A.32 Visible Light Image Information Object Definitions
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## A.32 Visible Light Image Information Object Definitions

The Visible Light (VL) Image Information Object Definition (IOD) specifies images that are acquired by means of a camera or other sensors that are sensitive to visible or near-visible light.

Examples of types of equipment that create Visible Light Images include:

1. Rigid and flexible endoscopy equipment

2. Operation microscopes / colposcopes

3. Ophthalmology equipment

4. Digital or Video Cameras

5. Analysis microscopes

Separate IODs have been defined for specialized applications. Some support only single frame images, some support both single frame and multi-frame video images.

### A.32.1 VL Endoscopic Image IOD

#### A.32.1.1 VL Endoscopic Image IOD Description

The VL Endoscopic Image IOD specifies the Attributes of Single-frame VL Endoscopic Images.

#### A.32.1.2 VL Endoscopic 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 VL Endoscopic Image IOD, with exception of the VOI LUT, Frame of Reference and Modality LUT entities, which are not used. Additionally, Image in Figure A.1-1 represents a Single Frame image. A frame denotes a two-dimensional organization of pixels recorded as a single exposure. Table A.32.1-1 specifies the Modules of the VL Endoscopic Image IOD.

### Note

1. An endoscopic procedure might include multiple series of single frame endoscopic images as well as one or more additional series of related diagnostic images. The procedure might involve multiple Performed Procedure Steps, multiple endoscopes, and multiple anatomic regions and might be supervised, performed, and/or interpreted by one or more individuals.

2. Several distinct diagnostic or therapeutic processes might occur during an endoscopic procedure. For example: Endoscopic examination of duodenal mucosa, biopsy, lavage, or biliary stone removal.

3. The Curve entity was previously include in the list of entities that are not used, but has been retired from DICOM. It is still not used in this IOD. See PS3.3-2004.

Table A.32.1-1. VL Endoscopic 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
Clinical Trial Series | C.7.3.2 | U
Equipment | General Equipment | C.7.5.1 | M
Image | General Image | C.7.6.1 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Device | C.7.6.12 | U
Specimen | C.7.6.22 | U
VL Image | C.8.12.1 | M
Overlay Plane | C.9.2 | U
ICC Profile | C.11.15 | U
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | U

#### A.32.1.3 VL Endoscopic Image IOD Content Constraints

##### A.32.1.3.1 Modality

The value of Modality (0008,0060) shall be ES.

### A.32.2 VL Microscopic Image IOD

#### A.32.2.1 VL Microscopic Image IOD Description

The VL Microscopic Image IOD specifies the Attributes of Single-frame VL Microscopic Images, including both imaging of specimens and direct microscopic imaging of the patient (e.g., perioperative microscopy). Microscopic Images with Slide Coordinates shall not be encoded with this IOD.

#### A.32.2.2 VL Microscopic Image IOD Entity-Relationship Model

The E-R Model in Section A.1.2 depicts those components of the DICOM Information Model that are referenced by the VL Microscopic Image IOD. Below the Series IE, only the Image IE is used, which represents a Single Frame image. Table A.32.1-2 specifies the Modules of the VL Microscopic Image IOD.

### Note

1. The Curve entity was previously include in the list of entities that are not used, but has been retired from DICOM. It is still not used in this IOD. See PS3.3-2004.

2. 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.

Table A.32.1-2. VL Microscopic 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
Clinical Trial Series | C.7.3.2 | U
Equipment | General Equipment | C.7.5.1 | M
Image | General Image | C.7.6.1 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Device | C.7.6.12 | U
Specimen | C.7.6.22 | C - Required if Imaging Subject is a specimen
VL Image | C.8.12.1 | M
Optical Path | C.8.12.5 | U
Overlay Plane | C.9.2 | U
ICC Profile | C.11.15 | U
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | U

#### A.32.2.3 VL Microscopic Image IOD Content Constraints

##### A.32.2.3.1 Modality

The value of Modality (0008,0060) shall be GM.

### A.32.3 VL Slide-coordinates Microscopic Image IOD

#### A.32.3.1 VL Slide-coordinates Microscopic Image IOD Description

The VL Slide-Coordinates Microscopic Image IOD specifies the Attributes of VL Single-frame Slide-Coordinates Microscopic Images.

#### A.32.3.2 VL Slide-coordinates Microscopic Image IOD Entity-Relationship Model

The E-R Model in Section A.1.2 depicts those components of the DICOM Information Model that are referenced by the VL Slide-Coordinates Microscopic Image IOD. Below the Series IE, only the Image IE is used, which represents a Single Frame image. Table A.32.1-3 specifies the Modules of the VL Slide-Coordinates Microscopic Image IOD.

