XiO® DICOM Conformance Statementcf20ec46-9397-4d97... · XiO 1 1. Overview The following is the DICOM Conformance Statement for the XiO product as of release 5.10. XiO is a 3‐dimensional

XiO® DICOM Conformance Statement For Release 5.10

IMPAC Medical Systems, Inc. Document ID: LEDDCMXIO0001 Language: English

DICOM Conformance Statement ii Document Name: LEDDCMXIO0001

Copyright statement

©2014IMPACMedicalSystems,Inc.Allrightsreserved.Donotmakeprintedorelectroniccopiesofthisguide,orpartsofit,withoutwrittenpermissionfromIMPACMedicalSystems,Inc.

TheinformationinthisguideisforthesoleuseofIMPACMedicalSystems,Inc.personnel,authorizedusersandlicenseesofIMPACMedicalSystems,Inc.products,andnootherpurpose.

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TheElektatrademarks,servicemarks,logos,andtradenamesthatweuseinthisdocumentaretheregisteredandunregisteredtrademarksandtradenamesofElektaAB publ. ,itsaffiliatesorathirdpartythathaslicenseditstrademarksandtradenamestoElektaAB publ. oritsaffiliates.Donotmakecopies,show,orusetrademarksortradenameswithoutwrittenpermissionfromIMPACMedicalSystems,Inc.anaffiliateofElektaAB publ. .

Acknowledgement of other trademarks and trade names

Elektaacknowledgesthetrademarksandtradenamesofothermanufacturersthatweuseinthisdocument.

Referenced documents

Elektadoesnotsupplyalldocumentsthatwerefertointhisdocumentwiththeequipment.Elektareservestherighttomakethedecisiononwhichofthedocumentsitsupplies.

Contact information

GLOBAL ELEKTA SOFTWARE SUPPORT

Contact Software Support:http://www.elekta.com/healthcare‐professionals/products/elekta‐services/service‐and‐support/software‐support.html

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Training Calendar:www.elekta.com/training

XiO iii

Revision History

Revision Date Purpose

LEDDCMXIO0001 9.0 May2012 Updatedlegalentityinformation.

LEDDCMXIO0001 10.0 September2012

Updatedfor4.80changes:RTIONPLANimportdetailsaddedFlatteningFilterFreeSupportinExport FluenceModeSequence

LEDDCMXIO0001 11.0 November2013 Updatedfor5.00changesDefaultexportinoriginalimageframeofreferenceAddedRTStructuresetdetailsinnewappendix

LEDDCMXIO0001 12.0 October2013 WhereverCMSInc.ismentioned,addasword † symbolandparagraphatthebottomofthetableorpagetoindicatetheIMPACMedicalSystemsInc.successorship.

LEDDCMXIO0001 13.0 February 2014 Updatedfor5.00.01 changes.Changesrelateto:reportFIXED_SSDattheappropriatetime, anddescriptionofmonitorunitsforMotorizedWedgeDCATbeams.

LEDDCMXIO0001 14.0 November2014 Updatedfor5.10changes.Nonewfeaturesinrelease;fixedsomeerrors intext.RemovedElektaofficeaddresses.

LEDDCMXIO0001 15.0 December2014 Addedadescriptiononpage31forGeneralStudyModuleC.7.2.1,StudyInstanceUID.

DICOM Conformance Statement iv Document Name: LEDDCMXIO0001

Contents 1. Overview ............................................................................................................... 1

2. Introduction .......................................................................................................... 3 2.1 Audience ............................................................................................................................... 3 2.2 Remarks ................................................................................................................................ 3 2.3 Definitions, Terms and Abbreviations .................................................................................... 3 2.4 References ............................................................................................................................. 3

3. Networking ........................................................................................................... 5 3.1 Implementation Model .......................................................................................................... 5 3.1.1 Application Data Flow Diagram ............................................................................................. 5 3.1.2 Functional Definition of AE Titles .......................................................................................... 6 3.1.3 Sequencing of Real World Activities ....................................................................................... 7 3.2 AE Specifications .................................................................................................................... 9 3.2.1 AE Specification for MERGECOM_SCP ...................................................................................... 9 3.2.2 Association Acceptance Policies for MERGECOM_SCP ............................................................. 9 3.2.3 AE Specification for MERGE_STORE_SCU ............................................................................... 10 3.2.4 AE Specification: DRR_NET_OUT/DRR_PR_OUT ................................................................... 13 3.3 Network Interfaces .............................................................................................................. 15 3.3.1 Supported Communication Stacks ....................................................................................... 15

4. Media Interchange ................................................................................................ 17 4.1 Application Data Flow Diagram ........................................................................................... 17 4.2 Functional Definition of MERGECOM_SCP with a DICOM media ........................................... 17 4.2.1 CT and MR Import into XiO .................................................................................................. 17 4.2.2 CT/MR Image Import ............................................................................................................ 17

5. Support of Extended Character Sets ........................................................................ 19

6. Appendices........................................................................................................... 21 Appendix 1 Import Processing ................................................................................................................ 21 A1.1 Import Processing for DICOM CT, MR and PET images .......................................................... 21 A1.2 Import Processing for DICOM RT Structure Set ..................................................................... 24 A1.3 Import Processing for DICOM RTPLAN .................................................................................. 25 Appendix 2 Export of CT Images, RT Structure Set, RT Plan RT Dose and RT Image from XiO

(common module content except RT Ion) ............................................................................ 31 Appendix 3 Export of RT Structure Set .................................................................................................... 33 Appendix 4 Export of RT PLAN ................................................................................................................ 35 Appendix 5 Export of RT DOSE ................................................................................................................ 47 Appendix 6 Secondary Capture and RT IMAGE Export of DRR and Intensity Map .................................... 49 Appendix 7 DRR and Intensity Map Patient Orientation tag (0020,0020) Reported Values ...................... 53 Appendix 8 DICOM RT Ion Plan Export/Import (available only with PROTON planning license) .............. 56 Appendix 9 Private Data Elements .......................................................................................................... 73

Figures Figure 3-1 - Application Data Flow Diagram: Image, Structure Set and RT Plan Transfer to XiO

diagram ................................................................................................................... 5

Figure 3-2 - Application Data Flow Diagram: CT IMAGE, RT Structure Set, RT (Ion) Plan, RT Dose and RT Image Export from XiO ................................................................................... 5

Figure 3-3 - Application Data Flow Diagram: DRR Image Export and DRR Print ................................. 6

