Mobile Access to DICOM Objects (MADO)
0.1.0-SNAPSHOT - ci-build

Mobile 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 0.1.0-SNAPSHOT built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/bvdh/bvdh-ihe-mado/ and changes regularly. See the Directory of published versions

## Resource Profile: MadoImagingStudy - Detailed Descriptions

Page standards status: Draft | Maturity Level: 1

Definitions for the MadoImagingStudy resource profile.

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

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

0. ImagingStudy
Definition | Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.
Short | A set of images produced in single study (one or more series of references images)
Control | 0..*
Is Modifier | 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().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: 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()) MadoImagingStudy-endpoint-required: 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())`)
2. ImagingStudy.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 it's 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 it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ImagingStudy.extension
Definition | An Extension 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 manageable, 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 | ExtensionAdditional 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 | 10..*
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())
Slicing | This element introduces a set of slices on `ImagingStudy.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. ImagingStudy.extension:anatomical-region
Slice Name | anatomical-region
Definition | The anatomical regions covered by the study, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from `ImagingStudy.serie.bodysite`.
Short | The anatomical regions covered by the study.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. ImagingStudy.extension:creator
Slice Name | creator
Definition | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context.
Short | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension: Creator of the MADO) (Extension Type: Reference(MADO Creator))
Is Modifier | false
Summary | false
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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. ImagingStudy.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 manageable, 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
Summary | false
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())
12. ImagingStudy.identifier
Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number.
Short | Identifiers for the whole study
Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2.
Alternate Names | StudyInstanceUID, AccessionNumber
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `ImagingStudy.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this
14. ImagingStudy.identifier:study-instance-uid
Slice Name | study-instance-uid
Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number.
Short | Identifiers for the whole study
Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1*
Type | Identifier(MADO Study Instance UID Identifier)
Is Modifier | false
Summary | true
Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2.
Alternate Names | StudyInstanceUID, AccessionNumber
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ImagingStudy.status
Definition | The current state of the ImagingStudy.
Short | registered | available | cancelled | 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 ImagingStudyStatus http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1` ) The status of the ImagingStudy.
Type | code
Is Modifier | true because This element is labelled 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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ImagingStudy.subject
Definition | The subject, typically a patient, of the imaging study.
Short | Who or what is the subject of the study
Comments | QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group.
Control | 1..1
Type | Reference(Patient, Device, Group)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ImagingStudy.basedOn
Definition | A list of the diagnostic requests that resulted in this imaging study being performed.
Short | Request fulfilled
Control | 0..*
Type | Reference(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
Is Modifier | false
Summary | true
Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `ImagingStudy.basedOn`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
22. ImagingStudy.basedOn:order
Slice Name | order
Definition | A list of the diagnostic requests that resulted in this imaging study being performed.
Short | Request fulfilled
Control | 0..1*
Type | Reference(MADO Referenced Accession Number Identifier)(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task, CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
Is Modifier | false
Summary | true
Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ImagingStudy.endpoint
Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.
Short | Study access endpoint
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; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.
Control | 0..*
Type | Reference(Endpoint)
Is Modifier | false
Summary | true
Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `ImagingStudy.endpoint`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
26. ImagingStudy.endpoint:wado
Slice Name | wado
Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.
Short | Study access endpoint
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; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.
Control | 0..*
Type | Reference(Endpoint: WADO, Endpoint)
Is Modifier | false
Summary | true
Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ImagingStudy.endpoint:xcwado
Slice Name | xcwado
Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.
Short | Study access endpoint
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; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.
Control | 0..*
Type | Reference(Endpoint: IHE-XC-WADO, Endpoint)
Is Modifier | false
Summary | true
Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.
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 foundhere

