Beams Module within referenced RT Plan.

(300A,00C2) >Beam Name 3 User-defined name for delivered Beam. (300A,00C3) >Beam Description 3 User-defined description for delivered Beam.

(300A,00C4) >Beam Type 1 Motion characteristic of delivered Beam. Enumerated Values: STATIC = all beam parameters remain unchanged during delivery DYNAMIC = one or more beam parameters changes during delivery

(300A,00C6) >Radiation Type 1 Particle type of delivered Beam. Defined Terms: PHOTON, ELECTRON, NEUTRON, PROTON.








(300A,00B4) >Source-Axis Distance 3 Radiation source to gantry rotation axis distance of the equipment that was used for beam delivery (mm).

(3008,00A0) >Beam Limiting Device Leaf Pairs Sequence

1 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) leaf pair values. The sequence may contain one or more items.







1 Type of beam limiting device (collimator). Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction

(300A,00BC) >>Number of Leaf/Jaw Pairs


(300A,00D0) >Number of Wedges 1 Number of wedges associated with current delivered Beam. (3008,00B0) >Recorded Wedge

Sequence 1C Introduces sequence of treatment wedges present during

delivered Beam. Required if Number of Wedges (300A,00D0) is non-zero. The sequence may contain one or more items.

(300A,00D2) >>Wedge Number 3 Identification number of the Wedge. The value of Wedge Number (300A,00D2) shall be unique within the wedge sequence.

(300A,00D3) >>Wedge Type 2C Type of wedge defined for delivered Beam. Required if Recorded Wedge Sequence (3008,00B0) is sent. Defined Terms: STANDARD = standard (static) wedge DYNAMIC = moving Beam Limiting Device (collimator) jaw simulating wedge MOTORIZED = single wedge which can be removed from beam remotely

(300A,00D4) >>Wedge ID 3 User-supplied identifier for wedge. (300A,00F9) >>Accessory Code 3 An identifier for the accessory intended to be read by a device

such as a bar-code reader. (300A,00D5) >>Wedge Angle 3 Nominal wedge angle delivered (degrees). (300A,00D8) >>Wedge Orientation 3 Orientation of wedge, i.e. orientation of IEC WEDGE

FILTER coordinate system with respect to IEC BEAM LIMITING DEVICE coordinate system (degrees).


2 Number of compensators associated with current delivered Beam.

(300A,00ED) >Number of Boli 2 Number of boli used with current Beam. (300A,00F0) >Number of Blocks 2 Number of shielding blocks or Electron Inserts associated

with Beam. (3008,00D0) >Recorded Block

Sequence 3 Introduces sequence of blocks associated with current Beam.

The sequence may contain one or more items. (300A,00F5) >>Block Tray ID 3 User-supplied identifier for block tray or Electron Insert.







(300C,00E0) >>Referenced Block Number

3 Uniquely identifies block specified by Block Number (300A,00FC) within Beam referenced by Referenced Beam Number (300C,0006).

(300A,00FE) >>Block Name 2C User-defined name for block. Required if Recorded Block Sequence (3008,00D0) is sent.

(300A,0107) >Applicator Sequence 3 Introduces sequence of Applicators associated with Beam. Only a single item shall be permitted in this sequence.

(300A,0108) >>Applicator ID 1C User or machine supplied identifier for Applicator. Required if Applicator Sequence (300A,0107) is sent.


(300A,0109) >>Applicator Type 1C Type of Applicator. Required if Applicator Sequence (300A,0107) is sent. Defined Terms: ELECTRON_SQUARE = square electron applicator ELECTRON_RECT = rectangular electron applicator ELECTRON_CIRC = circular electron applicator ELECTRON_SHORT = short electron applicator ELECTRON_OPEN = open (dummy) electron applicator INTRAOPERATIVE = intraoperative (custom) applicator STEREOTACTIC = stereotactic applicator

(300A,010A) >>Applicator Description

3 User-defined description for Applicator.

(3008,0022) >Current Fraction Number

2 Fraction number for this beam administration.

(300A,00CE) >Treatment Delivery Type


(3008,002A) >Treatment Termination Status

1 Conditions under which treatment was terminated. Enumerated Values: NORMAL = treatment terminated normally OPERATOR = operator terminated treatment MACHINE = machine terminated treatment UNKNOWN = status at termination unknown

(3008,002B) >Treatment Termination Code

3 Treatment machine termination code. This code is dependent upon the particular application and equipment.






(3008,002C) >Treatment Verification Status

2 Conditions under which treatment was verified by a verification system. Enumerated Values: VERIFIED = treatment verified VERIFIED_OVR = treatment verified with at least one out-of-range value overridden NOT_VERIFIED = treatment verified manually

(3008,0032) >Specified Primary Meterset

3 Desired machine setting of primary meterset.

(3008,0036) >Delivered Primary Meterset

3 Machine setting actually delivered as recorded by primary meterset.

(3008,003A) >Specified Treatment Time

3 Treatment Time set (sec).

(3008,003B) >Delivered Treatment Time

3 Treatment Time actually delivered (sec).


1 Number of control points delivered.

(3008,0040) >Control Point Delivery Sequence

1 Introduces sequence of beam control points for current treatment beam. The sequence may contain one or more items

(300C,00F0) >>Referenced Control Point Index

3 Uniquely identifies Control Point specified by Control Point Index (300A,0112) within Beam referenced by Referenced Beam Number (300C,0006).

(3008,0024) >>Treatment Control Point Date

1 Date administration of treatment beam began.

(3008,0025) >>Treatment Control Point Time

1 Time administration of treatment beam began.

(3008,0042) >>Specified Meterset 2 Desired machine setting for current control point. (3008,0044) >>Delivered Meterset 1 Machine setting actually delivered at current control point.

(300A,0115) >>Dose Rate Set 2 Dose Rate set on treatment machine for segment beginning at current control point (meterset/min).

(3008,0048) >>Dose Rate Delivered 2 Dose Rate actually delivered for segment beginning at current control point (meterset/min).


3 Nominal Beam Energy at control point.

(300A,0015) >>Nominal Beam Energy Unit

1C Units used for Nominal Beam Energy (300A,0114). Required if Nominal Beam Energy (300A,0114) is sent. Defined Terms: MV = Megavolt MEV = Mega electron-Volt If Radiation Type (300A,00C6) is PHOTON, Nominal Beam Energy Unit (300A,0015) shall be MV. If Radiation Type (300A,00C6) is ELECTRON, Nominal Beam Energy Unit (300A,0015) shall be MEV.






(300A,0116) >>Wedge Position Sequence

3 Introduces sequence of Wedge positions for current control point. The sequence may contain one or more items.


1C Uniquely identifies wedge specified by Wedge Number (300A,00D2) within Beam referenced by Referenced Beam Number (300C,0006). Required if Wedge Position Sequence (300A,0116) is sent.

(300A,0118) >>>Wedge Position 1C Position of Wedge at current control point. Required if Wedge Position Sequence (300A,0116) is sent. Enumerated Values: IN, OUT.

(300A,011A) >>Beam Limiting Device Position Sequence

1C Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if beam limiting device (collimator) changes during beam administration. The sequence may contain one or more items.

(300A,00B8) >>>RT Beam Limiting Device Type

1C Type of beam limiting device. The value of this attribute shall correspond to RT Beam Limiting Device Type (300A,00B8) defined in an element of Beam Limiting Device Leaf Pairs Sequence (3008,00A0). Required if Beam Limiting Device Position Sequence (300A,011A) is sent. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction

(300A,011C) >>>Leaf/Jaw Positions 1C Positions of beam limiting device (collimator) leaf (element) or jaw pairs (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), e.g. X-axis for MLCX, Y-axis for MLCY. Contains 2N values, where N is the Number of Leaf/Jaw Pairs (300A,00BC) in Beam Limiting Device Sequence (300A,00B6). Values shall be listed in IEC leaf (element) subscript order 101, 102, ... 1N, 201, 202, ... 2N.

(300A,011E) >>Gantry Angle 1C Treatment machine gantry angle, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Gantry Angle changes during beam administration.







1C Direction of Gantry Rotation when viewing gantry from isocenter, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040), or if Gantry Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0120) >>Beam Limiting Device Angle

1C Beam Limiting Device (collimator) angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if beam limiting device (collimator) angle changes during beam delivery.

(300A,0121) >>Beam Limiting Device Rotation Direction

1C Direction of Beam Limiting Device Rotation when viewing beam limiting device (collimator) from radiation source, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Beam Limiting Device Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation


1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Patient Support Angle changes during beam administration.


1C Direction of Patient Support Rotation when viewing table from above, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040), or if Patient Support Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0124) >>Table Top Eccentric Axis Distance

3 Distance (positive) from the IEC PATIENT SUPPORT vertical axis to the IEC TABLE TOP ECCENTRIC vertical axis (mm).






(300A,0125) >>Table Top Eccentric Angle

1C Table Top (non-isocentric) angle, i.e. orientation of IEC TABLE TOP ECCENTRIC coordinate system with respect to IEC PATIENT SUPPORT coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Eccentric Angle changes during beam administration.

(300A,0126) >>Table Top Eccentric Rotation Direction

1C Direction of Table Top Eccentric Rotation when viewing table from above, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Eccentric Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation


2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Vertical Position changes during beam administration.


2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Longitudinal Position changes during beam administration.


2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Lateral Position changes during beam administration.

13.3.9 RT TREATMENT SUMMARY RECORD MODULE


(3008,0200) Current Treatment Status

1 Status of the Treatment at the time the Treatment Summary was created. Enumerated Values: NOT_STARTED, ON_TREATMENT, ON_BREAK, SUSPENDED, STOPPED, COMPLETED.

(3008,0202) Treatment Status Comment

3 Comment on current treatment status.

(3008,0054) First Treatment Date 2 Date of delivery of the first treatment. (3008,0056) Most Recent Treatment

Date 2 Date of delivery of the most recent administration.






(3008,0220) Fraction Group Summary Sequence

3 Introduces sequence describing current state of planned vs. delivered fraction groups. The sequence may contain one or more items.

(300C,0022) >Referenced Fraction Group Number

3 References Fraction Group Number (300A,0071) in Fraction Group Sequence (300A,0070) in the referenced RT Plan.

(3008,0224) >Fraction Group Type 2C Indicates type of fraction group. Required if Fraction Group Summary Sequence (3008,0220) is sent. Enumerated Values: EXTERNAL_BEAM, BRACHY.

(300A,0078) >Number of Fractions Planned

2C Number of fractions planned for this fraction group. Required if Fraction Group Summary Sequence (3008,0220) is sent.

(3008,005A) >Number of Fractions Delivered

2C Number of fractions delivered as of Treatment Summary Report. Required if Fraction Group Summary Sequence (3008,0220) is sent.

(3008,0240) >Fraction Status Summary Sequence

3 Introduces sequence describing status of fractions in Fraction Group. The sequence may contain one or more items.

(3008,0223) >>Referenced Fraction Number

1C Identifies fraction. Required if Fraction Status Summary Sequence (3008,0240) is sent.

(3008,0250) >>Treatment Date 2C Date when fraction was delivered. Required if Fraction Status Summary Sequence (3008,0240) is sent.

(3008,0251) >>Treatment Time 2C Time when fraction was delivered. Required if Fraction Status Summary Sequence (3008,0240) is sent.

(3008,002A) >>Treatment Termination Status

2C Conditions under which treatment was terminated. Required if Fraction Status Summary Sequence (3008,0240) is sent. Enumerated Values: NORMAL = treatment terminated normally OPERATOR = operator terminated treatment MACHINE = machine terminated treatment for other than NORMAL condition UNKNOWN = status at termination unknown




MOSAIQ DICOM Conformance Statement Appendix I




14 APPENDIX I 14.1 SPECIFIC CONFORMANCE FOR RT BEAMS TREATMENT RECORD IMPORT The Radiotherapy Beams Treatment Record Information Object Definition (RT Beams Treatment Record IOD) is used to provide information regarding the dose delivered on specific beams to a treatment delivery system (Linear Accelerator or LINAC Control Console).

Communication between the Treatment Management System (MOSAIQ) and Treatment Delivery System (the LINAC control console) is not fully standardized, but the RT Beams Treatment Record can be used as one of the standardized “building blocks” for this communication.

14.2 RT BEAMS TREATMENT RECORD IOD MODULES The following table identifies the modules used when creating an RT Beams Treatment Record object. A module is shown with a reference of Not Used if none of its attributes are accessed or translated during import.



General Study Not Used M Patient Study Not Used U


General Equipment Not Used M RT General Treatment Record

§14.3.3 M

RT Patient Setup Not Used U

RT Treatment Machine Record

Not Used M


Not Used U


Not Used U

RT Beams Session Record

§14.3.4 M


Not Used M







14.3.1 PATIENT MODULE The following table lists the attributes that are used to match the RT Plan with a patient in the database. If the patient in the RT Plan cannot be identified and uniquely matched with an existing patient in the database, the RT Plan is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the RT Plan. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the RT Plan.


(0010,0010) Patient’s Name 2 Patient’s full legal name. The import process is configured to use the last name in this attribute, in addition to Patient ID, to match the RT Plan with the patient under treatment. in the database.

(0010,0020) Patient ID 2 Primary hospital identification number or code for the patient. The RT Beams Treatment Record will only be imported if this attribute and Patient’s Name can be uniquely matched with the patient under treatment.



(0008,0060) Modality 1 Type of equipment that originally acquired the data. Enumerated value must match RTRECORD for import to proceed.











14.3.4 RT BEAMS SESSION RECORD MODULE







(0008,1070) Operator Name 2 Name of operator administering treatment session. (300C,0022) Referenced Fraction

Group Number 3 Identifier of Fraction Group within referenced RT Plan.

(300A,0078) Number of Fractions Planned

2 Total number of treatments (Fractions) planned for current Fraction Group.



(3008,0020) Treatment Session Beam Sequence

1 Introduces sequence of Beams administered during treatment session. The sequence may contain one or more items.


3 References Beam specified by Beam Number (300A,00C0) in Beam Sequence (300A,00B0) in RT Beams Module within referenced RT Plan.

(300A,00C2) >Beam Name 3 User-defined name for delivered Beam. (300A,00C3) >Beam Description 3 User-defined description for delivered Beam.

