Computed Radiography ImageCIOD
CT ImageCIOD
MR 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 ImageCIOD
RT DoseCIOD
PatientMModule - Patient
Clinical Trial SubjectUModule - Patient
General StudyMModule - Study
Patient StudyUModule - Study
Clinical Trial StudyUModule - Study
RT SeriesMModule - Series
Clinical Trial SeriesUModule - Series
Frame of ReferenceMModule - Frame of Reference
General EquipmentMModule - Equipment
General ImageCModule - Dose
Image PlaneCModule - Dose
Image PixelCModule - Dose
Multi-frameCModule - Dose
RT DoseMModule - Dose
RT DVHUModule - Dose
(3004,0040) DVH Normalization Point3Decimal String
(3004,0042) DVH Normalization Dose Value3Decimal String
(3004,0050) DVH Sequence1Sequence
(3004,0001) DVH Type1Code String
(3004,0002) Dose Units1Code String
(3004,0004) Dose Type1Code String
(3004,0052) DVH Dose Scaling1Decimal String
(3004,0054) DVH Volume Units1Code String
(3004,0056) DVH Number of Bins1Integer String
(3004,0058) DVH Data1Decimal String
(3004,0060) DVH Referenced ROI Sequence1Sequence
(3004,0062) DVH ROI Contribution Type1Code String
(3006,0084) Referenced ROI Number1Integer String
(3004,0070) DVH Minimum Dose3Decimal String
(3004,0072) DVH Maximum Dose3Decimal String
(3004,0074) DVH Mean Dose3Decimal String
(300C,0060) Referenced Structure Set Sequence1Sequence
SOP CommonMModule - Dose
Common Instance ReferenceUModule - Dose
Frame ExtractionCModule - Dose
RT Structure SetCIOD
RT PlanCIOD
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
12-Lead ECGCIOD
General ECGCIOD
Ambulatory ECGCIOD
Hemodynamic WaveformCIOD
Basic Cardiac Electrophysiology WaveformCIOD
Arterial Pulse WaveformCIOD
Respiratory WaveformCIOD
General Audio WaveformCIOD
Real-Time Audio WaveformCIOD
Routine Scalp ElectroencephalogramCIOD
ElectromyogramCIOD
ElectrooculogramCIOD
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
Chest CAD SRCIOD
Procedure LogCIOD
X-Ray Radiation Dose SRCIOD
Spectacle Prescription ReportCIOD
Colon CAD SRCIOD
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 PlanCIOD
RT Ion Beams Treatment RecordCIOD
SegmentationCIOD
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
InventoryCIOD
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 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.

Referenced ROI Number Attribute

Tag(3006,0084)
TypeRequired (1)
KeywordReferencedROINumber
Value Multiplicity1
Value RepresentationInteger String (IS)

Uniquely identifies ROI used to calculate DVH specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set referenced by referenced RT Plan in Referenced RT Plan Sequence (300C,0002) in RT Dose Module.

Structure Set Module

C.8.8.5 Structure Set Module

A structure set defines a set of areas of significance. Each area can be associated with a Frame of Reference and zero or more images. Information that can be transferred with each region of interest (ROI) includes geometrical and display parameters, and generation technique.

Table C.8-41. Structure Set Module Attributes

Attribute Name

Tag

Type

Attribute Description

Structure Set Label

(3006,0002)

1

User-defined label for Structure Set.

Structure Set Name

(3006,0004)

3

User-defined name for Structure Set.

Structure Set Description

(3006,0006)

3

User-defined description for Structure Set.

Instance Number

(0020,0013)

3

A number that identifies this object Instance.

Structure Set Date

(3006,0008)

2

Date at which the content of the Structure Set was last modified.

Structure Set Time

(3006,0009)

2

Time at which the content of the Structure Set was last modified.

Referenced Frame of Reference Sequence

(3006,0010)

3

Sequence describing Frames of Reference in which the ROIs are defined. One or more Items are permitted in this Sequence. See Section C.8.8.5.1.

