Manifest-based Access to DICOM Objects (MADO)
0.0.1-current - ci-build

Manifest-based Access to DICOM Objects (MADO), 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.MADO/ and changes regularly. See the Directory of published versions

## Resource Profile: MADO Imaging Study

Official URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoImagingStudy | Version: 0.0.1-current
Standards status: Draft | Maturity Level: 1 | Computable Name: MadoImagingStudy

Profile for ImagingStudy resources used in the MADO context. This profile is used for the ImagingStudy resources that represent the imaging studies in the MADO context. It includes additional constraints and extensions specific to the MADO context, such as the type of imaging study, the clinical specialty, and the anatomical region of interest.

Usages:

- Use this Profile: MADO FHIR Bundle
- Examples for this Profile: ImagingStudy/ExampleImagingStudy

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: MadoImagingStudy-endpoint-required
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region |  | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (required)
extension:creator |  | 1..1 | Reference(MADO Creator) | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
subject | Σ | 1..1 | Reference(Patient | Device | Group) | Who or what is the subject of the study
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | Σ | 0..1 | Reference(ServiceRequest: Requested Procedure for Imaging Study) | Request fulfilled
identifier | Σ | 0..1 | MadoAccessionNumberIdentifier | SHALL contain the identifier for the referenced ServiceRequest that contains the Accession Number Identifier when present.
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | Σ | 0..* | Reference(Endpoint: WADO) | Study access endpoint
endpoint:xcwado | Σ | 0..* | Reference(Endpoint: IHE-XC-WADO) | Study access endpoint
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
MadoImagingStudy-endpoint-required | error | ImagingStudy | An endpoint reference is required for each series in the ImagingStudy, or for the ImagingStudy itself if there are no series. | `endpoint.exists() or series.endpoint.all($this.exists())`
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from ImagingStudy