Figure 4-4 - Application Data flow diagram for Interface with a DICOM CD. ..................................... 17

XiO v

Tables Table 1-1: Network Services ....................................................................................................... 1

Table 1-2: UID Values ................................................................................................................ 2

Table 1-3: Media Services ........................................................................................................... 2

Table 3.2-1: SOP Classes for MERGECOM_SCP ................................................................................ 9

Table 3.2-2: Number of Associations as an Association Acceptor for MERGECOM_SCP ...................... 9

Table 3.2-3: SOP Classes for MERGE_STORE_SCU .......................................................................... 10

Table 3.2-4: Number of Associations as an Association Initiator for MERGE_STORE_SCU .................. 10

Table 3.2-5: Proposed Presentation Contexts for MERGE_STORE_SCU ............................................. 11

Table 3.2-6: SOP Classes for DRR_NET_OUT ................................................................................. 13

Table 3.2-7: Number of Associations as an Association Acceptor for DRR_NET_OUT/DRR_PR_OUT ................................................................................. 14

Table 3.2-8: Proposed Presentation Contexts for DRR_NET_OUT ................................................... 14

Patient Module (C.7.1.1) ............................................................................................................ 21

General Study Module (C.7.2.1) ................................................................................................... 21

General Series Module (C.7.3.1) .................................................................................................. 22

Frame of Reference Module (C.7.4.1) .......................................................................................... 22

General Equipment Module (C.7.5.1) ........................................................................................... 22

General Image Module (C.7.6.1) .................................................................................................. 22

Image Plane Module (C.7.6.2) ..................................................................................................... 23

Image Pixel Module (C.7.6.3) ...................................................................................................... 23

CT Image Module (C.8.2.1) ......................................................................................................... 23

MR Image Module (C.8.3.1) ........................................................................................................ 24

PET Image Module (C.8.9.4) ........................................................................................................ 24

Curve Module (C.10.2) ................................................................................................................ 24

Patient Module (C.7.1.1) ............................................................................................................ 24


Structure Set Module (C.8.8.5) .................................................................................................... 25

ROI Contour Module (C.8.8.6) ..................................................................................................... 25

RT ROI Observations Module (C.8.8.8) ......................................................................................... 25

Patient Module (C.7.1.1) ............................................................................................................ 25



RT Series Module (C.8.8.1) .......................................................................................................... 26

RT General Plan Module (C.8.8.9) ................................................................................................ 26

RT Beams Module (C.8.8.14) ....................................................................................................... 27

Patient Module (C.7.1.1) ............................................................................................................ 31


DICOM Conformance Statement vi Document Name: LEDDCMXIO0001

RT Series Module (C.8.8.1) .......................................................................................................... 32


SOP Common Module (C.12.1) .................................................................................................... 32

Structure Set Module (C.8.8.5) .................................................................................................... 33

ROI Contour Module (C.8.8.6) ..................................................................................................... 33

RT ROI Observations Module (C.8.8.8) ......................................................................................... 34

RT General Plan Module (C.8.8.9) ............................................................................................... 35

RT Prescription Module (C.8.8.10) ............................................................................................... 36

RT Tolerance Tables Module (C.8.8.11) ........................................................................................ 36

RT Fraction Scheme Module (C.8.8.13) ......................................................................................... 37

RT Beams Module (C.8.8.14) ....................................................................................................... 38

RT Patient Setup Module (Part 3 C8.8.12) .................................................................................... 45

Approval Module (C.8.8.16) ........................................................................................................ 46

RT Dose Module ........................................................................................................................ 47

Secondary Capture (DRR and Intensity Map Fluence) .................................................................... 49

RT IMAGE (DRR)......................................................................................................................... 50

RT IMAGE (Intensity Map Fluence) ............................................................................................... 52

Head First plan, patient is supine ............................................................................................... 53

Feet First plan, patient is supine................................................................................................. 53

Head First plan, patient is prone ................................................................................................ 54

Feet first plan, patient is prone .................................................................................................. 54

SOP Common Module (Part 3 C12.1) (See also Part 3 C12.1.1.2) ...................................................... 56

Patient Module (Part 3 C7.1.1) .................................................................................................... 56

General Study Module (Part 3 C7.2.1) .......................................................................................... 57

RT Series Module General Series Module (Defined: Part 3 C7.3.1 Defined: Part 3 C8.8 ...................... 57

RT Series Module General Series Module (Defined: Part 3 C7.3.1 Defined: Part 3 C8.8 See also: Part 3 C7.3.1.1) ............................................................................................. 58

Frame of Reference Module (Part 3 C7.4.1 See also Part 3 C7.4.1.1.1) ............................................ 58

Frame of Reference Module (Part 3 C7.4.1 See also Part 3 C7.4.1.1.2) ............................................ 58

General Equipment Module (Part 3 C7.5.1) .................................................................................. 58

RT Series (Part 3 C8.8) ................................................................................................................ 59

RT General Plan (Part 3 C8.8.9) ................................................................................................... 59

RT Prescription Module (C.8.8.10) ............................................................................................... 60

RT Patient Setup (Part 3 C8.8.12) ................................................................................................ 61

RT Fraction Scheme (Part 3 C8.8.13) ............................................................................................ 61

Approval Module (Part 3 C.8.8.16) .............................................................................................. 62

RT Ion Beams Module (Part 3 C.8.8.25) ........................................................................................ 63

XiO vii

Table 9.1 Private Creator Identification (IMPAC) .......................................................................... 73

Table 9.2 Private Creator Identification (ION_PRIVATE11) ............................................................ 73

Table 9.3 Private Creator Identification (IBA) .............................................................................. 73

XiO 1

1. Overview

ThefollowingistheDICOMConformanceStatementfortheXiOproductasofrelease5.10.

XiOisa3‐dimensionalradiationtreatmentplanningsystemthatusesmedicalimagestodevelopradiationtreatmentplansforcancerpatients.XiOusesDICOMservicestoimportimages,structuresandplanparametersandtoexportimages,structures,planparametersanddosetoothervendors.XiOsupportsthenetworkimportofCT,MRandPETimages,RTStructureSets,RTPlansandRTIonPlansandthenetworkexportofCTImages,RTStructureSets,RTPlans,RTIonPlans,RTDoseandexportofDRRsandIntensityMapsasSecondaryCaptureorRTImage.XiOimportsCTandMRimagesfromDICOMmediaCDorDICOMMediamagnetoopticaldisks MOD .XiOprintsdigitalreconstructedradiographs DRR’s toDICOMcompatibleprinters.

