MII IG Befunde bildgebender Verfahren DE v2025

Extension Modalität Nuklearmedizin

Die Extension NM (Nuklearmedizinische Bildgebung) ermöglicht das Erfassen relevanter DICOM-Tags, um Rückschlüsse über die Bildgewinnung ziehen zu können. Eine Besonderheit der Nuklearmedizin ist die Verwendung eines Radiopharmakons, das aus einem Tracer und einem Radioisotop besteht und somit Stoffwechselbildgebung ermöglicht. Diese Informationen über das Radiopharmakon liegen verschachtelt in dem DICOM-Tag RadiopharmaceuticalInformationSequence (0054,0016) vor, sogenannte nested DICOM-Tags.

Beispiel des Zugriffs auf ein nested DICOM-Tag mit Python aus einer DICOM-Schicht(Instanz):

RadiopharmaceuticalStartTime = layer['RadiopharmaceuticalInformationSequence'][0]['RadiopharmaceuticalStartTime'].value

Implementation:

Radiopharmakon (ValueSet mit Codes: https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_25.html): Das Radiopharmakon kann unter Bestimmung des Codes „0054,0016“ (Radiopharmaceutical Information Sequence) → „0054,0304“ (Radiopharmaceutical Code Sequence) → „0008,0100“ (Code Value) als Code in den Klarnamen umgewandelt werden. Ist der nicht vorhanden, kann der Wert direkt aus dem Tag „0054,0016“ (Radiopharmaceutical Information Sequence) → „0054,0304“ (Radiopharmaceutical Code Sequence) → „0008,0104“ (Code Meaning) direkt extrahiert werden. Falls unter Umständen sich der Klarname von dem ValueSet unterscheidet, kann ein lokales Mapping am Standort gemacht werden. Alternativ kann bei weiterem Fehlen auch noch das Tag „0054,0016“ (Radiopharmaceutical Information Sequence) → "0018,0031" (Radiopharmaceutical) zu rate gezogen werden, bitte nur verwenden Falls im String sich konstant der Tracer UND das Radionuklid befinden (siehe Link des Valuesets).
Radionuklid (ValueSet mit Codes: https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_18.html) Das Radionuklid kann unter Bestimmung des Codes „0054,0016“ (Radiopharmaceutical Information Sequence) → „0054,0300“ (Radiopharmaceutical Code Sequence) → „0008,0100“ (Code Value) als Code in den Klarnamen umgewandelt werden.
Tracer-Einwirkzeit: Dies ist ein Custom Tag und wird aus der Differenz zwischen den Zeitangaben in Sekunden der Acquisition Time "0008,0032" (oder ähnlichem) und der „0054,0016“ (Radiopharmaceutical Information Sequence) → "0018, 1072" RadiopharmaceuticalStartTime gebildet.
Halbwertszeit ["0018, 1075" RadionuclideHalfLife] in Sekunden [s]
Gesamte Radionukliddosis ["0018, 1074" RadionuclideTotalDose] in Becquerel [Bq]
Skalierungseinheit ["0054,1001" Units] Falls Units nicht vorhanden oder leer, kann das Tag "0028,1054" (RescaleType) verwendet werden.

Name	Status	Version	Canonical	Basis
MII_EX_Bildgebung_Modalitaet_NM	active	2025.0.0	https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-nm	http://hl7.org/fhir/StructureDefinition/Extension

