MII IG Befunde bildgebender Verfahren DE v2025
MII-Initiative

MII IG Befunde bildgebender Verfahren DE v2025

Extension für erweiterte Informationen auf Instanzebene

Die Extension für DICOM-Instanzen ermöglicht das Erfassen relevanter DICOM-Tags, um detaillierte Informationen über die Bildinstanzen zu erhalten. Diese Instanzen enthalten wesentliche Parameter zur Beschreibung und Klassifikation der Bilddaten und ihrer Eigenschaften. Dies ermöglicht das Nachvollziehen der Eigenschaften der einzelnen Schichten und gibt somit Hinweise auf die Eigenschaften der gesamten Serie. Beispielsweise kann die Homogenität der Pixelabstände oder Schichtdicken über die ganze Serie hinweg untersucht werden, was gleichzeitig als Ein- oder Ausschlusskriterium für Studien dient.

Relevante DICOM-Tags:

  • Schichtdicke [(0018, 0050) SliceThickness] in [mm]
  • Bildtyp [(0008, 0008) ImageType]
  • Pixelabstand (x) [(0028, 0030) PixelSpacing] in [mm]
  • Pixelabstand (y) [(0028, 0030) PixelSpacing] in [mm]

Die Pixelabstände sind in X und Y aufgeteilt und müssen aus dem zugrunde liegenden DICOM-Tag extrahiert werden. Das DICOM-Tag PixelSpacing speichert X- und Y-Abstände gleichzeitig als String in folgendem Format: z. B. [0.703125, 0.703125].

NameStatusVersionCanonicalBasis
MII_EX_Bildgebung_Instanz_Detailsactive2025.0.0https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-detailshttp://hl7.org/fhir/StructureDefinition/Extension

Inhalt

id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
valueΣ0..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1stringPattern
systemΣ I0..1uriPattern
codeΣ0..1codePattern
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
valueΣ0..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1stringPattern
systemΣ I0..1uriPattern
codeΣ0..1codePattern
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
valueΣ0..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1stringPattern
systemΣ I0..1uriPattern
codeΣ0..1codePattern
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
pixelDataΣ0..*CodingBinding
patientExaminationΣ0..*CodingBinding
modalityCTΣ0..*CodingBinding
modalityMRΣ0..*CodingBinding
modalityNMΣ0..*CodingBinding
implementationNMΣ0..*CodingBinding
textΣ0..1string
url1..1uriFixed Value

Die Extension ermöglicht es, Informationen zur ausgewählten Serie auf Instanz-Ebene anzugeben.

