DICOM PS3.17 2021b - Explanatory Information

NN.6.2 Slide (Current)
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### NN.6.2 Slide

This is an example of how the Specimen Module can be populated for a slide (from a lung lobe resection received from surgery). The associated image would be a whole slide image.

Table NN.6-3. Specimen Module for a Slide

Attribute Name | Tag | Attribute Description | Example Value | Comments
--- | --- | --- | --- | ---
Container Identifier | (0040,0512) | The identifier for the container that contains the specimen(s) being imaged. | S07-100 A 5 1 |
Issuer of the Container Identifier Sequence | (0040,0513) | Organization that assigned the Container Identifier |  |
>Local Namespace Entity ID | (0040,0031) | Identifies an entity within the local namespace or domain. | Case Medical Center |
Container Type Code Sequence | (0040,0518) | Type of container that contains the specimen(s) being imaged. Only a single item shall be permitted in this sequence |  | This would likely be a default container value for all slide specimens.
>Code Value | (0008,0100) |  | 258661006 | This is a code sequence item
>Coding Scheme Designator | (0008,0102) |  | SCT
>Code Meaning | (0008,0104) |  | Slide
Container Component Sequence | (0040,0520) | Description of one or more components of the container (e.g., description of the slide and of the coverslip). One or more Items may be included in this Sequence. |  |
>Container Component Type Code Sequence | (0050,0012) | Type of container component. One Item shall be included in this Sequence. |  |
>>Code Value | (0008,0100) |  | 433472003 | This is a code sequence item
>>Coding Scheme Designator | (0008,0102) |  | SCT
>>Code Meaning | (0008,0104) |  | Microscope slide coverslip
>Container Component Material | (0050,001A) | Material of container component. | GLASS |
Specimen Description Sequence | (0040,0560) | Sequence of identifiers and detailed description of the specimen(s) being imaged. One or more Items shall be included in this Sequence. |  |
>Specimen Identifier | (0040,0551) | A departmental information system identifier for the Specimen. | S07-100 A 5 1 | Specimen and Container have same ID
>Issuer of the Specimen Identifier Sequence | (0040,0562) | The name or code for the institution that has assigned the Specimen Identifier. |  |
>>Local Namespace Entity ID | (0040,0031) | Identifies an entity within the local namespace or domain. | Case Medical Center |
>Specimen UID | (0040,0554) | Unique Identifier for Specimen | 1.2.840.99790.986.33.1677.1.1.19.5 |
>Specimen Short Description | (0040,0600) | Short textual specimen description | Part A: LEFT UPPER LOBE, Block 5: Mass (2 pc), Slide 1: H&E | This Attribute concatenates four LIS fields: 1. Specimen Received, 2. Cassette Summary, 3. Number of Pieces in Block, 4. Staining. This does not always work this nicely. Often one or more of fields is empty or confusing. ### Note This field is limited to 64 characters
>Specimen Detailed Description | (0040,0602) | Detailed textual specimen description | A: Received fresh for intraoperative consultation, labeled with the patient's name, number and "left upper lobe," is a pink-tan, wedge-shaped segment of soft tissue, 6.9 x 4.2 x 1.0 cm. The pleural surface is pink-tan and glistening with a stapled line measuring 12.0 cm. in length. The pleural surface shows a 0.5 cm. area of puckering. The pleural surface is inked black. The cut surface reveals a 1.2 x 1.1 cm, white-gray, irregular mass abutting the pleural surface and deep to the puckered area. The remainder of the cut surface is red-brown and congested. No other lesions are identified. Representative sections are submitted. Block 5: "Mass" (2 pieces) | This is a mapping from the LIS Gross Description Field and the Block Summary. Note that in Case S07-100, there were six parts. This means the LIS gross description field will have six sections (A - F). We would have to parse the gross description field into those parts (A-F) and then only incorporate section "A" into this Attribute. The same would be true of the Blocks. ### Note One could consider listing all the Blocks associated with Part A. It would be easy to do and might give useful information.
>Specimen Preparation Sequence | (0040,0610) | Sequence of Items identifying the process steps used to prepare the specimen for image acquisition. One or more Items may be present. This Sequence includes description of the specimen sampling step from a parent specimen, potentially back to the original part collection. | (see Table NN.6-4) |
>>Specimen Preparation Step Content Item Sequence | (0040,0612) | Sequence of Content Items identifying the processes used in one preparation step to prepare the specimen for image acquisition. One or more Items may be present.
>Primary Anatomic Structure Sequence | (0008,2228) | Original anatomic location in patient of specimen. This location may be inherited from the parent specimen, or further refined by modifiers depending on the sampling procedure for this specimen. |  |
>>Code Value | (0008,0100) |  | 44714003 | This is a code sequence item
>>Coding Scheme Designator | (0008,0102) |  | SCT
>>Code Meaning | (0008,0104) |  | Left Upper Lobe of Lung

The example Specimen Preparation Sequence first describes the most recent processing of the slide (staining), then goes back to show its provenance. Notice that there is no sampling process for the slide described here; the LIS did not record the step of slicing of blocks into slides.

