DICOM PS3.3 2020e - Information Object Definitions

C.29 Implant Modules (Current)
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## C.29 Implant Modules

### C.29.1 Generic Implant Template Modules

This section describes the specific Modules for the Generic Implant Template IOD.

#### C.29.1.1 Generic Implant Template Description Module

Table C.29.1.1-1 defines the general Attributes of the Generic Implant Template Description Module.

Table C.29.1.1-1. Generic Implant Template Description Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Manufacturer | (0008,0070) | 1 | Name of the manufacturer that produces the implant.
Frame of Reference UID | (0020,0052) | 1 | Defines a 3D Frame of Reference for this component.
Implant Name | (0022,1095) | 1 | The (product) name of the implant.
Implant Size | (0068,6210) | 1C | The size descriptor of the component. Required if the component exists in different sizes and the size number is not part of the name or identifier. May be present otherwise. See Section C.29.1.1.1.1 for details.
Implant Part Number | (0022,1097) | 1 | The (product) identifier of the implant.
Implant Template Version | (0068,6221) | 1 | The version code of the implant template. If Implant Type (0068,6223) is DERIVED, this shall have the same value as the Implant Template Version (0068,6221) of the manufacturer's implant template from which this Instance was derived.
Replaced Implant Template Sequence | (0068,6222) | 1C | Reference to the Implant Template that is replaced by this template. Only a single Item shall be included in this Sequence. Required if this Instance replaces another Instance.
>Include Table 10-11 “SOP Instance Reference Macro Attributes” |
Implant Type | (0068,6223) | 1 | Indicates whether the Implant Template is derived from another Implant Template. Enumerated Values: ORIGINAL DERIVED
Original Implant Template Sequence | (0068,6225) | 1C | Reference to the Implant Template Instance with Implant Type (0068,6223) ORIGINAL from which this Instance was ultimately derived. Only a single Item shall be included in this Sequence. Required if Implant Type (0068,6223) is DERIVED.
>Include Table 10-11 “SOP Instance Reference Macro Attributes” |
Derivation Implant Template Sequence | (0068,6224) | 1C | Reference to Implant Template Instance from which this Instance was directly derived. Only a single Item shall be included in this Sequence. Required if Implant Type (0068,6223) is DERIVED.
>Include Table 10-11 “SOP Instance Reference Macro Attributes” |
Effective DateTime | (0068,6226) | 1 | Date and time from which this Instance is or will be valid.
Implant Target Anatomy Sequence | (0068,6230) | 3 | Sequence that identifies the anatomical region the implant is to be implanted to. One or more Items are permitted in this Sequence.
>Anatomic Region Sequence | (0008,2218) | 1 | Sequence that identifies the anatomic region of interest in this Instance (i.e., external anatomy, surface anatomy, or general region of the body). Only a single Item shall be included in this Sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | DCID 7304 “Implant Target Anatomy”.
Notification From Manufacturer Sequence | (0068,6265) | 1C | Information from the manufacturer concerning a critical notification, recall, or discontinuation of the implant or implant template. One or more Items shall be included in this Sequence. Required if such information has been issued.
>Information Issue DateTime | (0068,6270) | 1 | Date and Time the information was issued.
>Information Summary | (0068,6280) | 1 | Summary of the information.
>Encapsulated Document | (0042,0011) | 3 | The complete manufacturer notification describing the template. Encapsulated Document stream, containing a document encoded according to the MIME Type.
>MIME Type of Encapsulated Document | (0042,0012) | 1C | The type of the encapsulated document stream described using the MIME Media Type (see RFC 2046). Required if Encapsulated Document (0042,0011) is present in this Sequence Item. Enumerated Values: application/pdf
Information From Manufacturer Sequence | (0068,6260) | 3 | Information from Manufacturer other than described in Notification From Manufacturer Sequence (0068,6265). One or more Items shall be included in this Sequence.
>Information Issue DateTime | (0068,6270) | 1 | Date and Time the information was issued.
>Information Summary | (0068,6280) | 1 | Summary of the information.
>Encapsulated Document | (0042,0011) | 3 | Encapsulated Document stream, containing a document encoded according to the MIME Type. The complete manufacturer information.
>MIME Type of Encapsulated Document | (0042,0012) | 1C | The type of the encapsulated document stream described using the MIME Media Type (see RFC 2046). Required if Encapsulated Document (0042,0011) is present in this Sequence Item. Enumerated Values: application/pdf
Implant Regulatory Disapproval Code Sequence | (0068,62A0) | 1C | Sequence containing countries and regions in which the implant is not approved for usage. One or more Items shall be included in this Sequence. Required if the implant has been disapproved in a country or a region.
>Include Table 8.8-1 “Code Sequence Macro Attributes” | DCID 5001 “Countries”.
Overall Template Spatial Tolerance | (0068,62A5) | 2 | Tolerance in mm applying to all distance measurements and spatial locations in this Implant Template.
Materials Code Sequence | (0068,63A0) | 1 | A Code Sequence specifying the materials the implant was built from. One or more Items shall be included in this Sequence.
>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7300 “Implant Materials”.
Coating Materials Code Sequence | (0068,63A4) | 1C | A Code Sequence specifying the materials the implant is coated with. One or more Items shall be included in this Sequence. Required if the implant is coated.
>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7300 “Implant Materials”.
Implant Type Code Sequence | (0068,63A8) | 1 | Sequence containing a coded description of the type of implant the template reflects. Only a single Item shall be included in this Sequence.
>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7307 “Implant Component Types”.
Fixation Method Code Sequence | (0068,63AC) | 1 | The method that will be used to fixate the implant in the body. Only a single Item shall be included in this Sequence.
>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7310 “Implant Fixation Method”.

