Radiopharmaceutical
Administration
Radiation Dose
Reporting
RARD Reporting White Paper
A RARD report proposes a solution to connect the
radiopharmaceutical management dominion with the image
modalities and imaging dominion.
Charles Smith, Lawrence Smith, George Gregg, Numa Inc.
2/13/2012
For latest version go to: www.numa-inc.com
Contents
Radiopharmaceutical Administration Radiation Dose Reporting ................................................................. 3
Introduction .............................................................................................................................................. 3
Who is this for? ......................................................................................................................................... 5
Molecular Imaging Use Cases: .................................................................................................................. 5
Considerations: ..................................................................................................................................... 5
Review of IHE Radiation Exposure Monitoring (REM) technical framework. ........................................... 6
IHE REM Use cases: ............................................................................................................................... 6
Integrating Molecular Imaging workflow into REM workflow. ................................................................ 8
RARD Actor Transaction ........................................................................................................................ 8
Workflow diagrams ................................................................................................................................... 9
Real-World Molecular Imaging current workflow ................................................................................ 9
RARD Workflow with hot lab manager implemented RARD Actor..................................................... 10
RARD Workflow administrated dose without imaging. ...................................................................... 11
RARD Workflow with an infusion system implementing the RARD Actor. ......................................... 12
Radiopharmaceutical Dose Check........................................................................................................... 13
Radiopharmaceutical Dose Check workflow ...................................................................................... 14
Challenges ............................................................................................................................................... 14
Technoligist “Push Back”..................................................................................................................... 14
Assay of residual dose ......................................................................................................................... 15
DICOM Standard ................................................................................................................................. 15
Product labels Radiation Dosimetry estimation ................................................................................. 15
Radiopharmaceutical Quality Control, Isotope and Reagent Kit attributes ....................................... 16
Intervention drugs and Contrast Agent characteristics report ........................................................... 16
Product Administration Approval ....................................................................................................... 16
Conculsion ............................................................................................................................................... 16
Appendix ................................................................................................................................................. 17
RARD PET\CT Sequence Example........................................................................................................ 17
Review of Existing Standards .............................................................................................................. 18
DICOM SAS Substance Administration Services ................................................................................. 19
Radiopharmaceutical Administration Radiation Dose Structure Report Template................................ 20
Radiopharmaceutical Administration Dose Template ........................................................................ 20
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Radiopharmaceutical Administration Accumulated Dose .................................................................. 21
Radiopharmaceutical Administration Event ....................................................................................... 22
Substance Administration Approval Code Reference Extension ............................................................ 25
Radiopharmaceutical administration Dose Exposure per Organ........................................................ 25
Radioisotope Assay Data Template .................................................................................................... 26
Patient Characteristics template......................................................................................................... 26
Glomerular filtration rate.................................................................................................................... 27
Current published DICOM Codes ............................................................................................................ 28
Radiopharmaceuticals Context Id 25 ...................................................................................................... 28
CID 25
Radiopharmaceuticals ......................................................................................................... 28
Isotopes in Radiopharmaceuticals CID 18 ........................................................................................... 32
PET Cardiology Radiopharmaceuticals CID 3107 ................................................................................ 33
Nuclear Cardiology Radiopharmaceuticals CID 3111 ......................................................................... 33
PET Radiopharmaceutical CID 4021 .................................................................................................... 33
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Radiopharmaceutical Administration Radiation Dose Reporting
Introduction
The following is a white paper comprised from a review of the DICOM, IHE, HL7 standards and
current Molecular Imaging industry. The goal of this document is to raise awareness, stimulate
discussion and help begin the process of finding solution to existing problems. We assume it is
best to follow IHE and DICOM approach for X-Ray and CT exposure and develop DICOM
structure report (SR) for radiopharmaceutical administration. There are other approaches to the
problem but DICOM SR offers the best alignment with existing standards, profiles and systems.
We will identify current parts of standards that refer to radiopharmaceuticals; define attributes of
the report, define the role of the creator of the report and propose a “Dose Check” in the
workflow.
There are many opportunities for the molecular image industry with adoption of a
standardization of dose report. A Radiopharmaceutical Administration Radiation Dose Structure
Report (RARD) would create a means for communication between the radiopharmaceutical
segment of the industry and the imaging segment. With communication established there are
numerous uses for the report which could solve existing problems in the Molecular Imaging
industry.
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The report would document radiopharmaceutical exposures and distribute them as
defined in the IHE Radiation Exposure Monitoring (REM) Profile.
The RARD contains radiopharmaceutical administration information required by PET
systems for accurate and consistent SUV calculations.
A standardized report and a time managed workflow is essential for the RSNA QIBA
PET SUV Biomarker.
A RARD report is a DICOM object so the information would flow with the images to
reading stations and archives.
The report could be de-identified and transferred from site to site or information could be
gathered from sampling of RARD reports. (e.g. dose amount, uptake times and other
patient characteristics) This information would be valuable for clinical research and
setting exposure benchmarks in the imaging department. A National registry could be
established to gather dose reports.
Developing a radiation dose report for Molecular Imaging is a complex problem. The
radiopharmaceutical product causes the radiation exposure to the patient, not the imaging
system itself unlike other modalities. Doses are often created in specialized pharmacies outside
of the imaging facilities. Doses are measured and recorded in systems (hot lab managers). The
doses are often administered to patients several minutes before the patient is imaged. Hot lab
managers currently have limited HL7 and DICOM Worklist capabilities. Currently, there is no
defined standard to digital communicate radiopharmaceutical administration information
in a time managed format to radiopharmaceutical imagers. For an accurate Radionuclide
Total Dose it is essential that time is managed (consistent) for, when the dose is assayed, when
the dose is administered and when the imager records the start of the acquisition.
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The RARD report needs to contain the information required to accurately compute exposure
from a radiopharmaceutical. These components are:
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the radiopharmaceutical and radioisotope
the measured activity and the time it was measured
the time the product was administered
the residual activity measured and the time it was measured
the patient state (stress or rest) when the product was administered.
Time is a reoccurring attribute in many of the exposure components. If the imaging modality is
going to relate these components to acquired images (like in PET SUV) then it needs to be
able too relate the exposure component times to the imagers acquisition start time.
Another aspect of the radiopharmaceuticals that should be considered is that they are
substances that are administered to patients. There are many parts of the DICOM standard that
pertain to substances (e.g. Contrast Agent and Interventional drugs). The Interventional Drug
Code Sequence is now part of the Nuclear Medicine and PET IOD. For hybrid PET/CT,
SPECT/CT and PET/MR scanners, the contrast agent information is part of the CT and MR
IOD. Though not as critical as radiopharmaceutical information, contrast agents and intervention
drugs have the same problem; the technologist has to manually enter data about products
administered several minutes earlier at the modality console. Hot lab management systems can
track the administration substances other than radiopharmaceuticals. In this document we will
review and incorporate appropriate information into the RARD report. Contrast Agents and
interventional drugs should be handled in a different and separate Product Administration
report. A product administration report would share many of the same attributes and workflow
as the RARD report.