(300A,00C4) >Beam Type 1 Motion characteristic of delivered Beam. Enumerated Values: STATIC = all beam parameters remain unchanged during delivery DYNAMIC = one or more beam parameters changes during delivery

(300A,00C6) >Radiation Type 1 Particle type of delivered Beam. Defined Terms: PHOTON, ELECTRON, NEUTRON, PROTON.


3 Sequence defining whether the primary fluence of the treatment beam used a non-standard fluence-shaping when the beam was delivered. Only a single item is permitted in this sequence.

(3002,0051) >>Fluence Mode 1 Describes whether the fluence shaping is the standard mode for the beam or an alternate. Enumerated Values: STANDARD Uses standard fluence-shaping NON_STANDARD Uses a non-standard fluence-shaping

mode

(3002,0052) >>Fluence Mode ID 1C Identifier for the specific fluence-shaping mode. Required if Fluence Mode (3002,0051) has value NON_STANDARD.








(300A,00B4) >Source-Axis Distance 3 Radiation source to gantry rotation axis distance of the equipment that was used for beam delivery (mm).

(3008,00A0) >Beam Limiting Device Leaf Pairs Sequence

1 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) leaf pair values. The sequence may contain one or more items.


1 Type of beam limiting device (collimator). Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction

(300A,00BC) >>Number of Leaf/Jaw Pairs


(300A,00D0) >Number of Wedges 1 Number of wedges associated with current delivered Beam. (3008,00B0) >Recorded Wedge

Sequence 1C Introduces sequence of treatment wedges present during

delivered Beam. Required if Number of Wedges (300A,00D0) is non-zero. The sequence may contain one or more items.

(300A,00D2) >>Wedge Number 3 Identification number of the Wedge. The value of Wedge Number (300A,00D2) shall be unique within the wedge sequence.

(300A,00D3) >>Wedge Type 2C Type of wedge defined for delivered Beam. Required if Recorded Wedge Sequence (3008,00B0) is sent. Defined Terms: STANDARD = standard (static) wedge DYNAMIC = moving Beam Limiting Device (collimator) jaw simulating wedge MOTORIZED = single wedge which can be removed from beam remotely

(300A,00D4) >>Wedge ID 3 User-supplied identifier for wedge. (300A,00D5) >>Wedge Angle 3 Nominal wedge angle delivered (degrees).






(300A,00D8) >>Wedge Orientation 3 Orientation of wedge, i.e. orientation of IEC WEDGE FILTER coordinate system with respect to IEC BEAM LIMITING DEVICE coordinate system (degrees).

(300A,0107) >Applicator Sequence 3 Introduces sequence of Applicators associated with Beam. Only a single item shall be permitted in this sequence.

(300A,0108) >>Applicator ID 1C User or machine supplied identifier for Applicator. Required if Applicator Sequence (300A,0107) is sent.

(3008,0022) >Current Fraction Number

2 Fraction number for this beam administration.










1 Number of control points delivered.

(3008,0040) >Control Point Delivery Sequence

1 Introduces sequence of beam control points for current treatment beam. The sequence may contain one or more items


3 Uniquely identifies Control Point specified by Control Point Index (300A,0112) within Beam referenced by Referenced Beam Number (300C,0006).










(3008,0042) >>Specified Meterset 2 Desired machine setting for current control point. (3008,0044) >>Delivered Meterset 1 Machine setting actually delivered at current control point. (300A,0115) >>Dose Rate Set 2 Dose Rate set on treatment machine for segment beginning

at current control point (meterset/min). (3008,0048) >>Dose Rate Delivered 2 Dose Rate actually delivered for segment beginning at

current control point (meterset/min). (300A,0114) >>Nominal Beam

Energy 3 Nominal Beam Energy at control point.

(300A,0015) >>Nominal Beam Energy Unit

1C Units used for Nominal Beam Energy (300A,0114). Required if Nominal Beam Energy (300A,0114) is sent. Defined Terms: MV = Megavolt MEV = Mega electron-Volt If Radiation Type (300A,00C6) is PHOTON, Nominal Beam Energy Unit (300A,0015) shall be MV. If Radiation Type (300A,00C6) is ELECTRON, Nominal Beam Energy Unit (300A,0015) shall be MEV.

(300A,0116) >>Wedge Position Sequence

3 Introduces sequence of Wedge positions for current control point. The sequence may contain one or more items.


1C Uniquely identifies wedge specified by Wedge Number (300A,00D2) within Beam referenced by Referenced Beam Number (300C,0006). Required if Wedge Position Sequence (300A,0116) is sent.

(300A,0118) >>>Wedge Position 1C Position of Wedge at current control point. Required if Wedge Position Sequence (300A,0116) is sent. Enumerated Values: IN, OUT.

(300A,011A) >>Beam Limiting Device Position Sequence

1C Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if beam limiting device (collimator) changes during beam administration. The sequence may contain one or more items.






(300A,00B8) >>>RT Beam Limiting Device Type

1C Type of beam limiting device. The value of this attribute shall correspond to RT Beam Limiting Device Type (300A,00B8) defined in an element of Beam Limiting Device Leaf Pairs Sequence (3008,00A0). Required if Beam Limiting Device Position Sequence (300A,011A) is sent. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction

(300A,011C) >>>Leaf/Jaw Positions 1C Positions of beam limiting device (collimator) leaf (element) or jaw pairs (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), e.g. X-axis for MLCX, Y-axis for MLCY. Contains 2N values, where N is the Number of Leaf/Jaw Pairs (300A,00BC) in Beam Limiting Device Sequence (300A,00B6). Values shall be listed in IEC leaf (element) subscript order 101, 102, ... 1N, 201, 202, ... 2N.

(300A,011E) >>Gantry Angle 1C Treatment machine gantry angle, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Gantry Angle changes during beam administration.


1C Direction of Gantry Rotation when viewing gantry from isocenter, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040), or if Gantry Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation


1C Beam Limiting Device (collimator) angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if beam limiting device (collimator) angle changes during beam delivery.







1C Direction of Beam Limiting Device Rotation when viewing beam limiting device (collimator) from radiation source, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Beam Limiting Device Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation


1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Patient Support Angle changes during beam administration.


1C Direction of Patient Support Rotation when viewing table from above, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040), or if Patient Support Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0124) >>Table Top Eccentric Axis Distance

3 Distance (positive) from the IEC PATIENT SUPPORT vertical axis to the IEC TABLE TOP ECCENTRIC vertical axis (mm).

(300A,0125) >>Table Top Eccentric Angle

1C Table Top (non-isocentric) angle, i.e. orientation of IEC TABLE TOP ECCENTRIC coordinate system with respect to IEC PATIENT SUPPORT coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Eccentric Angle changes during beam administration.

(300A,0126) >>Table Top Eccentric Rotation Direction

1C Direction of Table Top Eccentric Rotation when viewing table from above, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Eccentric Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation







2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Vertical Position changes during beam administration.


2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Longitudinal Position changes during beam administration.


2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Lateral Position changes during beam administration.





MOSAIQ DICOM Conformance Statement Appendix J




15 APPENDIX J 15.1 SPECIFIC CONFORMANCE FOR RT ION BEAMS TREATMENT RECORD IMPORT The Radiotherapy Ion Beams Treatment Record Information Object Definition (RT Ion Beams Treatment Record IOD) is used to provide information regarding the dose delivered on specific beams to a treatment delivery system (Proton Accelerator or Proton Accelerator Control Console).

Communication between the Treatment Management System (MOSAIQ) and Treatment Delivery System (the Proton control console) is not fully standardized, but the RT Ion Beams Treatment Record can be used as one of the standardized “building blocks” for this communication.

15.2 RT ION BEAMS TREATMENT RECORD IOD MODULES The following table identifies the modules used when creating an RT Ion Beams Treatment Record object. A module is shown with a reference of Not Used if none of its attributes are accessed or translated during import.



General Study Not Used M Patient Study Not Used U


General Equipment Not Used M RT General Treatment Record

§15.3.3 M


Not Used M

RT Patient Setup Not Used U RT Treatment Machine Record

M


Not Used U


Not Used U

RT Ion Beams Session Record

§15.3.4 M







15.3.1 PATIENT MODULE The following table lists the attributes that are used to match the RT Ion Beams Treatment Record with the patient under treatment in the database. If the patient in the RT Ion Beams Treatment Record cannot be identified and uniquely matched with an existing patient in the database, the RT Ion Beams Treatment Record is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the RT Ion Beams Treatment Record. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the RT Ion Beams Treatment Record.


(0010,0010) Patient’s Name 2 Patient’s full legal name. The import process is configured to use the last name in this attribute, in addition to Patient ID, to match the RT Ion Beams Treatment Record with the patient under treatment. in the database.

(0010,0020) Patient ID 2 Primary hospital identification number or code for the patient. The RT Ion Beams Treatment Record will only be imported if this attribute and Patient’s Name can be uniquely matched with the patient under treatment.



(0008,0060) Modality 1 Type of equipment that originally acquired the data. Enumerated value must match RTRECORD for import to proceed.



(3008,0250) Treatment Date 2 Date when current fraction was delivered, or Date last fraction was delivered in case of RT Treatment Summary Record IOD.

(3008,0251) Treatment Time 2 Time when current fraction was delivered (begun), or Time last fraction was delivered (begun) in case of RT Treatment Summary Record IOD.











15.3.4 RT ION BEAMS SESSION RECORD MODULE


(3008,0021) Treatment Session Ion Beam Sequence

1 Introduces sequence of setup and/or treatment beams administered during treatment session. One or more items shall be included in this sequence.


1 References Beam specified by Beam Number (300A,00C0) in Ion Beam Sequence (300A,03A2) in RT Ion Beams Module within the referenced RT Ion Plan.

(300A,00C4) >Beam Type 1 Motion characteristic of Beam. Enumerated Values: STATIC = all beam parameters remain unchanged during delivery DYNAMIC = one or more beam parameters changes during delivery

(300A,00C6) >Radiation Type 1 Particle type of Beam. Defined Terms: PHOTON PROTON ION

(300A,0302) >Radiation Mass Number

1C Mass number of radiation. Required if Radiation Type (300A,00C6) is ION

(300A,0304) >Radiation Atomic Number

1C Atomic number of radiation. Required if Radiation Type (300A,00C6) is ION

(300A,0306) >Radiation Charge State

1C Charge state of radiation. Required if Radiation Type (300A,00C6) is ION

(300A,0308) >Scan Mode 1 The method of beam scanning used during treatment. Defined Terms: NONE = No beam scanning is performed. UNIFORM = The beam is scanned between control points to create a uniform lateral fluence distribution across the field. MODULATED = The beam is scanned between control points to create a modulated lateral fluence distribution across the field.

(300C,0040) >Referenced Verification Image Sequence

3 Introduces sequence of verification images obtained during delivery of current beam. One or more items may be included in this sequence.

(0008,1150) >>Referenced SOP Class UID

1C Uniquely identifies the referenced SOP Class. Required if Referenced Verification Image Sequence is sent.

(0008,1155) >>Referenced SOP Instance UID

1C Uniquely identifies the referenced SOP Instance. Required if Referenced Verification Image Sequence is sent.


1 Number of range compensators associated with current Beam.






(3008,00C0) >Recorded Compensator Sequence

1C Introduces sequence of treatment compensators. Required if Number of Compensators (300A,00E0) is non-zero. The number of items shall be identical to the value of Number of Compensators (300A,00E0).

(300C,00D0) >>Referenced Compensator Number

1 Uniquely identifies compensator specified by Compensator Number (300A,00E4) within Beam referenced by Referenced Beam Number (300C,0006).

(300A,00E5) >>Compensator ID 3 User-supplied identifier for compensator. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader. (300A,00F0) >Number of Blocks 1 Number of shielding blocks associated with Beam.

(3008,00D0) >Recorded Block Sequence

1C Introduces sequence of blocks associated with Beam. Required if Number of Blocks (300A,00F0) is non-zero. The number of items shall be identical to the value of Number of Blocks (300A,00F0).

(300A,00F5) >>Block Tray ID 3 User-supplied identifier for block tray. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader. (300C,00E0) >>Referenced Block

Number 1 Uniquely identifies block specified by Block Number

(300A,00FC) within Beam referenced by Referenced Beam Number (300C,0006).

(300A,00FE) >>Block Name 3 User-defined name for block.

(3008,00F0) >Recorded Snout Sequence

1C Introduces sequence of Snouts associated with Beam. Required if Snout Sequence (300A,030C) is included in the RT Ion Plan referenced within the Referenced RT Plan Sequence (300C,0002). Only a single item shall be permitted in this sequence.

(300A,030F) >>Snout ID 1 User or machine supplied identifier for Snout. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader. (300A,0312) >Number of Range

Shifters 1 Number of range shifters associated with current beam.

(3008,00F2) >Recorded Range Shifter Sequence

1C Introduces sequence of range shifters recorded with Beam. Required if Number of Range Shifters (300A,0312) is non-zero. The number of items shall be identical to the value of Number of Range Shifters (300A,0312).

(300C,0100) >>Referenced Range Shifter Number

1 Uniquely identifies range shifter specified by Range Shifter Number (300A,0316) within Beam referenced by Referenced Beam Number (300C,0006).

(300A,0318) >>Range Shifter ID 1 User or machine supplied identifier for Range Modulator. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader. (300A,0330) >Number of Lateral

Spreading Devices 1 Number of lateral spreading devices associated with current

beam.






(3008,00F4) >Recorded Lateral Spreading Device Sequence

1C Introduces sequence of lateral spreading devices associated with Beam. Required if Number of Lateral Spreading Devices (300A,0330) is non-zero. The number of items shall be identical to the value of Number of Lateral Spreading Devices (300A,0330).

(300C,0102) >>Referenced Lateral Spreading Device Number

1 Uniquely identifies lateral spreading device specified by Lateral Spreading Device Number (300A,0334) within Beam referenced by Referenced Beam Number (300C,0006).

(300A,0336) >>Lateral Spreading Device ID

1 User or machine supplied identifier for Lateral Spreading Device.


(300A,0340) >Number of Range Modulators

1 Number of range modulators associated with current beam.

(3008,00F6) >Recorded Range Modulator Sequence

1C Introduces sequence of range modulators associated with Beam. Required if Number of Range Modulators (300A,0340) is non-zero. The number of items shall be identical to the value of Number of Range Modulators (300A,0340).