Feldname
Extension.extension:pixelSpacingX
Extension.extension:pixelSpacingY
Extension.extension:sliceThickness
Extension.extension:imageType
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="mii-ex-bildgebung-instanz-details" />
    <extension url="https://www.medizininformatik-initiative.de/fhir/modul-meta/StructureDefinition/mii-ex-meta-license-codeable">
        <valueCodeableConcept>
            <coding>
                <system value="http://hl7.org/fhir/spdx-license" />
                <code value="CC-BY-4.0" />
                <display value="Creative Commons Attribution 4.0 International" />
            </coding>
        </valueCodeableConcept>
    </extension>
    <url value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details" />
    <version value="2025.0.0" />
    <name value="MII_EX_Bildgebung_Instanz_Details">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="MII_EX_Instance_Details" />
            </extension>
        </extension>
    </name>
    <title value="MII EX Bildgebung Instanzdetails">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="MII EX Instance Details" />
            </extension>
        </extension>
    </title>
    <status value="active" />
    <experimental value="false" />
    <publisher value="Medizininformatik Initiative" />
    <contact>
        <telecom>
            <system value="url" />
            <value value="https://www.medizininformatik-initiative.de" />
        </telecom>
    </contact>
    <description value="Die Extension erm&#246;glicht es, Informationen zur ausgew&#228;hlten Serie auf Instanz-Ebene anzugeben.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="The extension allows specifying information about the selected series at the instance level." />
            </extension>
        </extension>
    </description>
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="ImagingStudy.series.instance" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension.extension:pixelSpacingX">
            <path value="Extension.extension" />
            <sliceName value="pixelSpacingX" />
            <min value="0" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Extension.extension:pixelSpacingX.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:pixelSpacingX.url">
            <path value="Extension.extension.url" />
            <fixedUri value="pixelSpacingX" />
        </element>
        <element id="Extension.extension:pixelSpacingX.value[x]">
            <path value="Extension.extension.value[x]" />
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
        </element>
        <element id="Extension.extension:pixelSpacingX.value[x].unit">
            <path value="Extension.extension.value[x].unit" />
            <patternString value="millimeter" />
        </element>
        <element id="Extension.extension:pixelSpacingX.value[x].system">
            <path value="Extension.extension.value[x].system" />
            <patternUri value="http://unitsofmeasure.org" />
        </element>
        <element id="Extension.extension:pixelSpacingX.value[x].code">
            <path value="Extension.extension.value[x].code" />
            <patternCode value="mm" />
        </element>
        <element id="Extension.extension:pixelSpacingY">
            <path value="Extension.extension" />
            <sliceName value="pixelSpacingY" />
            <min value="0" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Extension.extension:pixelSpacingY.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:pixelSpacingY.url">
            <path value="Extension.extension.url" />
            <fixedUri value="pixelSpacingY" />
        </element>
        <element id="Extension.extension:pixelSpacingY.value[x]">
            <path value="Extension.extension.value[x]" />
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
        </element>
        <element id="Extension.extension:pixelSpacingY.value[x].unit">
            <path value="Extension.extension.value[x].unit" />
            <patternString value="millimeter" />
        </element>
        <element id="Extension.extension:pixelSpacingY.value[x].system">
            <path value="Extension.extension.value[x].system" />
            <patternUri value="http://unitsofmeasure.org" />
        </element>
        <element id="Extension.extension:pixelSpacingY.value[x].code">
            <path value="Extension.extension.value[x].code" />
            <patternCode value="mm" />
        </element>
        <element id="Extension.extension:sliceThickness">
            <path value="Extension.extension" />
            <sliceName value="sliceThickness" />
            <min value="0" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Extension.extension:sliceThickness.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:sliceThickness.url">
            <path value="Extension.extension.url" />
            <fixedUri value="sliceThickness" />
        </element>
        <element id="Extension.extension:sliceThickness.value[x]">
            <path value="Extension.extension.value[x]" />
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
        </element>
        <element id="Extension.extension:sliceThickness.value[x].unit">
            <path value="Extension.extension.value[x].unit" />
            <patternString value="millimeter" />
        </element>
        <element id="Extension.extension:sliceThickness.value[x].system">
            <path value="Extension.extension.value[x].system" />
            <patternUri value="http://unitsofmeasure.org" />
        </element>
        <element id="Extension.extension:sliceThickness.value[x].code">
            <path value="Extension.extension.value[x].code" />
            <patternCode value="mm" />
        </element>
        <element id="Extension.extension:imageType">
