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 - Detailed Descriptions

Draft as of 2024-06-25

Definitions for the idr-report-key-images resource profile.

- Differential Elements Table
- Key Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be found here

0. ImagingSelection
2. ImagingSelection.status
Pattern Value | `available`
4. ImagingSelection.subject
Type | Reference(Patient)
6. ImagingSelection.derivedFrom
Type | Reference(ImagingStudy)

Guidance on how to interpret the contents of this table can be found here

0. ImagingSelection
Definition | 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.
Short | A selection of DICOM SOP instances and/or frames
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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 (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()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImagingSelection.implicitRules
Definition | 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.
Short | A set of rules under which this content was created
Comments | 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.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ImagingSelection.contained
Definition | 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.
Short | Contained, inline Resources
Comments | 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.
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
6. ImagingSelection.modifierExtension
Definition | 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).
Short | Extensions that cannot be ignored
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Support | false
Summary | true
Requirements | 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.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. ImagingSelection.status
Definition | The current state of the ImagingSelection resource. This is not the status of any ImagingStudy, ServiceRequest, or Task resources associated with the ImagingSelection.
Short | available | entered-in-error | unknown
Comments | Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.
Control | 1..1
Binding | The codes SHALL be taken from ImagingSelectionStatus http://hl7.org/fhir/ValueSet/imagingselection-status|5.0.0 (required to `http://hl7.org/fhir/ValueSet/imagingselection-status|5.0.0` ) The status of the ImagingSelection.
Type | code
Is Modifier | true because 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
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Pattern Value | `available`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ImagingSelection.subject
Definition | 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.
Short | Subject of the selected instances
Control | 0..1
Type | Reference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance, Specimen)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ImagingSelection.code
Definition | Reason for referencing the selected content.
Short | Imaging Selection purpose text or code
Comments | 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.
Control | 1..1
Binding | For example codes, see http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html (example to `http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html` ) Key Object Selection Document Title.
Type | CodeableConcept
Is Modifier | false
Must Support | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names | Description
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ImagingSelection.derivedFrom
Definition | The imaging study from which the imaging selection is made.
Short | The imaging study from which the imaging selection is derived
Control | 0..*
Type | Reference(ImagingStudy, DocumentReference)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. ImagingSelection
Definition | 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.
Short | A selection of DICOM SOP instances and/or frames
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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 (`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()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. ImagingSelection.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | 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.
Control | 0..1
Type | id
Is Modifier | false
Must Support | false
Summary | true
4. ImagingSelection.meta
Definition | 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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. ImagingSelection.implicitRules
Definition | 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.
Short | A set of rules under which this content was created
Comments | 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.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. ImagingSelection.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | 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).
Control | 0..1
Binding | The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages|5.0.0` ) IETF language tag for a human language
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. ImagingSelection.text
Definition | 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | 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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1 This element is affected by the following invariants: dom-6
Type | Narrative
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. ImagingSelection.contained
Definition | 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.
Short | Contained, inline Resources
Comments | 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.
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. ImagingSelection.extension
Definition | 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.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. ImagingSelection.modifierExtension
Definition | 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).
Short | Extensions that cannot be ignored
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Support | false
Summary | true
Requirements | 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.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. ImagingSelection.identifier
Definition | A unique identifier assigned to this imaging selection.
Short | Business Identifier for Imaging Selection
Comments | This is a business identifier, not a resource identifier -- see discussion under Business Identifiers.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | false
Summary | true
Requirements | Allows imaging selections to be distinguished and referenced.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. ImagingSelection.status
Definition | The current state of the ImagingSelection resource. This is not the status of any ImagingStudy, ServiceRequest, or Task resources associated with the ImagingSelection.
Short | available | entered-in-error | unknown
Comments | Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.
Control | 1..1
