EU Imaging Manifest and Access (IHE-MADO additions)
1.0.0-ballot - ballot
150
EU Imaging Manifest and Access (IHE-MADO additions)
1.0.0-ballot - ballot
150
This page is part of the EU Manifest-based Access to DICOM Objects (EU-MADO) (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
| Page standards status: Draft | Maturity Level: 1 |
Definitions for the EuMadoImagingStudy resource profile
See the documentation on how to interpret the contents of this table
| 0. ImagingStudy | ||||||||||
| Definition | Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities. | |||||||||
| Short | A set of images produced in single study (one or more series of references images) | |||||||||
| Control | 0..* | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) mado-reqproc-1: Procedure code should be present in a way that it can be shown to an end-user. ( procedureCode.text.exists() or procedureCode.coding.display.exists()) | |||||||||
| 2. ImagingStudy.implicitRules | ||||||||||
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | |||||||||
| Short | A set of rules under which this content was created | |||||||||
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | |||||||||
| Control | 0..1 | |||||||||
| Type | uri | |||||||||
| Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 4. ImagingStudy.extension | ||||||||||
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | |||||||||
| Short | ExtensionAdditional content defined by implementations | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 10..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Alternate Names | extensions, user content | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||||||
| 6. ImagingStudy.extension:anatomical-region | ||||||||||
| Slice Name | anatomical-region | |||||||||
| Definition | The anatomical region in an ImagingStudy instance. This is additional information next to ImagingStudy.series.bodySite. | |||||||||
| Short | Extension: Anatomical Region | |||||||||
| Control | 1..* This element is affected by the following invariants: ele-1 | |||||||||
| Type | Extension(Extension: Anatomical Region) (Extension Type: CodeableConcept) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| 8. ImagingStudy.extension:anatomical-region.extension | ||||||||||
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | |||||||||
| Short | ExtensionAdditional content defined by implementations | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..0* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Alternate Names | extensions, user content | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 10. ImagingStudy.extension:anatomical-region.url | ||||||||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | |||||||||
| Short | identifies the meaning of the extension | |||||||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | |||||||||
| Control | 1..1 | |||||||||
| Type | uri | |||||||||
| Is Modifier | false | |||||||||
| XML Format | In the XML format, this property is represented as an attribute. | |||||||||
| Summary | false | |||||||||
| Fixed Value | | |||||||||
| 12. ImagingStudy.extension:anatomical-region.value[x] | ||||||||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | |||||||||
| Short | Value of extension | |||||||||
| Control | 0..1 | |||||||||
| Binding | The codes SHALL be taken from For codes, see ValueSet: Anatomical Region (required to https://profiles.ihe.net/RAD/MADO/ValueSet/ValueSetAnatomicalRegion) | |||||||||
| Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time | |||||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 14. ImagingStudy.modifierExtension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | |||||||||
| Short | Extensions that cannot be ignored | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | |||||||||
| Summary | false | |||||||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | |||||||||
| Alternate Names | extensions, user content | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| 16. ImagingStudy.identifier | ||||||||||
| Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. | |||||||||
| Short | Identifiers for the whole study | |||||||||
| Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. | |||||||||
| Note | This is a business identifier, not a resource identifier (see discussion) | |||||||||
| Control | 10..* | |||||||||
| Type | Identifier | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. | |||||||||
| Alternate Names | StudyInstanceUID, AccessionNumber | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 18. ImagingStudy.identifier:study-instance-uid | ||||||||||
| Slice Name | study-instance-uid | |||||||||
| Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. | |||||||||
| Short | Identifiers for the whole study | |||||||||
| Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. | |||||||||
| Note | This is a business identifier, not a resource identifier (see discussion) | |||||||||
| Control | 10..1* | |||||||||
| Type | Identifier(MADO Study Instance UID Identifier  ) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. | |||||||||
| Alternate Names | StudyInstanceUID, AccessionNumber | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 20. ImagingStudy.status | ||||||||||
| Definition | The current state of the ImagingStudy. | |||||||||
| Short | registered | available | cancelled | entered-in-error | unknown | |||||||||
| Comments | Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. | |||||||||
| Control | 1..1 | |||||||||
| Binding | The codes SHALL be taken from ImagingStudyStatushttp://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1)The status of the ImagingStudy. | |||||||||
| Type | code | |||||||||
| Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 22. ImagingStudy.modality | ||||||||||
| Definition | A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19). | |||||||||
| Short | All series modality if actual acquisition modalities | |||||||||
