Computed Radiography ImageCIOD
Nuclear Medicine ImageCIOD
Ultrasound ImageCIOD
Ultrasound Multi-frame ImageCIOD
Secondary Capture ImageCIOD
Multi-frame Single Bit Secondary Capture ImageCIOD
Multi-frame Grayscale Byte Secondary Capture ImageCIOD
Multi-frame Grayscale Word Secondary Capture ImageCIOD
Multi-frame True Color Secondary Capture ImageCIOD
X-Ray Angiographic ImageCIOD
X-Ray Radiofluoroscopic ImageCIOD
RT Structure SetCIOD
Positron Emission Tomography ImageCIOD
Digital X-Ray ImageCIOD
Digital Mammography X-Ray ImageCIOD
Digital Intra-Oral X-Ray ImageCIOD
RT Beams Treatment RecordCIOD
RT Brachy Treatment RecordCIOD
RT Treatment Summary RecordCIOD
VL Endoscopic ImageCIOD
VL Microscopic ImageCIOD
VL Slide-Coordinates Microscopic ImageCIOD
VL Photographic ImageCIOD
Video Endoscopic ImageCIOD
Video Microscopic ImageCIOD
Video Photographic ImageCIOD
VL Whole Slide Microscopy ImageCIOD
Real-Time Video Endoscopic ImageCIOD
Real-Time Video Photographic ImageCIOD
Dermoscopic Photography ImageCIOD
Grayscale Softcopy Presentation StateCIOD
Color Softcopy Presentation StateCIOD
Pseudo-Color Softcopy Presentation StateCIOD
Blending Softcopy Presentation StateCIOD
Basic Structured DisplayCIOD
PatientMModule - Patient
Clinical Trial SubjectUModule - Patient
General StudyMModule - Study
Patient StudyUModule - Study
Clinical Trial StudyUModule - Study
General SeriesMModule - Series
Clinical Trial SeriesUModule - Series
Presentation SeriesMModule - Series
General EquipmentMModule - Equipment
Enhanced General EquipmentUModule - Equipment
Structured DisplayMModule - Presentation State
Structured Display Image BoxMModule - Presentation State
(0072,0422) Structured Display Image Box Sequence1Sequence
(0008,1134) Referenced Stereometric Instance Sequence1CSequence
(0008,1140) Referenced Image Sequence2CSequence
(0008,1150) Referenced SOP Class UID1Unique Identifier
(0008,1155) Referenced SOP Instance UID1Unique Identifier
(0008,1160) Referenced Frame Number1CInteger String
(0008,9237) Referenced Presentation State Sequence1CSequence
(0062,000B) Referenced Segment Number1CUnsigned Short
(0008,114A) Referenced Instance Sequence1CSequence
(0008,2142) Start Trim2CInteger String
(0008,2143) Stop Trim2CInteger String
(0008,2144) Recommended Display Frame Rate1CInteger String
(0008,9237) Referenced Presentation State Sequence1CSequence
(0018,0042) Initial Cine Run State1CCode String
(0018,1244) Preferred Playback Sequencing1CUnsigned Short
(0072,0108) Display Environment Spatial Position1Double
(0072,0302) Image Box Number1Unsigned Short
(0072,0304) Image Box Layout Type1Code String
(0072,0306) Image Box Tile Horizontal Dimension1CUnsigned Short
(0072,0308) Image Box Tile Vertical Dimension1CUnsigned Short
(0072,0320) Image Box Overlap Priority3Unsigned Short
(0072,0330) Cine Relative to Real-Time1CDouble
(0072,0427) Referenced First Frame Sequence2CSequence
(0072,0717) Display Set Horizontal Justification3Code String
(0072,0718) Display Set Vertical Justification3Code String
(0072,0430) Image Box Synchronization Sequence1CSequence
Structured Display AnnotationUModule - Presentation State
Common Instance ReferenceMModule - Presentation State
SpecimenUModule - Presentation State
SOP CommonMModule - Presentation State
XA/XRF Grayscale Softcopy Presentation StateCIOD
Advanced Blending Presentation StateCIOD
Variable Modality LUT Softcopy Presentation StateCIOD
Basic Voice Audio WaveformCIOD
Ambulatory ECGCIOD
Hemodynamic WaveformCIOD
Basic Cardiac Electrophysiology WaveformCIOD
Arterial Pulse WaveformCIOD
Respiratory WaveformCIOD
