CodeX Radiation Therapy
2.0.0 - STU2 United States of America flag

CodeX Radiation Therapy, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/codex-radiation-therapy/ and changes regularly. See the Directory of published versions

Representing Radiotherapy Treatment

The following table documents how the 4 Procedure and 6 ServiceRequest profiles defined in this IG capture the key aspects of radiation therapy using fields and extensions. Many of the extensions are incorporated across all 10 profiles, whereas some are selectively incorporated. Links to relevant definitions are provided. Profiles or Extensions that are new in STU2 are marked as New. This table is for the convenience of the reader and should not be used to assess conformance with the IG.

Field or Extension Data Element Component Notes Prescriptions Plans Performed Treatment
E Treatment Intent Treatment Intent The purpose of a treatment, medication, or procedure, as defined in mCODE. x x x
E Course Involves Reirradiation Course Involves Reirradiation The course of treatment involves reirradiation of targets or organs at risk. x x x
E Uniform Fractionation Uniform Fractionation This flag is true if the fractionation was uniform (i.e., treated with same modality and dose per fraction) and false if the fractionation was mixed. x
F Reason for Termination Status Reason A code explaining the unplanned or premature termination, or normal completion, of a plan of treatment, course of medication, or research study as defined in mCODE. x
E Reason for Revision or Adaptation The reason a planned or prescribed radiotherapy treatment was revised, superceded, or adapted. x x x x x x
F Treatment Site Body Site Described using TG-263 terms mapped to SNOMEDCT codes and qualifiers as defined in mCODE. x x x x x x x x x x
E Treatment Modality and Technique Modality As defined in mCODE x x x x x x x x x x
Technique As defined in mCODE x x x x x x x x x x
Energy or Isotope The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum acceleration voltage, or the used isotope. x x x x x x x x x x
Treatment Applicator Type Type of Radiotherapy Treatment Applicator used in Brachytherapy. x x x x x x x x x x
E Fraction Number in Phase *New* Fraction Number in Phase The fraction number that was treated in the phase. x
E Fraction Number in Plan *New* Fraction Number in Plan The fraction number that was treated in the plan. x
E Actual Number of Sessions Actual Number of Sessions The number of sessions in a course of radiotherapy. x
E Number of Fractions (Prescribed, Planned, or Delivered) Number of Fractions The number of prescribed, planned, or delivered treatment fractions for all volumes in this resource. x x x x x x
E Prescribed, Planned, or Delivered Dose Volume Reference to a RadiotherapyVolume as defined in mCODE. x x x x x x x x x x
Total Dose Total physical radiation dose in cGy. x x x x x x x x x x
Dose per Fraction Physical radiation dose per fraction in cGy. x x x x
Fractions Number of Fractions (Prescribed, Planned, or Delivered) for this volume. x x x
Point Dose This flag is true if the dose is determined at a single point. Point doses are often used to check dose at a specific point in a calculated 3D dose distribution. Since point doses mostly have a technical role, high-level summaries may decide to exclude them from displays. x x x x x x x
Primary Plan Dose This flag is true if the dose is the primary plan dose in a radiotherapy treatment plan. For a single treatment plan, the primary plan dose serves as the main dose value for tracking delivered dose vs. planned dose. In summaries over multiple treatment plans, the flag indicates that the dose is a primary plan dose in any of the summarized plans. x x x x x x x
Radiobiologic Metric *New* Radiobiologic dose metric using a regular expression: BED, CGE, RBE, RBE(factor = <decimal>), EQD2Gy, EQD2Gy(a/b = <decimal>), as defined by TG-263. x x x x x x x x x x
E Image Guided Radiotherapy Modality Image Guided Radiotherapy Modality The modality and associated energy used for imaging in Image Guided Radiotherapy (IGRT). x x x x x x x x x x
E Respiratory Motion Management Method applied to manage respiratory motion. x x x x x x x x x
E Free Breathing Motion Management Technique Technique to manage respiratory motion with free-breathing. Only allowed if respiratory motion management is free-breathing. x x x x x x x x x x
E Intrafraction Verification *New* Verification of the patient or target position during a treatment fraction. Specified with a procedure and an optional qualifier. x x x x x x x x x x
E DICOM Treatment Plan Reference to a DICOM SOP instance representing a treatment plan such as an RT Plan or an RT Ion Plan. x
E DICOM Treatment Record Reference to a DICOM SOP instance representing a treatment record such as an RT Beams Treatment Record or an RT Ion Beams Treatment Record. One or more treatment records are expected from each treatment session. x x