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DICOM PS3.17 2020a - Explanatory Information​

Page 191​

where MRBWS is a matrix of type RIGID_SCALE and MRB is a matrix of type RIGID.​

•​AFFINE:​

No constraints apply to this matrix, so it contains twelve degrees of freedom. This type of Frame of Reference Transformation​ Matrix allows shearing in addition to rotation, translation and scaling.​

For a RIGID type of Frame of Reference Transformation Matrix, the inverse is easily computed using the following formula (inverse​ of an orthonormal matrix):​

−1

M

M

12

M

13

T −1

M

M

21

M

31

−(M

11

Tx + M

21

Ty + M

31

Tz)

 

11

 

 

x

11

 

 

 

 

 

 

 

( A MB)

= M21

M22

M23

Ty

= M12

M22

M32

−(M12 Tx + M22Ty + M32Tz)

(P-8)​

 

M31

M32

M33

Tz

M13

M23

M33

−(M13 Tx + M23Ty + M33Tz)

 

 

0

0

0 1

0

0

0

 

 

1

 

 

 

 

For RIGID_SCALE and AFFINE types of Registration Matrices, the inverse cannot be calculated using the above equation, and must​ be calculated using a conventional matrix inverse operation.​

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Page 192​

DICOM PS3.17 2020a - Explanatory Information​

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DICOM PS3.17 2020a - Explanatory Information​

Page 193​

Q Breast Imaging Report (Informative)​

Q.1 Breast Imaging Report Content Tree Structure​

The templates for the Breast Imaging Report are defined in PS3.16. Relationships defined in the Breast Imaging Report templates​ are by-value. This template structure may be conveyed using the Enhanced SR SOP Class or the Basic Text SR SOP Class.​

Breast Imaging

Report (CONTAINER)

HAS CONCEPT

CONTAINS

 

CONTAINS

MODIFIER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Language of Content Item

 

Breast Imaging

 

Breast Imaging Report

and Descendants

 

Report Narrative

 

Supplementary Data

TID (1204)

 

TID (4202)

 

TID (4208)

(INCLUDE)

 

(INCLUDE)

 

(INCLUDE)

 

 

 

See Figure Q.1-3

 

See Figure Q.1-4

 

 

 

Breast Imaging

 

Breast Imaging Report

 

 

 

Report Narrative

 

Supplementary Data

Figure Q.1-1. Top Level of Breast Imaging Report Content Tree​

As shown in Figure Q.1-1, the Breast Imaging Report Narrative and Breast Imaging Report Supplementary Data sub-trees together​ form the content tree of the Breast Imaging Report.​

Breast Imaging

Procedure Reported

(CODE)

HAS CONCEPT

 

HAS CONCEPT

 

HAS

 

 

 

 

HAS

 

PROPERTIES

 

 

 

PROPERTIES

MODIFIER

 

MODIFIER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Laterality

 

Procedure Modifier

 

 

 

Reason for

 

 

 

Study Date

 

 

 

 

Procedure

 

 

 

(CODE)

 

(CODE)

 

 

 

 

 

 

(DATE)

 

 

 

 

(CODE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS CONCEPT

 

 

 

 

HAS CONCEPT

 

 

 

 

 

MODIFIER

 

 

 

 

MODIFIER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clinical Finding

 

 

 

 

Relative Time

 

 

 

 

 

 

(CODE)

 

 

 

 

(CODE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS

PROPERTIES

Laterality

(CODE)

Figure Q.1-2. Breast Imaging Procedure Reported Content Tree​

The Breast Imaging Procedure Reported sub-tree is a mandatory child of the Supplementary Data content item, to describe all of the​ procedurestowhichthereportappliesusingcodedterminology.Itmayalsobeusedasasub-treeofsectionswithintheSupplementary​ Data sub-tree, for the instance in which a report covers more than one procedure, but different sections of the Supplementary Data​ record the evidence of a subset of the procedures.​

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Page 194​

DICOM PS3.17 2020a - Explanatory Information​

Narrative Summary

(CONTAINER)

CONTAINS

DCID (6052)

Breast Imaging Report

Section Title (CONTAINER)

HAS OBS

 

CONTAINS

CONTEXT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Observer Context

 

BCID (6053)

TID (1002)

 

Breast Imaging

(INCLUDE)

 

Report Elements

 

 

 

(TEXT)

 

 