0. ImagingStudy
Invariants | MadoImagingStudy-endpoint-required: 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())`)
2. ImagingStudy.extension
Control | 1..?
Slicing | This element introduces a set of slices on `ImagingStudy.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
4. ImagingStudy.extension:anatomical-region
Slice Name | anatomical-region
Definition | The anatomical regions covered by the study, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from `ImagingStudy.serie.bodysite`.
Short | The anatomical regions covered by the study.
Control | 0..*
Type | Extension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
6. ImagingStudy.extension:creator
Slice Name | creator
Short | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context.
Control | 1..1
Type | Extension(Extension: Creator of the MADO) (Extension Type: Reference(MADO Creator))
8. ImagingStudy.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
Slicing | This element introduces a set of slices on `ImagingStudy.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this
10. ImagingStudy.identifier:study-instance-uid
Slice Name | study-instance-uid
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier(MADO Study Instance UID Identifier)
12. ImagingStudy.basedOn
Slicing | This element introduces a set of slices on `ImagingStudy.basedOn`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
14. ImagingStudy.basedOn:order
Slice Name | order
Control | 0..1
Type | Reference(MADO Referenced Accession Number Identifier)(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
16. ImagingStudy.endpoint
Slicing | This element introduces a set of slices on `ImagingStudy.endpoint`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
18. ImagingStudy.endpoint:wado
Slice Name | wado
Control | 0..*
Type | Reference(Endpoint: WADO)
20. ImagingStudy.endpoint:xcwado
Slice Name | xcwado
Control | 0..*
Type | Reference(Endpoint: IHE-XC-WADO)
22. ImagingStudy.series
24. ImagingStudy.series.extension
Slicing | This element introduces a set of slices on `ImagingStudy.series.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
26. ImagingStudy.series.extension:representative-instance
Slice Name | representative-instance
Short | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series.
Control | 0..1
Type | Extension(Extension: Representative Instance) (Extension Type: boolean)
28. ImagingStudy.series.endpoint
Slicing | This element introduces a set of slices on `ImagingStudy.series.endpoint`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
30. ImagingStudy.series.endpoint:wado
Slice Name | wado
Control | 0..*
Type | Reference(Endpoint: WADO)
32. ImagingStudy.series.endpoint:xcwado
Slice Name | xcwado
Control | 0..*
Type | Reference(Endpoint: IHE-XC-WADO)
34. ImagingStudy.series.instance
36. ImagingStudy.series.instance.extension
Slicing | This element introduces a set of slices on `ImagingStudy.series.instance.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
38. ImagingStudy.series.instance.extension:representative-instance
Slice Name | representative-instance
Short | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series.
Control | 0..1
Type | Extension(Extension: Representative Instance) (Extension Type: boolean)
40. ImagingStudy.series.instance.extension:number-of-frames
Slice Name | number-of-frames
Short | The number of frames in an ImagingStudy instance.
Control | 0..1
Type | Extension(Extension: Number of Frames) (Extension Type: integer)

