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Page 1646​

DICOM PS3.3 2020a - Information Object Definitions​

C.36.10.1 RT Radiation Set Attribute Descriptions​

C.36.10.1.1 RT Radiation Set Intent​

Defined Terms for RT Radiation Set Intent (300A,0637)​

TREATMENT​The RT Radiation Set is for the purpose of treatment delivery. This does not constitute an approval for treatment. All​ parameters necessary to guide the delivery of RT Radiations are included.​

PLAN_QA​ The RT Radiation Set is for validating the patient-specific dose. For example, by delivering the RT Radiations to a​ phantom and comparing the calculated dose to the phantom with actual measurements made in the phantom.​

MACHINE_QA​The RT Radiation Set is for system quality assurance and calibration (geometric, dosimetric or both) procedures of​ the delivery machine and is not patient-specific.​

RESEARCH​ The RT Radiation Set is for performing research and is not delivered to a patient.​

SERVICE​ The RT Radiation Set is for diagnostics and assessment for machine repair or to perform measurements for a main-​ tenance or calibration operation by a service technician.​

C.36.10.1.2 RT Radiation Sequence​

All SOP Instances referenced in this Sequence shall:​

•​share the same Frame of Reference (defined by the Frame of Reference UID (0020,0052) in the Frame Of Reference Module),​ and​

•​be defined for the same treatment device (specified by the Treatment Device Identification Macro within the RT Delivery Device​ Common Module).​

The SOP Classes referenced in this Sequence shall contain the following Modules:​

•​Section C.36.3 Enhanced RT Series Module.​

•​Section C.36.4 Radiotherapy Common Instance Module.​

•​Section C.36.12 RT Delivery Device Common Module.​

•​Section C.36.13 RT Radiation Common Module.​

C.36.10.1.3 Treatment Position Groups​

Radiation Instances that share a fixed spatial relation and thus can share the result of a position verification can be assigned to the​ same Treatment Position Group because the relationship of positions in one Instance to those in other Instances in the Treatment​ Position Group can be known with sufficient certainty to allow deterministic movement.​

Whether it is reasonable to put Instances together in Treatment Position Group can depend on several factors and may involve a​ degree of judgment.​

For example,​

1.​In a Radiation Set treating a single target with two beams at the same spatial location, both Radiation Instances belong to the​ same Treatment Position Group.​

2.​In a Radiation Set treating two targets in different anatomical regions (e.g., lung and pelvis), typically the Radiation Instances​ belongtodifferentTreatmentPositionGroups,becauseaseparatesetupverificationisrequiredtoestablishthetreatmentposition​ for each Radiation.​

3.​In a Radiation Set treating two targets whose spatial relationship is fixed such that a single setup verification is sufficient, the​ Radiation Instances may belong to the same Treatment Position Group, but the planner may choose to assign them to different​ Treatment Position Groups.​

C.36.10.1.4 Intended Number of Fractions and Radiation Fraction Pattern Macro​

The values of Intended Number of Fractions (300A,0636) and the attributes in Radiation Fraction Pattern Macro provide information​ about the planned treatment at the time the RT Radiation Set Instance was created.​

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DICOM PS3.3 2020a - Information Object Definitions​

Page 1647​

C.36.11 RT Dose Contribution Module​

The RT Dose Contribution Module contains information about the contribution of dose of the RT Radiations referenced by this RT​ Radiation Set IOD. Dose contributions refer to the RT Radiations delivering the dose and to anatomical structures receiving the dose.​

Notethatananatomicalstructure(asdefinedbytheConceptualVolumeMacro)caneitherbeatextuallytaggeddefinition,orareference​ to a Conceptual Volume defined in the RT Segment Annotation IOD. In all cases, Conceptual Volumes are identified by a UID which​ allows accumulation of dose to a given Conceptual Volume across RT Radiation Sets and comparison with prescribed Dosimetric​ Objectives.​

