C.10 Curve, Graphic and Waveform
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## C.10 Curve, Graphic and Waveform

### C.10.1 Curve Identification Module (Retired)

Retired. See PS3.3-2004.

### C.10.2 Curve Module (Retired)

Retired. See PS3.3-2004.

### C.10.3 Audio Module (Retired)

Retired. See PS3.3-2004.

### C.10.4 Displayed Area Module

This Module describes Attributes required to define a Specified Displayed Area space.

The Specified Displayed Area is that portion of the image displayed on the device.

If Presentation Size Mode (0070,0100) is specified as SCALE TO FIT, then the specified area shall be displayed as large as possible within the available area on the display or window, i.e., magnified or minified if necessary to fit the display or window space available.

If Presentation Size Mode (0070,0100) is specified as TRUE SIZE, then the physical size of the rendered image pixels shall be the same on the screen as specified in Presentation Pixel Spacing (0070,0101).

If Presentation Size Mode (0070,0100) is specified as MAGNIFY, then the factor that shall be used to spatially interpolate image pixels to create pixels on the display is defined.

### Note

If this factor is specified as 1.0, then one image pixel will correspond to one displayed pixel, and if the Specified Displayed Area is the entire image, and it fits on the display, then the number of displayed pixels will equal the number of image pixels.

In all modes, the actual area rendered on a display device may be greater than the Specified Display Area, if the ratio of rows and columns of the Specified Display Area differs from the ratio of rows and columns of the display device or window. The Displayed Area relative annotations specified in Section C.10.5 Graphic Annotation Module are rendered relative to the Specified Displayed Area, not the actual rendered displayed area.

### Note

1. The content of a display outside the Specified Display Area is not defined. In particular no padding value (such as black) is specified.

2. In the TRUE SIZE and MAGNIFY modes, if the entire Specified Displayed Area is not visible, then display relative graphic annotations may be obscured.

This Module explicitly specifies the aspect ratio to be used to display the image, even if it is 1:1, and it may be different from that specified in the referenced image.

### Note

1. Depending on the mode, the aspect ratio is either specified using the Presentation Pixel Aspect Ratio (0070,0102), or derived from the Presentation Pixel Spacing (0070,0101).

2. This explicit definition of aspect ratio implies that graphic objects that are specified relative to the Specified Display Area will not change their shape regardless of the size or shape of the presentation device (e.g., whether a landscape or portrait monitor is used).

3. The mechanism of interpolation, if necessary, is not specified.

4. The image may need to be cropped and scroll bars or a panning mechanism provided in order to provide access to sections of the image that do not fit within the available area on the display or window.

Table C.10-4. Displayed Area Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Displayed Area Selection Sequence | (0070,005A) | 1 | A sequence of Items each of which describes the displayed area selection for a group of images or frames. Sufficient Items shall be present to describe every image and frame listed in the Presentation State Relationship Module. One or more Items shall be included in this sequence.
>Referenced Image Sequence | (0008,1140) | 1C | The subset of images and frames listed in the Presentation State Relationship Module, to which this displayed area selection applies. One or more Items shall be included in this sequence. Required if the displayed area selection in this Item does not apply to all the images and frames listed in the Presentation State Relationship Module.
>>Include Table 10-3 “Image SOP Instance Reference Macro Attributes” |
>Pixel Origin Interpretation | (0048,0301) | 1C | For a referenced multi-frame image, specifies whether the Displayed Area Top Left Hand Corner (0070,0052) and Displayed Area Bottom Right Hand Corner (0070,0053) are to be interpreted relative to the individual frame pixel origins, or relative to the Total Pixel Matrix origin (see Section C.8.12.4.1.4). Required if the value of Referenced SOP Class UID (0008,1150) within Referenced Image Sequence (0008,1140) is 1.2.840.10008.5.1.4.1.1.77.1.6 (VL Whole Slide Microscopy Image). May be present otherwise. Enumerated Values: FRAME relative to individual frame VOLUME relative to Total Image Matrix If not present, TLHC and BRHC are defined relative to the frame pixel origins.
>Displayed Area Top Left Hand Corner | (0070,0052) | 1 | The top left (after spatial transformation) pixel in the referenced image to be displayed, given as column\row. Column is the horizontal (before spatial transformation) offset (X) and row is the vertical (before spatial transformation) offset (Y) relative to the origin of the pixel data before spatial transformation, which is 1\1. See Figure C.10.4-1.
>Displayed Area Bottom Right Hand Corner | (0070,0053) | 1 | The bottom right (after spatial transformation) pixel in the referenced image to be displayed, given as column\row. Column is the horizontal (before spatial transformation) offset (X) and row is the vertical (before spatial transformation) offset (Y) relative to the origin of the pixel data before spatial transformation, which is 1\1. See Figure C.10.4-1.
>Presentation Size Mode | (0070,0100) | 1 | Manner of selection of display size. Enumerated Values: SCALE TO FIT TRUE SIZE MAGNIFY See Section C.10.4 for further explanation.
>Presentation Pixel Spacing | (0070,0101) | 1C | Physical distance between the center of each pixel in the referenced image (before spatial transformation), specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing in mm. See Section 10.7.1.3 for further explanation of the value order. ### Note This value may be different from Pixel Spacing (0028,0030) or Imager Pixel Spacing (0018,1164) specified in the referenced image, which are ignored, since some form of calibration may have been performed (for example by reference to an object of known size in the image). If the row and column spacing are different, then the pixel aspect ratio of the image is not 1:1. Required if Presentation Size Mode (0070,0100) is TRUE SIZE, in which case the values will correspond to the physical distance between the center of each pixel on the display device. May be present if Presentation Size Mode (0070,0100) is SCALE TO FIT or MAGNIFY, in which case the values are used to compute the aspect ratio of the image pixels.
>Presentation Pixel Aspect Ratio | (0070,0102) | 1C | Ratio of the vertical size and the horizontal size of the pixels in the referenced image, to be used to display the referenced image, specified by a pair of integer values where the first value is the vertical pixel size and the second value is the horizontal pixel size. See Section C.7.6.3.1.7. Required if Presentation Pixel Spacing (0070,0101) is not present. ### Note This value may be different from the aspect ratio specified by Pixel Aspect Ratio (0028,0034) in the referenced image, or implied by the values of Pixel Spacing (0028,0030) or Imager Pixel Spacing (0018,1164) specified in the referenced image, which are ignored. This value must be specified even if the aspect ratio is 1:1.
>Presentation Pixel Magnification Ratio | (0070,0103) | 1C | Ratio of displayed pixels to source pixels, specified in one dimension. Required if Presentation Size Mode (0070,0100) is MAGNIFY. ### Note A value of 1.0 would imply that one pixel in the referenced image would be displayed as one pixel on the display (i.e., it would not be interpolated if the aspect ratio of the image pixels is 1:1). A value of 2.0 would imply that one pixel in the referenced image would be displayed as 4 pixels on the display (i.e., up-sampled by a factor of 2 in each of the row and column directions). A value of 0.5 would imply that 4 pixels in the referenced image would be displayed as 1 pixel on the display (i.e., down-sampled by a factor of 2 in each of the row and column directions). If the source pixels have an aspect ratio of other than 1:1, then they are assumed to have been interpolated to a display pixel aspect ratio of 1:1 prior to magnification.

### Note

1. In scale to fit mode, the Displayed Area Top Left Hand Corner (TLHC) and Bottom Right Hand Corner (BRHC) have the effect of defining how any zoom or magnification and/or pan has been applied to select a region of an image to be displayed (the Specified Displayed Area), without assuming anything about the size of the actual display.

2. The TLHC and BRHC may be outside the boundaries of the image pixel data (e.g., the TLHC may be 0 or negative, or the BRHC may be greater than Rows or Columns), allowing minification or placement of the image pixel data within a larger Specified Displayed Area. There is no provision to position a zoomed selected sub-area of the image pixel data within a larger Specified Displayed Area.

3. When Pixel Origin Interpretation (0048,0301) value is VOLUME, the selected Display Area may extend across multiple frames, and may include pixel locations for which there is no pixel data (outside the edge of the imaged volume, not encoded in a sparse encoding, or not within explicitly selected frames).

Figure C.10.4-1. Example of Displayed Area Selection Addressing of Pixels Before and After Spatial Transformation

### C.10.5 Graphic Annotation Module

This Module defines Attributes of vector graphics and text annotation that shall be made available by a display device to be applied to an image. The graphics and text are defined in position and size relative to the image pixel coordinates or the Specified Displayed Area space (defined in Section C.10.4). A Graphic Annotation shall be related to an Image.

