C.10.10 Waveform Annotation Module
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### 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.

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