CR ImageCIOD
CT ImageCIOD
MR ImageCIOD
NM ImageCIOD
US ImageCIOD
US Multi-frame ImageCIOD
Secondary Capture ImageCIOD
Multi-frame Single Bit SC ImageCIOD
Multi-frame Grayscale Byte SC ImageCIOD
Multi-frame Grayscale Word SC ImageCIOD
Multi-frame True Color SC ImageCIOD
X-Ray Angiographic ImageCIOD
X-Ray Radiofluoroscopic ImageCIOD
RT ImageCIOD
RT DoseCIOD
RT Structure SetCIOD
RT PlanCIOD
PET 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
Grayscale Softcopy Presentation StateCIOD
Color Softcopy Presentation StateCIOD
Pseudo-Color Softcopy Presentation StateCIOD
Blending Softcopy Presentation StateCIOD
Basic Structured DisplayCIOD
XA/XRF Grayscale Softcopy Presentation StateCIOD
Advanced Blending Presentation StateCIOD
Basic Voice Audio WaveformCIOD
12-Lead ECGCIOD
General ECGCIOD
Ambulatory ECGCIOD
Hemodynamic WaveformCIOD
Basic Cardiac Electrophysiology WaveformCIOD
Arterial Pulse WaveformCIOD
Respiratory WaveformCIOD
General Audio WaveformCIOD
Real-Time Audio WaveformCIOD
Basic Text SRCIOD
Enhanced SRCIOD
Comprehensive SRCIOD
Key Object Selection DocumentCIOD
Mammography CAD SRCIOD
Chest CAD SRCIOD
Procedure LogCIOD
X-Ray Radiation Dose SRCIOD
Spectacle Prescription ReportCIOD
Colon CAD SRCIOD
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 Structured ReportCIOD
Planned Imaging Agent Administration SRCIOD
Performed Imaging Agent Administration SRCIOD
Rendition Selection DocumentCIOD
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 PlanCIOD
RT Ion Beams Treatment RecordCIOD
SegmentationCIOD
Ophthalmic Tomography ImageCIOD
X-Ray 3D Angiographic ImageCIOD
X-Ray 3D Craniofacial ImageCIOD
Breast Tomosynthesis ImageCIOD
PatientMModule - Patient
Clinical Trial SubjectUModule - Patient
General StudyMModule - Study
Patient StudyUModule - Study
Clinical Trial StudyUModule - Study
General SeriesMModule - Series
Clinical Trial SeriesUModule - Series
Enhanced Mammography SeriesMModule - Series
Frame of ReferenceMModule - Frame of Reference
SynchronizationCModule - Frame of Reference
General EquipmentMModule - Equipment
Enhanced General EquipmentMModule - Equipment
Image PixelMModule - Image
Enhanced Contrast/BolusCModule - Image
DeviceUModule - Image
InterventionUModule - Image
Acquisition ContextMModule - Image
Multi-frame Functional GroupsMModule - Image
Multi-frame DimensionUModule - Image
Image - Equipment Coordinate RelationshipUModule - Image
SpecimenUModule - Image
X-Ray 3D ImageMModule - Image
Breast Tomosynthesis Contributing SourcesUModule - Image
Breast Tomosynthesis AcquisitionUModule - Image
(0018,9507) X-Ray 3D Acquisition Sequence1Sequence
(0008,2112) Source Image Sequence1CSequence
(0018,0010) Contrast/Bolus Agent1CLong String
(0018,0012) Contrast/Bolus Agent Sequence1CSequence
(0018,0060) KVP1CDecimal String
(0018,1006) Grid ID3Long String
(0018,1110) Distance Source to Detector1Decimal String
(0018,1111) Distance Source to Patient1Decimal String
(0018,1114) Estimated Radiographic Magnification Factor1Decimal String
(0018,1147) Field of View Shape1Code String
(0018,1160) Filter Type1Short String
(0018,1166) Grid1CCode String
(0018,1190) Focal Spot(s)1Decimal String
(0018,1191) Anode Target Material1Code String
(0018,11A0) Body Part Thickness1Decimal String
(0018,11A2) Compression Force1Decimal String
(0018,11A3) Compression Pressure3Decimal String
(0018,11A4) Paddle Description1Long String
(0018,11A5) Compression Contact Area3Decimal String
(0018,7001) Detector Temperature1Decimal String
(0018,701A) Detector Binning1CDecimal String
(0018,7030) Field of View Origin1CDecimal String
(0018,7032) Field of View Rotation1CDecimal String
(0018,7034) Field of View Horizontal Flip1CCode String
(0018,7040) Grid Absorbing Material3Long Text
(0018,7041) Grid Spacing Material3Long Text
(0018,7042) Grid Thickness3Decimal String
(0018,7044) Grid Pitch3Decimal String
(0018,7046) Grid Aspect Ratio3Integer String
(0018,7048) Grid Period3Decimal String
(0018,704C) Grid Focal Distance3Decimal String
(0018,7050) Filter Material1Code String
(0018,7052) Filter Thickness Minimum3Decimal String
(0018,7054) Filter Thickness Maximum3Decimal String
(0018,7056) Filter Beam Path Length Minimum3Single
(0018,7058) Filter Beam Path Length Maximum3Single
(0018,7060) Exposure Control Mode1Code String
(0018,7062) Exposure Control Mode Description1Long Text
(0018,9328) Exposure Time in ms1CDouble
(0018,9330) X-Ray Tube Current in mA1CDouble
(0018,9332) Exposure in mAs1CDouble
(0018,9420) X-Ray Receptor Type1Code String
(0018,9461) Field of View Dimension(s) in Float1CSingle
(0018,9508) Primary Positioner Scan Arc1CSingle
(0018,9509) Secondary Positioner Scan Arc1CSingle
(0018,9510) Primary Positioner Scan Start Angle1CSingle
(0018,9511) Secondary Positioner Scan Start Angle1CSingle
(0018,9514) Primary Positioner Increment1CSingle
(0018,9515) Secondary Positioner Increment1CSingle
(0018,9516) Start Acquisition DateTime1CDate Time
(0018,9517) End Acquisition DateTime1CDate Time
(0018,9518) Primary Positioner Increment Sign3Signed Short
(0018,9519) Secondary Positioner Increment Sign3Signed Short
(0018,9538) Per Projection Acquisition Sequence1Sequence
(0040,0314) Half Value Layer1Decimal String
(0040,0316) Organ Dose3Decimal String
(0040,8302) Entrance Dose in mGy3Decimal String
(0040,8303) Entrance Dose Derivation3Code String
X-Ray 3D ReconstructionUModule - Image
Breast ViewMModule - Image
SOP CommonMModule - Image
Common Instance ReferenceUModule - Image
Frame ExtractionCModule - Image
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
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
Basic DirectoryCIOD

