DICOM® SR to FHIR Resource Mapping IG
1.0.0 - STU1 Ballot International flag

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

Example

This chapter describes the complete mapping of a DICOM SR Measurement Report into FHIR resources following the method of this implementation guide.

The source DICOM SR Measurement Report is in DICOM JSON format. See the DICOM PS3.18 Section F for more information.

Example Patient Mapping

DICOM FHIR Resource Reference FHIR Identifier Reference 
{
  "00100010": { "vr": "PN", "Value": [ { "Alphabetic": "EXAMPLE^MEASUREMENT^PATIENT}" } ]},
  "00100020": { "vr": "LO", "Value": [ "PID-11235" ] },
  "00100024": { "vr": "SQ",  "Value": [ {
        "00400031": { "vr": "UT", "Value": [ "Test Hospital" ] },
        "00400032": { "vr": "UT", "Value": [ "http://testhospital.org/mr" ] },
        "00400033": { "vr": "CS", "Value": [ "URI" ] }
      } ] }
}

"subject": {
  "type": "Patient",
  "reference": "Patient/measurement-report-patient"
}

"subject": {
  "type": "Patient",
  "identifier": { 
    "system": "http://testhospital.org/mr",
    "value": "PID-11235",
    "assigner": { "display": "Test Hospital" } 
  }
}
  1. Search for FHIR Patient with identifier testhospital.org|PID-11235
    1. If a result is found, use the found Patient resource as the subject for all created resources
    2. If a result is not found, use a logical reference to the Patient ID from DICOM as the subject for all created resources

See Example Patient.

FHIR Resources

  • Referenced
    • Patient

Example ServiceRequest Mapping

DICOM FHIR Resource Reference FHIR Identifier Reference 
{
  "00080050": { "vr": "SH" , "Value": "ACSN-235813" },
  "00080051": { "vr": "SQ",  "Value": [ {
        "00400031": { "vr": "UT", "Value": [ "Test Hospital" ] },
        "00400032": { "vr": "UT", "Value": [ "http://testhospital.org/acsn" ] },
        "00400033": { "vr": "CS", "Value": [ "URI" ] }
      } ] }
}

"basedOn": [{
  "type": "ServiceRequest",
  "reference": "ServiceRequest/measurement-report-service-request"
}]

"basedOn": [{
  "type": "ServiceRequest
  "identifier": {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
        "code" : "ACSN" }]},
    "system": "http://testhospital.org/acsn",
    "value": "ACSN-235813",
    "assigner": { "display": "Test Hospital" } 
  }
}]
  1. Search for FHIR ServiceRequest with identifier radiology.testhospital.org|ACSN-235813
    1. If a result is found, use the found ServiceRequest resource as the basedOn value for all created Observation resources
    2. If a result is not found, use a logical reference to the Accession Number from DICOM as the basedOn value for all created Observation resources

See Example ServiceRequest.

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest

Example ImagingStudy Mapping

DICOM FHIR Resource References FHIR Identifier Reference 
{
  "0020000E": { "vr": "UI", "Value": [ "1.2.840.113747.20080222.83311413144566317081790268995" ] }
}

"derivedFrom": [{
  "type": "ImagingStudy",
  "reference": "ImagingStudy/measurement-report-imaging-study"
}]

"derivedFrom": [{
  "type": "ImagingStudy",
  "identifier": { 
    "system": "urn:dicom:uid",
    "value": "urn:oid:1.2.840.113747.20080222.83311413144566317081790268995" 
  }
}]
  1. Search for FHIR ImagingStudy with identifier urn:dicom:uid|urn:oid:1.2.840.113747.20080222.83311413144566317081790268995
    1. If a result is found, use the found ImagingStudy resource as the derivedFrom value for all created Observation and ImagingSelection resources
    2. If a result is not found, use a logical reference to the Study Instance UID ID from DICOM as the derivedFrom value for all created Observation and ImagingSelection resources

See Example ImagingStudy.

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest
    • ImagingStudy

Example Device Mapping

DICOM FHIR Resource FHIR Reference 
{
  "00080070": { "vr": "LO", "Value": [ "Example Device Manufacturer" ] },
  "001081090": { "vr": "LO", "Value": [ "Example Imaging Measurement Device" ] },
  "00181002": { "vr": "UI", "Value": [ "1.2.840.113747.20080222.83311413144566317081790268995.8888" ] }
}

{
  "resourceType" : "Device",
  "id" : "measurement-report-general-equipment",
  "identifier" : [{
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
        "code" : "UDI"
      }]
    },
    "system" : "urn:dicom:uid",
    "value" : "1.2.840.113747.20080222.83311413144566317081790268995.8888"
  }],
  "displayName" : "Example Imaging Measurement Device",
  "manufacturer" : "Example Device Manufacturer"
}

"device": [{
  "type": "Device",
  "reference": "Device/measurement-report-general-equipment"
}]

See Example Device.

