5
Digital Imaging and Communications in Medicine (DICOM)
Supplement 164: Substance Administration Report
10
15
20
DICOM Standards Committee, Working Group 6 (Base Standard) Ad Hoc Group
1300 N. 17th Street, Suite 1752
Rosslyn, Virginia 22209 USA
25
Status:
VERSION:
Draft
Public Comment Draft
Nov 5, 2012
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Page 2
Table of Contents
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40
45
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55
60
65
70
75
Table of Contents ........................................................................................................................................... 2
DOCUMENT HISTORY .................................................................................................................................. 3
Scope and Field of Application ....................................................................................................................... 5
LIMITATIONS OF CURRENT STANDARD ............................................................................................. 5
TO DO............................................................................................................................................................. 6
OPEN ISSUES ............................................................................................................................................... 6
CLOSED ISSUES ........................................................................................................................................... 6
Changes to NEMA Standards Publication PS 3.2-2011 ................................................................................. 9
Changes to NEMA Standards Publication PS 3.3-2011 ............................................................................... 10
A.35.X1 Planned Substance Administration SR Information Object Definition ............................... 12
A.35.X1.1 Planned Substance Administration SR Information Object Description ............... 12
A.35.X1.2 Planned Substance Administration SR IOD Entity-Relationship Model ............... 12
A.35.X1.3 Planned Substance Administration SR IOD Module Table .................................. 12
A.35.X1.3.1
Planned Substance Administration SR IOD Content Constraints12
A.35.X2 Performed Substance Administration SR Information Object Definition ........................... 14
A.35.X2.1 Performed Substance Administration SR Information Object Description ........... 14
A.35.X2.2 Performed Substance Administration SR IOD Entity-Relationship Model ............ 14
A.35.X2.3 Performed Substance Administration SR IOD Module Table ............................... 14
A.35.X2.3.1
Performed Substance Administration SR IOD Content Constraints
14
A.35.X3 Basic Performed Substance Administration Information Object Definition........................ 16
A.35.X3.1 Basic Performed Substance Administration Information Object
Description ............................................................................................................................. 16
A.35.X3.2 Basic Performed Substance Administration IOD Entity-Relationship Model ........ 16
A.35.X3.3 Basic Performed Substance Administration IOD Module Table ........................... 16
A.35.X4 Defined Substance Administration SR Information Object Definition ................................ 11
A.35.X4.1 Defined Substance Administration SR Information Object Description ................ 11
A.35.X4.2 Defined Substance Administration IOD Entity-Relationship Model ...................... 11
A.35.X4.3 Defined Substance Administration IOD Module Table ......................................... 11
A.35.X4.3.1
Defined Substance Administration IOD Content Constraints .. 11
C.7.3.1.1
General Series Attribute Descriptions ...................................... 17
Annex C
INFORMATION MODULE DEFINITIONS (NORMATIVE) .................................................... 17
C.xx.x
Substance Administration Module ................................. Error! Bookmark not defined.
Changes to NEMA Standards Publication PS 3.3-2011 ............................................................................... 18
B.5
STANDARD SOP CLASSES ................................................................................................. 18
I.4
MEDIA STORAGE STANDARD SOP CLASSES .................................................................. 19
Changes to NEMA Standards Publication PS 3.6-2011 ............................................................................... 21
Changes to NEMA Standards Publication PS 3.16-2011 ............................................................................. 23
DEFINED SUBSTANCE ADMINISTRATION SR IOD TEMPLATES .................................................... 23
TID xxx16
Defined Substance Administration ..................................................................... 24
PLANNED SUBSTANCE ADMINISTRATION SR IOD TEMPLATES ................................................... 25
TID xxxx1
Planned Substance Administration .................................................................... 26
TID xxxx2
Pre-Medication Context for Substance Administration ...................................... 28
TID xxxx3
Patient Risk-Factor Context related to Imaging Agents ..................................... 29
TID xxxx5
Substance Information ....................................................................................... 30
TID xxxx6
Substance Administration Consumables ........................................................... 31
Page 3
80
85
90
95
100
105
TID xxxx7
Substance Administration Delivery Plan Template ............................................ 33
TID xxxx8
Substance Administration Delivery Step Template ............................................ 34
TID xxxx9
Substance Administration Delivery Phase Template ......................................... 34
PERFORMED SUBSTANCE ADMINISTRATION SR IOD TEMPLATES ............................................. 36
TID xxx10
Performed Substance Administration ................................................................. 38
TID xxx11
Substance Administration Adverse Events ........................................................ 39
TID xxx12
Substance Administration Device Information ................................................... 40
TID xxx14
Substance Administration Plan Template ............ Error! Bookmark not defined.
TID XXX15
Radiopharmaceutical Substance Administration Data ....................................... 41
CID 9300 Procedure Discontinuation Reasons ............................................................................ 42
CID xxxx1
Substance Administration Adverse Event Reaction List .................................... 43
CID CXX10
Intravenous Extravasation Symptoms ................................................................ 43
CID xxxx2
Temporal Periods Relating To Contrast Procedure ........................................... 44
CID xxxx3
Contrast Agent Injection Substance Administration Syringe Type..................... 44
CID xxxx4
Contrast Agent Substance Administration Phase Type ..................................... 44
CID xxxx5
Substance Type ................................................................................................. 45
CID xxxx6
Substance Administration Consumable ............................................................. 45
CID xxxx7
Temporal Periods Relating To Procedure .......................................................... 45
CID xxxx8
Substance Administration Mode......................................................................... 45
CID xxxx9
Substance Administration Related Risk-Factor Indications ............................... 46
CID xxxx10
Substance Administration Injector Head Type ................................................... 47
CID xxxx11
Substance Administration Plan Type ................................................................. 47
CID xxxx12
Pre-Medication Agents for Substance Administration ........................................ 47
CID xxxx13
GFR Assessment Methods ................................................................................ 48
CID xxxx14
Substance Administration Consumable Type .................................................... 48
CID xxxx15
Administration Completion Status ...................................................................... 49
Annex D
DICOM Controlled Terminology Definitions (Normative) ....................................................... 49
Changes to NEMA Standards Publication PS 3.17-2011 ............................................................................. 51
Annex XX Substance Administration Report Template (Informative) .......................................................... 52
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DOCUMENT HISTORY
Document
Version
110
Date
Content
01
2012/10/25
Initial Version
02
2013/01/22
Implemented review comments clean up
template structures.
03
2013/02/04
Implemented review comments
04
2013/06/12
1. Rename “Contrast Agent
Administration” to “Substance
Administration”
2. Added Contrast Agent Admin. Plan
SR IOD
3. Added Extravasation detail table
from supplement159
4. Added Fasting Period Concept in
Pre-Medication Context
05
2013/08/12
1. Renamed all concepts from
“Contrast Administration” to
“Substance Administration”
2. Added new “Defined” SOP Class
3. Removed Substance admin. Plan
storage (no need to have template)
Page 5
Scope and Field of Application
The supplement applies to all modalities in which radiographic, radiopharmaceutical or other imaging
agents are introduced into a circulatory system in a controlled fashion (CT, MR, XA, NM, US).
115
Following are the new SOP Classes introduced to describe administration events, flows, pressure, timings,
physio-chemical attributes and pharmacological attributes of the agent administration and also
consumables related to the administration. These SOP classes do not describe radioactivity or dosimetry
administered.

The Defined Substance Administration SR is for defining generic substance administration
protocols for known generic study protocols. The idea is to enable build a generic or default
substance administration protocols for known imaging study protocols, so as to be able to, further
customize them easily. These objects are not patient specific; rather serve as a look up source for
planning substance administration protocols.

The Planned Substance Administration SR Storage SOP Class is intended for representing the
plan or program to deliver imaging agent customized to a specific patient. Often, it is planned by
the radiologists where the plan is tuned to the characteristics of a patient and needs of that
procedure. The plan may be altered by the delivery system or a user based on a variety of factors.

The Performed Substance Administration SR is for reporting the actual plan or program that
was used to deliver the diagnostic imaging agent during a medical imaging study.

In addition, the Basic Performed Substance Administration provides a summarized version of
the performed substance administration. This is attribute based class instead of a SR document.
The primary use of this class is for communicating administration data to a modality system during
an imaging study
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125
130
135
This supplement defines SOP Classes and IODs for persisting and communication of information relevant
to the administration of imaging agents used in medical imaging examinations. Furthermore, the
supplement is constructed so as to convey planned and delivered substance administration using manual
methods or automated power-injector devices.
140
LIMITATIONS OF CURRENT STANDARD

145
Limited provision to record Planned Substance administration steps and detailed information
pertaining to the injection of the prescribed imaging agents relative to the scheduled and planned
injections. The current standard enables the encoding of some injection parameters like total
substance volume, adminstration flow rates and ingredient however there is insufficient specifity in the
existing IODs to enable the automated preperation of an injection device or fuller analysis of the
injection steps for quality assurance and improvement activities. For instance, the collection of
generated pressures, flow rate vectors, multi-phased infusions, and the persistance of events that may
occur during the delivery of substance (eg: flow rate limiting due to high pressures).
Page 6
TO DO
150
2
Add “CM” part of Modality type, under Part-3 Section C.7.3.1.1.1. This is a new modality attribute
value proposed, indicating a contrast agent administration.
3
Add explanatory information part of Part-17 describing Basic Performed Substance Administration
SOP class
4
Add ‘fasting period’ concept part of pre-medication as patients might have to fast in case of oral
contrast delivery.
5
How to add “Contrast Agent IE” into parts. What are the parts affected..?
See Open Issue#5
6
Ask WG-06 on putting plan into separate SR instance..
Closed. See Closed Item#11
7
Add templates from sup-159 – patient characteristics?
8
Fasting Period concept – Explain this concept clear in Pre-medication context. Additionally, add this
concept part of Contrast Admin.
OPEN ISSUES
6
Does the Basic Substance Administration need any additional attributes to make Q/R more
effective?
The design intent is that the pump will store the above SOP Instance directly to the modality.
7
Are the Enhanced Contrast/Bolus Module, Enhanced PET Isotope module and the Interventional
modules sufficient for recording radio-pharmaceutical substance administration? (For
PET/SPECT/Nucmed imaging)
Is UPC Code is the correct code to identify a consumable related to substance administration?
8
CLOSED ISSUES
155
1
Q: Should this supplement address the planned and delivered infusion data for
radiopharmaceuticals at NM studies? A conceivable use-case is that a contrast agent
administration SR object is created by a contrast dose manager containing the administered
radiopharmaceutical data. This object is accessed by a radiopharma manager actor and it extracts
the relevant data for population into a radiopharma administration dose report SR object.