>Frame of Reference UID

(0020,0052)

1

Uniquely identifies Frame of Reference within Structure Set.

>RT Referenced Study Sequence

(3006,0012)

3

Sequence of Studies containing Series to be referenced.

One or more Items are permitted in this Sequence.

See Section C.8.8.5.4.

>>Include Table 10-11 “SOP Instance Reference Macro Attributes”

>>RT Referenced Series Sequence

(3006,0014)

1

Sequence describing Series of images within the referenced Study that are used in defining the Structure Set.

One or more Items shall be included in this Sequence.

>>>Series Instance UID

(0020,000E)

1

Unique identifier for the Series containing the images.

>>>Contour Image Sequence

(3006,0016)

1

Sequence of Items describing images in a given Series used in defining the Structure Set (typically CT or MR images).

One or more Items shall be included in this Sequence.

>>>>Include Table 10-3 “Image SOP Instance Reference Macro Attributes”

Source Series Information Sequence

(3006,004C)

3

Information about Image Series that are sources of ROIs in this Instance.

This also includes Series present in the RT Referenced Series Sequence (3006,0014).

The Image Series may have been the source of the definition, but the ROI has been resampled to the Image Series referenced in the Referenced Frame of Reference Sequence (3006,0010).

One or more Items are permitted in this Sequence.

>Modality

(0008,0060)

1

Type of device, process or method that originally acquired or produced the data used to create the Instances in this Series.

>Series Date

(0008,0021)

1

Date the Series started.

>Series Time

(0008,0031)

1

Time the Series started.

>Series Description

(0008,103E)

1

Description of the Series.

>Series Instance UID

(0020,000E)

1

Unique identifier of the Series.

>Series Number

(0020,0011)

1

A number that identifies this Series.

Structure Set ROI Sequence

(3006,0020)

1

ROIs for current Structure Set.

One or more Items shall be included in this Sequence.

>ROI Number

(3006,0022)

1

Identification number of the ROI. The value of ROI Number (3006,0022) shall be unique within the Structure Set in which it is created.

>Conceptual Volume Identification Sequence

(3010,00A0)

3

Identifies the Conceptual Volume which is represented by this ROI.

Only a single Item is permitted in this Sequence.

>>Include Table 10.33-1 “Conceptual Volume Macro Attributes”.

>Referenced Frame of Reference UID

(3006,0024)

1

Uniquely identifies Frame of Reference in which ROI is defined, specified by Frame of Reference UID (0020,0052) in Referenced Frame of Reference Sequence (3006,0010).

>ROI Name

(3006,0026)

2

User-defined name for ROI.

>ROI Description

(3006,0028)

3

User-defined description for ROI.

>ROI Volume

(3006,002C)

3

Volume of ROI (cubic centimeters).

>ROI DateTime

(3006,002D)

3

DateTime when this ROI was created.

>ROI Generation Algorithm

(3006,0036)

2

Type of algorithm used to generate ROI.

Defined Terms:

AUTOMATIC

calculated ROI

SEMIAUTOMATIC

ROI calculated with user assistance

MANUAL

user-entered ROI

>ROI Generation Description

(3006,0038)

3

User-defined description of technique used to generate ROI.

>RT Protocol Code Sequence

(3010,005B)

3

The protocol(s) selected by the RT Physician.

One or more Items are permitted in this Sequence.

See Section C.36.5.1.2.

>>Include Table 8.8-1 “Code Sequence Macro Attributes”

No Baseline CID is defined.

>ROI Creator Sequence

(3006,004D)

3

The person or device that last modified this ROI.

Only a single Item is permitted in this Sequence.

>>Include Table C.17-3b “Identified Person or Device Macro Attributes”

Organizational Role Code Sequence (0044,010A) DCID 9555 “Radiotherapy Treatment Planning Person Role”.

>ROI Derivation Algorithm Identification Sequence

(3006,0037)

3

Software algorithm that derived the ROI.

Only a single Item is permitted in this Sequence.

