Colon CAD SR IOD Templates
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## Colon CAD SR IOD Templates

The templates that comprise the Colon CAD SR IOD are interconnected as in Figure A-9b. In Figure A-9b, '···' indicates possible recursive application of subordinate templates.

Figure A-9b. Colon CAD SR IOD Template Structure

### TID 4120 Colon CAD Document Root

This template forms the top of a content tree that allows a colon CAD device to describe the results of detection and analysis of colon evidence. This template, together with its subordinate templates, describes both the results for presentation to radiologists and partial product results for consumption by colon CAD devices in subsequent colon CAD reports.

This template defines a Container that contains the CAD results and summaries of the detection and analysis algorithms performed.

The atomic CAD results of Single Image Findings and Composite Features are described in the Colon CAD Findings Summary sub-tree.

The Summary of Detections and Summary of Analyses sub-trees gather lists of algorithms attempted, grouped by success/failure status. Algorithms not attempted are not mentioned in these sub-trees. This information forms the basis for understanding why a colon CAD report may produce no (or fewer than anticipated) results. Colon CAD results are constructed bottom-up, starting from Single Image Findings (see TID 4127 “Colon CAD Single Image Finding”), associated as Composite Features (see TID 4125 “Colon CAD Composite Feature”).

See Figure SS.1-1 “Top Levels of Colon CAD SR Content Tree” in PS3.17 .

Type:

  Non-Extensible

Order:

  Significant

Root:

  Yes

Table TID 4120. Colon CAD Document Root

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (112220, DCM, "Colon CAD Report") | 1 | M |  | Root node
2 | > | HAS CONCEPT MOD | INCLUDE | DTID 1204 “Language of Content Item and Descendants” | 1 | M |  |
3 | > | CONTAINS | INCLUDE | DTID 4122 “CAD Common Image Properties Entry” | 1-n | M |  |
4 | > | CONTAINS | INCLUDE | DTID 4121 “Colon CAD Findings Summary” | 1 | M |  |
5 | > | CONTAINS | CODE | EV (111064, DCM, "Summary of Detections") | 1 | M |  | DCID 6042 “Status of Results”
6 | >> | INFERRED FROM | INCLUDE | DTID 4015 “CAD Detections Performed” | 1 | MC | Shall be present unless the value of row 5 is (111225, DCM, "Not Attempted") | $DetectionCode = DCID 6201 “Colon Finding Or Feature”
7 | > | CONTAINS | CODE | EV (111065, DCM, "Summary of Analyses") | 1 | M |  | DCID 6042 “Status of Results”
8 | >> | INFERRED FROM | INCLUDE | DTID 4016 “CAD Analyses Performed” | 1 | MC | Shall be present unless the value of row 7 is (111225, DCM, "Not Attempted") | $AnalysisCode = DCID 6137 “Types of CAD Analysis”

Content Item Descriptions

Detections Performed | The "Detections Performed" and "Analyses Performed" sections of the Content Tree (TID 4120 “Colon CAD Document Root”, rows 6 and 8) together shall reference all Image SOP Instances included in the Current Requested Procedure Evidence Sequence (0040,A375) attribute of the SR Document General module.
Analyses Performed

### TID 4121 Colon CAD Findings Summary

The contents of this template describe the findings and aggregate features that the colon CAD device detected for the colon evidence presented. This template forms the colon CAD results sub-tree of the Colon CAD Document Root (TID 4120 “Colon CAD Document Root”). The data from which the details are inferred are expressed in the Composite Features (see TID 4125 “Colon CAD Composite Feature”) and/or Single Image Findings (see TID 4127 “Colon CAD Single Image Finding”), of which there may be several.

The sub-tree headed by this template is illustrated in Figure F.1-2 “Example of CAD Processing and Findings Summary Sub-Tree of Chest CAD SR Content Tree” in PS3.17 .

