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

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: MADO Imaging Study

Official URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoImagingStudy | Version: 0.1.0
Standards status: Draft | Maturity Level: 1 | Computable Name: MadoImagingStudy

Profile for ImagingStudy resources that represent the imaging studies manifest in the MADO context. It includes additional constraints and extensions specific to the MADO context, such as the study modality, the clinical specialty, the anatomical region of interest, the presence of significant images.

In the case significant images are present, an instance referenced in the `ImagingStudy` is a Key Object Selection document TID 2010, the `ImagingStudy.series.instance.extension[ko-document-title]` SHALL contain the Document Title code of the referenced document, and the `ImagingStudy.series.instance.description` field contains the contents of the KeyObjectSelectionDescription field.

Usages:

- Use this Profile: MADO Imaging Study Manifest FHIR Bundle

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: mado-reqproc-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region | S | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (preferred)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | S Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
modality | S Σ | 0..* | Coding | All series modality if actual acquisition modalities Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who or what is the subject of the study
started | S Σ | 0..1 | dateTime | When the study was started Example General: 2011-01-01T11:01:20+03:00
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | S Σ | 0..1 | MadoReferencedAccessionNumberIdentifier(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:webviewer | S Σ | 0..* | Reference(Endpoint: MADO profile for Web Viewer endpoints) | Study access endpoint
numberOfSeries | S Σ | 1..1 | unsignedInt | Number of Study Related Series
procedureCode | S Σ | 0..* | CodeableConcept | The `ProcedureCode`s associated with the study. Binding: http://www.rsna.org/RadLex_Playbook.aspx (extensible): The performed procedure type.
description | S Σ | 0..1 | string | Institution-generated description
series | Σ | 0..* | BackboneElement | Each study has one or more series of instances
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S Σ | 1..1 | id | DICOM Series Instance UID for the series Example General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
number | S Σ | 0..1 | unsignedInt | Numeric identifier of this series Example General: 3
modality | S Σ | 1..1 | Coding | The modality of the instances in the series Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
description | S Σ | 0..1 | string | A short human readable summary of the series Example General: CT Surview 180
numberOfInstances | S Σ | 1..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint | Σ | 1..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | S Σ | 1..* | Reference(Endpoint: MADO WADO endpoint) | Series access endpoint
bodySite | S Σ | 0..1 | Coding | Body part examined Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
specimen | S Σ | 0..* | Reference(Specimen) | Specimen imaged
started | S Σ | 0..1 | dateTime | When the series started
instance |  | 0..* | BackboneElement | A single SOP instance from the series
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:number-of-frames | S | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
extension:ko-document-title | S | 0..1 | CodeableConcept | When this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle Binding: KeyObjectSelectionDocumentTitle (required)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S | 1..1 | id | DICOM SOP Instance UID Example General: 2.16.124.113543.6003.189642796.63084.16748.2599092903
sopClass | S | 1..1 | Coding | DICOM class type Binding: http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible): The sopClass for the instance.
number | S | 0..1 | unsignedInt | The number of this instance in the series Example General: 1
title | S | 0..1 | string | Will contain the Key Object Description in the case the instance represents a Key Object.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.
ImagingStudy.modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.procedureCode | Base | extensible | http://www.rsna.org/RadLex_Playbook.aspx | Not State | Unknown
ImagingStudy.series.​modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.series.​bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​instance.sopClass | Base | extensible | http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 | Not State | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mado-reqproc-1 | error | ImagingStudy | Procedure code should be present in a way that it can be shown to an end-user. | `procedureCode.text.exists() or procedureCode.coding.display.exists()`