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

0. ImagingStudy
Definition | Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.
Short | A set of images produced in single study (one or more series of references images)
Control | 0..*
Is Modifier | 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().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: 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()`) MadoImagingStudy-endpoint-required: 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())`)
2. ImagingStudy.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 | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. ImagingStudy.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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. ImagingStudy.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 it's 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 it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. ImagingStudy.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 SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. ImagingStudy.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 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
Type | Narrative
Is Modifier | 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. ImagingStudy.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
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..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. ImagingStudy.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
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()`)
Slicing | This element introduces a set of slices on `ImagingStudy.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. ImagingStudy.extension:anatomical-region
Slice Name | anatomical-region
Definition | The anatomical regions covered by the study, depending on the study there can be zero, one or more regions. The regions SHALL overlap with the bodysite references from `ImagingStudy.serie.bodysite`.
Short | The anatomical regions covered by the study.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Extension: Anatomical Region) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
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. ImagingStudy.extension:creator
Slice Name | creator
Definition | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context.
Short | The creator of the MADO, which is the device that created the ImagingStudy resource in the MADO context.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension: Creator of the MADO) (Extension Type: Reference(MADO Creator))
Is Modifier | false
Summary | false
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()`)
20. ImagingStudy.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 manageable, 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
Summary | false
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()`)
22. ImagingStudy.identifier
Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number.
Short | Identifiers for the whole study
Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2.
Alternate Names | StudyInstanceUID, AccessionNumber
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `ImagingStudy.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this
24. ImagingStudy.identifier:study-instance-uid
Slice Name | study-instance-uid
Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number.
Short | Identifiers for the whole study
Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier(MADO Study Instance UID Identifier)
Is Modifier | false
Summary | true
Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2.
Alternate Names | StudyInstanceUID, AccessionNumber
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. ImagingStudy.status
Definition | The current state of the ImagingStudy.
Short | registered | available | cancelled | 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 ImagingStudyStatus (required to `http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1` ) The status of the ImagingStudy.
Type | code
Is Modifier | true because This element is labelled 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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. ImagingStudy.modality
Definition | A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19).
Short | All series modality if actual acquisition modalities
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from AcquisitionModality (extensible to `http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html` ) Type of acquired data in the instance.
Type | Coding
Is Modifier | false
Summary | true
Alternate Names | ModalitiesInStudy
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. ImagingStudy.subject
Definition | The subject, typically a patient, of the imaging study.
Short | Who or what is the subject of the study
Comments | QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group.
Control | 1..1
Type | Reference(Patient, Device, Group)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. ImagingStudy.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made.
Short | Encounter with which this imaging study is associated
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. ImagingStudy.started
Definition | Date and time the study started.
Short | When the study was started
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | StudyDate, StudyTime
Example | General: 2011-01-01T11:01:20+03:00
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. ImagingStudy.basedOn
Definition | A list of the diagnostic requests that resulted in this imaging study being performed.
Short | Request fulfilled
Control | 0..*
Type | Reference(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
Is Modifier | false
Summary | true
Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `ImagingStudy.basedOn`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
38. ImagingStudy.basedOn:order
Slice Name | order
Definition | A list of the diagnostic requests that resulted in this imaging study being performed.
Short | Request fulfilled
Control | 0..1
Type | Reference(MADO Referenced Accession Number Identifier)(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
Is Modifier | false
Summary | true
Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. ImagingStudy.referrer
Definition | The requesting/referring physician.
Short | Referring physician
Control | 0..1
Type | Reference(Practitioner, PractitionerRole)
Is Modifier | false
Summary | true
Alternate Names | ReferringPhysiciansName
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. ImagingStudy.interpreter
Definition | Who read the study and interpreted the images or other content.
Short | Who interpreted images
Control | 0..*
Type | Reference(Practitioner, PractitionerRole)
Is Modifier | false
Summary | true
Alternate Names | Name of Physician(s) Reading Study
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. ImagingStudy.endpoint
Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.
Short | Study access endpoint
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; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.
Control | 0..*
Type | Reference(Endpoint)
Is Modifier | false
Summary | true
Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `ImagingStudy.endpoint`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
46. ImagingStudy.endpoint:wado
Slice Name | wado
Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.
Short | Study access endpoint
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; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.
Control | 0..*
Type | Reference(Endpoint: WADO)
Is Modifier | false
Summary | true
Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. ImagingStudy.endpoint:xcwado
Slice Name | xcwado
Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.
Short | Study access endpoint
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; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.
Control | 0..*
Type | Reference(Endpoint: IHE-XC-WADO)
Is Modifier | false
Summary | true
Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. ImagingStudy.numberOfSeries
Definition | Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present.
Short | Number of Study Related Series
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | NumberOfStudyRelatedSeries
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. ImagingStudy.numberOfInstances
Definition | Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.
Short | Number of Study Related Instances
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | NumberOfStudyRelatedInstances
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. ImagingStudy.procedureReference
Definition | The procedure which this ImagingStudy was part of.
Short | The performed Procedure reference
Control | 0..1
Type | Reference(Procedure)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. ImagingStudy.procedureCode
Definition | The code for the performed procedure type.
Short | The performed procedure code
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from http://www.rsna.org/RadLex_Playbook.aspx (extensible to `http://www.rsna.org/RadLex_Playbook.aspx` ) The performed procedure type.
Type | CodeableConcept
Is Modifier | false
Summary | true
Alternate Names | ProcedureCodeSequence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. ImagingStudy.location
Definition | The principal physical location where the ImagingStudy was performed.
Short | Where ImagingStudy occurred
Control | 0..1
Type | Reference(Location)
Is Modifier | false
Summary | true
Requirements | Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. ImagingStudy.reasonCode
Definition | Description of clinical condition indicating why the ImagingStudy was requested.
Short | Why the study was requested
Control | 0..*
Binding | For example codes, see ProcedureReasonCodes (example to `http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1` ) The reason for the study.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. ImagingStudy.reasonReference
Definition | Indicates another resource whose existence justifies this Study.
Short | Why was study performed
Control | 0..*
Type | Reference(Condition, Observation, Media, DiagnosticReport, DocumentReference)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. ImagingStudy.note