### Note

1. The Curve entity was previously include in the list of entities that are not used, but has been retired from DICOM. It is still not used in this IOD. See PS3.3-2004.

2. 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.

3. The Frame of Reference IE was previously (incorrectly) identified as not used in this IOD, although the Frame of Reference Module was specified as Mandatory. See PS3.3-2009.

Table A.32.1-3. VL Slide-Coordinates Microscopic 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
Clinical Trial Series | C.7.3.2 | U
Frame of Reference | Frame of Reference | C.7.4.1 | M
Equipment | General Equipment | C.7.5.1 | M
Image | General Image | C.7.6.1 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Device | C.7.6.12 | U
Specimen | C.7.6.22 | M
VL Image | C.8.12.1 | M
Slide Coordinates | C.8.12.2 | M
Optical Path | C.8.12.5 | U
Overlay Plane | C.9.2 | U
ICC Profile | C.11.15 | U
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | U

#### A.32.3.3 VL Slide-coordinates Microscopic Image IOD Content Constraints

##### A.32.3.3.1 Modality

The value of Modality (0008,0060) shall be SM.

### A.32.4 VL Photographic Image IOD

#### A.32.4.1 VL Photographic Image IOD Description

The VL Photographic Image IOD specifies the attributes of VL Single-frame photographic Images.

#### A.32.4.2 VL Photographic 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 VL Photographic Image IOD, with exception of the VOI LUT, Frame of Reference and Modality LUT entities, which are not used. Additionally, Image in Figure A.1-1 represents a Single Frame image. A frame denotes a two-dimensional organization of pixels recorded as a single exposure. Table A.32.4-1 specifies the Modules of the VL Photographic Image IOD.

### Note

1. The Curve entity was previously include in the list of entities that are not used, but has been retired from DICOM. It is still not used in this IOD. See PS3.3-2004.

2. 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.

Table A.32.4-1. VL Photographic 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
Clinical Trial Series | C.7.3.2 | U
Equipment | General Equipment | C.7.5.1 | M
Image | General Image | C.7.6.1 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Device | C.7.6.12 | U
Specimen | C.7.6.22 | C - Required if Imaging Subject is a specimen
VL Image | C.8.12.1 | M
Overlay Plane | C.9.2 | U
ICC Profile | C.11.15 | U
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | U

#### A.32.4.3 VL Photographic Image IOD Content Constraints

##### A.32.4.3.1 Modality

The value of Modality (0008,0060) shall be XC.

### A.32.5 Video Endoscopic Image IOD

#### A.32.5.1 Video Endoscopic Image IOD Description

The Video Endoscopic Image IOD specifies the Attributes of Multi-frame Video Endoscopic Images.

#### A.32.5.2 Video Endoscopic 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 Video Endoscopic Image IOD, with exception of the VOI LUT, and Modality LUT entities, which are not used. Table A.32.5-1 specifies the Modules of the Video Endoscopic Image IOD.

### Note

1. The video may include audio channel(s) for acquiring patient voice or physiological sounds, healthcare professionals' commentary, or environmental sounds.

2. The Frame Pointers Module has not been included because the selection of relevant sub-sequence(s) is usually made in a second workflow step and stored into separate Key Object Selection Documents.

3. The Curve entity was previously include in the list of entities that are not used, but has been retired from DICOM. It is still not used in this IOD. See PS3.3-2004.

Table A.32.5-1. Video Endoscopic 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
Clinical Trial Series | C.7.3.2 | U
Equipment | General Equipment | C.7.5.1 | M
Image | General Image | C.7.6.1 | M
Cine | C.7.6.5 | M
Multi-frame | C.7.6.6 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Device | C.7.6.12 | U
Specimen | C.7.6.22 | C - Required if the Imaging Subject is a Specimen
VL Image | C.8.12.1 | M
ICC Profile | C.11.15 | 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.32.5.3 Video Endoscopic Image IOD Content Constraints

##### A.32.5.3.1 Modality

The value of Modality (0008,0060) shall be ES.

### Note

The use of a single value for Modality recognizes the fact that the same acquisition equipment is often used for different purposes (e.g., laparoscopy and colonoscopy). This means that Modality is not useful to distinguish one type of endoscopy from another when browsing a collection of studies. Therefore, the use of Procedure Code Sequence (0008,1032) and Anatomic Region Sequence (0008,2218) in the image instances and in the query response is recommended, though gathering sufficient information to populate these attributes in an unscheduled workflow environment (i.e., in the absence of Modality Worklist) may require operator intervention.

#### A.32.5.3.2 Image Related Data Encoding

The Modality LUT, VOI LUT, Graphic Annotation and Overlay Modules shall not be present.

### Note

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.