Table NN.6-4. Specimen Preparation Sequence for Slide

Specimen Preparation Sequence - Item # | Specimen Prep. Step Content Item Sequence - Item # | Template / Row | Value Type (0040,A040) | Concept Name Code Sequence (0040,A043) | Example Value | Comments
--- | --- | --- | --- | --- | --- | ---
1 | 1 | 8001 / 1 | TEXT | (121041, DCM, "Specimen Identifier") | S07-100 A | Part Collection in OR.
2 | 8001 / 2 | TEXT | (111724, DCM, "Issuer of Specimen Identifier") | Case Medical Center
3 | 8001 / 3 | CODE | (111701, DCM, "Processing type") | (17636008, SCT, "Specimen collection")
4 | 8001 / 4 | DATETIME | (111702, DCM, "DateTime of processing") | 200703230827
5 | 8001 / 5 | TEXT | (111703, DCM, "Processing step description") | Taken
6 | 8001 / 8 8002 / 1 | CODE | (111704, DCM, "Sampling Method") | (65801008, SCT, "Excision")
2 | 1 | 8001 / 1 | TEXT | (121041, DCM, "Specimen Identifier") | S07-100 A | Specimen received in Pathology department
2 | 8001 / 2 | TEXT | (111724, DCM, "Issuer of Specimen Identifier") | Case Medical Center
3 | 8001 / 3 | CODE | (111701, DCM, "Processing type") | (428995007, SCT, "Specimen Receiving")
4 | 8001 / 4 | DATETIME | (111702, DCM, "DateTime of processing") | 200703230943
3 | 1 | 8001 / 1 | TEXT | (121041, DCM, "Specimen Identifier") | S07-100 A 5 | Sampling to block
2 | 8001 / 2 | TEXT | (111724, DCM, "Issuer of Specimen Identifier") | Case Medical Center
3 | 8001 / 3 | CODE | (111701, DCM, "Processing type") | (433465004, SCT, "Sampling of tissue specimen")
4 | 8001 / 5 | TEXT | (111703, DCM, "Processing step description") | Block Creation
5 | 8001 / 8 8002 / 1 | CODE | (111704, DCM, "Sampling Method") | (122459003, SCT, "Dissection")
6 | 8001 / 8 8002 / 2 | TEXT | (111705, DCM, "Parent Specimen Identifier") | S07-100 A
7 | 8001 / 8 8002 / 3 | TEXT | (111706, DCM, "Issuer of Parent Specimen Identifier") | Case Medical Center
8 | 8001 / 8 8002 / 4 | CODE | (111707, DCM, "Parent specimen type") | (38866009, SCT, "Anatomic part")
9 | 8001 / 8 8002 / 6 | TEXT | (111709, DCM, "Location of sampling site") | Mass | This is coming from the summary of blocks field in the LIS
4 | 1 | 8001 / 1 | TEXT | (121041, DCM, "Specimen Identifier") | S07-100 A 5 | Block Processing
2 | 8001 / 2 | TEXT | (111724, DCM, "Issuer of Specimen Identifier") | Case Medical Center
3 | 8001 / 3 | CODE | (111701, DCM, "Processing type") | (9265001, SCT, "Specimen Processing")
4 | 8001 / 4 | DATETIME | (111702, DCM, "DateTime of processing") | 200703231900
5 | 8001 / 5 | TEXT | (111703, DCM, "Processing step description") | Standard Block Processing (Formalin)
6 | 8001 / 10 | CODE | (430864009, SCT, "Tissue Fixative") | (111095003, SCT, "Formalin")
5 | 1 | 8001 / 1 | TEXT | (121041, DCM, "Specimen Identifier") | S07-100 A 5 | Block embedding
2 | 8001 / 2 | TEXT | (111724, DCM, "Issuer of Specimen Identifier") | Case Medical Center
3 | 8001 / 3 | CODE | (111701, DCM, "Processing type") | (9265001, SCT, "Specimen Processing")
4 | 8001 / 4 | DATETIME | (111702, DCM, "DateTime of processing") | 200703240500
5 | 8001 / 5 | TEXT | (111703, DCM, "Processing step description") | Embedding (paraffin)
6 | 8001 / 11 | CODE | (430863003, SCT, "Embedding medium") | (255667006, SCT, "Paraffin")
6 | 1 | 8001 / 1 | TEXT | (121041, DCM, "Specimen Identifier") | S07-100 A 5 1 | Slide Staining
2 | 8001 / 3 | CODE | (111701, DCM, "Processing type") | (127790008, SCT, "Staining")
3 | 8001 / 4 | DATETIME | (111702, DCM, "DateTime of processing") | 200703240700
4 | 8001 / 9 8003 / 2 | TEXT | (424361007, SCT, "Using substance") | H&E (1)

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DICOM PS3.17 2021b - Explanatory Information