CT Radiation Dose SR IOD Templates
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## CT Radiation Dose SR IOD Templates

The templates that comprise the CT Radiation Dose SR are interconnected as in Figure A-15.

Figure A-15. CT Radiation Dose SR IOD Template Structure

### TID 10011 CT Radiation Dose

This template defines a container (the root) with subsidiary content items, each of which corresponds to a single CT X-Ray irradiation event entry. There is a defined recording observer (the system or person responsible for recording the log, generally the system). Accumulated values shall be kept for a whole Study or at least a part of a Study, if the Study is divided in the workflow of the examination, or a performed procedure step. Multiple CT Radiation Dose objects may be created for one Study.

Type:

  Extensible

Order:

  Significant

Root:

  Yes

Table TID 10011. CT Radiation Dose

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (113701, DCM, "X-Ray Radiation Dose Report") | 1 | M |  | Root node
2 | > | HAS CONCEPT MOD | CODE | EV (121058, DCM, "Procedure reported") | 1 | M |  | EV (P5-08000, SRT, "Computed Tomography X-Ray")
3 | >> | HAS CONCEPT MOD | CODE | EV (G-C0E8, SRT, "Has Intent") | 1 | M |  | DCID 3629 “Procedure Intent”
4 | > |  | INCLUDE | DTID 1002 “Observer Context” | 1-n | M |  |
5 | > | HAS OBS CONTEXT | DATETIME | EV (113809, DCM, "Start of X-Ray Irradiation") | 1 | M |  |
6 | > | HAS OBS CONTEXT | DATETIME | EV (113810, DCM, "End of X-Ray Irradiation") | 1 | M |  |
7 | > | HAS OBS CONTEXT | CODE | EV (113705, DCM, "Scope of Accumulation") | 1 | M |  | DCID 10000 “Scope of Accumulation”
8 | >> | HAS PROPERTIES | UIDREF | DCID 10001 “UID Types” | 1 | M |  |
9 | > | CONTAINS | INCLUDE | DTID 10012 “CT Accumulated Dose Data” | 1 | M |  |
10 | > | CONTAINS | INCLUDE | DTID 10013 “CT Irradiation Event Data” | 1-n | M |  |
11 | > | CONTAINS | TEXT | EV (121106, DCM, "Comment") | 1 | U |  |
12 | > | CONTAINS | CODE | EV (113854, DCM, "Source of Dose Information") | 1-n | M |  | DCID 10021 “Source of CT Dose Information”
13 | > | CONTAINS | INCLUDE | DTID 1020 “Person Participant” | 1 | U |  | $PersonProcedureRole = EV (113850, DCM, "Irradiation Authorizing")

Content Item Descriptions

Row 4 | The observer context may include both a Person Observer identification, as well as the identity of the equipment providing the values for the irradiation event (Device Observer identification), if not inherited.
Row 5 | Start, Date Time of the first CT Irradiation Event of the accumulation
Row 6 | End, Date Time of the last CT Irradiation Event of the accumulation
Row 12 | The primary source of information from which this dose object was constructed.
Row 13 | The physician responsible for determining that the irradiating procedure was appropriate for the indications. The value may come from Requesting Physician (0032,1032), Requesting Physician Identification Sequence (0032,1031) or somewhere else based on hospital policies.

### TID 10012 CT Accumulated Dose Data

This general template provides detailed information on CT X-Ray dose value accumulations over several irradiation events from the same equipment and over the scope of accumulation specified for the report (typically a Study or a Performed Procedure Step).

Type:

  Extensible

Order:

  Significant

Table TID 10012. CT Accumulated Dose Data

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (113811, DCM, "CT Accumulated Dose Data") | 1 | M |  |
2 | > | CONTAINS | NUM | EV (113812, DCM, "Total Number of Irradiation Events") | 1 | M |  | UNITS = EV ({events}, UCUM, "events")
3 | > | CONTAINS | NUM | EV (113813, DCM, "CT Dose Length Product Total") | 1 | M |  | UNITS = EV (mGy.cm, UCUM, "mGy.cm")
4 | > | CONTAINS | NUM | EV (113814, DCM, "CT Effective Dose Total") | 1 | U |  | UNITS = EV (mSv, UCUM, "mSv")
5 | >> | HAS PROPERTIES | TEXT | EV (121406, DCM, "Reference Authority") | 1 | MC | XOR row 6 |
6 | >> | HAS PROPERTIES | CODE | EV (121406, DCM, "Reference Authority") | 1 | MC | XOR row 5 | DCID 10015 “CT Dose Reference Authorities”
7 | >> | HAS CONCEPT MOD | CODE | EV (G-C036, SRT, "Measurement Method") | 1 | M |  | DCID 10011 “Effective Dose Evaluation Method”
8 | >> | HAS PROPERTIES | TEXT | EV (113815, DCM, "Patient Model") | 1 | MC | IF the value of row 7 equals (113800, DCM, "DLP to E conversion via MC computation") or equals (113801, DCM, "CTDIfreeair to E conversion via MC computation") |
9 | >> | HAS PROPERTIES | CONTAINER | EV (113816, DCM, "Condition Effective Dose measured") | 1 | MC | IF the value of row 7 equals (113802, DCM, "DLP to E conversion via measurement") or equals (113803, DCM, "CTDIfreeair to E conversion via measurement") |
10 | >>> | CONTAINS | TEXT | EV (113817, DCM, "Effective Dose Phantom Type") | 1 | M |  |
11 | >>> | CONTAINS | TEXT | EV (113818, DCM, "Dosimeter Type") | 1 | M |  |
12 | > | CONTAINS | TEXT | EV (121106, DCM, "Comment") | 1 | U |  |
13 | > | CONTAINS | INCLUDE | DTID 1021 “Device Participant” | 1 | MC | Required if the irradiating device is not the recording device and the dose was accumulated on a single device. | $DeviceProcedureRole = EV (113859, DCM, "Irradiating Device")

Content Item Descriptions

Rows 5, 6 | Total Number of CT irradiation events. A CT irradiation event is one continuous irradiation procedure and is defined through consistent acquisition parameters. In the case of dose modulation the calculations are based on the effective parameters (e.g., the effective mA recorded in the Mean X-Ray Tube Current), and these acquisition parameters are consistent.
Rows 5, 6 | The Dose Length Product (DLP) is calculated for every irradiation event. The Dose Length Product Total is the sum of the DLP values. The calculation is based on the CTDIvol result of each irradiation event.
Rows 5, 6 | Effective dose (E, in units of mSv) evaluated as a total over the scope is defined in Row 6 of template TID 10011 “CT Radiation Dose”. Effective dose is defined by the reference in Rows 5 or 6 of this template. It may be calculated from a product of DLP and an 'Effective Dose Conversion Factor' (E/DLP). Or it may be calculated from a product of the Mean CTDIfreeair and the ratio E/CTDIfreeair. The ratios E/DLP or E/CTDIfreeair may be evaluated either from computer simulations applying Monte Carlo (MC) sampling techniques or from dosimetric measurements in an anthropomorphic phantom, e.g., the Alderson-Rando phantom.. The specific method used is identified in Rows 7 through 11.
Row 5 - 6 | Reference of the base publication defining the Effective Dose, either as a coded value, or a textual bibliographic reference. ICRP Publications shall be referenced using their assigned coded values.
Row 7 | Description of the method used for Effective Dose evaluations.
Row 8 | Description of the reference-patient mathematical or computational model used when Effective Dose is derived via Monte Carlo simulations of radiation transport in such models. Examples of publications that specify particular reference patient models are NUREG/CR-1159, ORNL/NUREG/TM-367 (1980); NRPB-R186 (1985); GSF-Bericht S-885 (1986); Fill et al., Health Physics Vol. 86 (3): 253-272 (2004).
Row 9 | Description of the condition Effective Dose measured
Row 10 | Type of Effective Dose phantom used, e.g., Alderson-Rando
Row 11 | Type of dosimeter used, e.g., TLD (Thermo Luminescence Dosimeter)
Row 13 | The device that produced the irradiation accumulated in this template. I.e., the CT Scanner. This is not required to be present if the information is the same as that already recorded in TID 1004 “Device Observer Identifying Attributes” encoded via the inclusion of TID 1002 “Observer Context” in TID 10011 “CT Radiation Dose” Row 4, which in turn may be absent if identical to the content in the Enhanced General Equipment Module, or if more than one device produced the accumulated irradiation.

### TID 10013 CT Irradiation Event Data

This template conveys the dose and equipment parameters of a single irradiation event.

