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(300A,000E) Prescription Description3Short Text
(300A,0010) Dose Reference Sequence3Sequence
(3006,0084) Referenced ROI Number1CInteger String
(300A,0012) Dose Reference Number1Integer String
(300A,0013) Dose Reference UID3Unique Identifier
(300A,0014) Dose Reference Structure Type1Code String
(300A,0016) Dose Reference Description3Long String
(300A,0018) Dose Reference Point Coordinates1CDecimal String
(300A,001A) Nominal Prior Dose3Decimal String
(300A,0020) Dose Reference Type1Code String
(300A,0021) Constraint Weight3Decimal String
(300A,0022) Delivery Warning Dose3Decimal String
(300A,0023) Delivery Maximum Dose3Decimal String
(300A,0025) Target Minimum Dose3Decimal String
(300A,0026) Target Prescription Dose3Decimal String
(300A,0027) Target Maximum Dose3Decimal String
(300A,0028) Target Underdose Volume Fraction3Decimal String
(300A,002A) Organ at Risk Full-volume Dose3Decimal String
(300A,002B) Organ at Risk Limit Dose3Decimal String
(300A,002C) Organ at Risk Maximum Dose3Decimal String
(300A,002D) Organ at Risk Overdose Volume Fraction3Decimal String
(300A,061D) Dose Value Purpose3Code String
(300A,068B) Dose Value Interpretation3Code String
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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.

Dose Value Interpretation Attribute

Tag(300A,068B)
TypeOptional (3)
KeywordDoseValueInterpretation
Value Multiplicity1
Value RepresentationCode String (CS)

Interpretation of the dose values.

Enumerated Values:

NOMINAL

ACTUAL

See Section C.8.8.10.1 and Section C.8.8.14.7.

Section C.8.8.10.1

C.8.8.10.1 Dose Value Interpretation

The dose references listed in the Dose Reference Sequence (300A,0010) may receive dose contributions accumulated from different beams. Whereas the Beam Dose (300A,0084) that is used to determine the dose contribution of a beam to the Dose Reference may be calculated individually for each beam or on a fraction level carrying a nominal dose only, the accumulated dose values may also be interpreted as nominal or actual. For potential use cases, see Table C.8.8.10.3-1, for an example, and see Section C.8.8.14.7.

The Enumerated Value NOMINAL indicates that the dose value associated with the dose reference is a nominal value that was provided as an input for treatment planning. Such a value may be used to track delivered dose over a number of delivered RT Treatment Fractions in a Treatment Management System, or eventually to match against a prescribed dose value in a Hospital Information System for billing purposes.

The Enumerated Value ACTUAL indicates that the dose value associated with the dose reference was calculated during planning. Such a value may be used for quality assurance purposes where the plan parameters are used to re-calculate the dose and where a re-calculated value is expected to match the dose value provided by the Dose Reference.

Note

This differs from the usage of ACTUAL when recording measured values in treatment records.

Table C.8.8.10.3-1. Dose Value Interpretation Example Use Cases

Dose Reference Structure Type (300A,0014)

VOLUME/SITE

POINT/COORDINATE

Dose Value Interpretation (300A,068B)

NOMINAL

Tracking a nominal (e.g., prescribed) dose.

Tracking a nominal (e.g., prescribed) dose ("prescribed point dose").

ACTUAL

Tracking an actual (calculated) dose.

Comparison of calculated/measured dose values.


Section C.8.8.14.7

C.8.8.14.7 Cumulative Dose Reference Coefficient

The Cumulative Dose Reference Coefficient (300A,010C) is the value by which Beam Dose (300A,0084) is multiplied to obtain the dose to the referenced dose reference site at the current control point (and after previous control points have been successfully administered). The Cumulative Dose Reference Coefficient (300A,010C) is by definition zero for the initial control point. The Cumulative Dose Reference Coefficient (300A,010C) of the final control point multiplied by Beam Dose (300A,0084) results in the final dose to the referenced dose reference site for the current beam. Dose calculation for dose reference sites other than points is not well defined.

The sum of the doses of all beams calculated to the referenced dose reference may be used in different clinical scenarios, indicated by the Dose Value Purpose (300A,061D) attribute value, see Section C.8.8.10.1.

Example

In a single target case with two beams, a volume prescription of 20 Gy over 10 fractions, the single target may be represented by two Items in the Dose Reference Sequence (300A,0010): one for tracking of the dose values over the course of the delivery of a treatment plan, and one for QA purposes, where the dose value is recalculated and compared to the planned value. The first Item may therefore contain a nominal dose by a physician (e.g., 20Gy), the second Item a calculated dose at a given spatial location (e.g., 21.785Gy). The dose values are determined using the Beam Dose (300A,0084) with a Beam Dose Meaning (300A,008B) FRACTION_LEVEL (indicating that the beam dose was calculated on fraction level and carries a nominally distributed dose only).

Dose Reference Sequence

(300A,0010)

<Sequence>

>Item 1

>Dose Reference Number

(300A,0012)

1

>Dose Reference UID

(300A,0013)

1.2.3.4.1

>Dose Reference Structure Type

(300A,0014)

VOLUME

>Dose Value Purpose

(300A,061D)

TRACKING

>Dose Value Interpretation

(300A,068B)

NOMINAL

>Dose Reference Description

(300A,0016)

Tumor

>Referenced ROI Number

(3006,0084)

5

>Dose Reference Type

(300A,0020)

TARGET

>Item 2

>Dose Reference Number

(300A,0012)

2

>Dose Reference UID

(300A,0013)

1.2.3.4.2

>Dose Reference Structure Type

(300A,0014)

COORDINATES

>Dose Value Purpose

(300A,061D)

QA

>Dose Value Interpretation

(300A,068B)

ACTUAL

>Dose Reference Description

(300A,0016)

Tumor

>Dose Reference Point Coordinates

(300A,0018)

3.1\4.2\5.3

>Dose Reference Type

(300A,0020)

TARGET

Table C.8.8.14.7-1. Cumulative Dose Reference Calculation Example

Beam Dose (300A,0084) with Beam Dose Meaning (300A,008B): FRACTION_LEVEL

Dose Reference Number (300A,0012): 1

Dose Reference Number (300A,0012): 2

Final value of Cumulative Dose Reference Coefficient (300A,010C)

Final Dose Value

Dose Value Purpose (300A,061D) / Dose Value Interpretation (300A,068B)

Final value of Cumulative Dose Reference Coefficient (300A,010C)

Final Dose Value

Dose Value Purpose (300A,061D) / Dose Value Interpretation (300A,068B)

Beam 1

1.2 Gy

1.0

1.2 Gy

1.1476

1.3771 Gy

Beam 2

0.8 Gy

1.0

0.8 Gy

1.00175

0.8014 Gy

Sum

2.0 Gy

TRACKING / NOMINAL

2.1785 Gy

QA / ACTUAL

Sum x Fractions

20.0 Gy

21.785 Gy