##### C.29.1.1.1 Generic Implant Template Description Attribute Descriptions

###### C.29.1.1.1.1 Implant Size

Implant Size (0068,6210) is the descriptor defined by the manufacturer to distinguish between different sizes of one kind of implant, e.g., size S/M/L/XL.

###### C.29.1.1.1.2 Frame of Reference

The Frame of Reference UID (0020,0052) Attribute is used as an identifier for spatial registration in 3D. The Frame Of Reference UID uniquely identifies the spatial Frame of Reference of all 3D models contained in an Implant Template UID Instance.

If the Frame Of Reference UIDs in two Instances are identical, the contained 3D Models are defined in the same 3D space, i.e., require no additional registration.

#### C.29.1.2 Generic Implant Template 2D Drawings Module

Table C.29.1.2-1 defines the general Attributes of the Generic Implant Template 2D Drawings Module. This Module contains all Attributes required for the inclusion of technical 2D drawings in an IOD, e.g., the Implant Template IOD. The Module specification contains the definition of a subset of the HPGL plotter language that is used for the graphical definition of the drawings.

Table C.29.1.2-1. Generic Implant Template 2D Drawings Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
HPGL Document Sequence | (0068,62C0) | 1 | The 2D template representations of this implant. One or more Items shall be included in this Sequence.
>HPGL Document ID | (0068,62D0) | 1 | Identification number of the HPGL Document. Uniquely identifies an HPGL Document within this SOP Instance. The value shall start at 1, and increase monotonically by 1.
>HPGL Document Label | (0068,62D5) | 3 | Label describing the document.
>View Orientation Code Sequence | (0068,62E0) | 1 | Coded description of the direction of view represented by this 2D template. Only a single Item shall be included in this Sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7302 “Implant Templates View Orientations”.
>View Orientation Modifier Code Sequence | (0068,62F0) | 3 | View Orientation Modifier.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7303 “Implant Templates Modified View Orientations”.
>HPGL Document Scaling | (0068,62F2) | 1 | Conversion factor (real world mm/printed mm) See Section C.29.1.2.1.1.
>HPGL Document | (0068,6300) | 1 | The HPGL document as a byte stream. See Section C.29.1.2.1.2.
>HPGL Contour Pen Number | (0068,6310) | 1 | Numeric ID of the pen used in the encapsulated HPGL document for outlines.
>HPGL Pen Sequence | (0068,6320) | 1 | Labels for each pen used in the encapsulated HPGL Document. One or more Items shall be included in this Sequence. Shall contain one Item per pen used in the HPGL document.
>>HPGL Pen Number | (0068,6330) | 1 | Numeric ID of the pen in the HPGL document
>>HPGL Pen Label | (0068,6340) | 1 | Label of the pen.
>>HPGL Pen Description | (0068,6345) | 3 | Description of the kind of information drawn with the pen.
>Recommended Rotation Point | (0068,6346) | 1 | Point around which the 2D template is rotated in manual planning, in HPGL coordinates.
>Bounding Rectangle | (0068,6347) | 1 | HPGL coordinates of the smallest rectangle parallel to the paper axes that contains the whole drawing.