Inhalt

MII_EX_Bildgebung_Modalitaet_NM (Extension)	I		Extension	There are no (further) constraints on this element Element id Extension Short description Optional Extensions Element Definition Optional Extension Element - found in all resources. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
radiopharmaceutical	I	0..1	Extension	There are no (further) constraints on this element Element id Extension.extension:radiopharmaceutical Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radiopharmaceutical.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension:radiopharmaceutical.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.extension:radiopharmaceutical.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value radiopharmaceutical Mappings rim: N/A
value[x]		0..1	Binding	Element id Extension.extension:radiopharmaceutical.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding Radiopharmaceutical (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueCodeableConcept			CodeableConcept	Data type CodeableConcept
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radiopharmaceutical.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.extension:radiopharmaceutical.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Extension.extension:radiopharmaceutical.value[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id Extension.extension:radiopharmaceutical.value[x].text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
radionuclide	I	0..1	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclide Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radionuclide.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclide.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.extension:radionuclide.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value radionuclide Mappings rim: N/A
value[x]		0..1	Binding	Element id Extension.extension:radionuclide.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding RadiopharmaceuticalIsotope (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueCodeableConcept			CodeableConcept	Data type CodeableConcept
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radionuclide.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclide.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Extension.extension:radionuclide.value[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id Extension.extension:radionuclide.value[x].text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
tracerExposureTime	I	0..1	Extension	There are no (further) constraints on this element Element id Extension.extension:tracerExposureTime Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:tracerExposureTime.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension:tracerExposureTime.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.extension:tracerExposureTime.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value tracerExposureTime Mappings rim: N/A
value[x]	I	0..1		Element id Extension.extension:tracerExposureTime.value[x] Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a rim: N/A v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
valueQuantity			SimpleQuantity	Data type SimpleQuantity
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:tracerExposureTime.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.extension:tracerExposureTime.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
value	Σ	0..1	decimal	There are no (further) constraints on this element Element id Extension.extension:tracerExposureTime.value[x].value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Extension.extension:tracerExposureTime.value[x].comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	stringPattern	Element id Extension.extension:tracerExposureTime.value[x].unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern Seconds Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uriPattern	Element id Extension.extension:tracerExposureTime.value[x].system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern http://unitsofmeasure.org Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	codePattern	Element id Extension.extension:tracerExposureTime.value[x].code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern s Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
units	I	0..1	Extension	There are no (further) constraints on this element Element id Extension.extension:units Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:units.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension:units.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.extension:units.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value units Mappings rim: N/A
value[x]		0..1	Binding	Element id Extension.extension:units.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding PETUnit (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueCodeableConcept			CodeableConcept	Data type CodeableConcept
radionuclideTotalDose	I	0..1	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclideTotalDose Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radionuclideTotalDose.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclideTotalDose.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.extension:radionuclideTotalDose.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value radionuclideTotalDose Mappings rim: N/A
value[x]	I	0..1		Element id Extension.extension:radionuclideTotalDose.value[x] Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a rim: N/A v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
valueQuantity			SimpleQuantity	Data type SimpleQuantity
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radionuclideTotalDose.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclideTotalDose.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
value	Σ	0..1	decimal	There are no (further) constraints on this element Element id Extension.extension:radionuclideTotalDose.value[x].value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Extension.extension:radionuclideTotalDose.value[x].comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	stringPattern	Element id Extension.extension:radionuclideTotalDose.value[x].unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern Megabecquerel Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uriPattern	Element id Extension.extension:radionuclideTotalDose.value[x].system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern http://unitsofmeasure.org Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	codePattern	Element id Extension.extension:radionuclideTotalDose.value[x].code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern MBq Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
radionuclideHalfLife	I	0..1	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclideHalfLife Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radionuclideHalfLife.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclideHalfLife.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.extension:radionuclideHalfLife.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value radionuclideHalfLife Mappings rim: N/A
value[x]	I	0..1		Element id Extension.extension:radionuclideHalfLife.value[x] Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a rim: N/A v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
valueQuantity			SimpleQuantity	Data type SimpleQuantity
id		0..1	string	There are no (further) constraints on this element Element id Extension.extension:radionuclideHalfLife.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.extension:radionuclideHalfLife.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
value	Σ	0..1	decimal	There are no (further) constraints on this element Element id Extension.extension:radionuclideHalfLife.value[x].value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Extension.extension:radionuclideHalfLife.value[x].comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	stringPattern	Element id Extension.extension:radionuclideHalfLife.value[x].unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern Seconds Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uriPattern	Element id Extension.extension:radionuclideHalfLife.value[x].system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern http://unitsofmeasure.org Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	codePattern	Element id Extension.extension:radionuclideHalfLife.value[x].code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern s Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
url		1..1	uriFixed Value	Element id Extension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-nm Mappings rim: N/A
value[x]		0..0		There are no (further) constraints on this element Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A

Die Extension ermöglicht es die Ressourcen und Machbarkeitsanalysen auf NM Daten zu erweitern.

