Philips Epiq 5 Manual

							 
Structured Reporting uses codes supplied by DCMR (DICOM Code Mapping Resource, PS 3-16), LOINC, SRT and 
99PMSBLUS (Philips Private Codes for Ultrasound).  
9.4   GRAYSCALE IM AGE CONS ISTENCY 
The high- resolution display monitor is calibrated according to the Grayscale Standard Display Function (GSDF).   
9.5   STANDARD EXTENDED/SP ECIALIZED/PRIVATE SOP CLASSES 
9.5.1  Ultrasound Image and Multi -frame Image SOP Classes  
The US or US Multiframe Image Storage SOP Classes are extended to create a Standard Extended SOP Class by 
addition of standard and private attributes to the created SOP Instanc es as documented in section 8.1 as well as the 
standard attributes listed in Table  9.30 . 
Table 9.30  
ULTRASOUND IMAGE EXTENDED ATTRIBUTES  
Tag Attribute Name Added to 
(0028,0030)  Pixel Spacing   Images with a single 2D region or dual 2D with same depth  
(0008,0068)  Presentation Intent Type  Indicates that Pixel Data (7FE0,0010) contains 3D volume 
data
 
(0008,2112)  Source Image Sequence  Extended to use codes from CID 7205.  See Table  9.31 . 
 
Pixel Spacing (0028,0030)  is added to the exported DICOM file when the user has configured this attribute  to be 
included and the image contains only  one 2D calibration region and no Doppler or M- Mode calibration regions.  This 
attribute is system generated, if used:  
•   Contain the Pixel Spacing attribute:  2D still, 2D loop, 2D color still, 2D color loop, Mm ode Preview Still, PW 
Preview Still, CW Preview still,  and Dual with same calibration on both images.  
•   Do NOT contain the Pixel Spacing attribute:  Mmode live trace,  Mmode frozen trace, PW live trace, PW 
Frozen trace, CW live trace, CW frozen trace, Reports and dual images with different calibration on each 
image.  
Ultrasound Multi frame Image instances may be used to store 3D and 4D ultrasound volume information.  The 
presence of the Presentation Intent Type (0008,0068) value “FOR PRESENTATION” indicates that Pixel Data 
(7FE0,0010) contains spatially related frames of a 3D volume rather than the normal temporally related frames.  3D 
Temporal (a.k.a. 4D) volume information is  stored using private attributes within a normal Ultrasound Multi frame 
Image object.  
The  private  attributes  that are sent via network or media are depend ent on settings for the specific destination, as 
found in “Print/Network>Device Selection and either t he “Media” tab or “Archive” tab and the “Advanced” button for the 
highlighted archive device.  
Table 9.31  
SOURCE IMAGE SEQUENCE ITEM EXTENDED ATTRIBUTES 
Attribute Name  Tag  Type  VR  Description   Value 
Source  Image 
Sequence   (
0008,2112)  3  SQ The set of Image SOP Class/Instance 
pairs of the Images that were used to 
derive this image.
   
>Purpose of 
Reference Code 
(
0040,A170)  3  SQ Describes the purpose for which the 
reference is made.
   
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DICOM Conformance Statement 000490000000111   Rev  A   Page 91   
						

							 
Sequence 
>> Code Value (0008,0100)  1  SH Code Value   121324 
>>Code Meaning  (0008,0104)  1  LO  Code Meaning   Source Image 
 
 
9.5.2 3D Presentation State Private  SOP Class 
EPIQ  7 only  may create instances of the following Private SOP Class:  
 
Table  9.32  
PRIVATE  SOP CLASS FOR 3D PRESENTATION STATE  
SOP Class Name   SOP Class UID SCU  SCP 
Private 3D Presentation State  1.3.46.670589.2.5.1.1 Yes  No 
 
