Imaging Diagnostic Report
0.0.1-current - ci-build

Imaging Diagnostic Report, published by IHE Radiology Technical Committee. This guide is not an authorized publication; it is the continuous build for version 0.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/RAD.IDR/ and changes regularly. See the Directory of published versions

## Resource Profile: ReportKeyImages - XML Profile

Draft as of 2024-06-25

XML representation of the idr-report-key-images resource profile.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="idr-report-key-images"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-idr-report-key-images-definitions.html#ImagingSelection">ImagingSelection</a><a name="ImagingSelection"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/imagingselection.html">ImagingSelection</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">A selection of DICOM SOP instances and/or frames</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-idr-report-key-images-definitions.html#ImagingSelection.status">status</a><a name="ImagingSelection.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R5/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">available | entered-in-error | unknown</span><br/><span style="font-weight:bold">Required Pattern: </span><span style="color: darkgreen">available</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-idr-report-key-images-definitions.html#ImagingSelection.subject">subject</a><a name="ImagingSelection.subject"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/references.html">Reference</a>(<a href="http://hl7.org/fhir/R5/patient.html">Patient</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Subject of the selected instances</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-idr-report-key-images-definitions.html#ImagingSelection.derivedFrom">derivedFrom</a><a name="ImagingSelection.derivedFrom"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/references.html">Reference</a>(<a href="http://hl7.org/fhir/R5/imagingstudy.html">ImagingStudy</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">The imaging study from which the imaging selection is derived</span></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <url
           value="https://profiles.ihe.net/RAD/IDR/StructureDefinition/idr-report-key-images"/>
      <version value="0.0.1-current"/>
      <name value="ReportKeyImages"/>
      <title
             value="ImagingSelection for key images in an imaging diagnostic report"/>
      <status value="draft"/>
      <date value="2024-06-25T17:20:59+00:00"/>
      <publisher value="IHE Radiology Technical Committee"/>
      <contact>
        <telecom>
          <system value="url"/>
          <value value="https://www.ihe.net/ihe_domains/radiology/"/>
        </telecom>
      </contact>
      <contact>
        <telecom>
          <system value="email"/>
          <value value="radiology@ihe.net"/>
        </telecom>
      </contact>
      <contact>
        <name value="IHE Radiology Technical Committee"/>
        <telecom>
          <system value="email"/>
          <value value="radiology@ihe.net"/>
        </telecom>
      </contact>
      <description
                   value="IHE IDR ImagingSelection to be used to capture key images associated with an Observation"/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="001"/>
        </coding>
      </jurisdiction>
      <fhirVersion value="5.0.0"/>
      <mapping>
        <identity value="workflow"/>
        <uri value="http://hl7.org/fhir/workflow"/>
        <name value="Workflow Pattern"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <uri value="http://hl7.org/fhir/fivews"/>
        <name value="FiveWs Pattern Mapping"/>
      </mapping>
      <mapping>
        <identity value="dicom"/>
        <uri value="http://nema.org/dicom"/>
        <name value="DICOM Tag Mapping"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <uri value="http://hl7.org/v3"/>
        <name value="RIM Mapping"/>
      </mapping>
      <kind value="resource"/>
      <abstract value="false"/>
      <type value="ImagingSelection"/>
      <baseDefinition
                      value="http://hl7.org/fhir/StructureDefinition/ImagingSelection"/>
      <derivation value="constraint"/>
      <snapshot>
        <element id="ImagingSelection">
          <path value="ImagingSelection"/>
          <short value="A selection of DICOM SOP instances and/or frames"/>
          <definition
                      value="A selection of DICOM SOP instances and/or frames within a single Study and Series. This might include additional specifics such as an image region, an Observation UID or a Segmentation Number, allowing linkage to an Observation Resource or transferring this information along with the ImagingStudy Resource."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <constraint>
            <key value="dom-2"/>
            <severity value="error"/>
            <human
                   value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
            <expression value="contained.contained.empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-3"/>
            <severity value="error"/>
            <human
                   value="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"/>
            <expression
                        value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-4"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
            <expression
                        value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-5"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
            <expression value="contained.meta.security.empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
              <valueBoolean value="true"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
              <valueMarkdown
                             value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
            </extension>
            <key value="dom-6"/>
            <severity value="warning"/>
            <human
                   value="A resource should have narrative for robust management"/>
            <expression value="text.`div`.exists()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Entity, Role, or Act"/>
          </mapping>
          <mapping>
            <identity value="workflow"/>
            <map value="Event"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="clinical.diagnostics"/>
          </mapping>
          <mapping>
            <identity value="dicom"/>
            <map value="Reference DICOM PS 3 Table 10-3b"/>
          </mapping>
        </element>
        <element id="ImagingSelection.id">
          <path value="ImagingSelection.id"/>
          <short value="Logical id of this artifact"/>
          <definition
                      value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
          <comment