            <path value="Extension.extension" />
            <sliceName value="imageType" />
            <min value="0" />
            <max value="*" />
            <mustSupport value="true" />
        </element>
        <element id="Extension.extension:imageType.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:imageType.url">
            <path value="Extension.extension.url" />
            <fixedUri value="imageType" />
        </element>
        <element id="Extension.extension:imageType.value[x]">
            <path value="Extension.extension.value[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
        </element>
        <element id="Extension.extension:imageType.value[x].coding">
            <path value="Extension.extension.value[x].coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="coding" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="Extension.extension:imageType.value[x].coding:pixelData">
            <path value="Extension.extension.value[x].coding" />
            <sliceName value="pixelData" />
            <min value="0" />
            <max value="*" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-pixel-data" />
            </binding>
        </element>
        <element id="Extension.extension:imageType.value[x].coding:patientExamination">
            <path value="Extension.extension.value[x].coding" />
            <sliceName value="patientExamination" />
            <min value="0" />
            <max value="*" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-patient-examination" />
            </binding>
        </element>
        <element id="Extension.extension:imageType.value[x].coding:modalityCT">
            <path value="Extension.extension.value[x].coding" />
            <sliceName value="modalityCT" />
            <min value="0" />
            <max value="*" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-ct" />
            </binding>
        </element>
        <element id="Extension.extension:imageType.value[x].coding:modalityMR">
            <path value="Extension.extension.value[x].coding" />
            <sliceName value="modalityMR" />
            <min value="0" />
            <max value="*" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-mr" />
            </binding>
        </element>
        <element id="Extension.extension:imageType.value[x].coding:modalityNM">
            <path value="Extension.extension.value[x].coding" />
            <sliceName value="modalityNM" />
            <min value="0" />
            <max value="*" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-nm" />
            </binding>
        </element>
        <element id="Extension.extension:imageType.value[x].coding:implementationNM">
            <path value="Extension.extension.value[x].coding" />
            <sliceName value="implementationNM" />
            <min value="0" />
            <max value="*" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-nm-implementation" />
            </binding>
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "mii-ex-bildgebung-instanz-details",
    "extension":  [
        {
            "url": "https://www.medizininformatik-initiative.de/fhir/modul-meta/StructureDefinition/mii-ex-meta-license-codeable",
            "valueCodeableConcept": {
                "coding":  [
                    {
                        "code": "CC-BY-4.0",
                        "system": "http://hl7.org/fhir/spdx-license",
                        "display": "Creative Commons Attribution 4.0 International"
                    }
                ]
            }
        }
    ],
    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details",
    "version": "2025.0.0",
    "name": "MII_EX_Bildgebung_Instanz_Details",
    "_name": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "MII_EX_Instance_Details"
                    }
                ]
            }
        ]
    },
    "title": "MII EX Bildgebung Instanzdetails",
    "_title": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "MII EX Instance Details"
                    }
                ]
            }
        ]
    },
    "status": "active",
    "experimental": false,
    "publisher": "Medizininformatik Initiative",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "https://www.medizininformatik-initiative.de"
                }
            ]
        }
    ],
    "description": "Die Extension ermöglicht es, Informationen zur ausgewählten Serie auf Instanz-Ebene anzugeben.",
    "_description": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "The extension allows specifying information about the selected series at the instance level."
                    }
                ]
            }
        ]
    },
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "ImagingStudy.series.instance"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension.extension:pixelSpacingX",
                "path": "Extension.extension",
                "sliceName": "pixelSpacingX",
                "min": 0,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Extension.extension:pixelSpacingX.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:pixelSpacingX.url",
                "path": "Extension.extension.url",
                "fixedUri": "pixelSpacingX"
            },
            {
                "id": "Extension.extension:pixelSpacingX.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ]
            },
            {
                "id": "Extension.extension:pixelSpacingX.value[x].unit",
                "path": "Extension.extension.value[x].unit",
                "patternString": "millimeter"
            },
            {
                "id": "Extension.extension:pixelSpacingX.value[x].system",
                "path": "Extension.extension.value[x].system",
                "patternUri": "http://unitsofmeasure.org"