Table C.10-5. Graphic Annotation Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Graphic Annotation Sequence | (0070,0001) | 1 | A sequence of Items each of which represents a group of annotations composed of graphics or text or both. One or more Items shall be included in this sequence.
>Referenced Image Sequence | (0008,1140) | 1C | The subset of images and frames listed in the Presentation State Relationship Module, to which this graphic annotation applies. One or more Items shall be included in this sequence. Required if graphic annotations in this Item do not apply to all the images and frames listed in the Presentation State Relationship Module.
>>Include Table 10-3 “Image SOP Instance Reference Macro Attributes” |
>Graphic Layer | (0070,0002) | 1 | The layer defined in the Graphic Layer Module Section C.10.7 in which the graphics or text is to be rendered.
>Text Object Sequence | (0070,0008) | 1C | Sequence that describes a text annotation. One or more Items shall be included in this sequence. Either one or both of Text Object Sequence (0070,0008) or Graphic Object Sequence (0070,0009) are required.
>>Bounding Box Annotation Units | (0070,0003) | 1C | Units of measure for the axes of the text bounding box. Defines whether or not the annotation is Image or Displayed Area relative. Both dimensions shall have the same units. Enumerated Values: PIXEL Image relative position specified with sub-pixel resolution such that the origin, which is at the Top Left Hand Corner (TLHC) of the TLHC pixel is 0.0\0.0, the Bottom Right Hand Corner (BRHC) of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is Columns\Rows (see Figure C.10.5-1). The values must be within the range 0\0 to Columns\Rows. DISPLAY Fraction of Specified Displayed Area where 0.0\0.0 is the TLHC and 1.0\1.0 is the BRHC. The values must be within the range 0.0 to 1.0. MATRIX Image relative position specified with sub-pixel resolution such that the origin, which is at the Top Left Hand Corner (TLHC) of the TLHC pixel of the Total Pixel Matrix, is 0.0\0.0, the Bottom Right Hand Corner (BRHC) of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel of the Total Pixel Matrix is Total Pixel Matrix Columns\Total Pixel Matrix Rows (see Section C.8.12.4.1.3). The values must be within the range 0.0\0.0 to Total Pixel Matrix Columns\Total Pixel Matrix Rows. MATRIX may be used only if the value of Referenced SOP Class UID (0008,1150) within Referenced Image Sequence (0008,1140) is 1.2.840.10008.5.1.4.1.1.77.1.6 (VL Whole Slide Microscopy Image). Required if Bounding Box Top Left Hand Corner (0070,0010) or Bounding Box Bottom Right Hand Corner (0070,0011) is present.
>>Anchor Point Annotation Units | (0070,0004) | 1C | Units of measure for the axes of the text anchor point annotation. Enumerated Values for Anchor Point Annotation Units (0070,0004) are the same as for Bounding Box Annotation Units (0070,0003). Required if Anchor Point (0070,0014) is present.
>>Unformatted Text Value | (0070,0006) | 1 | Text data that is unformatted and whose manner of display within the defined bounding box or relative to the specified anchor point is implementation dependent. See Section C.10.5.1.1. The text value may contain spaces, as well as multiple lines separated by CR LF, but otherwise no format control characters (such as horizontal or vertical tab and form feed) shall be present, even if permitted by the Value Representation of ST. The text shall be interpreted as specified by Specific Character Set (0008,0005) if present in the SOP Common Module. ### Note The text may contain single or multi-byte characters and use code extension techniques as described in PS3.5 if permitted by the values of Specific Character Set (0008,0005).
>>Include Table C.10-5a “Text Style Sequence Macro Attributes” | See Section C.10.5.1.3.12.
>>Bounding Box Top Left Hand Corner | (0070,0010) | 1C | Location of the Top Left Hand Corner (TLHC) of the bounding box in which Unformatted Text Value (0070,0006) is to be displayed, in Bounding Box Annotation Units (0070,0003), given as column\row. Column is the horizontal offset and row is the vertical offset. Required if Anchor Point (0070,0014) is not present. May be present otherwise. Required if Bounding Box Bottom Right Hand Corner (0070,0011) is present.
>>Bounding Box Bottom Right Hand Corner | (0070,0011) | 1C | Location of the Bottom Right Hand Corner (BRHC) of the bounding box in which Unformatted Text Value (0070,0006) is to be displayed, in Bounding Box Annotation Units (0070,0003), given as column\row. Column is the horizontal offset and row is the vertical offset. Required if Anchor Point (0070,0014) is not present. May be present otherwise. Required if Bounding Box Top Left Hand Corner (0070,0010) is present.
>>Bounding Box Text Horizontal Justification | (0070,0012) | 1C | Location of the text relative to the vertical edges of the bounding box. Enumerated Values: LEFT closest to left edge RIGHT closest to right edge CENTER centered Required if Bounding Box Top Left Hand Corner (0070,0010) is present.
>>Anchor Point | (0070,0014) | 1C | Location of a point in the image or Specified Displayed Area to which the Unformatted Text Value (0070,0006) is related, in Anchor Point Annotation Units (0070,0004), given as column\row. Column is the horizontal offset and row is the vertical offset. Required if Bounding Box Top Left Hand Corner (0070,0010) and Bounding Box Bottom Right Hand Corner (0070,0011) are not present. May be present otherwise.
>>Anchor Point Visibility | (0070,0015) | 1C | Flag to indicate whether or not a visible indication (such as a line or arrow) of the relationship between the text and the anchor point is to be displayed. Enumerated Values: Y yes N no Required if Anchor Point (0070,0014) is present.
>>Compound Graphic Instance ID | (0070,0226) | 3 | The identifier of the Compound Graphic represented, in part, by this Item. The value of this attribute shall be equal to the value of Compound Graphic Instance ID (0070,0226) of the corresponding Item in the Compound Graphic Sequence (0070,0209). See Section C.10.5.1.3.1.
>>Graphic Group ID | (0070,0295) | 3 | A number identifying the group from the Graphic Group Sequence (0070,0234) to which this Item belongs. If this attribute is not present, this Item does not belong to a group. If Compound Graphic Instance ID (0070,0226) is present in this Item, the value of Graphic Group ID (0070,0295) shall be the same as the value of Graphic Group ID (0070,0295) of the corresponding Item in the Compound Graphic Sequence (0070,0209) with the same Compound Graphic Instance ID (0070,0226).
>Graphic Object Sequence | (0070,0009) | 1C | Sequence that describes a graphic annotation. One or more Items shall be included in this sequence. Either one or both of Text Object Sequence (0070,0008) or Graphic Object Sequence (0070,0009) are required.
>>Graphic Annotation Units | (0070,0005) | 1 | Units of measure for the axes of the graphic annotation. Enumerated Values for Graphic Annotation Units (0070,0005) are the same as for Bounding Box Annotation Units (0070,0003).
>>Graphic Dimensions | (0070,0020) | 1 | Enumerated Values: 2
>>Number of Graphic Points | (0070,0021) | 1 | Number of data points in this graphic.
>>Graphic Data | (0070,0022) | 1 | Coordinates that specify this graphic annotation. See Section C.10.5.1.2 for further explanation.
>>Graphic Type | (0070,0023) | 1 | The shape of graphic that is to be drawn. See Section C.10.5.1.2. Enumerated Values: POINT POLYLINE INTERPOLATED CIRCLE ELLIPSE
>>Include Table C.10-5b “Line Style Sequence Macro Attributes” | See Section C.10.5.1.3.13.
>>Graphic Filled | (0070,0024) | 1C | Whether or not the closed graphics element is displayed as filled (in some unspecified manner that shall be distinguishable from an outline) or as an outline. See Section C.10.5.1.2. Enumerated Values: Y yes N no Required if Graphic Data (0070,0022) is "closed", that is Graphic Type (0070,0023) is CIRCLE or ELLIPSE, or Graphic Type (0070,0023) is POLYLINE or INTERPOLATED and the first data point is the same as the last data point.
>>Include Table C.10-5c “Fill Style Sequence Macro Attributes” | See Section C.10.5.1.3.14.
>>Compound Graphic Instance ID | (0070,0226) | 3 | The identifier of the Compound Graphic represented, in part, by this Item. The value of this attribute shall be equal to the value of Compound Graphic Instance ID (0070,0226) of the corresponding Item in the Compound Graphic Sequence (0070,0209). See Section C.10.5.1.3.1.
>>Graphic Group ID | (0070,0295) | 3 | A number identifying the group from the Graphic Group Sequence (0070,0234) to which this Item belongs. If this attribute is not present, this Item does not belong to a group. If Compound Graphic Instance ID (0070,0226) is present in this Item, the value of Graphic Group ID (0070,0295) shall be the same as the value of Graphic Group ID (0070,0295) of the corresponding Item in the Compound Graphic Sequence (0070,0209) with the same Compound Graphic Instance ID (0070,0226).
>Compound Graphic Sequence | (0070,0209) | 3 | A sequence of Items that describe Compound Graphics. One or more Items are permitted in this sequence. For each Compound Graphic there shall be an alternate rendering encoded as Items in the Text Object Sequence (0070,0008) and Graphic Object Sequence (0070,0009) linked by the Compound Graphic Instance ID (0070,0226). See Section C.10.5.1.3.1.
>>Compound Graphic Instance ID | (0070,0226) | 1 | A number that identifies the Compound Graphic described in this Item. The value shall be unique within this SOP instance. See Section C.10.5.1.3.1.
>>Compound Graphic Units | (0070,0282) | 1 | Type of dimension used in attributes for the Compound Graphic when specifying distances and locations. Enumerated Values: PIXEL When an attribute value specifies a location, it shall be an image relative position specified with sub-pixel resolution such that the origin at the Top Left Hand Corner (TLHC) of the TLHC pixel is 0.0\0.0, the Bottom Right Hand Corner (BRHC) of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is Columns\Rows (see Figure C.10.5-1). The values must be within the range 0\0 to Columns\Rows. When an attribute value specifies a distance the distance shall be in pixels. DISPLAY When an attribute value specifies a location, it shall be a fraction of Specified Displayed Area where 0.0\0.0 is the TLHC and 1.0\1.0 is the BRHC. The values must be within the range 0.0 to 1.0. When an attribute value specifies a distance the distance shall be in fraction of Specified Displayed Area.
>>Graphic Dimensions | (0070,0020) | 1 | Enumerated Values: 2
>>Number of Graphic Points | (0070,0021) | 1 | Number of data Items, e.g., points, in this Compound Graphic.
>>Graphic Data | (0070,0022) | 1 | Numerical data Items that specify this Compound Graphic (points, vectors and scalars). See Section C.10.5.1.3 for further explanation.
>>Compound Graphic Type | (0070,0294) | 1 | The shape of this Compound Graphic. See Section C.10.5.1.3. Defined Terms: MULTILINE INFINITELINE CUTLINE RANGELINE RULER AXIS CROSSHAIR ARROW RECTANGLE ELLIPSE ### Note Implementers may add private graphic types.
>>Include Table C.10-5a “Text Style Sequence Macro Attributes” | See Section C.10.5.1.3.12
>>Include Table C.10-5b “Line Style Sequence Macro Attributes” | See Section C.10.5.1.3.13
>>Rotation Angle | (0070,0230) | 3 | The rotation of this Compound Graphic in degrees. Value shall be in degrees, between 0 and 360. See Section C.10.5.1.3.
>>Rotation Point | (0070,0273) | 1C | The rotation point of this Compound Graphic. See Section C.10.5.1.3. Required if Rotation Angle (0070,0230) is present or if Compound Graphic Type (0070,0294) is CUTLINE or INFINITELINE.
>>Gap Length | (0070,0261) | 1C | Diameter of the circle around Rotation Point (0070,0273) where the CUTLINE or INFINITELINE is not rendered. Diameter of the circle around the origin, specified by Graphic Data (0070,0022) where the CROSSHAIR is not rendered. The Compound Graphic Units (0070,0282) of Gap Length (0070,0261) shall be DISPLAY. See Section C.10.5.1.3. Required if Compound Graphic Type (0070,0294) equals CUTLINE, INFINITELINE or CROSSHAIR.
>>Diameter of Visibility | (0070,0262) | 1C | Diameter of the circle around the CROSSHAIR origin where the CROSSHAIR is visible. The Compound Graphic Units (0070,0282) of the Diameter of Visibility (0070,0262) shall be DISPLAY. See Section C.10.5.1.3.10 Required if Compound Graphic Type (0070,0294) equals CROSSHAIR.
>>Major Ticks Sequence | (0070,0287) | 1C | The sequence of major ticks on the AXIS object. Two or more Items shall be present. Required if Compound Graphic Type (0070,0294) equals AXIS.
>>>Tick Position | (0070,0288) | 1 | The position of the tick in the range 0.0 (start point) to 1.0 (end point).
>>>Tick Label | (0070,0289) | 1 | The label of the tick.
>>Tick Alignment | (0070,0274) | 1C | The alignment of the ticks with respect to the line. Enumerated Values: BOTTOM CENTER TOP See Section C.10.5.1.3. Required if Compound Graphic Type (0070,0294) equals RULER, AXIS or CROSSHAIR.
>>Tick Label Alignment | (0070,0279) | 1C | The alignment of the label with respect to the tick. Enumerated Values: BOTTOM TOP See Section C.10.5.1.3. Required if Compound Graphic Type (0070,0294) equals RULER, AXIS. or CROSSHAIR.
>>Show Tick Label | (0070,0278) | 1C | Indicates whether the tick label should be initially visible. Enumerated Values: Y Yes N No Required if Compound Graphic Type (0070,0294) equals RULER, AXIS or CROSSHAIR.
>>Graphic Filled | (0070,0024) | 1C | Indicates whether or not the Compound Graphics is displayed as filled. Enumerated Values: Y yes N no Required if Compound Graphic Type (0070,0294) equals RECTANGLE or ELLIPSE.
>>Include Table C.10-5c “Fill Style Sequence Macro Attributes” | In this Module, attribute Fill Style Sequence (0070,0233) is Type 1C. Required if Graphic Filled (0070,0024) equals Y. See Section C.10.5.1.3.14
>>Graphic Group ID | (0070,0295) | 3 | A number that defines the corresponding group object in the Graphic Group Sequence (0070,0234). If the attribute is not present the object does not belong to a group.