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest
    • ImagingStudy
  • Created
    • Device (GeneralEquipment)

Example Document Mapping

DICOM FHIR Resource FHIR Observation Fields 
{
  "00080023": { "vr": "DA", "Value": [ "20240724" ] },
  "00080033": { "vr": "TM", "Value": [ "082342" ] },
  "0040A496": { "vr": "CS", "Value": [ "FINAL" ] },
  "0040A730": { "vr": "SQ", "Value": [ {
        "0040A010": { "vr": "CS", "Value": [ "HAS OBS CONTEXT" ] },
        "0040A040": { "vr": "CS", "Value": [ "CODE" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "121005" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Observer Type" ] }
            } ] },
        "0040A168": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "121006" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Person" ] }
            } ] }
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "HAS OBS CONTEXT" ] },
        "0040A040": { "vr": "CS", "Value": [ "PNAME" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "121008" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Person Observer Name" ] }
            } ] },
        "0040A123": { "vr": "PN", "Value": [ { "Alphabetic": "RADIOLOGIST^EXAMPLE" } ] }
      }
}

{
  "resourceType" : "Practitioner",
  "id" : "measurement-report-practitioner",
  "name": [{
    "family": "RADIOLOGIST",
    "given": ["EXAMPLE"]
  }]
}

{
  "resource": {
    "resourceType": "Observation",
    "subject": {
      "reference": "Patient/measurement-report-patient"
    },
    "basedOn": [{
      "type": "ServiceRequest",
      "reference": "ServiceRequest/measurement-report-service-request"
    }],
    "derivedFrom": [{
      "type": "ImagingStudy",
      "reference": "ImagingStudy/measurement-report-imaging-study"
    }],
    "issued": "2024-07-24T08:23:42",
    "status": "final",
    "performer": [{
      "type": "Practitioner",
      "reference": "Practitioner/measurement-report-practitioner"
    }],
    ...
  }
}
  1. Extract ContentDate, ContentTime, and PreliminaryFlag values
  2. Extract ObserverType and PersonObserverName values to identify the Practitioner resource
  3. Use these values to populate the issued, status and performer fields in the created FHIR Observation resources
    issued may be overridden by more specific values in specific content items

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest
    • ImagingStudy
    • Practitioner
  • Created
    • Device (GeneralEquipment)

Example Imaging Measurement Container Mapping

DICOM FHIR Resources 
{
  "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
  "0040A040": { "vr": "CS", "Value": [ "CONTAINER" ] },
  "0040A043": { "vr": "SQ", "Value": [ {
        "00080100": { "vr": "SH", "Value": [ "126010" ] },
        "00080102": { "vr": "SH", "Value": [ "DCM" ] },
        "00080104": { "vr": "LO", "Value": [ "Imaging Measurements" ] }
      } ] },
  "0040A050": { "vr": "CS", "Value": [ "SEPARATE" ] },
  "0040A730": { "vr": "SQ", "Value": [
     {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "CONTAINER" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
           "00080100": { "vr": "SH", "Value": [ "125007" ] },
           "00080102": { "vr": "SH", "Value": [ "DCM" ] },
           "00080104": { "vr": "LO", "Value": [ "Measurement Group" ] }
            } ] },
        ...
     }
  ]}
}

[
  {
    "resource": {
      "resourceType": "Observation",
      "id": "imaging-measurement-group-001"
       "subject": {
         "reference": "Patient/measurement-report-patient"
       },
       "basedOn": [{
         "type": "ServiceRequest",
         "reference": "ServiceRequest/measurement-report-service-request"
       }],
       "derivedFrom": [{
         "type": "ImagingStudy",
         "reference": "ImagingStudy/measurement-report-imaging-study"
       }],
      "issued": "2024-07-24T08:23:42"
      "status": "final",
      "category" : [{ "coding" : [{
        "system" : "http://dicom.nema.org/resources/ontology/DCM",
        "code" : "125007",
        "display" : "Measurement Group"
        }]
      }],
     "device": {
        "reference": "Device/measurement-report-general-equipment"
      },
      ...
    }
  } 
]
  1. Find the CONTAINER content item with the Concept Name Code Sequence (0040,A043) value of DCM#126010 "Imaging Measurements"
  2. Find the Content Sequence (0040,A730) for this container
  3. Create a new ImagingMeasurementGroup Observation resource for each child content item with a Concept Name Code Sequence (0040,A043) value of DCM#125007 "Measurement Group"