9.6   PRIVATE TRANSFER SYN T AXES 
There are no Private Transfer Syntaxes.  
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							 APPENDIX A  – Structured Reports  
A.1   STRUCTURED REPORTS  
A.1.1  Introduction  
EPIQ/Affiniti  implement  DICOM Structured Report Templates TID 5000 ( OB-GYN Ultrasound Procedure Report ), TID 
5100 ( Vascular Ultrasound Report ), TID 5200 (Echocardiography Procedure Report )
, TID 5220 ( Pediatric, Fetal and 
Congenital Cardiac Ultrasound Reports)
,  p rivate TID 995300 (Ped Echo) based on s upplement 78 version 2, May 8 
2004 , and private TID 995400 (Small Parts ). See section A.2 for the DICOM Structured Report export capabilities for 
each  EPIQ/Affiniti  model.  
DICOM PS 3.17 of the DICOM Standard includes tree diagrams showing graphic examples of the structure of each 
template.  
Briefly, a  Structured Report (SR) document will contain only the measurements, calculations and observations made 
during  the exam.  Its exact structure is therefore determined by two main components, the measurements that are 
available within the context of the template and its referenced Templates and Context groups, and those 
measurements and calculations that are implemented on the system creating the report.  Supplementing these 
constraints are private and user defined measurements and calculations, which may be added if the Root Container 
Template is extensible.  
In  EPIQ/Affiniti , the calculation packages contain a combi nation of template and user defined measurements and 
calcul ations.  
 
A.1.1.1  Measurements  Linked to Images   
Spatial Coordinates (as defined by TID 320 row 3) are included for measurement sub- results whose measurement 
tools have been captured in an image (as defined by TID 300 row 13).  
There  are three special cases in which the Value Multiplicity for DTID 320 shall be greater than one:  
a.   If more than one image is captured of the same measurement tool, the sub- result will reference each image. 
b.   For a complex measurement tool (the Simpson’s Method of Disk Volume measurement) which with one user 
action creates 22 unique spatial coordinates, the first 20 spatial coordinate shall be the Chord values, the 21st 
 ROOT Document Title CONTAINER 
CONTAINS Patient Characteristics CONTAINER 
0-1 
CONTAINS Observations NUM, CODE, TEXT, DATE 
1-N 
CONTAINS Procedure Summary CONTAINER 
0-1 
CONTAINS Observations NUM, CODE, TEXT, DATE 
1-N 
CONTAINS Image LIbrary CONTAINER 
0-1 
CONTAINS Image Entry IMAGE 
1-N 
CONTAINS Observations NUM, CODE, TEXT 
0-N 
CONTAINS Heading CONTAINER 
0-N 
CONTAINS Measurement Group CONTAINER, CODE 
0-N 
CONTAINS, HAS PROP Observations NUM, CODE, TEXT 
1-N 
CONTAINS Fetus Summary CONTAINER 
0-n 
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							 spatial coordinate shall be the ventricular length measurement, and the 22nd spatial coordinat e shall be the 
v entricular area measurement.  
c.   For Doppler velocity measurements made with a two- point or trace tool, there shall be two spatial coordinates 
per measurement.   The first shall be the single point associated with the velocity measurement, and t he 
second shall consist of all the points of the measurement tool . 
A.1.2  Clinical Scope  
The supported measurements are located in Calcs packages accessed with the “Measure” hard key on EPIQ/Affiniti . 
Measurements for a given SR section may come from several calc s sidebars/touch screens.  
A.2   APPLICATIONS THAT  EXPORT STRUCTURED REPORTS F ROM EPIQ AND AFFINITI  
The following table describes the DICOM Structured R eport export capabilities by a pplication for the  EPIQ 7 and 5 
ultrasound systems .  A following table shows those for Affiniti 70 and 50.  
• “G” is optimized for General Imaging, Shared Service, and Radiology use  
• “C” is optimized for Cardiology use  
• “W” is optimized for Women’s Healthcare use   
 
OB/Gyn 
TID 5000  
Vascular 
TID 5100  
Abdominal  
TID 5100 
TCD 
TID 5100  
Adult 
Echo 
TID 
5200  
Pediatric 
Echo 
TID 5220  
Fetal Echo 
TID 5220 
Pediatric 
Echo 
TID 995300  
(Private ) 
Small Parts  
TID 995400  
(Private ) 
EPIQ 7G  
Affiniti 70G           
EPIQ 7C 
Affiniti 70C            
EPIQ 7W  
Affiniti 70W            
EPIQ 5G  
Affiniti 50G           
EPIQ 5C 
Affiniti 50C            
EPIQ 5W  
Affiniti 50W            
 
