Manifest-based Access to DICOM Objects (MADO)
0.1.0 - trial-use International flag

Manifest-based Access to DICOM Objects (MADO), published by IHE Radiology Technical Committee. 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/IHE/RAD.MADO/ and changes regularly. See the Directory of published versions

Resource Profile: MadoImagingStudy - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the MadoImagingStudy resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. ImagingStudy
Definition

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

ShortA set of images produced in single study (one or more series of references images)
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImagingStudy.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ImagingStudy.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ImagingStudy.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. ImagingStudy.extension:anatomical-region
    Slice Nameanatomical-region
    Definition

    The anatomical regions covered by the study, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from ImagingStudy.series.bodysite.

    ShortThe anatomical regions covered by the study.
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. ImagingStudy.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. ImagingStudy.identifier
    Definition

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

    ShortIdentifiers for the whole study
    Comments

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


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

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

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

    Alternate NamesStudyInstanceUID, AccessionNumber
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ImagingStudy.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ $this
    • 12. ImagingStudy.identifier:study-instance-uid
      Slice Namestudy-instance-uid
      Definition

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

      ShortIdentifiers for the whole study
      Comments

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


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

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1*
      TypeIdentifier(MADO Study Instance UID Identifier)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Alternate NamesStudyInstanceUID, AccessionNumber
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. ImagingStudy.status
      Definition

      The current state of the ImagingStudy.

      Shortregistered | available | cancelled | entered-in-error | unknown
      Comments

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

      Control1..1
      BindingThe codes SHALL be taken from ImagingStudyStatushttp://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1)

      The status of the ImagingStudy.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. ImagingStudy.modality
      Definition

      A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19).

      ShortAll series modality if actual acquisition modalities
      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from AcquisitionModalityhttp://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
      (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)

      Type of acquired data in the instance.

      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Alternate NamesModalitiesInStudy
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. ImagingStudy.subject
      Definition

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

      ShortWho or what is the subject of the study
      Comments

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

      Control1..1
      TypeReference(MADO Patient, Patient, Device, Group)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ImagingStudy.started
      Definition

      Date and time the study started.

      ShortWhen the study was started
      Control0..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate NamesStudyDate, StudyTime
      ExampleGeneral: 2011-01-01T11:01:20+03:00
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ImagingStudy.basedOn
      Definition

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

      ShortRequest fulfilled
      Control0..*
      TypeReference(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
      Is Modifierfalse
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on ImagingStudy.basedOn. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 24. ImagingStudy.basedOn:order
        Slice Nameorder
        Definition

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

        ShortRequest fulfilled
        Control0..1*
        TypeReference(MADO Referenced Accession Number Identifier)(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task, CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. ImagingStudy.endpoint
        Definition

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

        ShortStudy access endpoint
        Comments

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

        Control0..*
        TypeReference(Endpoint)
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on ImagingStudy.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ $this.resolve()
        • 28. ImagingStudy.endpoint:webviewer
          Slice Namewebviewer
          Definition

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

          ShortStudy access endpoint
          Comments

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

          Control0..*
          TypeReference(Endpoint: MADO profile for Web Viewer endpoints, Endpoint)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. ImagingStudy.numberOfSeries
          Definition

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

          ShortNumber of Study Related Series
          Control10..1
          TypeunsignedInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesNumberOfStudyRelatedSeries
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. ImagingStudy.procedureCode
          Definition

          The code for the performed procedure type.

          ShortThe performed procedure code
          Control0..*
          BindingUnless not suitable, these codes SHALL be taken from http://www.rsna.org/RadLex_Playbook.aspx
          (extensible to http://www.rsna.org/RadLex_Playbook.aspx)

          The performed procedure type.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesProcedureCodeSequence
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. ImagingStudy.description
          Definition

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

          ShortInstitution-generated description
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesStudyDescription
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. ImagingStudy.series
          Definition

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

          ShortEach study has one or more series of instances
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. ImagingStudy.series.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          40. ImagingStudy.series.uid
          Definition

          The DICOM Series Instance UID for the series.

          ShortDICOM Series Instance UID for the series
          Comments

          See DICOM PS3.3 C.7.3.

          Control1..1
          Typeid
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          DICOM Series Instance UID.

          Alternate NamesSeriesInstanceUID
          ExampleGeneral: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. ImagingStudy.series.number
          Definition

          The numeric identifier of this series in the study.