XiOcandefinemultipleexport SCP locationstowhichtheusercanchoosetoexportCTIMAGE,STRUCTURESET,RTPLAN,RTIONPLAN,RTDOSEandRTIMAGE.

DRRImagesexportedfromthePrint,DRRoption asSecondaryCaptureorRTImage canbeexportedtoone,pre‐definednetworklocationandprintedtoone,pre‐definedprinter.IntensityMaps asSecondaryCaptureorRTImage cancurrentlybeexportedtoone,pre‐definednetworklocationandprintedtoone,pre‐definedprinter.TheIntensityMaplocationandprintercanbedifferentthantheoneusedforDRRs.

TheusercanedittheAEtitleforeachXiOworkstation’sexportofCTIMAGES,RTSTRUCTURESETS,RTPLANS,RTIONPLANS,RTDOSEandRTIMAGE.TheAEtitleforstand‐aloneexportingofDRR viathePrint,DRRoption andIntensityMapsSecondaryCaptureorRTImage orforDICOMprintingisnoteditable.

ThetablesbelowprovideanoverviewofthenetworkservicessupportedbyXiO.

Table 1-1: Network Services

SOP Classes User of Service (SCU)

Provider of Service (SCP)

Transfer

CTImageStorage Yes Yes

MRImageStorage No Yes

PETImageStorage No Yes

SECONDARYCAPTUREStorage

Yes No

STRUCTURESETStorage Yes Yes

RTIONPLANStorage Yes Yes

RTPLANStorage Yes Yes

RTDOSEStorage Yes No

1. Overview

2

SOP Classes User of Service (SCU)

Provider of Service (SCP)

RTImageStorage Yes No

Print Management

BasicGrayscalePrintManagement

Yes No

Table 1-2: UID Values

UID Value UID Name Category

1.2.840.10008.1.1 Verification Transfer

1.2.840.10008.5.1.4.1.1.2 CTImageStorage Transfer

1.2.840.10008.5.1.4.1.1.4 MRImageStorage Transfer

1.2.840.10008.5.1.4.1.1.128 PositronEmissionTomography PET ImageStorage

Transfer

1.2.840.10008.5.1.4.1.1.7 SecondaryCaptureImageStorage Transfer

1.2.840.10008.5.1.4.1.1.481.3 RTStructureSetStorage Transfer

1.2.840.10008.5.1.4.1.1.481.5 RTPlanStorage Transfer

1.2.840.10008.5.1.4.1.1.481.8 RTIonPlan Storage Transfer

1.2.840.10008.5.1.4.1.1.481.2 RTDoseStorage Transfer

1.2.840.10008.5.1.4.1.1.481.1 RTImageStorage Transfer

1.2.840.10008.5.1.1.9 BasicGrayscalePrintManagementMetaSOPClass

PrintManagement

Table 1-3: Media Services

Media Storage Application Profile

Write Files (FSC or FSU)

Read Files (FSR)

CompactDisk‐Recordable

GeneralPurposeCD‐R No Yes

Magneto‐OpticalDisk

CT/MRMOD No Yes

XiO 3

2. Introduction

2.1 Audience

DICOMinterfaceimplementers RadiationTherapyproductsupportpersonnel RadiationOncologyMedicalPhysicists RadiationOncologyMarketingandSalespersonnel

2.2 Remarks

XiO’sroleasatreatmentplanningsystemmeansthatitbothimportsandexportsDICOMdata.

XiO’sPFM patientfilemaintenance programinitiallycreatestheexistenceofapatientwithinXiOusingimages CT,MR,PET andcontours usingRTSTRUCTURESETortheCurvemoduleofasetofCTimages “pushed”toitfromanimagingsourceorPACSsystem.

XiO’sTeletherapyprogramistheplacewhereusersdevelopexternalbeamtreatmentplans.Theycanimportpartiallydevelopedplans usingDICOMRTPLANorRTIONPLANimport ,editandaddtothisplanordevelopanewplan.XiOcalculatesdoseandtheusersavestheproposedtreatmentplan.Attheendoftheplanningprocess,optionswithinTeletherapyallowtheusertoexportcombinationsofCTImages,RTSTRUCTUREsetrepresentationsofcontours,markersandreferencepoints,RTPLAN,RTIONPLAN,3DRTDOSEandDRR’sasRTIMAGE.TheusercanalsoexportDRRsbythemselvesthroughtheFile|Print|DRRoption.IfDRRsaresentfromthismenuorwithouttheRTPLANontheregularexportmenu,thentheseDRR’sdoNOTreferencetheRTPLANtowhichthebeamsbelong.

2.3 Definitions, Terms and Abbreviations

DRR‐DigitallyReconstructedRadiograph

PFM‐PatientFileMaintenance‐XiO’scontouringapplication

Teletherapy‐XiO’smainexternalbeamtreatmentplanninganddosecalculationapplication

2.4 References

DigitalImagingandCommunicationsinMedicine DICOM StandardNEMA,Rosslyn,VA

2. Introduction

2.4 References

4

IECStandard61217,RadiotherapyEquipment‐Coordinates,MovementsandScalesReferenceCEI/IEC61217:2001

XiO 5

3. Networking

3.1 Implementation Model

3.1.1 Application Data Flow Diagram

ThediagramsbelowillustratetheinteractionsthatXiOmakeswiththeDICOMworld.

Figure 3-1 - Application Data Flow Diagram: Image, Structure Set and RT Plan Transfer to XiO diagram

Figure 3-2 - Application Data Flow Diagram: CT IMAGE, RT Structure Set, RT (Ion) Plan, RT Dose and RT Image Export from XiO

3. Networking


6

Figure 3-3 - Application Data Flow Diagram: DRR Image Export and DRR Print

3.1.2 Functional Definition of AE Titles

3.1.2.1 Functional Definition of MERGECOM_SCP

CT,MR,PET,STRUCTURESET,RTPLANandRTIONPLANImportintoXiO.

Theexportingsysteminitiatesthenegotiationofanassociationwiththemerge3srvapplicationrunningonXiOoverthenetwork.Themerge3srvapplicationwillnegotiatewiththeclientandaccepttheassociationifitcanperformtherequestedservice.Iftheassociationisacceptedbytheserver,anyDICOMobjectsaretransferredfromtheclienttomerge3srvovertheassociationandstoredinatemporarydirectoryontheXiOsystem.Whenthetransferiscompletetheclientapplicationclosestheassociation.Later,theXiOuserimportsacceptableDICOMdataintotheXiOapplicationatwhichpointitisconvertedtotheinternalXiOformat.

