An anatomical prostate lesion identified on MRI and localized using the PI-RADS 39-sector model. Lesion location is encoded using specific SNOMED CT body structure concepts representing exact prostate sectors (base/mid/apex, zone, side and position).

CarePlan tracking the ADPP (Early Diagnosis and Prevention Programme) cycle for prostate cancer screening. Captures programme enrollment, current status, scheduled activities (PSA testing, urologist consultations, mpMRI referrals), and risk group assignment.

Used by the ESPBI IS subsystem to track participant lifecycle through the screening programme workflow (steps T1–T29 in the operational model).

Synoptic imaging composition for the prostate programme: inherits the ImagingCompositionLt section layout (imaging study, order, history, procedure, comparison, findings, impression, recommendation). Used as the narrative partner for ProstateReportLtProstate. Authoritative pathology documents remain profiled in LT Lab; cross-reference them in section.text or exchange bundles when needed.

Diagnostic report representing a prostate MRI examination (bi-parametric or multi-parametric) that serves as the clinical anchor for imaging-based prostate assessment.

Anchor resource for the Lithuanian prostate cancer prevention and early diagnostic programme: links ProstateCompositionLtProstate (Base imaging composition) with Observation results (PSA, PI-RADS, sequence scores, PI-QUAL, PRECISE, Gleason/ISUP, etc.). Parent ImagingReportLt follows the national imaging-report pattern. Pathology DiagnosticReport resources from LT Lab are not listed in result (see DiagnosticReportLt); link them via encounter, bundles, or documentation.

Bladder changes observed during prostate cancer MRI staging. Captures both the presence/absence status and the nature of the change (neoplasm-related, benign, or non-neoplastic/incidental) as required by the national mpMRI reporting form.

Assessment of bone metastatic changes on prostate MRI. Records whether bone metastases are absent, present (SNOMED 94222008), or unclear/requiring further investigation.

Digital rectal examination (DRE) finding for prostate assessment. Records the palpation findings from the urologist's examination as part of the prostate cancer early diagnosis programme (ADPP step T21).

Histopathological grading of prostate cancer using Gleason score and ISUP Grade Group.

PI-QUAL is a quality assurance score for prostate MRI examinations. It reflects whether the technical image quality of a specific MRI exam is sufficient to allow reliable interpretation and PI-RADS assessment.

This score applies to the entire MRI examination (not to individual lesions).

Low PI-QUAL scores indicate that PI-RADS results should be interpreted with caution or may not be reliable.

Observation representing a numeric (1–5) assessment score for a specific prostate MRI sequence (T2-weighted, DWI, ADC or DCE), evaluated for a defined prostate lesion. These sequence-level scores represent the individual imaging components used to derive the overall PI-RADS assessment, but do not themselves constitute a final diagnostic conclusion. Anatomical localization is provided via the referenced prostate lesion.

Direct invasion of prostate-related structures by neoplasm.

Incidental prostate conditions observed during mpMRI or PRECISE assessment (e.g. benign prostatic hyperplasia, prostatitis, fibrotic changes). Value is coded from ProstateOtherConditionsVS with extensible binding, allowing free-text descriptions via CodeableConcept.text.

Rectal and other pelvic organ changes in prostate cancer staging. For bladder-specific changes use BladderChangesLtProstate (with change nature component). For bone metastasis use BoneMetastasisLtProstate.

PI-RADS assessment (score 1–5) assigned to a specific prostate lesion based on mpMRI findings. The anatomical location is represented using detailed PI-RADS sector-based prostate body structures (39-sector map).

PRECISE is an exam-level longitudinal assessment for prostate MRI follow-up. It summarizes overall change compared to a prior MRI examination, using the PRECISE framework.

PRECISE does not replace PI-RADS (which is lesion-level). Instead, it provides a patient/exam-level progression/regression category informed by lesion changes.