(300C,0104) >>Referenced Range Modulator Number

1 Uniquely identifies range modulator specified by Range Modulator Number (300A,0344) within Beam referenced by Referenced Beam Number (300C,0006).

(300A,0346) >>Range Modulator ID 1 User or machine supplied identifier for Range Modulator. (300A,00F9) >>Accessory Code 3 An accessory identifier to be read by a device such as a bar

code reader. (300A,0348) >>Range Modulator

Type 1 Type of Range Modulator.

Defined Terms: FIXED = fixed modulation width and weights using ridge filter or constant speed wheel with constant beam current WHL_FIXEDWEIGHTS = selected wheel/track (Range Modulator ID) is spinning at constant speed. Modulation width is adjusted by switching constant beam current on and off at wheel steps indicated by Range Modulator Interrupt Values WHL_MODWEIGHTS = selected wheel/track (Range Modulator ID) is spinning at constant speed. Weight per wheel step is adjusted by modulating beam current according to selected Beam Current Modulation ID (300A,034C) Only one item in the Recorded Range Modulator Sequence (3008,00F6) can have a Range Modulator Type (300A,0348) of WHL_MODWEIGHTS.

(300A,034C) >>Beam Current Modulation ID

1C User-supplied identifier for the beam current modulation pattern. Required if Range Modulator Type (300A,0348) is WHL_MODWEIGHTS






(300A,0356) >Fixation Light Azimuthal Angle

3 Azimuthal angle (degrees) of the fixation light coordinate around IEC PATIENT SUPPORT Y-axis. Used for eye treatments.

(300A,0358) >Fixation Light Polar Angle

3 Polar angle (degrees) of the fixation light coordinate. Used for eye treatments.


2 Delivery Type of treatment. Defined Terms: TREATMENT = normal patient treatment OPEN_PORTFILM = portal image acquisition with open field (the source of radiation is specified by Radiation Type (300A,00C6)) TRMT_PORTFILM = portal image acquisition with treatment port (the source of radiation is specified by Radiation Type (300A,00C6)) CONTINUATION = continuation of interrupted treatment SETUP = no treatment beam was applied for this RT Beam. To be used for specifying the gantry, couch, and other machine positions where X-ray set-up images or measurements were taken.







(3008,0032) >Specified Primary Meterset

3 Desired machine setting of primary meterset in units specified by Primary Dosimeter Unit (300A,00B3).

(3008,0036) >Delivered Primary Meterset

3 Machine setting actually delivered as recorded by primary meterset in units specified by Primary Dosimeter Unit (300A,00B3).

(3008,0037) >Delivered Secondary Meterset

3 Machine setting actually delivered as recorded by secondary meterset.

(3008,003A) >Specified Treatment Time

3 Treatment Time set (sec).






(3008,003B) >Delivered Treatment Time

3 Treatment Time actually delivered (sec).


1 Number of control points in Beam.

(3008,0041) >Ion Control Point Delivery Sequence

1 Introduces sequence of beam control points for current ion treatment beam. The number of items shall be identical to the value of Number of Control Points (300A,0110).


1 Uniquely identifies Control Point specified by Control Point Index (300A,0112) within the Beam referenced by Referenced Beam Number (300C,0006).





(3008,0044) >>Delivered Meterset 1 Machine setting actually delivered at current control point in units specified by Primary Dosimeter Unit (300A,00B3).

(3008,0046) >>Meterset Rate Delivered

3 The delivered speed of delivery of the specified dose in units specified by Primary Dosimeter Unit (300A,00B3) per minute.


1C Nominal Beam Energy at control point in MeV per nucleon. Defined at nozzle entrance before all Beam Modifiers. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Nominal Beam Energy (300A,0114) changes during beam administration, and KVp (0018,0060) is not present.

(300A,0360) >>Range Shifter Settings Sequence

1C Introduces sequence of Range Shifter settings for the current control point. One or more items may be included in this sequence. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Range Shifter Setting (300A,0362) changes during beam administration, and Number of Range Shifters (300A,0312) is non-zero.

(300C,0100) >>>Referenced Range Shifter Number

1 Uniquely references Range Shifter described by Range Shifter Number (300A,0316) in Range Shifter Sequence (300A,0314).

(300A,0362) >>>Range Shifter Setting

1 Machine specific setting attribute for the range shifter. The specific encoding of this value should be documented in a Conformance Statement.

(300A,0370) >>Lateral Spreading Device Settings Sequence

1C Introduces sequence of Lateral Spreading Device settings for the current control point. One or more items may be included in this sequence. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Lateral Spreading Device Setting (300A,0372) changes during beam administration, and Number of Lateral Spreading Devices (300A,0330) is non-zero.






(300C,0102) >>>Referenced Lateral Spreading Device Number

1 Uniquely references Lateral Spreading Device described by Lateral Spreading Device Number (300A,0334) in Lateral Spreading Device Sequence (300A,0332).

(300A,0372) >>>Lateral Spreading Device Setting

1 Machine specific setting attribute for the lateral spreading device. The specific encoding of this value should be documented in a Conformance Statement.

(300A,0380) >>Range Modulator Settings Sequence

1C Introduces sequence of Range Modulator Settings for current control point. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041), or if Range Modulator Settings change during beam administration, and Number of Range Modulators (300A,0340) is non-zero.

(300C,0104) >>>Referenced Range Modulator Number

1 Uniquely references Range Modulator described by Range Modulator Number (300A,0344) in Range Modulator Sequence (300A,0342).

(300A,0382) >>>Range Modulator Gating Start Value

1C Start position defines the range modulator position at which the beam is switched on. Required if Range Modulator Type (300A,0348) of the range modulator referenced by Referenced Range Modulator Number (300C,0104) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS

(300A,0384) >>>Range Modulator Gating Stop Value

1C Stop position defines the range modulator position at which the beam is switched off. Required if Range Modulator Type (300A,0348) of the range modulator referenced by Referenced Range Modulator Number (300C,0104) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS

(300A,011E) >>Gantry Angle 1C Treatment machine gantry angle, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Gantry Angle changes during beam administration.


1C Direction of Gantry Rotation when viewing gantry from isocenter, for segment beginning at current Control Point. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041), or if Gantry Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,014A) >>Gantry Pitch Angle 2C Gantry Pitch Angle. i.e. the rotation of the IEC GANTRY coordinate system about the X-axis of the IEC GANTRY coordinate system (degrees). Required for first item of Control Point Sequence, or if Gantry PitchRotation Angle changes during Beam.






(300A,014C) >>Gantry Pitch Rotation Direction

2C Direction of Gantry PitchAngle when viewing along the positive X-axis of the IEC GANTRY coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Gantry PitchRotation Direction changes during Beam. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation


1C Beam Limiting Device (collimator) angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if beam limiting device (collimator) angle changes during beam administration.


1C Direction of Beam Limiting Device Rotation when viewing beam limiting device (collimator) from radiation source, for segment beginning at current Control Point. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Beam Limiting Device Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation


1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Patient Support Angle changes during beam administration.


1C Direction of Patient Support Rotation when viewing table from above, for segment beginning at current Control Point. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041), or if Patient Support Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0140) >>Table Top Pitch Angle

2C Table Top Pitch Angle, i.e. the rotation of the IEC TABLE TOP coordinate system about the X-axis of the IEC TABLE TOP coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Pitch Angle changes during Beam.






(300A,0142) >>Table Top Pitch Rotation Direction

2C Direction of Table Top Pitch Rotation when viewing the table along the positive X-axis of the IEC TABLE TOP coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Pitch Rotation Direction changes during Beam. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation

(300A,0144) >>Table Top Roll Angle 2C Table Top Roll Angle, i.e. the rotation of the IEC TABLE TOP coordinate system about the Y-axis of the IEC TABLE TOP coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Roll Angle changes during Beam.

(300A,0146) >>Table Top Roll Rotation Direction

2C Direction of Table Top Roll Rotation when viewing the table along the positive Y-axis of the IEC TABLE TOP coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Roll Rotation Direction changes during Beam. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation


2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Table Top Vertical Position changes during beam administration.


2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Table Top Longitudinal Position changes during beam administration.


2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Table Top Lateral Position changes during beam administration.

(300A,0390) >>Scan Spot Tune ID 1C User-supplied or machine code identifier for machine configuration to produce beam spot. This may be the nominal spot size or some other machine specific value. Required if Scan Mode (300A,0308) is MODULATED






(300A,0392) >>Number of Scan Spot Positions

1C Number of spot positions used to specify scanning pattern for current segment beginning at control point. Required if Scan Mode (300A,0308) is MODULATED.

(300A,0394) >>Scan Spot Position Map

1C The x and y coordinates of the scan spots are defined as projected onto the machine isocentric plane in the IEC GANTRY coordinate system (mm). Required if Scan Mode (300A,0308) is MODULATED. Contains 2N values where N is the Nof Scan Spot Positions (300A,0392).

(300A,0396) >>Scan Spot Meterset Weights

1C A data set of meterset weights corresponding to scan spot positions. The order of weights matches the positions in Scan Spot Positions (300A,0394). The sum contained in all meterset weights shall match the difference of the cumulative meterset weight of the current control point to the following control point. Required if Scan Mode (300A,0308) is MODULATED.

(300A,0398) >>Scanning Spot Size 3 The Scanning Spot Size as calculated using the Full Width Half Maximum (FWHM). Specified by a numeric pair - the size measured in air at isocenter in IEC GANTRY X direction followed by the size in the IEC GANTRY Y direction (mm).

(300A,039A) >>Number of Paintings 1C The number of times the scan pattern given by Scan Spot Position Map (300A,0394) and Scan Spot Meterset Weights (300A,0396) shall be applied at the current control point. To obtain the meterset weight per painting, the values in the Scan Spot Meterset Weights (300A,0396) should be divided by the value of this attribute. Required if Scan Mode (300A,0308) is MODULATED.

(300A,030D) >>Snout Position 2C Axial position of the snout (in mm) measured from isocenter to the downstream side of the snout (without consideration of variable length elements such as blocks, MLC and/or compensators). Required for Control Point 0 of Ion Control Point Delivery Sequence (3008,0041) or if Snout Position changes during beam administration.

MOSAIQ DICOM Conformance Statement Appendix K




16 APPENDIX K 16.1 SPECIFIC CONFORMANCE FOR QUERY/RETRIEVE (SCU) INFORMATION MODELS

Tag Name Matching Type

Description

(0010,0010) Patient’s Name Single Value

Patient’s full legal name. The Query Key is encoded and the Value is populated

(0010,0020) Patient ID Single Value

Primary hospital identification number or code for the patient. The Query Key is encoded and the Value is populated

(0008,0020) Study Date Range Date the Study started.

(0020,000D) Study Instance UID List of UID

Unique Identifier for the Study. Value is populated for SERIES level queries (single value)

(0020,0010) Study ID Universal User or equipment generated Study identifier. Query Key encoded. Universal matching (value is zero length)

(0008,1030) Study Description Universal Institution-generated description or classification of the Study (component) performed.

(0008,0021) Series Date Universal Date the Series started (0008,0060) Modality Single

Value or Universal

Type of equipment that originally acquired the data. User selection drives whether the attribute will have a single modality specified or if the value is zero length. There is application level functionality to perform more complex filtering on modality.

(0020,000E) Series Instance UID Universal Unique Identifier of the Series.

(0020,0011) Series Number Universal A number that identifies this Series

(0020,103E Series Description Universal User provided description of the Series

MOSAIQ DICOM Conformance Statement Appendix L




17 APPENDIX L 17.1 SPECIFIC CONFORMANCE FOR RT DOSE IMPORT The Radiotherapy Dose Information Object Definition (RT Dose IOD) provides information regarding the dose distributions calculated by radiotherapy treatment planning systems. These distributions must be represented as 3D grids. Dose Point and DVH information, if provided, will be ignored.

17.2 RT DOSE IOD MODULES The following table identifies the modules used when importing an RT Dose object. A module is shown with a reference of Not Used if none of its attributes are accessed or translated during import.

Module Name Reference Usage Patient §17.3.1 M

Clinical Trial Subject Not Used U General Study §17.3.2 M Patient Study Not Used U


Frame of Reference §17.3.4 M General Equipment §17.3.5 M General Image Not Used C – Required if dose data contains grid-based doses

Image Plane §17.3.7 C – Required if dose data contains grid-based doses Image Pixel §17.3.8 C – Required if dose data contains grid-based doses

Multi-Frame §17.3.9 C – Required if dose data contains grid-based doses and pixel data is multi-frame data

Overlay Plane Not Used U Multi-Frame Overlay Not Used U

Modality LUT Not Used U RT Dose §17.3.13 M RT DVH Not Used U

Structure Set Not Used C – Required if dose data contains dose points or isodose curves ROI Contour Not Used C – Required if dose data contains dose points or isodose curves RT Dose ROI Not Used C – Required if dose data contains dose points or isodose curves

SOP Common §17.3.18 M Frame Extraction Not Used C – Required if the SOP Instance was created in response to a Frame-

Level retrieve request






17.3.1 PATIENT MODULE

The following table lists the attributes that are used to match the RT Dose with a patient in the database. If the patient in the RT Dose cannot be identified and uniquely matched with an existing patient in the database, the RT Dose is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the RT Dose. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the RT Dose.


(0010,0010) Patient’s Name 2 Required for import. Patient’s full legal name. The import process is configurable to use the last name in this attribute, in addition to Patient ID, to match with a pre-registered patient.

(0010,0020) Patient ID 2 Required for import Primary hospital identification number or code for the patient. The RT Dose will only be imported if this attribute (and optionally, Patient’s Name) can be uniquely matched with a pre-registered patient.

(0010,0030) Patient’s Birth Date 2 Not imported

(0010,0040) Patient’s Sex 2 Not imported



(0020,000D) Study Instance UID 1 Required for import Unique identifier for the study; Study Instance UID is patient specific.

(0008,0020) Study Date 2 Not required but saved upon import if provided Date the Study started

(0008,0030) Study Time 2 Not required but saved upon import if provided Time the Study started

(0008,0090) Referring Physician’s Name

2 Not imported

(0020,0010) Study ID 2 Not required but saved upon import if provided User or equipment generated Study identifier.






(0008,0050) Accession Number 2 Not required but saved upon import if provided A RIS generated number that identifies the order for the Study.