            },
            {
                "id": "Extension.extension:pixelSpacingX.value[x].code",
                "path": "Extension.extension.value[x].code",
                "patternCode": "mm"
            },
            {
                "id": "Extension.extension:pixelSpacingY",
                "path": "Extension.extension",
                "sliceName": "pixelSpacingY",
                "min": 0,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Extension.extension:pixelSpacingY.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:pixelSpacingY.url",
                "path": "Extension.extension.url",
                "fixedUri": "pixelSpacingY"
            },
            {
                "id": "Extension.extension:pixelSpacingY.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ]
            },
            {
                "id": "Extension.extension:pixelSpacingY.value[x].unit",
                "path": "Extension.extension.value[x].unit",
                "patternString": "millimeter"
            },
            {
                "id": "Extension.extension:pixelSpacingY.value[x].system",
                "path": "Extension.extension.value[x].system",
                "patternUri": "http://unitsofmeasure.org"
            },
            {
                "id": "Extension.extension:pixelSpacingY.value[x].code",
                "path": "Extension.extension.value[x].code",
                "patternCode": "mm"
            },
            {
                "id": "Extension.extension:sliceThickness",
                "path": "Extension.extension",
                "sliceName": "sliceThickness",
                "min": 0,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Extension.extension:sliceThickness.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:sliceThickness.url",
                "path": "Extension.extension.url",
                "fixedUri": "sliceThickness"
            },
            {
                "id": "Extension.extension:sliceThickness.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ]
            },
            {
                "id": "Extension.extension:sliceThickness.value[x].unit",
                "path": "Extension.extension.value[x].unit",
                "patternString": "millimeter"
            },
            {
                "id": "Extension.extension:sliceThickness.value[x].system",
                "path": "Extension.extension.value[x].system",
                "patternUri": "http://unitsofmeasure.org"
            },
            {
                "id": "Extension.extension:sliceThickness.value[x].code",
                "path": "Extension.extension.value[x].code",
                "patternCode": "mm"
            },
            {
                "id": "Extension.extension:imageType",
                "path": "Extension.extension",
                "sliceName": "imageType",
                "min": 0,
                "max": "*",
                "mustSupport": true
            },
            {
                "id": "Extension.extension:imageType.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:imageType.url",
                "path": "Extension.extension.url",
                "fixedUri": "imageType"
            },
            {
                "id": "Extension.extension:imageType.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ]
            },
            {
                "id": "Extension.extension:imageType.value[x].coding",
                "path": "Extension.extension.value[x].coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "coding"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "Extension.extension:imageType.value[x].coding:pixelData",
                "path": "Extension.extension.value[x].coding",
                "sliceName": "pixelData",
                "min": 0,
                "max": "*",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-pixel-data"
                }
            },
            {
                "id": "Extension.extension:imageType.value[x].coding:patientExamination",
                "path": "Extension.extension.value[x].coding",
                "sliceName": "patientExamination",
                "min": 0,
                "max": "*",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-patient-examination"
                }
            },
            {
                "id": "Extension.extension:imageType.value[x].coding:modalityCT",
                "path": "Extension.extension.value[x].coding",
                "sliceName": "modalityCT",
                "min": 0,
                "max": "*",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-ct"
                }
            },
            {
                "id": "Extension.extension:imageType.value[x].coding:modalityMR",
                "path": "Extension.extension.value[x].coding",
                "sliceName": "modalityMR",
                "min": 0,
                "max": "*",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-mr"
                }
            },
            {
                "id": "Extension.extension:imageType.value[x].coding:modalityNM",
                "path": "Extension.extension.value[x].coding",
                "sliceName": "modalityNM",
                "min": 0,
                "max": "*",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-nm"
                }
            },
            {
                "id": "Extension.extension:imageType.value[x].coding:implementationNM",
                "path": "Extension.extension.value[x].coding",
                "sliceName": "implementationNM",
                "min": 0,
                "max": "*",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/ValueSet/mii-vs-bildgebung-instance-image-type-nm-implementation"
                }
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "max": "0"
            }
        ]
    }
}