Definition | Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element.
Short | User-defined comments
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. ImagingStudy.description
Definition | The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed.
Short | Institution-generated description
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | StudyDescription
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. ImagingStudy.series
Definition | Each study has one or more series of images or other content.
Short | Each study has one or more series of instances
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. ImagingStudy.series.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
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
72. ImagingStudy.series.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
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()`)
Slicing | This element introduces a set of slices on `ImagingStudy.series.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
74. ImagingStudy.series.extension:representative-instance
Slice Name | representative-instance
Definition | 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.
Short | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension: Representative Instance) (Extension Type: boolean)
Is Modifier | false
Summary | false
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()`)
76. ImagingStudy.series.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 manageable, 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()`)
78. ImagingStudy.series.uid
Definition | The DICOM Series Instance UID for the series.
Short | DICOM Series Instance UID for the series
Comments | See DICOM PS3.3 C.7.3.
Control | 1..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | DICOM Series Instance UID.
Alternate Names | SeriesInstanceUID
Example | General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. ImagingStudy.series.number
Definition | The numeric identifier of this series in the study.
Short | Numeric identifier of this series
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | SeriesNumber
Example | General: 3
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. ImagingStudy.series.modality
Definition | The modality of this series sequence.
Short | The modality of the instances in the series
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from AcquisitionModality (extensible to `http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html` ) Type of acquired data in the instance.
Type | Coding
Is Modifier | false
Summary | true
Alternate Names | Modality
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. ImagingStudy.series.description
Definition | A description of the series.
Short | A short human readable summary of the series
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | SeriesDescription
Example | General: CT Surview 180
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. ImagingStudy.series.numberOfInstances
Definition | Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.
Short | Number of Series Related Instances
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | NumberOfSeriesRelatedInstances
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. ImagingStudy.series.endpoint
Definition | The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType.
Short | Series access endpoint
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; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.
Control | 0..*
Type | Reference(Endpoint)
Is Modifier | false
Summary | true
Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `ImagingStudy.series.endpoint`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this.resolve()
90. ImagingStudy.series.endpoint:wado
Slice Name | wado
Definition | The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType.
Short | Series access endpoint
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; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.
Control | 0..*
Type | Reference(Endpoint: WADO)
Is Modifier | false
Summary | true
Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. ImagingStudy.series.endpoint:xcwado
Slice Name | xcwado
Definition | The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType.
Short | Series access endpoint
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; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.
Control | 0..*
Type | Reference(Endpoint: IHE-XC-WADO)
Is Modifier | false
Summary | true
Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. ImagingStudy.series.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. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality.
Short | Body part examined
Control | 0..1
Binding | For example codes, see SNOMEDCTBodyStructures (example to `http://hl7.org/fhir/ValueSet/body-site|4.0.1` ) Codes describing anatomical locations. May include laterality.
Type | Coding
Is Modifier | false
Summary | true
Alternate Names | BodyPartExamined
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. ImagingStudy.series.laterality
Definition | The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite.
Short | Body part laterality
Control | 0..1
Binding | For example codes, see Laterality (example to `http://hl7.org/fhir/ValueSet/bodysite-laterality|4.0.1` ) Codes describing body site laterality (left, right, etc.).
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. ImagingStudy.series.specimen
Definition | The specimen imaged, e.g., for whole slide imaging of a biopsy.
Short | Specimen imaged
Control | 0..*
Type | Reference(Specimen)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. ImagingStudy.series.started
Definition | The date and time the series was started.
Short | When the series started
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. ImagingStudy.series.performer
Definition | Indicates who or what performed the series and how they were involved.
Short | Who performed the series
Comments | If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers.
Alternate Names | PerformingPhysicianName, OperatorName
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. ImagingStudy.series.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
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
106. ImagingStudy.series.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 manageable, 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()`)
108. ImagingStudy.series.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 manageable, 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()`)
110. ImagingStudy.series.performer.function
Definition | Distinguishes the type of involvement of the performer in the series.
Short | Type of performance
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ImagingStudySeriesPerformerFunction (extensible to `http://hl7.org/fhir/ValueSet/series-performer-function|4.0.1` ) The type of involvement of the performer.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows disambiguation of the types of involvement of different performers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. ImagingStudy.series.performer.actor
Definition | Indicates who or what performed the series.
Short | Who performed the series
Control | 1..1
Type | Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, Device, RelatedPerson)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. ImagingStudy.series.instance
Definition | A single SOP instance within the series, e.g. an image, or presentation state.
Short | A single SOP instance from the series
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. ImagingStudy.series.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
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
118. ImagingStudy.series.instance.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
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()`)
Slicing | This element introduces a set of slices on `ImagingStudy.series.instance.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
120. ImagingStudy.series.instance.extension:representative-instance
Slice Name | representative-instance
Definition | 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.
Short | Indicates that a referenced instance on and ImagingStudy series is a representative instance for that series.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension: Representative Instance) (Extension Type: boolean)
Is Modifier | false
Summary | false
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()`)
122. ImagingStudy.series.instance.extension:number-of-frames
Slice Name | number-of-frames
Definition | The number of frames in an ImagingStudy instance.
Short | The number of frames in an ImagingStudy instance.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension: Number of Frames) (Extension Type: integer)
Is Modifier | false
Summary | false
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()`)
124. ImagingStudy.series.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 manageable, 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()`)
126. ImagingStudy.series.instance.uid
Definition | The DICOM SOP Instance UID for this image or other DICOM content.
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
Summary | false
Requirements | DICOM SOP Instance UID.
Alternate Names | SOPInstanceUID
Example | General: 2.16.124.113543.6003.189642796.63084.16748.2599092903
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. ImagingStudy.series.instance.sopClass
Definition | DICOM instance type.
Short | DICOM class type
Control | 1..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` ) The sopClass for the instance.
Type | Coding
Is Modifier | false
Summary | false
Alternate Names | SOPClassUID
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. ImagingStudy.series.instance.number
Definition | The number of instance in the series.
Short | The number of this instance in the series
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Alternate Names | InstanceNumber
Example | General: 1
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. ImagingStudy.series.instance.title
Definition | The description of the instance.
Short | Description of instance
Comments | Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)