0.1.0 - ci-build

MADO, published by Example Publisher. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/MADO-through-FHIR-Publisher/ and changes regularly. See the Directory of published versions

MADO Content Modules

MADO Content Modules

5 IHE Namespaces, Concept Domains and Vocabularies

5.1 IHE MADO Namespaces

The MADO profile defines the following namespaces:

Namespace URI Description
MADO http://ihe.net/fhir/mado Base namespace for MADO FHIR resources
MADO-KOS http://ihe.net/mado/dicom/kos Namespace for DICOM KOS manifest definitions

5.2 IHE MADO Concept Domains

The following concept domains are defined for the MADO profile:

Concept Domain Description Binding
ManifestType Types of imaging manifests Required
RetrievalMethod Methods for retrieving imaging content Extensible
StudyPurpose Purpose codes for imaging studies Preferred

5.3 IHE MADO Format Codes and Vocabularies

5.3.1 IHE Format Codes

Format Code Description MIME Type
urn:ihe:mado:kos:2025 DICOM Key Object Selection Manifest application/dicom
urn:ihe:mado:fhir:2025 FHIR-based Imaging Manifest application/fhir+json

5.3.2 IHEActCode Vocabulary

Act Code Display Name Definition
MADO-MANIFEST Imaging Manifest A manifest document that references imaging studies and instances
MADO-RETRIEVE Manifest-based Retrieval Retrieval of imaging content based on manifest information

5.3.3 IHERoleCode Vocabulary

Role Code Display Name Definition
MANIFEST-CREATOR Manifest Creator System or person responsible for creating imaging manifests
MANIFEST-CONSUMER Manifest Consumer System that processes and acts upon imaging manifests

5.3.4 Imaging Study Manifest Search Metadata

The following metadata elements support searching for imaging study manifests:

Metadata Element Description Type
patient-id Patient identifier Identifier
study-uid Study instance UID Identifier
modality Imaging modality CodeableConcept
study-date Study acquisition date Date
manifest-type Type of manifest CodeableConcept

7 MADO DICOM Content Definitions

7.1 Conventions

7.1.1 DICOM Structured Report

The MADO profile utilizes DICOM Key Object Selection (KOS) documents as one format for imaging manifests. These documents follow the DICOM Structured Report framework.

7.1.2 Display Requirements

DICOM manifests shall support appropriate display mechanisms for human-readable presentation of manifest content.

7.2 General Definitions

Imaging Manifest: A document that contains references to one or more imaging studies, series, or instances, along with relevant metadata for retrieval and processing.

Key Object Selection (KOS): A DICOM object that identifies and describes a set of DICOM objects (studies, series, instances) for a specific purpose.

Manifest Consumer: An entity that processes imaging manifests to facilitate subsequent imaging retrieval operations.

7.3 IOD Definitions

7.3.1 Key Object Selection Document IODs

7.3.1.1 Key Object Selection Document IOD
7.3.1.1.1 Key Object Selection Document IOD MADO Context

####### 7.3.1.1.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions
  • DICOM PS3.4: Service Class Specifications
  • DICOM PS3.6: Data Dictionary

####### 7.3.1.1.1.2 IOD Definition

The Key Object Selection Document IOD for MADO purposes shall include the following modules:

IE Module Reference Usage
Patient Patient C.7.1.1 M
Study General Study C.7.2.1 M
Series Key Object Document Series C.17.6.1 M
Equipment General Equipment C.7.5.1 M
Document Key Object Document C.17.6.2 M
Document SR Document Content C.17.3 M
Document SOP Common C.12.1 M

Legend: M = Mandatory, U = User Defined, C = Conditional

7.4 Module Definitions

7.4.1 Key Object Selection Document Modules

7.4.1.1 Patient Module
7.4.1.1.1 Patient Module MADO Context

####### 7.4.1.1.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions, Section C.7.1.1

####### 7.4.1.1.1.2 Module Definition

Attribute Name Tag Type Attribute Description
Patient's Name (0010,0010) 2 Patient's full name
Patient ID (0010,0020) 2 Primary identifier for the patient
Patient's Birth Date (0010,0030) 2 Patient's date of birth
Patient's Sex (0010,0040) 2 Patient's sex

