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
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
SOP CommonMModule - Hanging Protocol
Hanging Protocol DefinitionMModule - Hanging Protocol
Hanging Protocol EnvironmentMModule - Hanging Protocol
Hanging Protocol DisplayMModule - Hanging Protocol
(0072,0200) Display Sets Sequence1Sequence
(0072,0032) Image Set Number1Unsigned Short
(0072,0202) Display Set Number1Unsigned Short
(0072,0203) Display Set Label3Long String
(0072,0204) Display Set Presentation Group1Unsigned Short
(0072,0206) Display Set Presentation Group Description3Long String
(0072,0300) Image Boxes Sequence1Sequence
(0072,0400) Filter Operations Sequence2Sequence
(0072,0500) Blending Operation Type3Code String
(0072,0510) Reformatting Operation Type3Code String
(0072,0512) Reformatting Thickness1CDouble
(0072,0514) Reformatting Interval1CDouble
(0072,0516) Reformatting Operation Initial View Direction1CCode String
(0072,0520) 3D Rendering Type1CCode String
(0072,0600) Sorting Operations Sequence2Sequence
(0072,0700) Display Set Patient Orientation3Code String
(0072,0702) VOI Type3Code String
(0072,0704) Pseudo-Color Type3Code String
(0072,0705) Pseudo-Color Palette Instance Reference Sequence1CSequence
(0072,0706) Show Grayscale Inverted3Code String
(0072,0710) Show Image True Size Flag3Code String
(0072,0712) Show Graphic Annotation Flag3Code String
(0072,0714) Show Patient Demographics Flag3Code String
(0072,0716) Show Acquisition Techniques Flag3Code String
(0072,0717) Display Set Horizontal Justification3Code String
(0072,0718) Display Set Vertical Justification3Code String
(0072,0208) Partial Data Display Handling2Code String
(0072,0210) Synchronized Scrolling Sequence3Sequence
(0072,0214) Navigation Indicator Sequence3Sequence
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.

Show Graphic Annotation Flag Attribute

TypeOptional (3)
Value Multiplicity1
Value RepresentationCode String (CS)

Indicates whether or not to display Items from the Graphic Annotation Sequence (0070,0001) in an applied Presentation State, and the Attributes of the Overlay Plane Module in the image objects or applied Presentation State.

Enumerated Values:



Overlay Plane Module

C.9.2 Overlay Plane Module

Table C.9-2 specifies the Attributes of the Overlay Plane Module, which describe characteristics of an Overlay Plane.

An Overlay Plane describes graphics or bit-mapped text that is associated with an Image. It may also describe a Region of Interest in an Image.

Each Overlay Plane is one bit deep. Sixteen separate Overlay Planes may be associated with an Image.

Overlay data is stored in Overlay Data (60xx,3000). See the Section Repeating Groups in PS3.5 for a description of permitted values of 60xx.


Overlay data stored in unused bit planes of Pixel Data (7FE0,0010) with Samples Per Pixel (0028,0002) of 1 was previously described in DICOM. This usage has now been retired. See PS3.3-2004 and PS3.5-2004.

Attributes describing display of grayscale and color overlays were defined in a previous release of the DICOM Standard. These have now been retired. How an Overlay Plane is rendered is undefined; specifically there is no mechanism to specify with what color or intensity an Overlay Plane is to be displayed, except when rendered under the control of a Softcopy Presentation State SOP Instance.

Table C.9-2. Overlay Plane Module Attributes

Attribute Name



Attribute Description

Overlay Rows



Number of Rows in Overlay.

Overlay Columns



Number of Columns in Overlay.

Overlay Type



Indicates whether this overlay represents a region of interest or other graphics.

Enumerated Values:





Overlay Origin



Location of first overlay point with respect to pixels in the image, given as row\column.

The upper left pixel of the image has the coordinate 1\1.

