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RT ImageCIOD
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PatientMModule - Patient
Clinical Trial SubjectUModule - Patient
General StudyMModule - Study
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General SeriesMModule - Series
Clinical Trial SeriesUModule - Series
DX SeriesMModule - Series
Frame of ReferenceUModule - Frame of Reference
General EquipmentMModule - Equipment
General AcquisitionMModule - Acquisition
General ImageMModule - Image
General ReferenceUModule - Image
Image PixelMModule - Image
Contrast/BolusUModule - Image
Display ShutterUModule - Image
DeviceUModule - Image
InterventionUModule - Image
SpecimenUModule - Image
DX Anatomy ImagedMModule - Image
DX ImageMModule - Image
(0008,0008) Image Type1Code String
(0008,2111) Derivation Description3Short Text
(0018,1400) Acquisition Device Processing Description3Long String
(0018,1401) Acquisition Device Processing Code3Long String
(0020,0020) Patient Orientation1CCode String
(0028,0002) Samples per Pixel1Unsigned Short
(0028,0004) Photometric Interpretation1Code String
(0028,0100) Bits Allocated1Unsigned Short
(0028,0101) Bits Stored1Unsigned Short
(0028,0102) High Bit1Unsigned Short
(0028,0103) Pixel Representation1Unsigned Short
(0028,0301) Burned In Annotation1Code String
(0028,1040) Pixel Intensity Relationship1Code String
(0028,1041) Pixel Intensity Relationship Sign1Signed Short
(0028,1050) Window Center1CDecimal String
(0028,1051) Window Width1CDecimal String
(0028,1052) Rescale Intercept1Decimal String
(0028,1053) Rescale Slope1Decimal String
(0028,1054) Rescale Type1Long String
(0028,1055) Window Center & Width Explanation3Long String
(0028,2110) Lossy Image Compression1Code String
(0028,2112) Lossy Image Compression Ratio1CDecimal String
(0028,3010) VOI LUT Sequence1CSequence
(0050,0004) Calibration Image3Code String
(2050,0020) Presentation LUT Shape1Code String
DX DetectorMModule - Image
X-Ray CollimatorUModule - Image
DX PositioningUModule - Image
X-Ray Tomography AcquisitionUModule - Image
X-Ray Acquisition DoseUModule - Image
X-Ray GenerationUModule - Image
X-Ray FiltrationUModule - Image
X-Ray GridUModule - Image
Overlay PlaneCModule - Image
VOI LUTCModule - Image
Image HistogramUModule - Image
Acquisition ContextMModule - Image
SOP CommonMModule - Image
Common Instance ReferenceUModule - Image
Digital Mammography X-Ray ImageCIOD
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RT Beams Treatment RecordCIOD
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Grayscale Softcopy Presentation StateCIOD
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Basic Structured DisplayCIOD
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Basic Voice Audio WaveformCIOD
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Key Object Selection DocumentCIOD
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Procedure LogCIOD
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Implantation Plan SR DocumentCIOD
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Stereometric RelationshipCIOD
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SegmentationCIOD
Ophthalmic Tomography ImageCIOD
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Color PaletteCIOD
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Lensometry MeasurementsCIOD
Autorefraction MeasurementsCIOD
Keratometry MeasurementsCIOD
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Ophthalmic Axial MeasurementsCIOD
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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
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Corneal Topography MapCIOD
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Parametric MapCIOD
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Tractography ResultsCIOD
RT Brachy Application Setup Delivery InstructionCIOD
Planar MPR Volumetric Presentation StateCIOD
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Content Assessment ResultsCIOD
CT Performed Procedure ProtocolCIOD
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Built with by Innolitics, a team of medical imaging software developers.

Data synced with official DICOM standard on 19 March 2024. The DICOM Standard is under continuous maintenance, and the current official version is available at http://www.dicomstandard.org/current/. 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.

Patient Orientation Attribute

Tag(0020,0020)
TypeConditionally Required (1C)
KeywordPatientOrientation
Value Multiplicity2
Value RepresentationCode String (CS)
Example Values
  • ['P', 'F']
  • ['L', 'P']
  • ['L', 'F']

Patient direction of the rows and columns of the image.

