DICOM Supplement 147
Digital Imaging and Communications in Medicine (DICOM)
Supplement 147: Second Generation Radiotherapy
DICOM Standards Committee, Working Group 7, Radiation Therapy
1300 N. 17th Street, Suite 1752
Rosslyn, Virginia 22209 USA
VERSION: Sup 147 - Revision 42
January 8, 2014
Developed pursuant to DICOM Work Item 2007-06-B
This is a draft document. Do not circulate, quote, or reproduce it except with the approval of NEMA.
Table of Contents
Table of Contents 2
Foreword 11
Scope and Field of Application 11
Part 2 Addendum 12
Part 3 Addendum 13
7.12 Extension of the DICOM model of the real-world for Second Generation Radiotherapy Information Objects 13
7.12.1 RT Course 14
7.12.2 RT Physician Intent 15
7.12.3 Conceptual Volume 15
7.12.4 RT Segment Annotation 15
7.12.5 RT Radiation Set 15
7.12.6 RT Radiation 15
7.12.7 RT Radiation Record 15
7.12.8 RT Dose Image 16
7.12.9 RT Dose Histogram 16
7.12.10 RT Dose Samples 16
7.12.11 RT Treatment Phase 16
A.VV Second Generation Radiation Therapy 20
A.VV.1 Second Generation Radiation Therapy Objects 20
A.VV.1.1 Second Generation Radiation Therapy Common Information 20
A.VV.1.1.1 Second Generation Radiation Therapy Entity-Relationship Model 20
A.VV.1.2 RT Course Information Object Definition 24
A.VV.1.2.1 RT Course IOD Description 24
A.VV.1.2.2 RT Course IOD Entity-Relationship Model 24
A.VV.1.2.3 RT Course IOD Module Table 24
A.VV.1.3 RT Physician Intent Information Object Definition 25
A.VV.1.3.1 RT Physician Intent IOD Description 25
A.VV.1.3.2 RT Physician Intent IOD Entity-Relationship Model 25
A.VV.1.3.3 RT Physician Intent IOD Module Table 25
A.VV.1.4 RT Radiation Set Information Object Definition 25
A.VV.1.4.1 RT Radiation Set IOD Description 25
A.VV.1.4.2 RT Radiation Set IOD Entity-Relationship Model 25
A.VV.1.4.3 RT Radiation Set IOD Module Table 25
A.VV.1.5 RT Segment Annotation Information Object Definition 26
A.VV.1.5.1 RT Segment Annotation IOD Description 26
A.VV.1.5.2 RT Segment Annotation IOD Entity-Relationship Model 26
A.VV.1.5.3 RT Segment Annotation IOD Module Table 26
A.VV.1.6 Tomotherapeutic Radiation Information Object Definition 26
A.VV.1.6.1 Tomotherapeutic Radiation IOD Description 26
A.VV.1.6.2 Tomotherapeutic Radiation IOD Entity-Relationship Model 26
A.VV.1.6.3 Tomotherapeutic Radiation IOD Module Table 26
A.VV.1.7 C-Arm Photon Radiation Information Object Definition 26
A.VV.1.7.1 C-Arm Photon Radiation IOD Description 26
A.VV.1.7.2 C-Arm Photon Radiation IOD Entity-Relationship Model 26
A.VV.1.7.3 C-Arm Photon Radiation IOD Module Table 27
A.VV.1.8 C-Arm Electron Radiation Information Object Definition 27
A.VV.1.8.1 C-Arm Electron Radiation IOD Description 27
A.VV.1.8.2 C-Arm Electron Radiation IOD Entity-Relationship Model 27
A.VV.1.8.3 C-Arm Electron Radiation IOD Module Table 27
A.VV.1.9 Multiple Fixed Source Radiation Information Object Definition 27
A.VV.1.9.1 Multiple Fixed Source Radiation IOD Description 27
A.VV.1.9.2 Multiple Fixed Source Radiation IOD Entity-Relationship Model 27
A.VV.1.9.3 Multiple Fixed Source Radiation IOD Module Table 28
A.VV.1.10 Robotic Radiation Information Object Definition 28
A.VV.1.10.1 Robotic Radiation IOD Description 28
A.VV.1.10.2 Robotic Radiation IOD Entity-Relationship Model 28
A.VV.1.10.3 Robotic Radiation IOD Module Table 28
A.VV.1.11 Multi-Axial Radiation Information Object Definition 28
A.VV.1.11.1 Multi-Axial Radiation IOD Description 28
A.VV.1.11.2 Multi-Axial Radiation IOD Entity-Relationship Model 28
A.VV.1.11.3 Multi-Axial Radiation IOD Module Table 28
A.VV.1.12 RT Dose Image Information Object Definition 29
A.VV.1.12.1 RT Dose Image IOD Description 29
A.VV.1.12.2 RT Dose Image IOD Entity-Relationship Model 29
A.VV.1.12.3 RT Dose Image IOD Module Table 29
A.VV.1.12.4 RT Dose Image IOD Content Constraints 29
A.VV.1.12.5 RT Dose Image Functional Group Macros 29
A.VV.1.13 RT Dose Histogram Information Object Definition 30
A.VV.1.13.1 RT Dose Histogram IOD Description 30
A.VV.1.13.2 RT Dose Histogram IOD Entity-Relationship Model 30
A.VV.1.13.3 RT Dose Histogram IOD Module Table 30
A.VV.1.14 RT Dose Samples Information Object Definition 30
A.VV.1.14.1 RT Dose Samples IOD Description 30
A.VV.1.14.2 RT Dose Samples IOD Entity-Relationship Model 30
A.VV.1.14.3 RT Dose Samples IOD Module Table 30
A.VV.1.15 Tomotherapeutic Radiation Record Information Object Definition 31
A.VV.1.15.1 Tomotherapeutic Radiation Record IOD Description 31
A.VV.1.15.2 Tomotherapeutic Radiation Record IOD Entity-Relationship Model 31
A.VV.1.15.3 Tomotherapeutic Radiation Record IOD Module Table 31
A.VV.1.16 C-Arm Photon Radiation Record Information Object Definition 31
A.VV.1.16.1 C-Arm Photon Radiation Record IOD Description 31
A.VV.1.16.2 C-Arm Photon Radiation Record IOD Entity-Relationship Model 31
A.VV.1.16.3 C-Arm Photon Radiation Record IOD Module Table 31
A.VV.1.17 C-Arm Electron Radiation Record Information Object Definition 32
A.VV.1.17.1 C-Arm Electron Radiation Record IOD Description 32
A.VV.1.17.2 C-Arm Electron Radiation Record IOD Entity-Relationship Model 32
A.VV.1.17.3 C-Arm Electron Radiation Record IOD Module Table 32
A.VV.1.18 Multiple Fixed Source Radiation Record Information Object Definition 32
A.VV.1.18.1 Multiple Fixed Source Record Radiation IOD Description 32
A.VV.1.18.2 Multiple Fixed Source Radiation Record IOD E-R Model 32
A.VV.1.18.3 Multiple Fixed Source Radiation Record IOD Module Table 32
A.VV.1.19 Robotic Radiation Record Information Object Definition 32
A.VV.1.19.1 Robotic Radiation Record IOD Description 32
A.VV.1.19.2 Robotic Radiation Record IOD Entity-Relationship Model 32
A.VV.1.19.3 Robotic Radiation Record IOD Module Table 32
A.VV.1.20 Multi-Axial Radiation Record Information Object Definition 33
A.VV.1.20.1 Multi-Axial Radiation Record IOD Description 33
A.VV.1.20.2 Multi-Axial Radiation Record IOD Entity-Relationship Model 33
A.VV.1.20.3 Multi-Axial Radiation Record IOD Module Table 33
C.AA Second Generation Radiotherapy Modules 34
C.AA.1 Second Generation Radiotherapy Definitions 34
C.AA.1.1 Control Points 34
C.AA.1.1.1 Control Points of Radiations 34
C.AA.1.1.2 Verification Control Points 34
C.AA.1.2 Nominal Energy 34
C.AA.1.3 Fractionation, Fractionation Scheme 34
C.AA.1.4 Treatment RT Radiation Set 34
C.AA.1.5 Meterset 35
C.AA.1.6 Radiation Dose Point 35
C.AA.1.7 Treatment Phase 35
C.AA.2 Second Generation Radiotherapy General-Purpose Macros 36
C.AA.2.1 RT Entity Labeling Macro 36
C.AA.2.1.1 RT Entity Labeling Macro Attribute Description 36
C.AA.2.2 RT Entity Long Labeling Macro 36
C.AA.2.3 RT Item State Macro 37
C.AA.2.3.1 RT Item State Macro Attribute Description 37
C.AA.2.4 RT Operation State Macro 38
C.AA.2.5 Conceptual Volume Macro 40
C.AA.2.5.1 Conceptual Volume Macro Attribute Description 41
C.AA.2.6 Conceptual Volume Combination and Segmentation Macro 41
C.AA.2.6.1 Conceptual Volume Combination and Segmentation Macro Attribute Description 46
C.AA.2.9 Radiation Fraction Pattern Macro 52
C.AA.2.9.1 Radiation Fraction Pattern Macro Attribute Description 52
C.AA.2.10 Treatment Device Identification Macro 54
C.AA.2.11 Device Model Macro 54
C.AA.2.12 RT Patient Support Devices Macro 54
C.AA.2.13 Patient Support Position Macro 55
C.AA.2.14 Device Identification Macro 55
C.AA.2.15 RT Accessory Device Identification Macro 56
C.AA.2.16 Control Point General Attributes Macro 57
C.AA.2.16.1 Control Point Attribute Requirements 57
C.AA.2.17 External Beam Control Point General Attributes Macro 59
C.AA.2.17.1 External Beam Control Point General Attributes Macro Attribute Description 60
C.AA.2.18 External Beam Sub-Control Point General Attributes Macro 60
C.AA.2.18.1 RT Beam Limiting Device Definition Macro Attribute Description 61
C.AA.2.18.1.1 Sub-Control Point Attribute Requirements 61
C.AA.2.18.1.2 Cumulative Radiation Meterset 61
C.AA.2.19 Beam Mode Macro 61
C.AA.2.19.1 Beam Mode 63
C.AA.2.20 RT Beam Limiting Device Definition Macro 64
C.AA.2.20.1 RT Beam Limiting Device Definition Macro Attribute Description 65
C.AA.2.21 RT Beam Limiting Device Positions Macro 65
C.AA.2.22 Wedges Definition Macro 66
C.AA.2.23 Wedge Positions Macro 67
C.AA.2.24 Compensators Definition Macro 68
C.AA.2.24.1 Compensators Definition Macro Attributes Description 71
C.AA.2.25 Blocks Definition Macro 71
C.AA.2.25.1 Blocks Definition Macro Attribute Description 72
C.AA.2.26 Accessory Holder Definition Macro 73
C.AA.2.26.1 Accessory Holder Description 74
C.AA.2.27 General Accessories Definition Macro 74
C.AA.2.28 Boluses Definition Macro 74
C.AA.2.28.1 Bolus Definition Macro Attribute Description 75
C.AA.2.29 Outline Definition Macro 75
C.AA.2.30 RT Tolerance Set Macro 76
C.AA.2.30.1 RT Tolerance Set Attribute Description 77
C.AA.2.30.1.2 Patient Support Position Tolerance Sequence 77
C.AA.2.31 Patient to Equipment Relationship Macro 77
C.AA.2.31.1 Patient to Equipment Relationship Macro Attributes Description 79
C.AA.2.32 RT Treatment Position Macro 79
C.AA.2.33 User Content Identification Macro 80
C.AA.2.33.1 User Content Identification Macro Attribute Description 81
C.AA.2.34 RT Treatment Phase Macro 81
C.AA.2.34.1 RT Treatment Phase Macro Attribute Description 81
C.AA.2.35 RT Treatment Phase Interval Macro 82
C.AA.2.35.1 Referenced Treatment Phases 83
C.AA.A1 Enhanced RT Series Module 84
C.AA.A1.1 Enhanced RT Series Attribute Description 84
C.AA.A1.1.1 Modality 84
C.AA.A2 Radiotherapy Common Instance Module 84
C.AA.A3 RT Course Module 85
C.AA.A3.1 RT Course Attribute Description 87
C.AA.A3.1.1 RT Course Scope Indicator 87
C.AA.A3.1.2 Delivered Radiation Dose Sequence 87
C.AA.A3.1.3 RT Course State Sequence 87
C.AA.A4 RT Prescription Reference Module 87
C.AA.A4.1 RT Prescription Reference Attribute Description 88
C.AA.A4.1.1 RT Item State Macro Meanings 88
C.AA.A5 RT Treatment Phase Module 89
C.AA.A5.1 RT Treatment Phase Attribute Description 89
C.AA.A5.1.1 RT Item State Macro Meanings 89
C.AA.A6 RT Radiation Set Reference Module 90
C.AA.A6.1 RT Radiation Set Reference Attribute Description 95
C.AA.A6.1.1 RT Item State Macro Meanings 95
C.AA.A6.1.2 Radiation Set Start Delay 95
C.AA.A7 RT Course Associated Instance Reference Module 98
C.AA.B1 RT Physician Intent Module 98
C.AA.B1.1 RT Physician Intent Attribute Description 100
C.AA.B1.1.1 RT Physician Intent Sequence 100
C.AA.B1.1.2 RT Protocol Code Sequence 100
C.AA.B1.1.3 RT Diagnostic Image Set Sequence 100
C.AA.B2 RT Prescription Module 100
C.AA.B2.1 RT Prescription Attribute Description 107
C.AA.B2.1.1 Anatomy Property Type Code Sequence 107
C.AA.B2.1.2 Dosimetric Objective Parameter Sequence 108
C.AA.B2.1.3 Dosimetric Objective Parameter Sequence Examples 109
C.AA.B2.1.4 Conceptual Volume Sequence 110
C.AA.B2.1.5 Prescription Anatomy Role 110
C.AA.B2.1.6 Radiobiological Structural Type 110
C.AA.B2.1.7 Dosimetric Objective Priority 110
C.AA.B2.2 Dosimetric Objective Scope 111
C.AA.B3 RT Treatment Phase Intent Module 111
C.AA.C1 RT Radiation Set Module 111
C.AA.C1.1 RT Radiation Set Attribute Description 113
C.AA.C1.1.1 Radiation Set Type 113
C.AA.C1.1.2 Radiation Sequence 113
C.AA.C2 RT Dose Contribution Module 113
C.AA.C2.1 RT Dose Contribution Attribute Description 117
C.AA.C2.1.1 Meterset to Dose Mapping Sequence 117
C.AA.C2.1.2 Conceptual Volume Sequence 118
C.AA.C2.1.3 Primary Dose Value Indicator 118
C.AA.C2.2 Radiation Verification Control Point Description 118
C.AA.C2.2.1 Referenced Control Point 118
C.AA.C2.2.2 Distance Parameters 118
C.AA.C2.2.3 Radiation Dose Value 118
C.AA.D1 RT Segment Annotation Module 118
C.AA.D1.1 RT Segment Annotation Description 122
C.AA.D1.1.1 Segmentation SOP Instance Reference Sequence 122
C.AA.D1.1.2 Alternate Segmented Property Type Code Sequence 123
C.AA.D1.1.3 Segmented Property Type Code Sequence 124
C.AA.D1.1.4 Segmented RT Accessory Device Sequence 124
C.AA.D1.1.5 Direct Segment Reference Sequence 124
C.AA.D1.1.6 Combination Segment Reference Sequence 125
C.AA.D1.1.7 Segment Properties Sequence 125
C.AA.E1 RT Delivery Device Common Module 125
C.AA.E1.1 RT Delivery Device Common Module Attribute Description 126
C.AA.E1.1.3 Equipment Frame of Reference UID 127
C.AA.E2 RT Radiation Common Module 128
C8.A.E2.1 RT Radiation Common Attribute Description 128
C.AA.E2.1.1 Radiotherapy Procedure Technique Sequence 128
C.AA.E2.1.2 RT Treatment Position Macro 128
C.AA.E2.1.3 RT Radiation Data Scope 129
C.AA.E2.1.4 Treatment Times 129
C.AA.F1 Tomotherapeutic Delivery Device Module 129
C.AA.F1.1 Tomotherapeutic Delivery Device Attribute Description 130
C.AA.F1.1.1 Leaf Slot Definition 130
C.AA.F2 Tomotherapeutic Beam Module 130
C.AA.G1 C-Arm Photon-Electron Delivery Device Module 132
C.AA.G2 C-Arm Photon-Electron Beam Module 132
C.AA.G2.1 C-Arm Photon-Electron Beam Attribute Description 134
C.AA.G2.1.1 Radiation Particle 134
C.AA.H1 Multiple Fixed Source Delivery Device Module 134
C.AA.H1.1 Multiple Fixed Source Delivery Device Attribute Description 135
C.AA.H1.1.1 Radiation Source Angles 135
C.AA.H2 Multiple Fixed Source Beam Set Module 135
C.AA.J1 Robotic Delivery Device Module 136
C.AA.J2 Robotic Path Module 136
C.AA.L1 Multi-Axial Delivery Device Module 138
C.AA.L2.1 Multi Axial Delivery Device Attribute Description 139
C.AA.L1.1 Source-Axis Distance 139
C.AA.L2 Multi-Axial Beam Module 139
C.AA.L2.1 Multi Axial Beam Attribute Description 143
C.AA.L2.1.1 Multi-Axial Gantry Angles 143
C.AA.L2.1.2 Gantry Head Angles 143
C.AA.L2.1.3 Multi Axial Beam Delimiter Positions 143
C.AA.M1 Enhanced RT Dose Module 145
C.AA.M1.1 Enhanced RT Dose Attribute Description 151
C.AA.M1.1.1 Dose Scope 151
C.AA.M1.1.2 Radiation Absorption Model 151
C.AA.M2 RT Dose Image Module 152
C.AA.M2.1 RT Dose Image Attribute Description 153
C.AA.M2.1.1 Image Type and Frame Type 153
C.AA.M2.1.2 Dose Grid Geometry 153
C.AA.M2.1.3 Dose Grid Real World Values 153
C.AA.M3 RT Dose Image Functional Group Macros 154
C.AA.M3.1 RT Dose Image Frame Type Macro 154
C.AA.M4 RT Dose Histogram Module 154
C.AA.M4.1 RT Dose Histogram Attribute Description 156
C.AA.M4.1.1 Referenced Segmentation Properties Sequence 156
C.AA.M4.1.2 Dose Histogram Data 156
C.AA.M4.1.3 Dose Histogram Referenced Segment Sequence 156
C.AA.M5 Dose Samples Module 157
C.AA.M5.1 RT Dose Samples Attribute Description 157
C.AA.M5.1.1 Dose Samples Data 157
C.AA.P1 RT Radiation Record Common Module 157
C.AA.P1.1 RT Radiation Record Common Attribute Description 160
C.AA.P1.1.1 Control Point References 160
C.AA.P1.1.2 Referenced RT Patient Setup Sequence 161
C.AA.P2 RT Dose Record Common Module 161
C.AA.P2.1 RT Dose Record Common Module Attribute Description 162
C.AA.P2.1.1 Conceptual Volume Sequence 162
F.5.X Radiotherapy Directory Record Definition 167
C.7.5.1 General Equipment Module 168
C.7.6.3 Image Pixel Module 169
Part 4 Addendum 170
Part 6 Addendum 173
6 Registry of DICOM Data Elements 173
Annex A Registry of DICOM unique identifiers (UID) (Normative) 189
Part 16 Addendum 192
CID 9231 General Purpose Workitem Definition 192
CID SUP147001 Dosimetric Objective Value Types 193
CID SUP147002 Prescription Anatomy Categories 193
CID SUP147003 Radiotherapy Segment Categories 193
CID SUP147004 Radiotherapy Targets 194
CID SUP147005 RT Geometric Information 194
CID SUP147006 Fixation or Positioning Devices 195
CID SUP147007 Brachytherapy Devices 195
CID SUP147009 Segmentation Combination 196
CID SUP147010 Beam Limiting Device Types 196
CID SUP147011 Radiotherapy Robotic Paths 196
CID SUP147012 General External Radiotherapy Procedure Techniques 197
CID SUP147013 Tomotherapeutic Radiotherapy Procedure Techniques 197
CID SUP147014 Treatment RT Radiation Set Alteration Types 198
CID SUP147015 Treatment Termination Reasons 198
CID SUP147016 Compensator Device Types 199
CID SUP147017 Radiotherapy Treatment Machine Modes 199
CID SUP147018 Pre-Treatment RT Radiation Set Roles 199
CID SUP147020 Instance Reference Purposes 200
CID SUP147021 Patient Setup Techniques 200
CID SUP147022 Fixation Device Types 201
CID SUP147023 Shielding Device Types 201
CID SUP147024 Setup Devices 201
CID SUP147025 RT Patient Support Devices 202
CID SUP147026 Dose Statistics 202
CID SUP147027 Fixed Beam Limiting Device Types 202
CID SUP147028 Radiotherapy Wedge Types 203
CID SUP147030 General Accessory Device Types 203
CID SUP147031 Radiotherapy Bolus Device Types 204
CID SUP147032 Radiotherapy Block Device Types 204
CID SUP147033 Radiotherapy Accessory Holder Device Types 204
CID SUP147034 Radiotherapy Dose Real World Units 204
CID SUP147035 Effective Dose Method Code Definition 205
CID SUP147037 Dose Data Source Measurement Definition 205
CID SUP147039 Dose Histogram Spatial Unit Definition 206
CID SUP147040 Segmented RT Accessory Devices 206
CID SUP147041 Dose Algorithm Class 206
CID SUP147042 Energy Unit 207
CID SUP147043 RT Item States 207
CID SUP147044 RT Operation States 208
CID SUP147045 Multi-Source Radiation Technique 208
CID SUP147046 Robotic Radiation Technique 208
CID SUP147047 Radiotherapy Procedure Techniques 209
CID SUP147048 Revised value 209
CID SUP147049 Radiotherapy General Workitem Definition 209
CID SUP147050 Beam Mode Type Definition 210
CID SUP147051 Delivery Rate Unit Definition 210
CID SUP147052 Radiation Particle 210
CID SUP147053 Regulatory Device Identifier Type 211
CID SUP147054 Treatment Delvery Device Type 211
CID SUP147055 Dosimeter Unit Definition 211
CID SUP147060 Single Dose-related Dosimetric Objectives 212
CID SUP147061 Percentage and Dose-related Dosimetric Objectives 212
CID SUP147062 Volume and Dose-related Dosimetric Objectives 212
CID SUP147063 Dimensionless and Dose-related Dosimetric Objectives 213
CID SUP147064 Coded Dosimetric Objectives 213
CID 9241 RADIOTHERAPY GENERAL Radiotherapy Treatment Workitem Definition 214
CID 9242 RADIOTHERAPY ACQUISITION Radiotherapy Acquisition Workitem Definition 214
CID 9243 RADIOTHERAPY REGISTRATION Radiotherapy Registration Workitem Definition 214
Annex C Acquisition and Protocol Context Templates (Normative) 215
TID SUP147001 RT Prescription Annotation 215
TID SUP147003 RT Segment Annotation Properties 217
TID SUP147004 Patient Support Position Parameters 217
Annex D Dicom controlled terminology definitions (normative) 219
Part 17 Addendum 236
Annex Z Second Generation RT (Informative) 236
ZZ.1 Introduction 236
ZZ.2 Entity Descriptions 240
ZZ.2.1 RT Course 240
ZZ.2.2 RT Physician Intent 242
ZZ.2.3 RT Segment Annotation 245
ZZ.2.4 RT Radiation Set 245
ZZ.2.5 RT Radiation 246
ZZ.2.6 RT Dose Image 247
ZZ.2.7 RT Dose Histogram 248
ZZ.2.8 RT Dose Samples 249
ZZ.2.9 RT Radiation Record 250
ZZ.3 Notes on RT Course 251
ZZ.3.1 Introduction 251
ZZ.3.2 Evolution of an RT Course SOP Instance 251
ZZ.3.3 Elements of the RT Course 252
ZZ.3.3.1. Physician Intent 252
ZZ.3.3.2. Treatment Phase 252
ZZ.3.3.3. Radiation Sets 252
ZZ.3.3.4 Clinical State Information 253
ZZ.4 Notes on Second-Generation IODs 254
ZZ.4.1 RT Radiation Set IOD 254
ZZ.4.1.1 General Notes 254
ZZ.4.1.2. Fractionation 254
ZZ.4.1.2. Meterset and other parameters resolution 254
ZZ.4.2 RT Radiation IODs 254
ZZ.4.2.1 Control Points 254
ZZ.4.2.2 Sub-Control Points 254
ZZ.4.3 RT Segment Annotation IOD 254
ZZ.4.3.1 Conceptual Volume 254
ZZ.4.3.2 Segment 255
ZZ.5 Example Use Cases 255
ZZ.5.1 Use Case Actors 255
ZZ.5.2 Treatment Planning Using Managed Workflow 256
ZZ.5.2.1 Message Sequencing 256
ZZ.5.2.2 Transactions and Message Flow 256
ZZ.5.3 Treatment Planning Using Received RT Course 259
ZZ.5.3.1 Message Sequencing 259
ZZ.5.3.2 Transactions and Message Flow 259
ZZ.5.4 Treatment Planning Using DICOM Media 261
ZZ.5.4.1 Message Sequencing 261
ZZ.5.4.2 Transactions and Message Flow 261
ZZ.5.5 Treatment Planning Using Archive Query of RT Course 263
ZZ.5.5.1 Message Sequencing 263
ZZ.5.5.2 Transactions and Message Flow 263
Foreword
This Supplement specifies the additional IODs necessary to support the new Second Generation Radiotherapy IODs and operations.
This document is an extension to the following parts of the published DICOM Standard:
PS 3.2 Conformance
PS 3.3 Information Object Definitions
PS 3.4 Service Class Specifications
PS 3.6 Data Dictionary
PS 3.16 Content Mapping Resource
PS 3.17 Explanatory Information
Scope and Field of Application
Introduction
Existing radiotherapy IODs were designed to provide a set of containers for use in communicating radiation therapy data of all types, in a generic and flexible way.
Since the development of those the initial IODs, both radiation therapy practice and the DICOM Standard itself have evolved considerably. In particular, workflow management is now a key aspect of DICOM’s domain of application, and the introduction of Unified Worklist and Procedure Step (by Supplement 74 in conjunction with Supplement 96) have begun the growth of radiation therapy into workflow management.
This supplement addresses the need for a new generation of IODs and processes required for use in radiation therapy. The general principles under which these IODs and processes have been developed are documented below.
General Architectural Principles
The DICOM “STRATEGIC DOCUMENT Version 10.4, October 25, 2010” outlines a number of principles applicable across the entire DICOM standard. The key relevant points, and how this supplement addresses those concerns, are as follows:
• Image IOD development follows the “enhanced multi-frame” paradigm, rather than stacks of 2D SOP Instances. The new RT Dose Image follows this paradigm.
• Different representations of data are encoded in different IODs. This is in contrast to first-generation objects, where multiple different types of data are encoded in a single IOD, such as RT Structure Set.
• These new IODs do not define an architecture for the entire system, or functional requirements beyond behavior required for specific services. This is because the mode of manual exchange of objects (see PS3.17) supports an arbitrary system architecture. The worklist mode of operation does place some constraints on the architecture – for example, it implies the existence of one or more workflow servers that have knowledge of department-wide scheduling. The Radiation Oncology domain of the IHE initiative may adapt workflows that will utilize 2nd Generation Radiotherapy objects and define their usage in a clinical workflow, as it was done with Supplement 74 and the IHE-RO Technical Profile "Treatment and Delivery Workflow".
RT Architectural Principles
In addition to the general principles outlined above, additional principles specific to radiation therapy have been used in the development of this supplement:
• Support for available technologies: The new IODs are designed to support legacy and full-featured, modern equipment.
• Compatibility with First-Generation IODs: In general, where the technologies continue to be supported, it will be possible for the content of first-generation IODs to be re-encoded into the second generation IODs described in the supplement. However, such a translation will not be a basic re-encoding and will require additional information supplied by the translating device.
• New data representation approaches in DICOM: Where possible, use has been made of new and powerful approaches, such as 3D segmentation, mesh representation, rigid and deformable registrations.
• IODs specific to use cases: Explicit separate IODs have been developed for specific treatment modalities with the concept of RT Radiation IOD – for example, Tomotherapeutic, C-Arm, and Robotic beams are modeled separately. This allows more stringent conditions to be applied to the presence or absence of attributes within those IODs, and thereby increases the potential for interoperability.
• Expandability of concept: New treatment modalities currently not considered by this standard can be modeled along the existing RT Radiation IODs and be introduced later on, fitting into the existing concept.
• Workflow Management: The concept of workflow management using Unified Procedure Step has been fully integrated into the new IODs. However, specific instruction and result IODs needed for some of these workflows will be standardized in a subsequent supplement.
• New techniques in oncology: The existence of new treatment techniques (such as robotic therapy and tomotherapy) have been taken into account, along with new treatment strategies (such as image-guided therapy and adaptive therapy).
See Part 17 for descriptions of new radiotherapy entities and sample use cases.
Part 2 Addendum
Add new SOP Classes to PS3.2 Table A.1-2 UID Values:
|UID Value |UID Name |Category |
|1.2.840.10008.5.1.4.1.1.481.XN.1 |RT Course Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.2 |RT Physician Intent Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.3 |RT Radiation Set Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.4 |RT Segment Annotation Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.5.1 |Tomotherapeutic Radiation Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.5.2 |C-Arm Photon Radiation Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.5.3 |C-Arm Electron Radiation Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.5.4 |Multiple Fixed Source Radiation Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.5.5 |Robotic Radiation Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.5.7 |Multi-Axial Radiation Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.6.1 |Tomotherapeutic Radiation Record Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.6.2 |C-Arm Photon Radiation Record Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.6.3 |C-Arm Electron Radiation Record Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.6.4 |Multiple Fixed Source Radiation Record Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.6.5 |Robotic Radiation Record Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.6.7 |Multi-Axial Radiation Record Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.7.1 |RT Dose Image Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.7.2 |RT Dose Histogram Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.7.3 |RT Dose Samples Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.8 |RT Patient Setup Storage |Transfer |
|1.2.840.10008.5.1.4.1.1.481.XN.20 |Radiation Set Delivery Instruction Storage |Workflow Management |
Part 3 Addendum
Add the following in PS3.3 Chapter 7 DICOM model of the real-world
7.12 Extension of the DICOM model of the real-world for Second Generation of Radiotherapy Information Objects
For the purpose of Radiotherapy Second Generation SOP Classes the DICOM Model of the Real-World is described in this section. This subset of the real-world model covers the requirements for transferring information about planned and performed radiotherapeutic treatments and associated data.
Figure 7.12-1 describes the most important elements involved in radiotherapy domain in DICOM.
[pic]
Figure 7.12-1 — DICOM MODEL OF THE REAL WORLD – RADIOTHERAPY
7.12.1 RT Course
The RT Course is a top-level entity that represents a radiotherapy treatment course, specified in one or more RT Pprescriptions, generally for a defined tumor or group of tumors. A patient undergoing treatments of radiotherapy has one treatment course at a time. The RT Course may consist of several Treatment Phases (possibly with breaks of treatment in between them); each Phase may consist of one or more Treatment Sessions. A Treatment Session is delivered in one patient visit to a venue with a treatment machine and will typically deliver a fraction of one or more Radiation Sets. A new RT Course is administered, when the patient is treated for a re-occurrence or a new tumor site – typically after a period of a year or more after the previous RT Course has been finished.
The RT Course is to be seencan be thought of as a container as a binder collecting all major objects which are relevant to this course. The most important objects are the Physician Intent and RT Radiation Sets; they in turn reference other companion objects necessary to prepare, conduct and review the treatment. Timing information (start dates and phasing of treatment, breaks etc.) are also part of the RT Course entity information. Additionally it contains information of the ongoing status in treatment planning and delivery. The RT Course is a dynamic object thattherefore represents the current status of the patient’s treatment.
The RT Course may also include information about previously conducted treatments bye referencing previous RT Course objectss or by directly recording the information in attributes to record information about previous treatment having been available in any other form.
7.12.2 RT Physician Intent and Prescription
The RT Physician Intent represents the prescription content: it describes how the physician wishes to achieve curative or palliative therapy. This information includes, but is not limited to the use of external radiation therapy or brachytherapy, total and fractional doses and fractionation schemes, treatment sites, dosimetric objectives, envisioned treatment technique and beam energy, and patient setup notes.
7.12.3 Conceptual Volume
The Conceptual Volume serves asis a reference to a certain anatomical region or point where therapeutic doses or dosimetric constraints are specified, calculated and tracked during the course of treatment. For exaaxmple at the time of prescription, physicians specify regions to which dose is prescribed to. Subsequently those regions are referenced in other objects in order to track calculated and delivered dose in the course of treatment. This referencing capability is provided by the Conceptual Volume facility. Conceptual Volumes may or may not have a representation in segmented images, e.g. in case of ‘emergency’ treatments, sites may be treated which are not volumetrically segmented, but still are to be identified by labeling and textual annotations to be able to track doses. In most cases though, they will be related to one or more volumetric representations in various image sets taken at different times during the course of treatment.
7.12.4 RT Segment Annotation
The RT Segment Annotation annotates segmented regions defined in other SOP Instances with radiotherapy-specific information about the role and RT-specific types of the regions (e.g. clinical target volume, organ at risk, bolus), and other information such as density definitions. An RT Segment Annotation SOP instance always references one of these three general-purpose representation entities: Segmentation, Surface Segmentation or RT Structure Set.
7.12.5 RT Radiation Set
An RT Radiation Set is a collection of RT Radiations. An RT Radiation Set which constitute defines a fraction of a radiation therapy treatment fraction, which will be applied one or more times. The RT Radiation Set is treated delivered by delivering the radiation of all referenced RT Radiations which are included in this set.
Parallel and intermittent fractionation schemes, e.g. treatment ofto several target sites within different timing schemes, are represented by different multiple RT Radiation Sets, where each set consists of the group of beams.
7.12.6 RT Radiation
An RT Radiation is a contiguous set of control points, describing machine and positioning parameters to be applied during treatment delivery. An RT Radiation describes one portion of an RT Radiation Set; this is perceived as and represents an uninterrupted delivery of therapeutic radiation and intended to be delivered in an contiguous and indivisible manner. An RT Radiation is typically referred to in end-user terminology used as a in external beam treatment to annotate an RT Radiation entity is beam (in external beam treatment) or a catheter (or in Bbrachytherapy) a catheter. An RT Radiation is a contiguous set of control points, describing machine and positioning parameters to be applied during treatment delivery.
7.12.7 RT Radiation Record
The RT Radiation Record represents a records of actual treatment parameters which have been applied during thea delivery of a fractionof an RT Radiation in the context of a specific fraction. Typically, those parameters are the same as those described within an RT Radiation, but may differ due to therapist decisions and/or circumstances of the delivery technology and/or for various other reasons.
7.12.8 RT Dose Image
The RT Dose Image contains the representation of a 3-dimensional dose distribution using the multi-frame and functional group paradigms. This dose distribution may represent entity has references to treatment parameter scope definitions (likethe planned or delivered dose corresponding to an RT Radiation Set orf an individual RT Radiation) which have been utilized to calculate the dose.
7.12.9 RT Dose Histogram
The RT Dose Histogram describes dose-volume histogram data, based on a volumetric dose calculation and references a segmented Conceptual Volume and an RT Segment Annotation object that annotates the anatomical region where the histogram applies.
7.12.10 RT Dose Samples
The RT Dose Samples allows represents a representation of dose point data, which are calculated or measured.
7.12.11 RT Treatment Phase
An RT Course may be divided into multiple RT Treatment Phases. The Each RT Treatment Phase represents a period of time during which a defined number of treatment fractionss are delieverd by RT Radiation Sets is delivered to the patient in order to reach a specific treatment goal. In some cases a different treatment phase may follow one already delivered with a defined break in-between.
Add the following columns in PS3.3 Section A.1.4, Table A.1-3 COMPOSITE INFORMATION OBJECT MODULES OVERVIEW – RADIOTHERAPY
|IODs |RT Course |RT Phys Intent |RT Rad Set |
|Modules | | | |
|Patient |Patient |C.7.1.1 |M |
| |Clinical Trial Subject |C.7.1.3 |U |
|Study |General Study |C.7.2.1 |M |
| |Patient Study |C.7.2.2 |U |
| |Clinical Trial Study |C.7.2.3 |U |
|Series |General Series |C.7.3.1 |M |
| |Clinical Trial Series |C.7.3.2 |U |
| |Enhanced RT Series |C.AA.A0 |M |
|Equipment |General Equipment |C.7.5.1 |M |
| |Enhanced General Equipment |C.7.5.2 |M |
|Common Instance-level |Radiotherapy Common Instance Module |C.AA.A2 |M |
|IEs | | | |
| |Common Instance Reference Module |C.12.2 |M |
| |SOP Common |C.12.1 |M |
A.VV.1.1.1.4 RT Radiation IOD Modules Macro
Specific RT Radiation IODs (Tomotherapeutic Radiation IOD, C-Arm Photon Radiation IOD, etc.) share common modules as defined in the following Table A.VV.1.1.1-2. This macro is always used in conjunction with the specific RT Radiation IODs.
Table A.VV.1.1.1-2
RT RADIATION IOD MODULES MACRO
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|Frame of Reference |Frame of Reference |C.7.4.1 |M |
|RT Radiation |RT Delivery Device Common |C.AA.E1 |M |
| |RT Radiation Common |C.AA.E2 |M |
A.VV.1.1.1.5 RT Radiation Record IOD Modules Macro
Specific RT Radiation Record IODs (Tomotherapeutic Radiation Record IOD, C-Arm Photon Radiation Record IOD, etc.) share common modules as defined in the following Table A.VV.1.1.1-3. This macro is always used in conjunction with the specific RT Radiation Record IODs.
Table A.VV.1.1.1-3
RT RADIATION RECORD IOD MODULES MACRO
|IE |Module |Reference |Usage |
|RT Treated Radiation |RT Radiation Record Common |C.AA.P1 |M |
| |RT Dose Record Common |C.AA.P2 |M |
A.VV.1.2 RT Course Information Object Definition
A.VV.1.2.1 RT Course IOD Description
The RT Course IOD binds together various entities needed in radiotherapy for preparation, execution and review of radiotherapeutic treatment of a patient. It facilitates complete archiving of a patient RT treatment delivery and communication of data needed for planning or treatment steps not managed by DICOM workflow.
The content of an RT Course may undergo frequent updates resulting in a new SOP Instance UID following each update. As a result, querying for the current Each query on an RT Course object may create return a new SOP Instance UID different than previously used to access the object because content details change often.
It is not necessary to keep track of all versions triggered by such queries. A system keeping the RT Course could store some historical versions at some point in time when clinically of interest (e.g. in between two series of radiation). Those persistent versions are tracked in this sequence for later retrieval. Note however, that for essential information about the whole treatment course, the latest SOP Instance is always sufficient.
See PS 3.17Part 17 for further explanation.
A.VV.1.2.2 RT Course IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.2.3 RT Course IOD Module Table
Table A.VV.1.2-4
RT COURSE IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|RT Course |RT Course |C.AA.A3 |M |
| |RT Prescription Reference |C.AA.A4 |C |
| | | |Required if RT Prescription Reference Presence |
| | | |Flag (30xx,0805) equals YES. |
| |RT Treatment Phase |C.AA.A5 |C |
| | | |Required if RT Treatment Phase Presence Flag |
| | | |(30xx,0806) equals YES. |
| |RT Radiation Set Reference |C.AA.A6 |C |
| | | |Required if RT Radiation Set Reference Presence |
| | | |Flag (30xx,0807) equals YES. |
| |RT Course Associated Instance |C.AA.A7 |U |
| |Reference | | |
A.VV.1.3 RT Physician Intent Information Object Definition
A.VV.1.3.1 RT Physician Intent IOD Description
The RT Physician Intent carries the prescriptions by which the physician describes the therapeutic goal and strategy for the radiotherapeutic treatment.
A.VV.1.3.2 RT Physician Intent IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.3.3 RT Physician Intent IOD Module Table
Table A.VV.1.3-1
RT PHYSICIAN INTENT IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|RT Physician Intent |RT Physician Intent |C.AA.B1 |M |
| |RT Prescription |C.AA.B2 |U |
| |RT Treatment Phase Intent |C.AA.B3 |C |
| | | |Required if RT Treatment Phase Presence Flag |
| | | |(30xx,0806) equals YES. |
A.VV.1.4 RT Radiation Set Information Object Definition
A.VV.1.4.1 RT Radiation Set IOD Description
The RT Radiation Set represents a set of radiation deliveries which are intended to be delivered together in a single fraction. The RT Radiation Set also contains a description of the fractionation pattern and the Number of Fractions and the associated dose contributions. See Part 17 for further explanation.
A.VV.1.4.2 RT Radiation Set IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.4.3 RT Radiation Set IOD Module Table
Table A.VV.1.4-1
RT RADIATION SET IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|RT Radiation Set |RT Radiation Set |C.AA.C1 |M |
| |RT Dose Contribution |C.AA.C2 |C |
| | | |Required if RT Dose Contribution Presence Flag|
| | | |(30xx,5012) equals YES. |
A.VV.1.5 RT Segment Annotation Information Object Definition
A.VV.1.5.1 RT Segment Annotation IOD Description
The RT Segment Annotation IOD annotates a Segmentation IOD, Surface Segmentation IOD, or RT Structure Set IOD with radiotherapy-specific information that cannot be encoded in the content of the annotated SOP Instance, or overrides that content with new or additional interpretation.
A.VV.1.5.2 RT Segment Annotation IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.5.3 RT Segment Annotation IOD Module Table
Table A.VV.1.5-1
RT SEGMENT ANNOTATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|RT Segment Annotation|RT Segment Annotation |C.AA.D1 |M |
A.VV.1.6 Tomotherapeutic Radiation Information Object Definition
A.VV.1.6.1 Tomotherapeutic Radiation IOD Description
The Tomotherapeutic Radiation IOD represents the information required to describe a radiotherapy treatment on a serial or helical tomotherapeutic delivery device.
A.VV.1.6.2 Tomotherapeutic Radiation IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.6.3 Tomotherapeutic Radiation IOD Module Table
Table A.VV.1.6-1
TOMOTHERAPEUTIC RADIATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Radiation IOD Modules Macro' Table A.VV.1.1.1-2 |
|RT Radiation |Tomotherapeutic Delivery Device |C.AA.F1 |M |
| |Tomotherapeutic Beam |C.AA.F2 |M |
A.VV.1.6.3.1 RT Radiation Common Module in RT Radiation IOD Modules Macro
For the Tomotherapeutic Radiation IOD, the Code Sequence Macro in the Radiotherapy Procedure Technique Sequence (30xx,0C99) in the RT Radiation Common Module will shall use Defined CID SUP147013.
A.VV.1.7 C-Arm Photon Radiation Information Object Definition
A.VV.1.7.1 C-Arm Photon Radiation IOD Description
The C-Arm Photon Radiation IOD represents the information required to describe a radiotherapy treatment on a C-Arm photon delivery device.
A.VV.1.7.2 C-Arm Photon Radiation IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.7.3 C-Arm Photon Radiation IOD Module Table
Table A.VV.1.7-1
C-ARM PHOTON RADIATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Radiation IOD Modules Macro' Table A.VV.1.1.1-2 |
|RT Radiation |C-Arm Photon-Electron Delivery Device |C.AA.G1 |M |
| |C-Arm Photon-Electron Beam |C.AA.G2 |M |
A.VV.1.7.3.1 RT Radiation Common Module in RT Radiation IOD Modules Macro
For the C-Arm Photon Radiation IOD, the Code Sequence Macro in the Radiotherapy Procedure Technique Sequence (30xx,0C99) in the RT Radiation Common Module will shall use Defined CID SUP147012.
A.VV.1.8 C-Arm Electron Radiation Information Object Definition
A.VV.1.8.1 C-Arm Electron Radiation IOD Description
The C-Arm Electron Radiation IOD represents the information required to describe a radiotherapy treatment on a C-Arm electron delivery device.
A.VV.1.8.2 C-Arm Electron Radiation IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.8.3 C-Arm Electron Radiation IOD Module Table
Table A.VV.1.8-1
C-ARM ELECTRON RADIATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Radiation IOD Modules Macro' Table A.VV.1.1.1-2 |
|RT Radiation |C-Arm Photon-Electron Delivery Device |C.AA.G1 |M |
| |C-Arm Photon-Electron Beam |C.AA.G2 |M |
A.VV.1.8.3.1 RT Radiation Common Module in RT Radiation IOD Modules Macro
For the C-Arm Electron Radiation IOD, the Code Sequence Macro in the Radiotherapy Procedure Technique Sequence (30xx,0C99) in the RT Radiation Common Module will shall use Defined CID SUP147012.
A.VV.1.9 Multiple Fixed Source Radiation Information Object Definition
A.VV.1.9.1 Multiple Fixed Source Radiation IOD Description
The Multiple Fixed Source Radiation IOD represents the information required to describe a radiotherapy treatment on a multiple fixed source photon delivery device.
A.VV.1.9.2 Multiple Fixed Source Radiation IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.9.3 Multiple Fixed Source Radiation IOD Module Table
Table A.VV.1.9-1
MULTIPLE FIXED SOURCE RADIATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Radiation IOD Modules Macro' Table A.VV.1.1.1-2 |
|RT Radiation |Multiple Fixed Source Delivery Device |C.AA.H1 |M |
| |Multiple Fixed Source Beam Set |C.AA.H2 |M |
A.VV.1.9.3.1 RT Radiation Common Module in RT Radiation IOD Modules Macro
For the Multiple Fixed Source Radiation IOD, the Code Sequence Macro in the Radiotherapy Procedure Technique Sequence (30xx,0C99) in the RT Radiation Common Module will shall use Defined CID SUP147045.
A.VV.1.10 Robotic Radiation Information Object Definition
A.VV.1.10.1 Robotic Radiation IOD Description
The Robotic Radiation IOD represents the information required to describe a radiotherapy treatment on a robotic delivery device, such as paths, nodes, and collimation type.
A.VV.1.10.2 Robotic Radiation IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.10.3 Robotic Radiation IOD Module Table
Table A.VV.1.10-1
ROBOTIC RADIATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Radiation IOD Modules Macro' Table A.VV.1.1.1-2 |
|RT Radiation |Robotic Delivery Device |C.AA.J1 |M |
| |Robotic Path |C.AA.J2 |M |
A.VV.1.10.3.1 RT Radiation Common Module in RT Radiation IOD Modules Macro
For the Robotic Radiation IOD, the Code Sequence Macro in the Radiotherapy Procedure Technique Sequence (30xx,0C99) in the RT Radiation Common Module will shall use Defined CID SUP147046.
A.VV.1.11 Multi-Axial Radiation Information Object Definition
A.VV.1.11.1 Multi-Axial Radiation IOD Description
The Multi-Axial Radiation IOD represents the information required to describe a radiotherapy treatment on a C-arm device having additional degrees of freedom in source positioning.
A.VV.1.11.2 Multi-Axial Radiation IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.11.3 Multi-Axial Radiation IOD Module Table
Table A.VV.1.11-1
MULTI-AXIAL RADIATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Radiation IOD Modules Macro' Table A.VV.1.1.1-2 |
|RT Radiation |Multi-Axial Delivery Device |C.AA.L1 |M |
| |Multi-Axial Beam |C.AA.L2 |M |
A.VV.1.11.3.1 RT Radiation Common Module in RT Radiation IOD Modules Macro
For the Multi-Axial Radiation IOD, the Code Sequence Macro in the Radiotherapy Procedure Technique Sequence (30xx,0C99) in the RT Radiation Common Module will shall use Defined CID SUP147012.
A.VV.1.12 RT Dose Image Information Object Definition
A.VV.1.12.1 RT Dose Image IOD Description
The RT Dose Image IOD represents 2D or 3D calculated or measured dose distributions in the DICOM Patient Coordinate System. This IOD does not provide for definition of doses in beam or other coordinate systems. The application is responsible for transforming data in other, non-patient based coordinate systems to the patient based coordinate system described in C.7.6.2.1.1.
A.VV.1.12.2 RT Dose Image IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.12.3 RT Dose Image IOD Module Table
Table A.VV.1.12-1
RT DOSE IMAGE IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|Frame of Reference |Frame of Reference |C.7.4.1 |M |
| |Synchronization |C.7.4.2 |C – Required if time synchronization was |
| | | |applied. |
|RT Dose Image |Image Pixel |C.7.6.3 |M |
| |Multi-frame Functional Groups |C.7.6.16 |M |
| |Multi-frame Dimension |C.7.6.17 |M |
| |Respiratory Synchronization |C.7.6.18.2 |C – Required if respiratory |
| | | |synchronization was applied. |
| |Acquisition Context |C.7.6.14 |M |
| |Enhanced RT Dose |C.AA.M1 |M |
| |RT Dose Image |C.AA.M2 |M |
A.VV.1.12.4 RT Dose Image IOD Content Constraints
The General Image Module, Overlay Plane Module, Curve Module and VOI LUT Module shall not be used in a Standard Extended SOP Class of the RT Dose Image IOD.
A.VV.1.12.5 RT Dose Image Functional Group Macros
Table A.VV.1.12-2
RT DOSE IMAGE FUNCTIONAL GROUP MACROS
|Function Group Macro |Section |Usage |
|Pixel Measures |C.7.6.16.2.1 |M – Shall be used as a Shared Functional Group |
|Plane Position (Patient) |C.7.6.16.2.3 |M – Shall be used as a Per-Frame Functional Group |
|Plane Orientation (Patient) |C.7.6.16.2.4 |M – Shall be used as a Shared Functional Group |
|Respiratory Trigger |C.7.6.16.2.17 |C – Required if Respiratory Synchronization Technique is used. |
| | |May be present otherwise. |
|RT Dose Image Frame Type |C.AA.M3.1 |M |
|Real World Value Mapping |C.7.6.16.2.11 |M – Shall be used as a Shared Functional Group |
| | |Defined CID for Measurement Units Code Sequence (0040,08EA) |
| | |shall be SUP147034. |
A.VV.1.13 RT Dose Histogram Information Object Definition
A.VV.1.13.1 RT Dose Histogram IOD Description
The RT Dose Histogram IOD specifies dose-volume histogram (DVH) and dose-area histogram data and statistics, calculated by radiotherapy treatment planning systems.
A.VV.1.13.2 RT Dose Histogram IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.13.3 RT Dose Histogram IOD Module Table
Table A.VV.1.13-1
RT DOSE HISTOGRAM RADIATION IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|RT Dose Histogram |Acquisition Context |C.7.6.14 |M |
| |Enhanced RT Dose |C.AA.M1 |M |
| |RT Dose Histogram |C.AA.M4 |M |
A.VV.1.14 RT Dose Samples Information Object Definition
A.VV.1.14.1 RT Dose Samples IOD Description
The RT Dose Samples IOD specifies a list of spatial locations and associated dose values created by a treatment planning system or dose measurement device. Spatial locations are specified in the patient based coordinate system described in C.7.6.2.1.1.
A.VV.1.14.2 RT Dose Samples IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.14.3 RT Dose Samples IOD Module Table
Table A.VV.1.14-1
RT DOSE SAMPLES IOD MODULES
|IE |Module |Reference |Usage |
|Include 'RT Second Generation IOD Modules Macro' Table A.VV.1.1.1-1 |
|Frame of Reference |Frame of Reference |C.7.4.1 |M |
| |Synchronization |C.7.4.2 |C – Required if time |
| | | |synchronization was applied.|
|RT Dose Samples |Acquisition Context |C.7.6.14 |M |
| |Enhanced RT Dose |C.AA.M1 |M |
| |Dose Samples |C.AA.M5 |M |
A.VV.1.15 Tomotherapeutic Radiation Record Information Object Definition
A.VV.1.15.1 Tomotherapeutic Radiation Record IOD Description
The Tomotherapeutic Radiation Record IOD records the radiation delivered using the Tomotherapeutic Radiation IOD.
A.VV.1.15.2 Tomotherapeutic Radiation Record IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.15.3 Tomotherapeutic Radiation Record IOD Module Table
Table A.VV.1.15-1
TOMOTHERAPEUTIC RADIATION RECORD IOD MODULES
|IE |Module |Reference |Usage |
|Include 'Tomotherapeutic Radiation IOD Modules' Table A.VV.1.6-1 |
|Include 'RT Radiation Record IOD Modules Macro' Table A.VV.1.1.1-3 |
A.VV.1.16 C-Arm Photon Radiation Record Information Object Definition
A.VV.1.16.1 C-Arm Photon Radiation Record IOD Description
The C-Arm Photon Radiation Record IOD records the radiation delivered using the C-Arm Photon Radiation IOD.
A.VV.1.16.2 C-Arm Photon Radiation Record IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.16.3 C-Arm Photon Radiation Record IOD Module Table
Table A.VV.1.16-1
C-ARM PHOTON RADIATION RECORD IOD MODULES
|IE |Module |Reference |Usage |
|Include ‘C-Arm Photon Radiation IOD Modules’ Table A.VV.1.7-1 |
|Include ’RT Radiation Record IOD Modules’ Table A.VV.1.1.1-3 |
A.VV.1.17 C-Arm Electron Radiation Record Information Object Definition
A.VV.1.17.1 C-Arm Electron Radiation Record IOD Description
The C-Arm Electron Radiation Record IOD records the radiation delivered using the C-Arm Electron Radiation IOD.
A.VV.1.17.2 C-Arm Electron Radiation Record IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.17.3 C-Arm Electron Radiation Record IOD Module Table
Table A.VV.1.17-1
C-ARM ELECTRON RADIATION RECORD IOD MODULES
|IE |Module |Reference |Usage |
|Include ‘C-Arm Electron Radiation IOD Modules’ Table A.VV.1.8-1 |
|Include ‘RT Radiation Record IOD Modules’ Table A.VV.1.1.1-3 |
A.VV.1.18 Multiple Fixed Source Radiation Record Information Object Definition
A.VV.1.18.1 Multiple Fixed Source Record Radiation IOD Description
The Multiple Fixed Source Radiation Record IOD records the radiation delivered using the Multiple Fixed Source Radiation IOD.
A.VV.1.18.2 Multiple Fixed Source Radiation Record IOD E-R Model
See Figure A.VV.1.1.1-1.
A.VV.1.18.3 Multiple Fixed Source Radiation Record IOD Module Table
Table A.VV.1.18-1
MULTIPLE FIXED SOURCE RADIATION RECORD IOD MODULES
|IE |Module |Reference |Usage |
|Include ‘Multiple Fixed Source Radiation IOD Modules’ Table A.VV.1.9-1 |
|Include ‘RT Radiation Record IOD Modules’ Table A.VV.1.1.1-3 |
A.VV.1.19 Robotic Radiation Record Information Object Definition
A.VV.1.19.1 Robotic Radiation Record IOD Description
The Robotic Radiation Record IOD records the radiation delivered using the Robotic Radiation IOD.
A.VV.1.19.2 Robotic Radiation Record IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.19.3 Robotic Radiation Record IOD Module Table
Table A.VV.1.19-1
ROBOTIC RADIATION RECORD IOD MODULES
|IE |Module |Reference |Usage |
|Include ‘Robotic Radiation IOD Modules’ Table A.VV.1.10-1 |
|Include ‘RT Radiation Record IOD Modules Table A.VV.1.1.1-3 |
A.VV.1.20 Multi-Axial Radiation Record Information Object Definition
A.VV.1.20.1 Multi-Axial Radiation Record IOD Description
The Multi-Axial Radiation Record IOD records the radiation delivered using the Multi-Axial Radiation IOD.
A.VV.1.20.2 Multi-Axial Radiation Record IOD Entity-Relationship Model
See Figure A.VV.1.1.1-1.
A.VV.1.20.3 Multi-Axial Radiation Record IOD Module Table
Table A.VV.1.20-1
MULTI-AXIAL RADIATION RECORD IOD MODULES
|IE |Module |Reference |Usage |
|Include ‘Multi-Axial Radiation IOD Modules’ Table A.VV.1.11-1 |
|Include ‘RT Radiation Record IOD Modules’ Table A.VV.1.1.1-3 |
Add the following to PS3.3 Annex C:
C.AA Second Generation Radiotherapy Modules
The following macros and modules are used by the second generation radiotherapy IODs.
C.AA.1 Second Generation Radiotherapy Definitions
This chapter section lists some of the most-often used terms in the scope of Second Generation Radiotherapy Modules and provides definitions for a better understanding.
NeverthelessNotes:, 1. Tthis ssection does not replace a profound understanding of clinical knowledge related to radiotherapy treatments.
2. Please also refer to See the explanations to in Sectionchapter 7.12 “Extension of the DICOM model of the real-world for Second Generation of Radiotherapy Information Objects”, to the in IOD definitions in Sectionchapter A.VV.1 and to in Part PS 3.17 Addendum Annex ZZ.
C.AA.1.1 Control Points
A Control Point represents the planned state of a (delivery) device at one of a series sequence of instances states defined by a progress variable. For radiation delivery the Cumulative Radiation Meterset (30xx,5021) is the progress variable is the Cumulative Radiation Meterset (30xx,5021).
The Control Point Sequence represents the geometric and radiological parameters as a sequence of states at specified values of the Cumulative Radiation Meterset. The sequence is used by the delivery device to implement a planned delivery and to record the actual delivery.
Some treatment modalities may use sub-control points to specify changes of a subset of parameters within a control point.
C.AA.1.1.1 Verification Control Points
Verification Control Points represent the expected expected cumulative dose for a set of geometric parameters. Verification is performed by comparing the expected dose at a Verification Control Point to a corresponding dose. The corresponding dose may be directly measured or recalculated.
The purpose of Verification Control Points is to verify the dose (e.g. by measuring or calculating) by comparing it to planned dose.
C.AA.1.2 Nominal Energy
A nominal energy is an equipment setting used by the manufacturer to characterize the penetration of the beam into a material. For photon beam delivery, the maximum energy of the delivered photon spectrum is typically specified. For electron beam delivery, the most probable energy of the spectrum is typically specified.
C.AA.1.3 Fractionation, Fractionation Scheme
Fractionation describes the splitting of a course of radiation into multiple sessions. Each session may consist of the delivery of one or more RT Radiation Sets. Traditionally, in ionizing radiation treatments, fractionation allows healthy tissue to recover from radiation effects over the course of treatment. The temporal pattern of deliveries is termed called a fractionation scheme.
