StructureDefinition-UKCore-ImagingStudy

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.hl7.org.uk/StructureDefinition/UKCore-ImagingStudydraft1.1.02023-12-12

This profile defines the UK constraints and extensions on the International FHIR resource ImagingStudy


Profile_Purpose

This profile allows exchange of the content produced in a DICOM imaging study.

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionC0..*Extension
modifierExtension?! C0..*Extension
identifierΣ0..*Identifier
statusS Σ ?!1..1codeBinding
modalityS Σ0..*CodingBinding
subjectS Σ1..1Reference(Patient | Device | Group)
encounterS Σ0..1Reference(Encounter)
startedΣ0..1dateTime
basedOnΣ0..*Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)
referrerΣ0..1Reference(Practitioner | PractitionerRole)
interpreterΣ0..*Reference(Practitioner | PractitionerRole)
endpointΣ0..*Reference(Endpoint)
numberOfSeriesΣ0..1unsignedInt
numberOfInstancesΣ0..1unsignedInt
procedureReferenceΣ0..1Reference(Procedure)
procedureCodeΣ0..*CodeableConceptBinding
locationΣ0..1Reference(Location)
reasonCodeΣ0..*CodeableConcept
reasonReferenceΣ0..*Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference)
noteΣ0..*Annotation
descriptionΣ0..1string
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
uidΣ1..1id
numberΣ0..1unsignedInt
modalityΣ1..1CodingBinding
descriptionΣ0..1string
numberOfInstancesΣ0..1unsignedInt
endpointΣ0..*Reference(Endpoint)
bodySiteΣ0..1Coding
lateralityΣ0..1Coding
specimenΣ0..*Reference(Specimen)
startedΣ0..1dateTime
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
functionΣ0..1CodeableConceptBinding
actorΣ1..1Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
uid1..1id
sopClass1..1CodingBinding
number0..1unsignedInt
title0..1string

Detailed Descriptions

ImagingStudy
ShortA set of images produced in single study (one or more series of references images)
Definition

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

Cardinality0..*
Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Act[classCode=COMPOSITION, moodCode=EVN]
  • dicom: Reference IHE radiology TF vol 2 table 4.14-1
ImagingStudy.id
ShortLogical id of this artifact
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

ImagingStudy.meta
ShortMetadata about the resource
Definition

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

Cardinality0..1
TypeMeta
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ImagingStudy.implicitRules
ShortA set of rules under which this content was created
Definition

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

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ImagingStudy.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ImagingStudy.text
ShortText summary of the resource, for human interpretation
Definition

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

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
ImagingStudy.contained
ShortContained, inline Resources
Definition

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

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

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

Mappings
  • rim: N/A
ImagingStudy.extension
ShortAdditional content defined by implementations
Definition

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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
ImagingStudy.modifierExtension
ShortExtensions that cannot be ignored
Definition

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
ImagingStudy.identifier
ShortIdentifiers for the whole study
Definition

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

Cardinality0..*
TypeIdentifier
SummaryTrue
AliasStudyInstanceUID, AccessionNumber
Requirements

If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2.

Comments

See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • rim: .id and .inboundRelationship[typeCode=COMP].source[classCode=ACSN, moodCode=EVN].id
  • dicom: StudyInstanceUID (0020,000D) | Accession Number and Issuer (0080,0050)+(0080,0051) | Study ID (0020,0010)
ImagingStudy.status
Shortregistered | available | cancelled | entered-in-error | unknown
Definition

The current state of the ImagingStudy.

Cardinality1..1
Typecode
Binding

The status of the ImagingStudy.

ImagingStudyStatus (required)

Must SupportTrue
ModifierTrue
SummaryTrue
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.status
  • w5: FiveWs.status
  • v2: Varies by domain
  • rim: .status
ImagingStudy.modality
ShortAll series modality if actual acquisition modalities
Definition

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

Cardinality0..*
TypeCoding
Binding

Type of acquired data in the instance.

http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible)

Must SupportTrue
SummaryTrue
AliasModalitiesInStudy
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .code
  • dicom: (0008,0061)
ImagingStudy.subject
ShortWho or what is the subject of the study
Definition

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

Cardinality1..1
TypeReference(Patient | Device | Group)
Must SupportTrue
SummaryTrue
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • rim: .participation[typeCode=SBJ].role
  • dicom: (0010/*)
  • w5: FiveWs.subject
ImagingStudy.encounter
ShortEncounter with which this imaging study is associated
Definition

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

Cardinality0..1
TypeReference(Encounter)
Must SupportTrue
SummaryTrue
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.encounter
  • w5: FiveWs.context
  • rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
ImagingStudy.started
ShortWhen the study was started
Definition

Date and time the study started.