##### A.32.5.3.3 Anatomic Region Sequence

The Defined Context Group for Anatomic Region Sequence (0008,2218) shall be CID 4040 “Endoscopy Anatomic Regions”.

### A.32.6 Video Microscopic Image IOD

#### A.32.6.1 Video Microscopic Image IOD Description

The Video Microscopic Image IOD specifies the Attributes of Video Microscopic Images, including both imaging of specimens and direct microscopic imaging of the patient (e.g., perioperative microscopy). Microscopic Images with Slide Coordinates shall not be encoded with this IOD.

#### A.32.6.2 Video Microscopic 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 Video Microscopic Image IOD, with exception of the VOI LUT, and Modality LUT entities, which are not used. Table A.32.6-1 specifies the Modules of the Video Microscopic Image IOD.

### Note

1. The video may include audio channel for acquiring patient voice or physiological sounds, healthcare professionals comment, or environment sounds.

2. The Frame Pointers Module has not been included because the selection of relevant sub-sequence(s) is usually made in a second step and stored into separate Key Object Selection Documents.

3. The Curve entity was previously include in the list of entities that are not used, but has been retired from DICOM. It is still not used in this IOD. See PS3.3-2004.

4. 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.

Table A.32.6-1. Video Microscopic 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
Clinical Trial Series | C.7.3.2 | U
Equipment | General Equipment | C.7.5.1 | M
Image | General Image | C.7.6.1 | M
Cine | C.7.6.5 | M
Multi-frame | C.7.6.6 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Device | C.7.6.12 | U
Specimen | C.7.6.22 | C - Required if the Imaging Subject is a Specimen
VL Image | C.8.12.1 | M
ICC Profile | C.11.15 | 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.32.6.3 Video Microscopic Image IOD Content Constraints

##### A.32.6.3.1 Modality

The value of Modality (0008,0060) shall be GM.

#### A.32.6.3.2 Image Related Data Encoding

The Modality LUT, VOI LUT, Graphic Annotation and Overlay Modules shall not be present.

### Note

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.

### A.32.7 Video Photographic Image IOD

#### A.32.7.1 Video Photographic Image IOD Description

The Video Photographic Image IOD specifies the attributes of VL Multi-frame photographic Images.

#### A.32.7.2 Video Photographic 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 Video Photographic Image IOD, with exception of the VOI LUT and Modality LUT entities, which are not used. Table A.32.7-1 specifies the Modules of the Video Photographic Image IOD.

### Note

1. The video may include audio channel for acquiring patient voice or physiological sounds, healthcare professionals comment, or environment sounds.

2. The Frame Pointers Module has not been included because the selection of relevant sub-sequence(s) is usually made in a second step and stored into separate Key Object Selection Documents.

3. The Curve entity was previously include in the list of entities that are not used, but has been retired from DICOM. It is still not used in this IOD. See PS3.3-2004.

4. 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.

Table A.32.7-1. Video Photographic 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
Clinical Trial Series | C.7.3.2 | U
Equipment | General Equipment | C.7.5.1 | M
Image | General Image | C.7.6.1 | M
Cine | C.7.6.5 | M
Multi-frame | C.7.6.6 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Device | C.7.6.12 | U
Specimen | C.7.6.22 | C - Required if the Imaging Subject is a Specimen
VL Image | C.8.12.1 | M
ICC Profile | C.11.15 | 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.32.7.3 Video Photographic Image IOD Content Constraints

##### A.32.7.3.1 Modality

The value of Modality (0008,0060) shall be XC.

#### A.32.7.3.2 Image Related Data Encoding

The Modality LUT, VOI LUT, Graphic Annotation and Overlay Modules shall not be present.

### Note

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.

### A.32.8 VL Whole Slide Microscopy Image IOD

#### A.32.8.1 VL Whole Slide Microscopy Image IOD Description

The VL Whole Slide Microscopy Image IOD specifies the Attributes of a multi-frame visible light whole slide microscopy image encoded as a tiled decomposition. Each frame encodes a single tile within a three-dimensional imaged volume at a uniform resolution.

### Note

1. An entire set of tiles for an acquisition may be encoded in the frames of a single SOP Instance, in multiple SOP Instances of a single concatenation, or in multiple SOP Instances in a series (with or without concatenations). E.g., a single SOP Instance may contain an entire low resolution image as a single tile (single frame), or a single SOP Instance may contain an entire high resolution, multi-focal depth, multi-spectral acquisition (multiple frames).

2. Attention is called to the possibility that conformance with the VL Whole Slide Microscopy Image Storage SOP Class utilizing this IOD may involve the use of claimed Intellectual Property Rights, among which may be US Patent 6,272,235 referenced in Section 2. The DICOM Standards Committee takes no position concerning the evidence, validity or applicability of claimed Intellectual Property Rights, whether asserted by members of the DICOM Standards Committee or others.