C.AA.1.4 Treatment RT Radiation Set
A The term Treatment RT Radiation Set is used to indicate an RT Radiation Set that has been selected for treatment, is being treated, or has been treated. RT Radiation Sets which are not called Treatment RT Radiation Set include alternatives or rejected proposals for treatment.
C.AA.1.5 Meterset
A parameter from which, through a calibration procedure with additional information, the absorbed dose delivered can be calculated. (fFor meterset representing monitor units, the definition is based on IEC 60601-2-64).,
The meterset can be is used to measure the progress of radiation delivery during treatment, or report on progress after treatment.
C.AA.1.6 Radiation Dose Point
A point chosen in space, or in the patient treatment volume, to measure or plan for a specific amount of radiation. The point usually is placed at a significant location, such as within a tumor, or within healthy tissue to be spared or where a measurement device can be positioned.
C.AA.1.7 Treatment Phase
A specific period within a treatment course when the prescribed medical treatment is applied to the patient. Typically, if more than one RT Radiation Set is delivered, they are in overlapping or sequential phases.
C.AA.2 Second Generation Radiotherapy General-Purpose Macros
C.AA.2.1 RT Entity Labeling Macro
The RT Entity Labeling Macro contains the attributes needed to identifiesy a radiotherapy concept using a 16-character label, a name, and a description.
This information is intended only for display to human readers and shall not be used programmatically.
Table C.AA.2.1-1
RT ENTITY LABELING MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|RT Entity Label |(30xx,51E2) |1 |User defined label for this entity. |
| | | |See C.AA.2.1.1.1. |
|RT Entity Name |(30xx,51E3) |3 |User defined name for this entity. |
| | | |See C.AA.2.1.1.2. |
|RT Entity Description |(30xx,51E4) |3 |User defined description for this entity. |
| | | |See C.AA.2.1.1.2. |
C.AA.2.1.1 RT Entity Labeling Macro Attribute Description
C.AA.2.1.1.1 RT Entity Label
The RT Entity Label (30xx,51E2) attribute represents a user-definable short free text providing the primary identification of this entity to other users. The label may be used to provide unique identification to the user.
C.AA.2.1.1.2 RT Entity Name and RT Entity Description
The optional attribute RT Entity Name (30xx,51E3) allows a longer string containing additional descriptive identifying text for one-line headings etc. The optional attribute RT Entity Description (30xx,51E4) allows adding additional information when needed.
C.AA.2.2 RT Entity Long Labeling Macro
The RT Entity Long Labeling Macro contains the attributes needed to identifiesy a radiotherapy concept using a 64-character label and a description.
This information is intended only for display to human readers and shall not be used programmatically.
Table C.AA.2.2-1
RT ENTITY LONG LABELING MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|RT Entity Long Label |(30xx,51E5) |1 |User defined label for this entity. |
| | | |See C.AA.2.1.2.1 |
|RT Entity Description |(30xx,51E4) |3 |User defined description for this entity. |
| | | |See C.AA.2.1.1.2. |
C.AA.2.1.2.1 RT Entity Long Label
The RT Entity Long Label (30xx,51E5) attribute represents a user-definable free text providing the primary identification of this entity to other users. The label may be used to provide unique identification to the user.
C.AA.2.3 RT Item State Macro
This macro may beis invoked to record the clinical state, such as approval or review,ed of either an entire SOP Instance or for a specific part of the information content of a SOP Instance.
Table C.AA.2.3-1
RT ITEM STATE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|RT Item State Sequence |(30xx,5080) |1 |States that have been set on the item that the|
| | | |RT Item State belongs to. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Include 'Assertion Macro' Table 10-XW1-1 |No Baseline CID defined. |
|(Editor’s Note: That Macro is defined in Sup 121. The version referenced in |See C.AA.2.3.1.1. |
|here is Sup 121_pc, 2013-04-11) | |
|>Active Item Indicator |(30xx,5082) |1 |Indicator of the active versus historic status|
| | | |of this item. |
| | | |Enumerated Values: |
| | | |ACTIVE |
| | | |HISTORIC |
| | | |See C.AA.2.3.1.2. |
|> RT Item State Creation Authority Description |(30xx,5084) |3 |User defined description of authority used to |
|Sequence | | |create this Item State entry. |
|>>Include 'HL7v2 Hierarchic Designator' Macro Table 10-17 |
C.AA.2.3.1 RT Item State Macro Attribute Description
C.AA.2.3.1.1 RT Item State Sequence
The RT Item State Sequence (30xx,5080) contains a sequence of items which define the state. The CIDs which define the codes to be used in Assertion Code Sequence (30xx,50A0) attribute of the Assertion Macro are defined at the invocation of the macro.
C.AA.2.3.1.2 Active Item Indicator
The Active Item Indicator (30xx,5082) attribute is used to specify which state definiton items in the RT Item State Sequence (30xx,5080) are active and which items do only convey an audit trail of states having been in place in the past at the time the SOP instance was created.
This indication additionally allows conveying more than one state entry of different persons as being active. E.g. if the department requires approvals by more than one person, several items having an approved state can be marked as active, indicating the list of persons having provided approval.
The semantics of the states are defined in the code definition and may be further specialized at invocation of that macro. Which state transitions are allowed and which are the pre-conditions to perform a state transition if outside of the scope of the standard.
C.AA.2.4 RT Operation State Macro
This macro describes the attributes that record the operation state of referenced SOP Instances. The RT Operation State encodes the progress of the entity through the delivery process, rather than the approval status as encoded in RT Item State (see Section C.AA.2.3).
The initial state of a SOP Instance, to which the sequence applies, is undefined and specified by an empty sequence.
Table C.AA.2.4-1
RT OPERATION STATE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|RT Operation State Sequence |(30xx,5086) |2 |Operation state of the item the state belongs to. |
| | | |The current state is the one with the latest |
| | | |Date/Time as denoted in Assertion Macro in |
| | | |Assertion DateTime (30xx,50A4). |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>Include ‘Assertion Macro’ Table 10-XW1 |Defined CID shall be SUP147044. |
|RT Operation State Code Sequence |(30xx,508A) |1 |The code representing the operation state. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include ‘Code Sequence Macro’ Table 8.8-1 |Defined CID shall be SUP147044. |
|Author Observer Sequence |(0040,A078) |1C |The person or device updating the operation state.|
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See below) |
|>Include ‘Identified Person or Device Macro’ Table C.17-3b |No Baseline CIDs defined |
|(Editor’s Note: That Macro used here is one defined in PS3.3 with the | |
|extensions of Sup 121. The supplement version referenced in here is Sup | |
|121_pc, 2013-04-11) | |
|RT Operation State DateTime |(30xx,508C) |1 |Date and time at which the operation state did |
| | | |change. |
|RT Operation State Change Reason Description|(30xx,508E) |3 |Description of the reason for moving to this |
| | | |state, especially in the case of early completion |
|>RT Operation State Change Reason Code |(30xx,5088) |3 |Code describing the reason for moving to this |
|Sequence | | |state, especially in the case of early completion.|
| | | | |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |No Baseline CID is specified. |
|>Include 'Digital Signatures Macro' Table C.12-6 |
C.AA.2.5 Conceptual Volume Reference Macro
A Conceptual Volume is an abstract spatial entity . It can be used to identify an anatomic region (such as a planning target volume or a combination of multiple anatomic segments) or non-anatomic volumes such as a bolus or a marker. A Conceptual Volume can be established without necessarily defining its spatial extent (for example a Conceptual Volume for a tumor can be established prior to segmenting it). The spatial extent of a Conceptual Volume may change over time (for example as treatment proceeds the tumor volume corresponding to the Conceptual Volume will change).
The spatial extent of Conceptual Volumes may also be defined as a combination of other Conceptual Volumes.
The Conceptual Volume can be referenced by SOP Instances without necessarily defining its spatial or temporal extent. aA Conceptual Volume exists may be defined independently of by any Segmentation, Surface Segmentation or RT Structure Set SOP Instance that may be associated with itor a combination thereof, although the Conceptual Volume does exist independently of a specific definition of its spatial extent. (i.e. the segmentations may not be definitive representations of the Conceptual Volume).
A Conceptual Volume may also be defined as a combination of other Conceptual Volumes.
Examples for Conceptual Volumes:
1. A Conceptual Volume (with a Conceptual Volume UID) can be used to represent the treatment target in an RT Physician Intent SOP Instance based upon a diagnostic image set, although the actual delineation of a specific target volume has not yet taken place. Later, the target volume is contoured. The RT Segment Annotation SOP Instance references the volume contours and associates it with the Conceptual Volume via the Conceptual Volume UID.
2. In an adaptive workflow, the anatomic volume may change over time. The Conceptual Volume on the other hand does not change. Multiple RT Segment Annotation SOP Instances, each referencing different Segmentation instances, can be associated with the same Conceptual Volume via the Conceptual Volume UID, making it possible to track the volume over time.
3. A Conceptual Volume may be used to define fraction doses, for example in emergency treatments in RT Physician Intent SOP instances and subsequently defined RT Radiation SOP instances where the beam dose is manually calculated. After treatment, these conceptual volumes are used in radiation Records to track the delivered dose. Such conceptual volumes may never reference a segmentation, but serve as a key for referencing the conceptual volume across different SOP instances.
The Conceptual Volume Macro contains the attributes needed to reference a conceptual volume from other SOP instances by using the same Conceptual Volume UID.
Table C.AA.2.5-1
CONCEPTUAL VOLUME REFERENCE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Conceptual Volume UID |(30xx,1301) |1 |A UID identifying the Conceptual Volume. |
|Originating SOP Instance Reference Sequence |(30xx,1302) |1C |Reference to the SOP Instance that contains the |
| | | |original definition of this Conceptual Volume |
| | | |identified by Conceptual Volume UID (30xx,1301). |
| | | |Required when the Conceptual Volume UID |
| | | |(30xx,1301) was not issued in the current SOP |
| | | |Instance, but read from another SOP instance. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |Note: The SOP Instance should be taken from the |
| | | |Originating SOP Instance Reference Sequence of the|
| | | |Instance from which the Conceptual Volume UID was |
| | | |read unless that Instance was the originating SOP |
| | | |Instance in which case the Originating SOP |
| | | |Instance Reference Sequence will be absent. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|Equivalent Conceptual Volumes Sequence |(30xx,1305) |3 |References one or more existing Conceptual Volumes|
| | | |that represent the same concept as the current |
| | | |Conceptual Volume. |
| | | |This sequence might be used when Conceptual Volume|
| | | |references of existing SOP instances are |
| | | |retrospectively identified as representing the |
| | | |same entity. |
| | | |One or more Items are permitted in this sequence. |
| | | |See C.AA.2.5.1.1. |
|>Conceptual Volume UID |(30xx,1301) |1 |A UID identifying the Conceptual Volume. |
|>Equivalent Conceptual Volume Instance |(30xx,1304) |1 |Reference to the SOP Instance that contains the |
|Reference Sequence | | |referenced Conceptual Volume UID (30xx,1301) of |
| | | |the Equivalent Conceptual Volume. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.2.5.1 Conceptual Volume Macro Attribute Description
C.AA.2.5.1.1 Equivalent Conceptual Volumes
Conceptual Volumes can also be relatedbe declared to be equivalent to other Conceptual Volumes. In such cases, the Equivalent Conceptual Volumes Sequence (30xx,1305) is used in derived SOP instances which are aware of other SOP instances defining a semantically equivalent volume, but using different Conceptual Volume UIDs. A reason for this might be that these Conceptual Volume UIDs have been defined independently from each other.
C.AA.2.6 Extended Conceptual Volume Segmentation Reference and Combination Macro
The Extended Conceptual Volume Reference Base MacroThis macro allows the combination of conceptual Volumes as constituents of a combined volume. A representative example is to have the Left Lung and the Right Lung segmented, and then to declare the LungLungs as a combined Conceptual Volume, where, for example,which prescription constraints can be defined for.
The Extended Conceptual Volume Reference Base adds the facility tomacro also allows reference to RT Segment Annotation SOP instances, which contain a segmented representation of the conceptual volumeConceptual Volume. At the invocation of this macro it is declared, whether this segmented representation is required or not.
[pic]
[pic]
Figure C.AA.2.6-1
Conceptual Volume References
Figure C.AA.2.6-1 describes an RT Physician Intent instance where Conceptual Volumes “Lung, left” and “Lung, right” are referenced, but not defined. In this example, the RT Segmentation Annotation Instances then define the volumetric information of the Conceptual Volumes by referencing a specific segment of a Segmentation Instance and a specific ROI in an RT Structure Set Instance.a SOP Instance 1 where a Conceptual Volume A is fully defined, but Conceptual Volume B does not yet have a reference to an actual instance. SOP Instance 2 then defines the volumetric information of Conceptual Volume B by referencing a different Segmentation SOP Instance 2.
[pic]
[pic]
Figure C.AA.2.6-2
Conceptual Volume Combination References
Figure C.AA.2.6-2 describes an RT Physician Intent Instance defining Conceptual Volumes “Lung, left” and “Lung, right” and Conceptual Volume “Lung” as a combination of the first two without a direct reference to a volume definitiona SOP Instance 1 defining Conceptual Volumes A and B and Conceptual Volume C as a combination of A and B without a direct reference to a volume definition.
Table C.AA.2.6-1
EXTENDED CONCEPTUAL VOLUME REFERENCESEGMENTATION REFERENCE AND COMBINATION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Include 'Conceptual Volume Reference Macro' Table C.AA.2.5-1 |
|Conceptual Volume Combination IndicatorFlag |(30xx,1309) |1 |Indication that this Conceptual Volume reference |
| | | |is a combination of other Conceptual Volumes. |
| | | |Enumerated Values: |
| | | |YES |
| | | |NO |
|Conceptual Volume Combination Expression |(30xx,1307) |1C |Symbolic expression specifying the combination of |
| | | |Conceptual Volumes as a text string consisting of |
| | | |Conceptual Volume Constituent Index (30xx,1308) |
| | | |values, combination operators and parentheses. |
| | | |Required if Conceptual Volume Combination |
| | | |Indicator (30xx,1309) equals YES. |
| | | |See C.AA.2.6.1.2. |
|Conceptual Volume Combination Description |(30xx,1310) |2C |Human readable annotation describing the |
| | | |combination of Conceptual Volumes. This |
| | | |description is for display only and shall not be |
| | | |used programmatically. |
| | | |Required if Conceptual Volume Combination |
| | | |Indicator (30xx,1309) equals YES. |
|Conceptual Volume Constituent Sequence |(30xx,1303) |1C |References to other Conceptual Volumes which are |
| | | |constituents of this Conceptual Volume. |
| | | |See C.AA.2.6.1.12. |
| | | |Required if Conceptual Volume Combination |
| | | |Indicator Flag (30xx,1309) equals YES. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
| | | |The combined Conceptual Volume UID shall not be |
| | | |included in the sequence. |
|>Conceptual Volume Constituent Index |(30xx,1308) |1 |An index referened in the Conceptual Volume |
| | | |Combination Expression (30xx,1307) identifying the|
| | | |Conceptual Volume Constituent Item index. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Conceptual Volume UID |(30xx,1301) |1 |UID identifying the Conceptual Volume that is a |
| | | |constituent of thisthe combined Conceptual Volume.|
|>Originating SOP Instance Reference Sequence |(30xx,1302) |1C |Reference to the SOP Instance that contains the |
| | | |original definition of the Conceptual Volume |
| | | |constituent identified by Conceptual Volume UID |
| | | |(30xx,1301) in this sequence. |
| | | |Required if this UID was not issued within the |
| | | |current SOP Instance containing this macro, but |
| | | |read from another SOP Instance for reference. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|Conceptual Volume Combination Expression |(30xx,1307) |1C |Symbolic expression specifying the combination of |
| | | |Conceptual Volumes as a text string consisting of |
| | | |Conceptual Volume Constituent Index (30xx,1308) |
| | | |values, combination operators and parentheses. |
| | | |Required if Conceptual Volume Combination Flag |
| | | |(30xx,1309) equals YES. |
| | | |See C.AA.2.6.1.1. |
|Conceptual Volume Combination Description |(30xx,1310) |2C |Human readable description of the combination of |
| | | |Conceptual Volumes. This description is for |
| | | |display only and shall not be used |
| | | |programmatically. |
| | | |Required if Conceptual Volume Combination Flag |
| | | |(30xx,1309) equals YES. |
|Conceptual Volume Segmentation Defined Flag |(30xx,1311) |1 |States whether the Conceptual Volumes present in |
| | | |this Item have segmentations referenced. |
| | | |Enumerated Values |
| | | |YES |
| | | |NO |
|Conceptual Volume Segmentation Reference |(30xx,1312) |1C |Contains the reference to the RT Segment |
|Sequence | | |Annotation instance defining this Conceptual |
| | | |Volume. |
| | | |Required when Conceptual Volume Segmentation |
| | | |Defined Flag (30xx,1311) Flag equals YES and |
| | | |Conceptual Volume Combination Flag Indicator |
| | | |(30xx,1309) equals NO. |
| | | |If Conceptual Volume Combination Indicator |
| | | |(30xx,1309) equals YES, the number of Items |
| | | |included in this sequence shall equal the number |
| | | |of Items in the Conceptual Volume Constituent |
| | | |Sequence (30xx,1303). If Conceptual Volume |
| | | |Combination Indicator (30xx,1309) equals NO, only |
| | | |a single Item shall be included in this sequence. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See C.AA.2.6.1.23. |
|>Referenced Conceptual Volume Constituent |(30xx,1313) |1C |A reference to a Conceptual Volume Constituent |
|Index | | |Index (30xx,1308) within the Conceptual Volume |
| | | |Constituent Sequence (30xx,1303) for which the |
| | | |reference to the segmentation is provided. |
| | | |Required if Conceptual Volume Combination |
| | | |Indicator (30xx,1309) equals YES. |
|>Referenced RT Segment Annotations Sequence |(30xx,0874) |1 |Reference to the RT Segment Annotations SOP |
| | | |instance that contains the segmentation. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Referenced Segment Annotation Index |(30xx,0151) |1 |Reference to the Segment Index (30xx,0121) in the |
| | | |Segment Sequence (0062,0002) of the referenced RT |
| | | |Segment Annotation instance. |
|Conceptual Volume Constituent Segmentation |(30xx,1314) |1C |Contains the reference to the constituents of the |
|Reference Sequence | | |RT Segment Annotation instance defining this |
| | | |Conceptual Volume. |
| | | |Required when Conceptual Volume Segmentation |
| | | |Defined Flag (30xx,1311) equals YES and Conceptual|
| | | |Volume Combination Flag Indicator (30xx,1309) |
| | | |equals YES. |
| | | |The number of Items included in this sequence |
| | | |shall equal the number of Items in the Conceptual |
| | | |Volume Constituent Sequence (30xx,1303). |
| | | |See C.AA.2.6.1.23. |
|>Referenced Conceptual Volume Constituent |(30xx,1313) |1 |A reference to a Conceptual Volume Constituent |
|Index | | |Index (30xx,1308) within the Conceptual Volume |
| | | |Constituent Sequence (30xx,1303) for which the |
| | | |reference to the segmentation is provided. |
|>Referenced RT Segment Annotations Sequence |(30xx,0874) |1 |Reference to the RT Segment Annotations SOP |
| | | |instance that contains the segmentation. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Referenced Segment Annotation Index |(30xx,0151) |1 |Reference to the Segment Index (30xx,0121) in the |
| | | |Segment Sequence (0062,0002) of the referenced RT |
| | | |Segment Annotation instance. |
|Referenced Spatial Registration Sequence |(0070,0404) |1C |Registrations between referenced segmentations, of|
| | | |which the relation is not the unity transformation|
| | | |and which are present in Conceptual Volume |
| | | |Segmentation Reference Sequence (30xx,1312). |
| | | |May only be present, if Conceptual Volume |
| | | |Combination Flag Indicator (30xx,1309) equals YES,|
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.2.6.1 Conceptual Volume Combination and Segmentation Base Macro Attribute Description
C.AA.2.6.1.1 Conceptual Volume Combination Expression
For Conceptual Volume referencesVolumes specified as a combination of other referenced Conceptual Volumes, the effective volumecombination logic is specified asby the text string value of the Conceptual Volume Combination Expression (30xx,1307). The combination syntax uses a symbolic expression notation similar to that used in the Lisp programming language.
A nested list notation is used to apply geometric operators to a set of Conceptual Volumes.
A list isshall be delimited by parentheses and consists of two or more elements.
The first element of the list is a geometric operator.
c. Subsequent elements specify arguments of the geometric operator and are either Conceptual Volume Constituent Index (positive integer) values or parenthesized lists.
2. The shall be one of the following geometric operators are defined:
• UNION – geometric union of 2 or more arguments
• INTERSECTION – geometric intersection of 2 or more arguments
• NEGATION – geometric inverse of (a single) argument
• EXCLUSION – geometric difference of second argument from the first
Subsequent elements shall specify arguments of the geometric operator. An argument is either a Conceptual Volume Combination Expression (30xx,1307) shall only ocntain characters of the default Character Repertoire Constituent Index value, i.e. positive integer, or a parenthesized list.
Examples:
1. Union of paired organs 1X and 2Y (disjoint).
[pic][pic]
Conceptual Volume Combination Expression (30xx,1307):
(UNION 1 2)
Items in Conceptual Volume Constituent Sequence (30xx,1303):
|Conceptual Volume Constituent Index |Conceptual Volume |
|(30xx,1308) | |
|1 |Right LungX |
|2 |Left LungY |
2. Union of paired organs 1 and 2 (non-disjoint)
[pic][pic]
Conceptual Volume Combination Expression (30xx,1307):
(UNION 1 2)
Items in Conceptual Volume Constituent Sequence (30xx,1303):
|Conceptual Volume Constituent Index |Conceptual Volume |
|(30xx,1308) | |
|1 |Spinal Cord PRV |
|2 |Left Lung |
3: Union of paired organs (e.g., lungs) X and Y, with excluded volume W (e.g., PTV).
[pic][pic]
Conceptual Volume Combination Expression (30xx,1307):
(EXCLUSION (UNION 1 2) 3)
Items in Conceptual Volume Constituent Sequence (30xx,1303):
|Conceptual Volume Constituent Index |Conceptual Volume |
|(30xx,1308) | |
|1 |X |
|2 |Y |
|3 |W |
3. Union of two organs 1 and 2 with excluded volume 3 using NEGATION.
[pic][pic]
Conceptual Volume Combination Expression (30xx,1307):
(INTERSECTION (UNION 1 2) (NEGATION 3))
Items in Conceptual Volume Constituent Sequence (30xx,1303):
|Conceptual Volume Constituent Index |Conceptual Volume |
|(30xx,1308) | |
|1 |Heart |
|2 |Left Lung |
|3 |CTV |
43. Union of paired organs (e.g., lungs) X and Y1 and 2, with exclusion of multiple volumes 3, 4 and 5organs U, V, and W (e.g. target volumes and organs at risk).
[pic][pic]
Conceptual Volume Combination Expression (30xx,1307):
(INTERSECTION (UNION 1 2) (NEGATION (UNION 3 4 5)))(EXCLUSION (UNION 1 2) (UNION 3 4 5))
Items in Conceptual Volume Constituent Sequence (30xx,1303):
|Conceptual Volume Constituent Index |Conceptual Volume |
|(30xx,1308) | |
|1 |R LungX |
|2 |L LeftY |
|3 |Node 1U |
|4 |Node 2V |
|5 |CTVW |
54. Intersection of overlapping volumes 1X (e.g., PTV) and volume 2Y (e.g. Rectum).
[pic][pic]
Conceptual Volume Combination Expression (30xx,1307):
(INTERSECTION 1 2)
Items in Conceptual Volume Constituent Sequence (30xx,1303):
|Conceptual Volume Constituent Index |Conceptual Volume |
|(30xx,1308) | |
|1 |RectumX |
|2 |Prostate PTVY |
6. Intersection of disjoint volumes 1 and 2.
[pic][pic]
Conceptual Volume Combination Expression (30xx,1307):
(INTERSECTION 1 2)
Items in Conceptual Volume Constituent Sequence (30xx,1303):
|Conceptual Volume Constituent Index |Conceptual Volume |
|(30xx,1308) | |
|1 |Bladder |
|2 |Prostate |
C.AA.2.6.1.2 Conceptual Volume Segmentation ReferencesThe Conceptual Volume Segmentation Reference Sequence (30xx,1312) is used to refer to the segmentation(s) representing this Conceptual Volume respectively the constituent parts of the Combination of Conceptual Volumes in the context, in which this macro is invoked.
C.AA.2.6.1.23 Conceptual Volume Segmentation Reference Sequence
The Conceptual Volume Segmentation Reference Sequence (30xx,1312) contains a reference to a Segmentation, which represnetrepresent that volumvolume geometically.
In case of combination, the Conceptual Volume Segmentation Reference Sequence (30xx,1312) lists the segmentations used for definition of a combined Conceptual Volume. The segmentations referenced may be in one or more Frames of Reference. The constituent Conceptual Volumes in this sequence must not include the combined Conceptual Volume being defined. Applications that wish to combine existing segmentations within the same Conceptual Volume must create a new Segmentation Instance.
C.AA.2.7 Conceptual Volume Combination and Segmentation Macro
The Conceptual Volume Combination and Segmentation Macro uses all capabilities of the Conceptual Volume Combination and Segmentation Base Macro. It does not require the presence of the segmented volume representation.
Table C.AA.2.7-1
EXTENDED CONCEPTUAL VOLUME REFERENCE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Include Conceptual Volume Reference Base Macro' Table C.AA.2.6-1 |
|Conceptual Volume Segmentation Defined |(30xx,1311) |1 |States whether the Conceptual Volumes present in |
| | | |this Item have segmentations referenced in the |
| | | |following. |
| | | |Enumerated Values |
| | | |YES |
| | | |NO |
C.AA.2.8 Segmented Conceptual Volume Macro
The Segmented Conceptual Volume Macro uses all capabilities of the Extended Conceptual Volume Reference Base Macro, but requires the presence of the segmented volume representation.
Table C.AA.2.8-1
SEGMENTED CONCEPTUAL VOLUME REFERENCE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Include 'Extended Conceptual Volume Reference Base Macro' Table C.AA.2.6-1 |
|Conceptual Volume Segmentation Defined |(30xx,1311) |1 |States whether the Conceptual Volumes present in |
| | | |this Item have segmentations referenced in the |
| | | |following. |
| | | |Enumerated Values |
| | | |YES |
C.AA.2.9 Radiation Fractionation Pattern Macro
The Radiation Fractionation PatternRadiation Fraction Pattern Macro contains the attributes needed to specifiesy the intended fractionation pattern to be used to deliver the radiation treatment.
Table C.AA.2.9-1
RADIATION FRACTIONATION PATTERNRADIATION FRACTION PATTERN MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Fraction Pattern Sequence |(30xx,0965) |1C |A description of tThe fractionation pattern in a |
| | | |machine-readable form. |
| | | |Required if a fraction pattern has been defined. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Number of Fraction Pattern Digits Per Day |(300A,0079) |1 |Number of digits in a Fraction Pattern (300A,007B) |
| | | |used to represent one day. See C.AA.2.9.1.1. |
|>Repeat Fraction Cycle Length |(300A,007A) |1 |Number of weeks needed to describe treatment |
| | | |fraction pattern. See C.AA.2.9.1.1. |
|>Fraction Pattern |(300A,007B) |1 |String of 0's (no treatment) and 1's (treatment) |
| | | |describing the treatment fraction pattern for the |
| | | |fractions defined by this set. Length of string is |
| | | |7 x Number of Fraction Pattern Digits Per Day x |
| | | |Repeat Fraction Cycle Length. Pattern shall start |
| | | |on a Monday. |
| | | |See C.AA.2.9.1.1. |
C.AA.2.9.1 Radiation Fractionation PatternRadiation Fraction Pattern Macro Attribute Description
C.AA.2.9.1.1 Fractionation
The Radiation Fractionation PatternRadiation Fraction Pattern describes the intended scheme, i.e. how fractions are to be distributed along calendar days for the actual radiation set.
Examples of Fractionation Patterns:
a) 1 fraction per day (Monday to Fridayy), no fractions on Saturday and Sunday:
Number of Fraction Pattern Digits per Day = 1
Repeat Fraction Cycle Length = 1
Fraction Pattern = 1111100
b) 2 fractions per day (Monday to Friday), no fractions on Saturday and Sunday:
Number of Fraction Pattern Digits Per Day = 2
Repeat Fraction Cycle Length = 1
Fraction Pattern = 1111111111000000
c) 1 fraction per day (Monday, Wednesday, to Friday), no fractions on Saturday and Sundayfractions every second day:
Number of Fraction Pattern Digits Per Day = 1
Repeat Fraction Cycle Length = 1
Fraction Pattern = 1010100
d) 2 fraction per day (Monday, Wednesday, Friday), one fraction on Saturday and Sunday:
Number of Fraction Pattern Digits Per Day = 2
Repeat Fraction Cycle Length = 1
Fraction Pattern = 11001100111010
e) 1 fraction per day every other day:
Number of Fraction Pattern Digits Per Day = 1
Repeat Fraction Cycle Length = 2
Fraction Pattern = 10101010101010
C.AA.2.10 Treatment Device Identification Macro
The Treatment Device Identification Macro iis invoked to identifiesy a device used to deliver radiation to the patient during a radiotherapy treatment session.
Table C.AA.2.10-1
Treatment Device Identification Macro Attributes
|Attribute Name |Tag |Type |Attribute Description |
|Treatment Device Identification|(30xx,5015) |1 |Identifies treatment device to be used. |
|Sequence | | |Only a single Item shall be included in this sequence. |
|>Treatment Machine Name |(300A,00B2) |1 |User-defined name identifying treatment device to be used for |
| | | |radiation delivery. |
|>Treatment Machine Delivery |(30xx,0BB2) |1C |User-supplied identifier for the device, when this device is a |
|Subsystem ID | | |sub-device of a treatment device, e.g. the gantry. |
| | | |Required, if the treatment machine consists of several |
| | | |sub-devices for delivery. |
|>Include 'RT Device Model Macro' Table C.AA.2.11-1 |
|>Include 'Device Model Macro' Table C.AA.2.11-1 |Identifies the device model for the Treatment Device. |
| |If Treatment Machine Delivery Subsystem ID (30xx,0BB2) is |
| |present, these attributes identify that subsystem. |
|>Include 'Device Identification Macro' Table C.AA.2.14-1. |Defined CID SUP147054. |
|>Institution Name |(0008,0080) |3 |Institution where the equipment is located. |
|>Institution Address |(0008,0081) |3 |Mailing address of the institution where the equipment is |
| | | |located. |
|>Institutional Department Name |(0008,1040) |3 |Department in the institution where the equipment is located. |
C.AA.2.11 RT Device Model Macro
The RT Device Model Macro contains general attributes needed to specify a radiotherapy device.
Table C.AA.2.11-1
RT DEVICE MODEL MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Manufacturer |(0008,0070) |2 |Manufacturer of the device. |
|Manufacturer's Model Name |(0008,1090) |2 |Manufacturer’s model name of the device. |
|Manufacturer's Model Version |(30xx,1324) |2 |A more detailed definition of the Manufacturer’s |
| | | |model of the device. |
|Device Manufacturer's Model Class UID |(30xx,0BB0) |2 |Manufacturer’s Unique identifier (UID) for the |
| | | |specific model class of of the device. |
|Device Serial Number |(0018,1000) |2 |Manufacturer’s serial number of the device. |
|Software Versions |(0018,1020) |2 |Manufacturer’s designation of software version of |
| | | |the equipment. |
C.AA.2.12 RT Patient Support Devices Macro
The RT Patient Support Devices Macro identifies a patient support device (table, table top, chair or similar) which shall be used for treatment.
Table C.AA.2.12-1
RT PATIENT SUPPORT DEVICES IDENTIFICATION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Patient Support Devices Sequence |(30xx,51F1) |1C |Patient support device definitions. |
| | | |Required if one or more patient support devices |
| | | |are present. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>>Include 'RT Device Model Macro' Table C.AA.2.11-1 |
|>Include 'Device Identification Macro' Table C.AA.2.14-1. |Defined CID SUP147006. |
|>Conceptual Volume Sequence |(30xx,1346) |2 |References a conceptual volume that describes |
| | | |the geometry and properties of the patient |
| | | |support device. |
| | | |Zero or one a single Item is permitted in this |
| | | |sequence. |
|>>Include ‘Conceptual Volume Segmentation Reference and Combination Macro' Table C.AA.2.6-1 |
C.AA.2.13 Patient Support Position Macro
This macro may be invoked to define those attributes describingprovides the device-specific geometric settings for the settings of the various attributes related to a Patient Support devicedevice.
The information is intended only for display to human readers, while the authoritative definition of the patient position with respect to the treatment device is contained in the Patient Frame of Reference to Equipment Mapping Matrix (30xx,6040).
The items in this macro shall only serve the purpose of annotating geometric information with numerical values using vendor-specific definitions of device axes.
The authoritative definition of the patient position with respect to the device system is contained in the Patient Frame of Reference to Equipment Mapping Matrix (30xx,6040).
Table C.AA.2.13-1
PATIENT SUPPORT POSITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Patient Support Position |(30xx,5142) |2 |Patient Support tTranslational and rotational parameters |
|Parameter Sequence | | |supported forby a particular Patient Support systemdevice. |
| | | |Zero or more Items shall be included in this sequence. |
|>Include Content Item Macro Table 10-2 |Baseline TID of Concept Name Code Sequence is TID SUP147004. |
| |See C.AA.G2.1.4 for description of Continuous Rotation Angle |
| |usage. |
C.AA.2.14 Device Component Identification Macro
The Device Identification Component Identification Macro contains the attributes needed to identifyidentifies (physical or virtual) which is used by a certaindevice in using or creating the SOP instance where the macro is included.
Table C.AA.2.14-1
DEVICE IDENTIFICATION COMPONENT IDENTIFICATION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Device Type Code Sequence |(30xx,5026) |1 |The type of the device. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1. | |
|Device Index |(30xx,0112) |1 |Index of the Device in the sequence, where the |
| | | |macro is invoked, used for internal or external |
| | | |references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|Device Label |(30xx,5025) |1 |A user-readable label identifying the device. |
|Device Component Subtype Code Sequence |(30xx,5026) |1 |A fine-granular specification of the component. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1. |Context ID defined at the location of macro usage.|
|Device Description |(30xx,5027) |3 |User defined description for the device. |
|Device Serial Number |(0018,1000) |2 |Manufacturer’s serial number of the device. |
|Software Versions |(0018,1020) |2 |Manufacturer’s designation of software version of |
| | | |the equipment. |
|Regulatory Device Identifier Sequence |(30xx,5031) |2 |Regulatory Identifiers for this device. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>Regulatory Device Identifier |(30xx,5033) |1 |The Regulatory Device Identifier |
|>Regulatory Device Identifier Type Code |(30xx,5035) |1 |The type of the regulatory device identifier. |
|Sequence | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1. |Defined CID SUP147053 |
|Manufacturer's Device CodeIdentifier |(30xx,054D) |2 |An identifier issued by the manufacturer. |
| | | |Note. Typically, the Device Identifier is a code |
| | | |which can be electronically read by the machine |
| | | |utilizing that device, e.g. to verifiy the |
| | | |presence of that device. for the component |
| | | |intended as a machine-readable code of the device.|
|Device Alternate Identifier |(30xx,1326) |1C |An identifier intended to be read by a device such|
| | | |as a bar code reader. |
| | | |Required, if a hospital-issued identifier is used,|
| | | |e.g. attached as a bar code. |
|Device Alternate Identifier Type |(30xx,1327) |1C |Defines the type of Device Alternate Identifier. |
| | | |Required if Device Alternate Identifier |
| | | |(30xx,1326) is present. |
| | | |Defined Terms: |
| | | |BARCODE |
| | | |RFID |
|Device Alternate Identifier Symbology |(30xx,TBD) | |(Maybe not – look at the history of the |
| | | |barcode-related attributes – Issue R57) |
C.AA.2.15 RT Accessory Device Identification Macro
The RT Accessory Device Identification Macro contains the attributes needed to identify identifies an RT accessory device and it’s location, along with the device type and (if known) concrete SOP Instance details. The macro is intended to support a consistent header tag block across all IODs and RT devices.
Certain RT devices may define a specific macro, which includes this macro and additional type-specific tags.
Table C.AA.2.15-1
RT ACCESSORY DEVICE IDENTIFICATION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Include 'Device Model Macro' Table C.AA.2.11-1 |
|Include 'Device Component Identification Macro' Table C.AA.2.14-1. |
|Context ID defined at the location of macro usage. |
|Include 'RT Device Model Macro' Table C.AA.2.11-1 |
|Hospital Specific Accessory Code |(30xx,1326) |2C |A hospital-specific code used instead of the |
| | | |Device Component Code (30xx,054D) intended to be |
| | | |read by a device such as a bar-code reader. |
| | | |Required if the device has an Accessory Code |
| | | |defined, but the hospital uses a different code |
| | | |for verification, e.g. attached as a bar code. |
|Hospital Specific Accessory Code Type |(30xx,1327) |2C |Defines the type of Hospital Specific Accessory |
| | | |Code. |
| | | |Required if Hospital Specific Accessory Code |
| | | |(30xx,1326) is present. |
| | | |Defined Terms: |
| | | |BARCODE |
|RT Accessory Device Slot ID |(30xx,054B) |1C |Identifier for location (slot) of RTadiation |
| | | |Modifier accessory. |
| | | |Required if accessory is located in a slot and . |
| | | |Shall not be present if RT Accessory Holder Device|
| | | |SequenceDevice Index (30xx,054AB) is not present. |
|RT Accessory Holder Device Sequence |(30xx,054B) |2C |Identifier of the holder which this accessory. |
| | | |Required if accessory is mounted on a holder |
| | | |device. Shall not be present if Device Component |
| | | |Subtype Code Sequence (30xx,5026) contains |
| | | |(S147481, 99SUP147, “Applicator”). |
|>RT Accessory Holder Device Index |(30xx,05400112) |1C |Reference to the Device Index (30xx,0112) index of|
| | | |the Accessory Holder device in the Accessory |
| | | |Holder Definition Sequence (30xx,5170). |
| | | |Required if accessory is mounted on a holder |
| | | |device and RT Accessory Slot ID (30xx,054B) is not|
| | | |present. |
|>RT Accessory Device Slot ID |(30xx,054B) |2C |Identifier for location (slot) of Radiation |
| | | |Modifier in the Accessory Holding device. |
| | | |Required if Device Component Subtype Code Sequence|
| | | |(30xx,5026) contains (S147481, 99SUP147, |
| | | |“Applicator”). |
|RT Accessory Holder Slot ID |(30xx,054A) |1C |Identifier for location (slot) of Radiation |
| | | |Modifier in the Accessory Holding device. |
| | | |Required if RT Accessory Holder Device Index |
| | | |(30xx,0540) is present. |
C.AA.2.16 Control Point General Attributes Macro
This macro specifies the base attributes for the definition of a Radiation Control Point.
Table C.AA.2.16-1
CONTROL POINT GENERAL ATTRIBUTES MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Control Point Item Index |(30xx,0111) |1 |The order the control points are executed. |
| | | |Index used to reference items corresponding to a control point |
| | | |in a sequenceo.f the Control Point Item in the sequence used for|
| | | |internal or external references. |
| | | |The value shall start at 1, and increase monotonically by 1. |
|Cumulative Radiation Meterset |(30xx,5021) |1C |Meterset at the Control Point expressed in the units of the |
| | | |reported by Primary Radiation Dosimeter Unit (30xx,5113). |
| | | |The Meterset of the first Control Point shall be equal to 0.0. |
| | | |Required at all Control Points if RT Radiation Data Scope |
| | | |(30xx,5013) is not GEOMETRIC. |
| | | |See C.AA.2.16.1.12. |
C.AA.2.16.1 Control Point Attribute RequirementsConcept
The treatment-modality modules use a common formalism to represent parameters that define the behaviour of a delivery device during delivery of radiation. along with certain meterset values. These parameters are communicated as a sequence of values, organized as ‘Control Points’, see C.AA.1.1. The resolution of Control Points depends on the level of detail required to define the behaviour of the delivery device.
For any given treatment technique, some parameters may be constant for all Control Points. Such static parameters shall only be present at the first Control Point and shall be absent in all other Control Points. All other parameters that are changing at any of the Control Points shall be present in each single Control Point.
For all beam deliveries there are at least two control points, corresponding to the start and end of delivery. E.g. Ffor a simple Static Beam delivery with a constant field aperture, only two Control Points are needed to define the start and the end, as there are no changes in between. For a dDynamic delivery, where in which the MLC leavefs are changingmoving while radiation is delivered, the number of Control Points will be higher to provide enough detail to define the leaf movement with a sufficient resolution to achieve the radiation fluence distribution expected for the prescribed dose.
A Control Point is a point on a timeline of a delivery process. Control Points are sequenced using an index number starting with 1, e.g. 1, 2, 3, 4. The Control Point parameters reflect the state of the delivery device at that point in time. The Control Point Cumulative Meterset reflects the dose that has been delivered from the beginning of the delivery process up to that point in time.
DICOM does not specify the behavior of the machine parameters between Control Points. The planning system needs to know the hardware-specific characteristics of the delivery system for which the plan is being created.
C.AA.2.16.1.1 Control Point Attribute Requirements
Attributes that are constant for all Control Points shall only be specified at the first Control Point with Control Point Item Index (30xx,0111) equal to 1. Attributes that change at any Control Point shall be specified explicitly at all Control Points.
C.AA.2.16.1.2 Control Point Sequence Attribute Requirements
Sequences with constant attribute values for all Items at all Control Points shall only be present at the first Control Point with Control Point Item Index (30xx,0111) equal to 1. Sequences with attribute values changing at any Item at any Control Point shall be present at all Control Points.
C.AA.2.16.1.3 Control Point Attribute Examples
The following examples illustrate the specification of parameters using Control Points:
1. Static Beam delivery example:
Control Point 1: Cumulative Meterset = 0
All applicable treatment parameters defined
Control Point 2: Cumulative Meterset = 76
No other parameters defined
At completion this beam delivers 76 Monitor Units using a fixed static set of treatment parameters defined in Control Point 1.
2. Arc delivery example:
Control Point 1: Cumulative Meterset = 0
Gantry Rotation Direction = CW, Gantry Angle = initial angle
All other applicable treatment parameters defined
Gantry Rotation Direction = CW, Gantry Angle = initial angle
Control Point 2: Cumulative Meterset = 56
the following parameters are defined onlyGantry Rotation Direction = NONE, Gantry Angle = final angle
No other parameters defined
At completion this delivers 56 Monitor Units while rotating the gantry from initial angle to final angle.
3. Dynamic delivery of two equally weighted segments example:
Control Point 1: Cumulative Meterset = 0
All applicable treatment parameters defined
Collmator Opening X: 2x2
Collmator Opening Y: 2x2
All other applicable treatment parameters defined
Control Point 2: Cumulative Meterset = 40
All treatment parameters defined which change at any control point (including those which do not change at this specific Control Point)
Collmator Opening X: 2x2
Collmator Opening Y: 4x4
All other treatment parameters which change at any control point (including those which do not change at this specific Control Point)
Control Point 3: Cumulative Meterset Weight = 80
All treatment parameters defined which change at any control point (including those which do not change at this specific Control Point)
Collmator Opening X: 4x4
Collmator Opening Y: 4x4
All other treatment parameters which change at any control point (including those which do not change at this specific Control Point)
At completion this delivers 80 Monitor Units while first increasing the Y opening and then increasing the X opening.
4. Dynamic Delivery of two unequally weighted segments with a step change of 5 degrees in the clock-wise direction of the table angle example:
Control Point 1: Cumulative Meterset Weight = 0
All applicable treatment parameters defined
Patient Support Angle = initial angle0
Patient Support Rotation Direction = rotation directionNONE,
All other applicable treatment parameters defined
Control Point 2: Cumulative Meterset = 30
All treatment parameters defined which change at any control point (including those which do not change at this specific control point)
Patient Support Angle = initial angle0
Patient Support Rotation Direction = NONECW
All other treatment parameters defined which change at any control point (including those which do not change at this specific control point)
Control Point 3: Cumulative Meterset = 30
All treatment parameters defined which change at any control point (including those which do not change at this specific control point)
Patient Support Angle = new angle5
Patient Support Rotation Direction = rotation directionNONE
All other treatment parameters defined which change at any control point (including those which do not change at this specific control point)
Control Point 4: Cumulative Meterset = 90
All treatment parameters defined which change at any control point (including those which do not change at this specific control point)
Patient Support Angle = new angle5
Patient Support Rotation Direction = NONE
All other treatment parameters defined which change at any control point (including those which do not change at this specific control point)
At completion this delivers 90 Monitor Units, while between Control Point 2 and 3 the patient support angle is changed and no radiation is delivered.
No assumptions are made about the behavior of machine parameters between specified Control Points and communicating devices shall agree on this behavior outside the current standard.
C.AA.2.16.1.1 Meterset Calculations
The Meterset at a given Control Point is specified in the Cumulative Meterset (30xx,5021). That value is specified in units defined by Radiation Dosimeter Unit (30xx,5113) in the RT Delivery Device Common Module in section C.AA.E1.
The meterset values correspond to the meterset readout of a RT Radiation Delivery Device. In case that device has multiple meterset readouts, the values correspond to the primary meterset readout.
C.AA.2.17 External Beam Control Point General Attributes Macro
This macro may be invoked to specify the generic Control Point attributes used to model external beam radiation.
Table C.AA.2.17-1
EXTERNAL BEAM CONTROL POINT GENERAL ATTRIBUTES MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Include ‘Control Point General Attributes Macro’ Table C.AA.1.16-1 |
|Primary Meterset Delivery Rate |(30xx,5023) |12C |Specifies tThe intended nominal rate of delivery of the |
| | | |specified Cumulative Primary Meterset (30xx,5021TBD). See |
| | | |C.AA.2.17.1.2 for units. |
| | | |Required if |
| | | |the Control Point Index (30xx,0111) equals 1 |
| | | |or |
| | | |this attribute value attribute value changes at any Control |
| | | |Point,. |
| | | |and |
| | | |the specification of the Delivery Rate is required by the |
| | | |Delivery Device for RT treatment delivery |
| | | |and |
| | | |RT Radiation Data Scope (30xx,5013) is not GEOMETRIC. |
| | | |Maybe present otherwise. |
| | | |and all of the following are true all of the following are true:|
| | | |a) Primary Radiation Dosimeter Unit (30xx,5113) is not RELATIVE |
| | | |and not BQ_SECOND, |
| | | |and |
| | | |b) RT Radiation Data Scope (30xx,5013) is not GEOMETRIC and |
| | | |See C.AA.2.16.1 and C.AA.2.17.1.1. |
|Primary MetersetDelivery Rate |(30xx,5024) |1C |The unit of the Primary MMetersetDelivery Rate (30xx,5023). |
|Unit Sequence | | |Required if the Primary DeliveryMeterset Rate (30xx,5023) is |
| | | |present with a valueand Primary Radiation Dosimeter Unit |
| | | |(30xx,5113) is SECOND and if the Control Point Item Index |
| | | |(30xx,0111) equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1 and C.AA.2.17.1.121. |
| | | |Only a single Item shall be included in this sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147051 |
|Beam-On Area Sequence |(30xx,6050) |1C |Sequence defining an aArea in which the treatment beam is |
| | | |enabled. Required if patient geometry requires limitation of the|
| | | |beam delineation. |
| | | |Only a single Item shall be included in this sequence. |
| | | |Required if patient geometry requires limitation of the beam |
| | | |delineation and if the Control Point Index (30xx,0111) equals 1 |
| | | |or this attribute value changes at any Control Point. |
| | | |See C.AA.2.16.1. |
|>Include 'Outline Definition Macro' Table C.AA.2.29-1 |
C.AA.2.17.1 External Beam Control Point General Attributes Macro Attribute Description
C.AA.2.17.1.1 Meterset Calculations
The Meterset at a given Control Point for RT Radiation objects working with a Radiation Device as described in the module RT Delivery Device Common Module in section C.AA.E1 is specified in the Cumulative Radiation Meterset (30xx,5021). The Meterset is specified in units defined by Primary Radiation Dosimeter Unit (30xx,5113) in the RT Delivery Device Common Module in section C.AA.E1.
C.AA.2.17.1.12 Primary MetersetDelivery Rate
When the delivery device requires the Delivery Rate (30xx,5023) to be specified, the application specifying that attribute shall ensure that the code in the Delivery Rate Unit Sequence (30xx,5024) is the code expected by the delivery device.
Units used for Primary Meterset Rate (30xx,5023) shall be determined by the value of Primary Radiation Dosimeter Unit (30xx,5113) as follows:
• MU: Units shall be MU/sec
• NP: Units shall be particles/sec
• RELATIVE Attribute not present
Machines working with a Primary Radiation Dosimeter Unit (30xx,5113) having the value SECOND use different units for the Primary Meterset Rate (30xx,5023). This unit shall be encoded in Primary Meterset Rate Unit Sequence (30xx,5024).
C.AA.2.18 External Beam Sub-Control Point General Attributes Macro
This macro may be invoked to specify the generic Control Point attributes used to model external beam radiation on Sub-Control Point level.
Table C.AA.2.18-1
EXTERNAL BEAM SUB-CONTROL POINT GENERAL ATTRIBUTES MACRO
|Attribute Name |Tag |Type |Attribute Description |
|Sub-Control Point Index |(30xx,0115) |1 |Index of the items in the sequence. Used for |
| | | |internal or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|Cumulative Meterset |(30xx,5021) |1C |Meterset at sequence level expressed in units of |
| | | |the Radiation Dosimeter Unit (30xx,5113). |
| | | |The Meterset is on the same absolute scale as the |
| | | |Meterset on control point level. |
| | | |Required, if RT Radiation Data Scope (30xx,5013) |
| | | |is not GEOMETRIC, and Sub-Control Point Index |
| | | |(30xx,0115) equals 1 or attribute value changes at|
| | | |any Sub-Control Point. |
| | | |See Section C.8.1.18.1.2. |
|Include 'RT Beam Limiting Device Positions Macro' Table C.AA.2.21-1 |
C.AA.2.18.1 RT Beam Limiting Device Definition Macro Attribute Description
C.AA.2.18.1.1 Sub-Control Point Attribute Requirements
No assumptions are made about the behavior of machine parameters between specified items in the sequence. , and Ccommunicating devices shall agree on this behavior outside the current standard.
The representation of parameters in sub-control points follows the formalism as descibed in C.AA.2.16.1.
C.AA.2.18.1.2 Cumulative Meterset
The values of the Cumulative Meterset (30xx,5021) are defined on the same absolute scale as the Cumulative Meterset (30xx,5021) in the Control Point Sequence.
The value of the Cumulative Meterset (30xx,5021) of the first item of this sequence (having a value of 1 in the Sub-Control Point Index (30xx,0115)) shall have exactly the same value as the Cumulative Meterset (30xx,5021) of the Control Point which containings this Sub-Control Point sequence.
The value of the Cumulative Meterset (30xx,5021) of the last item of this sequence (having the highest value in the Sub-Control Point Index (30xx,0115)) shall have exactly the same value as the Cumulative Meterset (30xx,5021) of the Control Point which follows the Control Point, which containings this Sub-Control Point sequence.
C.AA.2.19 Beam Mode Macro
The Beam Mode Macro contains attributes to identify the beam mode of a delivery device.
Table C.AA.2.19-1
BEAM MODE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Beam Mode Sequence |(30xx,51C0) |1 |Sequence defining the Beam Mode. |
| | | |One or more Items shall be included in this sequence.|
|>Beam Mode Index |(30xx,0113) |1 |Index of thise Beam Mode Item in the Beam Mode |
| | | |Ssequence. Uused for internal or external references.|
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Referenced Control Point Index |(30xx,0141) |1 |References the Control Point Index (30xx,0111) |
| | | |identifying the first Control Point, at which thisat |
| | | |Beam Mode is first applied. |
| | | |Only Control Points at which changes occur shall be |
| | | |referenced. No Control Point shall be referenced more|
| | | |the once. The referenced Control Point Index |
| | | |(30xx,0111) shall be monotonically increasing. |
| | | |The first item in the Beam Mode Sequence (30xx,51C0) |
| | | |having the value 1 in the Beam Mode Index (30xx,0113)|
| | | |shall have the value 1. |
|>Beam Mode Label |(30xx,51C1) |1 |User readable label that identifies this beam mode.e |
| | | |primary beam configuration used by the device. It is |
| | | |expected that each distinct combination of beam |
| | | |parameters which produces a distinct beam profile |
| | | |uses a unique identifier. |
| | | |See Note 1. |
|>Beam Mode Description |(30xx,51C2) |2 |User-defined description of the beam mode. |
|>Beam Mode Machine Code |(30xx,51C3) |1 |An internal vendor-specified machine-readable code |
| | | |thato uniquely identifiesy thise beam mode with a |
| | | |code as specified by the treatment device vendor. |
|>Radiation Type |(300A,00C6) |1 |Type of Radiation for thisat Beam Mode. |
| | | |Defined Terms: |
| | | |PHOTON |
| | | |ELECTRON |
| | | |NEUTRON |
| | | |PROTON |
| | | |ION |
| | | |Within the context of specific IODs in which this |
| | | |macro occurs, only a subset of these terms may be |
| | | |valid as defined by the IOD. |
|>Nominal Energy |(30xx,51C5) |1C |The Nominal Energy in units as defined in the Energy |
| | | |Unit Code Sequence (30xx,51C9). |
| | | |Required if Minimum Nominal Energy (30xx,51C6) and |
| | | |Maximum Nominal Energy (30xx,51C7) are not present, |
| | | |i.e. if the beam energy is fixed within the scope of |
| | | |a Control Point. |
|>Minimum Nominal Energy |(30xx,51C6) |1C |The minimum nominal beam energy in units as defined |
| | | |in the Energy Unit Code Sequence (30xx,51C9). |
| | | |Required if Nominal Energy (30xx,51C5) is not |
| | | |present, i.e. if the beam energy is modulated (e.g. |
| | | |via energy map) over a range within the scope of a |
| | | |Control Point. |
|>Maximum Nominal Energy |(30xx,51C7) |1C |The maximum nominal beam energy in units as defined |
| | | |in the Energy Unit Code Sequence (30xx,51C9). |
| | | |Required if Nominal Energy (30xx,51C5) is not |
| | | |present, i.e.if the beam energy is modulated (e.g. |
| | | |via energy map) over a range within the scope of a |
| | | |Control Point. |
|>Energy Unit Code Sequence |(30xx,51C9) |1 |The unit of energy values specified used in Nominal |
| | | |Energy (30xx,51C5), Minimum Nominal Energy |
| | | |(30xx,51C6), Maximum Nominal Energy (30xx,51C7). |
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147042 |
|>Beam Mode Type Code Sequence |(30xx,51C8) |1 |Identifies the general category of this beam. |
| | | |One or more Items shall be included in this sequence.|
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147050 |
Notes: 1. In particular, each unique combination of energy, radiation type and beam filter requires a distinct identifier.
C.AA.2.19.1 Beam Mode
Treatment devices can produce a multitude of different beams with unique properties such as energy spectrum, depth dose, surface dose and beam profile. A particular combination of such properties is referred to as a beam mode. These beams modes are created in the machine by using different primary electron beams, flattening and scattering filters, etc. In many cases, the beam mode identifies characterizes the fluence just below the Monitor Chamber. Subsequently these primary beams may be modulated by beam modifiers such as Beam Limiting Devices, Wedges, Spreaders etc. While these beam modifiers are described in the Control Point Sequence, the primary beam is assumed to have fixed characteristics within the range as specified by the control point index using Control Point Index (30xx,0111). In many cases, the beam mode will be constant throughout the Radiation, encoded as therefore thea Beam Mode MacroSequence (30xx,51C0) will only containing one item with the Beam Mode Index (30xx,0113) equal to 1 and the Referenced Control Point Index (30xx,0141)Control Point Index (30xx,0111) equal to 1.
The vendors provide codes (TBD). For each unique combination of machine parameters that produces a distinct beam profile and distinsct set of values of the attributes contained in that macroan item in the sequence, a device specific unique identifer is to be provided. Beam Mode Machine Code (30xx,51C3) is assigned a vendor provided code that permits lookup by the machine of the corresponding machine configuration matching that mode. In particular, each unique combination of energy, radiation type and beam filter requires a distinct identifier.
In many cases, the beam mode will correspond to a specific nominal energy which remains fixed. The Nominal Energy (30xx,51C5) parameter is provided for beams, where a single discrete energy is annotated by that value. Energy modulation can be used at the control point level (both discrete and contiguous), in which case the Minimal Nominal Energy (30xx,51C6) and Maximal Nominal Energy (30xx,51C7) is used.
Other than uniquely identifying a specific mode within a machine, no assumptions shall be made about the structure, encoding or syntax of the Beam Mode Label (30xx,51C1).
Different BBeam mModes Labels (30xx,51C1) shall are intended only be used to identify characterize different primary beams. It is inappropriate to , but shall not be used to convey any other meaning by using different beam modes having the same fluence, e.g. , like annotation offor annotating the role of the beam in the clinical process or the usage of that beam at a treatment session.
C.AA.2.20 RT Beam Limiting Device Definition Macro
This macro may be invoked to define those attributes describing the configuration of the Beam Limiting Device which cannot vary during delivery.