See Section C.7.6.1.1.1 for further explanation.

Required if View Code Sequence (0054,0220) is not present or is present with an Item value other than (119376003, SCT, "tissue specimen") or (127457009, SCT, "tissue specimen from breast"). May be present otherwise.

Section C.7.6.1.1.1

C.7.6.1.1.1 Patient Orientation

Patient Orientation (0020,0020) relative to the image plane shall be specified by two values that designate the anatomical direction of the positive row axis (left to right) and the positive column axis (top to bottom). The first entry is the direction of the rows, given by the direction of the last pixel in the first row from the first pixel in that row. The second entry is the direction of the columns, given by the direction of the last pixel in the first column from the first pixel in that column. Shall be consistent with Image Orientation (Patient) (0020,0037), if both Attributes are present and Patient Orientation (0020,0020) is not zero length.

If Anatomical Orientation Type (0010,2210) is absent or has a value of BIPED, anatomical direction shall be designated by abbreviations using the capital letters:

  • A (anterior)

  • P (posterior)

  • R (right)

  • L (left)

  • H (head)

  • F (foot)

If Anatomical Orientation Type (0010,2210) has a value of QUADRUPED, anatomical direction shall be designated by the abbreviations using capital letters:

  • LE (Le or Left)

  • RT (Rt or Right)

  • D (Dorsal)

  • V (Ventral)

  • CR (Cr or Cranial)

  • CD (Cd or Caudal)

  • R (Rostral)

  • M (Medial)

  • L (Lateral)

  • PR (Pr or Proximal)

  • DI (Di or Distal)

  • PA (Pa or Palmar)

  • PL (Pl or Plantar)

Note

  1. These abbreviations are capitalized versions of those defined in Smallwood et al for describing radiographic projections. Because of the Code String (CS) Value Representation of Patient Orientation (0020,0020), lowercase letters cannot be used.

  2. It is unfortunate that the conventional veterinary abbreviations (e.g., R for rostral and Rt for right) differ from those chosen for humans for DICOM usage (e.g., R for right), but confusion with in the respective human and non-human organism domains will be reduced. Hanging protocols may need to account for the difference by checking for the correct species.

  3. Smallwood et al define an O (Oblique) abbreviation, which is useful for describing radiographic projections, but do not specify its use for directional terms, and hence it is not included here for describing the row and column directions.

  4. The terms "anterior" and "posterior" are commonly used in vertebrate zoology to describe the cranial and caudal directions respectively, the veterinary terms are used in preference here, also in order to avoid confusion with the contradictory human use of anterior and posterior to mean ventral and dorsal.

  5. For non-human organisms other than quadrupeds, for example, birds and fish, it is anticipated that the same nomenclature can be logically extended to describe, for example, wings and fins.

Each value of the orientation Attribute shall contain at least one of these abbreviations. If refinements in the orientation descriptions are to be specified, then they shall be designated by one or two additional abbreviations in each value. Within each value, the abbreviations shall be ordered with the principal orientation designated in the first abbreviations.

Note

  1. For bipeds, since each abbreviation is a single character, no delimiter is required within a single value and none is used. For quadrupeds, though lowercase letters cannot be used, delimiters are not necessary within a single value to eliminate ambiguity, since the abbreviations used are sufficiently distinct, and can be parsed from left to right with a single character of lookahead.

  2. E.g., a medio-lateral oblique projection of the left breast of a human might be encoded with Patient Orientation values of "A\FR" rather than "A\F", since the plane is obliquely inclined such that the columns are directed both downwards and medially, which for a left breast is towards the right, though the downwards direction is the principal column orientation.

  3. E.g., a right dorsal-left ventral oblique view of a quadruped's abdomen might be encoded with Patient Orientation values of "LEV\CD", rather than "LE\CD", since the plane is obliquely inclined such that the rows are directed both to the left and ventrally, though the left direction is the principal row orientation. The abbreviations "LEV", "LE" and "CD", correspond to the designations in Smallwood et al of "LeV", "Le" and "Cd", respectively