|Patient||M||Module - Patient|
|Patient's Name||2||Person Name|
|Patient ID||2||Long String|
|Issuer of Patient ID||3||Long String|
|Issuer of Patient ID Qualifiers Sequence||3||Sequence|
|Patient's Birth Date||2||Date|
|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|
|Referenced Patient Photo Sequence||3||Sequence|
|Quality Control Subject||3||Code String|
|Referenced Patient Sequence||3||Sequence|
|Patient's Birth Time||3||Time|
|Other Patient IDs Sequence||3||Sequence|
|Other Patient Names||3||Person Name|
|Ethnic Group||3||Short String|
|Patient Comments||3||Long Text|
|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|
|Strain Description||3||Unlimited Characters|
|Strain Nomenclature||3||Long String|
|Strain Code Sequence||3||Sequence|
|Strain Additional Information||3||Unlimited Text|
|Strain Stock Sequence||3||Sequence|
|Genetic Modifications Sequence||3||Sequence|
|Responsible Person||2C||Person Name|
|Responsible Person Role||1C||Code String|
|Responsible Organization||2C||Long String|
|Patient Identity Removed||3||Code String|
|De-identification Method||1C||Long String|
|De-identification Method Code Sequence||1C||Sequence|
|Source Patient Group Identification Sequence||3||Sequence|
|Group of Patients Identification Sequence||3||Sequence|
|Patient ID||1||Long String|
|Issuer of Patient ID||3||Long String|
|Issuer of Patient ID Qualifiers Sequence||3||Sequence|
|Subject Relative Position in Image||3||Unsigned Short|
|Patient Position||3||Code String|
|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|
|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|
|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|
|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||CIOD|
|Basic Cardiac EP||CIOD|
|Arterial Pulse Waveform||CIOD|
|General 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|
|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 X-Ray Angiographic Image||CIOD|
|Enhanced X-Ray RF 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 OCT 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|
|Table 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|
|Value Representation||Code String (CS)|
Patient position descriptor relative to the equipment. See Section C.220.127.116.11.1.1.
See Section C.18.104.22.168.2 for Defined Terms and further explanation.
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
Patient Position (0018,5100) specifies the position of the patient relative to the imaging equipment space. This Attribute is intended for annotation purposes only. It does not provide an exact mathematical relationship of the patient to the imaging equipment.
When multiple subjects are present in the same image, and arranged with different positions, then the Patient Position (0018,5100) in the General Series Module is nominal, does not apply to each subject, but does define the relationship of the nominal Patient-Based Coordinate System to the machine.
In conjunction with the Patient Position (0018,5100) in each Item of the Group of Patients Identification Sequence (0010,0027), Patient Position (0018,5100) in the General Series Module may be helpful to compute patient-relative spatial information for each subject from the Attributes of the Image Plane Module.
When facing the front of the imaging equipment, Head First is defined as the patient's head being positioned toward the front of the imaging equipment (i.e., head entering the front of the equipment). Feet First is defined as the patient's feet being positioned toward the front of the imaging equipment (i.e., feet entering the front of the equipment). Left First is defined as the patient's left side being positioned towards the front of the imaging equipment (i.e., patient's left side entering the front of the equipment). Right First is defined as the patient's right being positioned towards the front of the imaging equipment (i.e., patient's right side entering the front of the equipment). Prone is defined as the patient's face being positioned in a downward (gravity) direction. Supine is defined as the patient's face being in an upward direction. Decubitus Right is defined as the patient's right side being in a downward direction. Decubitus Left is defined as the patient's left side being in a downward direction.
Head First-Decubitus Right
Head First-Decubitus Left
Feet First-Decubitus Right
Feet First-Decubitus Left
Anterior First-Decubitus Right
Anterior First-Decubitus Left
Posterior First-Decubitus Right
Posterior First-Decubitus Left
For quadrupeds, separate concepts for ventral and dorsal are not introduced, rather it is expected that anterior and posterior will be considered synonymous as they are when applied to the trunk.
There are no decubitus variants of left or right first, since for imaging equipment that is aligned horizontally with respect to gravity the patient cannot be both decubitus and have the left or right side towards the front of the imaging equipment.
There are no prone or supine variants of anterior or posterior first, since for imaging equipment that is aligned horizontally with respect to gravity the patient cannot be prone or supine and have the anterior or posterior side towards the front of the imaging equipment.
The Figure C.22.214.171.124.2-1 illustrates some of these Defined Terms for imaging equipment with a table, such as in X-Ray Angiography. The orientation of the patient related to gravity is always recumbent.
Figure C.126.96.36.199.2-1. Representation of the Eight Different Patient Positions on the X-Ray Table
Figure C.188.8.131.52.2-2. Example of Right First-Prone (RFP) Patient Position Relative to the Gantry and Table for a Small Animal