Type Legend: 1 = Required, 2 = Required if known, 3 = Optional

Additional MADO Requirements:

  • Patient ID shall be present for manifest-based retrieval scenarios
  • Patient demographics should be consistent across referenced studies
7.4.1.2 General Study Module
7.4.1.2.1 General Study Module MADO Context

####### 7.4.1.2.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions, Section C.7.2.1

####### 7.4.1.2.1.2 Module Definition

Attribute Name Tag Type Attribute Description
Study Instance UID (0020,000D) 1 Unique identifier for the Study
Study Date (0008,0020) 2 Date the Study started
Study Time (0008,0030) 2 Time the Study started
Referring Physician's Name (0008,0090) 2 Name of the physician referring the patient
Study ID (0020,0010) 2 User or equipment generated Study identifier
Accession Number (0008,0050) 2 RIS generated number identifying the order
Study Description (0008,1030) 3 User-defined description of the Study

MADO Requirements:

  • Study Instance UID is mandatory for manifest-based retrieval
  • Study metadata should support efficient filtering and selection
7.4.1.3 Key Object Document Series Module
7.4.1.3.1 Key Object Document Series Module MADO Context

####### 7.4.1.3.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions, Section C.17.6.1

####### 7.4.1.3.1.2 Module Definition

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Type of equipment that originally acquired the data
Series Instance UID (0020,000E) 1 Unique identifier of the Series
Series Number (0020,0011) 1 A number that identifies this Series

MADO Specifications:

  • Modality shall be set to "KO" for Key Object Selection documents
  • Series Instance UID shall be unique for each manifest document
7.4.1.4 General Equipment Module
7.4.1.4.1 General Equipment Module MADO Context

####### 7.4.1.4.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions, Section C.7.5.1

####### 7.4.1.4.1.2 Module Definition

Attribute Name Tag Type Attribute Description
Manufacturer (0008,0070) 2 Manufacturer of the equipment
Institution Name (0008,0080) 3 Institution where equipment is located
Software Versions (0018,1020) 3 Manufacturer's software versions

MADO Requirements:

  • Equipment information should identify the system creating the manifest
7.4.1.5 Key Object Document Module
7.4.1.5.1 Key Object Document Module MADO Context

####### 7.4.1.5.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions, Section C.17.6.2

####### 7.4.1.5.1.2 Module Definition

Attribute Name Tag Type Attribute Description
Instance Number (0020,0013) 1 A number that identifies this KO Document
Content Date (0008,0023) 1 Date the document content creation
Content Time (0008,0033) 1 Time the document content creation
Referenced Request Sequence (0040,A370) 1C Sequence of Items referencing requests
Current Requested Procedure Evidence Sequence (0040,A375) 1 Evidence sequence for current procedure

Current Requested Procedure Evidence Sequence Items:

Attribute Name Tag Type Attribute Description
Study Instance UID (0020,000D) 1 UID of the referenced Study
Referenced Series Sequence (0008,1115) 1 Sequence of referenced Series

Referenced Series Sequence Items:

Attribute Name Tag Type Attribute Description
Series Instance UID (0020,000E) 1 UID of the referenced Series
Referenced SOP Sequence (0008,1140) 1C Sequence of referenced SOP Instances

Referenced SOP Sequence Items:

Attribute Name Tag Type Attribute Description
Referenced SOP Class UID (0008,1150) 1 SOP Class UID of referenced object
Referenced SOP Instance UID (0008,1155) 1 SOP Instance UID of referenced object

MADO Specifications:

  • Current Requested Procedure Evidence Sequence shall contain all studies referenced in the manifest
  • Referenced SOP Sequence may be used to specify individual instances when needed
7.4.1.6 SR Document Content Module
7.4.1.6.1 SR Document Module MADO Context

####### 7.4.1.6.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions, Section C.17.3

####### 7.4.1.6.1.2 Module Definition

Attribute Name Tag Type Attribute Description
Value Type (0040,A040) 1 Type of value stored in this content item
Concept Name Code Sequence (0040,A043) 1 Coded concept name of this content item
Content Sequence (0040,A730) 1C Sequence of content items