This structure is derived from ImagingStudy

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: mado-reqproc-1
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region | S | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (preferred)
Slices for identifier |  | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | S | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
modality | S | 0..* | Coding | All series modality if actual acquisition modalities
subject | S | 1..1 | Reference(MADO Patient) | Who or what is the subject of the study
started | S | 0..1 | dateTime | When the study was started
Slices for basedOn |  | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | S | 0..1 | MadoReferencedAccessionNumberIdentifier(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled
Slices for endpoint |  | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:webviewer | S | 0..* | Reference(Endpoint: MADO profile for Web Viewer endpoints) | Study access endpoint
numberOfSeries | S | 1..1 | unsignedInt | Number of Study Related Series
procedureCode | S | 0..* | CodeableConcept | The `ProcedureCode`s associated with the study.
description | S | 0..1 | string | Institution-generated description
series |  |  |  |
uid | S | 1..1 | id | DICOM Series Instance UID for the series
number | S | 0..1 | unsignedInt | Numeric identifier of this series
modality | S | 1..1 | Coding | The modality of the instances in the series
description | S | 0..1 | string | A short human readable summary of the series
numberOfInstances | S | 1..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint |  | 1..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | S | 1..* | Reference(Endpoint: MADO WADO endpoint) | Series access endpoint
bodySite | S | 0..1 | Coding | Body part examined
specimen | S | 0..* | Reference(Specimen) | Specimen imaged
started | S | 0..1 | dateTime | When the series started
instance |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:number-of-frames | S | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
extension:ko-document-title | S | 0..1 | CodeableConcept | When this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle Binding: KeyObjectSelectionDocumentTitle (required)
uid | S | 1..1 | id | DICOM SOP Instance UID
sopClass | S | 1..1 | Coding | DICOM class type
number | S | 0..1 | unsignedInt | The number of this instance in the series
title | S | 0..1 | string | Will contain the Key Object Description in the case the instance represents a Key Object.
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
mado-reqproc-1 | error | ImagingStudy | Procedure code should be present in a way that it can be shown to an end-user. | `procedureCode.text.exists() or procedureCode.coding.display.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: mado-reqproc-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region | S | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (preferred)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | S Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
modality | S Σ | 0..* | Coding | All series modality if actual acquisition modalities Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who or what is the subject of the study
encounter | Σ | 0..1 | Reference(Encounter) | Encounter with which this imaging study is associated
started | S Σ | 0..1 | dateTime | When the study was started Example General: 2011-01-01T11:01:20+03:00
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | S Σ | 0..1 | MadoReferencedAccessionNumberIdentifier(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled
referrer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Referring physician
interpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole) | Who interpreted images
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:webviewer | S Σ | 0..* | Reference(Endpoint: MADO profile for Web Viewer endpoints) | Study access endpoint
numberOfSeries | S Σ | 1..1 | unsignedInt | Number of Study Related Series
numberOfInstances | Σ | 0..1 | unsignedInt | Number of Study Related Instances
procedureReference | Σ | 0..1 | Reference(Procedure) | The performed Procedure reference
procedureCode | S Σ | 0..* | CodeableConcept | The `ProcedureCode`s associated with the study. Binding: http://www.rsna.org/RadLex_Playbook.aspx (extensible): The performed procedure type.
location | Σ | 0..1 | Reference(Location) | Where ImagingStudy occurred
reasonCode | Σ | 0..* | CodeableConcept | Why the study was requested Binding: ProcedureReasonCodes (example): The reason for the study.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference) | Why was study performed
note | Σ | 0..* | Annotation | User-defined comments
description | S Σ | 0..1 | string | Institution-generated description
series | Σ | 0..* | BackboneElement | Each study has one or more series of instances
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S Σ | 1..1 | id | DICOM Series Instance UID for the series Example General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
number | S Σ | 0..1 | unsignedInt | Numeric identifier of this series Example General: 3
modality | S Σ | 1..1 | Coding | The modality of the instances in the series Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
description | S Σ | 0..1 | string | A short human readable summary of the series Example General: CT Surview 180
numberOfInstances | S Σ | 1..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint | Σ | 1..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | S Σ | 1..* | Reference(Endpoint: MADO WADO endpoint) | Series access endpoint
bodySite | S Σ | 0..1 | Coding | Body part examined Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
laterality | Σ | 0..1 | Coding | Body part laterality Binding: Laterality (example): Codes describing body site laterality (left, right, etc.).
specimen | S Σ | 0..* | Reference(Specimen) | Specimen imaged
started | S Σ | 0..1 | dateTime | When the series started
performer | Σ | 0..* | BackboneElement | Who performed the series
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | Type of performance Binding: ImagingStudySeriesPerformerFunction (extensible): The type of involvement of the performer.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson) | Who performed the series
instance |  | 0..* | BackboneElement | A single SOP instance from the series
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:number-of-frames | S | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
extension:ko-document-title | S | 0..1 | CodeableConcept | When this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle Binding: KeyObjectSelectionDocumentTitle (required)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S | 1..1 | id | DICOM SOP Instance UID Example General: 2.16.124.113543.6003.189642796.63084.16748.2599092903
sopClass | S | 1..1 | Coding | DICOM class type Binding: http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible): The sopClass for the instance.
number | S | 0..1 | unsignedInt | The number of this instance in the series Example General: 1
title | S | 0..1 | string | Will contain the Key Object Description in the case the instance represents a Key Object.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.
ImagingStudy.modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.procedureCode | Base | extensible | http://www.rsna.org/RadLex_Playbook.aspx | Not State | Unknown
ImagingStudy.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.series.​bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​laterality | Base | example | Laterality | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​performer.function | Base | extensible | ImagingStudy series performer function | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​instance.sopClass | Base | extensible | http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 | Not State | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mado-reqproc-1 | error | ImagingStudy | Procedure code should be present in a way that it can be shown to an end-user. | `procedureCode.text.exists() or procedureCode.coding.display.exists()`