>>Include Table 10-19 “Algorithm Identification Macro Attributes”.

>Derivation Code Sequence

(0008,9215)

3

A coded description of how this ROI was derived.

One or more Items are permitted in this Sequence.

See Section C.8.8.5.3 for further explanation.

>>Include Table 8.8-1 “Code Sequence Macro Attributes”.

Enumerated Value (113085, DCM, "Spatial resampling").

>Definition Source Sequence

(0008,1156)

3

Instances containing the source of the ROI Contour information.

Only a single Item is permitted in this Sequence.

>>Include Table 10-11 “SOP Instance Reference Macro Attributes”.

>>Referenced Segment Number

(0062,000B)

1C

The value of Segment Number (0062,0004) in the referenced SOP Instance that identifies the segment that is the source of the ROI Contour information.

Required if Referenced SOP Class UID (0008,1150) is Segmentation Storage ("1.2.840.10008.5.1.4.1.1.66.4").

>>Referenced Fiducial UID

(0070,031B)

1C

The value of Fiducials UID (0070,031A) in the referenced SOP Instance that identifies the fiducial that is the source of the ROI Contour information.

Required if Referenced SOP Class UID (0008,1150) is Spatial Fiducials Storage ("1.2.840.10008.5.1.4.1.1.66.2").

Predecessor Structure Set Sequence

(3006,0018)

3

The Structure Set that has been used to derive the current Structure Set.

Only a single Item is permitted in this Sequence.

>Include Table 10-11 “SOP Instance Reference Macro Attributes”


C.8.8.5.1 Frames of Reference

The Referenced Frame of Reference Sequence (3006,0010) describes a set of frames of reference in which some or all of the ROIs are expressed. Since the Referenced Frame of Reference UID (3006,0024) is required for each ROI, each Frame of Reference used to express the coordinates of an ROI shall be listed in the Referenced Frame of Reference Sequence (3006,0010) once and only once.

Note

As an example, a set of ROIs defined using a single image Series would list the image Series in a single Referenced Frame of Reference Sequence (3006,0010) Item, providing the UID for this referenced Frame of Reference (obtained from the source images), and listing all pertinent images in the Contour Image Sequence (3006,0016).

C.8.8.5.2 Frame of Reference Relationship Sequence and Transformation Matrix (Retired)

Retired. See PS3.3-2011.

Note

The concept of definition of registered Frame of References using the Frame of Reference Relationship Sequence (3006,00C0) formerly present in the Standard is retired. The use of Registration IODs is advised since the introduction of Spatial Registration IOD, which is a much stronger and more general concept, and independent from the specifics of RT Structure Sets. Additionally it is of importance that registrations are decoupled from image and segmentation objects.

C.8.8.5.3 ROI Derivation Sequence

If an ROI is created by re-sampling an existing ROI that is either (a) present in a different Frame of Reference (FoR) and has been resampled to align with the image Series referenced by the current structure set, or (b) present in the same FoR, but its contours are referenced to a different image Series, it is useful to be able to identify that the ROI is resampled. The Derivation Code Sequence (0008,9215) shall be used with code (113085, DCM, "Spatial resampling") to indicate the resampled ROI.

C.8.8.5.4 SOP Class UID in RT Referenced Study Sequence

Since RT Referenced Study Sequence (3006,0012) is Type 3, the Attribute may be omitted.

If RT Referenced Study Sequence (3006,0012) is present with an Item, for each Item, the SOP Class UID is that of the Study itself, not of the Instances within the Study. The Detached Study Management SOP Class (Retired) ("1.2.840.10008.3.1.2.3.1") may be used in Referenced SOP Class UID (0008,1150) in lieu of there being any other private or standard Study SOP Class defined.

Note

The SOP Class of an Instance (e.g., of one of the images within the referenced Study) is not used, even if all of the Instances within the Study are of the same Instance SOP Class.