Binding | The codes SHALL be taken from ImagingSelectionStatus (required to `http://hl7.org/fhir/ValueSet/imagingselection-status|5.0.0` ) The status of the ImagingSelection.
Type | code
Is Modifier | true because 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
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Pattern Value | `available`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. ImagingSelection.subject
Definition | 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.
Short | Subject of the selected instances
Control | 0..1
Type | Reference(Patient)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. ImagingSelection.issued
Definition | The date and time this imaging selection was created.
Short | Date / Time when this imaging selection was created
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. ImagingSelection.performer
Definition | Selector of the instances – human or machine.
Short | Selector of the instances (human or machine)
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. ImagingSelection.performer.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
30. ImagingSelection.performer.extension
Definition | 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.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
32. ImagingSelection.performer.modifierExtension
Definition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | 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.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
34. ImagingSelection.performer.function
Definition | Distinguishes the type of involvement of the performer.
Short | Type of performer
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ImagingStudySeriesPerformerFunction (extensible to `http://hl7.org/fhir/ValueSet/series-performer-function` ) The type of involvement of the performer.
Type | CodeableConcept
Is Modifier | false
Must Support | false
Summary | true
Requirements | Allows disambiguation of the types and involvement of different performers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. ImagingSelection.performer.actor
Definition | Author – human or machine.
Short | Author (human or machine)
Control | 0..1
Type | Reference(Practitioner, PractitionerRole, Device, Organization, CareTeam, Patient, RelatedPerson, HealthcareService)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. ImagingSelection.basedOn
Definition | A list of the diagnostic requests that resulted in this imaging selection being performed.
Short | Associated request
Control | 0..*
Type | Reference(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | AccessionNumber
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. ImagingSelection.category
Definition | Classifies the imaging selection.
Short | Classifies the imaging selection
Control | 0..*
Binding | For example codes, see http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html (example to `http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html` ) Key Object Selection Document Title.
Type | CodeableConcept
Is Modifier | false
Must Support | false
Summary | true
Requirements | Used for filtering what imaging selections are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. ImagingSelection.code
Definition | Reason for referencing the selected content.
Short | Imaging Selection purpose text or code
Comments | 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.
Control | 1..1
Binding | For example codes, see http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html (example to `http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7010.html` ) Key Object Selection Document Title.
Type | CodeableConcept
Is Modifier | false
Must Support | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names | Description
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. ImagingSelection.studyUid
Definition | The Study Instance UID for the DICOM Study from which the images were selected.
Short | DICOM Study Instance UID
Comments | See DICOM PS3.3 C.7.2.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | DICOM Study Instance UID. Required unless frameOfReferenceUid and imageRegion are present and instance is not present.
Alternate Names | StudyInstanceUID
Example | <br/><b>General</b>:1.2.840.113747.20080222.12753225430534207565993148475333748793
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. ImagingSelection.derivedFrom
Definition | The imaging study from which the imaging selection is made.
Short | The imaging study from which the imaging selection is derived
Control | 0..*
Type | Reference(ImagingStudy)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. ImagingSelection.endpoint
Definition | The network service providing retrieval access to the selected images, frames, etc. See implementation notes for information about using DICOM endpoints.
Short | The network service providing retrieval for the images referenced in the imaging selection
Comments | 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.
Control | 0..*
Type | Reference(Endpoint)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the selected images, frames, etc.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. ImagingSelection.seriesUid
Definition | The Series Instance UID for the DICOM Series from which the images were selected.
Short | DICOM Series Instance UID
Comments | See DICOM PS3.3 C.7.3.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | DICOM Series Instance UID. Required unless frameOfReferenceUid and imageRegion are present and instance is not present.
Alternate Names | SeriesInstanceUID
Example | <br/><b>General</b>:1.2.840.113747.20080222.12753225430534207565993148475333748793.1
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. ImagingSelection.seriesNumber
Definition | The Series Number for the DICOM Series from which the images were selected.
Short | DICOM Series Number
Comments | See DICOM PS3.3 C.7.3.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | DICOM Series Number.
Alternate Names | SeriesNumber
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. ImagingSelection.frameOfReferenceUid
Definition | The Frame of Reference UID identifying the coordinate system that conveys spatial and/or temporal information for the selected images or frames.
Short | The Frame of Reference UID for the selected images
Comments | See DICOM PS3.3 C.7.4.1.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | DICOM Frame of Reference UID. Required if studyInstanceUid and seriesInstanceUid are not present.
Alternate Names | FrameOfReferenceUID
Example | <br/><b>General</b>:1.2.840.113747.20080222.12753225430534207565993148475333748793.2
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. ImagingSelection.bodySite
Definition | 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.
Short | Body part examined
Control | 0..1
Binding | For example codes, see SNOMEDCTBodyStructures (example to `http://hl7.org/fhir/ValueSet/body-site` ) SNOMED CT Body site concepts