MADO Content Structure:

  • Root content item shall have concept name "MADO Manifest"
  • Child content items shall describe manifest purpose and scope
  • Referenced studies and selection criteria should be documented
7.4.1.7 SOP Common Module
7.4.1.7.1 SOP Common Module MADO Context

####### 7.4.1.7.1.1 Referenced Standards

  • DICOM PS3.3: Information Object Definitions, Section C.12.1

####### 7.4.1.7.1.2 Module Definition

Attribute Name Tag Type Attribute Description
SOP Class UID (0008,0016) 1 Uniquely identifies the SOP Class
SOP Instance UID (0008,0018) 1 Uniquely identifies the SOP Instance
Specific Character Set (0008,0005) 1C Character set used for text values
Instance Creation Date (0008,0012) 3 Date the SOP Instance was created
Instance Creation Time (0008,0013) 3 Time the SOP Instance was created

MADO Requirements:

  • SOP Class UID shall be "1.2.840.10008.5.1.4.1.1.88.59" (Key Object Selection Document Storage)
  • SOP Instance UID shall be unique for each manifest document

8 MADO HL7 FHIR Content Definitions

The MADO profile supports FHIR-based manifests using the following resource types:

8.1 ImagingStudy Resource

The ImagingStudy resource is used to represent imaging studies referenced in FHIR-based manifests.

Key Elements:

  • identifier: Study identifiers including Study Instance UID
  • status: Status of the imaging study
  • subject: Reference to the Patient
  • encounter: Reference to the encounter context
  • started: Date/time when study was started
  • series: Series within the study
  • endpoint: DICOM endpoints for retrieval

8.2 List Resource

The List resource serves as the primary manifest container for FHIR-based implementations.

Key Elements:

  • status: Status of the manifest list
  • mode: Mode of the list (typically "working")
  • title: Human-readable title for the manifest
  • code: Code identifying this as an imaging manifest
  • subject: Reference to the Patient
  • date: Date the manifest was created
  • source: Creator of the manifest
  • entry: References to ImagingStudy resources

8.3 Endpoint Resource

The Endpoint resource defines DICOM endpoints for image retrieval.

Key Elements:

  • status: Endpoint status
  • connectionType: Type of connection (e.g., DICOM WADO-RS)
  • address: Base URL for the endpoint
  • payloadType: Supported payload types

9 MADO DICOM – FHIR Manifest Mapping Specification

9.1 Overview

This section defines the mapping between DICOM KOS-based manifests and FHIR-based manifests to enable interoperability between the two formats.

9.2 DICOM to FHIR Mapping

DICOM Element FHIR Element Mapping Notes
Patient ID (0010,0020) Patient.identifier Direct mapping
Study Instance UID (0020,000D) ImagingStudy.identifier Use DICOM UID format
Series Instance UID (0020,000E) ImagingStudy.series.uid Direct mapping
SOP Instance UID (0008,0018) ImagingStudy.series.instance.uid Direct mapping
Study Date (0008,0020) ImagingStudy.started Convert to FHIR dateTime
Referring Physician (0008,0090) ImagingStudy.referrer Map to Practitioner reference

9.3 FHIR to DICOM Mapping

FHIR Element DICOM Element Mapping Notes
Patient.identifier Patient ID (0010,0020) Use primary identifier
ImagingStudy.identifier Study Instance UID (0020,000D) Extract DICOM UID
ImagingStudy.series.uid Series Instance UID (0020,000E) Direct mapping
ImagingStudy.series.instance.uid SOP Instance UID (0008,0018) Direct mapping
ImagingStudy.started Study Date/Time (0008,0020/0030) Convert from FHIR dateTime

9.4 Mapping Implementation Considerations

  • Identifier Handling: Ensure consistent identifier mapping between formats
  • Date/Time Conversion: Handle timezone and precision differences appropriately
  • Reference Resolution: Maintain referential integrity across format boundaries
  • Extension Handling: Define extensions for FHIR elements without DICOM equivalents