Cardinality0..1
TypedateTime
SummaryTrue
AliasStudyDate, StudyTime
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
2011-01-01T11:01:20+03:00
Mappings
  • workflow: Event.occurrence[x]
  • w5: FiveWs.init
  • rim: .effectiveTime
  • dicom: (0008,0020)+(0008,0030)
ImagingStudy.basedOn
ShortRequest fulfilled
Definition

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

Cardinality0..*
TypeReference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)
SummaryTrue
Requirements

To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.basedOn
  • w5: FiveWs.cause
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO]
  • dicom: (0032,1064)
ImagingStudy.referrer
ShortReferring physician
Definition

The requesting/referring physician.

Cardinality0..1
TypeReference(Practitioner | PractitionerRole)
SummaryTrue
AliasReferringPhysiciansName
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.cause
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO].participation[typeCode=AUT].role
  • dicom: (0008,0090)+(0008,0096)
ImagingStudy.interpreter
ShortWho interpreted images
Definition

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

Cardinality0..*
TypeReference(Practitioner | PractitionerRole)
SummaryTrue
AliasName of Physician(s) Reading Study
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.witness
  • rim: .participation[typeCode=PRF].role
  • dicom: (0008,1060)
ImagingStudy.endpoint
ShortStudy access endpoint
Definition

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

Cardinality0..*
TypeReference(Endpoint)
SummaryTrue
Requirements

Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Not supported
ImagingStudy.numberOfSeries
ShortNumber of Study Related Series
Definition

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

Cardinality0..1
TypeunsignedInt
SummaryTrue
AliasNumberOfStudyRelatedSeries
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=OBSSER, moodCode=EVN].repeatNumber
  • dicom: (0020,1206)
ImagingStudy.numberOfInstances
ShortNumber of Study Related Instances
Definition

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

Cardinality0..1
TypeunsignedInt
SummaryTrue
AliasNumberOfStudyRelatedInstances
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber
  • dicom: (0020,1208)
ImagingStudy.procedureReference
ShortThe performed Procedure reference
Definition

The procedure which this ImagingStudy was part of.

Cardinality0..1
TypeReference(Procedure)
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.partOf
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN]
  • dicom: (0008,1032)
ImagingStudy.procedureCode
ShortThe performed procedure code
Definition

The code for the performed procedure type.

Cardinality0..*
TypeCodeableConcept
Binding

The performed procedure type.

http://www.rsna.org/RadLex_Playbook.aspx (extensible)

SummaryTrue
AliasProcedureCodeSequence
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.code
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN]
  • dicom: (0008,1032)
ImagingStudy.location
ShortWhere ImagingStudy occurred
Definition

The principal physical location where the ImagingStudy was performed.

Cardinality0..1
TypeReference(Location)
SummaryTrue
Requirements

Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.location
  • w5: FiveWs.where[x]
  • v2: EVN.7
  • rim: .participation[typeCode=LOC].role
  • dicom: (0008,1040) | (0040,0243)
ImagingStudy.reasonCode
ShortWhy the study was requested
Definition

Description of clinical condition indicating why the ImagingStudy was requested.

Cardinality0..*
TypeCodeableConcept
Binding

The reason for the study.

ProcedureReasonCodes (example)

SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.reasonCode
  • w5: FiveWs.why[x]
  • rim: .reasonCode
  • dicom: (0040,1002)
ImagingStudy.reasonReference
ShortWhy was study performed
Definition

Indicates another resource whose existence justifies this Study.

Cardinality0..*
TypeReference(Condition | Observation | Media | DiagnosticReport | DocumentReference)
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.reasonReference
  • w5: FiveWs.why[x]
  • v2: EVN.4 or by domain
  • rim: .outboundRelationship[typeCode=RSON].target
ImagingStudy.note
ShortUser-defined comments
Definition

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

Cardinality0..*
TypeAnnotation
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.note
  • rim: unknown
ImagingStudy.description
ShortInstitution-generated description
Definition

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

Cardinality0..1
Typestring
SummaryTrue
AliasStudyDescription
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • dicom: (0008,1030)
ImagingStudy.series
ShortEach study has one or more series of instances
Definition

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

Cardinality0..*
TypeBackboneElement
Must SupportTrue
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=OBSSER, moodCode=EVN]
ImagingStudy.series.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ImagingStudy.series.extension
ShortAdditional content defined by implementations
Definition

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

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
ImagingStudy.series.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
ImagingStudy.series.uid
ShortDICOM Series Instance UID for the series
Definition

The DICOM Series Instance UID for the series.

Cardinality1..1
Typeid
SummaryTrue
AliasSeriesInstanceUID
Requirements

DICOM Series Instance UID.