| Control | 0..* | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from AcquisitionModalityhttp://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)Type of acquired data in the instance. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | ModalitiesInStudy | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 24. ImagingStudy.subject | ||||||||||
| Definition | The subject, typically a patient, of the imaging study. | |||||||||
| Short | Who or what is the subject of the study | |||||||||
| Comments | QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group. | |||||||||
| Control | 1..1 | |||||||||
| Type | Reference(EU MADO Patient, Patient, Device, Group) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 26. ImagingStudy.started | ||||||||||
| Definition | Date and time the study started. | |||||||||
| Short | When the study was started | |||||||||
| Control | 0..1 | |||||||||
| Type | dateTime | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | StudyDate, StudyTime | |||||||||
| Example | General: 2011-01-01T11:01:20+03:00 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 28. ImagingStudy.basedOn | ||||||||||
| Definition | A list of the diagnostic requests that resulted in this imaging study being performed. | |||||||||
| Short | Request fulfilled | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.basedOn. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 30. ImagingStudy.basedOn:order | ||||||||||
| Slice Name | order | |||||||||
| Definition | A list of the diagnostic requests that resulted in this imaging study being performed. | |||||||||
| Short | Request fulfilled | |||||||||
| Control | 0..1* | |||||||||
| Type | Reference(MADO Referenced Accession Number Identifier )(EU MADO Requested Procedure, CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 32. ImagingStudy.endpoint | ||||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Study access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer. | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 34. ImagingStudy.endpoint:webviewer | ||||||||||
| Slice Name | webviewer | |||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Study access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer. | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(EU MADO Web Viewer Endpoint, Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 36. ImagingStudy.numberOfSeries | ||||||||||
| Definition | Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present. | |||||||||
| Short | Number of Study Related Series | |||||||||
| Control | 10..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | NumberOfStudyRelatedSeries | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 38. ImagingStudy.numberOfInstances | ||||||||||
| Definition | Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. | |||||||||
| Short | Number of Study Related Instances | |||||||||
| Control | 0..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | NumberOfStudyRelatedInstances | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 40. ImagingStudy.procedureCode | ||||||||||
| Definition | The code for the performed procedure type. | |||||||||
| Short | The `ProcedureCode`s associated with the study.The performed procedure code | |||||||||
| Control | 0..* | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from http://www.rsna.org/RadLex_Playbook.aspx (extensible to http://www.rsna.org/RadLex_Playbook.aspx)The performed procedure type. | |||||||||
| Type | CodeableConcept | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | ProcedureCodeSequence | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 42. ImagingStudy.description | ||||||||||
| Definition | The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed. | |||||||||
| Short | Institution-generated description | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | StudyDescription | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 44. ImagingStudy.series | ||||||||||
| Definition | Each study has one or more series of images or other content. | |||||||||
| Short | Each study has one or more series of instances | |||||||||
| Control | 10..* | |||||||||
| Type | BackboneElement | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 46. ImagingStudy.series.modifierExtension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | |||||||||
| Short | Extensions that cannot be ignored even if unrecognized | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | |||||||||
| Summary | true | |||||||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | |||||||||
| Alternate Names | extensions, user content, modifiers | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| 48. ImagingStudy.series.uid | ||||||||||
| Definition | The DICOM Series Instance UID for the series. | |||||||||
| Short | DICOM Series Instance UID for the series | |||||||||
| Comments | See DICOM PS3.3 C.7.3. | |||||||||
| Control | 1..1 | |||||||||
| Type | id | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | DICOM Series Instance UID. | |||||||||
| Alternate Names | SeriesInstanceUID | |||||||||
| Example | General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 50. ImagingStudy.series.number | ||||||||||
| Definition | The numeric identifier of this series in the study. | |||||||||
| Short | Numeric identifier of this series | |||||||||
| Control | 0..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | SeriesNumber | |||||||||
| Example | General: 3 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 52. ImagingStudy.series.modality | ||||||||||
| Definition | The modality of this series sequence. | |||||||||
| Short | The modality of the instances in the series | |||||||||
| Control | 1..1 | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from AcquisitionModalityhttp://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)Type of acquired data in the instance. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | Modality | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 54. ImagingStudy.series.description | ||||||||||