A: Yes. Look up Supplement 159 for dosimtery. This issue is closed
Page 7
2
Q. It was discussed that the summary object (Basic Performed Substance Admin) could reference
the detailed objects (contrast agent admin SR Objects) - Under General Series, how do we refer to
detailed objects, from the summary object?
A: Contrast Agent Admin SR has been eliminated. In case of such a need to refer “performed”
instance, use explicit UID reference.
This issue is Closed.
3
Q: In Basic Contrast Administration SOP, the series is under General Series Module C.7.3.1
What is the value for modality attribute (0008,0060)? Do we assign a new modality value?
A: Yes, there will be new value for all objects.
4
Q: Under module table of all new SOP definitions, “Synchronization” (C.7.4.2) module is included
under “Frame Of Reference” IE. This module has Frame Of Reference UID as type 1 – which may
not be available to the contrast infusion manager; Do we include a new module attribute table?
A: Generate new UID for “Frame of Reference UID”.
This issue is Closed.
5
Q: Similar to Issue 3, The Performed Substance Admin SOP could reference scheduled SOP
instance? In this case, do we include this reference under series module?
A: Either put an explicit UID reference in performed object or directly look up based on the Study
UID.
This issue is closed.
6
Q: What is the use of Contrast Agent Administration SR? Can we instead use Key-ObjectionSelection SR document for this purpose?
A: Originally, when proposed, the ‘Contrast Agent Administration SR’ is designed to hold various
contexts like Patient risk-factor context, pre-medication contexts, other than the ‘Scheduled’ and
‘Performed’ Contrast Agent Admin. SR objects.
This issue stands closed as ‘Contrast Agent Administration SR’ is eliminated.
7
Q: Design of Basic Performed Substance IOD: Treat it as SR (KOS Style) or treat it like standard
tags, which require adding a new IE (Contrast/Bolus Agent IE).
A: Adding a new Contrast/Bolus Agent IE. Closed.
8
To discuss: On a multiple injection per accession-number scenario, (where the injection is aborted
for some reasons and redone again, or when a test injection is delivered before a main injection,
etc.) there could be simply n “performed” objects – as we are not aggregating all of them under one
“performed” object.
What are the workflow implications? We want to ensure this point is clearly understood and
handled before we finalize this design.
A: Yes. Aggregated reporting is not considered. Closed
Page 8
9
Could we add concept code values indicating if the contrast agent administration was completed or
aborted. (this is for quick “Yes/No” indication to help consumer know if the injection was successful
or not)
Secondly, if we agree for the above, how does one add it under “Enhanced Contrast/Bolus
Module” (C.7.6.4b of Part-3) “Basic Contrast Agent Admin. IOD”? - Should we go ahead and
extend this module?
A: Yes, we could flag Completed / Terminated / User Aborted, however cannot say successful.
10
Another workflow scenario question: As the “Basic Performed Substance Admin.” object is
primarily meant for sending out to modality, the infusion manager that creates this object has to
accurately obtain this Study UID? – how does one ensure this works especially when the modality
is “site configured” to ignore sharing Study-UID coming from the worklist-server but generate one
on its own?
In other words, if the “Basic Performed Substance Admin.” object has a different Study-UID from
that of the images cut by the modality, what is the impact?
A: Question is Out of scope.
11
Substance Admin. Plan - Separate instance or just template?
It was ideated to create another SOP for ‘Substance Administration Plan’, to be referenced under
planned/performed objects – however it was then decided not to go in that direction (in Jun 2013
WG-06 meeting). Instead, will add “Defined” object, which is non-patient specific similar to hangingprotocol objects.
12
Should we create performed object if the agent was never administered but only attempted?
Yes, Utilization of suites, inventory perspective we generate one. Make up your own StudyUID in
case not if there is’nt one available. It’s up to the PACS to re-concile.
13
Work on Adverse Event Grade under adverse event template.
Not a WG-06 question.
14
Should 7.4.2 Synchronization module be optional under Planned/Performed Substance Admin.
IODs?
It is mandatory in performed object, not required to add in planned object.
15
Design of Defined SR IOD – Add Defined Subst. Admin. IE?
How does it affect ‘Contrast Agent IE’ under Basic-Performed Object change then? Should we
change it to ‘Subst. Admin. IE’?
Use ‘Substance Admin. IE’ in both defined and Basic sop modules.
Make ‘Defined’ object using the same document IE without Patient/Study/Series IE.
Add ‘Subst. Admin IE’ and use it in Basic object – See Enhanced Contrast/Bolus module attributes
C.7.64b and Substance Administration module attributes
Closed.
Page 9
16
As an Infusion Manager, one who creates the Contrast Agent Admin. objects, how do we link to the
related radioactivity/dosimetry objects (sup159) ? Do we share a common event UID and have it
referred under use General Series module?
If the answer is yes for the above question, how does one obtain the Event UID string?
Closed.
Ans: They are permitted to be same and how they are coordinated is out of scope of the
document. If they are different, it seems tractable to find pairing on based on patient and
time.
17
In relation to closed issue#1 – if we have decided to support data from radiopharmaceuticals, then
what items from radiopharmaceutical template should be included? Sup159 has exhaustive details
What data from supplement 159 related to radio-pharma administration needs inclusion?
Closed.
18
Consider renaming Contrast Agent Administration Reporting to Substance Administration Report?
Yes. This would be a replacement for Substance Administration log.
Need to include substance administration approval? – Wanted to clarify if this contradicts with the
existing Substance Administration?
19
In a scenario when an injector is physically moved to from modality A to modality B (but still
configured to modality A), how do we prevent/handle the issue of injector device sending report to
the wrong destination (i.e., modality A)?
Closed. Nothing could be done about it. Cannot be addressed in DICOM.
160
Changes to NEMA Standards Publication PS 3.2-2011
Digital Imaging and Communications in Medicine (DICOM)
Part 2: Conformance
Item #01: Add new SOP Classes in Table A.1-2
165
Table A.1-2
UID VALUES
Page 10
UID Value
UID NAME
Category
…
1.2.840.10008.5.1.4.1.1.88.X4
Defined Substance
Administration SR
Transfer
1.2.840.10008.5.1.4.1.1.88.X1
Planned Substance
Administration SR
Transfer
1.2.840.10008.5.1.4.1.1.88.X2
Performed Substance
Administration SR
Transfer
1.2.840.10008.5.1.4.1.1.88.X3
Basic Performed
Substance Administration
Storage
Transfer
…
170
Changes to NEMA Standards Publication PS 3.3-2011
Part 3: Information Object Definitions
Page 11
Item#2: Add new SR IOD of PS 3.3 A.35:
175
A.35.X0 Defined Substance Administration SR Information Object Definition
A.35.X0.1 Defined Substance Administration SR Information Object Description
180
The Defined Substance Administration SR is for defining generic substance administration protocols for
known generic study protocols. The idea is to enable build a generic or pre-defined set of default
substance administration protocols for known imaging study protocols, so as to further customize them into
planned or performed substance administration protocols easily. These objects are not patient specific.
A.35.X4.2 Defined Substance Administration IOD Entity-Relationship Model
A Defined Substance Administration IOD is not related to other Information Entities of the DICOM realworld model, as it is not associated with a specific patient.
Defined
Substance
SR Admin
IOD
185
A.35.X0.3 Defined Substance Administration IOD Module Table
Table A.35.X0-1
DEFINED SUBSTANCE ADMINISTRATION IOD MODULES
IE
Module
Equipment
Document
Reference
Usage
General Equipment
C.7.5.1
M
Enhanced General
Equipment
C.7.5.2
M
SR Document General
C.17.2
M
SR Document Content
C.17.3
M
SOP Common
C.12.1
M
190
A.35.X0.3.1
Defined Substance Administration IOD Content Constraints
A.35.X0.3.1.2
Relationship Constraints
A.35.X0.3.1.3
Content Constraints
195
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200
A.35.X1 Planned Substance Administration SR Information Object Definition
A.35.X1.1 Planned Substance Administration SR Information Object Description
The Planned Substance Administration SR IOD is used in the process of managing, protocoling, and
administering imaging agent material to patients during contrast-enhanced medical imaging studies.
A.35.X1.2 Planned Substance Administration SR IOD Entity-Relationship Model
205
The E-R Model in Section A.1.2 of this Part applies to the Planned Substance Administration SR IOD.
Table A.35.X1-1 specifies the Modules of the Planned Substance Administration SR IOD.
A.35.X1.3 Planned Substance Administration SR IOD Module Table
Table A.35.X1-1
PLANNED SUBSTANCE ADMINISTRATION SR IOD MODULES
IE
Module
Reference
Usage
Patient
Patient
C.7.1.1
M
Clinical Trial Subject
C.7.1.3
U
General Study
C.7.2.1
M
Patient Study
C.7.2.2
U
Clinical Trial Study
C.7.2.3
U
SR Document Series
C.17.1
M
Clinical Trial Series
C.7.3.2
U
Equipment
General Equipment
C.7.5.1
M
Document
SR Document General
C.17.2
M
SR Document Content
C.17.3
M
SOP Common
C.12.1
M
Study
Series
210
A.35.X1.3.1
Planned Substance Administration SR IOD Content Constraints
A.35.X1.3.1.1
Value Type
Value Type (0040,A040) in the Content Sequence (0040,A730) of the SR Document Content Module is
constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):
215
220
225
TEXT
CODE
NUM
DATETIME
DATE
TIME
UIDREF
PNAME
COMPOSITE
IMAGE
WAVEFORM
CONTAINER
Page 13
A.35.X1.3.1.2
230
Relationship Constraints
Relationships between content items in the content of this IOD may be conveyed either by-value or byreference. Table A.35.X1-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for
Relationship Type definitions.
Table A.35.X1-2
RELATIONSHIP CONTENT CONSTRAINTS FOR EXTENSIBLE SR IOD
Source Value Type
235
240
245
Note:
Relationship Type
(Enumerated Values)
Target Value Type
CONTAINER
CONTAINS
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
COMPOSITE1, IMAGE1, WAVEFORM1,
CONTAINER (See below).
TEXT, CODE, NUM,
CONTAINER
HAS OBS CONTEXT
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
COMPOSITE1
CONTAINER, IMAGE1,
WAVEFORM1,
COMPOSITE1, NUM
HAS ACQ CONTEXT
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
CONTAINER.
any type
HAS CONCEPT MOD
TEXT, CODE2
TEXT, CODE, NUM
HAS PROPERTIES
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
IMAGE1, WAVEFORM1, COMPOSITE1,
CONTAINER.
