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10.6 Resource ImagingSelection - Content

Imaging Integration icon Work GroupMaturity Level: 1 Trial UseSecurity Category: Patient Compartments: Group, Patient

A selection of DICOM SOP instances and/or frames within a single Study and Series. This might include additional specifics such as an image region, an Observation UID or a Segmentation Number, allowing linkage to an Observation Resource or transferring this information along with the ImagingStudy Resource.

10.6.1 Scope and Usage

This resource is an event resource from a FHIR workflow perspective - see Workflow.

A selection of data from an ImagingStudy. The selection MAY be:

  • All DICOM SOP Instances in a single DICOM Series
  • A set of DICOM SOP Instances within a single DICOM Series
  • A set of frames within one or more DICOM multiframe image SOP Instances
  • A set of segments within one or more DICOM segmentation SOP Instances
  • A set of content items within one or more DICOM Structured Report SOP Instances
  • ...

May also represent regions within the ImagingStudy, including:

  • A 2D region within one or more DICOM image SOP Instances
  • A 3D region within a DICOM frame of reference

Uses for ImagingSelection resources include:

  • Identifying a specific set of images or frames as the focus of an Observation
  • Identifying a spatial region or volume as the focus of an Observation
  • Identifying the set of image coordinates as the focus of a measurement represented by an Observation
  • Identifying a node in a DICOM Structured Report SOP Instance from which an Observation is derived
  • Identifying images, frames or presentation states selected as part of shared application context in a context-sharing environment
  • Identifying a specific set of images, frames or presentation states to be presented

All DICOM SOP Instances referenced in a single ImagingSelection resource SHALL be part of the same DICOM Series (and therefore also the same DICOM Study). In order to reference SOP Instances in multiple Studies or Series it is necessary to create multiple ImagingSelection resources.

10.6.2 Boundaries and Relationships

The ImagingStudy resource is used to store details of an entire DICOM Study and associated information, including its relationship to other resources, such as ServiceRequest and Encounter.

The ImagingSelection resource is used to reference to a specific set of specific set of images, frames, waveforms or image regions. Instances of this resource are created for specific clinical purposes and are unlikely to change once created.

An Observation MAY be related to a set of images in the following ways.

The DocumentReference resource is used to to store non-DICOM images, video, or audio with relevant metadata. The DocumentReference resource might be appropriate for including a rendered DICOM image in cases where only the image is needed and not the full image context.

The Binary resource to store arbitrary content.

10.6.3 References to this Resource

10.6.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImagingSelection TU DomainResource A selection of DICOM SOP instances and/or frames
+ Rule: At least one of seriesUid or imageRegion3D shall be present
+ Rule: seriesUid SHALL only be present if studyUid is present
+ Rule: seriesNumber SHALL only be present if seriesUid is present
+ Rule: instance SHALL only be present if seriesUid is present
+ Rule: imageRegion3D SHALL only be present if frameOfReferenceUid is present
+ Rule: imageRegion3D SHALL only be present if instance.imageRegion2D is not present

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ 0..* Identifier Business Identifiers for Imaging Selection

... status ?!Σ 1..1 code available | entered-in-error | inactive | unknown
Binding: Imaging Selection Status (Required)
... category Σ 0..* CodeableConcept Classifies the imaging selection
Binding: KeyObjectSelectionDocumentTitle icon (Preferred)

... subject Σ 0..1 Reference(Patient | Group | Device | Procedure | Practitioner | Medication | Substance | Specimen) Subject of the selected instances
... issued Σ 0..1 instant Date / Time when this imaging selection was created
... performer Σ 0..* BackboneElement Selectors of the instances (human or machine)

.... function Σ 0..1 CodeableConcept Type of performer
Binding: ImagingStudy series performer function (Extensible)
.... actor Σ 0..1 Reference(Practitioner | PractitionerRole | Device | Organization | CareTeam | Patient | RelatedPerson | HealthcareService) Author (human or machine)
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest | Appointment | Task) Associated requests

... derivedFrom Σ 0..1 Reference(ImagingStudy | DocumentReference) The imaging study from which the imaging selection is derived
... studyUid ΣC 0..1 id DICOM Study Instance UID
... seriesUid ΣC 0..1 id DICOM Series Instance UID
... seriesNumber ΣC 0..1 unsignedInt DICOM Series Number
... frameOfReferenceUid ΣC 0..1 id The Frame of Reference UID for the selected images
... bodySite Σ 0..* CodeableReference(BodyStructure) Body part examined
Binding: SNOMED CT Body Structures (Example)

... focus Σ 0..* Reference(ImagingSelection) Related resources that are the focus for the imaging selection

... endpoint Σ 0..* Reference(Endpoint) The network services providing retrieval for the images referenced in the imaging selection

... instance ΣC 0..* BackboneElement The selected instances

.... uid Σ 1..1 id DICOM SOP Instance UID
.... number Σ 0..1 unsignedInt DICOM Instance Number
.... sopClass 0..1 oid DICOM SOP Class UID
.... subset 0..* string The selected subset of the SOP Instance

.... imageRegion2D C 0..* BackboneElement A specific 2D region in a DICOM image / frame