                   value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="id"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.meta">
          <path value="ImagingSelection.meta"/>
          <short value="Metadata about the resource"/>
          <definition
                      value="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."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.meta"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Meta"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.implicitRules">
          <path value="ImagingSelection.implicitRules"/>
          <short value="A set of rules under which this content was created"/>
          <definition
                      value="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."/>
          <comment
                   value="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 its narrative along with other profiles, value sets, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.implicitRules"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.language">
          <path value="ImagingSelection.language"/>
          <short value="Language of the resource content"/>
          <definition
                      value="The base language in which the resource is written."/>
          <comment
                   value="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)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.language"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Language"/>
            </extension>
            <strength value="required"/>
            <description value="IETF language tag for a human language"/>
            <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/>
            <additional>
              <purpose value="starter"/>
              <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
            </additional>
          </binding>
        </element>
        <element id="ImagingSelection.text">
          <path value="ImagingSelection.text"/>
          <short value="Text summary of the resource, for human interpretation"/>
          <definition
                      value="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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
          <comment
                   value="Contained resources do not have a 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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
          <alias value="narrative"/>
          <alias value="html"/>
          <alias value="xhtml"/>
          <alias value="display"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Narrative"/>
          </type>
          <condition value="dom-6"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Act.text?"/>
          </mapping>
        </element>
        <element id="ImagingSelection.contained">
          <path value="ImagingSelection.contained"/>
          <short value="Contained, inline Resources"/>
          <definition
                      value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/>
          <comment
                   value="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."/>
          <alias value="inline resources"/>
          <alias value="anonymous resources"/>
          <alias value="contained resources"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.contained"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Resource"/>
          </type>
          <condition value="dom-2"/>
          <condition value="dom-4"/>
          <condition value="dom-3"/>
          <condition value="dom-5"/>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ImagingSelection.extension">
          <path value="ImagingSelection.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="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 managable, 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."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ImagingSelection.modifierExtension">
          <path value="ImagingSelection.modifierExtension"/>
          <short value="Extensions that cannot be ignored"/>
          <definition
                      value="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 managable, 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)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ImagingSelection.identifier">
          <path value="ImagingSelection.identifier"/>
          <short value="Business Identifier for Imaging Selection"/>
          <definition
                      value="A unique identifier assigned to this imaging selection."/>
          <comment
                   value="This is a business identifier, not a resource identifier -- see discussion under [Business Identifiers](http://hl7.org/fhir/R5/resource.html#identifiers)."/>
          <requirements
                        value="Allows imaging selections to be distinguished and referenced."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.identifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Identifier"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.identifier"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.identifier"/>
          </mapping>
        </element>
        <element id="ImagingSelection.status">
          <path value="ImagingSelection.status"/>
          <short value="available | entered-in-error | unknown"/>
          <definition
                      value="The current state of the ImagingSelection resource. This is not the status of any ImagingStudy, ServiceRequest, or Task resources associated with the ImagingSelection."/>
          <comment
                   value="Unknown does not represent &quot;other&quot; - one of the defined statuses must apply.  Unknown is used when the authoring system is not sure what the current status is."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.status"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <patternCode value="available"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="This element is labeled 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"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImagingSelectionStatus"/>
            </extension>
            <strength value="required"/>
            <description value="The status of the ImagingSelection."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/imagingselection-status|5.0.0"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.status"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.status"/>
          </mapping>
        </element>
        <element id="ImagingSelection.subject">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
            <valueString
                         value="dicom=http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.2.2.html"/>
          </extension>
          <path value="ImagingSelection.subject"/>
          <short value="Subject of the selected instances"/>