| Definition | A description of the series. | |||||||||
| Short | A short human readable summary of the series | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | SeriesDescription | |||||||||
| Example | General: CT Surview 180 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 56. ImagingStudy.series.numberOfInstances | ||||||||||
| Definition | Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. | |||||||||
| Short | Number of Series Related Instances | |||||||||
| Control | 10..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | NumberOfSeriesRelatedInstances | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 58. ImagingStudy.series.endpoint | ||||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Series access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances. | |||||||||
| Control | 10..* | |||||||||
| Type | Reference(Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.series.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 60. ImagingStudy.series.endpoint:wado | ||||||||||
| Slice Name | wado | |||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Series access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances. | |||||||||
| Control | 10..* | |||||||||
| Type | Reference(EU MADO WADO Endpoint, Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 62. ImagingStudy.series.bodySite | ||||||||||
| Definition | The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality. | |||||||||
| Short | Body part examined | |||||||||
| Control | 0..1 | |||||||||
| Binding | For example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site|4.0.1 (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)Codes describing anatomical locations. May include laterality. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | BodyPartExamined | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 64. ImagingStudy.series.laterality | ||||||||||
| Definition | The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite. | |||||||||
| Short | Body part laterality | |||||||||
| Control | 0..1 | |||||||||
| Binding | For example codes, see Lateralityhttp://hl7.org/fhir/ValueSet/bodysite-laterality|4.0.1 (example to http://hl7.org/fhir/ValueSet/bodysite-laterality|4.0.1)Codes describing body site laterality (left, right, etc.). | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 66. ImagingStudy.series.specimen | ||||||||||
| Definition | The specimen imaged, e.g., for whole slide imaging of a biopsy. | |||||||||
| Short | Specimen imaged | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(Specimen) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 68. ImagingStudy.series.started | ||||||||||
| Definition | The date and time the series was started. | |||||||||
| Short | When the series started | |||||||||
| Control | 0..1 | |||||||||
| Type | dateTime | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 70. ImagingStudy.series.instance | ||||||||||
| Definition | A single SOP instance within the series, e.g. an image, or presentation state. | |||||||||
| Short | A single SOP instance from the series | |||||||||
| Control | 10..* | |||||||||
| Type | BackboneElement | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 72. ImagingStudy.series.instance.extension:number-of-frames | ||||||||||
| Slice Name | number-of-frames | |||||||||
| Definition | The number of frames in an ImagingStudy instance. | |||||||||
| Short | Extension: Number of Frames | |||||||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | |||||||||
| Type | Extension(Extension: Number of Frames) (Extension Type: integer) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| 74. ImagingStudy.series.instance.extension:ko-document-title | ||||||||||
| Slice Name | ko-document-title | |||||||||
| Definition | The document title code of the Key Object Selection document TID 2010 this instance refers to. | |||||||||
| Short | Extension: MADO Document Title of Key Object Selection documents | |||||||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | |||||||||
| Type | Extension(Extension: MADO Document Title of Key Object Selection documents) (Extension Type: CodeableConcept) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| 76. ImagingStudy.series.instance.modifierExtension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | |||||||||
| Short | Extensions that cannot be ignored even if unrecognized | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | |||||||||
| Summary | true | |||||||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | |||||||||
| Alternate Names | extensions, user content, modifiers | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | |||||||||
| 78. ImagingStudy.series.instance.uid | ||||||||||
| Definition | The DICOM SOP Instance UID for this image or other DICOM content. | |||||||||
| Short | DICOM SOP Instance UID | |||||||||
| Comments | See DICOM PS3.3 C.12.1. | |||||||||
| Control | 1..1 | |||||||||
| Type | id | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Requirements | DICOM SOP Instance UID. | |||||||||
| Alternate Names | SOPInstanceUID | |||||||||
| Example | General: 2.16.124.113543.6003.189642796.63084.16748.2599092903 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 80. ImagingStudy.series.instance.sopClass | ||||||||||
| Definition | DICOM instance type. | |||||||||
| Short | DICOM class type | |||||||||
| Control | 1..1 | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1)The sopClass for the instance. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Alternate Names | SOPClassUID | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 82. ImagingStudy.series.instance.number | ||||||||||
| Definition | The number of instance in the series. | |||||||||
| Short | The number of this instance in the series | |||||||||
| Control | 0..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Alternate Names | InstanceNumber | |||||||||