##### C.29.1.2.1 Generic Implant Template 2D Drawings Attribute Descriptions

###### C.29.1.2.1.1 HPGL Document Scaling and Coordinate System

HPGL Documents use integer coordinates based on a 25µm grid in the printing space - i.e., the paper to print on - rather than the object space. HPGL Document Scaling (0068,62F2) is used to scale the printed dimensions measured in millimeters to match the real dimensions of the implant measured in millimeters.

### Note

1. For example, if HPGL Document Scaling is 2.5, then a line in HPGL that goes from (0,0) to (0,500) that is 12.5 mm long when printed represents 31.25 mm in the real world.

2. In HPGL, the origin of the printing space is placed in the lower left corner with the x-axis pointing to the right. No negative coordinates are allowed.

This Attribute does not compensate for any radiographic geometric magnification effect caused by the diverging X-Ray beam in the projection patient images used for planning. Such compensation is the responsibility of the application based on calibration of the imaging process.

###### C.29.1.2.1.2 HPGL Document

The HPGL files encapsulated in the Attribute HPGL Document (0068,6300) is restricted to a subset of HPGL commands called DICOM-HPGL specified in this section.

###### C.29.1.2.1.2.1 Scope

The aim of DICOM-HPGL is to facilitate the storage of 2D template graphics in DICOM implant objects. DICOM-HPGL is a subset of HPGL-2 that is kept as minimal as possible to comply with the needs of 2D implant templates.

###### C.29.1.2.1.2.2 Syntax

DICOM-HPGL documents consist of valid HPGL commands terminated by a semicolon. Commands consist of a two-letter mnemonic and zero or more numeric parameters separated by commas. To separate between commands, line breaks (x0D, x0A or x0Dx0A) or whitespaces (x20) may be used but are not mandatory.

Only the following commands shall be used in a DICOM-HPGL document

Table C.29.1.2-2. Permitted HPGL Commands

Command | Parameter | Meaning
--- | --- | ---
IN | - | Initialize.
PA | [X,Y] | Plot Absolute. The optional parameter assigns an initial position for the pen.
PC | Pen Number, Red, Green, Blue | Set Color of Pen with the given Pen Number. Colors are in RGB, intensities are encoded 0…255. The colors for pen number 0 shall be white and the color for pen number 1 shall be black. It is recommended to use only the pen numbers up to 255 to ensure compatibility with older HPGL viewers.
SP | Pen Number | Select Pen It is recommended to use only the pen numbers up to 255 to ensure compatibility with older HPGL viewers. Only pen numbers shall be used to which a color has been specified in a precedent PC command.
PU | [X,Y,…[,X,Y]] | Pen Up. The optional sequence of paired parameters describe subsequent pen motions after lifting the pen.
PD | [X,Y,…[,X,Y]] | Pen Down. The optional sequence of paired parameters describe subsequent pen motions after lowering the pen.

According to the parameter definition in HPGL, [] indicate optional parameters. The expression [X,Y,…[,X,Y]] indicates a sequence of arbitrary length of paired parameters X and Y. The commands and their parameters shall be interpreted as specified in the HP PCL/PJL Reference.

### Note

This document can be obtained from URL: http://h20000.www2.hp.com/bc/docs/support/SupportManual/bpl13211/bpl13211.pdf

The coordinates in a DICOM-HPGL document are absolute values with respect to the lower left corner of the drawing space. The units of length within HPGL are 25 µm with respect to pen movements in the drawing space.

The DICOM-HPGL Document shall be structured as shown in Figure C.29.1.2-1.

Figure C.29.1.2-2 shows an example for a DICOM-HPGL Document in plain text (as byte stream), and plotted.

Figure C.29.1.2-1. DICOM-HPGL Document

Figure C.29.1.2-2. DICOM-HPGL Document - Example

#### C.29.1.3 Generic Implant Template 3D Models Module

Table C.29.1.3-1 defines the general Attributes of the Generic Implant Template 3D Models Module. This Module contains Attributes that add context and scaling information to surfaces specified in the Surface Mesh Module, for 3D Models in an Implant Template Instance.

