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Page 716​ DICOM PS3.3 2020a - Information Object Definitions​

Table C.8-39. RT Dose Module Attributes​

Attribute Name​

Tag​

Type​

 

Attribute Description​

Samples per Pixel​

(0028,0002)​

1C​

Number of samples (planes) in this image. See Section C.8.8.3.4.1 for​

 

 

 

specialization. Required if Pixel Data (7FE0,0010) is present.​

PhotometricInterpretation​

(0028,0004)​

1C​

Specifies the intended interpretation of the pixel data. See​

 

 

 

SectionC.8.8.3.4.2forspecialization.RequiredifPixelData(7FE0,0010)​

 

 

 

is present.​

 

Bits Allocated​

(0028,0100)​

1C​

Number of bits allocated for each pixel sample. Each sample shall have​

 

 

 

the same number of bits allocated. See Section C.8.8.3.4.3 for​

 

 

 

specialization. Required Pixel Data (7FE0,0010) is present.​

Bits Stored​

(0028,0101)​

1C​

Number of bits stored for each pixel sample. Each sample shall have the​

 

 

 

same number of bits stored. See Section C.8.8.3.4.4 for specialization.​

 

 

 

Required if Pixel Data (7FE0,0010) is present.​

High Bit​

(0028,0102)​

1C​

Most significant bit for each pixel sample. Each sample shall have the​

 

 

 

samehighbit.SeeSectionC.8.8.3.4.5forspecialization.RequiredifPixel​

 

 

 

Data (7FE0,0010) is present.​

Pixel Representation​

(0028,0103)​

1C​

Data representation of the pixel samples. Each sample shall have the​

 

 

 

same pixel representation. See Section C.8.8.3.4.6 for specialization.​

 

 

 

Required Pixel Data (7FE0,0010) is present.​

Content Date​

(0008,0023)​

3​

The date the content of this Module was created.​

Content Time​

(0008,0033)​

3​

The time the content of this Module was created.​

Dose Units​

(3004,0002)​

1​

Units used to describe dose.​

 

 

 

Enumerated Values:​

 

 

 

GY​

Gray​

 

 

 

RELATIVE​dose relative to implicit reference value​

Dose Type​

(3004,0004)​

1​

Type of dose.​

 

 

 

Defined Terms:​

 

 

 

PHYSICAL​ physical dose​

 

 

 

EFFECTIVE​physical dose after correction for biological effect using​

 

 

 

 

user-defined modeling technique​

 

 

 

ERROR​

difference between desired and planned dose​

SpatialTransformofDose​

(3004,0005)​

3​

The use of transformation in the calculation of the combined dose.​

 

 

 

Defined Terms:​

 

 

 

NONE​

No transformation. Calculated on the original image set​

 

 

 

RIGID​

Only Rigid transform used (see definition in​

 

 

 

 

Section C.20.2.1.2)​

 

 

 

NON_RIGID​Any other transform used​

Referenced Spatial​

(0070,0404)​

2C​

AreferencetoaSpatialRegistrationSOPInstanceoraDeformableSpatial​

Registration Sequence​

 

 

Registration SOP Instance, which defines the transformation used to​

 

 

 

transform the dose.​

Required, if Spatial Transform of Dose (3004,0005) is provided and has​ a value of RIGID or NON_RIGID.​

Zero or more Items shall be included in this Sequence.​

See Section C.8.8.3.5​

>Include Table 10-11 “SOP Instance Reference Macro​

Attributes”​

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DICOM PS3.3 2020a - Information Object Definitions​

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Attribute Name​

Tag​

Type​

 

Attribute Description​

 

Instance Number​

(0020,0013)​

3​

A number that identifies this object instance.​

 

Dose Comment​

(3004,0006)​

3​

User-defined comments for dose data.​

 

Normalization Point​

(3004,0008)​

3​

Coordinates(x,y,z)ofnormalizationpointinthepatient-BasedCoordinate​

 

 

 

System described in Section C.7.6.2.1.1 (mm). See Section C.8.8.3.1.​

Dose Summation Type​

(3004,000A)​

1​

Type of dose summation.​

 

 

 

 

Defined Terms:​

 

 

 

 

 

PLAN​

dose calculated for entire delivery of all fraction​

 

 

 

 

groups of RT Plan​

 

 

 

 

MULTI_PLAN​

dose calculated for entire delivery of 2 or more​

 

 

 

 

RT Plans​

 

 

 

 

FRACTION​

dose calculated for entire delivery of a single​

 

 

 

 

Fraction Group within RT Plan​

 

 

 

 

BEAM​

dosecalculatedforentiredeliveryofoneormore​

 