RT Dose Module

C.8.8.3 RT Dose Module

The RT Dose Module is used to convey 2D or 3D radiation dose data generated from treatment planning systems or similar devices. The Attributes defined within the Module support dose for a single radiation beam (potentially comprised of multiple segments, as delivered in a dynamic treatment) or a group of beams comprising either a fraction group (see Section C.8.8.13) or a complete treatment plan (potentially the sum of multiple fraction groups).

The RT Dose Module provides the mechanism to transmit a 3D array of dose data as a set of 2D dose planes that may or may not be related to CT or MR image planes. This mechanism works via the DICOM Multi-frame Module that is required if multi-frame pixel data are present.

Table C.8-39. RT Dose Module Attributes

Attribute Name

Tag

Type

Attribute Description

Samples per Pixel

(0028,0002)

1C

Number of samples (planes) in this image. See Section C.8.8.3.4.1 for specialization. Required if Pixel Data (7FE0,0010) is present.

Photometric Interpretation

(0028,0004)

1C

Specifies the intended interpretation of the pixel data. See Section C.8.8.3.4.2 for specialization. Required if Pixel Data (7FE0,0010) is present.

Bits Allocated

(0028,0100)

1C

Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See Section C.8.8.3.4.3 for specialization. Required if Pixel Data (7FE0,0010) is present.

Bits Stored

(0028,0101)

1C

Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. See Section C.8.8.3.4.4 for specialization. Required if Pixel Data (7FE0,0010) is present.

High Bit

(0028,0102)

1C

Most significant bit for each pixel sample. Each sample shall have the same high bit. See Section C.8.8.3.4.5 for specialization. Required if Pixel Data (7FE0,0010) is present.

Pixel Representation

(0028,0103)

1C

Data representation of the pixel samples. Each sample shall have the same pixel representation. See Section C.8.8.3.4.6 for specialization. Required if Pixel Data (7FE0,0010) is present.

Content Date

(0008,0023)

3

The date the content of this Module was created.

Content Time

(0008,0033)

3

The time the content of this Module was created.

Dose Units

(3004,0002)

1

Units used to describe dose.

Enumerated Values:

GY

Gray

RELATIVE

dose relative to implicit reference value

Dose Type

(3004,0004)

1

Type of dose.

Defined Terms:

PHYSICAL

physical dose

EFFECTIVE

physical dose after correction for biological effect using user-defined modeling technique

ERROR

difference between desired and planned dose

Spatial Transform of Dose

(3004,0005)

3

The use of transformation in the calculation of the combined dose.

Defined Terms:

NONE

No transformation. Calculated on the original image set

RIGID

Only Rigid transform used (see definition in Section C.20.2.1.2)

NON_RIGID

Any other transform used

Referenced Spatial Registration Sequence

(0070,0404)

2C

A reference to a Spatial Registration SOP Instance or a Deformable Spatial Registration SOP Instance, which defines the transformation used to transform the dose.

Required, if Spatial Transform of Dose (3004,0005) is provided and has a value of RIGID or NON_RIGID.

Zero or more Items shall be included in this Sequence.

See Section C.8.8.3.5

>Include Table 10-11 “SOP Instance Reference Macro Attributes”

Instance Number

(0020,0013)

3

A number that identifies this object Instance.

Entity Long Label

(3010,0038)

3

User-defined label for dose data.

See Section 10.32.2.1.

Dose Comment

(3004,0006)

3

User-defined comments for dose data.

Normalization Point

(3004,0008)

3

Coordinates (x, y, z) of normalization point in the patient-Based Coordinate System described in Section C.7.6.2.1.1 (mm). See Section C.8.8.3.1.

Dose Summation Type

(3004,000A)

1

Type of dose summation.