| Example | General: 1 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 84. ImagingStudy.series.instance.title | ||||||||||
| Definition | The description of the instance. | |||||||||
| Short | Will contain the Key Object Description in the case the instance represents a Key Object.Description of instance | |||||||||
| Comments | Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc. | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
See the documentation on how to interpret the contents of this table
| 0. ImagingStudy | ||||||||||
| 2. ImagingStudy.extension | ||||||||||
| Control | 1..? | |||||||||
| 4. ImagingStudy.extension:anatomical-region | ||||||||||
| Slice Name | anatomical-region | |||||||||
| Control | 1..? | |||||||||
| Obligations |
| |||||||||
| 6. ImagingStudy.extension:anatomical-region.value[x] | ||||||||||
| Binding | The codes SHALL be taken from ValueSet: Anatomical Region (required to https://profiles.ihe.net/RAD/MADO/ValueSet/ValueSetAnatomicalRegion) | |||||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | |||||||||
| 8. ImagingStudy.identifier:study-instance-uid | ||||||||||
| Slice Name | study-instance-uid | |||||||||
| Note | This is a business identifier, not a resource identifier (see discussion) | |||||||||
| Obligations |
| |||||||||
| 10. ImagingStudy.modality | ||||||||||
| Obligations |
| |||||||||
| 12. ImagingStudy.subject | ||||||||||
| Type | Reference(EU MADO Patient) | |||||||||
| Obligations |
| |||||||||
| 14. ImagingStudy.started | ||||||||||
| Obligations |
| |||||||||
| 16. ImagingStudy.basedOn:order | ||||||||||
| Slice Name | order | |||||||||
| Type | Reference(MADO Referenced Accession Number Identifier)(EU MADO Requested Procedure) | |||||||||
| Obligations |
| |||||||||
| 18. ImagingStudy.endpoint:webviewer | ||||||||||
| Slice Name | webviewer | |||||||||
| Type | Reference(EU MADO Web Viewer Endpoint) | |||||||||
| Obligations |
| |||||||||
| 20. ImagingStudy.numberOfSeries | ||||||||||
| Obligations |
| |||||||||
| 22. ImagingStudy.numberOfInstances | ||||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| 24. ImagingStudy.procedureCode | ||||||||||
| Obligations |
| |||||||||
| 26. ImagingStudy.description | ||||||||||
| Obligations |
| |||||||||
| 28. ImagingStudy.series | ||||||||||
| Control | 1..? | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| 30. ImagingStudy.series.uid | ||||||||||
| Obligations |
| |||||||||
| 32. ImagingStudy.series.number | ||||||||||
| Obligations |
| |||||||||
| 34. ImagingStudy.series.modality | ||||||||||
| Obligations |
| |||||||||
| 36. ImagingStudy.series.description | ||||||||||
| Obligations |
| |||||||||
| 38. ImagingStudy.series.numberOfInstances | ||||||||||
| Obligations |
| |||||||||
| 40. ImagingStudy.series.endpoint:wado | ||||||||||
| Slice Name | wado | |||||||||
| Type | Reference(EU MADO WADO Endpoint) | |||||||||
| Obligations |
| |||||||||
| 42. ImagingStudy.series.bodySite | ||||||||||
| Obligations |
| |||||||||
| 44. ImagingStudy.series.laterality | ||||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| 46. ImagingStudy.series.specimen | ||||||||||
| Obligations |
| |||||||||
| 48. ImagingStudy.series.started | ||||||||||
| Obligations |
| |||||||||
| 50. ImagingStudy.series.instance | ||||||||||
| 52. ImagingStudy.series.instance.extension:number-of-frames | ||||||||||
| Slice Name | number-of-frames | |||||||||
| Obligations |
| |||||||||
| 54. ImagingStudy.series.instance.extension:ko-document-title | ||||||||||
| Slice Name | ko-document-title | |||||||||
| Obligations |
| |||||||||
| 56. ImagingStudy.series.instance.uid | ||||||||||
| Obligations |
| |||||||||
| 58. ImagingStudy.series.instance.sopClass | ||||||||||
| Obligations |
| |||||||||
| 60. ImagingStudy.series.instance.number | ||||||||||
| Obligations |
| |||||||||
| 62. ImagingStudy.series.instance.title | ||||||||||
| Obligations |
| |||||||||
See the documentation on how to interpret the contents of this table
| 0. ImagingStudy | ||||||||||
| Definition | Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities. | |||||||||
| Short | A set of images produced in single study (one or more series of references images) | |||||||||
| Control | 0..* | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource ( contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated ( contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())dom-5: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty())dom-6: A resource should have narrative for robust management ( text.`div`.exists())mado-reqproc-1: Procedure code should be present in a way that it can be shown to an end-user. ( procedureCode.text.exists() or procedureCode.coding.display.exists()) | |||||||||
| 2. ImagingStudy.id | ||||||||||
| Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | |||||||||
| Short | Logical id of this artifact | |||||||||
| Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | |||||||||
| Control | 0..1 | |||||||||
| Type | id | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| 4. ImagingStudy.meta | ||||||||||
| Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | |||||||||
| Short | Metadata about the resource | |||||||||
| Control | 0..1 | |||||||||
| Type | Meta | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 6. ImagingStudy.implicitRules | ||||||||||
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | |||||||||
| Short | A set of rules under which this content was created | |||||||||
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | |||||||||
| Control | 0..1 | |||||||||
| Type | uri | |||||||||
| Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 8. ImagingStudy.language | ||||||||||
| Definition | The base language in which the resource is written. | |||||||||
| Short | Language of the resource content | |||||||||
| Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | |||||||||
| Control | 0..1 | |||||||||
| Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)A human language.