A.3   DICOM STRUCTURED REP ORT EXPORT SPECIFICATIONS 
A.3.1  Philips  Healthcare  Ultrasound Data Portal Website  
Rather than  list  the  thousands of DICOM export encodings  in this document, t he Philips Healthcare  Ultrasound Data 
Portal  website (see link below) provides detailed DICOM export specifications for all Philips ultrasound products in a 
convenient  downloadable  spreadsheet form at. These spreadsheets allow users to quickly filter for specific areas of 
interests such as application, template, label, or DICOM attribute. In addition to DICOM Structured Report 
specifications, the link also provides many DICOM Structured Report exampl e files and images for import and display 
testing.  
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To access the Philips Healthcare  Ultrasound Data Portal,  
•   Using a  browser,  to n avigate to the link below . 
•   Select the ult rasound product of interest.  
•   Provide  an email address and press the submit button.  
•   Download “ Philips_EPIQAffiniti_v1.5_DICOM_SR_Specification.xlsx ” 
   
Philip Ultrasound Data Portal  Website Link:  http://129.33.58.186/portal/index.asp?pid=us  
 
 
A.4   PRIVATE TEMPLATE EXT ENSIONS 
 
The PDE and Study Info data that is not already part of the DICOM templates is included using the following template 
extensions, per the appropriate application.  
A.4.1  TID5001: OB -GYN  Patient  Characteristics  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
9 > CONTAINS TEXT or DATE or NUM 
DCID (99002) General Study Info 
1 U   
10 > CONTAINS TEXT or DATE or NUM 
DCID (99003) OB Study Info 1 U   
11 > CONTAINS TEXT or DATE or NUM 
DCID (99004) Gyn Study Info 
1 U   
 
Line 4.1 is used only with a user -defined table or equation.  
 
A.4.2  TID5008: Fetal Biometry Group  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
3 > CONTAINS NUM EV (18185-9 , LN, 1 MC At least one of row 2 and 3 Units = EV (d, UCUM, days) 
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“Gestational Age”) shall be present 
4 >> INFERRED FROM CODE DCID (228) Equation or 
Table 1 U IF row 4.1 is absent  DCID (12013) Gestational Age 
Equations and 
Tables 
4.1 >> INFERRED FROM TEXT DCID (228) Equation or Table 
1 U IF row 4 is absent   
5 >> R-INFERRED FROM 
NUM  1-n U   
 
 
A.4.3 TID5101: Vascular Patient Characteristics  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
7 > CONTAINS TEXT or DATE or NUM 
DCID (99002) General Study Info 
1 U   
8 > CONTAINS TEXT or DATE or NUM 
DCID (99005) Vascular Study Info 
1 U   
9 > CONTAINS TEXT or DATE or NUM 
DCID (99006) Abdominal Study Info 
1 U   
 
 
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A.4.4 TID5202: Echocardiography Patient Characteristics 
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
9 > CONTAINS TEXT or DATE or NUM 
DCID (99002) General Study Info 
1 U   
10 > CONTAINS TEXT or DATE or NUM 
DCID (99007) Adult Echo Study Info 
1 U   
 
 
 
 
 
 
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A.5  USER -DEFINED MEASUREMENTS  AND CALCULATIONS 
A.5.1  Description  
EPIQ/Affiniti  provides 2 different DICOM  export formats for creating  user defined  measurements and calculations. The 
DICOM Encoding  format provides a way to create and export user -defined measurements and calculations or user -
defined OB  authors to PACS using the existing DICOM SR templates. The P hilips Generic export format allows users 
to create measurements and calculations without specifying complete DICOM encoding attributes and will be exported 
in a generic DICOM encoding format.  
A.5.1.1  Philips Generic DICOM Export Format  
For quickly creating exportable measurement s and calculations without specific DICOM encodings, a generic structure 
was created that does not assign specific codes to the individual measurements, rather uses the label given by the 
user.  This will allow all user -defined measur ements to be treated in a uniform manner, without needing a per -site 
dictionary of user -defined codes.  
 
