DICOM® SR to FHIR Resource Mapping IG
1.0.0 - STU1 Ballot
DICOM® SR to FHIR Resource Mapping IG
1.0.0 - STU1 Ballot
DICOM® SR to FHIR Resource Mapping IG, published by HL7 International / Imaging Integration. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/dicom-sr/ and changes regularly. See the Directory of published versions
This chapter describes the architecture of this implementation guide.
The mapping of the core DICOM SR measurement groups, measurements and qualitative analysis content items are covered by the following resource profiles:
Derived Imaging Measurement profiles the Observation resource representing the DICOM SR derived measurement template DTID 1420 “Measurements Derived From Multiple ROI Measurements”
CODE and TEXT children of Content Item with Concept Name DCM#125007 "Measurement Group"The above resource profiles depend on the following resource profiles:
There is no special supporting DataType profiles defined by this IG.
There is no special supporting extensions defined by this IG.
The content of a DICOM SR is a tree of "content items". Each content item has:
The content item value types relevant to this implementation guide are:
CONTAINER: a container with children but no valueNUM: a numerical value with unitsTEXT: a textual valueCODE: a coded value
CODE content item has a coded concept name and a coded valueThis implementation guide maps content items contained within the DICOM TID 1500 Measurement Report to FHIR resources.
All mapped content items are children of the following CONTAINER content items:
| Container Concept Name | Child FHIR Resource Profile | Notes |
|---|---|---|
| DCM#126010 "Imaging Measurements" | Imaging Measurement Group | See Imaging Measurement Group relationship |
| DCM#126011 "Derived Imaging Measurements" | Derived Imaging Measurements | See Derived Imaging Measurements relationship |
| UMLS#C0034375 "Qualitative Evaluations" | Imaging Qualitative Evaluation | See Imaging Qualitative Evaluations relationship |
e.g. the children of the CONTAINER with a Concept Name of DCM#126010 "Imaging Measurements" are mapped to Measurement Group Observations.
An Imaging Measurement Group CONTAINER contains 0-n NUM content items representing numerical measurements. Each of these is mapped to an Imaging Measurement Observation.
An Imaging Measurement Group CONTAINER contains 0-n TEXT or CODE content items representing qualitative evaluations. Each of these is mapped to an Imaging Qualitative Evaluation Observation.
The Imaging Measurement Group CONTAINER is mapped to a Imaging Measurement Group Observation.
The Imaging Measurement Group Observation hasMember element references the child Imaging Measurement and Imaging Qualitative Evaluation Observations.
Note: Not all TEXT or CODE content items contained within the Imaging Measurement Group represent qualitative evaluations.
A TEXT or CODE child content item should only be interpreted as a qualitative evaluation if it does not have a Concept Name from the following list:
A Derived Imaging Measurement CONTAINER contains 0-n NUM content items representing derived numerical measurements. Each of these is mapped to a Derived Measurement Observation.
A Derived Imaging Measurement CONTAINER contains 0-n Imaging Measurement Group CONTAINER content items. Each of these is mapped to an Imaging Measurement Group Observation (see Imaging Measurement Group relationship).
The Derived Imaging Measurements Observation derivedFrom element references the child Imaging Measurement Group Observations.
An Imaging Qualitative Evaluations CONTAINER contains 0-n TEXT or CODE content items representing qualitative evaluations. Each of these is mapped to an Imaging Qualitative Evaluation Observation.
A FHIR Observation can only have a single device value. However, a DICOM SR can have two types of devices:
The DICOM SR General Equipment Module attributes are mapped to an General Equipment Device.
If an Imaging Measurement Group, Imaging Measurement or Imaging Qualitative Evaluation has a child with Concept Name DCM#111001 "Algorithm Name" then it is mapped to an Algorithm Identification Device.
All algorithm devices will use the General Equipment Device to populate the parent element.
If an Imaging Measurement Group, Imaging Measurement or Imaging Qualitative Evaluation does not have a defined device then the device element references the Equipment Device.
e.g.
device element will reference the Equipment DeviceAll DICOM SOP Instances include information relating to the patient, service request, procedure, etc.
Typically, these resources are managed by the EMR and the imaging system is not able to create or update these resources in the FHIR server.
Therefore, this implementation guide assumes that these resources already exist in the destination FHIR server and does not include a full mapping between their DICOM representation and their FHIR representation.
Instead, it specifies the identifier mapping to allow newly-created resources to be associated with the appropriate existing FHIR resources.
See DICOM SR Information Object Definition (IOD) Mapping to FHIR and DICOM SR Document Information Entity (IE) Mapping to FHIR.
Exchanging imaging measurement report resources makes use of patient-specific information which could be exploited by malicious actors resulting in exposure of patient data. For these reasons, all data exchange between the different actors must be secured appropriately with access to limited authorized individuals, data protected in transit, and appropriate audit measures taken.
Implementers SHOULD be aware of these security considerations associated with FHIR transactions, particularly those related to:
These security requirements are highlighted in the context of this IG:
IG © 2024+ HL7 International / Imaging Integration. Package hl7.fhir.uv.dicom-sr#1.0.0 based on FHIR 5.0.0. Generated 2024-09-23
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