(0008,1030) Study Description 3 Not required but saved upon import if provided Institution-generated description or classification of the Study (component) performed; if missing or NULL defaults to blank.

(0008,1048) Physician(s) of Record 3 Not imported



(0008,0060) Modality 1 Required for import Must equal RTDOSE

(0020,000E) Series Instance UID 1 Required for import Unique identifier of the series; Series Instance UID is study specific

(0020,0011) Series Number 2 Not required but saved upon import if provided A number that identifies this series.

(0008,103E) Series Description 3 Not required but saved upon import if provided Description of the series.

0008,1070) Operator’s Name 2 Not required but saved upon import if provided




1 Required for import Uniquely identifies the frame of reference for a Series.


2 Not required but saved upon import if provided Part of the imaging target used as a reference.



(0008,0070) Manufacturer 2 Not required but saved upon import if provided Manufacturer of the equipment that produced the composite instances.






(0008,1010) Station Name 3 Not required but saved upon import if provided User defined name identifying the machine that produced the composite instances.


3 Not required but saved upon import if provided Manufacturer’s model name of the equipment that produced the composite instances.

(0018,1020) Software Versions 3 Not required but saved (first value only) upon import if provided Manufacturer’s designation of software version of the equipment that produced the composite instances

17.3.6 GENERAL IMAGE MODULE -- NOT SUPPORTED



(0028,0030) Pixel Spacing 1 Required for import Physical distance in the patient between the center of each pixel, specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing in mm.

(0020,0037) Image Orientation (Patient)

1 Required for import The direction cosines of the first row and the first column with respect to the patient.

(0020,0032) Image Position (Patient)

1 Required for import The x, y, and z coordinates of the upper left hand corner (center of the first voxel transmitted) of the image, in mm.

(0018,0050) Slice Thickness 2 Not imported (0020,1041) Slice Location 3 Not imported



(0028,0002) Samples per Pixel 1 Required for import Number of samples (planes) in this image.


1 Required for import Specifies the intended interpretation of the pixel data.

(0028,0010) Rows 1 Required for import Number of rows in the image.

(0028,0011) Columns 1 Required for import Number of columns in the image

(0028,0100) Bits Allocated 1 Required for import Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated.






(0028,0101) Bits Stored 1 Required for import Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored.

(0028,0102) High Bit 1 Required for import Most significant bit for pixel sample data. Each sample shall have the same high bit.

(0028,0103) Pixel Representation 1 Required for import Data representation of the pixel samples. Each sample shall have the same pixel representation. Enumerated Values: 0000H = unsigned integer. 0001H = 2's complement

(7FE0,0010) Pixel Data 1C Required for import A data stream of the pixel samples that comprise the Image.

(0028,0006) Planar Configuration 1C Not imported (0028,0034) Pixel Aspect Ratio 1C Not imported

(0028,0106) Smallest Image Pixel Value

3 Not imported

(0028,0107) Largest Image Pixel Value

3 Not imported

(0028,2000) ICC Profile 3 Not imported (0028,7FE0) Pixel Data Provider

URL 1C Not imported

(0028,0121) Pixel Padding Range Limit

1C Not imported

17.3.9 MULTI-FRAME MODULE

Tag Name Type Description (0028,0008) Number of Frames 1 Required for import

Number of frames in a Multi-frame Image. (0028,0009) Frame Increment

Pointer 1 Required for import

Contains the Data Element Tag of the attribute that is used as the frame increment in Multi-frame pixel data.

17.3.10 OVERLAY PLANE MODULE – NOT SUPPORTED

17.3.11 MULTI-FRAME OVERLAY MODULE – NOT SUPPORTED

17.3.12 MODALITY LUT MODULE – NOT SUPPORTED

17.3.13 RT DOSE MODULE






(0028,0002) Samples per Pixel 1C Required for import Number of samples (planes) in this image. For RT Dose, shall have the Enumerated Value of 1.


1C Required for import Specifies the intended interpretation of the pixel data. For RT Dose, shall have the Enumerated Value of MONOCHROME2.

(0028,0100) Bits Allocated 1C Required for import Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. For RT Dose, shall have an Enumerated Value of 16 or 32.

(0028,0101) Bits Stored 1C Required for import Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. For RT Dose, shall be equal to Bits Allocated.

(0028,0102) High Bit 1C Required for import Most significant bit for each pixel sample. Each sample shall have the same high bit. For RT Dose, shall have an Enumerated Value of one less than Bits Stored.

(0028,0103) Pixel Representation 1C Required for import

Data representation of the pixel samples. Each sample shall have the same pixel representation. For RT Dose, is specified to use the following Enumerated Values:

0001H = two’s complement integer, when Dose Type (3004,0004) = ERROR 0000H = unsigned integer, otherwise.

(3004,0002) Dose Units 1 Required for import Units used to describe dose. Enumerated Values: GY = Gray RELATIVE = dose relative to implicit reference value

(3004,0004) Dose Type 1 Required for import Type of dose. Defined Term supported: PHYSICAL = physical dose Defined Terms not supported: EFFECTIVE = physical dose after correction for biological effect using user-defined modeling technique ERROR = difference between desired and planned dose

(0020,0013) Instance Number 3 Not imported (3004,0006) Dose Comment 3 Not required but saved if provided

User-defined comments for dose data.






(3004,0008) Normalization Point 3 Not imported (3004,000A) Dose Summation Type 1 Required for import

Type of dose summation. Defined Terms supported: PLAN = dose calculated for entire RT Plan FRACTION = dose calculated for a single Fraction Group within RT Plan BEAM = dose calculated for one or more Beams within RT Plan BRACHY = dose calculated for one or more Brachy Application Setups within RT Plan Defined Terms not supported: MULTI_PLAN = dose calculated for 2 or more RT Plans CONTROL_POINT = dose calculated for one or more Control Points within a Beam

(300C,0002) Reference RT Plan Sequence

1C Required for import Sequence describing RT Plan associated with dose. Only a single item shall be included in this sequence.

> SOP Instance Reference Macro Table 10-11

(300C,0020) >Referenced Fraction Group Sequence

1C Required for import if Dose Summation Type is FRACTION, BEAM or BRACHY Introduces sequence of one Fraction Group containing beams or brachy application setups contributing to dose. Only a single item shall be included in this sequence.

(300C,0022) >>Referenced Fraction Group Number

1 Required for import if Dose Summation Type is FRACTION, BEAM or BRACHY Uniquely identifies Fraction Group specified by Fraction Group Number (300A,0071) in Fraction Group Sequence of RT Fraction Scheme Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002).

(300C,0004) >>Referenced Beam Sequence

1C Required for import if Dose Summation Type is BEAM Introduces sequence of Beams in current Fraction Group contributing to dose. Required if Dose Summation Type is BEAM. One or more items shall be included in this sequence.

(300C,0006) >>>Referenced Beam Number

1 Required for import if Dose Summation Type is BEAM Uniquely identifies Beam specified by Beam Number (300A,00C0) in Beam Sequence of RT Beams Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002).






(300C,000A) >>Referenced Brachy Application Setup Sequence

1C Not required by application Introduces sequence of Brachy Application Setups in current Fraction Group contributing to dose. One or more items shall be included in this sequence.

(300C,000C) >>Referenced Brachy Application Setup Number

1 Not required by application. Uniquely identifies Brachy Application Setup specified by Brachy Application Setup Number (300A,0234) in Brachy Application Setup Sequence (300A,0230) of RT Brachy Application Setups Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002).

(3004,000C) Grid Frame Offset Vector

1C Required for import An array which contains the dose image plane offsets (in mm) of the dose image frames in a multi-frame dose. Required if multi-frame pixel data are present and Frame Increment Pointer (0028,0009) points to Grid Frame Offset Vector (3004,000C).

(3004,000E) Dose Grid Scaling 1C Required for import Scaling factor that when multiplied by the dose grid data found in the Pixel Data (7FE0,0010) attribute of the Image Pixel Module, yields grid doses in the dose units as specified by Dose Units (3004,0002). Required if Pixel Data (7FE0,0010) is present.

(3004,3014) Tissue Heterogeneity Correction

3 Not required for import but saved if provided Specifies a list of patient heterogeneity characteristics used for calculating dose. This attribute shall be multi-valued if beams used to compute the dose have differing correction techniques. Enumerated Values: IMAGE = image data ROI_OVERRIDE = one or more ROI densities

override image or water values where they exist WATER = entire volume treated as water equivalent

17.3.14 RT DVH MODULE – NOT SUPPORTED

17.3.15 STRUCTURE SET MODULE – NOT SUPPORTED

17.3.16 ROI CONTOUR MODULE – NOT SUPPORTED

17.3.17 RT DOSE ROI MODULE – NOT SUPPORTED







(0008,0016) SOP Class UID 1 Required for import, must be equal to 1.2.840.10008.5.1.4.1.1.481.2 for RT Dose Uniquely identifies the SOP Class.

(0008,0018) SOP Instance UID 1 Required for import Uniquely identifies the SOP Instance.

(0008,0005) Specific Character Set 1C Not required but saved upon import if provided; if not provided ASCII assumed. Character Set that expands or replaces the Basic Graphic Set. Required if an expanded or replacement character set is used. Defined Terms supported:

17.3.19 SINGLE BYTE AND SINGLE BYTE EXTENDED CHARACTER SET SUPPORT: • ASCII (ISO-IR 6) IS0 646, • Latin Alphabet No. 2 (ISO IR 101), • Latin Alphabet No. 3 (ISO IR 109), • Latin Alphabet No. 4 (ISO IR 110), • Cyrrlic (ISO IR 144), • Arabic (ISO IR 127), • Greek (ISO IR 126), • Hebrew (ISO IR 138), • Latin Alphabet No. 5 (ISO IR 148), • Thai (ISO IR 166), • Japanese (ISO IR 13)

17.3.20 MULTI-BYTE CHARACTER SET SUPPORT: • ASCII (ISO-IR 6) IS0 646, • JIS X 0201 Katakana (ISO-IR 13), • JIS X 0208 Kanji (ISO-IR 87), • JIS X 0212 Kanji (ISO-IR 159), • JIS-X 0201 Romaji (ISO-IR 14) • Latin Alphabet No.1 (ISO IR 100) –

Supplementary set of ISO 8859.

(0008,0012) Instance Creation Date 3 Not imported

(0008,0013) Instance Creation Time 3 Not imported

(0008,0014) Instance Creator UID 3 Not imported

(0020,0013) Instance Number 3 Not imported





17.3.21 FRAME EXTRACTOR MODULE – NOT SUPPORTED

MOSAIQ DICOM Conformance Statement Appendix M




18 APPENDIX M 18.1 SPECIFIC CONFORMANCE FOR SPATIAL REGISTRATION IMPORT The Spatial Registration IOD specifies the spatial relationship between Frames of Reference.

18.2 SPATIAL REGISTRATION IOD MODULES The following table identifies the modules used when importing a Spatial Registration object. A module is shown with a reference of Not Used if none of its attributes are accessed or translated during import.



General Study §18.3.2 M Patient Study Not Used U Clinical Trial Study Not Used U

General Series §18.3.3 M Clinical Trial Series Not Used U Spatial Registration Series

§18.3.4 M

Frame of Reference §18.3.5 M General Equipment §18.3.6 M Spatial Registration §18.3.7 M

Common Instance Reference

§18.3.8 M


Note: The Specimen Identification Module was previously included in this IOD but has been retired. See PS 3.3-2008.


18.3.1 PATIENT MODULE The following table lists the attributes that are used to match the Spatial Registration with a patient in the database. If the patient in the Spatial Registration object cannot be identified and uniquely matched with an existing patient in the database, the Spatial Registration object is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the Spatial Registration object. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the Spatial Registration.






(0010,0010) Patient’s Name 2 Required for import. Patient’s full legal name. The import process is configurable to use the last name in this attribute, in addition to Patient ID, to match to a pre-registered patient.

(0010,0020) Patient ID 2 Required for import Primary hospital identification number or code for the patient. The Spatial Registration will only be imported if this attribute (and optionally, Patient’s Name) can be uniquely matched to a pre-registered patient.

(0010,0030) Patient’s Birth Date 2 Not imported

(0010,0040) Patient’s Sex 2 Not imported



(0020,000D) Study Instance UID 1 Required for import, may only be associated with a single patient Unique identifier for the study


(0008,0030) Study Time 2 Not required but saved upon import if provided Date the Study started


2 Not imported





18.3.3 GENERAL SERIES MODULE

Tag Name Type Description (0008,0060) Modality 1 See Spatial Registration Series Module

(0020,000E) Series Instance UID 1 Required for import; may only be associated with a single study Unique identifier of the Series






(0020,0011) Series Number 2 Not required but saved upon import if provided A number that identifies this Series.

(0008,0021) Series Date 3 Not required but saved upon import if provided Date the Series started.

(0008,0031) Series Time 3 Not required but saved upon import if provided Time the Series started.

(0008,103E) Series Description 3 Not required but saved upon import if provided Description of the Series

(0018,5100) Patient Position 2C Not Imported Patient position descriptor relative to the equipment. Required for images where Patient Orientation Code Sequence (0054,0410) is not present and whose SOP Class is one of the following: CT ("1.2.840.10008.5.1.4.1.1.2") or MR ("1.2.840.10008.5.1.4.1.1.4") or Enhanced CT ("1.2.840.10008.5.1.4.1.1.2.1") or Enhanced MR Image ("1.2.840.10008.5.1.4.1.1.4.1") or Enhanced Color MR Image ("1.2.840.10008.5.1.4.1.1.4.3") or MR Spectroscopy ("1.2.840.10008.5.1.4.1.1.4.2") Storage SOP Classes. May be present for other SOP Classes if Patient Orientation Code Sequence (0054,0410) is not present.

18.3.4 SPATIAL REGISTRATION SERIES MODULE


(0008,0060) Modality 1 Modality type. Enumerated Value: REG









(0008,0070) Manufacturer 2 Not required but saved upon import if provided Manufacturer of the equipment that produced the composite instances.






(0008,1010) Station Name 3 Not required but saved upon import if provided User defined name identifying the machine that produced the composite instances.


3 Not required but saved upon import if provided Manufacturer’s model name of the equipment that produced the composite instances.

(0018,1020) Software Versions 3 Not required but saved (first value only) upon import if provided Manufacturer’s designation of software version of the equipment that produced the composite instances

18.3.7 SPATIAL REGISTRATION MODULE


(0008,0023) Content Date 1 Required for import The date the content creation started.