What we are proposing is a four item solution.
1. Radiopharmaceutical Administration Radiation Dose SR IOD template (RARD SR). The
report contains dose assay components and exposure components.
2. A RARD Creator Actor which defines the role and features of the RARD report creator.
The profile can then be integrated in to IHE REM profile.
3. A Dose Alert component for the RARD Creator. It could act much like the CT Dose
Check Initiative.
4. A Product Administration Report SR IOD template. It is used to communicate
Intervention drugs and contrast products to the imaging modalities. Radiopharmaceutical
Reports are differentiated from Product Administration reports so they can easily be
identified by REM Dose information consumers. RARD should have a different SOP
Class UID from Product Administration Reports. A product administration report and a
RARD would share many of the same attributes, but a product administration report is
beyond the scope of this document.
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Who is this for?
There are many aspects to reporting exposure within the MI department. Therefore, there are
many players who should be aware and involved in developing the report. The following is a list
of potential players.
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Facilities exposing patient to radiation from radiopharmaceuticals.
MI Physician and Technologist
Modality Manufacturers of Nuclear Medicine, PET and Hybrid systems.
Radiopharmaceutical manufacturers
Radiopharmaceutical Pharmacies
Dose Management System Developers
Dose calibrator manufacturers
Rubidium Generator manufacturers
Infusion System manufacturers
Non-Imaging Nuclear Medicine systems manufactures, Uptake Probe, Blood Volume.
Molecular Imaging Use Cases:
In the following list we will try to capture the use cases and other considerations we used for the
design of the RARD report. The RARD Report will:
1.) Record radiopharmaceutical exposure in an IHE REM compatible format.
2.) Record product information not entered/available to the scanner at time of the
acquisition or must be edited after the acquisition.
3.) Support multiple scans (and/or, multiple reconstructed images series) in a study, from 1
product administration.
4.) Support multiple product administration within a study (e.g. Cardiac Rest/Stress study)
5.) Create reports for non-imaging procedures. (e.g. Thyroid Uptakes probes, Blood volume
systems)
6.) Create reports for administered products even if patient cancels imaging step.
7.) Create reports for therapeutic doses that are not imaged.
8.) Record the Patient State when the radiopharmaceutical was administered. Patient state
affects radiopharmaceutical dose.
Considerations:
1.) Exposure Reporting
a. Effective Dose (as per product label)
b. Organ Exposure (as per product label)
2.) Model Injection/Administration as event, and include some mechanism of uniquely
identifying that administration event (analogous to CT “irradiation event”).
3.) Accumulated Dose
4.) Dose Information is transferred and stored with images.
5.) Coded Radiopharmaceutical
6.) Coded Radioisotope
7.) Coded Route of Administration
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8.) PET SUV Components
a. Total dose
b. Administration date/time
c. Patient Weight
d. Patient Size (height)
9.) Radioisotope Assay Data
a. Observer Context
10.) Time Management (Consistent Time when recording the dose, and product
administration)
11.) Patient Uptake Location
12.) Patient Characteristics
a. Patient State Stress\Rest
b. Glucose level
c. GFR/eGFR
d. Allergies
e. Patient Medications
13.) Product characteristics
a. Product Package Identifier
b. Manufacturer
c. Product Type Code Sequence
d. Product Lot identifier
e. Product Expiration Date Time
f. Product QC data
g. Isotope characteristics
h. Reagent Kit characteristics
14.) Volume Administered
15.) Interventional Drugs (Stress Agents)
16.) Prescription Id
17.) Unit Dose or local compounded
18.) Clinical Trials integration
19.) Image report
20.) Product administration integration (Medicine Administration Report)
21.) Product approval
22.) Meaningful Use (MU) component requirements
Review of IHE Radiation Exposure Monitoring (REM) technical framework.
The following is a list of the use cases identified for REM. The use cases were identified for CT,
X-ray and fluoroscopy system but most of these points are applicable to molecular imaging.
IHE REM Use cases:
1.) Department QA (Process Control)
2.) Patient Impact Evaluation
3.) Population Dose and Dose Indicators
4.) Dose Reference Levels
5.) Site Benchmarking
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6.) Population Epidemiology
7.) Clinical Trials
8.) Procedure Operational Awareness (Quasi-real time)
9.) Clinical Management
10.) Longitudinal Patient Dose Record
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Integrating Molecular Imaging workflow into REM workflow.
The following is a drawing that is identical to the Actor diagram in the IHE REM profile except for
the Acquisition modality actor has been replaced with a RARD Creator actor. Molecular Imaging
modalities, which only image, do not appear in the diagram because they do not expose
patients. For PET especially, the camera should perform the role of the Dose Information
consumer. The RARD report contains information essential for SUV calculations.
Figure 1 RARD Creator in IHE Actor diagram
RARD Actor Transaction
Actor
Transactions
Optionality
Reference
RARD Creator
Maintain Time [ITI-1]
Query Modality Worklist [RAD-5]
Store Dose Information[RAD-62]
Storage Commitment [RAD-10]
Modality PS in Progress [RAD-6]
Modality PS in Complete [RAD-7]
O
R
R
R
O
O
IHE IT Infrastructure Vol. 1 Section 7
IHE Radiology Vol. II Section 4.5
IHE REM Vol. 4 Section 62
IHE REM Vol 4 Section 10
IHE Radiology Vol. II Section 4.6
IHE Radiology Vol. II Section 4.7
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Workflow diagrams
Real-World Molecular Imaging current workflow
The following figure is a diagram of the “typical” current molecular imaging workflow. The blue
represents RIS\HIS scheduling workflow. The orange represents radiopharmaceutical
management workflow. The green represents the patient workflow. The red is imaging modality
workflow. Some dose management systems are connected to the HIS/RIS for ordering. Note
there is no connection between the radiopharmaceutical management and the imaging
modality. Time is not managed between dose measurement and product administration and the
imaging scanner.
Figure 2 Current Molecular Imaging Workflow
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RARD Workflow with hot lab manager implemented RARD Actor.
The following diagram demonstrates workflow where there is a RARD actor. It is recording the
dose measurements and the product administration measurements. In this instance the RARD
report is being sent directly to the imaging scanner. The scanner can read the report to populate
the radiopharmaceutical administration information it requires. The scanner’s images can now
reference the RARD report. The scanner images and the RARD report can be stored and read
from the image manager/archive (PACS).
Figure 3 Dose Management system RARD Actor Workflow
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RARD Workflow administrated dose without imaging.