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: MadoImagingStudy-endpoint-required
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region |  | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (required)
extension:creator |  | 1..1 | Reference(MADO Creator) | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
Slices for identifier |  | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid |  | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
Slices for basedOn |  | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order |  | 0..1 | Reference(ServiceRequest: Requested Procedure for Imaging Study) | Request fulfilled
identifier |  | 0..1 | MadoAccessionNumberIdentifier | SHALL contain the identifier for the referenced ServiceRequest that contains the Accession Number Identifier when present.
Slices for endpoint |  | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado |  | 0..* | Reference(Endpoint: WADO) | Study access endpoint
endpoint:xcwado |  | 0..* | Reference(Endpoint: IHE-XC-WADO) | Study access endpoint
series |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
Slices for endpoint |  | 0..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado |  | 0..* | Reference(Endpoint: WADO) | Series access endpoint
endpoint:xcwado |  | 0..* | Reference(Endpoint: IHE-XC-WADO) | Series access endpoint
instance |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
extension:number-of-frames |  | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
MadoImagingStudy-endpoint-required | error | ImagingStudy | An endpoint reference is required for each series in the ImagingStudy, or for the ImagingStudy itself if there are no series. | `endpoint.exists() or series.endpoint.all($this.exists())`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: MadoImagingStudy-endpoint-required
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region |  | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (required)
extension:creator |  | 1..1 | Reference(MADO Creator) | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
modality | Σ | 0..* | Coding | All series modality if actual acquisition modalities Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
subject | Σ | 1..1 | Reference(Patient | Device | Group) | Who or what is the subject of the study
encounter | Σ | 0..1 | Reference(Encounter) | Encounter with which this imaging study is associated
started | Σ | 0..1 | dateTime | When the study was started Example General: 2011-01-01T11:01:20+03:00
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | Σ | 0..1 | Reference(ServiceRequest: Requested Procedure for Imaging Study) | Request fulfilled
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | MadoAccessionNumberIdentifier | SHALL contain the identifier for the referenced ServiceRequest that contains the Accession Number Identifier when present.
display | Σ | 0..1 | string | Text alternative for the resource
referrer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Referring physician
interpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole) | Who interpreted images
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | Σ | 0..* | Reference(Endpoint: WADO) | Study access endpoint
endpoint:xcwado | Σ | 0..* | Reference(Endpoint: IHE-XC-WADO) | Study access endpoint
numberOfSeries | Σ | 0..1 | unsignedInt | Number of Study Related Series
numberOfInstances | Σ | 0..1 | unsignedInt | Number of Study Related Instances
procedureReference | Σ | 0..1 | Reference(Procedure) | The performed Procedure reference
procedureCode | Σ | 0..* | CodeableConcept | The performed procedure code Binding: http://www.rsna.org/RadLex_Playbook.aspx (extensible): The performed procedure type.
location | Σ | 0..1 | Reference(Location) | Where ImagingStudy occurred
reasonCode | Σ | 0..* | CodeableConcept | Why the study was requested Binding: ProcedureReasonCodes (example): The reason for the study.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference) | Why was study performed
note | Σ | 0..* | Annotation | User-defined comments
description | Σ | 0..1 | string | Institution-generated description
series | Σ | 0..* | BackboneElement | Each study has one or more series of instances
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | Σ | 1..1 | id | DICOM Series Instance UID for the series Example General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
number | Σ | 0..1 | unsignedInt | Numeric identifier of this series Example General: 3
modality | Σ | 1..1 | Coding | The modality of the instances in the series Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
description | Σ | 0..1 | string | A short human readable summary of the series Example General: CT Surview 180
numberOfInstances | Σ | 0..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | Σ | 0..* | Reference(Endpoint: WADO) | Series access endpoint
endpoint:xcwado | Σ | 0..* | Reference(Endpoint: IHE-XC-WADO) | Series access endpoint
bodySite | Σ | 0..1 | Coding | Body part examined Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
laterality | Σ | 0..1 | Coding | Body part laterality Binding: Laterality (example): Codes describing body site laterality (left, right, etc.).
specimen | Σ | 0..* | Reference(Specimen) | Specimen imaged
started | Σ | 0..1 | dateTime | When the series started
performer | Σ | 0..* | BackboneElement | Who performed the series
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | Type of performance Binding: ImagingStudySeriesPerformerFunction (extensible): The type of involvement of the performer.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson) | Who performed the series
instance |  | 0..* | BackboneElement | A single SOP instance from the series
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
extension:number-of-frames |  | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid |  | 1..1 | id | DICOM SOP Instance UID Example General: 2.16.124.113543.6003.189642796.63084.16748.2599092903
sopClass |  | 1..1 | Coding | DICOM class type Binding: http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible): The sopClass for the instance.
number |  | 0..1 | unsignedInt | The number of this instance in the series Example General: 1
title |  | 0..1 | string | Description of instance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.
ImagingStudy.modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.basedOn:order.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
ImagingStudy.procedureCode | Base | extensible | http://www.rsna.org/RadLex_Playbook.aspx | Not State | Unknown
ImagingStudy.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.series.​bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​laterality | Base | example | Laterality | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​performer.function | Base | extensible | ImagingStudy series performer function | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​instance.sopClass | Base | extensible | http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 | Not State | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
MadoImagingStudy-endpoint-required | error | ImagingStudy | An endpoint reference is required for each series in the ImagingStudy, or for the ImagingStudy itself if there are no series. | `endpoint.exists() or series.endpoint.all($this.exists())`
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from ImagingStudy

Summary

Mandatory: 4 elements

Structures

This structure refers to these other structures:

- MADO Study Instance UID Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoStudyInstanceUidIdentifier)
- ServiceRequest: Requested Procedure for Imaging Study (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRequestedProcedureOrder)
- MADO Accession Number Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAccessionNumberIdentifier)
- Endpoint: WADO (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoWadoEndpoint)
- Endpoint: IHE-XC-WADO (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoXcWadoEndpoint)

Extensions

This structure refers to these extensions:

- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of ImagingStudy.identifier
- The element 1 is sliced based on the value of ImagingStudy.basedOn
- The element 1 is sliced based on the value of ImagingStudy.endpoint
- The element 1 is sliced based on the value of ImagingStudy.series.endpoint