Feldname
Extension.extension:radiopharmaceutical.value[x].text
Extension.extension:radionuclide.value[x].text

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="mii-ex-bildgebung-modalitaet-nm" />
    <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-modalitaet-nm" />
    <version value="2025.0.0" />
    <name value="MII_EX_Bildgebung_Modalitaet_NM">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="MII_EX_Imaging_Modality_NM" />
            </extension>
        </extension>
    </name>
    <title value="MII EX Bildgebung Modalit&#228;t PT/NM">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="MII EX Imaging Modality NM" />
            </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 die Ressourcen und Machbarkeitsanalysen auf NM Daten zu erweitern.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="The extension allows to extend the resources and feasibility analysis to NM data." />
            </extension>
        </extension>
    </description>
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="ImagingStudy.series" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension.extension:radiopharmaceutical">
            <path value="Extension.extension" />
            <sliceName value="radiopharmaceutical" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:radiopharmaceutical.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:radiopharmaceutical.url">
            <path value="Extension.extension.url" />
            <fixedUri value="radiopharmaceutical" />
        </element>
        <element id="Extension.extension:radiopharmaceutical.value[x]">
            <path value="Extension.extension.value[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <binding>
                <strength value="extensible" />
                <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_25.html" />
            </binding>
        </element>
        <element id="Extension.extension:radiopharmaceutical.value[x].text">
            <path value="Extension.extension.value[x].text" />
            <mustSupport value="true" />
        </element>
        <element id="Extension.extension:radionuclide">
            <path value="Extension.extension" />
            <sliceName value="radionuclide" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:radionuclide.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:radionuclide.url">
            <path value="Extension.extension.url" />
            <fixedUri value="radionuclide" />
        </element>
        <element id="Extension.extension:radionuclide.value[x]">
            <path value="Extension.extension.value[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <binding>
                <strength value="extensible" />
                <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_18.html" />
            </binding>
        </element>
        <element id="Extension.extension:radionuclide.value[x].text">
            <path value="Extension.extension.value[x].text" />
            <mustSupport value="true" />
        </element>
        <element id="Extension.extension:tracerExposureTime">
            <path value="Extension.extension" />
            <sliceName value="tracerExposureTime" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:tracerExposureTime.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:tracerExposureTime.url">
            <path value="Extension.extension.url" />
            <fixedUri value="tracerExposureTime" />
        </element>
        <element id="Extension.extension:tracerExposureTime.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:tracerExposureTime.value[x].unit">
            <path value="Extension.extension.value[x].unit" />
            <patternString value="Seconds" />
        </element>
        <element id="Extension.extension:tracerExposureTime.value[x].system">
            <path value="Extension.extension.value[x].system" />
            <patternUri value="http://unitsofmeasure.org" />
        </element>
        <element id="Extension.extension:tracerExposureTime.value[x].code">
            <path value="Extension.extension.value[x].code" />
            <patternCode value="s" />
        </element>
        <element id="Extension.extension:units">
            <path value="Extension.extension" />
            <sliceName value="units" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:units.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:units.url">
            <path value="Extension.extension.url" />
            <fixedUri value="units" />
        </element>
        <element id="Extension.extension:units.value[x]">
            <path value="Extension.extension.value[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <binding>
                <strength value="extensible" />
                <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_84.html" />
            </binding>
        </element>
        <element id="Extension.extension:radionuclideTotalDose">
            <path value="Extension.extension" />
            <sliceName value="radionuclideTotalDose" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:radionuclideTotalDose.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:radionuclideTotalDose.url">
            <path value="Extension.extension.url" />
            <fixedUri value="radionuclideTotalDose" />
        </element>
        <element id="Extension.extension:radionuclideTotalDose.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:radionuclideTotalDose.value[x].unit">
            <path value="Extension.extension.value[x].unit" />
            <patternString value="Megabecquerel" />
        </element>
        <element id="Extension.extension:radionuclideTotalDose.value[x].system">
            <path value="Extension.extension.value[x].system" />
            <patternUri value="http://unitsofmeasure.org" />
        </element>
        <element id="Extension.extension:radionuclideTotalDose.value[x].code">
            <path value="Extension.extension.value[x].code" />
            <patternCode value="MBq" />
        </element>
        <element id="Extension.extension:radionuclideHalfLife">
            <path value="Extension.extension" />
            <sliceName value="radionuclideHalfLife" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:radionuclideHalfLife.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:radionuclideHalfLife.url">
            <path value="Extension.extension.url" />
            <fixedUri value="radionuclideHalfLife" />
        </element>
        <element id="Extension.extension:radionuclideHalfLife.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:radionuclideHalfLife.value[x].unit">
            <path value="Extension.extension.value[x].unit" />
            <patternString value="Seconds" />
        </element>
        <element id="Extension.extension:radionuclideHalfLife.value[x].system">
            <path value="Extension.extension.value[x].system" />
            <patternUri value="http://unitsofmeasure.org" />
        </element>
        <element id="Extension.extension:radionuclideHalfLife.value[x].code">
            <path value="Extension.extension.value[x].code" />
            <patternCode value="s" />
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-nm" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "mii-ex-bildgebung-modalitaet-nm",