3.1.2.1.1 CT/MR/PET Image Import

IftheDICOMheaderfora16‐bitCTimagefiledefinesapixelpaddingvalue,XiOwillconvertallpixelsequaltothatpaddingvaluetotheminimumpixelvaluethatcanberepresentedbythedatatypeofthatimage.ItisassumedthattheCTmanufacturerhasselectedapaddingpixelvaluethatisoutsidetherangeofthepixelvaluesthatmakeuptheimage.PixelPaddingvaluesareignoredforMRandPET.

XiOwillapplytheslopeandintercepttothepixelvaluesforCTandPETimagesbeforesavingtheminXiO’sinternalformat.XiOwillnotapplyanyslopeandinterceptforMRimages.

3. Networking


XiO 7

3.1.2.1.2 RT Structure Set Import

TheXiOapplicationimportsstructuresetswhichhaveassociatedimagespresent.Itcannotimportstructuresetsbythemselves.XiOwillmovePOINTStothenearestimagelocation afterwarningtheuser .

3.1.2.1.3 RT Plan Import

TheXiOapplicationcanimportplanswithoutreferencedimagesorstructuresets.Restrictionsontheacceptabledataaregivenintheappendices.

3.1.2.2 Functional Definition of MERGE_STORE_SCU

CTImage,RTStructureSet,RTPlan,RTIonPlan,RTDoseExportandRTImagefromXiO’sTeletherapyDICOMExportpage

TheXiOclientapplicationrequestsStorageServicesofauser‐selected oneoffive DICOMserveroveranassociation.Iftheassociationisacceptedbytheserver,theuser‐selectedDICOMobjectcombinationistransferredfromtheXiOclienttotheselectedserver.Whenthetransferiscompleted,theclientapplicationclosestheassociation.

MERGE_STORE_SCUisthedefaultnamefortheXiOworkstation’sAE‐Title.ItcanbeeditedtobeuniqueforeachworkstationthroughXiO’sSettingsapplication.

3.1.2.3 Functional Definition of DRR_NET_OUT/DRR_PR_OUT

DRRandIntensityMapfilminganddigitalimageexportviaSecondaryCapture,RTImageandDICOMprintexporttoSCP.

Whenoutputto"Film"isselected,theXiOclientapplicationrequestsPrintServicesofone,pre‐definedDICOMserveroveranassociation.Iftheassociationisacceptedbytheserver,secondarycaptureimagesarethentransferredfromtheXiOclienttotheprintserver.Whenthetransferiscompleted,theclientapplicationclosestheassociation.

Whenoutputto"Network"isselected,theXiOclientapplicationrequestsImageStorageServicesofone,pre‐definedDICOMserveroveranassociation.IfXiOislicensedforRTImageexport,theassociationisrequestedforRTImagestorage.Ifnot,theassociationisrequestedforSecondaryCapturestorage.Iftheassociationisacceptedbytheserver,theimagesaretransferredfromtheXiOclienttothestorageserver.Whenthetransferiscompleted,theclientapplicationclosestheassociation.

3.1.3 Sequencing of Real World Activities

3.1.3.1 CT/MR/PET/SC Image; RT Structure Set; RT Plan; RT Ion Plan Import

AnoperatorinitiatesthetransferofdatafromasystemthatwantstosenddatatoXiO CT,MR,PETmachineorCTSimulator .TheclientapplicationinitiatesthestoragecommandforCT,MR,PET,RTStructureSetand/orRTPlanorRTIonPlan.TheXiOserverreceivesthedataandplacesitinatemporarydiskdirectoryonXiO.

3. Networking


8

AsynchronoustotheDICOMtransferofthisdata,theusercanimporttheimagesandstructuresettocreateanewpatientimagesetusingXiO’sPFMprogramorcreateaninitialexternalbeamplanforanexistingpatientbyimportingRTPlaninXiO’sTeletherapyprogram.

StructureSetscanonlybeimportedifthecorrespondingimagesarepresentatthesametimetheCTimagesareusedtocreateanewXiOimageset.

RTPLANandRTIONPLANimportinTeletherapywillcheckforthepatientIDandwarnifthepatientIDisdifferentbuttheusercanstillproceed.

RTIonPlanImportforIBAmachinesisnotcurrentlysupported.

3.1.3.2 DRR or Intensity Map Export

StandaloneDRRimagetransferisinitiatedbyselectingtheFilemenuinXiO’sTeletherapyapplicationthenselectingPrint,DRR.Theusercanselectoutputto"Film"forprintingor"Network"foradigitalimagetransfer.TheDRRcalculationandoutputareperformedinthebackground.

Thehostname,AE‐Titleandportnumberofone“Network”locationandone“Film”locationperXiOworkstationmustbespecifiedinXiO’sSettings,WorkstationDRRoutputapplication,aheadoftime.

IntensityMaptransferisinitiatedbyselectingtheFilemenuinXiO’sTeletherapyapplicationthenselectingPrint,IntensityMap.Theusercanselectoutputto"Film"forprintingor"Network"foradigitalimagetransfer.

Thehostname,AE‐Titleandportnumberofone“Network”locationandone“Film”locationperworkstationfortheintensitymapmustbespecifiedinXiO’sSettings,Workstation,IntensityMapoutputapplicationaheadoftime.

3.1.3.3 CT IMAGE, STRUCTURE SET, RTPLAN, RT ION PLAN, RT DOSE and RT IMAGE Export

FromtheXiODICOMexportpageinTeletherapy,theuserselectswhichcombinationofDICOMobjectstoexport CT,STRUCTURESET,RTPLAN,RTIONPLAN,RTDOSE,RTIMAGE andtowhichDICOMlocation.Ifdosecalculationisfinished,allfourobjectswillbeavailabletoexport.RTDosecannotbeexportedwithoutacorrespondingRTPlan;RTPlancanbeexportedwithorwithoutRTStructureSet.RTStructureSetcanbesentwithorwithoutCTimages.IfnoRTStructureSetisselected,theRTPlanwillhaveRTPlanGeometry 300A,000C settothevalueofTREATMENT_DEVICEandnoStructureSetwillbereferenced.

TheusercanexporttomultipleDICOMSCPswithhostdata,AE‐Titleandportnumberpre‐definedinXiO’sSettings|DICOMsettingsdialog.