| |||||||||
| Type | code | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 10. ImagingStudy.text | ||||||||||
| Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | |||||||||
| Short | Text summary of the resource, for human interpretation | |||||||||
| Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | |||||||||
| Control | 0..1 | |||||||||
| Type | Narrative | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Alternate Names | narrative, html, xhtml, display | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 12. ImagingStudy.contained | ||||||||||
| Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | |||||||||
| Short | Contained, inline Resources | |||||||||
| Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | |||||||||
| Control | 0..* | |||||||||
| Type | Resource | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Alternate Names | inline resources, anonymous resources, contained resources | |||||||||
| 14. ImagingStudy.extension | ||||||||||
| Definition | An Extension | |||||||||
| Short | Extension | |||||||||
| Control | 1..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||||||
| 16. ImagingStudy.extension:anatomical-region | ||||||||||
| Slice Name | anatomical-region | |||||||||
| Definition | The anatomical region in an ImagingStudy instance. This is additional information next to ImagingStudy.series.bodySite. | |||||||||
| Short | Extension: Anatomical Region | |||||||||
| Control | 1..* This element is affected by the following invariants: ele-1 | |||||||||
| Type | Extension(Extension: Anatomical Region) (Extension Type: CodeableConcept) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 18. ImagingStudy.extension:anatomical-region.id | ||||||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |||||||||
| Short | Unique id for inter-element referencing | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| XML Format | In the XML format, this property is represented as an attribute. | |||||||||
| Summary | false | |||||||||
| 20. ImagingStudy.extension:anatomical-region.extension | ||||||||||
| Definition | An Extension | |||||||||
| Short | Extension | |||||||||
| Control | 0..0 | |||||||||
| Type | Extension | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 22. ImagingStudy.extension:anatomical-region.url | ||||||||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | |||||||||
| Short | identifies the meaning of the extension | |||||||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | |||||||||
| Control | 1..1 | |||||||||
| Type | uri | |||||||||
| Is Modifier | false | |||||||||
| XML Format | In the XML format, this property is represented as an attribute. | |||||||||
| Summary | false | |||||||||
| Fixed Value | | |||||||||
| 24. ImagingStudy.extension:anatomical-region.value[x] | ||||||||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | |||||||||
| Short | Value of extension | |||||||||
| Control | 0..1 | |||||||||
| Binding | The codes SHALL be taken from ValueSet: Anatomical Region (required to https://profiles.ihe.net/RAD/MADO/ValueSet/ValueSetAnatomicalRegion) | |||||||||
| Type | CodeableConcept | |||||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 26. ImagingStudy.modifierExtension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | |||||||||
| Short | Extensions that cannot be ignored | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | |||||||||
| Summary | false | |||||||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | |||||||||
| Alternate Names | extensions, user content | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 28. ImagingStudy.identifier | ||||||||||
| Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. | |||||||||
| Short | Identifiers for the whole study | |||||||||
| Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. | |||||||||
| Note | This is a business identifier, not a resource identifier (see discussion) | |||||||||
| Control | 1..* | |||||||||
| Type | Identifier | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. | |||||||||
| Alternate Names | StudyInstanceUID, AccessionNumber | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 30. ImagingStudy.identifier:study-instance-uid | ||||||||||
| Slice Name | study-instance-uid | |||||||||
| Definition | Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. | |||||||||
| Short | Identifiers for the whole study | |||||||||
| Comments | See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. | |||||||||
| Note | This is a business identifier, not a resource identifier (see discussion) | |||||||||
| Control | 1..1 | |||||||||
| Type | Identifier(MADO Study Instance UID Identifier ) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. | |||||||||
| Alternate Names | StudyInstanceUID, AccessionNumber | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 32. ImagingStudy.status | ||||||||||
| Definition | The current state of the ImagingStudy. | |||||||||
| Short | registered | available | cancelled | entered-in-error | unknown | |||||||||
| Comments | Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. | |||||||||
| Control | 1..1 | |||||||||
| Binding | The codes SHALL be taken from ImagingStudyStatus (required to http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1)The status of the ImagingStudy. | |||||||||
| Type | code | |||||||||
| Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 34. ImagingStudy.modality | ||||||||||
| Definition | A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19). | |||||||||
| Short | All series modality if actual acquisition modalities | |||||||||
| Control | 0..* | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from AcquisitionModality (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)Type of acquired data in the instance. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | ModalitiesInStudy | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 36. ImagingStudy.subject | ||||||||||
| Definition | The subject, typically a patient, of the imaging study. | |||||||||
| Short | Who or what is the subject of the study | |||||||||
| Comments | QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group. | |||||||||
| Control | 1..1 | |||||||||
| Type | Reference(EU MADO Patient) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 38. ImagingStudy.encounter | ||||||||||
| Definition | The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made. | |||||||||
