DICOM PS3.3 2021d - Information Object Definitions

A.86 RT Second Generation (Current)
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## A.86 RT Second Generation

### A.86.1 RT Second Generation Objects

This section provides a brief description of the IODs of RT Second Generation. Specifically, this description includes:

- The Real-World Object which is represented by the IOD.

- Information as to the scope of the represented object, if appropriate.

#### A.86.1.1 RT Second Generation Common Information

This section provides a description of the Module structure which is shared by the RT Second Generation IODs.

##### A.86.1.1.1 RT Second Generation Entity-Relationship Model

The E-R Model in Figure A.86.1.1.1-1 depicts those components of the DICOM Information Model that are relevant to RT Second Generation IODs.

Figure A.86.1.1.1-1. RT Second Generation IOD Information Model

###### A.86.1.1.1.1 Use of Study and Series in RT Second Generation Radiotherapy

For first generation IODs, no specific semantics are attached to a Study or a Series in RT. Similarly, for RT Second Generation IODs, internal references shall be used to relate and locate SOP Instances rather than making assumptions about how related SOP Instances are grouped into Studies or Series. For practical reasons it may be indicated to create a new Study separate from imaging Studies that are used for radiotherapeutic planning because of billing or reimbursement for Series that contain RT Instances.

Implementers should also note that the DICOM Standard, in general, does place some restrictions on how such SOP Instances should be grouped, as defined in Section A.1.2.3.

For non-image modalities like radiotherapy, the Series may not be the most efficient way to search for objects. Instead, an application might find it easier to use references in the RT Course object, Key Object Selection objects or Unified Worklist Procedure Steps to directly retrieve required Instances rather than search for them.

#### A.86.1.2 RT Physician Intent IOD

##### A.86.1.2.1 RT Physician Intent IOD Description

The RT Physician Intent IOD carries the prescriptions by which the physician describes the therapeutic goal and strategy for the radiotherapeutic treatment.

##### A.86.1.2.2 RT Physician Intent IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.2.3 RT Physician Intent IOD Module Table

Table A.86.1.2-1. RT Physician Intent IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
RT Physician Intent | General Reference | C.12.4 | M
RT Physician Intent | C.36.5 | M
RT Enhanced Prescription | C.36.6 | U
RT Treatment Phase Intent | C.36.7 | C - Required if RT Treatment Phase Intent Presence Flag (3010,0045) equals YES.
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.2.4 RT Physician Intent IOD Constraints

###### A.86.1.2.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTINTENT.

###### A.86.1.2.4.2 Radiotherapy Common Instance Module

The following Code Sequences shall have a value from the specified CID:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | For Organizational Role Code Sequence (0044,010A) DCID 9536 “Radiotherapy Prescribing and Segmenting Person Roles” shall be used.

#### A.86.1.3 RT Segment Annotation IOD

##### A.86.1.3.1 RT Segment Annotation IOD Description

The RT Segment Annotation IOD annotates any general-purpose entity that represents geometric information such as Segmentation IOD, Surface Segmentation IOD, and RT Structure Set IOD with radiotherapy-specific information that cannot be encoded in the content of the annotated SOP Instance, or overrides that content with new or additional interpretation.

##### A.86.1.3.2 RT Segment Annotation IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.3.3 RT Segment Annotation IOD Module Table

Table A.86.1.3-1. RT Segment Annotation IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
RT Segment Annotation | RT Segment Annotation | C.36.8 | M
Segment Reference | C.36.9 | M
General Reference | C.12.4 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.3.4 RT Segment Annotation IOD Constraints

###### A.86.1.3.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTSEGANN.

###### A.86.1.3.4.2 Radiotherapy Common Instance Module

The following Code Sequences shall have a value from the specified CID:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | For Organizational Role Code Sequence (0044,010A) DCID 9536 “Radiotherapy Prescribing and Segmenting Person Roles” shall be used.

