|Patient||M||Module - Patient|
|Referenced Patient Sequence||3||Sequence|
|Patient's Name||2||Person Name|
|Patient ID||2||Long String|
|Issuer of Patient ID||3||Long String|
|Type of Patient ID||3||Code String|
|Issuer of Patient ID Qualifiers Sequence||3||Sequence|
|Source Patient Group Identification Sequence||3||Sequence|
|Group of Patients Identification Sequence||3||Sequence|
|Patient's Birth Date||2||Date|
|Patient's Birth Time||3||Time|
|Patient's Birth Date in Alternative Calendar||3||Long String|
|Patient's Death Date in Alternative Calendar||3||Long String|
|Patient's Alternative Calendar||1C||Code String|
|Patient's Sex||2||Code String|
|Quality Control Subject||3||Code String|
|Strain Description||3||Unlimited Characters|
|Strain Nomenclature||3||Long String|
|Strain Stock Sequence||3||Sequence|
|Strain Additional Information||3||Unlimited Text|
|Strain Code Sequence||3||Sequence|
|Genetic Modifications Sequence||3||Sequence|
|Other Patient Names||3||Person Name|
|Other Patient IDs Sequence||3||Sequence|
|Referenced Patient Photo Sequence||3||Sequence|
|Ethnic Group||3||Short String|
|Patient Species Description||1C||Long String|
|Patient Species Code Sequence||1C||Sequence|
|Patient Breed Description||2C||Long String|
|Patient Breed Code Sequence||2C||Sequence|
|Breed Registration Sequence||2C||Sequence|
|Responsible Person||2C||Person Name|
|Responsible Person Role||1C||Code String|
|Responsible Organization||2C||Long String|
|Patient Comments||3||Long Text|
|Patient Identity Removed||3||Code String|
|De-identification Method||1C||Long String|
|De-identification Method Code Sequence||1C||Sequence|
|Clinical Trial Subject||U||Module - Patient|
|General Study||M||Module - Study|
|Patient Study||U||Module - Study|
|Clinical Trial Study||U||Module - Study|
|General Series||M||Module - Series|
|CR Series||M||Module - Series|
|Clinical Trial Series||U||Module - Series|
|General Equipment||M||Module - Equipment|
|General Image||M||Module - Image|
|General Reference||U||Module - Image|
|Image Pixel||M||Module - Image|
|Contrast/Bolus||C||Module - Image|
|Display Shutter||U||Module - Image|
|Device||U||Module - Image|
|Specimen||U||Module - Image|
|CR Image||M||Module - Image|
|Overlay Plane||U||Module - Image|
|Modality LUT||U||Module - Image|
|VOI LUT||U||Module - Image|
|SOP Common||M||Module - Image|
|Common Instance Reference||U||Module - Image|
|US Multi-frame Image||CIOD|
|Secondary Capture Image||CIOD|
|Multi-frame Single Bit SC Image||CIOD|
|Multi-frame Grayscale Byte SC Image||CIOD|
|Multi-frame Grayscale Word SC Image||CIOD|
|Multi-frame True Color SC Image||CIOD|
|X-Ray Angiographic Image||CIOD|
|X-Ray Radiofluoroscopic Image||CIOD|
|RT Structure Set||CIOD|
|Digital X-Ray Image||CIOD|
|Digital Mammography X-Ray Image||CIOD|
|Digital Intra-Oral X-Ray Image||CIOD|
|RT Beams Treatment Record||CIOD|
|RT Brachy Treatment Record||CIOD|
|RT Treatment Summary Record||CIOD|
|VL Endoscopic Image||CIOD|
|VL Microscopic Image||CIOD|
|VL Slide-Coordinates Microscopic Image||CIOD|
|VL Photographic Image||CIOD|
|Video Endoscopic Image||CIOD|
|Video Microscopic Image||CIOD|
|Video Photographic Image||CIOD|
|VL Whole Slide Microscopy Image||CIOD|