3. Networking

3.2 AE Specifications

XiO 9


3.2.1 AE Specification for MERGECOM_SCP

3.2.1.1 SOP Classes

ThisApplicationEntityprovidesStandardConformancetoallStorageSOPClassesbutonlythefollowingSOPclassesareofcurrentinteresttoXiOusers:

Table 3.2-1: SOP Classes for MERGECOM_SCP

SOP Class Name SOP Class UID SCU SCP

Verification 1.2.840.10008.1.1 No Yes

CTImageStorage 1.2.840.10008.5.1.4.1.1.2 No Yes

MRImageStorage 1.2.840.10008.5.1.4.1.1.4 No Yes

PositronEmissionTomographyPET ImageStorage

1.2.840.10008.5.1.4.1.1.128 No Yes

RTStructureSetStorage 1.2.840.10008.5.1.4.1.1.481.3 No Yes

RTPlanStorage 1.2.840.10008.5.1.4.1.1.481.5 No Yes

RTIonPlanStorage 1.2.840.10008.5.1.4.1.1.481.8 No Yes

3.2.1.2 Association Policies for MERGECOM_SCP

3.2.1.2.1 General

The PDU sizeproposedinanassociationrequestwilldefaultto16Kbytesandisconfigurableinthe ASSOC_PARMS sectionofthemergecom‐Linux.profiletobeanythingfrom2Kbytesto512KbytesusingtheparameterPDU_MAXIMUM_LENGTH.

3.2.1.2.2 Number of Associations

Table 3.2-2: Number of Associations as an Association Acceptor for MERGECOM_SCP

Maximumnumberofsimultaneousassociations 5

3.2.2 Association Acceptance Policies for MERGECOM_SCP

MERGECOM_SCPrunsasaserverinthebackgroundoftheXiOmainworkstationusuallyrtp1 listeningforassociationrequestsfromDICOMsourceswishingtosendtoXiO.AssociationswillonlybeacceptedfromrecognizedIPaddressalreadyenteredinthe/etc/hostsorDomainNameServer DNS fileofthemainXiOworkstation.

3. Networking


10

3.2.2.1 MERGECOM_SCP SOP Specific Conformance for SOP Classes

AllDICOMobjectsareacceptedbyMERGECOM_SCPandwrittentoalocaldiskforlater,asynchronousselection.XiOusersarethenabletoimporttheXiOcompatibleobjectsintothetreatmentplanningapplication.ErrorsorinconsistenciesinDICOMobjectcontentwillnotbedetecteduntilXiOgoesthroughitsimport.

SeeAppendicesonpage21orspecifictag‐by‐tagdatausedbyXiO.

3.2.3 AE Specification for MERGE_STORE_SCU

3.2.3.1 SOP Classes

ThisApplicationEntityprovidesStandardConformancetothefollowingSOPclasses:

Table 3.2-3: SOP Classes for MERGE_STORE_SCU


CTImageStorage 1.2.840.10008.5.1.4.1.1.2 Yes No

RTStructureSetStorage 1.2.840.10008.5.1.4.1.1.481.3 Yes No

RTPlanStorage 1.2.840.10008.5.1.4.1.1.481.5 Yes No

RTDoseStorage 1.2.840.10008.5.1.4.1.1.481.2 Yes No

RTIonPlanStorage 1.2.840.10008.5.1.4.1.1.481.8 Yes No

RTImageStorage 1.2.840.10008.5.1.4.1.1.481.1 Yes No

3.2.3.2 Association Policies for MERGE_STORE_SCU

3.2.3.2.1 General

The PDU sizeproposedinanassociationrequestwilldefaultto16Kbytesandisconfigurableinthe ASSOC_PARMS sectionofthemergecom‐Linux.protobeanythingfrom2Kbytesto512KbytesusingtheparameterPDU_MAXIMUM_LENGTH.


Table 3.2-4: Number of Associations as an Association Initiator for MERGE_STORE_SCU


3.2.3.3 Association Initiation Policy for MERGE_STORE_SCU

3.2.3.3.1 Store CT Image, RT Structure Set, RT Plan, RT Dose or RT Image

TheXiOclientapplicationrequestsStorageServicesofauser‐selected oneoffive DICOMserveroveranassociation.Iftheassociationisacceptedbytheserver,the

3. Networking


XiO 11

user‐selectedDICOMobjectcombinationistransferredfromtheXiOclienttotheselectedserverovertheassociation.Whenthetransferiscompleted,theclientapplicationclosestheassociation.

MERGE_STORE_SCUisthedefaultnamefortheXiOworkstation’sAE‐Title.ItcanbeeditedtobeuniqueforeachworkstationinXiO’sSettingsmenu.

Table 3.2-5: Proposed Presentation Contexts for MERGE_STORE_SCU

Presentation Context Table

Abstract Syntax Transfer Syntax Role Extended Negotiation

Name UID Name UID

CTImageStorage

1.2.840.10008.5.1.4.1.1.2

DICOMImplicitVRLittleEndian

1.2.840.10008.1.2 SCU None

RTStructureSetStorage

1.2.840.10008.5.1.4.1.1.481.3


1.2.840.10008.1.2 SCU None

RTPlanStorage

1.2.840.10008.5.1.4.1.1.481.5


1.2.840.10008.1.2 SCU None

RTIonPlanStorage

1.2.840.10008.5.1.4.1.1.481.8


1.2.840.10008.1.2 SCU None

DICOMExplicitVRLittleEndian foranyprivateelementcontent

1.2.840.10008.1.2.1

SCU None

RTDoseStorage

1.2.840.10008.5.1.4.1.1.481.2


1.2.840.10008.1.2 SCU None

RTImageStorage

1.2.840.10008.5.1.4.1.1.481.1


1.2.840.10008.1.2 SCU None

3.2.3.3.2 SOP Specific Conformance for all storage SOP classes with MERGE_STORE_SCU

ExceptfortheStudyInstanceandFrameofReferenceUID,XiOalwaysgeneratesnewUIDswitheachnewexport.ThePatientName 0010,0010 ,PatientID0010,0020 ,Patient’sBirthDate 0010,0030 ,PatientSex 0010,0040 ,StudyID

3. Networking


12

0020,0010 ,StudyInstanceUID 0020,000D andFrameofReferenceUID 0020,0052 willbethesameforallobjectsexportedatthesametime.SpecificCharacterSet 0008,0005 willbeISO_IR100forallobjects.