Table C.29.1.3-1. Generic Implant Template 3D Models Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Implant Template 3D Model Surface Number | (0068,6350) | 1 | Surface Number (0066,0003) of the surface that represents the shape of the entire implant.
Surface Model Description Sequence | (0068,6360) | 1 | The description of the Surface Model. One or more Items shall be included in this Sequence. Shall contain one Item per Item in Surface Sequence (0066,0002).
>Referenced Surface Number | (0066,002C) | 1 | Reference to a Surface Number (0066,0003) present in Surface Sequence (0066,0002).
>Surface Model Label | (0068,6380) | 1 | Label for this surface.
Surface Model Scaling Factor | (0068,6390) | 1 | Scaling factor (mm/Surface unit) See Section C.29.1.3.1.1.

##### C.29.1.3.1 Generic Implant Template 3D Models Attribute Descriptions

###### C.29.1.3.1.1 Surface Model Scaling Factor

Surface Model Scaling Factor (0068,6390) is used to scale dimensions of the surface mesh representation to match the real dimensions of the implant measured in millimeters.

This Attribute does not compensate for any radiographic geometric magnification effect caused by the diverging X-Ray beam in the projection patient images used for planning. Such compensation is the responsibility of the application based on calibration of the imaging process.

#### C.29.1.4 Generic Implant Template Mating Features Module

Table C.29.1.4-1 defines the general Attributes of the Generic Implant Template Mating Features Module. This Module adds coordinate systems that can be utilized to geometrically constrain mating of Implant Templates when planning the implantation of a modular implant.

### Note

An Implant Template may contain 2D drawings of the described implant, 3D surface models of the described implant, or both. In this Module mating features that constrain the geometric matching of implants in multi-component assemblies are specified. These geometric features (points and axes) can be specified in the 2D drawings as well as the 3D models. Mating features are grouped into mating feature sets (see PS3.17). Based on the existence of 2D drawings and/or 3D models in the Instance, either or both is possible. In this Module, there are a number of conditions on Attribute use to support the following cases:

- Specification of 2D mating features is only possible if at least one 2D drawing is present in the Instance.

- Specification of 3D mating features is only possible if at least one 3D model is present in the Instance.

