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

## FHIR Imaging Manifest

The FHIR imaging manifest represents a summary of the data stored in a DICOM imaging study as is stored in a PACS expressed in FHIR. It is the FHIR equivalent of the DICOM KOS manifest. It is the 'document' that is searched for and provides the URL's that allow download of the imaging content.

### FHIR Manifest overview

The figure below presents an overview of the data that is part of the imaging-manifest. In order to keep the diagram readable, not all references are included.

Figure: FHIR Manifest Overview

The manifest is a FHIR bundle that SHALL conform to the MADO FHIR Bundle profile. This `Bundle` includes the MADO FHIR ImagingStudy resource, the , at least one `Endpoint` and additional resources. The `Bundle` SHALL contain all available data elements in the FHIR column in Table 4.3-1 (see DICOM KOS <-> FHIR mappings).

> Feedback is requested from the implementer community whether we need to highlight these fields more explicitly and how (e.g. using FHIR obligations).

`Endpoint` resources contain the information that allows the client to access the DICOM data. The current model identifies two different `Endpoint`s:

- The MADO FHIR WADO Endpoint endpoint which provides a WADO endpoint corresponding the WADO profile defined in this specification.
- The MADO FHIR XC-WADO Endpoint endpoint which provides an IHE-RAD-XC-WADO endpoint corresponding the IHE-RAD-XC-WADO specification.

The profile provides information on the system that generated the manifest.

Besides the `ImagingStudy` and `Endpoint` resources, also additional resources are present that reflect information present in DICOM such as information on the patient, performer, procedure and imaging device. What resources to include depends on the information to be included, see DICOM KOS <-> FHIR mappings for more information on when to include what resource.

### Related FHIR profiles

The following links are provided for convenience.

Name | Title | Description
MadoAccessionNumberIdentifier | MADO Accession Number Identifier | Profile for the Accession Number Identifier used in the MADO context. This profile is used for the Identifier that represents the Accession Number in the MADO context. It includes additional constraints and extensions specific to the MADO context, such as the value set for the type of identifier and the fixed value for the system of the identifier.
MadoAnatomicalRegionExtension | Extension: Anatomical Region | The anatomical region in an ImagingStudy instance. This is additional information next to ImagingStudy.series.bodySite.
MadoCreator | MADO Creator | A profile for the Device resource that represents the creator of an ImagingStudy in the MADO context. This profile is used for the Device resource that represents the author of an ImagingStudy in the MADO context.
MadoCreatorExtension | Extension: Creator of the MADO | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context.
MadoFhirBundle | MADO FHIR Bundle | Profile for FHIR Bundles used in the MADO context. This profile is used for the FHIR Bundles that represent imaging manifests using the DICOM KOS format in the MADO context. It includes additional constraints and extensions specific to imaging manifests, such as the type of report, the clinical specialty, and the anatomical region of interest.
MadoFillerNumberIdentifier | MADO Filler Number Identifier | Profile for the Filler Number Identifier used in the MADO context. This profile is used for the Identifier that represents the Filler Number in the MADO context. It includes additional constraints and extensions specific to the MADO context, such as the value set for the type of identifier and the fixed value for the system of the identifier.
MadoImagingStudy | MADO Imaging Study | 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.
MadoNumberOfFrames | Extension: Number of Frames | The number of frames in an ImagingStudy instance.
MadoPlacerNumberIdentifier | MADO Placer Number Identifier | Profile for the Placer Number Identifier used in the MADO context. This profile is used for the Identifier that represents the Placer Number in the MADO context. It includes additional constraints and extensions specific to the MADO context, such as the value set for the type of identifier and the fixed value for the system of the identifier.
MadoReferencedStudyInstanceUidIdentifier | MADO Referenced Study Instance UID Identifier | Profile for the Reference that contains the Study Instance UID Identifier used in the MADO context. This profile is used for the Reference that contains the Identifier that represents the Study Instance UID in the MADO context. It includes additional constraints and extensions specific to the MADO context, such as the value set for the type of identifier and the fixed value for the system of the identifier.
MadoRepresentativeInstanceExtension | Extension: Representative Instance | An extension to indicate that a referenced instance on and ImagingStudy series is a representative instance for that series. This extension is used in the MADO context to indicate that a referenced instance on an ImagingStudy series is a representative instance for that series, which can be used for display purposes in the MADO context.
MadoRequestedProcedureOrder | ServiceRequest: Requested Procedure for Imaging Study | This profile on ServiceRequest represents the order for the Imaging Study and report. In DICOM this is referred to as the Requested Procedure. The `code` element represents the requested imaging procedure type which includes the requested modality.
MadoStudyInstanceUidIdentifier | MADO Study Instance UID Identifier | Profile for the Study Instance UID Identifier used in the MADO context. This profile is used for the Identifier that represents the Study Instance UID in the MADO context. It includes additional constraints and extensions specific to the MADO context, such as the value set for the type of identifier and the fixed value for the system of the identifier.
MadoWadoEndpoint | Endpoint: WADO | This profile defines the WADO endpoint for accessing imaging study content.
MadoXcWadoEndpoint | Endpoint: IHE-XC-WADO | This profile defines the XC-WADO endpoint for accessing imaging study content. It is a regular WADO endpoint with an additional extension that holds the `locationUID` of the domain where the content can be accessed. See the IHE XC-WADO specification for more details. Note that in XC-WADO the address is optional. When no address is known, a placeholder value is inserted and a data absent exception with the code `not-applicable`.
XcWadoLocationUIDExtension | Extension: Location UID | The location UID of the source of the WADO URL. See XC-WADO and https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_A.35.4.3.html#table_A.35.4-1.