(0008,0033) Content Time 1 Required for import The time the content creation started.

Include Content Identification Macro Table 10-12

(0070,0308) Registration Sequence 1 Required for import A sequence of registration items. Each item defines a spatial registration of the images referenced in that item to the Registered RCS established by this SOP instance. All referenced images are in the same spatial frame of reference or atlas. Exactly 2 Items shall be included in this sequence.

(0020,0052) >Frame of Reference UID

1C Required for import; Registration Sequence items must have differing Frame of Reference UIDs Identifies the Frame of Reference of the referenced data, that may or may not be an image set (e.g. atlas or physical space). Required if Referenced Image Sequence (0008,1140) is absent. May be present otherwise.

(0008,1140) >Referenced Image Sequence

1C Not required but saved upon import if provided Identifies the set of images of the referenced data, registered in this sequence item. One or more Items shall be included in this sequence. Required if Frame of Reference UID (0020,0052) is absent. May be present otherwise.

>>Include 'Image SOP Instance Reference Macro' Table 10-3






(0070,0309) >Matrix Registration Sequence

1 Required for import A sequence that specifies one spatial registration. Only a single Item shall be included in this sequence.

(3006,00C8) >>Frame of Reference Transformation Comment

3 Not required but saved if provided User description or comments about the registration.

(0070,030D) >>Registration Type Code Sequence

2 Not imported

>>>Include ‘Code Sequence Macro’ Table 8.8-1

(0070,030A) >>Matrix Sequence 1 Required for import Specifies one transformation, that registers the Source RCS/images to the Registered RCS. It is expressible as multiple matrices, each in a separate item of the sequence. Only a single item shall be included in this sequence.

(3006,00C6) >>>Frame of Reference Transformation Matrix

1 Required for import; One of the items in the Registration Sequence must equal the IDENTITY matrix. If the other item in the Registration Sequence equals the IDENTITY matrix, it shall be treated as a standard transformation matrix. A 4x4 homogeneous transformation matrix that registers a coordinate system A to B. Matrix elements shall be listed in row-major order.

(0070,030C) >>>Frame of Reference Transformation Matrix Type

1 Required for import Type of Frame of Reference Transformation Matrix (3006,00C6). Defined term supported: RIGID Defined terms not supported: RIGID_SCALE AFFINE

18.3.8 COMMON INSTANCE REFERENCE MODULE – NOT SUPPORTED



(0008,0016) SOP Class UID 1 Required for import, must be equal to 1.2.840.10008.5.1.4.1.1.66.1 for Spatial Registration Uniquely identifies the SOP Class.


MOSAIQ DICOM Conformance Statement Appendix N





(0008,0005) Specific Character Set 1C Not required but used for internal processing if present otherwise. Character Set that expands or replaces the Basic Graphic Set.

18.1.1 SINGLE BYTE AND SINGLE BYTE EXTENDED CHARACTER SET SUPPORT • ASCII (ISO-IR 6) IS0 646, • Latin Alphabet No. 2 (ISO IR 101), • Latin Alphabet No. 3 (ISO IR 109), • Latin Alphabet No. 4 (ISO IR 110), • Cyrrlic (ISO IR 144), • Arabic (ISO IR 127), • Greek (ISO IR 126), • Hebrew (ISO IR 138), • Latin Alphabet No. 5 (ISO IR 148), • Thai (ISO IR 166), • Japanese (ISO IR 13)

18.1.2 MULTI-BYTE CHARACTER SET SUPPORT • ASCII (ISO-IR 6) IS0 646, • JIS X 0201 Katakana (ISO-IR 13), • JIS X 0208 Kanji (ISO-IR 87), • JIS X 0212 Kanji (ISO-IR 159), • JIS-X 0201 Romaji (ISO-IR 14) • Latin Alphabet No.1 (ISO IR 100) –

Supplementary set of ISO 8859. (0008,0012) Instance Creation Date 3 Not required but saved upon import if provided

(0008,0013) Instance Creation Time 3 Not required but saved upon import if provided



19 APPENDIX N 19.1 SPECIFIC CONFORMANCE FOR CT, MR AND PET IMAGE IMPORT The Standard CT Image Information Object Definition (CT IOD) specifies an image that has been created by a Computed Tomography imaging device.

The MR Image Information Object Definition (MR IOD) specifies an image that has been created by a Magnetic Resonance imaging device.





The Positron Emission Tomography Image Information Object Definition (PET IOD) specifies an image that has been created by a Positron Emission Tomography imaging device.

19.2 COMMON MODULES FOR CT, MR AND PET IMAGE IOD’S

19.2.1 PATIENT MODULE The following table lists the attributes that are used to match the Image with a patient in the database. If the patient in the Image cannot be identified and uniquely matched with an existing patient in the database, the Image is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the Image. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the Image.


(0010,0010) Patient’s Name 2 Required for import. Patient’s full legal name. The import process is configurable to use the last name in this attribute, in addition to Patient ID, to match to a pre-registered patient.

(0010,0020) Patient ID 2 Required for import Primary hospital identification number or code for the patient. The Image will only be imported if this attribute (and optionally, Patient’s Name) can be uniquely matched to a pre-registered patient.

(0010,0030) Patient’s Birth Date 2 Not imported (0010,0040) Patient’s Sex 2 Not imported



(0020,000D) Study Instance UID 1 Required for import, may only be associated with a single patient Unique identifier for the study


(0008,0030) Study Time 2 Not required but saved upon import if provided Date the Study started


2 Not imported










19.2.3 GENERAL SERIES MODULE


(0008,0060) Modality 1 See Image Module

(0020,000E) Series Instance UID 1 Required for import; may only be associated with a single study Unique identifier of the Series

(0020,0011) Series Number 2 Not required but saved upon import if provided A number that identifies this Series.

(0008,0021) Series Date 3 Not required but saved upon import if provided Date the Series started.

(0008,0031) Series Time 3 Not required but saved upon import if provided Time the Series started.

(0008,103E) Series Description 3 Not required but saved upon import if provided Description of the Series

(0018,5100) Patient Position 2C Required for import





19.2.4 GENERAL EQUIPMENT MODULE The following table lists the attributes in this module that are used to identify the image source.


(0008,0070) Manufacturer 2 Manufacturer of the equipment that produced the image. This attribute may be used, in addition to Modality, to identify the image source. This allows the import process to differentiate image objects with the same Modality. Only the first 40 characters of this attribute are used.

(0008,1010) Station Name 3 User-defined name identifying the machine that produced the image. This attribute may be used, in addition to Modality, to identify the image source. This allows the import process to differentiate image objects with the same Modality and Manufacturer.

(0008,1090) Manufacturer's Model Name

3 Manufacturer's model name of the equipment that produced the image. This attribute may be used, in addition to Modality, to identify the image source. This allows the import process to differentiate image objects with the same Modality. Only the first 40 characters of this attribute are used.



(0020,0013) Instance Number 2 A number that identifies this image. (0020,0020) Patient Orientation 2C Patient direction of the rows and columns of the image.

Required if image does not require Image Orientation (Patient) (0020,0037) and Image Position (Patient) (0020,0032)



(0008,0008) Image Type 3 Image identification characteristics







(0020,0037)

Image Orientation (Patient)

1 The direction cosines of the first row and the first column with respect to the patient. See C.7.6.2.1.1 for further explanation.

(0020,0032) Image Position (Patient)

1 The x, y, and z coordinates of the upper left hand corner (center of the first voxel transmitted) of the image, in mm. See C.7.6.2.1.1 for further explanation.

(0018,0050) Slice Thickness 2 Nominal slice thickness, in mm. If the value is unknown, the import process defaults to 0.

(0020,1041) Slice Location 3 Relative position of exposure expressed in mm. If the attribute is absent or the value is unknown, the import process defaults to 0.

(0028,0030) Pixel Spacing 1 Physical distance in the patient between the center of each pixel, in mm. If the row and column spacing values are not equal (pixels are not square), the image appears distorted when displayed and measurements made on the image are inaccurate.



(0028,0010) Rows 1 Number of rows in the image. The value must be within the range 16 to 4096. Otherwise the image object is not imported.

(0028,0011) Columns 1 Number of columns in the image. The value must be within the range 16 to 4096. Otherwise the image object is not imported.

(0028,0034) Pixel Aspect Ratio 1C Ratio of the vertical size and horizontal size of the pixels in the image. This attribute is not explicitly used; pixel aspect ratio is assumed to be 1\1. Otherwise the image appears distorted when displayed and measurements made on the image are inaccurate.


(7FE0,0010) Pixel Data 1C A data stream of the pixel samples that comprise the image.













(0008,0016) SOP Class UID 1 Required for import, must be equal to 1.2.840.10008.5.1.4.1.1.66.1 for Spatial Registration Uniquely identifies the SOP Class.


(0008,0005) Specific Character Set 1C Not required but used for internal processing if present otherwise. Character Set that expands or replaces the Basic Graphic Set.

19.2.10 SINGLE BYTE AND SINGLE BYTE EXTENDED CHARACTER SET SUPPORT • ASCII (ISO-IR 6) IS0 646, • Latin Alphabet No. 2 (ISO IR 101), • Latin Alphabet No. 3 (ISO IR 109), • Latin Alphabet No. 4 (ISO IR 110), • Cyrrlic (ISO IR 144), • Arabic (ISO IR 127), • Greek (ISO IR 126), • Hebrew (ISO IR 138), • Latin Alphabet No. 5 (ISO IR 148), • Thai (ISO IR 166), • Japanese (ISO IR 13)

19.2.11 MULTI-BYTE CHARACTER SET SUPPORT • ASCII (ISO-IR 6) IS0 646, • JIS X 0201 Katakana (ISO-IR 13), • JIS X 0208 Kanji (ISO-IR 87), • JIS X 0212 Kanji (ISO-IR 159), • JIS-X 0201 Romaji (ISO-IR 14) • Latin Alphabet No.1 (ISO IR 100) –

Supplementary set of ISO 8859. (0008,0012) Instance Creation Date 3 Not required but saved upon import if provided

(0008,0013) Instance Creation Time 3 Not required but saved upon import if provided







CT IMAGE IOD MODULES The following table identifies the modules used when importing a PET Image object. A module is shown with a reference of Not Used if none of its attributes are accessed or translated during import.




Clinical Trial Study Not Used U General Series §19.2.3 M Clinical Trial Series Not Used U

Frame of Reference §19.2.8 M General Equipment §19.2.4 M General Image §19.2.5 M

Image Plane §19.2.6 M Image Pixel §19.2.7 M Contrast/bolus §19.3.2 C

Device U Specimen U CT Image §19.3.1 M

Overlay Plane U VOI LUT U

Not Used for CT Image Series Import at this time SOP Common §19.2.9 M

19.2.12 CT IMAGE MODULE

Attribute Name Tag Type Description

Image Type (0008,0008) 1 Required for import Image identification characteristics. See C.8.2.1.1.1 for specialization.

Samples per Pixel (0028,0002) 1 Required for import Number of samples (planes) in this image. See C.8.2.1.1.2 for specialization.

Photometric Interpretation (0028,0004) 1 Required for import Specifies the intended interpretation of the pixel data. See C.8.2.1.1.3 for specialization.

Bits Allocated (0028,0100) 1 Required for import Number of bits allocated for each pixel sample. Each sample shall have the same






number of bits allocated. See C.8.2.1.1.4 for specialization.

Bits Stored (0028,0101) 1 Required for import Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. See C.8.2.1.1.5 for specialization.

High Bit (0028,0102) 1 Required for import Most significant bit for pixel sample data. Each sample shall have the same high bit. See C.8.2.1.1.6 for specialization.

Rescale Intercept (0028,1052) 1 Required for import The value b in relationship between stored values (SV) and the output units. Output units = m*SV+b

If Image Type (0008,0008) Value 1 is ORIGINAL and Value 3 is not LOCALIZER, output units shall be Hounsfield Units (HU).

Rescale Slope (0028,1053) 1 Required for import m in the equation specified in Rescale Intercept (0028,1052).

Rescale Type (0028,1054) 1C Not Imported Specifies the output units of Rescale Slope (0028, 1053) and Rescale Intercept (0028, 1052).

See C.11.1.1.2 for Defined Terms and further explanation. Required if the Rescale Type is not HU (Hounsfield Units). May be present otherwise.

KVP (0018,0060) 2 Not required but saved upon import if provided Peak kilo voltage output of the x-ray generator used

Acquisition Number (0020,0012) 2 Not required but saved upon import if provided A number identifying the single continuous gathering of data over a period of time which resulted in this image

Scan Options (0018,0022) 3 Not Imported Parameters of scanning sequence.






Data Collection Diameter (0018,0090) 3 Not required but saved upon import if provided The diameter in mm of the region over which data were collected

Data Collection Center (Patient) (0018,9313) 3 Not Imported

The x, y, and z coordinates (in the patient coordinate system) in mm of the center of the region in which data were collected. See C.8.15.3.6.1.

Reconstruction Diameter (0018,1100) 3 Not required but saved upon import if provided Diameter in mm of the region from within which data were used in creating the reconstruction of the image. Data may exist outside this region and portions of the patient may exist outside this region.

Reconstruction Target Center (Patient)

(0018,9318) 3 Not Imported

The x, y, and z coordinates (in the patient coordinate system) of the reconstruction center target point as used for reconstruction in mm. See C.8.15.3.6.1.

Note: If the reconstructed image is not magnified or panned the value corresponds with the Data Collection Center (Patient) (0018,9313) attribute.

Distance Source to Detector (0018,1110) 3 Not required but saved upon import if provided Distance in mm from source to detector center.

Note: This value is traditionally referred to as Source Image Receptor Distance (SID).

Distance Source to Patient (0018,1111) 3 Not required but saved upon import if provided Distance in mm from source to isocenter (center of field of view).

Note: This value is traditionally referred to as Source Object Distance (SOD).

Gantry/Detector Tilt (0018,1120) 3 Not required but saved upon import if provided Nominal angle of tilt in degrees of the scanning gantry. Not intended for






mathematical computations.

Table Height (0018,1130) 3 Not required but saved upon import if provided The distance in mm of the top of the patient table to the center of rotation; below the center is positive.