PNAME
HAS PROPERTIES
TEXT, CODE, DATETIME, DATE,
TIME, UIDREF, PNAME
TEXT, CODE, NUM
INFERRED FROM
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
IMAGE1, WAVEFORM1, COMPOSITE1,
CONTAINER.
1. The SOP Classes to which an IMAGE, WAVEFORM or COMPOSITE Value Type may refer, is
documented in the Conformance Statement for an application (see PS 3.2 and PS 3.4).
2. The HAS CONCEPT MOD relationship is used to modify the meaning of the concept name of a parent
node (or Source Content Item), with a modifier or qualifier in a child (target node) to provide a more
descriptive explanation, a different coded language translation, or to define a post-coordinated concept.
Page 14
A.35.X2 Performed Substance Administration SR Information Object Definition
A.35.X2.1 Performed Substance Administration SR Information Object Description
250
The Performed Substance Administration SR IOD is used to convey the contrast medication that was
delivered using manual methods or using automated power-injector devices, to a patient during a contrast
study. It includes references to the Planned Substance Administration Procedure SR SOP instance.
A.35.X2.2 Performed Substance Administration SR IOD Entity-Relationship Model
The E-R Model in Section A.1.2 of this Part applies to the Performed Substance Administration SR IOD.
Table A.35.X2-1 specifies the Modules of the Performed Substance Administration SR IOD.
A.35.X2.3 Performed Substance Administration SR IOD Module Table
Table A.35.X2-1
PERFORMED SUBSTANCE ADMINISTRATION SR IOD MODULES
255
IE
Module
Reference
Usage
Patient
Patient
C.7.1.1
M
Clinical Trial Subject
C.7.1.3
U
General Study
C.7.2.1
M
Patient Study
C.7.2.2
U
Clinical Trial Study
C.7.2.3
U
SR Document Series
C.17.1
M
Clinical Trial Series
C.7.3.2
U
Frame of
Reference
Synchronization
C.7.4.2
M
Equipment
General Equipment
C.7.5.1
M
Enhanced General
Equipment
C.7.5.2
M
SR Document General
C.17.2
M
SR Document Content
C.17.3
M
SOP Common
C.12.1
M
Study
Series
Document
260
265
270
A.35.X2.3.1
Performed Substance Administration SR IOD Content Constraints
A.35.X2.3.1.1
Value Type
Value Type (0040,A040) in the Content Sequence (0040,A730) of the SR Document Content Module is
constrained to the following Enumerated Values (see Table C.17.3-7 for Value Type definitions):
TEXT
CODE
NUM
DATETIME
DATE
TIME
UIDREF
PNAME
COMPOSITE
IMAGE
Page 15
WAVEFORM
CONTAINER
275
A.35.X2.3.1.2
Relationship Constraints
Relationships between content items in the content of this IOD may be conveyed either by-value or byreference. Table A.35.X-2 specifies the relationship constraints of this IOD. See Table C.17.3-8 for
Relationship Type definitions.
Table A.35.X-2
RELATIONSHIP CONTENT CONSTRAINTS FOR EXTENSIBLE SR IOD
280
Source Value Type
Note:
285
Target Value Type
CONTAINER
CONTAINS
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
COMPOSITE1, IMAGE1, WAVEFORM1,
CONTAINER (See below).
TEXT, CODE, NUM,
CONTAINER
HAS OBS CONTEXT
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
COMPOSITE1
CONTAINER, IMAGE1,
WAVEFORM1,
COMPOSITE1, NUM
HAS ACQ CONTEXT
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
CONTAINER.
any type
HAS CONCEPT MOD
TEXT, CODE2
TEXT, CODE, NUM
HAS PROPERTIES
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
IMAGE1, WAVEFORM1, COMPOSITE1,
CONTAINER.
PNAME
HAS PROPERTIES
TEXT, CODE, DATETIME, DATE,
TIME, UIDREF, PNAME
TEXT, CODE, NUM
INFERRED FROM
TEXT, CODE, NUM, DATETIME,
DATE, TIME, UIDREF, PNAME,
IMAGE1, WAVEFORM1, COMPOSITE1,
CONTAINER.
1. The SOP Classes to which an IMAGE, WAVEFORM or COMPOSITE Value Type may refer, is
documented in the Conformance Statement for an application (see PS 3.2 and PS 3.4).
2. The HAS CONCEPT MOD relationship is used to modify the meaning of the concept name of a parent
node (or Source Content Item), with a modifier or qualifier in a child (target node) to provide a more
descriptive explanation, a different coded language translation, or to define a post-coordinated concept.
A.35.X2.3.1.3
290
Relationship Type
(Enumerated Values)
Content Constraints
The Performed Substance Administration SR IOD may refer to maximum of two different Substance
administration Plan SR SOP instances, one indicating programmed plan and another delivered plan. In the
case of manual administration of contrast agent, there shall be only one Substance administration Plan
object, indicating the delivered plan.
Page 16
A.35.X3 Basic Performed Substance Administration Information Object Definition
295
A.35.X3.1 Basic Performed Substance Administration Information Object Description
The Basic Performed Substance Administration IOD is used to convey the contrast medication that was
delivered using manual methods or using automated power-injector devices, to a patient during a contrast
study.
300
The Basic Performed Substance Administration IOD enables contrast infusion managers to encode and
transfer only relevant summary information data in a standard attribute based structure for interested
consumers like Acquisition modalities.
A.35.X3.2 Basic Performed Substance Administration IOD Entity-Relationship Model
The E-R Model in Section A.1.2 of this Part applies to the Basic Performed Substance Administration IOD.
Table A.35.X3-1 specifies the Modules of the Basic Performed Substance Administration IOD.
305
A.35.X3.3 Basic Performed Substance Administration IOD Module Table
Table A.35.X3-1
BASIC PERFORMED SUBSTANCE ADMINISTRATION IOD MODULES
IE
Module
Reference
Usage
Patient
Patient
C.7.1.1
M
Clinical Trial Subject
C.7.1.3
U
General Study
C.7.2.1
M
Patient Study
C.7.2.2
U
Clinical Trial Study
C.7.2.3
U
General Series
C.7.3.1
M
Clinical Trial Series
C.7.3.2
U
Frame of
Reference
Synchronization
C.7.4.2
M
Equipment
General Equipment
C.7.5.1
M
Enhanced General
Equipment
C.7.5.2
M
Enhanced Contrast/Bolus
C.7.6.4b
C – Required if non-radiopharmaceutical
substance was administered
Enhanced PET Isotope
C.8.22.4
C – Required if radiopharmaceutical
substance was administered
Intervention
C.7.6.13
C – Required if interventional substance was
administered
C.12.1
M
Study
Series
Substance
Administration
SOP Common
310
Page 17
315
A.35.X3.X
Basic Substance Administration IOD Content Constraints
A.35.X3.3.1
Modality
The value of Modality (0008,0060) shall be IA.
A.35.X3.3.2
Radionuclide Code Sequence
The Baseline Context Group for Radionuclide Code Sequence (0054,0300) are CID 18 and CID 4020.
320
A.35.X3.3.3
Radiopharmaceutical Code Sequence
The Baseline Context Group for Radiopharmaceutical Code Sequence (0054,0304) are CID 25 and CID
4021.
325
Add new Modality Type to PS 3.3:
C.7.3.1.1
General Series Attribute Descriptions
C.7.3.1.1.1
Modality
Defined Terms for the Modality (0008,0060) are:
IA
= Imaging Agent Delivery System
330
.
Add new IOD Definitions to PS 3.3:
335
340
Annex C
INFORMATION MODULE DEFINITIONS
(NORMATIVE)
Page 18
Changes to NEMA Standards Publication PS 3.3-2011
Digital Imaging and Communications in Medicine (DICOM)
Part 4: Service Class Specifications
345
350
355
Add new SOP Class to PS 3.4 Annex B and I tables:
360
B.5
STANDARD SOP CLASSES
The SOP Classes in the Storage Service Class identify the Composite IODs to be stored. Table B.5-1
identifies Standard SOP Classes.
SOP Class Name
Table B.5-1
STANDARD SOP CLASSES
SOP Class UID
IOD Specification
(defined in PS 3.3)
…
…
…
Basic Text SR
1.2.840.10008.5.1.4.1.1.88.11
Basic Text SR
Enhanced SR
1.2.840.10008.5.1.4.1.1.88.22
Enhanced SR
Comprehensive SR
1.2.840.10008.5.1.4.1.1.88.33
Comprehensive SR
Procedure Log
1.2.840.10008.5.1.4.1.1.88.40
Procedure Log
Page 19
Mammography CAD SR
1.2.840.10008.5.1.4.1.1.88.50
Mammography CAD
SR IOD
Key Object Selection
1.2.840.10008.5.1.4.1.1.88.59
Key Object Selection
Document
Chest CAD SR
1.2.840.10008.5.1.4.1.1.88.65
Chest CAD SR IOD
X-Ray Radiation Dose SR
1.2.840.10008.5.1.4.1.1.88.67
X-Ray Radiation Dose
SR
Defined Substance
Administration
1.2.840.10008.5.1.4.1.1.88.xx4
Defined Substance
Administration
Planned Substance
Administration SR
1.2.840.10008.5.1.4.1.1.88.xx1
Planned Substance
Administration SR
Performed Substance
Administration SR
1.2.840.10008.5.1.4.1.1.88.xx2
Performed Substance
Administration SR
Basic Performed Substance
Administration
1.2.840.10008.5.1.4.1.1.88.xx3
Basic Performed
Substance
Administration
Encapsulated PDF Storage
1.2.840.10008.5.1.4.1.1.104.1
Encapsulated PDF IOD
…
…
…
365
…
I.4
MEDIA STORAGE STANDARD SOP CLASSES
The SOP Classes in the Media Storage Service Class identify the Composite and Normalized IODs to be
stored. The following Standard SOP Classes are identified in Table I.4-1
370
SOP Class Name
…
Table I.4-1
Media Storage Standard SOP Classes
SOP Class UID
…
IOD Specification
…
Basic Text SR
1.2.840.10008.5.1.4.1.1.88.11
Basic Text SR
Enhanced SR
1.2.840.10008.5.1.4.1.1.88.22
Enhanced SR
Comprehensive SR
1.2.840.10008.5.1.4.1.1.88.33
Comprehensive SR
Procedure Log
1.2.840.10008.5.1.4.1.1.88.40
Procedure Log
Mammography CAD SR
1.2.840.10008.5.1.4.1.1.88.50
Mammography CAD
SR IOD
Key Object Selection Document
1.2.840.10008.5.1.4.1.1.88.59
Key Object Selection
Document
Chest CAD SR
1.2.840.10008.5.1.4.1.1.88.65
Chest CAD SR IOD
X-Ray Radiation Dose SR
1.2.840.10008.5.1.4.1.1.88.67
X-Ray Radiation
Dose SR
Encapsulated PDF Storage
1.2.840.10008.5.1.4.1.1.104.1
Encapsulated PDF
IOD
Defined Substance
1.2.840.10008.5.1.4.1.1.88.xx4
Defined Substance
Page 20
Administration SR
375
380
385
390
Administration
Planned Substance
Administration SR
1.2.840.10008.5.1.4.1.1.88.xx1
Planned Substance
Administration SR
Performed Substance
Administration SR
1.2.840.10008.5.1.4.1.1.88.xx2
Performed
Substance
Administration SR
Basic Performed Substance
Administration
1.2.840.10008.5.1.4.1.1.88.xx3
Basic Performed
Substance
Administration
…
…
…
Page 21
395
Changes to NEMA Standards Publication PS 3.6-2011
Digital Imaging and Communications in Medicine (DICOM)
Part 6: Data Dictionary
400
405
410
415
420
Page 22
Add new SOP Class to PS 3.6 Table A-1:
425
…
…
…
...