|Real-Time Video Endoscopic Image||CIOD|
|Real-Time Video Photographic Image||CIOD|
|Grayscale Softcopy Presentation State||CIOD|
|Color Softcopy Presentation State||CIOD|
|Pseudo-Color Softcopy Presentation State||CIOD|
|Blending Softcopy Presentation State||CIOD|
|Basic Structured Display||CIOD|
|XA/XRF Grayscale Softcopy Presentation State||CIOD|
|Advanced Blending Presentation State||CIOD|
|Basic Voice Audio Waveform||CIOD|
|Basic Cardiac Electrophysiology Waveform||CIOD|
|Arterial Pulse Waveform||CIOD|
|General Audio Waveform||CIOD|
|Real-Time Audio Waveform||CIOD|
|Basic Text SR||CIOD|
|Key Object Selection Document||CIOD|
|Mammography CAD SR||CIOD|
|Chest CAD SR||CIOD|
|X-Ray Radiation Dose SR||CIOD|
|Spectacle Prescription Report||CIOD|
|Colon CAD SR||CIOD|
|Macular Grid Thickness and Volume Report||CIOD|
|Implantation Plan SR Document||CIOD|
|Comprehensive 3D SR||CIOD|
|Radiopharmaceutical Radiation Dose SR||CIOD|
|Acquisition Context SR||CIOD|
|Simplified Adult Echo SR||CIOD|
|Patient Radiation Dose Structured Report||CIOD|
|Planned Imaging Agent Administration SR||CIOD|
|Performed Imaging Agent Administration SR||CIOD|
|Rendition Selection Document||CIOD|
|Enhanced MR Image||CIOD|
|Enhanced MR Color Image||CIOD|
|Enhanced CT Image||CIOD|
|Deformable Spatial Registration||CIOD|
|Ophthalmic Photography 8 Bit Image||CIOD|
|Ophthalmic Photography 16 Bit Image||CIOD|
|Real World Value Mapping||CIOD|
|Enhanced XA Image||CIOD|
|Enhanced XRF Image||CIOD|
|RT Ion Plan||CIOD|
|RT Ion Beams Treatment Record||CIOD|
|Ophthalmic Tomography Image||CIOD|
|X-Ray 3D Angiographic Image||CIOD|
|X-Ray 3D Craniofacial Image||CIOD|
|Breast Tomosynthesis Image||CIOD|
|Enhanced PET Image||CIOD|
|Enhanced US Volume||CIOD|
|Subjective Refraction Measurements||CIOD|
|Visual Acuity Measurements||CIOD|
|Ophthalmic Axial Measurements||CIOD|
|Intraocular Lens Calculations||CIOD|
|Generic Implant Template||CIOD|
|Implant Assembly Template||CIOD|
|Implant Template Group||CIOD|
|RT Beams Delivery Instruction||CIOD|
|Ophthalmic Visual Field Static Perimetry Measurements||CIOD|
|Intravascular Optical Coherence Tomography Image||CIOD|
|Ophthalmic Thickness Map||CIOD|
|Surface Scan Mesh||CIOD|
|Surface Scan Point Cloud||CIOD|
|Legacy Converted Enhanced CT Image||CIOD|
|Legacy Converted Enhanced MR Image||CIOD|
|Legacy Converted Enhanced PET Image||CIOD|
|Corneal Topography Map||CIOD|
|Breast Projection X-Ray Image||CIOD|
|Wide Field Ophthalmic Photography Stereographic Projection Image||CIOD|
|Wide Field Ophthalmic Photography 3D Coordinates Image||CIOD|
|RT Brachy Application Setup Delivery Instruction||CIOD|
|Planar MPR Volumetric Presentation State||CIOD|
|Volume Rendering Volumetric Presentation State||CIOD|
|Content Assessment Results||CIOD|
|CT Performed Procedure Protocol||CIOD|
|CT Defined Procedure Protocol||CIOD|
|Ophthalmic Optical Coherence Tomography En Face Image||CIOD|
|Ophthalmic Optical Coherence Tomography B-scan Volume Analysis||CIOD|
|RT Physician Intent||CIOD|
|RT Segment Annotation||CIOD|
|RT Radiation Set||CIOD|
|C-Arm Photon-Electron Radiation||CIOD|
|Type||Required, Empty if Unknown (2)|
|Value Representation||Long String (LO)|
Primary identifier for the Patient.