 

 

 

 

 

 

INFERRED

 

 

 

FROM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References to

 

 

 

Supporting Evidence

 

 

 

TID (350)

 

 

 

(INCLUDE)

Figure Q.1-3. Breast Imaging Report Narrative Content Tree​

An instance of the Breast Imaging Report Narrative sub-tree contains one or more text-based report sections, with a name chosen​ from CID 6052 “Breast Imaging Report Section Title”. Within a report section, one or more observers may be identified. This sub-tree​ is intended to contain the report text as it was created, presented to, and signed off by the verifying observer. It is not intended to​ convey the exact rendering of the report, such as formatting or visual organization. Report text may reference one or more image or​ other composite objects on which the interpretation was based.​

Supplementary Data

(CONTAINER)

CONTAINS

CONTAINS

CONTAINS

CONTAINS

CONTAINS

CONTAINS

CONTAINS

Breast Imaging

Procedure Reported

See Figure Q.1-2

TID (4201)

Breast Imaging

(INCLUDE)

Procedure Reported

Baseline screening mammogram (CODE)

First mammogram ever

(CODE)

Breast Composition

Section

TID (4205) (INCLUDE)

Breast Imaging Report

Finding Section

TID (4206)

(INCLUDE)

Breast Imaging Report

Intervention Section

TID (4204)

(INCLUDE)

Overall

 

Assessment

CONTAINS

(CONTAINER)

 

Breast Imaging

See Figure Q.1-5

Assessment TID

Breast Imaging

(4203)

Assessment

(INCLUDE)

 

Figure Q.1-4. Breast Imaging Report Supplementary Data Content Tree​

AninstanceoftheBreastImagingReportSupplementaryDatasub-treecontainsoneormoreof:BreastImagingProcedureReported,​

BreastCompositionSection,BreastImagingReportFindingSection,BreastImagingReportInterventionSection,OverallAssessment.​

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DICOM PS3.17 2020a - Explanatory Information​

Page 195​

Thissub-treeisintendedtocontainthesupportingevidencefortheBreastImagingReportNarrativesub-tree,usingcodedterminology​ and numeric data.​

Breast Imaging

Assessment

(INCLUDE)

 

 

 

HAS CONCEPT

 

 

 

 

HAS CONCEPT

 

 

 

 

 

 

MODIFIER

 

 

 

 

 

MODIFIER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Assessment Category

 

 

 

Recommended Follow-up

 

 

 

 

 

 

 

 

(CODE)

 

 

 

 

 

(CODE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS

 

 

 

 

 

 

HAS

 

 

 

 

HAS

 

HAS

PROPERTIES

PROPERTIES

 

 

 

PROPERTIES

 

PROPERTIES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Laterality

 

 

 

 

Recommended

 

 

 

Recommended

 

Breast Imaging

 

 

 

Follow-up Interval

 

 

 

Follow-up Date

 

Pathology Results

(CODE)

 

 

 

 

 

 

 

 

 

 

 

 

(NUM)

 

 

 

(DATE)

 

TID (4207)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(INCLUDE)

Figure Q.1-5. Breast Imaging Assessment Content Tree​

The Breast Imaging Assessment sub-tree may be instantiated as the content of an Overall Assessment section of a report (see Fig-​ ure Q.1-4), or as part of a Findings section of a report (see TID 4206 “Breast Imaging Report Finding Section”). Reports may provide​ an individual assessment for each Finding, and then an overall assessment based on an aggregate of the individual assessments.​

Q.2 Breast Imaging Report Examples​

The following are simple illustrations of encoding Mammography procedure based Breast Imaging Reports.​

Q.2.1 Example 1: Screening Mammogram With Negative Findings​

Ascreeningmammographycase,i.e.,therearetypicallyfourfilmsandnosuspiciousabnormalities.Theresultisanegativemammogram​ with basic reporting. This example illustrates a report encoded as narrative text only:​

Example Q.2-1. Report Sample: Narrative Text Only​

Procedure reported

Film screen mammography, both breasts.

Reason for procedure

Screening

Findings

Comparison was made to exam from 11/14/2001. The breasts are heterogeneously dense. This may lower the sensitivity of mammography. No significant masses, calcifications, or other abnormalities are present. There is no significant change from the prior exam.

Impressions

BI-RADS® Category 1: Negative. Recommend normal interval follow-up in 12 months

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