1.2.840.10008.5.1.4.1.1.88.1
Text SR Storage – Trial (Retired)
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.2
Audio SR Storage – Trial (Retired)
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.3
Detail SR Storage – Trial (Retired)
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.4
Comprehensive SR Storage – Trial
(Retired)
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.11
Basic Text SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.22
Enhanced SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.33
Comprehensive SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.40
Procedure Log Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.50
Mammography CAD SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.59
Key Object Selection Document
Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.65
Chest CAD SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.67
X-Ray Radiation Dose SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.xx4
Defined Substance
Administration SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.xx1
Planned Substance
Administration SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.xx2
Performed Substance
Administration SR Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.88.xx3
Basic Performed Substance
Administration Storage
SOP Class
PS 3.4
1.2.840.10008.5.1.4.1.1.104.1
Encapsulated PDF Storage
SOP Class
PS 3.4
…
…
…
…
Page 23
430
435
Changes to NEMA Standards Publication PS 3.16-2011
Digital Imaging and Communications in Medicine (DICOM)
Part 16: Content Mapping Resource
440
445
Add new Section to Annex A of PS 3.16:
DEFINED SUBSTANCE ADMINISTRATION SR IOD TEMPLATES
The templates that comprise the Defined Substance Administration are interconnected as in Figure A-x.0
450
Page 24
TID 1003
Person Observer
Identifying Attributes
TID xxx16
Defined Substance
Administration
TID 1005
Procedure Context
TID xxxx5
Substance Information
TID xxxx7
Substance
Administration Plan
Figure A.x-0: Defined Substance Administration SR IOD Template Structure
TID xxx16
Defined Substance Administration
This template describes single defined administration plan.
455
TID xxx16
Defined Substance Administration
Type: Extensible
Order: Significant
NL Rel with
Parent
1
2
>
CONTAINS
3
>
HAS
PROPERTIES
4
>
HAS OBS
CONTEXT
VT
Concept Name VM Req Condition
Type
CONTAINER EV (xx??,
99SUP164, “Defined
Substance
Administration”)
INCLUDE
DTID (1200)
Language
Designation
EV (121144, DCM,
TEXT
“Document Title")
1
M
1
U
1
U
INCLUDE
1
M
DTID (1003) Person
Observer Identifying
Attribtues
Value Set Constraint
Page 25
460
5
>
HAS OBS
CONTEXT
INCLUDE
DTID (1005)
Procedure Context
6
>
CONTAINS
CODE
EV(xx9, 99SUP164,
“Injection Mode”)
7
>
CONTAINS
INCLUDE
8
>
CONTAINS
9
>
10
1
U
DTID (xxxx5)
Substance
Information
1-n
U
NUM
EV(xx??,
99SUP164,
“Maximum
Administered
Activity”)
1
UC IFF TID xxxx5 Row 5 Units = EV (MBq, UCUM,
=EV(xx??, DCM,
“MBq”)
“Radiopharmaceutical”
)
CONTAINS
NUM
EV(xx??,
99SUP164,
“Minimum
Administered
Activity”)
1
UC IFF TID xxxx5 Row 5 Units = EV (MBq, UCUM,
=EV(xx??, DCM,
“MBq”)
“Radiopharmaceutical”
)
>
CONTAINS
NUM
EV(xx??,
99SUP164,
“Maximum
Administered
Volume”)
1
UC IFF TID xxxx5 Row 5 Units = EV (cm3, UCUM,
=EV(xx??, DCM,
“cm3”)
“Radiopharmaceutical”
)
11
>
CONTAINS
DATETIME
EV(xx??,
99SUP164,
“Scheduled
Administration
Time”)
1
UC IFF TID xxxx5 Row 5
=EV(xx??, DCM,
“Radiopharmaceutical”
)
12
>
CONTAINS
NUM
EV(xx??,
99SUP164, “Uptake
Time”)
1
UC IFF TID xxxx5 Row 5 UNITS = DT (min, UCUM,
=EV(xx??, DCM,
"min")
“Radiopharmaceutical”
)
Content Item Descriptions
Row 3
Describes a human readable text description of this defined substance administration
Row 4
Person responsible for authoring the content of this object
Row 5
This is to provide context information so as to understand – what type of study is this plan intended
for.
Row 7
Information about the substance or imaging-agent that is defined to be used.
Maximum allowed amount of activity to be administered
Row 10
465
DCID (xxxx8) Substance
Administration Mode
PLANNED SUBSTANCE ADMINISTRATION SR IOD TEMPLATES
The templates that comprise the Planned Substance Administration are interconnected as in Figure A-x.1
Page 26
TID xxxx1
Planned Substance
Agent Admin.
TID 1003
Person Observer
Identifying Attributes
TID 1005
Procedure Context
TID xxxx2
Pre-Medication Context
TID xxxx3
Patient Risk-factors
TID xxxx5
Substance Information
TID xxxx6
Substance
Administration
Consumables
TID xxxx7
Substance
Administration Plan
Figure A.x-1: Planned Substance Administration SR IOD Template Structure
470
TID xxxx1
Planned Substance Administration
This template describes single scheduled administration plan.
Page 27
TID xxxx1
Planned Substance Administration
Type: Extensible
Order: Significant
475
NL Rel with
Parent
VT
Concept Name VM Req Condition
Type
Value Set Constraint
2
>
CONTAINS
3
>
HAS
PROPERTIES
CONTAINER EV (xx8, 99SUP164,
“Planned Substance
Administration
Procedure Report”)
INCLUDE
DTID (1200)
Language
Designation
EV (121144, DCM,
TEXT
“Document Title")
4
>
CONTAINS
INCLUDE
DTID (xxxx2)
Pre-Medication
Context For
Substance
Administration
1
U
5
>
CONTAINS
INCLUDE
DTID (xxxx3)
Patient Risk-Factor
Context related to
Imaging Agents
1
U
7
>
HAS OBS
CONTEXT
INCLUDE
DTID (1003) Person
Observer Identifying
Attribtues
1
M
8
>
HAS OBS
CONTEXT
INCLUDE
DTID (1005)
Procedure Context
9
>
CONTAINS
INCLUDE
DTID (xxxx5)
Substance
Information
1-n
U
10
>
CONTAINS
CODE
EV(xx9, 99SUP164,
“Injection Mode”)
1
U
11
>
CONTAINS
TEXT
EV(xx10,
99SUP164,
Rationale for
Administering
Substance)
1-n
U
12
>
CONTAINS
INCLUDE
DTID (xxxx6)
Substance
Administration
Consumables
1-n
U
13
>
CONTAINS
NUM
EV(xx??,
99SUP164,
“Scheduled
Administered
Activity”)
1
MC IFF TID xxxx5 Row 5 Units = EV (MBq, UCUM,
=EV(xx??, DCM,
“MBq”)
“Radiopharmaceutical”
)
14
>
CONTAINS
NUM
EV(xx??,
99SUP164,
“Maximum
Administered
Activity”)
1
UC IFF TID xxxx5 Row 5 Units = EV (MBq, UCUM,
=EV(xx??, DCM,
“MBq”)
“Radiopharmaceutical”
)
1
1
M
1
U
1
U
DCID (xxxx8) Substance
Administration Mode
Page 28
15
>
CONTAINS
NUM
EV(xx??,
99SUP164,
“Minimum
Administered
Activity”)
1
UC IFF TID xxxx5 Row 5 Units = EV (MBq, UCUM,
=EV(xx??, DCM,
“MBq”)
“Radiopharmaceutical”
)
16
>
CONTAINS
NUM
EV(xx??,
99SUP164,
“Maximum
Administered
Volume”)
1
UC IFF TID xxxx5 Row 5 Units = EV (cm3, UCUM,
=EV(xx??, DCM,
“cm3”)
“Radiopharmaceutical”
)
17
>
CONTAINS
DATETIME
EV(xx??,
99SUP164,
“Scheduled
Administration
Time”)
1
UC IFF TID xxxx5 Row 5 Units = EV (s, UCUM,
=EV(xx??, DCM,
“seconds”)
“Radiopharmaceutical”
)
18
>
CONTAINS
NUM
EV(xx??,
99SUP164, “Uptake
Time”)
1
UC IFF TID xxxx5 Row 5 UNITS = DT (min, UCUM,
=EV(xx??, DCM,
"min")
“Radiopharmaceutical”
)
19
>
CONTAINS
INCLUDE
DTID(xxxx7)
Substance
Administration Plan
1
UC IFF TID xxxx5 Row 5
=EV(xx??, DCM,
“Contrast Agent”)
$PlanType = EV(xx??, DCM,
“Planned”)
Content Item Descriptions
Row 3
Describes a human readable text description of this planned substance administration
Row 4
Information about premedication administration available at the time of scheduling the Substance
Administration protocol.
Row 5
Information about patient risk-factors available at the time of scheduling the Substance
Administration protocol.
Row 7
Person responsible for authoring the content of this object.
Row 8
This is to provide context information so as to understand – what type of study is this plan intended
for.
Row 9
Information about the substance or imaging-agent scheduled to be used for the plan.
Row 11
Each item should contain a single rationale however multiple such items could be included
Row 12
Only imaging agent consumable details that are known at the time of scheduling (e.g., Needle
length)
Row 13
The desired activity to be administered.
