A.56 Enhanced PET Image IOD
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## A.56 Enhanced PET Image IOD

### A.56.1 Enhanced PET Image IOD Description

The Enhanced Positron Emission Tomography (PET) Image Information Object Definition (IOD) specifies an image that has been created by a positron emission tomography coincidence imaging device.

### A.56.2 Enhanced PET Image IOD Entity-Relationship Model

The E-R Model in Section A.1.2 depicts those components of the DICOM Information Model that directly reference the Enhanced PET Image IOD.

### A.56.3 Enhanced PET Image IOD Module Table

Table A.56-1. Enhanced PET Image IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Enhanced PET Series | C.8.22.1 | M
Clinical Trial Series | C.7.3.2 | U
Frame of Reference | Frame of Reference | C.7.4.1 | M
Synchronization | C.7.4.2 | C - Required if time synchronization was applied.
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Image | Image Pixel | C.7.6.3 | M
Intervention | C.7.6.13 | U
Acquisition Context | C.7.6.14 | M
Multi-frame Functional Groups | C.7.6.16 | M
Multi-frame Dimension | C.7.6.17 | M
Cardiac Synchronization | C.7.6.18.1 | C - Required if cardiac synchronization was applied.
Respiratory Synchronization | C.7.6.18.2 | C - Required if respiratory synchronization was applied.
Specimen | C.7.6.22 | U
Enhanced PET Isotope Module | C.8.22.4 | M
Enhanced PET Acquisition | C.8.22.2 | M
Enhanced PET Image | C.8.22.3 | M
Enhanced PET Corrections | C.8.22.6 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | U
Frame Extraction | C.12.3 | C - Required if the SOP Instance was created in response to a Frame-Level retrieve request

#### A.56.3.1 Enhanced PET Image IOD Content Constraints

The Modality Type attribute (0008,0060) shall have the value PT.

The General Image Module, Overlay Plane Module, VOI LUT Module, Supplemental Palette Color Lookup Table Module, and the Softcopy Presentation LUT Module shall not be used in a Standard Extended SOP Class of the Enhanced PET Image.

### Note

1. In order to annotate images, whether during acquisition or subsequently, SOP Instances of the Grayscale Softcopy Presentation State Storage, Color Softcopy Presentation State Storage, or the Structured Report Storage SOP Classes that reference the image SOP Instance, may be used.

2. No standard mechanism is provided for inclusion of annotations within the image SOP Instance itself, and implementers are discouraged from using private extensions to circumvent this restriction.

3. The Blending Softcopy Presentation State and Spatial Registration SOP Classes can be used to relate this SOP Instance to related image, registration, or fiducial SOP Instances.

4. If contrast was administered during a CT acquisition used for attenuation correction, this information can be obtained from the CT SOP Instances and is not encoded in the PET SOP Instances.

### A.56.4 Enhanced PET Image Functional Group Macros

Table A.56-2 specifies the use of the Functional Group Macros used in the Multi-frame Functional Group Module for the Enhanced PET Image IOD.

Table A.56-2. Enhanced PET Image Functional Group Macros

Functional Group Macro | Section | Usage
--- | --- | ---
Pixel Measures | C.7.6.16.2.1 | M
Frame Content | C.7.6.16.2.2 | M - May not be used as a Shared Functional Group.
Plane Position (Patient) | C.7.6.16.2.3 | M
Plane Orientation (Patient) | C.7.6.16.2.4 | M
Referenced Image | C.7.6.16.2.5 | C - Required if the image or frame has been planned on another image or frame, may be present otherwise.
Derivation Image | C.7.6.16.2.6 | C - Required if the image or frame has been derived from another SOP Instance.
Frame Anatomy | C.7.6.16.2.8 | M
Pixel Value Transformation | C.7.6.16.2.9 | M
Frame VOI LUT | C.7.6.16.2.10 | M
Real World Value Mapping | C.7.6.16.2.11 | M - The Defined CID for Measurement Units Code Sequence shall be CID 84 “PET Units for Real World Value Mapping”.
Cardiac Synchronization | C.7.6.16.2.7 | C - Required if Cardiac Synchronization Technique (0018,9037) equals other than NONE. May be present otherwise.
Respiratory Synchronization | C.7.6.16.2.17 | C - Required if Respiratory Motion Compensation Technique (0018,9170) equals other than NONE. May be present otherwise.
Radiopharmaceutical Usage | C.7.6.16.2.19 | M
Patient Physiological State | C.7.6.16.2.20 | C - Required for cardiac rest and stress images.
PET Frame Type | C.8.22.5.1 | M
PET Frame Acquisition | C.8.22.5.2 | C - Required if Image Type (0008,0008) Value 1 equals ORIGINAL. May be present otherwise.
PET Detector Motion Details | C.8.22.5.3 | C - Required if Image Type (0008,0008) Value 1 equals ORIGINAL and Type of Detector Motion (0054,0202) is not equal to STATIONARY.
PET Position | C.8.22.5.4 | C - Required if Image Type (0008,0008) Value 1 equals ORIGINAL. May be present otherwise.
PET Frame Correction Factors | C.8.22.5.5 | C - Required if Image Type (0008,0008) Value 1 equals ORIGINAL. May be present otherwise.
PET Reconstruction | C.8.22.5.6 | C - Required if Image Type (0008,0008) Value 1 equals ORIGINAL. May be present otherwise.
PET Table Dynamics | C.8.22.5.7 | C - Required if Image Type (0008,0008) Value 1 equals ORIGINAL and Table Motion (0018,1134) is equal to DYNAMIC.

### A.56.5 Acquisition Context Module

The Defined TID for Acquisition Context Sequence (0040,0555) is TID 3471 “PET Covariates Acquisition Context”, which includes the blood glucose measurement. In contrast to the PET Image IOD, the description of the cardiovascular rest or stress state is encoded in the Enhanced PET Image IOD using the Patient Physiological State Functional Group Macro, rather than the Acquisition Context.

The Acquisition Context information may be entered during acquisition, or obtained from the Modality Worklist using information supplied in the Protocol Context, using TID 15101 “NM/PET Protocol Context”.

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