A.48 Enhanced X-Ray RF Image IOD
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## A.48 Enhanced X-Ray RF Image IOD

### A.48.1 Enhanced XRF Image IOD Description

The focus for this enhanced X-Ray RF Image IOD (XRF IOD) is to address the requirements for image transfer found in general Radiofluoroscopic applications performed on a table with a column. For applications performed on X-Ray RF acquisition systems that support a patient based coordinate system with cranial/caudal, LAO/RAO angles, etc. the enhanced XA Image IOD may be used.

### Note

1. An example of a case where the enhanced XA IOD may be preferred to the enhanced RF IOD are RF acquisition system equipped with an X-Ray source and an image Receptor positioned by what is generally called a C-arm (e.g., Interventional Procedures, Myelography, Biopsy, and Neurology).

2. For the purpose of X-Ray Radiofluoroscopy, this IOD can be used to encode a single frame image, or a cine run, or a single multi-frame image with non-time related dimensions.

3. A typical study might include all the images generated between the time a patient gets on and gets off the procedure table. As several separable diagnostic or therapeutic processes may occur during a single study, a series may be defined as comprising a set of images (single or multi-frame) associated with one such process within a study.

### A.48.2 Enhanced XRF Image IOD Entity-Relationship Model

The E-R Model in Section A.1.2 depicts those components of the DICOM Application Information Model that directly reference the X-Ray RF Image IOD. Additionally, "Image" in Figure A.1-1 may represent a single frame or a multi-frame image. A frame denotes a two-dimensional organization of pixels recorded as a single exposure.

### A.48.3 Enhanced XRF Image IOD Module Table

Table A.48.-1. Enhanced X-Ray RF 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
XA/XRF Series | C.8.19.1 | M
Clinical Trial Series | C.7.3.2 | U
Frame of Reference | Frame of Reference | C.7.4.1 | U
Synchronization | C.7.4.2 | U
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Image | Image Pixel | C.7.6.3 | M
Enhanced Contrast/Bolus | C.7.6.4b | C - Required if contrast media was applied and the system is able to register contrast usage.
Mask | C.7.6.10 | U
Device | C.7.6.12 | U
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 Module | C.7.6.17 | U
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
X-Ray Tomography Acquisition | C.8.7.7 | U
X-Ray Filtration | C.8.7.10 | U
X-Ray Grid | C.8.7.11 | U
Enhanced XA/XRF Image | C.8.19.2 | M
XA/XRF Acquisition | C.8.19.3 | C - Required if Image Type (0008,0008) Value 1 equals ORIGINAL. May be present otherwise.
X-Ray Image Intensifier | C.8.19.4 | C - Required if X-Ray Receptor Type (0018,9420) is present and equals IMG_INTENSIFIER.
X-Ray Detector | C.8.19.5 | C - Required if X-Ray Receptor Type (0018,9420) is present and equals DIGITAL_DETECTOR.
XA/XRF Multi-frame Presentation | C.8.19.7 | U
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.48.3.1 Enhanced XRF Image IOD Content Constraints

##### A.48.3.1.1 Modality Type Attribute

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

##### A.48.3.1.2 Overlay Plane, Curve, VOI LUT and Specimen Identification Modules

The Overlay Plane Module, VOI LUT Module and Softcopy Presentation LUT Module shall not be used in a Standard Extended SOP Class of the Enhanced XRF Image.

### Note

1. The VOI LUT function is provided by a Frame VOI LUT Functional Group.

2. The Curve Module was previously include in the list of Modules that shall not be present, but has been retired from DICOM. It is still not permitted to be present. See PS3.3-2004.

3. The Specimen Identification Module was previously included in this IOD but has been retired, and its functionality replaced by the Specimen Module. See PS3.3-2008.

##### A.48.3.1.3 Positioner Type

Positioner Type (0018,1508) shall have the value COLUMN if the XA/XRF Acquisition Module is present.

### A.48.4 Enhanced XRF Image Functional Group Macros

Table A.48-2 specifies the use of the Functional Group Macros used in the Multi-frame Functional Groups Module for the Enhanced XRF Image IOD.

Table A.48-2. Enhanced XRF Image Functional Group Macros

Functional Group Macro | Section | Usage
--- | --- | ---
Frame Content | C.7.6.16.2.2 | M - May not be used as a Shared Functional Group.
Referenced Image | C.7.6.16.2.5 | U
Derivation Image | C.7.6.16.2.6 | C - Required if the image or frame has been derived from another SOP Instance.
Cardiac Synchronization | C.7.6.16.2.7 | U
Frame Anatomy | C.7.6.16.2.8 | M
Frame VOI LUT | C.7.6.16.2.10 | M
Contrast/Bolus Usage | C.7.6.16.2.12 | C - Required if the Enhanced Contrast/Bolus Module is present
Pixel Intensity Relationship LUT | C.7.6.16.2.13 | C - Required if Pixel Intensity Relationship (0028,1040) equals LOG. May be present otherwise.
Frame Pixel Shift | C.7.6.16.2.14 | U
Patient Orientation in Frame | C.7.6.16.2.15 | U
Frame Display Shutter | C.7.6.16.2.16 | U
Respiratory Synchronization | C.7.6.16.2.17 | U
Irradiation Event Identification | C.7.6.16.2.18 | M
X-Ray Frame Characteristics | C.8.19.6.1 | U
X-Ray Field of View | C.8.19.6.2 | U
X-Ray Exposure Control Sensing Regions | C.8.19.6.3 | U
X-Ray Frame Pixel Data Properties | C.8.19.6.4 | M
X-Ray Frame Detector Parameters | C.8.19.6.5 | C - Required if X-Ray Receptor Type (0018,9420) is present and equals DIGITAL_DETECTOR.
X-Ray Calibration Device Usage | C.8.19.6.6 | U
X-Ray Object Thickness | C.8.19.6.7 | U
X-Ray Frame Acquisition | C.8.19.6.8 | U
X-Ray Positioner | C.8.19.6.10 | U
X-Ray Table Position | C.8.19.6.11 | U
X-Ray Collimator | C.8.19.6.12 | U
X-Ray Geometry | C.8.19.6.14 | U

#### A.48.4.1 Enhanced XRF Image Functional Group Macros Content Constraints

##### A.48.4.1.1 Frame Anatomy Functional Group Macro

The Defined CID for the Anatomic Region Sequence (0008,2218) shall be CID 4042 “XA/XRF Anatomy Imaged”.

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