| Short | Encounter with which this imaging study is associated | |||||||||
| Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test). | |||||||||
| Control | 0..1 | |||||||||
| Type | Reference(Encounter) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 40. ImagingStudy.started | ||||||||||
| Definition | Date and time the study started. | |||||||||
| Short | When the study was started | |||||||||
| Control | 0..1 | |||||||||
| Type | dateTime | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | StudyDate, StudyTime | |||||||||
| Example | General: 2011-01-01T11:01:20+03:00 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 42. ImagingStudy.basedOn | ||||||||||
| Definition | A list of the diagnostic requests that resulted in this imaging study being performed. | |||||||||
| Short | Request fulfilled | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.basedOn. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 44. ImagingStudy.basedOn:order | ||||||||||
| Slice Name | order | |||||||||
| Definition | A list of the diagnostic requests that resulted in this imaging study being performed. | |||||||||
| Short | Request fulfilled | |||||||||
| Control | 0..1 | |||||||||
| Type | Reference(MADO Referenced Accession Number Identifier )(EU MADO Requested Procedure) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 46. ImagingStudy.referrer | ||||||||||
| Definition | The requesting/referring physician. | |||||||||
| Short | Referring physician | |||||||||
| Control | 0..1 | |||||||||
| Type | Reference(Practitioner, PractitionerRole) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Alternate Names | ReferringPhysiciansName | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 48. ImagingStudy.interpreter | ||||||||||
| Definition | Who read the study and interpreted the images or other content. | |||||||||
| Short | Who interpreted images | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(Practitioner, PractitionerRole) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Alternate Names | Name of Physician(s) Reading Study | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 50. ImagingStudy.endpoint | ||||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Study access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer. | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 52. ImagingStudy.endpoint:webviewer | ||||||||||
| Slice Name | webviewer | |||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Study access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer. | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(EU MADO Web Viewer Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 54. ImagingStudy.numberOfSeries | ||||||||||
| Definition | Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present. | |||||||||
| Short | Number of Study Related Series | |||||||||
| Control | 1..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | NumberOfStudyRelatedSeries | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 56. ImagingStudy.numberOfInstances | ||||||||||
| Definition | Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. | |||||||||
| Short | Number of Study Related Instances | |||||||||
| Control | 0..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | NumberOfStudyRelatedInstances | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 58. ImagingStudy.procedureReference | ||||||||||
| Definition | The procedure which this ImagingStudy was part of. | |||||||||
| Short | The performed Procedure reference | |||||||||
| Control | 0..1 | |||||||||
| Type | Reference(Procedure) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 60. ImagingStudy.procedureCode | ||||||||||
| Definition | The code for the performed procedure type. | |||||||||
| Short | The `ProcedureCode`s associated with the study. | |||||||||
| Control | 0..* | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from http://www.rsna.org/RadLex_Playbook.aspx (extensible to http://www.rsna.org/RadLex_Playbook.aspx)The performed procedure type. | |||||||||
| Type | CodeableConcept | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | ProcedureCodeSequence | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 62. ImagingStudy.location | ||||||||||
| Definition | The principal physical location where the ImagingStudy was performed. | |||||||||
| Short | Where ImagingStudy occurred | |||||||||
| Control | 0..1 | |||||||||
| Type | Reference(Location) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting). | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 64. ImagingStudy.reasonCode | ||||||||||
| Definition | Description of clinical condition indicating why the ImagingStudy was requested. | |||||||||
| Short | Why the study was requested | |||||||||
| Control | 0..* | |||||||||
| Binding | For example codes, see ProcedureReasonCodes (example to http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1)The reason for the study. | |||||||||
| Type | CodeableConcept | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 66. ImagingStudy.reasonReference | ||||||||||
| Definition | Indicates another resource whose existence justifies this Study. | |||||||||
| Short | Why was study performed | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(Condition, Observation, Media, DiagnosticReport, DocumentReference) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 68. ImagingStudy.note | ||||||||||
| Definition | Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element. | |||||||||
| Short | User-defined comments | |||||||||
| Control | 0..* | |||||||||
| Type | Annotation | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 70. ImagingStudy.description | ||||||||||
| Definition | The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed. | |||||||||
| Short | Institution-generated description | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | StudyDescription | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 72. ImagingStudy.series | ||||||||||
| Definition | Each study has one or more series of images or other content. | |||||||||
| Short | Each study has one or more series of instances | |||||||||
| Control | 1..* | |||||||||
| Type | BackboneElement | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 74. ImagingStudy.series.id | ||||||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |||||||||