#### A.86.1.4 RT Radiation Set IOD

##### A.86.1.4.1 RT Radiation Set IOD Description

The RT Radiation Set IOD represents an RT Radiation Set, which is a set of radiation deliveries that are intended to be delivered together in a single fraction (see Section 7.14.5). The RT Radiation Set also contains a description of the fractionation pattern, the intended number of fractions and the associated dose contributions.

##### A.86.1.4.2 RT Radiation Set IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.4.3 RT Radiation Set IOD Module Table

Table A.86.1.4-1. RT Radiation Set IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | M
RT Radiation Set | General Reference | C.12.4 | M
RT Radiation Set | C.36.10 | M
RT Dose Contribution | C.36.11 | C - Required if the dose delivered is tracked.
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.4.4 RT Radiation Set IOD Constraints

###### A.86.1.4.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.4.4.2 RT Radiation Set and Referenced RT Radiation Instances

The User Content Label (3010,0033) in each RT Radiation Instance shall be unique across all SOP Instances referenced by an Instance of the RT Radiation Set.

###### A.86.1.4.4.3 Radiotherapy Common Instance Module

The following Code Sequences shall have a value from the specified CID:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | For Organizational Role Code Sequence (0044,010A) DCID 9555 “Radiotherapy Treatment Planning Person Roles” shall be used.

###### A.86.1.4.4.4 RT Dose Contribution Module

Where dose contributions are not available at the time of RT Radiation Set definition and application (e.g., for emergency treatments) this Module may be absent. This does not exclude retrospective dose calculation and creation of associated RT Dose Image objects.

#### A.86.1.5 C-Arm Photon-Electron Radiation IOD

##### A.86.1.5.1 C-Arm Photon-Electron Radiation IOD Description

The C-Arm Photon-Electron Radiation IOD describes a radiotherapy treatment to be performed on a C-Arm delivery device using photon or electron radiation.

##### A.86.1.5.2 C-Arm Photon-Electron Radiation IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.5.3 C-Arm Photon-Electron Radiation IOD Module Table

Table A.86.1.5-1. C-Arm Photon-Electron Radiation IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | M
RT Radiation | General Reference | C.12.4 | M
RT Delivery Device Common | C.36.12 | M
RT Radiation Common | C.36.13 | M
C-Arm Photon-Electron Delivery Device | C.36.14 | M
C-Arm Photon-Electron Beam | C.36.15 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.5.4 C-Arm Photon-Electron Radiation IOD Constraints

###### A.86.1.5.4.1 Modality Attribute

The Value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.5.4.2 RT Delivery Device Common Module

The Equipment Frame of Reference UID (300A,0675) shall be 1.2.840.10008.1.4.3.1, which identifies the IEC 61217 Fixed Coordinate System Frame of Reference; see Section C.36.12.2.1.

The Frame of Reference identifies the Patient Coordinate System used to define the geometric setup of the radiation beam with respect to the patient. The relationship of the patient-based coordinates to the Equipment Frame of Reference is specified by a transformation (see Section 10.39).

The following Code Sequences shall have a value from the specified CID:

Code Sequence | CID
--- | ---
Radiation Dosimeter Unit Sequence (300A,0658) | DCID 9552 “C-Arm Photon-Electron Dosimeter Units”.

The RT Device Distance Reference Location Code Sequence (300A,0659) shall contain the value (130358, DCM, “Nominal Radiation Source Location”).

###### A.86.1.5.4.3 RT Radiation Common Module

The value of RT Record Flag (300A,0639) shall be NO.

The following Code Sequences shall have a value from the specified CID:

Code Sequence | CID
--- | ---
RT Treatment Technique Code Sequence (3010,0080) | DCID 9511 “General External Radiotherapy Procedure Techniques”.
Treatment Machine Special Mode Code Sequence (300A,0635) | DCID 9543 “Radiotherapy Treatment Machine Modes”.