A CT irradiation event is the loading of X-Ray equipment caused by a single continuous actuation of the equipment's irradiation switch, from the start of the loading time of the first pulse until the loading time trailing edge of the final pulse. Any on-off switching of the radiation source during the event shall not be treated as separate events; rather the event includes the time between start and stop of radiation as triggered by the user, e.g., a single sequence of scanning comprised of multiple slices acquired with successive tube rotations and table increments shall be treated as a single irradiation event. Depending on the examination workflow and the anatomical target region the CT irradiation event data may split into multiple instances of this template for better dose estimation. The irradiation event is the "smallest" information entity to be recorded in the realm of Radiation Dose reporting. Individual Irradiation Events are described by a set of accompanying physical parameters that are sufficient to understand the "quality" of irradiation that is being applied. This set of parameters may be different for the various types of equipment that are able to create irradiation events.

Type:

  Extensible

Order:

  Significant

Table TID 10013. CT Irradiation Event Data

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (113819, DCM, "CT Acquisition") | 1 | M |  |
2 | > | CONTAINS | TEXT | EV (125203, DCM, "Acquisition Protocol") | 1 | U |  |
3 | > | CONTAINS | CODE | EV (123014, DCM, "Target Region") | 1 | M |  | DCID 4030 “CT, MR and PET Anatomy Imaged”
4 | > | CONTAINS | CODE | EV (113820, DCM, "CT Acquisition Type") | 1 | M |  | DCID 10013 “CT Acquisition Type”
4b | >> | CONTAINS | CODE | EV (113961, DCM, "Reconstruction Algorithm") | 1-n | U |  | DCID 10033 “CT Reconstruction Algorithm”
5 | > | CONTAINS | CODE | EV (G-C32C, SRT, "Procedure Context") | 1 | U |  | DCID 10014 “Contrast Imaging Technique”
6 | > | CONTAINS | UIDREF | EV (113769, DCM, "Irradiation Event UID") | 1 | M |  |
6b | > | CONTAINS | TEXT | EV (113605, DCM, "Irradiation Event Label") | 1 | U |  |
6c | >> | HAS CONCEPT MOD | CODE | EV (113606, DCM, "Label Type") | 1 | MC | IF the value of Row 6b is the value of an Attribute in the images. | DCID 10022 “Label Types”
7 | > | CONTAINS | CONTAINER | EV (113822, DCM, "CT Acquisition Parameters") | 1 | M |  |
8 | >> | CONTAINS | NUM | EV (113824, DCM, "Exposure Time") | 1 | M |  | UNITS = EV (s, UCUM, "s")
9 | >> | CONTAINS | INCLUDE | DTID 10014 “Scanning Length” | 1 | M |  |
10 | >> | CONTAINS | NUM | EV (113826, DCM, "Nominal Single Collimation Width") | 1 | M |  | UNITS = EV (mm, UCUM, "mm")
11 | >> | CONTAINS | NUM | EV (113827, DCM, "Nominal Total Collimation Width") | 1 | M |  | UNITS = EV (mm, UCUM, "mm")
12 | >> | CONTAINS | NUM | EV (113828, DCM, "Pitch Factor") | 1 | MC | IF row 4 equals (P5-08001, SRT, "Spiral Acquisition") or equals (113804, DCM, "Sequenced Acquisition") | UNITS = EV ({ratio}, UCUM, "ratio")
13 | >> | CONTAINS | NUM | EV (113823, DCM, "Number of X-Ray Sources") | 1 | M |  | UNITS = EV ({X-Ray sources}, UCUM, "X-Ray sources")
14 | >> | CONTAINS | CONTAINER | EV (113831, DCM, "CT X-Ray Source Parameters") | 1-n | M |  |
15 | >>> | CONTAINS | TEXT | EV (113832, DCM, "Identification of the X-Ray Source") | 1 | M |  |
16 | >>> | CONTAINS | NUM | EV (113733, DCM, "KVP") | 1 | M |  | UNITS = EV (kV, UCUM, "kV")