This structure is derived from ImagingStudy

Summary

Mandatory: 3 elements(3 nested mandatory elements)
Must-Support: 25 elements

Structures

This structure refers to these other structures:

- MADO Study Instance UID Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoStudyInstanceUidIdentifier)
- MADO Patient (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoPatient)
- MADO Referenced Accession Number Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoReferencedAccessionNumberIdentifier)
- Endpoint: MADO profile for Web Viewer endpoints (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoWebViewerEndpoint)
- Endpoint: MADO WADO endpoint (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoWadoEndpoint)

Extensions

This structure refers to these extensions:

- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of ImagingStudy.identifier
- The element 1 is sliced based on the value of ImagingStudy.basedOn
- The element 1 is sliced based on the value of ImagingStudy.endpoint
- The element 1 is sliced based on the value of ImagingStudy.series.endpoint

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: mado-reqproc-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region | S | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (preferred)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | S Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
modality | S Σ | 0..* | Coding | All series modality if actual acquisition modalities Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who or what is the subject of the study
started | S Σ | 0..1 | dateTime | When the study was started Example General: 2011-01-01T11:01:20+03:00
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | S Σ | 0..1 | MadoReferencedAccessionNumberIdentifier(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:webviewer | S Σ | 0..* | Reference(Endpoint: MADO profile for Web Viewer endpoints) | Study access endpoint
numberOfSeries | S Σ | 1..1 | unsignedInt | Number of Study Related Series
procedureCode | S Σ | 0..* | CodeableConcept | The `ProcedureCode`s associated with the study. Binding: http://www.rsna.org/RadLex_Playbook.aspx (extensible): The performed procedure type.
description | S Σ | 0..1 | string | Institution-generated description
series | Σ | 0..* | BackboneElement | Each study has one or more series of instances
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S Σ | 1..1 | id | DICOM Series Instance UID for the series Example General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
number | S Σ | 0..1 | unsignedInt | Numeric identifier of this series Example General: 3
modality | S Σ | 1..1 | Coding | The modality of the instances in the series Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
description | S Σ | 0..1 | string | A short human readable summary of the series Example General: CT Surview 180
numberOfInstances | S Σ | 1..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint | Σ | 1..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | S Σ | 1..* | Reference(Endpoint: MADO WADO endpoint) | Series access endpoint
bodySite | S Σ | 0..1 | Coding | Body part examined Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
specimen | S Σ | 0..* | Reference(Specimen) | Specimen imaged
started | S Σ | 0..1 | dateTime | When the series started
instance |  | 0..* | BackboneElement | A single SOP instance from the series
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:number-of-frames | S | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
extension:ko-document-title | S | 0..1 | CodeableConcept | When this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle Binding: KeyObjectSelectionDocumentTitle (required)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S | 1..1 | id | DICOM SOP Instance UID Example General: 2.16.124.113543.6003.189642796.63084.16748.2599092903
sopClass | S | 1..1 | Coding | DICOM class type Binding: http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible): The sopClass for the instance.
number | S | 0..1 | unsignedInt | The number of this instance in the series Example General: 1
title | S | 0..1 | string | Will contain the Key Object Description in the case the instance represents a Key Object.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.
ImagingStudy.modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.procedureCode | Base | extensible | http://www.rsna.org/RadLex_Playbook.aspx | Not State | Unknown
ImagingStudy.series.​modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.series.​bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​instance.sopClass | Base | extensible | http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 | Not State | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mado-reqproc-1 | error | ImagingStudy | Procedure code should be present in a way that it can be shown to an end-user. | `procedureCode.text.exists() or procedureCode.coding.display.exists()`