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

Data synced with official DICOM standard on 12 May 2020. The DICOM Standard is under continuous maintenance, and the current official version is available at //dicom.nema.org/. 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.

Secondary Positioner Increment Attribute

Tag(0018,9515)
TypeConditionally Required (1C)
KeywordSecondaryPositionerIncrement
Value Multiplicity1
Value RepresentationSingle (FL)

Constant increment of the secondary positioner angle in degrees. Positive increment indicates an increasing value of the secondary positioner angle. See Section C.8.7.5.1.2 or Section C.8.11.7 for the sign conventions depending on modality and positioner type.

See Section C.8.21.3.1.3.1 for further explanation.

Required if present and consistent in the contributing SOP Instances.

Section C.8.7.5.1.2

C.8.7.5.1.2 Positioner Primary and Secondary Angles

The definitions of Positioner Angles shall be with respect to the patient as illustrated in Figure C.8-11 and Figure C.8-12. Zero degree is referenced to the origin perpendicular to the patient's chest. The Positioner Primary Angle definition is like longitude (in the equatorial plan); the Positioner Secondary Angle definition is like latitude (in the sagittal plane). The Positioner Angle Attributes apply to the first frame of a multi-frame image. The valid range of Primary Positioner Angle is -180 to +180 degrees and the Secondary Positioner Angle range is -90 to + 90 degrees.