Type | CodeableReference(BodyStructure)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | BodyPartExamined
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. ImagingSelection.focus
Definition | 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.
Short | Related resource that is the focus for the imaging selection
Comments | 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.
Control | 0..*
Type | Reference(ImagingSelection)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. ImagingSelection.instance
Definition | Each imaging selection includes one or more selected DICOM SOP instances.
Short | The selected instances
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | true
Requirements | Required if the the selection does not include all instances in the specified series.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. ImagingSelection.instance.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
64. ImagingSelection.instance.extension
Definition | 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.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
66. ImagingSelection.instance.modifierExtension
Definition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | 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.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
68. ImagingSelection.instance.uid
Definition | The SOP Instance UID for the selected DICOM instance.
Short | DICOM SOP Instance UID
Comments | See DICOM PS3.3 C.12.1.
Control | 1..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | DICOM SOP Instance UID.
Alternate Names | SOPInstanceUID
Example | <br/><b>General</b>:1.2.840.113747.20080222.12753225430534207568475333748793.1.1
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. ImagingSelection.instance.number
Definition | The Instance Number for the selected DICOM instance.
Short | DICOM Instance Number
Comments | See DICOM PS3.3 C.7.6.1. Note: A multiframe instance has a single instance number with each frame identified by a frame number.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | DICOM Instance Number.
Alternate Names | InstanceNumber
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. ImagingSelection.instance.sopClass
Definition | The SOP Class UID for the selected DICOM instance.
Short | DICOM SOP Class UID
Comments | See DICOM PS3.3 C.12.1.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible to `http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1` ) DICOM SOP Classes.
Type | Coding
Is Modifier | false
Must Support | false
Summary | false
Requirements | DICOM SOP Class UID.
Alternate Names | SOPClassUID
Example | <br/><b>General</b>:1.2.840.10008.5.1.4.1.1.2
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. ImagingSelection.instance.subset
Definition | 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.
Short | The selected subset of the SOP Instance
Control | 0..*
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Example | <br/><b>General</b>:6
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. ImagingSelection.instance.imageRegion2D
Definition | 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.
Short | A specific 2D region in a DICOM image / frame
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | false
Requirements | Shall not be present if the parent imagingSelection.instance is not an image.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. ImagingSelection.instance.imageRegion2D.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
80. ImagingSelection.instance.imageRegion2D.extension
Definition | 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.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
82. ImagingSelection.instance.imageRegion2D.modifierExtension
Definition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | 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.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
84. ImagingSelection.instance.imageRegion2D.regionType
Definition | Specifies the type of image region.
Short | point | polyline | interpolated | circle | ellipse
Comments | See DICOM PS3.3 C.10.5.1.2.
Control | 1..1
Binding | The codes SHALL be taken from ImagingSelection2DGraphicType (required to `http://hl7.org/fhir/ValueSet/imagingselection-2dgraphictype|5.0.0` ) The type of image region.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Alternate Names | GraphicType
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. ImagingSelection.instance.imageRegion2D.coordinate
Definition | 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.
Short | Specifies the coordinates that define the image region
Comments | For a description of how 2D coordinates are encoded, see DICOM PS3.3 C.18.6.
Control | 1..*
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Requirements | The number of values must be a multiple of two.
Alternate Names | GraphicData
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. ImagingSelection.instance.imageRegion3D
Definition | Each imaging selection might includes a 3D image region, specified by a region type and a set of 3D coordinates.
Short | A specific 3D region in a DICOM frame of reference
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | false
Summary | false
Requirements | Requires that the ImagingSelection.frameOfReferenceUid element is present.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. ImagingSelection.instance.imageRegion3D.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
92. ImagingSelection.instance.imageRegion3D.extension
Definition | 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.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
94. ImagingSelection.instance.imageRegion3D.modifierExtension
Definition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | 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.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
96. ImagingSelection.instance.imageRegion3D.regionType
Definition | Specifies the type of image region.
Short | point | multipoint | polyline | polygon | ellipse | ellipsoid
Comments | See DICOM PS3.3 C.18.9.1.2.
Control | 1..1
Binding | The codes SHALL be taken from ImagingSelection3DGraphicType (required to `http://hl7.org/fhir/ValueSet/imagingselection-3dgraphictype|5.0.0` ) The type of image region.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Alternate Names | GraphicType
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. ImagingSelection.instance.imageRegion3D.coordinate
Definition | 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.
Short | Specifies the coordinates that define the image region
Comments | For a description of how 3D coordinates are encoded, see DICOM PS3.3 C.18.9.
Control | 1..*
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Requirements | The number of values must be a multiple of three.
Alternate Names | GraphicData
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)