###### A.86.1.5.4.4 Radiotherapy Common Instance Module

The following Code Sequences shall have a value from the specified CID:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | Organizational Role Code Sequence (0044,010A) DCID 9555 “Radiotherapy Treatment Planning Person Roles”

#### A.86.1.6 Tomotherapeutic Radiation IOD

##### A.86.1.6.1 Tomotherapeutic Radiation IOD Description

The Tomotherapeutic Radiation IOD represents the information required to describe a radiotherapy treatment on a serial or helical tomotherapeutic delivery device.

##### A.86.1.6.2 Tomotherapeutic Radiation IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.6.3 Tomotherapeutic Radiation IOD Module Table

Table A.86.1.6-1. Tomotherapeutic Radiation IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | M
RT Radiation | General Reference | C.12.4 | M
RT Delivery Device Common | C.36.12 | M
RT Radiation Common | C.36.13 | M
Tomotherapeutic Delivery Device | C.36.16 | M
Tomotherapeutic Beam | C.36.17 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.6.4 Tomotherapeutic Radiation IOD Constraints

###### A.86.1.6.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.6.4.2 RT Delivery Device Common Module

The Equipment Frame of Reference UID (300A,0675) shall be 1.2.840.10008.1.4.3.1, which identifies the IEC 61217 Fixed Coordinate System Frame of Reference; see Section C.36.12.2.1.

The Frame of Reference identifies the Patient Coordinate System used to define the geometric setup of the radiation beam with respect to the patient. The relationship of the patient-based coordinates to the Equipment Frame of Reference is specified by a transformation (see Section 10.39).

The following Code Sequence shall have a value from the identified CID:

Code Sequence | CID
--- | ---
Radiation Dosimeter Unit Sequence (300A,0658) | DCID 9557 “Tomotherapeutic Dosimeter Units”

The RT Device Distance Reference Location Code Sequence (300A,0659) shall contain the value (130358, DCM, “Nominal Radiation Source Location”).

###### A.86.1.6.4.3 RT Radiation Common Module

The value of RT Record Flag (300A,0639) shall be NO.

The following Code Sequences shall have a value from the identified CIDs:

Code Sequence | CID
--- | ---
RT Treatment Technique Code Sequence (3010,0080) | DCID 9512 “Tomotherapeutic Radiotherapy Procedure Techniques”
Treatment Machine Special Mode Code Sequence (300A,0635) | DCID 9543 “Radiotherapy Treatment Machine Modes”

###### A.86.1.6.4.4 Radiotherapy Common Instance Module

The following code sequence shall have a value from the identified CID:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | Organizational Role Code Sequence (0044,010A) DCID 9555 “Radiotherapy Treatment Planning Person Roles”

#### A.86.1.7 Robotic-Arm Radiation IOD

##### A.86.1.7.1 Robotic-Arm Radiation IOD Description

The Robotic-Arm Radiation IOD specifies the Robotic Path and collimation parameters required to describe a radiotherapy treatment on a robotic-arm delivery device. A Robotic Path is a sequence of Robotic Nodes. A Robotic Node specifies a Radiation Source location for a Robotic-Arm delivery device.

##### A.86.1.7.2 Robotic-Arm Radiation IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.7.3 Robotic-Arm Radiation IOD Module Table

Table A.86.1.7-1. Robotic-Arm Radiation IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | M
RT Radiation | General Reference | C.12.4 | M
RT Delivery Device Common | C.36.12 | M
RT Radiation Common | C.36.13 | M
Robotic-Arm Delivery Device | C.36.18 | M
Robotic-Arm Path | C.36.19 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.7.4 Robotic-Arm Radiation IOD Module Constraints

###### A.86.1.7.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.7.4.2 RT Delivery Device Common Module

The Equipment Frame of Reference UID (300A,0675) shall be 1.2.840.10008.1.4.3.2, which identifies the Standard Robotic-Arm Coordinate System Frame of Reference; see Section C.36.12.2.2.

The Frame of Reference identifies the Patient Coordinate System used to define the geometric setup of the radiation beam with respect to the patient. The relationship of the patient-based coordinates to the Equipment Frame of Reference is specified by a transformation (see Section 10.39).