The following figure shows the workflow for non-imaging dose or procedure where the patient is
administered a radiopharmaceutical but is not imaged. A record of the administration is still
produced and stored. This action may prompt the billing system that the procedure step was
performed. Time is managed between the dose assay time and the product administration time.
Figure 4 RARD Workflow with no imaging step
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RARD Workflow with an infusion system implementing the RARD Actor.
The following is the workflow if the RARD Actor is an infusion system or generator. The
consistent time triangle was removed from the drawing for simplifcation. Keeping consistent
time is simpler because the infusion system is electronically preforming dose assays and dose
administration. If time is managed between the infusion system and scanner then very accurate
dose reports can be achieved. Also, since the patient characteristics can be entered in to the
infusion system, patient specific dose reduction routines can be easily implemented. Dose
assys are recorded electronically without technologist “push back”.
Figure 5 Infusion System RARD Actor Workflow
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Radiopharmaceutical Dose Check
If the MI industry implemented a dose check feature simular to CT industry, a logical place to
put the check dose feature is in the RARD creator. RARD creator would ensure the
radiopharmaceutical attributes. The following is a list of attributes for the RARD dose check.
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Radiopharmaceutical (Coded Value)
Radiopharmaceutical Assay Measurement
Assay Time (Time Managed)
Electronic setting of dose calibrator for radiopharmaceutical
Electronic reading of dose assay values.
Schedule Administration Time or current time in same managed time as assay.
Patient Age
Procedure
Configured Notification Value
Reason for Proceding
Person Participant
Allergies
Mediciations
Other QC data
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Radiopharmaceutical Dose Check workflow
The following is a proposed workflow for a radiopharmaceutical “Dose Check”. Patient age,
weight, scheduled start time and requested procedure are gathered from DICOM Worklist.
Products for the procedure are selected from inventory. The radiopharmaceutical is assayed in
the dose calibrator. The electronic connection to the dose calibrator is important. First the RARD
creator can ensure the dose calibrator is set to the correct isotope for the selected
radiopharmaceutical. Secondly it eliminates transcription errors. Third it ensures the dose is
assayed and the time. The patient is prepared for the administration of the radiopharmaceutical.
Then just before administration there is a check of patient id to product id. It would be possible
to check radiopharmaceutical dose using current time and last assay to ensure the dose is
being administered at the proper time. Product approval by local pharmacy, drug interaction and
patient interview results are not included in the workflow.
Figure 6 Dose Check Workflow
Challenges
Technologist “Push Back”
Electronic recording of Assay
For several years, dose calibrators have had the ability to read assays electronically.
Additionally, hot lab management systems have had the ability to read dose assays from the
dose calibrators; however, today, few departments have their dose calibrators and hot lab
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managers connected. There may be several reasons for this including compatibility with the hot
lab management system and dose calibrator, inexperience of the nuclear medicine technologist,
and/or lack of recognition of the value of using integrated systems to reduce regulatory record
keeping related to each administered dose. Education is the answer. The industry should
educate physicians and technologists of the value of doses read electronically - and more
specifically, work with individual departments to assure that the technology is well understood
and super users are available within the institution for questions. An example of problems that
can occur with manual dose measurements was cited from a study that was performed for QIBA
PET SUV Biomarker that resulted in a rejection of 10% of the data because of dose calibrator
isotope setting errors. The following summarizes the value of stressing electronic readings for
dose assay:
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minimize transcription error
minimize dose calibrator isotope setting errors
improved accuracy of dose administration data based on time synchronization of
the reading computer and imaging camera
improved department efficiency and productivity (minimize time with manual data
entry)
improved dose reporting accuracy
ensuring doses are validated and assayed before administration
Assay of residual dose
With the exception of PET, many departments do not record residual activity for most
procedures following administration of the radiopharmaceutical. Multiple reasons are cited
including residual dose information is not required for study interpretation; inadequate time in an
already overbooked schedule; the actual time required to measure the residual dose, which for
most dose calibrators takes longer based on the lower activity levels; the inability to enter the
data in the hot lab management system and most importantly, the additional radiation exposure
associated with handling a non-shielded radioactive syringe. The challenge is to note when the
administration step is complete. Is the administration step complete when the dose is
administered or when the residual dose has been assayed?
DICOM Standard
 Duplicate codes for the same radiopharmaceutical exist between Nuclear Medicine
Radiopharmaceutical and Nuclear Medicine Cardiology Radiopharmaceutical. The same
for PET and PET Cardiology.
 Not all organs reported in the radiopharmaceutical product labels appear in the DICOM
standard. (CP 1127 Add fields for Organ Dose to Dose SR)
 TID 15101 NM/PET Protocol Context. See Appendix
 Supplement 107 Substance Administration Information Services. See Appendix
Product labels Radiation Dosimetry estimation
The radiation dose on product labels provides an estimated dose to organs. Much like CT
exposures these exposures are based on models. Patient’s actual exposure may vary.
Radiopharmaceuticals expose the whole body. This report estimates the total effective dose and
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the dose to each organ. If a better method of measuring dose is developed it would most likely
report information in the same categories.
Radiopharmaceutical Quality Control, Isotope and Reagent Kit attributes
This document attempts to identify some of the attributes for quality control and component
attributes but there may be other attributes that are needed. DICOM SRs are customizable so
local department or applications can add attributes as needed.
Intervention drugs and Contrast Agent characteristics report
Intervention drug and contrast agent were not added to the RARD report for compatibility with
REM. A SR report could be developed that would have the same workflow as RARD. It seems
that if a camera is parsing a SR file for radiopharmaceutical information, it could parse an SR
document for intervention drugs and contrast agent. The cross-enterprise document (XDS)
would provide a good solution to product administration reporting.
Product Administration Approval
Product Administration reporting. (Joint Commission Medication Management (MM) standards).
DICOM Substance Administration Services have a component to aid in integrating contrast
agent and intervention drugs with pharmacy system. See appendix
“Drug-use controls in radiology present a difficult and challenging circumstance, one in which millions of
patients per year are routinely exposed to dangerous drugs without the protections uniformly offered
elsewhere in the hospital. Pharmacy must assume responsibility for the well-being of these patients and
ensure best medication-related outcomes for patients referred for medical imaging. All patients should
be protected by the safeguards pharmacy is uniquely positioned to provide.”
http://www.pppmag.com/article/858/April_2011/Managing_Radiopharmaceuticals/
Conculsion
It is possible to leverage existing standards and systems to provide a radiation dose report for
radiopharmaceuticals. The report provides a Win-Win situation. Dose reporting systems can
now gather more information to give a more complete picture of a patient’s dose. Molecular
Imaging wins by improved accuracy and efficiency in radiopharmaceutical administration. There
are a number of challenges to completing the RARD report, but defining the report is the first
step towards solving the problem.