Dose contributions are defined using Meterset values. The definition points in the Meterset to Dose Mapping Sequence may or may​ not align with the Meterset values at the Control Points of the RT Radiation SOP Instance. For example, where a dose deposition​ between Control Points cannot be determined individually per segment or where this definition is not useful, the lookup table may just​ contain the Meterset of first and last Control Points. The Meterset and dose contribution of the first Control Point are always zero. For​ further details see Section C.36.11.1.1.​

Where dose contributions are not available at the time of RT Radiation Set definition and application (e.g., for emergency treatments)​ this Module may be absent. This does not exclude retrospective dose calculation and creation of associated RT Dose Image objects.​

Table C.36.11-1. RT Dose Contribution Module Attributes​

Attribute Name​

Tag​

Type​

 

Attribute Description​

Radiation Dose Identification​

(300A,0618)​

1​

Parameterstoidentifyandscopethedosevaluesthataredelivered​

Sequence​

 

 

by this RT Radiation Set SOP Instance.​

 

 

 

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

>Radiation Dose Identification​

(300A,0603)​

1​

Index of this Itemin this Sequence.​

Index​

 

 

The value shall start at 1 and increase monotonically by 1.​

 

 

 

>Radiation Dose Identification​

(300A,0619)​

1​

Label of this Radiation Dose for the user.​

Label​

 

 

 

 

>Reference Dose Type​

(300A,061A)​

1​

Type of reference dose.​

 

 

 

Defined Terms:​

 

 

 

 

PER_RADIATION​Dosevaluesarecalculatedindividuallyforeach​

 

 

 

 

referenced RT Radiation SOP Instance.​

 

 

 

NOMINAL​

DosevaluesarecalculatedontheFractionlevel​

 

 

 

 

and assigned to individual RT Radiation SOP​

 

 

 

 

Instanceswithoutinstance-specificcalculations.​

>Reference Dose Point​

(300A,061E)​

1C​

The x, y, and z coordinates, in mm of the reference dose point in​

Coordinates​

 

 

the DICOM Patient Coordinate System at which the dose values​

 

 

 

are calculated.​

 

 

 

 

Required if dose is calculated at a point.​

>ConceptualVolumeSequence​

(3010,0025)​

1​

Reference to a Conceptual Volume that receives dose.​

 

 

 

See Section C.36.11.1.2.​

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

Each Conceptual Volume UID (3010,0006) shall appear only once​ in the Radiation Dose Identification Sequence (300A,0618).​

>>Include Table 10.34-1 “Conceptual Volume Segmentation Reference And Combination Macro Attributes”.​

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DICOM PS3.3 2020a - Information Object Definitions​

Attribute Name​

Tag​

Type​

 

Attribute Description​

Radiation Dose Sequence​

(300A,0617)​

1​

Parameters that describe dose contributed by referenced RT​

 

 

 

Radiation SOP instances.​

 

 

 

For every SOP instance referenced in RT Radiation Sequence​

 

 

 

(300A,0616) exactly one item shall be present in this Sequence.​

>Referenced RT Radiation​

(300A,0630)​

1​

References the RT Radiation SOP Instance that describes​

Sequence​

 

 

parameters for dose delivery.​

 

 

 

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

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

 

>Radiation Dose Values​

(300A,061F)​

1​

Dose values of this RT Radiation with respect to the dose​

Parameters Sequence​

 

 

identification items defined in the Radiation Dose Identification​

 

 

 

Sequence (300A,0618).​

 

 

 

The number of Itemsincluded in this Sequenceshall be the same​

 

 

 

as the number of Items in the Radiation Dose Identification​

 

 

 

Sequence (300A,0618).​

>>PrimaryDoseValueIndicator​

(300A,061B)​

1​

Whether the dose value serves as the primary dose indicator for​

 

 

 

the RT Radiation SOP Instance.​

 

 

 

Enumerated Values:​

 

 

 

YES​

 

 

 

 

NO​

 

 

 

 

Exactly one item in the Radiation Dose Values Parameters​

 

 

 

Sequence (300A,061F) shall have the value YES.​

 

 

 

