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Page 346​

DICOM PS3.17 2020a - Explanatory Information​

The specimen IDs must be different from each other and from the container (slide) ID. The specimens may be localized, for example,​ by descriptive text "Short direction smear" and "Long direction smear".​

Slide ID

Tissue Section Item ID

Tissue Section Item ID

Figure NN.4-4. Two specimens smears on one slide​

NN.4.5 Tissue Micro Array​

Slides created from a TMA block have small fragments of many different tissues coming from different patients, all of which may be​ processedatthesametime,underthesameconditionsbyadesiredtechnique.Thesearetypicallyutilizedinresearch.SeeFigureNN.4-​ 5. Tissue items (spots) on the TMA slide come from different tissue items (cores) in TMA blocks (from different donor blocks, different​ parts and different patients).​

Each Specimen (spot) must have its own ID. The specimens may be localized, for example, by X-Y coordinates, or by a textual​ column-row identifier for the spot (e.g., "E3" for fifth column, third row).​

If the TMA slide is imaged as a whole, e.g., at low resolution as an index, it must be given a "pseudo-patient" identifier (since it does​ not relate to a single patient). Images created for each spot should be assigned to the real patients.​

Cassette

 

Cassette

 

Cassette

 

Cassette

 

Cassette

 

Cassette

(Tissue dice

 

(Tissue dice

 

(Tissue dice

 

(Tissue dice

 

(Tissue dice

 

(Tissue dice

embedded in a

 

embedded in a

 

embedded in a

 

embedded in a

 

embedded in a

 

embedded in a

Block)

 

Block)

 

Block)

 

Block)

 

Block)

 

Block)

 

 

 

 

 

 

 

 

 

 

 

Cassette (Tissue dice embedded in a Block) Cassette ID

Slide ID

Cassette (Tissue dice embedded in a Block) Cassette ID

Tissue Section Item IDs

Tissue Section Item IDs

Figure NN.4-5. Sampling for TMA Slide​

NN.5 Structure of The Specimen Module​

The Specimen Module content is specified as a Macro as an editorial convention to facilitate its use in both Composite IODs and in​ the Modality Worklist Information Model.​

The Module has two main sections. The first deals with the specimen container. The second deals with the specimens within that​ container. Because more than one specimen may reside in single container, the specimen section is set up as a sequence.​

The Container section is divided two "sub-sections":​

•​One deals with the Specimen Container ID and the Container Type. Note that the "Container Identifier" is a required field.​

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DICOM PS3.17 2020a - Explanatory Information​

Page 347​

•​One deals with Container Components. Because there may be more than one component, this section is set up as a sequence.​

The Specimen Description Sequence contains five "sub-sections"​

•​One deals with the Specimen ID​

•​One deals with descriptions of the specimen​

•​One deals with preparation of the specimen and its ancestor specimens (including sampling, processing and staining). Because​ of its importance in interpreting slide images, staining is distinguished from other processing. Specimen preparation is set up as​ sequence of process steps (multiple steps are possible); each step is in turn a sequence of content items (Attributes using coded​ vocabularies). This is the most complex part of the module.​

•​One deals with the original anatomic location of the specimen in the patient.​

•​One deals with specimen localization within a container. This is used to identify specimens when there is more than one in a con-​ tainer. It is set up as sequence.​

NN.6 Examples of Specimen Module Use​

This section includes examples of the use of the Specimen Module. Each example has two tables.​

The first table contains the majority of the container and specimen elements of the Specimen Module. The second includes the Spe-​ cimen Preparation Sequence (which documents the sampling, processing and staining steps).​

In the first table, invocations of Macros have been expanded to their constituent Attributes. The Table does not include Type 3 (op-​ tional) Attributes that are not used for the example case.​

The second table shows the Items of the Specimen Preparation Sequence and its subsidiary Specimen Preparation Step Content​ ItemSequence.ThatlattersequenceitselfhassubsidiaryCodeSequenceItems,buttheseareshowninthecanonicalDICOM"triplet"​ format (see PS3.16), e.g., (44714003, SCT, "Left Upper Lobe of Lung"). In the table, inclusions of subsidiary templates have been​ expanded to their constituent Content Items. The Table does not include Type U (optional) Content Items that are not used for the​ example case.​

Values in the colored columns of the two tables actually appear in the image object.​

NN.6.1 Gross Specimen​

ThisisanexampleofhowtheSpecimenModulecanbepopulatedforagrossspecimen(alungloberesectionreceivedfromsurgery).​ The associated image would be a gross image taken in gross room.​

Table NN.6-1. Specimen Module for Gross Specimen​

Attribute Name​

Tag​

Attribute Description​

Example Value​

Container Identifier​(0040,0512)​The identifier for the container​ S07-100 A​ that contains the specimen(s)​

being imaged.​

Issuer of the​

(0040,0513)​Organization that assigned the​

Container Identifier​

Container Identifier​

Sequence​

 

 

>Local Namespace​(0040,0031)​Identifiesanentitywithinthelocal​Case Medical Center​