The Patient Plane is defined by the isocenter of the imaging device and slices through the patient such that it is perpendicular to the sagittal plane of the body. The Primary Axis of rotation is defined at the intersection of the Patient Plane and of the Sagittal Plane. The Positioner Primary Angle is defined in the transaxial plane at the isocenter with zero degrees in the direction perpendicular to the patient's chest and + 90 degrees at the patient left hand side (LAO) and -90 at the patient right hand side (RAO). The valid range of Primary Positioner Angle is -180 to +180 degrees.

The Secondary Axis is in the Patient Plane and is perpendicular to the Primary Axis at the isocenter. The Positioner Secondary Angle is defined in the Sagittal Plane at the isocenter with zero degrees in the direction perpendicular to the patient's chest. +90 degrees corresponds to the cranial direction. The Secondary Positioner Angle range is -90 to + 90 degrees.

At a 0 angle for both Primary Angle (0018,1510) and Secondary Angle (0018,1511), the patient faces the Image Intensifier or digital detector.

The Positioner Primary Angle (0018,1510) and Secondary Angle (0018,1511) apply to the first frame of a multi-frame image.

Figure C.8-11. Positioner Primary Angle


Figure C.8-12. Positioner Secondary Angle


Section C.8.11.7

C.8.11.7 Mammography Image Module

Table C.8-74 contains IOD Attributes that describe a Digital Mammography X-Ray Image including its acquisition and positioning.

Table C.8-74. Mammography Image Module Attributes

Attribute Name

Tag

Type

Attribute Description

Image Type

(0008,0008)

1

Image identification characteristics.

See Section C.8.11.7.1.4 for specialization.

Positioner Type

(0018,1508)

1

Enumerated Values:

MAMMOGRAPHIC

NONE

Distance Source to Detector

(0018,1110)

3

Distance in mm from source to detector center on the chest wall line

Note

  1. This value is traditionally referred to as Source Image Distance (SID).

  2. See Section C.8.11.7.1.1.

Distance Source to Patient

(0018,1111)

3

Distance in mm from source to the breast support side that is closest to the Imaging Subject, as measured along the X-Ray beam vector.

Note

  1. This value is traditionally referred to as Source Object Distance (SOD).

  2. See notes for this Attribute in Section C.8.11.5 DX Positioning Module.

  3. See Section C.8.11.7.1.1 for description of X-Ray beam vector.

Positioner Primary Angle

(0018,1510)

3

Signed position in degrees of the X-Ray beam vector in the coronal anatomical plane as if the patient were standing facing the equipment where vertical is zero.

Positioner Primary Angle Direction

(0018,9559)

3

The interpretation of the sign of the Positioner Primary Angle (0018,1510).

Enumerated Values:

CW

Clockwise. Positioner Primary Angle movement is positive when movement is from vertical to the patient's right (with patient standing, facing equipment).

CC

Counter clockwise. Positioner Primary Angle is positive when movement is from vertical to the patient's left (with patient standing, facing the equipment).

See Section C.8.31.2.1.

Positioner Secondary Angle

(0018,1511)

3

Position in degrees of the X-Ray beam vector in the sagittal anatomical plane as if the patient were standing where movement of the X-Ray source from anterior to posterior is positive, and vertical is zero.

Image Laterality

(0020,0062)

1

Laterality of the region examined.

Enumerated Values:

R

right

L

left

B

both (e.g., cleavage)

Shall be consistent with any laterality information contained in Primary Anatomic Structure Modifier Sequence (0008,2230) and/or Laterality (0020,0060), if present.

Note

Laterality (0020,0060) is a Series level Attribute and must be the same for all Images in the Series, hence it must be absent if Image Laterality (0020,0062) has different values for Images in the same Series.

Organ Exposed

(0040,0318)

1

Organ to which Organ Dose (0040,0316) applies.