Table C.AA.2.20-1
RT BEAM LIMITING DEVICE DEFINITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|RT Beam Limiting Device |(30xx,504D) |1 |Beam limiting device (collimator) jaw or leaf (element) sets. |
|Definition Sequence | | |One or more Items shall be included in this sequence. |
|>Include 'RT Accessory Device Identification Macro' Table |Defined CID SUP147010 |
|C.AA.2.15-1 | |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase monotonically by 1. |
|>RT Beam Limiting Device |(30xx,504F) |2 |Distances (in mm) from the RT Beam Distance Reference Location |
|Distance | | |(30xx,5114) to the beam limiting device (collimator) along the |
| | | |beam axis. |
| | | |Two values shall be provided. |
| | | |The first value shall be the distance from the Reference |
| | | |Location (30xx,5114) to the proximal end of the device. |
| | | |The second value shall be the distance from the Reference |
| | | |Location (30xx,5114) to the distal end of the device. |
|>Number of RT Beam Delimiter |(30xx,5048) |1C |Number of beam delimiter pairs. E.g. standard beam limiting |
|Pairs | | |device jaws have one delimiter pair. |
| | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |either (S147172, 99SUP147, “X Leaves”) or (S147173, 99SUP147, |
| | | |“Y Leaves”). May be present otherwise. |
|>RT Beam Delimiter Element |(30xx,5049) |1C |Boundaries of beam delimiter elements (in mm) with respect to |
|Position Boundaries | | |the Coordinate System Declaration (30xx,5208) axis appropriate |
| | | |to RT Beam Limiting Device Type (300A,00B8) i.e. X-axis for Y, |
| | | |Y-axis for X. |
| | | |See C.AA.2.20.1.1. |
| | | |N+1 values shall be provided, where N is the Number of RT Beam |
| | | |Delimiter Pairs (30xx,5048) starting from pPair 1. |
| | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |either (S147172, 99SUP147, “X Leaves”) or (S147173, 99SUP147, |
| | | |“Y Leaves”). May be present otherwise. |
|>RT Beam Delimiter Geometry |(30xx,504C) |1C |The outline of the Beam Limiting Device position. |
|Sequence | | |Required if Device Type Code Sequence (30xx,5026) is part of |
| | | |CID SUP147027. |
| | | |Only a single Item shall be included in this sequence. |
|>>Include ‘Outline Definition Macro’ Table C.AA.2.29-1 |
C.AA.2.20.1 RT Beam Limiting Device Definition Macro Attribute Description
C.AA.2.20.1.1 RT Beam Delimiter Element Position Boundaries
The RT Beam Delimiter Element Position Boundaries (30xx,5049) shall be the positions of the mechanical boundaries (projected on the plane defined by the Beam Limiting Device Definition Distance (30xx,5210) ) between beam delimiter elements, fixed for a given beam limiting device (collimator). RT Beam Delimiter Element Positions (30xx,504A) are values specific to a given control point, specifying the beam limiting device (collimator) leaf (element) openings.
C.AA.2.21 RT Beam Limiting Device Positions Macro
This macro may be invoked to define the positions of RT Beam Limiting Devices used in a specific Control Point or set of Control Points.
Table C.AA.2.21-1
RT BEAM LIMITING DEVICE POSITIONS MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|RT Beam Limiting Device |(30xx,5070) |1C |Beam limiting device (collimator) jaw or leaf (element) |
|Settings Sequence | | |positions for the current Control Point. |
| | | |Required if the Control Point Index (30xx,0111) equals 1 or |
| | | |attribute values change at any Control Point. |
| | | |See C.AA.2.16.1. |
| | | |One or more Items shall be included in this sequence. |
|>Referenced Device Index |(30xx,0142) |1 |Value of Device Index (30xx,0112) from the RT Beam Limiting |
| | | |Device Definition Sequence (30xx,504D) for Beam Limiting Device |
| | | |used in this Iitem. |
|>RT Beam Limiting Device |(30xx,51B4) |1C |RT Beam Limiting Device angle, i.e. orientation of the |
|Continuous Angle | | |coordinate system referenced in Coordinate System Declaration |
| | | |(30xx,5208) with respect to the beam line axis. |
| | | |See C.AA.G2.1.4. |
| | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |(S147170, 99SUP147, “X Jaw”), (S147171, 99SUP147, “Y Jaw”), |
| | | |(S147172, 99SUP147, “X Leaves”) or (S147173, 99SUP147, “Y |
| | | |Leaves”). |
|>RT Beam Delimiter Element |(30xx,504A) |1C |Positions (in mm) of beam delimiter elements projected as |
|Positions | | |defined in C.AA.20.1.1. . |
| | | |Contains 2N values, where N is the Number of RT Beam Delimiter |
| | | |Pairs (30xx,5048) in RT Beam Limiting Device Sequence |
| | | |(30xx,504D). Values shall be listed in the Coordinate System |
| | | |Declaration (30xx,5208) leaf (element) subscript order. |
| | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |(S147170, 99SUP147, “X Jaw”), (S147171, 99SUP147, “Y Jaw”), |
| | | |(S147172, 99SUP147, “X Leaves”) or (S147173, 99SUP147, “Y |
| | | |Leaves”). |
|>RT Beam Delimiter Geometry |(30xx,504C) |1C |The outline of the Beam Limiting Device position. |
|Sequence | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |(S147174, 99SUP147, “Variable Circular Collimator”). |
| | | |Only a single Item shall be included in this sequence. |
|>>Include ‘Outline Definition Macro’ Table C.AA.2.29-1 |
C.AA.2.22 Wedges Definition Macro
This macro may be invoked to define those attributes describing the geometric configuration of Wedges which cannot vary during delivery.
Table C.AA.2.22-1
WEDGES DEFINITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Wedge Definition Sequence |(30xx,5062) |1C |Treatment wedge definitions. |
| | | |Required if one or more wedges are present. |
| | | |One or more Items shall be included in this sequence. |
|>Include 'RT Accessory Device Identification Macro' Table |Defined CID SUP147028. |
|C.AA.2.15-1 | |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase monotonically by 1. |
|>Wedge Angle |(300A,00D5) |1 |Nominal wedge angle (degrees). |
|>Wedge Orientation |(300A,00D8) |1 |Orientation of wedge, with respect to the Coordinate System |
| | | |Declaration (30xx,5208) (degrees). When the wedge orientation |
| | | |has the values of 0, the thin edge of the wedge is directed |
| | | |towards the positive direction of the y-axis of the declared |
| | | |coordinate system. The rotation is defined as a positive |
| | | |rotation around the z-axis. |
|>Wedge Factor |(300A,00D6) |2 |Nominal wedge factor under machine calibration conditions at the|
| | | |beam energy as specified by Nominal Reference Energy |
| | | |(30xx,51CA). The wedge factor is the field dose with the wedge |
| | | |divided by the field does with open field. |
|>Nominal Reference Energy |(30xx,51CA) |1C |The beam energy at which the Total Compensator Tray Factor |
| | | |(300A,00E2) is specified, expressed in units as specified in |
| | | |Unit Energy Unit Code Sequence (30xx,51C9). |
| | | |Required, if Total Compensator Tray Factor (300A,00E2) is |
| | | |present and not empty. |
C.AA.2.23 Wedge Positions Macro
This macro may be invoked to define the positions of Wedges used in a specific Control Point or set of Control Points.
Table C.AA.2.23-1
WEDGE POSITIONS MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Wedge Position Sequence |(300A,0116) |1C |A Sequence of Items describing Wedge Positions for thise current|
| | | |Control Point. |
| | | |Required ifs Wedge Definition Sequence (30xx,5062) is present |
| | | |and as specified in C.AA.16.2.1.2. |
| | | |Required |
| | | |if the Control Point Index (30xx,0111) equals 1 or attribute any|
| | | |attribute value in an item of this sequence changes at any |
| | | |Control Point. |
| | | |The number of items in this sequence shall equal the number of |
| | | |items in Wedge Definition Sequence (30xx,5062). |
| | | |See C.AA.2.16.1. |
|>Referenced Device Index |(30xx,0142) |1 |Uniquely references Wedge described by Device Index (30xx,0112) |
| | | |in Wedge Definition Sequence (30xx,5062) |
|>Wedge Position |(300A,0118) |1 |Position of Wedge at current Control Point. Enumerated Values: |
| | | |IN = Wedge is in fully inserted position |
| | | |OUT = Wedge is in fully retracted position |
| | | |PARTIAL = wedge is inserted only part the way to the fully |
| | | |inserted position |
|>Wedge Thin Edge Position |(300A,00DB) |1C |Closest distance (in mm) from the central axis of the beam along|
| | | |a wedge axis to the thin edge as projected on the plane defined |
| | | |by the Beam Limiting Device Definition Distance (30xx,5210) |
| | | |(mm). Value is positive if the wedge does not cover the central |
| | | |axis, negative if it does. Required if Wedge Position |
| | | |(300A,0118) is PARTIAL. See section C.8.8.25.6.4. |
C.AA.2.24 Compensators Definition Macro
This macro may be invoked to define those attributes describing the geometric configuration of Compensators which cannot vary during delivery.
Table C.AA.2.24-1
COMPENSATORS DEFINITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Total Compensator Tray Factor |(300A,00E2) |2C |Compensator Tray transmission factor (between 0 and 1), at the |
| | | |beam energy specified as specified by Nominal Reference Energy |
| | | |(30xx,51CA). |
| | | |Required if Compensator Definition Sequence (30xx,5150) is |
| | | |present. |
|Nominal Reference Energy |(30xx,51CA) |1C |The beam energy at which the Total Compensator Tray Factor |
| | | |(300A,00E2) is specified, expressed in units as specified in |
| | | |Unit Energy Unit Code Sequence (30xx,51C9). |
| | | |Required, if Total Compensator Tray Factor (300A,00E2) is |
| | | |present and not empty. |
|Compensator Definition Sequence|(30xx,5150) |1C |Treatment compensator definitions. |
| | | |Required if one or more compensators are present in the beam. |
| | | |One or more Items shall be included in this sequence. |
|>Include 'RT Accessory Device Identification Macro' Table |Defined CID SUP147016. |
|C.AA.2.15-1 | |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase monotonically by 1. |
|>Material ID |(300A,00E1) |2 |User-supplied identifier for material used to manufacture |
| | | |Compensator. |
|>Compensator Divergence |(300A,02E0) |1 |Specifies Whether or not the compensator is shaped according to |
| | | |the beam geometrical divergencepresence or absence of |
| | | |geometrical divergence of the compensator. |
| | | |Enumerated Values: |
| | | |PRESENT = the compensator is shaped according to the beam |
| | | |geometrical divergence. |
| | | |ABSENT = the compensator is not shaped according to the beam |
| | | |geometrical divergence. |
|>Compensator Mounting Position |(300A,02E1) |1 |Specifies on which side of the Compensator Tray the compensator |
| | | |is mounted. |
| | | |Enumerated Values: |
| | | |PATIENT_SIDE = the compensator is mounted on the side of the |
| | | |Compensator Tray which is towards the patient. |
| | | |SOURCE_SIDE = the compensator is mounted on the side of the |
| | | |Compensator Tray which is towards the radiation source. |
| | | |DOUBLE_SIDED = the compensator has a shaped (i.e. non-flat) |
| | | |surface on both sides of the Compensator Tray. |
|>Compensator Rows |(300A,00E7) |1 |Number of rows in the compensator. A row is defined to be in the|
| | | |X direction with respect to the Coordinate System Declaration |
| | | |(30xx,5208). |
|>Compensator Columns |(300A,00E8) |1 |Number of columns in the compensator. A column is defined to be |
| | | |in the Y direction with respect to the Coordinate System |
| | | |Declaration (30xx,5208). |
|>Compensator Pixel Spacing |(300A,00E9) |1 |Physical distance (in mm) between the center of each adjacent |
| | | |pixels projected on the plane defined by the Beam Limiting |
| | | |Device Definition Distance (30xx,5210). Specified by a numeric |
| | | |pair - adjacent row spacing (delimiter) adjacent column spacing.|
| | | |See 10.7.1.3 for further explanation of the value order. |
|>Compensator Position |(300A,00EA) |1 |The x and y coordinates with respect to the Coordinate System |
| | | |Declaration (30xx,5208) of the upper left hand corner (first |
| | | |pixel transmitted) of the compensator, projected on the plane |
| | | |defined by the Beam Limiting Device Definition Distance |
| | | |(30xx,5210) (mm). |
|>Compensator Column Offset |(300A,02E5) |1C |The offset distance (in mm) applied to the x coordinate of the |
| | | |Compensator Position (300A,00EA) for even numbered rows. |
| | | |Required if the compensator pattern is hexagonal. |
|>Compensator Transmission Map |(30xx,5151) |1C |A data stream of the pixel samples which comprise the |
| | | |compensator, expressed as broad-beam transmission values |
| | | |(between 0 and 1) along a ray line passing through the pixel, at|
| | | |the beam energy as specified by Nominal Reference Energy |
| | | |(30xx,51CA). The order of pixels sent is left to right, top to |
| | | |bottom (i.e., the upper left pixel is sent first followed by the|
| | | |remainder of the first row, followed by the first pixel of the |
| | | |2nd row, then the remainder of the 2nd row and so on) when |
| | | |viewed from the radiation source. |
| | | |Required if Material ID (300A,00E1) is zero-length,has a value |
| | | |may be present otherwise. |
| | | |See C.AA.2.23.1.1. |
|>Compensator Thickness Map |(30xx,5152) |1C |A map of the physical thickness in mm of the compensator. A data|
| | | |stream of the pixel samples that comprise the compensator, |
| | | |expressed as physical The thickness (in mm), eitheris either |
| | | |parallel to the radiation beam axis if Compensator Divergence |
| | | |(300A,02E0) equals ABSENT, or geometrically divergent from the |
| | | |radiation beam axis according to the beam geometrical divergence|
| | | |if Compensator Divergence (300A,02E0) equals PRESENT. |
| | | |The order of pixels samples sent is left to right, top to bottom|
| | | |(upper left-samplepixel, followed by the remainder of row 1, |
| | | |followed by the remainder of the rows). |
| | | |Required if Material ID (300A,00E1) is non-zero lengthhas a |
| | | |value, may be present otherwise. |
| | | |See C.AA.2.23.1.1 and C.AA.2.23.1.2. |
|>Compensator Distance Map |(30xx,5153) |1C |A data stream of the pixel samples which comprise the distance |
| | | |from the RT Beam Distance Reference Location (30xx,5114) to the |
| | | |compensator surface closest to the radiation source (in mm). The|
| | | |order of pixels sent is left to right, top to bottom (upper left|
| | | |pixel, followed by the remainder of row 1, followed by the |
| | | |remainder of the rows). |
| | | |Required if Material ID (300A,00E1) is non-zero lengthhas a |
| | | |value, and Compensator Mounting Position (300A,02E1) is |
| | | |DOUBLE_SIDED. May be present if Material ID (300A,00E1) is zero |
| | | |lengthhas a value and Compensator Mounting Position (300A,02E1) |
| | | |is DOUBLE_SIDED. |
| | | |For the geometric definition, section C.8.8.14.10 applies. |
| | | |See C.AA.2.23.1.1 and C.AA.2.23.1.2. |
|>Compensator Milling Tool |(300A,02E8) |3 |The diameter (in mm) of the milling tool to be used to create |
|Diameter | | |the compensator. The diameter is expressed as the actual |
| | | |physical size and not a size projected on the plane defined by |
| | | |the Beam Limiting Device Definition Distance (30xx,5210). |
C.AA.2.24.1 Compensators Definition Macro Attributes Description
C.AA.2.24.1.1 Compensator Thickness and Transmission Map Precedence
If Compensator Thickness Map (30xx,5152) and Compensator Transmission Map (30xx,5151) are present, Compensator Transmission Map (30xx,5151) shall have precedence for dosimetric calculations.
C.AA.2.24.1.2 Compensator Thickness Map and Tray Distance
The values stored in Compensator Thickness Map (30xx,5152) and Tray Distance (30xx,5148) shall be parallel to the radiation beam axis if Compensator Divergence (300A,02E0) equals ABSENT, or divergent according to the beam geometrical divergence if Compensator Divergence (300A,02E0) equals PRESENT.
C.AA.2.25 Blocks Definition Macro
This macro may be invoked to define those attributes describing the geometric configuration of Blocks or Apertures which cannot vary during delivery.
Table C.AA.2.25-1
BLOCKS DEFINITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Total Block Tray Factor |(300A,00F2) |2C |Total block tray transmission for all block trays (between 0 and|
| | | |1) at the beam energy as specified by Nominal Reference Energy |
| | | |(30xx,51CA). |
| | | |Required when if Radiation Particle (30xx,5110) is PHOTON or |
| | | |ELECTRON. |
|Nominal Reference Energy |(30xx,51CA) |1C |The beam energy at which the Total Compensator Tray Factor |
| | | |(300A,00E2) is specified, expressed in units as specified in |
| | | |Unit Energy Unit Code Sequence (30xx,51C9). |
| | | |Required, if Total Compensator Tray Factor (300A,00E2) is |
| | | |present and has a valuenot empty. |
|Block Definition Sequence |(30xx,5160) |1C |Block definitions. |
| | | |Required if one or more blocks are present in the beam. |
| | | |One or more Items shall be included in this sequence. |
|>Include 'RT Accessory Device Identification Macro' Table |Defined CID SUP147032. |
|C.AA.2.15-1 | |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase monotonically by 1. |
|>Block Divergence |(300A,00FA) |1 |Specifies presence or otherwise of geometrical divergence. |
| | | |Enumerated Values: |
| | | |PRESENT = block edges are shaped for beam divergence |
| | | |ABSENT = block edges are not shaped for beam divergence |
|>Block Mounting Position |(300A,00FB) |1 |Specifies on which side of the Block Tray the block is mounted. |
| | | |Enumerated Values: |
| | | |PATIENT_SIDE = the block is mounted on the side of the Block |
| | | |Tray which is towards the patient. |
| | | |SOURCE_SIDE = the block is mounted on the side of the Block Tray|
| | | |which is towards the radiation source. |
|>Material ID |(300A,00E1) |2 |User-supplied identifier for material used to manufacture the |
| | | |Block. |
|>Block Thickness |(300A,0100) |2C |Physical thickness of block (in mm) parallel to radiation beam |
| | | |axis. Required if Material ID (300A,00E1) is non-zero length. |
| | | |May be present if Material ID (300A,00E1) is zero lengthhas a |
| | | |value. |
| | | |See C.AA.2.25.1.1 and C.AA.2.25.1.2. |
|>Block Transmission |(300A,0102) |2C |Transmission through the block (between 0 and 1) at the beam |
| | | |energy as specified by Nominal Reference Energy (30xx,51CA). |
| | | |The values of transmission shall be between 0.0 and 1.0 |
| | | |inclusive. |
| | | |Required if the SOP Class UID of the instance using this |
| | | |attribute is either 1.2.840.10008.5.1.4.1.1.481.XN.5.2 (C-Arm |
| | | |Photon Radiation Storage) or 1.2.840.10008.5.1.4.1.1.481.XN.5.3 |
| | | |(C-Arm Electron Radiation Storage), and Material ID (300A,00E1) |
| | | |is zero lengthhas a value. May be present if Material ID |
| | | |(300A,00E1) is non-zero length. |
| | | |See C.AA.2.25.1.1 and C.AA.2.25.1.2. |
|>Block Edge Data |(30xx,5161) |2 |A data stream of (x,y) pairs with respect to the Coordinate |
| | | |System Declaration (30xx,5208) which comprise the block edge. |
| | | |The pairs shall be interpreted as a closed polygon. Coordinates |
| | | |are projected on the plane defined by the Beam Limiting Device |
| | | |Definition Distance (30xx,5210) (mm). |
C.AA.2.25.1 Blocks Definition Macro Attribute Description
C.AA.2.25.1.1 Multiple aperture blocks
All blocks with Device Type Code Sequence (30xx,5026) with a value of (S147471, 99SUP147, “Aperture Block”) for a given beam shall have equal values of Block Transmission (300A,0102) and/or Block Thickness (300A,0100) if they are specified. The composite aperture shall be evaluated as the union of the individual apertures within a single Block. Shielding block transmission(s) shall be applied multiplicatively after the (composite) aperture has been evaluated.
C.AA.2.25.1.2 Block Thickness and Transmission Precedence
If Block Thickness (300A,0100) and Block Transmission (300A,0102) are both present, Block Transmission (300A,0102) shall have precedence for dosimetric calculations.
C.AA.2.26 Accessory Holder Definition Macro
This macro may be invoked to define those attributes describing the Accessory Holders which are used to hold accessories.
Table C.AA.2.26-1
ACCESORY HOLDER DEFINITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Accessory Holder Definition |(30xx,5170) |1C |Accessory Holder definitions. |
|Sequence | | |Required if one or more Accessory Holders are present in the beam.|
| | | |One or more Items shall be included in this sequence. |
|>Include 'RT Accessory Device Identification Macro' Table |Defined CID SUP147033. |
|C.AA.2.15-1 | |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase monotonically by 1. |
|>Tray Water-Equivalent |(30xx,02E3) |2C |Water-Equivalent thickness of the tray (in mm) parallel to |
|Thickness | | |radiation beam axis. |
| | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |(S147480, 99SUP147, “Tray””). |
|>Tray Distance |(30xx,5148) |2C |Distance (in mm) from the RT Beam Distance Reference Location |
| | | |(30xx,5114) to the tray edge to which the mounted item is |
| | | |attached. |
| | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |(S147480, 99SUP147, “Tray””). |
|>Slot Sequence |(30xx,) |1C |Slots being available in this Accessory Holder. |
| | | |Required if Device Type Code Sequence (30xx,5026) contains |
| | | |(S147481, 99SUP147, “Applicator”). |
| | | |One or more Items shall be included in this sequence. |
|>>RT Accessory Holder Slot ID |(30xx,054A) |1 |The ID of the slot where the accessory is inserted |
|>>Slot Distance |(30xx,) |2 |Distances (in mm) from the RT Beam Distance Reference Location |
| | | |(30xx,5114) to the slot along the beam axis. |
C.AA.2.26.1 Accessory Holder Description
A treatment delivery unit may allow the attachment of one or more aAccessory hHolders within which the user may install various devices for applying the beam to the patient. These installed devices may include, but not be limited to, one or more of the following items:
(TBD: construct as a list) custom blocks for patient specific lateral collimation (beam limiting), pre-collimators for general lateral collimation (beam limiting), uniform thickness range shifter for modifying the range uniformly across the beam, two-dimensional range shifters (custom boluses) for modifying the range differentially across the defined field, ridge filters for creating multiple ranges within the beam, cross-wires for aligning the patient with the beam, a mirror or camera for aligning or viewing the irradiated area, beam monitoring detectors, and a applicator sealer for preventing fluids from entering the applicator.
Several beam applicators may be available with a single radiation head to reduce the weight of components lifted by therapists, decrease the block and/or bolus to skin distance, and reduce leakage of radiation.
C.AA.2.27 General Accessories Definition Macro
This macro may be invoked to define those attributes describing the geometric configuration of General Accessories which cannot vary during delivery.
Table C.AA.2.27-1
GENERAL ACCESSORIES DEFINITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|General Accessory Definition |(30xx,5180) |1C |General accessories. |
|Sequence | | |Required if one or more general accessories are present in the |
| | | |beam. |
| | | |One or more Items shall be included in this sequence. |
|>Include 'RT Accessory Device Identification Macro' Table |Baseline CID SUP147030. |
|C.AA.2.15-1 | |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase monotonically by 1. |
C.AA.2.28 Boluses Definition Macro
This macro may be invoked to define those attributes describing the geometric configuration of Boluses which cannot vary during delivery.
Table C.AA.2.28-1
BOLUSES DEFINITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Boluses Definition Sequence |(30xx,5190) |1C |Bolus definitions. |
| | | |Required if one or more boluses are presentutilized for that |
| | | |beam. |
| | | |One or more Items shall be included in this sequence. |
|>Include 'RT Accessory Device Identification Macro' Table |Defined CID SUP147031. |
|C.AA.2.15-1 | |
|>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase monotonically by 1. |
|>Conceptual Volume Sequence |(30xx,1346) |23 |References a conceptual volume that describes the geometry and |
| | | |properties of the bolus. |
| | | |See Section C.AA.2.28.1.1. |
| | | |Only Zero or one a single Item is permitted in this sequence. |
|>>Include ‘Conceptual Volume Segmentation Reference and Combination Macro' Table C.AA.2.6-1 |
C.AA.2.28.1 Bolus Definition Macro Attribute Description
C.AA.2.28.1.1 Conceptual Volume Sequence
The Conceptual Volume Sequence (30xx,1346), if present, identifies the segmented Conceptual Volume used to define the bolus. The segment is defined by the Referenced Segment Annotation Index (30xx,0151) in the Conceptual Volume Segmentation Reference and Combination Macro (see section C.AA.2.6). Alternatively, the bolus may not be associated with a segment. For example, a bolus may cover the entire area of radiation and not require a specific segmentation for definition.
C.AA.2.29 Outline Definition Macro
The Outline Definition Macro contains attributes to describes a geometric 2D geometric outline in a given coordinate system.
Table C.AA.2.29-1
OUTLINE DEFINITON MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Outline Shape Type |(30xx,5200) |1 |Shape of the outline. |
| | | |Enumerated values: |
| | | |SQUARE |
| | | |RECTANGULAR |
| | | |CIRCULAR |
| | | |POLYGONAL |
|Outline Symmetry |(30xx,5201) |1 |Defines the s |
| | | |Symmetry of the Outline Shape with respect to the |
| | | |z- axis of the central axis of the beam. |
| | | |Enumerated Values: |
| | | |SYMMETRIC |
| | | |ASYMMETRIC |
| | | |See section C.AA.2.29.1.1. |
|Outline Definition Plane Distance |(30xx,5209) |1 |Distance along the beam line from the RT Beam |
| | | |Distance Reference Location (30xx,5114) to the |
| | | |plane in which the outline is outline definedition|
| | | |plane. The outline definition plane shall be |
| | | |normal to the beam line. |
|Outline Edges X |(30xx,5202) |1C |Position of the X1 and X2 edges of a rectangular |
| | | |outline with respect to the Coordinate System |
| | | |Declaration (30xx,5208). |
| | | |Required if Outline Shape Type (30xx,5200) is |
| | | |SQUARE or RECTANGULAR. |
| | | |Only a single value shall be present Item shall be|
| | | |included in this sequence if Outline Shape Type is|
| | | |(30xx,5200) is SQUARE and Outline Symmetry |
| | | |(30xx,5201) is SYMMETRIC which describes the X |
| | | |edges symmetrical to the y-axis with respect to |
| | | |the Coordinate System Declaration (30xx,5208). |
| | | |The absolute values of X1 and X2 shall be equal in|
| | | |case Outline Shape Type (30xx,5200) is RECTANGULAR|
| | | |and Outline Symmetry (30xx,5201) is SYMMETRIC. |
|Outline Edges Y |(30xx,5203) |1C |Position of the Y1 and Y2 edges of rectangular |
| | | |outline with respect to the Coordinate System |
| | | |Declaration (30xx,5208). |
| | | |Required if Outline Shape Type (30xx,5200) is |
| | | |RECTANGULAR.Required if Outline Shape Type |
| | | |(30xx,5200) is SQUARE or RECTANGULAR. |
| | | |Only a single Item shall be included in this |
| | | |sequence if Outline Shape Type is (30xx,5200) is |
| | | |SQUARE and Outline Symmetry (30xx,5201) is |
| | | |SYMMETRIC which describes the Y edges symmetrical |
| | | |to the x-axis with respect to the Coordinate |
| | | |System Declaration (30xx,5208). |
| | | |The absolute values of Y1 and Y2 shall be equal in|
| | | |case Outline Shape Type (30xx,5200) is RECTANGULAR|
| | | |and Outline Symmetry (30xx,5201) is SYMMETRIC. |
|Center of Circular Outline |(30xx,5204) |2C |Location (x,y) of the center of the circular |
| | | |outline in with respect to the Coordinate System |
| | | |Declaration (30xx,5208). |
| | | |Required if Outline Shape Type (30xx,5200) is |
| | | |CIRCULAR. and Outline Symmetry (30xx,5201) is |
| | | |ASYMMETRIC. |
|Diameter of Circular Outline |(30xx,5205) |1C |Diameter of circular outline in with respect to |
| | | |the Coordinate System Declaration (30xx,5208). If |
| | | |Outline Symmetry (30xx,5201) is SYMMETRIC the |
| | | |center location is defined as the center of the |
| | | |beam. |
| | | |Required if Outline Shape Type (30xx,5200) is |
| | | |CIRCULAR. |
|Number of Polygonal Vertices |(30xx,5206) |1C |Number of Vertices in Vertices of the Polygonal |
| | | |Outline (30xx,5207). Required if Outline Shape |
| | | |Type (30xx,5200) is POLYGONAL. |
|Vertices of the Polygonal Outline |(30xx,5207) |1C |List of (x,y) pairs with respect to the Coordinate|
| | | |System Declaration (30xx,5208). Polygonal outlines|
| | | |are implicitly closed from the last vertex to the |
| | | |origin vertex and all edges shall be |
| | | |non-intersecting except at the vertices. Required |
| | | |if Outline Shape Type (30xx,5200) is POLYGONAL. |
| | | |If Outline Symmetry (30xx,5201) is SYMMETRIC the |
| | | |polygonal shall be symmetric to the origin with |
| | | |respect to the Coordinate System Declaration |
| | | |(30xx,5208). |
C.AA.2.29.1 Outline Definition Macro Attribute Description
C.AA.2.29.1.1 Outline Symmetry
The term SYMMETRIC applies when the outline is mirror symmetric in respect to both the x-axis and the y-axis of the coordinate system referenced in Coordinate System Declaration (30xx,5208). This terminology also applies to outlines having the Outline Shape Type (30xx,5200) POLYGONAL, if those conditions are fulfilled.
C.AA.2.30 RT Tolerance Set Macro
The RT Tolerance Set Macro contains information describing the maximum permitted differences between planned and delivered values. This information is used in the context of delivery of the RT Radiation Set. If the absolute difference between a planned and delivered value exceeds the tolerance value, then delivery of the RT Radiation Set shall be inhibited unless an authorized operator confirms that the tolerance may be exceeded.
Table C.AA.2.30-1
RT TOLERANCE SET MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|RT Tolerance Set Label |(30xx,0BA2) |1 |User defined label for the Tolerance Set. |
|RT Tolerance Set Index |(30xx,0114) |1 |Index of the item in the sequence used for internal or external |
| | | |references |
| | | |The value shall start at 1, and increase monotonically by 1. |
|Attribute Tolerance Values |(30xx,0BA6) |21C |Tolerance values representing the allowed difference between the|
|Sequence | | |planned and actual values. |
| | | |for the attributes specified by tThe Selector Attribute Macro |
| | | |identifies the attributes for which the tolerances are |
| | | |specified. |
| | | |Zero or more Items shall be included in this sequence. |
| | | |Required, if a tolerance value is specified for at least one |
| | | |attribute which can be referenced by the Selector Attribute |
| | | |Macro. |
| | | |For further information sSee section C.AA.2.30.1. |
| | | |Zero or more Items shall be included in this sequence. |
|>Include 'Selector Attribute Macro' Table 10-20 |
|>Tolerance Value |(30xx,0BA8) |1 |Maximum permitted difference between the planned and the |
| | | |delivered value. Units are those specified for the corresponding|
| | | |attribute referenced by the Selector Attribute Macro. |
|Patient Support Position |(30xx,0BAA) |21C |Tolerance values for a patient support position as supported by |
|Tolerance Sequence | | |a delivery device. |
| | | |Required if a tolerance value is specified for at least one |
| | | |patient support position parameter. |
| | | |For further information sSee section C.AA.2.30.1.2. |
| | | |Zero Zero or more Items shall be included in this sequence. |
|>Include 'Content Item Macro' Table 10-2 |Baseline TID of Concept Name Code Sequence is TID SUP147004. |
| |Content items shall use UCUM units of mm and degrees where |
| |applicable. |
C.AA.2.30.1 RT Tolerance Set Attribute Description
C.AA.2.30.1.1 Attribute Tolerance Values Sequence
The Attribute Tolerance Values Sequence (30xx,0BA6) allows for the reference to any numerical parameter in a Radiation IOD. The RT Tolerance Set Macro is invoked to specify a tolerance value for this parameter. The reference specification is conveyed by the Selector Attribute Macro, which allows reference to a tag on any level of nested sequences, and to refer to specific items in the sequence.
If the specified tolerance applies to the values of the specified tag in all items of a sequence, the identification of the Selector Sequence Pointer Items (0074,1057) on the level in question shall have the value 0.
The unit of the tolerance value is the unit as specified by the data element tag referenced in the Selector Attribute (0072,0026).
C.AA.2.30.1.2 Patient Support Position Tolerance Sequence
When describing a tolerance for a specific patient support position value, the patient support device parameter is defined using the same code otherwise used in the Patient Support Position Macro in section C.AA.2.13.
C.AA.2.31 Patient to Equipment Relationship Macro
The Patient to Equipment Relationship Macro describes a position of the patient in respect to an RT device. That position could be a Treatment Position, an Imaging Position, a Setup Position or anything else. The purpose of the patient position in the equipment system is defined at the invocation of the macro. The position is defined by either the means of a transformation matrix between a patient frame of reference and a equipment system, or by a set of device-specific parameters, or both.
Table C.AA.2.31-1
PATIENT TO EQUIPMENT RELATIONSHIP MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Frame of Reference |(3006,00C8) |3 |Comments about the relationship between the patient frame of |
|Transformation Comment | | |reference and the equipment. Shall be free text entered by a |
| | | |human operator, shall not be used programmatically. |
|Patient Frame of Reference to |(30xx,6040) |1C |A rigid, homogeneous 4x4 transformation matrix that maps the |
|Equipment Mapping Matrix | | |patient coordinate space in the Frame of Reference used for the|
| | | |patient model to the equipment-defined Equipment Frame of |
| | | |Reference. Matrix elements shall be listed in row-major order. |
| | | |See C.AA.2.31.1. |
| | | |Required if the relation of the patient coordinate system to |
| | | |the treatment equipment coordinate system can be described by a|
| | | |transformation between these systems. |
|Patient Location Coordinates |(30xx,6042) |2C |Sequence of patient coordinates for transformation to the |
|Sequence | | |equipment coordinate system. |
| | | |Required, if the Patient Frame of Reference to Equipment |
| | | |Mapping Matrix (30xx,6040) is present and if any specific |
| | | |points should be annotated, which are useful at the position |
| | | |where the patient located in respect to the equipment. |
| | | |Zero or more Items shall be included in this sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1 | |
|>3D Point Coordinate |(0068,6590) |1C |Coordinate describing a location in the patient Frame of |
| | | |Reference that will be transformed to the Equipment Frame of |
| | | |Reference by using the Patient Frame of Reference to Equipment |
| | | |Mapping Matrix (30xx,6040). |
| | | |Required if Fiducial UID (0070,031A) is not present. |
|>Fiducial UID |(0070,031A) |1C |The UID that identifies the fiducial describing a location in |
| | | |the patient Frame of Reference that will be transformed to the |
| | | |Equipment Frame of Reference by using the Patient Frame of |
| | | |Reference to Equipment Matrix (30xx,6040). |
| | | |Required if 3D Point Coordinate (0068,6590) is not present. |
|Patient Support Position |(30xx,6046) |1C |Sequence of items describing the actual Patient Support |
|Sequence | | |Position Parameters. |
| | | |Required if the patient position is only available by |
| | | |machine-parameters of the patient support system. May be |
| | | |present otherwise. See C.AA.2.31.1. |
| | | |Only a single Item shall be included in this sequence. |
|>Include 'Patient Support Position Macro' Table C.AA.2.13-1. |
C.AA.2.31.1 Patient to Equipment Relationship Macro Attributes Description
C.AA.2.31.1.1 Patient Frame of Reference to Equipment Mapping Matrix and Patient Support Position Macro
The Patient Frame of Reference to Equipment Mapping Matrix (30xx,6040) describes the relationship between the Patient-oriented coordinate system and an RT Device-Specific coordinate system. This matrix AMB describes how to transform a point (Bx,By,Bz) with respect to the Patient coordinate system into (Ax,Ay,Az) with respect to the equipment coordinate system as defined in chapter C.7.6.21.1. It shall be a rigid transformation that only includes rotations and translations.
The RT Device-specific coordinate system is identified by the Equipment Frame of Reference UID (30xx,51A0). For further information on the definition of the Equipment Frame of Reference, see Section C.AA.E1.1.3. The patient-oriented coordinate system is identified by the Frame Of Reference UID (0020,0052) in the Frame of Reference Module of the SOP instance it is used within. Both coordinate systems are expressed in millimeters.
The Patient Support Position Macro allows the specification of device-specific parameters for the patient support device, and thereby provides the relationship between a Patient Support System and the RT Device-Specific coordinate System. This relationship is known to all applications which know the geometric interpretation of those parameters. Applications which do not know that cannot construct this geometric relationship, but will be able to display the labels and numerical values of those parameters.
In standard planning cases where the relation between the patient system and the equipment system is known, the Patient Frame of Reference to Equipment Mapping Matrix (30xx,6040) shall be used over the Patient Support Position Sequence (30xx,6046). The Patient Support Position Sequence (30xx,6046) may be present in this case to annotate the matrix and visualize the decomposed matrix contents. No programmatic information shall then be derived from the Patient Support Position Macro in this case.
In some cases (e.g. emergency treatments), the relationship between the DICOM Patient Coordinate System and the Equipment Frame of Reference may not be known or a Patient Coordinate System may not be administered at all. In this case an arbitrary Frame of Reference is used for the patient coordinate system in the Frame of Reference Module of the SOP instance, but the Patient Frame of Reference to Equipment Mapping Matrix may not be used. In this case, the patient support parameters shall be supplied by the Patient Support Position Sequence (30xx,6046).
If the Patient Frame of Reference to Equipment Mapping Matrix and the Patient Support Position Sequence (30xx,6046) are both present, the information in both locations shall be consistent.
C.AA.2.32 RT Treatment Position Macro
The RT Treatment Position Macro establishes a connection between the patient’s geometry and the treatment delivery equipment to define the treatment position. This treatment position is the one as prescribed, when used in a RT Radiation object, and one as recorded in the RT Radiation Record object.
Table C.AA.2.32-1
RT TREATMENT POSITION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Patient Orientation Code Sequence |(0054,0410) |1 |Sequence that describes the orientation of the |
| | | |patient with respect to gravity. See C.8.4.6.1.1 |
| | | |for further explanation. |
| | | |Only one item shall be present. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID 19 |
|Patient Orientation Modifier Code Sequence |(0054,0412) |1 |Sequence describing the orientation of the patient |
| | | |with respect to gravity. |
| | | |Only one item shall be present. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID 20 |
|Patient Gantry Relationship Code Sequence |(0054,0414) |1 |Sequence describing the orientation of the patient |
| | | |with respect to gantry. |
| | | |Only one item shall be present. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID 21 |
|Patient Setup UID |(30xx,5060) |1 |Identifies a conceptual patient setup, realized by |
| | | |one or more RT Patient Setup instances. |
|Treatment Position Sequence |(30xx,5028) |1 |Sequence of items describing the treatment |
| | | |position. |
| | | |There shall be no more items present than number of|
| | | |items in the enclosing Control Point Sequence. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Referenced Control Point Index |(30xx,0141) |1 |References the Control Point Index (30xx,0111) |
| | | |identifying the control point, starting from which |
| | | |that treatment position is applied. |
| | | |Only control points at which changes occur shall be|
| | | |referenced. No control point shall be referenced |
| | | |more than once. The Referenced Item Number shall be|
| | | |monotonically increasing. |
| | | |The first item in the Treatment Position Sequence |
| | | |(30xx,5028) shall have the value 1. |
|>Include 'Patient to Equipment Relationship Macro' Table C.AA.2.31-1 |Defined CID SUP147005 |
C.AA.2.33 User Content Identification Macro
The User Content Identification Macro identifies content using a label supporting lower case characters and differing character sets. If a Code String is required, see Content Identification Macro (Section 10.9).
Table C.AA.2.33-1
USER CONTENT IDENTIFICATION MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|User Content Label |(30xx,51E0) |1 |A short, free text label that is used to identify |
| | | |this SOP Instance. |
| | | |See C.AA.2.33.1.1. |
|Content Description |(0070,0081) |2 |A description of the content of the SOP Instance. |
| | | |See C.AA.2.33.1.1. |
|Content Creator’s Name |(0070,0084) |2 |Name of operator (such as a technologist or |
| | | |physician) creating the content of the SOP |
| | | |Instance. |
|Content Creator’s Identification Code Sequence|(0070,0086) |3 |Identification of the person who created the real |
| | | |world value mapping. |
| | | |Only a single Item is permitted in this sequence. |
|> Include 'Person Identification Macro' Table 10-1 |
C.AA.2.33.1 User Content Identification Macro Attribute Description
C.AA.2.33.1.1 User Content Label and Content Description
User Content Label (30xx,51E0) shall represent a user-definable short free text providing the primary identification of this entity to other users. Note that the Content Label (0070,0080) attribute used in the widely-used Content Identification Macro is a Code String, not free text. Content Description (0070,0081) allows a longer string containing additional descriptive identifying text for one-line headings etc.
This information is intended only for display to human readers and shall not be used programmatically.
For RT Radiation IODs (those including the RT Radiation Common Module), User Content Label (30xx,51E0) is intended to be unique across a particular radiation set. Content Description (0070,0081) contains additional information intended for detailed display, such as in a tool tip.
C.AA.2.34 RT Treatment Phase Macro
The treatment phase macro contains the information about a RT Treatment Phase
Table C.AA.2.34-1
RT TREATMENT PHASE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Treatment Phase Index |(30xx,0116) |1 |Index of the Treatment Phase in the sequence used |
| | | |for internal or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|Include 'RT Entity Labeling Macro' Table C.AA.2.1-1 |
|Intended Phase Start Date |(30xx,088C) |2 |The date, when this treatment phase is suggested |
| | | |to start. |
| | | |See section C.AA.2.34.1 |
|Intended Phase End Date |(30xx,088E) |2 |The date, when this treatment phase is suggested |
| | | |to be completed. |
| | | |See section C.AA.2.34.1 |
C.AA.2.34.1 RT Treatment Phase Macro Attribute Description
C.AA.2.34.1.1 Intended Phase Start Date, Intended Phase end Date
The Intended Phase Start Date (30xx,088C) and Intended Phase End Date (30xx,088E) contains the definition of the date, when this treatment phase is intended to be started respectively to be completed. It is important not to confuse the content of that attribute with date when the treatment delivery actual starts respectively ends. That effective date is managed by workflow systems, where definitive treatment session scheduling is maintained. Actual dates of performed delivery will then be available by RT Radiation Record IODs. Those actual dates may differ from the Intended Phase Start Date (30xx,088C) and/or Intended Phase End Date (30xx,088E).
C.AA.2.35 RT Treatment Phase Interval Macro
The Treatment Phase Interval Macro contains the information about time-relationship between RT Treatment Phases.
Table C.AA.2.35-1
RT TREATMENT PHASE INTERVAL MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Treatment Phase Interval Sequence |(30xx,0890) |2 |Sequence of intervals between treatment phases. |
| | | |Zero or more items shall be included in that |
| | | |sequence. |
| | | |See C.AA.2.35.1. |
|>Previous Treatment Phase Index |(30xx,0116) |1 |The Treatment Phase for which a Treatment Phase |
| | | |Interval is defined. |
| | | |This index corresponds to an item in the Treatment|
| | | |Phase Sequence (30xx,0880). Each Treatment Phase |
| | | |Index value shall appear only once in this |
| | | |sequence. |
| | | |See C.AA.2.35.1. |
|>Consecutive Treatment Phase Index |(30xx,0146) |1 |The Treatment Phase to which the phase identified |
| | | |by Treatment Phase Index (30xx,0116) is related. |
| | | |See C.AA.2.35.1. |
|>Temporal Relationship Interval Anchor |(30xx,0892) |1C |The anchor point of the Interval specified in that|
| | | |item in respect to the phase referenced by the |
| | | |Consecutive Treatment Phase Index (30xx,0146). |
| | | |Enumerated Values: |
| | | |START: The interval is specified with respect to |
| | | |the start of the reference phase. |
| | | |END: The interval is specified with respect to the|
| | | |end of the reference phase. |
| | | |Required if Minimum Number of Interval Days |
| | | |(30xx,0894) or Maximum Number of Interval Days |
| | | |(30xx,0896) is present and not empty. |
|>Minimum Number of Interval Days |(30xx,0894) |2C |The minimum number of days when the actual phase |
| | | |should follow the treatment phase referenced in |
| | | |Referenced Treatment Phase Index (30xx,0146). |
| | | |Fractional days and negative values are allowed. |
|>Maximum Number of Interval Days |(30xx,0896) |2C |The maximum number of days when the actual phase |
| | | |should follow the treatment phase referenced in |
| | | |Referenced Treatment Phase Index (30xx,0146). |
| | | |Fractional days and negative values are allowed. |
C.AA.2.35.1 Referenced Treatment Phases
The Treatment Phase Interval Sequence (30xx,0890) allows to define an interval between two treatment phases. Treatment Phases referenced by Previous Treatment Phase Index (30xx,0116) and Consecutive Treatment Phase Index (30xx,0146) are linked together along with the definition of the number of days in-between them. Note that the number of days can also be negative and therefore the consecutive treatment phase will start before the prior treatment phase.
As a result of the combinations possible, The maximum number of Items in the Treatment Phase Interval Sequence (30xx,0890) shall be one less than the number of treatment phases present.
C.AA.A1 Enhanced RT Series Module
The Second Generation Radiotherapy IODs use the General Series module described in section C.7.3.1, specialized by the Enhanced RT Series Module.
Table C.AA.A0-1 specifies the attributes that identify and describe general information about the Enhanced RT Series.
Table C.AA.A1-1
ENHANCED RT SERIES MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Modality |(0008,0060) |1 |Type of equipment that originally acquired the data|
| | | |used to create the images in this Series. See |
| | | |C.AA.A1.1.1. |
| | | |Enumerated Values: |
| | | |RT |
|Referenced Performed Procedure Step Sequence |(0008,1111) |1C |Uniquely identifies the Performed Procedure Step |
| | | |SOP Instance that resulted in creation of the |
| | | |Series (e.g. a Modality or Unified Procedure Step |
| | | |SOP Instance). |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |Required if this instance has been created as a |
| | | |result of a procedure step request. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.A1.1 Enhanced RT Series Attribute Description
C.AA.A1.1.1 Modality
The Modality (0008,0060) of ‘RT’ allows a single device to include SOP instances of different SOP Classes created in the same session of activity to be stored in the same series. A treatment planning system creating a segmentation properties object, plan, and dose as output of a planning process is one such example. See Section A.VV.1.1.1.2 for further explanation on use of Modality in radiotherapy.
C.AA.A2 Radiotherapy Common Instance Module
Table C.AA.A2-1 specifies the attributes that identify and describe general information about any and all Second Generation Radiotherapy IODs.
Table C.AA.A2-1
RADIOTHERAPY COMMON INSTANCE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Instance Number |(0020,0013) |1 |A number that identifies this SOP Instance. |
|Include 'User Content Identification Macro' Table C.AA.2.33-1 |
|Include 'RT Entity Labeling Macro' Table C.AA.2.1-1 |
C.AA.A3 RT Course Module
The RT Course module contains general information for the RT Course IOD.
Table C.AA.A3-1
RT COURSE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|RT Course Creation DateTime |(30xx,0800) |1 |The date and time when this RT Course definition was |
| | | |created. |
|RT Course Scope Indicator |(30xx,0804) |2 |Definition of the scope of this RT Course. |
| | | |Defined Terms: |
| | | |PARTIAL = RT Course SOP Instance contains a subset of|
| | | |all data related to the treatment course at the time |
| | | |it was created. |
| | | |COMPLETE = The RT Course originated from an |
| | | |application with an authoritative role in managing |
| | | |the RT Course in a department. |
| | | |See C.AA.A3.1.1. |
|RT Prescription Reference Presence Flag |(30xx,0805) |1 |Defines whether an RT Prescription Reference is |
| | | |present. |
| | | |Enumerated Values: |
| | | |YES |
| | | |NO |
|RT Treatment Phase Presence Flag |(30xx,0806) |1 |Defines whether an RT Treatment Phase definition is |
| | | |present. |
| | | |Enumerated Values: |
| | | |YES |
| | | |NO |
|RT Radiation Set Reference Presence Flag |(30xx,0807) |1 |Defines whether a RT Radiation Set Reference is |
| | | |present. |
| | | |Enumerated Values: |
| | | |YES |
| | | |NO |
|Current Course Predecessor Sequence |(30xx,080A) |2 |Reference to historical versions of the RT Course. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
| | | |See Note 1. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|Prior Treatment Sequence |(30xx,0822) |2C |Former treatments that have been delivered to this |
| | | |patient. |
| | | |Required if a previous radiation therapy treatment of|
| | | |the patient occurred and is known. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>Prior RT Course Sequence |(30xx,0824) |1C |Reference to an RT Course previously established and |
| | | |terminated. |
| | | |Required if Delivered Radiation Dose Sequence |
| | | |(30xx,0826) is not present. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See Note 1. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Delivered Radiation Dose Sequence |(30xx,0826) |1C |Delivered doses from former treatments before the |
| | | |current RT Course. |
| | | |Required if Prior RT Course Sequence (30xx,0824) is |
| | | |not present. May be present otherwise. |
| | | |One or more Items shall be included in this sequence.|
| | | |See Note 2. |
|>>Delivered Radiation Dose |(30xx,0828) |1 |The Dose (in Gray) that was delivered. |
|>>Conceptual Volume Sequence |(30xx,1346) |1C |References to conceptual volumes which received dose |
| | | |in former treatments. |
| | | |Required if the former dose can be traced back to a |
| | | |conceptual volume. |
| | | |One or more Items shall be included in this sequence.|
|>>>Include ‘Conceptual Volume Segmentation Reference and Combination Macro' Table C.AA.2.6-1 |
|>>Delivered Irradiated Volume Description |(30xx,082C) |1C |A textual description of the volume that received |
| | | |dose in former treatments. |
| | | |Required if Conceptual Volume Sequence (30xx,1346) is|
| | | |not present. May be present otherwise. |
|RT Course State Sequence |(30xx,0830) |1 |Defines the state of this RT Course. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See Note 3. |
|>Include 'RT Item State Macro’ Table C.AA.2.3-1 |Defined CIDfor the Assertion Code Sequence |
| |(30xx,50A0) shall be SUP147043. |
| |See C.AA.A3.1.3. |
C.AA.A3.1 RT Course Attribute Description
C.AA.A3.1.1 RT Course Scope Indicator
It is generally assumed that there is only one ‘active’ RT Course SOP Instance at a given time, for a given ‘course’ of treatment. However, this is not guaranteed by technical means, and therefore it is the specific configuration of devices and the workflow definition within a department that defines the roles with respect to the RT Course (for further information see DICOM Part 17, Section ZZ.2). Within this paradigm, a device may know that it has only a partial knowledge of all involved SOP Instances (e.g. only that knowledge needed to perform a specific activity), and therefore deliberately annotate an RT Course with a RT Course Scope Indicator (30xx,0804) of PARTIAL.
In absence of a value no statement can be made about the scope of the current RT Course SOP instance.
C.AA.A3.1.2 Delivered Radiation Dose Sequence
The Delivered Radiation Dose Sequence (30xx,0826) in the Prior Treatment Sequence is intended to contain information about treatments that have not been under the regime of a former RT Course, and therefore have to be recorded explicitly. This shall address especially the situation of denoting former treatments handled by an application which does not support the 2nd generation RT IODs.
C.AA.A3.1.3 RT Course State Sequence
A value of (S147652, 99SUP147, “Approved”) means, that all of the information in this instance of the RT Course SOP instance is approved, but not the information in objects referenced by the RT Course . Those referenced object have their own states at the place, where they are referenced.
The transitions between states are not defined in DICOM.
C.AA.A4 RT Prescription Reference Module
The RT Prescription Reference Module contains information about the physician’s prescriptions and the intended time structure of treatment delivery.
Table C.AA.A4-1
RT PRESCRIPTION REFERENCE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Physician Intent Prescription Sequence |(30xx,0860) |1 |Referenced physician intents for the RT Course. |
| | | |One or more Items shall be included in this sequence.|
|>RT Prescription Index |(30xx,0118) |1 |Index of the item in the sequence used for internal |
| | | |or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Referenced Physician Intent Sequence |(30xx,0864) |1 |Reference to RT Physician Intent SOP Instance that |
| | | |contains the prescription referenced in this |
| | | |sequence. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>Referenced RT Prescription Index |(30xx,0148) |1 |Reference to the RT Prescription Index (30xx,0118) in|
| | | |the SOP Instance encoded in the Referenced Physician |
| | | |Intent Sequence (30xx,0864), identifying the |
| | | |prescription for this sequence. |
|>Physician Intent Prescription Status |(30xx,0866) |1 |Defines the status of the prescription in the |
|Sequence | | |physician intent. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'RT Item State Macro’ Table C.AA.2.3-1 |Defined CID for the Assertion Code Sequence |
| |(30xx,50A0) shall be SUP147043. |
| |See C.AA.A4.1.1 |
|>Treatment Phase Reference Sequence |(30xx,0870) |1C |Referenced treatment phase(s) to which this |
| | | |prescription applies, and which will contain the |
| | | |radiation sets for the treatments administered by |
| | | |this prescription. |
| | | |Required if Treatment Phase Sequence (30xx,0880) is |
| | | |present in the RT Treatment Phase module of this RT |
| | | |Course SOP instance. |
| | | |One or more Items shall be included in this sequence.|
|>>Referenced Treatment Phase Index |(30xx,0146) |1 |Reference to the Treatment Phase Index (30xx,0116) |
| | | |where this prescription does apply to. |
|>Referenced RT Segment Annotation Sequence |(30xx,0874) |2 |Referenced RT Segment Annotation SOP Instances for |
| | | |which this prescription applies. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.A4.1 RT Prescription Reference Attribute Description
C.AA.A4.1.1 RT Item State Macro Meanings
For the states listed in the following, further annotations are provided, how the definitions in ANNEX D, DICOM CONTROLLED TERMINOLOGY DEFINITIONS shall be applied in this context:
A value of (S147651, 99SUP147, “Reviewed”) means, that the Intent has been reviewed.
A value of (S147652, 99SUP147, “Approved”) means, that the Intent has been approved. It is ready to be used for treatment planning.
A value of (S147653, 99SUP147, “Rejected”) means, that the Intent has been rejected shall not be used for treatment planning.
C.AA.A5 RT Treatment Phase Module
The treatment phases defined for this RT Course. Treatment phases define the time structure of the RT Course, by defining phases for treatment and the time order in which radiation sets are treated in relation to each other.
Table C.AA.A5-1
RT TREATMENT PHASE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Treatment Phase Sequence |(30xx,0880) |1 |Phases for the current RT Course. The treatment |
| | | |phases serve as the basis to define the chronological|
| | | |relationship between radiation sets, which are |
| | | |concurrently and/or subsequently treated in a defined|
| | | |relationship to each other. |
| | | |The order of the Treatment Phase Index (30xx,0116) |
| | | |defines the date sequencing of the phases. |
| | | |One or more Items shall be included in this sequence.|
|>Include 'RT Treatment Phase Macro' Table C.AA.2.34-1 |
|>RT Treatment Phase State Sequence |(30xx,088A) |1 |Defines the state of this phase. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'RT Item State Macro' Table C.AA.2.3-1 |Defined CID for the Assertion Code Sequence |
| |(30xx,50A0) shall be SUP147043. |
| |See C.AA.A5.1.1 |
|Include 'RT Treatment Phase Interval Macro' Table C.AA.2.35-1 |
C.AA.A5.1 RT Treatment Phase Attribute Description
C.AA.A5.1.1 RT Item State Macro Meanings
For the states listed in the following, further annotations are provided, how the definitions in ANNEX D, DICOM CONTROLLED TERMINOLOGY DEFINITIONS shall be applied in this context:
A value of (S147651, 99SUP147, “Reviewed”) means, that the treatment phase has been reviewed.
A value of (S147652, 99SUP147, “Approved”) means, that the treatment phase has been approved. The intended timing is ready to be used for fractionation.
A value of (S147653, 99SUP147, “Rejected”) means, that the current treatment phase has been rejected and shall not be used.
C.AA.A6 RT Radiation Set Reference Module
The RT Radiation Set Reference Module contains information about radiation sets being prepared, in treatment and finished (discontinued or retired). These radiation sets will typically refer to prescriptions contained in the RT Prescription Reference Module, as being part of the realization of a certain prescription. The module also contains information about the chronological relation of the radiation sets to each other (subsequent, in parallel, etc.).
The top-level sequence is called the ‘Meta RT Radiation Set Sequence’ because it may include several radiation sets for several purposes. Those may be a set to perform and record a virtual or real simulation, a set to calculate dose, and typically the actual radiation set(s) to be treated.