In the case of imaging a group of small animals simultaneously, the single value of this identifier corresponds to the identification of the entire group. See also Section C.22.214.171.124.1.
It is common to image multiple small animals for pre-clinical research as a group at the same time.
In such cases, the single value of Patient ID (0010,0020) corresponds to the identification of the entire group. The same applies to related Attributes, if present, such as Issuer of Patient ID (0010,0021). Other Attributes of the Patient Module that are present shall be those shared by the entire group of animals, otherwise they shall be absent or empty (e.g., Patient's Sex (0010,0040)). Any acquisition-related Attributes that are Patient-specific (e.g., injected contrast or radiopharmaceutical dose) shall also be absent or empty (and the information may be communicated in separate acquisition context Instances).
The Group of Patients Identification Sequence (0010,0027) provides a means of describing the identifiers and locations of the individual subjects, if known at the time of acquisition, regardless of whether or not the group images are later segmented into individual images.
It is also common to segment the acquired images of the group of animals and extract the image pixel data for each animal into separate images.
The Source Patient Group Identification Sequence (0010,0026) provides a "backward reference" within the segmented (individual subject) images to the Patient ID (0010,0020) used to identify the whole group.
Individual derived SOP Instances may reference the source image explicitly by its SOP Instance UID. Additional objects, such as Segmentations, may be created to encode the regions segmented for individual animals, and referenced from the derived images. See also Annex VVV “Segmentation of Images of Groups of Animals (Informative)” in PS3.17.
For example, an image of a group of 6 mice in a 3 column, 2 row single longitudinal plane array might be described as:
Patient ID (0010,0020) = "Inv234_Exp_56_Group78"
Issuer of Patient ID (0010,0021) = "MyMouseLab"
Group of Patients Identification Sequence (0010,0027)
>Patient ID (0010,0020) = "Inv234_Exp_56_Group78_Mouse01"
>Issuer of Patient ID (0010,0021) = "MyMouseLab"
>Subject Relative Position in Image (0010,0028) = 1\1\1
>Patient ID (0010,0020) = "Inv234_Exp_56_Group78_Mouse06"
>Issuer of Patient ID (0010,0021) = "MyMouseLab"
>Subject Relative Position in Image (0010,0028) = 3\2\1
In this example, the optional Issuer of Patient ID (0010,0021) is shown to emphasize that if it is needed, it should be repeated; i.e., there is no "inheritance" of the issuer from the Data Set enclosing the Sequence.
The naming of the group and the individual animals in the identifier is purely illustrative; it is not meant to imply preference for one local convention or another, or for using a discrete identifier for the group as opposed to, say, a concatenated list of individual animal identifiers used as the group identifier.
See Figure C.7.1.4-1.
For example, segmented images of an individual animal derived from the group image might be described as:
Patient ID (0010,0020) = "Inv234_Exp_56_Group78_Mouse04"
Issuer of Patient ID (0010,0021) = "MyMouseLab"
Source Patient Group Identification Sequence (0010,0026)
>Patient ID (0010,0020) = "Inv234_Exp_56_Group78"
>Issuer of Patient ID (0010,0021) = "MyMouseLab"
Subject Relative Position in Image (0010,0028) shall be encoded as a 3D ordinal position in machine-relative orthogonal dimensions, such that when facing the front of the machine (gantry):
the first value starts at one for the left most subject holder and monotonically increases by one for each successive subject holder towards the right,
the second value starts at one for the top most subject holder and monotonically increases by one for each successively lower subject holder,
the third value starts at one for the outer most subject holder and monotonically increases by one for each successive subject holder inwards (i.e., increasing values from the front to the back of the gantry along the direction orthogonal to the first two dimensions, usually the long axis of the table).