Enumerated Values:

BREAST

Note

In the Mammography IOD, Organ Dose (0040,0316) refers to the mean glandular dose.

Breast Implant Present

(0028,1300)

3

Whether or not the imaged breast contains a breast implant regardless of the visibility of a breast implant in the Pixel Data.

Enumerated Values:

YES

NO

Note

The value is expected to be YES for all images acquired on a breast that contains a breast implant, even when a breast implant is displaced during image acquisition.

Partial View

(0028,1350)

3

Indicates whether this image is a partial view, that is a subset of a single view of the breast.

Enumerated Values:

YES

NO

If this Attribute is absent, then the image may or may not be a partial view.

Note

This may occur when a breast is larger than the active area of the detector.

If this Attribute is present, its value shall be NO if there is a View Modifier Code Sequence (0054,0222) Item of value (399163009, SCT, "Magnification") or (399055006, SCT, "Spot Compression").

Partial View Description

(0028,1351)

3

Free text description of the portion of the breast captured in a partial view image.

This Attribute shall not be present if there is a View Modifier Code Sequence (0054,0222) Item of value (399163009, SCT, "Magnification") or (399055006, SCT, "Spot Compression").

Partial View Code Sequence

(0028,1352)

3

Sequence that describes the portion or section of the breast captured in a partial view image.

Only one or two Items are permitted in this Sequence.

See Section C.8.11.7.1.3.

If this Attribute is absent, then the image may or may not be a partial view.

This Attribute shall not be present if there is a View Modifier Code Sequence (0054,0222) Item of value (399163009, SCT, "Magnification") or (399055006, SCT, "Spot Compression").

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

DCID 4005 “Partial View Section for Mammography”.

Include Table 10-5 “General Anatomy Mandatory Macro Attributes”

Defined CID for the Anatomic Region Sequence is CID 4013 “Anatomic Region for Mammography”.

View Code Sequence

(0054,0220)

1

Sequence that describes the projection of the anatomic region of interest on the image receptor.

Only a single Item shall be included in this Sequence.

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

DCID 4014 “View for Mammography”.

>View Modifier Code Sequence

(0054,0222)

2

View modifier.

Zero or more Items shall be included in this Sequence.

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

DCID 4015 “View Modifier for Mammography”.

Biopsy Target Sequence

(0018,2041)

3

Sequence that identifies the targets of a biopsy procedure. One or more Items are permitted in this Sequence, where the coordinate system is the same for all Items within a pair of stereo images.

>Target UID

(0018,2042)

1

Unique identifier for the target.

Note

To identify the same target in corresponding minus and plus stereo images.

>Localizing Cursor Position

(0018,2043)

1

Coordinates of localizing cursor position with respect to pixels in the image specified by a column (delimiter) row pair. The values shall be in the range 0\0 (TLHC) to Columns\Rows (BRHC).

>Calculated Target Position

(0018,2044)

1

The calculated target position (x, y, z) in mm in an equipment relative right-handed coordinate system where the origin is under the central X-Ray beam at the chest wall, and a z value of zero is located at the surface that the breast is in contact with that is closest to the detector.

X is parallel to the chest wall, y is positive toward the patient's nipple, and z is positive toward the X-Ray source.

>Displayed Z Value

(0018,2046)

1

The z value in mm displayed to the user at the time of biopsy.

Note

  1. This may be the same as the z value of Calculated Target Position or different in direction or reference point, such as relative to the compression paddle.

  2. This is not the distance that the needle was inserted, particularly for a lateral (parallel) approach.

>Target Label

(0018,2045)

3

Target description.


C.8.11.7.1 Mammography Image Attribute Descriptions
C.8.11.7.1.1 Mammography X-Ray Beam and X-Ray Beam Vector Definition

Figure C.8.11.7-1 shows the X-Ray beam for a digital mammography system. The X-Ray beam vector is defined from the Focal Spot to the center of the chest wall line of the Image Detection device.