Differential View

This structure is derived from ImagingStudy

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: mado-reqproc-1
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region | S | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (preferred)
Slices for identifier |  | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | S | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
modality | S | 0..* | Coding | All series modality if actual acquisition modalities
subject | S | 1..1 | Reference(MADO Patient) | Who or what is the subject of the study
started | S | 0..1 | dateTime | When the study was started
Slices for basedOn |  | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | S | 0..1 | MadoReferencedAccessionNumberIdentifier(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled
Slices for endpoint |  | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:webviewer | S | 0..* | Reference(Endpoint: MADO profile for Web Viewer endpoints) | Study access endpoint
numberOfSeries | S | 1..1 | unsignedInt | Number of Study Related Series
procedureCode | S | 0..* | CodeableConcept | The `ProcedureCode`s associated with the study.
description | S | 0..1 | string | Institution-generated description
series |  |  |  |
uid | S | 1..1 | id | DICOM Series Instance UID for the series
number | S | 0..1 | unsignedInt | Numeric identifier of this series
modality | S | 1..1 | Coding | The modality of the instances in the series
description | S | 0..1 | string | A short human readable summary of the series
numberOfInstances | S | 1..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint |  | 1..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | S | 1..* | Reference(Endpoint: MADO WADO endpoint) | Series access endpoint
bodySite | S | 0..1 | Coding | Body part examined
specimen | S | 0..* | Reference(Specimen) | Specimen imaged
started | S | 0..1 | dateTime | When the series started
instance |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:number-of-frames | S | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
extension:ko-document-title | S | 0..1 | CodeableConcept | When this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle Binding: KeyObjectSelectionDocumentTitle (required)
uid | S | 1..1 | id | DICOM SOP Instance UID
sopClass | S | 1..1 | Coding | DICOM class type
number | S | 0..1 | unsignedInt | The number of this instance in the series
title | S | 0..1 | string | Will contain the Key Object Description in the case the instance represents a Key Object.
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
mado-reqproc-1 | error | ImagingStudy | Procedure code should be present in a way that it can be shown to an end-user. | `procedureCode.text.exists() or procedureCode.coding.display.exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: mado-reqproc-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region | S | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (preferred)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | S Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
modality | S Σ | 0..* | Coding | All series modality if actual acquisition modalities Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who or what is the subject of the study
encounter | Σ | 0..1 | Reference(Encounter) | Encounter with which this imaging study is associated
started | S Σ | 0..1 | dateTime | When the study was started Example General: 2011-01-01T11:01:20+03:00
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | S Σ | 0..1 | MadoReferencedAccessionNumberIdentifier(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled
referrer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Referring physician
interpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole) | Who interpreted images
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:webviewer | S Σ | 0..* | Reference(Endpoint: MADO profile for Web Viewer endpoints) | Study access endpoint
numberOfSeries | S Σ | 1..1 | unsignedInt | Number of Study Related Series
numberOfInstances | Σ | 0..1 | unsignedInt | Number of Study Related Instances
procedureReference | Σ | 0..1 | Reference(Procedure) | The performed Procedure reference
procedureCode | S Σ | 0..* | CodeableConcept | The `ProcedureCode`s associated with the study. Binding: http://www.rsna.org/RadLex_Playbook.aspx (extensible): The performed procedure type.
location | Σ | 0..1 | Reference(Location) | Where ImagingStudy occurred
reasonCode | Σ | 0..* | CodeableConcept | Why the study was requested Binding: ProcedureReasonCodes (example): The reason for the study.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference) | Why was study performed
note | Σ | 0..* | Annotation | User-defined comments