Defined Terms:

PLAN

dose calculated for entire delivery of all fraction groups of RT Plan

MULTI_PLAN

dose calculated for entire delivery of 2 or more RT Plans

PLAN_OVERVIEW

dose calculated with respect to plan overview parameters

FRACTION

dose calculated for entire delivery of a single Fraction Group within RT Plan

BEAM

dose calculated for entire delivery of one or more Beams within RT Plan

BRACHY

dose calculated for entire delivery of one or more Brachy Application Setups within RT Plan

FRACTION_SESSION

dose calculated for a single session ("fraction") of a single Fraction Group within RT Plan

BEAM_SESSION

dose calculated for a single session ("fraction") of one or more Beams within RT Plan

BRACHY_SESSION

dose calculated for a single session ("fraction") of one or more Brachy Application Setups within RT Plan

CONTROL_POINT

dose calculated for one or more Control Points within a Beam for a single fraction

RECORD

dose calculated for RT Beams Treatment Record

Referenced RT Plan Sequence

(300C,0002)

1C

Sequence describing RT Plan associated with dose.

Required if Dose Summation Type (3004,000A) is PLAN, MULTI_PLAN, FRACTION, BEAM, BRACHY, FRACTION_SESSION, BEAM_SESSION, BRACHY_SESSION or CONTROL_POINT.

May be present if Dose Summation Type (3004,000A) is PLAN_OVERVIEW.

Only a single Item shall be included in this Sequence, unless Dose Summation Type (3004,000A) is MULTI_PLAN, in which case two or more Items shall be included in this Sequence. See Note 1.

>Include Table 10-11 “SOP Instance Reference Macro Attributes”

>Referenced Plan Overview Index

(300C,0118)

1C

The value of Plan Overview Index (300C,0117) from the Plan Overview Sequence (300C,0116) to which this RT Plan corresponds. Shall be unique, i.e., not be duplicated within another Item of this Referenced RT Plan Sequence (300C,0002).

Required if Plan Overview Sequence (300C,0116) is present.

>Referenced Fraction Group Sequence

(300C,0020)

1C

Sequence of one Fraction Group containing beams or brachy application setups contributing to dose.

Required if Dose Summation Type (3004,000A) is FRACTION, BEAM, BRACHY, FRACTION_SESSION, BEAM_SESSION, BRACHY_SESSION or CONTROL_POINT.

Only a single Item shall be included in this Sequence. See Note 1.

>>Referenced Fraction Group Number

(300C,0022)

1

Uniquely identifies Fraction Group specified by Fraction Group Number (300A,0071) in Fraction Group Sequence of RT Fraction Scheme Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002).

>>Referenced Beam Sequence

(300C,0004)

1C

Sequence of Beams in current Fraction Group contributing to dose. Required if Dose Summation Type (3004,000A) is BEAM, BEAM_SESSION or CONTROL_POINT.

One or more Items shall be included in this Sequence.

>>>Referenced Beam Number

(300C,0006)

1

Uniquely identifies Beam specified by Beam Number (300A,00C0) in Beam Sequence (300A,00B0) of RT Beams Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002) or in Ion Beam Sequence (300A,03A2) of RT Ion Beams Module within RT Ion Plan referenced in Referenced RT Plan Sequence (300C,0002).

>>>Referenced Control Point Sequence

(300C,00F2)

1C

Sequence defining the Control Points in current Beam contributing to dose.

Required if Dose Summation Type (3004,000A) is CONTROL_POINT.

Only a single Item shall be included in this Sequence.

>>>>Referenced Start Control Point Index

(300C,00F4)

1

Identifies Control Point specified by Control Point Index (300A,0112) within Beam referenced by Referenced Beam Number (300C,0006). This is the first of the two Control Points from which the Dose contribution to the Control Point can be calculated.

>>>>Referenced Stop Control Point Index

(300C,00F6)

1

Identifies Control Point specified by Control Point Index (300A,0112) within Beam referenced by Referenced Beam Number (300C,0006). This is the second of the two Control Points from which the Dose contribution to the Control Point can be calculated.

The Control Point Index (300A,0112) referenced by Referenced

Stop Control Point Index (300C,00F6) shall be the Control Point Index (300A,0112) immediately following the Control Point Index (300A,0112) referenced by Referenced Start Control Point Index (300C,00F4) within the Referenced Beam Number (300C,0006).