 

 

 

Beams within RT Plan​

 

 

 

 

BRACHY​

dosecalculatedforentiredeliveryofoneormore​

 

 

 

 

Brachy Application Setups within RT Plan​

 

 

 

FRACTION_SESSION​dose calculated for a single session ("fraction")​

 

 

 

 

of a single Fraction Group within RT Plan​

 

 

 

BEAM_SESSION​

dose calculated for a single session ("fraction")​

 

 

 

 

of one or more Beams within RT Plan​

 

 

 

BRACHY_SESSION​ dose calculated for a single session ("fraction")​

 

 

 

 

of one or more Brachy Application Setups within​

 

 

 

 

RT Plan​

 

 

 

 

CONTROL_POINT​

dose calculated for one or more Control Points​

 

 

 

 

within a Beam for a single fraction​

 

 

 

 

RECORD​

dosecalculatedforRTBeamsTreatmentRecord​

Referenced RT Plan​

(300C,0002)​

1C​

Sequence describing RT Plan associated with dose. Required if Dose​

Sequence​

 

 

SummationType(3004,000A)isPLAN,MULTI_PLAN,FRACTION,BEAM,​

 

 

 

BRACHY,FRACTION_SESSION,BEAM_SESSION,BRACHY_SESSION​

 

 

 

or CONTROL_POINT.​

 

 

 

 

Only a single Item shall be included in this Sequence, unless Dose​

 

 

 

SummationType(3004,000A)isMULTI_PLAN,inwhichcasetwoormore​

 

 

 

Items shall be included in this Sequence. See Note 1.​

 

>Include Table 10-11 “SOP Instance Reference Macro​

 

 

 

Attributes”​

 

 

 

 

 

>Referenced Fraction​

(300C,0020)​

1C​

Sequence of one Fraction Group containing beams or brachy application​

Group Sequence​

 

 

setups contributing to dose. Required if Dose Summation Type​

 

 

 

(3004,000A) is FRACTION, BEAM, BRACHY, FRACTION_SESSION,​

 

 

 

BEAM_SESSION, BRACHY_SESSION or CONTROL_POINT.​

 

 

 

Only a single Item shall be included in this Sequence. See Note 1.​

>>Referenced Fraction​

(300C,0022)​

1​

Uniquely identifies Fraction Group specified by Fraction Group Number​

Group Number​

 

 

(300A,0071)inFractionGroupSequenceofRTFractionSchemeModule​

 

 

 

withinRTPlanreferencedinReferencedRTPlanSequence(300C,0002).​

>>Referenced Beam​

(300C,0004)​

1C​

Sequence of Beams in current Fraction Group contributing to dose.​

Sequence​

 

 

Required if Dose Summation Type (3004,000A) is BEAM,​

 

 

 

 

BEAM_SESSION or CONTROL_POINT.​

 

One or more Items shall be included in this Sequence.​

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DICOM PS3.3 2020a - Information Object Definitions​

Attribute Name​

Tag​

Type​

Attribute Description​

>>>Referenced Beam​

(300C,0006)​

1​

Uniquely identifies Beam specified by Beam Number (300A,00C0) in​

Number​

 

 

Beam Sequence (300A,00B0) of RT Beams Module within RT Plan​

 

 

 

referencedinReferencedRTPlanSequence(300C,0002)orinIonBeam​

 

 

 

Sequence (300A,03A2) of RT Ion Beams Module within RT Ion Plan​

 

 

 

referenced in Referenced RT Plan Sequence (300C,0002).​

>>>Referenced Control​

(300C,00F2)​

1C​

Sequence defining the Control Points in current Beam contributing to​

Point Sequence​

 

 

dose.​

 

 

 

Required if Dose Summation Type (3004,000A) is CONTROL_POINT.​

 

 

 

Only a single Item shall be included in this Sequence.​

>>>>Referenced Start​

(300C,00F4)​

1​

IdentifiesControlPointspecifiedbyControlPointIndex(300A,0112)within​

Control Point Index​

 

 

Beam referenced by Referenced Beam Number (300C,0006). This is the​

 

 

 

first of the two Control Points from which the Dose contribution to the​

 

 

 

Control Point can be calculated.​

>>>>Referenced Stop​

(300C,00F6)​

1​

IdentifiesControlPointspecifiedbyControlPointIndex(300A,0112)within​

Control Point Index​

 

 

Beam referenced by Referenced Beam Number (300C,0006). This is the​

 

 

 

second of the two Control Points from which the Dose contribution to the​

 

 

 

Control Point can be calculated.​

 

 

 