Row 14
Maximum allowed amount of activity to be administered
Row 16
Some radiopharmaceuticals can be deadly if too much is given to the patient
TID xxxx2
480
Pre-Medication Context for Substance Administration
Detailed information on medications administered to the patient, prior to the Substance Administration.
Page 29
TID xxxx2
Pre-Medication Context For Substance Administration
Type: Extensible
Order: Significant
NL Rel with
Parent
1
VT
Concept Name
CODE
EV(xx1, 99SUP164,
Drug Product
Identifier)
VM Req Condition
Type
1-n
U
Value Set Constraint
DCID (xxxx12) PreMedication Agents for
Substance Administration
2
>
CODE
HAS
PROPERTIES
1-n
EV(xx2, 99SUP164,
Equivalent Drug Code)
U
3
>
TEXT
HAS
PROPERTIES
EV(xxx, 99SUP164,
Drug Name)
1-n
U
4
>
NUM
HAS
PROPERTIES
DCID (3410) Numeric
Parameters of
Drugs/Contrast
1-n
U
5
>
CODE
HAS
PROPERTIES
EV (G-C340, SRT,
“Route of
Administration”)
1
U
DCID (11) Route of
Administration
6
>
NUM
HAS
PROPERTIES
EV(x222, 99SUP164,
Fasting Period)
1
U
UNITS = DT (h, UCUM, "h")
Content Item Descriptions
485
Row 2
Local national code equivalent for the drug in Row 1
Row 3
Describes drug name in text indicated in Row 1
Row 6
Fasting period in hours prior to substance administration
TID xxxx3
Patient Risk-Factor Context related to Imaging Agents
TID xxxx3
Patient Risk-Factor Context related to Imaging Agents Type: Extensible
490
NL Rel with
Parent
1
VT
Concept Name
CONTAINER EV (xxxx,
99SUP164, ”ImagingAgent Related Risk
Factors”)
VM Req Condition
Type
1
U
Order: Significant
Value Set Constraint
2
>
CONTAINS
CODE
EV (F-01500,
SRT, ”Risk factor”)
1-n
U
DCID (xxxx9)
Imaging Agent Related Riskfactor Indications
3
>
CONTAINS
NUM
EV (xx4, 99SUP164,
“Serum Creatinine”)
1-n
U
UNITS =
DT( mg/dL,UCUM,”mg/dL”)
4
>>
HAS OBS
CONTEXT
DATETIME
EV (121135, DCM,
“Observation Date
time”)
1
M
5
>
CONTAINS
NUM
EV (xx5, 99SUP164,
“Glomerular Filtration
Rate“)
1-n
U
UNITS =
DT(mL/min/1.73m2, UCUM,
“mL/min/1.73m2”)
6
>>
HAS OBS
CONTEXT
CODE
EV(xx6, 99SUP164,
“Assessment Method”)
1
M
DCID (xxxx13) GFR
Assessment Method
Page 30
7
>>
HAS OBS
CONTEXT
DATETIME
EV (121135,
99SUP164,
“Observation Date
time”)
1
M
Content Item Descriptions
Row 3
There may be multiple sCRs on record for the patient.. there are some clinical algorithms that
assess the slope of the sCR (and/or eGFR) to ascertain whether a patient should receive contrast
(Iodinated or Gadolinum) or if a reduced volume etc should be used.
495
TID xxxx5
Substance Information
This template describes the nature of the substance in the scope of Substance administration for the
purpose of imaging.
TID xxxx5
Substance Information
Type: Extensible
Order: Significant
500
NL Rel with
Parent
VT
Concept Name
CONTAINER EV(xxxxx, “99SUP164”,
Substance Admin.)
1
EV(xxxx, “99SUP164”,
“Substance”)
EV(xx12,”99SUP164”,
“Substance Code”)
2
>
CONTAINS
TEXT
3
>
CONTAINS
CODE
4
>
CODE
HAS
PROPERTIES
EV(xx2, 99SUP164,
Equivalent Drug Code)
5
>
CODE
HAS
PROPERTIES
6
>
CONTAINS
CODE
7
>
CONTAINS
TEXT
VM Req Condition
Typ
e
1
M
1
U
Value Set Constraint
1
M
1-n
U
EV(xxx, 99SUP164,
Substance Type)
EV(G-C52F, SRT,
“Active Ingredient”)
1
M
DCID (xxxx16) Administrable
Substance Type
1
U
DCID (13) Radiographic
Contrast Agent Ingredient
EV (xx??,
$99SUP164,
“Substance
Manufacturer”)
1
U
BCID (12) Radiographic
Contrast Agent
or
BCID (25)
Radiopharmaceuticals
or
BCID (3107) PET
Cardiology
Radiopharmaceuticals
or
BCID (3111) Nuclear
Cardiology
Radiopharmaceutical
or
BCID (4021) PET
Radiopharmaceutical
Page 31
8
>
CONTAINS
DATETIME
EV(xx20, 99SUP164,
“Substance Order Date”)
1
U
9
>
CONTAINS
NUM
1
U
UNITS = EV(Mg/L, UCUM,
“Mg/L”)
10
>
CONTAINS
NUM
1
U
11
>
CONTAINS
NUM
EV(xx13,”99SUP164”,
“Contrast
Concentration”)
EV(xx14, 99SUP164,
“Molarity”)
EV(xx15, 99SUP164,
“Relaxivity”)
1
U
UNITS = EV(mmol/L,
UCUM,“ mmol/L” )
UNITS = EV (mM^-1*sec^-1,
UCUM, “mM^-1*sec^-1”)
12
>
CONTAINS
NUM
EV(xx16, 99SUP164,
“Osmolality at 37C”)
1
U
13
>
CONTAINS
NUM
EV(xx17, 99SUP164,
“Osmolarity at 37C”)
1
U
14
>
CONTAINS
NUM
EV(xx18, 99SUP164,
“Viscosity at 37C”)
1
U
CONTAINS
NUM
EV(xx19, 99SUP164,
“Flush Concentration”)
1
U
15
>
UNITS = EV (mOsm/kg,
UCUM, “mOsmol/kg”)
UNITS = EV(mmol/L,
UCUM,“ mmol/L” )
UNITS = EV(mOsm/kg H20,
“UCUM”, “mOsm/kg H20”)
UNITS = EV(Mg/L, UCUM,
“Mg/L”)
>
CONTAINS
CODE
EV (G-C340, SRT,
"Route of
administration")
1
U
17 >
CONTAINS
TEXT
EV (CDXX24,
$99SUP159, “Reagent
Identifier”)
1
U
18 >
CONTAINS
CODE
EV (C-B1000, SRT,
“Diagnostic
Radioisotope”)
1
UC IFF Row 5 Equals Yes BCID 18 (NM) or 4020 (PET)
19 >
CONTAINS
NUM
EV (CDXX25,
$99SUP159,
“Radionuclide Half Life”)
1
UC IFF Row 5 Equals Yes Units = EV (s, UCUM,
“seconds”)
20 >
CONTAINS
TEXT
EV (CDXX26,
$99SUP159,
“Radionuclide Identifier”)
1
16
U
DCID (11) Route of
Administration
IFF Row 5 Equals Yes
IFF Row 5 Equals Yes
Content Item Descriptions
505
Row 4
Local equivalent drug code for Row 3
Row 5
Indicates whether the substance is radiopharmaceutical or contrast agent
Row 6
Row 7
Mg/ml of active ingredient
Substance or Imaging-Agent Manufacturer. Could be department for locally compounded items.
Reagent manufacturer is noted in reagent parameters.
Row 8
Date-time the Contrast-Agent was ordered by the physician.
Row 9
Row 10
Contrast Concentration, referring to the concentration of contrast type given in row 4
One of: “Iodine”, “Gadolinium”, etc
Row 11
Relaxivity at 37C at B0 field strength
Row 20
Identification for the radionuclide component of the radiopharmaceutical
TID xxxx6
Substance Administration Consumables
These are consumable used in the course of a substance administration procedure.
Page 32
TID xxxx6
Substance Administration Consumables
Type: Extensible
Order: Significant
NL Rel with
Parent
1
VT
Concept Name
VM Req Condition
Type
CONTAINER EV(xx21, 99SUP164,
“Substance
Administration
Consumable
Information”)
1
U
1-n
U
Value Set Constraint
2
>
CONTAINS
CODE
EV(xx45, 99SUP164,
“Substance
Consumable Type”)
3
>
CONTAINS
TEXT
1
EV (121148, SRT,
“Unit Serial Identifier”)
U
4
>
CONTAINS
TEXT
EV (121149, DCM,
“Lot identifier”)
1
U
5
>
CONTAINS
TEXT
EV(xx46, 99SUP164,
“UPC Code”)
1
U
6
>
CONTAINS
TEXT
EV (121145,
SRT, ”Description of
Material”)
1
U
7
>
CONTAINS
DATE
EV(xx22,99SUP164,
"Expiry Date")
1
U
8
>
CONTAINS
NUM
EV (111467, DCM,
“Needle Length”)
1
C
9
>
CONTAINS
NUM
EV (122319, DCM,
“Catheter Size”)
1
U
10
>
CONTAINS
TEXT
EV(xx23, 99SUP164, 1
“Manufacturer Name”)
U
11
>
CONTAINS
CODE
EV(xx24, 99SUP164,
“Syringe Type”)
1
C
IFF Row 2 Equals
DCID (xxxx3) Substance
(xxxx, DCM, “Syringe”) Administration Injection
Syringe Type
12
>
HAS
NUM
PROPERTIES
1
EV (121146, DCM,
“Quantity of material”)
U
Units = EV (1,UCUM,”no
units”)
13
>
CONTAINS
EV (121147, DCM,
"Billing
Code")
U
TEXT
1
510
Content Item Descriptions
Row 3
Serial ID of the substance consumable
Row 4
LOT identifier of the substance
Row 6
Description about the substance material if any
Row 7
Expiry date of Substance
Row 8
Needle Length of the catheter used
Row 10
Syringe manufacturer name
Row 11
See new CID for syringe type (Pre-filled or Empty)
Row 12
Syringe quantity number
DCID (xxxx14) Substance
Administration Consumable
Type
IFF Row 2 Equals
UNITS = EV (cm,
(xxxx, DCM, “Syringe”) UCUM, ”centimeter”)
UNITS = DCID (3510)
Catheter Size Units
Page 33
TID xxxx7
Substance Administration Delivery Plan Template
This template provides detailed information on Substance Administration delivery plan. A plan consists of multiple
steps of delivery; a step in turn consists of multiple phases.