Table C.29.1.4-1. Generic Implant Template Mating Features Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Mating Feature Sets Sequence | (0068,63B0) | 3 | Mating feature sets used to combine the implant with other implants. One or more Items shall be included in this Sequence.
>Mating Feature Set ID | (0068,63C0) | 1 | Identification number of the set. Uniquely identifies a mating feature set within this SOP Instance. The value shall start at 1, and increase monotonically by 1 for each Item.
>Mating Feature Set Label | (0068,63D0) | 1 | Label of the set.
>Mating Feature Sequence | (0068,63E0) | 1 | The mating features of the set. One or more Items shall be included in this Sequence.
>>Mating Feature ID | (0068,63F0) | 1 | Numeric ID of the mating feature. Uniquely identifies a mating feature within this Sequence Item.
>>3D Mating Point | (0068,64C0) | 1C | Origin of the contact system. Required if 2D Mating Feature Coordinates Sequence (0068,6430) is not present and Implant Template 3D Model Surface Number (0068,6350) is present. May be present if 2D Mating Feature Coordinates Sequence (0068,6430) is present and Implant Template 3D Model Surface Number (0068,6350) is present. See Section C.29.1.4.1.1
>>3D Mating Axes | (0068,64D0) | 1C | The Axes of contact described as direction cosines in the 3D coordinate system defined by the Frame Of Reference UID. Required if 3D Mating Point (0068,64C0) is present. See Section C.29.1.4.1.1
>>2D Mating Feature Coordinates Sequence | (0068,6430) | 1C | Coordinates of the mating feature in the HPGL documents. One or more Items shall be included in this Sequence. Required if 3D Mating Point (0068,64C0) is not present and HPGL Document Sequence (0068,62C0) is present. May be present if 3D Mating Point (0068,64C0) is present and HPGL Document Sequence (0068,62C0) is present.
>>>Referenced HPGL Document ID | (0068,6440) | 1 | Value of the HPGL Document ID (0068,62D0) present in the HPGL Document Sequence (0068,62C0) that contains the 2D Drawing including the Mating Feature. Shall be unique within the Sequence.
>>>2D Mating Point | (0068,6450) | 1 | Origin of the contact system, in HPGL coordinates. See Section C.29.1.4.1.1
>>>2D Mating Axes | (0068,6460) | 1 | Direction cosines of the contact system. See Section C.29.1.4.1.1
>>Mating Feature Degree of Freedom Sequence | (0068,6400) | 3 | Degrees of freedom in this mating feature. One or more Items are permitted in this Sequence. See Section C.29.1.4.1.2.
>>>Degree of Freedom ID | (0068,6410) | 1 | Numeric ID of the degree of freedom. Uniquely identifies a degree of freedom within this Sequence Item. The value shall start at 1, and increase monotonically by 1 for each Item.
>>>Degree of Freedom Type | (0068,6420) | 1 | Indicates the type of the degree of freedom. Enumerated Values: TRANSLATION ROTATION See Section C.29.1.4.1.2.
>>>2D Degree of Freedom Sequence | (0068,6470) | 1C | Geometric specifications of the degrees of freedom for this HPGL Document. One or more Items shall be included in this Sequence. Required if 2D Mating Feature Coordinates Sequence (0068,6430) is present. See Section C.29.1.4.1.2.
>>>>Referenced HPGL Document ID | (0068,6440) | 1 | Value of the HPGL Document ID (0068,62D0) present in the HPGL Document Sequence (0068,62C0) that contains the 2D Drawing including the Mating Feature. See Section C.29.1.4.1.2. Shall be unique within the Sequence.
>>>>2D Degree Of Freedom Axis | (0068,64F0) | 1 | Direction cosines of the axis of the degree of freedom. See Section C.29.1.4.1.2.
>>>>Range of Freedom | (0068,64A0) | 1 | Interval of freedom for this degree of freedom. See Section C.29.1.4.1.2.
>>>3D Degree Of Freedom Axis | (0068,6490) | 1C | Direction cosines of the axis of the degree of freedom in the Frame of Reference of the template. See Section C.29.1.4.1.2. Required if 3D Mating Point (0068,64C0) is present.
>>>Range of Freedom | (0068,64A0) | 1C | Two floating point numbers defining a value range for this degree of freedom. See Section C.29.1.4.1.2. Required if 3D Mating Point (0068,64C0) is present.

##### C.29.1.4.1 Generic Implant Template 2D Drawings Attribute Descriptions

###### C.29.1.4.1.1 Mating Features

These Attributes establish a Cartesian coordinate system relative to the Frame of Reference of the implant. When two implants are assembled using a pair of mating features, a rigid spatial registration can be established, that transforms one Frame of Reference so that the mating features align.

###### C.29.1.4.1.2 Degrees of Freedom

Mating Feature Degree of Freedom Sequence (0068,6400) is used to specify that a mating feature allows mating with another implant not only in one defined pose, but within a certain range of freedom. One Sequence Item specifies one degree of freedom that may be a rotation around or a translation along an arbitrary axis. The Degree of Freedom Type (0068,6420) specifies whether the degree of freedom describes a rotation or a translation.

The 3D coordinates of the axis of translation or rotation is specified by 3D Degree Of Freedom Axis (0068,6490) with respect to the Implant Template's Frame of Reference as three-dimensional vector in x-y-z order. Range Of Freedom (0068,64A0) specifies an interval, in millimeters or degrees, by which this 3D coordinate system mating feature may be moved along or around the axis.

For each HPGL Document, the 2D Degree Of Freedom Axis (0068,64F0) may be specified as a 3D vector encoded in x-y-z order, where the z-coordinate is equal to the direction of projection, i.e., equal to the cross product of the x- and y-axis of the printing space. Range Of Freedom (0068,64A0) specifies an interval, in millimeters or degrees, by which the 3D coordinate system of this mating feature may be moved along or around the axis.

#### C.29.1.5 Generic Implant Template Planning Landmarks Module

Table C.29.1.5-1 defines the general Attributes of the Generic Implant Template Planning Landmarks Module. This Module adds planning landmarks, i.e., geometric annotations that constrain implant template registration to anatomical features, to the Implant Template IOD.

