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ImagingStudy

Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.

Elements

NameRequiredTypeDescription
identifierIdentifier[]

Identifiers for the whole study

Details

Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number.

See discussion under [Imaging Study Implementation Notes](imagingstudy.html#notes) for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.

statuscode

registered | available | cancelled | entered-in-error | unknown

Details

The current state of the ImagingStudy.

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

modalityCoding[]

All series modality if actual acquisition modalities

Details

A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19).

subjectReference< Patient | Device | Group >

Who or what is the subject of the study

Details

The subject, typically a patient, of the imaging study.

QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group.

encounterReference<Encounter>

Encounter with which this imaging study is associated

Details

The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made.

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).

starteddateTime

When the study was started

Details

Date and time the study started.

basedOnReference< CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task >[]

Request fulfilled

Details

A list of the diagnostic requests that resulted in this imaging study being performed.

referrerReference<Practitioner | PractitionerRole>

Referring physician

Details

The requesting/referring physician.

interpreterReference<Practitioner | PractitionerRole>[]

Who interpreted images

Details

Who read the study and interpreted the images or other content.

endpointReference<Endpoint>[]

Study access endpoint

Details

The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.

numberOfSeriesunsignedInt

Number of Study Related Series

Details

Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present.

numberOfInstancesunsignedInt

Number of Study Related Instances

Details

Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

procedureReferenceReference<Procedure>

The performed Procedure reference

Details

The procedure which this ImagingStudy was part of.

procedureCodeCodeableConcept[]

The performed procedure code

Details

The code for the performed procedure type.

locationReference<Location>

Where ImagingStudy occurred

Details

The principal physical location where the ImagingStudy was performed.

reasonCodeCodeableConcept[]

Why the study was requested

Details

Description of clinical condition indicating why the ImagingStudy was requested.

reasonReferenceReference< Condition | Observation | Media | DiagnosticReport | DocumentReference >[]

Why was study performed

Details

Indicates another resource whose existence justifies this Study.

noteAnnotation[]

User-defined comments

Details

Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element.

descriptionstring

Institution-generated description

Details

The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed.

seriesImagingStudyseries[]

Each study has one or more series of instances

Details

Each study has one or more series of images or other content.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

uidid

DICOM Series Instance UID for the series

Details

The DICOM Series Instance UID for the series.

See [DICOM PS3.3 C.7.3](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.3.html).

numberunsignedInt

Numeric identifier of this series

Details

The numeric identifier of this series in the study.

modalityCoding

The modality of the instances in the series

Details

The modality of this series sequence.

descriptionstring

A short human readable summary of the series

Details

A description of the series.

numberOfInstancesunsignedInt

Number of Series Related Instances

Details

Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

endpointReference<Endpoint>[]

Series access endpoint

Details

The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType.

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.

bodySiteCoding

Body part examined

Details

The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality.

lateralityCoding

Body part laterality

Details

The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite.

specimenReference<Specimen>[]

Specimen imaged

Details

The specimen imaged, e.g., for whole slide imaging of a biopsy.

starteddateTime

When the series started

Details

The date and time the series was started.

performerImagingStudyseriesperformer[]

Who performed the series

Details

Indicates who or what performed the series and how they were involved.

If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

functionCodeableConcept

Type of performance

Details

Distinguishes the type of involvement of the performer in the series.

actorReference< Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson >

Who performed the series

Details

Indicates who or what performed the series.

instanceImagingStudyseriesinstance[]

A single SOP instance from the series

Details

A single SOP instance within the series, e.g. an image, or presentation state.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

uidid

DICOM SOP Instance UID

Details

The DICOM SOP Instance UID for this image or other DICOM content.

See [DICOM PS3.3 C.12.1](http://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.12.html#sect_C.12.1).

sopClassCoding

DICOM class type

Details

DICOM instance type.

numberunsignedInt

The number of this instance in the series

Details

The number of instance in the series.

titlestring

Description of instance

Details

The description of the instance.

Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc.

Search Parameters

NameTypeDescriptionExpression
identifiertoken Identifiers for the Study, such as DICOM Study Instance UID and Accession number ImagingStudy.identifier
patientreference Who the study is about ImagingStudy.subject.where(resolve() is Patient)
basedonreferenceThe order for the imageImagingStudy.basedOn
bodysitetokenThe body site studiedImagingStudy.series.bodySite
dicom-classtokenThe type of the instanceImagingStudy.series.instance.sopClass
encounterreferenceThe context of the studyImagingStudy.encounter
endpointreferenceThe endpoint for the study or seriesImagingStudy.endpoint | ImagingStudy.series.endpoint
instancetokenSOP Instance UID for an instanceImagingStudy.series.instance.uid
interpreterreferenceWho interpreted the imagesImagingStudy.interpreter
modalitytokenThe modality of the seriesImagingStudy.series.modality
performerreferenceThe person who performed the studyImagingStudy.series.performer.actor
reasontokenThe reason for the studyImagingStudy.reasonCode
referrerreferenceThe referring physicianImagingStudy.referrer
seriestokenDICOM Series Instance UID for a seriesImagingStudy.series.uid
starteddateWhen the study was startedImagingStudy.started
statustokenThe status of the studyImagingStudy.status
subjectreferenceWho the study is aboutImagingStudy.subject

Inherited Elements

NameRequiredTypeDescription
idstring

Logical id of this artifact

Details

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

metaMeta

Metadata about the resource

Details

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

implicitRulesuri

A set of rules under which this content was created

Details

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

languagecode

Language of the resource content

Details

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

textNarrative

Text summary of the resource, for human interpretation

Details

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

containedResource[]

Contained, inline Resources

Details

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored

Details

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.