General Audio WaveformCIOD
Real-Time Audio WaveformCIOD
Routine Scalp ElectroencephalogramCIOD
Sleep ElectroencephalogramCIOD
Multi-channel Respiratory WaveformCIOD
Body Position WaveformCIOD
General 32-bit ECGCIOD
Basic Text SRCIOD
Enhanced SRCIOD
Comprehensive SRCIOD
Key Object Selection DocumentCIOD
Mammography CAD SRCIOD
Procedure LogCIOD
X-Ray Radiation Dose SRCIOD
Spectacle Prescription ReportCIOD
Macular Grid Thickness and Volume ReportCIOD
Implantation Plan SR DocumentCIOD
Comprehensive 3D SRCIOD
Radiopharmaceutical Radiation Dose SRCIOD
Extensible SRCIOD
Acquisition Context SRCIOD
Simplified Adult Echo SRCIOD
Patient Radiation Dose SRCIOD
Planned Imaging Agent Administration SRCIOD
Performed Imaging Agent Administration SRCIOD
Rendition Selection DocumentCIOD
Enhanced X-Ray Radiation Dose SRCIOD
Enhanced MR ImageCIOD
MR SpectroscopyCIOD
Enhanced MR Color ImageCIOD
Raw DataCIOD
Enhanced CT ImageCIOD
Spatial RegistrationCIOD
Deformable Spatial RegistrationCIOD
Spatial FiducialsCIOD
Ophthalmic Photography 8 Bit ImageCIOD
Ophthalmic Photography 16 Bit ImageCIOD
Stereometric RelationshipCIOD
Hanging ProtocolCIOD
Encapsulated PDFCIOD
Encapsulated CDACIOD
Real World Value MappingCIOD
Enhanced XA ImageCIOD
Enhanced XRF ImageCIOD
RT Ion Beams Treatment RecordCIOD
Ophthalmic Tomography ImageCIOD
X-Ray 3D Angiographic ImageCIOD
X-Ray 3D Craniofacial ImageCIOD
Breast Tomosynthesis ImageCIOD
Enhanced PET ImageCIOD
Surface SegmentationCIOD
Color PaletteCIOD
Enhanced US VolumeCIOD
Lensometry MeasurementsCIOD
Autorefraction MeasurementsCIOD
Keratometry MeasurementsCIOD
Subjective Refraction MeasurementsCIOD
Visual Acuity MeasurementsCIOD
Ophthalmic Axial MeasurementsCIOD
Intraocular Lens CalculationsCIOD
Generic Implant TemplateCIOD
Implant Assembly TemplateCIOD
Implant Template GroupCIOD
RT Beams Delivery InstructionCIOD
Ophthalmic Visual Field Static Perimetry MeasurementsCIOD
Intravascular Optical Coherence Tomography ImageCIOD
Ophthalmic Thickness MapCIOD
Surface Scan MeshCIOD
Surface Scan Point CloudCIOD
Legacy Converted Enhanced CT ImageCIOD
Legacy Converted Enhanced MR ImageCIOD
Legacy Converted Enhanced PET ImageCIOD
Corneal Topography MapCIOD
Breast Projection X-Ray ImageCIOD
Parametric MapCIOD
Wide Field Ophthalmic Photography Stereographic Projection ImageCIOD
Wide Field Ophthalmic Photography 3D Coordinates ImageCIOD
Tractography ResultsCIOD
RT Brachy Application Setup Delivery InstructionCIOD
Planar MPR Volumetric Presentation StateCIOD
Volume Rendering Volumetric Presentation StateCIOD
Content Assessment ResultsCIOD
CT Performed Procedure ProtocolCIOD
CT Defined Procedure ProtocolCIOD
Protocol ApprovalCIOD
XA Performed Procedure ProtocolCIOD
XA Defined Procedure ProtocolCIOD
Ophthalmic Optical Coherence Tomography En Face ImageCIOD
Ophthalmic Optical Coherence Tomography B-scan Volume AnalysisCIOD
Encapsulated STLCIOD
Encapsulated OBJCIOD
Encapsulated MTLCIOD
RT Physician IntentCIOD
RT Segment AnnotationCIOD
RT Radiation SetCIOD
C-Arm Photon-Electron RadiationCIOD
Tomotherapeutic RadiationCIOD
Robotic-Arm RadiationCIOD
RT Radiation Record SetCIOD
RT Radiation Salvage RecordCIOD
C-Arm Photon-Electron Radiation RecordCIOD
Tomotherapeutic Radiation RecordCIOD
Robotic-Arm Radiation RecordCIOD
RT Radiation Set Delivery InstructionCIOD
RT Treatment PreparationCIOD
Enhanced RT ImageCIOD
Enhanced Continuous RT ImageCIOD
RT Patient Position Acquisition InstructionCIOD
Microscopy Bulk Simple AnnotationsCIOD
Photoacoustic ImageCIOD
Confocal Microscopy ImageCIOD
Confocal Microscopy Tiled Pyramidal ImageCIOD
Basic DirectoryCIOD