17 | >>> | CONTAINS | NUM | EV (113833, DCM, "Maximum X-Ray Tube Current") | 1 | M |  | UNITS = EV (mA, UCUM, "mA")
18 | >>> | CONTAINS | NUM | EV (113734, DCM, "X-Ray Tube Current") | 1 | M |  | UNITS = EV (mA, UCUM, "mA")
19 | >>> | CONTAINS | NUM | EV (113834, DCM, "Exposure Time per Rotation") | 1 | MC | IF row 4 does not equal (113805, DCM, "Constant Angle Acquisition") | UNITS = EV (s, UCUM, "s")
20 | >>> | CONTAINS | NUM | EV (113821, DCM, "X-Ray Filter Aluminum Equivalent") | 1 | U |  | UNITS = EV (mm, UCUM, "mm")
21 | > | CONTAINS | CONTAINER | EV (113829, DCM, "CT Dose") | 1 | MC | IF row 4 does not equal (113805, DCM, "Constant Angle Acquisition") |
22 | >> | CONTAINS | NUM | EV (113830, DCM, "Mean CTDIvol") | 1 | M |  | UNITS = EV (mGy, UCUM, "mGy")
23 | >> | CONTAINS | CODE | EV (113835, DCM, "CTDIw Phantom Type") | 1 | M |  | DCID 4052 “Phantom Devices”
24 | >> | CONTAINS | NUM | EV (113836, DCM, "CTDIfreeair Calculation Factor") | 1 | U |  | UNITS = EV (mGy/mA.s, UCUM, "mGy/mA.s")
25 | >> | CONTAINS | NUM | EV (113837, DCM, "Mean CTDIfreeair") | 1 | U |  | UNITS = EV (mGy, UCUM, "mGy")
26 | >> | CONTAINS | NUM | EV (113838, DCM, "DLP") | 1 | M |  | UNITS = EV (mGy.cm, UCUM, "mGy.cm")
27 | >> | CONTAINS | NUM | EV (113839, DCM, "Effective Dose") | 1 | U |  | UNITS = EV (mSv, UCUM, "mSv")
28 | >>> | HAS CONCEPT MOD | CODE | EV (G-C036, SRT, "Measurement Method") | 1 | MC | IF row 27 is present | DCID 10011 “Effective Dose Evaluation Method”
29 | >>>> | HAS PROPERTIES | NUM | EV (113840, DCM, "Effective Dose Conversion Factor") | 1 | MC | IF row 28 is present and equals (113800, DCM, "DLP to E conversion via MC computation") or equals (113802, DCM, "DLP to E conversion via measurement") | UNITS = EV (mSv/mGy.cm, UCUM, "mSv/mGy.cm")
30 | >> | CONTAINS | NUM | EV (113930, DCM, "Size Specific Dose Estimation") | 1-n | U |  | UNITS = EV (mGy, UCUM, "mGy")
31 | >>> | HAS CONCEPT MOD | CODE | EV (G-C036, SRT, "Measurement Method") | 1 | M |  | DCID 10023 “Size Specific Dose Estimation Method for CT”
32 | >>>> | INFERRED FROM | NUM | EV (113931, DCM, "Measured Lateral Dimension") | 1 | MC | IF row 31 equals (113934, DCM, "AAPM 204 Lateral Dimension") or (113936, DCM, "AAPM 204 Sum of Lateral and AP Dimension") | UNITS = EV (mm, UCUM, "mm")
33 | >>>> | INFERRED FROM | NUM | EV (113932, DCM, "Measured AP Dimension") | 1 | MC | IF row 31 equals (113935, DCM, "AAPM 204 AP Dimension") or (113936, DCM, "AAPM 204 Sum of Lateral and AP Dimension") | UNITS = EV (mm, UCUM, "mm")
34 | >>>> | INFERRED FROM | NUM | EV (113933, DCM, "Derived Effective Diameter") | 1 | MC | IF row 31 equals (113934, DCM, "AAPM 204 Lateral Dimension") or (113935, DCM, "AAPM 204 AP Dimension") or (113936, DCM, "AAPM 204 Sum of Lateral and AP Dimension") or (113937, DCM, "AAPM 204 Effective Diameter Estimated From Patient Age") | UNITS = EV (mm, UCUM, "mm")
35 | >> | CONTAINS | INCLUDE | DTID 10015 “CT Dose Check Details” | 1 | M |  |
36 | > | CONTAINS | TEXT | EV (113842, DCM, "X-Ray Modulation Type") | 1 | U |  |
37 | > | CONTAINS | TEXT | EV (121106, DCM, "Comment") | 1 | U |  |
38 | > | CONTAINS | INCLUDE | DTID 1020 “Person Participant” | 1-n | U |  | $PersonProcedureRole = EV (113851, DCM, "Irradiation Administering")
39 | > | CONTAINS | INCLUDE | DTID 1021 “Device Participant” | 1 | MC | Required if the irradiating device is not the recording device. | $DeviceProcedureRole = EV (113859, DCM, "Irradiating Device")