SeeAppendix2fortag‐by‐tagconversionfromXiOdataoftheDICOMmodulescommontoallexportedobjects.

3.2.3.3.2.1 SOP Specific Conformance for CT Image Storage SOP Class with MERGE_STORE_SCU

TheManufacturer 0008,0070 isreportedasCMS,Inc.†.TheCTimagesarederivedfromincomingoriginalimagesandarenotoriginalcopies;theImageType0008,0008 willbereportedasORIGINAL\SECONDARY\AXIAL.

AsoftheXiO5.00release,thedefaultexportbehaviorforXiOistoexportDICOMdataintheoriginalCTimagesframeofreference “OriginalDICOM”coordinate .

Ifnecessary,auserwithadministratorrightscansettheexportframeofreferencebacktothepre‐XiO5.00typewheretheCTdataisinapatientrelativecoordinatesystembutmaynothavethesameoriginastheoriginalimages.Inthis“XiOGenerated”coordinatemode,theimageswillalwaysbesettoHeadFirst eveniftheplanisFeetFirst andthis“XiOGenerated”coordinatewillhaveanewframe‐of‐referenceUID.

TheCTPixeldatawillhavehadtheslopeandinterceptappliedandtherefore,atexport,theimageswillalwaysbe16‐bitsigned.

RTStructureSetsandRTDoseexportedfromXiOwillbeintheframeofreferenceestablishedbytheCTimages‐“OriginalDICOM”or“XiOGenerated”.†CMSInc.hasbeensucceededasacorporationbyIMPACMedicalSystemsInc.;forsustaineddatacompatibilitywithDICOMreceiversthatmightusethisnameforspecificimportfilteringorprocessing,wehaverefrainedfromchangingtheManufacturernameintheDICOMexportobjects.

3.2.3.3.2.2 SOP Specific Conformance for RT Structure Set Storage SOP Class with MERGE_STORE_SCU

OriginalDICOMexportframeofreferencemode:

IftheRTStructureSetisexportedwithouttheCTImages,theRTSTRUCTobjectwillreferencetheoriginalUIDsfortheoriginalCTimages

XiOGeneratedexportframeofreferencemode:

IftheRTStructureSetisexportedwithouttheCTImages,theRTSTRUCTobjectwillreferenceUIDsforCTimagesasifXiOwasexportingnewCTimages.

3.2.3.3.2.3 SOP Specific Conformance for RT Plan Storage SOP Class with MERGE_STORE_SCU

IfRTPlanissentwithoutanRTStructureSet,RTPlanGeometry 300A,000C willbesettoTREATMENT_DEVICE,otherwisethevaluewillbePATIENTandtheRTPlanwillreferencetheRTStructureSetexportedatthesametime.

3. Networking


XiO 13

SeeAppendix4onpage47fortag‐by‐tagconversionfromXiOdatafortheRTPLANIOD.

3.2.3.3.2.4 SOP Specific Conformance for RT Dose Storage with MERGE_STORE_SCU

XiOexportsDoseTypetag 300A,0004 equaltoPHYSICALandDoseSummationtag 300A,000A equaltoPLAN.

RTDosewillnotexportwithoutitscorresponding,referencedDICOMRTPLAN.XiOwillforcethisthroughtheexportuserinterface.

Withthisrelease,RTDoseisexportedwithBitsAllocated 0028,0100 16,BitsStored 002,0101 16andHighBit 0026,0102 15.

XiOusestheGridFrameOffsetVector 3004,000C toindicatetheDICOMzvalueforthe3Ddoses.XiOsupportsonlymonotonicallyincreasingoffsetsinthezdirectionandthevaluesinthevectorareconsideredrelativetotheImagePositionPatient 0020,0032 zvalue.

SeeAppendix5onpage49fortag‐by‐tagconversionfromXiOdatafortheRTDOSEIOD.

3.2.3.3.2.5 SOP Specific Conformance for RT Ion Plan Storage with MERGE_STORE_SCU

IfanyoftheplandataconditionsaremetsuchthatprivatetagsareaddedtotheRTIonPlanobject,thesystemwillfirstnegotiatetousetheExplicitVRLittleEndiantransfersyntax.Ifthereceivingdeviceisactingasa“fullfidelitystoragedevice”,itshouldutilizethissyntax,suchthatitcanretainandre‐transmitalltheprivatedataelements.

SeeAppendix8onpage56fortag‐by‐tagconversionfromXiOdatafortheRTIONPLANIOD.

3.2.3.3.2.6 SOP Specific Conformance for RT Image with MERGE_STORE_SCU

IfRTIMAGEisexportedwithouttheRTPLAN,thentheDRRdoesnotcontainareferencetotheRTPLANandthereforethebeamforwhichitwasgenerated.

3.2.4 AE Specification: DRR_NET_OUT/DRR_PR_OUT

3.2.4.1 SOP Classes

ThisApplicationEntityprovidesStandardConformancetothefollowingSOPclasses:

Table 3.2-6: SOP Classes for DRR_NET_OUT


RTImageStorage 1.2.840.10008.5.1.4.1.1.481.1DRR_NET_OUT

Yes No

3. Networking


14


SecondaryCaptureImageStorage

1.2.840.10008.5.1.4.1.1.7DRR_NET_OUT

Yes No

BasicGrayscalePrintManagementMetaSOPClass

1.2.840.10008.5.1.1.9DRR_PR_OUT

Yes No

3.2.4.2 Association Policies

3.2.4.2.1 General

The PDU sizeproposedinanassociationrequestwilldefaultto16Kbytesandisconfigurableinthe ASSOC_PARMS sectionofthemergecomprofiletobeanythingfrom2Kbytesto512KbytesusingtheparameterPDU_MAXIMUM_LENGTH.


Table 3.2-7: Number of Associations as an Association Acceptor for DRR_NET_OUT/DRR_PR_OUT


3.2.4.3 Association Initiation Policy for DRR_NET_OUT/ DRR_NET_OUT

3.2.4.3.1 Export DRR to film and network

Whenoutputto"Film"isselected,theXiOclientapplicationrequestsPrintServicesofonepre‐definedDICOMserveroveranassociation.Iftheassociationisacceptedbytheserver,theimagesarethentransferredfromtheXiOclienttotheprintserverovertheassociation.Whenthetransferiscompletedtheclientapplicationclosestheassociation.

