DICOM PS3.3 2021b - Information Object Definitions

C.8.21.6 Breast View Module (Current)
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#### C.8.21.6 Breast View Module

Table C.8.21.6-1 contains IOD Attributes that describe the view of a digital breast tomosynthesis image.

Table C.8.21.6-1. Breast View Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Image Type | (0008,0008) | 1 | Image identification characteristics. See Section C.8.21.6.1.1 for specialization.
View Code Sequence | (0054,0220) | 1 | Sequence that describes the view of the patient anatomy in this image. Only a single Item shall be included in this Sequence.
>Include Table 8.8-1 “Code Sequence Macro Attributes” . | DCID 4014 “View for Mammography”.
>View Modifier Code Sequence | (0054,0222) | 2 | Sequence that provides modifiers for the view of the patient anatomy. Zero or more Items shall be included in this Sequence.
>>Include Table 8.8-1 “Code Sequence Macro Attributes”. | DCID 4015 “View Modifier for Mammography”.
Breast Implant Present | (0028,1300) | 1C | Whether or not the imaged breast contains a breast implant regardless of the visibility of a breast implant in the Pixel Data. Enumerated Values: YES NO Required if Modality (0008,0060) is MG. May be present otherwise. ### Note The value is expected to be YES for all images acquired on a breast that contains a breast implant, even when a breast implant is displaced during image acquisition.
Partial View | (0028,1350) | 3 | Indicates whether this image is a partial view, that is a subset of a single view of the breast. Enumerated Values: YES NO If this Attribute is absent, then the image may or may not be a partial view. ### Note This may occur when a breast is larger than the active area of the detector. If this Attribute is present, its value shall be NO if there is a View Modifier Code Sequence (0054,0222) Item of value (399163009, SCT, "Magnification") or (399055006, SCT, "Spot Compression").
Partial View Code Sequence | (0028,1352) | 1C | Sequence that describes the portion or section of the breast captured in a partial view image. One or two Items shall be included in this Sequence. See Section C.8.11.7.1.3. Required if Partial View (0028,1350) is present with a value of YES.
>Include Table 8.8-1 “Code Sequence Macro Attributes” | DCID 4005 “Partial View Section for Mammography”.

##### C.8.21.6.1 Breast View Module Attribute Description

###### C.8.21.6.1.1 Image Type and Frame Type

In addition to the requirements specified in Section C.8.21.1.1.1 Image Type and Frame Type, the following Defined Terms are specified for Value 3 of Image Type (0008,0008) and Frame Type (0008,9007):

Table C.8.21.6-1a. Defined Terms of Image Type (0008,0008) Value 3 for Contrast Enhanced, Tomosynthesis and Biopsy

Defined Term | Definition | ACR MQCM Equivalent
--- | --- | ---
Contrast
PRE_CONTRAST | Collected before contrast was administered. | n/a
POST_CONTRAST | Collected during or after contrast was administered. | n/a
Tomosynthesis
TOMO_PROJ | Identifies the image as a digital breast tomosynthesis projection image. | n/a
TOMOSYNTHESIS | Tomographic reconstruction from limited angle projection data. | n/a
Biopsy
TOMO_SCOUT | A localizer image set that may be used to determine positioning coordinates prior to needle positioning. | …SC
PREFIRE | An image set obtained with the biopsy needle in position prior to needle deployment. | …PRF
POSTFIRE | An image set obtained with the biopsy needle in position following needle deployment through the targeted lesion. | …POF
POSTBIOPSY | An image set obtained following tissue acquisition with the X-Ray source in the scout position. | …POB
POSTMARKER | An image set obtained following micromarker placement with the X-Ray source in the scout position. | …POM

### Note

There is no need for _MINUS or _PLUS because a single digital breast tomosynthesis acquisition produces a projection and/or reconstruction image set that replaces the _MINUS and _PLUS image pair used in conventional 2D breast biopsy imaging (see Section C.8.11.7.1.4).

If more than one characteristic (biopsy, tomosynthesis, contrast enhanced) applies to an image, Value 3 shall contain the biopsy image type. If biopsy is not involved, Value 3 shall contain the tomosynthesis image type.