#### C.10.5.1 Graphic Annotation Attribute Descriptions

##### C.10.5.1.1 Unformatted Text Value

The text shall be displayed if any part of the bounding box or anchor point is within the Specified Display Area.

The text need not be confined to within the bounding box, but shall be rendered in a direction from the Top Left Hand Corner (TLHC) of the bounding box to the Bottom Right Hand Corner (BRHC) of the bounding box, even if these coordinates have been specified in an image relative space and then transformed (rotated, flipped or scaled).

### Note

1. An implementation may render text outside the confines of the bounding box if necessary to display all the specified text.

2. Alternatively, an implementation may choose to render the text in a scrolling box, or a link to another fixed or popup window as appropriate.

Whether the contents of the bounding box completely opacify the underlying image or whether the box is "transparent" is undefined.

### Note

1. For example, an implementation may choose an "exclusive or" style opacification to be sure that the text is discernible over light and dark portions of the image.

2. Commonly, the region of the bounding box around the text will be rendered "transparently", i.e., the image will be visible, though some implementations may choose to opacify the bounding box behind the text to improve its readability.

An alternative to specifying a bounding box, is to specify an Anchor Point (0070,0014), i.e., some point in an image or Specified Displayed Area that is related to the text. The semantics of this relationship, and the manner of positioning or linking the text to this point, are unspecified.

### Note

1. For example, a description of a feature may be linked to a point in the image, and when that image is displayed, if it is magnified and panned, the rendered text (and any arrow or line drawn in response to Anchor Point Visibility (0070,0015)) might be repositioned as appropriate so as not to be cropped out of the Specified Displayed Area.

2. As another example, the text could be rendered in a pop-up window when a hypertext link flagged on the displayed image at the location of Anchor Point (0070,0014) is selected.

3. The bounding box and anchor point need not be defined with the same axis units, i.e., one can be image pixel relative, and the other displayed area relative.

The size, font and rotation of the individual rendered text characters are unspecified.

##### C.10.5.1.2 Graphic Data and Graphic Type

Graphic Data (0070,0022) contains the points in the graphic annotation, each dimension for the first point, followed by dimensions for second point, etc. For a two dimensional curve: X1, Y1, X2, Y2, etc. The first (X) dimension corresponds to the image or Specified Displayed Area column (horizontal offset), and the second (Y) dimension corresponds to the image or Specified Displayed Area row (vertical offset). The Value Representation of all components of the N-tuple shall be the same. The image or Specified Displayed Area relative drawing space is defined in Graphic Annotation Units (0070,0005).

If Graphic Type (0070,0023) is POINT, then two values (one point) shall be specified and the single point specified is to be drawn.

If Graphic Type (0070,0023) is POLYLINE, then the points are to be interpreted as an n-tuple list of end points between which straight lines are to be drawn.

If Graphic Type (0070,0023) is INTERPOLATED, then the points are to be interpreted as an n-tuple list of end points between which some form of implementation dependent curved lines are to be drawn. The rendered line shall pass through all the specified points.

If Graphic Type (0070,0023) is CIRCLE, then exactly two points shall be present; the first point is to be interpreted as the center and the second point as a point on the circumference of a circle, some form of implementation dependent representation of which is to be drawn.

If Graphic Type (0070,0023) is ELLIPSE, then exactly four points shall be present; the first two points are to be interpreted as the endpoints of the major axis and the second two points as the endpoints of the minor axis of an ellipse, some form of implementation dependent representation of which is to be drawn.

The notion of "open" or "closed" has no inherent meaning in the context of an arbitrary graphic, other than in the condition for the presence of Graphic Filled (0070,0024). The graphic has no semantic notion of an associated observation such as a region of interest, except that which the unformatted text in the same Item may describe.

The choice of pixel value used to represent the graphic on a display is defined in the Graphic Layer Module Section C.10.7.

Figure C.10.5-1. Sub-pixel Addressing Units in PIXEL Space

##### C.10.5.1.3 Compound Graphic Sequence

The attributes of the Compound Graphic Sequence (0070,0209) are described within this section.

For point encoding rules of Graphic Data (0070,0022) See Section C.10.5.1.2.

All graphics are applied after the application of the image rendering pipeline.

###### C.10.5.1.3.1 Compound Graphic Instance ID

Every Item in the Compound Graphic Sequence shall have a Compound Graphic Instance ID (0070,0226) with a value that is unique within this sequence.

There shall be one or more Items in the Graphic Object Sequence or Text Object Sequence that represents an alternate rendering of the Compound Object Sequence Item. As a linkage for backward compatibility these Items share the same Compound Graphic Instance ID (0070,0226).

### Note

Every Compound Graphic has an equivalent rendering encoded as a set of simple graphic objects linked by the Compound Graphic Instance ID (0070,0226). Simple graphic objects are elements such as points, polylines, interpolated lines, circles and ellipses. The equivalent rendering is a set of simple graphic objects to support an SCP that only understands the simple graphical objects.

###### C.10.5.1.3.2 Rotation

All Compound Graphics can be rotated by specifying a Rotation Angle (0070,0230) value and a Rotation Point (0070,0273). The convention for rotation is that positive angle values are defined as counterclockwise around Rotation Point (0070,0273).

###### C.10.5.1.3.3 Ellipses

For the Compound Graphic Type (0070,0294) ELLIPSE, exactly 2 points shall be present inside Graphic Data (0070,0022). The first point is the top/left hand corner (TLHC) and the second point is the bottom/right hand corner (BRHC) of the bounding rectangle (see Figure C.10.5-2).

Figure C.10.5-2. ELLIPSE on the left and RECTANGLE object on the right

###### C.10.5.1.3.4 Rectangles

For the Compound Graphic Type (0070,0294) RECTANGLE, exactly 2 points shall be present inside Graphic Data (0070,0022). The first point is the top/left hand corner of the rectangle (TLHC) and the second point is the bottom/right hand corner (BRHC) of the rectangle (see Figure C.10.5-2).

###### C.10.5.1.3.5 Multi-lines

For the Compound Graphic Type (0070,0294) MULTILINE, the list of points inside Graphic Data (0070,0022) is an n-tuple list of start and end points of straight lines to be drawn (see Figure C.10.5-3).

If Rotation Angle (0070,0230) is present, all points in the MULTILINE are rotated around the same Rotation Point (0070,0273).