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest
    • ImagingStudy
    • Practitioner
  • Created
    • Device (GeneralEquipment)

Example Imaging Measurement Group Mapping

DICOM FHIR Observation 
{
  "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
  "0040A040": { "vr": "CS", "Value": [ "CONTAINER" ] },
  "0040A043": { "vr": "SQ", "Value": [ {
        "00080100": { "vr": "SH", "Value": [ "125007" ] },
        "00080102": { "vr": "SH", "Value": [ "DCM" ] },
        "00080104": { "vr": "LO", "Value": [ "Measurement Group" ] }
      } ] },
  "0040A050": { "vr": "CS", "Value": [ "SEPARATE" ] },
  "0040A504": { "vr": "SQ", "Value": [ {
        "00080105": { "vr": "CS", "Value": [ "DCMR" ] },
        "00080118": { "vr": "UI", "Value": [ "1.2.840.10008.8.1.1" ] },
        "0040DB00": { "vr": "CS", "Value": [ "1411" ] }
      } ] },
  "0040A730": { "vr": "SQ", "Value": [ {
        "0040A010": { "vr": "CS", "Value": [ "HAS OBS CONTEXT" ] },
        "0040A040": { "vr": "CS", "Value": [ "TEXT" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "112039" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Tracking Identifier" ] }
            } ] },
        "0040A160": { "vr": "UT", "Value": [ "Nodule 1" ] }
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "HAS OBS CONTEXT" ] },
        "0040A040": { "vr": "CS", "Value": [ "UIDREF" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "112040" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Tracking Unique Identifier" ] }
            } ] },
        "0040A124": { "vr": "UI", "Value": [ "1.2.840.113747.20080222.83311413144566317081790268995.100" ] }
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "CODE" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "276214006" ] },
              "00080102": { "vr": "SH", "Value": [ "SCT" ] },
              "00080104": { "vr": "LO", "Value": [ "Finding category" ] }
            } ] },
        "0040A168": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "241053004" ] },
              "00080102": { "vr": "SH", "Value": [ "SCT" ] },
              "00080104": { "vr": "LO", "Value": [ "Radiographic measurement of lung volume" ] }
            } ] }
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "CODE" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "121071" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Finding" ] }
            } ] },
        "0040A168": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "427359005" ] },
              "00080102": { "vr": "SH", "Value": [ "SCT" ] },
              "00080104": { "vr": "LO", "Value": [ "Solitary nodule of lung" ] }
            } ] }
      },
      {
        "00081199": { "vr": "SQ", "Value": [ {
              "00081150": { "vr": "UI", "Value": [ "1.2.840.10008.5.1.4.1.1.66.4" ] },
              "00081155": { "vr": "UI", "Value": [ "1.2.276.0.7230010.3.1.4.0.57823.1553343864.578878" ] },
              "0062000B": { "vr": "US", "Value": [ 1 ] }
            } ] },
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "IMAGE" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "121191" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Referenced Segment" ] }
            } ] }
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "UIDREF" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "121232" ] },
              "00080102": { "vr": "SH", "Value": [ "DCM" ] },
              "00080104": { "vr": "LO", "Value": [ "Source series for segmentation" ] }
            } ] },
        "0040A124": { "vr": "UI", "Value": [ "1.3.6.1.4.1.14519.5.2.1.6279.6001.273525289046256012743471155680" ] }
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "HAS CONCEPT MOD" ] },
        "0040A040": { "vr": "CS", "Value": [ "CODE" ] },
        "0040A043": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "363698007" ] },
              "00080102": { "vr": "SH", "Value": [ "SCT" ] },
              "00080104": { "vr": "LO", "Value": [ "Finding Site" ] }
            } ] },
        "0040A168": { "vr": "SQ", "Value": [ {
              "00080100": { "vr": "SH", "Value": [ "39607008" ] },
              "00080102": { "vr": "SH", "Value": [ "SCT" ] },
              "00080104": { "vr": "LO", "Value": [ "Lung" ] }
            } ] }
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "NUM" ] },
        ...
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "NUM" ] },
        ...
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "NUM" ] },
        ...
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "CODE" ] },
        ...
      },
      {
        "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
        "0040A040": { "vr": "CS", "Value": [ "CODE" ] },
        ...
      } ] }
}

