HL7 Czech Imaging Report IG
0.1.0-ballot - ci-build Czechia flag

HL7 Czech Imaging Report IG, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/img/ and changes regularly. See the Directory of published versions

Resource Profile: CZ_StudyImaging - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the cz-study-imaging 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())
imagingstudy-01: A DICOM instance UID must start with 'urn:oid:' (identifier.where(system='urn:dicom:uid').value.startsWith('urn:oid:'))
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.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())
6. 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:
  • value @ system
  • 8. ImagingStudy.identifier:studyInstanceUid
    Slice NamestudyInstanceUid
    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(Study Instance UID Identifier)
    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()))
    10. 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()))
    12. 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..*
    BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from CZ Modalityhttp://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
    (required to https://hl7.cz/fhir/img/ValueSet/cz-modality-vs)
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Alternate NamesModalitiesInStudy
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. 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(Patient (CZ core), Device: Performer/Observer (CZ), Patient, Device, Group)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. 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
    • 18. ImagingStudy.basedOn:orderaccession
      Slice Nameorderaccession
      Definition

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

      ShortRequest fulfilled
      Control0..1*
      TypeReference(Service Request: Imaging Report (CZ), 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()))
      20. ImagingStudy.basedOn:orderaccession.identifier
      Definition

      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

      ShortLogical reference, when literal reference is not known
      Comments

      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1
      TypeIdentifier(Imaging Accession Number Identifier)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ImagingStudy.referrer
      Definition

      The requesting/referring physician.

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

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

      ShortWho interpreted images
      Control0..*
      TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), 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()))
      26. ImagingStudy.procedureReference
      Definition

      The procedure which this ImagingStudy was part of.

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

      The principal physical location where the ImagingStudy was performed.

      ShortWhere ImagingStudy occurred
      Control0..1
      TypeReference(Location (CZ core), 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()))
      30. ImagingStudy.reasonReference
      Definition

      Indicates another resource whose existence justifies this Study.

      ShortWhy was study performed
      Control0..*
      TypeReference(Condition: Imaging Report (CZ), Observation: Imaging Report (CZ), Media, Diagnostic Report: Imaging Report (CZ), DocumentReference, 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()))

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

      0. ImagingStudy
      Invariantsimagingstudy-01: A DICOM instance UID must start with 'urn:oid:' (identifier.where(system='urn:dicom:uid').value.startsWith('urn:oid:'))
      2. 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:
      • value @ system
      • 4. ImagingStudy.identifier:studyInstanceUid
        Slice NamestudyInstanceUid
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..1
        TypeIdentifier(Study Instance UID Identifier)
        6. ImagingStudy.modality
        BindingThe codes SHALL be taken from CZ Modality
        (required to https://hl7.cz/fhir/img/ValueSet/cz-modality-vs)
        8. ImagingStudy.subject
        TypeReference(Patient (CZ core), Device: Performer/Observer (CZ))
        10. 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
        • 12. ImagingStudy.basedOn:orderaccession
          Slice Nameorderaccession
          Control0..1
          TypeReference(Service Request: Imaging Report (CZ))
          14. ImagingStudy.basedOn:orderaccession.identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..?
          TypeIdentifier(Imaging Accession Number Identifier)
          16. ImagingStudy.referrer
          TypeReference(Practitioner (CZ core), Practitioner Role (CZ core))
          18. ImagingStudy.interpreter
          TypeReference(Practitioner (CZ core), Practitioner Role (CZ core))
          20. ImagingStudy.procedureReference
          TypeReference(Procedure: Imaging Report (CZ))
          22. ImagingStudy.location
          TypeReference(Location (CZ core))
          24. ImagingStudy.reasonReference
          TypeReference(Condition: Imaging Report (CZ), Observation: Imaging Report (CZ), Media, Diagnostic Report: Imaging Report (CZ), DocumentReference)
          26. ImagingStudy.series
          28. ImagingStudy.series.modality
          BindingUnless not suitable, these codes SHALL be taken from CZ Modality
          (extensible to https://hl7.cz/fhir/img/ValueSet/cz-modality-vs)
          30. ImagingStudy.series.specimen
          TypeReference(Specimen (CZ))
          32. ImagingStudy.series.performer
          SlicingThis element introduces a set of slices on ImagingStudy.series.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ actor
          • 34. ImagingStudy.series.performer.function
            BindingUnless not suitable, these codes SHALL be taken from Imaging Study Performer Type Value Set
            (extensible to https://hl7.cz/fhir/img/ValueSet/cz-imaging-study-performer-type)
            36. ImagingStudy.series.performer.actor
            TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Organization (CZ core), CareTeam, Patient (CZ core), Related Person (CZ core), Device: Performer/Observer (CZ), Device)
            38. ImagingStudy.series.performer:performer
            Slice Nameperformer
            Control0..1
            40. ImagingStudy.series.performer:performer.function
            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                "code" : "PRF"
              }]
            }
            42. ImagingStudy.series.performer:performer.actor
            TypeReference(Practitioner Role (CZ core))
            44. ImagingStudy.series.performer:device
            Slice Namedevice
            Control0..1
            46. ImagingStudy.series.performer:device.function
            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                "code" : "DEV"
              }]
            }
            48. ImagingStudy.series.performer:device.actor
            TypeReference(Device: Performer/Observer (CZ))
            50. ImagingStudy.series.performer:custodian
            Slice Namecustodian
            Control0..1
            52. ImagingStudy.series.performer:custodian.function
            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                "code" : "CST"
              }]
            }
            54. ImagingStudy.series.performer:custodian.actor
            TypeReference(Organization (CZ core))
            56. ImagingStudy.series.instance
            58. 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
            • 60. ImagingStudy.series.instance.extension:instance-description
              Slice Nameinstance-description
              Control0..1
              TypeExtension(Instance Description) (Extension Type: string)