The Control Point Index (300A,0112) referenced by Referenced​

 

 

 

Stop Control Point Index (300C,00F6) shall be the Control Point Index​

 

 

 

(300A,0112) immediately following the Control Point Index (300A,0112)​

 

 

 

referenced by Referenced Start Control Point Index (300C,00F4) within​

 

 

 

the Referenced Beam Number (300C,0006).​

>>Referenced Brachy​

(300C,000A)​

1C​

Sequence of Brachy Application Setups in current Fraction Group​

Application Setup​

 

 

contributing to dose. Required if Dose Summation Type (3004,000A) is​

Sequence​

 

 

BRACHY or BRACHY_SESSION. One or more Items shall be included​

 

 

 

in this Sequence.​

>>>Referenced Brachy​

(300C,000C)​

1​

Uniquely identifies Brachy Application Setup specified by Brachy​

ApplicationSetupNumber​

 

 

Application Setup Number (300A,0234) in Brachy Application Setup​

 

 

 

Sequence (300A,0230) of RT Brachy Application Setups Module within​

 

 

 

RT Plan referenced in Referenced RT Plan Sequence (300C,0002).​

Referenced Treatment​

(3008,0030)​

1C​

SequencedescribingRTBeamsTreatmentRecordassociatedwithdose.​

Record Sequence​

 

 

One or more Items shall be included in this Sequence.​

 

 

 

 

 

 

Required if Dose Summation Type (3004,000A) is RECORD.​

>Include Table 10-11 “SOP Instance Reference Macro​

 

Attributes”​

 

 

 

>Referenced Beam​

(300C,0004)​

1C​

Sequence of Beams contributing to dose.​

Sequence​

 

 

One or more Items shall be included in this Sequence.​

 

 

 

 

 

 

Required,ifthedosedoesnotapplytothecompleteRTBeamsTreatment​

 

 

 

Record referenced in the Referenced Treatment Record Sequence​

 

 

 

(3008,0030).​

>>Referenced Beam​

(300C,0006)​

1​

Uniquely identifies Beam specified by Referenced Beam Number​

Number​

 

 

(300C,0006) in Treatment Session Beam Sequence (3008,0020) of RT​

 

 

 

Beams Session Record Module within RT Beams Treatment Record​

 

 

 

referenced in the Referenced Treatment Record Sequence (3008,0030)​

 

 

 

or in Treatment Session Ion Beam Sequence (3008,0021) of RT Ion​

 

 

 

Beams Session Record Module within RT Ion Beams Treatment Record​

 

 

 

referenced in the Referenced Treatment Record Sequence (3008,0030).​

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Attribute Name​

Tag​

Type​

 

Attribute Description​

 

Grid Frame Offset Vector​

(3004,000C)​

1C​

An array that contains the dose image plane offsets (in mm) of the dose​

 

 

 

image frames in a multi-frame dose. Required if multi-frame pixel data​

 

 

 

are present and Frame Increment Pointer (0028,0009) points to Grid​

 

 

 

Frame Offset Vector (3004,000C). See Section C.8.8.3.2.​

 

Dose Grid Scaling​

(3004,000E)​

1C​

Scaling factor that when multiplied by the dose grid data found in Pixel​

 

 

 

Data (7FE0,0010) Attribute of the Image Pixel Module, yields grid doses​

 

 

 

in the dose units as specified by Dose Units (3004,0002).​

 

 

 

 

Required if Pixel Data (7FE0,0010) is present.​

 

Tissue Heterogeneity​

(3004,0014)​

3​

Specifiesalistofpatientheterogeneitycharacteristicsusedforcalculating​

Correction​

 

 

dose. This Attribute shall be multi-valued if beams used to compute the​

 

 

 

dose have differing correction techniques.​

 

 

 

 

Enumerated Values:​

 

 

 

 

IMAGE​

image data​

 

 

 

 

ROI_OVERRIDE​one or more ROI densities override image or water​

 

 

 

 

values where they exist​

 

 

 

 

WATER​

entire volume treated as water equivalent​

 

Derivation Code​

(0008,9215)​

3​

A coded description of how this dose was derived from other RT Dose​

Sequence​

 

 

and/or RT Plan objects.​

 

 

 

 

One or more Items are permitted in this Sequence. More than one Item​

 

 

 

indicates that successive derivation steps have been applied.​

>Include Table 8.8-1 “Code Sequence Macro Attributes”​DCID 7220 “RT Dose Derivation”.​

 

Referenced Instance​

(0008,114A)​

3​

The set of SOP Instances used to derive this RT Dose SOP instance.​

Sequence​

 

 

One or more Items are permitted in this Sequence.​

 