Whenoutputto"Network"isselected,theXiOclientapplicationrequestsImageStorageServicesofonepre‐definedDICOMserveroveranassociation.IfXiOislicensedforRTImageexport,theassociationisrequestedforRTImagestorage.Ifnot,theassociationisrequestedforSecondaryCapturestorage.Iftheassociationisacceptedbytheserver,theimagesarethentransferredfromtheXiOclienttothestorageserverovertheassociation.Whenthetransferiscompleted,theclientapplicationclosestheassociation.

Table 3.2-8: Proposed Presentation Contexts for DRR_NET_OUT


Abstract Syntax Transfer Syntax Role Extended Negotiation

Name UID Name UID

RTImageStorage

1.2.840.10008.5.1.4.1.1.481.1


1.2.840.10008.1.2

SCU None

3. Networking

3.3 Network Interfaces

XiO 15


SCImageStorage

1.2.840.10008.5.1.4.1.1.7 DICOMImplicitVRLittleEndian

1.2.840.10008.1.2

SCU None

BasicGrayscalePrintManagementMetaSOPClass

1.2.840.10008.5.1.1.9 DICOMImplicitVRLittleEndian

1.2.840.10008.1.2

SCU None

3.2.4.3.1.1 SOP Specific Conformance for SOP Classes with DRR_NET_OUT (film and network export)

3.2.4.3.1.1.1 Stand alone DRR Export as RT IMAGE or Secondary Capture (File|Print|DRR option)

Eachtimeanimageisexported,anewUIDiscreated.ImageUIDsarenotpersistent.

SeeAppendix6onpage53andAppendix7onpage53fortag‐by‐tagcontentofDRRandIntensityMapsasRTImageandSecondaryCapture.


Themerge3srvandXiOapplicationsrunovertheTCP/IPprotocolstackonanyphysicalinterconnectionmediasupportingtheTCP/IPstack.

3.3.1 Supported Communication Stacks

3.3.1.1 TCP/IP stack

Merge3srvisimplemented viaMergeCOM‐3basiclibrary usingthe"BerkeleySockets"interfacetoTCP/IPservices.

TheXiOclientsoftwareisimplemented viaMergeCOM‐3advancedlibrary usingthe"BerkeleySockets"interfacetoTCP/IPservices.

3.3.1.2 Physical Media Support

AnyphysicalmediasupportedbytheTCP/IPstackbeingrunonthehostmachineissupported.

3. Networking


16

XiO 17

4. Media Interchange

4.1 Application Data Flow Diagram

Figure 4-4 - Application Data flow diagram for Interface with a DICOM CD.

4.2 Functional Definition of MERGECOM_SCP with a DICOM media

4.2.1 CT and MR Import into XiO

TheXiOsysteminitiatesthereadingoftheDICOMmediaapplicationrunningonXiO.IftheDICOMDIRisfound,thelistingofCTorMRstudiesispresented.Theuserthenchoosesonestudytoimportfromthemedia.Whenthetransferiscompletetheapplicationclosesthemedia.Afollow‐onmenuthenletstheXiOuserimporttheimagesintotheXiOapplicationatwhichpointtheyareconvertedtotheinternalXiOformat.

4.2.2 CT/MR Image Import

IftheDICOMheaderfora16bitCTimagefiledefinesapixelpaddingvalue,XiOwillconvertallpixelsequaltothatpaddingvaluetotheminimumpixelvaluethatcanberepresentedbythedatatypeofthatimage.ItisassumedthattheCTmanufacturerhasselectedapaddingpixelvaluethatisoutsidetherangeofthepixelvaluesthatmakeuptheimage.PixelPaddingvaluesareignoredforMRandPET.

XiOwillapplytheslopeandintercepttothepixelvaluesforCTimagesbeforesavingtheminXiO’sinternalformat.XiOwillnotapplyanyslopeandinterceptforMRimages.

ForPETimages,theaverageofslopeisfoundandappliedtotheentiresetofimages.XiOwillnotapplyinterceptforPETimages.

4. Media Interchange

4.2 Functional Definition of MERGECOM_SCP with a DICOM media

18

XiO 19

5. Support of Extended Character Sets

AsanSCU,XiOexportstheextendedCharacterSetvalueofISO‐IR100fortheIMAGE,STRUCTURESET,RTPLAN,RTIMAGEandSecondaryCaptureobjects.

AsanSCP,XiOacceptsthebasicandextendedcharactersetofISO‐IR100.XiOdoesnotvalidatethatcharactersreceivedconformtothesecharactersets.

5. Support of Extended Character Sets

20

XiO 21

6. Appendices

Appendix 1 Import Processing

A1.1 Import Processing for DICOM CT, MR and PET images

Thefollowingmodules,whichmakeuptheCTandMRimageIOD,areread.TheelementsusedbyXiOarelisted.SinceXiOhasnousefortheunlistedelements,theyarenotread.

Patient Module (C.7.1.1)

Group Element Description

0010 0010 Patient Name

0010 0020 Patient ID

0010 0030 Patient’s Birth Date

0010 0040 Patient’s Sex

0010 1000Other Patient ID’s Ifexists,importedfromCTforre‐export

0010 1001Other Patient Names Ifexists,importedfromCTforre‐export

General Study Module (C.7.2.1)


0008 000D Study Instance UID

0008 0020 Study Date

0008 0030 Study Time

0008 0090 Referring Physician’s Name

0020 0010 Study ID

0008 0050 Accession Number



22

General Series Module (C.7.3.1)


0008 0060 Modality

0018 5100

Patient Position ReadfromCTimagestoestablishdefaultorientationofpatientimagesandtoestablishtheexportframeofreferencewhen‘OriginalDICOM’frameofreferenceisused.Duringimport,thesystemacceptsonlyHFS,HFP,FFSorFFP;systemwillpromptforusertoeditfromanyothervalue.

Frame of Reference Module (C.7.4.1)


0020 0052 Frame of Reference UID

0020 1040 Position Reference Indicator

General Equipment Module (C.7.5.1)


0008 0070Manufacturer usedtocreateaninitialstoragelocation

0008 1090Manufacturer's Model usedtocreateaninitialstoragelocation

0028 0120 Pixel Padding Value

General Image Module (C.7.6.1)


0020 0013 Image Number



XiO 23

Image Plane Module (C.7.6.2)


0028 0030 Pixel Spacing

0020 0032 Image Position (Patient)

0020 0037 Image Orientation (Patient)

0020 0030 Image Position RetiredelementwhichisusedonlyifImagePosition Patient isnotavailable

0018 0050 Slice Thickness

0020 1041 Slice Location

Image Pixel Module (C.7.6.3)


0028 0010 Rows

0028 0011 Columns

0028 0100 Bits Allocated

0028 0101 Bits Stored

0028 0103 Pixel Representation

7FE0 0010 Pixel Data

0028 0106 Smallest Image Pixel Value

CT Image Module (C.8.2.1)


0008 0008 Image Type

0028 1052Rescale Intercept ThisisappliedtothepixeldatabeforeitisstoredinXiO.