### Note

An Implant Template may contain 2D drawings from several viewpoints, 3D surface models, or both. The planning landmarks that are specified with this Module may occur in all of these, but may also only occur in some of these (due to their invisibility or irrelevance in some drawings or the 3D representation). Each 2D drawing specifies its own 2D drawing space, which requires a separate geometric description for each drawing. The 3D models share one Frame of Reference. Thus, each landmark needs only one 3D representation that then applies to all 3D models contained in one Instance. The Attribute Descriptions of the Attributes that geometrically define landmarks (in Table C.29.1.5-2 and Table C.29.1.5-3 and Table C.29.1.5-4) contain complicated Conditions that express the following constraints:

- If 2D drawings are present in an Implant Template Instance, there may be 2D specifications of landmarks present in this Implant Template Instance.

- 2D specifications of landmarks will refer to HPGL Document Numbers (0068,62D0) that are present in an Implant Template Instance.

- Landmarks are not required to be geometrically defined in all existing HPGL documents.

- If 3D models are present in a Implant Template Instance, there may be 3D specifications of landmarks present in this Implant Template Instance

- 2D and 3D specifications may be present for one landmark in an Instance if both, 2D drawings and 3D models are contained in the Instance.

Table C.29.1.5-1. Generic Implant Template Planning Landmarks Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Planning Landmark Point Sequence | (0068,6500) | 3 | Point landmarks for planning. One or more Items are permitted in this Sequence.
>Include Table C.29.1.5-2 “Planning Landmark Point Macro Attributes” |
>Planning Landmark ID | (0068,6530) | 1 | Numeric ID of the planning landmark. Uniquely identifies a planning landmark within the SOP Instance. The value shall start at 1, and increase monotonically by 1 for each Item.
>Planning Landmark Description | (0068,6540) | 3 | Purpose or intended use of the landmark.
>Planning Landmark Identification Code Sequence | (0068,6545) | 2 | Coded Description of the real-world point that is represented by the landmark. Zero or more Items shall be included in this Sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7305 “Implant Planning Landmarks”
Planning Landmark Line Sequence | (0068,6510) | 3 | Line landmarks for planning. One or more Items are permitted in this Sequence.
>Include Table C.29.1.5-3 “Planning Landmark Line Macro Attributes” |
>Planning Landmark ID | (0068,6530) | 1 | Numeric ID of the planning landmark. Uniquely identifies the planning landmark within the SOP Instance. The value shall start at 1, and increase monotonically by 1 for each Item.
>Planning Landmark Description | (0068,6540) | 3 | Purpose or intended use of this landmark.
>Planning Landmark Identification Code Sequence | (0068,6545) | 2 | Coded Description of the real-world line that is represented by this landmark. Zero or more Items shall be included in this Sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7305 “Implant Planning Landmarks”
Planning Landmark Plane Sequence | (0068,6520) | 3 | Plane landmarks for planning. One or more Items are permitted in this Sequence.
>Include Table C.29.1.5-4 “Planning Landmark Plane Macro Attributes” |
>Planning Landmark ID | (0068,6530) | 1 | Numeric ID of the planning landmark. Uniquely identifies the planning landmark within the SOP Instance. The value shall start at 1, and increase monotonically by 1 for each Item.
>Planning Landmark Description | (0068,6540) | 3 | Purpose or intended use of the landmark.
>Planning Landmark Identification Code Sequence | (0068,6545) | 2 | Coded Description of the real-world plane that is represented by this landmark. Zero or more Items shall be included in this Sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes” | BCID 7305 “Implant Planning Landmarks”

##### C.29.1.5.1 Planning Landmark Macros

Table C.29.1.5-2, Table C.29.1.5-3 and Table C.29.1.5-4 contain Macros for the definition of landmarks that can be used during planning to align an implant template with patient geometry.

All Attributes within these Macros that contain 3D points or vectors are in x, y, z order. If multiple elements are encoded, the ordering is x1y1z, …, xnynzn, The points are in the coordinate system identified by the Frame of Reference UID 0020,0052.