>>Referenced Brachy Application Setup Sequence

(300C,000A)

1C

Sequence of Brachy Application Setups in current Fraction Group contributing to dose. Required if Dose Summation Type (3004,000A) is BRACHY or BRACHY_SESSION. One or more Items shall be included in this Sequence.

>>>Referenced Brachy Application Setup Number

(300C,000C)

1

Uniquely identifies Brachy Application Setup specified by Brachy Application Setup Number (300A,0234) in Brachy Application Setup Sequence (300A,0230) of RT Brachy Application Setups Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002).

Referenced Treatment Record Sequence

(3008,0030)

1C

Sequence describing RT Beams Treatment Record associated with dose.

One or more Items shall be included in this Sequence.

Required if Dose Summation Type (3004,000A) is RECORD.

>Include Table 10-11 “SOP Instance Reference Macro Attributes”

>Referenced Beam Sequence

(300C,0004)

1C

Sequence of Beams contributing to dose.

One or more Items shall be included in this Sequence.

Required, if the dose does not apply to the complete RT Beams Treatment Record referenced in the Referenced Treatment Record Sequence (3008,0030).

>>Referenced Beam Number

(300C,0006)

1

Uniquely identifies Beam specified by Referenced Beam Number (300C,0006) in Treatment Session Beam Sequence (3008,0020) of RT Beams Session Record Module within RT Beams Treatment Record referenced in the Referenced Treatment Record Sequence (3008,0030) or in Treatment Session Ion Beam Sequence (3008,0021) of RT Ion Beams Session Record Module within RT Ion Beams Treatment Record referenced in the Referenced Treatment Record Sequence (3008,0030).

Grid Frame Offset Vector

(3004,000C)

1C

An array that contains the dose image plane offsets (in mm) of the dose image frames in a multi-frame dose. Required if multi-frame pixel data are present and Frame Increment Pointer (0028,0009) points to Grid Frame Offset Vector (3004,000C). See Section C.8.8.3.2.

Dose Grid Scaling

(3004,000E)

1C

Scaling factor that when multiplied by the dose grid data found in Pixel Data (7FE0,0010) Attribute of the Image Pixel Module, yields grid doses in the dose units as specified by Dose Units (3004,0002).

Required if Pixel Data (7FE0,0010) is present.

Tissue Heterogeneity Correction

(3004,0014)

3

Specifies a list of patient heterogeneity characteristics used for calculating dose. This Attribute shall be multi-valued if beams used to compute the dose have differing correction techniques.

Enumerated Values:

IMAGE

image data

ROI_OVERRIDE

one or more ROI densities override image or water values where they exist

WATER

entire volume treated as water equivalent

Derivation Code Sequence

(0008,9215)

3

A coded description of how this dose was derived from other RT Dose and/or RT Plan objects.

One or more Items are permitted in this Sequence. More than one Item indicates that successive derivation steps have been applied.

>Include Table 8.8-1 “Code Sequence Macro Attributes”

DCID 7220 “RT Dose Derivation”.

Referenced Instance Sequence

(0008,114A)

3

The set of SOP Instances used to derive this RT Dose SOP Instance.

One or more Items are permitted in this Sequence.

>Include Table 10-11 “SOP Instance Reference Macro Attributes”

>Purpose of Reference Code Sequence

(0040,A170)

1

Code describing the purpose of the reference to the Instance(s).

Only a single Item is permitted in this Sequence.

>>Include Table 8.8-1 “Code Sequence Macro Attributes”

DCID 7221 “RT Dose Purpose of Reference”.

Plan Overview Sequence

(300C,0116)

1C

Parameters providing an overview of the plan used to create this RT Dose Instance.

Required if Dose Summation Type (3004,000A) is PLAN_OVERVIEW. May be present if Dose Summation Type (3004,000A) is PLAN, MULTI_PLAN or RECORD.

One or more Items shall be included in this Sequence if Dose Summation Type (3004,000A) is PLAN_OVERVIEW.