              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())
              imagingstudy-01: A DICOM instance UID must start with 'urn:oid:' (identifier.where(system='urn:dicom:uid').value.startsWith('urn:oid:'))
              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

              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.

              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())
              16. 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())
              18. 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:
              • value @ system
              • 20. ImagingStudy.identifier:studyInstanceUid
                Slice NamestudyInstanceUid
                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(Study Instance UID Identifier)
                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()))
                22. 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()))
                24. 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..*
                BindingThe codes SHALL be taken from CZ Modality
                (required to https://hl7.cz/fhir/img/ValueSet/cz-modality-vs)
                TypeCoding
                Is Modifierfalse
                Summarytrue
                Alternate NamesModalitiesInStudy
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                26. 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(Patient (CZ core), Device: Performer/Observer (CZ))
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. 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()))
                30. 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
                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()))
                32. 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
                • 34. ImagingStudy.basedOn:orderaccession
                  Slice Nameorderaccession
                  Definition

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

                  ShortRequest fulfilled
                  Control0..1
                  TypeReference(Service Request: Imaging Report (CZ))
                  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()))
                  36. ImagingStudy.basedOn:orderaccession.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
                  38. ImagingStudy.basedOn:orderaccession.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())
                  SlicingThis element introduces a set of slices on ImagingStudy.basedOn.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 40. ImagingStudy.basedOn:orderaccession.reference
                    Definition

                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                    ShortLiteral reference, Relative, internal or absolute URL
                    Comments

                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                    Control0..1
                    This element is affected by the following invariants: ref-1
                    Typestring
                    Is Modifierfalse
                    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()))
                    42. ImagingStudy.basedOn:orderaccession.type
                    Definition

                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                    ShortType the reference refers to (e.g. "Patient")
                    Comments

                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                    (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                    Aa resource (or, for logical models, the URI of the logical model).

                    Typeuri
                    Is Modifierfalse
                    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()))
                    44. ImagingStudy.basedOn:orderaccession.identifier
                    Definition

                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                    ShortLogical reference, when literal reference is not known
                    Comments

                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control1..1
                    TypeIdentifier(Imaging Accession Number Identifier)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    46. ImagingStudy.basedOn:orderaccession.display
                    Definition

                    Plain text narrative that identifies the resource in addition to the resource reference.

                    ShortText alternative for the resource
                    Comments

                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    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()))
                    48. ImagingStudy.referrer
                    Definition

                    The requesting/referring physician.

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

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

                    ShortWho interpreted images
                    Control0..*
                    TypeReference(Practitioner (CZ core), Practitioner Role (CZ core))
                    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()))
                    52. 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()))
                    54. 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
                    Control0..1
                    TypeunsignedInt
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Alternate NamesNumberOfStudyRelatedSeries
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    56. 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()))
                    58. ImagingStudy.procedureReference
                    Definition

                    The procedure which this ImagingStudy was part of.

                    ShortThe performed Procedure reference
                    Control0..1
                    TypeReference(Procedure: Imaging Report (CZ))
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    60. 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
                    Summarytrue
                    Alternate NamesProcedureCodeSequence
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. ImagingStudy.location
                    Definition

                    The principal physical location where the ImagingStudy was performed.

                    ShortWhere ImagingStudy occurred
                    Control0..1
                    TypeReference(Location (CZ core))
                    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()))
                    64. 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()))
                    66. ImagingStudy.reasonReference
                    Definition

                    Indicates another resource whose existence justifies this Study.