Column values greater than 1 indicate the overlay plane origin is to the right of the image origin. Row values greater than 1 indicate the overlay plane origin is below the image origin. Values less than 1 indicate the overlay plane origin is above or to the left of the image origin.


Values of 0\0 indicate that the overlay pixels start 1 row above and one column to the left of the image pixels.

Overlay Bits Allocated



Number of Bits Allocated in the Overlay.

The value of this Attribute shall be 1.


Formerly the Standard described embedding the overlay data in the Image Pixel Data (7FE0,0010), in which case the value of this Attribute was required to be the same as Bits Allocated (0028,0100). This usage has been retired. See PS3.3-2004.

Overlay Bit Position



The value of this Attribute shall be 0.


Formerly the Standard described embedding the overlay data in the Image Pixel Data (7FE0,0010), in which case the value of this Attribute specified the bit in which the overlay was stored. This usage has been retired. See PS3.3-2004.

Overlay Data



Overlay pixel data.

The order of pixels encoded for each overlay is left to right, top to bottom, i.e., the upper left pixel is encoded first followed by the remainder of the first row, followed by the first pixel of the 2nd row, then the remainder of the 2nd row and so on.

Overlay data shall be contained in this Attribute.

See Section C. for further explanation.

Overlay Description



User-defined comments about the overlay.

Overlay Subtype



Defined Term that identifies the intended purpose of the Overlay Type. See Section C. for further explanation.

Overlay Label



A user defined text string that may be used to label or name this overlay.

ROI Area



Number of pixels in ROI area.

See Section C. for further explanation.

ROI Mean



ROI Mean.

See Section C. for further explanation.

ROI Standard Deviation



ROI standard deviation.

See Section C. for further explanation.

C.9.2.1 Overlay Plane Module Attribute Descriptions

C. Overlay Type

There are two specific types of overlays. The type is specified in this Attribute.

A Region of Interest (ROI) is a specific use of an Overlay. The overlay bits corresponding to all the pixels included in the ROI shall be set to 1. All other bits are set to 0. This is used to specify an area of the image of particular interest.

A Graphics overlay may express reference marks, graphic annotation, or bit mapped text, etc. A Graphics overlay may be used to mark the boundary of a ROI. If this is the case and the ROI statistical parameters are used, they will only refer to the pixels under the boundaries, not those in the included regions.

The overlay bits corresponding to all the pixels included in the Graphics shall be set to 1. All other bits are set to 0.

C. ROI Area, ROI Mean and ROI Standard Deviation

These Attributes contain the statistical parameters of the ROI. The values of these parameters are for the overlay pixel values set to 1.

C. Overlay Subtype

Defined Terms:


User created graphic annotation (e.g., operator)


Machine or algorithm generated graphic annotation, such as output of a Computer Assisted Diagnosis algorithm


Identification of the active area of an image


Additional or alternative Defined Terms may be specified in modality specific Modules, such as the specific use of "ACTIVE 2D/BMODE IMAGE AREA" as described in the Section C. Overlay Subtype.

An active image area overlay identifies all pixels in the Pixel Data that are generated from image data acquisition. Each pixel in the active area shall have an overlay bit value of 1; all other bits are set to 0. Any area of burned in annotation (not generated from image data acquisition) shall be excluded from the active image area.


  1. For example, the active image area overlay may delineate a non-rectangular (e.g., fan) shaped acquisition by an ultrasound transducer, or a circular reconstructed field of view from a tomographic acquisition.

  2. Whether or not the excluded area of burned in annotation extends beyond the specifically modified pixels, e.g. to exclude an entire bounding box area around the text or graphic annotation, is not specified by the Standard.

  3. The active image area for projection X-ray is specified by the Section C.8.7.3 X-Ray Collimator Module.

C. Multi-frame Image

When an overlay is part of a Multi-frame Image and is not a Multi-frame Overlay (Number of Frames in Overlay (60xx,0015) and Image Frame Origin (60xx,0051) are absent), the overlay shall be applied to all frames in the image.