Beispiele

Hinweis
Warning Aus Gründen der Übersichtlichkeit wurde in diesem Beispiel darauf verzichtet, alle dazugehörigen Serien bzw. Instanzen mit einzubinden. Natürlich ist es bei der Implkementierung vorgesehen, dass alle zur jeweiligen Studie gehörenden Serien und Instanzen auch in der resultierenden FHIR-Ressource enthalten sind - dafür wird dann einfach die Sequenz "series" bzw "instance" für jede Serie bzw. Instanz wiederholt und mit den entsprechenden Werten befüllt.

Beispiele von ImagingStudy-Ressourcen mit der Extension für Intanzdetails:

Beispiel eines CTs:

{
    "resourceType": "ImagingStudy",
    "id": "mii-exa-bildgebung-bildgebungsstudie-ct",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-pr-bildgebung-bildgebungsstudie"
        ]
    },
    "extension":  [
        {
            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-bildgebungsgrund",
            "valueString": "Verdacht auf Karzinom"
        }
    ],
    "series":  [
        {
            "extension":  [
                {
                    "extension":  [
                        {
                            "valueQuantity": {
                                "unit": "milligray",
                                "value": 4.04
                            },
                            "url": "CTDIvol"
                        },
                        {
                            "valueQuantity": {
                                "unit": "kilovolt",
                                "value": 110
                            },
                            "url": "KVP"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliampere second",
                                "value": 38
                            },
                            "url": "exposure"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliseconds",
                                "value": 600
                            },
                            "url": "exposureTime"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliampere",
                                "value": 96
                            },
                            "url": "xRayTubeCurrent"
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-ct"
                },
                {
                    "extension":  [
                        {
                            "url": "contrastBolus",
                            "valueBoolean": true
                        },
                        {
                            "url": "contrastBolusDetails",
                            "valueReference": {
                                "reference": "MedicationAdministration/mii-exa-bildgebung-kontrastmittelgabe"
                            }
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-kontrastmittel"
                }
            ],
            "instance":  [
                {
                    "extension":  [
                        {
                            "extension":  [
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 1.36
                                    },
                                    "url": "pixelSpacingX"
                                },
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 1.36
                                    },
                                    "url": "pixelSpacingY"
                                },
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 4
                                    },
                                    "url": "sliceThickness"
                                },
                                {
                                    "url": "imageType",
                                    "valueCodeableConcept": {
                                        "coding":  [
                                            {
                                                "code": "DERIVED",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            },
                                            {
                                                "code": "PRIMARY",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            },
                                            {
                                                "code": "AXIAL",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            }
                                        ]
                                    }
                                }
                            ],
                            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details"
                        }
                    ],
                    "uid": "instance-example-uid",
                    "sopClass": {
                        "code": "urn:oid:1.2.840.10008.5.1.4.1.1.2",
                        "system": "urn:ietf:rfc:3986"
                    },
                    "number": 31
                }
            ],
            "performer":  [
                {
                    "actor": {
                        "reference": "Device/mii-exa-bildgebung-geraet"
                    }
                }
            ],
            "uid": "series-example-uid",
            "number": 1,
            "modality": {
                "code": "CT",
                "system": "http://dicom.nema.org/resources/ontology/DCM",
                "display": "Computed Tomography"
            },
            "description": "AC LD CT Whole Body 4.0 HD Field of View",
            "numberOfInstances": 195,
            "bodySite": {
                "code": "51185008",
                "system": "http://snomed.info/sct",
                "display": "Thoracic structure (body structure)"
            },
            "laterality": {
                "code": "7771000",
                "system": "http://snomed.info/sct",
                "display": "Left"
            },
            "started": "2024-07-19T12:03:30+02:00"
        }
    ],
    "status": "available",
    "modality":  [
        {
            "code": "CT",
            "system": "http://dicom.nema.org/resources/ontology/DCM",
            "display": "Computed Tomography"
        }
    ],
    "subject": {
        "reference": "Patient/PatExample",
        "identifier": {
            "type": {
                "coding":  [
                    {
                        "code": "MR",
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "display": "Medical record number"
                    }
                ]
            },
            "system": "https://system-url",
            "value": "study-uid"
        }
    },
    "encounter": {
        "reference": "Encounter/EncExample"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/mii-exa-bildgebung-anforderung-bildgebung"
        }
    ],
    "numberOfSeries": 2,
    "numberOfInstances": 390,
    "procedureReference": {
        "reference": "Procedure/mii-exa-bildgebung-bildgebungsprozedur"
    },
    "reasonReference":  [
        {
            "reference": "Condition/CondExample"
        }
    ],
    "description": "whole body aquisition"
}