    "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-modalitaet-nm",
    "version": "2025.0.0",
    "name": "MII_EX_Bildgebung_Modalitaet_NM",
    "_name": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "MII_EX_Imaging_Modality_NM"
                    }
                ]
            }
        ]
    },
    "title": "MII EX Bildgebung Modalität PT/NM",
    "_title": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "MII EX Imaging Modality NM"
                    }
                ]
            }
        ]
    },
    "status": "active",
    "experimental": false,
    "publisher": "Medizininformatik Initiative",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "https://www.medizininformatik-initiative.de"
                }
            ]
        }
    ],
    "description": "Die Extension ermöglicht es die Ressourcen und Machbarkeitsanalysen auf NM Daten zu erweitern.",
    "_description": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "The extension allows to extend the resources and feasibility analysis to NM data."
                    }
                ]
            }
        ]
    },
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "ImagingStudy.series"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension.extension:radiopharmaceutical",
                "path": "Extension.extension",
                "sliceName": "radiopharmaceutical",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:radiopharmaceutical.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:radiopharmaceutical.url",
                "path": "Extension.extension.url",
                "fixedUri": "radiopharmaceutical"
            },
            {
                "id": "Extension.extension:radiopharmaceutical.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_25.html"
                }
            },
            {
                "id": "Extension.extension:radiopharmaceutical.value[x].text",
                "path": "Extension.extension.value[x].text",
                "mustSupport": true
            },
            {
                "id": "Extension.extension:radionuclide",
                "path": "Extension.extension",
                "sliceName": "radionuclide",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:radionuclide.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:radionuclide.url",
                "path": "Extension.extension.url",
                "fixedUri": "radionuclide"
            },
            {
                "id": "Extension.extension:radionuclide.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_18.html"
                }
            },
            {
                "id": "Extension.extension:radionuclide.value[x].text",
                "path": "Extension.extension.value[x].text",
                "mustSupport": true
            },
            {
                "id": "Extension.extension:tracerExposureTime",
                "path": "Extension.extension",
                "sliceName": "tracerExposureTime",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:tracerExposureTime.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:tracerExposureTime.url",
                "path": "Extension.extension.url",
                "fixedUri": "tracerExposureTime"
            },
            {
                "id": "Extension.extension:tracerExposureTime.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ]
            },
            {
                "id": "Extension.extension:tracerExposureTime.value[x].unit",
                "path": "Extension.extension.value[x].unit",
                "patternString": "Seconds"
            },
            {
                "id": "Extension.extension:tracerExposureTime.value[x].system",
                "path": "Extension.extension.value[x].system",
                "patternUri": "http://unitsofmeasure.org"
            },
            {
                "id": "Extension.extension:tracerExposureTime.value[x].code",
                "path": "Extension.extension.value[x].code",
                "patternCode": "s"
            },
            {
                "id": "Extension.extension:units",
                "path": "Extension.extension",
                "sliceName": "units",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:units.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:units.url",
                "path": "Extension.extension.url",
                "fixedUri": "units"
            },
            {
                "id": "Extension.extension:units.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_84.html"
                }
            },
            {
                "id": "Extension.extension:radionuclideTotalDose",
                "path": "Extension.extension",
                "sliceName": "radionuclideTotalDose",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:radionuclideTotalDose.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:radionuclideTotalDose.url",
                "path": "Extension.extension.url",
                "fixedUri": "radionuclideTotalDose"
            },
            {
                "id": "Extension.extension:radionuclideTotalDose.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ]
            },
            {
                "id": "Extension.extension:radionuclideTotalDose.value[x].unit",
                "path": "Extension.extension.value[x].unit",
                "patternString": "Megabecquerel"
            },
            {
                "id": "Extension.extension:radionuclideTotalDose.value[x].system",
                "path": "Extension.extension.value[x].system",
                "patternUri": "http://unitsofmeasure.org"
            },
            {
                "id": "Extension.extension:radionuclideTotalDose.value[x].code",
                "path": "Extension.extension.value[x].code",
                "patternCode": "MBq"
            },
            {
                "id": "Extension.extension:radionuclideHalfLife",
                "path": "Extension.extension",
                "sliceName": "radionuclideHalfLife",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:radionuclideHalfLife.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:radionuclideHalfLife.url",
                "path": "Extension.extension.url",
                "fixedUri": "radionuclideHalfLife"
            },
            {
                "id": "Extension.extension:radionuclideHalfLife.value[x]",
                "path": "Extension.extension.value[x]",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ]
            },
            {
                "id": "Extension.extension:radionuclideHalfLife.value[x].unit",
                "path": "Extension.extension.value[x].unit",
                "patternString": "Seconds"
            },
            {
                "id": "Extension.extension:radionuclideHalfLife.value[x].system",
                "path": "Extension.extension.value[x].system",
                "patternUri": "http://unitsofmeasure.org"
            },
            {
                "id": "Extension.extension:radionuclideHalfLife.value[x].code",
                "path": "Extension.extension.value[x].code",
                "patternCode": "s"
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-nm"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "max": "0"
            }
        ]
    }
}