[
  {
    "resource": {
      "resourceType": "BodyStructure",
      "id": "measurement-report-tracking-identifier",
      "identifier": [
        {
          "type": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/uv/dicom-sr/CodeSystem/dicom-identifier-type",
                "code": "tracking-identifier",
                "display": "Tracking Identifier"
              }
            ]
          },
          "value": "Nodule 1"
        },
        {
          "type": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/uv/dicom-sr/CodeSystem/dicom-identifier-type",
                "code": "tracking-uid",
                "display": "Tracking UID"
              }
            ]
          },
          "system": "urn:dicom:uid",
          "value": "urn:oid:1.2.840.113747.20080222.83311413144566317081790268995.100"
        }
      ],
      "patient": {
        "reference": "Patient/measurement-report-patient"
      },
      "includedStructure": [
        "structure": {
          "text": "Nodule 1"
        }
      ]
    }
  },
  {
    "resource": {
      "resourceType": "BodyStructure",
      "id": "measurement-report-finding-site",
      "patient": {
        "reference": "Patient/measurement-report-patient"
      },
      "includedStructure": [
        "structure": {
          "coding": [{
            "system" : "http://snomed.info/sct",
            "code" : "39607008",
            "display" : "Lung"
          }]
        }
      ]
    }
  },
    {
    "resource": {
      "resourceType": "ImagingSelection",
      "id": "measurement-report-referenced-segment",
      "status": "available",
      "subject": {
        "reference": "Patient/measurement-report-patient"
      },
      "code": {
        "coding": [
          {
            "system": "http://dicom.nema.org/resources/ontology/DCM",
            "code": "121191",
            "display": "Referenced Segment"
          }
        ]
      },
      "derivedFrom": [
        {
          "reference": "ImagingStudy/measurement-report-imaging-study"
        }
      ],
      "seriesUid": "1.2.840.113747.20080222.83311413144566317081790268995.2"
      "instance": [
        {
          "uid": "11.2.840.113747.20080222.83311413144566317081790268995.2.1",
          "sopClass": {
            "system": "urn:ietf:rfc:3986",
            "code": "urn:oid:1.2.840.10008.5.1.4.1.1.66.4"
          }
          "subset": "1"
        }
      ]
    }
  },
  {
    "resource": {
      "resourceType": "Observation",
      "id": "imaging-measurement-group"
       "subject": {
         "reference": "Patient/measurement-report-patient"
       },
       "basedOn": [{
         "type": "ServiceRequest",
         "reference": "ServiceRequest/measurement-report-service-request"
       }],
       "derivedFrom": [{
         "type": "ImagingStudy",
         "reference": "ImagingStudy/measurement-report-imaging-study"
       }],
      "issued": "2024-07-24T08:23:42+00:00"
      "status": "final",
      "code" : { "coding" : [{
        "system" : "http://snomed.info/sct/MAIN/version/2024-07-01",
        "code" : "241053004",
        "display" : "Radiographic measurement of lung volume"
        }]
      },      
      "category" : [{ "coding" : [{
        "system" : "http://dicom.nema.org/resources/ontology/DCM",
        "code" : "125007",
        "display" : "Measurement Group"
        }]
      }],
      "focus": [
        {
          "reference": "ImagingSelection/measurement-report-referenced-segment"
        },
        {
          "reference": "BodyStructure/measurement-report-tracking-identifier"
        }
      ],
      "bodyStructure": {
        "reference": "BodyStructure/measurement-report-finding-site"
      },
     "device": {
        "reference": "Device/measurement-report-general-equipment"
      },
      "valueCodeableConcept": {
        "coding": [{
            "system": "http://snomed.info/sct",
            "code": "427359005",
            "display": "Solitary nodule of lung"
          }]
      },
      "hasMember": [
        {
          "reference": "Observation/imaging-measurement-001"
        },
        {
          "reference": "Observation/imaging-measurement-002"
        },
        {
          "reference": "Observation/imaging-measurement-003"
        },
        {
          "reference": "Observation/qualitative-evaluation-001"
        },
        {
          "reference": "Observation/qualitative-evaluation-002"
        }
      ]
    }
  }
]

For each Measurement Group:

