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Page 846​

DICOM PS3.3 2020a - Information Object Definitions​

 

Scan Spot Position Map (300A,0394)​

Scan Spot Metersets Delivered (3008,0047)​

 

x2,y2​

m2​

 

x3,y3​

m3​

 

x4,y4​

m4​

Since there was no re-ordering, Scan Spot Reordered (300A,0393) is absent or NO and Scan Spot Prescribed Indices (300A,0391)​ shall be absent.​

C.8.8.26.2.4 Use Case 2: Pause​

This use case is an example of a spot broken up into two reported spots due to a pause in the middle of treatment.​

Scan Spot Position Map (300A,0394)​

Scan Spot Metersets Delivered​

Scan Spot Prescribed Indices​

 

(3008,0047)​

(300A,0391)​

x1,y1​

m1​

1​

x2,y2​

m2​

2​

x3a,y3a​

m3a​

3​

x3b,y3b​

m3b​

3​

x4,y4​

m4​

4​

The pause occurred during the delivery of the 3rd spot. When the delivery resumed, the spot was not located at the same position​ prior to the pause. The notations x3a,y3a represent the position of the spot prior to the pause. x3b,y3b represent the position of the​ resumed spot. Both spots refer to the same prescribed spot. The Meterset m3a represents the measured Meterset prior to the pause​ and m3b represents the measured Meterset after resumption.​

C.8.8.26.2.5 Use Case 3: Tuning Spot​

Some delivery systems use a tuning spot (aka pulse) to adjust the different beam parameters. This tuning spot can be delivered at​ the beginning of the beam or at any time during the beam. The tuning spot may not reach exactly the same position as a prescribed​ spot.​

The suffix 't' indicates a tuning spot.​

 

 

Scan Spot Position Map (300A,0394)​

Scan Spot Metersets Delivered​

Scan Spot Prescribed Indices​

 

(3008,0047)​

(300A,0391)​

x4t,y4t​

m4t​

4​

x1,y1​

m1​

1​

x2,y2​

m2​

2​

x3,y3​

m3​

3​

x4,y4​

m4​

4​

x5,y5​

m5​

5​

A tuning spot was delivered at the beginning of a control point. The tuning spot will be present in the treatment record. As it is the first​ one being delivered for that control point, it will be the first one in the record.​

The tuning spot in this example was targeting the 4th spot of the prescription. In the record the Scan Spot Prescribed Indices will refer​ to the 4th position. As the tuning spot may not match the prescribed position, it will have its own coordinates represented by the suffix​ 't'.​

C.8.8.26.2.6 Use Case 4: Repainting​

Use case demonstrating how re-paints of the spot map within the same control point can be represented.​

The suffix 'p<n>' indicates a painting iteration.​

- Standard -​

DICOM PS3.3 2020a - Information Object Definitions​

Page 847​

Scan Spot Position Map (300A,0394)​

Scan Spot Metersets Delivered​

Scan Spot Prescribed Indices​

 

(3008,0047)​

(300A,0391)​

x1p1,y1p1​

m1p1​

1​

x2p1,y2p1​

m2p1​

2​

x3p1,y3p1​

m3p1​

3​

x4p1,y4p1​

m4p1​

4​

x5p1,y5p1​

m5p1​

5​

x1p2,y1p2​

m1p2​

1​

x2p2,y2p2​

m2p2​

2​

x3p2,y3p2​

m3p2​

3​

x4p2,y4p2​

m4p2​

4​

x5p2,y5p2​

m5p2​

5​

x1p3,y1p3​

m1p3​

1​

x2p3,y2p3​

m2p3​

2​

x3p3,y3p3​

m3p3​

3​

x4p3,y4p3​

m4p3​

4​

x5p3,y5p3​

m5p3​

5​

When repainting is requested (Number of Paintings (300A,039A) is greater than 1), the record shall contain each of the delivered​ paintings.​

