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
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
PatientMModule - Patient
Clinical Trial SubjectUModule - Patient
General StudyMModule - Study
Patient StudyUModule - Study
Clinical Trial StudyUModule - Study
General SeriesMModule - Series
Ophthalmic Tomography En Face SeriesMModule - Series
Clinical Trial SeriesUModule - Series
Frame of ReferenceMModule - Frame of Reference
General EquipmentMModule - Equipment
Enhanced General EquipmentMModule - Equipment
General AcquisitionMModule - Acquisition
General ImageMModule - Image
Image PixelMModule - Image
Palette Color Lookup TableCModule - Image
Ophthalmic Optical Coherence Tomography En Face ImageMModule - Image
(0008,0008) Image Type1Code String
(0008,0023) Content Date1Date
(0008,0033) Content Time1Time
(0008,2112) Source Image Sequence1Sequence
(0008,1150) Referenced SOP Class UID1Unique Identifier
(0008,1155) Referenced SOP Instance UID1Unique Identifier
(0008,1160) Referenced Frame Number1CInteger String
(0040,A170) Purpose of Reference Code Sequence1Sequence
(0062,000B) Referenced Segment Number1CUnsigned Short
(0020,0013) Instance Number1Integer String
(0022,1019) Ophthalmic Axial Length3Single
(0022,1515) Ophthalmic Axial Length Method3Code String
(0022,1517) Ophthalmic FOV3Single
(0022,1612) Derivation Algorithm Sequence1Sequence
(0022,1615) Ophthalmic Image Type Code Sequence1Sequence
(0022,1616) Ophthalmic Image Type Description3Long String
(0022,1620) Referenced Surface Mesh Identification Sequence1Sequence
(0028,0002) Samples per Pixel1Unsigned Short
(0028,0004) Photometric Interpretation1Code String
(0028,0030) Pixel Spacing1Decimal 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
(0028,0302) Recognizable Visual Features1Code String
(0028,1050) Window Center1Decimal String
(0028,1051) Window Width1Decimal String
(0028,2110) Lossy Image Compression1Code String
(0028,2112) Lossy Image Compression Ratio1CDecimal String
(0028,2114) Lossy Image Compression Method1CCode String
(0050,0004) Calibration Image3Code String
(2050,0020) Presentation LUT Shape1CCode String
Ocular Region ImagedMModule - Image
Ophthalmic Optical Coherence Tomography En Face Image Quality RatingCModule - Image
ICC ProfileUModule - Image
SOP CommonMModule - Image
Common Instance ReferenceUModule - Image
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.

Source Image Sequence Attribute

TypeRequired (1)
Value Multiplicity1
Value RepresentationSequence (SQ)

A Sequence that identifies the Images that were used to derive this Image.

One or more Items shall be included in this Sequence.

See Section C. and Section C. for further explanation.

Section C.

C. Source Image Sequence

If an Image is identified to be a Derived Image (see Section C. “Image Type”), Source Image Sequence (0008,2112) is an optional list of source images used to create the Derived image. Source Instance Sequence (0042,0013) is an optional list of non-image source Instances that were used to create this Instance. Source Image Sequence (0008,2112) and/or Source Instance Sequence (0042,0013) may be used whether or not there is a description of the way the Instance was derived in Derivation Description (0008,2111) or Derivation Code Sequence (0008,9215).

Images shall not be referenced by Source Instance Sequence (0042,0013).


Multiple Items may be present within Source Image Sequence (0008,2112) and/or Source Instance Sequence (0042,0013), in which case either:

  1. those Instance were combined to make the derived Instance (e.g., multiple source images to make an MPR or MIP), or

  2. each of the Items represents a step in the successive derivation of an Instance (e.g., when an image has had successive lossy compression steps applied to it),

  3. some combination of the above.

The Purpose of Reference Code Sequence (0040,A170) and the Attributes within the referenced Instances themselves may be used to determine the history of the derivation, which is not otherwise explicitly specified.

Section C.

C. Source Image Sequence

An OCT en face image is derived from images obtained using OCT technology. The Source Image Sequence (0008,2112) shall convey the SOP Instances used to derive this en face SOP Instance.

If Attribute Purpose of Reference Code Sequence (0040,A170) is set to (128250, DCM, "Structural image for image processing"), the Source Image Sequence will reference an Ophthalmic Tomography SOP Instance.

If Attribute Purpose of Reference Code Sequence (0040,A170) is set to (128251, DCM, "Flow image for image processing"), the Source Image Sequence will reference an Ophthalmic Optical Coherence Tomography B-scan Volume Analysis SOP Instance.

A typical example of the image processing stages performed to generate en face images is shown in Figure C.8.17.14-1.

Figure C.8.17.14-1. Example of the Image Process Performed to Generate En Face Images

Figure Legend:

  1. OCT proprietary B-scan data (possibly a DICOM Raw Data Instance)

  2. Volumetric structural ophthalmic tomography image (Ophthalmic Tomography Image Instance)

  3. OCT angiographic flow volume information (Ophthalmic Optical Coherence Tomography B-scan Volume Analysis Instance)

  4. OCT surface mesh (Surface Segmentation Instance)

  5. Structural en face image (Ophthalmic Optical Coherence Tomography En Face Image Instance)

  6. En face angiographic flow image (Ophthalmic Optical Coherence Tomography En Face Image Instance)

Stage 1: OCT technology is used to acquire a volumetric data set from a retinal region of interest. This volumetric data set (A) consists of multiple B-scans in a raster pattern, and multiple frames are acquired at each B-scan location. The B-scans are acquired in the manufacturer's proprietary format for analysis and storage. If this information is stored in DICOM, it can use the Raw Data Storage SOP Class.

Stage 2: The OCT proprietary B-scan data (A) (or DICOM Raw Data SOP Instance) is then analyzed to derive the volumetric structural ophthalmic tomography image (B). From (B) one or more OCT surface meshes (D) are generated to delineate the anatomical boundaries. The difference in signal between the frames of each individual B-scan is analyzed to produce the OCT angiographic flow volume information (C).

Stage 3: Clinicians typically make their assessment based upon two types of OCT en face images. The structural OCT en face image (E) is derived by using pixel information in (B) and two surface meshes (D). The OCT angiographic flow en face image (F) may be derived using the OCT angiographic flow volume information (C) and the OCT surface mesh (D).

En face images are typically derived by the acquisition modality that generated the Ophthalmic Tomography Image, Surface Segmentation and Ophthalmic Optical Coherence Tomography B-scan Volume Analysis SOP Instances or by image workstations that received the respective Ophthalmic Image, Surface Segmentation and Ophthalmic Optical Tomography B-scan Volume Analysis SOP Instances via DICOM Storage.


Image workstations receiving ophthalmic tomography images may choose to evaluate the structural ophthalmic tomography image and generate a different set of segmented surfaces than defined by an acquisition device. The surface segmentation information can be stored in a separate Surface Segmentation SOP Instance.

The Ophthalmic Tomography Image, Surface Segmentation, Ophthalmic Optical Coherence Tomography B-scan Volume Analysis and the Ophthalmic Optical Coherence Tomography En Face Image SOP Instances all reside in different DICOM Series. They share the same spatial Frame of Reference which is identified in Attribute Frame of Reference UID (0020,0052) (i.e., the value of Frame of Reference UID (0020,0052) is the same in each SOP Instance). Figure C.8.17.14-2 illustrates the relationships between the OCT angiography based SOP Instances.

Figure C.8.17.14-2. Relationships Between OCT-A Based SOP Instances