Content Item Descriptions

Row 2 | User-defined type of clinical acquisition protocol for creating images or image-derived measurements. May be taken from Protocol Name (0018,1030) or from Performed Procedure Step Description (0040,0254).
Row 3 | The target region is the anatomy exposed.
Row 4 | Description of the method used during acquisition of this CT irradiation event, may be derived from Acquisition Type (0018,9302).
Row 4b | Though not a characteristic of the acquisition per se, the type of reconstruction intended has a bearing on the technique used. If multiple types of reconstruction are performed, multiple values can be listed. These values should correspond to the values of Reconstruction Algorithm (0018,9315) in the reconstructed images.
Row 5 | The acquisition was performed with or without contrast medium application.
Row 8 | Total time the patient has received X-Ray exposure during the irradiation event.
Row 10 | The value of the nominal width (referenced to the location of the isocenter along the z axis) of a single collimated slice in mm.
Row 11 | The value of the nominal width (referenced to the location of the isocenter along the z axis) of the nominal total collimation in mm over the area of active X-Ray detection (z-coverage).
Row 12 | Pitch Factor: For Spiral Acquisition, the Pitch Factor is the ratio of the Table Feed per Rotation to the Nominal Total Collimation Width. For Sequenced Acquisition, the Pitch Factor is the ratio of the Table Feed per single sequenced scan to the Nominal Total Collimation Width.
Row 14 | CT X-Ray source parameters related to the acquisition. For each X-Ray source an item must be present. For multi-energy acquisitions, multiple items may be present for each X-Ray source, each item describing one energy level.
Row 15 | Identification of the X-Ray source. Identifies the particular X-Ray source (in a multi-source CT system) for which the set of X-Ray source parameter values is reported.
Row 16 | KVP value as measured/recorded by system.
Row 18 | Mean tube current as measured/recorded by system.
Row 19 | Exposure time as measured/recorded by the system per rotation.
Row 20 | Thickness of an equivalent filter constructed from aluminum, in case of multi-source CT systems AND if Row 4 is not present
Row 21 | CT Dose for one acquisition
Rows 5, 6 | "Mean CTDIvol" refers to the average value of the CTDIvol applied within this acquisition. CTDIvol is the volume CTDIw, where CTDIw is the weighted computed tomography dose index 100 as defined in IEC 60601-2-44. For Sequenced and Spiral scanning, CTDIvol = CTDIw / Pitch Factor. For Stationary and Free scanning, CTDIvol = CTDIw ✕ Cumulative Exposure Time/ Exposure Time Per Rotation. According to IEC 60601-2-44 Ed 3 for Constant Angle Acquisition may be calculated as CTDIvol = (CTDIw / Current Time Product (mAs)) ✕ X-Ray Tube Current (mA) x (Nominal Total Collimation Width (mm) / Table Speed (mm/s)). ### Note The ratio CTDIw / Current Time Product is evaluated independently of the Constant Angle Acquisition but with the same settings of tube voltage and Total Collimation Width as those of the Constant Angle Acquisition. See also CTDIvol (0018,9345) and Spiral Pitch Factor (0018,9311) in the “Enhanced Computed Tomography Image IOD” in PS3.3 .
Row 23 | The type of phantom used for CTDI measurement according to IEC 60601-2-44(e.g., Head 16 cm diameter PMMA, Body 32 cm diameter PMMA).
Rows 5, 6 | The CTDIfree air Calculation Factor is the CTDIfree air per mAs, expressed in units of mGy/mAs. The CTDIfree air Calculation Factor may be used in one method calculating Dose. For example, for this acquisition, Effective Dose = Mean X-Ray Tube Current ✕ Cumulative Exposure Time ✕ CTDIfree air Calculation Factor ✕ (Effective Dose/ CTDIfree air).
Rows 5, 6 | MeanCTDIfree air is the mean CTDI for this acquisition, evaluated free-in-air according to IEC 60601-2-44. MeanCTDIfree air = Mean X-Ray Tube Current ✕ Cumulative Exposure Time ✕ CTDIfree air Calculation Factor. The CTDIfree air may be used in one method of calculating Effective Dose.
Rows 5, 6 | For Spiral scanning, DLP = CTDIvol ✕ Scanning Length. For Sequenced scanning, DLP = CTDIvol ✕ Nominal Total Collimation Width ✕ Cumulative Exposure Time / Exposure Time per Rotation. For Stationary and Free scanning, DLP = CTDIvol ✕ Nominal Total Collimation Width (according to IEC 60601-2-44).
Row 27 | Effective Dose in mSv of the single continuous time-frame of the irradiation computed as described in TID 10012 “CT Accumulated Dose Data”.
Row 29 | The Effective Dose Conversion Factor is the ratio of the Effective Dose to the DLP, expressed in units of mSv/mGy.cm, and it is used as a factor in one method of estimating Effective Dose. Monte Carlo Simulations (or dosimetric measurements in an anthropomorphic phantom, e.g., the Alderson-Rando phantom) may be used as a basis for the evaluation of Effective Dose Conversion Factors.
Row 30 | More than one Size Specific Dose Estimation may be included, for example if different computation methods are used.
Row 31 | The methods of AAPM Report 204 are listed in CID 10023 “Size Specific Dose Estimation Method for CT”; other methods may be used. The phantom size (16cm or 32cm) used for the calculation is available from the phantom type defined in Row 23.
Row 32 | The condition specifies inclusion of the Measured Lateral Dimension if it was used in the calculation.
Row 33 | The condition specifies inclusion of the Measured AP Dimension if it was used in the calculation.
Row 34 | The Derived Effective Diameter is conditionally included, whether it was derived from measurements or estimated from age, but may not be used for other (non-AAPM Report 204) methods.
Row 35 | Record of details associated with using the NEMA Dose Check Standard (NEMA XR-25-2010).
Row 36 | The type of exposure modulation. May use the value of Exposure Modulation Type (0018,9323) from CT Exposure Macro or from CT Image Module.
Row 38 | People responsible for the administration of the radiation reported in the irradiation event. May include values that would appear in Performing Physicians' Name (0008,1050), Performing Physician Identification Sequence (0008,1052), Operators' Name (0008,1070) and/or Operator Identification Sequence (0008,1072).
Row 39 | The device that produced the irradiation in this Irradiation Event. I.e., the CT scanner. This is not required to be present if the information is the same as that already recorded in the TID 1004 “Device Observer Identifying Attributes” encoded via the inclusion of TID 1002 “Observer Context” in TID 10011 “CT Radiation Dose” Row 4, which in turn may be absent if identical to the content in the Enhanced General Equipment Module.