Comments
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
2.16.124.113543.6003.2588828330.45298.17418.2723805630
Mappings
  • rim: .id
  • dicom: (0020,000E)
ImagingStudy.series.number
ShortNumeric identifier of this series
Definition

The numeric identifier of this series in the study.

Cardinality0..1
TypeunsignedInt
SummaryTrue
AliasSeriesNumber
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
3
Mappings
  • rim: .inboundRelationship[type=COMP, source[classCode=COMPOSITION, moodCode=EVN]].sequenceNumber
  • dicom: (0020,0011)
ImagingStudy.series.modality
ShortThe modality of the instances in the series
Definition

The modality of this series sequence.

Cardinality1..1
TypeCoding
Binding

Type of acquired data in the instance.

http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible)

SummaryTrue
AliasModality
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .code
  • dicom: (0008,0060)
ImagingStudy.series.description
ShortA short human readable summary of the series
Definition

A description of the series.

Cardinality0..1
Typestring
SummaryTrue
AliasSeriesDescription
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
CT Surview 180
Mappings
  • rim: .text
  • dicom: (0008,103E)
ImagingStudy.series.numberOfInstances
ShortNumber of Series Related Instances
Definition

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

Cardinality0..1
TypeunsignedInt
SummaryTrue
AliasNumberOfSeriesRelatedInstances
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber
  • dicom: (0020,1209)
ImagingStudy.series.endpoint
ShortSeries access endpoint
Definition

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

Cardinality0..*
TypeReference(Endpoint)
SummaryTrue
Requirements

Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Not supported
ImagingStudy.series.bodySite
ShortBody part examined
Definition

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

Cardinality0..1
TypeCoding
Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

SummaryTrue
AliasBodyPartExamined
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .targetSiteCode
  • dicom: (0018,0015)
ImagingStudy.series.laterality
ShortBody part laterality
Definition

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

Cardinality0..1
TypeCoding
Binding

Codes describing body site laterality (left, right, etc.).

Laterality (example)

SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .targetSiteCode
  • dicom: (0020,0060)
ImagingStudy.series.specimen
ShortSpecimen imaged
Definition

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

Cardinality0..*
TypeReference(Specimen)
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Role[classCode=SPEC]
  • dicom: (0040,0551) + (0040,0562)
ImagingStudy.series.started
ShortWhen the series started
Definition

The date and time the series was started.

Cardinality0..1
TypedateTime
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .effectiveTime
  • dicom: (0008,0021) + (0008,0031)
ImagingStudy.series.performer
ShortWho performed the series
Definition

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

Cardinality0..*
TypeBackboneElement
SummaryTrue
AliasPerformingPhysicianName, OperatorName
Requirements

The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer
  • rim: .participation[typeCode=PRF].role
  • dicom: (0008, 1050) | (0008, 1052) | (0008, 1070) | (0008, 1072)
ImagingStudy.series.performer.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ImagingStudy.series.performer.extension
ShortAdditional content defined by implementations
Definition

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

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
ImagingStudy.series.performer.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
ImagingStudy.series.performer.function
ShortType of performance
Definition

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

Cardinality0..1
TypeCodeableConcept
Binding

The type of involvement of the performer.

ImagingStudySeriesPerformerFunction (extensible)

SummaryTrue
Requirements

Allows disambiguation of the types of involvement of different performers.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode=PRF].role
ImagingStudy.series.performer.actor
ShortWho performed the series
Definition

Indicates who or what performed the series.

Cardinality1..1
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.actor
  • v2: EVN.5 or by domain
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
ImagingStudy.series.instance
ShortA single SOP instance from the series
Definition

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

Cardinality0..*
TypeBackboneElement
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=DGIMG, moodCode=EVN]
ImagingStudy.series.instance.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ImagingStudy.series.instance.extension
ShortAdditional content defined by implementations
Definition

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

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
ImagingStudy.series.instance.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
ImagingStudy.series.instance.uid
ShortDICOM SOP Instance UID
Definition

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

Cardinality1..1
Typeid
AliasSOPInstanceUID
Requirements

DICOM SOP Instance UID.

Comments
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
2.16.124.113543.6003.189642796.63084.16748.2599092903
Mappings
  • rim: .id
  • dicom: (0008,0018)
ImagingStudy.series.instance.sopClass
ShortDICOM class type
Definition

DICOM instance type.

Cardinality1..1
TypeCoding
Binding

The sopClass for the instance.

http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible)

AliasSOPClassUID
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=COMP]. source[classCode=OBS, moodCode=EVN, code="sop class"].value
  • dicom: (0008,0016)
ImagingStudy.series.instance.number
ShortThe number of this instance in the series
Definition

The number of instance in the series.