          ShortNumeric identifier of this series
          Control0..1
          TypeunsignedInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesSeriesNumber
          ExampleGeneral: 3
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. ImagingStudy.series.modality
          Definition

          The modality of this series sequence.

          ShortThe modality of the instances in the series
          Control1..1
          BindingUnless not suitable, these codes SHALL be taken from AcquisitionModalityhttp://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
          (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)

          Type of acquired data in the instance.

          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesModality
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. ImagingStudy.series.description
          Definition

          A description of the series.

          ShortA short human readable summary of the series
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesSeriesDescription
          ExampleGeneral: CT Surview 180
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. ImagingStudy.series.numberOfInstances
          Definition

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

          ShortNumber of Series Related Instances
          Control10..1
          TypeunsignedInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesNumberOfSeriesRelatedInstances
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. ImagingStudy.series.endpoint
          Definition

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

          ShortSeries access endpoint
          Comments

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

          Control10..*
          TypeReference(Endpoint)
          Is Modifierfalse
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on ImagingStudy.series.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • profile @ $this.resolve()
          • 52. ImagingStudy.series.endpoint:wado
            Slice Namewado
            Definition

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

            ShortSeries access endpoint
            Comments

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

            Control10..*
            TypeReference(Endpoint: MADO WADO endpoint, Endpoint)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. ImagingStudy.series.bodySite
            Definition

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

            ShortBody part examined
            Control0..1
            BindingFor example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site|4.0.1
            (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

            Codes describing anatomical locations. May include laterality.

            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Alternate NamesBodyPartExamined
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. ImagingStudy.series.specimen
            Definition

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

            ShortSpecimen imaged
            Control0..*
            TypeReference(Specimen)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. ImagingStudy.series.started
            Definition

            The date and time the series was started.

            ShortWhen the series started
            Control0..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. ImagingStudy.series.instance
            Definition

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

            ShortA single SOP instance from the series
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. ImagingStudy.series.instance.extension
            Definition

            An Extension


            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortExtensionAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on ImagingStudy.series.instance.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 64. ImagingStudy.series.instance.extension:number-of-frames
              Slice Namenumber-of-frames
              Definition

              The number of frames in an ImagingStudy instance.

              ShortThe number of frames in an ImagingStudy instance.
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Extension: Number of Frames) (Extension Type: integer)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              66. ImagingStudy.series.instance.extension:ko-document-title
              Slice Nameko-document-title
              Definition

              The document title code of the Key Object Selection document TID 2010 this instance refers to.

              ShortWhen this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document.
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Extension: MADO Document Title of Key Object Selection documents) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              68. ImagingStudy.series.instance.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              70. ImagingStudy.series.instance.uid
              Definition

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

              ShortDICOM SOP Instance UID
              Comments

              See DICOM PS3.3 C.12.1.

              Control1..1
              Typeid
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              DICOM SOP Instance UID.

              Alternate NamesSOPInstanceUID
              ExampleGeneral: 2.16.124.113543.6003.189642796.63084.16748.2599092903
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. ImagingStudy.series.instance.sopClass
              Definition

              DICOM instance type.

              ShortDICOM class type
              Control1..1
              BindingUnless not suitable, these codes SHALL be taken from http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1
              (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1)

              The sopClass for the instance.

              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Alternate NamesSOPClassUID
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. ImagingStudy.series.instance.number
              Definition

              The number of instance in the series.

              ShortThe number of this instance in the series
              Control0..1
              TypeunsignedInt
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Alternate NamesInstanceNumber
              ExampleGeneral: 1
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. ImagingStudy.series.instance.title
              Definition

              The description of the instance.

              ShortWill contain the Key Object Description in the case the instance represents a Key Object.Description of instance
              Comments

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

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

              Guidance on how to interpret the contents of this table can be foundhere

              0. ImagingStudy
              2. ImagingStudy.extension
              SlicingThis element introduces a set of slices on ImagingStudy.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 4. ImagingStudy.extension:anatomical-region
                Slice Nameanatomical-region
                Definition

                The anatomical regions covered by the study, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from ImagingStudy.series.bodysite.

                ShortThe anatomical regions covered by the study.
                Control0..*
                TypeExtension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
                Must Supporttrue
                6. ImagingStudy.identifier
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..?
                SlicingThis element introduces a set of slices on ImagingStudy.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • profile @ $this
                • 8. ImagingStudy.identifier:study-instance-uid
                  Slice Namestudy-instance-uid
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..1
                  TypeIdentifier(MADO Study Instance UID Identifier)
                  Must Supporttrue
                  10. ImagingStudy.modality
                  Must Supporttrue
                  12. ImagingStudy.subject
                  TypeReference(MADO Patient)
                  Must Supporttrue
                  14. ImagingStudy.started
                  Must Supporttrue
                  16. ImagingStudy.basedOn
                  SlicingThis element introduces a set of slices on ImagingStudy.basedOn. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 18. ImagingStudy.basedOn:order
                    Slice Nameorder
                    Control0..1
                    TypeReference(MADO Referenced Accession Number Identifier)(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    20. ImagingStudy.endpoint
                    SlicingThis element introduces a set of slices on ImagingStudy.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • profile @ $this.resolve()
                    • 22. ImagingStudy.endpoint:webviewer
                      Slice Namewebviewer
                      Control0..*
                      TypeReference(Endpoint: MADO profile for Web Viewer endpoints)
                      Must Supporttrue
                      24. ImagingStudy.numberOfSeries
                      Control1..?
                      Must Supporttrue
                      26. ImagingStudy.procedureCode
                      Must Supporttrue
                      28. ImagingStudy.description
                      Must Supporttrue
                      30. ImagingStudy.series
                      32. ImagingStudy.series.uid
                      Must Supporttrue
                      34. ImagingStudy.series.number
                      Must Supporttrue
                      36. ImagingStudy.series.modality
                      Must Supporttrue
                      38. ImagingStudy.series.description
                      Must Supporttrue
                      40. ImagingStudy.series.numberOfInstances
                      Control1..?
                      Must Supporttrue
                      42. ImagingStudy.series.endpoint
                      Control1..?
                      SlicingThis element introduces a set of slices on ImagingStudy.series.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • profile @ $this.resolve()
                      • 44. ImagingStudy.series.endpoint:wado
                        Slice Namewado
                        Control1..*
                        TypeReference(Endpoint: MADO WADO endpoint)
                        Must Supporttrue
                        46. ImagingStudy.series.bodySite
                        Must Supporttrue
                        48. ImagingStudy.series.specimen
                        Must Supporttrue
                        50. ImagingStudy.series.started
                        Must Supporttrue
                        52. ImagingStudy.series.instance
                        54. ImagingStudy.series.instance.extension
                        SlicingThis element introduces a set of slices on ImagingStudy.series.instance.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 56. ImagingStudy.series.instance.extension:number-of-frames
                          Slice Namenumber-of-frames
                          ShortThe number of frames in an ImagingStudy instance.
                          Control0..1
                          TypeExtension(Extension: Number of Frames) (Extension Type: integer)
                          Must Supporttrue
                          58. ImagingStudy.series.instance.extension:ko-document-title
                          Slice Nameko-document-title
                          ShortWhen this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document.
                          Control0..1
                          TypeExtension(Extension: MADO Document Title of Key Object Selection documents) (Extension Type: CodeableConcept)
                          Must Supporttrue
                          60. ImagingStudy.series.instance.uid
                          Must Supporttrue
                          62. ImagingStudy.series.instance.sopClass
                          Must Supporttrue
                          64. ImagingStudy.series.instance.number
                          Must Supporttrue
                          66. ImagingStudy.series.instance.title
                          ShortWill contain the Key Object Description in the case the instance represents a Key Object.
                          Must Supporttrue

                          Guidance on how to interpret the contents of this table can be foundhere

                          0. ImagingStudy
                          Definition

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

                          ShortA set of images produced in single study (one or more series of references images)
                          Control0..*
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                          dom-6: A resource should have narrative for robust management (text.`div`.exists())
                          2. ImagingStudy.id
                          Definition

                          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                          ShortLogical id of this artifact
                          Comments

                          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                          Control0..1
                          Typeid
                          Is Modifierfalse
                          Summarytrue
                          4. ImagingStudy.meta
                          Definition

                          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                          ShortMetadata about the resource
                          Control0..1
                          TypeMeta
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          6. ImagingStudy.implicitRules
                          Definition

                          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                          ShortA set of rules under which this content was created
                          Comments

                          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                          Control0..1
                          Typeuri
                          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          8. ImagingStudy.language
                          Definition

                          The base language in which the resource is written.

                          ShortLanguage of the resource content
                          Comments

                          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                          Control0..1
                          BindingThe codes SHOULD be taken from CommonLanguages
                          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                          A human language.