Figure C.8.11.7-1. X-Ray Beam for a Digital Mammography System


C.8.11.7.1.2 Detector Primary and Secondary Angles

Detector Angles are defined in a fashion similar to the positioner angles, except that the angle of the X-Ray beam vector is relative to the detector plane rather than the patient plane. Zero degrees is referenced to the normal of the detector plane pointing toward the X-Ray source. The valid range of the Detector Angles is -90 to + 90 degrees.

The Primary Axis of rotation is defined along the line in the column direction of the detector plane that intersects the X-Ray beam vector. The Detector Primary Angle is defined in the plane perpendicular to the Primary Axis of rotation at the point where the X-Ray beam vector intersects the detector plane, with zero degrees in the direction normal to the detector plane and +90 in the direction of the higher numbered columns of the detector in that plane. The valid range of Detector Primary Angle is -90 to +90 degrees.

The Secondary Axis is in the detector plane and is perpendicular to the Primary Axis at the intersection of the beam vector with the detector plane (i.e., it is along the row direction). The Detector Secondary Angle is defined in the plane perpendicular to the Secondary Axis at the point where the X-Ray beam vector intersects the detector plane, with zero degrees in the direction normal to the detector plane. +90 degrees corresponds to the direction of the lower numbered rows of the detector in that plane. The Detector Secondary Angle range is -90 to + 90 degrees.

C.8.11.7.1.3 Partial View Code Sequence

Combinations of coded terms may be used in the Partial View Code Sequence (0028,1352) to express the breast section imaged. Figure C.8.11.7-2 shows examples for the right and left FB, XCC, XCCL and XCCM views, and Figure C.8.11.7-3 shows examples for the right and left ML, MLO, LM, LMO, SIO and ISO views.

Partial View Code Sequence Items (Code Meaning)

Partial View Images (A, B, C, D, E)

A) Item 1 = Lateral

B) Item 1 = Medial

A) Item 1 = Posterior

B) Item 1 = Anterior

A) Item 1 = Lateral, Item 2 = Posterior

B) Item 1 = Medial, Item 2 = Posterior

C) Item1 = Anterior

A) Item 1 = Lateral, Item 2 = Posterior

B) Item 1 = Medial, Item 2 = Posterior

C) Item 1 = Lateral, Item 2 = Anterior

D) Item 1 = Medial, Item 2 = Anterior

A) Item 1 = Lateral, Item 2 = Posterior

B) Item 1 = Central, Item 2 = Posterior

C) Item 1 = Medial, Item 2 = Posterior

D) Item 1 = Lateral, Item 2 = Anterior

E) Item 1 = Medial, Item 2 = Anterior

Figure C.8.11.7-2. CC, FB, XCCL and XCCM partial views


Note

If six images are required, then the "Central, Anterior" combination would be added.

Partial View Code Sequence Items (Code Meaning)

Partial View Images (A, B, C, D, E)

A) Item 1 = Superior

B) Item 1 = Inferior

A) Item 1 = Posterior

B) Item 1 = Anterior

A) Item 1 = Superior, Item 2 = Posterior

B) Item1 = Inferior, Item 2 = Posterior

C) Item 1 = Anterior

A) Item 1 = Superior, Item 2 = Posterior

B) Item 1 = Inferior, Item 2 = Posterior

C) Item 1 = Superior, Item 2 = Anterior

D) Item 1 = Inferior, Item 2 = Anterior

A) Item 1 = Superior, Item 2 = Posterior

B) Item 1 = Central, Item 2 = Posterior

C) Item 1 = Inferior, Item 2 = Posterior

D) Item 1 = Superior, Item 2 = Anterior

E) Item 1 = Inferior, Item 2 = Anterior

Figure C.8.11.7-3. ML, MLO, LM, LMO, SIO and ISO partial views


Note

If six images are required, then the "Central, Anterior" combination would be added.

C.8.11.7.1.4 Image Type

Image Type (0008,0008) Value 1 and Value 2 shall identify the Pixel Data Characteristics in accordance with Section C.8.11.3.1.1.

Value 3 shall be present and have zero length (null value), except when used to identify a stereotactic mammography image, digital breast tomosynthesis projection or generated 2D image, or contrast enhanced image.