Codes equal to linkId values on Questionnaire/prostate-adpp-primary-assessment. Used as ConceptMap.group.source.

Maps each linkId in CodeSystem/prostate-adpp-questionnaire-item to a prostate-fhir-mapping-target code. Use target.comment for implementation notes. Source Questionnaire: https://hl7.lt/fhir/prostate/Questionnaire/prostate-adpp-primary-assessment.

Maps each linkId in CodeSystem/prostate-pathology-questionnaire-item to a prostate-fhir-mapping-target code. Source Questionnaire: https://hl7.lt/fhir/prostate/Questionnaire/prostate-pathology-espbi.

Codes equal to linkId values on Questionnaire/prostate-pathology-espbi. Used as ConceptMap.group.source.

Target codes for ConceptMap entries: each code denotes a logical FHIR mapping destination (profile or element path). Used with prostate-adpp-questionnaire-item and prostate-pathology-questionnaire-item source codes.

Lithuanian Base Practitioner Role profile, used to define roles of the healthcare practitioner in the healthcare facilities

Findings from digital rectal examination (DRE) of the prostate, including consistency and palpable mass.

Body structures that may be affected by prostate cancer invasion or local organ changes.

Nature of observed change in pelvic organs: neoplasm-related, benign, or non-neoplastic/incidental.

Status of previously detected damage (capsule, seminal vesicle) from prior investigation: present, absent, or unknown.

ISUP Grade Groups for prostate cancer histopathology, aligned with Gleason grading. Includes sub-combination codes for Grade Groups 4 and 5.

Type of prostate MRI examination, including bi-parametric and multi-parametric MRI.

Incidental prostate conditions observed during mpMRI or PRECISE assessment: benign prostatic hyperplasia, prostatitis, and fibrotic changes.

Prostate Imaging Quality score for prostate MRI image quality assessment.

PI-RADS prostate sector locations based on the 39-sector PI-RADS map. Includes detailed SNOMED CT body structure codes for base/mid/apex, zone, side, and anterior/posterior subdivisions.

Allowed PRECISE categories for longitudinal prostate MRI assessment.

Pattern of change observed on follow-up prostate MRI examination (local, diffuse).

Codes for detailed PRECISE assessment components used in longitudinal prostate MRI follow-up evaluation.

Sequence/image types used in prostate mpMRI scoring (DICOM terminology).

Absent, suspected, or present damage and change status for prostate cancer staging.

PRECISE categories for longitudinal assessment of prostate MRI follow-up examinations. These categories describe overall change compared to a prior MRI examination.

Pattern of change on follow-up MRI.

Local codes for detailed PRECISE assessment components.

Prostate Imaging Quality assessment scores.

Illustrative codes for Questionnaire answer options for prostate ESPBI-style forms in this IG. Register or replace with national coded values in production.

Local codes extending SNOMED CT for prostate-related clinical findings not yet available in SNOMED CT. To be used until adopted by SNOMED CT.

Right mid-gland peripheral zone sector (PI-RADS 39-sector map).

Base of seminal vesicle without laterality.

Bone structure relevant for metastatic assessment.

Neurovascular bundle (blood vessel structure) with right laterality.

Prostate prostatic capsule with right laterality.

Rectum.

Regional lymph node with left laterality.

Seminal vesicle with left laterality.

Urinary bladder.

Prostate lesion in the anterior mid transition zone, crossing midline, identified on mpMRI.

Example of an ADPP prostate cancer screening programme CarePlan for a 55-year-old male participant.

ImComposition example summarizing prostate mpMRI findings for ADP diagnostic process.

Base imaging composition for prostate mpMRI report.

EU Imaging Composition for prostate mpMRI with structured sections.

Imaging composition for the national prostate programme, paired with ProstateReportLtProstate. Mirrors ADP mpMRI layout; pathology remains in LT Lab.

Example mpMRI report anchor for the base composition. Structured results are linked as separate observations.

Multiparametric prostate MRI diagnostic report with structured results.