Table C.AA.A6-1
RT RADIATION SET REFERENCE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Meta RT Radiation Set Sequence |(30xx,08B0) |1 |Meta RT Radiation Sets within this phase. |
| | | |One or more Items shall be included in this sequence.|
|>Include 'RT Entity Labeling Macro' Table C.AA.2.1-1 |
|>Meta RT Radiation Set Index |(30xx,0117) |1 |Index of the Meta RT Radiation Set in the sequence |
| | | |used for internal or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Referenced RT Prescription Index |(30xx,08C2) |1C |References the Prescription Index (30xx,0118) in the |
| | | |RT Prescription Reference Module for which this RT |
| | | |Radiation Set is defined. |
| | | |Required if the referenced RT Radiation Set is based |
| | | |on a Physician Intent. |
|>Referenced Treatment Phase Index |(30xx,08C3) |1C |References the Treatment Phase Index (30xx,0116) in |
| | | |the Treatment Phase Sequence (30xx,0880) in the RT |
| | | |Treatment Phase module of this SOP instance. |
| | | |Required if the Treatment Phase Sequence (30xx,0880) |
| | | |is present. |
|>Radiation Set Start Delay |(30xx,08C6) |1C |Defines the minimum delay in days for the first day |
| | | |of treatment with respect to the beginning of the |
| | | |treatment phase containing the referenced RT |
| | | |Radiation Set, as referenced by Treatment Phase |
| | | |Referenced Item Number (30xx,08C3). |
| | | |If a Fractionation Pattern (300A,007B) contains one |
| | | |or more zeros starting on the week day of the first |
| | | |day following the Radiation Set Start Delay |
| | | |(30xx,08C6), then treatment starts at the first |
| | | |occurrence of 1 in the pattern. |
| | | |Required if Treatment Phase Referenced Item Number |
| | | |(30xx,08C3) is present. |
| | | |See C.AA.A6.1.2 |
|>Meta RT Radiation Set Relationship Sequence|(30xx,0123) |2 |Fraction-based relationship to another Meta RT |
| | | |Radiation Set. |
| | | |Zero or one Item shall be included in this sequence. |
|>>Referenced Meta RT Radiation Set Index |(30xx,0122) |1 |The referenced RT Meta Radiation Set to which the |
| | | |current RT Meta Radiation Set is related. |
|>>Temporal Relationship Interval Anchor |(30xx,0892) |1 |The anchor point of the Interval specified in this |
| | | |Meta RT Radiation Set Sequence Item with respect to |
| | | |the Meta RT Radiation Set referenced by the |
| | | |Referenced Meta RT Radiation Set Index (30xx,0122). |
| | | |Enumerated Values: |
| | | |START: The interval is specified with respect to the |
| | | |start of the reference prescription. |
| | | |END: The interval is specified with respect to the |
| | | |end of the reference prescription. |
|>>Number of Fractions |(30xx,0972) |1 |The number of fractions in respect to Temporal |
| | | |Relationship Interval Anchor (30xx,0892) when the |
| | | |delivery of current RT Meta Radiation Set should be |
| | | |started. |
| | | |If Temporal Relationship Interval Anchor (30xx,0892) |
| | | |equals START, this is the number of fractions after |
| | | |the first fraction of the delivery of the referenced |
| | | |RT Meta Radiation Set , when the delivery of the |
| | | |current RT Meta Radiation Set should start. |
| | | |If Temporal Relationship Interval Anchor (30xx,0892) |
| | | |equals END, this is the number of fractions prior to |
| | | |the last fraction of the delivery of the referenced |
| | | |RT Meta Radiation Set, when the delivery of the |
| | | |current RT Meta Radiation Set should start. |
|>Pre-treatment RT Radiation Set Reference |(30xx,08CA) |1C |Referenced Pre-treatment RT Radiation Sets that have |
|Sequence | | |been used in developing the final Treatment RT |
| | | |Radiation sets. |
| | | |Required if the specified radiation sets have been |
| | | |used in the final Treatment RT Radiation sets. |
| | | |One or more Items shall be included in this sequence.|
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>Pre-treatment RT Radiation Set Role Code |(30xx,08CB) |1 |Defines the role of the referenced RT Pre-treatment |
|Sequence | | |RT Radiation Set, in preparation of the current |
| | | |treatment. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147018. |
|>>Referenced RT Segment Annotation Sequence |(30xx,0874) |1 |Referenced RT Segment Annotation SOP Instances which |
| | | |have been used during definition of the RT Radiation |
| | | |Set. |
| | | |One or more Items shall be included in this sequence.|
|>>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>>Conceptual Volume State Sequence |(30xx,08CC) |1C |A sequence of states associated with the Conceptual |
| | | |Volumes defined in the RT Segment Annotation SOP |
| | | |instance referenced in this sequence. |
| | | |Required if status information is available for |
| | | |Conceptual Volumes in this scope. |
| | | |One or more Items shall be included in this sequence.|
|>>>>Conceptual Volume UID |(30xx,1301) |1 |The Conceptual Volume UID of a Conceptual Volume |
| | | |defined in the Segment RT Annotations SOP instance |
| | | |referenced in this sequence |
|>>>>Include 'RT Item State Macro' Table C.AA.2.3-1 |Defined CID for the Assertion Code Sequence |
| |(30xx,50A0) shall be SUP147043. |
| |See C.AA.A6.1.1 |
|>>RT Radiation Set State Sequence |(30xx,08C8) |1 |Defines the state of this Pre-Treatment RT Radiation |
| | | |Set. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>>Include 'RT Item State Macro' Table C.AA.2.3-1 |Defined CID for the Assertion Code Sequence |
| |(30xx,50A0) shall be SUP147043. |
| |See C.AA.A6.1.1 |
|>Treatment RT Radiation Set Reference |(30xx,08F2) |1C |Referenced RT Radiation Sets to be used in this RT |
|Sequence | | |Course. |
| | | |Required if Treatment RT Radiation Sets are defined. |
| | | |One or more Items shall be included in this sequence.|
| | | |See Note 1. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>Treatment RT Radiation Set Sequence Number|(30xx,08F4) |1 |A number ordering the radiation sets as their |
| | | |reference has been added to this sequence. |
| | | |See Note 1. |
|>>Treatment RT Radiation Set State Sequence |(30xx,08F6) |1 |Defines the state of this Radiation Set. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>>Include 'RT Item State Macro' Table C.AA.2.3-1 |Defined CID for the Assertion Code Sequence |
| |(30xx,50A0) shall be SUP147043. |
| |See C.AA.A6.1.1 |
|>>Treatment RT Radiation Set Operation State|(30xx,08F8) |1 |Defines the operation state of this Radiation Set. |
|Sequence | | |Only one item in the enclosing Treatment RT Radiation|
| | | |Set Reference Sequence (30xx,08F2) shall have a value|
| | | |of IN PROGRESS for RT Operation State (30xx,5051) at |
| | | |a time. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>>Include 'RT Operation State Macro' Table C.AA.2.4-1 |
|>>Referenced RT Radiation Record Sequence |(30xx,08FF) |2C |The RT Radiation Records, which have been created in |
| | | |the course of delivery. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>Treatment RT Radiation Set Relation |(30xx,08FA) |1C |Defines the relation to another Treatment RT |
|Sequence | | |Radiation set within this Treatment RT Radiation Set |
| | | |Reference Sequence (30xx,08F2) of this Meta Radiation|
| | | |Set to denote the reason for retiring the referenced |
| | | |Treatment RT Radiation Set item. |
| | | |Required if the Treatment RT Radiation Set Reference |
| | | |Sequence (30xx,08F2) has more than one item and this |
| | | |item in the RT Treatment RT Radiation Set Reference |
| | | |Sequence (30xx,08F2) is not the first item in the |
| | | |sequence. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>>Treatment RT Radiation Set Sequence |(30xx,08F4) |1 |References the previous Treatment T Radiation Set |
|Number | | |identified by the RT Treatment RT Radiation Set |
| | | |Sequence Number (30xx,08F4) within this actual RT |
| | | |Treatment RT Radiation Set Reference Sequence |
| | | |(30xx,08F2). References to other Meta RT Radiation |
| | | |Sets are not permitted. |
| | | |Defines the previous Treatment RT Radiation set that |
| | | |was altered to form this radiation set. |
|>>>Treatment RT Radiation Set Alteration |(30xx,08FC) |2 |Defines the nature of the changes when this radiation|
|Type Sequence | | |set was altered. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>>>>Include 'Code Sequence Macro Table 8.8-1 |Defined CID SUP147014. |
|>>>Treatment RT Radiation Set Change |(30xx,08FE) |2 |User defined description of the change to the RT |
|Description | | |Radiation Set. |
Notes: 1. The sequence of radiation sets supports versioning of radiation sets. The typical situations to cover are small adaptations (perhaps after a few days, or daily) of a radiation set without changing the beam layout, treatment technique etc. Typically, the higher numbers in the Treatment RT Radiation Set Sequence Number (30xx,08F4) denote radiation set references that have been added later, and normally the latest one is in treatment. However, those numbers only serve as a first-level ordering scheme. The binding state information of the Treatment RT Radiation Sets contained in this sequence is handled by the state macros of this sequence. Note that different treatment phases, different treatment targets, fractionation pattern etc are covered by treatment phases and not within this sequence.
C.AA.A6.1 RT Radiation Set Reference Attribute Description
C.AA.A6.1.1 RT Item State Macro Meanings
For the states listed in the following, further annotations are provided, how the definitions in ANNEX D, DICOM CONTROLLED TERMINOLOGY DEFINITIONS shall be applied in this context:
Usage for Pre-Treatment RT Radiation Set:
• A value of (S147651, 99SUP147, “Reviewed”) means, that the Radiation Set has been reviewed.
• A value of (S147652, 99SUP147, “Approved”) means, that the Radiation Set is approved to be used to define initial geometric setup for the planning step.
• A value of (S147653, 99SUP147, “Rejected”) means, that the Radiation Set has been rejected and shall not be used as planning input.
Usage for Treatment RT Radiation Set:
• A value of (S147651, 99SUP147, “Reviewed”) means, that the Radiation Set has been reviewed.
• A value of (S147652, 99SUP147, “Approved”) means, that the Radiation Set is ready for treatment.
• A value of (S147653, 99SUP147, “Rejected”) means, that the Radiation Set shall not be used for treatment.
C.AA.A6.1.2 Radiation Set Start Delay
C.AA.A6.1.2.1 Radiation Set Start Delay Overview
The Radiation Set Start Delay (30xx,08C6) describes the minimum delay in days after the beginning of the treatment phase. Treatment will be on next available non-zero day of the fractionation pattern.
The Radiation Set Start Delay (30xx,08C6) belongs to the Radiation Set Reference module, while the Fraction Pattern is defined at the Radiation Set level. The Radiation Set Start Delay (30xx,08C6) is counted from the Treatment Phase start. The Treatment Phase groups one or more Radiation Sets. Hence, Radiation Set Start Delay (30xx,08C6) can be used to individually shift Radiation Sets within their Treatment Phase.
[pic]
C.AA.A6.1.2.2 Examples of Radiation Set Start Delay
a) Scenario 1: Single Fraction Each Day
Description: First Calender Day of Phase Start is Wednesday. The Delay for Start of Treatment is defined as 1 day.
Attributes:
Number of Fraction Pattern Digits per Day = 1
Repeat Fraction Cycle Length = 1
Fraction Pattern = 1111100
Radiation Set Start Delay = 1
Result: Radiation Set treatment begins Thursday.
|Day of the week |Mo |Tu |We |
|RT Course Associated Instance Reference |(30xx,0900) |1 |References to other SOP instances of any SOP class |
|Sequence | | |supporting specific use cases, with the role or |
| | | |purpose of those instances. |
| | | |One or more Items shall be included in this sequence.|
|>Associated Instance State Sequence |(30xx,0903) |1C |Defines the state of this associated instance. |
| | | |Required if a state has been defined in the context |
| | | |of the RT Course. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'RT Item State Macro’ Table C.AA.2.3-1 |Defined CID for the Assertion Code Sequence |
| |(30xx,50A0) shall be SUP147043. |
|>Instance Reference Purpose Code Sequence |(30xx,0901) |1 |The purpose or role of the RT Course Associated |
| | | |Instance Reference Sequence item. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147020. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.B1 RT Physician Intent Module
The RT Physician Intent Module contains information about the overall intent of the treatment. The data are mostly descriptive text and allow freely formulated advice by the physician along the established nomenclature of the actual institution.
Table C.AA.B1-1
RT PHYSICIAN INTENT MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|RT Treatment Phase Presence Flag |(30xx,0806) |1 |Defines whether an RT Treatment Phase definition is |
| | | |present. |
| | | |Enumerated Values: |
| | | |YES |
| | | |NO |
|RT Physician Intent Sequence |(30xx,0912) |1 |Sequence of Items representing physician intents. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
| | | |See C.AA.B1.1.1 |
|>RT Physician Intent Index |(30xx,0913) |1 |Index of the Physician Intent in the sequence used |
| | | |for internal or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>RT Treatment Intent Type |(30xx,0914) |2 |Type of treatment intent. |
| | | |Defined Terms: |
| | | |CURATIVE |
| | | |PALLIATIVE |
| | | |PROPHYLACTIC |
|>RT Physician Intent Narrative |(30xx,0915) |2 |Narrative of RT Physician Intent. |
|>RT Physician Intent Predecessor Sequence |(30xx,0910) |1C |Reference to the RT Physician Intent SOP Instance |
| | | |which was replaced by current Physician Intent. |
| | | |Required if this intent replaces a previous version.|
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>Supersession Reason |(30xx,0917) |2 |Reason that the previous RT Physician Intent was |
| | | |superseded by the current SOP Instance. |
|>RT Protocol Code Sequence |(30xx,0916) |2C |The protocol(s) to be used. |
| | | |Required if this intent is based on a known |
| | | |protocol. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
| | | |See C.AA.B1.1.2. |
|>>Include 'Code Sequence Macro’ Table 8.8-1 |No Baseline Context Group ID defined |
|>RT Diagnosis Code Sequence |(30xx,0918) |2C |Diagnostic codes to describe the disease handled by |
| | | |this intent. |
| | | |Required if a diagnosis code is known. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
| | | |See Note 1. |
|>>Include 'Code Sequence Macro’ Table 8.8-1 |No Baseline CID is defined |
|>RT Diagnostic Image Set Sequence |(30xx,091A) |2 |Reference to the Image SOP Instances or reference to|
| | | |frames from multi-frame Image SOP Instances used in |
| | | |the definition of the initial diagnosis. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See C.AA.B1.1.3. |
|>>Include 'Image SOP Instance Reference Macro' Table 10-3 |
Notes 1. The RT Diagnosis Code Sequence (30xx,0918) may contain clinical codes, which are used at the prescription state and for other categorization purposes of the diagnosis covered by that Intent like charging. There is no specific baseline CID recommended. Possible coding schemes that could be used include ICD-10 (i10) or SNOMED (SRT). ICD-10 is widely used in the USA, while SNOMED is the preferred DICOM classification. However, any other coding schemes are applicable as well if preferred by the user.
C.AA.B1.1 RT Physician Intent Attribute Description
C.AA.B1.1.1 RT Physician Intent Sequence
The RT Physician Intent Sequence allows one or more clinical intents to be identified for treatment in a single temporal period (e.g. a treatment course). For example, the simultaneous treatment of multiple primaries would usually require separate intents to be defined, each with its own prescription(s) and having different sets of reference imaging studies.
C.AA.B1.1.2 RT Protocol Code Sequence
RT Protocol Code Sequence (30xx,0916) contains a coded description of the radiotherapy clinical protocol the patient is following. This is not necessarily the same as the Procedure Step protocol.
C.AA.B1.1.3 RT Diagnostic Image Set Sequence
Diagnostic image references contained in the RT Diagnostic Image Set Sequence (30xx,091A) shall reference images which were present when the initial diagnosis was established. Images used in treatment planning for radiotherapy treatments are referenced in the RT Prescription Module. If those are the same images, they shall be referenced at both places.
C.AA.B2 RT Prescription Module
The RT Prescription Module contains the prescription(s) by the physician to define the intended treatment for a specific target. The content of this module consists mainly of descriptive text and allows to freely formulating advice by the physician along the established nomenclature of the institution.
Table C.AA.B2-1
RT PRESCRIPTION MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|RT Prescription Sequence |(30xx,0940) |1 |Prescriptions to deliver therapeutic radiation. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>RT Prescription Label |(30xx,0902) |1 |User defined label for this prescription. |
| | | |See C.AA.2.1.1.1. |
|>Prescription Index |(30xx,0118) |1 |Index of the Prescription in the sequence used for |
| | | |internal or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Referenced RT Physician Intent Index |(30xx,0919) |1C |Reference to the RT Physician Intent Index |
| | | |(30xx,0913) in the RT Physician Intent Sequence |
| | | |(30xx,0912). |
| | | |Shall not be present if a Parent RT Prescription |
| | | |Index (30xx,0149) is present. |
|>Parent RT Prescription Index |(30xx,0149) |2C |Reference to a prescription that represents a parent|
| | | |prescription to this one. |
| | | |Shall not be present if the Referenced RT Physician |
| | | |Intent Index (30xx,0919) is present or if the |
| | | |referenced prescription contains a Parent RT |
| | | |Prescription Index (30xx,0149). |
|>Referenced Dosimetric Objectives Sequence |(30xx,0951) |1C |Sequence of Items referencing Dosimetric Objectives |
| | | |that are dosimetrically relevant to this |
| | | |prescription. |
| | | |Required if Dosimetric Objectives are defined for |
| | | |this prescription. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>Referenced Dosimetric Objective UID |(30xx,0949) |1 |Reference to a Dosimetric Objective UID (30xx,0948) |
| | | |in the RT Anatomic Prescription Sequence |
| | | |(30xx,0920), identifying the anatomic prescription |
| | | |for this sequence. |
|>Treatment Phase Reference Sequence |(30xx,0870) |1C |Referenced treatment phase(s) to which this |
| | | |prescription applies, and which will contain the |
| | | |radiation sets for the treatments administered by |
| | | |this prescription. |
| | | |Required if RT Treatment Phase Presence Flag |
| | | |(30xx,0806) of this RT Physician Intent SOP instance|
| | | |equals YES. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>Referenced Treatment Phase Index |(30xx,0146) |1 |Reference to the Treatment Phase Index (30xx,0116) |
| | | |where this prescription does apply to. |
|>Fractionation Relationship Sequence |(30xx,0982) |2 |Fraction-based relationship to another prescription.|
| | | |Zero or one Item shall be included in this sequence.|
|>>Referenced RT Prescription Index |(30xx,0148) |1 |The referenced prescription to which the current |
| | | |prescription is related. |
|>>Temporal Relationship Interval Anchor |(30xx,0892) |1 |The anchor point of this RT Prescription Sequence |
| | | |Item with respect to the prescription referenced by |
| | | |Referenced RT Prescription Index (30xx,0148). |
| | | |Enumerated Values: |
| | | |START: The interval is specified with respect to the|
| | | |start of the reference prescription. |
| | | |END: The interval is specified with respect to the |
| | | |end of the reference prescription. |
|>>Number of Fractions |(30xx,0972) |1 |The number of fractions with respect to Temporal |
| | | |Relationship Interval Anchor (30xx,0892) when the |
| | | |delivery of current prescription should be started. |
| | | |If Temporal Relationship Interval Anchor (30xx,0892)|
| | | |equals START, this is the number of fractions after |
| | | |the first fraction of the delivery of the referenced|
| | | |prescription, when the delivery of the current |
| | | |prescription should start. |
| | | |If Temporal Relationship Interval Anchor (30xx,0892)|
| | | |equals END, this is the number of fractions prior to|
| | | |the last fraction of the delivery of the referenced |
| | | |prescription, when the delivery of the current |
| | | |prescription should start. |
|>Prior Dose Description |(30xx,0924) |3 |Description of dose previously delivered to the |
| | | |patient. |
|>Prior Dose Reference Sequence |(30xx,0925) |2 |Reference to RT Dose Image or RT Dose SOP Instance |
| | | |representing dose previously delivered to the |
| | | |patient, that may be used to evaluate dosimetric |
| | | |objectives for this prescription. |
|>>Include 'SOP Instance Reference Macro' Table 10-11’ |
|>Planning Input Information Sequence |(30xx,0960) |2C |Instances which are intended to be used for the |
| | | |planning process. |
| | | |Required if planning shall be advised to use certain|
| | | |objects like images and Segment RT Annotations for |
| | | |the planning process. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>General Prescription Notes |(30xx,0970) |2 |Notes on this prescription in general. |
|>Number of Fractions |(30xx,0972) |2 |Number of Fractions. |
|>Intended Delivery Duration |(30xx,0973) |2 |Number of days across which the fractions prescribed|
| | | |here shall be delivered. |
|>Fractionation Description |(30xx,0974) |2 |Description of the fractionation approach |
| | | |(Bi-fractionation, Breaks, Hyper-fractionation, |
| | | |etc.) to be used. |
|>Include 'Radiation Fraction Pattern Macro' Table C.AA.2.9-1 |
|>Treatment Technique Description |(30xx,0966) |2 |Description of the treatment technique to be used. |
|>Radiotherapy Procedure Technique Sequence |(30xx,0C99) |2 |The treatment technique that should be used for |
| | | |treatment. |
| | | |Zero or one Item shall be included in this sequence.|
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147047 |
|>Prescription Annotation Sequence |(30xx,0978) |1C |Further Annotations to the preparation and execution|
| | | |of the treatment covered by this prescription. |
| | | |Required if there are annotations for the |
| | | |prescription. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>Include 'Content Item Macro' Table 10-2 |Defined TID is SUP147001 RT Prescription Annotation |
|>>Prescription Annotation DateTime |(30xx,0979) |2 |Date and time on which the annotation was made. |
|RT Anatomic Prescription Sequence |(30xx,0920) |1 |Prescriptions for Conceptual Volumes defining |
| | | |anatomy. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Anatomy Label |(30xx,0922) |1 |Descriptive definition of the anatomy. |
|>Conceptual Volume Sequence |(30xx,1346) |1 |Reference to a conceptual volume which identify |
| | | |anatomic regions etc. where therapeutic goals are |
| | | |prescribed against. See C.AA.B2.1.4. |
| | | |Only a single Item shall be included in this |
| | | |sequence. Each Conceptual Volume UID (30xx,1301) |
| | | |shall only appear once in that sequence. |
|>>Include ‘Conceptual Volume Segmentation Reference and Combination Macro' Table C.AA.2.6-1 |
|>Prescription Anatomy Notes |(30xx,0928) |2C |Additional notes on what to pay attention to in |
| | | |respect to this anatomy. |
| | | |Required if the Dosimetric Objective Sequence |
| | | |(30xx,0942) is empty. May be present otherwise. |
|>Prescription Anatomy Role |(30xx,0930) |1 |The radiotherapeutic designation of the anatomy. |
| | | |See C.AA.B2.1.5. |
| | | |Defined Terms: |
| | | |TARGET |
| | | |OAR |
| | | |AVOIDANCE |
| | | |DOSE_SHAPING |
| | | |CONFORMALITY_SHELL |
| | | |OTHER |
|>Radiobiological Structural Type |(30xx,0932) |2 |The radiobiological type of the anatomy. |
| | | |See C.AA.B2.1.6. |
| | | |Enumerated Values: |
| | | |SERIAL |
| | | |PARALLEL |
| | | |OTHER |
|>Conceptual Volume Optimization Precedence |(30xx,0933) |2 |Integer (1-n) used in dose optimization to resolve |
| | | |ownership of regions from two Conceptual Volumes |
| | | |that overlap. Regions shall belong to the Conceptual|
| | | |Volume with the lowest value of this attribute. |
|>Conceptual Volume Optimization Blocking |(30xx,0935) |1 |Specifies whether or not primary radiation shall be |
| | | |allowed to pass through the conceptual volume when |
| | | |performing a dose optimization. |
| | | |Enumerated Values: |
| | | |NONE = No restrictions |
| | | |UPSTREAM = Primary radiation not permitted prior to |
| | | |reaching target |
| | | |DOWNSTREAM = Primary radiation not permitted after |
| | | |passing through target |
| | | |TOTAL = No primary radiation permitted |
|>Anatomy Category Code Sequence |(30xx,0934) |2 |Sequence defining the general category of this |
| | | |anatomy for radiotherapy purposes. |
| | | |Zero or one Item shall be included in this sequence.|
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147002. |
|>Anatomy Property Type Code Sequence |(30xx,0936) |2 |Sequence defining the specific property type of this|
| | | |anatomy for radiotherapy purposes. |
| | | |Zero or one Item shall be included in this sequence.|
|>>Include 'Code Sequence Macro' Table 8.8-1 |See C.AA.B2.1.1. |
|>Alternate Segmented Property Type Code |(30xx,134E) |3 |Sequence defining alternate specific property types |
|Sequence | | |of this segment for radiotherapy purposes. |
| | | |One or more Items are permitted in this sequence. |
| | | |See C.AA.D1.1.2. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |No baseline CID defined. |
|>>Purpose of Alternate Segmented Property |(30xx,134F) |3 |Identifies the purpose for which the identification |
|Type Code Sequence | | |code is assigned. |
| | | |Only a single Item is permitted in this sequence. |
| | | |See C.AA.D1.1.2. |
|>>>Include 'Code Sequence Macro' Table 8.8-1 |No baseline CID defined. |
|>Dosimetric Objective Sequence |(30xx,0942) |2C |Objectives applicable for this anatomy. |
| | | |Required if objectives are known for this anatomy. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>>Dosimetric Objective UID |(30xx,0948) |1 |A UID by which a Dosimetric Objective can be |
| | | |cross-referenced between prescriptions. |
| | | |Required, if Type of Prescription (30xx,0944) is |
| | | |CONSTRAINTS. |
| | | |See C.AA.B2.2. |
|>>Originating SOP Instance Reference |(30xx,1302) |1C |Reference to the SOP Instance that contains the |
|Sequence | | |original definition of this Dosimetric Objective |
| | | |identified by Dosimetric Objective UID (30xx,0948). |
| | | |Required when the Dosimetric Objective UID |
| | | |(30xx,0948) was not issued in the current SOP |
| | | |Instance, but read from another SOP instance. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>Dosimetric Objective Value Type Code |(30xx,0943) |1 |The type of dose objective which this item |
|Sequence | | |represents. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>>Include ‘Code Sequence Macro' Table 8.8-1 |Defined CID SUP147001. |
|>>Dosimetric Objective Parameter Sequence |(30xx,0950) |2 |Parameters of the objective. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
| | | |See C.AA.B2.1.2 |
|>>>Dosimetric Objective Parameter Index |(30xx,0119) |1 |Index of the Dosimetric Objective Parameter in the |
| | | |sequence used for internal or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>>>Include 'Content Item Macro' Table 10-2 |See C.AA.B2.1.2 |
|>>Dosimetric Objective Preservation |(30xx,0954) |1 |Defines, whether the objective has to be preserved |
| | | |under all conditions or not. |
| | | |Enumerated Values: |
| | | |ABSOLUTE = Objective shall be attained under all |
| | | |conditions |
| | | |NOT_ABSOLUTE = Objective is desired, but may be not |
| | | |be met under all conditions. |
|>>Dosimetric Objective Priority |(30xx,0956) |1C |Objective Penalty Weight (Importance). A higher |
| | | |value means that this objective is more important. |
| | | |Values are not scaled in absolute terms, but are |
| | | |scaled across the items in this sequence. |
| | | |Required if Dosimetric Objective Preservation |
| | | |(30xx,0954) is NOT_ABSOLUTE. |
| | | |See C.AA.B2.1.7. |
|>>Dosimetric Objective Priority Type |(30xx,0958) |2C |The type of priority, which defines how the priority|
| | | |shall be used. |
| | | |Shall be present, when Dosimetric Objective Priority|
| | | |(30xx,0956) is present. |
| | | |Enumerated Values: |
| | | |OPTIMIZATION = used as an input to the optimization |
| | | |process |
| | | |EVALUATION = used as a tool for evaluation |
| | | |BOTH = used as both OPTIMIZATION and EVALUATION |
| | | |See C.AA.B2.1.7. |
|>>Dosimetric Objective Evaluation Including |(30xx,0926) |1 |Dosimetric objective is to be evaluated including |
|Prior Dose | | |prior dose delivered to the patient. |
| | | |Enumerated Values: |
| | | |YES |
| | | |NO |
| | | |See C.AA.B2.2. |
C.AA.B2.1 RT Prescription Attribute Description
C.AA.B2.1.1 Anatomy Property Type Code Sequence
The Anatomy Property Type Code Sequence (30xx,0936) further specifies the anatomy along the Anatomy Category. The following conditions apply to the codes permitted in the Anatomy Property Type Code Sequence (30xx,0936), when the code used in the Anatomy Category Code Sequence (30xx,0934) is as follows:
• Value of Conceptual Volume Category Code Sequence (S147050, 99SUP147, “Target”): Defined CID for Property Type shall be SUP147004.
C.AA.B2.1.2 Dosimetric Objective Parameter Sequence
A dosimetric objective for optimization is described by specifying a functional identity (defined by the Dosimetric Objective Value Type Code Sequence (30xx,0943) using CID SUP147001) for the objective and a sequence of zero or more parameters necessary to quantify the objective (Dosimetric Objective Parameter Sequence (30xx,0950)) as defined in the following.
C.AA.B2.1.2.1 Single Dose Parameter
If the Dosimetric Objective Value Type Code Sequence (30xx,0943) contains a code included in CID SUP147060 Single Dose-related Dosimetric Objectives, the Dosimetric Objective Parameter Sequence (30xx,0950) shall include the following parameter.
|Dosimetric Objective |Concept Name Code |Value Type |Measurement Units Code |
|Parameter Index | | | |
|(30xx,0119) | | | |
|1 |EV (S147025, 99SUP147, “Dose |NUMERIC |Units = EV (Gy,UCUM,”Gray”) |
| |Parameter”) | | |
C.AA.B2.1.2.2 Percentage and Dose Parameter
If the Dosimetric Objective Value Type Code Sequence (30xx,0943) contains a code included in CID SUP147061 Percentage and Dose-related Dosimetric Objectives, the Dosimetric Objective Parameter Sequence (30xx,0950) shall include the following parameters.
|Dosimetric Objective |Concept Name Code |Value Type |Measurement Units Code |
|Parameter Index | | | |
|(30xx,0119) | | | |
|1 |EV (S147027, 99SUP147, “Percent |NUMERIC |Units = EV (%,UCUM,”Percent”) |
| |Parameter”) | | |
|2 |EV (S147025, 99SUP147, “Dose |NUMERIC |Units = EV (Gy,UCUM,”Gray”) |
| |Parameter”) | | |
C.AA.B2.1.2.3 Volume and Dose Parameter
If the Dosimetric Objective Value Type Code Sequence (30xx,0943) contains a code included in CID SUP147062 Volume and Dose-related Dosimetric Objectives, the Dosimetric Objective Parameter Sequence (30xx,0950) shall include the following parameters.
|Dosimetric Objective |Concept Name Code |Value Type |Measurement Units Code |
|Parameter Index | | | |
|(30xx,0119) | | | |
|1 |EV (S147026, 99SUP147, “Volume |NUMERIC |Units = EV (cm3,UCUM,”Cubic |
| |Parameter”) | |Centimeter”) |
|2 |EV (S147025, 99SUP147, “Dose |NUMERIC |Units = EV (Gy,UCUM,”Gray”) |
| |Parameter”) | | |
C.AA.B2.1.2.4 Unitless and Dose Parameter
If the Dosimetric Objective Value Type Code Sequence (30xx,0943) contains a code included in CID SUP147063 Dimensionless and Dose-related Dosimetric Objectives, the Dosimetric Objective Parameter Sequence (30xx,0950) shall include the following parameters.
|Dosimetric Objective |Concept Name Code |Value Type |Measurement Units Code |
|Parameter Index | | | |
|(30xx,0119) | | | |
|1 |EV (S147028, 99SUP147, “Numeric |NUMERIC |Units = EV (1,UCUM,”no units”) |
| |Parameter”) | | |
|2 |EV (S147025, 99SUP147, “Dose |NUMERIC |Units = EV (Gy,UCUM,”Gray”) |
| |Parameter”) | | |
C.AA.B2.1.2.5 Coded Parameter
If the Dosimetric Objective Value Type Code Sequence (30xx,0943) contains a code included in CID SUP147064 Coded Dosimetric Objectives, the Dosimetric Objective Parameter Sequence (30xx,0950) shall include the following coded parameter.
|Coding Scheme Designator |Code Value |Code Meaning |CID used in |
|(0008,0102) |(0008,0100) |(0008,0104) |Dosimetric Objective Parameter |
| | | |Sequence (30xx,0950) |
|99SUP147 |S147018 |Minimize MeterSet |Defined CID is |
| | | |DCID (230) Yes-No |
C.AA.B2.1.3 Dosimetric Objective Parameter Sequence Examples
For example, to describe the objective of specifying the maximum volume that can receive 50 Gy or more (V50 Include 'RT Treatment Phase Macro' Table C.AA.2.34-1 |
|Include 'RT Treatment Phase Interval Macro' Table C.AA.2.35-1 |
C.AA.C1 RT Radiation Set Module
The RT Radiation Set Module contains information describing treatment fractions, containing a set of beams and/or brachytherapy setups being used within a treatment session to help achieve the dosimetric requirements of a given phase.
It references a set of RT Radiation instances describing the geometrical and physical parameters defining the delivery of dose within a fraction. The whole set defines a fraction of treatment. For those fractions, the number of treatments is defined, as well as possibly the interval schema along which those fractions shall be treated. It also specifies weighting of the beams and brachytherapy setups contained for those fractions.
An RT Radiation Set can be referenced externally for dosimetric purposes. A treatment phase is achieved by delivering one or more RT Radiation Sets. One or more new RT Radiation Sets may be required each time adaptive therapy is used to attempt to maintain a phase prescription.
The chronological relationships between Radiation Sets (the actual start of each set, the order or timing among sets etc.) are handled outside the Radiation Set.
Table C.AA.C1-1
RT RADIATION SET MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Number of Fractions |(30xx,0972) |1 |Number of Fractions. |
|Include 'Radiation Fraction Pattern Macro' Table C.AA.2.9-1 |
|RT Radiation Set Intent |(30xx,5011) |1 |A general indication of the type of information |
| | | |contained within this RT Radiation Set. This |
| | | |annotation does not specify whether or not the |
| | | |Radiation Set has been approved for that type of use.|
| | | | |
| | | |Defined Terms: |
| | | |PATIENT_TREATMENT |
| | | |PLAN_QA |
| | | |MACHINE_QA |
| | | |RESEARCH |
| | | |SERVICE |
| | | |See C.AA.C1.1.1. |
|RT Dose Contribution Presence Flag |(30xx,5012) |1 |Indicates whether this object contains an RT Dose |
| | | |Contribution. |
| | | |Enumerated Values |
| | | |YES |
| | | |NO |
|Radiation Sequence |(30xx,0B26) |1C |Radiation instances which are referenced by this RT |
| | | |Radiation Set. |
| | | |Required once Radiations have been added to this RT |
| | | |Radiation Set. |
| | | |One or more Items shall be included in this sequence.|
| | | |See C.AA.C1.1.2. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.C1.1 RT Radiation Set Attribute Description
C.AA.C1.1.1 Radiation Set Type
PATIENT_TREATMENT = The Radiation Set has been prepared to be ready for treatment delivery. All parameters necessary to guide the delivery of radiation beams are included.
PLAN_QA = The Radiation Set has been created for the purpose of validating the dose to be deposited in a patient by delivering the identical beams to a phantom and comparing the calculated dose to the phantom with actual measurements made in the phantom.
MACHINE_QA= The Radiation Set is used for quality assurance procedures of the delivery machine and is not patient specific. It has been created for the purpose of performing system quality assurance and calibration (geometric, dosimetric or both).
RESEARCH = The Radiation Set is used in a Research project. It has been created for the purpose of performing independent research on the treatment planning system and/or the delivery system
SERVICE = The Radiation Set is created by a service technician for machine repair or to perform a maintenance operation.
C.AA.C1.1.2 Radiation Sequence
All SOP Instances referenced in that sequence shall have the same SOP Class.
The SOP Classes permitted to be referenced in this sequence are SOP Classes representing Radiation IODs describing a radiotherapy delivery. The pre-requisite to belong to this type of SOP Class is the presence of the following modules:
• The modules specified in Table A.VV.1.1.1-2 RT RADIATION IOD MODULES MACRO.
• The RT Delivery Device Common Module specified in section C.AA.E1.
• The RT Radiation Common Module specified in section C.AA.E2.
C.AA.C2 RT Dose Contribution Module
The RT Dose Contribution module contains information about the contribution of dose of the radiations in this Radiation Set to the patient. Dose contributions refer to the radiations delivering the dose and to anatomies receiving the dose.
Note that an anatomical structure (as defined by the Conceptual Volume Macro) can be a textually tagged definition only, or a reference to a Conceptual Volume defined in the Segment RT Annotation IOD. In any case, Conceptual Volumes are at minimum identified by a UID, which allows accumulation of dose across RT Radiation Sets and comparison with originally prescribed dose objectives.
Dose contributions are defined along the meterset value. The definition points in the lookup table may, but do not need to, align with the metersets at the control points of the Radiation SOP Instance. For example, where a dose deposition between control points cannot be determined individually per segment, or where this definition is not useful, the lookup table may just contain the meterset of first and last control points. The meterset and dose contribution of the first control point are always zero.
Where dose contributions are not available at the time or radiation set definition and application (e.g. for emergency treatments), the module may be absent. This does not exclude retrospective dose calculation and creation of associated RT Dose Image objects.
Table C.AA.C2-1
RT DOSE CONTRIBUTION MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Radiation Dose Identification Sequence |(30xx,0B42) |1 |Radiation Dose parameters to identify and scope the |
| | | |dose values that are delivered by this radiation. |
| | | |One or more Items shall be included in this sequence.|
|>Radiation Dose Identification Index |(30xx,0120) |1 |Index of the Radiation Dose Identification in the |
| | | |sequence used for internal or external references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Radiation Dose Identification Label |(30xx,0B46) |1 |User defined label for the radiation dose definition.|
| | | |See C.AA.2.1.1.1. |
|>Reference Dose Type |(30xx,0B48) |1 |Defines type of reference dose for the radiation. |
| | | |Defined terms: |
| | | |NOMINAL: Nominal radiation dose. Dose values are |
| | | |nominally assigned to the individual RT Radiation SOP|
| | | |instances only. Dose may be calculated on the |
| | | |Fraction level only, or otherwise be assigned to |
| | | |individual RT Radiation instance without |
| | | |instance-specific calculations. RADIATION: Dose |
| | | |values carry a representative dose specifically |
| | | |calculated for each referenced RT Radiation SOP |
| | | |instance. |
|>Reference Dose Point Coordinates |(30xx,0B62) |1C |Coordinates of the reference dose in DICOM Patient |
| | | |Coordinate System. If present, the dose values are |
| | | |calculated to the specified point. |
| | | |Required, if dose is calculated at a point. |
|>Conceptual Volume Sequence |(30xx,1346) |1 |Reference to a conceptual volume which receive dose. |
| | | |See C.AA.C2.1.2. |
| | | |Only a single Item shall be included in this |
| | | |sequence. Each Conceptual Volume UID (30xx,1301) |
| | | |shall only appear once in that sequence. |
|>>Include 'Conceptual Volume Segmentation Reference and Combination Macro' Table C.AA.2.6-1 |
|Radiation Dose Sequence |(30xx,0B40) |1C |SOP instances by which dose is delivered. |
| | | |Required if Radiation Sequence (30xx,0B26) in the |
| | | |Radiation Set module is present. |
| | | |Exactly the same SOP instance references as present |
| | | |in Radiation Sequence (30xx,0B26) shall be present in|
| | | |this sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Radiation Dose Values Sequence |(30xx,0B64) |1 |Dose values of this actual radiation in respect to |
| | | |the dose identification items defined in the |
| | | |Radiation Dose Identification Sequence (30xx,0B42). |
| | | |The number of items shall be exactly the number of |
| | | |items in the Radiation Dose Identification Sequence |
| | | |(30xx,0B42). |
|>>Referenced Radiation Dose |(30xx,0150) |1 |Reference to the Radiation Dose Identification Index |
|Identification Index | | |(30xx,0120) in the Radiation Dose Identification |
| | | |Sequence within this SOP Instance identifying the |
| | | |dose contribution. |
|>>Primary Dose Value Indicator |(30xx,0B49) |1 |Defines, if the dose value serves as the primary dose|
| | | |indicator for this Radiation Set. |
| | | |Enumerated Values: |
| | | |YES |
| | | |NO |
| | | |Exactly one item in the Radiation Dose Values |
| | | |Sequence (30xx,0B64) shall have the value YES. |
| | | |See C.AA.C2.1.3. |
|>>Dose Type |(3004,0004) |1 |Type of Dose of the Radiation Dose Values |
| | | |(30xx,0B6C). |
| | | |Defined Terms: |
| | | |PHYSICAL |
| | | |EFFECTIVE |
|>> Meterset to Dose Mapping Sequence |(30xx,0B68) |1C |Sequence of Items containing the mapping of Meterset |
| | | |Value (30xx,0B6A) to Radiation Dose Value |
| | | |(30xx,0B6C). |
| | | |Required, if the meterset to dose mapping is known. |
| | | |See C.AA.C2.1. |
| | | |Two or more Items shall be included in this sequence.|
|>>>Cumulative Meterset |(30xx,5021) |1 |The meterset value, where the corresponding dose |
| | | |value is delivered as specified in Radiation Dose |
| | | |Values (30xx,0B6C). See C.AA.C2.1. |
|>>>Radiation Dose Value |(30xx,0B7B) |1 |The dose value (in Gy) delivered at the corresponding|
| | | |meterset value. See C.AA.C2.1. |
|>>Radiation Verification Control Point |(30xx,0B6D) |2 |Sequence of Items containing Radiation Verification |
|Sequence | | |Control Points. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>>>Cumulative Meterset |(30xx,5021) |1 |The Cumulative Meterset value, at which the Radiation|
| | | |Verification Control Point Parameters in that |
| | | |sequence item apply, are expressed in units of the |
| | | |Radiation Dosimeter Unit (30xx,5113). |
|>>>Radiation Dose Value |(30xx,0B7B) |1 |Cumulative dose value (in Gy) for the Cumulative |
| | | |Meterset (30xx,5021) and the geometric parameters |
| | | |provided in this sequence Item. |
| | | |See C.AA.C2.2.3 |
|>>>Referenced Control Point Index |(30xx,0141) |1C |Value of Control Point Index (30xx,0111) from the |
| | | |Control Point Sequence of the Radiation SOP Instance |
| | | |referenced within this Radiation Dose Sequence Item |
| | | |(30xx,0B40). |
| | | |See C.AA.C2.2.1. |
| | | |Required if the Cumulative Meterset (30xx,5021) |
| | | |corresponds to a Control Point in the Control Point |
| | | |Sequence of the Radiation SOP instance referenced |
| | | |within this Radiation Dose Sequence Item (30xx,0B40) |
|>>>Reference Dose Point Coordinates |(30xx,0B62) |2 |Coordinates (x,y,z) of the reference dose point in |
| | | |DICOM Patient Coordinate System. |
|>>>Radiation Dose Point Depth |(30xx,0B70) |2C |The depth (in mm) in the patient along a ray from the|
| | | |source to the dose point specified by the Reference |
| | | |Dose Point Coordinates (30xx,0B62) from the current |
| | | |Radiation Verification Control Point to the next one.|
| | | |See C.AA.C2.2.2. |
| | | |Required for all items in this sequence but the last |
| | | |one. |
|>>>Radiation Dose Point Equivalent Depth|(30xx,0B72) |2C |The radiological depth (in mm) - water-equivalent |
| | | |depth, taking tissue heterogeneity into account - in |
| | | |the patient along a ray from the source to the dose |
| | | |point specified by the Reference Dose Point |
| | | |Coordinates (30xx,0B62) from the current Radiation |
| | | |Verification Control Point to the next one. |
| | | |See C.AA.C2.2.2. |
| | | |Required for all items in this sequence but the last |
| | | |one. |
|>>>Radiation Dose Point SSD |(30xx,0B74) |2C |Source to patient surface distance (in mm) along a |
| | | |ray from the source to the dose point specified by |
| | | |the Reference Dose Point Coordinates (30xx,0B62) from|
| | | |the current Radiation Verification Control Point to |
| | | |the next one. |
| | | |See C.AA.C2.2.2. |
| | | |Required for all items in this sequence but the last |
| | | |one. |
|>Radiation Dose In Vivo Measurement |(30xx,0B76) |1C |In vivo measurement reference doses. |
|Sequence | | |Required if in vivo measurement doses are calculated |
| | | |for this Radiation SOP Instance. |
| | | |One or more Items shall be included in this sequence.|
|>>Radiation Dose In Vivo Measurement |(30xx,0B78) |1 |Label to identify the in vivo measurement point. |
|Label | | |See C.AA.2.1.1.1. |
|>>Radiation Dose Central Axis |(30xx,0B7A) |1C |Displacement vector of the point from the central |
|Displacement | | |axis (in mm). |
| | | |Required if radiation technique uses a central beam |
| | | |axis. |
|>>Radiation Dose Value |(30xx,0B7B) |1 |Dose Value (in Gy) for comparison to the measured |
| | | |dose. |
|>>Radiation Dose Source-Skin Distance |(30xx,0B7C) |2 |Source to patient surface distance along the ray from|
| | | |the source to the in vivo measurement point (in mm). |
|>>Radiation Dose Measurement Point |(30xx,0B7D) |2 |Coordinates of the point in the frame of reference as|
|Coordinates | | |referred to by this Radiation Set SOP Instance. |
C.AA.C2.1 RT Dose Contribution Attribute Description
C.AA.C2.1.1 Meterset to Dose Mapping Sequence
The Meterset to Dose Mapping Sequence (30xx,0B68) establishes a lookup table of dose values delivered at certain metersets. The first value of Cumulative Meterset (30xx,5021) and of Radiation Dose Value (30xx,0B7B) shall always be zero. The value of Meterset Value in the last item shall be the meterset of the final control point of the referenced RT Radiation. The value of Radiation Dose Value in the last item therefore represents the dose delivered to the referenced anatomy when one fraction is completely delivered. Meterset Values shall be strictly monotonically increasing. Radiation Dose Values shall be monotonically non-decreasing. The actual clinical behavior of the increase of dose between 2 points of the lookup table is in a strict sense unknown, but shall be interpreted as linear, where fractional doses in between 2 points are exposed to the user.
C.AA.C2.1.2 Conceptual Volume Sequence
The Conceptual Volume Sequence (30xx,1346) identifies a Conceptual Volume defining a volume for which dose is tracked during treatments. If the Conceptual Volume is associated with a segment, the segment is defined by the Referenced Segment Annotation Index (30xx,0151) in the Conceptual Volume ReferenceCombination and Segmentation Macro (see section C.AA.2.6). Alternatively, the dosimetric volume may not be associated with a segment. For example, dose tracking may be specified using a nominal dose to a anatomical region of interest and the tracking coefficients approximated by meterset values.
C.AA.C2.1.3 Primary Dose Value Indicator
The Primary Dose Value Indicator (30xx,0B49) is intended to be used to indicate the one representative dose value out of the list of doses which is used for display purposes. Typically, this value refers to the primary target, while the other non-primary values may refer to e.g. organs at risk.
C.AA.C2.2 Radiation Verification Control Point Description
C.AA.C2.2.1 Referenced Control Point
The number of items in the Radiation Verification Control Point Sequence is not required to be the same as in the Control Point sequence of the Radiation. A different sampling can be chosen for the Radiation Verification Control Point Sequence, but where the Cumulative Meterset (30xx,5021) of a Control Point of the Radiation is the same it shall be referenced by the Referenced Control Point Index (30xx,0141).
C.AA.C2.2.2 Distance Parameters
The values given in Radiation Dose Point Depth (30xx,0B70), Radiation Dose Point Equivalent Depth (30xx,0B72) and Radiation Dose Point SSD (30xx,0B74) shall always contain average values from the current Radiation Verification Control Point to the next. In case of e.g. an arc therapy, these values reflect the changing depth parameters. In case these distances do not change, e.g. for a static beam treatment, the average value equals the static value under the given geometric conditions.
C.AA.C2.2.3 Radiation Dose Value
The Radiation Dose Value (30xx,0B7B) represents the cumulative dose delivered from the beginning of radiation delivery to the Cumulative Meterset (30xx,5021).
C.AA.D1 RT Segment Annotation Module
The RT Segment Annotation Module references segments and provides radiotherapy-specific annotations for them. The geometry of each segment is defined by a referenced Segmentation, Surface Segmentation, or RT Structure Set instance. Any segment-related information used in radiotherapy shall only be derived from a RT Segment Annotation object. The referenced instances shall not be used to supply any information that is unspecified in the RT Segment Annotation. Only the geometric definition of the segments shall be extracted from the referenced instances.
Table C.AA.D1-1
RT SEGMENT ANNOTATION MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Segment Sequence |(0062,0002) |1 |Segments described in this module. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Segment Index |(30xx,0121) |1 |Index of the Segment used for internal or external |
| | | |references. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Include ‘RT Entity Long Labeling Macro’ Table C.AA.2.2-1 |
|>Segmented Property Category Code Sequence|(0062,0003) |1 |Sequence defining the general category of this |
| | | |segment for radiotherapy purposes. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147003. |
|>Segmented Property Type Code Sequence |(0062,000F) |1 |Sequence defining the specific property type of this|
| | | |segment for radiotherapy purposes. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See C.AA.D1.1.3. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID is defined in C.AA.D1.1.3. |
|>Alternate Segmented Property Type Code |(30xx,134E) |3 |Sequence defining alternate specific property types |
|Sequence | | |of this segment for radiotherapy purposes. |
| | | |One or more Items are permitted in this sequence. |
| | | |See C.AA.D1.1.2. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |No baseline CID defined. |
|>>Purpose of Alternate Segmented Property |(30xx,134F) |3 |Identifies the purpose for which the identification |
|Type Code Sequence | | |code is assigned. |
| | | |Only a single Item is permitted in this sequence. |
| | | |See C.AA.D1.1.2. |
|>>>Include 'Code Sequence Macro' Table 8.8-1 |No baseline CID defined. |
|>Segmentation Template Label |(30xx,1332) |3 |Label for the template that was used when defining |
| | | |the segmentation. |
|>Segmentation Template UID |(30xx,1334) |3 |Unique identifier of the template that was used when|
| | | |defining the segmentation. |
|>Segmented RT Accessory Device Sequence |(30xx,1349) |2 |Describes an RT accessory device, if the segment |
| | | |represents such a device. |
| | | |See section C.AA.D1.1.4. |
| | | |Zero or more shall be included in this sequence. |
|>>Include 'RT Accessory Device Identification Macro' Table C.AA.2.15-1 |Defined CID SUP147040. |
|>>Device Index |(30xx,0112) |1 |Index of the Device. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Segment Properties Sequence |(30xx,134B) |3 |Segment properties associated with the current |
| | | |segment’s interpretation. |
| | | |One or more Items are permitted in this sequence. |
| | | |See C.AA.D1.1.7. |
|>>Include 'Content Item Macro' Table 10-2’ |Defined TID of Concept Name Code Sequence is TID |
| |SUP147003. |
|>>Segment Properties Modifier Sequence |(30xx,134B) |3 |Physical properties modifier for the property. |
| | | |One or more Items are permitted in this sequence. |
| | | |See C.AA.D1.1.7. |
|>>>Include 'Content Item Macro' Table 10-2 |No Baseline defined. |
|>Recommended Display Grayscale Value |(0062,000C) |3 |A default single gray unsigned value in which it is |
| | | |recommended that the maximum pixel value in this |
| | | |surface be rendered on a monochrome display. The |
| | | |units are specified in P-Values from a minimum of |
| | | |0000H (black) up to a maximum of FFFFH (white). |
| | | |Note: The maximum P-Value for this Attribute may be |
| | | |different from the maximum P-Value from the output |
| | | |of the Presentation LUT, which may be less than 16 |
| | | |bits in depth. |
|>Recommended Display CIELab Value |(0062,000D) |3 |A default triplet value in which it is recommended |
| | | |that the surface be rendered on a color display. The|
| | | |units are specified in PCS-Values, and the value is |
| | | |encoded as CIELab. |
|>Recommended Presentation Opacity |(0066,000C) |3 |Specifies the opacity in which it is recommended |
| | | |that the surface be rendered. |
| | | |See C.27.1.1.3. |
|>Recommended Presentation Type |(0066,000D) |3 |Specifies the representation type in which it is |
| | | |recommended that the surface be rendered. |
| | | |See C.27.1.1.3. |
|>Direct Segment Reference Sequence |(30xx,1343) |1C |Identifies the segment geometric definition in the |
| | | |SOP instance referenced in the Segmentation SOP |
| | | |Instance Reference Sequence (30xx,1331). |
| | | |Shall not be present, if Combination Segment |
| | | |Reference Sequence (30xx,1344) is present. |
| | | |Only a single Item shall be included in this |
| | | |sequence. Each Conceptual Volume UID (30xx,1301) |
| | | |shall only appear once in that sequence. |
| | | |See C.AA.D1.1.5. |
|>>Include 'Conceptual Volume Macro' Table C.AA.2.5-1 |
|>>Referenced ROI Number |(3006,0084) |1C |Uniquely identifies the referenced ROI described in |
| | | |the Structure Set ROI Sequence (3006,0020). |
| | | |Required if Referenced SOP Class UID (0008,1150) in |
| | | |Segmentation SOP Instance Reference Sequence |
| | | |(30xx,1331) has the value of |
| | | |“1.2.840.10008.5.1.4.1.1.481.3” (RT Structure Set). |
|>>Referenced Segment Number |(0062,000B) |1C |Uniquely identifies the segment described in the |
| | | |Segment Sequence (0062,0002) by reference to the |
| | | |Segment Number (0062,0004). Referenced Segment |
| | | |Number (0062,000B) shall not be multi-valued. |
| | | |Required if Referenced SOP Class UID in Segmentation|
| | | |SOP Instance Reference Sequence (30xx,1331) has the |
| | | |value of either “1.2.840.10008.5.1.4.1.1.66.4” |
| | | |(Segmentation IOD) or “1.2.840.10008.5.1.4.1.1.66.5”|
| | | |(Surface Segmentation IOD). |
|>>Referenced Segmentation Instance Index |(30xx,1351) |1 |References the Segmentation Instance Index |
| | | |(30xx,1350) in Segmentation SOP Instance Reference |
| | | |Sequence (30xx,1331) defining the SOP instance this |
| | | |Direct Segment Reference refers to. |
|>Combination Segment Reference Sequence |(30xx,1344) |1C |Identifies the segment geometric definition in the |
| | | |SOP instance referenced in the Segmentation SOP |
| | | |Instance Reference Sequence (30xx,1331), when this |
| | | |segment is a combination of other segments present |
| | | |in the Segment Sequence (0062,0002). |
| | | |Shall not be present, if Direct Segment Reference |
| | | |Sequence (30xx,1343) is present. |
| | | |Only a single Item shall be included in this |
| | | |sequence. Each Conceptual Volume UID (30xx,1301) |
| | | |shall only appear once in the Segment Sequence |
| | | |(0062,0002). |
| | | |See C.AA.D1.1.6. |
| |
|>>Include ‘Conceptual Volume Segmentation Reference and Combination |The value of Conceptual Volume Combination Flag |
|Macro' Table C.AA.2.6-1 |(30xx,1309) shall be YES, |
| |The value of Conceptual Volume Segmentation Defined |
| |Flag (30xx,1311) shall be YES. |
|Segmentation SOP Instance Reference |(30xx,1331) |1 |Identifies the SOP Instance, which is augmented by |
|Sequence | | |the content of the SOP Instance including this |
| | | |module. |
| | | |One or more Items shall be included in this |
| | | |sequence. For further information, see section |
| | | |C.AA.D1.1.1. |
|>Segmentation Instance Index |(30xx,1350) |1 |Index of the Instance items in the sequence. |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.D1.1 RT Segment Annotation Description
C.AA.D1.1.1 Segmentation SOP Instance Reference Sequence
Only the following SOP Classes are permitted to be referenced in this sequence:
Table C.AA.D1.1-1
PERMITTED SOP CLASSES
|SOP Class Name |SOP Class UID |
|Segmentation Storage |1.2.840.10008.5.1.4.1.1.66.4 |
|Surface Segmentation Storage |1.2.840.10008.5.1.4.1.1.66.5 |
|RT Structure Set |1.2.840.10008.5.1.4.1.1.481.3 |
In case more than one Item is included in this sequence, all referenced objects shall use the same Frame of Reference UID.
C.AA.D1.1.2 Alternate Segmented Property Type Code Sequence
The Alternate Segmented Property Type Code Sequence (30xx,134E) associates one or more additional identifiers with a segment to support uniform naming of anatomic structures and target volumes for data registries and clinical trials, cross-institutional, cross-application classification for clinical workflow, automated treatment planning, DVH analysis etc. Any relevant Context IDs defined by clinical trial or other organizations may be used in this code.
Examples of the use of the Alternate Segmented Property Type Code Sequence are shown below. In the first example, an anatomic structure representing the right lung of a patient with a right-lung lesion (Segmented Property Type Code of “Lung_R”) is further identified as the ipsi-lateral lung using Alternate Property Type Code of “Lung_Ipsi” as required by Clinical Trial Protocol 1234.
|>Segmented Property Category Code Sequence |(0062,0003) |(SRT, T-D000A, Anatomical Structure) |
|>Segmented Property Type Code Sequence |(0062,000F) |(CODESCHEME1, Lung_R, Right Lung) |
|>Alternate Segmented Property Type Code |(30xx,134E) |(CODESCHEME2, Lung_Ipsi, Ipsi-lateral Lung) |
|Sequence | | |
|>>Purpose of Alternate Segmented Property |(30xx,134F) |(CODESCHEME3,CT1234, Clinical Trial Protocol 1234) |
|Type Code Sequence | | |
In the second example, a Clinical Target Volume (CTV) is further identified as the volume whose prescription dose is 5400 cGy as required by Clinical Trial Protocol 1234.
|>Segmented Property Category Code Sequence |(0062,0003) |(99SUP147, S147050, Target) |
|>Segmented Property Type Code Sequence |(0062,000F) |(CODESCHEME1, CTV, Clinical Target Volume) |
|>Alternate Segmented Property Type Code |(30xx,134E) |(CODESCHEME2, CTV_5400, CTV 5400 cGy) |
|Sequence | | |
|>>Purpose of Alternate Segmented Property |(30xx,134F) |(CODESCHEME3, ,CT1234, Clinical Trial Protocol 1234) |
|Type Code Sequence | | |
In the third example, a Gross Tumor Volume (GTV) is further identified as the Gross Tumor Volume delineated on the Cone-Beam CT image acquired in fraction 3 to support processing of IGRT data in clinical workflow.
|>Segmented Property Category Code Sequence |(0062,0003) |(99SUP147, S147050, Target) |
|>Segmented Property Type Code Sequence |(0062,000F) |(CODESCHEME1, GTV, Gross Tumor Volume) |
|>Alternate Segmented Property Type Code |(30xx,134E) |(CODESCHEME2, GTV_CBCT3, GTV delineated on fraction 3 |
|Sequence | |CBCT) |
|>>Purpose of Alternate Segmented Property |(30xx,134F) |(CODESCHEME3, IGRT Target, Target Segmented on IGRT) |
|Type Code Sequence | | |
C.AA.D1.1.3 Segmented Property Type Code Sequence
If the Segmented Property Category Code Sequence (0062,0003) has the code value specified in the left column below, the CID for Segmented Property Type Code Sequence (0062,000F) shall be the one specified in the right column below.
|Code Value of Category |CID for Property Type |
|(S147050, 99SUP147, “Target”) |DCID SUP147004 Radiotherapy Targets |
|(S147053, 99SUP147, “Geometrical Information”) |DCID SUP147005 RT Geometric Information |
|(S147054, 99SUP147, “Fixation or Positioning Device”) |DCID SUP147006 Fixation or Positioning Devices |
|(S147055, 99SUP147, “Internal Brachytherapy Device”) |DCID SUP147007 Brachytherapy Devices |
|(S147056, 99SUP147, “Artifical Structure”) |BCID 7157 Device Segmentation Types |
|(S147057, 99SUP147, “Geometric Combination”) |DCID SUP147009 Combination |
C.AA.D1.1.4 Segmented RT Accessory Device Sequence
A segment represents an RT accessory, when the Segmented Property Category Code Sequence (0062,0003) contains one of the following values:
• Value of (S147054, 99SUP147, “Fixation or Positioning Device”)
• Value of (S147055, 99SUP147, “Internal Brachytherapy Device”)
• Value of (S147056, 99SUP147, “Artificial Structure”)
C.AA.D1.1.5 Direct Segment Reference Sequence
This sequence defines the reference to the geometric representation of the segment annotated in the actual item of Segment Sequence (0062,0002).