| Short | Unique id for inter-element referencing | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| XML Format | In the XML format, this property is represented as an attribute. | |||||||||
| Summary | false | |||||||||
| 76. ImagingStudy.series.extension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | |||||||||
| Short | Additional content defined by implementations | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Alternate Names | extensions, user content | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 78. ImagingStudy.series.modifierExtension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | |||||||||
| Short | Extensions that cannot be ignored even if unrecognized | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | |||||||||
| Summary | true | |||||||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | |||||||||
| Alternate Names | extensions, user content, modifiers | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 80. ImagingStudy.series.uid | ||||||||||
| Definition | The DICOM Series Instance UID for the series. | |||||||||
| Short | DICOM Series Instance UID for the series | |||||||||
| Comments | See DICOM PS3.3 C.7.3. | |||||||||
| Control | 1..1 | |||||||||
| Type | id | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | DICOM Series Instance UID. | |||||||||
| Alternate Names | SeriesInstanceUID | |||||||||
| Example | General: 2.16.124.113543.6003.2588828330.45298.17418.2723805630 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 82. ImagingStudy.series.number | ||||||||||
| Definition | The numeric identifier of this series in the study. | |||||||||
| Short | Numeric identifier of this series | |||||||||
| Control | 0..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | SeriesNumber | |||||||||
| Example | General: 3 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 84. ImagingStudy.series.modality | ||||||||||
| Definition | The modality of this series sequence. | |||||||||
| Short | The modality of the instances in the series | |||||||||
| Control | 1..1 | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from AcquisitionModality (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)Type of acquired data in the instance. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | Modality | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 86. ImagingStudy.series.description | ||||||||||
| Definition | A description of the series. | |||||||||
| Short | A short human readable summary of the series | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | SeriesDescription | |||||||||
| Example | General: CT Surview 180 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 88. ImagingStudy.series.numberOfInstances | ||||||||||
| Definition | Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. | |||||||||
| Short | Number of Series Related Instances | |||||||||
| Control | 1..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | NumberOfSeriesRelatedInstances | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 90. ImagingStudy.series.endpoint | ||||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Series access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances. | |||||||||
| Control | 1..* | |||||||||
| Type | Reference(Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.series.endpoint. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 92. ImagingStudy.series.endpoint:wado | ||||||||||
| Slice Name | wado | |||||||||
| Definition | The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. | |||||||||
| Short | Series access endpoint | |||||||||
| Comments | Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances. | |||||||||
| Control | 1..* | |||||||||
| Type | Reference(EU MADO WADO Endpoint) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Requirements | Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 94. ImagingStudy.series.bodySite | ||||||||||
| Definition | The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality. | |||||||||
| Short | Body part examined | |||||||||
| Control | 0..1 | |||||||||
| Binding | For example codes, see SNOMEDCTBodyStructures (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)Codes describing anatomical locations. May include laterality. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Alternate Names | BodyPartExamined | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 96. ImagingStudy.series.laterality | ||||||||||
| Definition | The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite. | |||||||||
| Short | Body part laterality | |||||||||
| Control | 0..1 | |||||||||
| Binding | For example codes, see Laterality (example to http://hl7.org/fhir/ValueSet/bodysite-laterality|4.0.1)Codes describing body site laterality (left, right, etc.). | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 98. ImagingStudy.series.specimen | ||||||||||
| Definition | The specimen imaged, e.g., for whole slide imaging of a biopsy. | |||||||||
| Short | Specimen imaged | |||||||||
| Control | 0..* | |||||||||
| Type | Reference(Specimen) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 100. ImagingStudy.series.started | ||||||||||
| Definition | The date and time the series was started. | |||||||||
| Short | When the series started | |||||||||
| Control | 0..1 | |||||||||
| Type | dateTime | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 102. ImagingStudy.series.performer | ||||||||||
| Definition | Indicates who or what performed the series and how they were involved. | |||||||||
| Short | Who performed the series | |||||||||
| Comments | If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images. | |||||||||
| Control | 0..* | |||||||||
| Type | BackboneElement | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers. | |||||||||
| Alternate Names | PerformingPhysicianName, OperatorName | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 104. ImagingStudy.series.performer.id | ||||||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |||||||||
| Short | Unique id for inter-element referencing | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| XML Format | In the XML format, this property is represented as an attribute. | |||||||||
| Summary | false | |||||||||
| 106. ImagingStudy.series.performer.extension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | |||||||||
| Short | Additional content defined by implementations | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Alternate Names | extensions, user content | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 108. ImagingStudy.series.performer.modifierExtension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | |||||||||
