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DICOM PS3.3 2020a - Information Object Definitions​

Page 1231​

Attribute Name​

Tag​

Type​

Attribute Description​

 

>Exposure in mAs​

(0018,9332)​

1​ The exposure expressed in mAs, for example calculated from Exposure Time​

 

 

and X-Ray Tube Current.​

 

>Relative X-Ray​

(0018,1405)​

3​ Indication of the applied dose, in manufacturer specific units.​

 

Exposure​

 

Note​

 

 

 

 

 

 

1.​This value is intended to provide a single location where​

 

 

 

manufacturer specific information can be found for annotation​

 

 

 

on a display or film, that has meaning to a knowledgeable​

 

 

 

observer.​

 

 

 

2.​This may be a calculated or measured value. Examples are the​

 

 

 

detectorentrancedose(KB),theCRsensitivityvalue(S),orthe​

 

 

 

logarithmic median (lgM).​

 

 

 

3.​DICOM specifies Standard Attributes in Table 10-23 “Exposure​

 

 

 

Index Macro Attributes”, which are recommended.​

 

>Half Value Layer​

(0040,0314)​

3​ The thickness of Aluminum in mm required to reduce the X-Ray Output​

 

 

(0040,0312) by a factor of two.​

 

 

 

Note​

 

 

 

This value may be a calibrated value rather than measured during​

 

 

the exposure.​

 

>Organ Dose​

(0040,0316)​

1​ Average organ dose value measured in dGy during the acquisition of this​

 

 

image.​

 

 

 

 

Note​

 

 

 

This may be an estimated value.​

 

>Entrance Dose in mGy​

(0040,8302)​

1​ Average entrance dose value measured in mGy at the surface of the patient​

 

 

during the acquisition of this image.​

 

 

 

Note​

 

 

 

This may be an estimated value based on assumptions about the​

 

 

patient's body size and habitus.​

 

>Entrance Dose​

(0040,8303)​

3​ Describes what type of dose is represented by the values of Entrance Dose​

Derivation​

 

in mGy (0040,8302).​

 

 

 

Enumerated Values:​

 

 

 

IAK​

Represents air kerma at the entrance surface, no backscatter​

 

 

 

included, no air kerma to tissue dose conversion applied.​

 

 

ESAK​ Represents air kerma at the entrance surface, with backscatter​

included, no air kerma to tissue dose conversion applied.​ ESDBS​ Represents absorbed dose in tissue at the entrance surface, with​

backscatter included.​

ESDNOBS​Represents absorbed dose in tissue at the entrance surface,​ without backscatter included.​

C.8.31.6 Breast X-Ray Isocenter Reference System Macro​

Table C.8.31.6-1 specifies the Attributes of the Breast X-Ray Isocenter Reference System Functional Group Macro.​

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Page 1232​ DICOM PS3.3 2020a - Information Object Definitions​

Table C.8.31.6-1. Breast X-Ray Isocenter Reference System Macro Attributes​

Attribute Name​

Tag​

Type​

Attribute Description​

Isocenter Reference System​

(0018,9462)​

1​ ASequencethatdescribestheIsocenterReferenceCoordinateSystem​

Sequence​

 

 

(O, X, Y, Z).​

 

 

 

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

>X-Ray Source Isocenter​

(0018,9543)​

1​ Primary angle of the X-Ray source in the isocenter reference system​

Primary Angle​

 

 

(deg).​

 

 

 

See C.8.31.6.1.2 for further explanation.​

>X-Ray Source Isocenter​

(0018,9544)​

1​ SecondaryangleoftheX-Raysourceintheisocenterreferencesystem​

Secondary Angle​

 

 

(deg).​

 

 

 

See C.8.31.6.1.2 for further explanation.​

>Breast Support Isocenter​

(0018,9545)​

1​ PrimaryangleoftheBreastSupportintheisocenterreferencesystem​

Primary Angle​

 

 

(deg).​

 

 

 

See C.8.31.6.1.3 for further explanation.​

>Breast Support Isocenter​

(0018,9546)​

1​ Secondary angle of the Breast Support in the isocenter reference​

Secondary Angle​

 

 

system (deg).​

See C.8.31.6.1.3 for further explanation.​

>Breast Support X Position to​ (0018,9547)​ Isocenter​

1C​ X position of the Breast Support Reference Point with respect to the​ Isocenter (mm).​

See C.8.31.6.1.3 for further explanation.​

Required if Presentation Intent Type (0008.0068) = FOR​ PROCESSING. May be present otherwise.​

>Breast Support Y Position to​

(0018,9548)​

1C​

Y position of the Breast Support Reference Point with respect to the​

Isocenter​

 

 

Isocenter (mm).​

 

 

 

See C.8.31.6.1.3 for further explanation.​

 

 

 

Required if Presentation Intent Type (0008.0068) = FOR​

 

 

 

PROCESSING. May be present otherwise.​

>Breast Support Z Position to​

(0018,9549)​

1C​

Z position of the Breast Support Reference Point with respect to the​

Isocenter​

 

 

Isocenter (mm).​

 

 

 

See C.8.31.6.1.3 for further explanation.​

 

 

 

Required if Presentation Intent Type (0008.0068) = FOR​

 

 

 

PROCESSING. May be present otherwise.​

>Detector Isocenter Primary​

(0018,9550)​

1​

PrimaryangleoftheDetectorintheisocenterreferencesystem(deg).​

Angle​

 

 

See C.8.31.6.1.4 for further explanation.​

 

 

 

>Detector Isocenter Secondary​

(0018,9551)​

1​

Secondary angle of the Detector in the in the isocenter reference​

Angle​

 