### TID 10014 Scanning Length

Type:

  Extensible

Order:

  Significant

Table TID 10014. Scanning Length

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | NUM | EV (113825, DCM, "Scanning Length") | 1 | M |  | UNITS = EV (mm, UCUM, "mm")
2 |  |  | NUM | EV (113893, DCM, "Length of Reconstructable Volume") | 1 | U |  | UNITS = EV (mm, UCUM, "mm")
3 |  |  | NUM | EV (113899, DCM, "Exposed Range") | 1 | UC | IFF TID 10013 “CT Irradiation Event Data” row 4 CT Acquisition Type equals (P5-08001, SRT, "Spiral Acquisition") | UNITS = EV (mm, UCUM, "mm")
4 |  |  | NUM | EV (113895, DCM, "Top Z Location of Reconstructable Volume") | 1 | U |  | UNITS = EV (mm, UCUM, "mm")
5 |  |  | NUM | EV (113896, DCM, "Bottom Z Location of Reconstructable Volume") | 1 | U |  | UNITS = EV (mm, UCUM, "mm")
6 |  |  | NUM | EV (113897, DCM, "Top Z Location of Scanning Length") | 1 | U |  | UNITS = EV (mm, UCUM, "mm")
7 |  |  | NUM | EV (113898, DCM, "Bottom Z Location of Scanning Length") | 1 | U |  | UNITS = EV (mm, UCUM, "mm")
8 |  |  | UIDREF | EV (112227, DCM, "Frame of Reference UID") | 1 | MC | IF any of Rows 4 through 7 are present. | If present, shall be the same UID as in the images reconstructed from this irradiation event.