### Note

For example, Attributes of the Enhanced Contrast/Bolus Module may be used to identify contrast enhanced characteristics of a biopsy and/or tomosynthesis image that is also contrast enhanced.

Value 4 shall be NONE except for applicable contrast enhanced images, mathematically generated 2D images and other tomosynthesis reconstructions. The following Defined Terms are specified for Value 4 of Image Type (0008,0008) and Frame Type (0008,9007). For additional Defined Terms see Section C.8.16.1.4.

Table C.8.21.6-1b. Defined Terms of Image Type (0008,0008) Value 4 for Contrast Enhanced and Tomosynthesis

Defined Term | Definition
--- | ---
Tomosynthesis
GENERATED_2D | Mathematically generated 2D view.
MAXIMUM | Created through Pixel by pixel maximum operation.
MEAN | Created through Pixel by pixel mean operation.
Contrast
ADDITION | Created through Pixel by pixel addition operation.
SUBTRACTION | Created through Pixel by pixel subtraction operation.

If more than one characteristic (contrast enhanced, tomosynthesis) applies to an image, Value 4 shall contain the contrast enhanced image type. If contrast enhanced is not involved, Value 4 shall contain the tomosynthesis image type.

Value 5 shall be present for images acquired using contrast enhanced digital X-Ray imaging of the breast, but may be empty if none of the Defined Terms applies. For non-contrast images Value 5 remains optional and implementation specific.

Table C.8.21.6-1c. Defined Terms of Image Type (0008,0008) Value 5 for Contrast Enhanced Images

Enumerated Value | Definition
--- | ---
LOW_ENERGY | Low energy image.
HIGH_ENERGY | High energy image.

### Note

A recipient may use the different values for biopsy, tomosynthesis and contrast views to determine how to display them, for example in hanging protocols:

| Image Type Value 3 | Image Type Value 4 | Image Type Value 5
--- | --- | --- | ---
Tomosynthesis thin reconstructed slices | TOMOSYNTHESIS | NONE | -
Tomosynthesis thick reconstructed slices | TOMOSYNTHESIS | MAXIMUM | -
Tomosynthesis generated 2D | TOMOSYNTHESIS | GENERATED_2D | -
Tomosynthesis projections | TOMO_PROJ | NONE | -
Tomosynthesis thin reconstructed slices biopsy post-fire | POSTFIRE | NONE | -
Tomosynthesis thick reconstructed slices post-biopsy | POSTBIOPSY | MEAN | -
Tomosynthesis generated 2D biopsy pre-fire | PREFIRE | GENERATED_2D | -
Tomosynthesis projections biopsy scout | TOMO_SCOUT | NONE | -
Tomosynthesis thick reconstructed slices pre-contrast | TOMOSYNTHESIS | MAXIMUM | empty
Tomosynthesis thin reconstructed slices post-contrast subtraction | TOMOSYNTHESIS | SUBTRACTION | empty
Tomosynthesis thick reconstructed slices post-contrast subtraction | TOMOSYNTHESIS | SUBTRACTION | empty
Tomosynthesis generated 2D post-contrast addition | TOMOSYNTHESIS | ADDITION | empty
Tomosynthesis generated 2D post-contrast low energy | TOMOSYNTHESIS | GENERATED_2D | LOW_ENERGY
Tomosynthesis projections post-contrast high energy | TOMO_PROJ | NONE | HIGH_ENERGY
Tomosynthesis thick reconstructed slices biopsy scout pre-contrast | TOMO_SCOUT | MAXIMUM | empty
Tomosynthesis thin reconstructed slices biopsy pre-fire post-contrast subtraction | PREFIRE | SUBTRACTION | empty
Tomosynthesis thick reconstructed slices biopsy post-fire post-contrast subtraction | POSTFIRE | SUBTRACTION | empty
Tomosynthesis generated 2D post-biopsy post-contrast addition | POSTBIOPSY | ADDITION | empty
Tomosynthesis generated 2D biopsy scout post-contrast low energy | TOMO_SCOUT | GENERATED_2D | LOW_ENERGY
Tomosynthesis projections post-biopsy post-contrast high energy | POSTBIOPSY | NONE | HIGH_ENERGY

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DICOM PS3.3 2021b - Information Object Definitions