                          Additional BindingsPurpose
                          AllLanguagesMax Binding
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          10. ImagingStudy.text
                          Definition

                          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                          ShortText summary of the resource, for human interpretation
                          Comments

                          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                          Control0..1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesnarrative, html, xhtml, display
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          12. ImagingStudy.contained
                          Definition

                          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                          ShortContained, inline Resources
                          Comments

                          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                          Control0..*
                          TypeResource
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesinline resources, anonymous resources, contained resources
                          14. ImagingStudy.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on ImagingStudy.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 16. ImagingStudy.extension:anatomical-region
                            Slice Nameanatomical-region
                            Definition

                            The anatomical regions covered by the study, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from ImagingStudy.series.bodysite.

                            ShortThe anatomical regions covered by the study.
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            18. ImagingStudy.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                            Summaryfalse
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            20. ImagingStudy.identifier
                            Definition

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

                            ShortIdentifiers for the whole study
                            Comments

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

                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control1..*
                            TypeIdentifier
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

                            Alternate NamesStudyInstanceUID, AccessionNumber
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on ImagingStudy.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • profile @ $this
                            • 22. ImagingStudy.identifier:study-instance-uid
                              Slice Namestudy-instance-uid
                              Definition

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

                              ShortIdentifiers for the whole study
                              Comments

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

                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control1..1
                              TypeIdentifier(MADO Study Instance UID Identifier)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

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

                              Alternate NamesStudyInstanceUID, AccessionNumber
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              24. ImagingStudy.status
                              Definition

                              The current state of the ImagingStudy.

                              Shortregistered | available | cancelled | entered-in-error | unknown
                              Comments

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

                              Control1..1
                              BindingThe codes SHALL be taken from ImagingStudyStatus
                              (required to http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1)

                              The status of the ImagingStudy.

                              Typecode
                              Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              26. ImagingStudy.modality
                              Definition

                              A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19).

                              ShortAll series modality if actual acquisition modalities
                              Control0..*
                              BindingUnless not suitable, these codes SHALL be taken from AcquisitionModality
                              (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)

                              Type of acquired data in the instance.

                              TypeCoding
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Alternate NamesModalitiesInStudy
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              28. ImagingStudy.subject
                              Definition

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

                              ShortWho or what is the subject of the study
                              Comments

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

                              Control1..1
                              TypeReference(MADO Patient)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              30. ImagingStudy.encounter
                              Definition

                              The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made.

                              ShortEncounter with which this imaging study is associated
                              Comments

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

                              Control0..1
                              TypeReference(Encounter)
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              32. ImagingStudy.started
                              Definition

                              Date and time the study started.

                              ShortWhen the study was started
                              Control0..1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Alternate NamesStudyDate, StudyTime
                              ExampleGeneral: 2011-01-01T11:01:20+03:00
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              34. ImagingStudy.basedOn
                              Definition

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

                              ShortRequest fulfilled
                              Control0..*
                              TypeReference(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
                              Is Modifierfalse
                              Summarytrue
                              Requirements

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on ImagingStudy.basedOn. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 36. ImagingStudy.basedOn:order
                                Slice Nameorder
                                Definition

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

                                ShortRequest fulfilled
                                Control0..1
                                TypeReference(MADO Referenced Accession Number Identifier)(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
                                Is Modifierfalse
                                Must Supporttrue
                                Must Support TypesNo must-support rules about the choice of types/profiles
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                38. ImagingStudy.referrer
                                Definition

                                The requesting/referring physician.

                                ShortReferring physician
                                Control0..1
                                TypeReference(Practitioner, PractitionerRole)
                                Is Modifierfalse
                                Summarytrue
                                Alternate NamesReferringPhysiciansName
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                40. ImagingStudy.interpreter
                                Definition

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

                                ShortWho interpreted images
                                Control0..*
                                TypeReference(Practitioner, PractitionerRole)
                                Is Modifierfalse
                                Summarytrue
                                Alternate NamesName of Physician(s) Reading Study
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                42. ImagingStudy.endpoint
                                Definition

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

                                ShortStudy access endpoint
                                Comments

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

                                Control0..*
                                TypeReference(Endpoint)
                                Is Modifierfalse
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on ImagingStudy.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • profile @ $this.resolve()
                                • 44. ImagingStudy.endpoint:webviewer
                                  Slice Namewebviewer
                                  Definition