Figure C.10.5-3. Example for MULTILINE Object

###### C.10.5.1.3.6 Cut and Infinite-lines

For the Compound Graphic Type (0070,0294) CUTLINE or INFINITELINE, exactly two points shall be present inside Graphic Data (0070,0022). The rendering of these lines always extends to the borders of the render area of a view(see Figure C.10.5-4).

Figure C.10.5-4. INFINITELINE

Figure C.10.5-5. CUTLINE on the Left and CUTLINE with gap on the Right

In case of a CUTLINE, two arrows shall be drawn perpendicular to the cutline. The arrows ends shall be positioned at the midpoints of each half of the cutline. The arrow heads shall point toward the cutline and shall be drawn in the positive right half-plane of the cutline before rotation. Typically, the arrows indicate the viewing direction for MPR renderings that are referenced by these lines.

Gap Length (0070,0261) defines the diameter of the circular area where the CUTLINE or INFINITELINE is not rendered. Center of the circular area is Rotation Point (0070,0273). Since the dimension units of the Gap Length is DISPLAY, independent of the value of Compound Graphic Units (0070,0282), the length of the gap is not changed by zoom operations on the image performed by the application.

###### C.10.5.1.3.7 Range Lines

For the Compound Graphic Type (0070,0294) RANGELINE exactly two points shall be present inside Graphic Data (0070,0022).

Figure C.10.5-6. RANGELINE Example

###### C.10.5.1.3.8 Ruler

For the Compound Graphic Type (0070,0294) RULER, exactly two points shall be present inside Graphic Data (0070,0022) defining the ruler line.

Tick Alignment (0070,0274) defines the alignment of the ticks.

BOTTOM - ticks are aligned to the lower part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

CENTER - ticks are centered on the line.

TOP - ticks are aligned to the upper part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

Tick Label Alignment (0070,0279) defines the alignment of the tick labels.

BOTTOM - labels are aligned to the lower part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

TOP - labels are aligned to the upper part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

The presence, labeling and units of the ticks on the line is application dependent(see Figure C.10.5-7). If present as numerical values, the labels of the ticks shall increase toward the second point.

###### C.10.5.1.3.9 Axis

For the Compound Graphic Type (0070,0294) AXIS, exactly two points shall be present inside Graphic Data (0070,0022) defining the axis line.

Figure C.10.5-7. RULER / AXIS Example Showing TOP Tick Alignment and TOP Tick Label Alignment

The Major Ticks Sequence (0070,0287) specifies the placement and label of the ticks. The rendering of the minor ticks is left to the application.

Tick Alignment (0070,0274) defines the alignment of the ticks.

BOTTOM - ticks are aligned to the lower part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

CENTER - ticks are centered on the line.

TOP - ticks are aligned to the upper part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

Tick Label Alignment (0070,0279) defines the alignment of the tick labels.

BOTTOM - labels are aligned to the lower part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

TOP - labels are aligned to the upper part of the line, where the first point of the line is on the left and the line extends horizontally to the right.

###### C.10.5.1.3.10 Crosshairs

For Compound Graphic Type (0070,0294) CROSSHAIR, exactly one point shall be present inside Graphic Data (0070,0022). This point is the origin of the CROSSHAIR (see Figure C.10.5-8).

Tick Alignment (0070,0274) and Tick Label Alignment (0070,0279) are also valid for the CROSSHAIR. Tick rendering is application dependent.

Figure C.10.5-8. CROSSHAIR Example Showing BOTTOM Tick Labels Alignment

Gap Length (0070,0261) defines the diameter of the circular area around the origin where the CROSSHAIR is not rendered. Since the dimension units of the Gap Length is DISPLAY, independent of the value of Compound Graphics Units (0070,0282), the length of the gap is not changed by zoom operations on the image performed by the application.

Diameter of Visibility (0070,0262) defines the diameter of the circular area around the origin where the CROSSHAIR is rendered. Since the dimension units of the Diameter of Visibility is DISPLAY, independent of the value of Compound Graphic Units (0070,0282), the size of the crosshair is not changed by zoom operations on the image performed by the application.

The value of Tick Alignment (0070,0274) shall be CENTER.

###### C.10.5.1.3.11 Arrows

For the Compound Graphic Type (0070,0294) ARROW, two points shall be present inside Graphic Data (0070,0022). The first point is the anchor point, the second point is the foot point of the arrow(see Figure C.10.5-9). The arrow head style at the anchor point is not specified.

Figure C.10.5-9. ARROW Example

###### C.10.5.1.3.12 Text Style Sequence

Text Style Sequence (0070,0231) contains the text style for each text object. This attribute gives recommendations on how the annotation text should be rendered at the display.

Table C.10-5a specifies the attributes that describe Text Style Sequence Macro.

Table C.10-5a. Text Style Sequence Macro Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Text Style Sequence | (0070,0231) | 3 | Sequence that describes the text style. Only a single item shall be included in this sequence.
>Font Name | (0070,0227) | 3 | Font name in a standard type.
>Font Name Type | (0070,0228) | 1C | Defined Terms: ISO_32000 Required if Font Name (0070,0227) is present. ### Note This is the font naming system used by Adobe PDF and defined in ISO/IEC 14496-22.
>CSS Font Name | (0070,0229) | 1 | Generic font name as defined within CSS (Cascading Style Sheets). Default fontname, if the font specified in Font Name (0070,0227) is not present or can not be rendered.
>Text Color CIELab Value | (0070,0241) | 1 | A default color triplet value used to specify the text color in which it is recommended that the text be rendered on a color display. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1. This value shall override the Graphic Layer Recommended Display CIELab Value (0070,0401).
>Horizontal Alignment | (0070,0242) | 3 | Specifies the horizontal position of the text relative to the vertical edges of the bounding box. Horizontal Alignment shall override the Bounding Box Text Horizontal Justification (0070,0012) of the Text Object Sequence Item. See Section C.10.5.1.3.12.1 Enumerated Values: LEFT CENTER RIGHT Required if Bounding Box Top Left Hand Corner (0070,0010) is present.
>Vertical Alignment | (0070,0243) | 3 | Specifies the vertical position of the text relative to the horizontal edges of the bounding box. See Section C.10.5.1.3.12.1 Enumerated Values: TOP CENTER BOTTOM Required if Bounding Box Top Left Hand Corner (0070,0010) is present.
>Shadow Style | (0070,0244) | 1 | The shadow style of the text to be displayed. Enumerated Values: NORMAL the shadow is drawn on 1 side of the contour of the text object OUTLINED the shadow is drawn around the contour of the text object OFF no shadow See Section C.10.5.1.3.13.1
>Shadow Offset X | (0070,0245) | 1 | Floating point value that defines the shadow offset in X direction in Anchor Point Annotation Units (0070,0004) if used in Text Object Sequence Item or in Graphic Annotation Units (0070,0005) if used in Graphic Object Sequence Item. See Section C.10.5.1.3.13.1
>Shadow Offset Y | (0070,0246) | 1 | Floating point value that defines the shadow offset in Y direction in Anchor Point Annotation Units (0070,0004) if used in Text Object Sequence Item or in Graphic Annotation Units (0070,0005) if used in Graphic Object Sequence Item. See Section C.10.5.1.3.13.1
>Shadow Color CIELab Value | (0070,0247) | 1 | A color triplet value used to encode the Shadow Color. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1.
>Shadow Opacity | (0070,0258) | 1 | Encodes the shadow opacity. The value is encoded as floating point alpha value (0.0-1.0).
>Underlined | (0070,0248) | 1 | Specifies whether or not the text shall be rendered underlined. Enumerated Values: Y yes N no
>Bold | (0070,0249) | 1 | Specifies whether or not the text shall be rendered in bold. Enumerated Values: Y yes N no
>Italic | (0070,0250) | 1 | Specifies whether or not the text shall be rendered italicized. Enumerated Values: Y yes N no

###### C.10.5.1.3.12.1 Text Alignment

Horizontal Alignment (0070,0242) and Vertical Alignment (0070,0243) define the position of the text relative to the bounding box of the text object (see Figure C.10.5-10).

Figure C.10.5-10. Example of Horizontal and Vertical CENTER Alignment

###### C.10.5.1.3.13 Line Style Sequence

Table C.10-5b specifies the attributes that describe Line Style Sequence Macro.

Table C.10-5b. Line Style Sequence Macro Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Line Style Sequence | (0070,0232) | 3 | Sequence that describes the line style. Only a single item shall be included in this sequence.
>Pattern On Color CIELab Value | (0070,0251) | 1 | A color triplet value used to encode the foreground. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1. This value shall override the Graphic Layer Recommended Display CIELab Value (0070,0401).
>Pattern Off Color CIELab Value | (0070,0252) | 3 | A color triplet value used to encode the color of parts of the line that are off, i.e., the background. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1.
>Pattern On Opacity | (0070,0284) | 1 | Encodes the foreground opacity. The value is encoded as floating point alpha value (0.0-1.0).
>Pattern Off Opacity | (0070,0285) | 3 | Encodes the background opacity. The value is encoded as floating point alpha value (0.0-1.0).
>Line Thickness | (0070,0253) | 1 | Specifies the line thickness. The dimension for this attribute is defined by Graphic Annotation Units (0070,0005) or Compound Graphic Units (0070,0282).
>Line Dashing Style | (0070,0254) | 1 | The dashing style of the line to be displayed. Enumerated Values: SOLID DASHED Draws one part of the line with the Pattern On Color CIELab Value (0070,0251) and the other part with the Pattern Off Color CIELab Value (0070,0252). See Section C.10.5.1.3.13.1.
>Line Pattern | (0070,0255) | 1C | Pattern that defines the line dashing style. The Line Pattern is a 32 bit value. If the bit inside the pattern is set to 1 the foreground color is drawn, else the background color is drawn. ### Note For example, 00FFH defines the dashes with an equal size. Required if Line Dashing Style (0070,0254) has a value of DASHED.
>Shadow Style | (0070,0244) | 1 | The shadow style of the line to be displayed. Enumerated Values: NORMAL the shadow is drawn on 1 side of the contour of the text object OUTLINED the shadow is drawn around the contour of the text object OFF no shadow See Section C.10.5.1.3.13.2
>Shadow Offset X | (0070,0245) | 1 | Floating point value that defines the shadow offset in X direction in Graphic Annotation Units (0070,0005). See Section C.10.5.1.3.13.2.
>Shadow Offset Y | (0070,0246) | 1 | Floating point value that defines the shadow offset in Y direction in Graphic Annotation Units (0070,0005). See Section C.10.5.1.3.13.2.
>Shadow Color CIELab Value | (0070,0247) | 1 | A color triplet value used to encode the Shadow Color. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1.
>Shadow Opacity | (0070,0258) | 1 | Encodes the shadow opacity. The value is encoded as floating point alpha value (0.0-1.0).