Only one Item shall be included in this Sequence if Dose Summation Type (3004,000A) is PLAN or RECORD.

Two or more Items shall be included in this Sequence if Dose Summation Type (3004,000A) is MULTI_PLAN.

>Plan Overview Index

(300C,0117)

1

The index of the Plan Overview within this Sequence.

The value shall start at 1 and increase monotonically by 1.

>RT Plan Label

(300A,0002)

2

User-defined label of treatment plan.

>Number of Fractions Included

(300C,0119)

1C

Number of fractions of the plan included in this RT Dose Instance.

Required if Dose Summation Type (3004,000A) is PLAN_OVERVIEW, PLAN or MULTI_PLAN.

If Dose Summation Type is PLAN or MULTI_PLAN the Number of Fractions Included (300C,0119) shall equal the Number of Fractions Planned (300A,0078) of the referenced RT Plan Instance.

>Current Fraction Number

(3008,0022)

1C

Fraction Number of the fraction included in this RT Dose Instance.

Required if Dose Summation Type (3004,000A) is RECORD.

>Treatment Site

(3010,0077)

2

A free-text label describing the anatomical treatment site.

>Treatment Site Code Sequence

(3010,0078)

2

Coded description of the treatment site.

Zero or more Items are permitted in this Sequence.

>>Include Table 8.8-1 “Code Sequence Macro Attributes”

BCID 4 “Anatomic Region”.

>>Treatment Site Modifier Code Sequence

(3010,0089)

3

Coded description of the laterality of the treatment site.

Only a single Item is permitted in this Sequencee.

>>>Include Table 8.8-1 “Code Sequence Macro Attributes”

BCID 244 “Laterality”.

>Prescription Overview Sequence

(300C,0114)

2

Prescription parameters for evaluation of the dose matrix.

Zero or more Items shall be included in this Sequence.

>>Entity Long Label

(3010,0038)

1C

Label identifying the Prescription Overview.

For example, this may be the name of the related target ROI or the description of a Dose Reference.

Required if Prescription Overview Sequence (300C,0114) has more than one Item. May be present otherwise.

>>Total Prescription Dose

(300C,0115)

1

Prescribed total dose in Gy for all fractions for the dose type defined in Dose Type (3004,0004).

>>Referenced ROI Number

(3006,0084)

3

ROI for which the prescription parameters in this Sequence apply, specified by ROI Number (3006,0022) in the Instance referenced by Referenced Structure Set Sequence (300C,0060).

>Referenced Structure Set Sequence

(300C,0060)

1C

Structure Set containing structures that were used to calculate the RT Dose.

Required if Referenced Image Sequence (0008,1140) is not present.

Only a single Item shall be included in this Sequence.

>>Include Table 10-11 “SOP Instance Reference Macro Attributes”

>Referenced Image Sequence

(0008,1140)

1C

Images used to calculate the RT Dose.

Required if Referenced Structure Set Sequence (300C,0060) is not present.

One or more Items shall be included in this Sequence.

>>Include Table 10-11 “SOP Instance Reference Macro Attributes”


Note

  1. In order to prevent misrepresentation of the dose summation:

    1. If the Dose Summation Type (3004,000A) is PLAN, then only a single Instance of RT Plan is referenced and the dose will be for the entire plan (i.e., it is not viable to combine only certain fraction groups of different plans).

    2. If the Dose Summation Type (3004,000A) is MULTI_PLAN, then 2 or more Instances of RT Plan may be referenced. As above, each reference will be for the entire plan.

    3. If the Dose Summation Type (3004,000A) is FRACTION or FRACTION_SESSION, then only a single Instance of RT PLAN and a single Fraction Group are referenced (i.e., component beams or brachy application setups are not referenced).

C.8.8.3.1 Normalization Point

Normalization Point (3004,0008) aids in the interpretation and subsequent use of the transmitted data. If used, it shall be a point receiving dose contributions from all referenced components of the dose summation.