Type:

  Non-Extensible

Order:

  Significant

Table TID 4121. Colon CAD Findings Summary

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CODE | EV (111017, DCM, "CAD Processing and Findings Summary") | 1 | M |  | DCID 6047 “CAD Processing and Findings Summary”
2 | > | HAS PROPERTIES | CODE | EV (112222, DCM, "Colon Overall Assessment") | 1 | U |  | DCID 6200 “Colon Overall Assessment”
3 | > | INFERRED FROM | INCLUDE | DTID 4125 “Colon CAD Composite Feature” | 1-n | U |  |
4 | > | INFERRED FROM | INCLUDE | DTID 4127 “Colon CAD Single Image Finding” | 1-n | U |  |

Content Item Descriptions

CAD Processing and Findings Summary | This code value is used to express if and why the Colon CAD Findings Summary sub-tree is empty. The Summary of Detections and Summary of Analyses sub-trees of the Document Root node contain detail about which (if any) algorithms succeeded or failed. If the code value indicates that there were no findings, then the code value can be used to determine whether colon CAD processing occurred successfully, without parsing the Summary of Detections and Summary of Analyses sub-trees.

### TID 4122 CAD Common Image Properties Entry

Each instance of the CAD Common Image Properties Entry template contains selected attributes for a set of parallel contiguous equally spaced slices (with identical properties) from which CAD findings are derived.

Type:

  Extensible

Order:

  Significant

Table TID 4122. CAD Common Image Properties Entry

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (112224, DCM, "Image Set Properties") | 1 | M |  |
2 | > | CONTAINS | UIDREF | EV (112227, DCM, "Frame of Reference UID") | 1 | M |  |
3 | > | CONTAINS | UIDREF | EV (110180, DCM, "Study Instance UID") | 1 | M |  |
4 | > | CONTAINS | DATE | EV (111060, DCM, "Study Date") | 1 | M |  | Shall be taken from Study Date (0008,0020) in the Image Instances.
5 | > | CONTAINS | TIME | EV (111061, DCM, "Study Time") | 1 | M |  | Shall be taken from Study Time (0008,0030) in the Image Instances.
6 | > | CONTAINS | CODE | EV (121139, DCM, "Modality") | 1 | M |  | Shall be taken from Modality (0008,0060) in the Image Instances.
7 | > | CONTAINS | NUM | EV (111026, DCM, "Horizontal Pixel Spacing") | 1 | M |  | Shall be taken from value 1 of Pixel Spacing (0028,0030) in the Image Instances. UNITS = EV (mm/{pixel}, UCUM, "millimeters per pixel")
8 | > | CONTAINS | NUM | EV (111066, DCM, "Vertical Pixel Spacing") | 1 | M |  | Shall be taken from value 2 of Pixel Spacing (0028,0030) in the Image Instances. UNITS = EV (mm/{pixel}, UCUM, "millimeters per pixel")
9 | > | CONTAINS | NUM | EV (112225, DCM, "Slice Thickness") | 1 | M |  | Shall be taken from Slice Thickness (0018,0050) in the Image Instances. UNITS = EV (mm, UCUM, "millimeter")
10 | > | CONTAINS | NUM | EV (112226, DCM, "Spacing between slices") | 1 | M |  | Shall be computed from the Image Position (Patient) (0020,0032) projected onto the normal to the Image Orientation (Patient) (0020,0037); may or may not be the same as the Spacing Between Slices (0018,0088) if present. UNITS = EV (mm, UCUM, "millimeter")
11 | > | CONTAINS | CODE | EV (112228, DCM, "Recumbent Patient Position with respect to gravity") | 1 | MC | Required if Patient Position (0018,5100) is present in the image instances and has a value. | Shall be derived from Patient Position (0018,5100) in the Image Instances. DCID 6206 “Recumbent Patient Orientation for Colon”

### TID 4125 Colon CAD Composite Feature

This template collects a composite feature for a lesion, non-lesion object, or correlation of related objects (see TID 4121 “Colon CAD Findings Summary”). The details of the composition are expressed in the Colon CAD Composite Feature Body (see TID 4126 “Colon CAD Composite Feature Body”). The data from which the details are inferred, are expressed in the Composite Features (see TID 4125 “Colon CAD Composite Feature”) and/or Single Image Findings (see TID 4127 “Colon CAD Single Image Finding”), of which there may be several.