Cardinality0..1
TypeunsignedInt
AliasInstanceNumber
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
1
Mappings
  • rim: .inboundRelationship[typeCode=COMP, source[classCode=OBSSER, moodCode=EVN]].sequenceNumber
  • dicom: (0020,0013)
ImagingStudy.series.instance.title
ShortDescription of instance
Definition

The description of the instance.

Cardinality0..1
Typestring
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .title
  • dicom: (0008,0008) | (0007,0080) | (0040,A043) + (0008,0104) | (0042,0010)

Table View

ImagingStudy..
ImagingStudy.status..
ImagingStudy.modality..
ImagingStudy.subject..
ImagingStudy.encounter..
ImagingStudy.series..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="UKCore-ImagingStudy" />
<url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-ImagingStudy" />
<version value="1.1.0" />
<name value="UKCoreImagingStudy" />
<title value="UK Core Imaging Study" />
<status value="draft" />
<date value="2023-12-12" />
<publisher value="HL7 UK" />
<name value="HL7 UK" />
<system value="email" />
<value value="ukcore@hl7.org.uk" />
<use value="work" />
<rank value="1" />
</telecom>
</contact>
<description value="This profile defines the UK constraints and extensions on the International FHIR resource [ImagingStudy](https://hl7.org/fhir/R4/ImagingStudy.html)" />
<purpose value="This profile allows exchange of the content produced in a DICOM imaging study." />
<copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="ImagingStudy" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" />
<derivation value="constraint" />
<element id="ImagingStudy.status">
<path value="ImagingStudy.status" />
<mustSupport value="true" />
</element>
<element id="ImagingStudy.modality">
<path value="ImagingStudy.modality" />
<mustSupport value="true" />
</element>
<element id="ImagingStudy.subject">
<path value="ImagingStudy.subject" />
<mustSupport value="true" />
</element>
<element id="ImagingStudy.encounter">
<path value="ImagingStudy.encounter" />
<mustSupport value="true" />
</element>
<element id="ImagingStudy.series">
<path value="ImagingStudy.series" />
<mustSupport value="true" />
</element>
</differential>
</StructureDefinition>

JSON View

{
"resourceType": "StructureDefinition",
"id": "UKCore-ImagingStudy",
"url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-ImagingStudy",
"version": "1.1.0",
"name": "UKCoreImagingStudy",
"title": "UK Core Imaging Study",
"status": "draft",
"date": "2023-12-12",
"publisher": "HL7 UK",
"contact": [
{
"name": "HL7 UK",
"telecom": [
{
"system": "email",
"value": "ukcore@hl7.org.uk",
"use": "work",
"rank": 1
}
]
}
],
"description": "This profile defines the UK constraints and extensions on the International FHIR resource [ImagingStudy](https://hl7.org/fhir/R4/ImagingStudy.html)",
"purpose": "This profile allows exchange of the content produced in a DICOM imaging study.",
"copyright": "Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "ImagingStudy",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/ImagingStudy",
"derivation": "constraint",
"element": [
{
"id": "ImagingStudy.status",
"path": "ImagingStudy.status",
"mustSupport": true
},
{
"id": "ImagingStudy.modality",
"path": "ImagingStudy.modality",
"mustSupport": true
},
{
"id": "ImagingStudy.subject",
"path": "ImagingStudy.subject",
"mustSupport": true
},
{
"id": "ImagingStudy.encounter",
"path": "ImagingStudy.encounter",
"mustSupport": true
},
{
"id": "ImagingStudy.series",
"path": "ImagingStudy.series",
"mustSupport": true
}
]
}
}

Usage

This Profile has the following derived profiles:


This Profile is referenced in the following Extensions:


This Profile is referenced in the following Profiles:

Feedback

Click here to:

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Examples

CT Chest Scan - An example to illustrate sharing CT scan imagery.
Example UKCore-ImagingStudy-CTChestScan

Example Usage Scenarios

The following are example usage scenarios for the UK Core Imaging Study profile:

  • Query and share DICOM images

Profile Specific Implementation Guidance:

Minimum Viable Content

A minimum viable content that all provider and consumer systems SHALL support are the following elements.

Element Reason
ImagingStudy.status The current state of the ImagingStudy.
ImagingStudy.modality All series modality if actual acquisition modalities.
ImagingStudy.subject Who or what is the subject of the study.
ImagingStudy.encounter The encounter with which this imaging study is associated
ImagingStudy.series Each study has one or more series of images or other content.

subject

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


encounter

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Encounter.


basedOn

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


referrer

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


interpreter

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


procedureReference

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Procedure.


location

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Location.


reasonReference

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


note

The resource being referenced by ImagingStudy.note.authorReference SHALL conform to one of the following:


series

ImagingStudy.series.specimen

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Specimen.

ImagingStudy.series.performer.actor

The resource being referenced by ImagingStudy.note.authorReference SHALL conform to one of the following: