General Remarks on the mapping of DICOM header module attributes:

SR Document General Module

SOP Common Module

Header Mapping Tables

Figure A.5.1.1-1. Clinical Document Header Participations

Clinical Document

For the mapping of parent document attributes (i.e., the transformed original DICOM SR document) refer to Table A.5.1.1-19.

Authenticator Participation

The attributes of the SR Document General Module Participant Sequence (0040,A07A), PS3.3 are mapped to the authenticator participation, associated role and entity as specified in Table A.5.1.1-2, Table A.5.1.1-3 and Table A.5.1.1-4, if the participation type value equals "ATTEST" (Attestor). One or more such items of the Participant Sequence can be mapped to the authenticator participation that has cardinality 0..*.

Legal Authenticator Participation

The SR Document General Module attributes related to document verification (PS3.3) are mapped to the legal authenticator participation, associated role and entities as specified in Table A.5.1.1-5, Table A.5.1.1-6, Table A.5.1.1-7 and Table A.5.1.1-8.

SR Document General Module, Verifying Observer Sequence (0040,A073): The constrained DICOM SR Basic Diagnostic Imaging Report is restricted to cover exactly one Verifying Observer since CDA R2 only allows for a single Legal Authenticator. The Verification Flag (0040,A493) cannot be mapped since CDA Release 2 does not specify such flags. If however legalAuthenticator attribute values are set, that implies that the document is verified. If not, the document is unverified. Recommendation: Each transformed DICOM SR document that is sent to information systems should be verified after it has been transcoded. Only verified documents should be exported.

Information Recipient Participation

The referring physician is considered the primary information recipient for both, inpatient as well as outpatient delivery of imaging services by default.

Information on the attending physician may be encoded by using the encompassing encounter | encounter participation (refer to Table A.5.1.1-25, Table A.5.1.1-26 and Table A.5.1.1-27). This participation may also be used for encoding information of the referrer if the primary information recipient is different from the referring physician.

The PRCP (Primary Information Recipient) code shall be used as a fixed value for type code as specified in Table A.5.1.1-9.

Attribute values of the original SR document General Study Module, Referring Physician Identification Sequence (0008,0096) are mapped as specified in Table A.5.1.1-10, Table A.5.1.1-11 and Table A.5.1.1-12. Only a single item is permitted in this sequence.

Data Enterer Participation

The attributes of the SR Document General Module Participant Sequence (0040,A07A), PS3.3 are mapped to the dataEnterer participation, associated role and entity as specified in Table A.5.1.1-13, Table A.5.1.1-14 and Table A.5.1.1-15 if the participation type value equals "ENT" (Data Enterer). The constrained DICOM SR Basic Diagnostic Imaging Report is restricted to cover exactly one Data Enterer since CDA R2 only allows for a single dataEnterer (dataEnterer participation has cardinality 0..1).

Participant (Referrer) Participation

Attribute values of the original SR document General Study Module, Referring Physician Identification Sequence (0008,0096) are mapped as specified in Table A.5.1.1-16, Table A.5.1.1-17 and Table A.5.1.1-18. Only a single item is permitted in this sequence.

Figure A.5.1.1-2. Clinical Document Header Act Relationships

Parent Document

RelatedDocument act relationship: Set typeCode to fixed value "XFRM" (for transformed parent DICOM SR document). The multiplicity of the act relationship is constrained to cardinality 1..1 (for a single original DICOM SR document that has been transformed to CDA).

Related Parent Document

The SOP Instance UID (0008,0016) attribute value of the SOP Common Module is mapped to the required CDA attribute ParentDocument.id.

Order Fulfillment

If available from the source SR document, at least one of the following numbers of DICOM TID 1005 "Procedure Context" should be mapped to the CDA Order.id set of instance identifiers: Placer Number, Filler Number or Accession Number. Each of the numbers should be combined with "Issuer of Identifier" (TID 1005) if available. Multiple procedure codes and the associated placer/filler/accession number(s) can be mapped to order acts as specified in Table A.5.1.1-20 (the CDA act relationship "infulfillmentOf" has cardinality 0..*).

Service Event

For the diagram related to the serviceEvent mapping refer to Section A.5.1.4.2 Procedure Context.

DICOM General Study Attributes Mapping:

Service Event Performer Participation

Attribute values of original SR document General Study Module, Physician(s) Reading Study (0008,1060) and Physician(s) Reading Study Identification Sequence (0008,1062) are mapped as specified in Table A.5.1.1-21, Table A.5.1.1-22 and Table A.5.1.1-23. Information on multiple physicians can be mapped to multiple AssignedEntity roles and Person entities since the encounterParticipant participation has cardinality 0..*.

Encompassing Encounter

EncompassingEncounter shall be sent if there is information on either the admission or the attender participation and not otherwise. EncompassingEncounter.effectiveTime is a required attribute. There is no DICOM SR attribute specified that can be mapped, i.e., Visit Date and Time are not available. If the value cannot be obtained from some other source, the null flavor "NI" (No Information) is assigned as the default Encompassing Encounter effectiveTime value. A complete list of null flavor values is available in CDA R2 DIR IG.

Attender Participation

Attribute values of Physician(s) of Record (0008,1048) and the Physician(s) of Record Identification Sequence (0008,1049) within the General Study module (PS3.3) are mapped to the encompassing encounter act | encounter participation (typeCode = "ATND" for Attender), associated roles and entities. Information on multiple physicians can be mapped to multiple AssignedEntity roles and Person entities since the encounterParticipant participation has cardinality 0..*.

General Mapping of Document Sections

DICOM SR Section Container Content Items are mapped to CDA Clinical Document Sections. CDA section elements shall have a code element that shall contain a LOINC code if available, or DICOM codes for sections that have no LOINC equivalent. The mapping of section codes is specified in CDA R2 DIR IG.

CDA Section Text

Section.text contains the narrative text (attested content) of the document. Section.text is populated from DICOM SR content items of the original document in a way that the full meaning can be conveyed in an unambiguous manner by applications that render the document.

Structured CDA entries may be referenced within the narrative section text of the CDA document (refer to the CDA Release 2 Standard, Section 4.3.5.1 on <content>). Parts of the structured body of the CDA document that are part of the attested content of the document shall be included in the narrative section text. To that end corresponding CDA entries are extended by originalText elements and reference values that can be derived from the entry act class code displayName.

<observation classCode="OBS" moodCode="EVN">
	<templateId root="2.16.840.1.113883.10.20.6.2.9"/>
	<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
	<value xsi:type="CD" code="121112" codeSystem="1.2.840.10008.2.16.4"
	       codeSystemName="DCM" displayName="Source of Measurement">
	<originalText>
		<reference value="#SrceOfMeas2"/>
	</originalText>
	</value>
</observation>

<observation classCode="OBS" moodCode="EVN">
	<templateId root="2.16.840.1.113883.10.20.6.2.12"/>
	<code code="121073" codeSystem="1.2.840.10008.2.16.4"
	      codeSystemName="DCM" displayName="Impression"/>
	<value xsi:type="ED">
		<reference value="#Fndng3"/>
	</value>
</observation>

Within section text a new paragraph may be used for CDA entries that are inserted as part of the attested content. The caption value may be derived from the code displayName value. The attribute value of the reference value shall be used for the content ID attribute.

<paragraph>
  <caption>Source of Measurement</caption>
  <content ID=" SrceOfMeas2"/>
…
</paragraph>
…
<paragraph>
<caption>Impression</caption>
<content ID="Fndng3">No acute cardiopulmonary process. Round density in left superior hilus,
further evaluation with CT is recommended as underlying malignancy is not excluded.</content>
…
</paragraph>

For CDA entries (structured part) WADO references are included in observation text as reference value.

<observation classCode="DGIMG" moodCode="EVN">
…
  <text  mediaType="application/DICOM">
    <!--reference to CR DICOM image (PA view) -->
    <reference value="http://www.example.org/wado?requestType=WADO
        &amp;studyUID=1.2.840.113619.2.62.994044785528.114289542805
        &amp;seriesUID=1.2.840.113619.2.62.994044785528.20060823223142485051
        &amp;objectUID=1.2.840.113619.2.62.994044785528.20060823.200608232232322.3
        &amp;contentType=application/DICOM"
    />
  </text>
…
</observation>

Within section text the same WADO reference may be included as the linkHtml href attribute value and the element value can be derived from the DICOM Study Description attribute value.

<linkHtml href="http://www.example.org/wado?requestType=WADO
   &amp;studyUID=1.2.840.113619.2.62.994044785528.114289542805
   &amp;seriesUID=1.2.840.113619.2.62.994044785528.20060823223142485051
   &amp;objectUID=1.2.840.113619.2.62.994044785528.20060823.200608232232322.3
   &amp;contentType=application/DICOM">Chest_PA
</linkHtml>

Section.title and Section.text values shall be populated as shown in Table A.5.1.2-1 above if the section is intended to be rendered. Sections that are not intended to be rendered such as the DICOM Objects Catalog shall not contain title and/or text values.

Structured Body and Sections

Figure A.5.1.2-1. Nested Sections

DICOM SR Basic Diagnostic Imaging Reports include nested container content items. The root content item (value type "CONTAINER") includes document sections (content items of value type "CONTAINER") by applying relationships between those content items (relationship type "CONTAINS").

The ClinicalDocument act class is associated with the StructuredBody act class by an act relationship (typeCode "COMP"). The structured body of the CDA contains sections that may be nested (recursive act relationship, typeCode = "COMP"). Nested DICOM SR sections within the document body are not used for SR Basic Diagnostic Imaging Reports (TID 2000). For other SR document types nested sections are mapped as shown in Figure A.5.1.2-1.

DICOM Object Catalog Section

The DICOM Object Catalog Section provides a single location for the identifying information of the study/series/instance hierarchical context of DICOM composite objects that are referenced for a specific purpose (Refer to Section A.7.1 A_DicomSequence minimal (COCT_RM830110UV) for details. In the context of the CDA, entry act class and actRelationships names shall be used as specified for the CDA mapping).

Coded Observations

DICOM TID 2000 specifies that Imaging Report Elements of Value Type Code are contained in sections (row 6 and 8). The Imaging Report Elements are inferred from Basic Diagnostic Imaging Report Observations (Row 9) that consist of image references and measurements (linear, area, volume and numeric). Coded DICOM Imaging Report Elements in this context are mapped to CDA coded observations that are section components and are related to the SopInstance or QuantityMeasurement act classes by the SPRT (Support) act relationship (Figure A.5.1.3-1).

Figure A.5.1.3-1. Coded Observation Within Section

Table A.5.1.3-1 shows the mapping of attribute values for DICOM Imaging Report Elements to CDA coded observation. The component act relationship between Section and CodedObservation is encoded as a section entry in CDA; CodedObservation as an observation CDA entry and the support act relationship as entryRelationship.

Text Observations

DICOM TID 2000 specifies that Imaging Report Elements of Value Type Text are contained in sections (Rows 6 and 10). The Imaging Report Elements are inferred from Basic Diagnostic Imaging Report Observations (Row 11) that consist of image references and measurements (linear, area, volume and numeric). Coded DICOM Imaging Report Elements in this context are mapped to CDA text observations that are section components and are related to the SopInstance or QuantityMeasurement act classes by the SPRT (Support) act relationship (Figure A.5.1.3-2).

Figure A.5.1.3-2. Text Observation Within Section

Table A.5.1.3-2 shows the mapping of attribute values for DICOM Imaging Report Elements to CDA text observation. The component act relationship between Section and TextObservation is encoded as a section entry in CDA; TextObservation as an observation CDA entry and the support act relationship as entryRelationship.

Image References and Measurements within Section

Image references and measurements (linear, area, volume and numeric) may also be inserted directly within sections (TID 2000, Rows 6 and 12). In this case CDA sections are related to SopInstance and/or QuantityMeasurement act classes via component (COMP) act relationships.

Quantity Measurement + DICOM Composite Object References

For the modeling of DICOM Composite Object References refer to Section A.7.2 Updated Pattern Based on A_DicomCompositeObjectReference Minimal (COCT_RM830120UV). In the context of the CDA, entry act class and actRelationships names shall be used as specified for the CDA mapping.

The mapping of observations (i.e., quantity measurements based on image data) is specified below (structured contents of linear, area, volume and numeric measurements). The updated pattern based on CMET COCT_RM830120 "ReferencedDicomComposite Object" (refer to Section A.7.2) is reused for the mapping. Instead of starting directly with the SopInstance Act Class, the COCT_RM830120 pattern is applied in the context of Quantity Measurements (refer to Figure A.5.1.3-3 for details).

Quantity Measurement Act Class (Observation)

Table A.5.1.3-4, Table A.5.1.3-5 and Table A.5.1.3-6 list the code value and code meaning of SNOMED codes contained in DICOM CID 7470, CID 7471 and CID 7472 and corresponding attribute values of SNOMED observable entity codes for DICOM SR TID 2000 based diagnostic imaging reports. For the latter codes SNOMED Concept IDs are used as code values.

Subject Act Relationship (QuantityMeasurement to SopInstance)

Equivalent DICOM relationship types of the CDA SUBJ actRelationship in this context are: INFERRED FROM and R-INFERRED. CDA Release 2 does not specify reference relationships. However act class clones that carry a unique identifier only and omit other attribute values of the original act class may be used to that purpose.

The relation of quantity measurements to procedures and acts is specified in Section A.5.1.4.2 Procedure Context.

Figure A.5.1.3-3. Quantity Measurement and DICOM Composite Object Reference

The act relationships shown in Figure A.5.1.3-3 are encoded as entryRelationships in CDA; the act classes are represented as observations.

DICOM SR numeric measurements (value type NUM) are mapped to the QuantityMeasurement act class.

The QuantityMeasurement act class is associated with one or more SopInstance act classes. SopInstance is associated with zero or one PurposeOfReference act class through the reason entry relationship.

Multi-frame Image References

The DICOM Image Reference Macro (used for SR content items of value type IMAGE) allows for referencing individual frames of a multi-frame image if the reference does not apply to all frames. The individual referenced frames (DICOM attribute "Referenced Frame Number" (0008,1160)) are mapped to the value attribute (list of integers) of the boundary act class. For mapping quantity measurements (applies to SR template 1400, 1401, 1402 and 1404) that are related to frames of a multi-frame image, one ReferencedFrames act class is associated with SopInstance through an entryRelationship of type code component (Figure A.5.1.3-3). The DICOM code 121190 "ReferencedFrames" is assigned to the ReferencedFrames.code attribute. The ReferencedFrames act class is related to one Boundary act class through an entryRelationship of type code component. In the context of mapping DICOM TID 2000 the Boundary.value attribute contains the referenced frame number of the frame that is the basis for measurements or coded purpose of reference terms.

The observation context comprises the observer context data (the human observer or device that made the observation), the procedure context data (related to data acquisition and interpretation) and the subject context data (for patient, specimen and fetus being subject to the reported procedure). Section A.5.1.4.1, Section A.5.1.4.2 and Section A.5.1.4.3 specify the mapping.

A.5.1.4.1 Subject Context

Subject Context, Patient

Figure A.5.1.3-4. Patient Context

DICOM TID 2000 constrains the multiplicity of the patient subject to one per document. Attributes of the Patient Module (PS3.3) and the Patient Subject Context (TID 1007) are mapped to the recordTarget participation, associated roles and entities, if the Subject Class Code (TID 1006) equals "Patient".

Table A.5.1.3-7. Patient Role

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	PAT
id	SET<II>	1..*	"Subject ID": Defaults to value of Patient ID(0010,0020) in Patient Module. Other Patient IDs (0010,1000): may be mapped if appropriate infrastructure (master person index) and policies for domain identifier assignment are in place. The SET <II> data type does not provide use codes to distinguish multiple patient identifiers.
addr	SET<AD>	0..*	Patient's Address (0010,1040) in Patient Demographic Module.
telecom	SET<TEL>	0..*	Patient's Telephone Numbers (0010,2154)) in Patient Demographic Module.

Note

If information on Issuer of Patient ID is available from the DICOM SR document (Patient Module), Universal Entity ID (0040,0032) of the Issuer of Patient ID Qualifiers Sequence (0010,0024) are mapped to PatientRole.id II root and Patient ID (0010,0020) to PatientRole.id II extension. Otherwise a globally unique identifier (ISO Object Identifier) may be generated for the PatientRole.id II root portion. If available Issuer of Patient ID (0010,0021) shall be mapped to PatientRole.id assigningAuthorityName.

Table A.5.1.3-8. Patient Entity

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	PSN
determinerCode	CS	1..1	INSTANCE
name	SET<PN>	0..*	"Subject Name": Defaults to value of Patient's Name (0010,0010) in Patient Module. Other Patient Names (0010,1001) may be mapped, appropriate infrastructure (master person index) and policies for domain identifier assignment are in place. No specific use codes are provided by DICOM.
administrativeGenderCode	CE	0..1	"Subject Sex": Defaults to value equivalent to Patient's Sex (0010,0040) in Patient Module. The DICOM coded string (CS) values maps to HL7 V3 administrativeGenderCode values (codeSystem="2.16.840.1.113883.5.1") as follows: DICOM HL7 V3 CS Meaning Concept Code Print Name F Female F Female M Male M Male O Undetermined sex Use "UNK" (unknown) null flavor value "Subject Sex" value not available Use appropriate null flavor value
birthTime	TS	0..1	"Subject Birth Date": Defaults to value of Patient's Birth Date (0010,0030) in Patient Module.
maritalStatusCode	CE	0..1	Shall not be sent.
religiousAffiliationCode	CE	0..1	Shall not be sent.
raceCode	CE	0..1	Shall not be sent.
ethnicGroupCode	CE	0..1	Ethnic Group (0010,2160) of Patient Module if present. (DICOM short string: SH shall be converted to the appropriate ethnicGroupCode attribute code)

Subject Context, Fetus

Document Level

The header attributes shall contain values for mother as specified in Table A.5.1.3-7 and Table A.5.1.3-8. Refer to Figure A.5.1.3-4 for an overview on the recordTarget participation. The mother of the fetus is considered the patient and is therefore the recordTarget. Patient.name (Patient Entity, Table A.5.1.3-8) or "Subject Name": Defaults to value of Patient's Name (0010,0010) in Patient Module, which shall be identical to TID 1008 PNAME ("Mother of fetus").

Section Level

The fetus subject is specified at section level.

Figure A.5.1.3-5. Subject Context, Fetus

Table A.5.1.3-9. Related Subject, Fetus

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	PRS (Personal Relationship)
code	CE	1..1	"Fetus" code (CID 271) extends value domain PersonalRelationshipRoleType <121026> as code property, 1.2.840.10008.2.16.4 as codeSystem property, DCM as codeSystemName property, "Fetus" as displayName property>
templateId	LIST<II>	1..*	Set root portion of II to "2.16.840.1.113883.10.20.6.2.3" (identifies the template that defines constraints on "Fetus Subject Context" of CDA Diagnostic Imaging Reports as specified by CDA R2 DIR IG).
administrativeGenderCode	CE	0..1	Shall not be sent.
birthTime	TS	0..0	Shall not be sent.

Table A.5.1.3-10. Subject Person, Fetus

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	PSN
determinerCode	CS	1..1	INSTANCE
name	SET<PN>	1..1	Subject ID or Fetus ID (TID 1008)
telecom	SET<TEL>	0..*	Shall not be sent.

CDA Release 2 does not specify a subject ID for mapping of Fetus Subject UID. Also the DICOM SR NUM content item that conveys the number of fetuses cannot be mapped because CDA Release 2 does not specify such an attribute. The fetus subject is always mapped in combination with the mother record target artifacts.

A.5.1.4.2 Procedure Context

CDA Header

Service Event Attribute Values default to DICOM SR "General Study" Module Header Attribute Values.

Figure A.5.1.3-6. CDA Header Procedure Context (Service Event)

Table A.5.1.3-11. Service Event

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	ACT
moodCode	CS	1..1	EVN
id	SET<II>	0..*	Study Instance UID (0020,000D) of the General Study Module
code	CE	0..1	Procedure Code Sequence (0008,1032) of the General Study Module or Procedure Code (TID 1005)
effectiveTime	IVL<TS>	0..1	Set low value of interval using: Study Date (0008,0020) and Study Time (0008,0030) of the General Study Module

For the mapping of Physician(s) reading study to the performer participation refer to Service Event Performer Participation (Table A.5.1.1-21, Table A.5.1.1-22 and Table A.5.1.1-23).

CDA Entries (Clinical Statement, Structured Body)

If individual sections are used to report on one or multiple procedures, the procedure code values of the Procedure Context (TID 1005) associated with the DICOM section container content item are mapped to the CDA clinical statement entry class attribute Act.code or Procedure.code. The selection of the "Procedure" or "Act" entry from the clinical statement choice box depends on the nature of the imaging service that has been performed. The "Procedure" entry shall be used for image-guided interventions and minimal invasive imaging services, whereas the "Act" entry shall be used for diagnostic imaging services (based on Procedure Code Sequence (0008,1032) or Procedure Code (TID 1005) values). The set of attributes is identical for the "Procedure" and "Act" Context.

Figure A.5.1.3-7. Procedure Context for Image-Guided Interventions

Figure A.5.1.3-7 and Figure A.5.1.3-8 show the procedure context for image-guided interventions and diagnostic imaging services and its relationship to CDA document sections plus quantity measurements. The component act relationship between Section and Procedure/Act is encoded as a section entry in CDA; QuantityMeasurement as an observation CDA entry and the component act relationship between Procedure/Act and QuantityMeasurement as entryRelationship.

Figure A.5.1.3-8. Procedure Context for Diagnostic Imaging Services

Table A.5.1.3-12. Common Set of Attributes for Procedure and Act Context

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	ACT
moodCode	CS	1..1	EVN
templateId	LIST<II>	1..*	Set root portion of II to "2.16.840.1.113883.10.20.6.2.5" (identifies the template that defines constraints on "Procedure Context" of CDA Diagnostic Imaging Reports as specified by CDA R2 DIR IG).
id	SET<II>	0..*	Shall not be sent, refer to Study Instance UID (0020,000D) of General Study Module mapped to ServiceEvent.id that is applied via context conduction
code	CE	1..1	Procedure Code (Section procedure context associated with DICOM section container content item:TID 1005)
text	ED	0..1	Study Description (0008,1030) of the General Study Module
effectiveTime	IVL<TS>	0..1	Set low value of interval using: Study Date (0008,0020) and Study Time (0008,0030) of the General Study Module

A.5.1.4.3 Observer Context

The Observer Context (TID 1002) maps to the author participation and associated roles and entities at document or section level. DICOM specifies a Person Observer (TID 1003) and a Device Observer (TID 1004). Depending on the DICOM SR Observer Type, attribute values are mapped to the Person or AuthoringDevice Entity in the AuthorChoice Box.

The Person and Device Observer Context used at document level (Figure A.5.1.3-9) may be overridden at section level (Figure A.5.1.3-10).

Figure A.5.1.3-9. Document Observer Context

Figure A.5.1.3-10. Section Observer Context

Table A.5.1.3-13. Author Participation (for both Person and Device Observer)

Attribute	Data Type	Multiplicity	Value
typeCode	CS	1..1	AUT
functionCode	CE	0..1	Shall not be sent
contextControlCode	CS	1..1	"OP"
time	TS	1..1	Content Date (0008,0023), Content Time (0008,0033) of the SR Document General Module and Timezone Offset from UTC (0008,0201) from SOP Common Module

A.5.1.4.3.1 Person Observer

Attribute values of TID 1003 Person Observer Identifying Attributes and the SR Document General Module are mapped to the CDA author participation, associated role and entities as specified in Table A.5.1.3-13, Table A.5.1.3-14, Table A.5.1.3-15 and Table A.5.1.3-16. The DICOM attribute values of Person Observer's Role in this procedure and Person Observer's Role in the Organization cannot be mapped to CDA Release 2 since it does not specify equivalent attributes.

Table A.5.1.3-14. Assigned Author, Person Observer Context

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	ASSIGNED
templateId	LIST<II>	1..*	At section level set root portion of II to "2.16.840.1.113883.10.20.6.2.4" (identifies the template that defines constraints on "Observer Context" of CDA Diagnostic Imaging Reports as specified by CDA R2 DIR IG).
id	SET<II>	1..*	Person Identification Code Sequence (0040,1101) of Author Observer Sequence (0040,A078) in SR Document General Module.
addr	SET<AD>	0..*	Shall not be sent.
telecom	SET<TEL>	0..*	Shall not be sent.

Table A.5.1.3-15. Organization, Person Observer Context

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	ORG
determinerCode	CS	1..1	INSTANCE
id	SET<II>	0..*	Institution Code Sequence (0008,0082) of Author Observer Sequence (0040,A078) in SR Document General Module
name	SET<ON>	0..*	Defaults to Institution Name (0008,0080) of the General Equipment Module; otherwise Person Observer's Organization Name as specified in TID 1003 is used.
telecom	SET<TEL>	0..*	Shall not be sent.
addr	SET<AD>	0..*	Shall not be sent.
standardIndustryClassCode	CE	0..1	Shall not be sent.

Table A.5.1.3-16. Person, Person Observer Context

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	PSN
determinerCode	CS	1..1	INSTANCE
name	SET<PN>	0..*	Defaults to Person Name (0040,A123) of Author Observer Sequence (0040,A078) in SR Document General Module; otherwise Person Observer Name as specified in TID 1003 is used.

A.5.1.4.3.2 Device Observer

Attribute values of TID 1004 Device Observer Identifying Attributes and the SR Document General Module are mapped to the CDA author participation, associated role and entities as specified in Table A.5.1.3-13 and Table A.5.1.3-17, Table A.5.1.3-18 and Table A.5.1.3-19. DICOM does not specify attributes that could be mapped to MaintainedEntity role and associated Person entity.

Table A.5.1.3-17. Assigned Author, Device Observer Context

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	ASSIGNED
templateId	LIST<II>	1..*	At section level set root portion of II to "2.16.840.1.113883.10.20.6.2.4" (identifies the template that defines constraints on "Observer Context" of CDA Diagnostic Imaging Reports as specified by CDA R2 DIR IG).
id	SET<II>	1..*	Device Observer UID as specified in TID 1004
addr	SET<AD>	0..*	Device Observer Physical Location During Observation as specified by TID 1004 is used.
telecom	SET<TEL>	0..*	Shall not be sent.

The DICOM attribute Device Observer Serial Number specified in TID 1004 cannot be mapped to CDA Release 2 because there is no equivalent attribute specified.

Table A.5.1.3-18. Authoring Device, Device Observer Context

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	DEV
determinerCode	CS	1..1	INSTANCE
code	CE	0..1	Defaults to Station Name (0008,1010) of Author Observer Sequence (0040,A078) in SR Document General Module.
manufacturerModelName	SC	0..1	Defaults to Manufacturer's Model Name (0008,1090) of Author Observer Sequence (0040,A078) in SR Document General Module; otherwise to Device Observer Model Name as specified by TID 1004 is used.
softwareName	SC	0..1	Shall not be sent.

Table A.5.1.3-19. Organization, Device Observer Context

Attribute	Data Type	Multiplicity	Value
classCode	CS	1..1	ORG
determinerCode	CS	1..1	INSTANCE
id	SET<II>	0..*	Shall not be sent.
name	SET<ON>	0..*	Manufacturer (0008,0070) of Author Observer Sequence (0040,A078) in SR Document General Module
telecom	SET<TEL>	0..*	Shall not be sent.
addr	SET<AD>	0..*	Shall not be sent.
standardIndustryClassCode	CE	0..1	Shall not be sent.