Table C.29.1.5-2. Planning Landmark Point Macro Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
2D Point Coordinates Sequence | (0068,6550) | 1C | 2D coordinates of the point in the HPGL documents. One or more Items shall be included in this Sequence. Required if 3D Point Coordinates (0068,6590) is not present and HPGL Document Sequence (0068,62C0) is present. May be present if 3D Point Coordinates (0068,6590) is present and HPGL Document Sequence (0068,62C0) is present.
>Referenced HPGL Document ID | (0068,6440) | 1 | Value of the HPGL Document ID (0068,62D0) present in the HPGL Document Sequence (0068,62C0) that contains the 2D Drawing including the planning landmark. Shall be unique within the Sequence.
>2D Point Coordinates | (0068,6560) | 1 | Coordinates of the point in the HPGL document. Coordinates are measured in millimeters of the printing space. See Section C.29.1.2.1.1.
3D Point Coordinates | (0068,6590) | 1C | 3D Coordinates of the point. Required if 2D Point Coordinates Sequence (0068,6550) is not present and Implant Template 3D Model Surface Number (0068,6350) is present. May be present if 2D Point Coordinates Sequence (0068,6550) is present and Implant Template 3D Model Surface Number (0068,6350) is present.

Table C.29.1.5-3. Planning Landmark Line Macro Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
2D Line Coordinates Sequence | (0068,65A0) | 1C | 2D coordinates of the line in the HPGL documents. One or more Items shall be included in this Sequence. Required if 3D Line Coordinates (0068,65D0) is not present and HPGL Document Sequence (0068,62C0) is present. May be present if 3D Line Coordinates (0068,65D0) is present and HPGL Document Sequence (0068,62C0) is present.
>Referenced HPGL Document ID | (0068,6440) | 1 | Value of the HPGL Document ID (0068,62D0) present in the HPGL Document Sequence (0068,62C0) that contains the 2D Drawing including the planning landmark. Shall be unique within the Sequence.
>2D Line Coordinates | (0068,65B0) | 1 | Coordinates of the line in the HPGL document. Coordinates are measured in millimeters of the printing space. See Section C.29.1.2.1.1.
3D Line Coordinates | (0068,65D0) | 1C | 3D Coordinates of the line. Required if 2D Line Coordinates Sequence (0068,65A0) is not present and Implant Template 3D Model Surface Number (0068,6350) is present. May be present, if 2D Line Coordinates Sequence (0068,65A0) is present and Implant Template 3D Model Surface Number (0068,6350) is present.

Table C.29.1.5-4. Planning Landmark Plane Macro Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
2D Plane Coordinates Sequence | (0068,65E0) | 1C | 2D coordinates of the plane's intersection with the HPGL documents. One or more Items shall be included in this Sequence. Required if 3D Plane Origin (0068,6610) is not present and HPGL Document Sequence (0068,62C0) is present. May be present if 3D Plane Origin (0068,6610) is present and HPGL Document Sequence (0068,62C0) is present.
>Referenced HPGL Document ID | (0068,6440) | 1 | Value of the HPGL Document ID (0068,62D0) present in the HPGL Document Sequence (0068,62C0) that contains the 2D Drawing including the planning landmark. Shall be unique within the Sequence.
>2D Plane Intersection | (0068,65F0) | 1 | 2D Coordinates of the intersection of the plane with the projection plane. Coordinates are measured in Millimeters of the printing space. See Section C.29.1.2.1.1.
3D Plane Origin | (0068,6610) | 1C | 3D Coordinates of the plane origin. Required if 2D Plane Coordinates Sequence (0068,65E0) is not present and Implant Template 3D Model Surface Number (0068,6350) is present. May be present if 2D Plane Coordinates Sequence (0068,65E0) is present and Implant Template 3D Model Surface Number (0068,6350) is present.
3D Plane Normal | (0068,6620) | 1C | 3D Coordinates of the plane normal. Required if 3D Plane Origin (0068,6610) is present.

###### C.29.1.5.1.1 Planning Landmark Macros Attribute Descriptions

###### C.29.1.5.1.1.1 2D Coordinates Sequences

The 2D Point Coordinates Sequence (0068,6550) and 2D Line Coordinates Sequence (0068,65A0) contain the positions of point, line or plane landmarks in 2D templates. Each Sequence Item consists of a reference to one of the 2D templates and the point coordinates of the landmark with respect to that template. The Coordinates are with respect to the origin of the HPGL Document and are specified in Millimeters of the printing space.

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DICOM PS3.3 2020e - Information Object Definitions