Rotation Direction (0018,1140) 3 Not required but saved upon import if provided Both Enumerated Values supported. Direction of rotation of the source when relevant, about nearest principal axis of equipment. Enumerated Values: CW = clockwise CC = counter clockwise

Exposure Time (0018,1150) 3 Not required but saved upon import if provided Time of x-ray exposure in msec. If Acquisition Type (0018,9302) equals SPIRAL, the value of this attribute shall be Revolution Time (0018,9305) divided by the Spiral Pitch Factor (0018,9311). See C.8.15.3.8.1 and C.8.15.3.2.1.

X-Ray Tube Current (0018,1151) 3 Not required but saved upon import if provided X-Ray Tube Current in mA.

Exposure (0018,1152) 3 Not Imported The exposure expressed in mAs, for example calculated from Exposure Time and X-Ray Tube Current.

Exposure in µAs (0018,1153) 3 Not Imported The exposure expressed in µAs, for example calculated from Exposure Time and X-Ray Tube Current.

Filter Type (0018,1160) 3 Not Imported Label for the type of filter inserted into the x-ray beam.

Generator Power (0018,1170) 3 Not Imported Power in kW to the x-ray generator.

Focal Spot (0018,1190) 3 Not Imported Size of the focal spot in mm. For devices with variable focal spot or multiple focal






spots, small dimension followed by large dimension.

Convolution Kernel (0018,1210) 3 Not Imported A label describing the convolution kernel or algorithm used to reconstruct the data

Revolution Time (0018,9305) 3 Not Imported The time in seconds of a complete revolution of the source around the gantry orbit.

Single Collimation Width (0018,9306) 3 Not Imported The width of a single row of acquired data (in mm). Note: Adjacent physical detector rows may have been combined to form a single effective acquisition row.

Total Collimation Width (0018,9307) 3 Not Imported The width of the total collimation (in mm) over the area of active x-ray detection. Note: This will be equal the number of effective detector rows multiplied by single collimation width.

Table Speed (0018,9309) 3 Not Imported The distance in mm that the table moves in one second during the gathering of data that resulted in this image.

Table Feed per Rotation (0018,9310) 3 Not Imported Motion of the table (in mm) during a complete revolution of the source around the gantry orbit.

Spiral Pitch Factor (0018,9311) 3 Not Imported Ratio of the Table Feed per Rotation (0018,9310) to the Total Collimation Width (0018,9307).

Exposure Modulation Type (0018,9323) 3 Not Imported A label describing the type of exposure modulation used for the purpose of limiting the dose. Defined Terms: NONE

Estimated Dose Saving (0018,9324) 3 Not Imported A percent value of dose saving due to the use of Exposure Modulation Type (0018,9323). A negative percent value of dose savings reflects an increase of






exposure.

CTDIvol (0018,9345) 3 Not Imported Computed Tomography Dose Index (CTDIvol), im mGy according to IEC 60601-2-44, Ed.2.1 (Clause 29.1.103.4), The Volume CTDIvol. It describes the average dose for this image for the selected CT conditions of operation.

CTDI Phantom Type Code Sequence (0018,9346) 3 Not Imported The type of phantom used for CTDI measurement according to IEC 60601-2-44. Only a single Item is permitted in this Sequence.

>Include Code Sequence Macro Table 8.8-1 Defined CID 4052

Include 'General Anatomy Optional Macro' Table 10-7 Defined Context ID for the Anatomic Region Sequence is CID 4030.

Calcium Scoring Mass Factor Patient (0018,9351) 3 Not Imported

The calibration factor for the calcium mass score. These factors incorporate the effects of

• KV value of the CT image

• the patient size.

• machine specific corrections See C.8.2.1.1.7.

Calcium Scoring Mass Factor Device (0018,9352) 3 Not Imported The calibration factors for the calcium mass score of the device. These factors incorporate the effects of

• KV value of the CT image

• machine specific corrections This a multi-value attribute, the first value specifies the mass factor for a small patient size, the second value for a medium patient size and the third value for a large patient size. See C.8.2.1.1.7.

Energy Weighting Factor (0018,9353) 1C Not Imported The weighting factor of the data from the primary source in a multiple energy composition image. This factor incorporates the effects of

• the specific X-Ray source and kV






value

• examination specific characteristics.

Required if one Derivation Code Sequence (0008,9215) Item value is (113097, DCM, “Multi-energy proportional weighting”). May be present otherwise.

CT Additional X-Ray Source Sequence (0018,9360) 3 Not Imported Contains the attributes describing additional acquisition parameters beyond the primary source in a multiple X-Ray source system or a multi-energy acquisition. The primary X-Ray source is specified in other attributes of this module.

One or more Items are permitted in this sequence.

>kVP (0018,0060) 1 Not Imported Peak kilo voltage output of the X-Ray generator used.

>X-Ray Tube Current in mA (0018,9330) 1 Not Imported Nominal X-Ray tube current in milliamperes.

>Data Collection Diameter (0018,0090) 1 Not Imported The diameter in mm of the region over which data were collected.

>Focal Spot(s) (0018,1190) 1 Not Imported Used nominal size of the focal spot in mm.

>Filter Type (0018,1160) 1 Not Imported Type of filter(s) inserted into the X-Ray beam.

>Filter Material (0018,7050) 1 Not Imported The X-Ray absorbing material used in the filter.

>Exposure in mAs (0018,9332) 3 Not Imported The exposure expressed in milliampere seconds, for example calculated from exposure time and X-Ray tube current.

>Energy Weighting Factor (0018,9353) 1C Not Imported

The weighting factor of the data from this additional source in a multiple energy composition image. This factor






incorporates the effects of

• the specific X-Ray source and kV value

• examination specific characteristics.

Required if one Derivation Code Sequence (0008,9215) Item value is (113097, DCM, “Multi-energy proportional weighting”). May be present otherwise.

19.2.13 CONTRAST/BOLUS MODULE Not applicable

19.3 MR IMAGE IOD MODULES The following table identifies the modules used when importing a MR Image object. A module is shown with a reference of Not Used if none of its attributes are accessed or translated during import.



General Study §19.2.2 M Patient Study Not Used U Clinical Trial Study Not Used U

General Series §19.2.3 M Clinical Trial Series Not Used U

Frame of Reference §19.2.4 M General Equipment M General Image M

Image Plane M Image Pixel M Contrast/bolus §19.4.2 C

Device U Specimen U MR Image §19.4.1 M

Overlay Plane U VOI LUT U

Not Used for MR Image Series Import at this time Acquisition Context U







19.3.1 MR IMAGE MODULE


Image Type (0008,0008) 1 Required for import Image identification characteristics. See C.8.3.1.1.1 for specialization.

Samples per Pixel (0028,0002) 1 Required for import Number of samples (planes) in this image. See C.8.3.1.1.2 for specialization.

Photometric Interpretation (0028,0004) 1 Required for import Specifies the intended interpretation of the pixel data. See C.8.3.1.1.3 for specialization.

Bits Allocated (0028,0100) 1 Required for import Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See C.8.3.1.1.4 for specialization.

Scanning Sequence (0018,0020) 1 Required for import All Enumerated Values supported Description of the type of data taken. Enumerated Values: SE = Spin Echo IR = Inversion Recovery GR = Gradient Recalled EP = Echo Planar RM = Research Mode

Note: Multi-valued, but not all combinations are valid (e.g. SE/GR, etc.).

Sequence Variant (0018,0021) 1 Required for import Variant of the Scanning Sequence. Defined Terms:

SK = segmented k-space MTC = magnetization transfer contrast SS = steady state TRSS = time reversed steady state SP = spoiled MP = MAG prepared OSP = oversampling phase NONE = no sequence variant






Scan Options (0018,0022) 2 Not required but saved upon import if provided All Defined Terms supported Parameters of scanning sequence. Defined Terms:

PER = Phase Encode Reordering RG = Respiratory Gating CG = Cardiac Gating PPG = Peripheral Pulse Gating FC = Flow Compensation PFF = Partial Fourier - Frequency PFP = Partial Fourier - Phase SP = Spatial Presaturation FS = Fat Saturation

MR Acquisition Type (0018,0023) 2 Not required but saved upon import if provided Identification of data encoding scheme. Enumerated Values:

2D = frequency x phase 3D = frequency x phase x phase

Repetition Time (0018,0080) 2C Not required but saved upon import if provided The period of time in msec between the beginning of a pulse sequence and the beginning of the succeeding (essentially identical) pulse sequence. Required except when Scanning Sequence (0018,0020) is EP and Sequence Variant (0018,0021) is not SK.

Echo Time (0018,0081) 2 Not required but saved upon import if provided Time in ms between the middle of the excitation pulse and the peak of the echo produced (kx=0). In the case of segmented k-space, the TE(eff) is the time between the middle of the excitation pulse to the peak of the echo that is used to cover the center of k-space (i.e.-kx=0, ky=0).

Echo Train Length (0018,0091) 2 Not required but saved upon import if provided Number of lines in k-space acquired per






excitation per image.

Inversion Time (0018,0082) 2C Not required but saved upon import if provided Time in msec after the middle of inverting RF pulse to middle of excitation pulse to detect the amount of longitudinal magnetization. Required if Scanning Sequence (0018,0020) has values of IR.

Trigger Time (0018,1060) 2C Not required but saved upon import if provided Time, in msec, between peak of the R wave and the peak of the echo produced. In the case of segmented k-space, the TE(eff) is the time between the peak of the echo that is used to cover the center of k-space. Required for Scan Options (0018,0022) which include heart gating (e.g. CG, PPG, etc.)

Sequence Name (0018,0024) 3 Not imported

User defined name for the Scanning Sequence (0018,0020) and Sequence Variant (0018,0021) combination.

Angio Flag (0018,0025) 3 Not imported Angio Image Indicator. Primary image for Angio processing. Enumerated Values:

Y = Image is Angio N = Image is not Angio

Number of Averages (0018,0083) 3 Not imported

Number of times a given pulse sequence is repeated before any parameter is changed

Imaging Frequency (0018,0084) 3 Not imported

Precession frequency in MHz of the nucleus being addressed

Imaged Nucleus (0018,0085) 3 Not imported Nucleus that is resonant at the imaging frequency. Examples: 31P, 1H

Echo Number (0018,0086) 3 Not imported The echo number used in generating this image. In the case of segmented k-space, it is the effective Echo Number.

Magnetic Field Strength (0018,0087) 3 Not imported Nominal field strength of MR magnet, in






Tesla

Spacing Between Slices (0018,0088) 3 Not imported Spacing between slices, in mm. The spacing is measured from the center-to-center of each slice.

Number of Phase Encoding Steps (0018,0089) 3 Not imported Total number of lines in k-space in the 'y' direction collected during acquisition.

Percent Sampling (0018,0093) 3 Not imported Fraction of acquisition matrix lines acquired, expressed as a percent.

Percent Phase Field of View (0018,0094) 3 Not imported Ratio of field of view dimension in phase direction to field of view dimension in frequency direction, expressed as a percent.

Pixel Bandwidth (0018,0095) 3 Not imported Reciprocal of the total sampling period, in hertz per pixel.

Nominal Interval (0018,1062) 3 Not imported

Average R-R interval used for the scans, in msec

Beat Rejection Flag (0018,1080) 3 Not imported

Beat length sorting has been applied. Enumerated Values: Y = yes N = No

Low R-R Value (0018,1081) 3 Not imported R-R interval low limit for beat rejection, in msec

High R-R Value (0018,1082) 3 Not imported R-R interval high limit for beat rejection, in msec

Intervals Acquired (0018,1083) 3 Not imported Number of R-R intervals acquired.

Intervals Rejected (0018,1084) 3 Not imported Number of R-R intervals rejected.

PVC Rejection (0018,1085) 3 Not imported

Description of type of PVC rejection criteria used.






Skip Beats (0018,1086) 3 Not imported Number of beats skipped after a detected arrhythmia.

Heart Rate (0018,1088) 3 Not imported Beats per minute.

Cardiac Number of Images (0018,1090) 3 Not imported Number of images per cardiac cycle.

Trigger Window (0018,1094) 3 Not imported

Percent of R-R interval, based on Heart Rate (0018,1088), prescribed as a window for a valid/usable trigger.

Reconstruction Diameter (0018,1100) 3 Not required but saved upon import if provided Diameter in mm. of the region from within which data were used in creating the reconstruction of the image. Data may exist outside this region and portions of the patient may exist outside this region.

Receive Coil Name (0018,1250) 3 Not imported Receive coil used.

Transmit Coil Name (0018,1251) 3 Not imported Transmit coil used.

Acquisition Matrix (0018,1310) 3 Not imported

Dimensions of the acquired frequency /phase data before reconstruction. Multi-valued: frequency rows\frequency columns\phase rows\phase columns.

In-plane Phase Encoding Direction (0018,1312) 3 Not imported The axis of phase encoding with respect to the image. Enumerated Values:

ROW = phase encoded in rows. COL = phase encoded in columns.

Flip Angle (0018,1314) 3 Not imported Steady state angle in degrees to which the magnetic vector is flipped from the magnetic vector of the primary field.

SAR (0018,1316) 3 Not imported Calculated whole body Specific Absorption Rate in watts/kilogram.

Variable Flip Angle Flag (0018,1315) 3 Not imported






Flip angle variation applied during image acquisition. Enumerated Values:

Y = yes N = no

dB/dt (0018,1318) 3 Not imported

The rate of change of the gradient coil magnetic flux density with time (T/s).

Temporal Position Identifier (0020,0100) 3 Not imported Temporal order of a dynamic or functional set of Images.

Number of Temporal Positions (0020,0105) 3 Not imported Total number of temporal positions prescribed.

Temporal Resolution (0020,0110) 3 Not imported Time delta between Images in a dynamic or functional set of Images.

Include 'General Anatomy Optional Macro' Table 10-7 Not imported Defined Context ID for the Anatomic Region Sequence is 4030.

19.3.2 CONTRAST/BOLUS MODULE

Not applicable

19.4 PET IMAGE IOD MODULES The following table identifies the modules used when importing a PET Image object. A module is shown with a reference of Not Used if none of its attributes are accessed or translated during import.