515
TID xxxx7 Parameters
Parameter Name
$PlanType
Parameter Usage
Coded term for Concept Name of a plan type
TID xxxx7
Substance Administration Delivery Plan Template
Type: Extensible
Order: Significant
520
NL Rel with
Parent
1
VT
Concept Name
VM Req Condition
Type
CONTAINER EV(xx26, 99SUP164,
“Substance Delivery
Procedure Plan”)
1
M
1
M
2
>
CONTAINS
CODE
EV(xx27, 99SUP164,
“Plan Type”)
3
>
CONTAINS
INCLUDE
1-n
DTID(xxx8)
“Substance
Administration Delivery
Step”
4
>
CONTAINS
NUM
EV(xx27, 99SUP164,
“Pressure Limit”)
5
>
CONTAINS
NUM
EV(122094, DCM,
“Rate of
administration”)
6
>
CONTAINS
WAVEFORM EV(xx??, DCM,
1-n MC
“Measurement Graph”)
1
$PlanType
M
UC
1
Value Set Constraint
IF TID xxxx1 Row 4 = UNITS = EV(kPa,UCUM,
EV(xx??, DCM,
“kPa“)
“Automated Injection”)
or TID xxx10 Row 8 =
EV(xx??, DCM,
“Automated Injection”)
U
UNITS = EV(ml/S,UCUM,
“ml/S“)
IF TID xxx10 Row 8 =
EV(xx??, DCM,
“Automated Injection”)
and Row 2 =
EV(xx??, DCM,
“Delivered”)
Content Item Descriptions
Row 1
Plan Name /Title or simply a Plan number as text
Row 2
Scheduled –To be encoded while this plan is scheduled under “Planned Substance Administration
Procedure SR IOD”
Programmed – To be encoded if this plan is programed at the injector under “Performed Substance
Administration Procedure SR IOD”.
Delivered – To be encoded if this plan was used in actual delivery of drug to the patient, under
“Performed Substance Administration Procedure SR IOD”.
Row 6
This item shall only be added for performed when the value for row 2 is “Delivered” with Injection
Page 34
mode as Power Injector
Generally, 3 waveform objects referenced:
a. Flow-Rate vs Time,
b. Pressure vs Time
c. Volume vs Time
525
TID xxxx8
Substance Administration Delivery Step Template
This template provides detailed information on Substance Administration delivery plan. A plan consists of multiple
steps of delivery; a step in turn consists of multiple phases.
TID xxxx8
Substance Administration Delivery Step Template
Type: Extensible
Order: Significant
530
NL Rel with
Parent
1
VT
Concept Name
VM Req Condition
Type
CONTAINER EV(xx28, 99SUP164,
“Substance Delivery
Procedure Step”)
1
M
Value Set Constraint
2
>
CONTAINS
NUM
EV(xx, 99SUP164,
“Substance Delivery
Step Number”)
1
M
Units = EV (1,UCUM,”no
units”)
3
>
CONTAINS
NUM
EV(xx29, 99SUP164,
“Injection Delay”)
1
M
4
>
CONTAINS
NUM
EV(xx30, 99SUP164,
"Scan Delay ")
1
M
UNITS = EV (s, UCUM,
“s”)
UNITS = EV (s, UCUM,
“s”)
5
>
CONTAINS
CODE
EV(xx31, 99SUP164,
“Substance Delivery
Phase”)
1-n
M
Content Item Descriptions
Row 2
Substance Delivery Step Number indicates a delivery step, it starts with 1 and increases
monotonically by 1.
535
TID xxxx9
Substance Administration Delivery Phase Template
This template provides detailed information on Substance Administration delivery plan. A plan may consist
of multiple steps of delivery; a step in turn may consist of multiple phases.
TID xxxx9
Substance Delivery Phase Template
Type: Extensible
Order: Significant
540
NL Rel with
Parent
1
VT
Concept Name
CONTAINER EV(xx32, 99SUP164,
“Substance Delivery
Phase”)
VM Req Condition
Type
1
M
Value Set Constraint
Page 35
2
>
CONTAINS
NUM
EV(xx, 99SUP164,
“Substance Delivery
Phase Number”)
1
M
Units = EV (1,UCUM,”no
units”)
3
>
CONTAINS
CODE
EV(xx62, 99SUP164,
“Substance Delivery
Phase Type”)
1
M
DCID (xxx4) Substance
Phase Type
4
>
CONTAINS
CODE
EV(xx33, 99SUP164,
“Substance Type”)
1
MC
IFF Row 3 equals
(xxxx9, DCM,
“Administration”)
DCID (xxxx5) Substance
Type
5
>
CONTAINS
NUM
EV(xx33, 99SUP164,
"Substance Flush
Ratio")
1
MC
IFF Row 3 equals
(xxxx9, DCM,
“Administration”)
UNITS = EV(%, UCUM, “%”)
6
>
CONTAINS
NUM
1
EV(122091, DCM,
“Volume Administered”
MC
IFF Row 3 equals
(xxxx9, DCM,
“Administration”)
UNITS = EV (ml, UCUM,
“ml”)
7
>
CONTAINS
NUM
EV(122094, DCM,
“Rate of
administration”)
1
UC
IFF Row 3 equals
(xxxx9, DCM,
“Administration”)
UNITS = EV(ml/s, UCUM
“ml/s”)
8
>
CONTAINS
NUM
EV(122095, DCM,
“Duration of
administration”)
1
U
9
>
CONTAINS
DATETIME
EV(111526, DCM,
“DateTime Started”
1
MC
IFF SOP class is
Performed Substance
Administration SR
10
>
CONTAINS
DATETIME
EV(111527, DCM,
“DateTime Ended”
1
MC
IFF SOP class is
Performed Substance
Administration SR
11
>
CONTAINS
NUM
EV(xx34, 99SUP164,
“Initial Volume of
Substance in
Container”)
1
UC
IFF Row 3 equals
(xx??, DCM,
“Administration”)
UNITS = EV (ml, UCUM,
“ml”)
12
>
CONTAINS
NUM
EV(xx3x, 99SUP164,
“Residual Volume of
Substance in
Container”)
1
UC
IFF Row 3 equals
(xx??, DCM,
“Administration”)
UNITS = EV (ml, UCUM,
“ml”)
13
>
CONTAINS
NUM
EV(xx35, 99SUP164,
“Rise Time")
1
MC
IF Row 3 equals
(xx??, DCM,
“Administration”)
And
IF TID xxxx7 Row 2
equals (xx??,DCM,
“Delivered”)
UNITS = EV (s, UCUM,
“s”)
UNITS = EV (s, UCUM,
“s”)
Content Item Descriptions
545
Row 2
Substance Delivery Phase Number indicates a delivery phase, it starts with 1 and increases
monotonically by 1.
Row 5
The ratio of volume of substance to volume of flush
Row 9
Date time of when the Substance delivery started for the current phase
Row 10
Date time of when the Substance delivery ended for the current phase
Page 36
PERFORMED SUBSTANCE ADMINISTRATION SR IOD TEMPLATES
550
The templates that comprise the Performed Substance Administration are interconnected as in Figure Ax.2
Page 37
TID xxxx10
Performed Substance
Admin.
TID 1003
Person Observer Identifying
Attributes
TID 1005
Procedure Context
TID xxx2
Pre-Medication Context
TID xxx3
Patient Risk-Factors
TID xxx11
Substance Information
TID xxxx5
Substance Administration
Device Information
TID xxxx6
Substance Administration
Consumables
TID xxxx7
Substance Administration Plan
TID xxx15
Radiopharmaceutical Substance
Administration Data
TID xxx11
Adverse Event Reactions
Page 38
Figure A.x-2: Performed Substance Administration SR IOD Template Structure
555
TID xxx10
Performed Substance Administration
This template defines a container (the root) with subsidiary content items, each of which corresponds to a
single Substance Administration delivered. There is a defined recording observer (the system or person
responsible for planning the schedule).
TID xxx10
Performed Substance Administration
Type: Extensible
560
NL Rel with
Parent
1
VT
Concept Name
VM Req Condition
Type
CONTAINER EV (xx??, DCM,
“Performed Substance
Administration
Procedure Report”)
INCLUDE
DTID (1204) Language
Designation
EV (xx??, DCM,
TEXT
“Summary Text")
1
M
1
U
1
U
2
>
CONTAINS
3
>
CONTAINS
4
>
CONTAINS
INCLUDE
DTID(xxxx1)
Pre-Medication
1
U
5
>
CONTAINS
INCLUDE
DTID (xxx3)
Patient Risk-Factor
Context related to
Imaging Agents
1
U
6
>
CONTAINS
INCLUDE
DTID (1003) Person
Observer Identfying
Attributes
1-n
U
7
>
CONTAINS
INCLUDE
DTID (1005)
Procedure Context
1
U
8
>
CONTAINS
CODE
EV(xx36, 99SUP164,
“Injection Mode”)
1
M
9
>
CONTAINS
INCLUDE
DTID (xxxx12)
Substance
Administration Device
Information
1
MC
10
>
CONTAINS
INCLUDE
DTID (xxxx5)
Substance Information
1
M
11
>
CONTAINS
INCLUDE
DTID (xxxxx6)
Substance
Administration
Consumables
1-n
M
12
>
CONTAINS
INCLUDE
DTID (xxxx7)
Substance
Administration Plan
1
MC
IFF TID xxxx5 Row 5
=EV(xx??, DCM,
“Contrast Agent”)
13
>
CONTAINS
INCLUDE
DTID (xxxx7)
Substance
Administration Plan
1
MC
IFF TID xxxx5 Row 5
=EV(xx??, DCM,
“Contrast Agent”)
14
>
CONTAINS
INCLUDE
DTID(xxx15)
Radiopharmaceutical
Substance
Administration Data
1
Value Set Constraint
DCID (xxxx8) Substance
Administration Mode
IFF Row 8 = EV(xx??,
DCM, “Automated
Injection”)
UC IFF TID xxxx5 Row 5
=EV(xx??, DCM,
“Radiopharmaceutical”)
$PlanType = EV(xx??,
DCM, “Performed”)
Page 39
15
>
CONTAINS
INCLUDE
DTID (xxx11)
Substance
Administration
Adverse Events
1
M
16
>
CONTAINS
CODE
EV(xx60,99SUP164,
“Substance
Administration
Completion Status”)
1
M
DCID (xxxx15) Substance
Administration Completion
Status
Content Item Descriptions
Row 3
Describes a human readable text description of substance administration
Row 6
Persons responsible for administering the substance .
Row 7
This is to provide context information so as to understand – what type of study is this plan intended
for.
Row 11
Substance consumable information
Row 12
Programmed plan, contains detailed steps of a delivery plan.