MII EX Bildgebung Modalität PT/NM

Beispiele

Hinweis
	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.

Hinweis

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.

Beispiel einer ImagingStudy-Ressource mit der Extension für PET Metadaten inkl. der modalitätsunabhängigen Extensions für Kontrastmittel, Instanzdetails und Gerätehersteller:

{
    "resourceType": "ImagingStudy",
    "id": "mii-exa-bildgebung-bildgebungsstudie-nm",
    "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": "77004003",
                                        "system": "http://snomed.info/sct",
                                        "display": "^18^Fluorine"
                                    }
                                ]
                            }
                        },
                        {
                            "valueQuantity": {
                                "unit": "Seconds",
                                "value": 10000
                            },
                            "url": "tracerExposureTime"
                        },
                        {
                            "url": "units",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "code": "BQML",
                                        "system": "http://unitsofmeasure.org"
                                    }
                                ]
                            }
                        },
                        {
                            "valueQuantity": {
                                "unit": "Megabecquerel",
                                "value": 196
                            },
                            "url": "radionuclideTotalDose"
                        },
                        {
                            "valueQuantity": {
                                "unit": "Seconds",
                                "value": 6586.2
                            },
                            "url": "radionuclideHalfLife"
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-modalitaet-nm"
                }
            ],
            "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",
                                                "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": "DYNAMIC",
                                                "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/CodeSystem/mii-cs-bildgebung-instance-image-type"
                                            },
                                            {
                                                "code": "EMISSION",
                                                "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:1.2.840.10008.5.1.4.1.1.128",
                        "system": "urn:ietf:rfc:3986"
                    },
                    "number": 31
                }
            ],
            "uid": "series-example-uid",
            "performer":  [
                {
                    "actor": {
                        "reference": "Device/mii-exa-bildgebung-geraet"
                    }
                }
            ],
            "number": 1,
            "modality": {
                "code": "NM",
                "system": "http://dicom.nema.org/resources/ontology/DCM",
                "display": "Nuclear Medicine"
            },
            "description": "NM WB",
            "numberOfInstances": 195,
            "bodySite": {
                "code": "51185008",
                "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": "NM",
            "system": "http://dicom.nema.org/resources/ontology/DCM",
            "display": "Nuclear Medicine"
        }
    ],
    "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"
}