The following code sequences shall have a value from the identified CID:

Code Sequence | CID
--- | ---
Radiation Dosimeter Unit Sequence (300A,0658) | DCID 9559 “Robotic Delivery Device Dosimeter Units”

The RT Device Distance Reference Location Code Sequence (300A,0659) shall contain the value (130358, DCM, “Nominal Radiation Source Location”).

###### A.86.1.7.4.3 RT Radiation Common Module

The value of RT Record Flag (300A,0639) shall be NO.

The following code sequences shall have a value from the identified CID:

Code Sequence | CID
--- | ---
RT Treatment Technique Code Sequence (3010,0080) | DCID 9523 “Robotic Radiotherapy Procedure Techniques”
Treatment Machine Special Mode Code Sequence (300A,0635) | DCID 9543 “Radiotherapy Treatment Machine Modes”

###### A.86.1.7.4.4 Radiotherapy Common Instance Module

The following code sequence shall have a value from the identified CID:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | Organizational Role Code Sequence (0044,010A) DCID 9555 “Radiotherapy Treatment Planning Person Roles”

#### A.86.1.8 RT Radiation Record Set IOD

The RT Radiation Record Set IOD references a set of RT Radiation Record Instances of a radiotherapy treatment that has been performed using a single RT Radiation Set SOP Instance and its referenced RT Radiation Instances.

##### A.86.1.8.1 RT Radiation Record Set IOD Description

##### A.86.1.8.2 RT Radiation Record Set IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.8.3 RT Radiation Record Set IOD Module Table

Table A.86.1.8-1. RT Radiation Record Set IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
RT Delivered Radiation | General Reference | C.12.4 | M
RT Radiation Record Set | C.36.20 | M
RT Dose Contribution Record | C.36.21 | C - Required if the dose delivered is tracked.
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.8.4 RT Radiation Record Set IOD Constraints

###### A.86.1.8.4.1 RT Dose Contribution Record

Where dose contributions are not available at the time of delivery of the radiotherapeutic treatments specified by the RT Radiation Set IOD (e.g., for emergency treatments), the RT Dose Contribution Record Module may be absent. This does not exclude retrospective dose calculation and creation of associated RT Dose Image objects.

#### A.86.1.9 RT Radiation Salvage Record IOD

##### A.86.1.9.1 RT Radiation Salvage Record IOD Description

The RT Radiation Salvage Record IOD contains the record of a complete or partial fraction of therapeutic radiation delivered using any therapeutic device where recording by the modality-specific RT Radiation Record IOD was not possible.

A device usually creates RT Radiation Record SOP Instances using modality-specific RT Radiation Record IODs and transfers these Instances to a system that captures treatment records. If this process fails (e.g. because of failed transfer operations) and the recorded SOP Instances are not recoverable from the device, the RT Radiation Salvage Record IOD may be used to represent radiation delivery captured by a manual entry of the delivered treatment. Systems providing manual entry capabilities might not be able to create a modality-specific RT Radiation Record SOP Instance covering all device-specific parameters in question and/or the user might not know all the details. Therefore, the modality-specific RT Radiation Record IODs cannot be properly populated. The RT Radiation Salvage Record IOD allows essential information to be recorded.

##### A.86.1.9.2 RT Radiation Salvage Record IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.9.3 RT Radiation Salvage Record IOD Module Table

Table A.86.1.9-1. RT Radiation Salvage Record IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | U
RT Delivered Radiation | General Reference | C.12.4 | M
RT Delivery Device Common | C.36.12 | M
RT Radiation Record Common | C.36.22 | M
RT Radiation Salvage Record | C.36.23 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.9.4 RT Radiation Salvage Record IOD Constraints

###### A.86.1.9.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.9.4.2 RT Delivery Device Common Module

The Equipment Frame of Reference UID (300A,0675) shall have the value used by the SOP Instance referenced in the Referenced RT Instance Sequence (300A,0631) of the RT Radiation Record Common Module.