..... regionType 1..1 code point | polyline | multipoint | circle | ellipse
Binding: Imaging Selection 2D Graphic Type (Required)
..... coordinate 1..* decimal Specifies the coordinates that define the image region
This repeating element order: The values are an ordered set of (x, y) coordinates.
... imageRegion3D C 0..* BackboneElement A specific 3D region in a DICOM frame of reference

.... regionType 1..1 code point | multipoint | polyline | polygon | ellipse | ellipsoid
Binding: Imaging Selection 3D Graphic Type (Required)
.... coordinate 1..* decimal Specifies the coordinates that define the image region
This repeating element order: The values are an ordered set of (x, y, z) coordinates.

doco Documentation for this format icon

See the Extensions for this resource

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

10.6.4.1 Terminology Bindings

Path ValueSet Type Documentation
ImagingSelection.status ImagingSelectionStatus Required

The status of the ImagingSelection.
ImagingSelection.category KeyObjectSelectionDocumentTitle icon Preferred

Transitive closure of CID 7010 KeyObjectSelectionDocumentTitle
ImagingSelection.code KeyObjectSelectionDocumentTitle icon Example

Transitive closure of CID 7010 KeyObjectSelectionDocumentTitle
ImagingSelection.performer.function ImagingStudySeriesPerformerFunction Extensible

Performer function of an agent in an imaging study series
ImagingSelection.bodySite SNOMEDCTBodyStructures Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
ImagingSelection.instance.imageRegion2D.regionType ImagingSelection2DGraphicType Required

The type of 2D coordinates describing a 2D image region.
ImagingSelection.imageRegion3D.regionType ImagingSelection3DGraphicType Required

The type of coordinates describing a 3D image region.

10.6.4.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
img isl-1Rule (base)At least one of seriesUid or imageRegion3D shall be presentseriesUid.exists() or imageRegion3D.exists()
img isl-2Rule (base)seriesUid SHALL only be present if studyUid is presentseriesUid.empty() or studyUid.exists()
img isl-3Rule (base)seriesNumber SHALL only be present if seriesUid is presentseriesNumber.empty() or seriesUid.exists()
img isl-4Rule (base)instance SHALL only be present if seriesUid is presentinstance.empty() or seriesUid.exists()
img isl-5Rule (base)imageRegion3D SHALL only be present if frameOfReferenceUid is presentimageRegion3D.empty() or frameOfReferenceUid.exists()
img isl-6Rule (base)imageRegion3D SHALL only be present if instance.imageRegion2D is not presentimageRegion3D.empty() or instance.imageRegion2D.empty()

10.6.5 Notes

10.6.5.1 Imaging Selection Subsets

Some DICOM SOP Instances contain multiple sub-resources, such as frames, segments, etc.

An Imaging Selection resource MAY specify the subset of these that are included in the selection using the instance.subset element.

The defined types of subsets are:

  • Frames selected from a multiframe SOP Instance
  • Referenced Content Item Identifiers selected from a DICOM SR or other structured document SOP Instance
  • Segments selected from a segmentation SOP Instance
  • Regions of interest selected from a radiotherapy structure set SOP Instance

The type of subset is determined by the SOP Class of the parent instance.

Subsets can only reference sub-resources that are already defined within the selected DICOM SOP Instance.

10.6.5.2 Use of ImagingSelection.code and ImagingSelection.category

The code and category element can be used to provide information relevant for applications that want to identify specific types of ImagingSelection resources.

For example, if an ImagingSelection is used to identify a set of images that make up a volume rendered view, the code could contain a code indicating Volume Rendering - such as RadLex RID35862 - and the category could contain values of the DICOM Image Type (0008,0008) attribute - such as DERVIED and SECONDARY. 

  {
    "resource": {
      "resourceType": "ImagingSelection",
      "id": "fa8e0948175f3117a3b8c4be2ff972ec",
      "subject": {
        "reference": "Patient/acb045960122378999c97cd7ca532f8b"
      },
      "code": {
        "coding": [
          {
            "system": "http://radlex.org/",
            "code": "RID12769",
            "display": "volume rendering"
          }
        ]
      },
      "category": [
        {
          "text": "DERIVED"
        },
        {
          "text": "SECONDARY"
        }
      ]
    }
  }

10.6.6 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
based-on reference The request associated with an imaging selection ImagingSelection.basedOn
(Appointment, CarePlan, Task, ServiceRequest)
body-site token The body site code associated with the imaging selection ImagingSelection.bodySite.concept
body-structure reference The body structure associated with the imaging selection ImagingSelection.bodySite.reference
category token The imaging selection category ImagingSelection.category
code token The imaging selection description text or code ImagingSelection.code 21 Resources
derived-from reference The imaging study from which the imaging selection was derived ImagingSelection.derivedFrom
(ImagingStudy, DocumentReference)
identifier token Identifiers for the imaging selection ImagingSelection.identifier 65 Resources
issued date The date / time the imaging selection was created ImagingSelection.issued
patient reference Who the study is about ImagingSelection.subject.where(resolve() is Patient)
(Patient)		 65 Resources
status token The status of the imaging selection ImagingSelection.status
study-uid token The DICOM Study Instance UID from which the images were selected ImagingSelection.studyUid
subject reference The subject of the Imaging Selection, such as the associated Patient ImagingSelection.subject
(Practitioner, Group, Specimen, Device, Medication, Patient, Procedure, Substance)