###### C.10.5.1.3.13.1 Line Dashing Style

The Line Dashing Style (0070,0254) value SOLID indicates the line to be drawn with the foreground color, which is specified by Pattern On Color CIELab Value (0070,0251).

The Line Dashing Style (0070,0254) attribute does not apply to shadows, which shall always be rendered in SOLID background color.

###### C.10.5.1.3.13.2 Shadows

Shadow Style (0070,0244) contains one of the values OFF, NORMAL or OUTLINED (see Figure C.10.5-11 and Figure C.10.5-12). Shadow shall be applied after rotation. The coordinate system of the shadow is relative to the line. Shadow Offset X (0070,0245) extends to the right and Shadow Offset Y (0070,0246) extends downward.

Figure C.10.5-11. Example for Shadow Style (0070,0244) NORMAL

The OUTLINED shadow defines a filled outline shadow. The length of the vector given by Shadow Offset X (0070,0245) and Shadow Offset Y (0070,0246) defines the radius of the shadow.

Figure C.10.5-12. Example for Shadow Style (0070,0244) OUTLINED

###### C.10.5.1.3.14 Fill Style Sequence

Table C.10-5c specifies the attributes that describe Fill Style Sequence Macro.

Table C.10-5c. Fill Style Sequence Macro Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Fill Style Sequence | (0070,0233) | 3 | Sequence that describes the fill style. Only a single item is permitted in this sequence.
>Pattern On Color CIELab Value | (0070,0251) | 1 | A color triplet value used to encode the foreground color. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1. This value shall override the Graphic Layer Recommended Display CIELab Value (0070,0401).
>Pattern Off Color CIELab Value | (0070,0252) | 3 | A color triplet value used to encode the background color. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1.
>Pattern On Opacity | (0070,0284) | 1 | Encodes the foreground opacity. The value is encoded as floating point alpha value (0.0-1.0).
>Pattern Off Opacity | (0070,0285) | 1 | Encodes the background opacity. The value is encoded as floating point alpha value (0.0-1.0).
>Fill Mode | (0070,0257) | 1 | The texture of the closed object to be displayed. Enumerated Values: SOLID STIPPELED See Section C.10.5.1.3.14.1.
>Fill Pattern | (0070,0256) | 1C | A binary fill pattern. A set bit corresponds to foreground. An unset bit corresponds to background. A 128 byte value defining a 32x32 1 bit matrix. This fill pattern is replicated in tiles inside the boundaries of the graphic type. The most significant bit corresponds to the leftmost pixel in the row. The fill pattern relates to display pixels where one bit value corresponds to one display pixel. Required if Fill Mode (0070,0257) equals STIPPELED.

###### C.10.5.1.3.14.1 Fill Mode

Fill Mode (0070,0257) value SOLID indicates that the graphic object is filled with the foreground.

Fill Mode (0070,0257) attribute does not interfere with (line) shadows, which shall always be rendered in SOLID background color.

### C.10.6 Spatial Transformation Module

This Module defines a manner of rotating an image by increments of ninety degrees and flipping an image.

Table C.10-6. Spatial Transformation Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Image Rotation | (0070,0042) | 1 | How far to rotate the image clockwise in degrees, before any Image Horizontal Flip (0070,0041) is applied. Enumerated Values: 0 90 180 270 ### Note Negative values are not permitted since the Value Representation is unsigned.
Image Horizontal Flip | (0070,0041) | 1 | Whether or not to flip the image horizontally after any Image Rotation has been applied such that the left side of the image becomes the right side. Enumerated Values: Y yes N no ### Note No vertical flip is specified since the same result can be achieved by a combination of a 180 degree rotation and a horizontal flip.

### Note

Given the definition of the Grayscale Transformation Sequence in PS3.4, it is apparent that the rotation, flipping and magnification will be applied AFTER the application of any bit-mapped overlays or graphic annotations that are specified in the image pixel spaces, but BEFORE the application of graphic annotations that apply in the Specified Displayed Area relative space.

### C.10.7 Graphic Layer Module

This Module defines the characteristics of the layers in which overlays, graphic and text may be rendered.

Layers group together graphics that are related. It is recommended that a layer be displayed such that it may be distinguished from other layers that have a different value for Graphic Layer Order (0070,0062).

### Note

The transparency, opacity, and any other interaction (such as exclusive or) with underlying layers or image data are not specified and are at the discretion of the implementation.

Table C.10-7. Graphic Layer Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Graphic Layer Sequence | (0070,0060) | 1 | A sequence of Items each of which represents a single layer in which overlays, curves, graphics or text may be rendered. One or more Items shall be included in this sequence. An Item is required for each layer referenced from the Graphic Annotation Module or the Overlay Activation Module.
>Graphic Layer | (0070,0002) | 1 | A string that identifies the layer. ### Note This identifier may be used by other Attributes within the same presentation state instance to reference this layer. There is no requirement for the same identifiers to be used in different presentation states, and there is no mechanism for referencing layers in other presentation states. That is, a UID is not required.
>Graphic Layer Order | (0070,0062) | 1 | An integer indicating the order in which it is recommended that the layer be rendered, if the display is capable of distinguishing. Lower numbered layers are to be rendered first.
>Graphic Layer Recommended Display Grayscale Value | (0070,0066) | 3 | A default single gray unsigned value in which it is recommended that the layer be rendered on a monochrome display. The units are specified in P-Values from a minimum of 0000H (black) up to a maximum of FFFFH (white). ### Note The maximum P-Value for this Attribute may be different from the maximum P-Value from the output of the Presentation LUT, which may be less than 16 bits in depth.
>Graphic Layer Recommended Display CIELab Value | (0070,0401) | 3 | A default color triplet value in which it is recommended that the layer be rendered on a color display. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1.
>Graphic Layer Description | (0070,0068) | 3 | A free text description of the contents of this layer.

### Note

Graphic Layer Recommended Display RGB Value (0070,0067) was previously used in this Module, but has been retired and its function replaced by Graphic Layer Recommended Display CIELab Value (0070,0401). See PS3.3-2004.

#### C.10.7.1 Graphic Layer Module Attributes

##### C.10.7.1.1 Encoding of CIELab Values

Attributes such as Graphic Layer Recommended Display CIELab Value (0070,0401) consist of three unsigned short values:

- An L value linearly scaled to 16 bits, such that 0x0000 corresponds to an L of 0.0, and 0xFFFF corresponds to an L of 100.0.

- An a* then a b* value, each linearly scaled to 16 bits and offset to an unsigned range, such that 0x0000 corresponds to an a* or b* of -128.0, 0x8080 corresponds to an a* or b* of 0.0 and 0xFFFF corresponds to an a* or b* of 127.0

### Note

This is the same form of encoding as used for the PCS in ICC Profiles.

### C.10.8 Waveform Identification Module

The table in this section contains Attributes that identify a Waveform as a separate information entity.

Table C.10-8. Waveform Identification Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Instance Number | (0020,0013) | 1 | A number that identifies this Waveform.
Content Date | (0008,0023) | 1 | The date the Waveform data was created.
Content Time | (0008,0033) | 1 | The time the Waveform data was created.
Acquisition DateTime | (0008,002A) | 1 | The date and time that the acquisition of data that resulted in this waveform started; the reference timestamp for the Multiplex Group Time Offset (0018,1068) for a waveform multiplex group ### Note The synchronization of this time with an external clock is specified in the Synchronization Module in Acquisition Time Synchronized (0018,1800).
Referenced Instance Sequence | (0008,114A) | 3 | Composite SOP Instances that are significantly related to this Waveform. One or more Items are permitted in this sequence.
>Include Table 10-11 “SOP Instance Reference Macro Attributes” |
>Purpose of Reference Code Sequence | (0040,A170) | 3 | Code describing the purpose of the reference to the Instance(s). Only a single Item is permitted in this sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | Defined CID 7004 “Waveform Purposes of Reference” for referenced waveforms.

### Note

Acquisition DateTime (0008,002A) is the time of the original waveform data capture. Derived waveforms that are processed (e.g., averaged or filtered) and encoded subsequent to the waveform Acquisition DateTime have a Content Date (0008,0023) and Content Time (0008,0033) representing the time of the processing. In all cases the actual date and time of creation of the SOP Instance for transmission or storage may be recorded in the Instance Creation Date (0008,0012) and Instance Creation Time (0008,0013) (see Section C.12.1).

### C.10.9 Waveform Module

The table in this section contains Attributes that describe a time-based waveform. A waveform consists of one or more multiplex groups, each encoded into an Item in the Waveform Sequence. All channels within a multiplex group are synchronously digitized at a common sampling frequency.