description | S Σ | 0..1 | string | Institution-generated description
series | Σ | 0..* | BackboneElement | Each study has one or more series of instances
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S Σ | 1..1 | id | DICOM Series Instance UID for the series Example General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
number | S Σ | 0..1 | unsignedInt | Numeric identifier of this series Example General: 3
modality | S Σ | 1..1 | Coding | The modality of the instances in the series Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
description | S Σ | 0..1 | string | A short human readable summary of the series Example General: CT Surview 180
numberOfInstances | S Σ | 1..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint | Σ | 1..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | S Σ | 1..* | Reference(Endpoint: MADO WADO endpoint) | Series access endpoint
bodySite | S Σ | 0..1 | Coding | Body part examined Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
laterality | Σ | 0..1 | Coding | Body part laterality Binding: Laterality (example): Codes describing body site laterality (left, right, etc.).
specimen | S Σ | 0..* | Reference(Specimen) | Specimen imaged
started | S Σ | 0..1 | dateTime | When the series started
performer | Σ | 0..* | BackboneElement | Who performed the series
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | Type of performance Binding: ImagingStudySeriesPerformerFunction (extensible): The type of involvement of the performer.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson) | Who performed the series
instance |  | 0..* | BackboneElement | A single SOP instance from the series
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:number-of-frames | S | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
extension:ko-document-title | S | 0..1 | CodeableConcept | When this instance represents a Key Object Selection document, this extension contains the document title code of the referenced document. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle Binding: KeyObjectSelectionDocumentTitle (required)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | S | 1..1 | id | DICOM SOP Instance UID Example General: 2.16.124.113543.6003.189642796.63084.16748.2599092903
sopClass | S | 1..1 | Coding | DICOM class type Binding: http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible): The sopClass for the instance.
number | S | 0..1 | unsignedInt | The number of this instance in the series Example General: 1
title | S | 0..1 | string | Will contain the Key Object Description in the case the instance represents a Key Object.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.
ImagingStudy.modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.procedureCode | Base | extensible | http://www.rsna.org/RadLex_Playbook.aspx | Not State | Unknown
ImagingStudy.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.series.​bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​laterality | Base | example | Laterality | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​performer.function | Base | extensible | ImagingStudy series performer function | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​instance.sopClass | Base | extensible | http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 | Not State | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mado-reqproc-1 | error | ImagingStudy | Procedure code should be present in a way that it can be shown to an end-user. | `procedureCode.text.exists() or procedureCode.coding.display.exists()`

This structure is derived from ImagingStudy

Summary

Mandatory: 3 elements(3 nested mandatory elements)
Must-Support: 25 elements

Structures

This structure refers to these other structures:

- MADO Study Instance UID Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoStudyInstanceUidIdentifier)
- MADO Patient (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoPatient)
- MADO Referenced Accession Number Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoReferencedAccessionNumberIdentifier)
- Endpoint: MADO profile for Web Viewer endpoints (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoWebViewerEndpoint)
- Endpoint: MADO WADO endpoint (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoWadoEndpoint)

Extensions

This structure refers to these extensions:

- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoKeyObjectDocumentTitle

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of ImagingStudy.identifier
- The element 1 is sliced based on the value of ImagingStudy.basedOn
- The element 1 is sliced based on the value of ImagingStudy.endpoint
- The element 1 is sliced based on the value of ImagingStudy.series.endpoint

Maturity: 1

Other representations of profile: CSV, Excel, Schematron