  1. Create BodyStructure resources for tracking and finding site (if not already existing)
  2. Create ImagingSelection resource for segment (if not already existing)
  3. Create Observation resource for ImagingMeasurementGroup
    1. Set code to value of Finding Category
    2. Set focus to reference ImagingSelection and tracking BodyStructure resources
    3. Set bodyStructure to reference finding site BodyStructure resource
    4. Set hasMember to reference Observation resources for imaging measurements and qualitative evaluations
      Note: Not yet created
    5. Set device to reference general equipment Device resource
      No Algorithm Identification is specified at the group level so the general equipment device is used
    6. Set valueCodeableConcept to value of Finding

See:

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest
    • ImagingStudy
    • Practitioner
  • Created
    • Device (GeneralEquipment)
    • Observation (ImagingMeasurementGroup)
    • BodyStructure (Tracking, FindingSite)
    • ImagingSelection (Segment)

Example Imaging Measurement Mapping

DICOM FHIR Observation 
{
    {
      "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
      "0040A040": { "vr": "CS", "Value": [ "NUM" ] },
      "0040A043": { "vr": "SQ", "Value": [ {
        "00080100": { "vr": "SH", "Value": [ "118565006" ] },
        "00080102": { "vr": "SH", "Value": [ "SCT" ] },
        "00080104": { "vr": "LO", "Value": [ "Volume" ] }
      } ] },
      "0040A300": { "vr": "SQ", "Value": [ {
        "004008EA": { "vr": "SQ", "Value": [ {
          "00080100": { "vr": "SH", "Value": [ "mm3" ] },
          "00080102": { "vr": "SH", "Value": [ "UCUM" ] },
          "00080104": { "vr": "LO", "Value": [ "cubic millimeter" ] }
        } ] },
        "0040A30A": { "vr": "DS", "Value": [ 3.111220E+04 ] }
      } ] },
        "0040A730": { "vr": "SQ", "Value": [ {
              "0040A010": { "vr": "CS", "Value": [ "HAS CONCEPT MOD" ] },
              "0040A040": { "vr": "CS", "Value": [ "TEXT" ] },
              "0040A043": { "vr": "SQ", "Value": [ {
                    "00080100": { "vr": "SH", "Value": [ "111001" ] },
                    "00080102": { "vr": "SH", "Value": [ "DCM" ] },
                    "00080104": { "vr": "LO", "Value": [ "Algorithm Name" ] }
                  } ] },
              "0040A160": { "vr": "UT", "Value": [ "pylidc" ] }
            },
            {
              "0040A010": { "vr": "CS", "Value": [ "HAS CONCEPT MOD" ] },
              "0040A040": { "vr": "CS", "Value": [ "TEXT" ] },
              "0040A043": { "vr": "SQ", "Value": [ {
                    "00080100": { "vr": "SH", "Value": [ "111003" ] },
                    "00080102": { "vr": "SH", "Value": [ "DCM" ] },
                    "00080104": { "vr": "LO", "Value": [ "Algorithm Version" ] }
                  } ] },
              "0040A160": { "vr": "UT", "Value": [ "0.2.0" ] }
            } ] }
      },
      ...
}

{
  "resourceType" : "Device",
  "id" : "measurement-report-algorithm",
  "displayName" : "pylidc",
  "version" : [
    {
      "value" : "0.2.0"
    }
  ],
  "parent" : {
    "reference" : "Device/measurement-report-general-equipment"
  }
},
{
  "resourceType" : "Observation",
  "id" : "imaging-measurement-001",
  "basedOn" : [
    {
      "reference" : "ServiceRequest/measurement-report-service-request"
    }
  ],
  "partOf" : [
    {
      "reference" : "ImagingStudy/measurement-report-imaging-study"
    }
  ],
  "status" : "final",
  "code" : {
    "coding" : [
      {
        "system" : "http://snomed.info/sct",
        "code" : "118565006"
      }
    ]
  },
  "subject" : {
    "reference" : "Patient/measurement-report-patient"
  },
  "focus" : [
    {
      "reference" : "ImagingSelection/measurement-report-referenced-segment"
    },
    {
      "reference" : "BodyStructure/measurement-report-tracking-identifier"
    }
  ],
  "effectiveDateTime" : "2024-07-24T08:23:42+00:00",
  "issued" : "2024-07-24T08:23:42+00:00",
  "performer" : [
    {
      "reference" : "Practitioner/measurement-report-practitioner"
    }
  ],
  "valueQuantity" : {
    "value" : 6705.54990898997,
    "unit" : "cubic millimeter",
    "system" : "http://unitsofmeasure.org",
    "code" : "mm3"
  },
  "bodyStructure" : {
    "reference" : "BodyStructure/measurement-report-finding-site"
  },
  "device" : {
    "reference" : "Device/measurement-report-algorithm"
  }
}

