Материал: part03

Display

System

1 has

1-n

<Item>

QA Result per Display Subsystem ID

1-n has

1

QA

Results

Figure 7.12-2. Display Subsystem Composition in the Display System IOD​

Figure 7.12-2 illustrates how the composition of Display Subsystems is represented in the Display System IOD.​

7.13 DICOM Model of the Real World for Non-Patient-Related Information​

The DICOM Model of the Real World is extended for a variety of non-patient-related information with the specification of entities that​ are generally separate from the rest of the DICOM Real World Information Model. These information entities are not associated with​ a specific Patient. While there may be entity relationships, there is no hierarchy applied to these entities.​

7.13.1 Hanging Protocol Information Entity​

A Hanging Protocol Information Entity specifies the viewing preferences of a specific user or group, for a specific type of Study​ (Modality,Anatomy,Lateralitycombination,andoptionallyProcedure,and/orReason).AHangingProtocoldefinitionincludesdescriptors​ that identify the Hanging Protocol, the creator, the type of Study it addresses, the type of image sets to display, the intended display​ environment, and the intended layout for the screen(s).​

The Hanging Protocol IE does not have any relationships with other Information Entities. See Figure 7.13-1.​

Hanging

Protocol

Figure 7.13-1. DICOM Model of the Real World - Hanging Protocol​

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7.13.2 Color Palette Information Entity​

A Color Palette Information Entity specifies a color palette suitable for application to an image with a single channel of information​ (grayscale) to render it in color, i.e., pseudo-coloring.​

The Color Palette IE may be referenced by Image or Presentation State Information Entities. See Figure 7.13-2.​

The Color Palette IOD instantiates the Color Palette IE only.​

Color Palette

Figure 7.13-2. DICOM Model of the Real World - Color Palette​

7.13.3 Implant Related Information Entities​

7.13.3.1 Implant Template Information Entity​

AnImplantTemplateInformationEntityspecifiesa2D-and/or3D-templaterepresentingaphysicalimplant.TheIEspecifiesmechanisms​ for implant assembly, i.e., the rigid connection of two or more implants.​

The Implant Template IE may be related to a Surface IE (see Section A.1.2.18) or to an Encapsulated Document IE (see Sec-​ tion A.1.2.16) for the specification of the 2Dor 3D-template.​

The Implant Template IE may be related to a Frame of Reference IE (see Section A.1.2.5) to support registration of the template with​ Patient anatomical landmarks in a separate Frame of Reference.​

TheImplantTemplateIEmayberelatedtoanImplantAssemblyTemplateIEforthespecificationofmulti-partassemblies.TheImplant​ Template IE may be related to an Implant Template Group IE for shared management of a set of templates.​

See Figure 7.13-3.​

Figure 7.13-3. DICOM Model of the Real World - Implant Templates​

7.13.3.2 Implant Assembly Template Information Entity​

An Implant Assembly Template Information Entity specifies how to combine several implants to fulfill a certain purpose.​

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The Implant Assembly Template IE is related to Implant Template IEs.​

7.13.3.3 Implant Template Group Information Entity​

An Implant Template Group Information Entity specifies a set of Implant Templates for shared specification and management. It facil-​ itates browsing through a set of similar implants by providing similar matching coordinates, and by ordering the referenced templates​ by dimensional size or similar attributes.​

The Implant Template Group IE is related to Implant Template IEs.​

7.13.4 Extension of The DICOM Model of The Real World For Protocol Storage​

The DICOM Model of the Real World is extended with the addition of Defined Procedure Protocol and Performed Procedure Protocol​ objects whose whose relationship to existing DICOM Real World objects is shown in Figure 7.13.4-1.​

Note that the information in the Equipment IE describes the equipment that created the instance. The information in the Protocol​ Parameters may describe the equipment on which the protocol is intended to be executed which may or may not be the same as the​ equipment that created the instance.​