Typically, there is only one delivery plan for a Planned Substance Administration SOP class, two for
Performed Substance Administration SOP class, indicating both programmed and delivered delivery
steps.
Row 13
Performed delivery plan, containing detailed steps for actual delivery of Substance
565
TID xxx11
Substance Administration Adverse Events
This general template provides detailed information on adverse events occurring to a patient as a reaction
to administration of Substance.
TID xxx11
Substance Administration Adverse Event Reactions
Type: Extensible
570
NL Rel with
Parent
1
VT
Concept Name
VM Req Condition
Type
CONTAINER EV (xx??, 99SUP164, 1
"Substance
Administration
Adverse Event”)
EV (xx??, 99SUP164, 1
NUM
"Number Of Adverse
Events”)
CODE
1-n
EV(xx??, DCM,
“Substance
Administration
Adverse Reaction”)
2
>
CONTAINS
3
>
CONTAINS
4
>>
CODE
HAS
PROPERTIES
5
>>
CODE
HAS
PROPERTIES
6
>>
DATETIME
HAS
PROPERTIES
EV(xxxx, 99SUP164, 1
“Adverse Event
Severity”)
EV (xxxxx, 99SUP164,
“Relative Time of
Occurrence of Adverse
Event”)
EV(xx37, 99SUP164, 1
“Adverse Event
Observation Date
Time”)
Value Set Constraint
M
Units = EV (1,UCUM,”no
units”)
M
MC
IFF Row 2 > 0
BDCID(9300) Procedure
Discontinuation Reasons
U
BCID (3716) Severity
U
DCID (xxxx2) Temporal
Periods Relating To Contrast
Procedure
M
Page 40
x
>
NUM
HAS
PROPERTIES
EV (CDXX16,
$99SUP159,
“Estimated
Extravasation Activity”)
1
U
x
>
NUM
HAS
PROPERTIES
EV (CDXX16,
$99SUP164,
“Estimated
Extravasation
Volume”)
1
U
7
>>
NUM
HAS
PROPERTIES
EV(xx38, 99SUP164,
“Adverse Reaction
Step”)
1
U
Units = EV (1,UCUM,”no
units”)
8
>>
NUM
HAS
PROPERTIES
1
U
Units = EV (1,UCUM,”no
units”)
9
>>
TEXT
HAS
PROPERTIES
EV(xx39, 99SUP164,
“Adverse Reaction
Phase”)
EV (121106, DCM,
“Comment”)
1
U
IFF TID xxxx5 Row 5 Units = EV (MBq, UCUM,
=EV(xx??, DCM,
“megabecquerel”)
“Radiopharmaceutical”
)
Units = EV (ml, UCUM, “ml”)
Content Item Descriptions
Row 6
Date and time when the adverse event was noted by the observer.
Row 7
Indicates the performed step number in this plan (as recorded in row 2 of TID xxx8) where an
adverse reaction found to occur.
Row 8
Indicates the performed phase number (as recorded in row x of TID xxx7) in the step of this plan
where an adverse reaction found to occur.
Row 9
For end user comments. Not to be used programmatically.
TID xxx12
575
Substance Administration Device Information
This template provides detailed information about the device that was used to administer the substance.
TID xxx12
Substance Administration Device Information Template
Type: Extensible
NL Rel with
Parent
1
VT
Concept Name
VM Req Condition
Type
CONTAINS
CONTAINER EV(xx40, 99SUP164, 1
“Substance
Administration Device
Information”)
M
INCLUDE
2
>
HAS OBS
CONTEXT
DTID (1004) Device
Observer Identifying
Attributes
1
M
3
>
CODE
HAS
PROPERTIES
EV(xx??, 99SUP164,
“Programmable
Device”)
1
U
4
>
TEXT
HAS
PROPERTIES
EV(xx??, 99SUP164,
“Device Observer
Software Version”)
1
U
5
>
TEXT
HAS
PROPERTIES
EV(xx44, 99SUP164,
“Injector HeadType”)
1
U
580
Content Item Descriptions
Value Set Constraint
DCID (230) Yes - No
DCID (xxxx10) Substance
Administration Injector Head
Type
Page 41
585
Row 3
Indicates whether the injector device is capable of programming a delivery plan for automated
administration of substance to the patient.
Row 5
Type of injector – Dual Head, Single Head, etc.
TID XXX15
Radiopharmaceutical Substance Administration Data
The Radiopharmaceutical Substance Administration Data conveys the dose and assay and time
information of a single radiopharmaceutical event. A Radiopharmaceutical Administration event is one
radioactive pharmaceutical dispensed to a patient.
TID XXXX3
RADIOPHARMACEUTICAL SUBSTANCE ADMINISTRATION DATA
Type: Extensible Order: Significant
590
NL
Rel with
Parent
1
VT
Concept Name
VM
Req Condition
Type
CONTAINER EV (CDXX05,
$99SUP159,
”Radiopharmaceutical
Administration”)
1
M
Value Set
Constraint
2
>
CONTAINS
CODE
EV (123001, DCM,
“Radiopharmaceutical
”)
1
M
3
>
CONTAINS
UIDREF
EV (CDXX12,
$99SUP159,
“Radiopharmaceutical
Administration Event
UID”)
1
MC
4
>
CONTAINS
TEXT
EV (CDX111,
$99SUP159,
“Purpose of
Administration ”)
1
M
7
>
DATETIME
HAS
PROPERTIES
EV (123003, DCM,
“Radiopharmaceutical
Start Time”)
1
M
8
>
DATETIME
HAS
PROPERTIES
EV (123004, DCM,
“Radiopharmaceutical
Stop Time”)
1
U
9
>
CONTAINS
NUM
EV (CDXX17,
$99SUP159,
“Administered
activity”)
1
M
Units = EV (MBq, UCUM,
“megabecquerel”)
10
>
CONTAINS
NUM
EV (123005, DCM,
“Radiopharmaceutical
Volume”)
1
U
Units = EV (cm3, UCUM,
“cm3”)
BCID (25)
Radiopharmaceuticals or
BCID (3107) PET
Cardiology
Radiopharmaceuticals or
BCID (3111) Nuclear
Cardiology
Radiopharmaceutical
BCID (4021) PET
Radiopharmaceutical
Page 42
11
>
CONTAINS
NUM
EV (123007, DCM,
“Radiopharmaceutical
Specific Activity”)
1
U
Units = EV (Bq/mol,
UCUM, “Bq/mol”)
12
>
CONTAINS
NUM
EV(xxxx, 99SUP164,
“Flush Delivered”)
1
U
Units = EV (ml, UCUM,
“ml”)
Content Item Descriptions
Row 3
Unique identification of a single radiopharmaceutical administration event.
Row 4
Local description of the purpose of the administration of the radiopharmaceutical in the
procedure (i.e. “Cardiac Stress Injection”, “Cardiac Rest Injection”) In order to facilitate
the selection of the proper dose when querying the image archive, Series Description
(0008,103E) should contain the same information as the Purpose of Administration.
Row 6
The estimated activity of extravasated radiopharmaceutical. This estimated value can be
subtracted from administered activity for PET SUV calculations. Observation DateTime
(0040,A032) shall be used to record the time of the estimate.
Row 7
The time the radiopharmaceutical was administered to the patient for imaging purposes.
Row 9
Total amount of radioactivity administered to the patient at Radiopharmaceutical Start
Time. It is a computed field from the TID XXX6 Measured Activity Row 2, TID XXX6
Measured Activity Date Time Row 3, Radionuclide Half Life Row 15 and
Radiopharmaceutical Start Time Row 7.
Does not include estimated extravasation activity.
Row 11
Activity per unit mass of the radiopharmaceutical at Radiopharmaceutical Start Time
595
Add the following CID’s to Part 16 Annex B:
CID 9300
Procedure Discontinuation Reasons
Context ID 9300
Procedure Discontinuation Reasons
Type: Extensible Version: 20110128
600
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
110526
Resource pre-empted
DCM
110527
Resource inadequate
DCM
110528
Discontinued Procedure Step rescheduled
DCM
110529
Discontinued Procedure Step rescheduling
recommended
Include CID 9301 Modality PPS Discontinuation Reasons
Include CID 9302 Media Import PPS Discontinuation Reasons
Include CID xxxx1 Substance Administration Adverse Event Reaction List
Page 43
CID xxxx1
Substance Administration Adverse Event Reaction List
Context ID xxxx1
Substance Administration Adverse Event Agent Reaction List
Type: Extensible
Version: 2012xxxx
605
Coding Scheme
Designator
(0008,0102)
Code Meaning
(0008,0104)
DCM
xxx1
Pressure limiting event occurred during injection,
DCM
xxx2
DCM
xxx3
DCM
xxx4
Flow-rate limiting event occurred during
injection.
Indicates occurrence of both pressure and flowrate limit event detections.