ImagingReportLt-based programme anchor listing prostate observations; composition links narrative sections.

Ambulatory prostate cancer screening encounter.

Imaging finding representing a prostate lesion identified on mpMRI.

Example multiparametric prostate MRI imaging study referenced by compositions and PRECISE observations.

ADC sequence score for prostate lesion 1.

Suspected urinary bladder wall thickening on mpMRI.

Benign bladder changes unrelated to prostate neoplasm.

Bladder changes suspected to be related to prostate neoplasm.

No bone metastatic changes on prostate MRI.

Bone metastatic changes detected on prostate MRI.

Suspected capsular involvement with long tumour contact anteriorly.

Dynamic contrast enhanced MRI score for prostate lesion 1.

Digital rectal examination finding: hard prostate consistency.

Digital rectal examination finding: palpable mass detected.

DWI sequence score for prostate lesion 1.

DWI sequence score 5 for prostate lesion 1.

Histopathological grading: ISUP Grade Group 1 (Gleason 3+3).

No neurovascular bundle involvement on mpMRI.

PI-QUAL image quality score 3 (sufficient diagnostic quality) for prostate MRI.

PI-RADS 5 assessment for anterior transition zone lesion.

PRECISE category 4 (likely progression) with dimensions, volume, Likert, and prior study context.

PRECISE category 3 (stable disease) longitudinal follow-up assessment.

Prostate-specific antigen (PSA) serum level.

PSA density (PSAD) calculated from PSA and prostate volume.

Diffuse contrast enhancement in the peripheral zone without focal lesion.

Shows suspected direct invasion by neoplasm to the base of seminal vesicle.

Shows present bone metastatic changes with narrative text.

Shows present direct invasion by neoplasm to the prostatic capsule with right laterality.

Shows absent direct invasion by neoplasm to the neurovascular bundle with right laterality.

Prostate-Specific Antigen Density (PSAD) Observation Example

Prostate Specific Antigen (PSA) Observation Example

Shows absent rectal changes with narrative text.

Shows present direct invasion by neoplasm to a regional lymph node with left laterality; narrative includes location and size.

Shows suspected direct invasion by neoplasm to the seminal vesicle with left laterality.

Shows suspected urinary bladder changes with change nature classification.

Prostate Volume Observation Example

Prostate volume measurement derived from MRI.

No rectal wall changes on mpMRI.

No regional lymphadenopathy on mpMRI.

No seminal vesicle invasion identified on mpMRI.

T2-weighted MRI sequence score for prostate lesion 1.

Example of a healthcare organization

An example male Patient conforming to the Lithuanian Base Profile.

An example Practitioner representing a doctor.

An example Practitioner conforming to the Lithuanian Base Profile.

An example Practitioner Role conforming to the Lithuanian Base Profile.

Radiologist practitioner role for prostate mpMRI reporting.

Example MRI procedure referenced by the base mpMRI composition.

Example multiparametric prostate MRI procedure referenced by the mpMRI and programme compositions.

Illustrative Questionnaire aligned with consultation / ADPP spreadsheet blocks (Patient demographics omitted). Coverage and FHIR mapping: IG page Questionnaires and ConceptMap prostate-adpp-questionnaire-to-fhir.

Illustrative FHIR Questionnaire aligned with dr-prostate spreadsheet (subset). Full coverage gaps and FHIR mapping: IG page Questionnaires and ConceptMap prostate-pathology-questionnaire-to-fhir.

Questionnaire for the Referral to a pathologist form (E014, form 014-1-1/a) in the Lithuanian prostate cancer screening programme. Patient demographics omitted (sourced from PatientLt).

Questionnaire for the referral to a radiologist (form E027) in the Lithuanian prostate cancer screening programme. Patient demographics are omitted — they come from PatientLt.

Example answers for the expanded ADPP primary assessment Questionnaire.

Example answers using valueCoding for choice questions.