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Appendix
RARD PET\CT Sequence Example
The following shows a sequence diagram to moving a RARD from the creator to PET/CT modality. PET/CT
system stores the CT radiation exposure report. Both reports are available to a DOSE information
reporter. Reports are then submitted to a Dose Registry.
Figure 7 RARD PET\CT REM Sequence
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Review of Existing Standards
TID 15101 NM/PET Protocol Context
This template defines the radiopharmaceutical information that can be added to the Protocol Context in
a DICOM Schedule Worklist Step or a Performed Procedure Step. It provides a standard method to move
information to the acquisition system via Modality Worklist or MPPS.
Figure 8. NM/PET Protocol Context Workflow
Pros
Pros
1.)
2.)
3.)
4.)
5.)
Cons
1.)
2.)
3.)
Coded Radiopharmaceutical
Coded Radioisotope
Total Dose measurement
Radiopharmaceutical Start Time
Route of Administration
No defined communication between worklist provider and dose measurement.
No Consistent Time with measurements
No Irradiation Event Id,Dose information could easily be confuse or duplicate duplicated
between systems.
4.) No Exposure Information
5.) Difficult to relate stress dose or rest dose.
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DICOM SAS Substance Administration Services
SAS introduces a new query SOP Class for imaging modalities to request verification of contrast agents
and other drugs administered during an imaging or image-guided treatment procedure, based on the
label bar code and the patient ID.
Figure 9. Substance Administration Workflow
Pros
1.)
2.)
3.)
4.)
Defined Product Character
Defined Substance Approval
Remote Administration
Defined workflow for Contrast agent and Intervention Drugs
Cons
1.)
2.)
3.)
4.)
5.)
6.)
7.)
Radiopharmaceuticals not defined.
No consistent time
Few if any implementations
No defined communication to Medicine Administration Record (MAR or eMAR)
No defined communication to Scheduled Workflow
No defined communication to pharmacy
No Interface with IHE REM, or IHE PRE.
3.) Nuclear Medicine and PET DICOM IOD defines fields for radiopharmaceuticals. The imaging
modality requires that the operator manually fill in these fields. Often these fields are not
completed and the manual process is prone to errors.
4.) Cardiac Stress Structure Reports have a define section for both PET and NM
radiopharmaceuticals. It would require the information to be read from the images or manually
input from the operator.
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5.) HL7 Structured Product Labels. HL7 and FDA worked together to develop a HL7 structure
for product label. All radiopharmaceuticals have a structured product label but the SPL did not
define a structure for the Radiation Dosimetry section.
Radiopharmaceutical Administration Radiation Dose Structure Report
Template
The template provides details on proposed structure of the RARD SR document. It is laid out similar to
the DICOM standard. It draws on many different defined attributes which exist in the DICOM standard.
1.) Radiopharmaceutical Administration Dose
2.) Radiopharmaceutical Administration Accumulated Dose
3.) Radiopharmaceutical Administration Dose Event Data
4.) Radiopharmaceutical administration Dose Exposure per Organ
5.) Radiopharmaceutical Administration Dose Measurement Data
6.) Radiopharmaceutical Administration Exposure
7.) Product Administration Patient Characteristics
8.) Product Characteristics
9.) Substance approval
10.) Substance Administration
Radiopharmaceutical Administration Dose Template
This template defines a container (the root) with subsidiary content items, each of which
corresponds to a single Radiopharmaceutical Administration Dose event entry. There is a
defined recording observer (the system or person responsible for recording the log, generally
the system). Accumulated values shall be kept for a whole Study or at least a part of a Study, if
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the Study is divided in the workflow of the examination, or a performed procedure step. Multiple
Radiopharmaceutical Administration Dose objects may be created for one Study.
NL
Rel with
Parent
1
VT
Concept Name
VM
Req
Type
CONTAINER
Radiopharmaceutical Dose
Report
EV (121058, DCM,
”Procedure reported”)
1
M
1
M
2
>
HAS
CONCEPT
MOD
CODE
3
>
HAS OBS
CONTEXT
CODE
EV (113705, DCM,
“Scope of Accumulation”)
1
M
4
>
UIDREF
DCID (10001) UID Types
1
M
5
>
HAS
PROPERTIES
CONTAINSs
INCLUDE
1
6
>
CONTAINS
INCLUDE
7
>
CONTAINS
TEXT
Radiopharmaceutical
Administration
Accumulated Dose
Radiopharmaceutical
Administration Event
EV (121106, DCM,
“Comment”)
1-n
M
1
U
Condition
Value Set
Constraint
Radiophar
maceutical
Administra
tion
DCID
(10000)
Scope of
Accumulati
on
Content Item Descriptions
Row 1
Row 2
Row 3
Row 4
Row 5
Radiopharmaceutical Dose Report. Code needs to be defined. In CT and XRAY this is EV (113701,
DCM. “X-Ray Radiation Dose Report”)
Notes this is a RARD report
Scope of Accumulation Study, Series, Performed Step, Irradiation Event, may need new Product
Administration.
Study Instance UID, Series Instance UID, Performed Procedure Step SOP Instance UID, Irradiation
Event UID
Holds accumulated does information in a sequence.
Radiopharmaceutical Administration Accumulated Dose
This general template provides detailed information on radiopharmaceutical dose value
accumulations over multiple administration events over the scope of accumulation specified for
the report (typically a Study or a Performed Procedure Step).
NL
Rel with
Parent
1
2
>
CONTAINS
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VT
Concept Name
VM
Req
Type
CONTAINER
“Accumulated
Radiopharmaceutical
Administration Dose”
“Total Number of
1
M
1
M
NUM
Condition
Value Set
Constraint
Units = EV
Page 21
Administration Events”
3
>
CONTAINS
NUM
Total Effective Dose
1
M
4
>
CODE
MC
>
1-n
U
6
>
CONTAINS
TEXT
Dose Reference
Authority
Radiopharmaceutical
administration Dose
Exposure per Organ
EV (121106, DCM,
“Comment”)
1
5
HAS
PROPERTIES
CONTAINS
1
U
INCLUDE
({events}
UCUM,
“events”)
Units = EV
(mSv,
UCUM,
“mSv”)
Product
Label
Content Item Descriptions
Row 1
Row 2
Row 3
Row 4
Row 5
Molecular Imaging Accumulated Dose Container.
Total Number of Administration Events.
Numa Molecular Imaging Total Effective Dose.
Product Label or some other reference.
Radiopharmaceutical administration Dose Exposure per Organ
Radiopharmaceutical Administration Event
The Radiopharmaceutical Administration Event conveys the dose and assay and time
information of a single radiopharmaceutical event.