The Conceptual Volume Macro in the Direct Segment Reference Sequence (30xx,1343) establishes the identification of the conceptual volume associated with the segment as referenced in that sequence. Where combination of segments is defined, the Combination Segment Reference Sequence (30xx,1344) shall be used instead.
C.AA.D1.1.6 Combination Segment Reference Sequence
This sequence allows establishing new segments as combinations of other segments. Those other segments are referenced in the Conceptual Volume Segmentation Reference and Combination Macro (see section C.AA.2.6).
All Conceptual Volume References in that Macro may reference only segments that are defined in the Direct Segment Reference Sequence (30xx,1343) in the Segment Sequence (0062,0002).
These segments are identified by referencing their corresponding Conceptual Volume UID (30xx,1301) within the Direct Segment Reference Sequence.
At least two sequence Items in the Segment Sequence including a Direct Segment Reference Sequence are required to be present in the Conceptual Volume Segmentation Reference and Combination Macro (see section C.AA.2.6).
C.AA.D1.1.7 Segment Properties Sequence
If a property of a segment requires only a single parameter, the parameter is specified by the Content Item in the Segment Properties Sequence (30xx,134B).
If a property of a segment requires more than one parameter, the first parameter is specified by the Content Item in the Segment Properties Sequence (30xx,134B). Subsequent parameters are specified in the Segment Properties Modifier Sequence (30xx,134B). The following table defines the additional parameters for properties having more then one parameter.
|Concept in Segment Properties Sequence |Concept in Segment Properties Modifier |Unit of Content Item in Segment |
|Sequence (30xx,134B) |Sequence (30xx,134B) |Properties Modifier Sequence (30xx,134B) |
|S147161, 99SUP147, "Elemental Composition|S147163, 99SUP147, “Elemental Composition|Units = EV (ratio, UCUM, "ratio") |
|Atomic Number" |Atomic Mass Fraction” | |
C.AA.E1 RT Delivery Device Common Module
The RT Delivery Device Common Module contains general information pertaining to the physical device used to deliver the treatment.
Table C.AA.E1-1
RT DELIVERY DEVICE COMMON MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Include 'Treatment Device Identification Macro' Table C.AA.2.10-1 |
|Alternate Treatment Device Sequence |(30xx,5016) |2 |Alternate Treatment Devices that are declared as |
| | | |equivalent for delivery purposes. |
| | | |See section C.AA.E1.1.1. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>Include 'Treatment Device Identification Macro' Table C.AA.2.10-1 |
|Radiation Dosimeter Unit Sequence |(30xx,5113) |1 |Measurement unit of machine dosimeter. |
| | | |See section C.AA.E1.1.2. |
| | | |Only a single item shall be present in the sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147055 |
|Coordinate System Declaration |(30xx,5208) |1 |Defines the coordinate system for use by beam |
| | | |limiting device measurements. |
| | | |Defined Terms: |
| | | |IEC_BM_LIMIT_DEV |
| | | |See section C.AA.E1.8.2.1 |
|RT Beam Distance Reference Location |(30xx,5114) |1 |Describes the point of reference for the distances |
| | | |measured to various devices within the beam line. |
| | | |Enumerated values: |
| | | |SOURCE = Distances measured from the source of |
| | | |radiation |
| | | |ISOCENTER = Distances measured from the isocenter |
|Beam Limiting Device Definition Distance |(30xx,5210) |1 |Distance along the beam line from the RT Beam |
| | | |Distance Reference Location (30xx,5114) to the beam |
| | | |limiting device definition plane. The beam limiting |
| | | |device definition plane shall be normal to the beam |
| | | |line. |
|Equipment Frame of Reference UID |(30xx,51A0) |1 |Frame of Reference identifier for the Treatment |
| | | |Delivery Device. See C.AA.E1.1.3. |
|Equipment Frame of Reference Description |(30xx,51A1) |3 |Informal description of device coordinate system |
| | | |identified by the Equipment Frame of Reference UID |
| | | |(30xx,51A0) used for the Treatment Delivery Device. |
| | | |See C.AA.E1.1.4. |
|Synchronization Frame of Reference UID |(0020,0200) |3 |UID of common synchronization environment. See |
| | | |C.7.4.2.1.1. |
|Include 'RT Patient Device Support Identification Macro' Table C.AA.2.12-1 |
C.AA.E1.1 RT Delivery Device Common Module Attribute Description
C.AA.E1.1.1 Alternate Treatment Device Sequence
The Alternate Treatment Device Sequence identifies treatment devices, which may be suited to deliver this radiation in lieu of the primary target machine defined by the top-level invocation of the ‘Treatment Device Identification Macro’. The scope of dosimetry equivalence of treatment delivered by an alternate device is not defined by the standard.
C.AA.E1.1.2 Radiation Dosimeter Unit
A Radiation Dosimeter Unit (30xx,5113) of RELATIVE is commonly used for delivery devices where calculation of MU is not possible at the planning stage, but where the radiation is calibrated prior to treatment, using some independent calibration step.
C.AA.E1.1.3 Equipment Frame of Reference UID
The Equipment Frame of Reference UID (30xx,51A0) uniquely identifies the coordinate system of the Treatment Device.
The Equipment Frame of Reference is always defined for any class of devices that share a common definition. The UID uniquely identifies this coordinate system. The coordinate system is described by a definition of where the origin is located in respect to this class of devices, and how the axes are oriented with respect to those devices. Each RT Delivery Device being called out in one of the IODs using this tag has to specify to which class of Equipment Frame of Reference it belongs, by specifying the Equipment Frame of Reference UID (30xx,51A0) in its Conformance Statement.
The choice of origin for the RT Delivery Device is device-specific. It could be a significant location on the machine such as a machine isocenter. The Equipment Frame of Reference is a right handed system, i.e. the vector cross product of a unit vector along the positive x-axis and a unit vector along the positive y-axis is equal to a unit vector along the positive z-axis. No recommendation is made concerning the orientation of the axes.
Instances of the C-Arm Photon Radiation Storage SOP Class and C-Arm Electron Radiation Storage SOP Class shall use the well-known UID for the IEC FIXED Reference System Frame of Reference.
It is the responsibility of any vendor or organization to provide a precise definition of location and orientation of this coordinate system for a class of devices covered when issuing a new Equipment Frame of Reference UID. Note that the Equipment Frame of Reference Description (30xx,51A1) is an informal annotation only and shall not be used for any normative description of the device coordinate system.
Note also that the use of the Equipment Frame of Reference UID is restricted to the classification of the device coordinate system and shall not be used for any patient-based Frame of Reference UID definition.
C.AA.E1.2 Conformance
C.AA.E1.2.1 Coordinate System Declaration
If IEC 61217 'Radiotherapy equipment – Coordinates, movements and scales' applies to the delivery device in question (this is true for most C-Arm type devices), this attribute shall equal IEC_BM_LIMIT_DEV.
If this attribute value is not IEC_BM_LIMIT_DEV, the DICOM Conformance Statement of the device shall specify the value of the Defined Term in this attribute. It shall also specify a right-handed coordinate system (RCS). The z-axis shall coincide with the beam axis. If needed, the Conformance Statement shall also specify a leaf entry order for this coordinate system e.g. for IEC: 101, 102, ... 1N, 201, 202, ... 2N.
C.AA.E2 RT Radiation Common Module
The RT Radiation Common Module contains a specification of attributes required by all Radiation IODs that are to be used in an external beam treatment delivery.
Table C.AA.E2-1
RT RADIATION COMMON MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|RT Radiation Data Scope |(30xx,5013) |1 |Intended use of this radiation. |
| | | |Defined Terms: |
| | | |GEOMETRIC = Treatment simulation |
| | | |DOSIMETRIC = Dosimetric verification |
| | | |See C.AA.E2.1.3. |
|Radiotherapy Procedure Technique Sequence |(30xx,0C99) |1 |Type of treatment technique. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See C.AA.E2.1.1. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID is defined in the IOD including this |
| |module |
|Include 'RT Treatment Position Macro' Table C.AA.2.32-1 |See C.AA.E2.1.2 |
|RT Tolerance Set Sequence |(30xx,0BA0) |3 |A set of tolerance values to be applied to delivery |
| | | |of the Radiation. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'RT Tolerance Set Macro' Table C.8.A1.27-1 |
|Treatment Time Limit |(30xx,0BAD) |2 |The expected maximum delivery time in [sec]. |
| | | |See C.AA.E2.1.4. |
C8.A.E2.1 RT Radiation Common Attribute Description
C.AA.E2.1.1 Radiotherapy Procedure Technique Sequence
The Radiotherapy Procedure Technique Sequence (30xx,0C99) describes the treatment technique, i.e. how the radiation beam is shaped and targeted. This information is generated from the content of the Radiation SOP instance (especially from the Control Point parameters), and shall be consistent with that content. Its primary purpose is to summarize the radiation technique for the end user by means of an established term.
C.AA.E2.1.2 RT Treatment Position Macro
The RT Treatment Position Macro describes how the patient has to be positioned with respect to the delivery device for treatment (Treatment Position).
Item Numbers in the Referenced Control Point Index (30xx,0141) identify the Control Point, at which the treatment position is first applied. In many cases, the treatment position will remain constant throughout the Radiation, therefore the RT Treatment Position Macro will only contain one item with the Referenced Control Point Index (30xx,0141) equal to 1. Otherwise, it will have one item in the Treatment Position Sequence (30xx,5028) for each control point, where the position has changed compared with the previous control point.
No assumptions are made about the behavior of machine parameters regarding the patient position between specified Control Points, and communicating devices shall agree on this behavior outside the current standard.
C.AA.E2.1.3 RT Radiation Data Scope
The value GEOMETRIC indicates, that the content of the SOP instance has the scope which allows to define geometric definitions, where any dosimetric information is not necessary. This scope is useful when such an object is instantiated in a context, where only geometric treatment parameters are being considered. A typical example is the virtual simulation use case.
C.AA.E2.1.4 Treatment Times
The Treatment Time Limit (30xx,0BAD) is the maximum time allowed for the accumulated time of radiation delivery to prevent significant overtreatments. Treatment is expected to be terminated upon reaching the Treatment Time Limit as a safety limit independent of the meterset. During actual delivery, fluences or dose rates may vary from nominal settings due to technical reasons. Therefore this limit is expected to include a factor greater than 1 to accommodate variations. The Treatment Time Limit will be greater than the Calculated Treatment Time.
C.AA.F1 Tomotherapeutic Delivery Device Module
The Tomotherapeutic Delivery Device Module contains tomotherapy-specific information pertaining to the physical device used to deliver the treatment, including geometrical parameters of the collimation system. This information is constant for all possible beam deliveries with this equipment.
Table C.AA.F1-1
TOMOTHERAPEUTIC DELIVERY DEVICE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Source-Axis Distance |(300A,00B4) |1 |Radiation source to Gantry rotation axis distance of |
| | | |the equipment that is to be used for beam delivery |
| | | |(mm). |
|Include ‘Accessory Holder Definition Macro' Table C.AA.2.26-1 |
|Tomotherapeutic Leaf Bank Definition |(30xx,1000) |1 |Describes the leaf slot positions for Leaf Banks. |
|Sequence | | |One or more Items shall be included in this sequence.|
|>Leaf Bank Offset |(30xx,1001) |1 |Offset in mm of central axis of Leaf Bank in X-axis |
| | | |of IEC BEAM LIMITING DEVICE coordinate system, |
| | | |relative to the nominal central axis of the delivery |
| | | |machine. |
|>Number of Leaf Slots |(30xx,1002) |1 |Number of leaf slots in the current Leaf Bank. |
| | | |See C.AA.F1.1.1. |
|>Binary MLC Leaf Slot Boundaries |(30xx,1003) |1 |Boundaries of beam limiting device (collimator) |
| | | |leaves (in mm) in Y-axis of IEC BEAM LIMITING DEVICE |
| | | |coordinate system. Contains N+1 values, where N is |
| | | |the Number of Binary MLC Leaf Slots. |
C.AA.F1.1 Tomotherapeutic Delivery Device Attribute Description
C.AA.F1.1.1 Leaf Slot Definition
A ‘Leaf Slot’ is a channel perpendicular to the binary collimator long axis that can be occluded by a leaf or leaves during treatment. A Leaf Slot could be occluded by a single leaf (for example, in the case of opposing banks of interleaved leaves), or by two leaves (in the case of opposed leaf pairs). The exact nature of these leaves is not described in this module: for beam characterization purposes it is sufficient to model the Leaf Slot dimensions only.
C.AA.F2 Tomotherapeutic Beam Module
The Tomotherapeutic Beam Module contains a specification of how a specific tomotherapeutic treatment beam is to be delivered.
Table C.8A.F2-1
TOMOTHERAPEUTIC BEAM MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Radiation Particle |(30xx,5110) |1 |Particle Type of Radiation. |
| | | |Defined Terms: |
| | | |PHOTON |
| | | |ELECTRON |
| | | |PROTON |
|Maximum Binary MLC Jaw 1 Opening |(30xx,1005) |1 |Position in mm of Jaw 1 (IEC Y1) edge defining the |
| | | |maximum extent of the opening for the current Beam, |
| | | |as defined by IEC BEAM LIMITING DEVICE coordinate |
| | | |system. |
|Maximum Binary MLC Jaw 2 Opening |(30xx,1006) |1 |Position in mm of Jaw 2 (IEC Y2) edge defining the |
| | | |maximum extent of the opening at the current Beam, as|
| | | |defined by IEC BEAM LIMITING DEVICE coordinate |
| | | |system. |
|Tomotherapeutic Nominal Couch Speed |(30xx,1007) |1 |Nominal Couch Speed for beam (mm/sec). |
|Tomotherapeutic Nominal Gantry Period |(30xx,1008) |1C |Nominal Gantry Period for beam (seconds). |
| | | |Required if Code Value in Radiotherapy Procedure |
| | | |Technique Sequence (30xx,0C99) is (S147240, 99SUP147,|
| | | |“Helical Beam”). May be present otherwise. |
|Tomotherapeutic Nominal Delivery Pitch |(30xx,1009) |1C |Nominal Delivery Pitch for beam. |
| | | |Required if Code Value in Radiotherapy Procedure |
| | | |Technique Sequence (30xx,0C99) is (S147240, 99SUP147,|
| | | |“Helical Beam”). May be present otherwise. |
|Include 'Beam Mode Macro' Table C.AA.2.19-1 |
|Tomotherapeutic Control Point Sequence |(30xx,1010) |1 |Control points used to model the beam delivery. |
| | | |Two or more Items shall be included in this sequence.|
|>Include 'External Beam Control Point General Attributes Macro' Table C.AA.2.17-1 |
|>Gantry Roll Continuous Angle |(30xx,51B5) |1C |Continuous gantry angle of radiation source at the |
| | | |Control Point in IEC GANTRY coordinate system with |
| | | |respect to IEC FIXED REFERENCE coordinate system |
| | | |(degrees). |
| | | |Required as specified in C.AA.16.2.1.1. |
| | | |Required if the Control Point Index (30xx,0111) |
| | | |equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1 and C.AA.G2.1.4. |
|>Tomotherapeutic Leaf Bank Position Sequence|(30xx,1020) |1 |Set of collimator bank settings for the projection |
| | | |following the current Control Point. Banks are |
| | | |encoded in spatial order, with the bank nearest the |
| | | |front of the machine first. |
| | | |One or more Items shall be included in this sequence.|
|>>Binary MLC Jaw 1 Opening |(30xx,1024) |1 |Position in mm of Jaw 1 (IEC Y1) edge defining the |
| | | |extent of the opening at the current Control Point, |
| | | |as defined by IEC Beam Limiting Device coordinate |
| | | |system. |
|>>Binary MLC Jaw 2 Opening |(30xx,1025) |1 |Position in mm of Jaw 2 (IEC Y2) edge defining the |
| | | |extent of the opening at the current Control Point, |
| | | |as defined by IEC Beam Limiting Device coordinate |
| | | |system. |
|>>Tomotherapeutic Leaf Open Percentages |(30xx,1030) |1 |Percentage of projection time jaw leaves are open |
| | | |during the projection following the Control Point for|
| | | |the current leaf bank. Value multiplicity is equal to|
| | | |Number of Leaf Slots. |
|>>Tomotherapeutic Leaf Open Start |(30xx,1031) |1C |Percentage of projection time at which jaw leaves |
|Percentages | | |open during the projection following the Control |
| | | |Point for the current leaf bank. Value multiplicity |
| | | |is equal to Number of Leaf Slots. |
| | | |Required if one or more leaf open times are not |
| | | |symmetrical about the projection center. May be |
| | | |present otherwise. |
C.AA.G1 C-Arm Photon-Electron Delivery Device Module
The C-Arm Photon-Electron Delivery Device Module contains C-Arm-specific information pertaining to the physical device used to deliver photon and electron treatments, including geometrical parameters of the collimation system. This information is constant for all possible beam deliveries with this equipment.
Table C.AA.G1-1
C-ARM PHOTON-ELECTRON DELIVERY DEVICE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Source-Axis Distance |(300A,00B4) |1 |Distance (in mm) from the Radiation source |
| | | |perpendicular to Gantry Roll rotation axis of the |
| | | |equipment that is to be used for beam delivery. |
|Include 'Beam Limiting Device Definition Macro' Table C.AA.2.20-1 |
|Include 'Wedges Definition Macro' Table C.AA.2.22-1 |
|Include 'Compensators Definition Macro' Table C.AA.2.24-1 |
|Include 'Blocks Definition Macro' Table C.AA.2.25-1 |
|Include 'Accessory Holder Definition Macro' Table C.AA.2.26-1 |
|Include 'General Accessories Definition Macro' Table C.AA.2.27-1 |
|Include 'Boluses Definition Macro' Table C.AA.2.28-1 |
C.AA.G2 C-Arm Photon-Electron Beam Module
The C-Arm Photon-Electron Beam Module contains a specification of how a specific C-Arm photon or electron treatment beam is to be delivered.
Table C.AA.G2-1
C-ARM PHOTON-ELECTRON BEAM MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Radiation Particle |(30xx,5110) |1 |Particle Type of Radiation. See C.AA.G2.1.1. |
| | | |Enumerated Values: |
| | | |PHOTON |
| | | |ELECTRON |
|Treatment Machine Mode Sequence |(30xx,0C97) |1 |Annotates the mode of operation for treatment |
| | | |machine. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See C.AA.G2.1.3. |
|>Include 'Code Sequence Macro' Table 8.8-1. |Defined CID SUP147017. |
|Include 'Beam Mode Macro' Table' C.AA.2.19-1 |
|C-Arm Photon-Electron Control Point Sequence|(30xx,0C00) |1 |Control points used to model the beam delivery. |
| | | |Two or more Items shall be included in this sequence.|
|>Include 'External Beam Control Point General Attributes Macro' Table C.AA.2.17-1 |
|>Include 'RT Beam Limiting Device Positions Macro' Table C.AA.2.21-1 |
|>Include 'Wedge Positions Macro' Table C.AA.2.23-1 |
|>Gantry Roll Continuous Angle |(30xx,51B5) |1C |Treatment machine gantry angle, i.e. orientation of |
| | | |IEC GANTRY coordinate system with respect to IEC |
| | | |FIXED REFERENCE coordinate system (degrees). |
| | | |Required if the Control Point Index (30xx,0111) |
| | | |equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1 and C.AA.G2.1.2. |
|>Surface Entry Point |(300A,012E) |2C |Patient surface entry point coordinates (x,y,z), |
| | | |along the central axis of the beam, in the patient |
| | | |based coordinate system described in C.7.6.2.1.1 |
| | | |(mm). |
| | | |Required if the Control Point Index (30xx,0111) |
| | | |equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1. |
|>Source to Surface Distance |(300A,0130) |2C |Source to Patient Surface distance (mm). |
| | | |Required if the Control Point Index (30xx,0111) |
| | | |equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1. |
C.AA.G2.1 C-Arm Photon-Electron Beam Attribute Description
C.AA.G2.1.1 Radiation Particle
If the C-Arm Photon-Electron Beam Module is contained within a C-Arm Photon Radiation IOD, the value of Radiation Particle (30xx,5110) shall be PHOTON.
If the C-Arm Photon-Electron Beam Module is contained within a C-Arm Electron Radiation IOD, the value of Radiation Particle (30xx,5110) shall be ELECTRON.
C.AA.G2.1.2 Continuous Rotation Angles
A continuous rotation angle is an angle in the range (-∞,+∞), such that:
• The continuous rotation angle modulo 360 yields the angle in the coordinate system as specified IEC 61217 'Radiotherapy equipment – Coordinates, movements and scales', where applicable.
• Relative to a previous continuous rotation angle, an increase in continuous rotation angle shall specifiy a clockwise (CW) rotation, where a difference of more than 360 between the two values specifies more than one CW rotation.
• Relative to a previous continuous rotation angle, a decrease in continuous rotation angle shall specify a counter-clockwise (CC) rotation, where a difference of less than -360 between the two values specifies more than one CC rotation.
The angles are called continuous to express the capability to run continuously beyond a full circle. This is especially important for rotational movement going beyond 360 degrees. This notion provides the ability to unambiguously specify the direction of rotation (CW or CC), when specifying a rotation from a start angle to a stop angle. For gantries which cannot rotate continuously but have over-travel capabilities beyond their nominal rotational limit, continuous rotation angle removes the need to flag the rotational position in the over-travel state.
C.AA.H1 Multiple Fixed Source Delivery Device Module
The Multiple Fixed Source Delivery Device Module contains multiple fixed source device-specific information pertaining to the physical device used to deliver the treatment, including geometrical parameters of the collimation system. This information is constant for all possible beam deliveries with this equipment.
Table C.AA.H1-1
MULTIPLE FIXED SOURCE DELIVERY DEVICE MODULE
|Attribute Name |Tag |Type |Description |
|Radiation Source Sequence |(30xx,5130) |1 |The radiation sources of the device. |
| | | |One or more Items shall be included in this sequence.|
|>Radiation Source Label |(30xx,5131) |1 |Identification label for the Radiation Source. The |
| | | |label shall be unique within the sequence. |
|>Radiation Source Collimator Size |(30xx,513B) |1 |Diameter (full width at half maximum) in the machine |
| | | |isocenter of the beam originating from the radiation |
| | | |source through the collimator (mm). |
|>Radiation Source Distance |(30xx,5132) |2 |Source to isocenter distance (mm). |
|>Radiation Source Theta |(30xx,5133) |1 |The theta angle from the isocenter to the radiation |
| | | |source (degrees). |
| | | |See C.AA.H1.1.1. |
|>Radiation Source Phi |(30xx,5134) |1 |The phi angle from the isocenter to the radiation |
| | | |source (degrees). |
| | | |See C.AA.H1.1.1. |
C.AA.H1.1 Multiple Fixed Source Delivery Device Attribute Description
C.AA.H1.1.1 Radiation Source Angles
Radiation Source Theta (30xx,5133) is the angle from the Z axis of the equipment coordinate system to the vector from the isocenter to the source. Radiation Source Phi (30xx,5134) is the angle from the X axis of the device coordinate system to the projection of the vector from the isocenter to the source on the XY plane of the device coordinate system.
C.AA.H2 Multiple Fixed Source Beam Set Module
The Multiple Fixed Source Beam Set Module contains a specification of how a specific multiple fixed source treatment beam is to be delivered. In this context “beam” refers to a radiation for a period of time from multiple radiation sources.
Table C.8A.H2-1
MULTIPLE FIXED SOURCE BEAM SET MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Radiation Particle |(30xx,5110) |1 |Particle Type of Radiation. |
| | | |Defined Terms: |
| | | |PHOTON |
|Radiation Source Pattern Sequence |(30xx,513C) |1 |Radiation source patterns. |
| | | |One or more Items shall be included in this sequence. |
|>Radiation Source Pattern Label |(30xx,513D) |1 |Identification label for the Radiation Source Pattern. The|
| | | |label shall be unique within this sequence. |
|>Radiation Source Pattern Source |(30xx,513F) |1 |Radiation sources used for the enclosing pattern. |
|Sequence | | |One or more Items shall be included in this sequence. |
|>>Referenced Radiation Source Label |(30xx,513A) |1 |Uniquely identifies the Radiation Source described in the |
| | | |Radiation Source Sequence (30xx,5130) by a reference to |
| | | |the Radiation Source Label (30xx,5131). |
|Radiation Source Control Point Sequence |(30xx,5137) |1 |Control points used to model the radiation delivery. |
| | | |The sequence shall contain an even number of items, where |
| | | |each pair marks the start and end of a radiation. |
| | | |Two or more Items shall be included in this sequence. |
|>Include 'External Beam Control Point General Attributes Macro' Table C.AA.2.17-1 |
|>Referenced Radiation Source Pattern |(30xx,513E) |1C |Uniquely identifies the Radiation Source Pattern described|
| | | |in the Radiation Source Pattern Sequence (30xx,513C) by a |
| | | |reference to the Radiation Source Pattern Label |
| | | |(30xx,513D). |
| | | |Required if the Control Point Index (30xx,0111) equals 1 |
| | | |or attribute value changes at any Control Point. |
| | | |See C.AA.2.16.1. |
C.AA.J1 Robotic Delivery Device Module
The Robotic Delivery Device Module contains robot-specific information pertaining to the physical device used to deliver the treatment, including geometrical parameters of the collimation system. This information is constant for all possible beam deliveries with this equipment.
Table C.AA.J1-1
ROBOTIC DELIVERY DEVICE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Robotic Device Geometry |(30xx,0F03) |1 |Imaging geometry with which this path is associated. |
| | | |Defined Terms: |
| | | |NORMAL |
| | | |MIRROR |
|Include 'RT Beam Limiting Device Definition Macro' Table C.AA.2.20-1 |
|Include ‘Accessory Holder Definition Macro' Table C.AA.2.26-1 |
C.AA.J2 Robotic Path Module
The Robotic Path Module contains a specification of how a specific robotic path is to be delivered. Each SOP Instance corresponds to a single robotic “path”. Multiple paths are encoded as separate Radiation instances defined by reference in the Radiation Set IOD.
Table C.AA.J2-1
ROBOTIC PATH MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Radiation Particle |(30xx,5110) |1 |Particle Type of Radiation. |
| | | |Defined Terms: |
| | | |PHOTON |
| | | |ELECTRON PROTON |
|Robotic Path Identifier Sequence |(30xx,0F15) |1 |Path Set identifier. |
| | | |Only a single Item shall be included in this sequence.|
|>Include 'Code Sequence Macro' Table 8.8-1. |Defined CID SUP147011. |
|Include 'Beam Mode Macro Table' C.AA.2.19-1 |
|Robotic Control Point Sequence |(30xx,0F50) |1 |Control points used to model the beam delivery. |
| | | |Two or more Items shall be included in this sequence. |
|>Include 'External Beam Control Point General Attributes Macro' Table C.AA.2.17-1 |
|>Robotic Path Node Number |(30xx,0F33) |1 |A unique number that determines the sequence of |
| | | |delivery of individual nodes within the path. The |
| | | |value monotonically increases but may be |
| | | |non-contiguous. |
| | | |See Note 1. |
|>RT Treatment Source Coordinate |(30xx,0F40) |1 |Coordinates (x,y,z) of the source of the beam in the |
| | | |equipment defined original (device) coordinate system.|
|>RT Treatment Target Coordinate |(30xx,0F44) |1C |Cartesian values (x,y,z) of the target of the beam in |
| | | |the equipment defined original (device) coordinate |
| | | |system. |
| | | |Required if Robotic Beam Sub-Control Point Sequence |
| | | |(30xx,0F42) is not present and the Control Point Index|
| | | |(30xx,0111) equals 1 or attribute value changes at any|
| | | |Control Point. |
| | | |See C.AA.2.16.1.1. |
|>Robot Head Yaw Angle |(30xx,0F46) |1C |Robot Head Yaw Angle, i.e. the rotation of ROBOTIC |
| | | |COLLIMATOR coordinate system about the Z-axis of the |
| | | |ROBOTIC HEAD coordinate system (degrees). |
| | | |Required if Robotic Beam Sub-Control Point Sequence |
| | | |(30xx,0F42) is not present and if the Control Point |
| | | |Index (30xx,0111) equals 1 or attribute value changes |
| | | |at any Control Point. |
| | | |See C.AA.2.16.1.1. |
|>Include 'RT Beam Limiting Device Positions Macro' Table C.AA.2.21-1 |
|>Robotic Beam Sub-Control Point Sequence |(30xx,0F42) |1C |Sequence of Items describing Beam parameters changes |
| | | |within a Control Point. |
| | | |Required at all Control Points but the last. C.AA. |
| | | |Two or more Items shall be included in this sequence. |
|>>Include 'External Beam Sub-Control Point General Attributes Macro’ Table C.AA.2.18-1 |
|>>RT Treatment Target Coordinate |(30xx,0F44) |1C |Cartesian values (x,y,z) of the target of the beam in |
| | | |the equipment defined original (device) coordinate |
| | | |system. |
| | | |Required if the Sub-Control Point Index (30xx,0115) |
| | | |equals 1 or attribute value changes at any Sub-Control|
| | | |Point. |
| | | |See C.AA.2.18.1.1. |
|>>Robot Head Yaw Angle |(30xx,0F46) |1C |Robot Head Yaw Angle, i.e. the rotation of ROBOTIC |
| | | |COLLIMATOR coordinate system about the Z-axis of the |
| | | |ROBOTIC HEAD coordinate system (degrees). |
| | | |Required if the Sub-Control Point Index (30xx,0115) |
| | | |equals 1 or attribute value changes at any Sub-Control|
| | | |Point. |
| | | |See C.AA.2.18.1.1. |
Note 1: The value may reference node positions being pre-defined in the device configuration. Therefore it is not the same as the Control Point Index (30xx,0111), but has another purpose then just indexing the items within the Robotic Control Point Sequence (30xx,0F50).
C.AA.L1 Multi-Axial Delivery Device Module
The Multi-Axial Delivery Device Module contains specific information pertaining to the physical device used to deliver photon and electron treatments, including geometrical parameters of the collimation system. This information is constant for all possible beam deliveries with this equipment.
Table C.AA.L1-1
MULTI-AXIAL DELIVERY DEVICE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Source-Axis Distance |(300A,00B4) |1 |Distance in (mm) from the Radiation source |
| | | |perpendicular to Gantry Roll rotation axis of the |
| | | |equipment that is to be used for beam delivery. |
| | | |See C.AA.L1.1. |
|Center of Rotation-Axis Distance |(30xx,1501) |1 |Distance in (mm) from the Center of Rotation of the |
| | | |Multi-Axial Gantry Head perpendicular to Gantry Roll |
| | | |rotation axis of the equipment that is to be used for|
| | | |beam delivery (mm). |
| | | |See C.AA.L2.1.3. |
|Include 'Beam Limiting Device Definition Macro' Table C.AA.2.20-1 |
|Include 'Wedges Definition Macro' Table C.AA.2.22-1 |
|Include 'Accessory Holder Definition Macro' Table C.AA.2.26-1 |
|Include 'Boluses Definition Macro' Table C.AA.2.28-1 |
C.AA.L2.1 Multi Axial Delivery Device Attribute Description
C.AA.L1.1 Source-Axis Distance
The Source Axis Distance (300A,00B4) for a Multi-Axial Delivery Device is defined with Gantry Head pitch and roll rotation angles at zero degree position (see figure C.AA.L2.1.3-1).
C.AA.L2 Multi-Axial Beam Module
The Multi-Axial Beam Module contains a specification of how a specific Multi-Axial treatment beam is to be delivered.
Table C.AA.L2-1
MULTI-AXIAL BEAM MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Description |
|Radiation Particle |(30xx,5110) |1 |Particle Type of Radiation. |
| | | |Enumerated Values: |
| | | |PHOTON |
| | | |ELECTRON |
|Gantry Head Mode |(30xx,1546) |1 |The Gantry Head Mode. |
| | | |Defined Terms: |
| | | |STATIC = no Gantry Head movement is allowed |
| | | |DYNAMIC_TRACKING = Gantry Head movement is allowed, |
| | | |but no detailed information is provided |
| | | |DYNAMIC = detailed Gantry Head movement information |
| | | |is provided |
|Include 'Beam Mode Macro' Table C.AA.2.19-1 |
|Multi-Axial Control Point Sequence |(30xx,1500) |1 |Control points used to model the beam delivery. |
| | | |Two or more Items shall be included in this sequence.|
|>Include 'External Beam Control Point General Attributes Macro' Table C.AA.2.17-1 |
|>Include 'RT Beam Limiting Device Positions Macro' Table C.AA.2.21-1. See C.AA.L2.1.1. |
|>Include 'Wedge Positions Macro' Table C.AA.2.23-1 |
|>Include 'Accessory Holder Definition Macro' Table C.AA.2.26-1 |
|>Gantry Pitch Continuous Angle |(30xx,51B7) |1C |Continuous gantry pitch angle at the Control Point, |
| | | |i.e. the rotation of the IEC GANTRY coordinate system|
| | | |about the x-axis of the system rotated by the Gantry |
| | | |Yaw Continuous Angle (30xx,51B3) in (degrees). See |
| | | |C.AA.G2.1.4 and C.AA.L2.1.3. |
| | | |Required if the Control Point Index (30xx,0111) |
| | | |equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1. |
|>Gantry Roll Continuous Angle |(30xx,51B5) |1C |Continuous gantry angle of radiation source at the |
| | | |Control Point, i.e. the rotation of the IEC GANTRY |
| | | |coordinate system about the y-axis of the system |
| | | |rotated by the Gantry Yaw Continuous Angle |
| | | |(30xx,51B3) and rotated by the Gantry Pitch |
| | | |Continuous Angle (30xx,51B7) in (degrees). See |
| | | |C.AA.G2.1.4 and C.AA.L2.1.3. |
| | | |Required if the Control Point Index (30xx,0111) |
| | | |equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1. |
|>Gantry Yaw Continuous Angle |(30xx,51B3) |1C |Continuous gantry yaw angle at the Control Point, |
| | | |i.e. the rotation of the IEC GANTRY coordinate system|
| | | |about the z-axis of the IEC FIXED SYSTEM in |
| | | |(degrees). See C.AA.G2.1.4 and C.AA.L2.1.3. |
| | | |Required if the Control Point Index (30xx,0111) |
| | | |equals 1 or attribute value changes at any Control |
| | | |Point. |
| | | |See C.AA.2.16.1. |
|>Gantry Head Pitch Angle |(30xx,1520) |1C |Gantry Head Pitch Angle, i.e. the rotation of the |
| | | |MULTI-AXIAL GANTRY HEAD coordinate system about the |
| | | |X-axis of the MULTI-AXIAL GANTRY HEAD coordinate |
| | | |system (degrees). |
| | | |Required if Multi-Axial Sub-Control Point Sequence |
| | | |(30xx,1540) is not present and if the Control Point |
| | | |Index (30xx,0111) equals 1 or attribute value changes|
| | | |at any Control Point. |
| | | |See C.AA.2.16.1 and C.AA.L2.1.2. |
|>Gantry Head Roll Angle |(30xx,1521) |1C |Gantry Head Roll Angle, i.e. the rotation of the |
| | | |MULTI-AXIAL GANTRY HEAD coordinate system about the |
| | | |Y-axis of the MULTI-AXIAL GANTRY HEAD coordinate |
| | | |system (degrees). |
| | | |Required if Multi-Axial Sub-Control Point Sequence |
| | | |(30xx,1540) is not present and if the Control Point |
| | | |Index (30xx,0111) equals 1 or attribute value changes|
| | | |at any Control Point. |
| | | |See C.AA.2.16.1 and C.AA.L2.1.2. |
|>Gantry Head Yaw Angle |(30xx,1522) |1C |Gantry Head Yaw Angle, i.e. the rotation of the |
| | | |MULTI-AXIAL GANTRY HEAD coordinate system about the |
| | | |Z-axis of the MULTI-AXIAL GANTRY HEAD coordinate |
| | | |system (degrees). |
| | | |Required if Multi-Axial Sub-Control Point Sequence |
| | | |(30xx,1540) is not present and if the Control Point |
| | | |Index (30xx,0111) equals 1 or attribute value changes|
| | | |at any Control Point. |
| | | |See C.AA.2.16.1 and C.AA.L2.1.2. |
|>Multi-Axial Target Coordinate |(30xx,1525) |2C |Target coordinates (x,y,z) in the patient based |
| | | |coordinate system described in C.7.6.2.1.1 (mm) at |
| | | |Source-Axis Distance. |
| | | |Required if Multi-Axial Sub-Control Point Sequence |
| | | |(30xx,1540) is not present and if the Control Point |
| | | |Index (30xx,0111) equals 1 or attribute value changes|
| | | |at any Control Point. |
| | | |See C.AA.2.16.1 and C.AA.L2.1.2. |
|>Surface Entry Point |(300A,012E) |2 |Patient surface entry point coordinates (x,y,z), |
| | | |along the central axis of the beam, in the patient |
| | | |based coordinate system described in C.7.6.2.1.1 |
| | | |(mm). |
|>Source to Surface Distance |(300A,0130) |2 |Source to Patient Surface distance (mm). |
|>Multi-Axial Sub-Control Point Sequence |(30xx,1540) |1C |Sequence of Items describing Sub-Control Points. |
| | | |Required at every Control Point but the last if |
| | | |Gantry Head Mode (30xx,1546) is DYNAMIC. |
| | | |May be present at every Control Point but the last if|
| | | |Gantry Head Mode is DYNAMIC_TRACKING. |
| | | |Two or more Items shall be included in this sequence.|
|>>Include 'External Beam Sub-Control Point General Attributes Macro’ Table C.AA.2.18-1 |
|>>Gantry Head Pitch Angle |(30xx,1520) |1C |Gantry Head Pitch Angle, i.e. the rotation of the |
| | | |MULTI-AXIAL GANTRY HEAD coordinate system about the |
| | | |X-axis of the MULTI-AXIAL GANTRY HEAD coordinate |
| | | |system (degrees). |
| | | |Required if the Sub-Control Point Index (30xx,0115) |
| | | |equals 1 or attribute value changes at any |
| | | |Sub-Control Point. |
| | | |See C.AA.2.18.1.1.and C.AA.L2.1.2. |
|>>Gantry Head Roll Angle |(30xx,1521) |1C |Gantry Head Roll Angle, i.e. the rotation of the |
| | | |MULTI-AXIAL GANTRY HEAD coordinate system about the |
| | | |Y-axis of the MULTI-AXIAL GANTRY HEAD coordinate |
| | | |system (degrees). |
| | | |Required if the Sub-Control Point Index (30xx,0115) |
| | | |equals 1 or attribute value changes at any |
| | | |Sub-Control Point. |
| | | |See C.AA.2.18.1.1.and C.AA.L2.1.2. |
|>>Gantry Head Yaw Angle |(30xx,1522) |1C |Gantry Head Yaw Angle, i.e. the rotation of the |
| | | |MULTI-AXIAL GANTRY HEAD coordinate system about the |
| | | |Z-axis of the MULTI-AXIAL GANTRY HEAD coordinate |
| | | |system (degrees). |
| | | |Required if the Sub-Control Point Index (30xx,0115) |
| | | |equals 1 or attribute value changes at any |
| | | |Sub-Control Point. |
| | | |See C.AA.2.18.1.1. and C.AA.L2.1.2. |
|>>Multi-Axial Target Coordinate |(30xx,1525) |2C |Target coordinates (x,y,z) in the patient based |
| | | |coordinate system described in C.7.6.2.1.1 (mm) at |
| | | |Source-Axis Distance. |
| | | |Required if the Sub-Control Point Index (30xx,0115) |
| | | |equals 1 or attribute value changes at any |
| | | |Sub-Control Point. |
| | | |See C.AA.2.18.1.1. |
C.AA.L2.1 Multi Axial Beam Attribute Description
C.AA.L2.1.1 Multi-Axial Gantry Angles
For a Multi-Axial treatment machine the Gantry Pitch Continuous Angle (30xx,51B7), Gantry Roll Continuous Angle (30xx,51B5) and Gantry Yaw Continuous Angle (30xx,51B3) shall be applied in the order z, x, y: first the yaw angle about the z-axis, then the pitch angle about the x-axis and then the roll angle about the y-axis.
C.AA.L2.1.2 Gantry Head Angles
Gantry Head Pitch Angle (30xx,1520), Gantry Head Roll Angle (30xx,1521) and Gantry Head Yaw Angle (30xx,1522) shall be applied in the order z, x, y: first the angle about the Zh-axis, then the angle about the Xh-axis and then the angle about the Yh-axis. These angles are the authoritative definition of the Gantry Head. The coordinate defined in Multi-Axial Target Coordinate (30xx,1525) shall only serve the purpose of annotation.
C.AA.L2.1.3 Multi Axial Beam Delimiter Positions
For the Multi-Axial Delivery Device, there is an "h" coordinate system which is fixed with respect to the MULTI-AXIAL GANTRY HEAD and its mother system is the IEC GANTRY coordinate system. Its origin Ih is the MULTI-AXIAL GANTRY HEAD center of rotation.
Its daughter system is the IEC BEAM LIMITING DEVICE or DELINEATOR coordinate system ("b").
[pic]
Figure C.AA.L2.1.3-1
Multi-Axial treatment machine GANTRY HEAD system
Thus, the RT Beam Delimiter Element Positions (30xx,504A) within RT Beam Limiting Device Positions Macro are always defined at Source-Axis Distance (300A,00B4) as defined in the Multi-Axial Delivery Device Module even if the Gantry Head Pitch Angle (30xx,1520) or the Gantry Head Roll Angle (30xx,1521) are not at a zero degree position. The distance from the Center of Rotation of the Gantry Head to the Axis, is called the Center of Rotation-Axis Distance (CoRAD).
The RADIATION FIELD or DELINEATED RADIATION FIELD (R/D F) is always normal to the beam axis. Therefore, if the Gantry Head Pitch Angle and/or Gantry Head Roll Angle are not at a zero degree position, the R/D F is not within the Treatment Position x-y-plane (respectively the X/Y plane of the IEC Gantry System at the isocenter).
C.AA.M1 Enhanced RT Dose Module
The Enhanced RT Dose module is used to convey non-image aspects of 2D or 3D radiation dose data generated from treatment planning systems or similar devices. The attributes defined within the module support dose for a single radiation instance (e.g. an external beam), one or more fractions of the planned dose of an RT Radiation Set, or composite dose derived from multiple RT Dose Image instances.
Table C.AA.M1-1
ENHANCED RT DOSE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Dose Type |(3004,0004) |1 |Type of dose. |
| | | |Defined Terms: |
| | | |PHYSICAL = physical dose |
| | | |EFFECTIVE = dose after correction for biological |
| | | |effect using user-defined modeling technique |
|Effective Dose Method Code Sequence |(30xx,1132) |2C |The method used to calculate the effective dose. |
| | | |Required, if Dose Type (3004,0004) is EFFECTIVE. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147035. |
|>Effective Dose Method Modifier Code Sequence|(30xx,1137) |3 |Modifier Code further defining the effective dose |
| | | |method. |
| | | |One or more Items are permitted in this sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |No baseline CID defined. |
|Referenced Dose Calculation Annotation Object|(30xx,1135) |3 |Reference to SOP instances describing dose |
|Sequence | | |calculation methods, parameters and / or other |
| | | |information used in calculation and / or |
| | | |modification of the dose. |
| | | |One or more Items are permitted in this sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Purpose of Reference Code Sequence |(0040,A170) |1 |Code describing the purpose of the reference to |
| | | |the Instance(s). |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147036. |
|Effective Dose Method Description |(30xx,1134) |2C |The description of the method used to calculate |
| | | |the effective dose. |
| | | |Required, if Dose Type (3004,0004) is EFFECTIVE. |
|Dose Purpose |(30xx,1136) |3 |The intended use of the dose. |
| | | |Defined Terms: |
| | | |PLAN_QA = for Dose QA |
| | | |TREATMENT = for treatment of a patient |
| | | |IMAGING = representing dose contributed by imaging|
| | | |procedures |
|Dose Data Source |(30xx,1138) |1 |The source of the dose data. |
| | | |Defined Terms: |
| | | |PLANNED = Dose calculated from Radiation(s) or |
| | | |Radiation Set(s). |
| | | |MEASUREMENT = Measured dose |
| | | |RECONSTRUCTED = Dose reconstructed from measured |
| | | |exit dose |
| | | |RECORD = Dose calculated using delivered dose |
| | | |values from radiation record |
| | | |IMAGE_ACQ = Dose record calculated for performed |
| | | |image acquisition |
|Dose Data Source Measurement Code Sequence |(30xx,113C) |1C |A detailed specification of the data source. |
| | | |Required, if Dose Data Source (30xx,1138) is |
| | | |MEASUREMENT. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147037. |
|Radiation Absorption Model |(30xx,1130) |1C |Specifies a list of patient heterogeneity |
| | | |characteristics used for calculating dose. This |
| | | |attribute shall be multi-valued if the computed |
| | | |dose has multiple differing correction techniques.|
| | | |Defined Terms: |
| | | |IMAGE = image data |
| | | |ROI_OVERRIDE = one or more ROI (segment) densities|
| | | |override image or water values where they exist |
| | | |WATER = entire volume treated as water equivalent |
| | | |OTHER = mixed model usage (when not specified by |
| | | |multiple values), other or unspecified |
| | | |Shall be present if Dose Data Source (30xx,1138) |
| | | |is PLANNED. May be present otherwise. |
| | | |See section C.AA.M1.1.2. |
|Effective Tissue Composition |(30xx,113E) |1 |Tissue composition used for dose reporting. |
| | | |Defined Terms: |
| | | |WATER = dose calculated assuming tissue has atomic|
| | | |characteristics similar to water |
| | | |MUSCLE = dose calculated assuming that tissue has |
| | | |atomic characteristics similar to muscle. |
| | | |MEDIUM = dose calculated using known |
| | | |characteristics of the material |
| | | |OTHER = methodology used for the dose calculation |
| | | |is not defined or unknown |
|Algorithm Type Code Sequence |(30xx,1144) |1C |The dose algorithm class. |
| | | |Shall be present if Dose Data Source (30xx,1138) |
| | | |is PLANNED. May be present otherwise. |
| | | |One or more items shall be present in this |
| | | |sequence. |
|>Include ‘Algorithm Identification Macro’ Table 10-19 |Defined CID for Algorithm Family Code shall be |
| |SUP147041. |
|Dose Scope |(30xx,113A) |1 |The Scope of the entities represented by that |
| | | |dose. |
| | | |Defined Terms: |
| | | |PARTIAL = dose for zero or more complete fractions|
| | | |and for partial delivery of one or more partial |
| | | |fractions of a single radiation instance. |
| | | |RADIATION = dose for one or more complete |
| | | |fractions of a single radiation instance. |
| | | |RADIATION_SET = dose for one or more complete |
| | | |fractions of a single RT Radiation Set. |
| | | |ACCUMULATED = dose for zero or more complete |
| | | |fractions and for partial delivery of one or more |
| | | |partial fractions of one or more RT Radiation |
| | | |Sets. |
| | | |COMPOSITE = composition of separate doses for one |
| | | |or more courses. |
|Dose Contribution Accumulation Type |(30xx,1124) |1C |The operator used to accumulate the dose from the |
| | | |referenced Instance(s). |
| | | |Required, if Contributing Radiation Sequence |
| | | |(30xx,1118), Contributing Radiation Set Sequence |
| | | |(30xx,1102), Composite Dose Sequence (30xx,1100) |
| | | |or Contributing RT Radiation Record Sequence |
| | | |(30xx,1128) includes more than one item. |
| | | |Defined terms: |
| | | |LINEAR = contributions are summed linearly. |
| | | |OTHER = Unspecified/non-linear contribution to the|
| | | |dose. |
|Contributing Radiation Sequence |(30xx,1118) |1C |Reference to the SOP Instance of Radiation that |
| | | |contributes to the dose. |
| | | |Required if the Dose Scope is RADIATION or |
| | | |PARTIAL. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Number of Complete Fractions Contributing |(30xx,1120) |1 |The number of complete fractions of the RT |
| | | |Radiation contributing to the dose. May be 0 if |
| | | |only a partial delivery is represented. |
|>Partial Delivery Limits Sequence |(30xx,1122) |1C |Reference to the cumulative meterset value(s) to |
| | | |which the dose is calculated for the partial |
| | | |fractions included. If several partial fractions |
| | | |are included in that dose, the segments defined by|
| | | |Start Meterset (30xx,1140) and Stop Meterset |
| | | |(30xx,1141) within that sequence may overlap. |
| | | |Required if Dose Scope (30xx,113A) is PARTIAL. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>Start Meterset |(30xx,1140) |1 |The value of Cumulative Meterset at which partial |
| | | |delivery of the referenced Radiation SOP Instance |
| | | |starts. |
|>>Stop Meterset |(30xx,1141) |1 |The value of Cumulative Meterset at which partial |
| | | |delivery of the referenced Radiation SOP Instance |
| | | |stops. |
|Contributing Radiation Set Sequence |(30xx,1102) |1C |Reference to one or more RT Radiation Sets |
| | | |instances that contribute to the dose. |
| | | |Required if Dose Scope is RADIATION_SET or |
| | | |ACCUMULATED. |
| | | |If Dose Scope is RADIATION_SET, only a single Item|
| | | |shall be included in this sequence. Otherwise, one|
| | | |or more Items shall be included in this sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Number of Complete Fractions Contributing |(30xx,1120) |1 |The number of complete fractions of the RT |
| | | |Radiation Set contributing to the dose. May be 0 |
| | | |if only a partial delivery is represented. |
|> Fraction Completion Status |(30xx,1123) |1C |Indication of whether the dose contribution from |
| | | |the current RT Radiation Set includes an |
| | | |incomplete fraction. |
| | | |Defined terms: |
| | | |COMPLETE = Dose represents contribution of an |
| | | |integral number of complete fractions |
| | | |INCOMPLETE = Dose represents contribution of one |
| | | |or more incomplete fractions |
| | | |Required, if Dose Scope (30xx,113A) is |
| | | |ACCUMULATED. |
|>Contributing Radiation Sequence |(30xx,1118) |1C |Reference to the SOP Instances of RT Radiation |
| | | |that contributes to the dose. |
| | | |Required if the Fraction Completion Status |
| | | |(30xx,1123) is INCOMPLETE. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>Include 'SOP Instance Reference Macro' Table 10-11 |
|>>Radiation Completion Status |(30xx,1125) |1 |Indication of whether the dose contribution from |
| | | |the current RT Radiation is complete. |
| | | |Defined terms: |
| | | |COMPLETE = Dose represents contribution of the |
| | | |complete radiation. |
| | | |INCOMPLETE = Dose represents contribution of one |
| | | |or more meterset intervals of a single incomplete |
| | | |fraction |
|>>Partial Delivery Limits Sequence |(30xx,1122) |1C |Reference to the cumulative meterset value(s) to |
| | | |which the dose is calculated. If several partial |
| | | |fractions are included in that dose, the segments |
| | | |defined by Start Meterset (30xx,1140) and Stop |
| | | |Meterset (30xx,1141) within that sequence may |
| | | |overlap. |
| | | |Required if the Radiation Completion Status |
| | | |(30xx,1125) is INCOMPLETE. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>>Start Meterset |(30xx,1140) |1 |The value of Cumulative Meterset at which partial |
| | | |delivery of the referenced Radiation SOP Instance |
| | | |starts. |
|>>>Stop Meterset |(30xx,1141) |1 |The value of Cumulative Meterset at which partial |
| | | |delivery of the referenced Radiation SOP Instance |
| | | |stops. |
|Composite Dose Sequence |(30xx,1100) |1C |RT Dose Image or RT Dose SOP instances that |
| | | |contribute to the dose. |
| | | |Required if the Dose Scope (30xx,113A) is |
| | | |COMPOSITE. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Dose Contribution Weight |(30xx,1110) |1C |A numeric value representing the scale factor used|
| | | |in compositing the referenced dose Instance. |
| | | |Negative values maybe used for dose differences. |
| | | |Required if the Dose Contribution Accumulation |
| | | |Operator Type (30xx,1124) is LINEAR. |
|Contributing RT Radiation Record Sequence |(30xx,1128) |1C |RT Radiation Record SOP instances used to |
| | | |calculate the dose. |
| | | |Required if Dose Data Source (30xx,1138) is |
| | | |RECORD. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|>Treatment Session UID |(30xx,6000) |1 |The UID identifying a treatment session. This UID |
| | | |serves as a key to collect all Radiation Record |
| | | |instances, which have been delivered within the |
| | | |same treatment session. |
|Spatial Transform of Dose |(3004,0005) |3 |The use of transformation in the calculation of |
| | | |the combined dose. |
| | | |Defined Terms: |
| | | |NONE: No transformation. Calculated on the |
| | | |original image set |
| | | |RIGID: Only Rigid transform used (see definition |
| | | |in C.20.2.1.2) |
| | | |NON_RIGID: Any other transform used |
|Referenced Spatial Registration Sequence |(0070,0404) |2C |A reference to a Spatial Registration SOP Instance|
| | | |or a Deformable Spatial Registration SOP Instance,|
| | | |which defines the transformation used to transform|
| | | |the dose. |
| | | |Required, if Spatial Transform of Dose (3004,0005)|
| | | |is provided and has a value of RIGID or NON_RIGID.|
| | | |Zero or one Item shall be included in this |
| | | |sequence. |
| | | |See Section C.8.8.3.5 |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|Referenced RT Segment Annotation Sequence |(30xx,0874) |2C |Reference to a RT Segment Annotation SOP Instance |
| | | |containing structures which were used to calculate|
| | | |the content of the current IOD. |
| | | |Required if Radiation Absorption Model(30xx,1130) |
| | | |contains ROI_OVERRIDE or if the module is used in |
| | | |the RT Dose Histogram IOD. May be present |
| | | |otherwise. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|Referenced Annotating Object Sequence |(30xx,1146) |3 |Reference to other SOP Instances that provide |
| | | |additional annotation to this dose object. |
| | | |One or more Items are permitted in this sequence. |
|>Include 'Referenced Instances and Access Macro' Table 10-3b |
C.AA.M1.1 Enhanced RT Dose Attribute Description
C.AA.M1.1.1 Dose Scope
The scope of the dose described in that module is given by the referenced SOP instances, which are included in the actual reference sequences as required by the Dose Scope (30xx,113A).
It is important, that a dose provided in absolute values (i.e the Real World Value Mapping C.7.6.16.2.11 macro contain the code (Gy, UCUM, “Gray”) for the unit) is consistent with the absolute planned or delivered Meterset values as specified by Cumulative Meterset (30xx,5021) in those referenced SOP instances.
C.AA.M1.1.2 Radiation Absorption Model
The multipicity of the value shall be 1 for dose objects which represent a dose having been directly calculated based on image data. For doses which have been calculated by compositing several other doses, the attribute shall contain each value found in the the composited doses once and only once.
C.AA.M2 RT Dose Image Module
The RT Dose Image module describes specializations for attributes in the General Image Module and provides information to position the image planes in the axial dimension and to scale the pixel data values to real-world dose values. It provides the mechanism to transmit a 3D array of dose data as a multi-frame image whose frames represent 2D dose image planes that may or may not be related to CT or MR image planes.
Table C.AA.M2-1
RT DOSE IMAGE MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Image Type |(0008,0008) |1 |Image identification characteristics. |
| | | |See C.AA.M2.1.1. |
|Samples per Pixel |(0028,0002) |1 |Number of samples (planes) in this image. This value|
| | | |shall be 1. |
|Photometric Interpretation |(0028,0004) |1 |Specifies the intended interpretation of the pixel |
| | | |data. Shall have the enumerated value MONOCHROME2. |
|Bits Allocated |(0028,0100) |1 |Number of bits allocated for each pixel sample. Each|
| | | |sample shall have the same number of bits allocated |
| | | |which shall be the Enumerated Value of 32. |
|Bits Stored |(0028,0101) |1 |Number of bits stored for each pixel sample. Each |
| | | |sample shall have the same number of bits stored |
| | | |which shall be Enumerated Value of 32. |
|High Bit |(0028,0102) |1 |Most significant bit for each pixel sample. Each |
| | | |sample shall have the same high bit which shall be |
| | | |Enumerated Value of 31. |
|Pixel Representation |(0028,0103) |1 |Data representation of the pixel samples. Each |
| | | |sample shall have the same pixel representation. |
| | | |Shall use the following enumerated value: |
| | | |0000H = unsigned integer |
|Dose Grid Geometry |(30xx,1150) |1 |Geometry of the Dose Grid array. Specifies whether |
| | | |dose grid planes form a cuboid or a sheared |
| | | |parallelepiped. |
| | | |Enumerated values: |
| | | |NON_SHEARED = planes of dose grid form a cuboid, |
| | | |i.e. a rectangular parallelepiped. |
| | | |SHEARED= successive planes of dose grid form a |
| | | |sheared parallelepiped. |
| | | |See C.AA.M2.1.2. |
|Source Image Sequence |(0008,2112) |1C |Reference to images from which the dose has been |
| | | |calculated. |
| | | |Required if Dose Data Source (30xx,1138) in the |
| | | |Enhanced RT Dose Module is PLANNED or RECORD. May be|
| | | |present otherwise. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Include 'Image SOP Instance Reference Macro' Table 10-3 |
C.AA.M2.1 RT Dose Image Attribute Description
C.AA.M2.1.1 Image Type and Frame Type
Value 1 of Image Type (0008,0008) and Frame Type (0008,9007) shall be used as follows: Value 1 shall be DERIVED.
C.AA.M2.1.1.1 Patient Examination Characteristics
Value 2 of Image Type (0008,0008) and Frame Type (0008,9007) shall be used as follows: Value 2 shall be SECONDARY.
C.AA.M2.1.1.2 Image Flavor
Value 3 of Image Type (0008,0008) and Frame Type (0008,9007) is discussed in C.8.16.1.3. No additional requirements. The value shall be VOLUME.
C.AA.M2.1.1.3 Derived Pixel Contrast
Value 4 of Image Type (0008,0008) and Frame Type (0008,9007) is discussed in C.8.16.1.4. The value shall be NONE.