Note

In a previous version of PS3.3, Value 3 was required to be zero length (null value). If Value 3 is zero length, the image may or may not be a stereotactic mammography image, digital breast tomosynthesis projection or generated 2D image, or contrast enhanced image, if the Instance was created before these terms were defined.

The Enumerated Values for Value 3 of stereotactic mammography images are listed in Table C.8-74a.

Table C.8-74a. Enumerated Values of Image Type (0008,0008) Value 3 for Stereotactic Mammography

Enumerated Value

Definition

ACR MQCM Equivalent

STEREO_SCOUT

A localizer image for a stereotactic acquisition.

…SC

STEREO_MINUS

The paired image obtained with the X-Ray source angle decreased from the scout position, to determine positioning coordinates prior to needle positioning.

…ST-

STEREO_PLUS

The paired image obtained with the X-Ray source angle increased from the scout position, to determine positioning coordinates prior to needle positioning.

…ST+

PREFIRE_MINUS

The paired image obtained with the X-Ray source angle decreased from the scout position, with the biopsy needle in position prior to needle deployment.

…PRF-

PREFIRE_PLUS

The paired image obtained with the X-Ray source angle increased from the scout position, with the biopsy needle in position prior to needle deployment.

…PRF+

POSTFIRE_MINUS

The paired image obtained with the X-Ray source angle decreased from the scout position, with the biopsy needle in position following needle deployment through the targeted lesion.

…POF-

POSTFIRE_PLUS

The paired image obtained with the X-Ray source angle increased from the scout position, with the biopsy needle in position following needle deployment through the targeted lesion.

…POF+

POSTBIOPSY_MINUS

The image obtained following tissue acquisition with the X-Ray source angle decreased from the scout position.

…POB-

POSTBIOPSY_PLUS

The image obtained following tissue acquisition with the X-Ray source angle increased from the scout position.

…POB+

POSTBIOPSY

The image obtained following tissue acquisition with the X-Ray source in the scout position.

…POB

POSTMARKER_MINUS

The image obtained following micromarker placement with the X-Ray source angle decreased from the scout position.

…POM-

POSTMARKER_PLUS

The image obtained following micromarker placement with the X-Ray source angle increased from the scout position.

…POM+

POSTMARKER

The image obtained following micromarker placement with the X-Ray source in the scout position.

…POM


The Enumerated Values for Value 3 of digital breast tomosynthesis projection images and mathematically generated 2D images are:

Table C.8-74b. Enumerated Values of Image Type (0008,0008) Value 3 for Digital Breast Tomosynthesis Projection and Generated 2D Images

Enumerated Value

Definition

ACR MQCM Equivalent

TOMO_PROJ

Identifies the image as a digital breast tomosynthesis projection image.

n/a

TOMOSYNTHESIS

Identifies the image as digital breast tomosynthesis; shall be used only for generated 2D images when no other Value 3 takes precedence.

n/a

TOMO_SCOUT

A localizer image that may be used to determine positioning coordinates prior to needle positioning.

…SC

PREFIRE

The image obtained with the biopsy needle in position prior to needle deployment.

…PRF

POSTFIRE

The image obtained with the biopsy needle in position following needle deployment through the targeted lesion.

…POF

POSTBIOPSY

The image obtained following tissue acquisition with the X-Ray source in the scout position.

…POB

POSTMARKER

The image obtained following micromarker placement with the X-Ray source in the scout position.

…POM


Note

Digital breast tomosynthesis projection images acquired as part of a biopsy procedure (and resulting derived images such as mathematically generated 2D) omit the _MINUS and _PLUS endings because a single digital breast tomosynthesis acquisition produces a set of projection images that replaces the _MINUS and _PLUS image pair used in conventional 2D breast biopsy imaging.

The Enumerated Values for Value 3 of contrast enhanced images are:

Table C.8-74c. Enumerated Values of Image Type (0008,0008) Value 3 for Contrast Enhanced Images

Enumerated Value

Definition

PRE_CONTRAST

Collected before contrast was administered.