Beispiel eines MRTs:

{
    "resourceType": "ImagingStudy",
    "id": "mii-exa-bildgebung-bildgebungsstudie-mr",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-pr-bildgebung-bildgebungsstudie"
        ]
    },
    "extension":  [
        {
            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-bildgebungsgrund",
            "valueString": "Verdacht auf Kreuzbandruptur"
        }
    ],
    "series":  [
        {
            "extension":  [
                {
                    "extension":  [
                        {
                            "valueQuantity": {
                                "unit": "tesla",
                                "value": 3
                            },
                            "url": "magneticFieldStrength"
                        },
                        {
                            "url": "scanningSequence",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "SE",
                                        "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-scanning-sequence"
                                    }
                                ]
                            }
                        },
                        {
                            "url": "scanningSequenceVariant",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "SP",
                                        "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-scanning-sequence-variant"
                                    },
                                    {
                                        "code": "SK",
                                        "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-scanning-sequence-variant"
                                    }
                                ]
                            }
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliseconds",
                                "value": 388
                            },
                            "url": "echoTime"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliseconds",
                                "value": 5000
                            },
                            "url": "repetitionTime"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliseconds",
                                "value": 900
                            },
                            "url": "inversionTime"
                        },
                        {
                            "valueQuantity": {
                                "unit": "plane angle degree",
                                "value": 130
                            },
                            "url": "flipAngle"
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-mr"
                },
                {
                    "extension":  [
                        {
                            "url": "contrastBolus",
                            "valueBoolean": false
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-kontrastmittel"
                }
            ],
            "instance":  [
                {
                    "extension":  [
                        {
                            "extension":  [
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 0.260417
                                    },
                                    "url": "pixelSpacingX"
                                },
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 0.260417
                                    },
                                    "url": "pixelSpacingY"
                                },
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 3
                                    },
                                    "url": "sliceThickness"
                                },
                                {
                                    "url": "imageType",
                                    "valueCodeableConcept": {
                                        "coding":  [
                                            {
                                                "code": "ORIGINAL",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            },
                                            {
                                                "code": "SECONDARY",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            },
                                            {
                                                "code": "OTHER",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            }
                                        ]
                                    }
                                }
                            ],
                            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details"
                        }
                    ],
                    "uid": "instance-example-uid",
                    "sopClass": {
                        "code": "urn:oid:1.2.840.10008.5.1.4.1.1.4",
                        "system": "urn:ietf:rfc:3986"
                    },
                    "number": 28
                }
            ],
            "performer":  [
                {
                    "actor": {
                        "reference": "Device/mii-exa-bildgebung-geraet"
                    }
                }
            ],
            "uid": "series-example-uid",
            "number": 9,
            "modality": {
                "code": "MR",
                "system": "http://dicom.nema.org/resources/ontology/DCM",
                "display": "Magnetic Resonance"
            },
            "description": "pd_tse_sag",
            "numberOfInstances": 28,
            "bodySite": {
                "code": "72696002",
                "system": "http://snomed.info/sct",
                "display": "Knee region structure (body structure)"
            },
            "laterality": {
                "code": "24028007",
                "system": "http://snomed.info/sct",
                "display": "Right"
            },
            "started": "2024-07-19T12:03:30+02:00"
        }
    ],
    "status": "available",
    "modality":  [
        {
            "code": "MR",
            "system": "http://dicom.nema.org/resources/ontology/DCM",
            "display": "Magnetic Resonance"
        }
    ],
    "subject": {
        "reference": "Patient/PatExample",
        "identifier": {
            "type": {
                "coding":  [
                    {
                        "code": "MR",
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "display": "Medical record number"
                    }
                ]
            },
            "system": "https://system-url",
            "value": "study-uid"
        }
    },
    "encounter": {
        "reference": "Encounter/EncExample"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/mii-exa-bildgebung-anforderung-bildgebung"
        }
    ],
    "numberOfSeries": 11,
    "numberOfInstances": 294,
    "procedureReference": {
        "reference": "Procedure/mii-exa-bildgebung-bildgebungsprozedur"
    },
    "reasonReference":  [
        {
            "reference": "Condition/CondExample"
        }
    ],
    "description": "Knie DOT"
}

