Материал: part03

Enumerated Values:​

CURRENT​The Dosimetric Objective applies to the referencing​ prescriptions.​

LIFETIME​ The Dosimetric Objective applies to the referencing​ prescriptions and accumulated lifetime dose.​

See Section C.36.6.1.7.​

C.36.6.1 RT Enhanced Prescription Attribute Descriptions​

C.36.6.1.1 Therapeutic Role Type Code Sequence​

TheTherapeuticRoleTypeCodeSequence(3010,0065)furtherspecifiestheroleoftheanatomyalongtheTherapeuticRoleCategory​ (3010,0064). Table C.36.6-3 describes the codes permitted in the Therapeutic Role Type Code Sequence (3010,0065), when the​ code used in the Therapeutic Role Category Code Sequence (3010,0064) is as specified.​

Table C.36.6-2. Therapeutic Role Type Codes​

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C.36.6.1.2 Conceptual Volume Type Code Sequence​

The Conceptual Volume Type Code Sequence (3010,0069) further specifies the type of the anatomy along the Conceptual Volume​ CategoryCodeSequence(3010,0067).TableC.36.6-3describesthecodespermittedintheConceptualVolumeTypeCodeSequence​ (3010,0069), when the code used in the Conceptual Volume Type Code Sequence (3010,0069) is as specified.​

Table C.36.6-3. Anatomy Property Type Codes​

CodeValueofConceptualVolumeCategoryCodeSequence​Context Group for Conceptual Volume Type Code Sequence​

For code values of the Conceptual Volume Type Code Sequence (3010,0069) not listed in Table C.36.6-3, no Baseline or Defined​ Context Group is specified.​

C.36.6.1.3 Conceptual Volume Sequence​

The Conceptual Volume Sequence (3010,0025) identifies the Conceptual Volume associated with an RT Anatomy Prescription Item.​ If the Conceptual Volume is associated with a segment, the segment is defined by the Referenced Segment Reference Index​ (3010,0020) in the Conceptual Volume Reference Combination and Segmentation Macro (see Section 10.34). Alternatively, the​ anatomyvolumemay not(yet)beassociatedwith a segment.For example, an initial prescription maybeentered priorto thedefinition​ of an organ at risk.​

C.36.6.1.4 Fraction-based Relationship Sequence​

The Fraction-Based Relationship Sequence (3010,0082) is used to specify the relationship between two prescriptions.​

The following example shows a treatment performed in 2 phases with a break of 7 days between phases.​

In RT Treatment Phase 1, the treatment of Prescription B is intended to start 10 fractions prior to the end of Prescription A.​

The Section C.36.7 RT Treatment Phase Intent Module is used to specify the relationship of treatment phases to each other.​

time

Figure C.36.6.1-1. Relationship of Phases and Prescriptions​

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C.36.6.1.5 Parent RT Prescription​

TheRTEnhancedPrescriptionModulesupportsatwo-levelprescriptionmodel(seeFigureC.36.6.1-2)inordertodocumentanapproach​ where a high-level prescription is created and then more details may be added. The first level would typically be created during the​ time of prescription definition with only high-level prescription information based on the RT Physician Intent. The second level, if​ present, would represent a derived prescription containing more detailed information, such as constraints and objectives. A third or​ subsequent levels are not permitted.​

Parent Prescription:

Right Oropharynx Cancer Treatment

•Curative

•Target Dose:: 80 Gy

•Two Phase with FIeld Reduction

Figure C.36.6.1-2. Parent and Child RT Prescriptions​

C.36.6.1.6 Dosimetric Objective Sequence​

The Dosimetric Objective Sequence (3010,006C) specifies a set of intended dosimetric goals.​

Each item of the Dosimetric Objective Sequence (3010,006C) shall be referenced by at least one item of the Referenced Dosimetric​ Objectives Sequence (3010,0071) in the current Instance.​

WithinanRTPhysicianIntentSOPInstance,aDosimetricObjectiveisapplicabletoallPrescriptionsinwhichtheDosimetricObjective​ UID (3010,006E) is referenced.​

A Dosimetric Objective is intended to be satisfied by the combined effect of all treatments associated with prescriptions that reference​

the Dosimetric Objective UID (3010,006F).​

For example, if there are primary and boost prescriptions that reference the same Dosimetric Objective UID (3010,006E) then the​ combined effect of both prescriptions is intended to comply with the limit in this Dosimetric Objective.​

C.36.6.1.7 Dosimetric Objective Evaluation Scope​

For Dosimetric Objectives that include a dose value, the value defines the total dose for all fractions of all prescriptions referencing​ this Dosimetric Objective, and potentially dose from previous treatment, depending on the value of Dosimetric Objective Evaluation​ Scope (3010,0063).​

If Dosimetric Objective Evaluation Scope (3010,0063) has a value of LIFETIME, information from prior treatments shall be included​ in the evalution of the Dosimetric Objective.​

For example, if an organ has received dose in a prior treatment, and Dosimetric Objective Evaluation Scope (3010,0063) is marked​ as LIFETIME, then the previously delivered dose shall be included in the evalution of this objective. Information about prior treatments​ may be described in Prior Treatment Dose Description (3010,0061) or by Instances referenced by the Prior Treatment Reference​ Sequence (3010,0062) in RT Prescription Sequence (3010,006B).​

IfDosimetricObjectiveEvaluationScope(3010,0063)hasavalueofCURRENT,theobjectiveincludesonlythoseprescriptionswhich​ reference the same Dosimetric Objective, even if information of a prior treatment is available.​

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C.36.6.1.8 Patient Equipment Relationship Code Sequence​

The Patient Equipment Relationship Code Sequence (3010,0030) specifies the orientation of the patient relative to the front of the​ equipment viewed from the patient support device. For example, in case of the equipment being a gantry, this is the direction from​ the table (being the patient support device) towards the gantry. In cases where it is not possible to understand unambigously the dir-​ ection for a certain equipment, the equipment vendor shall document this direction in its Conformance Statement.​

C.36.7 RT Treatment Phase Intent Module​

RT Treatment Phases define the intended phases of treatment and their temporal relationship.​

Table C.36.7-1. RT Treatment Phase Intent Module Attributes​

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

>Include Table C.36.2.1.2-1 “RT Treatment Phase Macro Attributes”​The RT Treatment Phase Index (3010,003A) shall start at 1​ and increase monotonically by 1 for successive Items in this​ Sequence.​

Include Table C.36.2.1.3-1 “RT Treatment Phase Interval Macro​

Attributes”​

C.36.8 RT Segment Annotation Module​

The RT Segment Annotation Module references segments and provides radiotherapy-specific annotations for them. The geometry​ of each segment is defined by a referenced Segmentation, Surface Segmentation, RT Structure Set or any other general-purpose​ Instance that represents geometric information.​

The values of the following Attribute shall take precedence over values in the referenced SOP Instances:​

•​Segment Annotation Category Code Sequence (3010,002B)​

•​Segment Annotation Type Code Sequence (3010,002C)​

Table C.36.8-1. RT Segment Annotation Module Attributes​

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>>IncludeTable10.2.1-1“ContentItemwithModifiersMacroAttributes”​DTID 15301 “RT Segment Characteristics”​

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