NL
Rel with
Parent
VT
Concept Name
VM
Req
Type
CONTAINER
EV (123001, DCM,
“Radiopharmaceutical”)
1
M
BCID (25)
Radiopharmaceuticals or
BCID (3107) PET
Cardiology
Radiopharmaceuticals or
BCID (3111) Nuclear
Cardiology
Radiopharmaceutical BCID
(4021) PET
Radiopharmaceutical
HAS
CONCEPT
MOD
CONTAINS
CODE
EV (G-C0E8, SRT,
“Has Intent”)
1
M
DCID (3629) Procedure
Intent
CODE
EV (G-C032,
SRT,
”Classification”)
1
U
HAS
PROPERTIES
TEXT
“Product Package
Identifier”
1
M
TID 9002
(0044,0007)
Product Type Code
Sequence
(DCM 121148 Unit
Serial Identifier)
Identifier of the contrast
agent, drug, or device
1
2
>>
3
>
4
>
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Cond
ition
Value Set Constraint
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being
characterized, typically
from a package bar
code,
RFID, or other materials
management ID. This ID
might not be globally
unique and might conflict
with other IDs used
within the scope of the
institution.
5
>
HAS
PROPERTIES
TEXT
6
>
CONTAINS
TEXT
7
>
HAS
PROPERTIES
TEXT
8
>
HAS
PROPERTIES
CODE
9
>
HAS
PROPERTIES
DATETIME
10
>
HAS
PROPERTIES
DATETIME
11
>
CONTAINS
NUMERIC
12
>
CONTAINS
UIDREF
13
>
CONTAINS
NUMERIC
14
>
HAS
PROPERTIES
PNAME
15
>
CONTAINS
CODE
16
>
CONTAINER
CODE
17
>
CONTAINS
NUMERIC
18
>
CONTAINS
NUMERIC
19
20
21
>
>
>
CONTAINS
CONTAINS
CONTAINS
CONTAINER
CONTAINER
CONTAINER
RARD White Paper
EV (111529, DCM, ”Brand
Name”)
EV(???,???, Manufacturer)
1
U
1
U
EV (121145, DCM,
"Description of Material")
EV (G-C340, SRT, "Route of
administration")
EV (123003, DCM,
“Radiopharmaceutical
Start
Time”)
EV (123004, DCM,
“Radiopharmaceutical
Stop
Time”)
EV (123006, DCM,
“Radionuclide Total
Dose”)
EV (113769, DCM,
“Irradiation Event UID”)
EV (123005, DCM,
“Radiopharmaceutical
Volume”)
EV (121152, DCM, “Person
administering
drug/contrast”)
“Dose Type”
1
U
1
M
1
M
1
U
1
M
Units = DT(Bq, UCUM,
“Bq”)
1
M
TID 10003
1
U
Units = DT(cm3, UCUM,
“cm3”)
1
M
1
U
EV (C-B1000, SRT,
“Diagnostic Radioisotope)
Radionuclide Half Life
1
U
1
M
EV (123007, DCM,
“Radiopharmaceutical
Specific Activity”)
Radioisotope Assay Data
Radioisotope Attributes
Radiopharmaceutical
Quality Control Attributes
1
U
1-n
1
1
U
U
Administration Log IOD
(0008,0070)
BCID (11) Route of
Administration
“Unit Dose,
Multidose Vial”
BCID 18 (NM) or 4020
(PET)
Units = (min, UCUM,
minute, h, UCUM, hour, d,
UCUM, day)
Units = DT(Bq/mol, UCUM,
“Bq/mol”)
Page 23
22
23
>
>
CONTAINS
CONTAINS
CONTAINER
NUM
Reagent Kit Attributes
Prescribed dosage
1
1
U
24
25
>
>
CONTAINS
CONTAINS
TEXT
CODE
1
1
U
U
26
>
CONTAINS
DATETIME
1
U
27
>
CONTAINS
TEXT
1
U
28
>
RX Number
Substance Administration
Approval
Administration Approval
Date Time
Approval Status
Description
Comments
TEXT
Units = DT(Bq, UCUM,
“Bq”)
Administration Log
IOD(0044,0002)
Administration Log IOD
(0044,0004)
Administration Log IOD
(0044,0003)
Content Item Descriptions
Row 1
Row 2
Row 3
Row 4
Row 6
Row 9
Row 11
Row 12
Row 13
Row 15
Row 18
Row 19
Row 20
Row 21
Row 22
Row 25
Row 26
Numa Molecular Imaging Dose Event Data Container.
Intent of the radiopharmaceutical, Diagnostic Intent, Therapeutic Intent, Combined Diagnostic and
Therapeutic Procedure
No context group is provided for the value set, but it is recommended that values from a standard
external coding scheme, such as SRT or NDC, be used. Also see (0044,0007) Product Type Code
Sequence RxNorm based (many radiopharmaceuticals do not have RxNorm)
Product Package Identifier. Code needs to be defined. From DICOM Product Characteristics Module
C.26.1 Identifier of the contrast agent, drug, or device being characterized, typically from a package
bar code, RFID, or other materials management ID. This ID might not be globally unique and might
conflict with other IDs used within the scope of the institution.
Manufacturer Code needs to be defined From DICOM Product Characteristics Module C.26.1
Manufacturer of product.
Time of radiopharmaceutical administration to the patient for imaging purposes
Total amount of radionuclide administered to the patient at Radiopharmaceutical Start Time
Is a computed field from the assay times, isotope half-life, radiopharmaceutical
Unique identification of a single irradiation event. This UID identifies unique and repeatable when
referencing the radiopharmaceutical administration to this patient.
Volume of radiopharmaceutical administered to the patient
Identifies the dose type as a unit dose, multi-dose vial, capsule Codes will need to be developed for
each type
Activity per unit mass of the radiopharmaceutical at Radiopharmaceutical Start Time
Radioisotope Assay Information
Radioisotope Attributes (not defined)
Radiopharmaceutical Quality Control Attributes (not defined)
Reagent Kit Attributes (not defined)
Substance Administration Approval Code needs to be defined. Status of request for substance
administration. Administration Log IOD(0044,0002)
Enumerated Values:
APPROVED – Use of the substance for the patient is approved, with related notes (e.g., appropriate
dose for age/weight) in Approval Status Further Description (0044,0003)
WARNING – The substance may be used for the patient subject to warnings described in Approval
Status Further Description (0044,0003)
CONTRA_INDICATED – The substance should not be used for the patient for the reasons described
in Approval Status Further Description (0044,0003)
Administration Approval Date Time Code needs to be defined. DICOM SUBSTANCE APPROVAL
MODULE ATTRIBUTES C.26-2 Timestamp for the Substance Administration Approval response
RARD White Paper
Page 24
Row 27
Approval Status Description. DICOM SUBSTANCE APPROVAL MODULE ATTRIBUTES C.26-2
Description of warning or contra-indication, or notes on approval.