See Section C.36.11.1.3.​

>>Referenced Radiation Dose​

(300A,060C)​

1​

ThevalueofRadiationDoseIdentification Index(300A,0603)inthe​

Identification Index​

 

 

RadiationDoseIdentificationSequence(300A,0618)identifyingthe​

 

 

 

dose contribution to which this Item in the Radiation Dose Values​

 

 

 

Parameters Sequence (300A,061F) applies.​

>>Dose Values Sequence​

(300A,061C)​

1C​

Dose values.​

 

 

 

Required if the Meterset to dose mapping is defined.​

 

 

 

One or more Items shall be present.​

 

 

 

Each Radiobiological Dose Effect Flag (3010,0002) value shall​

 

 

 

appear no more than once in this Sequence.​

>>>Dose Value Purpose​

(300A,061D)​

1​

Purpose(s) for which dose values in this Sequence Item are​

 

 

 

provided.​

 

 

 

 

Defined Terms:​

 

 

 

TRACKING​The dose values are used for tracking.​

 

 

 

QA​

The dose values are used for quality assurance.​

>>>Include Table C.36.2.1.5-1 “Radiobiological Dose Effect Description Macro Attributes”.​

>>>Meterset to Dose Mapping​

(300A,0620)​

1​

Mapping of Cumulative Meterset (300A,063C) to Radiation Dose​

Sequence​

 

 

Value (300A,0625).​

See Section C.36.11.1.1.​

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

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DICOM PS3.3 2020a - Information Object Definitions​

Page 1649​

Attribute Name​

Tag​

Type​

Attribute Description​

 

>>>>Cumulative Meterset​

(300A,063C)​

1​

Cumulative Meterset where a dose value is delivered.​

 

 

 

See Section C.36.11.1.1.​

 

>>>>Radiation Dose Value​

(300A,0625)​

1​

Dose value (in Gy) delivered at the corresponding Cumulative​

 

 

 

Meterset (300A,063C).​

 

 

 

 

See Section C.36.11.1.5.​

 

>Expected In-Vivo​

(300A,0621)​

1C​

Expected values against which in-vivo measurements may be​

MeasurementValuesSequence​

 

 

compared.​

 

 

 

 

Requiredifexpectedvaluesarecalculatedforin-vivomeasurement​

 

 

 

for this RT Radiation SOP Instance.​

 

 

 

 

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

>>Expected In-Vivo​

(300A,0622)​

1​

Index of this Itemin this Sequence.​

 

Measurement Value Index​

 

 

The value shall start at 1 and increase monotonically by 1.​

 

 

 

>>Radiation Dose In-Vivo​

(300A,0623)​

1​

Label to identify the in-vivo measurement point.​

 

Measurement Label​

 

 

See Section 10.31.1.1.​

 

 

 

 

 

>>Radiation Dose Central Axis​

(300A,0624)​

1C​

Displacement(x,y)inmmofthemeasurementpointfromthecentral​

Displacement​

 

 

axis along the x-axis and y-axis of the Beam Modifier Definition​

 

 

 

Plane.​

 

 

 

 

RequiredifacentralbeamaxisisdefinedfortheTreatmentDelivery​

 

 

 

Device and the Radiation Dose Measurement Point Coordinates​

 

 

 

(300A,0627) is not present.​

 

>>Radiation Dose Value​

(300A,0625)​

1​

Dose Value in Gy at the measurement point.​

 

>>Radiation Dose Source to​

(300A,0626)​

2​

Distance in mm from the nominal Radiation Source location to the​

Skin Distance​

 

 

patient skin along the central beam axis from the source to the​

 

 

 

measurement point.​

 

>>Radiation Dose Source to​

(300A,0628)​

2​

Distance in mm from the nominal Radiation Source location to the​

External Contour Distance​

 

 

External Contouralong the central beam axis from the source to the​

 

 

 

measurement pointincluding devices associated with the patient​

 

 

 

anatomy model. For dosimetric purposes this value may differ from​

 

 

 

theRadiation Dose Source to Skin Distance(300A,0626).​

 

 

 