          <definition
                      value="The patient, or group of patients, location, device, organization, procedure or practitioner this imaging selection is about and into whose or what record the imaging selection is placed."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.subject"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.subject"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.subject[x]"/>
          </mapping>
          <mapping>
            <identity value="dicom"/>
            <map value="(0010/*)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.issued">
          <path value="ImagingSelection.issued"/>
          <short value="Date / Time when this imaging selection was created"/>
          <definition
                      value="The date and time this imaging selection was created."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.issued"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="instant"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.recorded"/>
          </mapping>
        </element>
        <element id="ImagingSelection.performer">
          <path value="ImagingSelection.performer"/>
          <short value="Selector of the instances (human or machine)"/>
          <definition value="Selector of the instances – human or machine."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.performer"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.performer.actor"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.actor"/>
          </mapping>
          <mapping>
            <identity value="dicom"/>
            <map
                 value="(0008, 1050) | (0008, 1052) | (0008, 1070) | (0008, 1072)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.performer.id">
          <path value="ImagingSelection.performer.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.performer.extension">
          <path value="ImagingSelection.performer.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="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 managable, 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."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.performer.modifierExtension">
          <path value="ImagingSelection.performer.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="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 managable, 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)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ImagingSelection.performer.function">
          <path value="ImagingSelection.performer.function"/>
          <short value="Type of performer"/>
          <definition
                      value="Distinguishes the type of involvement of the performer."/>
          <requirements
                        value="Allows disambiguation of the types and involvement of different performers."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.performer.function"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EventPerformerFunction"/>
            </extension>
            <strength value="extensible"/>
            <description value="The type of involvement of the performer."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/series-performer-function"/>
          </binding>
        </element>
        <element id="ImagingSelection.performer.actor">
          <path value="ImagingSelection.performer.actor"/>
          <short value="Author (human or machine)"/>
          <definition value="Author – human or machine."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.performer.actor"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/HealthcareService"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.basedOn">
          <path value="ImagingSelection.basedOn"/>
          <short value="Associated request"/>
          <definition
                      value="A list of the diagnostic requests that resulted in this imaging selection being performed."/>
          <alias value="AccessionNumber"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.basedOn"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Appointment"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/AppointmentResponse"/>
            <targetProfile value="http://hl7.org/fhir/StructureDefinition/Task"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.basedOn"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.cause"/>
          </mapping>
          <mapping>
            <identity value="dicom"/>
            <map value="Accession Number and Issuer (0080,0050)+(0080,0051)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.category">
          <path value="ImagingSelection.category"/>
          <short value="Classifies the imaging selection"/>
          <definition value="Classifies the imaging selection."/>
          <requirements
                        value="Used for filtering what imaging selections are retrieved and displayed."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.category"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImagingSelectionCode"/>
            </extension>
            <strength value="example"/>
            <description value="Key Object Selection Document Title."/>
            <valueSet
                      value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html"/>
          </binding>
        </element>
        <element id="ImagingSelection.code">
          <path value="ImagingSelection.code"/>
          <short value="Imaging Selection purpose text or code"/>
          <definition value="Reason for referencing the selected content."/>
          <comment
                   value="*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation."/>
          <requirements
                        value="Knowing what kind of observation is being made is essential to understanding the observation."/>
          <alias value="Description"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.code"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImagingSelectionCode"/>
            </extension>
            <strength value="example"/>
            <description value="Key Object Selection Document Title."/>
            <valueSet
                      value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html"/>
          </binding>
          <mapping>
            <identity value="dicom"/>
            <map value="Concept Name Code Sequence (0040,A043)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.studyUid">
          <path value="ImagingSelection.studyUid"/>
          <short value="DICOM Study Instance UID"/>
          <definition
                      value="The Study Instance UID for the DICOM Study from which the images were selected."/>
          <comment
                   value="See [DICOM PS3.3 C.7.2](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.2.html)."/>
          <requirements
                        value="DICOM Study Instance UID.