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: MadoImagingStudy-endpoint-required
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region |  | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (required)
extension:creator |  | 1..1 | Reference(MADO Creator) | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
subject | Σ | 1..1 | Reference(Patient | Device | Group) | Who or what is the subject of the study
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | Σ | 0..1 | Reference(ServiceRequest: Requested Procedure for Imaging Study) | Request fulfilled
identifier | Σ | 0..1 | MadoAccessionNumberIdentifier | SHALL contain the identifier for the referenced ServiceRequest that contains the Accession Number Identifier when present.
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | Σ | 0..* | Reference(Endpoint: WADO) | Study access endpoint
endpoint:xcwado | Σ | 0..* | Reference(Endpoint: IHE-XC-WADO) | Study access endpoint
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
MadoImagingStudy-endpoint-required | error | ImagingStudy | An endpoint reference is required for each series in the ImagingStudy, or for the ImagingStudy itself if there are no series. | `endpoint.exists() or series.endpoint.all($this.exists())`
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from ImagingStudy

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: MadoImagingStudy-endpoint-required
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region |  | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (required)
extension:creator |  | 1..1 | Reference(MADO Creator) | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
Slices for identifier |  | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid |  | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
Slices for basedOn |  | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order |  | 0..1 | Reference(ServiceRequest: Requested Procedure for Imaging Study) | Request fulfilled
identifier |  | 0..1 | MadoAccessionNumberIdentifier | SHALL contain the identifier for the referenced ServiceRequest that contains the Accession Number Identifier when present.
Slices for endpoint |  | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado |  | 0..* | Reference(Endpoint: WADO) | Study access endpoint
endpoint:xcwado |  | 0..* | Reference(Endpoint: IHE-XC-WADO) | Study access endpoint
series |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
Slices for endpoint |  | 0..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado |  | 0..* | Reference(Endpoint: WADO) | Series access endpoint
endpoint:xcwado |  | 0..* | Reference(Endpoint: IHE-XC-WADO) | Series access endpoint
instance |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
extension:number-of-frames |  | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
MadoImagingStudy-endpoint-required | error | ImagingStudy | An endpoint reference is required for each series in the ImagingStudy, or for the ImagingStudy itself if there are no series. | `endpoint.exists() or series.endpoint.all($this.exists())`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImagingStudy | C | 0..* | ImagingStudy | A set of images produced in single study (one or more series of references images) Constraints: MadoImagingStudy-endpoint-required
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:anatomical-region |  | 0..* | CodeableConcept | The anatomical regions covered by the study. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension Binding: Anatomical Region (required)
extension:creator |  | 1..1 | Reference(MADO Creator) | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 1..* | Identifier | Identifiers for the whole study Slice: Unordered, Open by profile:$this
identifier:study-instance-uid | Σ | 1..1 | MadoStudyInstanceUidIdentifier | Identifiers for the whole study
status | ?!Σ | 1..1 | code | registered | available | cancelled | entered-in-error | unknown Binding: ImagingStudyStatus (required): The status of the ImagingStudy.
modality | Σ | 0..* | Coding | All series modality if actual acquisition modalities Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
subject | Σ | 1..1 | Reference(Patient | Device | Group) | Who or what is the subject of the study
encounter | Σ | 0..1 | Reference(Encounter) | Encounter with which this imaging study is associated
started | Σ | 0..1 | dateTime | When the study was started Example General: 2011-01-01T11:01:20+03:00
Slices for basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | Request fulfilled Slice: Unordered, Open by type:$this
basedOn:order | Σ | 0..1 | Reference(ServiceRequest: Requested Procedure for Imaging Study) | Request fulfilled
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | MadoAccessionNumberIdentifier | SHALL contain the identifier for the referenced ServiceRequest that contains the Accession Number Identifier when present.
display | Σ | 0..1 | string | Text alternative for the resource
referrer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Referring physician
interpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole) | Who interpreted images
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Study access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | Σ | 0..* | Reference(Endpoint: WADO) | Study access endpoint
endpoint:xcwado | Σ | 0..* | Reference(Endpoint: IHE-XC-WADO) | Study access endpoint
numberOfSeries | Σ | 0..1 | unsignedInt | Number of Study Related Series
numberOfInstances | Σ | 0..1 | unsignedInt | Number of Study Related Instances
procedureReference | Σ | 0..1 | Reference(Procedure) | The performed Procedure reference
procedureCode | Σ | 0..* | CodeableConcept | The performed procedure code Binding: http://www.rsna.org/RadLex_Playbook.aspx (extensible): The performed procedure type.