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Radiation Dosimeter Unit Sequence (300A,0658) | Defined CID is the CID specified for the SOP Instance referenced in the Referenced RT Instance Sequence (300A,0631) of the RT Radiation Record Common Module.

###### A.86.1.9.4.3 RT Radiation Record Common Module

The value of RT Record Flag (300A,0639) shall be YES.

The value of Treatment Record Content Origin (300A,0709) shall be USER.

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
RT Treatment Technique Code Sequence (3010,0080) | Defined CID is the CID specified for the SOP Instance referenced in the Referenced RT Instance Sequence (300A,0631) of the RT Radiation Record Common Module.
Treatment Machine Special Mode Sequence (300A,0635) | Defined CID is the CID specified for the SOP Instance referenced in the Referenced RT Instance Sequence (300A,0631) of the RT Radiation Record Common Module.

###### A.86.1.9.4.4 Radiotherapy Common Instance Module

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | For Organizational Role Code Sequence (0044,010A) DCID 9562 “Radiotherapy Treatment Delivery Person Roles” shall be used.

###### A.86.1.9.4.5 Frame of Reference Module

The Frame of Reference UID (0020,0052) identifies the patient-based Frame of Reference while the therapeutic radiation was delivered. The Frame of Reference UID relates the geometric parameters of this SOP Instance to other SOP Instances such as Images, Segmentations, etc. If the patient moves with respect to the patient positioning device between the delivery recorded by the current SOP Instance and another SOP Instance, a new Frame of Reference UID shall be issued for any SOP Instances created after the move. See also Section C.7.4.1.

The relationship between the patient-oriented coordinate system identified by this Frame of Reference and the Equipment Coordinate System is described in Section 10.39.1.

#### A.86.1.10 C-Arm Photon-Electron Radiation Record IOD

##### A.86.1.10.1 C-Arm Photon-Electron Radiation Record IOD Description

The C-Arm Photon-Electron Radiation Record IOD contains the record of a radiotherapy treatment that has been performed using a C-Arm Photon-Electron Radiation SOP Instance.

##### A.86.1.10.2 C-Arm Photon-Electron Radiation Record IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.10.3 C-Arm Photon-Electron Radiation Record IOD Module Table

Table A.86.1.10.3-1. C-Arm Photon-Electron Radiation Record IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | M
Synchronization | C.7.4.2 | C - Required if time synchronization was applied
RT Delivered Radiation | General Reference | C.12.4 | M
RT Delivery Device Common | C.36.12 | M
RT Radiation Record Common | C.36.22 | M
C-Arm Photon-Electron Delivery Device | C.36.14 | M
C-Arm Photon-Electron Beam | C.36.15 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.10.4 C-Arm Photon-Electron Radiation Record IOD Constraints

###### A.86.1.10.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.10.4.2 RT Delivery Device Common Module

The Equipment Frame of Reference UID (300A,0675) shall be 1.2.840.10008.1.4.3.1, which identifies the IEC 61217 Fixed Coordinate System Frame of Reference, see Section C.36.12.2.1.

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Radiation Dosimeter Unit Sequence (300A,0658) | DCID 9552 “C-Arm Photon-Electron Dosimeter Units”

The RT Device Distance Reference Location Code Sequence (300A,0659) shall contain the value (130358, DCM, "Nominal Radiation Source Location").

###### A.86.1.10.4.3 RT Radiation Record Common Module

The value of RT Record Flag (300A,0639) shall be YES. The value of RT Radiation Physical and Geometric Content Detail Flag (300A,0638) shall be IDENT_ONLY.

The following code sequences shall have a value from the identified CIDs:

Code Sequence | CID
--- | ---
RT Treatment Technique Code Sequence (3010,0080) | DCID 9511 “General External Radiotherapy Procedure Techniques”
Treatment Machine Special Mode Sequence (300A,0635) | DCID 9543 “Radiotherapy Treatment Machine Modes”

###### A.86.1.10.4.4 Radiotherapy Common Instance Module

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | For Organizational Role Code Sequence (0044,010A) DCID 9562 “Radiotherapy Treatment Delivery Person Roles” shall be used.