Injection aborted by clinician operator
DCM
xxx5
DCM
Include CID CXX10
xxx6
Intravenous Extravasation Symptoms (From Supplement 159)
CID CXX10
610
Code Value
(0008,0100)
Anaphylactic Reaction observed during
administration
Dyspnea wheezing
Intravenous Extravasation Symptoms
This list of Extravasation Symptoms are taken from ACR NRDR-ICE Registry, IV Contrast Extravasation Reporting
Form version 1.3 from NRDR.ACR.ORG
Context ID CXX10
Intravenous Extravasation Symptoms
Type: Extensible
Version: yyyymmdd
Coding Scheme
Designator
(0008,0102)
615
Code Value
(0008,0100)
Code Meaning
(0008,0104)
$99SUP159
CDX127
Decreased Perfusion
$99SUP159
CDX128
Skin Induration
$99SUP159
CDX129
Erythema
$99SUP159
CDX130
Altered sensation
$99SUP159
CDX131
No Signs or Symptoms
$99SUP159
CDX135
Swelling Mild
$99SUP159
CDX136
Swelling Moderate
$99SUP159
CDX137
Swelling Severe
$99SUP159
CDX138
Pain
$99SUP159
CDX139
Skin Blistering or Ulceration
$99SUP159
CDX140
Compartment Syndrome
$99SUP159
CDX141
Other Extravasation Symptom
Add new CID for Radiosensitive Organs in Part 16:
Page 44
CID xxxx2
Temporal Periods Relating To Contrast Procedure
Context ID xxxx2
Temporal Periods Relating To Contrast Procedure
Type: Extensible
Version: 2012xxxx
620
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
SRT
R-422A4
After Procedure
SRT
R-40FBA
During Procedure
SRT
R-40FB9
DCM
110514
Before Procedure
Procedure discontinued due to
incorrect patient or procedure
step selected from modality
work-list
CID xxxx3
Contrast Agent Injection Substance Administration Syringe Type
Context ID xxxx3
Contrast Agent Injection
Substance Administration Syringe Type
Type: Extensible
Version: 2012xxxx
625
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
DCM
xxxx7
Pre-filled
DCM
xxxx8
Empty (or Not Pre-filled)
CID xxxx4
Code Meaning
(0008,0104)
Contrast Agent Substance Administration Phase Type
Context ID xxxx4
Contrast Agent
Substance Administration Phase Type
Type: Extensible
Version: 2012xxxx
630
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
xxxx9
Administration
DCM
xxx10
Programmed Hold
DCM
xxx11
Manual Pause
Page 45
CID xxxx5
Substance Type
Context ID xxxx5
Substance Type
Type: Extensible
Version: 2012xxxx
635
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
DCM
xxx12
Flush or Saline
DCM
xxx13
Contrast-Agent
DCM
xxxxx
Radio-Pharmaceutical
CID xxxx6
Code Meaning
(0008,0104)
Substance Administration Consumable
Context ID xxxx6
Substance Administration Consumables
Type: Extensible
Version: 2012xxxx
640
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
121145
Description of Material
DCM
121148
Unit Serial Identifier
DCM
121149
Lot Identifier
CID xxxx7
Temporal Periods Relating To Procedure
Context ID xxxx7
Temporal Periods Relating To Procedure
Type: Extensible
Version: 2012xxxx
645
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
SRT
R-422A4
After Procedure
SRT
R-40FBA
During Procedure
SRT
R-40FB9
Before Procedure
CID xxxx8
Substance Administration Mode
Context ID xxxx8
Substance Administration Mode
Type: Extensible
Version: 2012xxxx
650
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
Page 46
DCM
xxx14
Automated Injection
DCM
xxx15
Manual Injection
655
660
CID xxxx9
Substance Administration Related Risk-Factor Indications
Context ID xxxx9
Substance Administration Related Risk-factor Indications
Type: Extensible
Version: 2012xxxx
665
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
xxx16
Renal Insufficiency
DCM
xxx17
Diabetes
DCM
xxx18
Asthma
DCM
xxx19
Other Cardiac Disease
DCM
xxx20
Aortic Stenosis
DCM
xxx21
Angina
DCM
xxx22
Congestive Heart Failure Symptoms
DCM
xxx23
Primary Pulmonary Hypertension
DCM
xxx24
Cardiomyopathy
DCM
xxx25
Anxiety
DCM
xxx26
Paraproteinemias
DCM
xxx27
Multiple myeloma
DCM
xxx28
Use of Beta-adrenergic
blocking agents
DCM
xxx29
Carcinoma of the thyroid
DCM
xxx30
Use of intra-arterial injection papaverine
DCM
xxx31
Dehydration
DCM
xxx32
Contrast Agent Allergy
DCM
xxx33
Infant or Neonate Patient
Page 47
CID xxxx10
Substance Administration Injector Head Type
Context ID xxxx10
Substance Administration Injector Head Type
Type: Extensible
Version: 2012xxxx
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
xxx34
Dual Head
DCM
xxx35
Single Head
670
CID xxxx11
Substance Administration Plan Type
Context ID xxxx11
Substance Administration Plan Type
Type: Extensible
Version: 2012xxxx
675
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
DCM
xxx36
Planned
DCM
xxx37
Programmed
DCM
xxx38
Delivered
DCM
xxx??
Defined
CID xxxx12
Code Meaning
(0008,0104)
Pre-Medication Agents for Substance Administration
Context ID xxxx12
Pre-Medication Agents for Substance Administration
Type: Extensible
Version: 2012xxxx
680
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
Trade Name
(Informative)
(From url)
SRT
C-37138
Prednisone
SRT
C-51450
Diphenhydramine
SRT
C-37128
Methylprednisolone
SRT
C-A01D1
Methylprednisolone sodium succinate
(Solu-Medrol)
SRT
C-A0173
Hydrocortisone sodium succinate
(Solu-Cortef)
SRT
C-913A4
Dexamethasone sodium sulfate
(Decadron)
SRT
C-51071
H-1 Antihistamine
Benadryl
Page 48
SRT
685
C-68050
CID xxxx13
Ephedrine
GFR Assessment Methods
Context ID xxxx13
GFR Assessment Methods
Type: Extensible
Version: 2012xxxx
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
xxx49
MDRD estimation of GFR
DCM
xxx50
Cockroft-Gault Formula estimation of GFR
DCM
xxx51
CKD-EPI Formula estimation of GFR
DCM
xxx52
Direct Measurement of GFR
690
CID xxxx14
Substance Administration Consumable Type
Context ID xxxx14
Substance Administration Consumable Type
Type: Extensible
Version: 2012xxxx
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
xxx53
Imaging agent
DCM
xxx54
Flush
DCM
xxx55
Syringe
DCM
xxx56
Cartridge
DCM
Xxx?
695
CID xxxx16
Administrable Substance Type
Context ID xxxx16
Administrable Substance Type
Type: Extensible
Version: 2012xxxx
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
xx??
Radiopharmaceutical
DCM
xx??
Flush
DCM
xx??
Contrast-Agent
Page 49
DCM
xx??
Flush
DCM
xx??
Interventional
700
CID xxxx15
Administration Completion Status
Context ID xxxx15
Substance Administration Completion Status
Type: Extensible
Version: 2012xxxx
705
Coding Scheme
Designator
(0008,0102)
Code Value
(0008,0100)
Code Meaning
(0008,0104)
DCM
xxx57
Administration Completed
DCM
xxx58
Administration Aborted
DCM
xxx59
User Aborted Injection
DCM
xxx59
Administration In Progress
710
Annex D
715
DICOM Controlled Terminology Definitions (Normative)
This Annex specifies the meanings of codes defined in DICOM, either explicitly or by reference to another
part of DICOM or an external reference document or standard.
DICOM Code Definitions (Coding Scheme Designator “DCM” Coding Scheme Version “01”)
Code
Value
Code Meaning
xxx1
Pressure limiting event
occurred during injection.
xxx2
Flow-rate limiting event
occurred during injection.
Definition
Notes
Generally, this does not abort the injection
however conveys if there was occurrence of any
pressure limiting event.
Generally, this does not abort the injection
however conveys if there was occurrence of any
flow-rate limiting event.
Page 50
xxx3
Indicates occurrence of both
pressure and flow-rate limit
event detections.
xxx4
xxx6
Injection aborted by clinician
operator
Anaphylactic Reaction
observed during administration
Dyspnea wheezing
xxxx7
Pre-filled
xxxx8
Empty (or Not Pre-filled)
xxxx9
Administration Fluid
xxx10
Administration Hold
xxx11
Administration Pause
xxx12
Flush or Saline
xxx13
Contrast-Agent
xxxxx
Radio-Pharmaceutical
xxx14
Automated Injection
xxx15
Manual Injection
xxx16
Renal Insufficiency
xxx17
Diabetes
xxx18
Asthma
xxx19
Other Cardiac Disease
xxx20
Aortic Stenosis
xxx21
Angina
xxx22
Congestive Heart Failure
Symptoms
xxx23
Primary Pulmonary
Hypertension
xxx24
Cardiomyopathy
xxx25
Anxiety
xxx26
Paraproteinemias
xxx27
Multiple myeloma
xxx28
Use of Beta-adrenergic
blocking agents
xxx29
Carcinoma of the thyroid
xxx30
Use of intra-arterial injection
papaverine
xxx31
Dehydration
xxx32
Contrast Agent Allergy
xxx33
Infant or Neonate Patient
xxx5
Page 51
xxx34
Dual Head
xxx35
Single Ahead
xxx36
Planned
xxx37
Programmed
xxx38
Delivered
Xxxxx
Defined
xxx49
MDRD estimation of GFR
xxx50
Cockroft-Gault Formula
estimation of GFR
xxx51
CKD-EPI Formula estimation
of GFR
xxx52
Direct Measurement Method of
GFR
xxx53
Contrast
xxx54
Flush
xxx55
Syringe
xxx56
Cartridge
xxx57
Administration Completed
xxx58
Administration Aborted
xxx59
Administration In Progress
720
Changes to NEMA Standards Publication PS 3.17-2011
725
Digital Imaging and Communications in Medicine (DICOM)
Part 17: Explanatory Information
Page 52
730
735
740
745
750
Add new Section to Annex XX of PS 3.17:
Annex XX Substance Administration Report Template (Informative)
XX.1 PURPOSE OF THIS ANNEX
755
This Annex describes the use of the Substance Administration Reporting. The Substance Administration
Report objects records the scheduled and performed delivery of contrasting agents.
Page 53
760
The Planned Substance Administration object is intended for representing the plan or program to deliver
contrast agent to the patient for a contrast study. It could be programmed at the time of schedule of a study
or beginning of the study. Often, it is programmed at the power-Injector device console by the modality
technician or radiologists. The plan may be altered by the delivery system or a user based on a variety of
factors.
The Performed Substance Administration SR IOD is for reporting the actual plan or program that was used
to deliver the contrast agent during a medical imaging study.
765
In addition to the above objects, the Basic Performed Substance Administration SOP class provides a
summarized version of the performed Substance Administration.
The scope is intended to cover all modalities in which radiographic, radiopharmaceutical or other agents
are introduced into a circulatory system in a controlled fashion (CT, MR, XA, NM, US)
XX.2 Real-World Substance Administration Reporting Workflow
Figure xx-1 demonstrates the workflow of administration of contrast agent during an imaging study.
770
Figure xx-1
Figure xx-2 shows Data flows with Contrast Agent Administration SR
Page 54
775
780
785
Figure xx-2
Page 55
Figure xx-3 shows the Case 1 – Manual Bolus Injection System
790
Figure xx-3
Case 2 – Manul Bolus Injection with input from DSS/Order Filler/Modality
Page 56
795
Figure xx-4
Case 3 – Automatic Infusion Pump – Contrast Reporting
Page 57
800
Figure xx-5
Case 4 – Automatic infusion pump contrast reporting : Dispense and Administration
Page 58
Figure xx-6
805
Page 59
810
Case 5 – Automatic infusion pump contrast reporting : Dispense, administration and realtime check of
dispensed product.
Figure xx-7
815
Page 60
Use case 6 – Integration with CT / MR
820
825
830
Figure xx-8
Page 61
Use case – Integration with CV
Figure xx-9
835
840
Page 62
Use case 8 – Reporting
845
Figure xx-10
850
Page 63
Use case 9 – Protocoling
855
860
Page 64
Template of Contrast Agent Administration SR structure
Page 65
Page 66
1
865