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

                                  ShortStudy access endpoint
                                  Comments

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

                                  Control0..*
                                  TypeReference(Endpoint: MADO profile for Web Viewer endpoints)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  46. ImagingStudy.numberOfSeries
                                  Definition

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

                                  ShortNumber of Study Related Series
                                  Control1..1
                                  TypeunsignedInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate NamesNumberOfStudyRelatedSeries
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  48. ImagingStudy.numberOfInstances
                                  Definition

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

                                  ShortNumber of Study Related Instances
                                  Control0..1
                                  TypeunsignedInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Alternate NamesNumberOfStudyRelatedInstances
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  50. ImagingStudy.procedureReference
                                  Definition

                                  The procedure which this ImagingStudy was part of.

                                  ShortThe performed Procedure reference
                                  Control0..1
                                  TypeReference(Procedure)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  52. ImagingStudy.procedureCode
                                  Definition

                                  The code for the performed procedure type.

                                  ShortThe performed procedure code
                                  Control0..*
                                  BindingUnless not suitable, these codes SHALL be taken from http://www.rsna.org/RadLex_Playbook.aspx
                                  (extensible to http://www.rsna.org/RadLex_Playbook.aspx)

                                  The performed procedure type.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate NamesProcedureCodeSequence
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  54. ImagingStudy.location
                                  Definition

                                  The principal physical location where the ImagingStudy was performed.

                                  ShortWhere ImagingStudy occurred
                                  Control0..1
                                  TypeReference(Location)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  56. ImagingStudy.reasonCode
                                  Definition

                                  Description of clinical condition indicating why the ImagingStudy was requested.

                                  ShortWhy the study was requested
                                  Control0..*
                                  BindingFor example codes, see ProcedureReasonCodes
                                  (example to http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1)

                                  The reason for the study.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  58. ImagingStudy.reasonReference
                                  Definition

                                  Indicates another resource whose existence justifies this Study.

                                  ShortWhy was study performed
                                  Control0..*
                                  TypeReference(Condition, Observation, Media, DiagnosticReport, DocumentReference)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  60. ImagingStudy.note
                                  Definition

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

                                  ShortUser-defined comments
                                  Control0..*
                                  TypeAnnotation
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  62. ImagingStudy.description
                                  Definition

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

                                  ShortInstitution-generated description
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate NamesStudyDescription
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  64. ImagingStudy.series
                                  Definition

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

                                  ShortEach study has one or more series of instances
                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  66. ImagingStudy.series.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  68. ImagingStudy.series.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  70. ImagingStudy.series.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  72. ImagingStudy.series.uid
                                  Definition

                                  The DICOM Series Instance UID for the series.

                                  ShortDICOM Series Instance UID for the series
                                  Comments

                                  See DICOM PS3.3 C.7.3.

                                  Control1..1
                                  Typeid
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  DICOM Series Instance UID.

                                  Alternate NamesSeriesInstanceUID
                                  ExampleGeneral: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  74. ImagingStudy.series.number
                                  Definition

                                  The numeric identifier of this series in the study.

                                  ShortNumeric identifier of this series
                                  Control0..1
                                  TypeunsignedInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate NamesSeriesNumber
                                  ExampleGeneral: 3
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  76. ImagingStudy.series.modality
                                  Definition

                                  The modality of this series sequence.

                                  ShortThe modality of the instances in the series
                                  Control1..1
                                  BindingUnless not suitable, these codes SHALL be taken from AcquisitionModality
                                  (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)

                                  Type of acquired data in the instance.

                                  TypeCoding
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate NamesModality
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  78. ImagingStudy.series.description
                                  Definition

                                  A description of the series.

                                  ShortA short human readable summary of the series
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate NamesSeriesDescription
                                  ExampleGeneral: CT Surview 180
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  80. ImagingStudy.series.numberOfInstances
                                  Definition

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

                                  ShortNumber of Series Related Instances
                                  Control1..1
                                  TypeunsignedInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate NamesNumberOfSeriesRelatedInstances
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  82. ImagingStudy.series.endpoint
                                  Definition

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

                                  ShortSeries access endpoint
                                  Comments

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

                                  Control1..*
                                  TypeReference(Endpoint)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on ImagingStudy.series.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • profile @ $this.resolve()
                                  • 84. ImagingStudy.series.endpoint:wado
                                    Slice Namewado
                                    Definition

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

                                    ShortSeries access endpoint
                                    Comments

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

                                    Control1..*
                                    TypeReference(Endpoint: MADO WADO endpoint)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    86. ImagingStudy.series.bodySite
                                    Definition

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

                                    ShortBody part examined
                                    Control0..1
                                    BindingFor example codes, see SNOMEDCTBodyStructures
                                    (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

                                    Codes describing anatomical locations. May include laterality.