Substance Administration Approval Code Reference Extension
Coding Scheme Designator
Code Value (0008,0100)
(0008,0102)
99RARDSAS
99RARDSASAPPROVED
99RARDSAS
99RARDSASWARNING
99RARDSAS
99RARDSAS CONTRA
Code Meaning (0008,0104)
APPROVED
WARNING
CONTRA_INDICATED
Radiopharmaceutical administration Dose Exposure per Organ
This general template provides detailed information on radiopharmaceutical dose value accumulations
per Organ over multiple administration events over the scope of accumulation specified for the report
(typically a Study or a Performed Procedure Step).
NL
Rel with
Parent
1
VT
Concept Name
VM
CONTAINER
"Dose Exposure Per
Organ”
“Exposure Anatomic
Region”
Region Exposure
1
Req
Typ
e
M
1
M
1
M
2
>
CONTAINS
CODE
3
>
CONTAINS
NUMERIC
4
>
CONTAINS
NUMERIC
Region Exposure
Conversion Factor
1
U
5
>
CONTAINS
CODE
Dose Reference Authority
1
U
Condition
Not used
for
accumulat
ed dose
Value Set
Constraint
DICOM
Annex I
Units
=EV(mGy,
UCUM,
“mGy”)
Units
=EV(mGy/B
q, UCUM,
“mGy/Bq”)
Product
Label
Content Item Descriptions
Row 1
Row 2
Row 3
Dose Exposure Per Region
Exposure Anatomic Region. Codes needs to be defined. DICOM Annex I MIRD Tables organ or
regions typically reported in Radio Product label have DICOM codes
SRT T-B3000 Adrenal gland, SRT T-A0100 Brain, SRT T-04000 Breast,T-63000 Gall bladder, SRT T58000 Small intestine, SRT T-57000 Stomach, SRT T-32000 Heart, SRT T-71000 Kidney, SRT T-62002
Liver, SRT T-28000 Lung, SRT T-13001 Muscle, SRT T-87000 Ovary, SRT T-65000 Pancreas, SRT TC3000 Spleen, SRT T-94000 Testis, SRT T-B6000 Thyroid, SRT T-C8000 Thymus Gland Thymus, SRT T74000 Bladder, SRT T-83000 Uterus
The follow organ or region without DICOM defined codes. LLI Wall (lower large intestine), ULI (upper
large intestine) Wall, Red Marrow, Bone Surfaces, Skin.
Region Exposure Codes needs to be defined.
RARD White Paper
Page 25
Row 4
Row 5
Region Exposure Conversion Factor Codes needs to be defined.
Radiopharmaceutical label, Oak Ridge Documentation, MIRD
Radioisotope Assay Data Template
NL
Rel with
Parent
VT
Concept Name
VM
Req
Type
1
2
>
CONTAINS
CODE
Numeric
"Radioisotope Assay Data"
“Dose Assay”
1
1
M
M
3
4
>
>
CONTAINS
CONTAINS
DATETIME
CODE
“Dose Assay Date Time”
EV (113854, DCM,
“Source of Dose
Information”)
1
1
M
M
5
6
>
>
“Assay Reason”
Observer
Context
1
1-n
U
M
CONTAINS
CODE
HAS OBS
INCLUDE
CONTEXT
Content Item Descriptions
Row 1
Row 2
Row 3
Row 4
Row 5
Condition
Value Set
Constraint
Units =
DT(Bq,
UCUM,
“Bq”)
EV
(6862NM2
00,
LNUMA,
“Dose
Calibrator”)
DTID(1002)
Radioisotope Assay Data. Code needs to be defined.
Dose Measurement Code needs to be defined. Dose Amount Measured
Dose Measurement Date Time Code needs to be defined. Dose Measured
Source of Dose Information ”Code needs to be defined for Dose Calibrator to DCID (10021)
Assay Reason Codes needs to be defined. Measure residual, Normal Dose Assessment, Dose
Correction, Dose Receipt Activity
Patient Characteristics template
NL
Rel with
Parent
1
VT
Concept Name
VM
Req
Type
CONTAINER
EV (121118, DCM, “Patient
Characteristics”)
EV (109054, DCM, ”Patient
State”)
DTID (3602)
Cardiovascular Patient
Characteristics
“Glucose Level”
1
M
1
MC
1
M
1
MC
Glomerular filtration rate
Sequence
Patient Weighed Date
1
U
1
U
2
>
CONTAINS
CODE
3
>
CONTAINS
INCLUDE
4
>
CONTAINS
NUMERIC
5
>
CONTAINS
CODE
6
>
CONTAINS
DATETIME
RARD White Paper
Condition
Value Set
Constraint
Cardiac
Procedure
CID 3102
Units =
DT(mg/dL,
UCUM,
“mg/dL”)
Page 26
7
8
>
>
CONTAINS
CONTAINS
TEXT
NUM
9
>
CONTAINS
TEXT
10
>
CONTAINS
INCLUDE
Time
Uptake Location
Uptake Duration
“SRT R-30246 Allergy and
Immunology”
DTID (9002) Medication,
Substance
1
1
U
U
1-n
U
1-n
U
Units =
DT(min,
UCUM,”mi
n”)
Content Item Descriptions
Row 2
Row 3
Row 4
Row 5
Row 6
Row 7
Row 8
Row 9
Row 11
Stress or Rest
Include Patient characteristics even if study is not cardiac
Glucose Level is important for PET studies. Provides a mean for the technologist to record the
glucose level and move the information to the camera.
Provides a mean to record the GFR of the patient and communicate the information to the camera.
Date time of patient note if patient is from a previous study or is stale. Weight based dosing should
have current weight.
Uptake Location room number or description
Number of minute to patient should wait before scanning
Allergies List
A classification of a medicinal substance.
Glomerular filtration rate
NL
Rel with
Parent
VT
Concept Name
VM
Req
Type
1
2
3
4
>
>
>
CONTAINS
CONTAINS
CONTAINS
CONTAINER
NUMERIC
CODE
NUMERIC
"Glomerular filtration rate"
Serum Creatinine Units
Traceable to IDMS
Glomerular filtration rate
1
1
1
1
M
M
U
M
5
>
CONTAINS
CODE
GFR Formula
1
U
>
CONTAINS
NUM
EV (121033, DCM, "Subject
Age”)
1
MC
>
CONTAINS
TEXT
Ethnic Group
1
MC
CODE
EV (121032, DCM, "Subject
Sex”)
RARD White Paper
Condition
Value Set
Constraint
mg/dL
YES NO
Units =
DT(mL/min/
1.73m2,
UCUM,
“mL/min/1.