           Required unless frameOfReferenceUid and imageRegion are present and instance is not present."/>
          <alias value="StudyInstanceUID"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.studyUid"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="id"/>
          </type>
          <example>
            <label value="General"/>
            <valueId
                     value="1.2.840.113747.20080222.12753225430534207565993148475333748793"/>
          </example>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="dicom"/>
            <map value="Study Instance UID (0020,000D)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.derivedFrom">
          <path value="ImagingSelection.derivedFrom"/>
          <short
                 value="The imaging study from which the imaging selection is derived"/>
          <definition
                      value="The imaging study from which the imaging selection is made."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.derivedFrom"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.endpoint">
          <path value="ImagingSelection.endpoint"/>
          <short
                 value="The network service providing retrieval for the images referenced in the imaging selection"/>
          <definition
                      value="The network service providing retrieval access to the selected images, frames, etc. See implementation notes for information about using DICOM endpoints."/>
          <comment
                   value="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."/>
          <requirements
                        value="Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the selected images, frames, etc."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.endpoint"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Endpoint"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.seriesUid">
          <path value="ImagingSelection.seriesUid"/>
          <short value="DICOM Series Instance UID"/>
          <definition
                      value="The Series Instance UID for the DICOM Series from which the images were selected."/>
          <comment
                   value="See [DICOM PS3.3 C.7.3](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.3.html)."/>
          <requirements
                        value="DICOM Series Instance UID.
           Required unless frameOfReferenceUid and imageRegion are present and instance is not present."/>
          <alias value="SeriesInstanceUID"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.seriesUid"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="id"/>
          </type>
          <example>
            <label value="General"/>
            <valueId
                     value="1.2.840.113747.20080222.12753225430534207565993148475333748793.1"/>
          </example>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="dicom"/>
            <map value="Series Instance UID (0020,000E)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.seriesNumber">
          <path value="ImagingSelection.seriesNumber"/>
          <short value="DICOM Series Number"/>
          <definition
                      value="The Series Number for the DICOM Series from which the images were selected."/>
          <comment
                   value="See [DICOM PS3.3 C.7.3](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.3.html)."/>
          <requirements value="DICOM Series Number."/>
          <alias value="SeriesNumber"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.seriesNumber"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="unsignedInt"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="dicom"/>
            <map value="Series Number (0020,0011)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.frameOfReferenceUid">
          <path value="ImagingSelection.frameOfReferenceUid"/>
          <short value="The Frame of Reference UID for the selected images"/>
          <definition
                      value="The Frame of Reference UID identifying the coordinate system that conveys spatial and/or temporal information for the selected images or frames."/>
          <comment
                   value="See [DICOM PS3.3 C.7.4.1](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.4.html)."/>
          <requirements
                        value="DICOM Frame of Reference UID.
                                Required if studyInstanceUid and seriesInstanceUid are not present."/>
          <alias value="FrameOfReferenceUID"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.frameOfReferenceUid"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="id"/>
          </type>
          <example>
            <label value="General"/>
            <valueId
                     value="1.2.840.113747.20080222.12753225430534207565993148475333748793.2"/>
          </example>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="dicom"/>
            <map value="Frame of Reference UID (0020,0052)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.bodySite">
          <path value="ImagingSelection.bodySite"/>
          <short value="Body part examined"/>
          <definition
                      value="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."/>
          <alias value="BodyPartExamined"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.bodySite"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableReference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/BodyStructure"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="BodySite"/>
            </extension>
            <strength value="example"/>
            <description value="SNOMED CT Body site concepts"/>
            <valueSet value="http://hl7.org/fhir/ValueSet/body-site"/>
          </binding>
          <mapping>
            <identity value="dicom"/>
            <map value="Body Part Examined (0018,0015)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.focus">
          <path value="ImagingSelection.focus"/>
          <short
                 value="Related resource that is the focus for the imaging selection"/>
          <definition
                      value="The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record.  The focus of an observation could also be an existing condition,  an intervention, the subject's diet,  another observation of the subject,  or a body structure such as tumor or implanted device.   An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus."/>
          <comment
                   value="An imaging selection may reference a DICOM resource that itself references other DICOM resources.