Type:

  Non-Extensible

Order:

  Significant

Table TID 4125. Colon CAD Composite Feature

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CODE | EV (111015, DCM, "Composite Feature") | 1 | M |  | DCID 6201 “Colon Finding Or Feature”
2 | > | HAS CONCEPT MOD | CODE | EV (112023, DCM, "Composite Feature Modifier") | 1 | U |  | DCID 6202 “Colon Finding Or Feature Modifier”
3 | > | HAS CONCEPT MOD | CODE | EV (111056, DCM, "Rendering Intent") | 1 | M |  | DCID 6034 “Intended Use of CAD Output”
4 | >> | HAS PROPERTIES | NUM | EV (111071, DCM, "CAD Operating Point") | 1 | UC | IFF value of row 3 is (111151, DCM, "Presentation Optional") and row 1 of TID 4023 “CAD Operating Points” is present for the feature identified in row 1. | UNITS = DT ({1:n}, UCUM, "range: 1:n"), where n is the maximum specified in Row 1 of TID 4023 “CAD Operating Points” for the feature identified in row 1. Value is restricted to being an integer.
5 | > | HAS OBS CONTEXT | INCLUDE | DTID 4108 “Tracking Identifier” | 1 | U |  |
6 | > | HAS OBS CONTEXT | INCLUDE | DTID 4022 “CAD Observation Context” | 1 | MC | Shall be present IFF this feature is duplicated from a different report than its parent. |
7 | > | HAS OBS CONTEXT | INCLUDE | DTID 4019 “CAD Algorithm Identification” | 1 | M |  |
8 | > | HAS PROPERTIES | INCLUDE | DTID 4126 “Colon CAD Composite Feature Body” | 1 | M |  |
9 | > | INFERRED FROM | INCLUDE | DTID 4125 “Colon CAD Composite Feature” | 1-n | U |  |
10 | > | INFERRED FROM | INCLUDE | DTID 4127 “Colon CAD Single Image Finding” | 1-n | U |  |

Content Item Descriptions

Rendering Intent | This content item constrains the SCP receiving the Colon CAD SR IOD in its use of the contents of this template and its target content items. Colon CAD devices may opt to use data marked "Not for Presentation" or "Presentation Optional" as input to subsequent colon CAD processing steps. Refer to Section O.2 “Structured Reporting Storage SOP Class SCU and SCP Behavior” in PS3.4 .

### TID 4126 Colon CAD Composite Feature Body

The details of a composite feature are expressed in this template. It is applied to Colon CAD Composite Feature (TID 4125 “Colon CAD Composite Feature”).

Type:

  Non-Extensible

Order:

  Significant

Table TID 4126. Colon CAD Composite Feature Body

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CODE | EV (111016, DCM, "Composite type") | 1 | M |  | DCID 6035 “Composite Feature Relations”
2 |  |  | CODE | EV (111057, DCM, "Scope of Feature") | 1 | M |  | DCID 6036 “Scope of Feature”
3 |  |  | NUM | EV (111011, DCM, "Certainty of feature") | 1 | U |  | UNITS = EV (%, UCUM, "Percent") Value = 0 - 100
4 |  |  | INCLUDE | DTID 4129 “Colon CAD Geometry” | 1 | U |  |
5 |  |  | INCLUDE | DTID 4128 “Colon CAD Descriptors” | 1 | U |  |
6 |  |  | NUM | DCID 6207 “Colon Quantitative Temporal Difference Type” | 1-n | UC | May be present IFF the value of row 1 is (111153, DCM, "Target content items are related temporally") |
7 | > | R-INFERRED FROM | NUM |  | 2 | U |  | The referenced numeric values shall have the same Concept Name. Their UNITS shall be the same as row 6
8 |  |  | CODE | EV (111049, DCM, "Qualitative Difference") | 1-n | UC | May be present only if the value of row 1 is (111153, DCM, "Target content items are related temporally") | DCID 6134 “Chest Qualitative Temporal Difference Type”
9 | > | HAS PROPERTIES | TEXT | EV (111021, DCM, "Description of Change") | 1 | U |  |
10 | > | R-INFERRED FROM | CODE |  | 2 | M |  | The referenced content items shall have the same Concept Name and their code values shall be from the same context group.

Content Item Descriptions

Certainty of Feature | The CAD device's certainty that the feature analyzed and classified by the CODE, as specified in the Composite Feature parent template is, in fact, that type of feature.
Row 6 | Values ≤ 0 are allowed. The two referenced numeric values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature. Given the equation, A - B, the value representing A shall be referenced first.
Qualitative Difference | The two referenced code values are target content items of the first generation Composite Feature or Single Image Finding children of this composite feature.