Patient §19.2.1 M

Clinical Trial Subject Not Used U General Study §19.2..2 M Patient Study Not Used U

Clinical Trial Study Not Used U General Series §19.2..3 M Clinical Trial Series Not Used U

PET Series §19.5.1 M






PET Isotope §19.5.2 M Not Used for PET Image Series Import at this time

PET Multi-gated Acquisition

§19.5.3 C - Required if Series Type (0054,1000) Value 1 is GATED. Not Used for PET Image Series Import at this time

NM/PET Patient Orientation

§19.5.4 M

Frame of Reference §19.2.4 M General Equipment M General Image M

Image Plane M Image Pixel M Device U

Specimen U PET Image §19.5.5 M Overlay Plane U

VOI LUT U Not Used for PET Image Series Import at this time

Acquisition Context U


19.4.1 PET SERIES The following table lists the attributes that are used to match the PET Series with a patient in the database. If the patient in the PET Series cannot be identified and uniquely matched with an existing patient in the database, the PET Series is not imported.

Once the patient is identified and matched, the Information Management System uses none of the patient information contained in the PET Series. The patient information already stored in the database is used for further reference and is not affected by patient information contained in the PET Series.


(0008,0021) Series Date 1 Required for import Date the Series started.

(0008,0031) Series Time 1 Required for import Time the Series started.






(0054,1001) Units 1 Required for import Pixel value units. Defined terms:

• CNTS • NONE • CM2 • CM2ML • PCNT • CPS • BQML • MGMINML • UMOLMINML • MLMING • MLG • 1CM • UMOLML • PROPCNTS • PROPCPS • MLMINML • MLML • GML • STDDEV

(0054,1006) SUV Type 3 Not imported Type of Standardized Uptake Value (SUV).

Enumerated Values: • BSA – body surface area • BW – body weight • LBM – lean body mass

If absent, and the Units (0054,1001) are GML, then the type of SUV shall be assumed to be BW.

(0054,1002) Counts Source 1 Required for import The primary source of counts. The primary source leads to the underlying image Units (0054,1001), as opposed to secondary sources which are used during reconstruction correction. Enumerated Values:

• EMISSION • TRANSMISSION






(0054,1000) Series Type 1 Required for import A multi-valued indicator of the type of Series. See C.8.9.1.1.4 for explanation. Value 1 Enumerated Values:

• STATIC

• DYNAMIC

• GATED

• WHOLE BODY Value 2 Enumerated Values:

• IMAGE • REPROJECTION

(0054,1004) Reprojection Method 2C Not required by application Method for projecting volumetric data onto planar projection. Required if Series Type (0054,1000), Value 2 is REPROJECTION. Defined terms:

• SUM • MAX PIXEL

(0054,0061) Number of R-R Intervals

1C Not required by application The maximum number of R-R Intervals that may exist in this Series. Required if Series Type (0054,1000), Value 1 is GATED.

(0054,0071) Number of Time Slots Not required by application The maximum number of Time Slots that may exist in this Series. Required if Series Type (0054,1000), Value 1 is GATED.

(0054,0101) Number of Time Slices 1C Not required by application The maximum number of Time Slices that may exist in this Series. Required if Series Type (0054,1000), Value 1 is DYNAMIC.

(0054,0081) Number of Slices 1 Required for import The maximum number of Slices that may exist in this Series.






(0028,0051) Corrected Image 2 Not required but saved upon import if provided One or more values that indicate which, if any, corrections have been applied to the images in this series.

Defined terms:

• DECY=decay corrected • ATTN=attenuation corrected • SCAT=scatter corrected • DTIM=dead time corrected • MOTN=gantry motion corrected (e.g. wobble,

clamshell) • PMOT=patient motion corrected • CLN=count loss normalization (correction for

count loss in gated Time Slots) • RAN=randoms corrected • RADL=non-uniform radial sampling corrected • DCAL=sensitivity calibrated using dose calibrator • NORM=detector normalization

(0054,1100) Randoms Correction Method

3 Not required by application Type of random correction processing. Defined terms:

• NONE = no randoms correction • DLYD = delayed event subtraction • SING = singles estimation

(0054,1101) Attenuation Correction Method

3 Not required but saved upon import if provided A textual description of the attenuation correction processing. e.g. measured vs. calculated, transmission source type (ring, line, point), assumed patient geometry (polygon, ellipse, segmented, attenuation coefficient, skull thickness), post-injection transmission, smoothing.

(0054,1105) Scatter Correction Method

3 Not required but saved upon import if provided A textual description of the scatter correction processing. e.g. convolution-subtraction, dual energy window, model-based, use of attenuation data.

(0054,1102) Decay Correction 1 Required for import

The real-world event to which images in this Series were decay corrected. See C.8.9.1.1.5 for explanation. Defined terms:

• NONE = no decay correction • START= acquisition start time • ADMIN = radiopharmaceutical administration time






(0018,1100) Reconstruction Diameter

3 Not imported Diameter, in mm, of the region within which the data was used in creating the reconstruction of the image. Data may exist outside this region and portions of the patient may exist outside this region.

(0018,1210) Convolution Kernel 3 Not imported Textual description of the convolution kernel(s) used to reconstruct the data (e.g. name, cutoff, radial/axial/angular, mathematical form, DC handling)

(0054,1103) Reconstruction Method 3 Not imported Textual description of reconstruction processing, e.g. 2D filtered backprojection, 2D iterative, 3D PROMIS, 3D FAVOR, 3D iterative.

(0054,1104) Detector Lines of Response Used

3 Not imported Textual description of which detector lines of response were used, mashed, or otherwise processed during tomographic reconstruction.

(0018,0073) Acquisition Start Condition

3 Not imported Description of how the data collection was started. Defined terms:

• DENS = density (counts/sec)

• RDD = relative density difference (change in counts/sec)

• MANU = manual

• TIME = time

• AUTO = automatic, when ready

• TRIG = physiological trigger

(0018,0074) Acquisition Start Condition Data

3 Not imported Count density, change in count density, or physiological triggers causing data collection to start.






(0018,0071) Acquisition Termination Condition

3 Not imported Description of how the data collection for the series was stopped. Defined terms:

• CNTS = counts

• DENS = density (counts/sec)

• RDD = relative density difference (change in counts/sec)

• MANU = manual

• OVFL = data overflow

• TIME = time • TRIG = physiological trigger

(0018,0075) Acquisition Termination Condition Data

3 Not imported Number of counts, count density, change in count density, or physiological triggers causing the termination.

(0018,1147) Field of View Shape 3 Not imported Shape of the field of view of the PET camera. Defined Terms:

• CYLINDRICAL RING • HEXAGONAL • MULTIPLE PLANAR

(0018,1149) Field of View Dimensions

3 Not imported Dimensions of the field of view, in mm. Transverse detector diameter followed by axial width.

(0018,1120) Gantry/Detector Tilt 3 Not imported Angle of tilt in degrees of the gantry.

(0018,1121) Gantry/Detector Slew 3 Not imported Angle of slew in degrees of the gantry. Positive slew is moving the gantry on the patient’s left toward the patient’s superior, when the patient is supine.

(0054,0202) Type of Detector Motion

3 Not imported Describes the detector motion during acquisition. Defined Terms:

• NONE = stationary gantry • STEP AND SHOOT = Interrupted motion, acquire

only while stationary • CONTINUOUS = Gantry motion and acquisition

are simultaneous and continuous • WOBBLE = wobble motion • CLAMSHELL = clamshell motion






(0018,1181) Collimator Type 2 Not imported Collimator Type. Defined Terms:

• NONE = no collimator • RING = transverse septa

(0018,1180) Collimator/Grid Name 3 Not imported Label describing the collimator used.

(0054,1200) Axial Acceptance 3 Not imported Maximum axial angle accepted, in degrees.

(0054,1201) Axial Mash 3 Not imported Number of adjacent axial lines of response mashed together.

(0054,1202) Transverse Mash 3 Not imported Number of adjacent transverse lines of response mashed together.

(0054,1203) Detector Element Size 3 Not imported Size of an individual detector element, in mm. Transverse dimension followed by axial dimension. For a discrete crystal, this is the crystal size. For a continuous detector, this is the pixel bin size.

(0054,1210) Coincidence Window Width

3 Not imported The width of the coincidence timing window, in nsec. The maximum time difference accepted between two single events.

(0054,0013) Energy Window Range Sequence

3 Not imported Sequence of Items that describes the energy windows used for this Series. One or more Items are permitted in this sequence.

(0054,0014) >Energy Window Lower Limit

3 Not imported The lower limit of the energy window, in KeV.

(0054,0015) >Energy Window Upper Limit

3 Not imported The upper limit of the energy window, in KeV.

(0054,1220) Secondary Counts Type 3 Not imported Array defining the type of additional counts accumulated during acquisition. Defined terms:

• DLYD=delayed events • SCAT=scattered events in secondary window • SING=singles • DTIM=events lost due to deadtime

19.4.2 PET ISOTOPE MODULE – NOT SUPPORTED

19.4.3 PET MULTI-GATED ACQUISITION MODULE – NOT SUPPORTED





19.4.4 NM/PET PATIENT ORIENTATION MODULE


(0054,0410) Patient Orientation Code Sequence

2 Not required but used upon import if provided Sequence that describes the orientation of the patient with respect to gravity. Zero or one item shall be included in this sequence.

NOTE: Special handling for Standard PET IOD. If the following Code Sequences are missing, there will be an attempt to fallback to Patient Position (0018,5100). If that attribute is also not available, then the PET Image Series will be rejected. -Patient Orientation Code Sequence (0054,0410) -Patient Orientation Modifier Code Sequence (0054,0412) -Patient Gantry Relationship Code Sequence (0054,0414)

>Include ‘Code Sequence Macro’ Table 8.8-1

Not required but used if present Baseline CID 19

The Coding Scheme Designator (0008,0102) shall have an Enumerated Value of “99SDM” for historical reasons. Code Meaning (0008,0104) shall be Type 3 for historical reasons. Not Supported (Rejected) Patient Orientation Code:

• F-10450 (recumbent)

(0054,0412) >Patient Orientation Modifier Code Sequence

2C Not required but used upon import if provided Patient Orientation Modifier. Required if needed to fully specify the orientation of the patient with respect to gravity. Zero or one item shall be included in this sequence. NOTE: Special handling for Standard PET IOD. If the following Code Sequences are missing, there will be an attempt to fallback to Patient Position (0018,5100). If that attribute is also not available, then the PET Image Series will be rejected. - Patient Orientation Code Sequence (0054,0410) - Patient Orientation Modifier Code Sequence (0054,0412) - Patient Gantry Relationship Code Sequence (0054,0414)






>>Include ‘Code Sequence Macro’ Table 8.8-1

Supported Patient Orientation Modifier Code Values: • F-10310 (Prone)

• F-10340 (Supine)

Not Supported (Rejected) Patient Orientation Modifier Code Values:

• F-10317 (Right Lateral Decubitus)

• F-10319 (Left Lateral Decubitus) Baseline CID 20 The Coding Scheme Designator (0008,0102) shall have an Enumerated Value of “99SDM” for historical reasons.

Code Meaning (0008,0104) shall be Type 3 for historical reasons.

(0054,0414) Patient Gantry Relationship Code Sequence

2 Not required but used upon import if provided Sequence which describes the orientation of the patient with respect to the gantry. Zero or one item shall be included in this sequence. NOTE: Special handling for Standard PET IOD. If the following Code Sequences are missing, there will be an attempt to fallback to Patient Position (0018,5100). If that attribute is also not available, then the PET Image Series will be rejected. - Patient Orientation Code Sequence (0054,0410) - Patient Orientation Modifier Code Sequence (0054,0412) - Patient Gantry Relationship Code Sequence (0054,0414)






>Include ‘Code Sequence Macro’ Table .8-1

Supported Patient Gantry Relationship Code Values: • F-10470 (head-first)

• F-10480 (feet-first)

Deprecated Code Values of G-5190 “head-first” and G-5191 “feet-first” are also supported for backward compatibility. Not Supported (Rejected) Patient Gantry Relationship Code Values:

• R-10516 (oblique)

• R-10515 (transverse) Baseline CID 21

The Coding Scheme Designator (0008,0102) shall have an Enumerated Value of “99SDM” for historical reasons.

Code Meaning (0008,0104) shall be Type 3 for historical reasons.

19.4.5 PET IMAGE MODULE

Tag Name Type Description (0008,0008) Image Type 1 Required for import

Image identification characteristics.

(0028,0002) Samples per Pixel 1 Required for import Number of samples (planes) in this image. This value shall be 1.


1 Required for import Specifies the intended interpretation of the pixel data.

(0028,0100) Bits Allocated 1 Required for import Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. Enumerated values: 16.

(0028,0101) Bits Stored 1 Required for import Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. The value shall be the same as the value in Bits Allocated (0028,0100).

(0028,0102) High Bit 1 Required for import Most significant bit for pixel sample data. Each sample shall have the same high bit. Shall be one less than the value in Bits Stored (0028,0101).






(0028,1052) Rescale Intercept 1 Required for import The value b in relationship between stored values (SV) and pixel value units (U) defined in Units (0054,1001): U = m*SV+b. The Rescale Intercept is always zero for PET images.

(0028,1053) Rescale Slope 1 Required for import m in the equation specified in Rescale Intercept (0028,1052).

(0054,1300) Frame Reference Time 1 Required for import The time that the pixel values in the image occurred. Frame Reference Time is the offset, in msec, from the Series reference time.

(0018,1060) Trigger Time 1C Not imported NOTE: No special handling in case of Series Type (0054,1000) of GATED. Time interval, in msec, from the start of the trigger to the beginning of data acquisition for this image. Required if Series Type (0054,1000), Value 1 is GATED.

(0018,1063) Frame Time 1C Not imported NOTE: No special handling in case of Series Type (0054,1000) of GATED. Nominal duration per individual frame, in msec. Required if Series Type (0054,1000), Value 1 is GATED.

(0018,1081) Low R-R Value 1C Not imported NOTE: No special handling in case of Series Type (0054,1000) of GATED. R-R interval lower limit for beat rejection, in msec. Required if Series Type (0054,1000), Value 1 is GATED and Beat Rejection Flag (0018,1080) is Y.

(0018,1082) High R-R Value 1C Not imported NOTE: No special handling in case of Series Type (0054,1000) of GATED. R-R interval upper limit for beat rejection, in msec. Required if Series Type (0054,1000), Value 1 is GATED and Beat Rejection Flag (0018,1080) is Y.