                                    TypeCoding
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Alternate NamesBodyPartExamined
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    88. ImagingStudy.series.laterality
                                    Definition

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

                                    ShortBody part laterality
                                    Control0..1
                                    BindingFor example codes, see Laterality
                                    (example to http://hl7.org/fhir/ValueSet/bodysite-laterality|4.0.1)

                                    Codes describing body site laterality (left, right, etc.).

                                    TypeCoding
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    90. ImagingStudy.series.specimen
                                    Definition

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

                                    ShortSpecimen imaged
                                    Control0..*
                                    TypeReference(Specimen)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    92. ImagingStudy.series.started
                                    Definition

                                    The date and time the series was started.

                                    ShortWhen the series started
                                    Control0..1
                                    TypedateTime
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    94. ImagingStudy.series.performer
                                    Definition

                                    Indicates who or what performed the series and how they were involved.

                                    ShortWho performed the series
                                    Comments

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

                                    Control0..*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

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

                                    Alternate NamesPerformingPhysicianName, OperatorName
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    96. ImagingStudy.series.performer.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    98. ImagingStudy.series.performer.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    100. ImagingStudy.series.performer.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                    Summarytrue
                                    Requirements

                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                    Alternate Namesextensions, user content, modifiers
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    102. ImagingStudy.series.performer.function
                                    Definition

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

                                    ShortType of performance
                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from ImagingStudySeriesPerformerFunction
                                    (extensible to http://hl7.org/fhir/ValueSet/series-performer-function|4.0.1)

                                    The type of involvement of the performer.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows disambiguation of the types of involvement of different performers.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    104. ImagingStudy.series.performer.actor
                                    Definition

                                    Indicates who or what performed the series.

                                    ShortWho performed the series
                                    Control1..1
                                    TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, Device, RelatedPerson)
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    106. ImagingStudy.series.instance
                                    Definition

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

                                    ShortA single SOP instance from the series
                                    Control0..*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    108. ImagingStudy.series.instance.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    110. ImagingStudy.series.instance.extension
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on ImagingStudy.series.instance.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 112. ImagingStudy.series.instance.extension:number-of-frames
                                      Slice Namenumber-of-frames
                                      Definition

                                      The number of frames in an ImagingStudy instance.

                                      ShortThe number of frames in an ImagingStudy instance.
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Extension: Number of Frames) (Extension Type: integer)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      114. ImagingStudy.series.instance.extension:ko-document-title
                                      Slice Nameko-document-title
                                      Definition

                                      The document title code of the Key Object Selection document TID 2010 this instance refers to.

                                      ShortWhen this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document.
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Extension: MADO Document Title of Key Object Selection documents) (Extension Type: CodeableConcept)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      116. ImagingStudy.series.instance.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      118. ImagingStudy.series.instance.uid
                                      Definition

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

                                      ShortDICOM SOP Instance UID
                                      Comments

                                      See DICOM PS3.3 C.12.1.

                                      Control1..1
                                      Typeid
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      DICOM SOP Instance UID.

                                      Alternate NamesSOPInstanceUID
                                      ExampleGeneral: 2.16.124.113543.6003.189642796.63084.16748.2599092903
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      120. ImagingStudy.series.instance.sopClass
                                      Definition

                                      DICOM instance type.

                                      ShortDICOM class type
                                      Control1..1
                                      BindingUnless not suitable, these codes SHALL be taken from http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1
                                      (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1)

                                      The sopClass for the instance.

                                      TypeCoding
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Alternate NamesSOPClassUID
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      122. ImagingStudy.series.instance.number
                                      Definition

                                      The number of instance in the series.

                                      ShortThe number of this instance in the series
                                      Control0..1
                                      TypeunsignedInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Alternate NamesInstanceNumber
                                      ExampleGeneral: 1
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      124. ImagingStudy.series.instance.title
                                      Definition

                                      The description of the instance.

                                      ShortWill contain the Key Object Description in the case the instance represents a Key Object.
                                      Comments

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

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))