                    ShortWhy was study performed
                    Control0..*
                    TypeReference(Condition: Imaging Report (CZ), Observation: Imaging Report (CZ), Media, Diagnostic Report: Imaging Report (CZ), DocumentReference)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. 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()))
                    70. 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
                    Summarytrue
                    Alternate NamesStudyDescription
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    72. 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()))
                    74. 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
                    76. 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())
                    78. 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())
                    80. 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
                    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()))
                    82. 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
                    Summarytrue
                    Alternate NamesSeriesNumber
                    ExampleGeneral: 3
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. 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 CZ Modality
                    (extensible to https://hl7.cz/fhir/img/ValueSet/cz-modality-vs)
                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Alternate NamesModality
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    86. 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
                    Summarytrue
                    Alternate NamesSeriesDescription
                    ExampleGeneral: CT Surview 180
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    88. 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
                    Control0..1
                    TypeunsignedInt
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Alternate NamesNumberOfSeriesRelatedInstances
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    90. 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.

                    Control0..*
                    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()))
                    92. 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
                    Summarytrue
                    Alternate NamesBodyPartExamined
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    94. 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()))
                    96. ImagingStudy.series.specimen
                    Definition

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

                    ShortSpecimen imaged
                    Control0..*
                    TypeReference(Specimen (CZ))
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    98. 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
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    100. 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()))
                    SlicingThis element introduces a set of slices on ImagingStudy.series.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ actor
                    • 102. 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
                      104. 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())
                      106. 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())
                      108. 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 Imaging Study Performer Type Value Set
                      (extensible to https://hl7.cz/fhir/img/ValueSet/cz-imaging-study-performer-type)
                      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()))
                      110. ImagingStudy.series.performer.actor
                      Definition

                      Indicates who or what performed the series.

                      ShortWho performed the series
                      Control1..1
                      TypeReference(Practitioner (CZ core), Practitioner Role (CZ core), Organization (CZ core), CareTeam, Patient (CZ core), Related Person (CZ core), Device: Performer/Observer (CZ), Device)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      112. ImagingStudy.series.performer:performer
                      Slice Nameperformer
                      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..1
                      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()))
                      114. ImagingStudy.series.performer: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
                      116. ImagingStudy.series.performer: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())
                      118. ImagingStudy.series.performer: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())
                      120. ImagingStudy.series.performer: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 Imaging Study Performer Type Value Set
                      (extensible to https://hl7.cz/fhir/img/ValueSet/cz-imaging-study-performer-type)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows disambiguation of the types of involvement of different performers.

                      Pattern Value{
                        "coding" : [{
                          "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                          "code" : "PRF"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      122. ImagingStudy.series.performer:performer.actor
                      Definition

                      Indicates who or what performed the series.

                      ShortWho performed the series
                      Control1..1
                      TypeReference(Practitioner Role (CZ core))
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      124. ImagingStudy.series.performer:device
                      Slice Namedevice
                      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..1
                      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()))
                      126. ImagingStudy.series.performer:device.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
                      128. ImagingStudy.series.performer:device.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())
                      130. ImagingStudy.series.performer:device.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())
                      132. ImagingStudy.series.performer:device.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 Imaging Study Performer Type Value Set
                      (extensible to https://hl7.cz/fhir/img/ValueSet/cz-imaging-study-performer-type)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows disambiguation of the types of involvement of different performers.

                      Pattern Value{
                        "coding" : [{
                          "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                          "code" : "DEV"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      134. ImagingStudy.series.performer:device.actor
                      Definition

                      Indicates who or what performed the series.

                      ShortWho performed the series
                      Control1..1
                      TypeReference(Device: Performer/Observer (CZ))
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      136. ImagingStudy.series.performer:custodian
                      Slice Namecustodian
                      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..1
                      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()))
                      138. ImagingStudy.series.performer:custodian.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
                      140. ImagingStudy.series.performer:custodian.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())
                      142. ImagingStudy.series.performer:custodian.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())
                      144. ImagingStudy.series.performer:custodian.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 Imaging Study Performer Type Value Set
                      (extensible to https://hl7.cz/fhir/img/ValueSet/cz-imaging-study-performer-type)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows disambiguation of the types of involvement of different performers.

                      Pattern Value{
                        "coding" : [{
                          "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                          "code" : "CST"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      146. ImagingStudy.series.performer:custodian.actor
                      Definition

                      Indicates who or what performed the series.

                      ShortWho performed the series
                      Control1..1
                      TypeReference(Organization (CZ core))
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      148. 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()))
                      150. 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
                      152. 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
                      • 154. ImagingStudy.series.instance.extension:instance-description
                        Slice Nameinstance-description
                        Definition

                        A description of the instance in an ImagingStudy.

                        ShortInstance Description
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Instance Description) (Extension Type: string)
                        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())
                        156. 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())
                        158. 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
                        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()))
                        160. 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
                        Summaryfalse
                        Alternate NamesSOPClassUID
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        162. 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
                        Summaryfalse
                        Alternate NamesInstanceNumber
                        ExampleGeneral: 1
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        164. ImagingStudy.series.instance.title
                        Definition

                        The description of the instance.

                        ShortDescription 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
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))