Content Item Descriptions

Row 1 | For Spiral scanning, the scanning length is normally the table travel in mm during the tube loading (see Figure A-16). For Sequenced scanning, the scanning length is the table travel between consecutive scans times the number of scans. For Stationary and Free scanning, the scanning length is the nominal width of the total collimation.
Row 2 | The length of the reconstructable volume is the maximum z-range between the outermost edges of the top and bottom slices that can be reconstructed from the acquisition. For Spiral scanning, the length of reconstructable volume is the z-range between the outermost beginning of the first reconstructable slice and the outermost end of the last reconstructable slice (see Figure A-16). For Sequenced scanning, the length of reconstructable volume is the z-range between the outermost beginning of the first slice and the outermost end of the last slice (i.e., including any skip). For Stationary and Free scanning, the length of reconstructable volume is the nominal width of the total collimation.
Row 3 | For Spiral scanning, the exposed range is as defined in IEC 60601-2-44 (Ed. 3) 302.115(b) (see Figure A-16). Exposed range is not defined for other modes of scanning.
Rows 4-5 | The Top and Bottom Z Locations of the Reconstructable Volume are independent of the slice width of any actual reconstructed slices. They are measured from the edges of the volume, and hence are not equal to the Z locations encoded in the images of any actual reconstructed slices, which are recorded as the center of the slice.
Rows 4-7 | These locations are patient (not table or gantry) relative, to allow them to be defined in the Patient Coordinate System and hence related to the Image Position (Patient) in the reconstructed images. They are also defined in terms of the top (towards the patient's head), and bottom (towards the patient's feet) of the corresponding ranges, in order to make them independent of whether the scan starts at the top or the bottom or shuttles back and forth in between (see Figure A-16).

Figure A-16. Spiral Acquisition Parameters

### TID 10015 CT Dose Check Details

This template records details related to the use of the NEMA Dose Check Standard (NEMA XR-25-2010).

Type:

  Extensible

Order:

  Significant

Table TID 10015. CT Dose Check Details

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (113900, DCM, "Dose Check Alert Details") | 1 | MC | IF the scanning device has implemented dose alerts |
2 | > | CONTAINS | CODE | EV (113901, DCM, "DLP Alert Value Configured") | 1 | M |  | DCID 230 “Yes-No”
3 | > | CONTAINS | CODE | EV (113902, DCM, "CTDIvol Alert Value Configured") | 1 | M |  | DCID 230 “Yes-No”
4 | > | CONTAINS | NUM | EV (113903, DCM, "DLP Alert Value") | 1 | MC | IFF value of Row 2 is (R-0038D, SRT, "Yes") | UNITS = EV (mGy.cm, UCUM, "mGy.cm")
5 | > | CONTAINS | NUM | EV (113904, DCM, "CTDIvol Alert Value") | 1 | MC | IFF value of Row 3 is (R-0038D, SRT, "Yes") | UNITS = EV (mGy, UCUM, "mGy")
6 | > | CONTAINS | NUM | EV (113905, DCM, "Accumulated DLP Forward Estimate") | 1 | MC | IF Accumulated DLP Forward Estimate (Row 6) exceeds DLP Alert Value (Row 4) | UNITS = EV (mGy.cm, UCUM, "mGy.cm")
7 | > | CONTAINS | NUM | EV (113906, DCM, "Accumulated CTDIvol Forward Estimate") | 1 | MC | IF Accumulated CTDIvol Forward Estimate (Row 7) exceeds CTDIvol Alert Value (Row 5) | UNITS = EV (mGy, UCUM, "mGy")
8 | > | CONTAINS | TEXT | EV (113907, DCM, "Reason for Proceeding") | 1 | UC | IFF Accumulated DLP Forward Estimate (Row 6) exceeds DLP Alert Value (Row 4) or Accumulated CTDIvol Forward Estimate (Row 7) exceeds CTDIvol Alert Value (Row 5) |
9 | > | CONTAINS | INCLUDE | DTID 1020 “Person Participant” | 1 | MC | IF Accumulated DLP Forward Estimate (Row 6) exceeds DLP Alert Value (Row 4) or Accumulated CTDIvol Forward Estimate (Row 7) exceeds CTDIvol Alert Value (Row 5) | $PersonProcedureRole = EV (113850, DCM, "Irradiation Authorizing")
10 |  |  | CONTAINER | EV (113908, DCM, "Dose Check Notification Details") | 1 | MC | IF the scanning device has implemented dose notifications |
11 | > | CONTAINS | CODE | EV (113909, DCM, "DLP Notification Value Configured") | 1 | M |  | DCID 230 “Yes-No”
12 | > | CONTAINS | CODE | EV (113910, DCM, "CTDIvol Notification Value Configured") | 1 | M |  | DCID 230 “Yes-No”
13 | > | CONTAINS | NUM | EV (113911, DCM, "DLP Notification Value") | 1 | MC | IFF value of Row 11 is (R-0038D, SRT, "Yes") | UNITS = EV (mGy.cm, UCUM, "mGy.cm")
14 | > | CONTAINS | NUM | EV (113912, DCM, "CTDIvol Notification Value") | 1 | MC | IFF value of Row 12 is (R-0038D, SRT, "Yes") | UNITS = EV (mGy, UCUM, "mGy")
15 | > | CONTAINS | NUM | EV (113913, DCM, "DLP Forward Estimate") | 1 | MC | IF DLP Forward Estimate (Row 15) exceeds DLP Notification Value (Row 13) | UNITS = EV (mGy.cm, UCUM, "mGy.cm")
16 | > | CONTAINS | NUM | EV (113914, DCM, "CTDIvol Forward Estimate") | 1 | MC | IF CTDIvol Forward Estimate (Row 16) exceeds CTDIvol Notification Value (Row 14) | UNITS = EV (mGy, UCUM, "mGy")
17 | > | CONTAINS | TEXT | EV (113907, DCM, "Reason for Proceeding") | 1 | UC | IFF DLP Forward Estimate (Row 15) exceeds DLP Notification Value (Row 13) or CTDIvol Forward Estimate (Row 16) exceeds CTDIvol Notification Value (Row 14) |
18 | > | CONTAINS | INCLUDE | DTID 1020 “Person Participant” | 1 | UC | IFF DLP Forward Estimate (Row 15) exceeds DLP Notification Value (Row 13) or CTDIvol Forward Estimate (Row 16) exceeds CTDIvol Notification Value (Row 14) | $PersonProcedureRole = EV (113850, DCM, "Irradiation Authorizing")

