This is the current version of the PS-CA Implementation Guide. Other releases of the PS-CA Implementation Guide may be found on a table on the Home Page of this Project.
ImagingStudy (PS-CA)
Additional information on this profile (including the JSON & XML structure and detailed element descriptions) can be found at package/structuredefinition-profile-imagingstudy-ca-ps.json
Profile
ImagingStudy | I | ImagingStudy | Element IdImagingStudy A set of images produced in single study (one or more series of references images) DefinitionRepresentation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities. Preliminary analysis has identified that imaging study information may have limited support in current systems intending to produce a diagnostic results section in their initial patient summaries, further feedback and investigation is required with participating jurisdictions to confirm the support of any of the imaging study elements - until then, initial constraints put forth in the IPS-UV specification have been mantained.
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identifier | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdImagingStudy.identifier Identifiers for the whole study Alternate namesStudyInstanceUID, AccessionNumber DefinitionIdentifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdImagingStudy.status registered | available | cancelled | entered-in-error | unknown DefinitionThe current state of the ImagingStudy. Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. The status of the ImagingStudy. ImagingStudyStatus (required)Constraints
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modality | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdImagingStudy.modality All series modality if actual acquisition modalities Alternate namesModalitiesInStudy DefinitionA list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19). 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. Type of acquired data in the instance. AcquisitionModality (extensible)Constraints
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subject | S Σ I | 1..1 | Reference(package/structuredefinition-profile-patient-ca-ps.json) | Element IdImagingStudy.subject Who or what is the subject of the study DefinitionThe subject, typically a patient, of the imaging study. QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group. Reference(package/structuredefinition-profile-patient-ca-ps.json) Constraints
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdImagingStudy.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdImagingStudy.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdImagingStudy.subject.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdImagingStudy.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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encounter | Σ I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdImagingStudy.encounter Encounter with which this imaging study is associated DefinitionThe healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made. This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).
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started | S Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdImagingStudy.started When the study was started Alternate namesStudyDate, StudyTime DefinitionDate and time the study started.
General 2011-01-01T11:01:20+03:00 Mappings
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basedOn | Σ I | 0..* | Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) | There are no (further) constraints on this element Element IdImagingStudy.basedOn Request fulfilled DefinitionA list of the diagnostic requests that resulted in this imaging study being performed. To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task) Constraints
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referrer | Σ I | 0..1 | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdImagingStudy.referrer Referring physician Alternate namesReferringPhysiciansName DefinitionThe requesting/referring physician. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole) Constraints
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interpreter | Σ I | 0..* | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdImagingStudy.interpreter Who interpreted images Alternate namesName of Physician(s) Reading Study DefinitionWho read the study and interpreted the images or other content. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole) Constraints
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endpoint | Σ I | 0..* | Reference(Endpoint) | There are no (further) constraints on this element Element IdImagingStudy.endpoint Study access endpoint DefinitionThe network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.
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numberOfSeries | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdImagingStudy.numberOfSeries Number of Study Related Series Alternate namesNumberOfStudyRelatedSeries DefinitionNumber of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present. 32 bit number; for values larger than this, use decimal
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numberOfInstances | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdImagingStudy.numberOfInstances Number of Study Related Instances Alternate namesNumberOfStudyRelatedInstances DefinitionNumber of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. 32 bit number; for values larger than this, use decimal
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procedureReference | Σ I | 0..1 | Reference(Procedure) | There are no (further) constraints on this element Element IdImagingStudy.procedureReference The performed Procedure reference DefinitionThe procedure which this ImagingStudy was part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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procedureCode | S Σ | 0..* | package/StructureDefinition-CodeableConcept-ca-ps.json | Element IdImagingStudy.procedureCode Concept - reference to a terminology or just text Alternate namesProcedureCodeSequence DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element. package/StructureDefinition-CodeableConcept-ca-ps.json BindingWork is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element http://www.rsna.org/RadLex_Playbook.aspx (example)Constraints
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location | Σ I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdImagingStudy.location Where ImagingStudy occurred DefinitionThe principal physical location where the ImagingStudy was performed. Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | S Σ | 0..* | package/StructureDefinition-CodeableConcept-ca-ps.json | Element IdImagingStudy.reasonCode Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text. package/StructureDefinition-CodeableConcept-ca-ps.json BindingThe reason for the study. ProcedureReasonCodes (example)Constraints
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reasonReference | Σ I | 0..* | Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdImagingStudy.reasonReference Why was study performed DefinitionIndicates another resource whose existence justifies this Study. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference) Constraints
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note | Σ | 0..* | Annotation | There are no (further) constraints on this element Element IdImagingStudy.note User-defined comments DefinitionPer the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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description | Σ | 0..1 | string | There are no (further) constraints on this element Element IdImagingStudy.description Institution-generated description Alternate namesStudyDescription DefinitionThe Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed. Note that FHIR strings SHALL NOT exceed 1MB in size
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series | S Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element IdImagingStudy.series Each study has one or more series of instances DefinitionEach study has one or more series of images or other content.