           e.g. a presentation state references a set of source images or frames."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.focus"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/ImagingSelection"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.instance">
          <path value="ImagingSelection.instance"/>
          <short value="The selected instances"/>
          <definition
                      value="Each imaging selection includes one or more selected DICOM SOP instances."/>
          <requirements
                        value="Required if the the selection does not include all instances in the specified series."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.instance"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ImagingSelection.instance.id">
          <path value="ImagingSelection.instance.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.extension">
          <path value="ImagingSelection.instance.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="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 managable, 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."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.modifierExtension">
          <path value="ImagingSelection.instance.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="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 managable, 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)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.uid">
          <path value="ImagingSelection.instance.uid"/>
          <short value="DICOM SOP Instance UID"/>
          <definition
                      value="The SOP Instance UID for the selected DICOM instance."/>
          <comment
                   value="See [DICOM PS3.3 C.12.1](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.12.html)."/>
          <requirements value="DICOM SOP Instance UID."/>
          <alias value="SOPInstanceUID"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.instance.uid"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="id"/>
          </type>
          <example>
            <label value="General"/>
            <valueId
                     value="1.2.840.113747.20080222.12753225430534207568475333748793.1.1"/>
          </example>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="dicom"/>
            <map value="SOP Instance UID (0008,0018)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.number">
          <path value="ImagingSelection.instance.number"/>
          <short value="DICOM Instance Number"/>
          <definition
                      value="The Instance Number for the selected DICOM instance."/>
          <comment
                   value="See [DICOM PS3.3 C.7.6.1](https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.6.html#sect_C.7.6.1).
           Note: A multiframe instance has a single instance number with each frame identified by a frame number."/>
          <requirements value="DICOM Instance Number."/>
          <alias value="InstanceNumber"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.instance.number"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="unsignedInt"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="dicom"/>
            <map value="Instance Number (0020,0011)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.sopClass">
          <path value="ImagingSelection.instance.sopClass"/>
          <short value="DICOM SOP Class UID"/>
          <definition value="The SOP Class UID for the selected DICOM instance."/>
          <comment
                   value="See [DICOM PS3.3 C.12.1](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.12.html)."/>
          <requirements value="DICOM SOP Class UID."/>
          <alias value="SOPClassUID"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.instance.sopClass"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Coding"/>
          </type>
          <example>
            <label value="General"/>
            <valueId value="1.2.840.10008.5.1.4.1.1.2"/>
          </example>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="sopClass"/>
            </extension>
            <strength value="extensible"/>
            <description value="DICOM SOP Classes."/>
            <valueSet
                      value="http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1"/>
          </binding>
          <mapping>
            <identity value="dicom"/>
            <map value="SOP Class UID (0008,0016)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.subset">
          <path value="ImagingSelection.instance.subset"/>
          <short value="The selected subset of the SOP Instance"/>
          <definition
                      value="Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance.
           May be one of:
           - A list of frame numbers selected from a multiframe SOP Instance.
           - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance.
           - A list of segment numbers selected from a segmentation SOP Instance.
           - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.instance.subset"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <example>
            <label value="General"/>
            <valueString value="6"/>
          </example>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ImagingSelection.instance.imageRegion2D">
          <path value="ImagingSelection.instance.imageRegion2D"/>
          <short value="A specific 2D region in a DICOM image / frame"/>
          <definition
                      value="Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates.
           If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all frames in the subset list."/>
          <requirements
                        value="Shall not be present if the parent imagingSelection.instance is not an image."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.instance.imageRegion2D"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ImagingSelection.instance.imageRegion2D.id">
          <path value="ImagingSelection.instance.imageRegion2D.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion2D.extension">
          <path value="ImagingSelection.instance.imageRegion2D.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="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 managable, 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."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion2D.modifierExtension">
          <path
                value="ImagingSelection.instance.imageRegion2D.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="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 managable, 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)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion2D.regionType">
          <path value="ImagingSelection.instance.imageRegion2D.regionType"/>
          <short value="point | polyline | interpolated | circle | ellipse"/>
          <definition value="Specifies the type of image region."/>
          <comment
                   value="See [DICOM PS3.3 C.10.5.1.2](https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.10.5.html#sect_C.10.5.1.2)."/>
          <alias value="GraphicType"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.instance.imageRegion2D.regionType"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImagingSelection2DGraphicType"/>
            </extension>
            <strength value="required"/>
            <description value="The type of image region."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/imagingselection-2dgraphictype|5.0.0"/>
          </binding>
          <mapping>
            <identity value="dicom"/>
            <map value="Graphic Type (0070,0023)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion2D.coordinate">
          <path value="ImagingSelection.instance.imageRegion2D.coordinate"/>
          <short value="Specifies the coordinates that define the image region"/>
          <definition
                      value="The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution.