Beispiel eine Röntgenbilds:

{
    "resourceType": "ImagingStudy",
    "id": "mii-exa-bildgebung-bildgebungsstudie-cr",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-pr-bildgebung-bildgebungsstudie"
        ]
    },
    "extension":  [
        {
            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-bildgebungsgrund",
            "valueString": "Verdacht auf Karzinom"
        }
    ],
    "series":  [
        {
            "extension":  [
                {
                    "extension":  [
                        {
                            "valueQuantity": {
                                "unit": "kilovolt",
                                "value": 110
                            },
                            "url": "KVP"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliampere second",
                                "value": 38
                            },
                            "url": "exposure"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliseconds",
                                "value": 600
                            },
                            "url": "exposureTime"
                        },
                        {
                            "valueQuantity": {
                                "unit": "milliampere",
                                "value": 96
                            },
                            "url": "xRayTubeCurrent"
                        },
                        {
                            "url": "viewPosition",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "399038007",
                                        "system": "http://snomed.info/sct",
                                        "display": "Right posterior oblique projection (qualifier value)"
                                    }
                                ]
                            }
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-mg-cr-dx"
                },
                {
                    "extension":  [
                        {
                            "url": "contrastBolus",
                            "valueBoolean": false
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-kontrastmittel"
                }
            ],
            "instance":  [
                {
                    "extension":  [
                        {
                            "extension":  [
                                {
                                    "url": "imageType",
                                    "valueCodeableConcept": {
                                        "coding":  [
                                            {
                                                "code": "ORIGINAL",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            },
                                            {
                                                "code": "PRIMARY",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            }
                                        ]
                                    }
                                }
                            ],
                            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details"
                        }
                    ],
                    "uid": "instance-example-uid",
                    "sopClass": {
                        "code": "urn:oid:1.2.840.10008.5.1.4.1.1.1",
                        "system": "urn:ietf:rfc:3986"
                    },
                    "number": 1
                }
            ],
            "performer":  [
                {
                    "actor": {
                        "reference": "Device/mii-exa-bildgebung-geraet"
                    }
                }
            ],
            "uid": "series-example-uid",
            "number": 1,
            "modality": {
                "code": "CR",
                "system": "http://dicom.nema.org/resources/ontology/DCM",
                "display": "Computed Radiography"
            },
            "description": "X Thorax a.p. liegend",
            "numberOfInstances": 1,
            "bodySite": {
                "code": "43799004",
                "system": "http://snomed.info/sct",
                "display": "Thoracic structure (body structure)"
            },
            "laterality": {
                "code": "66459002",
                "system": "http://snomed.info/sct",
                "display": "Unilateral"
            },
            "started": "2024-07-19T12:03:30+02:00"
        }
    ],
    "status": "available",
    "modality":  [
        {
            "code": "CR",
            "system": "http://dicom.nema.org/resources/ontology/DCM",
            "display": "Computed Radiography"
        }
    ],
    "subject": {
        "reference": "Patient/PatExample",
        "identifier": {
            "type": {
                "coding":  [
                    {
                        "code": "MR",
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "display": "Medical record number"
                    }
                ]
            },
            "system": "https://system-url",
            "value": "study-uid"
        }
    },
    "encounter": {
        "reference": "Encounter/EncExample"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/mii-exa-bildgebung-anforderung-bildgebung"
        }
    ],
    "numberOfSeries": 1,
    "numberOfInstances": 1,
    "procedureReference": {
        "reference": "Procedure/mii-exa-bildgebung-bildgebungsprozedur"
    },
    "reasonReference":  [
        {
            "reference": "Condition/CondExample"
        }
    ],
    "description": "Thorax auf Station;"
}