Entity ID​

 

namespace or domain.​

Comments​

Note that the container​ ID is required, even​ though the container​ itself does not figure in​ the image.​

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DICOM PS3.17 2020a - Explanatory Information​

 

Attribute Name​

Tag​

Attribute Description​

Example Value​

Comments​

Container Type​

(0040,0518)​Type of container that contains​

 

This would likely be a​

Code Sequence​

 

the specimen(s) being imaged.​

 

default container value​

 

 

Zero or one items shall be​

 

for all gross specimens.​

 

 

permitted in this sequence​

 

The LIS does not keep​

 

 

 

 

information on the gross​

 

 

 

 

container type, so this is​

 

 

 

 

an empty sequence.​

Specimen​

(0040,0560)​Sequence of identifiers and​

 

 

Description​

 

detailed description of the​

 

 

Sequence​

 

specimen(s) being imaged. One​

 

 

 

or more Items shall be included​

 

 

 

in this Sequence.​

 

 

>SpecimenIdentifier​(0040,0551)​A departmental information​

S07-100 A​

SpecimenandContainer​

 

 

system identifier for the​

 

have same ID​

 

 

Specimen.​

 

 

>Issuer of the​

(0040,0562)​The name or code for the​

 

 

Specimen Identifier​

institution that has assigned the​

 

Sequence​

 

Specimen Identifier.​

 

 

>> Local​

(0040,0031)​Identifiesanentitywithinthelocal​Case Medical Center​

 

Namespace Entity​

 

namespace or domain.​

 

 

ID​

 

 

 

 

>Specimen UID​

(0040,0554)​Unique Identifier for Specimen​ 1.2.840.99790.986.33.1677.1.1.17.1​

>Specimen Short​

(0040,0600)​Short textual specimen​

Part A: LEFT UPPER LOBE​

The LIS "Specimen​

Description​

 

description​

 

Received" field is​

 

 

 

 

mapped to this DICOM​

 

 

 

 

field​

>SpecimenDetailed​(0040,0602)​Detailed textual specimen​

A: Received fresh for intraoperative​This is a mapping from​

Description​

 

description​

consultation,labeledwiththepatient's​the LIS "Gross​

 

 

 

name, number and "left upper lobe,"​Description" field. Note​

 

 

 

isapink-tan,wedge-shapedsegment​that in Case S07-100​

 

 

 

of soft tissue, 6.9 x 4.2 x 1.0 cm. The​thereweresixparts.This​

 

 

 

pleural surface is pink-tan and​

means the LIS gross​

 

 

 

glistening with a stapled line​

descriptionfieldwillhave​

 

 

 

measuring 12.0 cm. in length. The​ six sections (A - F). We​

 

 

 

pleural surface shows a 0.5 cm. area​would have to parse the​

 

 

 

of puckering. The pleural surface is​gross description field​

 

 

 

inked black. The cut surface reveals​intothoseparts(A-F)and​

 

 

 

a 1.2 x 1.1 cm, white-gray, irregular​then only incorporate​

 

 

 

massabuttingthepleuralsurfaceand​section "A" into this​

 

 

 

deep to the puckered area. The​

Attribute. NOTE: One​

 

 

 

remainder of the cut surface is​

could consider listing all​

 

 

 

red-brown and congested. No other​the Blocks associated​

 

 

 

lesionsareidentified.Representative​with Part A. It would be​

 

 

 

sections are submitted.​

easytodoandmightgive​

 

 

 

 

useful information.​

>Specimen​

(0040,0610)​SequenceofItemsidentifyingthe​(see Table NN.6-2)​

 

Preparation​

 

process steps used to prepare​

 

 

Sequence​

 

the specimen for image​

 

 

 

 

acquisition. One or more Items​

 

 

may be present. This Sequence​ includes description of the​ specimen sampling step from a​ parentspecimen,potentiallyback​ to the original part collection.​

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DICOM PS3.17 2020a - Explanatory Information​

Attribute Name​

Tag​

Attribute Description​

Example Value​

>>Specimen​

(0040,0612)​Sequence of Content Items​

 

Preparation Step​

 

identifying the processes used in​

 

Content Item​

 

one preparation step to prepare​

 

Sequence​

 

the specimen for image​

 

 

 

acquisition. One or more Items​

 

 

 

may be present.​

 

>Primary Anatomic​(0008,2228)​Original anatomic location in​ Structure Sequence​ patientofspecimen.Thislocation​

may be inherited from the parent​ specimen, or further refined by​ modifiers depending on the​ sampling procedure for this​ specimen.​

>>Code Value​

(0008,0100)​

44714003​

>>Coding Scheme​(0008,0102)​

SCT​

Designator​

 

 

>>Code Meaning​

(0008,0104)​

Left Upper Lobe of Lung​

Page 349​

Comments​

This is a code sequence​ item​

Table NN.6-2. Specimen Preparation Sequence for Gross Specimen​

Specimen​ Specimen​Template/Row​ Value Type​ ConceptNameCodeSequence​ Example Value​

