DICOM PS3.17 2021c - Explanatory Information

OOOO.2 Encoding Relative Cerebral Tumor Blood Volume for ROIs in Measurement Report SR Documents (Current)
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## OOOO.2 Encoding Relative Cerebral Tumor Blood Volume for ROIs in Measurement Report SR Documents

This example shows how to describe the total relative cerebral blood volume value of a region of interest that is a tumor in the left temporal lobe. In this case the template used is TID 1419 “ROI Measurements” within TID 1411 “Volumetric ROI Measurements and Qualitative Evaluations” to separately encode the ROI with the total relative CBV and the ROI for the reference region with its size, with the relationship between them implicit in the presence of a coded reference region.

For clarity, the enclosure of the content items within a Measurement Group container and the accompanying tracking identifiers and spatial information (coordinates and image and/or segmentation references) are not shown here.

- CODE (121071, DCM, "Finding") = (86049000, SCT, "Neoplasm, Primary")

- NUM (126398, DCM, "Relative Regional Blood Volume) = 1.2 ({ratio}, UCUM, "ratio")

  - HAS CONCEPT MOD CODE (363698007, SCT, "Finding Site") = (78277001, SCT, "Temporal lobe")

    - HAS CONCEPT MOD CODE (272741003, SCT, "Laterality") = (7771000, SCT, "Left")

  - HAS CONCEPT MOD CODE (121401, DCM, "Derivation") = (255619001, SCT, "Total")

  - HAS CONCEPT MOD TEXT (121050, DCM, "Equivalent Meaning of Concept Name") = "Total tumor blood volume relative to 150mm2 contralateral normal cerebral white matter"

The reference region, its blood flow and size, would be specified as:

- CODE (121071, DCM, "Finding") = (C94970, NCIt, "Reference Region")

- NUM (126391, DCM, "Absolute Regional Blood Volume) = 34.6 (ml/(100.ml), UCUM, "ml/(100.ml)")

  - HAS CONCEPT MOD CODE (363698007, SCT, "Finding Site") = (68523003, SCT, "Cerebral White Matter")

    - HAS CONCEPT MOD CODE (272741003, SCT, "Laterality") = (255209002, SCT, "Contralateral")

  - HAS CONCEPT MOD CODE (121401, DCM, "Derivation") = (255619001, SCT, "Total")

- NUM (42798000, SCT, "Area") = 150 (mm2, UCUM, "mm2")

Alternatively, if the absolute blood volume of the reference region is not available, then its size can be specified alone, e.g.:

- CODE (121071, DCM, "Finding") = (C94970, NCIt, "Reference Region")

- NUM (42798000, SCT, "Area") = 150 (mm2, UCUM, "mm2")

  - HAS CONCEPT MOD CODE (363698007, SCT, "Finding Site") = (68523003, SCT, "Cerebral White Matter")

    - HAS CONCEPT MOD CODE (272741003, SCT, "Laterality") = (255209002, SCT, "Contralateral")

The use of a specific reference region may be made explicit if the detailed information for both of the two source measurements, the absolute CBV for the lesion and the reference region, is available, in which case they could be encoded as their own instances of TID 1411 “Volumetric ROI Measurements and Qualitative Evaluations”, and then the derived relative measurement encoded using TID 1420 “Measurements Derived From Multiple ROI Measurements”, as follows:

- NUM (126398, DCM, "Relative Regional Blood Volume) = 1.2 ({ratio}, UCUM, "ratio")

  - R-INFERRED FROM reference to measurement group content item of absolute measurement (Row 1 of TID 1411)

  - R-INFERRED FROM reference to measurement group content item of reference region measurement (Row 1 of TID 1411)

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DICOM PS3.17 2021c - Explanatory Information