The order and sign of the machine-relative directions is consistent with the Axis Definition in ACR-NEMA 300 1985.
Image-relative positions are not used, since there may be multiple acquisitions in different orientations. The machine-relative positions are applicable regardless of whether acquired images are cross-sections or projections.
Patient-relative positions are not used, since the animals may not be arranged in the same direction (e.g., a pair of animals may be arranged head-to-head).
There is no requirement that there be the same number of animals in each dimension. E.g., one in the top "row"and two below, in one longitudinal plane, would be represented as 1\1\1, 1\2\1, 2\1\1.
The goal is to describe only the relative locations of animals in any form of multiple animal holder ("mouse hotel"), without attempting to specify the exact physical dimensions or absolute locations, regardless of whether the holder is regular or symmetric in any particular dimension or not (e.g., to include "revolver-like" and hexagonal arrangements). Nor is the "distance" between each animal described.
The position is defined in terms of subject holders rather than subjects, since some holders may be empty or unused but still partially or completely visible in some of the images. In such cases the relative positions need to be consistently encoded by the acquisition device and recognized by automated segmentation algorithms. E.g., if the top row of in a two row holder is unoccupied, then the animals in the bottom row will be identified with a row position of 2, not 1.
Due to field of view and anatomical region of interest considerations, adjacent animals may sometimes be partially overlapped (e.g., Cheng TE et al. A rat head holder for simultaneous scanning of two rats in small animal PET scanners: Design, construction, feasibility testing and kinetic validation. Journal of Neuroscience Methods. 2009 Jan 15;176(1):24–33. http://dx.doi.org/10.1016/j.jneumeth.2008.08.031 and Xu S et al. In vivo multiple-mouse imaging at 1.5 T. Magnetic Resonance in Medicine. 2003;49(3):551–7. http://dx.doi.org/10.1002/mrm.10397); such cases may be described as a either a single plane or two planes of animals, as long as there is sufficient information to identify which animal is which.
See Figure C.7.1.4-3.
The description of the physical relative locations of the animals does not account for any spatial distortion that may occur in the images due to the acquisition technique used (e.g., aliasing in MRI).
Patient Position (0018,5100) may be used to describe the machine-relative position of each animal when the animals are not all arranged in the same direction.
Patient Position (0018,5100) is used rather than Patient Orientation Code Sequence (0054,0410) because Patient Position (0018,5100) is present in the IODs for those modalities most commonly used for small animal imaging in preclinical research.
For example, a pair of prone animals arranged head-to-head longitudinally along the bore of the machine would be described as:
Subject Relative Position in Image = 1\1\1 and Patient Position = HFP
Subject Relative Position in Image = 1\1\2 and Patient Position = FFP
See Figure C.7.1.4-2.
The presence of Subject Relative Position in Image (0010,0028) and Patient Position (0018,5100) within Group of Patients Identification Sequence (0010,0027) within the Patient Module implies that the relative locations and orientations of multiple animals within a group cannot change over time. I.e., a "group", identified by a particular Patient ID (0010,0020) (the unique key of the Patient entity in the Information Model), is defined not only by the animals that comprise it but also their relative locations and positioning. If the same animals are imaged together but in a different arrangement, a different Patient ID (0010,0020) for the group shall be used.
Figure C.7.1.4-1. Example of Subject Relative Position in Image for group of 6 mice in a 3 column, 2 row single longitudinal plane array, all feet first prone
Figure C.7.1.4-2. Example of Subject Relative Position in Image and differing Patient Position for group of 2 mice head-to-head
Figure C.7.1.4-3. Example of Subject Relative Position in Image and overlapping narrow field of view group of 2 mice head-to-head