Comments​

Preparation​Prep. Step​

(0040,A040)​

(0040,A043)​

 

 

Sequence -​ Content​

 

 

 

 

Item #​

 

Item​

 

 

 

 

 

Sequence -​

 

 

 

 

 

Item #​

 

 

 

 

1​

1​

8001 / 1​

TEXT​

(121041, DCM, "Specimen​

S07-100 A​

Collection​

 

 

 

 

Identifier")​

 

in OR​

 

2​

8001 / 2​

TEXT​

(111724, DCM, "Issuer of​

Case Medical Center​

 

 

 

 

 

Specimen Identifier")​

 

 

 

1​

8001 / 3​

CODE​

(111701, DCM, "Processing​

(17636008, SCT,​

 

 

 

 

 

type")​

"Specimen collection")​

 

2​

8001 / 4​

DATETIME​

(111702, DCM, "DateTime of​

200703230827​

 

 

 

 

 

processing")​

 

 

 

3​

8001 / 5​

TEXT​

(111703, DCM, "Processing step​Taken​

 

 

 

 

description")​

 

 

4​

8001 / 8​

CODE​

(111704, DCM, "Sampling​

(65801008, SCT,​

 

 

8002 / 1​

 

Method")​

"Excision")​

 

 

 

 

 

2​

1​

8001 / 1​

TEXT​

(121041, DCM, "Specimen​

S07-100 A​

 

 

 

 

Identifier")​

 

 

2​

8001 / 2​

TEXT​

(111724, DCM, "Issuer of​

Case Medical Center​

 

 

 

 

Specimen Identifier")​

 

Specimen​ received in​ Pathology​ department​

1​

8001 / 3​

CODE​

(111701, DCM, "Processing​

(428995007, SCT,​

 

 

 

type")​

"Specimen Receiving")​

2​

8001 / 4​

DATETIME​

(111702, DCM, "DateTime of​

200703230943​

 

 

 

processing")​

 

NN.6.2 Slide​

This is an example of how the Specimen Module can be populated for a slide (from a lung lobe resection received from surgery). The​ associated image would be a whole slide image.​

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Page 350​

DICOM PS3.17 2020a - Explanatory Information​

Table NN.6-3. Specimen Module for a Slide​

Attribute Name​

Tag​

Attribute Description​

Example Value​

Container Identifier​

(0040,0512)​The identifier for the container​S07-100 A 5 1​

 

 

that contains the specimen(s)​

 

 

 

being imaged.​

 

Issuer of the​

(0040,0513)​Organization that assigned the​

Container Identifier​

 

Container Identifier​

 

Sequence​

 

 

 

>Local Namespace​

(0040,0031)​Identifies an entity within the​

Case Medical Center​

Entity ID​

 

local namespace or domain.​

 

Container Type Code​(0040,0518)​Type of container that contains​

Sequence​

 

the specimen(s) being imaged.​

 

 

Only a single item shall be​

 

 

 

permitted in this sequence​

 

>Code Value​

(0008,0100)​

258661006​

>Coding Scheme​

(0008,0102)​

SCT​

Designator​

 

 

 

>Code Meaning​

(0008,0104)​

Slide​

ContainerComponent​(0040,0520)​Description of one or more​ Sequence​ components of the container​

(e.g.,descriptionoftheslideand​ of the coverslip). One or more​ Items may be included in this​ Sequence.​

>Container​

(0050,0012)​Type of container component.​

 

Component Type​

One Item shall be included in​

 

Code Sequence​

this Sequence.​

 

>>Code Value​

(0008,0100)​

433472003​

>>Coding Scheme​

(0008,0102)​

SCT​

Designator​

 

 

>>Code Meaning​

(0008,0104)​

Microscope slide coverslip​

>Container​

(0050,001A)​Materialofcontainercomponent.​GLASS​

Component Material​

 

 

SpecimenDescription​(0040,0560)​Sequence of identifiers and​

 

Sequence​

detailed description of the​

 

 

specimen(s)beingimaged.One​

 

or more Items shall be included​

 

in this Sequence.​

 

Comments​

This would likely be a​ default container value​ for all slide specimens.​

This is a code​ sequence item​

This is a code​ sequence item​

>Specimen Identifier​(0040,0551)​A departmental information​

S07-100 A 5 1​

Specimen and​

 

system identifier for the​

 

Container have same​

 

Specimen.​

 

ID​

>Issuer of the​

(0040,0562)​The name or code for the​

 

 

Specimen Identifier​

institution that has assigned the​

 

Sequence​

Specimen Identifier.​

 

 

>>Local Namespace​(0040,0031)​Identifies an entity within the​

Case Medical Center​

 

Entity ID​

local namespace or domain.​

 

 

>Specimen UID​

(0040,0554)​Unique Identifier for Specimen​1.2.840.99790.986.33.1677.1.1.19.5​

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Источник: https://studfile.net/preview/14585770/

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