#### A.32.8.2 VL Whole Slide Microscopy Image IOD Entity-Relationship Model

The E-R Model in Section A.1.2 depicts those components of the DICOM Information Model that comprise the VL Whole Slide Microscopy IOD.

#### A.32.8.3 VL Whole Slide Microscopy IOD Module Table

Table A.32.8-1. VL Whole Slide Microscopy 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
Whole Slide Microscopy Series | C.8.12.3 | M
Clinical Trial Series | C.7.3.2 | U
Frame of Reference | Frame of Reference | C.7.4.1 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Image | General Image | C.7.6.1 | M
Image Pixel | C.7.6.3 | M
Acquisition Context | C.7.6.14 | M
Multi-frame Functional Groups | C.7.6.16 | M
Multi-frame Dimension | C.7.6.17 | M
Specimen | C.7.6.22 | M
Whole Slide Microscopy Image | C.8.12.4 | M
Optical Path | C.8.12.5 | M
Multi-Resolution Navigation | C.8.12.7 | C - Required if Image Type (0008,0008) Value 3 is LOCALIZER
Slide Label | C.8.12.8 | C - Required if Image Type (0008,0008) Value 3 is LABEL; may be present otherwise
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Frame Extraction | C.12.3 | C - Required if the SOP Instance was created in response to a Frame-Level retrieve request

##### A.32.8.3.1 VL Whole Slide Microscopy IOD Content Constraints

###### A.32.8.3.1.1 Optical Path Module

The Code Sequences within the Optical Path Sequence (0048,0105) of the Optical Path Module (see Section C.8.12.5) are constrained as follows:

Baseline CID for Illuminator Type Code Sequence (0048,0100) is CID 8125 “Microscopy Illuminator Type”.

Baseline CID for Illumination Color Code Sequence (0048,0108) is CID 8122 “Microscopy Illuminator and Sensor Color”.

Baseline CID for Illumination Type Code Sequence (0022,0016) is CID 8123 “Microscopy Illumination Method”.

Baseline CID for Lenses Code Sequence (0022,0019) is CID 8121 “Microscopy Lens Type”.

Baseline CID for Light Path Filter Type Stack Code Sequence (0022,0017) and for Image Path Filter Type Stack Code Sequence (0022,0018) is CID 8124 “Microscopy Filter”.

Baseline CID for Channel Description Code Sequence (0022,001A) is CID 8122 “Microscopy Illuminator and Sensor Color”.

#### A.32.8.4 VL Whole Slide Microscopy Functional Group Macros

Table A.32.8-2 specifies the use of the Functional Group Macros used in the Multi-frame Functional Groups Module for the VL Whole Slide Microscopy IOD.

Table A.32.8-2. VL Whole Slide Microscopy Functional Group Macros

Functional Group Macro | Section | Usage
--- | --- | ---
Pixel Measures | C.7.6.16.2.1 | M - Shall be used as a Shared Functional Group.
Frame Content | C.7.6.16.2.2 | M - Shall 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.
Real World Value Mapping | C.7.6.16.2.11 | U
Plane Position (Slide) | C.8.12.6.1 | M
Optical Path Identification | C.8.12.6.2 | M
Specimen Reference | C.8.12.6.3 | U

##### A.32.8.4.1 VL Whole Slide Microscopy Functional Group Macros Content Constraints

###### A.32.8.4.1.1 Referenced Image

Defined CID for Purpose of Reference Code Sequence (0040,A170) in the Referenced Image Functional Group is CID 8120 “WSI Referenced Image Purposes of Reference”.

###### A.32.8.4.1.2 Plane Position (Slide)

Frames shall occupy plane positions in a regular tiling of the Total Image Matrix; the frames may extend beyond the edges of the Total Image Matrix. Therefore, the value of Column Position In Total Pixel Matrix (0048,021E) shall be an integer multiple of the value of Columns (0028,0011) plus a constant, and the value of Row Position In Total Pixel Matrix (0048,021F) shall be an integer multiple of the value of Rows (0028,0010) plus a (possibly different) constant.

### Note

Pixels beyond the edge of the Total Image Matrix may be encoded with a fixed padding value. For images with MONOCHROME2 Photometric Interpretation, see Pixel Padding Value (0028,0120) in Section C.7.5.1.1.2.

The encoding of tiles may be sparse; i.e., some tiles may not be encoded in frames. There are no constraints on the ordering of frames within the pixel data; each frame specifies its position in the Plane Position (Slide) Functional Group.

### Note

Different SOP Instances within a Series may have different tiling boundaries and sizes.

Frames associated with different optical paths may coincide in any spatial dimension.

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