C.8.8.3.2 Grid Frame Offset Vector

Grid Frame Offset Vector (3004,000C) shall be provided if a dose distribution is encoded as a multi-frame image. Values of the Grid Frame Offset Vector (3004,000C) shall vary monotonically and are to be interpreted as follows:

  1. If Grid Frame Offset Vector (3004,000C) is present and its first element is zero, this Attribute contains an array of n elements indicating the plane location of the data in the right-handed image coordinate system, relative to the position of the first dose plane transmitted, i.e., the point at which Image Position (patient) (0020,0032) is defined, with positive offsets in the direction of the cross product of the row and column directions.

  2. If Grid Frame Offset Vector (3004,000C) is present, its first element is equal to the third element of Image Position (patient) (0020,0032), and Image Orientation (patient) (0020,0037) has the value (1,0,0,0,1,0), then Grid Frame Offset Vector contains an array of n elements indicating the plane location (patient z coordinate) of the data in the Patient-Based Coordinate System.

In future implementations, use of option a) is strongly recommended.

This Attribute is conditional since the RT Dose Module may be included even if pixel doses are not being transmitted, or the image may be a single-frame image. If the Multi-frame Module is present, Frame Increment Pointer (0028,0009) shall have the Enumerated Value of 3004000C (Grid Frame Offset Vector).

Note

Option (a) can represent a rectangular-parallelepiped dose grid with any orientation with respect to the patient, while option (b) can only represent a rectangular-parallelepiped dose grid whose planes are in the transverse patient dimension and whose x- and y-axes are parallel to the patient x- and y-axes.

Example: Figure C.8.8.3-1 shows an example of plane positions for a dose grid with transverse planes.

Figure C.8.8.3-1. Dose Grid Frame Example


For this example, Table C.8-39b gives the values of elements in the Grid Frame Offset Vector (3004,000C) for both relative (option (a)) and absolute (option (b)) interpretations, under the following conditions:

  1. The value of Image Orientation (Patient) (0020,0037) is (1,0,0,0,1,0). I.e., the dose grid is transverse with x- and y-axes parallel to the patient x- and y-axes;

  2. The value of Image Position (Patient) (0020,0032), i.e., the position of the first element of the dose grid, is (4, 5, 6); and

  3. The spacing between adjacent dose grid planes is 2mm (uniform).

Table C.8-39b. Values of Dose Grid Frame Offset Vector Under Relative (A) and Absolute (B) Interpretations

Grid Frame Offset Vector Element

Option (a) Relative Coordinates

Option (b) Absolute Coordinates

Z1

0

6

Z2

2

8

Z3

4

10

ZN

2(N-1)

6 + 2(N-1)


C.8.8.3.3 Dose Units

Dose Units are specified in the RT Dose Module. The Attribute Dose Type present in the RT Dose Module shall apply to all doses present in the RT Dose IOD.

C.8.8.3.4 Image Pixel Attributes
C.8.8.3.4.1 Samples Per Pixel

Enumerated Values:

1

C.8.8.3.4.2 Photometric Interpretation

Enumerated Values:

MONOCHROME2

C.8.8.3.4.3 Bits Allocated

Enumerated Values:

16

32

C.8.8.3.4.4 Bits Stored

For RT Doses, Bits Stored (0028,0101) shall be equal to Bits Allocated (0028,0100).

C.8.8.3.4.5 High Bit

For RT Doses, High Bit (0028,0102) shall be one less than the value of Bits Stored (0028,0101).

C.8.8.3.4.6 Pixel Representation

Enumerated Values when Dose Type (3004,0004) = ERROR:

0001H

two's complement integer,

Enumerated Values when Dose Type (3004,0004) not ERROR:

0000H

unsigned integer, otherwise.

C.8.8.3.5 Referenced Spatial Registration Sequence

This Sequence lists the registrations used to create the dose. It is important to note, that this Sequence does not make any statement about how the dose was calculated or about the scope of objects contributing to a summed dose.