In the example, painting was performed three times. Each repainted spot is described by the Scan Spot Position, the Delivered​ Metersets of the specific painting, and the Scan Spot Prescribed Indices.​

C.8.8.26.2.7 Use Case 5: Spot Reordering​

In this use case, the number of spots remains the same, but they are simply treated in a different order than planned.​

Scan Spot Position Map (300A,0394)​

Scan Spot Metersets Delivered​

Scan Spot Prescribed Indices​

 

(3008,0047)​

(300A,0391)​

x4,y4​

m4​

4​

x2,y2​

m2​

2​

x5,y5​

m5​

5​

x3,y3​

m3​

3​

x1,y1​

m1​

1​

WhenScanSpotRe-Orderingisallowed,thespotsarelistedintheorderofthedeliveryandreferencetheScanSpotPrescribedIndices.​

C.8.8.26.2.8 Use Case 6: Combination​

This use case is a combination of all the above including tuning spots, repaints, and additional re-ordering.​

The suffix 't' indicates a tuning spot.​

The suffix 'p<n>' indicates a painting iteration.​

The suffix '(r)' in Scan Spot Prescribed Indices (300A,0391) indicates that the spot has been re-ordered.​

Scan Spot Position Map (300A,0394)​

Scan Spot Metersets Delivered​

Scan Spot Prescribed Indices​

 

(3008,0047)​

(300A,0391)​

x4t,y4t​

m4t​

4​

x2p1,y2p1​

m2p1​

2 (r)​

- Standard -​

Page 848​

DICOM PS3.3 2020a - Information Object Definitions​

 

Scan Spot Position Map (300A,0394)​

Scan Spot Metersets Delivered​

Scan Spot Prescribed Indices​

 

 

(3008,0047)​

(300A,0391)​

 

x5p1,y5p1​

m5p1​

5 (r)​

 

x1p1,y1p1​

m1p1​

1 (r)​

 

x4p1,y4p1​

m4p1​

4​

 

x3p1,y3p1​

m3p1​

3 (r)​

 

x3t,y3t​

m3t​

3​

 

x2p2,y2p2​

m2p2​

2 (r)​

 

x5p2,y5p2​

m5p2​

5 (r)​

 

x1p2,y1p2​

m1p2​

1 (r)​

 

x4p2,y4p2​

m4p2​

4​

 

x3p2,y3p2​

m3p2​

3 (r)​

 

x2p3,y2p3​

m2p3​

2 (r)​

 

x5p3,y5p3​

m5p3​

5 (r)​

 

x1p3,y1p3​

m1p3​

1 (r)​

 

x3p3,y3p3​

m3p3​

3 (r)​

The repainting is represented by recording the spot multiple times and referencing to the same scan spot prescribed index.​

Thetuning pulseisrecordedforthe firsttwopaintings andreferences thescan spotprescribed indexof thespot being usedfortuning.​

The order of the spots is the spot order actually delivered.​

The third painting did not deliver all the prescribed spots because some of the spot Metersets were below the minimum deliverable​ Meterset of the machine.​

C.8.8.27 Beam Limiting Device Position Macro​

Table C.8.8.27-1 specifies the Attributes that specify the Beam Limiting Device Sequence.​

Table C.8.8.27-1. Beam Limiting Device Position Macro Attributes​

Attribute Name​

Tag​

Type​

Description​

Beam Limiting Device​ (300A,011A)​ 1C​ Sequence of beam limiting device (collimator) jaw or leaf (element) positions.​

Position Sequence​

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

Required if Ion Beam Limiting Device Sequence (300A,03A4) or Beam Limiting​ Device Leaf Pairs Sequence (3008,00A0) is included in this SOP instance and for​ first Item of Ion Control Point Sequence, or if Beam Limiting Device changes during​ Beam.​

>RT Beam Limiting​

(300A,00B8)​ 1​ Typeofbeamlimitingdevice(collimator).ThevalueofthisAttributeshallcorrespond​