| Short | Extensions that cannot be ignored even if unrecognized | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | |||||||||
| Summary | true | |||||||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | |||||||||
| Alternate Names | extensions, user content, modifiers | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 110. ImagingStudy.series.performer.function | ||||||||||
| Definition | Distinguishes the type of involvement of the performer in the series. | |||||||||
| Short | Type of performance | |||||||||
| Control | 0..1 | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from ImagingStudySeriesPerformerFunction (extensible to http://hl7.org/fhir/ValueSet/series-performer-function|4.0.1)The type of involvement of the performer. | |||||||||
| Type | CodeableConcept | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Requirements | Allows disambiguation of the types of involvement of different performers. | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 112. ImagingStudy.series.performer.actor | ||||||||||
| Definition | Indicates who or what performed the series. | |||||||||
| Short | Who performed the series | |||||||||
| Control | 1..1 | |||||||||
| Type | Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, Device, RelatedPerson) | |||||||||
| Is Modifier | false | |||||||||
| Summary | true | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 114. ImagingStudy.series.instance | ||||||||||
| Definition | A single SOP instance within the series, e.g. an image, or presentation state. | |||||||||
| Short | A single SOP instance from the series | |||||||||
| Control | 1..* | |||||||||
| Type | BackboneElement | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 116. ImagingStudy.series.instance.id | ||||||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |||||||||
| Short | Unique id for inter-element referencing | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| XML Format | In the XML format, this property is represented as an attribute. | |||||||||
| Summary | false | |||||||||
| 118. ImagingStudy.series.instance.extension | ||||||||||
| Definition | An Extension | |||||||||
| Short | Extension | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | false | |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| Slicing | This element introduces a set of slices on ImagingStudy.series.instance.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | |||||||||
| 120. ImagingStudy.series.instance.extension:number-of-frames | ||||||||||
| Slice Name | number-of-frames | |||||||||
| Definition | The number of frames in an ImagingStudy instance. | |||||||||
| Short | Extension: Number of Frames | |||||||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | |||||||||
| Type | Extension(Extension: Number of Frames) (Extension Type: integer) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 122. ImagingStudy.series.instance.extension:ko-document-title | ||||||||||
| Slice Name | ko-document-title | |||||||||
| Definition | The document title code of the Key Object Selection document TID 2010 this instance refers to. | |||||||||
| Short | Extension: MADO Document Title of Key Object Selection documents | |||||||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | |||||||||
| Type | Extension(Extension: MADO Document Title of Key Object Selection documents) (Extension Type: CodeableConcept) | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 124. ImagingStudy.series.instance.modifierExtension | ||||||||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | |||||||||
| Short | Extensions that cannot be ignored even if unrecognized | |||||||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |||||||||
| Control | 0..* | |||||||||
| Type | Extension | |||||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | |||||||||
| Summary | true | |||||||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | |||||||||
| Alternate Names | extensions, user content, modifiers | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | |||||||||
| 126. ImagingStudy.series.instance.uid | ||||||||||
| Definition | The DICOM SOP Instance UID for this image or other DICOM content. | |||||||||
| Short | DICOM SOP Instance UID | |||||||||
| Comments | See DICOM PS3.3 C.12.1. | |||||||||
| Control | 1..1 | |||||||||
| Type | id | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Requirements | DICOM SOP Instance UID. | |||||||||
| Alternate Names | SOPInstanceUID | |||||||||
| Example | General: 2.16.124.113543.6003.189642796.63084.16748.2599092903 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 128. ImagingStudy.series.instance.sopClass | ||||||||||
| Definition | DICOM instance type. | |||||||||
| Short | DICOM class type | |||||||||
| Control | 1..1 | |||||||||
| Binding | Unless not suitable, these codes SHALL be taken from http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1)The sopClass for the instance. | |||||||||
| Type | Coding | |||||||||
| Is Modifier | false | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Alternate Names | SOPClassUID | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 130. ImagingStudy.series.instance.number | ||||||||||
| Definition | The number of instance in the series. | |||||||||
| Short | The number of this instance in the series | |||||||||
| Control | 0..1 | |||||||||
| Type | unsignedInt | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Alternate Names | InstanceNumber | |||||||||
| Example | General: 1 | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
| 132. ImagingStudy.series.instance.title | ||||||||||
| Definition | The description of the instance. | |||||||||
| Short | Will contain the Key Object Description in the case the instance represents a Key Object. | |||||||||
| Comments | Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc. | |||||||||
| Control | 0..1 | |||||||||
| Type | string | |||||||||
| Is Modifier | false | |||||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | |||||||||
| Must Support | true | |||||||||
| Obligations |
| |||||||||
| Summary | false | |||||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | |||||||||
IG © 2025+ HL7 Europe.
Package hl7.fhir.eu.imaging-manifest#1.0.0-ballot based on FHIR 4.0.1.
Generated
2026-10-16