See Section C.36.11.1.4.​

 

>>Radiation Dose​

(300A,0627)​

1C​

Coordinates(x,y,z)inmmintheDICOMPatientCoordinateSystem​

MeasurementPointCoordinates​

 

 

of the measurement point.​

 

RequiredifRadiationDoseCentralAxisDisplacement(300A,0624)​ is not present.​

C.36.11.1 RT Dose Contribution Attribute Description​

C.36.11.1.1 Meterset to Dose Mapping Sequence​

The Meterset to Dose Mapping Sequence (300A,0620) contains for each Meterset value the corresponding dose value.​

In the first item, the value of Cumulative Meterset (300A,063C) and of Radiation Dose Value (300A,0625) shall be zero.​

In the last item, the value of Cumulative Meterset (300A,063C) shall be the Meterset of the final Control Point. The value of Radiation​ Dose Value (300A,0625) in the last item represents the dose delivered to the referenced anatomy when one fraction is completely​ delivered.​

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Page 1650​

DICOM PS3.3 2020a - Information Object Definitions​

CumulativeMetersetValuesshallbestrictlymonotonicallyincreasing.RadiationDoseValuesshallbemonotonicallynon-decreasing.​ The increase of dose between two adjacent points of the lookup table shall be interpreted as linear.​

C.36.11.1.2 Conceptual Volume Sequence​

TheConceptualVolumeSequence(3010,0025)identifiesaConceptualVolumethatdefinesavolumeforwhichdoseistrackedduring​ treatments.​

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 Segmentation Reference and Combination Macro (see Section 10.34).​

Alternatively, the Conceptual Volume may not be associated with a segment. For example, dose tracking may specify a nominal dose​ to an anatomical region of interest and the tracking coefficients approximated by Meterset values.​

C.36.11.1.3 Primary Dose Value Indicator​

The Primary Dose Value Indicator (300A,061B) is intended to indicate the representative dose value out of the list of dose values​ which is used for display purposes. Typically this value refers to the primary target while the other non-primary values may refer to​ e.g., organs at risk.​

C.36.11.1.4 Radiation Dose Source to External Contour Distance​

The Radiation Dose Source to External Contour Distance (gggg,9B7E) is the distance to the beam entry point, which may include​ Bolus, Patient Positioning Devices, Patient Immobilization Devices or other devices. This value is useful for including the attenuation​ effects of external devices on the dose calculation and for patient setup.​

C.36.11.1.5 Radiation Dose Value​

The Radiation Dose Value (300A,0625) represents the cumulative dose delivered from the beginning of radiation delivery to the Cu-​ mulative Meterset (300A,063C).​

C.36.12 RT Delivery Device Common Module​

The RT Delivery Device Common Module contains general information pertaining to the physical device used to deliver the treatment.​

Table C.36.12-1. RT Delivery Device Common Module Attributes​

Attribute Name​

Tag​

Type​

Attribute Description​

Include Table C.36.2.2.1-1 “Treatment Device Identification Macro Attributes”.​

Radiation Dosimeter Unit​

(300A,0658)​

1​

Measurement units of the machine dosimeter.​

Sequence​

 

 

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

 

 

 

>Include Table 8.8-1 “Code Sequence Macro Attributes”.​

 

CID is specified in the IOD​

RT Device Distance Reference​

(300A,0659)​

1​

Point of reference used for measuring the distance to​

Location Code Sequence​

 

 

various devices.​

 

 

 

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

>Include Table 8.8-1 “Code Sequence Macro Attributes”.​

 

DCID 9544 “Radiotherapy Distance Reference​

 

 

 

Locations”.​

RT Beam Modifier Definition​

(300A,0688)​

1​

Absolute distance in mm along the z-axis of the Base​

Distance​

 

 

Beam Modifier Coordinate System from the reference​

location as specified by RT Device Distance Reference​ Location Code Sequence (300A,0659) to the Beam​ ModifierDefinition Plane.​

The value shall be greater than or equal to zero.​

See Section C.36.1.1.9.​

- Standard -​

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