Device Type​

to RT Beam Limiting Device Type (300A,00B8) defined in an Item of Ion Beam​

 

Limiting Device Sequence (300A,03A4).​

 

Enumerated Values:​

 

X​

symmetric jaw pair in IEC X direction​

 

Y​

symmetric jaw pair in IEC Y direction​

 

ASYMX​asymmetric jaw pair in IEC X direction​

 

ASYMY​asymmetric pair in IEC Y direction​

 

MLCX​multileaf (multi-element) jaw pair in IEC X direction​

 

MLCY​multileaf (multi-element) jaw pair in IEC Y direction​

- Standard -​

 

DICOM PS3.3 2020a - Information Object Definitions​

Page 849​

Attribute Name​

Tag​

Type​

Description​

 

>Leaf/Jaw Positions​

(300A,011C)​

1​

Positions of beam limiting device (collimator) leaf (element) or jaw pairs (in mm) in​

 

 

 

IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting​

 

 

 

Device Type (300A,00B8), e.g., X-axis for MLCX, Y-axis for MLCY. Contains 2N​

values,whereNistheNumberofLeaf/Jaw Pairs(300A,00BC)inIonBeamLimiting​ DeviceSequence(300A,03A4).ValuesshallbelistedinIECleaf(element)subscript​ order 101, 102, … 1N, 201, 202, … 2N. See Section C.8.8.25.3.​

C.8.8.28 Patient Support Identification Macro​

Table C.8.8.28-1 specifies the Attributes that identify the Patient Support System.​

Table C.8.8.28-1. Patient Support Identification Macro Attributes​

Attribute Name​

Tag​

Type​

Description​

Patient Support Type​

(300A,0350)​

1​

Defined Terms:​

 

 

 

TABLE​Treatment delivery system table​

 

 

 

CHAIR​Treatment delivery system chair​

 

 

 

See Section C.8.8.25.6.3.​

Patient Support ID​

(300A,0352)​

3​ User-specified identifier for manufacturer specific patient​

 

 

 

support devices.​

Patient Support Accessory Code​

(300A,0354)​

3​ A Patient Support accessory identifier to be read by a device​

 

 

 

such as a bar code reader.​

C.8.8.29 RT Beams Delivery Instruction Module​

The RT Beams Delivery Instruction Module contains additional information required by a Treatment Delivery System (TDS) when​ specifying delivery of an external beam radiotherapy treatment. This information is supplied by a Treatment Management System​ (TMS) when it creates an RT Beams Delivery Instruction SOP Instance, a composite SOP Instance in turn referenced by a Unified​ Procedure Step (UPS) in the Unified Procedure Step model.​

The RT Beams Delivery Instruction Module consists of a sequence of one or more beam tasks, where each beam task may also​ specify one or more Delivery Verification images to be acquired prior to, during, or after the treatment delivery.​

Table C.8.8.29-1. RT Beams Delivery Instruction Module Attributes​

Attribute Name​

Tag​

Type​

 

Description​

Referenced RT Plan​

(300C,0002)​

1​

Reference to a single RT Plan or RT Ion Plan SOP Instance (whose​

Sequence​

 

 

UID is also supplied in the Input Information Sequence - see PS3.4)​

 

 

 

containingalltheBeamsandtheFractionGroupreferencedinthisSOP​

 

 

 

Instance.​

 

 

 

 

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

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

 

 

Attributes”​

 

 

 

 

Beam Task Sequence​

(0074,1020)​

1​

Specification of beams to be delivered and/or verified.​

 

 

 

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

>Beam Task Type​

(0074,1022)​

1​

Indication whether beam is to be verified, treated (delivered), or both.​

 

 

 

Enumerated Values:​

 

 

 

 

VERIFY​

Beam verification only​

 

 

 

TREAT​

Beam treatment only​

 