C.AA.M2.1.2 Dose Grid Geometry
If Dose Grid Geometry (30xx,1150) is NON_SHEARED, the Image Position (Patient) values of all frames are co-linear and lie along a vector normal to each of the planes. Mathematically, all dose grid frames shall be aligned such that the vector difference (Xm-Xn, Ym-Yn, Zm-Zn) of Image Position (Patient) vectors (Xm, Ym, Zm) and (Xn, Yn, Zn) in the Plane Position Functional Group of any pair of frames is proportional to the cross product of row and column direction cosine vectors specified by Image Orientation (Patient) in the Shared Plane Orientation Functional Group.
C.AA.M2.1.3 Dose Grid Real World Values
C.AA.M2.1.3.1 Dose Grid Scaling
The real world values of the dose grid shall be derived from the stored pixel values by scaling according to the Real World Intercept (0040,9224) and Real World Value Slope (0040,9225). See C.7.6.16.2.11.1.2.
C.AA.M2.1.3.2 Dose Grid Pixel Padding
Long Dose Grid Padding Value (0028,xxxx) is used to identify pixels for which dose grid values are not specified (see C.7.5.1.1.2). Applications consuming RT Dose Image instances shall handle pixel padding correctly to avoid misinterpreting pixel padding as dose. In particular:
1. Long Dose Grid Padding Value (0028,xxxx) specifies a single value of this padding value.
2. The value of Long Pixel Padding Value (0028,xxxx) shall be valid values within the objectives defined by Bits Allocated (0028,0100) Bits Stored (0028,0101) and High Bit (0028,0102).
3. No points within the native dose grid shall have a value equal to pixel padding value. Values within the pixel padding range shall lie outside the range between the minimum and maximum values of valid dose values in the dose grid.
The applicable parts of section C.7.6.16.2.11.2 apply correspondingly.
The tag Pixel Padding Value (0028,0120) shall not be used.
C.AA.M3 RT Dose Image Functional Group Macros
The following sections contain Functional Group macros specific to the RT Dose Image IOD.
Note: The attribute descriptions in the Functional Group Macros are written as if they were applicable to a single frame (i.e., the macro is part of the Per-frame Functional Groups Sequence). If an attribute is applicable to all frames (i.e. the macro is part of the Shared Functional Groups Sequence) the phrase "this frame" in the attribute description shall be interpreted to mean "for all frames".
C.AA.M3.1 RT Dose Image Frame Type Macro
Table C.AA.M3.1-1 specifies the attributes of the RT Dose Image Frame Type Functional Group macro.
Table C.AA.M3.1-1
RT DOSE IMAGE FRAME TYPE MACRO ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|RT Dose Image Frame Type Sequence |(30xx,1116) |1 |Identifies the characteristics of this frame. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Frame Type |(0008,9007) |1 |Type of Frame. A multi-valued attribute analogous |
| | | |to the Image Type (0008,0008). |
| | | |Enumerated Values and Defined Terms are the same |
| | | |as those for the four values of the Image Type |
| | | |(0008,0008) attribute. |
| | | |See C.8.16.1 and C.AA.M2.1. |
C.AA.M4 RT Dose Histogram Module
The RT Dose Histogram module provides for the inclusion of dose volume histogram (DVH) and dose area histogram (DAH), and natural dose volume histogram (NDVH) data. Any combination of these dose histogram types may be contained within this module.
Table C.AA.M4-1
RT DOSE HISTOGRAM MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Dose Histogram Normalization Dose Value |(30xx,1201) |3 |Nominal Dose Reference Value indicating prescribed |
| | | |dose. |
|Dose Histogram Sequence |(30xx,1202) |1 |Sequence of Items describing Dose Histograms. |
| | | |One or more Items shall be included in this sequence.|
|>Dose Histogram Referenced Segment Sequence |(30xx,1203) |1 |Referenced anatomies used to calculate the Dose |
| | | |Histogram. |
| | | |See C.AA.M4.1.3. |
| | | |One or more Items shall be included in this sequence.|
|>>Include ' Conceptual Volume Segmentation Reference and Combination |The value of Conceptual Volume Segmentation Defined |
|Macro' Table C.AA.2.6-1 |Flag (30xx,1311) shall be YES. |
|>Dose Histogram Type |(30xx,1210) |1 |Type of Dose Histogram: |
| | | |Defined Terms: |
| | | |VOLUME = dose-volume histogram |
| | | |AREA = dose-area histogram |
|>Histogram Tally Type |(30xx,1205) |1 |Method of tallying spatial quantity in constructing |
| | | |dose histogram |
| | | |Defined Terms: |
| | | |DIFFERENTIAL = differential dose histogram |
| | | |NATURAL = natural dose (volume) histogram |
|>Dose Histogram Dose Unit Code Sequence |(30xx,1207) |1 |Units of measurement for the dose dimension of the |
| | | |histogram. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See C.7.6.16.2.11.1 for further explanation. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147034 |
|>Dose Histogram Spatial Unit Code Sequence |(30xx,1206) |1 |Units of measurement for the spatial dimension of the|
| | | |histogram. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147039 |
|>Segment Total Size |(30xx,1209) |1 |Total size of all segments referenced in Dose |
| | | |Histogram Referenced Segment Sequence (30xx,1203), in|
| | | |units of Dose Histogram Spatial Units (30xx,1206) |
|>Dose Histogram Data |(30xx,1204) |1 |A data stream describing the dose bin widths Dn and |
| | | |associated volumes (or areas) Vn in Dose Histogram |
| | | |Spatial Units (3004,0054) in the order D1V1, D2V2, |
| | | |... DnVn. |
|>Dose Statistics Sequence |(30xx,1211) |3 |Dose statistic information. |
| | | |One or more Items are permitted in this sequence. |
|>>Include 'Content Item Macro' Table 10-2 |Defined CID of Concept Name Code Sequence is CID |
| |SUP147026. |
| |The Content Item shall have a Value Type (0040,A040) |
| |of NUMERIC. |
| |Content items shall use UCUM units of Gy where |
| |applicable. |
|Source Image Sequence |(0008,2112) |2 |Reference to RT Dose Image SOP instances from which |
| | | |the dose histogram has been calculated. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
C.AA.M4.1 RT Dose Histogram Attribute Description
C.AA.M4.1.1 Referenced Segmentation Properties Sequence
The Conceptual Volume Macro in the Dose Histogram Referenced Segment Sequence (30xx,1203) is used to specify the segments or combinations of segments used to compute Dose Histograms. Segments are defined in the Segmentation Properties SOP Instance referenced by the Referenced RT Segment Annotation Sequence (30xx,0874) and are identified using their Conceptual Volume UIDs.
The geometry of segments represented in the referenced Segmentation Properties SOP Instance may be defined in an RT Structure Set, Segmentation, or Surface Segmentation SOP Instance. Segments defined by an RT Structure Set SOP Instance shall contain only contours with a Contour Geometric Type (3006,0042) of CLOSED_PLANAR.
C.AA.M4.1.2 Dose Histogram Data
The RT Dose Histogram Module differs from the earlier RT DVH module in that the attribute Dose Histogram Data (30xx,1204) is encoded with VR of OF. In the earlier DVH Module, the corresponding DVH Data (3004,0058) was encoded with VR of DS, leading to attribute value length limitations when the dataset was encoded with ELE transfer syntax and there were many histogram bins.
The RT Dose Histogram Module differs from the earlier RT DVH module in that Dose Histogram Data (30xx,1204) attribute represents DIFFERENTIAL dose-volume or dose-area histograms, i.e., in the sequence of pairs, D1V1, D2V2, ... DnVn the Values Vi represent the volume (or area) of the referenced segment(s) receiving dose < Di and > Di-1 for i>1 and dose > 0 for i=1.
C.AA.M4.1.3 Dose Histogram Referenced Segment Sequence
The Dose Histogram Referenced Segment Sequence (30xx,1203) identifies Conceptual Volumes used to define the volume for calculation of the dose histograms. In this context, the Conceptual Volume shall be well-defined and point to the appropriate segment as identified by the Referenced Segment Annotation Index (30xx,0151) in the Conceptual Volume Segmentation Reference and Combination Macro (see section C.AA.2.6).
C.AA.M5 Dose Samples Module
The Dose Samples module provides for the inclusion of a list of spatial dose sample data.
Table C.AA.M5-1
DOSE SAMPLES MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Number of Dose Samples |(30xx,1250) |1 |Number of sample values n used to store Dose Samples |
| | | |Data (3004,1251). |
|Dose Samples Data |(30xx,1251) |1 |A data stream describing locations of the dose |
| | | |samples X, Y, Z and associated dose values in the |
| | | |order X1Y1Z1D1, X2Y2Z2D2,, ... XnYnZnDn. |
|Dose Samples Dose Unit Code Sequence |(30xx,1253) |1 |Units of measurement for the dose dimension of the |
| | | |dose samples. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
| | | |See C.7.6.16.2.11.1 for further explanation. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147034. |
|Source Image Sequence |(0008,2112) |1C |Reference to images from which the dose has been |
| | | |calculated. Required if Dose Data Source (30xx,1138) |
| | | |in the Enhanced RT Dose Module is PLANNED or RECORD. |
| | | |May be present otherwise. |
| | | |One or more Items shall be included in this sequence.|
|>Include 'Image SOP Instance Reference Macro' Table 10-3 |
C.AA.M5.1 RT Dose Samples Attribute Description
C.AA.M5.1.1 Dose Samples Data
Dose Samples Module encodes a list of (x, y, z, dose) values with VR of OF. This VR avoids limitations in the VL specified using Explicit-VR transfer syntax.
The Dose Samples Module represents N dose samples as a sequence of 4-tuples: X1Y1Z1D1, X2Y2Z2D2,, ... XNYNZNDN, the Values Xi, Yi, Zi represent the location in patient coordinates of dose sample Di , expressed in units specified by Dose Samples Dose Unit Code Sequence(30xx,1253).
C.AA.P1 RT Radiation Record Common Module
The RT Radiation Record Common Module contains treatment-modality independent information about a delivered radiation. A delivered radiation may be a radiation to a patient or a radiation without a patient being present (e.g. for QA purposes).
The radiation record may refer to a Radiation SOP instance or Radiation Set SOP instance, which has been used to define delivery. It may however also record an unsolicited delivery.
Table C.AA.P1-1
RT RADIATION RECORD COMMON MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Treatment Session UID |(30xx,6000) |1 |The UID identifying a treatment session. This UID |
| | | |serves as a key to collect all Radiation Record |
| | | |instances, which have been delivered within the |
| | | |same treatment session. |
|Referenced RT Patient Setup Sequence |(30xx,0C20) |1C |References the RT Patient Setup SOP Instance that |
| | | |was used as the setup instruction to setup the |
| | | |patient prior to delivery of the radiation. |
| | | |Required if there was a Patient Setup SOP Instance |
| | | |defined providing the instructions to the delivery |
| | | |system. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|Referenced Radiation Set Sequence |(30xx,0C02) |1C |References the Radiation Set SOP Instance that was |
| | | |the instruction to deliver the radiation. |
| | | |Required if there was a Radiation Set SOP Instance |
| | | |defined providing the instructions to the delivery |
| | | |system. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|Referenced Radiation Sequence |(30xx,0C04) |1C |References the Radiation SOP Instance that was the |
| | | |instruction to deliver the radiation. |
| | | |Required if there was a Radiation SOP Instance |
| | | |defined providing the instructions to the delivery |
| | | |system. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'SOP Instance Reference Macro' Table 10-11 |
|Current Fraction Number |(3008,0022) |1C |Fraction number for this radiation. |
| | | |Required if Referenced Radiation Sequence |
| | | |(30xx,0C04) is present and Treatment Delivery Type |
| | | |(300A,00CE) is TREATMENT or CONTINUATION. May be |
| | | |present otherwise. |
|Treatment Delivery Type |(300A,00CE) |1 |Delivery Type of treatment. |
| | | |Defined Terms: |
| | | |TREATMENT = normal patient treatment |
| | | |CONTINUATION = continuation of interrupted |
| | | |treatment |
| | | |PLAN_QA = Treatment used for Quality Assurance |
| | | |rather than patient treatment |
|Treatment Termination Status |(3008,002A) |1 |Conditions under which treatment was terminated. |
| | | |Enumerated Values: |
| | | |NORMAL = treatment terminated normally |
| | | |OPERATOR = operator terminated treatment |
| | | |MACHINE = machine terminated treatment |
| | | |UNKNOWN = status at termination unknown |
|Treatment Termination Reason Code Sequence |(30xx,6015) |1C |Treatment machine termination code. This code is |
| | | |dependent upon the particular application and |
| | | |equipment. |
| | | |Required if Treatment Termination Status |
| | | |(3008,002A) is MACHINE or OPERATOR. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'Code Sequence Macro' Table 8.8-1 |Defined CID SUP147015 |
|>Machine-Specific Treatment Termination Code|(30xx,6016) |3 |Machine-specific termination codes. |
|Sequence | | |One or more Items are permitted in this sequence. |
|>>Include 'Code Sequence Macro' Table 8.8-1 |No Baseline CID is specified. |
|Treatment Termination Description |(30xx,6030) |2C |A user defined description for an abnormal |
| | | |termination. Required if Treatment Termination |
| | | |Status (3008,002A) is not NORMAL. |
|Treatment Recording Method |(30xx,6035) |1 |Method with which treatment was recorded. |
| | | |Enumerated Values: |
| | | |ELECTRONIC |
| | | |MANUAL |
|Treatment Tolerance Status |(30xx,6036) |1 |Tolerance status of delivery. |
| | | |Enumerated Values: |
| | | |IN_TOLERANCE = Delivery remained within tolerance |
| | | |MACH_TOL = Out of machine tolerance |
| | | |CLINICAL_TOL = Out of clinical tolerance, not |
| | | |overridden by operator. |
| | | |CLINICAL_TOL_OVR = Out of clinical tolerance, |
| | | |overridden by operator |
|Referenced Control Point Sequence |(300C,00F2) |1 |References the control point that is declared in |
| | | |the module containing the Control Points. |
| | | |This sequence shall contain the same number of |
| | | |items as the referenced Control Point Sequence. |
| | | |See C.AA.P1.1.1. |
|>Referenced Control Point Index |(30xx,0141) |1 |Index of the Control Point referenced by that item |
|>Treatment Control Point Start DateTime |(30xx,603A) |1 |Date and time when the delivery of radiation at |
| | | |this control point began. For the final control |
| | | |point this shall be the Date when the previous |
| | | |control point ended. |
|>Treatment Control Point End DateTime |(30xx,603C) |1C |Date and time when the delivery of radiation, which|
| | | |started at this control point, was ended. Required |
| | | |for all but the last control point. |
|Override Sequence |(3008,0060) |2 |Introduces sequence of parameters that were |
| | | |re-specified or overridden during the |
| | | |administration of the Radiation immediately prior |
| | | |to delivery. |
| | | |Zero or more Items shall be included in this |
| | | |sequence. |
|>Include 'Selector Attribute Macro' Table 10-20 |Point to attribute in current Record IOD |
|>Operators’ Name |(0008,1070) |1 |Name of operator who authorized override. |
|>Override Reason |(3008,0066) |2 |User-defined description of reason for override of |
| | | |parameter specified by Override Parameter Pointer |
| | | |(3008,0062). |
|Alternate Specified Value Sequence |(30xx,603E) |2 |Define new specified value for the referenced |
| | | |Attribute. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>Include 'Selector Attribute Macro' Table 10-20 |Point to attribute in current Record IOD |
|>Include 'Content Item Macro' Table 10-2 |Defined CID SUP147048 |
C.AA.P1.1 RT Radiation Record Common Attribute Description
C.AA.P1.1.1 Control Point References
The control point references in the Referenced Control Point Sequence (300C,00F2) refer to the control points defined in the specific radiation modules within this IOD. The reference is conveyed by the Referenced Control Point Index (30xx,0141), which refers to the corresponding Control Point Index (30xx,0111) present in the referenced RT Radiation IOD.
C.AA.P1.1.2 Referenced RT Patient Setup Sequence
The Referenced RT Patient Setup Sequence (30xx,0C20) references the specific RT Patient Setup instance used to position the patient. This is not to be confused with the Patient Setup UID (30xx,5060) which identifies a conceptual patient setup that can be realized by one or more RT Patient Setup SOP instances.
C.AA.P2 RT Dose Record Common Module
The RT Dose Record Common module contains information about the delivered and measured dose.
Table C.AA.P2-1
RT DOSE RECORD COMMON MODULE ATTRIBUTES
|Attribute Name |Tag |Type |Attribute Description |
|Radiation Dose Identification Sequence |(30xx,0B42) |1 |Dose values that are delivered by this radiation. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>Radiation Dose Identification Index |(30xx,0120) |1 |Index of the Radiation Dose Identification in the |
| | | |sequence used for internal or external references |
| | | |The value shall start at 1, and increase |
| | | |monotonically by 1. |
|>Radiation Dose Identification Label |(30xx,0B46) |1 |User defined label for the radiation dose |
| | | |definition. |
| | | |See C.AA.2.1.1.1. |
|>Conceptual Volume Sequence |(30xx,1346) |1 |Reference to a conceptual volume which received |
| | | |dose during treatment delivery.. |
| | | |See C.AA.P2.1.1. |
| | | |Only a single Item shall be included in this |
| | | |sequence. |
|>>Include ‘Conceptual Volume Segmentation Reference and Combination Macro' Table C.AA.2.6-1 |
|>Calculated Radiation Dose Values Sequence |(30xx,6110) |1C |Calculated dose values of this treated radiation. |
| | | |Required if Measured Radiation Dose Values Sequence|
| | | |(30xx,6114) is not present, may be present |
| | | |otherwise. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>Number of Dose Meterset Points |(30xx,0B68) |1 |The number of dose value points represented by the |
| | | |list of values in Meterset Values (30xx,0B6A) and |
| | | |Radiation Dose Values (30xx,0B6C). The number shall|
| | | |be greater than 1. See C.AA.C2.1. |
|>>Meterset Values |(30xx,0B6A) |1 |The list of meterset values, where the |
| | | |corresponding dose values are delivered as |
| | | |specified in Radiation Dose Values (30xx,0B6C). See|
| | | |C.AA.C2.1. |
|>>Radiation Dose Values |(30xx,0B6C) |1 |The dose values (in Gy) delivered at the |
| | | |corresponding meterset value. See C.AA.C2.1. |
|>Measured Radiation Dose Values Sequence |(30xx,6114) |1C |Measured dose values of this treated radiation. |
| | | |Required if Calculated Radiation Dose Values |
| | | |Sequence (30xx,6110) is not present, may be present|
| | | |otherwise. |
| | | |One or more Items shall be included in this |
| | | |sequence. |
|>>Number of Dose Meterset Points |(30xx,0B68) |1 |The number of dose value points represented by the |
| | | |list of values in Meterset Values (30xx,0B6A) and |
| | | |Radiation Dose Values (30xx,0B6C). The number shall|
| | | |be greater than 1. See C.AA.C2.1. |
|>>Meterset Values |(30xx,0B6A) |1 |The list of meterset values, where the |
| | | |corresponding dose values are delivered as |
| | | |specified in Radiation Dose Values (30xx,0B6C). See|
| | | |C.AA.C2.1. |
|>>Radiation Dose Values |(30xx,0B6C) |1 |The dose values (in Gy) delivered at the |
| | | |corresponding meterset value. See C.AA.C2.1. |
|>Measured Dose Type |(3008,0014) |2 |Type of dose measurement. |
| | | |Defined Terms: |
| | | |DIODE = semiconductor diode |
| | | |TLD = thermo-luminescent dosimeter |
| | | |ION_CHAMBER = ion chamber |
| | | |GEL = dose sensitive gel |
| | | |EPID = electronic portal imaging device |
| | | |FILM = dose sensitive film |
|>Measured Dose Description |(3008,0012) |3 |User-defined description of Dose Reference (e.g. |
| | | |“Exit dose”, “Point A”). |
C.AA.P2.1 RT Dose Record Common Module Attribute Description
C.AA.P2.1.1 Conceptual Volume Sequence
The Conceptual Volume Sequence (30xx,1346) identifies a Conceptual Volume defining a volume for which dose has been recorded during treatments. If the Conceptual Volume is associated with a segment, the segment is defined by the Referenced Segment Annotation Index (30xx,0151) in the Conceptual Volume Segmentation Reference and Combination Macro (see section C.AA.2.6). Alternatively, the dosimetric volume may not be associated with a segment. For example, dose recording may be specified using a nominal dose to a volume and the tracking coefficients approximated by meterset values.
Make the following additions to PS3.3, Annex F, Table F.4-1:
Table F.4-1
RELATIONSHIP BETWEEN DIRECTORY RECORDS
|Directory Record Type |Section |Directory Record Types which may be included in the next lower-level |
| | |directory Entity |
|(Root Directory Entity) |⎯ |PATIENT, HANGING PROTOCOL, PALETTE, PRIVATE |
|PATIENT |F.5.1 |STUDY, HL7 STRUC DOC, PRIVATE |
|STUDY |F.5.2 |SERIES, PRIVATE |
|SERIES |F.5.3 |IMAGE, RT DOSE, RT STRUCTURE SET, RT PLAN, RT TREAT RECORD, PRESENTATION, |
| | |WAVEFORM, SR DOCUMENT, KEY OBJECT DOC, SPECTROSCOPY, RAW DATA, |
| | |REGISTRATION, FIDUCIAL, ENCAP DOC, VALUE MAP, STEREOMETRIC, RADIOTHERAPY, |
| | |PRIVATE |
|IMAGE |F.5.4 |PRIVATE |
|RT DOSE |F.5.19 |PRIVATE |
|RT STRUCTURE SET |F.5.20 |PRIVATE |
|RT PLAN |F.5.21 |PRIVATE |
|RT TREAT RECORD |F.5.22 |PRIVATE |
|PRESENTATION |F.5.23 |PRIVATE |
|WAVEFORM |F.5.24 |PRIVATE |
|SR DOCUMENT |F.5.25 |PRIVATE |
|KEY OBJECT DOC |F.5.26 |PRIVATE |
|SPECTROSCOPY |F.5.27 |PRIVATE |
|RAW DATA |F.5.28 |PRIVATE |
|REGISTRATION |F.5.29 |PRIVATE |
|FIDUCIAL |F.5.30 |PRIVATE |
|HANGING PROTOCOL |F.5.31 |PRIVATE |
|ENCAP DOC |F.5.32 |PRIVATE |
|HL7 STRUC DOC |F.5.33 |PRIVATE |
|VALUE MAP |F.5.34 |PRIVATE |
|STEREOMETRIC |F.5.35 |PRIVATE |
|PALETTE |F.5.36 |PRIVATE |
|RADIOTHERAPY |F.5.X |PRIVATE |
|PRIVATE |F.6.1 |PRIVATE, (any of the above as privately defined) |
Add the “RADIOTHERAPY DR” box at the bottom of PS3.3, Annex F, Figure F.4-1:
[pic]
Add the following to PS3.3, Annex F, Section F.5.X:
F.5.X Radiotherapy Directory Record Definition
The Directory Record is based on the specification of Section F.3. It is identified by a Directory Record Type of Value "RADIOTHERAPY". Table F.5-X lists the set of keys with their associated Types for such a Directory Record Type. The description of these keys may be found in the Modules related to the Instance-level IEs of Second-generation Radiotherapy IODs. This Directory Record shall be used to reference one of the class of Second-generation Radiotherapy SOP Instances having a Modality (0008,0060) of “RT”. This type of Directory Record may reference a Lower-Level Directory Entity that includes one or more Directory Records as defined in Table F.4-1.
Table F.5-X
RADIOTHERAPY KEYS
|Key |Tag |Type |Attribute Description |
|Specific Character Set |(0008,0005) |1C |Required if an extended or replacement character set is|
| | | |used in one of the keys. |
|Instance Number |(0020,0013) |1 | |
|User Content Label |(30xx,51E0) |1 | |
|Content Description |(0070,0081) |2 | |
|Content Creator’s Name |(0070,0084) |2 | |
|Any other Attribute of the | |3 | |
|Instance-level IE Modules | | | |
Note: Because Referenced SOP Instance UID in File (0004,1511) may be used as a "pseudo" Directory Record Key (See Table F.3-3), it is not duplicated in this list of keys.
Change the following in PS3.3, section C.7.5.1 General Equipment Module
C.7.5.1 General Equipment Module
…
|Attribute Name |Tag |Type |Attribute Description |
|Pixel Padding Value |(0028,0120) |1C |Single pixel value or one limit (inclusive) of a |
| | | |range of pixel values used in an image to pad to |
| | | |rectangular format or to signal background that |
| | | |may be suppressed. See C.7.5.1.1.2 for further |
| | | |explanation. |
| | | |Required if Pixel Padding Range Limit (0028,0121) |
| | | |is present and either Pixel Data (7FE0,0010) or |
| | | |Pixel Data Provider URL (0028,7FE0) is present and|
| | | |Bits Stored (0028,0101) is less or equal 16. May |
| | | |be present otherwise only if Pixel Data |
| | | |(7FE0,0010) or Pixel Data Provider URL (0028,7FE0)|
| | | |is present. |
| | | |Notes: 1. The Value Representation of this |
| | | |Attribute is determined by the value of Pixel |
| | | |Representation (0028,0103). |
| | | |2. This Attribute is not used in Presentation |
| | | |State Instances; there is no means in a |
| | | |Presentation State to “override” any Pixel Padding|
| | | |Value specified in the referenced images. |
| | | |3. This Attribute does apply to RT Dose and |
| | | |Segmentation instances, since they include Pixel |
| | | |Data. |
|Long Pixel Padding Value |(0028,xxxx) |1C |Pixel Padding Value, which shall be used instead |
| | | |of Pixel Padding Value (0028,0120), when this |
| | | |attribute ir present. |
| | | |Required, when the rules of Pixel Padding Value |
| | | |(0028,0120) apply and Bits Stored (0028,0101) is |
| | | |greater than 16. |
| | | |Otherwise, all specifications of Pixel Padding |
| | | |Value (0028,0120) apply. |
Change the following in PS3.3, section C.7.6.3 Image Pixel Module
C.7.6.3 Image Pixel Module
|Attribute Name |Tag |Type |Attribute Description |
|Pixel Padding Range Limit |(0028,0121) |1C |Pixel value that represents one limit (inclusive) |
| | | |of a range of padding values used together with |
| | | |Pixel Padding Value (0028,0120) as defined in the |
| | | |General Equipment Module. See C.7.5.1.1.2 for |
| | | |further explanation. |
| | | |Required if pixel padding is to be defined as a |
| | | |range rather than a single value and Bits Stored |
| | | |(0028,0101) is less or equal 16. |
| | | |Notes: 1. The Value Representation of this |
| | | |Attribute is determined by the value of Pixel |
| | | |Representation (0028,0103). |
| | | |2. Pixel Padding Value (0028,0120) is also |
| | | |required when this Attribute is present. |
|Long Pixel Padding Range Limit |(0028,yyyy) |1C |Pixel Padding Value, which shall be used instead |
| | | |of Pixel Padding Value Range Limit (0028,0121), |
| | | |when this attribute ir present. |
| | | |Required, when the rules of Pixel Padding Value |
| | | |Range Limit (0028,0121) apply and Bits Stored |
| | | |(0028,0101) is greater than 16. |
| | | |Otherwise, all specifications of Pixel Padding |
| | | |Range Limit (0028,0121) apply. |
Part 4 Addendum
Add the following to PS3.4, Appendix B.5, Table B.5-1
|SOP Class Name |SOP Class UID |IOD Spec |
| | |(defined in PS|
| | |3.3) |
|RT Course Storage |1.2.840.10008.5.1.4.1.1.481.XN.1 | |
|RT Physician Intent Storage |1.2.840.10008.5.1.4.1.1.481.XN.2 | |
|RT Radiation Set Storage |1.2.840.10008.5.1.4.1.1.481.XN.3 | |
|RT Segment Annotation Storage |1.2.840.10008.5.1.4.1.1.481.XN.4 | |
|Tomotherapeutic Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.1 | |
|C-Arm Photon Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.2 | |
|C-Arm Electron Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.3 | |
|Multiple Fixed Source Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.4 | |
|Robotic Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.5 | |
|Multi-Axial Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.7 | |
|Tomotherapeutic Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.1 | |
|C-Arm Photon Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.2 | |
|C-Arm Electron Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.3 | |
|Multiple Fixed Source Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.4 | |
|Robotic Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.5 | |
|Multi-Axial Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.7 | |
|RT Dose Image Storage |1.2.840.10008.5.1.4.1.1.481.XN.7.1 | |
|RT Dose Histogram Storage |1.2.840.10008.5.1.4.1.1.481.XN.7.2 | |
|RT Dose Samples Storage |1.2.840.10008.5.1.4.1.1.481.XN.7.3 | |
Add the following to PS3.4, Table I.4-1
Table I.4-1 Media Storage Standard SOP Classes
|SOP Class Name |SOP Class UID |IOD Specification |
|RT Course Storage |1.2.840.10008.5.1.4.1.1.481.XN.1 |RT Course |
|RT Physician Intent Storage |1.2.840.10008.5.1.4.1.1.481.XN.2 |RT Physician Intent |
|RT Radiation Set Storage |1.2.840.10008.5.1.4.1.1.481.XN.3 |RT Radiation Set |
|RT Segment Annotation Storage |1.2.840.10008.5.1.4.1.1.481.XN.4 |RT Segment Annotation |
|Tomotherapeutic Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.1 |Tomotherapeutic Radiation |
|C-Arm Photon Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.2 |C-Arm Photon Radiation |
|C-Arm Electron Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.3 |C-Arm Electron Radiation |
|Multiple Fixed Source Radiation Storage|1.2.840.10008.5.1.4.1.1.481.XN.5.4 |Multiple Fixed Source Radiation |
|Robotic Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.5 |Robotic Radiation |
|Multi-Axial Radiation Storage |1.2.840.10008.5.1.4.1.1.481.XN.5.7 |Multi-Axial Radiation |
|Tomotherapeutic Radiation Record |1.2.840.10008.5.1.4.1.1.481.XN.6.1 |Tomotherapeutic Radiation Record |
|Storage | | |
|C-Arm Photon Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.2 |C-Arm Photon Radiation Record |
|C-Arm Electron Radiation Record Storage|1.2.840.10008.5.1.4.1.1.481.XN.6.3 |C-Arm Electron Radiation Record |
|Multiple Fixed Source Radiation Record |1.2.840.10008.5.1.4.1.1.481.XN.6.4 |Multiple Fixed Source Radiation |
|Storage | |Record |
|Robotic Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.5 |Robotic Radiation Record |
|Multi-Axial Radiation Record Storage |1.2.840.10008.5.1.4.1.1.481.XN.6.7 |Multi-Axial Radiation Record |
|RT Dose Image Storage |1.2.840.10008.5.1.4.1.1.481.XN.7.1 |RT Dose Image |
|RT Dose Histogram Storage |1.2.840.10008.5.1.4.1.1.481.XN.7.2 |RT Dose Histogram |
|RT Dose Samples Storage |1.2.840.10008.5.1.4.1.1.481.XN.7.3 |RT Dose Samples |
Add the following to PS3.4, Appendix Z.1.3, Table Z.1-1
Table Z.1-1
Attributes not to be Included in Instances Sent
|Attribute |Tag |
|Dose Samples Data |(30xx,1251) |
|Dose Histogram Data |(30xx,1204) |
Part 6 Addendum
Add the following data elements to PS3.6:
6 Registry of DICOM Data Elements
|(30xx,0111) |Control Point Index |ControlPointIndex |US |1 |
|(30xx,0112) |Device Index |DeviceIndex |US |1 |
|(30xx,0113) |Beam Mode Index |BeamModeIndex |US |1 |
|(30xx,0114) |RT Tolerance Set Index |RTToleranceSetIndex |US |1 |
|(30xx,0115) |Sub-Control Point Index |SubControlPointIndex |US |1 |
|(30xx,0116) |Treatment Phase Index |TreatmentPhaseIndex |US |1 |
|(30xx,0117) |Meta RT Radiation Set Index |MetaRTRadiationSetIndex |US |1 |
|(30xx,0118) |RT Prescription Index |RTPrescriptionIndex |US |1 |
|(30xx,0119) |Dosimetric Objective Parameter Index|DosimetricObjectiveParameterIndex |US |1 |
|(30xx,0120) |Radiation Dose Identification Index |RadiationDoseIdentificationIndex |US |1 |
|(30xx,0121) |Segment Index |SegmentIndex |US |1 |
|(30xx,0122) |Referenced Meta RT Radiation Set |ReferencedMetaRTRadiationSetIndex |US |1 |
| |Index | | | |
|(30xx,0123) |Meta RT Radiation Set Relationship |Meta RT Radiation Set Relationship Sequence |SQ |1 |
| |Sequence | | | |
|(30xx,0141) |Referenced Control Point Index |ReferencedControlPointIndex |US |1 |
|(30xx,0142) |Referenced Device Index |ReferencedDeviceIndex |US |1 |
|(30xx,0146) |Referenced Treatment Phase Index |ReferencedTreatmentPhaseIndex |US |1 |
|(30xx,0148) |Referenced RT Prescription Index |ReferencedRTPrescriptionIndex |US |1 |
|(30xx,0149) |Parent RT Prescription Index |ParentRTPrescriptionIndex |US |1 |
|(30xx,0150) |Referenced Radiation Dose |ReferencedRadiationDoseIdentificationIndex |US |1 |
| |Identification Index | | | |
|(30xx,0151) |Referenced Segment Annotation Index |ReferencedSegmentAnnotationIndex |US |1 |
|(30xx,02E3) |Tray Water-Equivalent Thickness |TrayWaterEquivalentThickness |FD |1 |
|(30xx,0540) |RT Accessory Holder Device Index |RTAccessoryHolderDeviceIndex |US |1 |
|(30xx,054A) |RT Accessory Holder Slot ID |RTAccessoryHolderSlotID |LO |1 |
|(30xx,054B) |RT Accessory Device Slot ID |RTAccessoryDeviceSlotID |LO |1 |
|(30xx,054D) |Manufacturer's Device Identifier |ManufacturerDeviceIdentifier |LO |1 |
|(30xx,0800) |RT Course Creation DateTime |RTCourseCreationDateTime |DT |1 |
|(30xx,0804) |RT Course Scope Indicator |RTCourseScopeIndicator |CS |1 |
|(30xx,0805) |RT Prescription Reference Presence |RTPrescriptionReferencePresenceFlag |CS |1 |
| |Flag | | | |
|(30xx,0806) |RT Treatment Phase Presence Flag |RTTreatmentPhasePresenceFlag |CS |1 |
|(30xx,0807) |RT Radiation Set Reference Presence |RTRadiationSetReferencePresenceFlag |CS |1 |
| |Flag | | | |
|(30xx,080A) |RT Course Predecessor Sequence |RTCoursePredecessorSequence |SQ |1 |
|(30xx,0822) |Prior Treatment Sequence |PriorTreatmentSequence |SQ |1 |
|(30xx,0824) |Prior RT Course Sequence |PriorRTCourseSequence |SQ |1 |
|(30xx,0826) |Delivered Radiation Dose Sequence |DeliveredRadiationDoseSequence |SQ |1 |
|(30xx,0828) |Delivered Radiation Dose |DeliveredRadiationDose |FD |1 |
|(30xx,082C) |Delivered Irradiated Volume |DeliveredIrradiatedVolumeDescription |ST |1 |
| |Description | | | |
|(30xx,0830) |RT Course State Sequence |RTCourseStateSequence |SQ |1 |
|(30xx,0832) |Person Role Code Sequence |PersonRoleCodeSequence |SQ |1 |
|(30xx,0860) |Physician Intent Prescription |PhysicianIntentPrescriptionSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0864) |Referenced Physician Intent Sequence|ReferencedPhysicianIntentSequence |SQ |1 |
|(30xx,0866) |Referenced Intent Prescription |ReferencedIntentPrescriptionStatusSequence |SQ |1 |
| |Status Sequence | | | |
|(30xx,0870) |Treatment Phase Reference Sequence |TreatmentPhaseReferenceSequence |SQ |1 |
|(30xx,0874) |Referenced RT Segment Annotation |ReferencedRTSegmentAnnotationSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0880) |Treatment Phase Sequence |TreatmentPhaseSequence |SQ |1 |
|(30xx,088A) |RT Treatment Phase State Sequence |RTTreatmentPhaseStateSequence |SQ |1 |
|(30xx,088C) |Intended Phase Start Date |IntendedPhaseStartDate |DA |1 |
|(30xx,088E) |Intended Phase End Date |IntendedPhaseEndDate |DA |1 |
|(30xx,0890) |Treatment Phase Relationship |TreatmentPhaseRelationshipSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0892) |Temporal Relationship Interval |TemporalRelationship IntervalAnchor |CS |1 |
| |Anchor | | | |
|(30xx,0894) |Minimum Number of Interval Days |MinimumNumberOfIntervalDays |DS |1 |
|(30xx,0896) |Maximum Number of Interval Days |MaximumNumberOfIntervalDays |DS |1 |
|(30xx,08B0) |Meta RT Radiation Set Sequence |MetaRTRadiationSetSequence |SQ |1 |
|(30xx,08C3) |Referenced Treatment Phase Index |ReferencedTreatmentPhaseIndex |US |1 |
|(30xx,08C6) |Radiation Set Start Delay |RadiationSetStartDelay |US |1 |
|(30xx,08C8) |RT Radiation Set State Sequence |RTRadiationSetStateSequence |SQ |1 |
|(30xx,08CA) |Pre-treatment RT Radiation Set |PretreatmentRTRadiationSetReferenceSequence |SQ |1 |
| |Reference Sequence | | | |
|(30xx,08CB) |Pre-treatment RT Radiation Set Role |PretreatmentRTRadiationSetRoleCodeSequence |SQ |1 |
| |Code Sequence | | | |
|(30xx,08CC) |Conceptual Volume State Sequence |ConceptualVolumeStateSequence |SQ |1 |
|(30xx,08F2) |Treatment RT Radiation Set Reference|TreatmentRTRadiationSetReferenceSequence |SQ |1 |
| |Sequence | | | |
|(30xx,08F4) |Treatment RT Radiation Set Sequence |TreatmentRTRadiationSetSequenceNumber |US |1 |
| |Number | | | |
|(30xx,08F6) |Treatment RT Radiation Set Status |TreatmentRTRadiationSetStatusSequence |SQ |1 |
| |Sequence | | | |
|(30xx,08F8) |Treatment RT Radiation Set Operation|TreatmentRTRadiationSetOperationStateSequence |SQ |1 |
| |State Sequence | | | |
|(30xx,08FA) |Treatment RT Radiation Set Relation |TreatmentRTRadiationSetRelationSequence |SQ |1 |
| |Sequence | | | |
|(30xx,08FC) |Treatment RT Radiation Set |TreatmentRTRadiationSetAlterationTypeSequence |SQ |1 |
| |Alteration Type Sequence | | | |
|(30xx,08FD) |Treatment RT Radiation Set |TreatmentRTRadiationSetAlterationTypeCodeSequence |SQ |1 |
| |Alteration Type Code Sequence | | | |
|(30xx,08FE) |Treatment RT Radiation Set Change |TreatmentRTRadiationSetChangeDescription |ST |1 |
| |Description | | | |
|(30xx,08FF) |Referenced RT Radiation Record |ReferencedRTRadiationRecordSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0900) |RT Course Associated Instance |RTCourseAssociatedInstanceReferenceSequence |SQ |1 |
| |Reference Sequence | | | |
|(30xx,0901) |Instance Reference Purpose Code |InstanceReferencePurposeCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0902) |RT Prescription Label |RTPrescriptionLabel |LO |1 |
|(30xx,0903) |Associated Instance State Sequence |AssociatedInstanceStateSequence |SQ |1 |
|(30xx,0910) |Physician Intent Predecessor |PhysicianIntentPredecessorSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0912) |RT Physician Intent Nominal Sequence|RTPhysicianIntentNominalSequence |FD |1 |
|(30xx,0913) |RT Physician Intent Index |RTPhysicianIntentIndex |US |1 |
|(30xx,0914) |RT Treatment Intent Type |RTTreatmentIntentType |CS |1 |
|(30xx,0915) |RT Physician Intent Narrative |RTPhysicianIntentNarrative |ST |1 |
|(30xx,0916) |RT Protocol Code Sequence |RTProtocolCodeSequence |SQ |1 |
|(30xx,0917) |Supersession Reason |SupersessionReason |ST |1 |
|(30xx,0918) |RT Diagnostic Code Sequence |RTDiagnosticCodeSequence |SQ |1 |
|(30xx,0919) |Referenced RT Physician Intent Index|ReferencedRTPhysicianIntentIndex |US |1 |
|(30xx,091A) |RT Diagnostic Image Set Sequence |RTDiagnosticImageSetSequence |SQ |1 |
|(30xx,0920) |RT Anatomic Prescription Sequence |RTAnatomicPrescriptionSequence |SQ |1 |
|(30xx,0922) |Anatomy Label |AnatomyLabel |LO |1 |
|(30xx,0924) |Prior Dose Description |PriorDoseDescription |ST |1 |
|(30xx,0925) |Prior Dose Reference Sequence |PriorDoseReferenceSequence |SQ |1 |
|(30xx,0926) |Dosimetric Objective Evaluation |DosimetricObjectiveEvaluationIncludingPriorDose |CS |1 |
| |Including Prior Dose | | | |
|(30xx,0928) |Prescription Anatomy Notes |PrescriptionAnatomyNotes |ST |1 |
|(30xx,0930) |Prescription Anatomy Role |PrescriptionAnatomyRole |CS |1 |
|(30xx,0932) |Radiobiological Structural Type |RadiobiologicalStructuralType |CS |1 |
|(30xx,0933) |Conceptual Volume Optimization |ConceptualVolumeOptimizationPrecedence |US |1 |
| |Precedence | | | |
|(30xx,0934) |Anatomy Category Code Sequence |AnatomyCategoryCodeSequence |SQ |1 |
|(30xx,0935) |Conceptual Volume Optimization |ConceptualVolumeOptimizationBlocking |CS |1 |
| |Blocking | | | |
|(30xx,0936) |Anatomy Property Type Code Sequence |AnatomyPropertyTypeCodeSequence |SQ |1 |
|(30xx,0940) |RT Prescription Sequence |RTPrescriptionSequence |SQ |1 |
|(30xx,0942) |Dosimetric Objective Sequence |DoseObjectiveSequence |SQ |1 |
|(30xx,0943) |Dosimetric Objective Value Type Code|DoseObjectiveValueTypeCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0944) |Type of Prescription |TypeofPrescription |CS |1 |
|(30xx,0946) |Dosimetric Objective Value Unit Code|DoseObjectiveValueUnitCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0948) |Dosimetric Objective UID |DosimetricObjectiveUID |UI |1 |
|(30xx,0949) |Referenced Dosimetric Objective UID |ReferencedDosimetricObjectiveUID |UI |1 |
|(30xx,0950) |Dosimetric Objective Parameter |DoseObjectiveParameterSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0951) |Referenced Dosimetric Objectives |ReferencedDosimetricObjectivesSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0954) |Dosimetric Objective Preservation |DoseObjectivePreservation |CS |1 |
|(30xx,0956) |Dosimetric Objective Priority |DoseObjectivePriority |FD |1 |
|(30xx,0958) |Dosimetric Objective Priority Type |DoseObjectivePriorityType |CS |1 |
|(30xx,0960) |Planning Input Information Sequence |PlanningInputInformationSequence |SQ |1 |
|(30xx,0965) |Fraction Pattern Sequence |FractionPatternSequence |SQ |1 |
|(30xx,0966) |Treatment Technique Description |TreatmentTechniqueDescription |ST |1 |
|(30xx,0970) |General Prescription Notes |GeneralPrescriptionNotes |ST |1 |
|(30xx,0972) |Number of Fractions |NumberOfFractions |US |1 |
|(30xx,0973) |Intended Delivery Duration |IntendedDeliveryDuration |US |1 |
|(30xx,0974) |Fractionation Description |FractionationDescription |ST |1 |
|(30xx,0976) |Treatment Technique Code Sequence |TreatmentTechniqueCodeSequence |SQ |1 |
|(30xx,0978) |Prescription Annotation Sequence |PrescriptionAnnotationSequence |SQ |1 |
|(30xx,0979) |Prescription Annotation DateTime |PrescriptionAnnotationDateTime |DT |1 |
|(30xx,0982) |Fractionation Relationship Sequence |FractionationRelationshipSequence |SQ |1 |
|(30xx,0B26) |Radiation Sequence |RadiationSequence |SQ |1 |
|(30xx,0B40) |Radiation Dose Sequence |RadiationDoseSequence |SQ |1 |
|(30xx,0B42) |Radiation Dose Identification |RadiationDoseIdentificationSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0B46) |Radiation Dose Identification Label |RadiationDoseIdentificationLabel |LO |1 |
|(30xx,0B48) |Reference Dose Type |ReferenceDoseType |CS |1 |
|(30xx,0B49) |Primary Dose Value Indicator |PrimaryDoseValueIndicator |CS |1 |
|(30xx,0B62) |Reference Dose Point Coordinates |ReferenceDosePointCoordinates |FD |3 |
|(30xx,0B64) |Radiation Dose Values Sequence |RadiationDoseValuesSequence |SQ |1 |
|(30xx,0B68) |Dose Meterset to Dose Mapping |DoseMetersetToDoseMappingSequencePo |SQ |1 |
| |SequencePo | | | |
|(30xx,0B6D) |Radiation Verification Control Point|RadiationVerificationControlPointSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0B70) |Radiation Dose Point Depth |RadiationDosePointDepth |FD |1 |
|(30xx,0B72) |Radiation Dose Point Equivalent |RadiationDosePointEquivalentDepth |FD |1 |
| |Depth | | | |
|(30xx,0B74) |Radiation Dose Point SSD |RadiationDosePointSSD |FD |1 |
|(30xx,0B76) |Radiation Dose In Vivo Measurement |RadiationDoseInVivoMeasurementSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0B78) |Radiation Dose In Vivo Measurement |RadiationDoseInVivoMeasurementLabel |LO |1 |
| |Label | | | |
|(30xx,0B7A) |Radiation Dose Central Axis |RadiationDoseCentralAxisDisplacement |FD |1 |
| |Displacement | | | |
|(30xx,0B7B) |Radiation Dose Value |RadiationDoseValue |FD |1 |
|(30xx,0B7C) |Radiation Dose Source-Skin Distance |RadiationDoseSourceSkinDistance |FD |1 |
|(30xx,0B7D) |Radiation Dose Measurement Point |RadiationDoseMeasurementPointCoordinates |FD |3 |
| |Coordinates | | | |
|(30xx,0BA0) |RT Tolerance Set Sequence |RTToleranceSetSequence |SQ |1 |
|(30xx,0BA2) |RT Tolerance Set Label |RTToleranceSetLabel |SH |1 |
|(30xx,0BA6) |Attribute Tolerance Values Sequence |AttributeToleranceValuesSequence |SQ |1 |
|(30xx,0BA8) |Tolerance Value |ToleranceValue |FD |1 |
|(30xx,0BAA) |Patient Support Position Tolerance |PatientSupportPositionToleranceSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0BAC) |Calculated Treatment Time |CalculatedTreatmentTime |FD |1 |
|(30xx,0BAD) |Treatment Time Limit |TreatmentTimeLimit |FD |1 |
|(30xx,0BB0) |Manufacturer's Model Class UID |ManufacturersModelClassUID |UI |1 |
|(30xx,0BB2) |Treatment Machine Delivery Subsystem|TreatmentMachineDeliverySubsystemID |SH |1 |
| |ID | | | |
|(30xx,0C00) |C-Arm Photon-Electron Control Point |CArmPhotonElectronControlPointSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0C02) |Referenced Radiation Set Sequence |ReferencedRadiationSetSequence |SQ |1 |
|(30xx,0C04) |Referenced Radiation Sequence |ReferencedRadiationSequence |SQ |1 |
|(30xx,0C97) |Treatment Machine Mode Sequence |TreatmentMachineModeSequence |SQ |1 |
|(30xx,0C99) |Radiotherapy Procedure Technique |RadiotherapyProcedureTechniqueSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0F00) |Robotic Beam Limiting Device |RoboticBeamLimitingDeviceSupportedType |CS |1 |
| |Supported Type | | | |
|(30xx,0F03) |Robotic Device Geometry |RoboticDeviceGeometry |CS |1 |
|(30xx,0F10) |Robotic Collimation Type |RoboticCollimationType |CS |1 |
|(30xx,0F15) |Robotic Path Identifier Sequence |RoboticPathIdentifierSequence |SQ |1 |
|(30xx,0F33) |Robotic Path Node Number |RoboticPathNodeSequenceNumber |UL |1 |
|(30xx,0F40) |RT Treatment Source Coordinates |RTTreatmentSourceCoordinates |FL |3 |
|(30xx,0F42) |Robotic Beam Sub-Control Point |RoboticBeamSubControlPointSequence |SQ |1 |
| |Sequence | | | |
|(30xx,0F44) |RT Treatment Target Coordinates |RTTreatmentTargetCoordinates |FL |3 |
|(30xx,0F46) |Robot Head Yaw Angle |RobotHeadYawAngle |FL |1 |
|(30xx,0F50) |Robotic Control Point Sequence |RoboticControlPointSequence |SQ |1 |
|(30xx,1000) |Tomotherapeutic Leaf Bank Definition|TomotherapeuticLeafBankDefinitionSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1001) |Leaf Bank Offset |LeafBankOffset |FD |1 |
|(30xx,1002) |Number of Leaf Slots |NumberOfLeafSlots |US |1 |
|(30xx,1003) |Binary MLC Leaf Slot Boundaries |BinaryMLCLeafSlotBoundaries |FD |2-n |
|(30xx,1005) |Maximum Binary MLC Jaw 1 Opening |MaximumBinaryMLCJaw1Opening |FD |1 |
|(30xx,1006) |Maximum Binary MLC Jaw 2 Opening |MaximumBinaryMLCJaw2Opening |FD |1 |
|(30xx,1007) |Tomotherapeutic Nominal Couch Speed |TomotherapeuticNominalCouchSpeed |FD |1 |
|(30xx,1008) |Tomotherapeutic Nominal Gantry |TomotherapeuticNominalGantryPeriod |FD |1 |
| |Period | | | |
|(30xx,1009) |Tomotherapeutic Nominal Delivery |TomotherapeuticNominalDeliveryPitch |FD |1 |
| |Pitch | | | |
|(30xx,1010) |Tomotherapeutic Control Point |TomotherapeuticControlPointSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1020) |Tomotherapeutic Leaf Bank Position |TomotherapeuticLeafBankPositionSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1024) |Binary MLC Jaw 1 Opening |BinaryMLCJaw1Opening |FL |1 |
|(30xx,1025) |Binary MLC Jaw 2 Opening |BinaryMLCJaw2Opening |FL |1 |
|(30xx,1030) |Tomotherapeutic Leaf Open |TomotherapeuticLeafOpenPercentages |FL |1-n |
| |Percentages | | | |
|(30xx,1031) |Tomotherapeutic Leaf Open Start |TomotherapeuticLeafOpenStartPercentages |FL |1-n |
| |Percentages | | | |
|(30xx,1100) |Composite Dose Sequence |CompositeDoseSequence |SQ |1 |
|(30xx,1102) |Contributing Radiation Set Sequence |ContributingRadiationSetSequence |SQ |1 |
|(30xx,1110) |Dose Contribution Weight |DoseContributionWeight |FD |1 |
|(30xx,1116) |RT Dose Image Frame Type Sequence |RTDoseImageFrameTypeSequence |SQ |1 |
|(30xx,1118) |Contributing Radiation Sequence |ContributingRadiationSequence |SQ |1 |
|(30xx,1120) |Number of Complete Fractions |NumberOfCompleteFractionsContributing |US |1 |
| |Contributing | | | |
|(30xx,1122) |Partial Delivery Limits Sequence |PartialDeliveryLimitsSequence |SQ |1 |
|(30xx,1123) |Fraction Completion Status |FractionCompletionStatus |CS |1 |
|(30xx,1124) |Dose Contribution Accumulation Type |DoseContributionAccumulationType |CS |1 |
|(30xx,1125) |Radiation Completion Status |RadiationCompletionStatus |CS |1 |
|(30xx,1128) |Contributing RT RadiationRecord |ContributingRTRadiationRecordSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1130) |Radiation Absorption Model |RadiationAbsorptionModel |CS |1-n |
|(30xx,1132) |Effective Dose Method Code Sequence |EffectiveDoseMethodCodeSequence |SQ |1 |
|(30xx,1134) |Effective Dose Method Description |EffectiveDoseMethodDescription |LO |1 |
|(30xx,1135) |Referenced Dose Calculation |ReferencedDoseCalculationAnnotationObjectSequence |SQ |1 |
| |Annotation Object Sequence | | | |
|(30xx,1136) |Dose Purpose |DosePurpose |CS |1 |
|(30xx,1137) |Effective Dose Method Modifier Code |EffectiveDoseMethodModifierCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1138) |Dose Data Source |DoseDataSource |CS |1 |
|(30xx,113A) |Dose Scope |DoseScope |CS |1 |
|(30xx,113C) |Dose Data Source Measurement Code |DoseDataSourceMeasurementCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,113E) |Effective Tissue Composition |EffectiveTissueComposition |CS |1 |
|(30xx,1140) |Start Meterset |StartMeterset |FD |1 |
|(30xx,1141) |Stop Meterset |StopMeterset |FD |1 |
|(30xx,1144) |Algorithm Type Code Sequence |AlgorithmTypeCodeSequence |SQ |1 |
|(30xx,1146) |Referenced Annotating Object |ReferencedAnnotatingObjectSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1150) |Dose Grid Geometry |DoseGridGeometry |CS |1 |
|(30xx,1201) |Dose Histogram Normalization Dose |DoseHistogramNormalizationDoseValue |FD |1 |
| |Value | | | |
|(30xx,1202) |Dose Histogram Sequence |DoseHistogramSequence |SQ |1 |
|(30xx,1203) |Dose Histogram Referenced Segment |DoseHistogramReferencedSegmentSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1204) |Dose Histogram Data |DoseHistogramData |OF |1 |
|(30xx,1205) |Histogram Tally Type |HistogramTallyType |CS |1 |
|(30xx,1206) |Dose Histogram Spatial Units |DoseHistogramSpatialUnits |CS |1 |
|(30xx,1207) |Dose Histogram Dose Unit Code |DoseHistogramDoseUnitCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1209) |Segment Total Size |SegmentTotalSize |FD |1 |
|(30xx,1210) |Dose Histogram Type |DoseHistogramType |CS |1 |
|(30xx,1211) |Dose Statistics Sequence |DoseStatisticsSequence |SQ |1 |
|(30xx,1250) |Number of Dose Samples |NumberOfDoseSamples |UL |1 |
|(30xx,1251) |Dose Samples Data |DoseSamplesData |OF |1 |
|(30xx,1253) |Dose Samples Dose Unit Code Sequence|DoseDoseSamplesUnitCodeSequence |SQ |1 |
|(30xx,1301) |Conceptual Volume UID |ConceptualVolumeUID |UI |1 |
|(30xx,1302) |Originating SOP Instance Reference |OriginatingSOPInstanceReferenceSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1303) |Conceptual Volume Constituent |ConceptualVolumeConstituentSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1304) |Equivalent Conceptual Volume |EquivalentConceptualVolumeInstanceReferenceSequence |SQ |1 |
| |Instance Reference Sequence | | | |
|(30xx,1305) |Equivalent Conceptual Volumes |EquivalentConceptualVolumesSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1306) |Conceptual Volume Set Sequence |ConceptualVolumeSetSequence |SQ |1 |
|(30xx,1307) |Conceptual Volume Combination |ConceptualVolumeCombinationExpression |ST |1 |
| |Expression | | | |
|(30xx,1308) |Conceptual Volume Constituent Index |ConceptualVolumeConstituentIndex |US |1 |
|(30xx,1309) |Conceptual Volume Combination Flag |ConceptualVolumeCombinationFlag |CS |1 |
|(30xx,1310) |Conceptual Volume Combination |ConceptualVolumeCombinationDescription |ST |1 |
| |Description | | | |
|(30xx,1311) |Conceptual Volume Segmentation |ConceptualVolumeSegmentationDefinedFlag |CS |1 |
| |Defined Flag | | | |
|(30xx,1312) |Conceptual Volume Segmentation |ConceptualVolumeSegmentationReferenceSequence |SQ |1 |
| |Reference Sequence | | | |
|(30xx,1313) |Referenced Conceptual Volume |ReferencedConceptualVolumeConstituentIndex |US |1 |
| |Constituent Index | | | |
|(30xx,1314) |Conceptual Volume Constituent |ConceptualVolumeConstituentSegmentationReferenceSequen|SQ |1 |
| |Segmentation Reference Sequence |ce | | |
|(30xx,1324) |Manufacturer's Model Version |ManufacturersModelVersion |LO |1 |
|(30xx,1326) |Device Alternate Identifier |DeviceAlternateIdentifier |ST |1 |
|(30xx,1327) |Device Alternate Identifier Type |DeviceAlternateIdentifierType |CS |1 |
|(30xx,1328) |Device Alternate Identifier |DeviceAlternateIdentifierSymbology |LO |1 |
| |Symbology | | | |
|(30xx,1331) |Segmentation SOP Instance Reference |SegmentationSOPInstanceReferenceSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1332) |Segmentation Template Label |SegmentationTemplateLabel |SH |1 |
|(30xx,1334) |Segmentation Template UID |SegmentationTemplateUID |UI |1 |
|(30xx,1343) |Direct Segment Reference Sequence |DirectROIReferenceSequence |SQ |1 |
|(30xx,1344) |Combination Segment Reference |CombinationSegmentReferenceSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1346) |Conceptual Volume Sequence |ConceptualVolumeSequence |SQ |1 |
|(30xx,1349) |Segment RT Accessory Device Sequence|SegmentRTAccessoryDeviceSequence |SQ |1 |
|(30xx,134B) |Segment Properties Sequence |SegmentPropertiesSequence |SQ |1 |
|(30xx,134C) |Segment Properties Modifier Sequence|SegmentPropertiesModifierSequence |SQ |1 |
|(30xx,134E) |Alternate Segmented Property Type |AlternateSegmentedPropertyTypeCodeSequence |SQ |1 |
| |Code Sequence | | | |
|(30xx,134F) |Purpose of Alternate Segmented |PurposeOfAlternateSegmentedPropertyTypeCodeSequence |SQ |1 |
| |Property Type Code Sequence | | | |
|(30xx,1350) |Segmentation Instance Index |SegmentationInstanceIndex |US |1 |
|(30xx,1351) |Referenced Segmentation Instance |ReferencedSegmentationInstanceIndex |US |1 |
| |Index | | | |
|(30xx,1500) |Multi-Axial Control Point Sequence |MultiAxialControlPointSequence |SQ |1 |
|(30xx,1501) |Center of Rotation Axis Distance |CenterOfRotationAxisDistance |FD |1 |
|(30xx,1520) |Gantry Head Pitch Angle |GantryHeadPitchAngle |FD |1 |
|(30xx,1521) |Gantry Head Roll Angle |GantryHeadRollAngle |FD |1 |
|(30xx,1522) |Gantry Head Yaw Angle |GantryHeadYawAngle |FD |1 |
|(30xx,1525) |Multi-Axial Target Coordinate |MultiAxialTargetCoordinate |FD |3 |
|(30xx,1540) |Multi-Axial Sub-Control Point |Multi-AxialSubControlPointSequence |SQ |1 |
| |Sequence | | | |
|(30xx,1542) |Target Position Meterset Weight |TargetPositionMetersetWeight |FL |1 |
|(30xx,1544) |Dynamic Beam Limiting Device |DynamicBeamLimitingDevicePositionsSequence |SQ |1 |
| |Positions Sequence | | | |
|(30xx,5011) |RT Radiation Set Intent |RTRadiationSetIntent |CS |1 |
|(30xx,5012) |RT Dose Contribution Presence Flag |RTDoseContributionPresenceFlag |CS |1 |
|(30xx,5013) |RT Radiation Data Scope |RTRadiationDataScope |CS |1 |
|(30xx,5014) |Alternate Patient Position Code |AlternatePatientPositionCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,5015) |Treatment Device Identification |TreatmentDeviceIdentificationSequence |SQ |1 |
| |Sequence | | | |
|(30xx,5016) |Alternate Treatment Device Sequence |AlternateTreatmentDeviceSequence |SQ |1 |
|(30xx,5017) |Treatment Device Equivalence UID |MachineEquivalenceUID |UI |1 |
|(30xx,5019) |Treatment Device Identifier |TreatmentDeviceIdentifier |SH |1 |
|(30xx,5021) |Cumulative Meterset |CumulativeMeterset |FD |1 |
|(30xx,5023) |Delivery Rate |DeliveryRate |FD |1 |
|(30xx,5024) |Delivery Rate Unit Sequence |DeliveryRateUnitSequence |SQ |1 |
|(30xx,5025) |Device Label |DeviceLabel |LO |1 |
|(30xx,5026) |Device Type Code Sequence |DeviceTypeCodeSequence |SQ |1 |
|(30xx,5027) |Device Description |DeviceDescription |ST |1 |
|(30xx,5028) |Treatment Position Sequence |TreatmentPositionSequence |SQ |1 |
|(30xx,5031) |Regulatory Device Identifier |RegulatoryDeviceIdentifierSequence |SQ |1 |
| |Sequence | | | |
|(30xx,5033) |Regulatory Device Identifier |RegulatoryDeviceIdentifier |ST |1 |
|(30xx,5035) |Regulatory Device Identifier Type |RegulatoryDeviceIdentifierTypeCodeSequence |SQ |1 |
| |Code Sequence | | | |
|(30xx,5048) |Number of RT Beam Delimiter Pairs |NumberOfRTBeamDelimiterPairs |US |1 |
|(30xx,5049) |RT Beam Delimiter Element Position |RTBeamDelimiterPositionElementBoundaries |FD |2-n |
| |Boundaries | | | |
|(30xx,504A) |RT Beam Delimiter Element Positions |RTBeamDelimiterElementPositions |FD |2-n |
|(30xx,504B) |RT Beam Delimiter Diameter |RTBeamDelimiterDiameter |FD |1 |
|(30xx,504C) |RT Beam Delimiter Geometry Sequence |RTBeamDelimiterGeometrySequence |SQ |1 |
|(30xx,504D) |RT Beam Limiting Device Definition |RTBeamLimitingDeviceDefinitionSequence |SQ |1 |
| |Sequence | | | |
|(30xx,504E) |RT Rectangular Beam Limiting Device |RTRectangularBeamLimitingDeviceDefinitionSequence |SQ |1 |
| |Definition Sequence | | | |
|(30xx,504F) |RT Beam Limiting Device Distance |RTBeamLimitingDeviceDistance |FD |2 |
|(30xx,5051) |RT Operation State |RTOperationState |CS |1 |
|(30xx,5060) |Patient Setup UID |PatientSetupUID |UI |1 |
|(30xx,5062) |Wedge Definition Sequence |WedgeDefinitionSequence |SQ |1 |
|(30xx,5070) |RT Beam Limiting Device Settings |BeamLimitingDeviceSettingsSequence |SQ |1 |
| |Sequence | | | |
|(30xx,5080) |RT Item State Sequence |RTItemStateSequence |SQ |1 |
|(30xx,5082) |Active Item Indicator |ActiveItemIndicator |CS |1 |