 

 

 

 

>Include Table 10-11 “SOP Instance Reference Macro​

 

 

 

Attributes”​

 

 

 

 

 

>Purpose of Reference​

(0040,A170)​

1​

Code describing the purpose of the reference to the Instance(s).​

Code Sequence​

 

 

Only a single Item is permitted in this Sequence.​

 

 

 

 

 

>>Include Table 8.8-1 “Code Sequence Macro Attributes”​DCID 7221 “RT Dose Purpose of Reference”.​

Note​

In order to prevent misrepresentation of the dose summation:​

a.​If the Dose Summation Type (3004,000A) is PLAN, then only a single instance of RT Plan is referenced and the dose​ will be for the entire plan (i.e., it is not viable to combine only certain fraction groups of different plans).​

b.​If the Dose Summation Type (3004,000A) is MULTI_PLAN, then 2 or more instances of RT Plan may be referenced.​ As above, each reference will be for the entire plan.​

c.​If the Dose Summation Type (3004,000A) is FRACTION or FRACTION_SESSION, then only a single instance of RT​ PLANandasingleFractionGrouparereferenced(i.e.,componentbeamsorbrachyapplicationsetupsarenotreferenced).​

C.8.8.3.1 Normalization Point​

Normalization Point (3004,0008) aids in the interpretation and subsequent use of the transmitted data. If used, it shall be a point re-​ ceiving dose contributions from all referenced components of the dose summation.​

C.8.8.3.2 Grid Frame Offset Vector​

Grid Frame Offset Vector (3004,000C) shall be provided if a dose distribution is encoded as a multi-frame image. Values of the Grid​ Frame Offset Vector (3004,000C) shall vary monotonically and are to be interpreted as follows:​

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DICOM PS3.3 2020a - Information Object Definitions​

a.​If Grid Frame Offset Vector (3004,000C) is present and its first element is zero, this Attribute contains an array of n elements in-​ dicating the plane location of the data in the right-handed image coordinate system, relative to the position of the first dose plane​ transmitted, i.e., the point at which Image Position (patient) (0020,0032) is defined, with positive offsets in the direction of the​ cross product of the row and column directions.​

b.​If Grid Frame Offset Vector (3004,000C) is present, its first element is equal to the third element of Image Position (patient)​ (0020,0032), and Image Orientation (patient) (0020,0037) has the value (1,0,0,0,1,0), then Grid Frame Offset Vector contains​ an array of n elements indicating the plane location (patient z coordinate) of the data in the Patient-Based Coordinate System.​

In future implementations, use of option a) is strongly recommended.​

This Attribute is conditional since the RT Dose Module may be included even if pixel doses are not being transmitted, or the image​ may be a single-frame image. If the Multi-frame Module is present, Frame Increment Pointer (0028,0009) shall have the Enumerated​ Value of 3004000C (Grid Frame Offset Vector).​

Note​

Option (a) can represent a rectangular-parallelepiped dose grid with any orientation with respect to the patient, while option​

(b) can only represent a rectangular-parallelepiped dose grid whose planes are in the transverse patient dimension and​ whose x- and y-axes are parallel to the patient x- and y-axes.​

Example: Figure C.8.8.3-1 shows an example of plane positions for a dose grid with transverse planes.​

+Y

Zn ... Z3 Z2 Z1

+Z

+X

Figure C.8.8.3-1. Dose Grid Frame Example​

For this example, Table C.8-39b gives the values of elements in the Grid Frame Offset Vector (3004,000C) for both relative​ (option (a)) and absolute (option (b)) interpretations, under the following conditions:​

1.​The value of Image Orientation (Patient) (0020,0037) is (1,0,0,0,1,0). I.e., the dose grid is transverse with x- and y-axes​ parallel to the patient x- and y-axes;​

2.​The value of Image Position (Patient) (0020,0032), i.e., the position of the first element of the dose grid, is (4, 5, 6); and​

3.​The spacing between adjacent dose grid planes is 2mm (uniform).​

Table C.8-39b. Values of Dose Grid Frame Offset Vector Under Relative (A) and Absolute (B)​

Interpretations​

Grid Frame Offset Vector Element​

Option (a) Relative Coordinates​

Option (b) Absolute Coordinates​

Z1​

0​

6​

Z2​

2​

8​

Z3​

4​

10​

ZN​

2(N-1)​

6 + 2(N-1)​

C.8.8.3.3 Dose Units​

Dose Units are specified in both the RT Dose Module and RT Dose ROI Module. The Attribute Dose Type present in the RT Dose​ Module shall apply to all doses present in the RT Dose IOD.​

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