73m2”)
eCcr,
MDRD,
CKD-EPI,
Mayo
Quadratic,
Schwartz
If not
recorded
else where
If not
recorded
else where
If not
DCID (7455)
Sex
Page 27
recorded
else where
GFR CODES
Coding
Scheme
Designator
99RARDGFR
99RARDGFR
99RARDGFR
99RARDGFR
99RARDGFR
Code Value
Code Meaning
99RARDGFR-1
99RARDGFR-2
99RARDGFR-3
99RARDGFR-4
99RARDGFR-5
Cockcroft-Gault formula (eCcr)
Modification of Diet in Renal Disease (MDRD) formula (eGFR)
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula (eGFR)
Mayo Quadratic formula (eGFR)
Schwartz formula (eGFR) for children
Current published DICOM Codes
Radiopharmaceuticals Context Id 25
CID 25 Radiopharmaceuticals
Context ID 25
Radiopharmaceuticals
Type: Extensible Version: 20110224
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
SRT
C-B1302
Carbon^14^ D-xylose
SRT
C-B1300
Carbon^14^ triolein
SRT
C-B1304
Cholyl-carbon^14^ glycine
SRT
C-B1140
Chromic phosphate P^32^
SRT
C-B1012
Chromium^51^ albumin
SRT
C-B1013
Chromium^51^ chloride
SRT
C-B1051
Colloidal gold Au^198^
SRT
C-B1063
Colloidal Indium^111^
SRT
C-B1017
Copper^64^ acetate
SRT
C-B1016
Copper^64^ versenate
SRT
C-B1018
Copper^67^ ceruloplasmin
SRT
C-B1021
Cyanocobalamin Co^57^
SRT
C-B1022
Cyanocobalamin Co^58^
SRT
C-B1023
Cyanocobalamin Co^60^
SRT
C-B1000
Diagnostic radioisotope
SRT
C-B1092
Diiodofluorecein I^131^
SRT
C-B1062
Disodium indium^111^
SRT
C-B1122
Ferrous chloride Fe^59^
SRT
C-B1121
Ferrous citrate Fe^59^
RARD White Paper
Code Meaning
(0008,0104)
Trade name
(informative)
Page 28
SRT
C-B1123
Ferrous sulfate Fe^59^
SRT
C-B1082
Fibrinogen I^123^
SRT
C-B1031
Fluorodeoxyglucose F^18^
SRT
C-B1041
Gallium^67^ citrate
SRT
C-145AB
Indium^111 Capromab Pendetide
Prostascint
SRT
C-14512
Indium^111 Chloride
Zevalin
SRT
C-145AA
Indium^111 Pentetreotide
Octreoscan
SRT
C-B1061
Indium^111^ pentetate
SRT
C-B1066
Indium^111^ red cell label
SRT
C-B1067
Indium^111^ transferrin
SRT
C-B1065
Indium^111^-Fe(OH)>3<
SRT
C-B1135
Indium^111^oxyquinoline
SRT
C-B1068
Indium^113m^ bleomycin
SRT
C-B1069
Indium^113m^ chloride
SRT
C-B1072
Indium^113m^ oxoquinoline platelet
label
SRT
C-B1073
Indium^113m^ oxoquinoline RBC
label
SRT
C-B1071
Indium^113m^ oxoquinoline WBC
label
SRT
C-B1070
Indium^113m^ pentetate
SRT
C-B1084
Iodinated I^125^ albumin
SRT
C-B1100
Iodinated I^125^ human serum
albumin
SRT
C-B1094
Iodinated I^125^ levothyroxine
SRT
C-B1093
Iodinated I^125^ oleic acid and
triolein
SRT
C-B1096
Iodinated I^125^ povidone
SRT
C-B1097
Iodinated I^125^ Rose Bengal
SRT
C-B1098
Iodinated I^125^ sealed source
SRT
C-B1099
Iodinated I^125^ sodium iodine
SRT
C-B1090
Iodinated I^131^ aggregated
albumin
SRT
C-B1089
Iodinated I^131^ albumin
SRT
C-B1111
Iodinated I^131^ gamma globulin
SRT
C-114AB
Iodine^123 15-(4-Iodophenyl)3(R,S)-Methylpentadecanoic Acid
BMIPP
SRT
C-B110E
Iodine^123 3-Iodobenzylguanidine
MIBG
SRT
C-B112D
Iodine^131 3-Iodobenzylguanidine
MIBG
SRT
C-114B6
Iodine^131 Methylnorcholestenol
RARD White Paper
Cardiodine
Adosterol
Page 29
SRT
C-B1109
Iodine^131^ polyvinylpyrrolidone
SRT
C-B1087
Iodocholesterol I^131^
SRT
C-B1095
Iodohippurate I^123^ sodium
SRT
C-B1105
Iodohippurate I^125^ sodium
SRT
C-B1091
Iodohippurate I^131^ sodium
SRT
C-B1108
Iofetamine I^123^ hydrochloride
SRT
C-B1088
Iothalamate sodium I^125^
SRT
C-B1124
Iron Fe^59^ labeled dextran
SRT
C-173A5
Krypton^81m
SRT
C-B1083
Oleic acid I^125^
SRT
C-B1251
Pentetate calcium trisodium
Yb^169^
SRT
C-B1151
Potassium carbonate K^42^
SRT
C-B1152
Potassium chloride K^42^
SRT
C-B1150
Potassium chloride K^43^
SRT
C-B1085
Rose Bengal sodium I^131^
SRT
C-B1172
Selenium^75^ HCAT
SRT
C-B1171
Selenomethionione Se^75^
SRT
C-B1176
Sodium chloride Na^22^
SRT
C-B1175
Sodium chloride Na^24^
SRT
C-B1011
Sodium chromate Cr^51^
SRT
C-B1032
Sodium fluoride F^18^
SRT
C-B1081
Sodium iodide I^123^
SRT
C-B1086
Sodium iodide I^131^
SRT
C-B1206
Sodium pertechnetate Tc^99m^
SRT
C-B1142
Sodium phosphate P^32^
SRT
C-B1180
Strontium chloride Sr^85^
SRT
C-B1181
Strontium chloride Sr^87^
SRT
C-B1182
Strontium nitrate Sr^85^
SRT
C-B1183
Strontium nitrate Sr^87^
SRT
C-B1205
Technetium Tc^99c^ albumin
microspheres
SRT
C-B1200
Technetium Tc^99m^ aggregated
albumin
SRT
C-B1204
Technetium Tc^99m^ albumin
colloid
SRT
C-B1133
Technetium Tc^99m^ depreotide
SRT
C-B1207
Technetium Tc^99m^ disofenin
SRT
C-B1223
Technetium Tc^99m^ exametazine
SRT
C-B1210
Technetium Tc^99m^ iron
ascorbate
SRT
C-B1209
Technetium Tc^99m^ lidofenin