location | Σ | 0..1 | Reference(Location) | Where ImagingStudy occurred
reasonCode | Σ | 0..* | CodeableConcept | Why the study was requested Binding: ProcedureReasonCodes (example): The reason for the study.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference) | Why was study performed
note | Σ | 0..* | Annotation | User-defined comments
description | Σ | 0..1 | string | Institution-generated description
series | Σ | 0..* | BackboneElement | Each study has one or more series of instances
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid | Σ | 1..1 | id | DICOM Series Instance UID for the series Example General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
number | Σ | 0..1 | unsignedInt | Numeric identifier of this series Example General: 3
modality | Σ | 1..1 | Coding | The modality of the instances in the series Binding: AcquisitionModality (extensible): Type of acquired data in the instance.
description | Σ | 0..1 | string | A short human readable summary of the series Example General: CT Surview 180
numberOfInstances | Σ | 0..1 | unsignedInt | Number of Series Related Instances
Slices for endpoint | Σ | 0..* | Reference(Endpoint) | Series access endpoint Slice: Unordered, Open by profile:$this.resolve()
endpoint:wado | Σ | 0..* | Reference(Endpoint: WADO) | Series access endpoint
endpoint:xcwado | Σ | 0..* | Reference(Endpoint: IHE-XC-WADO) | Series access endpoint
bodySite | Σ | 0..1 | Coding | Body part examined Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
laterality | Σ | 0..1 | Coding | Body part laterality Binding: Laterality (example): Codes describing body site laterality (left, right, etc.).
specimen | Σ | 0..* | Reference(Specimen) | Specimen imaged
started | Σ | 0..1 | dateTime | When the series started
performer | Σ | 0..* | BackboneElement | Who performed the series
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | Type of performance Binding: ImagingStudySeriesPerformerFunction (extensible): The type of involvement of the performer.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson) | Who performed the series
instance |  | 0..* | BackboneElement | A single SOP instance from the series
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:representative-instance |  | 0..1 | boolean | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
extension:number-of-frames |  | 0..1 | integer | The number of frames in an ImagingStudy instance. URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
uid |  | 1..1 | id | DICOM SOP Instance UID Example General: 2.16.124.113543.6003.189642796.63084.16748.2599092903
sopClass |  | 1..1 | Coding | DICOM class type Binding: http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible): The sopClass for the instance.
number |  | 0..1 | unsignedInt | The number of this instance in the series Example General: 1
title |  | 0..1 | string | Description of instance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImagingStudy.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ImagingStudy.status | Base | required | ImagingStudyStatus | 📍4.0.1 | FHIR Std.
ImagingStudy.modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.basedOn:order.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
ImagingStudy.procedureCode | Base | extensible | http://www.rsna.org/RadLex_Playbook.aspx | Not State | Unknown
ImagingStudy.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​modality | Base | extensible | AcquisitionModality | 📦2025.3.20250714 | DICOM v2025c
ImagingStudy.series.​bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​laterality | Base | example | Laterality | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​performer.function | Base | extensible | ImagingStudy series performer function | 📍4.0.1 | FHIR Std.
ImagingStudy.series.​instance.sopClass | Base | extensible | http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 | Not State | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
MadoImagingStudy-endpoint-required | error | ImagingStudy | An endpoint reference is required for each series in the ImagingStudy, or for the ImagingStudy itself if there are no series. | `endpoint.exists() or series.endpoint.all($this.exists())`
dom-2 | error | ImagingStudy | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ImagingStudy | 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ImagingStudy | 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 | error | ImagingStudy | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ImagingStudy | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from ImagingStudy

Summary

Mandatory: 4 elements

Structures

This structure refers to these other structures:

- MADO Study Instance UID Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoStudyInstanceUidIdentifier)
- ServiceRequest: Requested Procedure for Imaging Study (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRequestedProcedureOrder)
- MADO Accession Number Identifier (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAccessionNumberIdentifier)
- Endpoint: WADO (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoWadoEndpoint)
- Endpoint: IHE-XC-WADO (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoXcWadoEndpoint)

Extensions

This structure refers to these extensions:

- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoAnatomicalRegionExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoRepresentativeInstanceExtension
- https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoNumberOfFrames

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of ImagingStudy.identifier
- The element 1 is sliced based on the value of ImagingStudy.basedOn
- The element 1 is sliced based on the value of ImagingStudy.endpoint
- The element 1 is sliced based on the value of ImagingStudy.series.endpoint

Maturity: 1

Other representations of profile: CSV, Excel, Schematron