(0028,2110) Lossy Image Compression

1C Not required but used upon import if provided NOTE: Although lossy compression is not supported throughout MOSAIQ, this attribute is handled at time of import. Specifies whether an Image has undergone lossy compression. Enumerated values:

• 00 = Image has NOT been subjected to lossy compression.

• 01 = Image has been subjected to lossy compression.

Required if Lossy Compression has been performed on the image.

(0054,1330) Image Index 1 Required for import An index identifying the position of this image within a PET Series.

(0008,0022) Acquisition Date 2 Not imported The date the acquisition of data that resulted in this image started.

(0008,0032) Acquisition Time 2 Not imported The time the acquisition of data that resulted in this image started.

(0018,1242) Actual Frame Duration 2 Not imported Elapsed time of the data acquisition for this image, in msec.

(0018,1062) Nominal Interval 3 Not imported Average duration of accepted beats, in msec, of the R-R interval.

(0018,1083) Intervals Acquired 3 Not imported Number of heartbeats that fall within Low R-R Value (0018,1081) and High R-R Value (0018,1082), and were therefore accepted and contribute coincidence events to this R-R Interval.

(0018,1084) Intervals Rejected 3 Not imported Number of heartbeats that fall outside Low R-R Value (0018,1081) and High R-R Value (0018,1082), and do not contribute coincidence events to this R-R Interval. However, they may contribute coincidence events to other R-R Intervals.

(0054,1310) Primary (Prompts) Counts Accumulated

3 Not imported The sum of events that occur in the primary event channel. The counts include Trues +Scatter+ Randoms if Randoms Correction Method (0054,1100) is NONE; otherwise the counts are Trues +Scatter.






(0054,1311) Secondary Counts Accumulated

3 Not imported Sum of counts accumulated in secondary channels.

(0054,1320) Slice Sensitivity Factor 3 Not imported The slice-to-slice sensitivity correction factor that was used to correct this image. The value shall be one if no slice sensitivity correction was applied.

(0054,1321) Decay Factor 1C Not required but saved upon import if provided. The decay factor that was used to scale this image. Required if Decay Correction (0054,1102) is other than NONE. If decay correction is applied, all images in the Series shall be decay corrected to the same time.

(0054,1322) Dose Calibration Factor 3 Not imported Factor that was used to scale this image from counts/sec to Bq/ml using a dose calibrator. The value shall be one if no dose calibration was applied.

(0054,1323) Scatter Fraction Factor 3 Not imported An estimate of the fraction of acquired counts that were due to scatter and were corrected in this image. The value shall be zero if no scatter correction was applied.

(0054,1324) Dead Time Factor 3 Not imported The average dead time correction factor that was applied to this image. The value shall be one if no dead time correction was applied.

Include 'General Anatomy Optional Macro' Table 10-7

(0054,0500) Slice Progression Direction

3 Not required but saved upon import if provided. Describes the anatomical direction that slices are progressing as the slices are considered in order (as defined by the Slice Index. See section C.8.9.4.1.9 for a definition of Slice Index). Meaningful only for cardiac images. When View Code Sequence (0054,0220) indicates a short axis view, then Enumerated Values are:

• APEX_TO_BASE • BASE_TO_APEX

(0054,0220) View Code Sequence 3 Not imported Sequence that describes the projection of the anatomic region of interest.

Only a single Item is permitted in this sequence.

>Include ‘Code Sequence Macro’ Table 8.8-1

MOSAIQ DICOM Conformance Statement Appendix O





(0054,0222) >View Modifier Code Sequence

2C Not imported View Modifier. Required if needed to fully specify the View. Zero or one Item shall be included in this sequence.

>>Include ‘Code Sequence Macro’ Table 8.8-1

20 APPENDIX O

20.1 MODALITY WORKLIST MODULES

20.1.1 RECEIVE MODALITY WORKLIST REQUEST (C-FIND REQUEST)

Tag Name Matching Key Type

Return Key Type

Description

(0008,0050) Accession Number

R 1 Schedule.Sch_Set_Id

A departmental IS generated number that identifies the order for the Imaging Service Request.

Note: If the Accession Number is given, all other query attributes will be ignored. The query will return one response if the Schedule ID criteria is met.

(0040,0001) >Scheduled Station AE Title

R 1 Schedule.Location

The AE title of the modality on which the Scheduled Procedure Step is scheduled to be performed.

Notes:

The system shall convert the Station AE Title into a location ID first.

1. If the Station AE Title does not have a Location configured in the MWL filters, the response will be empty.

2. If there are no events scheduled for the configured Location, the response will be empty.

3. If the Station AE Title is not given, the






Return Key Type

Description

query will be filtered by the Modality.

(0008,0060) >Modality R 1 Schedule.Location

Get the AE Titles for a given Modality, and then convert the AE Titles to Location ID’s.

Notes: If the Station AE Title is not null, then Modality is irrelevant as we have a concrete location and modality by inference. In this case the modality query option will be ignored.

1. If the AE Title does not have a Location configured in the MWL filters, the response will be empty.

2. If there are no events scheduled for the configured Location, the response will be empty.

4. If the Modality is not given, the query will be based on the SCU AE Title.

a. If the SCU AE Title does not have a Location configured, the Location restriction will be ignored.

(0010,0020) Patient ID R 1 Schedule.Pat_ID1

Primary hospital identification number or code for the patient.

1. If there are no events scheduled for the given Patient ID, the response will be empty.

2. If there are multiple events scheduled for the Patient ID, the response will be filtered based on Accession Number.






Return Key Type

Description

(0010,0010) Patient’s Name

R 1 Schedule.Pat_ID1

The system shall convert the Patient’s Name to Patient IDs first.

Note: If the Patient ID is not null, then the Patient’s Name is irrelevant as we have a concrete pointer to the Patient ID. In this case the Patient’s Name will be ignored.

1. If there are no events scheduled for the given Patient ID, the response will be empty.

2. If there are multiple events scheduled for the Patient ID, the response will be filtered based on Accession Number.

(0040,0002) >Scheduled Procedure Step

Start Date

R 1 Schedule.App_DtTm

Date on which the Scheduled Procedure Step is scheduled to start.


Start Time


Time at which the Scheduled Procedure Step is scheduled to start.

Note: If start time is null then the query shall query for the start date plus one day.


ID

O 1 Schedule.Activity

Identifier that identifies the Scheduled Procedure Step. Required if the procedure was scheduled.

The Activity Column is the Hsp_Code stored in the CPT table.

(0040,0006) >Scheduled Performing

Physician's Name

R 2 Schedule.Staff_ID

Name of the physician scheduled to administer the Scheduled Procedure Step.

The system shall convert Scheduled Performing Physician into a Staff ID first.

1. If there are no events scheduled for the given Staff ID, the response will be empty.

20.1.2 RESPOND MODALITY WORKLIST REQUEST (C-FIND RESPONSE)






Return Key Type

Description

Scheduled Procedure Step

(0040,0100) Scheduled Procedure Step Sequence

R 1 One or more Scheduled Procedure Steps for one Requested Procedure.

(0040,0001) >Scheduled Station AE Title

R 1 Calling AETitle.

The AE title of the modality on which the Scheduled Procedure Step is scheduled to be performed.

(0040,0002) >Scheduled Procedure Step Start Date


Date on which the Scheduled Procedure Step is scheduled to start.

(0040,0003) >Scheduled Procedure Step Start Time


Time at which the Scheduled Procedure Step is scheduled to start.

(0040,0011) > Scheduled Procedure Step Location

O 2 The location at which the Procedure Step is scheduled to be performed.

(0008,0060) >Modality R 2 DcmApEnty. ModalityWorklistBehaviors.MWL_ModalityID

Source equipment for the image.

(0040,0006) >Scheduled Performing Physician's Name

R 2 Schedule.Staff_ID (Convert StaffID to Staff Name first)

Name of the physician scheduled to administer the Scheduled Procedure Step.

(0040,0009) >Scheduled Procedure Step ID


Identifier of the related Scheduled Procedure Step.

(0040,0007) >Scheduled Procedure Step Description

O 1C Schedule.CptEntityOnActivity.Description

Institution-generated description or classification of the Scheduled Procedure Step to be performed.

(0040,0008) >Scheduled Protocol Code Sequence

O 1C Either the Scheduled Procedure Step Description (0040,0007) or the Scheduled Protocol Code Sequence (0040,0008) shall be provided.

NOTE: The sequence is not included in






Return Key Type

Description

the response so in turn the attributes contained in the sequence are not set.

Sequence describing the Scheduled Protocol following a specific coding scheme. This sequence contains one or more Items.

(0008,0100) >>Code Value O 1 The Scheduled Protocol Code Sequence (0040,0008) is not included so in turn this attribute is not set.

(0008,0103) >>Coding Scheme Version

O 3 The Scheduled Protocol Code Sequence (0040,0008) is not included so in turn this attribute is not set.The coding scheme version associated with the Coding Scheme Designator (0008,0102).

(0008,0102) >>Coding Scheme Designator

O 1 The Scheduled Protocol Code Sequence (0040,0008) is not included so in turn this attribute is not set.

(0008,0104) >>Code Meaning

O 3 The Scheduled Protocol Code Sequence(0040,0008) is not included so in turn this attribute is not set.

Requested Procedure

(0040,1400) >Requested Procedure Comments

O 1C This attribute is not set.

(0032,1060) Requested Procedure Description

O 1C Schedule.CptEntityOnActivity.Description

Institution-generated administrative description or classification of Requested Procedure

(0032,1064) Requested Procedure Code Sequence

O 1C Either Requested Procedure Description (0032,1060) or the Requested Procedure Code Sequence (0032,1064) shall be provided.

NOTE: The sequence is not included in the response so in turn the attributes contained in the sequence are not set.

A sequence that conveys the Procedure Type of the requested procedure. The Requested Procedure Code Sequence shall contain only a single item.

(0008,0100) >Code Value O 1 The Requested Protocol Code Sequence






Return Key Type

Description

(0032,1064) is not included so in turn this attribute is not set.

(0008,0103) >Coding Scheme Version

O 3 The Requested Protocol Code Sequence (0032,1064) is not included so in turn this attribute is not set.

(0008,0102) >Coding Scheme Designator


(0008,0104) >Code Meaning


(0040,1001) Requested Procedure ID


Identifier that identifies the Requested Procedure in the Imaging Service Request. Required if procedure was scheduled. May be present otherwise.

(0040,1010) >Names of

Intended Recipients

of Results

O 3 This attribute is not set in response.

(0020,000D) Study Instance UID

O 1 GenerateStudyInstUID();

Unique identifier to be used to identify the Study.

(0008,1110) Referenced Study Sequence [IHE-3]

O 3 NOTE: The sequence is not included in the response so in turn the attributes contained in the sequence are not set.

Uniquely identifies the Study SOP Instances associated with the Patient SOP Instance. One or more Items may be included in this Sequence.


O 1 The Referenced Study Sequence (0008,1110) is not included so in turn this attribute is not set.


O 1 The Referenced Study Sequence (0008,1110) is not included so in turn this attribute is not set.

Imaging Service Request






Return Key Type

Description

(0040,2400) >Imaging Service Request Comments

O 3

(0008,0050) Accession Number

O 2 Schedule.Sch__Set_Id

An identifier of the Imaging Service Request for this Requested Procedure.

(0032,1032) >Requesting Physician

O 2 PatientChart.PatientDescriptor.PrimaryPhysicianName

Name of the physician who requested the Imaging Service Request.

(0032,1033) >Requesting Service

O 3

(0008,0090) >Referring Physician's Name

O 3 PatientChart.PatientDescriptor.ReferringPhysicianName

Name of the patient's referring physician for this Imaging Service Request.

Visit Identification

(0038,0010) Admission ID R 2 Empty.

Visit Status

(0038,0300) Current Patient Location

O 2 Empty.

Visit Relationship

(0008,1120) Referenced Patient Sequence

O 2 NOTE: The sequence is not included in the response so in turn the attributes contained in the sequence are not set.


O 1 The Referenced Patient Sequence (0008,1120) is not included so in turn this attribute is not set.


O 1 The Referenced Patient Sequence (0008,1120) is not included so in turn this attribute is not set.

Patient Identification

(0010,0010) Patient's Name R 1 PatientChart.PatientDescriptor.PatientNam






Return Key Type

Description

e

Patient's full legal name.

(0010,0020) Patient ID R 1 PatientChart.PatientDescriptor.ExternalPatientID

Primary hospital identification number or code for the patient.

(0010,1000) Other Patient IDs

O 3 NOTE: This attribute is not returned.

Patient Demographic

(0010,0030) Patients Birth Date

O 2 PatientChart.PatientDescriptor.PatientDOB

Date of birth of the named patient.

(0010,0040) Patient's Sex O 2 PatientChart.PatientDescriptor.PatientGender

Sex of the named patient. Enumerated Values:

M = male

F = female

O = other

(0040,3001) Confidentiality constraint on patient data

O 2 Empty.

Special indication to the modality operator about confidentiality of patient information (e.g., that s/he should not use the patient’s name where other patients are present).

(0010,2160) Ethnic Group O 3 NOTE: This attribute is not returned.

(0010,4000) Patient Comment


Patient Medical

(0038,0500) Patient State O 2 Empty.

Description of patient state (comatose, disoriented, vision impaired, etc.)

(0010,21C0) Pregnancy Status

O 2 Describes pregnancy state of patient.

Enumerated Values:

0001 = not pregnant

0002 = possibly pregnant






Return Key Type

Description

0003 = definitely pregnant

0004 = unknown

(0010,2000) Medical Alerts O 2 Empty.

Conditions to which medical staff should be alerted (e.g. contagious condition, drug allergies, etc.).

(0010,21B0) Additional Patient History


(0010,2110) Allergies O 2 Empty.

Description of prior reaction to contrast agents, or other patient allergies or adverse reactions.

(0010,1030) Patient’s Weight

O 2 Empty.

Weight of the patient in kilograms.

(0038,0050) Special Needs O 2 Empty.

Medical and social needs (e.g. wheelchair, oxygen, translator, etc.)





MOSAIQ™

Manufacturer

Elekta Business Area Software Systems

IMPAC Medical Systems, Inc.

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USA

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Representative

Elekta Limited

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Phone: +44 129 365 4242

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www.elekta.com Human Care Makes the Future Possible Corporate Head Office: Regional Sales, Marketing, and

Service:

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