Table C.10-9. Waveform Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Waveform Sequence | (5400,0100) | 1 | Sequence of Items, each representing one waveform multiplex group. One or more Items shall be included in this sequence. Ordering of Items in this Sequence is significant for external reference to specific multiplex groups.
>Multiplex Group Time Offset | (0018,1068) | 1C | Offset time in milliseconds from a reference time (see Section C.10.9.1.1). Required if Acquisition Time Synchronized (0018,1800) value is Y; may be present otherwise.
>Trigger Time Offset | (0018,1069) | 1C | Offset time in milliseconds from a synchronization trigger to the first sample of a waveform multiplex group. May be positive or negative. Required if waveform acquisition is synchronized to a trigger.
>Trigger Sample Position | (0018,106E) | 3 | Sample number whose time corresponds to a synchronization trigger (see Section C.10.9.1.2).
>Waveform Originality | (003A,0004) | 1 | See Section C.10.9.1.3. Enumerated Values: ORIGINAL DERIVED
>Number of Waveform Channels | (003A,0005) | 1 | Number of channels for this multiplex group.
>Number of Waveform Samples | (003A,0010) | 1 | Number of samples per channel in this multiplex group.
>Sampling Frequency | (003A,001A) | 1 | Frequency in Hz
>Multiplex Group Label | (003A,0020) | 3 | Label for multiplex group
>Channel Definition Sequence | (003A,0200) | 1 | Sequence of Items, with one Item per channel (see Section C.10.9.1.4). One or more Items shall be included in this sequence. Ordering of Items in this Sequence is significant for reference to specific channels.
>>Waveform Channel Number | (003A,0202) | 3 | Equipment physical channel number used for acquisition.
>>Channel Label | (003A,0203) | 3 | Text label for channel, which may be used for display purposes
>>Channel Status | (003A,0205) | 3 | One or more values for the status of this channel within this SOP Instance. Defined Terms: OK TEST DATA DISCONNECTED QUESTIONABLE INVALID UNCALIBRATED UNZEROED Precise location of a change in status may be noted in an Annotation.
>>Channel Source Sequence | (003A,0208) | 1 | A coded descriptor of the waveform channel source (metric, anatomical position, function, and technique). Only a single Item shall be included in this sequence. (see Section C.10.9.1.4.1)
>>>Include Table 8.8-1 “Code Sequence Macro Attributes”. | Baseline CID determined by IOD specialization
>>Channel Source Modifiers Sequence | (003A,0209) | 1C | Sequence of Items that further qualify the Waveform Source. One or more Items shall be included in this sequence. Ordering of Items in this Sequence may be semantically significant. Required if Channel Source Sequence (003A,0208) does not fully specify the semantics of the source.
>>>Include Table 8.8-1 “Code Sequence Macro Attributes”. | Baseline CID determined by IOD specialization
>>Source Waveform Sequence | (003A,020A) | 3 | A sequence that provides reference to a DICOM waveform from which this channel was derived. One or more Items are permitted in this Sequence.
>>>Include Table 10-11 “SOP Instance Reference Macro Attributes” |
>>>Referenced Waveform Channels | (0040,A0B0) | 1 | Identifies the waveform multiplex group and channel within the referenced SOP Instance. Pair of values (M,C).
>>Channel Derivation Description | (003A,020C) | 3 | Additional description of waveform channel derivation
>>Channel Sensitivity | (003A,0210) | 1C | Nominal numeric value of unit quantity of sample. Required if samples represent defined (not arbitrary) units.
>>Channel Sensitivity Units Sequence | (003A,0211) | 1C | A coded descriptor of the Units of measure for the Channel Sensitivity. Only a single Item shall be included in this sequence. (see Section C.10.9.1.4.2). Required if Channel Sensitivity (003A,0210) is present.
>>>Include Table 8.8-1 “Code Sequence Macro Attributes” | Defined CID 82 “Units of Measurement”.
>>Channel Sensitivity Correction Factor | (003A,0212) | 1C | Multiplier to be applied to encoded sample values to match units specified in Channel Sensitivity (003A,0210) (e.g., based on calibration data) (see Section C.10.9.1.4.2). Required if Channel Sensitivity (003A,0210) is present.
>>Channel Baseline | (003A,0213) | 1C | Offset of encoded sample value 0 from actual 0 using the units defined in the Channel Sensitivity Units Sequence (003A,0211). Required if Channel Sensitivity (003A,0210) is present.
>>Channel Time Skew | (003A,0214) | 1C | Offset of first sample of channel from waveform multiplex group start time, in seconds (see Section C.10.9.1.4.3) Required if Channel Sample Skew is not present.
>>Channel Sample Skew | (003A,0215) | 1C | Offset of first sample of channel from waveform multiplex group start time, in samples (see Section C.10.9.1.4.3) Required if Channel Time Skew is not present.
>>Channel Offset | (003A,0218) | 3 | Additional offset of first sample of channel to be used in aligning multiple channels for presentation or analysis, in seconds (see Section C.10.9.1.4.3)
>>Waveform Bits Stored | (003A,021A) | 1 | Number of significant bits within the waveform samples (see Section C.10.9.1.4.4)
>>Filter Low Frequency | (003A,0220) | 3 | Nominal 3dB point of lower frequency of pass band; in Hz
>>Filter High Frequency | (003A,0221) | 3 | Nominal 3dB point of upper frequency of pass band; in Hz
>>Notch Filter Frequency | (003A,0222) | 3 | Center frequency of notch filter(s); in Hz
>>Notch Filter Bandwidth | (003A,0223) | 3 | Nominal 3dB bandwidth of notch filter(s); in Hz
>>Channel Minimum Value | (5400,0110) | 3 | Minimum valid sample value as limited by the acquisition equipment (see Section C.10.9.1.4.5)
>>Channel Maximum Value | (5400,0112) | 3 | Maximum valid sample value as limited by the acquisition equipment (see Section C.10.9.1.4.5)
>Waveform Bits Allocated | (5400,1004) | 1 | Size of each waveform data sample within the Waveform Data; See Section C.10.9.1.5
>Waveform Sample Interpretation | (5400,1006) | 1 | Data representation of the waveform data points. See Section C.10.9.1.5.
>Waveform Padding Value | (5400,100A) | 1C | Value of waveform samples inserted in channels when input is absent or invalid. Required if acquisition equipment inserts padding. See Section C.10.9.1.6.
>Waveform Data | (5400,1010) | 1 | Encoded data samples - channel multiplexed. See Section C.10.9.1.7
Waveform Data Display Scale | (003A,0230) | 3 | The recommended time-based waveform data display scale in units of mm/s (see Section C.10.9.1.8).
Waveform Display Background CIELab Value | (003A,0231) | 3 | A color triplet value recommended for rendering the waveform display background on a color display. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1.
Waveform Presentation Group Sequence | (003A,0240) | 3 | Sequence of Items, each Item describing a Presentation Group of one or more waveform channels to be displayed together. ### Note A Presentation Group is conventionally denoted a "display page", and a waveform object may be rendered using several Presentation Groups under user display control. One or more Items are permitted in this sequence.
>Presentation Group Number | (003A,0241) | 1 | A number that identifies the Presentation Group.
>Channel Display Sequence | (003A,0242) | 1 | Sequence of Items, each Item describing a channel to be displayed in the Presentation Group. One or more Items shall be included in this sequence.
>>Referenced Waveform Channels | (0040,A0B0) | 1 | Identifier of the displayed channel, specified as a pair of values (M,C) where the first value is the ordinal of the sequence item of Waveform Sequence (5400,0100) (i.e., the Multiplex Group Number), and the second value is the ordinal of the sequence item of the Channel Definition Sequence (003A,0200) attribute (i.e., the Waveform Channel Number) within the multiplex group. ### Note In the context of a Channel Display Sequence (003A,0242) Item, only a single channel shall be referenced.
>>Channel Offset | (003A,0218) | 3 | The offset in seconds from the beginning of the channel waveform data to the first sample to be used for presentation. Value may be negative.
>>Channel Recommended Display CIELab Value | (003A,0244) | 1 | A color triplet value recommended for rendering the channel on a color display. The units are specified in PCS-Values, and the value is encoded as CIELab. See Section C.10.7.1.1.
>>Channel Position | (003A,0245) | 1 | Position of the Channel within the Presentation Group display area (see Section C.10.9.1.9).
>>Display Shading Flag | (003A,0246) | 3 | Specifies display area shading between the displayed waveform channel and another line. The nature of the shading (e.g., solid, or cross-hatching) is implementation dependent. Enumerated Values: NONE no shading BASELINE shading between the waveform and the channel display baseline (sample value 0 equivalent location) ABSOLUTE shading between the waveform and the channel real world actual value 0 (i.e., taking into account the Channel Baseline (003A,0213) value) DIFFERENCE shading between the waveform and a second waveform in the Presentation Group at the same Channel Position that also has Display Shading Flag (003A,0246) value DIFFERENCE.
>>Fractional Channel Display Scale | (003A,0247) | 1C | Fraction of the Presentation Group vertical display dimension assigned to the unit quantity (least significant bit) of the Channel samples (see Section C.10.9.1.10). Required if Absolute Channel Display Scale (003A,0248) is not present, may be present otherwise.
>>Absolute Channel Display Scale | (003A,0248) | 1C | Nominal vertical display height in mm assigned to the unit quantity (least significant bit) of the Channel samples (see Section C.10.9.1.10). Required if Fractional Channel Display Scale (003A,0247) is not present, may be present otherwise.

#### C.10.9.1 Waveform Attribute Descriptions

##### C.10.9.1.1 Multiplex Group Time Offset

Multiplex Group Time Offset (0018,1068) specifies the offset time in milliseconds from a reference time to the first sample of the multiplex group. The reference time is Acquisition DateTime (0008,002A), if present in the SOP Instance.