Content Item Descriptions

Row 1 | Container for Dose Check Alert details.
Row 2 | Indicates whether a DLP Alert Value was configured (e.g., by the institution) for the exam to which this irradiation event belongs.
Row 3 | Indicates whether a CTDIvol Alert Value was configured (e.g., by the institution) for the exam to which this irradiation event belongs.
Row 4 | The configured value applicable to the current exam that would trigger an alert if the accumulated DLP were projected to exceed it.
Row 5 | The configured value applicable to the current exam that would trigger an alert if the Accumulated CTDIvol at any given location were projected to exceed it.
Row 6 | The value estimated prior to performing this irradiation event of the projected DLP accumulated during this exam, including this irradiation event. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 7 | The value estimated prior to performing this irradiation event of the projected CTDIvol accumulated during this exam, including this irradiation event. The value is for the location with the highest estimated accumulation. The actual location is not recorded. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 8 | The reason provided by the operator for proceeding with an irradiation event projected to exceed an alert value.
Row 9 | Person responsible for authorizing irradiation projected to exceed an alert value.
Row 10 | Container for Dose Check Notification details.
Row 11 | Indicates whether a DLP Notification Value was configured (e.g., by the institution) for the Protocol Element Group to which this irradiation event corresponds.
Row 12 | Indicates whether a CTDIvol Notification Value was configured (e.g., by the institution) for the Protocol Element Group to which this irradiation event corresponds.
Row 13 | The configured value applicable to the current irradiation event that would trigger a notification if the DLP were projected to exceed it.
Row 14 | The configured value applicable to the current irradiation event that would trigger a notification if the CTDIvol were projected to exceed it.
Row 15 | The value estimated prior to performing this irradiation event of the DLP for this irradiation event. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 16 | The value estimated prior to performing this irradiation event of the CTDIvol for this irradiation event. The value is for the location with the highest estimated value. The actual location is not recorded. The estimate may include assumptions such as those described in NEMA XR 25-2010.
Row 17 | The reason provided by the operator for proceeding with an irradiation event projected to exceed a notification value.
Row 18 | Person responsible for authorizing irradiation projected to exceed a notification value.

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