Figure 7.13.4-1. DICOM Model of the Real World - Protocol Storage​

7.13.5 Approval Information Entity​

An Approval Information Entity describes an approval of an Instance.​

Figure 7.13.5-1. DICOM Model of the Real World - Approval​

7.14 Extension of The DICOM Model of The Real-world for Radiotherapy Second​ Generation Information Objects​

For the purpose of RT Second Generation SOP Classes the DICOM Model of the Real-World is described in this section. This subset​ ofthereal-worldmodelcoverstherequirementsfortransferringinformationaboutplannedandperformedradiotherapeutictreatments​ and associated data.​

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Figure 7.14-1 describes the most important elements involved in the radiotherapy domain in DICOM.​

Patient

or

Surfaces

or

Lines

or

Points

Figure 7.14-1. DICOM Model of the Real World - Radiotherapy​

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Note​

1.​IODswhichcontainarepresentationofVolumes,Surfaces,Lines,PointscanbeannotatedbyanRTSegmentAnnotation.​

2.​For better readability the diagram only contains the most important relationships, e.g. all objects have a relation to the​ Patient, but not all of these relationships are part of this diagram.​

7.14.1 RT Course​

TheRTCourseisatop-levelentitythatrepresentsaradiotherapytreatmentcourse,usuallyspecifiedinoneormoreRTPrescriptions,​ generally for a defined tumor or group of tumors. A patient undergoing treatments of radiotherapy has one treatment course at a time.​ The RT Course may consist of several RT Treatment Phases (possibly with breaks of treatment in between them). Each treatment​ phase may consist of one or more RT Treatment Sessions. An RT Treatment Session is delivered in one patient visit to a venue with​ a treatment machine and will typically deliver a fraction of one or more RT Radiation Sets. A new RT Course is administered, when​ the patient is treated for a re-occurrence or a new tumor site - typically after a period of a year or more after the previous RT Course​ has been finished.​

The RT Course can be thought of as a container collecting all major objects which are relevant to this course. The RT Physician Intent​ andRTRadiationSetsreferenceothercompanionobjectsnecessarytoprepare,conductandreviewthetreatment.Timinginformation​ (start dates and phasing of treatment, breaks etc.) are also part of the RT Course information. Additionally it contains information of​ the ongoing status in treatment planning and delivery. The RT Course is a dynamic object that represents the current status of the​ patient"s treatment.​

The RT Course may also include information about previously conducted treatments by referencing previous RT Course objects or​ by directly recording the information in Attributes.​

7.14.2 RT Physician Intent​

The RT Physician Intent describes how the physician wishes to achieve curative or palliative therapy. This information includes, but​ is not limited to the use of external radiation therapy or brachytherapy, total and fractional doses and fractionation schemes, treatment​ sites, Dosimetric Objectives, envisioned treatment technique, beam energy or isotopes, and patient setup notes.​

7.14.3 Conceptual Volume​

The Conceptual Volume is a reference to a certain anatomical region or point. Conceptual Volumes may or may not have a repres-​ entation in segmented images. In most cases they will be related to one or more volumetric representations in various image sets​ taken at different times.​

For example, during a radiotherapy course at the time of prescription, physicians specify regions to which dose is prescribed. Sub-​ sequently these regions are referenced in other objects in order to track calculated and delivered dose in the course of treatment.​ This referencing capability is provided by the Conceptual Volume.​

7.14.4 RT Segment Annotation​

The RT Segment Annotation annotates segmented regions defined in other SOP Instances with radiotherapy-specific information​ about the role and RT-specific types of the regions (e.g. clinical target volume, organ at risk, bolus) , and other information such as​ density definitions. An RT Segment Annotation SOP instance may reference any geometric general-purpose representation entity​ defined by DICOM.​

7.14.5 RT Radiation Set​

An RT Radiation Set is a collection of RT Radiations. An RT Radiation Set defines a Radiotherapy treatment fraction, which will be​ applied one or more times. The RT Radiation Set is delivered by delivering the radiation of all referenced RT Radiations.​

Parallel and intermittent fractionation schemes, e.g. treatment of several target sites with different timing schemes, are represented​ by multiple RT Radiation Sets.​

7.14.6 RT Radiation​

An RT Radiation is a contiguous set of Control Points, describing machine and positioning parameters to be applied during treatment​ delivery.AnRTRadiationdescribesoneportionofanRTRadiationSetandrepresentsansingle-fractiondeliveryoftherapeuticradiation​

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