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

Volume 1

This page reflects Volume 1 of the MADO specification MADO Volume 1. All content in MADO Volume 1 applies to this spec as well. This pages presents the EU specific extensions to IHE-MADO Volume 1.

EU-specific actors

The EU specific actor relevant to this IG are:

EU-1 - locate and access a patient study (informative)

This use case illustrates how a Document Consumer (Imaging Manifest) locates imaging manifests for a patient by using the patient's identifier and anatomical region, selects one of the matching manifests, and accesses the content of the imaging study represented by that manifest.

Preconditions:

  • The patient identifier is known to the Document Consumer.
  • The patient has one or more imaging manifests available in document sharing infrastructure.
  • The anatomical region used for the search is known or selected by the user.

Main flow:

The figure below illustrates this use case in a sequence diagram using IHE-MHD and WADO-RS.

EU-1 Locate and Access a Patient Study from an Imaging ManifestDocument Consumer (Imaging Manifest)Document Consumer (Imaging Manifest)Document Access Provider (Imaging Manifest)Document Access Provider (Imaging Manifest)Imaging Document SourceImaging Document SourceLocate and select manifestUse patient identifier and anatomical regionSearch manifests by patient identifier and anatomical region [ITI-67]Matching manifest metadata and referencesSelect a manifest from the search resultsRetrieve selected manifest [ITI-68]Manifest documentAccess study contentRead study, series, and instance referencesWADO-RS retrieval for content represented by the manifest [RAD-160]/[RAD-107]DICOM instances/series payloadRender or process the study
EU-1 sequence: locate and access a patient study from an imaging manifest


The steps are:

  1. The Document Consumer (Imaging Manifest) searches for manifests using the patient's identifier and the selected anatomical region.
  2. The Document Access Provider (Imaging Manifest) returns the matching manifest metadata and references.
  3. The Document Consumer (Imaging Manifest) reviews the results and selects a manifest.
  4. The Document Consumer (Imaging Manifest) retrieves the selected manifest from the Document Access Provider (Imaging Manifest).
  5. The Document Consumer (Imaging Manifest) reads the study and its series/instance references from the manifest.
  6. The Document Consumer (Imaging Manifest) accesses the content of the represented study from the Imaging Document Source through WADO-RS and renders or processes the retrieved DICOM data.

Example query pattern:

  • Locate manifests: GET DocumentReference?patient.identifier={system}|{value}&anatomical-region=extension-anatomical-region={region-code}
  • Retrieve the selected manifest: GET {DocumentReference.content.attachment.url}
  • Retrieve study content: GET {WADO-RS URL from the selected manifest}

EU-specific use case 2 - retrieve manifest based on EU Imaging Report (informative)

This use case illustrates the operational relationship between the HL7 Europe Imaging Report and this Imaging Manifest specification: the workflow starts from an imaging report and continues to retrieval of the related imaging study data.

Preconditions:

  • An imaging report is available in document sharing infrastructure.
  • The report can be linked to the corresponding manifest (for example via StudyInstanceUID and/or accession-number).

Main flow:

The figure below illustrates this use case in a sequence diagram using IHE-MHD.

EU-2 Report-driven Retrieval of Imaging DataDocument Consumer (Imaging Manifest)Document Consumer (Imaging Manifest)Document Access Provider (Imaging Manifest)Document Access Provider (Imaging Manifest)Imaging Document SourceImaging Document SourceStart from reportSearch and retrieve imaging report [ITI-67][ITI-68]Imaging reportDetermine image access is requiredResolve linked manifestDetermine StudyInstanceUID (or AccessionNumber) from reportSearch related manifest (using StudyInstanceUID or AccessionNumber) [ITI-67]Matching manifest entriesRetrieve selected manifest [ITI-68]Manifest documentRetrieve DICOM contentSelect target series and instancesWADO-RS retrieval from manifest endpoint [RAD-160]/[RAD-107]DICOM contentRender or process images with report context
EU-2 sequence: report-driven retrieval of manifest and images


The steps are:

  1. The Document Consumer (Imaging Manifest) searches for imaging reports for a patient and retrieves a selected report.
  2. The Document Consumer (Imaging Manifest) reviews the report and determines that image access is needed.
  3. The Document Consumer (Imaging Manifest) searches for the associated manifest using identifiers from the report/study context.
  4. The Document Consumer (Imaging Manifest) retrieves the selected manifest document from the Document Access Provider (Imaging Manifest).
  5. The Document Consumer (Imaging Manifest) selects relevant series/instances from the manifest.
  6. The Document Consumer (Imaging Manifest) retrieves the corresponding DICOM data from the Imaging Document Source through WADO-RS and renders or processes the images.

example query pattern:

  • Search report(s): GET DocumentReference?category=http://loinc.org|85430-7&subject=Patient/{id}
  • Search related manifest: GET DocumentReference?category=http://loinc.org|18748-4&subject:identifier={identifier}&identifier={StudyInstanceUID}
  • Retrieve selected payload: GET {DocumentReference.content.attachment.url}
  • Retrieve DICOM objects: GET {wado-rs url from manifest}