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
PatientMModule - Patient
Clinical Trial SubjectUModule - Patient
General StudyMModule - Study
Patient StudyUModule - Study
Clinical Trial StudyUModule - Study
RT SeriesMModule - Series
Clinical Trial SeriesUModule - Series
General EquipmentMModule - Equipment
Frame of ReferenceUModule - Frame of Reference
Structure SetMModule - Structure Set
ROI ContourMModule - Structure Set
RT ROI ObservationsMModule - Structure Set
(3006,0080) RT ROI Observations Sequence1Sequence
(0008,2218) Anatomic Region Sequence3Sequence
(0008,2228) Primary Anatomic Structure Sequence3Sequence
(0062,0003) Segmented Property Category Code Sequence3Sequence
(3006,002E) ROI Observation DateTime3Date Time
(3006,0030) RT Related ROI Sequence3Sequence
(3006,004E) ROI Interpreter Sequence1CSequence
(0008,0055) Station AE Title3Application Entity
(0008,0070) Manufacturer1CLong String
(0008,0080) Institution Name2Long String
(0008,0082) Institution Code Sequence2Sequence
(0008,1010) Station Name2CShort String
(0008,1040) Institutional Department Name3Long String
(0008,1041) Institutional Department Type Code Sequence3Sequence
(0008,1090) Manufacturer's Model Name1CLong String
(0018,1000) Device Serial Number3Long String
(0018,1002) Device UID1CUnique Identifier
(0018,1020) Software Versions3Long String
(0018,1204) Date of Manufacture3Date
(0018,1205) Date of Installation3Date
(0040,1101) Person Identification Code Sequence2CSequence
(0040,A084) Observer Type1Code String
(0040,A123) Person Name1CPerson Name
(0044,010A) Organizational Role Code Sequence3Sequence
(3006,004F) ROI Observation Context Code Sequence3Sequence
(3006,0082) Observation Number1Integer String
(3006,0084) Referenced ROI Number1Integer String
(3006,0086) RT ROI Identification Code Sequence3Sequence
(3006,00A0) Related RT ROI Observations Sequence3Sequence
(3006,00A4) RT ROI Interpreted Type2Code String
(3006,00A6) ROI Interpreter2Person Name
(3006,00B0) ROI Physical Properties Sequence3Sequence
(300A,00E1) Material ID3Short String
(3010,0064) Therapeutic Role Category Code Sequence3Sequence
(3010,0065) Therapeutic Role Type Code Sequence3Sequence
ApprovalUModule - Structure Set
General ReferenceUModule - Structure Set
SOP CommonMModule - Structure Set
Common Instance ReferenceUModule - Structure Set
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
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 19 March 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.

ROI Interpreter Sequence Attribute

TypeConditionally Required (1C)
Value Multiplicity1
Value RepresentationSequence (SQ)

Person or device performing the interpretation.

Required if ROI Creator Sequence (3006,004D) is present in the Structure Set Module, and the person or device performing the interpretation differs from ROI Creator Sequence (3006,004D). May be present otherwise.

Only a single Item shall be included in this Sequence.

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



Attribute Description

Structure Set Label



User-defined label for Structure Set.

Structure Set Name



User-defined name for Structure Set.

Structure Set Description



User-defined description for Structure Set.

Instance Number



A number that identifies this object Instance.

Structure Set Date



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

Structure Set Time



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

Referenced Frame of Reference Sequence



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

>Frame of Reference UID



Uniquely identifies Frame of Reference within Structure Set.

>RT Referenced Study Sequence



Sequence of Studies containing Series to be referenced.

One or more Items are permitted in this Sequence.

See Section C.

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

>>RT Referenced Series Sequence



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



Unique identifier for the Series containing the images.

>>>Contour Image Sequence



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



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.




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

>Series Date



Date the Series started.

>Series Time



Time the Series started.

>Series Description



Description of the Series.

>Series Instance UID



Unique identifier of the Series.

>Series Number



A number that identifies this Series.

Structure Set ROI Sequence



ROIs for current Structure Set.

One or more Items shall be included in this Sequence.

>ROI Number



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



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



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



User-defined name for ROI.

>ROI Description



User-defined description for ROI.

>ROI Volume



Volume of ROI (cubic centimeters).

>ROI DateTime



DateTime when this ROI was created.

>ROI Generation Algorithm



Type of algorithm used to generate ROI.

Defined Terms:


calculated ROI


ROI calculated with user assistance


user-entered ROI

>ROI Generation Description



User-defined description of technique used to generate ROI.

>RT Protocol Code Sequence



The protocol(s) selected by the RT Physician.

One or more Items are permitted in this Sequence.

See Section C.

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

No Baseline CID is defined.

>ROI Creator Sequence



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



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



A coded description of how this ROI was derived.

One or more Items are permitted in this Sequence.

See Section C. for further explanation.

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

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

>Definition Source Sequence



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



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.").

>>Referenced Fiducial UID



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.").

Predecessor Structure Set Sequence



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. 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.


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

Retired. See PS3.3-2011.


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. 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. 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.") may be used in Referenced SOP Class UID (0008,1150) in lieu of there being any other private or standard Study SOP Class defined.


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.