Beispiel eines PET-Scans:

{
    "resourceType": "ImagingStudy",
    "id": "mii-exa-bildgebung-bildgebungsstudie-pt",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-pr-bildgebung-bildgebungsstudie"
        ]
    },
    "extension":  [
        {
            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-bildgebungsgrund",
            "valueString": "Verdacht auf Karzinom"
        }
    ],
    "series":  [
        {
            "extension":  [
                {
                    "extension":  [
                        {
                            "url": "radiopharmaceutical",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "35321007",
                                        "system": "http://snomed.info/sct",
                                        "display": "Fluorodeoxyglucose (18-F) (substance)"
                                    }
                                ]
                            }
                        },
                        {
                            "url": "radionuclide",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "23451235",
                                        "system": "http://snomed.info/sct"
                                    }
                                ]
                            }
                        },
                        {
                            "valueQuantity": {
                                "unit": "Seconds",
                                "value": 10000
                            },
                            "url": "tracerExposureTime"
                        },
                        {
                            "url": "units",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "BQML",
                                        "system": "http://unitsofmeasure.org"
                                    }
                                ]
                            }
                        },
                        {
                            "valueQuantity": {
                                "unit": "Becquerel",
                                "value": 196
                            },
                            "url": "radionuclideTotalDose"
                        },
                        {
                            "valueQuantity": {
                                "unit": "Seconds",
                                "value": 6586.2
                            },
                            "url": "radionuclideHalfLife"
                        },
                        {
                            "url": "seriesType",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "DYNAMIC",
                                        "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-series-type"
                                    },
                                    {
                                        "code": "IMAGE",
                                        "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-series-type"
                                    }
                                ]
                            }
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-pt"
                }
            ],
            "instance":  [
                {
                    "extension":  [
                        {
                            "extension":  [
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 2.89
                                    },
                                    "url": "pixelSpacingX"
                                },
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 2.89
                                    },
                                    "url": "pixelSpacingY"
                                },
                                {
                                    "valueQuantity": {
                                        "unit": "millimeter",
                                        "value": 4
                                    },
                                    "url": "sliceThickness"
                                },
                                {
                                    "url": "imageType",
                                    "valueCodeableConcept": {
                                        "coding":  [
                                            {
                                                "code": "ORIGINAL"
                                            },
                                            {
                                                "code": "PRIMARY"
                                            }
                                        ]
                                    }
                                }
                            ],
                            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-instanz-details"
                        }
                    ],
                    "uid": "instance-example-uid",
                    "sopClass": {
                        "code": "urn:oid:1.2.840.10008.5.1.4.1.1.128",
                        "system": "urn:ietf:rfc:3986"
                    },
                    "number": 31
                }
            ],
            "uid": "series-example-uid",
            "performer":  [
                {
                    "actor": {
                        "reference": "Device/mii-exa-bildgebung-geraet"
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                }
            ],
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                "code": "51185008",
                "system": "http://snomed.info/sct",
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                "code": "66459002",
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            "started": "2024-07-19T12:03:30+02:00"
        }
    ],
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    "modality":  [
        {
            "code": "PT",
            "system": "http://dicom.nema.org/resources/ontology/DCM",
            "display": "Positron emission tomography"
        }
    ],
    "subject": {
        "reference": "Patient/PatExample",
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                        "code": "MR",
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
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            "system": "https://system-url",
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    "encounter": {
        "reference": "Encounter/EncExample"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/mii-exa-bildgebung-anforderung-bildgebung"
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    ],
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    "procedureReference": {
        "reference": "Procedure/mii-exa-bildgebung-bildgebungsprozedur"
    },
    "reasonReference":  [
        {
            "reference": "Condition/CondExample"
        }
    ],
    "description": "whole body aquisition"
}