|(30xx,5084) |RT Item State Creation Authority |RTItemStateCreationAuthorityDescriptionSequence |SQ |1 |
| |Description Sequence | | | |
|(30xx,5086) |RT Operation State Sequence |RTOperationStateSequence |SQ |1 |
|(30xx,5088) |RT Operation State Change Reason |RTOperationStateChangeReasonCodeSequence |SQ |1 |
| |Code Sequence | | | |
|(30xx,508A) |RT Operation State Code Sequence |RTOperationStateCodeSequence |SQ |1 |
|(30xx,508C) |RT Operation State DateTime |RTOperationStateDateTime |DT |1 |
|(30xx,508E) |RT Operation State Change Reason |RTOperationStateChangeReasonDescription |ST |1 |
| |Description | | | |
|(30xx,5110) |Radiation Particle |RadiationParticle |CS |1 |
|(30xx,5113) |Radiation Dosimeter Unit |RadiationDosimeterUnit |CS |1 |
|(30xx,5114) |RT Beam Distance Reference Location |RTBeamDistanceReferenceLocation |CS |1 |
|(30xx,5130) |Radiation Source Sequence |RadiationSourceSequence |SQ |1 |
|(30xx,5131) |Radiation Source Label |RadiationSourceLabel |LO |1 |
|(30xx,5132) |Radiation Source Distance |RadiationSourceDistance |FD |1 |
|(30xx,5133) |Radiation Source Theta |RadiationSourceTheta |FD |1 |
|(30xx,5134) |Radiation Source Phi |RadiationSourcePhi |FD |1 |
|(30xx,5137) |Radiation Source Control Point |RadiationSourceControlPointSequence |SQ |1 |
| |Sequence | | | |
|(30xx,513A) |Referenced Radiation Source Label |ReferencedRadiationSourceLabel |LO |1 |
|(30xx,513B) |Radiation Source Collimator Size |RadiationSourceCollimatorSize |FD |1 |
|(30xx,513C) |Radiation Source Pattern Sequence |RadiationSourcePatternSequence |SQ |1 |
|(30xx,513D) |Radiation Source Pattern Label |RadiationSourcePatternLabel |LO |1 |
|(30xx,513E) |Referenced Radiation Source Pattern |ReferencedRadiationSourcePattern |SH |1 |
|(30xx,513F) |Radiation Source Pattern Source |RadiationSourcePatternSourceSequence |SQ |1 |
| |Sequence | | | |
|(30xx,5142) |Patient Support Position Parameter |PatientSupportPositionParameterSequence |SQ |1 |
| |Sequence | | | |
|(30xx,5148) |Tray Distance |TrayDistance |FD |1 |
|(30xx,5150) |Compensator Definition Sequence |CompensatorDefinitionSequence |SQ |1 |
|(30xx,5151) |Compensator Transmission Map |CompensatorTransmissionMap |OF |1-n |
|(30xx,5152) |Compensator Thickness Map |CompensatorThicknessMap |OF |1-n |
|(30xx,5153) |Compensator Distance Map |CompensatorDistanceMap |OF |1-n |
|(30xx,5160) |Block Definition Sequence |BlockDefinitionSequence |SQ |1 |
|(30xx,5161) |Block Edge Data |BlockEdgeData |OF |1-n |
|(30xx,5170) |Accessory Holder Definition Sequence|AccessoryHolderDefinitionSequence |SQ |1 |
|(30xx,5180) |General Accessory Definition |GeneralAccessoryDefinitionSequence |SQ |1 |
| |Sequence | | | |
|(30xx,5185) |Tray Definition Sequence |TrayDefinitionSequence |SQ |1 |
|(30xx,5190) |Boluses Definition Sequence |BolusesDefinitionSequence |SQ |1 |
|(30xx,51A0) |Equipment Frame of Reference UID |EquipmentFrameOfReferenceUID |UI |1 |
|(30xx,51A1) |Equipment Frame of Reference |EquipmentFrameOfReferenceDescription |ST |1 |
| |Description | | | |
|(30xx,51B3) |Gantry Yaw Continuous Angle |GantryYawContinuousAngle |FD |1 |
|(30xx,51B4) |RT Beam Limiting Device Continuous |RTBeamLimitingDeviceContinuousAngle |FD |1 |
| |Angle | | | |
|(30xx,51B5) |Gantry Roll Continuous Angle |GantryRollContinuousAngle |FD |1 |
|(30xx,51B7) |Gantry Pitch Continuous Angle |GantryPitchContinuousAngle |FD |1 |
|(30xx,51C0) |Beam Mode Sequence |BeamModeSequence |SQ |1 |
|(30xx,51C1) |Beam Mode Label |BeamModeLabel |SH |1 |
|(30xx,51C2) |Beam Mode Description |BeamModeDescription |ST |1 |
|(30xx,51C3) |Beam Mode Machine Code |BeamModeMachineCode |LO |1 |
|(30xx,51C5) |Nominal Energy |NominalEnergy |IS |1 |
|(30xx,51C6) |Minimum Nominal Energy |MinimumNominalEnergy |IS |1 |
|(30xx,51C7) |Maximum Nominal Energy |MaximumNominalEnergy |IS |1 |
|(30xx,51C8) |Beam Mode Type Code Sequence |BeamModeTypeCodeSequence |SQ |1 |
|(30xx,51C9) |Energy Unit Code Sequence |EnergyUnitCodeSequence |SQ |1 |
|(30xx,51CA) |Nominal Reference Energy |NominalReferenceEnergy |IS |1 |
|(30xx,51E0) |User Content Label |UserContentLabel |SH |1 |
|(30xx,51E2) |RT Entity Label |RTEntityLabel |SH |1 |
|(30xx,51E3) |RT Entity Name |RTEntityName |LO |1 |
|(30xx,51E4) |RT Entity Description |RTEntityDescription |ST |1 |
|(30xx,51E5) |RT Entity Long Label |RTEntityLongLabel |LO |1 |
|(30xx,51F1) |Patient Support Devices Sequence |PatientSupportDevicesSequence |SQ |1 |
|(30xx,5200) |Outline Shape Type |OutlineShapeType |CS |1 |
|(30xx,5202) |Outline Edges X |OutlineEdgesX |FL |1-2 |
|(30xx,5203) |Outline Edges Y |OutlineEdgesY |FL |1-2 |
|(30xx,5204) |Center of Circular Outline |CenterOfCircularOutline |FL |2 |
|(30xx,5205) |Diameter of Circular Outline |DiameterOfCircularOutline |FL |1 |
|(30xx,5206) |Number of Polygonal Vertices |NumberOfPolygonalVertices |UL |1 |
|(30xx,5207) |Vertices of the Polygonal Outline |VerticesOfThePolygonalOutline |FL |2-2n |
|(30xx,5208) |Coordinate System Declaration |CoordinateSystemDeclaration |CS |1 |
|(30xx,5209) |Outline Definition Plane Distance |OutlineDefinitionPlaneDistance |FL |1 |
|(30xx,5210) |Beam Limiting Device Definition |BeamLimitingDeviceDefinitionDistance |FL |1 |
| |Distance | | | |
|(30xx,6000) |Treatment Session UID |TreatmentSessionUID |UI |1 |
|(30xx,6015) |Treatment Termination Reason Code |TreatmentTerminationReasonCodeSequence |SQ |1 |
| |Sequence | | | |
|(30xx,6016) |Machine-Specific Treatment |MachineSpecificTreatmentTerminationCodeSequence |SQ |1 |
| |Termination Code Sequence | | | |
|(30xx,6030) |Treatment Termination Description |TreatmentTerminationDescription |ST |1 |
|(30xx,6035) |Treatment Recording Method |TreatmentRecordingMethod |CS |1 |
|(30xx,6036) |Treatment Tolerance Status |TreatmentToleranceStatus |CS |1 |
|(30xx,603A) |Treatment Control Point Start |TreatmentControlPointStartDateTime |DT |1 |
| |DateTime | | | |
|(30xx,603C) |Treatment Control Point End DateTime|TreatmentControlPointEndDateTime |DT |1 |
|(30xx,603E) |Alternate Specified Value Sequence |AlternateSpecifiedValueSequence |SQ |1 |
|(30xx,6040) |Patient Frame of Reference to |PatientFrameOfReferenceToEquipmentMappingMatrix |FD |16 |
| |Equipment Mapping Matrix | | | |
|(30xx,6042) |Patient Location Coordinates |PatientLocationCoordinatesSequence |SQ |1 |
| |Sequence | | | |
|(30xx,6046) |Patient Support Position Sequence |PatientSupportPositionSequence |SQ |1 |
|(30xx,6050) |Beam-On Area Sequence |BeamOnAreaSequence |SQ |1 |
|(30xx,6110) |Calculated Radiation Dose Values |CalculatedRadiationDoseValuesSequence |SQ |1 |
| |Sequence | | | |
|(30xx,6114) |Measured Radiation Dose Values |MeasuredRadiationDoseValuesSequence |SQ |1 |
| |Sequence | | | |
|(0028,xxxx) |Long Pixel Padding Value |LongPixelPaddingValue |UL or |1 |
| | | |SL | |
|(0028,yyyy) |Long Pixel Padding Range Limit |LongPixelPaddingRangeLimit |UL or |1 |
| | | |SL | |
Add the following to PS3.6 Annex A:
Annex A Registry of DICOM unique identifiers (UID) (Normative)
Table A-1
UID VALUES
|UID Value |UID NAME |UID TYPE |Part |
|1.2.840.10008.5.1.4.1.1.481.XN.1 |RT Course Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.2 |RT Physician Intent Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.3 |RT Radiation Set Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.4 |RT Segment Annotation Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.5.1 |Tomotherapeutic Radiation Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.5.2 |C-Arm Photon Radiation Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.5.3 |C-Arm Electron Radiation Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.5.4 |Multiple Fixed Source Radiation Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.5.5 |Robotic Radiation Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.5.7 |Multi-Axial Radiation Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.6.1 |Tomotherapeutic Radiation Record Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.6.2 |C-Arm Photon Radiation Record Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.6.3 |C-Arm Electron Radiation Record Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.6.4 |Multiple Fixed Source Radiation Record |SOP Class |PS 3.4 |
| |Storage | | |
|1.2.840.10008.5.1.4.1.1.481.XN.6.5 |Robotic Radiation Record Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.6.7 |Multi-Axial Radiation Record Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.7.1 |RT Dose Image Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.7.2 |RT Dose Histogram Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.7.3 |RT Dose Samples Storage |SOP Class |PS 3.4 |
|1.2.840.10008.5.1.4.1.1.481.XN.8 |RT Patient Storage |SOP Class |PS 3.4 |
|1.2.840.10008.1.XN.1 |IEC FIXED Reference System Frame of |Well-known frame of|PS 3.3 |
| |Reference |reference | |
Add the following data elements to PS3.6, Annex A:
Table A-3
CONTEXT GROUP UID VALUES
|Context UID |Context Identifier |Context Group Name |
|1.2.840.10008.6.1.FFF.1 |SUP147001 |Dosimetric Objective Value Types |
|1.2.840.10008.6.1.FFF.2 |SUP147002 |Prescription Anatomy Categories |
|1.2.840.10008.6.1.FFF.3 |SUP147003 |Radiotherapy Segment Categories |
|1.2.840.10008.6.1.FFF.4 |SUP147004 |Radiotherapy Targets |
|1.2.840.10008.6.1.FFF.5 |SUP147005 |RT Geometric Information |
|1.2.840.10008.6.1.FFF.6 |SUP147006 |Fixation or Positioning Devices |
|1.2.840.10008.6.1.FFF.7 |SUP147007 |Brachytherapy Devices |
|1.2.840.10008.6.1.FFF.10 |SUP147010 |Beam Limiting Device Types |
|1.2.840.10008.6.1.FFF.11 |SUP147011 |Radiotherapy Robotic Paths |
|1.2.840.10008.6.1.FFF.12 |SUP147012 |General External Radiotherapy Procedure Techniques |
|1.2.840.10008.6.1.FFF.13 |SUP147013 |Tomotherapeutic Radiotherapy Procedure Techniques |
|1.2.840.10008.6.1.FFF.14 |SUP147014 |Treatment RT Radiation Set Alteration Types |
|1.2.840.10008.6.1.FFF.15 |SUP147015 |Treatment Termination Reasons |
|1.2.840.10008.6.1.FFF.16 |SUP147016 |Compensator Device Types |
|1.2.840.10008.6.1.FFF.17 |SUP147017 |Radiotherapy Treatment Machine Modes |
|1.2.840.10008.6.1.FFF.18 |SUP147018 |Pre-Treatment RT Radiation Set Roles |
|1.2.840.10008.6.1.FFF.19 |SUP147019 |RT Segment Annotation |
|1.2.840.10008.6.1.FFF.20 |SUP147020 |Instance Reference Purposes |
|1.2.840.10008.6.1.FFF.21 |SUP147021 |Patient Setup Techniques |
|1.2.840.10008.6.1.FFF.22 |SUP147022 |Fixation Device Types |
|1.2.840.10008.6.1.FFF.23 |SUP147023 |Shielding Device Types |
|1.2.840.10008.6.1.FFF.24 |SUP147024 |Setup Devices |
|1.2.840.10008.6.1.FFF.25 |SUP147025 |RT Patient Support Devices |
|1.2.840.10008.6.1.FFF.26 |SUP147026 |Dose Statistics |
|1.2.840.10008.6.1.FFF.27 |SUP147027 |Fixed Beam Limiting Device Types |
|1.2.840.10008.6.1.FFF.28 |SUP147028 |Radiotherapy Wedge Types |
|1.2.840.10008.6.1.FFF.30 |SUP147030 |General Accessory Device Types |
|1.2.840.10008.6.1.FFF.31 |SUP147031 |Radiotherapy Bolus Device Types |
|1.2.840.10008.6.1.FFF.32 |SUP147032 |Radiotherapy Block Device Types |
|1.2.840.10008.6.1.FFF.33 |SUP147033 |Radiotherapy Accessory Holder Device Types |
|1.2.840.10008.6.1.FFF.34 |SUP147034 |Radiotherapy Dose Real World Units |
|1.2.840.10008.6.1.FFF.35 |SUP147035 |Effective Dose Method Code Definition |
|1.2.840.10008.6.1.FFF.36 |SUP147036 |Purpose of Referenced Dose Calculation Annotation Object |
|1.2.840.10008.6.1.FFF.37 |SUP147037 |Dose Data Source Measurement Definition |
|1.2.840.10008.6.1.FFF.39 |SUP147039 |Dose Histogram Spatial Unit Definition |
|1.2.840.10008.6.1.FFF.41 |SUP147040 |Segemented Rt Accessory Devices |
|1.2.840.10008.6.1.FFF.42 |SUP147041 |Dose Algorithm Class |
|1.2.840.10008.6.1.FFF.43 |SUP147042 |Energy Unit |
|1.2.840.10008.6.1.FFF.44 |SUP147043 |RT Item States |
|1.2.840.10008.6.1.FFF.45 |SUP147044 |RT Operation States |
|1.2.840.10008.6.1.FFF.46 |SUP147045 |Multiple Fixed Sources Procedure Techniques |
|1.2.840.10008.6.1.FFF.47 |SUP147046 |Robotic Procedure Techniques |
|1.2.840.10008.6.1.FFF.48 |SUP147047 |Radiotherapy Procedure Techniques |
|1.2.840.10008.6.1.FFF.49 |SUP147048 |Revised value |
|1.2.840.10008.6.1.FFF.50 |SUP147049 |Radiotherapy General Workitem Definition |
|1.2.840.10008.6.1.FFF.51 |SUP147050 |Beam Mode Type Definition |
|1.2.840.10008.6.1.FFF.52 |SUP147051 |Meterset Rate Unit Definition |
|1.2.840.10008.6.1.FFF.53 |SUP147052 |Radiation Particle |
|1.2.840.10008.6.1.FFF.60 |SUP147060 |Single Dose-related Dosimetric Objectives |
|1.2.840.10008.6.1.FFF.61 |SUP147061 |Percentage and Dose-related Dosimetric Objectives |
|1.2.840.10008.6.1.FFF.62 |SUP147062 |Volume and Dose-related Dosimetric Objectives |
|1.2.840.10008.6.1.FFF.63 |SUP147063 |Dimensionless and Dose-related Dosimetric Objectives |
|1.2.840.10008.6.1.FFF.64 |SUP147064 |Coded Dosimetric Objectives |
Part 16 Addendum
Add the following workitem codes to CID 9231 of PS3.16, Annex B:
CID 9231 General Purpose Workitem Definition
Context ID 9231
General Purpose Workitem Definition
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |110014 |Registration |
|99SUP147 |110015 |Segmentation |
Add the following new CIDs to PS3.16, Annex B:
CID SUP147001 Dosimetric Objective Value Types
Context ID SUP147001
Dose Objective Value Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|Include CID SUP147060 Single Dose-related Dosimetric Objectives |
|Include CID SUP147061 Percentage and Dose-related Dosimetric Objectives |
|Include CID SUP147062 Volume and Dose-related Dosimetric Objectives |
|Include CID SUP147063 Dimensionless and Dose-related Dosimetric Objectives |
|Include CID SUP147064 Coded Dosimetric Objectives |
CID SUP147002 Prescription Anatomy Categories
Context ID SUP147002
Prescription Anatomy Categories
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147050 |Target |
|SRT |T-D000A |Anatomical Structure |
|99SUP147 |S147052 |Extended Anatomical Structure |
|99SUP147 |S147056 |Artificial Structure |
|99SUP147 |S147057 |Geometrical Combination |
|99SUP147 |S147058 |Dosimetric Optimization Structure |
CID SUP147003 Radiotherapy Segment Categories
Context ID SUP147003
Radiotherapy Segment Categories
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|INCLUDE CID SUP147002 Prescription Anatomy Categories |
|99SUP147 |S147053 |RT Geometrical Information |
|99SUP147 |S147054 |Fixation or Positioning Device |
|99SUP147 |S147055 |Internal Brachytherapy Device |
CID SUP147004 Radiotherapy Targets
Context ID SUP147004
Radiotherapy Targets
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147070 |CTV Nodal |
|99SUP147 |S147071 |CTV Primary |
|99SUP147 |S147072 |CTV |
|99SUP147 |S147073 |GTV Nodal |
|99SUP147 |S147074 |GTV Primary |
|99SUP147 |S147075 |GTV |
|99SUP147 |S147076 |PTV Nodal |
|99SUP147 |S147077 |PTV Primary |
|99SUP147 |S147078 |PTV |
|99SUP147 |S147079 |ITV |
|99SUP147 |S147080 |PRV |
|99SUP147 |S147081 |Avoidance |
|99SUP147 |S147082 |Treated Volume |
|99SUP147 |S147083 |Irradiated Volume |
|99SUP147 |S147084 |Body |
CID SUP147005 RT Geometric Information
Context ID SUP147005
RT Geometric Information
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147100 |Patient Setup Point |
|99SUP147 |S147101 |Patient Laser Setup Point |
|99SUP147 |S147102 |Moveable Laser Setup Point |
|99SUP147 |S147103 |Patient Position Verification Point |
|99SUP147 |S147104 |Reference Acquisition Point |
|99SUP147 |S147105 |Virtual Simulation Isocenter |
|99SUP147 |S147106 |Planning Treatment Point |
|99SUP147 |S147107 |Treatment Point |
|99SUP147 |S147108 |Planning Target Point |
|99SUP147 |S147109 |Target Point |
|99SUP147 |S147110 |External Marker |
|99SUP147 |S147111 |Internal Marker |
CID SUP147006 Fixation or Positioning Devices
Context ID SUP147006
Fixation or Positioning Devices
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|Include CID SUP147022 Fixation Device Type Identifiers |
|Include CID SUP147025 RT Patient Support Devices |
CID SUP147007 Brachytherapy Devices
Context ID SUP147007
Brachytherapy Devices
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147130 |Brachytherapy accessory device |
|99SUP147 |S147131 |Brachytherapy source applicator |
|99SUP147 |S147132 |Brachytherapy channel shield |
|99SUP147 |S147133 |Brachytherapy channel |
CID SUP147009 Segmentation Combination
Context ID SUP147009
Segmentation Combination
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147145 |Combination |
CID SUP147010 Beam Limiting Device Types
Context ID SUP147010
Beam Limiting Device Types
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147170 |X Jaw |
|99SUP147 |S147171 |Y Jaw |
|99SUP147 |S147172 |X Leaves |
|99SUP147 |S147173 |Y Leaves |
|99SUP147 |S147174 |Variable Circular Collimator |
|INCLUDE CID SUP147027 FIXED BEAM LIMITING DEVICE TYPES |
CID SUP147011 Radiotherapy Robotic Paths
Context ID SUP147011
Radiotherapy Robotic Paths
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147200 |One Path Head |
|99SUP147 |S147201 |One Path Body |
|99SUP147 |S147202 |Even Paths Head |
|99SUP147 |S147203 |Even Paths Body |
|99SUP147 |S147204 |Short Paths Head |
|99SUP147 |S147205 |Short Path Body |
|99SUP147 |S147206 |Prostate |
|99SUP147 |S147207 |Prostate Short |
|99SUP147 |S147208 |Trigeminal |
CID SUP147012 General External Radiotherapy Procedure Techniques
Context ID SUP147012
General External Radiotherapy Procedure Techniques
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147221 |Static Beam |
|99SUP147 |S147225 |Arc Beam |
|99SUP147 |S147226 |Conformal Arc Beam |
|99SUP147 |S147227 |Step and Shoot Beam |
|99SUP147 |S147228 |Sliding Window Beam |
|99SUP147 |S147229 |VMAT |
|99SUP147 |S147230 |Arc and Static Hybrid |
CID SUP147013 Tomotherapeutic Radiotherapy Procedure Techniques
Context ID SUP147013
Tomotherapeutic Radiotherapy Procedure Techniques
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147240 |Helical Beam |
|99SUP147 |S147241 |Topographic Beam |
CID SUP147014 Treatment RT Radiation Set Alteration Types
Context ID SUP147014
Treatment RT Radiation Set Alteration Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147250 |Collimator Change |
|99SUP147 |S147251 |Gantry Change |
|99SUP147 |S147252 |Gantry Pitch Change |
|99SUP147 |S147253 |MLC Change |
|99SUP147 |S147254 |Wedge Change |
|99SUP147 |S147255 |Accessory Holder Change |
|99SUP147 |S147256 |Block Change |
|99SUP147 |S147257 |Compensator Change |
|99SUP147 |S147258 |Other Beam Modifier Change |
|99SUP147 |S147259 |Meterset Change |
CID SUP147015 Treatment Termination Reasons
Context ID SUP147015
Treatment Termination Reasons
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147260 |Patient Morbidity |
|99SUP147 |S147261 |Patient Mortality |
|99SUP147 |S147262 |General Machine Interlock |
|99SUP147 |S147263 |Patient Support Interlock |
|99SUP147 |S147264 |Patient Choice |
CID SUP147016 Compensator Device Types
Context ID SUP147016
Compensator Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147270 |Standard Compensator |
CID SUP147017 Radiotherapy Treatment Machine Modes
Context ID SUP147017
Radiotherapy Treatment Machine Modes
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147280 |Normal |
|99SUP147 |S147281 |Total Body Irradiation |
|99SUP147 |S147282 |High Dose Rate |
CID SUP147018 Pre-Treatment RT Radiation Set Roles
Context ID SUP147018
Pre-Treatment RT Radiation Set Roles
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147290 |Dosimetric |
|99SUP147 |S147291 |Simulation on a Simulator Device |
|99SUP147 |S147292 |Virtual Simulation |
|99SUP147 |S147293 |Rejected Alternates |
|99SUP147 |S147294 |Plan QA |
|99SUP147 |S147295 |Simulation on a Treatment Device |
CID SUP147020 Instance Reference Purposes
Context ID SUP147020
Instance Reference Purposes
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147820 |Treatment Session Record of Delivered Radiation |
|99SUP147 |S147821 |Historical Prescription |
|99SUP147 |S147822 |Current Prescription |
|99SUP147 |S147823 |Volumetric Dose for Radiation Set |
|99SUP147 |S147824 |Volumetric Dose for Radiation |
|99SUP147 |S147825 |Volumetric Dose for Radiation Record |
|99SUP147 |S147826 |Dose Volume Histogram |
|99SUP147 |S147827 |Dose Sample |
|99SUP147 |S147828 |Segmentation Properties used in Planning |
|99SUP147 |S147829 |Segmentation Properties created during Treatment |
|99SUP147 |S147830 |Image used for Treatment Planning |
|99SUP147 |S147831 |Image Acquired during Treatment |
|99SUP147 |S147832 |Image used as Reference Image for Treatment |
|99SUP147 |S147833 |Registration used in Planning |
|99SUP147 |S147834 |Registration created during Treatment |
|99SUP147 |S147835 |Presentation during Planning |
|99SUP147 |S147836 |Presentation during Treatment |
|99SUP147 |S147837 |Key Object Selection during Planning |
|99SUP147 |S147838 |Images created during Planning |
CID SUP147021 Patient Setup Techniques
Context ID SUP147021
Patient Setup Techniques
Type: Extensible Version: yyyymmdd
|Coding Scheme Designator |Code Value |Code Meaning |
|(0008,0102) |(0008,0100) |(0008,0104) |
|99SUP147 |S147330 |Isocentric |
|99SUP147 |S147331 |Fixed SSD |
|99SUP147 |S147332 |Fixed Midline Distance |
CID SUP147022 Fixation Device Types
Context ID SUP147022
Fixation Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme Designator |Code Value |Code Meaning |
|(0008,0102) |(0008,0100) |(0008,0104) |
|99SUP147 |S147340 |Biteblock |
|99SUP147 |S147341 |Headframe |
|99SUP147 |S147342 |Head Mask |
|99SUP147 |S147343 |Head and Neck Mask |
|99SUP147 |S147344 |Mold |
|99SUP147 |S147345 |Cast |
|99SUP147 |S147346 |Headrest |
|99SUP147 |S147347 |Breast Board |
|99SUP147 |S147348 |Body Frame |
|99SUP147 |S147349 |Vacuum Mold |
|99SUP147 |S147350 |Whole Body Pod |
|99SUP147 |S147351 |Rectal Balloon |
|99SUP147 |S147352 |Head Ring |
CID SUP147023 Shielding Device Types
Context ID SUP147023
Shielding Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147380 |Gum Shielding |
|99SUP147 |S147381 |Eye Shielding |
|99SUP147 |S147382 |Gonad Shielding |
CID SUP147024 Setup Devices
Context ID SUP147024
Setup Devices
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147400 |Laser Pointer |
|99SUP147 |S147401 |Distance Meter |
|99SUP147 |S147402 |Table Height |
|99SUP147 |S147403 |Mechanical Pointer |
|99SUP147 |S147404 |Arc |
CID SUP147025 RT Patient Support Devices
Context ID SUP 147025
RT Patient Support Devices
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|SRT |A-17350 |Table |
|99SUP147 |S147411 |Chair |
CID SUP147026 Dose Statistics
Context ID SUP 147026
Dose Statistics
Type: Extensible Version: yyyymmdd
|Coding Scheme Designator|Code Value |Code Meaning |
|(0008,0102) |(0008,0100) |(0008,0104) |
|99SUP147 |S147420 |Maximum Dose |
|99SUP147 |S147421 |Minimum Dose |
|99SUP147 |S147422 |Median Dose |
|99SUP147 |S147423 |Mean Dose |
|99SUP147 |S147424 |Dose Standard Deviation |
CID SUP147027 Fixed Beam Limiting Device Types
Context ID SUP147027
Fixed Beam Limiting Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147431 |Electron Fixed Aperture |
|99SUP147 |S147432 |Photon Fixed Aperture |
|99SUP147 |S147433 |Intraoperative Aperture |
|99SUP147 |S147470 |Shielding Block |
|99SUP147 |S147471 |Aperture Block |
CID SUP147028 Radiotherapy Wedge Types
Context ID SUP147028
Radiotherapy Wedge Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147440 |Hard Wedge |
|99SUP147 |S147441 |Motorized Wedge |
|99SUP147 |S147442 |Dynamic Wedge |
CID SUP147030 General Accessory Device Types
Context ID SUP147030
General Accessory Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147451 |Graticule |
|99SUP147 |S147452 |Reticule |
|99SUP147 |S147453 |Image Detector |
|99SUP147 |S147454 |Film Holder |
|99SUP147 |S147455 |Winston-Lutz Pointer |
|99SUP147 |S147456 |Bowtie Filter |
CID SUP147031 Radiotherapy Bolus Device Types
Context ID SUP147031
Radiotherapy Bolus Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147460 |Bolus |
CID SUP147032 Radiotherapy Block Device Types
Context ID SUP147032
Radiotherapy Block Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147470 |Shielding Block |
|99SUP147 |S147471 |Aperture Block |
CID SUP147033 Radiotherapy Accessory Holder Device Types
Context ID SUP147033
Radiotherapy Accessory Holder Device Types
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147480 |Tray |
|99SUP147 |S147481 |Applicator |
CID SUP147034 Radiotherapy Dose Real World Units
Context ID SUP147034
Radiotherapy Dose Real World Units
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|UCUM |Gy |Gray |
CID SUP147036 Purpose of Referenced Dose Calculation Annotation Object
Context ID SUP147036
Purpose of Referenced Dose Calculation Annotation Object
Type: Extensible Version: yyyymmdd
|Coding Scheme Designator |Code Value |Code Meaning |
|(0008,0102) |(0008,0100) |(0008,0104) |
|99SUP147 |S147750 |Annotating Documents for the Calculated Dose |
CID SUP147035 Effective Dose Method Code Definition
Context ID SUP147035
Effective Dose Method Definition
Type: Extensible Version: yyyymmdd
|Coding Scheme Designator |Code Value |Code Meaning |
|(0008,0102) |(0008,0100) |(0008,0104) |
|99SUP147 |S147580 |LET-based method. |
|99SUP147 |S147581 |Fractionation-based or temporally-based method |
CID SUP147037 Dose Data Source Measurement Definition
Context ID SUP147037
Dose Data Source Measurement Definition
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147530 |Film |
|99SUP147 |S147531 |3D Gel |
|99SUP147 |S147532 |Diode Array |
|99SUP147 |S147533 |Ion Chamber Array |
|99SUP147 |S147534 |TLD |
|99SUP147 |S147535 |Diode |
|99SUP147 |S147536 |Liquid Ion Chamber |
|99SUP147 |S147537 |MOSFET |
|99SUP147 |S147538 |OSLD |
|99SUP147 |S147539 |Ion Chamber |
|99SUP147 |S147540 |EPID |
|99SUP147 |S147541 |Diamond Detector |
CID SUP147039 Dose Histogram Spatial Unit Definition
Context ID SUP147039
Dose Histogram Spatial Unit Definition
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|UCUM |cm2 |Square centimeter |
|UCUM |cm3 |Cubic centimeter |
|99SUP147 |S147600 |Cubic centimeter PER_U {cm3_PER_U} |
|UCUM |% |Percent |
Note: The unit PER_U is defined in: Anderson, LL: “A “natural” volume-dose histogram for brachytherapy”, Medical Physics 13(6) pp 898-903, 1986.
CID SUP147040 Segmented RT Accessory Devices
Context ID SUP147040
Segmented RT Accessory Devices
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|Include CID SUP147022 Fixation Device Types |
|Include CID SUP147007 Brachytherapy Devices |
|Include CID SUP147025 RT Patient Support Devices |
|Include CID SUP147031 Radiotherapy Bolus Device Types |
|Include CID SUP147032 Radiotherapy Block Device Types |
CID SUP147041 Dose Algorithm Class
Context ID SUP147041
Dose algorithm class
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147700 |Mixed |
|99SUP147 |S147701 |Other |
|99SUP147 |S147702 |Monte Carlo |
|99SUP147 |S147703 |Convolution |
|99SUP147 |S147704 |Superposition |
|99SUP147 |S147705 |Pencil Beam |
|99SUP147 |S147706 |Transport Equation |
|99SUP147 |S147707 |Measurement-based |
|99SUP147 |S147708 |Clarkson |
CID SUP147042 Energy Unit
Context ID SUP147042
Energy Unit
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|UCUM |MV |Mega-volt |
|UCUM |MeV |Mega-electronvolt |
|UCUM |kV |Kilo-volt |
CID SUP147043 RT Item States
Context ID SUP147043
RT Item States
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147650 |Created |
|99SUP147 |S147651 |Reviewed |
|99SUP147 |S147652 |Approved |
|99SUP147 |S147653 |Rejected |
|99SUP147 |S147654 |Demoted |
CID SUP147044 RT Operation States
Context ID SUP147044
RT Operation States
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147680 |New |
|99SUP147 |S147681 |In Preparation |
|99SUP147 |S147682 |Ready |
|99SUP147 |S147683 |In Progress |
|99SUP147 |S147685 |Suspended |
|99SUP147 |S147686 |Discontinued |
|99SUP147 |S147687 |Completed |
CID SUP147045 Multi-Source Radiation Technique
Context ID SUP147045
Multi-Source Radiation Technique
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147900 |Multiple Fixed Sources |
CID SUP147046 Robotic Radiation Technique
Context ID SUP147046
Robotic Radiation Technique
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147910 |Synchrony |
|99SUP147 |S147911 |Non-Synchrony |
CID SUP147047 Radiotherapy Procedure Techniques
Context ID SUP147047
Radiotherapy Procedure Techniques
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|Include CID SUP147012 General External Radiotherapy Procedure Techniques |
|Include CID SUP147013 Tomotherapeutic Radiotherapy Procedure Techniques |
|Include CID SUP147045 Multiple Fixed Sources Procedure Techniques |
|Include CID SUP147046 Robotic Procedure Techniques |
CID SUP147048 Revised value
Context ID SUP147048
Revised value
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147710 |Revised Value |
CID SUP147049 Radiotherapy General Workitem Definition
Context ID SUP147049
Radiotherapy General Workitem Definition
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |121731 |RT Prescription |
|99SUP147 |121732 |RT Simulation |
|99SUP147 |121733 |RT Forward Planning |
|99SUP147 |121734 |RT Inverse Planning |
|99SUP147 |121735 |RT Dose Computation |
|99SUP147 |121736 |RT Plan Review |
|99SUP147 |121737 |RT Delivery Review |
CID SUP147050 Beam Mode Type Definition
Context ID SUP147050
Beam Mode Type Definition
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147560 |Flattening Filter Beam |
|99SUP147 |S147561 |No Flattening Filter Beam |
|99SUP147 |S147562 |Partial Flattening Filter Beam |
CID SUP147051 Delivery Rate Unit Definition
Context ID SUP147051
Delivery Rate Unit Definition
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|UCUM |Gy/s |Gray / Second |
|99SUP147 |S147571 |MU / Second |
|99SUP147 |S147572 |Particles / Second |
|UCUM |[arb'U] |arbitrary unit |
CID SUP147052 Radiation Particle
Context ID SUP147052
Radiation Particle
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147950 |Photon |
|99SUP147 |S147951 |Electron |
|99SUP147 |S147952 |Proton |
|99SUP147 |S147953 |Carbon nucleus |
|99SUP147 |S147954 |Neutron |
CID SUP147053 Regulatory Device Identifier Type
Context ID SUP147053
Regulatory Device Identifier Type
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147590 |FDA Unique Device Identifier (UDI) |
CID SUP147054 Treatment Delvery Device Type
Context ID SUP147054
Treatment Delivery Device Type
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147890 |Radiotherapy Treatment Device |
CID SUP147055 Dosimeter Unit Definition
Context ID SUP147055
Dosimeter Unit Definition
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |MU |Monitor Units |
|99SUP147 |NP |Number of Particles |
|UCUM |s |Second |
|UCUM |Bq.s |Bequerel Second |
|UCUM |[arb'U] |arbitrary unit |
CID SUP147060 Single Dose-related Dosimetric Objectives
Context ID SUP147060
Single Dose-related Dosimetric Objectives
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147001 |Minimum Surface Dose |
|99SUP147 |S147002 |Maximum Surface Dose |
|99SUP147 |S147003 |Minimum Dose |
|99SUP147 |S147004 |Maximum Dose |
|99SUP147 |S147005 |Minimum Mean Dose |
|99SUP147 |S147006 |Maximum Mean Dose |
|99SUP147 |S147007 |Minimum Equivalent Uniform Dose |
|99SUP147 |S147008 |Maximum Equivalent Uniform Dose |
|99SUP147 |S147009 |Prescription Dose |
CID SUP147061 Percentage and Dose-related Dosimetric Objectives
Context ID SUP147061
Percentage and Dose-related Dosimetric Objectives
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147014 |Minimum Percent Volume at Dose |
|99SUP147 |S147015 |Maximum Percent Volume at Dose |
CID SUP147062 Volume and Dose-related Dosimetric Objectives
Context ID SUP147062
Volume and Dose-related Dosimetric Objectives
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147016 |Minimum Absolute Volume at Dose |
|99SUP147 |S147017 |Maximum Absolute Volume at Dose |
CID SUP147063 Dimensionless and Dose-related Dosimetric Objectives
Context ID SUP147063
Dimensionless and Dose-related Dosimetric Objectives
Type: Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147010 |Minimum Conformity Index (see Note 1) |
|99SUP147 |S147011 |Minimum Healthy Tissue Conformity Index (see Note 1) |
|99SUP147 |S147012 |Minimum Conformation Number (see Note 1) |
|99SUP147 |S147013 |Maximum Homogeneity Index (see Note 1) |
Note 1: These following dosimetric indices are defined by reference to Feuvret et al, (IJROBP 64(2):333-342, 2006):
|Dosimeter Index |Description in Feuvret et al, page 335 |
|Minimum Conformity Index |Conformity IndexRTOG |
|Minimum Healthy Tissue Conformity Index |Healthy Tissue Conformity Index |
|Minimum Conformation Number |Conformation Number (CN) |
|Maximum Homogeneity Index |Homogeneity Index |
CID SUP147064 Coded Dosimetric Objectives
Context ID SUP147064
Coded Dosimetric Objectives
Type: Non-Extensible Version: yyyymmdd
|Coding Scheme |Code Value |Code Meaning |
|Designator |(0008,0100) |(0008,0104) |
|(0008,0102) | | |
|99SUP147 |S147018 |Minimize MeterSet |
Rename the following definitions of existing CIDs of PS3.16, Annex B:
CID 9241 RADIOTHERAPY GENERAL Radiotherapy Treatment Workitem Definition
Context ID 9241
Radiotherapy General Treatment Workitem Definition
Correct cases of the following definitions of existing CIDs of PS3.16, Annex B:
CID 9242 RADIOTHERAPY ACQUISITION Radiotherapy Acquisition Workitem Definition
CID 9243 RADIOTHERAPY REGISTRATION Radiotherapy Registration Workitem Definition
Add the following workitem codes to CID 9231 of PS3.16, Annex C:
Annex C Acquisition and Protocol Context Templates (Normative)
TID SUP147001 RT Prescription Annotation
TID SUP147001
RT Prescription Annotation
Type: Extensible Order: Non-Significant
| |Value Type |Concept Name |VM |Req Type |Condition |Value Set Constraint |
|1 |TEXT |EV (S147030, 99SUP147, |1 |U | | |
| | |“Radiation Description”) | | | | |
|2 |TEXT |EV (S147031, 99SUP147, “Beam |1 |U | | |
| | |Shaping Means”) | | | | |
|3 |TEXT |EV (S147032, 99SUP147, |1 |U | | |
| | |“Planning Advice Note”) | | | | |
|4 |TEXT |EV (S147033, 99SUP147, |1 |U | | |
| | |“Special Procedure Note”) | | | | |
|5 |TEXT |EV (S147034, 99SUP147, |1 |U | | |
| | |“Patient Positioning Note”) | | | | |
|6 |TEXT |EV (S147035, 99SUP147, |1 |U | | |
| | |“Motion Compensation Note”) | | | | |
|7 |TEXT |EV (S147036, 99SUP147, |1 |U | | |
| | |“Patient Setup Note”) | | | | |
|8 |TEXT |EV (S147037, 99SUP147, |1 |U | | |
| | |“Previous Radiation Note”) | | | | |
|9 |TEXT |EV (S147038, 99SUP147, |1 |U | | |
| | |“Planning Imaging Note”) | | | | |
|10 |TEXT |EV (S147039, 99SUP147, |1 |U | | |
| | |“Delivery Verification Note”)| | | | |
|11 |TEXT |EV (S147040, 99SUP147, |1 |U | | |
| | |“Simulation Notes”) | | | | |
|12 |CODE |DT (S147041, 99SUP147, |1-n |U | |BCID (SUP147052) Radiation |
| | |“Radiation Type”) | | | |Particle |
|13 |NUMERIC |DT (S147042, 99SUP147, |1-n |U | |UNITS=DCID (SUP147042) |
| | |“Radiation Energy”) | | | |Energy Unit |
|14 |CODE |DT (S147034, 99SUP147, |1-n |U | |BCID (9242) Radiotherapy |
| | |“Positioning Procedures”) | | | |Acquisition Workitem |
| | | | | | |Definition |
Add the following templates to PS3.16, Annex A:
TID SUP147003 RT Segment Annotation Properties
TID SUP147003
RT Segment Annotation Properties
Type: Extensible Order: Non-Significant
| |NL |Value Type |Concept Name |VM |Req |Condition |Value Set |
| | | | | |Type | |Constraint |
|1 | |NUMERIC |EV (S147150, 99SUP147, |1 |U | |Units = EV (%, |
| | | |“Relative Mass Density”) | | | |UCUM, "Percent") |
|2 | |NUMERIC |EV (S147151, 99SUP147, |1 |U | |Units = EV (ratio,|
| | | |"Relative Electron | | | |UCUM, "ratio") |
| | | |Density") | | | | |
|3 | |NUMERIC |EV (S147152, 99SUP147, |1 |U | |Units = EV (1, |
| | | |"Effective Z") | | | |UCUM, "no units") |
|4 | |NUMERIC |EV (S147153, 99SUP147, |1 |U | |Units = EV (ratio,|
| | | |"Effective Z per A") | | | |UCUM, "ratio") |
|5 | |NUMERIC |EV (S147154, 99SUP147, |1 |U | |Units = EV (ratio,|
| | | |"Relative Stop Ratio") | | | |UCUM, "ratio") |
|6 | |NUMERIC |EV (S147156, 99SUP147, |1 |U | |Units = EV (ratio,|
| | | |"Linear Cell Kill Factor") | | | |UCUM, "ratio") |
|7 | |NUMERIC |EV (S147157, 99SUP147, |1 |U | |Units = EV (ratio,|
| | | |"Quadratic Cell Kill | | | |UCUM, "ratio") |
| | | |Factor") | | | | |
|8 | |NUMERIC |EV (S147158, 99SUP147, |1 |U | |Units = EV (ratio,|
| | | |"High Dose Fraction Linear | | | |UCUM, "ratio") |
| | | |Cell Kill Factor") | | | | |
|9 | |NUMERIC |EV (S147159, 99SUP147, |1 |U | |Units = EV (s, |
| | | |"Half-time for Tissue | | | |UCUM, "second") |
| | | |Repair ") | | | | |
|10 | |NUMERIC |EV (S147160, 99SUP147, |1 |U | |Units = EV (Gy, |
| | | |"High Dose Fraction | | | |UCUM, "Gray") |
| | | |Transition Dose") | | | | |
|11 | |NUMERIC |EV (S147161, 99SUP147, * |1-n |U | |Units = EV (1, |
| | | |Elemental Composition | | | |UCUM, "no units") |
| | | |Atomic Number ”) | | | | |
TID SUP147004 Patient Support Position Parameters
TID SUP147004
Patient Support Position Parameters
Type: Extensible Order: Non-Significant
| |Value Type |Concept Name |VM |Req |Condition |Value Set |
| | | | |Type | |Constraint |
|1 |NUMERIC |EV (S147300, 99SUP147, "IEC|1 |U | |Units = EV (deg, |
| | |Table Top Continuous Pitch | | | |UCUM, "º") |
| | |Angle ") | | | | |
|2 |NUMERIC |EV (S147301, 99SUP147, "IEC|1 |U | |Units = EV (deg, |
| | |Table Top Continuous Roll | | | |UCUM, "º") |
| | |Angle ") | | | | |
|3 |NUMERIC |EV (S147302, 99SUP147, "IEC|1 |U | |Units = EV (deg, |
| | |Patient Support Continuous | | | |UCUM, "º") |
| | |Angle ") | | | | |
|4 |NUMERIC |EV (S147303, 99SUP147, "IEC|1 |U | |Units = EV (mm, |
| | |Table Top Eccentric Axis | | | |UCUM, "mm") |
| | |Distance") | | | | |
|5 |NUMERIC |EV (S147304, 99SUP147, "IEC|1 |U | |Units = EV (deg, |
| | |Table Top Continuous | | | |UCUM, "º") |
| | |Eccentric Angle ") | | | | |
|6 |NUMERIC |EV (S147305, 99SUP147, "IEC|1 |U | |Units = EV (mm, |
| | |Table Top Lateral Position | | | |UCUM, "mm") |
| | |") | | | | |
|7 |NUMERIC |EV (S147306, 99SUP147, "IEC|1 |U | |Units = EV (mm, |
| | |Table Top Longitudinal | | | |UCUM, "mm") |
| | |Position ") | | | | |
|8 |NUMERIC |EV (S147307, 99SUP147, "IEC|1 |U | |Units = EV (mm, |
| | |Table Top Vertical Position| | | |UCUM, "mm") |
| | |") | | | | |
Add the following to the table in PS3.16, Annex D:
Annex D Dicom controlled terminology definitions (normative)
|Code Value |Code Meaning |Definition |Notes |
|121731 |Prescription |Determination of the patient prescription for a course | |
| | |of treatment. | |
|121732 |RT Simulation |Patient localization and (virtual) placement of external| |
| | |beam radiation therapy beams or brachytherapy sources. | |
|121733 |RT Forward Planning |The process of optimizing the dose distribution by | |
| | |manually varying beam angles, intensities and other | |
| | |properties. | |
|121734 |RT Inverse Planning |The process of optimizing the dose distribution by | |
| | |automatically varying beam angles, intensities and other| |
| | |properties, such that the resulting dose distribution | |
| | |approaches or exceeds the requirements of a specified | |
| | |set of dose constraints. | |
|121735 |RT Dose Computation |Calculation of the dose distribution based on a | |
| | |specified anatomy, beam geometry and beam or source | |
| | |fluence distribution. | |
|121736 |RT Plan Review |Human review of a treatment plan prior to plan approval | |
| | |for treatment. | |
|121737 |RT Delivery Review |Human review of one or more treatment deliveries in | |
| | |conjunction with the treatment plan. | |
|110014 |Registration |General Image registration work item, used to request an| |
| | |image registration through Unified Worklist and | |
| | |Procedure Step Protocol | |
|110015 |Segmentation |General Image segmentation work item, used to request an| |
| | |segmentation through Unified Worklist and Procedure Step| |
| | |Protocol | |
|S147001 |Minimum Surface Dose |The objective is a desired or constrained minimum dose | |
| | |(parameter 1) to the surface of the volume | |
|S147002 |Maximum Surface Dose |The objective is a desired or constrained maximum dose | |
| | |(parameter 1) to the surface of the volume | |
|S147003 |Minimum Dose |The objective is a desired or constrained minimum dose | |
| | |(parameter 1) to the volume | |
|S147004 |Maximum Dose |The objective is a desired or constrained maximum dose | |
| | |(parameter 1) to the volume | |
|S147005 |Minimum Mean Dose |The objective is a desired or constrained minimum mean | |
| | |dose (parameter 1) to the volume | |
|S147006 |Maximum Mean Dose |The objective is a desired or constrained maximum mean | |
| | |dose (parameter 1) to the volume | |
|S147007 |Minimum Equivalent Uniform Dose |The objective is a desired or constrained minimum EUD | |
| | |(parameter 1) to the volume | |
|S147008 |Maximum Equivalent Uniform Dose |The objective is a desired or constrained maximum EUD | |
| | |(parameter 1) to the volume | |
|S147009 |Prescription Dose |The objective is a desired or constrained nominal | |
| | |prescription dose (parameter 1) | |
|S147010 |Minimum Conformity Index |The objective is a minimum Conformity Index (parameter | |
| | |1) for a reference dose (parameter 2) | |
|S147011 |Minimum Healthy Tissue Conformity |The objective is a minimum Healthy Tissue Conformity | |
| |Index |Index (parameter 1) for a reference dose (parameter 2) | |
|S147012 |Minimum Conformation Number |The objective is a minimum Conformation Number | |
| | |(parameter 1) for a reference dose (parameter 2) | |
|S147013 |Maximum Homogeneity Index |The objective is a maximum Homogeneity Index (parameter | |
| | |1) for a reference dose (parameter 2) | |
|S147014 |Minimum Percent Volume at Dose |The objective is a desired or constrained minimum | |
| | |percent (parameter 1) of a volume with dose greater than| |
| | |or equal to a specified value (parameter 2) | |
|S147015 |Maximum Percent Volume at Dose |The objective is a desired or constrained maximum | |
| | |percent (parameter 1) of a volume with dose greater than| |
| | |or equal to a specified value (parameter 2) | |
|S147016 |Minimum Absolute Volume at Dose |The objective is a desired or constrained minimum | |
| | |absolute measure (parameter 1) of a volume with dose | |
| | |greater than or equal to a specified value (parameter 2)| |
|S147017 |Maximum Absolute Volume at Dose |The objective is a desired or constrained maximum | |
| | |absolute measure (parameter 1) of a volume with dose | |
| | |greater than or equal to a specified value (parameter 2)| |
|S147018 |Minimize MeterSet |The objective is to minimize the total meterset required| |
| | |to deliver the radiation set | |
| |
|S147025 |Dose Parameter |A value (in Gy) used as a Dosimetric Objective | |
|S147026 |Volume Parameter |A value (in cm3) used as a Dosimetric Objective | |
|S147027 |Percent Parameter |A value (in %) used as a Dosimetric Objective | |
|S147028 |Numeric Parameter |A value (dimensionless) used as a Dosimetric Objective | |
|S147030 |Radiation Description |General description of radiation | |
|S147031 |Beam Shaping Means |Description of the devices and techniques used to shape | |
| | |the radiation beam | |
|S147032 |Planning Advice Note |Advice for the planning process | |
|S147033 |Special Procedure Note |Notes on special procedures | |
|S147034 |Patient Positioning Note |Notes on patient positioning | |
|S147035 |Motion Compensation Note |Notes on motion compensation | |
|S147036 |Patient Setup Note |Notes on patient setup | |
|S147037 |Previous Radiation Note |Notes on any previous radiation | |
|S147038 |Planning Imaging Note |Notes on imaging obtained or required for planning | |
|S147039 |Delivery Verification Note |Notes on how delivery is to be verified | |
|S147040 |Simulation Notes |Notes on simluation procedures | |
|S147041 |Radiation Type |The type of Radiation intended to be used for the | |
| | |Radiotherapy Treatment | |
|S147042 |Radiation Energy |The Energy of Radiation intended to be used for the | |
| | |Radiotherapy Treatment | |
|S147043 |Positioning Procedures |The intended Positioning Procedures to be used at the | |
| | |time of Treatment Position Verification. | |
|S147050 |Target |Volume containing tissues to be irradiated to a | |
| | |specified dose, typically encompassing a tumor, and | |
| | |possibly including surrounding subclinical disease, and | |
| | |margin(s) to account for uncertainties in patient | |
| | |positioning, organ motion, and dose delivery. | |
|S147052 |Extended Anatomical Structure |Extension of an anatomical structure to include a | |
| | |surrounding margin, used in radiotherapy treatment | |
| | |planning to specify limits on doses to sensitive | |
| | |tissues, i.e planning risk volume. | |
|S147053 |Geometrical Information |Points or volumes used to locate spatial references, | |
| | |e.g., treatment or imaging device isocenter or fiducial | |
| | |markers. | |
|S147054 |Fixation or Positioning Device |Device used to reproducibly position or limit the motion| |
| | |of a patient or portion of a patient during treatment | |
|S147055 |Internal Brachytherapy Device |Device used to position radioactive sources to deliver | |
| | |radiation treatment interstitially or within a body | |
| | |cavity. | |
|S147056 |Artificial Structure |Artificial element inside the body, such as pace maker, | |
| | |prosthesis … | |
|S147057 |Geometrical Combination |A geometric combination of segments with heterogeneous | |
| | |properties. | |
|S147070 |CTV Nodal |Clinical Target Volume encompassing involved lymph | |
| | |node(s), with margin to include surrounding sub-clinical| |
| | |disease | |
|S147071 |CTV Primary |Clinical Target Volume encompassing (primary) tumor(s), | |
| | |with margin to include surrounding sub-clinical disease | |
|S147072 |CTV |Clinical Target Volume with margin to include | |
| | |surrounding sub-clinical disease | |
|S147073 |GTV Nodal |Gross Tumor Volume encompassing diseased lymph nodes | |
|S147074 |GTV Primary |Gross Tumor Volume encompassing (primary) tumor(s) | |
|S147075 |GTV |Gross Tumor Volume | |
|S147076 |PTV Nodal |Planning Target Volume encompassing a Nodal CTV, with | |
| | |margin to include surrounding sub-clinical disease and | |
| | |to account for uncertainty in patient positioning and | |
| | |organ motion | |
|S147077 |PTV Primary |Planning Target Volume encompassing a Primary CTV with | |
| | |margin to include surrounding sub-clinical disease and | |
| | |to account for uncertainty in patient positioning and | |
| | |organ motion | |
|S147078 |PTV |Planning Target Volume with margin to include | |
| | |surrounding sub-clinical disease and to account for | |
| | |uncertainty in patient positioning and organ motion | |
|S147079 |ITV |Internal Target Volume, used to account for internal | |
| | |motion of a Clinical Target Volume, often delineated | |
| | |using a composite of multiple images, e.g., acquired | |
| | |over a breathing cycle, cardiac cycle, etc. | |
|S147080 |PRV |Volume used in treatment planning for specifying limits | |
| | |on dose to be delivered. | |
|S147081 |Avoidance |Volume enclosed by an isodose surface appropriate to | |
| | |achieve the purpose of treatment (e.g., tumor | |
| | |eradication or palliation) | |
|S147082 |Treated Volume |Volume receiving radiation dose that is considered | |
| | |significant in relation to normal tissue tolerance | |
|S147083 |Irradiated Volume |Volume encompassing the patient’s external body surface | |
|S147084 |Body |Clinical Target Volume encompassing involved lymph | |
| | |node(s), with margin to include surrounding sub-clinical| |
| | |disease | |
|S147100 |Patient Setup Point |Point at which initial manual patient setup is | |
| | |performed. | |
|S147101 |Patient Laser Setup Point |A fixed point at which initial patient setup is | |
| | |performed based on room lasers. | |
|S147102 |Moveable Laser Setup Point |A movable point at which initial patient setup is | |
| | |performed based on room lasers. | |
|S147103 |Patient Position Verification |Point at which verification of patient position is | |
| |Point |performed | |
|S147104 |Reference Acquisition Point |Point at which patient position verification references | |
| | |are acquired. | |
|S147105 |Virtual Simulation Isocenter |Isocenter point defined by a virtual simulator. | |
|S147106 |Planning Treatment Point |Point at which the patient is planned to be positioned | |
| | |for treatment. | |
|S147107 |Treatment Point |Point at which the patient is positioned during | |
| | |treatment. | |
|S147108 |Planning Target Point |Point at which the center of the beam-line is planned to| |
| | |target. | |
|S147109 |Target Point |Point at which the center of the beam-line targets | |
| | |during treatment. | |
|S147110 |External Marker |External markers such as tattoos or adhesive metal | |
| | |spheres (‘BB’s) | |
|S147111 |Internal Marker |Internal markers such as fiducials or anatomical | |
| | |structures. | |
|S147130 |Brachytherapy accessory device |Accessory device used in brachytherapy treatment | |
| | |delivery | |
|S147131 |Brachytherapy source applicator |Source applicator used in brachytherapy treatment | |
| | |delivery | |
|S147132 |Brachytherapy channel shield |Channel shield used in brachytherapy treatment delivery | |
|S147133 |Brachytherapy channel |Accessory device used in brachytherapy treatment | |
| | |delivery | |
|S147150 |Relative Mass Density |Ratio of the mass density of a material relative to the | |
| | |mass density of water. | |
|S147151 |Relative Electron Density |Ratio of the electron density of a material relative to | |
| | |the electron density of water. | |
|S147152 |Effective Z |The average atomic number of a material. | |
|S147153 |Effective Z per A |Ratio of effective atomic number to mass (AMU-1) for a | |
| | |material. | |
|S147154 |Relative Linear Stopping Power |Ratio of the linear stopping power of a material to the | |
| | |linear stopping power of water. | |
|S147155 |Elemental Fraction |The fraction of the mass of one element to the total | |
| | |mass of the compound. | |
|S147156 |Linear Cell Kill Factor |Linear Cell Kill Factor (α) (Gy-1) | |
|S147157 |Quadratic Cell Kill Factor |Quadratic Cell Kill Factor (β) (Gy-1) | |
|S147158 |High Dose Fraction Linear Cell |High Dose Fraction Linear Cell Kill Factor (γ) (Gy-1) | |
| |Kill Factor | | |
|S147159 |Half-time for Tissue Repair |Half-time for Tissue Repair (Tr) (Hrs) | |
|S147160 |High Dose Fraction Transition Dose|High Dose Fraction Transition Dose (DT) (Gy) | |
|S147161 |Elemental Composition Atomic |The atomic number of the element. | |
| |Number |Any value of the atomic number shall only appear once in| |
| | |the sequence. | |
|S147162 |Elemental Composition Atomic Mass |The fractional weight of the element. | |
| |Fraction | | |
|S147170 |X Jaw |An adjustable jaw pair in the X direction | |
|S147171 |Y Jaw |An adjustable jaw pair in the Y direction | |
|S147172 |X Leaves |An adjustable multi-element jaw pair in X direction | |
|S147173 |Y Leaves |An adjustable multi-element jaw pair in Y direction | |
|S147174 |Variable Circular Collimator |A circular, aperture size adjustable beam limiting | |
| | |device. | |
|S147200 |One Path Head |The robotic path one path head | |
|S147201 |One Path Body |The robotic path one path body | |
|S147202 |Even Paths Head |The robotic path even paths head | |
|S147203 |Even Paths Body |The robotic path one path body | |
|S147204 |Short Paths Head |The robotic path short paths head | |
|S147205 |Short Path Body |The robotic path short path body | |
|S147206 |Prostate |The robotic path prostate | |
|S147207 |Prostate Short |The robotic path prostate short | |
|S147208 |Trigeminal |The robotic path trigeminal | |
|S147221 |Static Beam |Annotates a beam in which the beam field shape or | |
| | |position does not change during delivery. | |
|S147225 |Arc Beam |Annotates a beam that maintains a constant field shape | |
| | |while moving through a gantry arc. | |
|S147226 |Conformal Arc Beam |Annotates a beam that has a varying field shape as it | |
| | |moves through a gantry arc. | |
|S147227 |Step and Shoot Beam |Annotates a beam which does not change in field shape | |
| | |during delivery at each gantry position. The beam is | |
| | |turned off as the gantry is moved to its next position. | |
|S147228 |Sliding Window Beam |Annotates a beam which changes in field shape via a | |
| | |series of control points at each gantry position. The | |
| | |beam is turned off as the gantry is moved to its next | |
| | |position. | |
|S147229 |VMAT |Annotates a Volumetric intensity Modulated Arc Therapy | |
| | |beam, in which the MLC moves during delivery while the | |
| | |gantry speed and dose rate are also varied. | |
|S147230 |Arc and Static Hybrid |Annotates an intensity-modulated arc therapy beam in | |
| | |which one or more segments are delivered having a static| |
| | |gantry angle. | |
|S147240 |Helical Beam |Helical (spiral beam delivery), with continuous gantry | |
| | |rotation and simultaneous couch movement | |
|S147241 |Topographic Beam |Topographic (fixed angle) beam delivery, with fixed | |
| | |gantry angle during couch movement | |
|S147250 |Collimator Change |The plan has been modified by changes to the collimator | |
| | |angles for one or more of the beams | |
|S147251 |Gantry Change |The plan has been modified by changes to the collimator | |
| | |angles for one or more of the beams | |
|S147252 |Gantry Pitch Change |The plan has been modified by changes to the gantry | |
| | |pitch angles for one or more of the beams | |
|S147253 |MLC Change |The plan has been modified by changes to one or more of | |
| | |the MLC leaves for one or more of the beams | |
|S147254 |Wedge Change |The plan has been modified by using a different wedge | |
|S147255 |Applicator Change |The plan has been modified by using a different | |
| | |applicator | |
|S147256 |Block Change |The plan has been modified by using a different block | |
|S147257 |Compensator Change |The plan has been modified by using a different | |
| | |compensator | |
|S147258 |Other Beam Modifier Change |The plan has been modified by using a different beam | |
| | |modifier of any kind | |
|S147259 |Meterset Change |The plan has been modified setting a different meterset | |
| | |value of the specified unit. | |
|S147260 |Patient Morbidity |Patient unable to continue | |
|S147261 |Patient Mortality |Patient deceased | |
|S147262 |General Machine Interlock |Machine exception condition detected, stopping delivery | |
|S147263 |Patient Support Interlock |Patient support exception condition detected, stopping | |
| | |delivery | |
|S147264 |Patient Choice |Patient chose to discontinue treatment | |
|S147270 |Compensator |External beam compensator | |
|S147280 |Normal |’Normal’ radiation delivery (‘normal’ mode) | |
|S147281 |Total Body Irradiation |Total-body irradiation treatment mode | |
|S147282 |High Dose Rate |High dose rate treatment mode | |
|S147290 |Dosimetric |Annotates that a referenced RT Radiation Set included in| |
| | |a Meta Radiation Set was created to serve the purpose to| |
| | |calculate the dose delivered to the patient. This | |
| | |concept is especially useful when the final Treatment RT| |
| | |Radiation set has to be further altered to allow | |
| | |treatment. In this case, the treatment plan will not be | |
| | |associated with a 3.dimensional dose (although it may | |
| | |still contain single-valued dose information) | |
|S147291 |Simulation |Annotates that a referenced RT Radiation Set included in| |
| | |a Meta Radiation Set was used in simulate the patient | |
| | |treatment at a convention simulator device. | |
|S147292 |Virtual Simulation |Annotates that a referenced RT Radiation Set included in| |
| | |a Meta Radiation Set was used in determine information | |
| | |for the patient treatment during virtual simulation | |
| | |session at a CT scanner or similar (e.g. to determine | |
| | |the patient to treatment device transformation matrix or| |
| | |establish patient to device registration by external | |
| | |markers). | |
|S147293 |Rejected Alternates |Annotates that a referenced RT Radiation Set included in| |