           The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames."/>
          <comment
                   value="For a description of how 2D coordinates are encoded, see [DICOM PS3.3 C.18.6](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.18.6.html)."/>
          <requirements value="The number of values must be a multiple of two."/>
          <alias value="GraphicData"/>
          <min value="1"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.instance.imageRegion2D.coordinate"/>
            <min value="1"/>
            <max value="*"/>
          </base>
          <type>
            <code value="decimal"/>
          </type>
          <orderMeaning
                        value="The values are an ordered set of (x, y) coordinates."/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="dicom"/>
            <map value="Graphic Data (0070,0022)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion3D">
          <path value="ImagingSelection.instance.imageRegion3D"/>
          <short value="A specific 3D region in a DICOM frame of reference"/>
          <definition
                      value="Each imaging selection might includes a 3D image region, specified by a region type and a set of 3D coordinates."/>
          <requirements
                        value="Requires that the ImagingSelection.frameOfReferenceUid element is present."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.instance.imageRegion3D"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ImagingSelection.instance.imageRegion3D.id">
          <path value="ImagingSelection.instance.imageRegion3D.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion3D.extension">
          <path value="ImagingSelection.instance.imageRegion3D.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="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 managable, 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."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion3D.modifierExtension">
          <path
                value="ImagingSelection.instance.imageRegion3D.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="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 managable, 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)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion3D.regionType">
          <path value="ImagingSelection.instance.imageRegion3D.regionType"/>
          <short
                 value="point | multipoint | polyline | polygon | ellipse | ellipsoid"/>
          <definition value="Specifies the type of image region."/>
          <comment
                   value="See [DICOM PS3.3 C.18.9.1.2](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.18.9.html#sect_C.18.9.1.2)."/>
          <alias value="GraphicType"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ImagingSelection.instance.imageRegion3D.regionType"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImagingSelection3DGraphicType"/>
            </extension>
            <strength value="required"/>
            <description value="The type of image region."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/imagingselection-3dgraphictype|5.0.0"/>
          </binding>
          <mapping>
            <identity value="dicom"/>
            <map value="Graphic Type (0070,0023)"/>
          </mapping>
        </element>
        <element id="ImagingSelection.instance.imageRegion3D.coordinate">
          <path value="ImagingSelection.instance.imageRegion3D.coordinate"/>
          <short value="Specifies the coordinates that define the image region"/>
          <definition
                      value="The coordinates describing the image region. Encoded as an ordered set of (x,y,z) triplets (in mm and may be negative) that define a region of interest in the patient-relative Reference Coordinate System defined by ImagingSelection.frameOfReferenceUid element."/>
          <comment
                   value="For a description of how 3D coordinates are encoded, see [DICOM PS3.3 C.18.9](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.18.9.html)."/>
          <requirements
                        value="The number of values must be a multiple of three."/>
          <alias value="GraphicData"/>
          <min value="1"/>
          <max value="*"/>
          <base>
            <path value="ImagingSelection.instance.imageRegion3D.coordinate"/>
            <min value="1"/>
            <max value="*"/>
          </base>
          <type>
            <code value="decimal"/>
          </type>
          <orderMeaning
                        value="The values are an ordered set of (x, y, z) coordinates."/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="dicom"/>
            <map value="Graphic Data (0070,0022)"/>
          </mapping>
        </element>
      </snapshot>
      <differential>
        <element id="ImagingSelection">
          <path value="ImagingSelection"/>
        </element>
        <element id="ImagingSelection.status">
          <path value="ImagingSelection.status"/>
          <patternCode value="available"/>
        </element>
        <element id="ImagingSelection.subject">
          <path value="ImagingSelection.subject"/>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient"/>
          </type>
        </element>
        <element id="ImagingSelection.derivedFrom">
          <path value="ImagingSelection.derivedFrom"/>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/>
          </type>
        </element>
      </differential>
    </StructureDefinition>