Built with by Innolitics, a team of medical imaging software developers.

Data synced with official DICOM standard on 18 April 2024. The DICOM Standard is under continuous maintenance, and the current official version is available at DICOM Parts 3, 4, and 6, © NEMA. Please note that the most recent PDF version of the standard is the official reference, and should checked when making technical decisions.

Referenced Image Sequence Attribute

TypeConditionally Required, Empty if Unknown (2C)
Value Multiplicity1
Value RepresentationSequence (SQ)

Reference to the Image SOP Instances, or frames from multi-frame Image SOP Instances, to be displayed in this Image Box.

Zero or more Items shall be included in this Sequence.

Required if Referenced Presentation State Sequence (0008,9237), Referenced Stereometric Instance Sequence (0008,1134), and Referenced Instance Sequence (0008,114A) are not present.

See Section C.

Section C.

C. Referenced Image Sequence and Referenced Presentation State Sequence

Image SOP Instances, or frames from multi-frame SOP Instances, to be displayed in an Image Box may be identified either directly by the Referenced Image Sequence (0008,1140), or indirectly through the Referenced Presentation State Sequence (0008,9237).

Referenced Image Sequence (0008,1140) is permitted to be zero length, indicating an empty Image Box.


  1. The recommended display color for an empty Image Box is specified by Empty Image Box CIELab Value (0072,0421).

  2. When displaying a standard template such as a dental full mouth series, an empty image box may be used to indicate that the corresponding view was not taken.

If images are identified indirectly through the Referenced Presentation State Sequence (0008,9237), all of the image frames identified in the top level Referenced Series Sequence (0008,1115) Attribute shall be displayed. For images identified indirectly through a Blending Presentation State SOP Instance, all the image frames for which the Blending Position (0070,0405) value is UNDERLYING shall be displayed, with the relevant SUPERIMPOSED images blended as necessary.

If images are to be displayed, the number of frames referenced for display shall be consistent with the value of Image Box Layout Type (0072,0304). If the value of Image Box Layout Type is SINGLE, only a single frame shall be referenced, either directly or indirectly; if the value is CINE, only a single multi-frame SOP Instance shall be referenced.

If the value of Image Box Layout Type is STACK, more than one SOP Instance or frame may be referenced, and the frames constitute a stack to be displayed in the Image Box. For frames identified by the Referenced Image Sequence, the order of stepping through the stack shall be the order of Image SOP Instance references in that Sequence. If multiple frames are selected in Referenced Frame Number (0008,1160), those frames shall be stepped through in the order of their listing in that Attribute, within the order of display of their Image SOP Instance.

For a stack whose frames are selected indirectly through an Item of the Referenced Presentation State Sequence, the order of stepping through the stack shall be the order of SOP Instance references in the Referenced Series Sequence (0008,1115) of the referenced Presentation State. For a referenced Blending Softcopy Presentation State, this shall be the Referenced Series Sequence within the Blending Sequence (0070,0402) Item for which the Blending Position (0070,0405) value is UNDERLYING.


  1. Display of images using Blending Softcopy Presentation State must use indirect SOP Instance reference through the Referenced Presentation State Sequence (0008,9237) at the top level of Structured Display Image Box Sequence (0072,0422) Item, and cannot use the Referenced Presentation State Sequence within an Item of the Referenced Image Sequence (0008,1140).

  2. A Blending Presentation State that references a blending of a single underlying frame and a single superimposed frame may be associated with a SINGLE Image Box Layout.

  3. A reference to a single display frame, either directly through Referenced Image Sequence or indirectly through Referenced Presentation State Sequence, may be associated with either a STACK or a CINE Image Box Layout as a degenerate case.

  4. There is no requirement for the pixel matrix sizes of the images in the stack, or the image display area as selected by referenced Presentation State SOP Instances, to be identical, nor for the referenced images to be of the same SOP Class.

  5. Referenced Presentation States are an initial presentation control. The rendering Application Entity might allow a user to interactively enable/disable graphic layers, or change the zoom, rotation, window width / window level, or other presentation controls. Any such Application Entity functionality is beyond the scope of the Standard.