RARD White Paper
Page 30
SRT
C-B1208
Technetium Tc^99m^ mebrofenin
SRT
C-B1212
Technetium Tc^99m^ medronate
SRT
C-B1203
Technetium Tc^99m^
microaggregated albumin
SRT
C-B1225
Technetium Tc^99m^ N-substituted
iminodiacetate
SRT
C-B1213
Technetium Tc^99m^ oxidronate
SRT
C-B1214
Technetium Tc^99m^ pentetate
SRT
C-B1215
Technetium Tc^99m^ pyro and
polyphosphates
SRT
C-B1216
Technetium Tc^99m^ serum
albumin
SRT
C-163AB
Technetium Tc^99m^ sestamibi
SRT
C-B1220
Technetium Tc^99m^ sodium
glucoheptonate
SRT
C-B1211
Technetium Tc^99m^ stannous
etidronate
SRT
C-B1221
Technetium Tc^99m^ succimer
SRT
C-B1222
Technetium Tc^99m^ sulfur colloid
SRT
C-B1224
Technetium Tc^99m^ tagged red
cells
SRT
C-163AC
Technetium Tc^99m^Teboroxime
SRT
C-163AD
Technetium Tc^99m^Tetrofosmin
SRT
C-163BD
Technetium^99m
Dimercaptosuccinic Acid DMSA
Kidneyscinti
SRT
C-163B6
Technetium^99m Galactosyl
Human Serum Albumin
Diethylenetriamine GSA
Asialoscinti
SRT
C-163B7
Technetium^99m
Hydroxymethylene diphosphonate
HMDP
SRT
C-163B9
Technetium^99m labeled carbon
Technegas
SRT
C-163B8
Technetium^99m Mercaptoacetyl
triglycine MAG3
MAGscinti
SRT
C-163BA
Technetium^99m N-pyridoxyl-5methyltryptophan
Hepatimage
SRT
C-163BB
Technetium^99m Phytate
SRT
C-163BC
Technetium^99m Stannous Colloid
SRT
C-B1231
Thallous chloride Tl^201^
SRT
C-B1010
Therapeutic radioisotope
SRT
C-B1251
Yb^169^-DTPA - pentetate
RARD White Paper
Page 31
Isotopes in Radiopharmaceuticals CID 18
Context ID 18
Isotopes in Radiopharmaceuticals
Type: Extensible Version: 20110503
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
SRT
C-105A2
^14^Carbon
SRT
C-111A1
^18^Fluorine
SRT
C-155A1
^22^Sodium
SRT
C-155A2
^24^Sodium
SRT
C-106A1
^32^Phosphorus
SRT
C-135A2
^42^Potassium
SRT
C-135A3
^43^Potassium
SRT
C-129A2
^51^Chromium
SRT
C-144A3
^57^Cobalt
SRT
C-144A4
^58^Cobalt
SRT
C-130A3
^59^Iron
SRT
C-144A6
^60^Cobalt
SRT
C-127A2
^64^Copper
SRT
C-127A3
^67^Copper
SRT
C-131A2
^67^Gallium
SRT
C-116A3
^75^Selenium
SRT
C-173A5
^81m^Krypton
SRT
C-173A7
^85^Krypton
SRT
C-158A3
^85^Strontium
SRT
C-158A5
^87m^Strontium
SRT
C-158A6
^89^Strontium
SRT
C-162A7
^90^Yttrium
SRT
C-163A8
^99m^Technetium
SRT
C-145A4
^111^Indium
SRT
C-145A5
^113m^Indium
SRT
C-114A4
^123^Iodine
SRT
C-114A6
^125^Iodine
SRT
C-114B1
^131^Iodine
SRT
C-122A5
^133^Barium
SRT
C-172A8
^133^Xenon
SRT
C-178A8
^153^Gadolinium
SRT
C-B1134
^153^Samarium
SRT
C-181A3
^169^Ytterbium
SRT
C-101ED
^177^Lutetium
RARD White Paper
Code Meaning
(0008,0104)
Page 32
SRT
C-11906
^186^Rhenium
SRT
C-1018D
^188^Rhenium
SRT
C-146A9
^198^Gold
SRT
C-138A9
^201^Thallium
PET Cardiology Radiopharmaceuticals CID 3107
Context ID 3107
PET Cardiology Radiopharmaceuticals
Type: Extensible
Version: 20080927
Coding
Scheme
Designator
Code Value
Code Meaning
SRT
C-B1031
Fluorodeoxyglucose F^18^
SRT
C-107A1
^13^Nitrogen
SRT
C-159A2
^82^Rubidium
Nuclear Cardiology Radiopharmaceuticals CID 3111
Context ID 3111
Nuclear Cardiology Radiopharmaceuticals
Type: Extensible
Version: 20080927
Coding
Scheme
Designator
Code Value Code Meaning
SRT
C-B1130
Thallium-201
SRT
C-B10A2
Tc-99m sestamibi
SRT
C-B10A4
Tc-99m tetrofosmin
PET Radiopharmaceutical CID 4021
Context ID 4021
PET Radiopharmaceutical
Type: Extensible Version: 20070625
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
SRT
C-B1043
Acetate C^11^
SRT
C-B103C
Ammonia N^13^
SRT
C-B07DB
ATSM Cu^64^
SRT
C-B07DC
Butanol O^15^
SRT
C-B103B
Carbon dioxide O^15^
SRT
C-B1045
Carbon monoxide C^11^
SRT
C-B103A
Carbon monoxide O^15^
RARD White Paper
Code Meaning
(0008,0104)
Page 33
SRT
C-B103F
Carfentanil C^11^
SRT
C-B07DD
EDTA Ga^68^
SRT
C-B07DE
Flumazenil C^11^
SRT
C-B07DF
Flumazenil F^18^
SRT
C-B07E0
Fluorethyltyrosin F^18^
SRT
C-B1031
Fluorodeoxyglucose F^18^
SRT
C-B07E1
Fluoromisonidazole F^18^
SRT
C-B07E2
Fluoromethane F^18^
SRT
C-B07E3
Fluorouracil F^18^
SRT
C-B07E4
Fluorobenzothiazole F^18^
SRT
C-B1034
Fluoro-L-dopa F^18^
SRT
C-B1046
Germanium Ge^68^
SRT
C-B103D
Glutamate N^13^
SRT
C-B07E5
Mespiperone C^11^
SRT
C-B103E
Methionine C^11^
SRT
C-B07E6
Monoclonal antibody I^124^
SRT
C-B1038
Oxygen O^15^
SRT
C-B1039
Oxygen-water O^15^
SRT
C-B1044
Palmitate C^11^
SRT
C-B07E7
PTSM Cu^62^
SRT
C-B1042
Raclopride C^11^
SRT
C-B1037
Rubidium chloride Rb^82^
SRT
C-B1032
Sodium fluoride F^18^
SRT
C-B07E8
Sodium iodide I^124^
SRT
C-B1047
Sodium Na^22^
SRT
C-B1033
Spiperone F^18^
SRT
C-B1036
Thymidine (FLT)F^18^
RARD White Paper
Page 34