CONTAINS“User-defined concepts”CONTAINER
HAS CONCEPT MOD“Label” = “MyMeas”TEXT
CONTAINS“Measurement”CONTAINER
HAS CONCEPT MOD“Label” = “MyCalc”TEXT
CONTAINS“Calculation”CONTAINER
HAS CONCEPT MOD“Label” = “MyMeas2”TEXT
CONTAINS“Measurement”CONTAINER
HAS CONCEPT MODSelector = LastCODE
CONTAINS“Distance” = 12.3 mmNUM
CONTAINS“Value” = 34.5 mm/sNUM
CONTAINS“Distance” = 23.4 mmNUM
CONTAINS“Distance” = 17.9 mmNUM
HAS CONCEPT MODDerivation = MeanCODE
CONTAINS“DIstance” = 45.6 mmNUM
INFERRED FROMEquation = “MyEqn”TEXT
CONTAINS“Gestational Age” =10 days NUM
 
A.5.1.2  DICOM Template  Compatible Export Format  
EPIQ/Affiniti  can also export user defined  measurements, calculations and OB tables  which  are compatible with 
existing DICOM  standard  templates . These DICOM  objects are created  with user configurable  attributes for the 
DICOM code scheme designator, code value and code meaning. For more information on the DICOM attributes 
support ed, see t he Analysis section in the  EPIQ and Affiniti Setups menu.    
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A.5.1.3 Private Template and Template Extensions  
 
A.5.1.3.1  TID5000: OB -GYN Ultrasound Procedure Report  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
25 > CONTAINS INCLUDE TID (9902) Fetal Heart Section 
1 U   
26 > CONTAINS INCLUDE TID (9900) User-defined concepts 
1 U   
 
A.5.1.3.2  TID5100: Vascular Ultrasound Report  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
31 > CONTAINS INCLUDE TID (9900) User-defined concepts 
1 U   
 
A.5.1.3.3  TID5200: Echocardiography Procedure Report  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
22 > CONTAINS INCLUDE TID (9900) User-defined concepts 
1 U   
 
A.5.1.3.4  TID995300: Pediatric Echocardiography Procedure Report  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
… … … … … … … … … 
22 > CONTAINS INCLUDE TID (9900) User-defined concepts 
1 U   
 
A.5.1.3.5  TID9900: User -defined concepts  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
1   CONTAINER DT (T9900-01, 
99PMSBLUS, 
“User-defined 
concepts”) 
1 M   
2 > CONTAINS INCLUDE TID (9901) User -defined 
concept  1-n MC One of row 2 and 3 must be 
present $Type = DT (T9900- 02, 
99PMSBLUS, 
“Measurement”) 
3 > CONTAINS INCLUDE TID (9901) User -defined 
concept  1-n MC One of row 2 and 3 must be 
present $Type = DT (T9900- 03, 
99PMSBLUS, 
“Calculation”) 
 
A.5.1.3.6  TID9901: User -defined concept 
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 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
1   CONTAINER $Type 1 M   
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject 
Context, 
Fetus 1 MC IF this template is invoked more 
than once to 
describe more 
than one fetus 
 
3 > HAS CONCEPT 
MOD TEXT DT (T9900-04, 
99PMSBLUS, 
“Label”) 
1 M   
4 > HAS CONCEPT MOD 
CODE DT (G-C171, SRT, “Laterality”) 
1 U  DCID (244) Laterality  
5 > CONTAINS INCLUDE TID (300) 1 1-n IFF $Type = “Measurement”  $Measurement = DCID (99008) 
Results 
 $Derivation = 
DCID (3627) 
Measurement Type 
6 > CONTAINS INCLUDE TID (300)  1 1 IFF $Type = “Calculation”  $Measurement = DT (T9900-05, 
99PMSBLUS, 
“Value”) 
7 > CONTAINS NUM EV (18185-9  , 
LN, 
“Gestational 
Age”) 
1 U  $Units = EV (d, 1.4, UCUM, days)  
8 > INFERRED FROM TEXT DCID (228) Equation or Table 
1 U   
 
A.5.1.3.7  TID9902: Fetal Heart Section  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
1   CONTAINER DT (99999, 99PMSBLUS, “Fetal Heart”) 
1 M … … 
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject 
Context. 
Fetus 1 MC IF this template is 
invoked more 
than once to 
describe more 
than one fetus 
 
3 > CONTAINS INCLUDE DTID (5008) Fetal 
Biometry 
Group 
1-n M  $Biometery Type=MemberOf 
(DCID (99001) 
Fetal Heart) 
 
A.5.1.3.8  TID 5009: Fetal Biophysical Profile Section  
 NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 
1   CONTAINER DT 125006,DCM,”Biophysical Profile”) 
1 M   
2 > HAS OBS CONTEXT INCLUDE DTID (1008) Subject Context. Fetus  1 MC IF this template is invoked more than 
once to describe 
more than one 
 
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