| | |a Meta Radiation Set represents one of several | |
| | |alternatives for patient treatment, but was rejected in | |
| | |the course of clinical review. | |
|S147294 |Plan QA |Annotates that a referenced RT Radiation Set included in| |
| | |a Meta Radiation Set was used for any QA procedures, | |
| | |which have been performed on a different Radiation Set | |
| | |then the finally used one out of any reasons. | |
|S147300 |IEC Patient Support Continuous |Patient Support Continuous Angle in IEC PATIENT SUPPORT | |
| |Angle |Coordinate System | |
|S147301 |IEC Table Top Continuous Pitch |Table Top Continuous Pitch Angle in the direction of the| |
| |Angle |IEC TABLE TOP Coordinate System | |
|S147302 |IEC Table Top Continuous Roll |Table Top Continuous Roll Angle in the direction of the | |
| |Angle |IEC TABLE TOP Coordinate System | |
|S147303 |IEC Table Top Eccentric Axis |Table Top Eccentric Axis Distance | |
| |Distance | | |
|S147304 |IEC Table Top Continuous Eccentric|Table Top Continuous Eccentric Angle in the direction of| |
| |Angle |the IEC TABLE TOP ECCENTRIC Coordinate System | |
|S147305 |IEC Table Top Vertical Position |Table Top Vertical Position in IEC TABLE TOP Coordinate | |
| | |System | |
|S147306 |IEC Table Top Lateral Position |Table Top Lateral Position | |
|S147307 |IEC Table Top Longitudinal |Table Top Longitudinal Position | |
| |Position | | |
|S147330 |Isocentric |Delivery device isocenter remains at a fixed point in | |
| | |the patient for the all radiations using this patient | |
| | |setup. | |
|S147331 |Fixed SSD |Delivery device isocenter moves if necessary to maintain| |
| | |a constant distance between the virtual radiation source| |
| | |and the location of the beam’s first intersection with | |
| | |the patient for the all radiations using this patient | |
| | |setup. | |
|S147332 |Fixed Midline Distance |Delivery device isocenter moves if necessary to maintain| |
| | |a constant distance between the virtual radiation source| |
| | |and the location of the central axis of the beam’s first| |
| | |intersection with the patient for the all radiations | |
| | |using this patient setup. | |
|S147340 |Biteblock |A device attached to the table top that is also placed | |
| | |in the patient's mouth to position and orient the head | |
| | |in a prescribed geometry. | |
|S147341 |Headframe |A device attached to the tabletop that is also screwed | |
| | |into the skull of the patient's head to position and | |
| | |orient the head in a prescribed geometry relative to the| |
| | |tabletop. The device is commonly known as a "halo". | |
|S147342 |Head Mask |A device that is placed over the patient's face and | |
| | |attached to the tabletop to prevent the patient from | |
| | |moving relative to the tabletop. | |
|S147343 |Head and Neck Mask |A device that is placed over the patient's face and neck| |
| | |and attached to the tabletop to prevent the patient from| |
| | |moving relative to the tabletop. | |
|S147344 |Mold |Mold | |
|S147345 |Cast |Cast | |
|S147346 |Headrest |A device placed beneath a patient to support the head in| |
| | |a prescribed position and orientation relative to the | |
| | |table top. | |
|S147347 |Breast Board |A device placed on the tabletop to support the chest and| |
| | |arms of a patient in a prescribed position and | |
| | |orientation. | |
|S147348 |Body Frame |A device placed beneath a patient to support the whole | |
| | |body in a prescribed position and orientation relative | |
| | |to the table top. | |
|S147349 |Vacuum Mold |A device placed beneath a patient to support a body part| |
| | |in a prescribed position and orientation relative to the| |
| | |table top. It is commonly a bag containing low density | |
| | |polystyrene spheres that becomes semi-hard when vacuum | |
| | |is applied conforming to the bottom surface of the | |
| | |patient. | |
|S147350 |Whole Body Pod |A device placed beneath a patient to support the whole | |
| | |body in a prescribed position and orientation relative | |
| | |to the table top. It is commonly shaped like a hollow | |
| | |half cylinder. The space between the patient and the | |
| | |wall is commonly filled with a dual component foam that | |
| | |hardens conforming to the bottom surface of the patient.| |
|S147351 |Rectal Balloon |A flexible fluid container inserted into the rectum to | |
| | |maintain an immovable geometry during treatment. | |
|S147352 |Head Ring |’Head ring’ device fixed to patient head | |
|S147380 |Gum Shielding |Type of device shielding the gum | |
|S147381 |Eye Shielding |Type of device shielding the eye | |
|S147382 |Gonad Shielding |Type of device shielding the gonad | |
|S147400 |Laser Pointer |Laser position indicator | |
|S147401 |Distance Meter |Optical (visual) distance indicator | |
|S147402 |Table Height |Recorded table height | |
|S147403 |Mechanical Pointer |Mechanical front pointer | |
|S147404 |Arc |Arc shaped device for mechanical position indication | |
|S147405 |Film |A Port Film taken using a film cassette (rather than an | |
| | |EPID device) | |
|S147410 |Table |‘Table-like’ support device | |
|S147411 |Chair |‘Chair-like’ support device | |
|S147420 |Maximum Dose |Maximum dose to any point in the anatomical reference | |
|S147421 |Minimum Dose |Maximum dose to any point in the anatomical reference | |
|S147422 |Median Dose |Median of dose to the anatomical reference | |
|S147423 |Mean Dose |Mean of dose to the anatomical reference | |
|S147424 |Dose Standard Deviation |Standard deviation of dose to the anatomical reference | |
|S147431 |Electron Fixed Aperture |A device that is attached to the radiation head into | |
| | |which beam modifiers are installed. This device is also | |
| | |commonly known as a "cone". | |
| | |(TBD) | |
|S147432 |Photon Fixed Aperture |A device that attaches to the applicator carriage for | |
| | |the purpose of holding an aperture and a bolus close to | |
| | |the patient's skin. Several beam applicators may be | |
| | |available to reduce the weight of apertures lifted by | |
| | |therapists, decrease the aperture/bolus-to-skin | |
| | |distance, and reduce leakage radiation. This device is | |
| | |also commonly known as a "cone". | |
| | |(TBD) | |
|S147433 |Intraoperative Fixed Aperture |A device which is used to delimit the radiation in case | |
| | |of an intraoperative radiotherapeutic treatment. | |
| | |(TBD) | |
|S147440 |Hard Wedge |A physical device manually placed between the radiation | |
| | |head and the patient used to modify the fluence | |
| | |distribution across the field. It is motorized and can | |
| | |be inserting/extracted from the beam path without user | |
| | |action. | |
|S147441 |Motorized Wedge |A physical device placed inside the radiation head used | |
| | |to modify the fluence distribution across the field. | |
|S147442 |Dynamic Wedge |An effective wedge generated by the movement of jaw | |
| | |across the treatment field while delivering radiation. | |
|S147451 |Graticule |Mechanical grid | |
|S147452 |Reticule |Mechanical crosshair | |
|S147453 |Image Detector |A electronic imaging device | |
|S147454 |Film Holder |Mechanical device to hold imaging film | |
|S147455 |Winston-Lutz Pointer |A spherical mechanical indicator used for alignment | |
|S147456 |Bowtie Filter |A bowtie filter used in kV imaging to account for | |
| | |patient shape | |
|S147460 |Bolus |A device, typically placed on the patient, that provides| |
| | |differential penetration laterally across a beam | |
| | |generally to increase the dose delivered to shallow | |
| | |depths. Typically the bolus is made of a material with | |
| | |scatter and penetration characteristics similar to | |
| | |tissue. | |
|S147470 |Shielding Block |A device, typically made of a low temperature alloy such| |
| | |as Lipowitz’s metal, that provides constant attenuation | |
| | |across an area of the beam to prevent or reduce dose | |
| | |delivery to normal tissues. | |
| | |For shielding blocks, blocking material is inside the | |
| | |shape defined by the Outline Macro. | |
|S147471 |Aperture Block |A device, typically made of a low temperature alloy such| |
| | |as Lipowitz’s metal, that provides an opening in a whole| |
| | |beam block with constant attenuation across an area of | |
| | |the beam to prevent or reduce dose delivery to normal | |
| | |tissues. | |
| | |For aperture blocks, blocking material is outside the | |
| | |shape defined by the Outline Macro. | |
|S147480 |Tray |A device placed into a machine slot or an applicator or | |
| | |similar, to which accessories are attached. For ion | |
| | |beams, the tray is usually a virtual device used for | |
| | |determining the distance to the accessory. | |
|S147481 |Applicator |A device placed into a machine slot with one or more | |
| | |slots, to which accessories are attached. | |
|S147490 |Standard Flattening Filter |Standard Flattening Filter | |
|S147491 |Flattening Filter Free Mode |Flattening Filter Free Mode | |
|S147500 |Relative Biological Effectiveness |A number that expresses the amount of damage from an | |
| | |amount of ionizing radiation relative to the damage from| |
| | |a reference amount of a specific ionizing radiation. | |
|S147501 |Scale Factor |A number which multiplies a quantity. The result can be | |
| | |larger or smaller in magnitude than the original | |
| | |quantity. | |
|S147530 |Film |A sheet of plastic coated with light sensitive material | |
| | |which is chemically changed by the exposure to ionizing | |
| | |radiation or light. | |
|S147531 |3D Gel |A volume of gel that changes physical characteristics | |
| | |when exposed to ionizing radiation. | |
|S147532 |Diode Array |A number of semiconductor devices that generates current| |
| | |when exposed to ionizing radiation. The devices are | |
| | |arranged systematically in a regular pattern. | |
|S147533 |Ion Chamber Array |A number of devices that measures charge from the ions | |
| | |produced in a medium when exposed to ionizing radiation.| |
| | |The devices are arranged systematically in a regular | |
| | |pattern. | |
|S147534 |TLD |Thermoluminescent dosimeter. It is a crystal that when | |
| | |heated, emits visible light in proportion to the amount | |
| | |of ionizing radiation it has been exposed to. | |
|S147535 |Diode |A semiconductor device that generates current when | |
| | |exposed to ionizing radiation. | |
|S147536 |Liquid Ion Chamber |An ion chamber that uses a liquid as the medium. | |
|S147537 |MOSFET |Metal Oxide Semiconductor Field Effect Transistor. The | |
| | |transistor experiences a change in voltage upon | |
| | |irradiation with ionizing radiation. | |
|S147538 |OSLD |Optically Stimulated Luminescent Dosimeter. It is a | |
| | |crystal that when exposed to green light, emits blue | |
| | |light in proportion to the amount of ionizing radiation | |
| | |it has been exposed to. | |
|S147539 |Ion Chamber |A device that measures charge from the ions produced in | |
| | |a medium when exposed to ionizing radiation. | |
|S147540 |EPID |Electronic Portal Imaging Device. This device is able to| |
| | |record a digital image during treatment delivery on a | |
| | |teletherapy machine. It may consist of the image of an | |
| | |array of ion chambers, a CCD video camera or flat panel | |
| | |detectors. | |
|S147541 |Diamond Detector |A semiconductor detector that uses diamond as the | |
| | |medium. | |
|S147560 |Flattening Filter Beam |Beam that uses a flattening filter to produce a nearly | |
| | |uniform intensity profile. | |
|S147561 |No Flattening Filter Beam |Beam that does not use a flattening filter to produce a | |
| | |nearly uniform intensity profile. | |
|S147562 |Partial Flattening Filter Beam |Beam that uses a filter to produce a nearly uniform | |
| | |region across part of the intensity profile. | |
|S147571 |MU / Seconds |Unit for a dose rate, measured as the number of Monitor | |
| | |Units per second | |
|S147572 |Particles / Seconds |Unit for a dose rate, measured as the number of | |
| | |particles per second. | |
|S147580 |LET-based |An LET-based method has been used to incorporate the | |
| | |Relative Biological Effectiveness based on the quality | |
| | |of the radiation used | |
| | |[Wambersie A, RBE, reference RBE and clinical RBE: | |
| | |Applications of these concepts in hadron therapy, | |
| | |Strahlentherapie und Onkologie 1999 June, 175(2): 39-43]| |
| | |[Paganetti H, et al., Relative biological effectiveness | |
| | |(RBE) values for proton beam therapy, Int J Rad. Onc | |
| | |Biol Phys, 2002 June; 53(2): 407-421] | |
|S147581 |Fractionation-based |A Fractionation-based or temporally-based method has | |
| | |been used to assess the Biologically Effective Dose. | |
| | |[Fowler JF, Br J Radiol. 2010 July; 83(991): 554–568] | |
|S147590 |FDA unique device identifier (UDI)|The unique device identifier(UDI) is created and | |
| | |maintained by device labelers based on global device | |
| | |identification standards managed by FDA-accredited | |
| | |Issuing Agencies. | |
|S147600 |Cubic centimeter PER_U {cm3_PER_U}|Cubic centimeter PER_U {cm3_PER_U} | |
| | |The unit PER_U is defined in: Anderson, LL: “A “natural”| |
| | |volume-dose histogram for brachytherapy”, Medical | |
| | |Physics 13(6) pp 898-903, 1986. | |
|S147650 |Created |No review or approval has been performed. | |
|S147651 |Reviewed |Reviewer recorded that he has reviewed the item, but not| |
| | |yet finally approved it. | |
|S147652 |Approved |Reviewer recorded that the item met an implied | |
| | |criterion. | |
|S147653 |Rejected |Reviewer recorded that item failed to meet an implied | |
| | |criterion. | |
|S147654 |Demoted |An review or approval state has been demoted to a | |
| | |non-qualified state. | |
|S147680 |New |Preparation of this SOP Instance has not yet started. | |
|S147681 |In Preparation |SOP Instance is in preparation. | |
|S147682 |Ready |SOP Instance has been prepared, but not yet used for | |
| | |treatment. | |
|S147683 |In Progress |SOP Instance is currently being used in the treatment | |
| | |process. | |
|S147685 |Suspended |SOP Instance has been used in the treatment process, but| |
| | |is not currently in use. | |
|S147686 |Discontinued |The treatment based on this SOP Instance has been | |
| | |discontinued before it has been completely applied as | |
| | |originally planned. | |
|S147687 |Completed |The treatment based on this SOP Instance has been | |
| | |completed as originally planned. | |
|S147700 |Mixed |Contributing doses use different dose algorithm types | |
|S147701 |Other |Other unspecified algorithm | |
|S147702 |Monte Carlo |A Monte Carlo based algorithm | |
|S147703 |Convolution |A convolution based algorithm | |
|S147704 |Superposition |A superposition based algorithm | |
|S147705 |Pencil Beam |A pencil-beam based algorithm | |
|S147706 |Transport Equation |An algorithm based on diffusion or other transport | |
| | |mechanism | |
|S147707 |Measurement-based |An empirical algorithm based on physical measurements | |
|S147708 |Clarkson |A scatter-summation method using Clarkson integration | |
|S147710 |Revised Value |Identifies a value for a setting that is different from | |
| | |the one specified in the Radiation Set. | |
| | |E.g.: a change on the specified meterset or a specified | |
| | |gantry angle. | |
|S147720 |Multiple Fixed Sources |Multiple Fixed Sources | |
|S147730 |Synchrony |Synchronized with breathing | |
|S147731 |Non-Synchrony |Non synchronized | |
|S147750 |Annotating Documents for the |Documents, which annotate clinical and physics rationale| |
| |Calculated Dose |of the approach chosen to calculate the dose (e.g. | |
| | |choice of algorithms, dose composition approaches etc.).| |
|S147820 |Treatment Session Record of |A record of a treatment session previously delivered | |
| |Delivered Radiation | | |
|S147821 |Historical Prescription |A prescription given prior to the application of the | |
| | |current prescription | |
|S147822 |Current Prescription |The prescription currently in use | |
|S147823 |Volumetric Dose for Radiation Set |A Volumetric dose calculated for a Radiation Set | |
|S147824 |Volumetric Dose for Radiation |A Volumetric dose calculated for a Radiation | |
|S147825 |Volumetric Dose for Radiation |A Volumetric dose calculated for a Radiation Record | |
| |Record | | |
|S147826 |Dose Volume Histogram |A Dose Volume Histogram | |
|S147827 |Dose Sample |A collection of calculated Dose Sample Points | |
|S147828 |Segmentation Properties used in |Segmentation Properties on segmented SOP instances, | |
| |Planning |which have been used in the treatment planning process | |
|S147829 |Segmentation Properties created |Segmentation Properties on segmented SOP instances, | |
| |during Treatment Session |which have been created in the execution of a treatment | |
| | |session. | |
|S147830 |Image used for Treatment Planning |Images, which have been used in the treatment planning | |
| | |process. | |
|S147832 |Image Acquired during Treatment |Images, which have been acquired during a treatment | |
| | |session. | |
|S147833 |Image used as Reference Image for |Images, which are used in a treatment session as | |
| |Treatment |reference images to position the patient. | |
|S147834 |Registration used in Planning |Registrations, which have been used in the treatment | |
| | |planning process | |
|S147835 |Registration created during |Registrations, which have been created in the execution | |
| |Treatment Session |of a treatment session | |
|S147890 |Radiotherapy Treatment Device |A device delivering radiotherapy treatments. | |
|S147900 |Multiple Fixed Sources |Multiple Fixed Sources | |
|S147910 |Synchrony |Synchrony Treatment Technique on a Robotic Treatment | |
| | |Device | |
|S147911 |Non-Synchrony |Non-Synchrony Treatment Technique on a Robotic Treatment| |
| | |Device | |
|S147950 |Photon |Photon | |
|S147951 |Electron |Electron | |
|S147952 |Proton |Proton | |
|S147953 |Carbon |Carbon nucleus | |
|S147954 |Neutron |Neutron | |
|MU |Monitor Units |A measure of machine output of a radiotherapy treatment | |
| | |devices. The devices are calibrated to give a particular| |
| | |absorbed dose under particular conditions, although the | |
| | |definition and measurement configuration will vary | |
| | |between centres. | |
|NP |Number of Particles |A measure of machine output of a radiotherapy treatment | |
| | |devices along the number of particles, used by some Ion| |
| | |Therapy devices. | |
Part 17 Addendum
Add the following to PS3.17:
Annex Z Second Generation RT (Informative)
ZZ.1 Introduction
This annex provides additional explanations and sample use cases for the 2nd Generation RT IODs. It is not intended as an exhaustive list of procedure step types that could be undertaken with these objects.
The main clinical purposes of the relationships amongst the important IODs are show in the following diagram:
[pic]
Figure ZZ.1-1
Relationship between important IODs
The fundamental relationships between the entities are shown in the following diagram:
[pic]
Figure ZZ.1-2
Fundamental Entity Relationships
Note 1: Former Treatments refers to the sequence in the RT Course IOD that documents any rediologically significant delivery to this patient that is not captured in a previous RT Course instance.
ZZ.2 Entity Descriptions
The following entities are modeled:
ZZ.2.1 RT Course
A top-level entity that describes a given treatment course. All relevant objects are referenced, including acquisition images, registrations, segmentations, physician intent, beam sets, reference and verification imaging, and output records. In particular, all information relating to the current approval state of treatment, treatment phases, and changes due to adaptation of the therapy are described in this IOD. It describes the overall intended delivery scheme, including fractionation. This consists of one or more phases of treatment (e.g. ‘normal’ and ‘boost’). Each phase is achieved by referencing one or more RT Radiation Set instances (multiple sets are required if adaptive therapy is used to achieve the dosimetric objectives of the phase).
RT Course also contains phase-specific fractionation schemes that describe how the beams/catheters are combined to achieve the phase prescription. Note that multiple independent treatment sites will generally be represented by the same conceptual ‘course’ (i.e. chain of RT Course instances) when treated within the same treatment time frame, otherwise they should be represented by different courses. Phases are also modeled within the RT Course. The treatment session summary IODs in the first generation of RT IODs are also effectively replaced by RT Course.
The DICOM Standard does not specify how a given radiotherapy course is mapped onto the DICOM IE level hierarchy.To avoid a proliferation of series within a Study, one reasonable approach is to map a course of treatment to a DICOM Study, such that a Study contains all data created by radiotherapy systems for the purpose of addressing a particular course of treatment, however such a mapping is not mandated.
[pic]
Figure ZZ.2.1-1
RT Course IOD
The following diagram shows the referencing indeces used within the RT Course referenceing RT Prescriptions, RT Treatment Phases and RT Radiation Sets.
[pic]
Figure ZZ.2.1-2
Relationships in RT Course IOD using Indexes
ZZ.2.2 RT Physician Intent
Describes how the physician wishes to achieve curative or palliative therapy, as inputs to the planning process. The actual planned parameters may differ from the intended parameters described here. Items in the RT Physician Intent can include
• use of external therapy or brachytherapy,
• total and fractional dose,
• fractionation scheme,
• treatment sites,
• treatment target volume names,
• constructive solid geometry of targets and critical structures,
• field/MLC margins to be used (in case of 3D Conformal RT),
• dosimetric objectives (dose constraints for targets, organs at risk and normal tissue),
• beam energy,
• use of dose optimization and IMRT,
• use of motion management (e.g. gated treatment, tracking etc.),
• patient setup to be used including immobilization,
• image set(s) used for treatment planning,
• type of image-guided patient setup/treatment delivery (e.g. daily 3D CT, radiographic, fluoroscopic, ultrasound, etc.).
• There is also a location where the physician can enter details of dose from previous treatments.
[pic]
Figure ZZ.2.2-1
Physician Intent IOD
[pic]
Figure ZZ.2.2-2
Concepatual Volumes
ZZ.2.3 RT Segment Annotation
Describes the clinical segmentation types (e.g. clinical target volume, organ at risk, bolus), density overrides, and other RT-specific ROI properties.
[pic]
Figure ZZ.2.3-1
RT Segment annotation IOD
ZZ.2.4 RT Radiation Set
Describes a set of beams and/or catheters being used within a treatment session to help achieve the dosimetric requirements of a given phase. References a set of SOP Instances. A treatment phase is achieved by delivering one or more RT Radiation Sets. One or more new RT Radiation Sets may be required each time adaptive therapy is used to attempt to maintain a phase prescription.
[pic]
Figure ZZ.2.4-1
RT Radiation Set IOD
A new concept of meta-classes is modeled. Their content is inherent to all members of a such a meta-class and are to be considered as of one type. An example for this is the with its multiple concrete definitions. The notation such a meta-class is always within brackets.
ZZ.2.5 RT Radiation
A conceptual metaclass representing a means of administering a quantity of radiation generated by a radiation source and intended to be delivered in a contiguous and indivisible manner (such as a static beam, dynamic arc, helical delivery, step-and-shoot IMRT sequence or catheter). An description includes a contiguous set of control points.
An cannot be further subdivided in the DICOM model and is the delivery unit for which dose is reported. If the delivery of an is interrupted, this is considered to be an error condition and the remaining radiation required to complete the beam will usually need to be computed based upon the planned treatment versus delivered treatment.
An may be used for the purposes dosimetric verification or therapeutic treatment. Specific IODs that are members of this Meta-SOP Class include C-Arm Photon Radiation, Tomotherapeutic Radiation, etc.
ZZ.2.6 RT Dose Image
Describes a representation of 3D dose distributions using the multi-frame and functional group paradigms.
[pic]
Figure ZZ.2.6-1
RT Dose Image IOD
[pic]
Figure ZZ.2.6-2
Enhanced RT Dose IOD
ZZ.2.7 RT Dose Histogram
Describes a representation for dose-volume histogram data.
[pic]
Figure ZZ.2.7-1
RT Dose Histogram IOD
ZZ.2.8 RT Dose Samples
Describes a representation for dose point data.
[pic]
Figure ZZ.2.8-1
RT Dose Samples IOD
ZZ.2.9 RT Radiation Record
A conceptual metaclass representing the parameters of an actual delivery of an . Specific IODs that are members of this Meta-SOP Class include C-Arm Photon Radiation, Multi-Axial Radiation, etc.
ZZ.3 Notes on RT Course
ZZ.3.1 Introduction
The RT Course IOD is a composite representation of a course of radiation therapy, treating one or more anatomical sites in a coordinated sequence of events over time. It represents the state and history of a single coordinated process at a particular point in time.
The main elements of a treatment course are the specification of the physician’s desired treatment approach represented by physician intents, and the realization of this approach through radiation sets organized along the phases of treatments. The RT Course IOD provides a structure to represent the elements of a treatment course, but makes no assumption how the Physician Intents and Treatment Phases are interpreted or implemented. This is usually very specific to a department and case-dependent. While the RT Course IOD supports quite complex treatment strategies, it can also serve as the container for a simple Physician Intent with one Radiation Set as well, as it does not suggest any specific approaches.
The RT Course IOD represents the actual state of a treatment and links together the different RT IODs, maintaining their relation and status. It binds together various entities needed in radiotherapy for preparation, execution and review of a radiotherapeutic treatment of a patient. This is accomplished by providing data structures to reference the relevant SOP Instances and indicate their status and their progress in the treatment process.
These component IODs have been designed to represent smaller units of information as compared with the first-generation DICOM.
With the definition of RT Course, it is possible to render the second-generation RT SOP Instances (representing those entities) stateless. This allows them be stable data containers by isolating the changes in status or relationship with other data, thereby reducing the need to create new instances. In second-generation RT, RT Course factors out the process-related information and separate that from the content-related information in the referenced SOP Instances.
The RT Course can be used both in a worklist-driven managed environment as well as in an unmanaged Media-file driven environment. It is generally assumed that there is only one RT Course SOP Instance active at a time that serves as the reference for the current treatment definition for a patient. Since this cannot be guaranteed technically, it is the responsibility of the departmental workflow and/or policies and procedures to ensure that there is only one RT Course SOP Instance active at a time. This also applies to other objects in the radiotherapy context such as physician intents, radiation sets etc. See the example use cases below for further explanation.
It is not necessary to keep track of all versions triggered by queries for RT Course objects. A system keeping the RT Course could store some historical versions at some point in time when clinically of interest (e.g. in between two series of radiation). Those persistent versions are tracked in this sequence for later retrieval. Note however, that for essential information about the whole treatment course, the latest SOP Instance is always sufficient.
ZZ.3.2 Evolution of an RT Course SOP Instance
In a typical case, the RT Course SOP Instance initially contains references to the physician intent(s) for a specific case, references image sets, and segmentation objects used in setting up the physician intent.
Further on an RT Course SOP Instance has the capability to describe the treatment phases throughout the course of treatment. Phases represent the grouped fractions of certain treatment techniques/modalities, such as a photon treatment with a normal radiation phase and a boost phase, or a photon treatment phase followed by a ion treatment phases. A treatment course can have only one phase in the course, multiple phases build a sequence of consecutive periods of treatment within the course.
The RT Course IOD does not place any constraints on how a department or physician partitions the treatment of a patient into physician intents and treatment phases.
When treatment planning starts, an RT Course SOP Instance references RT Radiation Set SOP Instances in different states. It also carries the relations between RT Radiation Set SOP Instances, i.e. whether radiation sets have been derived from other radiation sets, which collections of radiation sets are grouped for dose summation, etc.
There will be a sequence of RT Course SOP Instances over the time of treatment. A change of the content of the treatment course (e.g. changing physician intents, new treatment phases, new radiation sets, changed radiation set status etc.) will be presented in a new RT Course SOP Instance. The most recent RT Course SOP Instance is always complete, i.e. it contains all physician intents, phases, and previous radiation sets of the course, whether they are already treated, in treatment, or foreseen. Therefore no cumulative logic across historic RT Course SOP Instances is needed. Previous versions referenced in an RT Course SOP Instance do however allow tracing of the evolution of the current course definition.
ZZ.3.3 Elements of the RT Course
ZZ.3.3.1. Physician Intent
A Physician Intent is the clinical roadmap of a physician to define the therapeutic goals and strategy to treat the disease. It is a high-level description in accordance with the nomenclatures and policies of a certain oncology department. The manner in which physician intents are structured and formulated is often very specifically defined in a given department. Therefore the physician intent provides flexibility for department-specific representation. In general, it allows the physician to describe the intended treatment mainly in free text as strategy to following process points like planning and simulation with the nomenclature and detail level as prescribed by the operating procedures in the department.
ZZ.3.3.2. Treatment Phase
Today’s radiotherapy treatments are increasingly complex. To support sequences of various treatments throughout the treatment course the treatment phases support explicit definitions to structure the course into segments. The Treatment Phase provides a means to represent changes in the patient’s radiation sets, by organizing the sequence of sets under treatment.
A radiation set which is currently in treatment will be frozen, while other sets might be in preparation and still undergo various changes until approved for treatment. The granularity of radiation sets supports the atomic units of treatment. The RT Course with its phases organizes those units into a structured time-related sequence of intended dose delivery. The arrangement of those radiation sets across time, and their grouping as treatment phases (e.g. a normal treatment and a boost treatment) are supported by the treatment phase sequence.
ZZ.3.3.3. Radiation Sets
The radiation set defines a set of beams which are treated together for one or multiple fractions. The radiation set therefore defines the physical and geometrical parameters of the treatment and indirectly the dose delivered. It is the smallest unit of delivery at one time.
A radiation set therefore describes a series of identical beam collections usually being applied repeatedly. A new treatment series (or another treatment phase, like a boost treatment etc.) is represented by one or more new radiation sets.
Relations between radiation sets are not handled within the radiation set IODs itself, but in the RT Course IOD as follows:
• The relation in respect to time, i.e. how those radiation sets should be treated in series or parallel, is described in the RT Treatment Phase module (describing the treatment phases in relation to each other) and the RT Radiation Set Reference module (describing the radiation sets of a treatment phase in relation to each other) of the RT Course IOD.
• The relation in respect to changes of a radiation set in the course of treatment are described in a specific sequence of the RT Radiation Set Reference module of the RT Course IOD. The use of those relations is restricted to small adaptations of the actual radiation set within the intended series of fractions, keeping the intended treatment technique, beam layout and planned dose distribution. Any change which lies beyond this scope, for example re-planning, is typically handled on a treatment phase level.
Radiation sets may be defined to a greater or lesser extent, depending on the progress of the treatment definition. For the typical stages (Simulation, Planning, Treatment), different radiation sets can be referenced. The final one, the Treatment RT Radiation Set, is intended to be a complete definition, deliverable by a TDS without further changes once approved.
ZZ.3.3.4 Clinical State Information
The RT SOP Classes handled in the RT Course exist in various states during the clinical process. Instances may have been just created, may have been reviewed by physicians but not yet approved, or may be finally approved to be ready to use. Those states are not part of the data IOD itself, because their transitions should not necessarily trigger a change of the SOP Instance. States are often set without further changes to the SOP Instance, for example final approval.
The RT Course SOP Class maintains information about the states for most of the SOP Instances it references. It does so by having 2 types of states:
• Clinical states are used to denote the clinical state in the decision process about the maturity and applicability of a SOP Instance.
• RT Operation State is applicable for objects used to effectively perform the treatment (most prominently the radiation sets) and denotes the current state of the execution.
ZZ.4 Notes on Second-Generation IODs
ZZ.4.1 RT Radiation Set IOD
ZZ.4.1.1 General Notes
The RT Radiation Set represents a fractionation and a set of external beams or brachytherapy radiation configurations which are treated as a collection and always grouped together. Radiation sets are delivered in fractions. Therefore a RT Radiation Set is a collection of SOP Instances which define treatments for the same modality. In some cases it is possible for multiple radiations sets to contain the same SOP Instance.
By referencing other SOP Instances, an RT Radiation Set SOP Instance specifies all physical and geometric information that is needed to define the delivery of the therapeutic dose to the patient.
The methods of defining, verifying and correcting the position of the patient as well as attributes varying within the treatment cycle of a specific radiation set are out of scope for this IOD. An instance of a radiation set remains unchanged across all fractions. A change in the desired treatment normally requires a new radiation set to be created.
ZZ.4.1.2. Fractionation
Fractionation defines the timing of treatments for a radiation set. It defines the number of fractions and the dose for each fraction. It also defines the Radiation Fraction Pattern to be delivered, i.e. daily and/or weekly patterns. Note that the actual schedule of treatments may not completely match the intended scheme (because of holidays, no-shows etc.), but the fractionation provides guidance for the scheduler.
ZZ.4.1.2. Meterset and other parameters resolution
It is strongly recommended that the specified Cumulative Meterset and other machine parameters match the resolution as expected by the Radiation Device to deliver the radiation. If the calculation for Meterset results in a meterset value which is not an exact multiple of the meterset resolution, the result should be rounded to the nearest allowed meterset value.
ZZ.4.2 RT Radiation IODs
ZZ.4.2.1 Control Points
The RT Radiation IODs make use of the Control Point concept as it was introduced within the Beam Sequence (300A,00B0) of the RT Beams Module in first generation RT objects. But due to the differenct characteristics of Control Points in different treatment devices, concrete definitions of Control Points will be device-specific. Examples are the Tomotherapeutic Control Point Sequence (30xx,1010) or the Multi-Axial Control Point Sequence (30xx,1500). Despite from that fact, the base concept is the same for all device-specific Control Points.
For the easy of reading, whenever the Control Point concept is referenced within this standard, it is only referenced as "Control Points" without relation to a specific device-related definition.
ZZ.4.2.2 Sub-Control Points
Due to additional requirements of some treatment techniques a new level below the Control Points is introduced, called Sub-Control Point. The base concept is the same for the Control Point level.
ZZ.4.3 RT Segment Annotation IOD
ZZ.4.3.1 Conceptual Volume
The term Conceptual Volume refers to an abstract spatial entity used in radiation therapy (or elsewhere) to identify the region of a patient that is relevant to treatment prescription, treatment planning, plan evaluation, and/or treatment verification.
Generally, a Conceptual Volume is a volume that has a diagnostic or therapeutic purpose. The Conceptual Volume may or may not be specified by a specific segmentation, as defined in a Segmentation, Surface Segmentation, or RT Structure Set SOP Instance. The Conceptual Volume UID ties together instances created at different times and from different imaging modalities. A Conceptual Volume can also be used to reference abstract spatial entities (prior to delineation) for the purpose of prescribing dosimetry constraints for therapy.
ZZ.4.3.2 Segment
The term Segment refers to a delineation of a spatial entity in a Segmentation, Surface Segmentation, or RT Structure Set SOP Instance. A Segment is a realization of a Conceptual Volume and is identified by its Conceptual Volume UID.
ZZ.5 Example Use Cases
Four different use cases are illustrated in this section:
• Using Managed Workflow: A treatment planning example where workflow is fully managed using a Workflow Manager (TMS) and the Unified Procedure Step – Pull (UPS-Pull) service class.
• Using Received RT Course: A treatment planning example where workflow is managed externally to DICOM and the work item is initiated as a result of a transfer from an actor that has performed a previous work item. This corresponds to the case where the RT Course SOP Instance corresponds to an “electronic chart” that is passed from actor to actor, by DICOM Network Storage (“push”) from the previous Performing Device.
• Using DICOM Media File Set: A treatment planning example where workflow is managed externally, but transfer occurs using DICOM storage media.
• Using Archive Query of RT Course: A treatment planning example where workflow is managed externally to DICOM and the work item is retrieved from a central location (the archive). This corresponds to the case where the RT Course SOP Instance corresponds to an “electronic chart”, and where the location of the “chart” is constant but its validity must be managed externally.
ZZ.5.1 Use Case Actors
The following actors are used in the example use cases:
• User: A person controlling the performing of the procedure step.
• Archive: A database storing SOP Instances (images, plans, structures, dose distributions, etc).
• Treatment Management System (TMS): A suite of applications managing worklists and tracks performance of procedures. This role is commonly fullfilled by an Oncology Information System in the Oncology Department.
• Virtual Simulation System (VSS): A workstation performing virtual simulation (localization, segmentation, and beam placement), often as part of a CT Simulation System.
• Treatment Planning System (TPS): A workstation performing radiotherapy treatment planning. This includes localization, segmentation, beam placement or optimization, dose calculation, and dose review.
• Treatment Delivery System (TDS): An application performing the treatment delivery specified by the worklist, updating a UPS, and storing treatment records and related SOP instances (such as verification images). Acts as a Performing SCU.
• Plan Review Station (PRS): A workstation performing radiotherapy treatment planning review, displaying and reviewing patient anatomy, beam geometry, and dose distributions.
• Delivery Review Station (DRS): A workstation performing radiotherapy treatment delivery review, displaying and reviewing for patient anatomy, beam geometry, and planned and delivered dose distributions.
ZZ.5.2 Treatment Planning Using Managed Workflow
ZZ.5.2.1 Message Sequencing
Figure ZZ.5.2.2-1 illustrates a message sequence example in the case where a Treatment Planning System (TPS) retrieves a UPS worklist and selects an inverse planning worklist item from a Treatment Management System (TMS). It then retrieves all necessary input objects such as instruction SOP Instances, image sets, Registration SOP Instances, Segmentation SOP Instances, a simulation RT Radiation Set and related SOP Instances, and an RT Prescription. The TPS then generates and stores SOP Instances such as a dosimetric RT Radiation Set, RT Dose Image and reference images or image sets to be used for delivery verification. Finally, it updates the procedure step.
ZZ.5.2.2 Transactions and Message Flow
[pic]
Figure ZZ.5.2.2-1
Treatment Planning Normal Flow - Message Sequence
1. ‘List Procedures for Planning’ on TPS
The User requests a of patients requiring treatment planning.
1. Query UPS
The TPS queries the TMS for Unified Procedure Steps (UPSs) that match its search criteria. For example, all worklist items with a Procedure Step State of ’SCHEDULED’ and Workitem Code Sequence containing an item corresponding to ‘RT Inverse Planning’. This message is conveyed using the C-FIND request primitive of the Unified Procedure Step - Pull SOP Class.
2. Receive 0-n UPS
The TPS receives the set of Unified Procedure Steps (UPSs) resulting from the Query UPS message. The Receive UPS message is conveyed via one or more C-FIND response primitives of the UPS - Pull SOP Class. Each response with status ‘Pending’ contains the requested attributes of a single UPS. The TMS returns a list of zero or more UPSs containing the planned tasks for the querying device.
3. ‘Select Procedure’ on TPS
The User selects one of the scheduled procedures specified on the TPS. If exactly one UPS was returned from the UPS query described above, then the returned UPS is selected by default.
4. Retrieve Archive Objects
Archive Objects are retrieved by a C-MOVE Request, transmitting the SOP Instances to the TPS. SOP instances locations are fully specified in the Input Information Sequence of the Worklist response.
5. Start ‘Planning Session’ on TPS
The User begins the planning process on the TPS.
6. Set UPS (IN PROGRESS)
As the User begins the planning process, the TPS sets a UPS to have the Procedure Step State of ‘IN PROGRESS’. The SOP Instance UID of the UPS will have been obtained via the returned worklist query response. This message is conveyed using the N-ACTION primitive of the Unified Procedure Step – Pull SOP Class with an action type “UPS Status Change”. This message allows the TMS to update its worklist and permits other Performing Devices to detect that the UPS is being worked on.
7. Complete ‘Planning Session’ on TPS
The User completes the planning process on the TPS.
8. Store Results
When the planning process is complete, the TPS stores the results to the Archive. This would typically be achieved using the Storage and/or Storage Commitment Service Classes. These SOP instances are detailed in Section ZZ.6.
9. Set UPS Progress to Final State
Upon completion of the final beam (although this is not required) the TPS may then update the UPS Progress Information Sequence. The TPS must include references to any results in the Output Information Sequence (results are themselves conveyed by the Store Results step). Any attributes still required for UPS completion must be assigned in this step. This message is conveyed using the N-SET primitive of the Unified Procedure Step - Pull SOP Class.
10. Set UPS (COMPLETED)
The TPS sets the Procedure Step State of the UPS to ‘COMPLETED’ upon completion of the scheduled step and storage of results. This message is conveyed using the N-ACTION primitive of the UPS SOP Class with an action type “Request UPS State Modification”. This message informs the TMS that the UPS is now complete.
11. Indicate ‘Planning Session Completed Successfully’ on TPS
Finally the TPS notifies the User that the requested procedure has completed successfully, and all generated SOP Instances have been stored.
ZZ.5.3 Treatment Planning Using Received RT Course
ZZ.5.3.1 Message Sequencing
Figure ZZ.5.3.2-1 illustrates a message sequence example in the case where a TPS performs a treatment planning operation. The operation is based on an RT Course SOP Instance received from another performing device. In this example the TPS needs to be a RT Course Storage SCP.
This use case supports a special case of the “electronic chart” scenario where an independent system (e.g. a physical patient chart) has been used to determine that the next task is a planning procedure, and the User has identified a suitable workstation for the planning procedure.
ZZ.5.3.2 Transactions and Message Flow
This section describes in detail the interactions illustrated in Figure ZZ.5.3.2-1.
[pic]
Figure ZZ.5.3.2-1
Treatment Planning Using Received RT Course - Message Sequence
1. Store RT Course to TPS
The User of another performing device (such as a Virtual Simulation System) initiates a transfer of an RT Course SOP Instance to the TPS. The TPS receives this instance (acting as an RT Course Storage SCP) and stores it locally. Other instances - originating from other devices, or sent at other times - may also have previously been stored.
12. ‘List Procedures for Planning’ on TPS
The User indicates on the TPS that they want the list of patients requiring treatment planning. The TPS then displays all relevant RT Course SOP Instances that have been stored locally.
13. Select ‘Active’ RT Course on TPS
The User selects one of the displayed RT Course objects as the active one. The TPS then extracts the required input SOP Instance UIDs from the selected RT Course.
14. Retrieve Archive Objects
The SOP Instances to be used as input information are transmittedby the Archive to the TPS in response to C-MOVE requests. Typical SOP Instances retrieved are detailed in Section ZZ.4. The TPS knows the location of these SOP instances by virtue of the fully-specified RT Course SOP Instance returned in the previous step.
15. Start ‘Planning Session’ on TPS
The User begins the planning process on the TPS.
16. Complete ‘Planning Session’ on TPS
The User completes the planning process on the TPS.
17. Store Results to Archive
When the planning process is complete, the TPS stores the results to the Archive. This would typically be achieved using the Storage and/or Storage Commitment Service Classes. These SOP Instances are detailed in Section ZZ.6.
18. Store RT Course on Next Performing Device
The TPS stores a new RT Course SOP Instance on the next performing device, such as a Treatment Delivery System (TDS). It contains the complete history of the treatment course, including the planning step just performed.
ZZ.5.4 Treatment Planning Using DICOM Media
ZZ.5.4.1 Message Sequencing
Figure ZZ.5.4.2-1 illustrates a message sequence example in the case where a TPS performs a treatment planning operation based upon an RT Course SOP Instance that it has received by reading DICOM Media. In this example the TPS needs to be DICOM Media File Set Reader (FSR) for this to occur.
This use case supports a special case of the “electronic chart” scenario where an independent system (e.g. a physical patient chart) is used to track and indicate the procedures to be performed.User has been able to obtain a DICOM Storage Media File Set containing the latest information regarding the treatment course.
As before, the SOP Instances that may be consumed and produced by this procedure are shown in Section ZZ.6.
ZZ.5.4.2 Transactions and Message Flow
This section describes in detail the interactions illustrated in Figure ZZ.5.4.2-1.
[pic]
Figure ZZ.5.4.2-1
Treatment Planning Using DICOM Media - Message Sequence
1. ‘List Procedures for Planning’ on TPS
The User indicates on the TPS that they want a the list of patients requiring treatment planning. The TPS initiates a retrieval of one or more RT Course SOP Instances from a DICOM Medium such as CD-R, DVD or BD. It does this by acting in the role of a DICOM File Set Reader (FSR). It then displays the list to the user.
19. Select ‘Active’ RT Course on TPS
The User confirms one of the displayed RT Course SOP Instances as the active one. The TPS then extracts the required input SOP Instance UIDs from the selected RT Course.
20. Read Input SOP Instances from Media
The TPS initiates a retrieval of required input SOP Instances from the DICOM Medium. It does this by acting in the role of a DICOM File Set Reader (FSR). Typical SOP Instances retrieved are detailed in Section ZZ.4. The TPS knows the location of these SOP instances by virtue of the fully-specified RT Course SOP Instance returned in the previous step.
21. Start ‘Planning Session’ on TPS
The User begins the planning process on the TPS.
22. Complete ‘Planning Session’ on TPS
The User completes the planning process on the TPS.
23. Store Results to Media
When the planning process is complete, the TPS stores the results to a DICOM Media File Set.The stored objects include a new RT Course SOP Instance referencing the planning procedure step and any generated SOP Instances. These SOP Instances are detailed in Section ZZ.6.
ZZ.5.5 Treatment Planning Using Archive Query of RT Course
ZZ.5.5.1 Message Sequencing
Figure ZZ.5.5.2-1 illustrates a message sequence example in the case where a TPS performs a treatment planning operation based upon the contents of an RT Course SOP Instance selected from the Archive.
The use case supports a special case of the “electronic chart” scenario where an independent system (e.g. a physical patient chart) is used to track and indicate the procedures to be performed, including the current RT Course SOP Instances retrieved from the Archive.
As before, the SOP Instances that may be consumed and produced by this procedure are shown in Section ZZ.6.
ZZ.5.5.2 Transactions and Message Flow
This section describes in detail the interactions illustrated in Figure ZZ.5.5.2-1.
[pic]
Figure ZZ.5.5.2-1
Treatment Planning Using Archive Query of RT Course - Message Sequence
1. ‘List Procedures for Planning’ on TPS
The User indicates on the TPS that they want a the list of patients requiring treatment planning.
24. Query RT Course
The TPS queries the Archive for RT Course SOP Instances that match its search criteria. For example, all RT Courses for a specific patient where the contents of the RT Course indicate that a simulation has already been performed. This message is conveyed using the C-FIND request primitive of the DICOM Query/Retrieve service class.
25. Receive 0-n C-FIND Responses
The TPS receives the set of results from the Query/Retrieve operation. The result set is conveyed via one or more C-FIND response primitives of the Query/Retrieve SOP Class. The Archive returns a list of zero or more items matching the specified search criteria.
26. ‘Select RT Course’ on TPS
The User selects one of the returned RT Course SOP Instances on the TPS.
27. Retrieve Selected RT Course
In response to a C-MOVE Request, the Archive transmits to the TPS the selected RT Course SOP Instance.
28. Retrieve Archive Objects
Archive Objects are retrieved by a C-MOVE Request, transmitting the SOP Instances to the TPS. SOP Instance locations are fully-specified in the RT Course SOP Instance returned in the previous step.
29. Start ‘Planning Session’ on TPS
The User begins the planning process on the TPS.
30. Complete ‘Planning Session’ on TPS
The User completes the planning process on the TPS.
31. Store Results
When the planning process is complete, the TPS stores the results to the Archive. This would typically be achieved using the Storage and/or Storage Commitment Service Classes. These SOP Instances are detailed in Section ZZ.6.
32. Store RT Course
The TPS stores a new RT Course SOP Instance on the Archive. It contains the complete history of the treatment course, including the planning step just performed and the locations of any objects generated.
-----------------------
Patient
is the
subject of
Study
contains
Series
1
1,n
1
1,n
contains
creates
1,n
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1
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spatially or temporally defines
Frame of Reference
RT Segment
Annotation
RT Radiation
RT Dose Image
RT Physician
Intent
RT Dose Samples
RT Course
RT Dose
Histogram
0,n
0,n
0,n
0,n
0,n
0,n
0,n
0,n
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RT Radiation Record
0,n
0,n
SOP Instance 1
Conceptual Volume A
Conceptual Volume B
Segmentation SOP Instance 1
SOP Instance 2
Conceptual Volume B
Conceptual Volume C
Segmentation SOP Instance 2
RT Structure Set
RT Physician Intent
Conceptual Volume
“Lung, left”
Conceptual Volume
“Lung, right”
RT Segmentation Annotation (I)
Conceptual Volume
“Lung, left”
Conceptual Volume
“Lung, right”
Segmentation
Segment 3
ROI 5
RT Segmentation Annotation (II)
SOP Instance
Conceptual Volume A
Conceptual Volume B
Conceptual Volume C
RT Physician Intent
Conceptual Volume
“Lung, left”
Conceptual Volume
“Lung, right”
Conceptual Volume
“Lung”
Right
Lung
Left
Lung
Input
Result
Result
Spinal Cord PRV
Left
Lung
Input
Heart
Left
Lung
CTV
Input
Result
Heart
Left
Lung
CTV
Input
Result
Result
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L Lung
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Node 1
Node 2
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RT Course IOD
RT Radiation IOD
RT Treatment Phase Module
RT Radiation Set Reference Module
+ Radiation Set Start Delay
RT Radiation Set IOD
+ Fraction Pattern
+ Number of Fraction Pattern Digits Per Day
+Repeat Fraction Cycle Length
RT Prescription
Reference
RT Treatment
Phase
RT Radiation Set
References
Conceptual Volume
Former
Treatments
RT Course IOD
RT Physician
Intent
RT Prescription
Conceptual Volume
IOD
Radiation References
RT Dose Contribution
Conceptual Volume
RT Radiation Set IOD
RT Physician Intent IOD
Control Points
Segment References
RT Segmentation
Properties
Conceptual Volume
Source IOD Reference
Volume
Segment
Surface
Segment
Volume
Segment
RT Segmentation Properties IOD
Segmentation IOD
Surface Segmentation IOD
RT Structure Set IOD
RT Dose Histogram IOD
RT Dose Image IOD &
RT Dose Samples IOD
Radiation Set
References
Radiation References
Reference by RT Course
Key Direct Reference
UID Reference
Other Direct Reference
................
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