US Multi-frame ImageCIOD
Multi-frame Single Bit SC ImageCIOD
Multi-frame Grayscale Byte SC ImageCIOD
Multi-frame Grayscale Word SC ImageCIOD
Multi-frame True Color SC ImageCIOD
X-Ray Angiographic ImageCIOD
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 ReferenceUModule - Frame of Reference
General EquipmentMModule - Equipment
General ImageMModule - Image
General ReferenceUModule - Image
Image PixelMModule - Image
Contrast/BolusCModule - Image
CineCModule - Image
Multi-frameCModule - Image
DeviceUModule - Image
RT ImageMModule - Image
(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
(0028,1040) Pixel Intensity Relationship3Code String
(0028,1041) Pixel Intensity Relationship Sign1CSigned Short
(3002,0002) RT Image Label1Short String
(3002,0003) RT Image Name3Long String
(3002,0004) RT Image Description3Short Text
(0008,0008) Image Type1Code String
(0008,0064) Conversion Type2Code String
(3002,000A) Reported Values Origin2CCode String
(3002,000C) RT Image Plane1Code String
(3002,000D) X-Ray Image Receptor Translation3Decimal String
(3002,000E) X-Ray Image Receptor Angle2Decimal String
(3002,0010) RT Image Orientation2CDecimal String
(3002,0011) Image Plane Pixel Spacing2Decimal String
(3002,0012) RT Image Position2Decimal String
(3002,0020) Radiation Machine Name2Short String
(300A,00B3) Primary Dosimeter Unit2Code String
(3002,0022) Radiation Machine SAD2Decimal String
(3002,0024) Radiation Machine SSD3Decimal String
(3002,0026) RT Image SID2Decimal String
(3002,0028) Source to Reference Object Distance3Decimal String
(300C,0002) Referenced RT Plan Sequence3Sequence
(300C,0006) Referenced Beam Number3Integer String
(300C,0022) Referenced Fraction Group Number3Integer String
(3002,0029) Fraction Number3Integer String
(300C,0008) Start Cumulative Meterset Weight3Decimal String
(300C,0009) End Cumulative Meterset Weight3Decimal String
(3002,0030) Exposure Sequence3Sequence
(3002,0040) Fluence Map Sequence1CSequence
(300A,011E) Gantry Angle3Decimal String
(300A,014A) Gantry Pitch Angle3Single
(300A,0120) Beam Limiting Device Angle3Decimal String
(300A,0122) Patient Support Angle3Decimal String
(300A,0124) Table Top Eccentric Axis Distance3Decimal String
(300A,0125) Table Top Eccentric Angle3Decimal String
(300A,0140) Table Top Pitch Angle3Single
(300A,0144) Table Top Roll Angle3Single
(300A,0128) Table Top Vertical Position3Decimal String
(300A,0129) Table Top Longitudinal Position3Decimal String
(300A,012A) Table Top Lateral Position3Decimal String
(300A,012C) Isocenter Position3Decimal String
(0018,5100) Patient Position1CCode String
(0018,1150) Exposure Time3Integer String
(0018,9328) Exposure Time in ms3Double
(3002,0032) Meterset Exposure3Decimal String
Modality LUTUModule - Image
VOI LUTUModule - Image
ApprovalUModule - Image
SOP CommonMModule - Image
Common Instance ReferenceUModule - Image
Frame ExtractionCModule - Image
RT Structure SetCIOD
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
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
Basic Voice AudioCIOD
Ambulatory ECGCIOD
Basic Cardiac EPCIOD
Arterial Pulse WaveformCIOD
Respiratory WaveformCIOD
General Audio WaveformCIOD
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 Structured ReportCIOD
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 X-Ray Angiographic ImageCIOD
Enhanced X-Ray RF 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 OCT 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
Table CT Performed Procedure ProtocolCIOD
CT Defined Procedure ProtocolCIOD
Protocol ApprovalCIOD
Ophthalmic Optical Coherence Tomography En Face ImageCIOD
Ophthalmic Optical Coherence Tomography B-scan Volume AnalysisCIOD
Encapsulated STLCIOD

Built with by Innolitics, a team of medical imaging software developers.

Data synced with official DICOM standard on 27 November 2018. The DICOM Standard is under continuous maintenance, and the current official version is available at DICOM Parts 3 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.

Pixel Intensity Relationship Sign Attribute

TypeConditionally Required (1C)
Value Multiplicity1
Value RepresentationSigned Short (SS)

The sign of the relationship between the Pixel sample values stored in Pixel Data (7FE0,0010) and the X-Ray beam intensity.

Required if Pixel Intensity Relationship (0028,1040) is present.

Enumerated Values:


Lower pixel values correspond to less X-Ray beam intensity


Higher pixel values correspond to less X-Ray beam intensity

See Section C. for further explanation.

Section C.

C. Pixel Intensity Relationship and Grayscale Transformations

Pixel Intensity Relationship (0028,1040) and Pixel Intensity Relationship Sign (0028,1041) describe how the stored pixel values in Pixel Data (7FE0,0010) are related to the X-Ray beam intensity incident on the detector.

They do not define a transformation intended to be applied to the pixel data for presentation.


For example, if Pixel Intensity Relationship (0028,1040) is LIN and Pixel Intensity Relationship Sign (0028,1041) is -1, then lower values of Pixel Data (7FE0,0010) indicate higher X-Ray beam intensities corresponding to less radiographically dense regions projected on the image such as through air, and higher values of Pixel Data (7FE0,0010) indicate lower X-Ray beam intensities corresponding to more radiographically dense regions projected on the image such as through bone and radio-opaque contrast agents.

The transformation to be applied to the pixel data for presentation is defined by the successive application of the conceptual Modality LUT, the VOI Attributes and the conceptual Presentation LUT. This shall result in the output of P-Values.

Rescale Slope (0028,1053) and Rescale Intercept (0028,1052) define a linear subset of a conceptual Modality LUT transformation. For IODs that include this Module, these Attributes define an identity transformation. IODs that include the DX Image Module shall not include the Modality LUT Module.

The Presentation LUT Shape (2050,0020) defines a subset of a conceptual Presentation LUT. For IODs that include this Module, this Attribute defines an identity transformation or inverse identity transformation. IODs that include the DX Image Module shall not include the Presentation LUT Module.

Photometric Interpretation (0028,0004) indicates whether lower values that are the output of the VOI Attributes should be displayed as darker or lighter. Since the output of the equivalent of a conceptual Presentation LUT is in P-Values, which are defined in PS3.14 such that lower values correspond to lower luminance levels, then the definition of the Presentation LUT Shape (2050,0020), otherwise intended to be an identity transformation, must take into account the effect of the value specified for Photometric Interpretation (0028,0004).


Regardless of the values of Pixel Intensity Relationship (0028,1040) and Pixel Intensity Relationship Sign (0028,1041), the grayscale transformations to be applied to Pixel Data (7FE0,0010) are defined by the equivalent of the Modality LUT (Rescale Slope (0028,1053) and Rescale Intercept (0028,1052)), Value of Interest Attributes, Photometric Interpretation (0028,0004) and the equivalent of the Presentation LUT (Presentation LUT Shape (2050,0020)). However, the combination of the grayscale transformations and the description of the pixel intensity relationship, together define whether, for example, air is expected to be displayed as black or white.