 

system (deg).​

See C.8.31.6.1.4 for further explanation.​

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DICOM PS3.3 2020a - Information Object Definitions​

Page 1233​

Attribute Name​

Tag​

Type​

Attribute Description​

 

>Detector X Position to​

(0018,9552)​

1C​

XpositionoftheDetectorReferencePointwithrespecttotheIsocenter​

Isocenter​

 

 

(mm).​

 

 

 

 

See C.8.31.6.1.4 for further explanation.​

 

 

 

 

Required if Presentation Intent Type (0008.0068) = FOR​

 

 

 

PROCESSING. May be present otherwise.​

 

>Detector Y Position to​

(0018,9553)​

1C​

YpositionoftheDetectorReferencePointwithrespecttotheIsocenter​

Isocenter​

 

 

(mm).​

 

 

 

 

See C.8.31.6.1.4 for further explanation.​

 

 

 

 

Required if Presentation Intent Type (0008.0068) = FOR​

 

 

 

PROCESSING. May be present otherwise.​

 

>DetectorZPositiontoIsocenter​

(0018,9554)​

1C​

ZpositionoftheDetectorReferencePointwithrespecttotheIsocenter​

 

 

 

(mm).​

 

 

 

 

See C.8.31.6.1.4 for further explanation.​

 

 

 

 

Required if Presentation Intent Type (0008.0068) = FOR​

 

 

 

PROCESSING. May be present otherwise.​

 

>Detector Active Area TLHC​

(0018,9557)​

1C​

The x, y, and z coordinates in mm of the center of the top left hand​

Position​

 

 

corner detector element of the detector active area in the Detector​

 

 

 

coordinate system.​

 

 

 

 

See C.8.31.6.1.5 for further explanation.​

 

 

 

 

Required if Presentation Intent Type (0008.0068) = FOR​

 

 

 

PROCESSING. May be present otherwise.​

 

>Detector Active Area​

(0018,9558)​

1C​

The direction cosines of the first row and the first column with respect​

Orientation​

 

 

to the Detector coordinate system.​

 

See C.8.31.6.1.5 for further explanation.​

Required if Presentation Intent Type (0008.0068) = FOR​

PROCESSING. May be present otherwise.​

C.8.31.6.1 Isocenter Reference System Attribute Descriptions​

TheIsocenterReferenceSystemAttributesdescribethe3DgeometryoftheX-RayequipmentcomposedbytheX-RaySource,Breast​

Support and the Detector.​

These Attributes define four coordinate systems in the 3D space:​

•​Isocenter coordinate system​

•​X-Ray Source coordinate system​

•​Breast Support coordinate system​

•​Detector coordinate system​

The Isocenter Reference System Attributes describe the relationship between the 3D coordinates of a point in the Breast Support​ coordinate system and the 3D coordinates of such point in the X-Ray Source and Detector coordinate systems (which may move in​ the equipment), by using the Isocenter coordinate system that is fixed in the equipment.​

Unlike in X-Ray Angiography, in stereotactic biopsy and breast tomosynthesis the X-Ray source does not move in lock-step with the​ detector.Thedetectormaybestationary,maytranslate,ormayrotateastheX-Raysourcemoves.Thusforthepurposeofstereotactic​

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Page 1234​

DICOM PS3.3 2020a - Information Object Definitions​

biopsyandbreasttomosynthesis,theX-RaySourceandDetectorCoordinateSystemsaredefinedseparately,andeachofthepotential​ detector positionings is considered separately.​

Note​

Annex Z “X-Ray Isocenter Reference Transformations (Informative)” in PS3.17 describes the transformations necessary to​ transpose between coordinate systems.​

The detector is anterior to the patient standing upright and facing the front of the gantry, as shown in Figure C.8.31.6-1.​

Detector

Chest Wall

Patient Left

Patient Right

Patient Posterior

Figure C.8.31.6-1. Patient/Detector Relationship (Patient Standing)​

As breast projection X-Ray imaging traditionally uses devices with similar physical appearance, the following terms are defined for​ the purpose of helping later convey the geometry associated with breast projection X-Ray imaging:​

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DICOM PS3.3 2020a - Information Object Definitions​

Page 1235​

GANTRY FRONT​The side of the equipment closest to the patient​

whenthepatientisstanding,positionedforbreast​ Gantry Rear projection X-Ray imaging.​

GANTRY RIGHT​ The right-hand side of the equipment when the​ patient is standing facing GANTRY FRONT.​

GANTRY LEFT​

The left-hand side of the equipment when the​

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

patient is standing facing GANTRY FRONT.​

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GANTRY REAR​

Thesideoftheequipmentfurthestfromthepatient​

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

whenthepatientisstanding,positionedforbreast​

 

 

 

 

 

 

 

 

projection X-Ray imaging.​

Gantry Left

 

 

 

 

Gantry Right

 

 

 

 

 

 

 

 

 

Gantry Front

Figure C.8.31.6-2. Gantry Sides​

C.8.31.6.1.1 Isocenter Coordinate System​

The Isocenter coordinate system (O,X,Y,Z) of the equipment is defined as follows (see Figure C.8.31.6-3) :​

•​OriginOistheSystemIsocenter,whichisthepointwheretheplaneofmotionoftheX-RaySourcespotintersectstheaxisofrotation​ of the X-Ray Source.​

•​+X direction is from GANTRY LEFT to GANTRY RIGHT in the horizontal plane (gravity plane).​

•​+Y direction is from GANTRY FRONT to GANTRY REAR in the horizontal plane (gravity plane).​

•​+Z direction is upward (anti-gravity).​

•​The isocenter coordinate system does not rotate when the tube head or C-arm rotates.​

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