###### A.86.1.10.4.5 Frame of Reference Module

See Section A.86.1.9.4.5.

#### A.86.1.11 Tomotherapeutic Radiation Record IOD

##### A.86.1.11.1 Tomotherapeutic Radiation Record IOD Description

The Tomotherapeutic Radiation Record IOD contains the record of a radiotherapy treatment that has been performed using a Tomotherapeutic Radiation SOP Instance.

##### A.86.1.11.2 Tomotherapeutic Radiation Record IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.11.3 Tomotherapeutic Radiation Record IOD Module Table

Table A.86.1.11-1. Tomotherapeutic Radiation Record IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | M
Synchronization | C.7.4.2 | C - Required if time synchronization was applied
RT Delivered Radiation | General Reference | C.12.4 | M
RT Delivery Device Common | C.36.12 | M
RT Radiation Record Common | C.36.22 | M
Tomotherapeutic Delivery Device | C.36.16 | M
Tomotherapeutic Beam | C.36.17 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.11.4 Tomotherapeutic Radiation Record IOD Constraints

###### A.86.1.11.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.11.4.2 RT Delivery Device Common Module

The Equipment Frame of Reference UID (300A,0675) shall be 1.2.840.10008.1.4.3.1, which identifies the IEC 61217 Fixed Coordinate System Frame of Reference, see Section C.36.12.2.1.

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Radiation Dosimeter Unit Sequence (300A,0658) | DCID 9557 “Tomotherapeutic Dosimeter Units”

The RT Device Distance Reference Location Code Sequence (300A,0659) shall contain the value (130358, DCM, "Nominal Radiation Source Location").

###### A.86.1.11.4.3 RT Radiation Record Common Module

The value of RT Record Flag (300A,0639) shall be YES. The value of RT Radiation Physical and Geometric Content Detail Flag (300A,0638) shall be IDENT_ONLY.

The following code sequences shall have a value from the identified CIDs:

Code Sequence | CID
--- | ---
RT Treatment Technique Code Sequence (3010,0080) | DCID 9512 “Tomotherapeutic Radiotherapy Procedure Techniques”
Treatment Machine Special Mode Sequence (300A,0635) | DCID 9543 “Radiotherapy Treatment Machine Modes”

###### A.86.1.11.4.4 Radiotherapy Common Instance Module

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | Organizational Role Code Sequence (0044,010A) DCID 9562 “Radiotherapy Treatment Delivery Person Roles”.

###### A.86.1.11.4.5 Frame of Reference Module

See Section A.86.1.9.4.5.

#### A.86.1.12 Robotic-Arm Radiation Record IOD

##### A.86.1.12.1 Robotic-Arm Radiation Record IOD Description

The Robotic-Arm Radiation Record IOD contains the record of a radiotherapy treatment that has been performed using a Robotic-Arm Radiation SOP Instance.

##### A.86.1.12.2 Robotic-Arm Radiation Record IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.12.3 Robotic-Arm Radiation Record IOD Module Table

Table A.86.1.12-1. Robotic-Arm Radiation Record IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Frame of Reference | Frame of Reference | C.7.4.1 | M
Synchronization | C.7.4.2 | C - Required if time synchronization was applied
RT Delivered Radiation | General Reference | C.12.4 | M
RT Delivery Device Common | C.36.12 | M
RT Radiation Record Common | C.36.22 | M
Robotic-Arm Delivery Device | C.36.18 | M
Robotic-Arm Path | C.36.19 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.12.4 Robotic-Arm Radiation Record IOD Constraints

###### A.86.1.12.4.1 Modality Attribute

The value of Modality (0008,0060) shall be RTRAD.

###### A.86.1.12.4.2 RT Delivery Device Common Module

The Equipment Frame of Reference UID (300A,0675) shall be 1.2.840.10008.1.4..3.2, which identifies the Standard Robotic-Arm Coordinate System Frame of Reference, see Section C.36.12.2.2.