In all other cases, the offset is from an arbitrary reference time that is the same for all Multiplex Groups in the SOP Instance; i.e., the Multiplex Group Time Offset allows only relative time synchronization between Multiplex Groups in the SOP Instance. The arbitrary reference time may nominally be assumed to be Content Time (0008,0033).

##### C.10.9.1.2 Trigger Sample Position

The Trigger Sample Position (0018,106E) specifies the sample that was digitized at the same time as a synchronization trigger. Sample positions are enumerated by channel, with the first sample enumerated 1. This provides a single trigger sample location for all channels of the multiplex group. Although channels may not have been sampled synchronously (as specified by Channel Time Skew or Channel Sample Skew), for the purpose of determining the location of the trigger with an integer value position, all channels are considered to be synchronous.

##### C.10.9.1.3 Waveform Originality

Waveform Originality (003A,0004) shall have the value ORIGINAL if the Waveform Data samples are the original or source data, and shall have the value DERIVED if the Waveform Data samples have been derived in some manner from the sample data of other waveforms.

### Note

1. Waveform Originality (003A,0004) is comparable to Image Type (0008,0008) Value 1 (see Section C.7.6.1.1.2). Within a single Multiplex Group, all channels shall have the same Originality value.

2. Waveform data that has been transcoded from a non-DICOM format may have Waveform Originality value ORIGINAL if the samples are unchanged from the originally acquired waveform samples.

##### C.10.9.1.4 Channel Definition Sequence

###### C.10.9.1.4.1 Channel Source and Modifiers

Channel Source Sequence (003A,0208) identifies the metric (quality being measured, e.g., voltage or pressure), the anatomical position of the sensor or probe, the function of the channel (e.g., measurement or stimulus), and any particulars of technique that affect those parameters (e.g., pull-back across multiple anatomic sites, or differential input from two distinct sites). If the full semantics of the source is not carried in a single coded entry (e.g., if it specifies the location but not the metric), additional qualifiers are identified in Channel Source Modifiers Sequence (003A,0209) coded entries.

When a single sensor channel is used to collect a waveform from two (or more) anatomic sites, e.g., in hemodynamic pull-back procedures, multiple Channel Source Modifier items will identify the sequence of sites, if not encoded in the semantics of the Channel Source Coded Entry. Transition times from one site to another may be indicated with an Annotation, or pull-back rate may be indicated with an Acquisition Context Sequence Item (see Section C.7.6.14).

The Baseline CIDs are defined by IOD in accordance with Section A.34. Restrictions in the IOD may also determine the pattern of specification of the waveform source, i.e., which item is to be encoded in the Channel Source sequence, and the order in which Channel Source Modifier items are to be encoded. Unless otherwise specified, pattern of specification of the waveform source shall be:

1. If the function of the channel is not measurement, the function (and optionally additional parameters of the channel source) shall be encoded in the Channel Source item.

2. If the function of the channel is measurement of a waveform originating in the patient (the implicit default function), the metric (and optionally additional parameters of the channel source) shall be encoded in the Channel Source item.

3. If not encoded in the Channel Source item, and a particular technique needs to be encoded, that technique shall be encoded in the first Channel Source Modifier item.

### Note

For example, an intracardiac measurement of a pressure waveform across the mitral valve by means of a catheter pullback may be encoded in one of the following three ways (using pseudo-coded terminology), depending on the availability of coded terms with sufficient expressive power:

Channel Source | Channel Source Modifiers
X-2311 "pressure measurement" | T-7663 "pullback"C-2001 "mitral valve"
X-2123 "pressure measurement, pullback" | C-2001 "mitral valve"
X-1234 "pressure measurement, mitral valve, pullback" | (none required)

###### C.10.9.1.4.2 Channel Sensitivity and Channel Sensitivity Units

Channel Sensitivity is the nominal value of one unit (i.e., the least significant bit) of each waveform sample in Waveform Data (5400,1010). It includes both the amplifier gain and the analog-digital converter resolution. It does not relate the vertical scaling of a waveform on a particular display.

### Note

A prior edition specified CID 3082 “Cardiology Units of Measurement (Retired)” as the Defined Context Group for Channel Sensitivity Units Sequence. CID 3082 “Cardiology Units of Measurement (Retired)” was a subset of CID 82 “Units of Measurement”, and has been retired in favor of the more general CID 82 “Units of Measurement”. See PS3.3-2011.

Channel Sensitivity Correction Factor (003A,0212) is the ratio of the actual (calibrated) value to the nominal Channel Sensitivity specified in Data Element (003A,0210). Thus a waveform sample value multiplied by the Channel Sensitivity value provides the nominal measured value in Channel Sensitivity Units, and that nominal value multiplied by the Channel Sensitivity Correction Factor provides the calibrated measured value.

###### C.10.9.1.4.3 Channel Skew and Channel Offset

Skew is also known as a sub-sample time delay, typically caused by using a multiplexed analog to digital converter that switches from channel to channel. For analysis it may be important to know if the analog channels were all latched simultaneously or sequentially and then digitized. Skew may be represented as time offset in seconds, or a fractional number of samples.

Separate and additional to skew is an offset time adjustment (sometimes called latency) by which one waveform channel is displaced significantly relative to others before sampling.

### Note

As an example, a hemodynamic pressure is measured at the external end of a catheter, and thus its measurement is delayed by the time for the pressure wave to propagate down the catheter. With a dual catheter measurement, two signals may be acquired at the same time, but one arrives by a longer distance (e.g., a pulmonary capillary wedge pressure, compared to a left ventricular pressure). To obtain an accurate comparison of the waveforms (e.g., the gradient across the mitral valve), one waveform has to be offset (perhaps as much as 30 ms) to synchronize them.

###### C.10.9.1.4.4 Waveform Bits Stored

Waveform Bits Stored (003A,021A) specifies the number of significant bits within the Waveform Bits Allocated of each sample, for signed or unsigned integers.

If Waveform Sample Value Representation is MB or AB, Waveform Bits Stored shall be 8.

###### C.10.9.1.4.5 Channel Minimum and Maximum Value

Channel Minimum and Maximum Value attributes (5400,0110) and (5400,0112) may be used to send the analog-to-digital converter limits (i.e., the clipping levels).

### Note

These values do not represent the maximum and minimum values in the data set, but rather the valid range of values.

##### C.10.9.1.5 Waveform Bits Allocated and Waveform Sample Interpretation

Waveform Bits Allocated (5400,1004) specifies the number of bits allocated for each sample, and Waveform Sample Interpretation (5400,1006) specifies the data representation of each waveform sample. Waveform Bits Allocated shall be a multiple of 8. These data elements are related, and their Defined Terms are specified in Table C.10-10.

Table C.10-10. Waveform Bits Allocated and Waveform Sample Interpretation

Waveform Bits Allocated - Defined Terms | Waveform Sample Interpretation - Defined Terms | Waveform Sample Interpretation Meaning
--- | --- | ---
8 | SB | signed 8 bit linear
UB | unsigned 8 bit linear
MB | 8 bit mu-law (in accordance with ITU-T Recommendation G.711)
AB | 8 bit A-law (in accordance with ITU-T Recommendation G.711)
16 | SS | signed 16 bit linear
US | unsigned 16 bit linear

### Note

1. The set of valid values from within this table may be constrained by definition of the IOD (see Section A.34).

2. mu-law and A-law encoding is without the alternate bit inversion used for PCM transmission through the telephone network.

This representation also applies to the Channel Minimum and Maximum Data Values, and Waveform Padding Value.

##### C.10.9.1.6 Waveform Padding Value

Equipment that produces digitized waveform curves may encode a specific value when the source is disconnected or otherwise invalid. This value is encoded like the Waveform Data attribute with one sample only.

The Waveform Padding Value need not be within the range specified by the Channel Minimum and Maximum Data Values.

##### C.10.9.1.7 Waveform Data

Each sample shall be encoded using the defined Waveform Sample Interpretation (5400,1006), using the defined number of Waveform Bits Stored (003A,021A) right justified in the sample. If the number of Waveform Bits Stored is less than the number of bits in Waveform Bits Allocated, the sign bit shall be extended to the highest order bit of the data sample.

Data values are encoded interleaved, incrementing by channel and then by sample (i.e., C1S1, C2S1,C3S1, … CnS1, C1S2, C2S2, C3S2, … CnSm), with no padding or explicit delimitation between successive samples. Cx denotes the channel defined in the Channel Definition Sequence Item in item number x.

### Note

1. With 8-bit Waveform Data, there may be an odd number of channels and an odd number of samples; see PS3.5 for rules on encoding.

2. The sign bit extension rule differs from the rules for pixel data, which do not require sign extension.

##### C.10.9.1.8 Waveform Data Display Scale

Waveform Data Display Scale (003A,0230) specifies the recommended display scale in the time dimension for the waveform data in units of mm/s. The display application needs to know the horizontal pixel scaling of the display device to effectively apply this attribute. Waveform Data Display Scale (003A,0230), divided by Sampling Frequency (003A,001A), times the display scaling in pixels/mm gives the number of horizontal pixels between subsequent samples.

### Note

1. This presumes a conventional waveform display with time in the horizontal dimension, and waveform measured quantity in the vertical dimension.

2. This attribute is useful for size consistency between softcopy display and classical hardcopy ECG printouts. E.g., for the channels of a multiplex group whose Sampling Frequency is 400 Hz, and whose Waveform Data Display Scale (003A,0230) is 25 mm/s, and that is being displayed on a monitor at 4.1 pixels/mm, the horizontal interval between samples is

   25 / 400 * 4.1 = 0.25625 pixels

How the display application renders samples at fractional pixel spacing is implementation dependent.