### TID 4127 Colon CAD Single Image Finding

This template describes a single image finding for a lesion or other object. The details of the finding are expressed in this template and/or more specific templates.

Type:

  Non-Extensible

Order:

  Significant

Table TID 4127. Colon CAD Single Image Finding

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CODE | EV (111059, DCM, "Single Image Finding") | 1 | M |  | DCID 6201 “Colon Finding Or Feature”
2 | > | HAS CONCEPT MOD | CODE | EV (112024, DCM, "Single Image Finding Modifier") | 1 | U |  | DCID 6202 “Colon Finding Or Feature Modifier”
3 | > | HAS CONCEPT MOD | CODE | EV (111056, DCM, "Rendering Intent") | 1 | M |  | DCID 6034 “Intended Use of CAD Output”
4 | >> | HAS PROPERTIES | NUM | EV (111071, DCM, "CAD Operating Point") | 1 | UC | IFF value of row 3 is (111151, DCM, "Presentation Optional") and row 1 of TID 4023 “CAD Operating Points” is present for the finding identified in row 1 | UNITS = DT ({1:n}, UCUM, "range: 1:n"), where n is the maximum specified in Row 1 of TID 4023 “CAD Operating Points” for the finding identified in row 1. Value is restricted to being an integer.
5 | > | HAS OBS CONTEXT | INCLUDE | DTID 4108 “Tracking Identifier” | 1 | U |  |
6 | > | HAS OBS CONTEXT | INCLUDE | DTID 4022 “CAD Observation Context” | 1 | MC | Shall be present IFF this finding is duplicated from a different report than its parent. |
7 | > | HAS OBS CONTEXT | INCLUDE | DTID 4019 “CAD Algorithm Identification” | 1 | M |  |
8 | > | HAS PROPERTIES | NUM | EV (111012, DCM, "Certainty of Finding") | 1 | U |  | UNITS = EV (%, UCUM, "Percent") Value = 0 - 100
9 | > | HAS PROPERTIES | TEXT | EV (111058, DCM, "Selected Region Description") | 1 | MC | Shall be present IFF value of row 1 is (111099, DCM, "Selected region") |
10 | > | HAS PROPERTIES | INCLUDE | DTID 4129 “Colon CAD Geometry” | 1 | MC | Shall be present unless value of row 1 is (111101, DCM, "Image quality") |
11 | > | HAS PROPERTIES | INCLUDE | DTID 4128 “Colon CAD Descriptors” | 1 | U |  |
12 | > | INFERRED FROM | IMAGE |  | 1 | MC | Shall be present IFF value of row 1 is (111101, DCM, "Image quality") and row 13 is not present |
13 | > | INFERRED FROM | SCOORD | EV (111030, DCM, "Image Region") | 1-n | MC | Shall be present IFF value of row 1 is (111101, DCM, "Image quality") and row 12 is not present |
14 | >> | SELECTED FROM | IMAGE |  | 1 | M |  | All the row 13 content items in a single invocation of this template shall reference the same IMAGE
15 | > | HAS PROPERTIES | INCLUDE | DTID 4014 “CAD Image Quality” | 1 | MC | Shall be present IFF value of row 1 is (111101, DCM, "Image quality") | $QualityFinding = DCID 6135 “Image Quality Finding” $QualityStandard = DCID 6208 “Colon Types of Quality Control Standard”

Content Item Descriptions

Rendering Intent | This content item constrains the SCP receiving the Colon CAD SR IOD in its use of the contents of this template and its target content items. Colon CAD devices may opt to use data marked "Not for Presentation" or "Presentation Optional" as input to subsequent colon CAD processing steps. Refer to Section O.2 “Structured Reporting Storage SOP Class SCU and SCP Behavior” in PS3.4 .
CAD Operating Point | Additional information to use when Rendering Intent is "Presentational Optional". A CAD Operating Point of zero is not sent, and is encoded as a Rendering Intent of "Presentation Required". See Section O.2 “Structured Reporting Storage SOP Class SCU and SCP Behavior” in PS3.4 and Section E.4 “CAD Operating Point” in PS3.17 .
Certainty of Finding | The certainty of the CAD device that the finding detected and classified by the Single Image Finding CODE specified is in fact that type of finding.