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uid | S Σ | 1..1 | id | There are no (further) constraints on this element Element IdImagingStudy.series.uid DICOM Series Instance UID for the series Alternate namesSeriesInstanceUID DefinitionThe DICOM Series Instance UID for the series. DICOM Series Instance UID. See DICOM PS3.3 C.7.3.
General 2.16.124.113543.6003.2588828330.45298.17418.2723805630 Mappings
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number | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdImagingStudy.series.number Numeric identifier of this series Alternate namesSeriesNumber DefinitionThe numeric identifier of this series in the study. 32 bit number; for values larger than this, use decimal
General 3 Mappings
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modality | S Σ | 1..1 | CodingBinding | There are no (further) constraints on this element Element IdImagingStudy.series.modality The modality of the instances in the series Alternate namesModality DefinitionThe modality of this series sequence. 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. Type of acquired data in the instance. AcquisitionModality (extensible)Constraints
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description | Σ | 0..1 | string | There are no (further) constraints on this element Element IdImagingStudy.series.description A short human readable summary of the series Alternate namesSeriesDescription DefinitionA description of the series. Note that FHIR strings SHALL NOT exceed 1MB in size
General CT Surview 180 Mappings
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numberOfInstances | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdImagingStudy.series.numberOfInstances Number of Series Related Instances Alternate namesNumberOfSeriesRelatedInstances DefinitionNumber of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. 32 bit number; for values larger than this, use decimal
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endpoint | Σ I | 0..* | Reference(Endpoint) | There are no (further) constraints on this element Element IdImagingStudy.series.endpoint Series access endpoint DefinitionThe network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.
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bodySite | Σ | 0..1 | Coding | There are no (further) constraints on this element Element IdImagingStudy.series.bodySite Body part examined Alternate namesBodyPartExamined DefinitionThe anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality. 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. Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example)Constraints
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laterality | Σ | 0..1 | Coding | There are no (further) constraints on this element Element IdImagingStudy.series.laterality Body part laterality DefinitionThe laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite. 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. Codes describing body site laterality (left, right, etc.). Laterality (example)Constraints
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specimen | Σ I | 0..* | Reference(Specimen) | There are no (further) constraints on this element Element IdImagingStudy.series.specimen Specimen imaged DefinitionThe specimen imaged, e.g., for whole slide imaging of a biopsy. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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started | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdImagingStudy.series.started When the series started DefinitionThe date and time the series was started.
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performer | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element IdImagingStudy.series.performer Who performed the series Alternate namesPerformingPhysicianName, OperatorName DefinitionIndicates who or what performed the series and how they were involved. The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers. If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images.
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function | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdImagingStudy.series.performer.function Type of performance DefinitionDistinguishes the type of involvement of the performer in the series. Allows disambiguation of the types of involvement of different performers. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The type of involvement of the performer. ImagingStudySeriesPerformerFunction (extensible)Constraints
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actor | Σ I | 1..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson) | There are no (further) constraints on this element Element IdImagingStudy.series.performer.actor Who performed the series DefinitionIndicates who or what performed the series. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson) Constraints
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instance | S | 0..* | BackboneElement | There are no (further) constraints on this element Element IdImagingStudy.series.instance A single SOP instance from the series DefinitionA single SOP instance within the series, e.g. an image, or presentation state.
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uid | S | 1..1 | id | There are no (further) constraints on this element Element IdImagingStudy.series.instance.uid DICOM SOP Instance UID Alternate namesSOPInstanceUID DefinitionThe DICOM SOP Instance UID for this image or other DICOM content. DICOM SOP Instance UID. See DICOM PS3.3 C.12.1.
General 2.16.124.113543.6003.189642796.63084.16748.2599092903 Mappings
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sopClass | S | 1..1 | CodingBinding | There are no (further) constraints on this element Element IdImagingStudy.series.instance.sopClass DICOM class type Alternate namesSOPClassUID DefinitionDICOM instance type. 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. The sopClass for the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible)Constraints
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number | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdImagingStudy.series.instance.number The number of this instance in the series Alternate namesInstanceNumber DefinitionThe number of instance in the series. 32 bit number; for values larger than this, use decimal
General 1 Mappings
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title | 0..1 | string | There are no (further) constraints on this element Element IdImagingStudy.series.instance.title Description of instance DefinitionThe description of the instance. Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc.
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Extensions
There are no additional extensions in this profile
Key Differences between the IPS-UV and PS-CA
Must Support Differences:
There are no Must support differences between this profile and IPS-UV
Cardinality Differences:
There are no cardinality differences between this profile and IPS-UV
Vocabulary Differences:
ImagingStudy.procedureCode
- additionalBindings added for:
- LOINC Codes ResultsRadiologyObservationUvIps
Note: Work is underway to define a pan-Canadian valueset for procedureCode.
- additionalBindings added for:
Other differences between the IPS and PS-CA Include:
There are no additional differences between this profile and IPS-UV