###### C.10.9.1.9 Channel Position

Channel Position (003A,0245) specifies the position of the channel display baseline in the Presentation Group vertical display dimension. The channel position is relative to the top of the display area. Each Presentation Group display area is defined with vertical dimension positions of 0.0 (top of display area) to 1.0 (bottom of display area).

### Note

1. This presumes a conventional waveform display with time in the horizontal dimension, and waveform measured quantity in the vertical dimension.

2. Compare Bounding Box Annotation Units (0070,0003) value DISPLAY in Section C.10.5.

Channel sample value 0 maps to the Channel Position (003A,0245) display baseline. The real world value associated with the baseline is specified in Channel Baseline (003A,0213).

Multiple channels may overlap, and may share the same Channel Position (003A,0245).

###### C.10.9.1.10 Channel Display Scale

Fractional Channel Display Scale (003A,0247) or Absolute Channel Display Scale (003A,0248) specifies the vertical scaling of the channel display. If both attributes are provided, the selection of which to use for display control is implementation dependent.

Fractional Channel Display Scale (003A,0247) specifies the fraction of the Presentation Group vertical display dimension used to offset each unit of the waveform sample value from the baseline Channel Position (003A,0245). Positive offset values are towards the top of the display area.

### Note

E.g., for a channel whose Fractional Channel Display Scale (003A,0247) value is 0.004, and whose Channel Position (003A,0245) value is 0.5, a sample whose value is -37 would be displayed at a position

0.5 - (-37 * 0.004) = 0.648

of the total vertical display dimension below the top of the Presentation Group display area.

Absolute Channel Display Scale (003A,0248) specifies the nominal physical distance on a display device (monitor) used to offset each unit of the waveform sample value from the baseline Channel Position (003A,0245). The display application needs to know the vertical pixel scaling of the display device to effectively apply this attribute. The Channel Sensitivity (003A,0210) value in Channel Sensitivity Units (003A,0211), divided by Absolute Channel Display Scale (003A,0248) value, gives the real-world scaling of the intended display.

### Note

1. This attribute is useful for size consistency between softcopy display and classical hardcopy waveform printed charts. E.g., a channel whose Channel Sensitivity (003A,0210) value is 44 uV (per least significant bit), and whose Absolute Channel Display Scale (003A,0248) value is 0.44 mm, has a real-world display scale of 0.1 mV/mm.

2. E.g., for a channel whose Absolute Channel Display Scale (003A,0248) value is 0.44 mm, and that is being displayed on a monitor at 4.1 pixels/mm, a sample whose value is 107 would be displayed at a position

   107 * 0.44 * 4 = 193.028

   pixels above the Channel Position (003A,0245) baseline.

Display for waveform samples that would lie outside the Presentation Group display area is unspecified.

Negative values of Fractional Channel Display Scale (003A,0247) and Absolute Channel Display Scale (003A,0248) are allowed.

### C.10.10 Waveform Annotation Module

The table in this section contains Attributes that identify annotations to the waveform of the current SOP Instance. Each annotation conceptually forms the equivalent of a overlay on a presentation display of the annotated entity. Annotations may represent a measurement or categorization based on the waveform data, identification of regions of interest or particular features of the waveform, or events during the data collection that may affect diagnostic interpretation (e.g., the time at which the subject coughed).

Each Annotation Item shall have the following components:

1. An annotation Text, Coded Name (only), Coded Name/Coded Value pair, or Coded Name/Numeric Measurement pair (mutually exclusive)

2. Temporal coordinates in the Waveform to which the annotation applies

Table C.10-11. Waveform Annotation Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Waveform Annotation Sequence | (0040,B020) | 1 | Sequence of Annotation Items. One or more items shall be included in this sequence.
>Unformatted Text Value | (0070,0006) | 1C | Text Observation Value (annotation). Mutually exclusive with Concept Name Code Sequence (0040,A043)
>Concept Name Code Sequence | (0040,A043) | 1C | Code representing the fully specified name of the NUMERIC measurement or CODED concept. Only a single Item shall be included in this sequence. Mutually exclusive with Text Value (0070,0006).
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | Baseline CID may be defined in IOD definition.
>>Modifier Code Sequence | (0040,A195) | 1C | A sequence of items modifying or specializing the Concept Name. One or more Items shall be included in this Sequence. Required if the value of Concept Name Code Sequence (0040,A043) does not fully describe the semantics of the measurement or concept.
>>>Include Table 8.8-1 “Code Sequence Macro Attributes” | Baseline CID may be defined in IOD definition.
>Concept Code Sequence | (0040,A168) | 3 | A sequence that conveys the categorical coded nominal value. Only a single Item is permitted in this sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | Baseline CID may be defined in IOD definition.
>>Modifier Code Sequence | (0040,A195) | 1C | A sequence of items modifying or specializing the Concept. One or more Items shall be included in this Sequence. Required if the value of Concept Code Sequence (0040,A168) does not fully describe the semantics of the concept value.
>>>Include Table 8.8-1 “Code Sequence Macro Attributes” | Baseline CID may be defined in IOD definition.
>Numeric Value | (0040,A30A) | 3 | Numeric measurement value or values.
>Measurement Units Code Sequence | (0040,08EA) | 3 | Units of measurement. Only a single Item is permitted in this sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | Baseline CID 82 “Units of Measurement”.
>Referenced Waveform Channels | (0040,A0B0) | 1 | List of channels in waveform to which annotation applies. See Section C.10.10.1.1
>Temporal Range Type | (0040,A130) | 1C | See Section C.10.10.1.2 for Enumerated Values. Required if Annotation does not apply to entire Referenced Waveform Channels; shall not be present if Annotation applies to entire temporal extent of referenced channels.
>Referenced Sample Positions | (0040,A132) | 1C | List of samples within a multiplex group specifying temporal points for annotation. Position of first sample is 1. Required if Temporal Range Type (0040,A130) is present, and if Referenced Time Offsets (0040,A138) and Referenced DateTime (0040,A13A) are not present. See Section C.10.10.1.3
>Referenced Time Offsets | (0040,A138) | 1C | Specifies temporal points for annotation by number of seconds after start of data. Required if Temporal Range Type (0040,A130) is present, and if Referenced Sample Positions (0040,A132) and Referenced DateTime (0040,A13A) are not present.
>Referenced DateTime | (0040,A13A) | 1C | Specifies temporal points for annotation by absolute time. Required if Temporal Range Type (0040,A130) is present, and if Referenced Sample Positions (0040,A132) and Referenced Time Offsets (0040,A138) are not present.
>Annotation Group Number | (0040,A180) | 3 | Number identifying associated annotations (see Section C.10.10.1.4).

#### C.10.10.1 Waveform Annotation Attribute Descriptions

##### C.10.10.1.1 Referenced Channels

Referenced Waveform Channels (0040,A0B0) is a multi-value attribute that lists the channels to which an annotation of a waveform applies. Each channel is specified as a pair of values (M,C), where the first value is the ordinal of the sequence item of Waveform Sequence (5400,0100) (i.e., the Multiplex Group Number), and the second value is the ordinal of the sequence item of the Channel Definition Sequence (003A,0200) attribute (i.e., the Waveform Channel Number) within the multiplex group.

If the specified channel number is 0, the annotation applies to all channels in the multiplex group.

### Note

As an example, an annotation that applies to the entire first multiplex group and channels 2 and 3 of the third multiplex group would have Referenced Channels value 0001 0000 0003 0002 0003 0003.

##### C.10.10.1.2 Temporal Range Type

The Temporal Range Type attribute (0040,A130) defines the type of temporal extent of the annotated region of interest. A temporal point (or instant of time) may be defined by a waveform sample offset (for a single waveform multiplex group only), time offset, or absolute time.

Enumerated Values:

POINT

  a single temporal point

MULTIPOINT

  multiple temporal points

SEGMENT

  a range between two temporal points

MULTISEGMENT

  multiple segments, each denoted by two temporal points

BEGIN

  a range beginning at one temporal point, and extending beyond the end of the acquired data

END

  a range beginning before the start of the acquired data, and extending to (and including) the identified temporal point

##### C.10.10.1.3 Referenced Sample Positions

Referenced Sample Positions (0040,A132) may be used only if Referenced Waveform Channels (0040,A0B0) refers to channels within a single multiplex group. The sample position is by channel, and applies to all channels specified in Referenced Channels (0040,A0B0).

##### C.10.10.1.4 Annotation Group Number

The Annotation Group Number (0040,A180) allows the logical association of multiple annotations within the current SOP Instance. Such linked annotations share an Annotation Group Number, but each annotation is semantically separable. The nature of the association is not defined. The number is not semantically significant.

### Note

For instance, the R-wave in several waveform channels may be annotated, and all occurrences of the same R-wave could be linked in an annotation group.

### C.10.11 Graphic Group Module

Graphic Group Module provides the label and description for the logical associations made by the Graphic Group ID (0070,0295) of graphic objects.

The grouping concept used in the Graphic Group Module differs from the grouping concept used in the Graphic Layer Module. Graphic Layer Module addresses the rendering order by using the Graphic Layer Order (0070,0062), which specifies which annotations are rendered first. The Graphic Group Module is used to specify which annotations belong together and shall be handled together(e.g., rotate, move) independent of the Graphic Layer to which they are assigned.

Table C.10-12. Graphic Group Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Graphic Group Sequence | (0070,0234) | 1 | Sequence that describes the combined graphic object. One or more Items shall be included in this sequence.
>Graphic Group ID | (0070,0295) | 1 | A unique number identifying the Graphic Group, i.e., the combined graphic object.
>Graphic Group Label | (0070,0207) | 1 | Name used to identify the Graphic Group, i.e., the combined graphic object.
>Graphic Group Description | (0070,0208) | 3 | Description of the group.

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