### TID 4128 Colon CAD Descriptors

This template provides qualitative detail for a Single Image Finding or Composite Feature. It is applied to Colon CAD Composite Feature (TID 4125 “Colon CAD Composite Feature”) and Colon CAD Single Image Finding (TID 4127 “Colon CAD Single Image Finding”).

Type:

  Non-Extensible

Order:

  Significant

Table TID 4128. Colon CAD Descriptors

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CODE | EV (G-C504, SRT, "Associated Morphology") | 1-n | U |  | DCID 6209 “Colon Morphology Descriptor”
2 |  |  | CODE | EV (G-C0E3, SRT, "Finding Site") | 1 | U |  | DCID 6210 “Location in Intestinal Tract”
3 |  |  | CODE | EV (111014, DCM, "Clockface or region") | 1 | U |  | DCID 6205 “Clockface Location for Colon”
4 |  | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = DCID 6212 “Calculated Value for Colon Findings” $Derivation = DCID 6140 “Calculation Methods” $DerivationParameter = EV (112032, DCM, "Threshold Attenuation Coefficient") $DerivationParameterUnits = EV ([hnsf'U], UCUM, "Hounsfield unit")
5 |  |  | INCLUDE | DTID 1400 “Linear Measurement” | 1-n | U |  |
6 |  |  | INCLUDE | DTID 1401 “Area Measurement” | 1-n | U |  |
7 |  |  | INCLUDE | DTID 1402 “Volume Measurement” | 1-n | U |  |
8 |  |  | INCLUDE | DTID 1406 “Three Dimensional Linear Measurement” | 1-n | U |  |
9 |  |  | NUM | DCID 6141 “Attenuation Coefficient Measurements” | 1-n | U |  | UNITS = EV ([hnsf'U], UCUM, "Hounsfield unit")
10 | > | HAS PROPERTIES | CODE | EV (112009, DCM, "Type of Content") | 1 | U |  | DCID 6211 “Colon CAD Material Description”

Content Item Descriptions

Row 3 | 12 o'clock position is the anterior direction of the patient regardless of the positioning with respect to gravity; clockwise is from the point of view of an observer located closer to the anus than the finding being observed.

### TID 4129 Colon CAD Geometry

All geometry template invocations require specification of either the location of the center of the object, the outline, or both. Geometry is a property of single image findings (see TID 4127 “Colon CAD Single Image Finding”) and composite features (see TID 4125 “Colon CAD Composite Feature”).

Type:

  Non-Extensible

Order:

  Significant

Table TID 4129. Colon CAD Geometry

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | SCOORD | EV (111010, DCM, "Center") | 1 | MC | At least one of rows 1, 3, 4, 6 or 10 shall be present. | GRAPHIC TYPE = {POINT}
2 | > | SELECTED FROM | IMAGE |  | 1 | M |  |
3 |  |  | SCOORD3D | EV (111010, DCM, "Center") | 1 | MC | At least one of rows 1, 3, 4, 6 or 10 shall be present. | GRAPHIC TYPE = {POINT}
4 |  |  | SCOORD | EV (111041, DCM, "Outline") | 1 | MC | At least one of rows 1, 3, 4, 6 or 10 shall be present. |
5 | > | SELECTED FROM | IMAGE |  | 1 | M |  |
6 |  |  | SCOORD3D | EV (111041, DCM, "Outline") | 1 | MC | At least one of rows 1, 3, 4, 6 or 10 shall be present. |
7 |  |  | SCOORD | DCID 6166 “CAD Geometry Secondary Graphical Representation” | 1-n | U |  |
8 | > | SELECTED FROM | IMAGE |  | 1 | M |  |
9 |  |  | SCOORD3D | DCID 6166 “CAD Geometry Secondary Graphical Representation” | 1-n | U |  |
10 |  |  | IMAGE | EV (112229, DCM, "Identifying Segment") | 1 | MC | At least one of rows 1, 3, 4, 6 or 10 shall be present. | Referenced image shall be a Segmentation and the content item shall include Referenced Segment Number (0062,000B)

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