 

 

VERIFY_AND_TREAT​Beam verification and treatment​

- Standard -​

Page 850​

DICOM PS3.3 2020a - Information Object Definitions​

Attribute Name​

Tag​

Type​

 

Description​

>Treatment Delivery Type​

(300A,00CE)​

1​

Delivery Type of treatment.​

 

 

 

Enumerated Values:​

 

 

 

TREATMENT​ normal patient treatment​

 

 

 

CONTINUATION​continuation of interrupted treatment​

>Primary Dosimeter Unit​

(300A,00B3)​

1C​

Measurement unit of machine dosimeter.​

 

 

 

Enumerated Values:​

 

 

 

MU​

Monitor Unit​

 

 

 

MINUTE​minute​

 

 

 

NP​

Number of Particles​

 

 

 

This value shall be the same as in the referenced RT Plan. It applies​

 

 

 

only to the Continuation Start Meterset (0074,0120) and Continuation​

 

 

 

End Meterset (0074,0121).​

 

 

 

RequiredifTreatmentDeliveryType(300A,00CE)isCONTINUATION.​

>ContinuationStartMeterset​

(0074,0120)​

1C​

Meterset within Beam referenced by Referenced Beam Number​

 

 

 

(300C,0006) at which treatment delivery starts, in units specified by​

 

 

 

Primary Dosimeter Unit (300A,00B3).​

 

 

 

RequiredifTreatmentDeliveryType(300A,00CE)isCONTINUATION.​

>Continuation End Meterset​

(0074,0121)​

1C​

Meterset within Beam referenced by Referenced Beam Number​

 

 

 

(300C,0006) at which treatment delivery ends, in units specified by​

 

 

 

Primary Dosimeter Unit (300A,00B3).​

 

 

 

RequiredifTreatmentDeliveryType(300A,00CE)isCONTINUATION.​

>Current Fraction Number​

(3008,0022)​

1​

The index of the fraction that is to be delivered or completed in this​

 

 

 

session. See Section C.8.8.29.1.​

>ReferencedFractionGroup​

(300C,0022)​

1C​

Indicates which fraction group of the referenced plan is to be treated in​

Number​

 

 

the treatment session. Only one Fraction Group shall be specified per​

 

 

 

Delivery Instruction SOP Instance.​

 

 

 

Required if the referenced plan has more than one Fraction Group​

 

 

 

Sequence (300A,0070) Item.​

>Referenced Beam Number​

(300C,0006)​

1​

Uniquely identifies the Beam that is specified by Beam Number​

 

 

 

(300A,00C0)withinBeamSequence(300A,00B0)inRTBeamsModule​

 

 

 

of referenced RT Plan or within Ion Beam Sequence (300A,03A2) in​

 

 

 

RT Ion Beams Module of the referenced RT Ion Plan.​

>Beam Order Index​

(0074,1324)​

3​

Identifies required ordering of beam delivery, monotonically increasing​

 

 

 

by 1, starting from 1. See Section C.8.8.29.5.​

>Autosequence Flag​

(0074,1025)​

3​

Enumerated Values:​

 

 

 

YES​The current beam shall be automatically treated following the​

 

 

 

 

preceding beam as defined by the Beam Order Index​

 

 

 

 

(0074,1324).​

 

 

 

NO​ The current beam shall not be auto-sequenced.​

 

 

 

See Section C.8.8.29.6.​

>TableTopVerticalAdjusted​

(0074,1026)​

2​

Adjusted Table Top Vertical position in the IEC TABLE TOP coordinate​

Position​

 

 

system in mm for patient setup. See Section C.8.8.29.2.​

>Table Top Longitudinal​

(0074,1027)​

2​

Adjusted Table Top Longitudinal position in the IEC TABLE TOP​

Adjusted Position​

 

 

coordinate system in mm for patient setup. See Section C.8.8.29.2.​

- Standard -​

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