DICOM SR to FHIR Resource Mapping IG
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DICOM SR to FHIR Resource Mapping IG, published by HL7 International / Imaging Integration. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/dicom-sr/ and changes regularly. See the Directory of published versions

Background

This chapter describes the scope of this guide, provides background information, key concepts, and describes the use cases supported by this implementation guide.

  1. Problem - Description of the Problem
  2. Scope - Scope of the IG
  3. Intended Readers - Intended readers of the IG
  4. Use cases - Key use cases covered by the IG
  5. Glossary - Glossary of terms used in this IG
  6. References - Useful references

Problem

DICOM Structured Report (DICOM SR) is a standard for recording clinical imaging observations made regarding a diagnostic or interventional imaging procedure. Imaging Observations are made by humans, such as a sonographer making measurements on recently acquired ultrasound image, a Radiologist recording observations on suspected lesions, or by a machine, such as an automated AI Algorithm providing qualitative and quantitative observations.

DICOM SR is widely adopted by Imaging-based devices and IT systems. Non-imaging based Healthcare IT Systems, generally, do not support DICOM SR. Non-imaging healthcare systems support HL7 standards, such as FHIR. HL7 has defined Observations as the standardized method for recording clinical observations. Bridging the two standards for clinical imaging observations is necessary for interoperability between these type of systems.

Scope

The standards for recording clinical observations, DICOM SR and HL7 FHIR Observation resource are bridged by this IG by the transformation of the DICOM SR attributes to the HL7 FHIR Observation Resource.

DICOM SR defines a multitude of templates for capturing Diagnostic imaging Observations. The input for this IG is limited to the DICOM SR template TID-1500 (Measurement Report). The mapping is limited the content within the tree structure.

The transformation described is one direction. Reconstruction of a complete DICOM SR is not expected to be re-constructed from a set of FHIR resources using this IG.

DICOM SR mapping is limited to the Observation Resource and a small set of related resources. The resultant mapping is provided, as a minimum, a composition or bundle of Observations. Depending on the use case, the observations may be a Diagnostic Report. Use case-specific requirements to construct a diagnostic report(e.g. Mammography) may require the transformation described by this IG. However, the specification of those use cases is not in scope for this IG.

Therefore, Observations created according to this IG may not include all context relevant to their interpretation.

Intended Readers

This Implementation Guide is intended for

  • clinical users of structured imaging data,
  • implementers of other health information systems wishing to use imaging data encapsulated using DICOM SR.
  • imaging device, image analysis and AI algorithm developers and imaging gateway system developers creating DICOM SR.

Use cases

Two use cases were identified.

Use case 1: Extracting imaging results for use in reporting

Use Case 1

Use case 2: Extracting imaging results for FHIRcast content sharing

Use Case 2

Excluded use cases

The following use cases are not covered by this Implementation Guide:

  • DICOM SR templates other than TID1500
  • Creating a FHIR DiagnosticReport or Composition from a DICOM SR
  • Creating HL7 v2 or v3 results from a DICOM SR

Glossary

The following terms and acronyms are used within the Radiation Dose Summary IG:

Term Definition
AIR AI Results
ATNA Audit Trail and Node Authentication
CID Context Identifier
DICOM Digital Imaging and Communications in Medicine
DLP Dose Length Product
EHR Electronic Health Record
EMR Electronic Medical Record
FHIR Fast Healthcare Interoperability Resources
HL7 Health Level Seven
IG Implementation Guide
IHE Integrating the Healthcare Enterprise
IOD Information Object Definition
RIS Radiology Information System
SR Structured Report
TID Template ID
TLS Transport Layer Security
UID Unique identifier
URL Uniform Resource Locator
URN Uniform Resource Name

References

  1. DICOM,DICOM PS3.16: Content Mapping Resource
  2. DICOM,TID 1500. Measurement Report
  3. IHE Radiology (RAD), Technical Framework Supplement, AI Results (AIR)
  4. D. Clunie, DICOM Structured Reporting