For each Numerical Measurement:

  1. Use the Algorithm Identification fields to create a new AlgorithmIdentification Device resource (if not already present).
    This Device resource should have the general equipment device as its parent.
  2. Copy focus values from the parent Measurement Group
  3. Copy bodyStructure value from the parent Measurement Group unless a Finding Site is defined for the specific Numerical Measurement
  4. Set the valueQuantity to the value of the Numerical Measurement

See:

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest
    • ImagingStudy
    • Practitioner
  • Created
    • Device (GeneralEquipment, AlgorithmIdentification)
    • Observation (ImagingMeasurementGroup, ImagingMeasurement x 3)
    • BodyStructure (Tracking, FindingSite)
    • ImagingSelection (Segment)

Example Imaging Qualitative Evaluation Mapping

DICOM FHIR Observation 
{
  {
    "0040A010": { "vr": "CS", "Value": [ "CONTAINS" ] },
    "0040A040": { "vr": "CS", "Value": [ "CODE" ] },
    "0040A043": { "vr": "SQ", "Value": [ {
          "00080100": { "vr": "SH", "Value": [ "C45992" ] },
          "00080102": { "vr": "SH", "Value": [ "NCIt" ] },
          "00080104": { "vr": "LO", "Value": [ "Subtlety score" ] }
        } ] },
    "0040A168": { "vr": "SQ", "Value": [ {
          "00080100": { "vr": "SH", "Value": [ "105" ] },
          "00080102": { "vr": "SH", "Value": [ "99LIDCQIICR" ] },
          "00080104": { "vr": "LO", "Value": [ "5 out of 5 (Obvious)" ] }
        } ] }
  },
  ...
}

{
  "resourceType" : "Observation",
  "id" : "qualitative-evaluation-001",
  "basedOn" : [
    {
      "reference" : "ServiceRequest/measurement-report-service-request"
    }
  ],
  "partOf" : [
    {
      "reference" : "ImagingStudy/measurement-report-imaging-study"
    }
  ],
  "status" : "final",
  "code" : {
    "coding" : [
      {
        "system" : "https://ncit.nci.nih.gov",
        "code" : "C45992"
      }
    ]
  },
  "category": [
    {
      "coding": [
        {
          "code": "C0034375",
          "system": "http://terminology.hl7.org/CodeSystem/umls",
          "display": "Qualitative Evaluations"
        }
      ]
    }
  ],
  "subject" : {
    "reference" : "Patient/measurement-report-patient"
  },
  "focus" : [
    {
      "reference" : "ImagingSelection/measurement-report-referenced-segment"
    },
    {
      "reference" : "BodyStructure/measurement-report-tracking-identifier"
    }
  ],
  "effectiveDateTime" : "2024-07-24T08:23:42+00:00",
  "issued" : "2024-07-24T08:23:42+00:00",
  "performer" : [
    {
      "reference" : "Practitioner/measurement-report-practitioner"
    }
  ],
  "valueCodeableConcept" : {
    "coding" : [
      {
        "system" : "http://cancerimagingarchive.net",
        "code" : "105"
      }
    ]
  },
  "bodyStructure" : {
    "reference" : "BodyStructure/measurement-report-finding-site"
  },
  "device" : {
    "reference" : "Device/measurement-report-general-equipment"
  }
}

For each Qualitative Evaluation:

  1. Use the Algorithm Identification fields to create a new AlgorithmIdentification Device resource (if not already present).
    This Device resource should have the general equipment device as its parent.
  2. Copy focus values from the parent Measurement Group
  3. Copy bodyStructure value from the parent Measurement Group unless a Finding Site is defined for the specific Numerical Measurement
  4. Set the valueCodeableConcept to the value of the Value Code in the Qualitative Evaluation

See:

FHIR Resources

  • Referenced
    • Patient
    • ServiceRequest
    • ImagingStudy
    • Practitioner
  • Created
    • Device (GeneralEquipment, AlgorithmIdentification)
    • Observation (ImagingMeasurementGroup, ImagingMeasurement x 3, QualitativeEvaluation x 2)
    • BodyStructure (Tracking, FindingSite)
    • ImagingSelection (Segment)

Example Measurement Report

See Example Measurement Report for a complete example of a Measurement Report containing the above resources.