POST_CONTRAST

Collected during or after contrast was administered.


If more than one characteristic (biopsy, tomosynthesis, contrast enhanced) applies to an image, Value 3 shall contain the biopsy image type. If biopsy is not involved, Value 3 shall contain the tomosynthesis image type.

Note

For example, Attributes of the Contrast/Bolus Module may be used to identify contrast enhanced characteristics of a biopsy and/or tomosynthesis projection or generated 2D image that is also contrast enhanced.

Value 4 shall be present for images acquired using contrast enhanced digital X-Ray imaging of the breast (but may be empty if none of the Defined Terms applies), and for mathematically generated 2D images. For other images Value 4 remains optional and implementation specific.

Table C.8-74d. Defined Terms of Image Type (0008,0008) Value 4 for Contrast Enhanced and Generated 2D Images

Enumerated Value

Definition

GENERATED_2D

Mathematically generated 2D view.

ADDITION

Created through Pixel by pixel addition operation.

SUBTRACTION

Created through Pixel by pixel subtraction operation.


If more than one characteristic (contrast enhanced, tomosynthesis) applies to an image, Value 4 shall contain the contrast enhanced image type. If contrast enhanced is not involved, Value 4 shall contain the generated 2D image type.

Value 5 shall be present for images acquired using contrast enhanced digital X-Ray imaging of the breast, but may be empty if none of the Defined Terms applies. For non-contrast images Value 5 remains optional and implementation specific.

Table C.8-74e. Defined Terms of Image Type (0008,0008) Value 5 for Contrast Enhanced 2D Images

Enumerated Value

Definition

LOW_ENERGY

Low energy image.

HIGH_ENERGY

High energy image.


Note

A recipient may use the different values for biopsy, tomosynthesis and contrast views to determine how to display them, for example in hanging protocols:

Image Type Value 3

Image Type Value 4

Image Type Value 5

Conventional 2D mammography

empty

-

-

Stereotactic post-biopsy

POSTBIOPSY

-

-

Pre-contrast 2D

PRE_CONTRAST

empty

empty

Post-contrast 2D low energy

POST_CONTRAST

-

LOW_ENERGY

Post-contrast 2D addition

POST_CONTRAST

ADDITION

empty

Stereotactic scout pre-contrast

STEREO_SCOUT

empty

empty

Stereotactic stereo post-contrast high energy

STEREO_PLUS

empty

HIGH_ENERGY

Stereotactic post-fire post-contrast subtraction

POSTFIRE_MINUS

SUBTRACTION

empty

Tomosynthesis generated 2D

TOMOSYNTHESIS

GENERATED_2D

-

Tomosynthesis biopsy scout generated 2D

TOMO_SCOUT

GENERATED_2D

-

Tomosynthesis generated 2D post-contrast low energy

TOMOSYNTHESIS

GENERATED_2D

LOW_ENERGY

Tomosynthesis generated 2D post-contrast subtraction

TOMOSYNTHESIS

SUBTRACTION

empty

Tomosynthesis projection

TOMO_PROJ

-

-

Tomosynthesis projection post-biopsy

POSTBIOPSY

-

-

Tomosynthesis projection post-biopsy post-contrast subtraction

POSTBIOPSY

SUBTRACTION

empty

Section C.8.21.3.1.3.1

C.8.21.3.1.3.1 Positioner Angle Increments

If the increments of the positioner angles are constant during the acquisition of the X-Ray projections, the Attributes Primary Positioner Increment (0018,9514) and the Secondary Positioner Increment (0018,9515) describe this angular change between projections.

If the change in positioner angle is not constant between the projections, omit the Positioner Angle Increment Attributes and record the individual positioner angle values in the Positioner Angle Attributes within each Item of the Per Projection Acquisition Sequence (0018,9538). In such case, the Attributes Primary Positioner Increment Sign (0018,9518) and Secondary Positioner Increment Sign (0018,9519) are used to describe the direction of the positioner rotation.