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Radiation Dosimeter Unit Sequence (300A,0658) | DCID 9559 “Robotic Delivery Device Dosimeter Units”

The RT Device Distance Reference Location Code Sequence (300A,0659) shall contain the value (130358, DCM, "Nominal Radiation Source Location").

###### A.86.1.12.4.3 RT Radiation Record Common Module

The value of RT Record Flag (300A,0639) shall be YES. The value of RT Radiation Physical and Geometric Content Detail Flag (300A,0638) shall be IDENT_ONLY.

The following code sequences shall have a value from the identified CIDs:

Code Sequence | CID
--- | ---
RT Treatment Technique Code Sequence (3010,0080) | DCID 9523 “Robotic Radiotherapy Procedure Techniques”
Treatment Machine Special Mode Sequence (300A,0635) | DCID 9543 “Radiotherapy Treatment Machine Modes”

###### A.86.1.12.4.4 Radiotherapy Common Instance Module

The following code sequences shall have values from the identified CIDs:

Code Sequence | CID
--- | ---
Author Identification Sequence (3010,0019) | For Organizational Role Code Sequence (0044,010A) DCID 9562 “Radiotherapy Treatment Delivery Person Roles” shall be used.

###### A.86.1.12.4.5 Frame of Reference Module

See Section A.86.1.9.4.5.

#### A.86.1.13 RT Radiation Set Delivery Instruction IOD

##### A.86.1.13.1 RT Radiation Set Delivery Instruction IOD Description

The RT Radiation Set Delivery Instruction IOD contains all the parameters needed to deliver a single RT Treatment Fraction of one RT Radiation Set in the scope of one RT Treatment Session. It handles either the delivery of the complete fraction of the RT Radiation Set or the continuation of a formerly treated fraction which was interrupted and not completely delivered.

##### A.86.1.13.2 RT Radiation Set Delivery Instruction IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.13.3 RT Radiation Set Delivery Instruction IOD Module Table

Table A.86.1.13-1. RT Radiation Set Delivery Instruction IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
Plan | General Reference | C.12.4 | M
RT Radiation Set Delivery Instruction | C.36.24 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.13.4 RT Radiation Set Delivery Instruction IOD Constraints

###### A.86.1.13.4.1 Modality Attribute

The value of Modality (0008,0060) shall be PLAN.

#### A.86.1.14 RT Treatment Preparation IOD

##### A.86.1.14.1 RT Treatment Preparation IOD Description

The RT Treatment Preparation IOD describes the setup of the patient in preparation for delivery of the therapeutic radiation within an RT Treatment Session. It may include an initial patient’s position in preparation for treatment delivery, the treatment setup positions, or setup procedures along with the use of any fixation or shielding devices.

##### A.86.1.14.2 RT Treatment Preparation IOD Entity-Relationship Model

See Figure A.86.1.1.1-1.

##### A.86.1.14.3 RT Treatment Preparation IOD Module Table

Table A.86.1.14-1. RT Treatment Preparation IOD Modules

IE | Module | Reference | Usage
--- | --- | --- | ---
Patient | Patient | C.7.1.1 | M
Clinical Trial Subject | C.7.1.3 | U
Study | General Study | C.7.2.1 | M
Patient Study | C.7.2.2 | U
Clinical Trial Study | C.7.2.3 | U
Series | General Series | C.7.3.1 | M
Clinical Trial Series | C.7.3.2 | U
Enhanced RT Series | C.36.3 | M
Equipment | General Equipment | C.7.5.1 | M
Enhanced General Equipment | C.7.5.2 | M
RT Treatment Preparation | General Reference | C.12.4 | M
RT Treatment Preparation | C.36.25 | M
SOP Common | C.12.1 | M
Common Instance Reference | C.12.2 | M
Radiotherapy Common Instance | C.36.4 | M

##### A.86.1.14.4 RT Treatment Preparation IOD Constraints

###### A.86.1.14.4.1 Modality Attribute

The value of Modality (0008,0060) shall be PLAN.

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DICOM PS3.3 2021d - Information Object Definitions