0028 1053Rescale Slope ThisisappliedtothepixeldatabeforeitisstoredinXiO.


A1.2 Import Processing for DICOM RT Structure Set

24

MR Image Module (C.8.3.1)



PET Image Module (C.8.9.4)



0028 1052Rescale Intercept ThisisappliedtothepixeldatabeforeitisstoredinXiO

0028 1053Rescale Slope ThisisappliedtothepixeldatabeforeitisstoredinXiO

Curve Module (C.10.2)

Used to read patient contours by systems licensed for PICKER PT_XFER only


5000 0010 Number of Points

5000 0022 Curve Description

5000 3000 Curve Data

A1.2 Import Processing for DICOM RT Structure Set

Thefollowingmodules,whichmakeuptheRTStructureSetIOD,areread.TheelementsusedbyXiOarelisted.SinceXiOhasnousefortheunlistedelements,theyarenotread.



0010 0010 Patient Name

0010 0020 Patient ID


A1.3 Import Processing for DICOM RTPLAN

XiO 25



0008 0070 Manufacturer

0008 1090 Manufacturer's Model

Structure Set Module (C.8.8.5)


3006 0002Structure Set Label Usedtocreatenameoftemporarystorage file

3006 0026ROI Name Importsandusesfirst25charactersofROIName

ROI Contour Module (C.8.8.6)


3006 002A ROI Display Color

3006 0042 Contour Geometric Type

3006 0046 Number of Contour Points

3006 0050 Contour Data

RT ROI Observations Module (C.8.8.8)


3006 00A4 RT ROI Interpreted Type


Thefollowingmodules,whichmakeuptheRTPlanIOD,areread.TheelementsusedbyXiOarelisted.SinceXiOhasnousefortheunlistedelements,theyarenotread.




26


0010 0010 Patient's Name Patient’sfulllegalnamePresentedasinformationduringimport.Warningissuedifnotthesameasthepatientinmemory;usercanoverrideandcontinue.

0010 0020 Patient ID. Presentedasinformationduringimport.Warningissuedifnotthesameasthepatientinmemory;usercanoverrideandcontinue.



0008 0020 Study Date Presentedasinformationduringimport



0008 0070 Manufacturer Import:Thisdataisusedtopickalocationforrtp1temporarylocaldiskstorageonXiO.Ithasnocurrentuserinterfaceorplanninguse.

RT Series Module (C.8.8.1)


0008 0060 Modality Import:mustbeRTPLAN.

RT General Plan Module (C.8.8.9)


300A 0002 RT Plan Label Import:Thisdatawillbepresentedintheplanindexasahelptotheuser,andwillbeusedtocreatetheXiOfilename.

300A 0006 RT Plan Date Import:Thisdatawillbepresentedintheplanindexasahelptotheuser,butwillnotbestoredasastudysetwillalreadyexist.

300A 0007 RT Plan Time Import:Thisdatawillbepresentedintheplanindexasahelptotheuser,butwillnotbestoredasastudysetwillalreadyexist.



XiO 27



300A 000C RT Plan Geometry Import:BothPATIENTandTREATMENT_DEVICE e.g.X‐raysimulator willbeaccepted.

RT Beams Module (C.8.8.14)


300A 00C0 Beam Number Import:ThiswillbemappedtoanXiObeamnumber anintegerbetween1and99 .

300A 00C2 Beam Name Import:ThiswillbeusedastheXiObeamdescriptionunlessBeamDescription 300A,00C3 exists.

300A 00C3 Beam Description Import:Thefirst24characterswillbeusedastheXiObeamdescription.

300A 00C4 Motion Characteristic of Beam IfDYNAMIC,the‘GantryRotationDirection’willbecheckedthatitissettoeither‘CW’or‘CCW’andthebeamwillbemarkedasarotationalbeam.Ifallnecessarygantryrotationdataisnotpresenttheplanimportwillbeabortedwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid: 300A,00C4 ".

300A 00C6 Radiation Type OnlyELECTRONandPHOTON areacceptedforRTPLANmodality.

300A 00B2 Treatment Machine Name Userdefinednameidentifyingtreatmentmachineusedinbeamdelivery.XiOwilluseitsDICOMimportmachinenamemappingtabletotrytouniquelyidentifyacorrespondingXiOtreatmentmachinenametousefordosecalculation.Ifthismappingisnotunique,XiOwillprompttheusertopickanXiOtreatmentmachine.IftheDICOMimportmachinemappingisnotdefinedinXiO,XiOwillusethefirst14characterstomatchtheimportedtreatmentmachinewithanXiOtreatmentmachine.Ifnomachinematchisfound,XiOwillprompttheusertopickanXiOtreatmentmachine.IftheXiOtreatmentmachineisnotofthesametypeastheimportedmachine 300A,00C6 ,theuserwillpromptedtopickanXiOtreatmentmachine.



28



300A 00B3 Primary Dosimeter Unit Import:Notused;ThisissetbytheXiOtreatmentmachine.

300A 00B4 Source-Axis Distance Import:NotUsed;ThisissetbytheXiOtreatmentmachine.

300A 00B8 RT Beam Limiting Device Type Import:ThisissavedasacheckagainstthedataintheControlPointSequence 300A,0111 .

300A 00BA Source to Beam Limiting Device Distance Import:NotUsed;ThisissetbytheXiOtreatmentmachine.

300A 00BC Number of Leaf/Jaw Pairs Import:IfMLC,thevalueischeckedthatitmatchestheXiOtreatmentmachineparameters;ifnottheimportisabortedwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid: 300A,00BC ".

300A 00BE Leaf Position Boundaries Import:NotUsed;ThisissetbytheXiOtreatmentmachine.

300A 006A Referenced Patient Setup Number Import:NotUsed.SystemassumesISOCENTRIC.

300A 00D0 Number of Wedges Import:Only0isallowed.

300A 00F0 Number of Blocks XiOaccepts1APERTURE i.e.PORT andupto19SHIELDINGentriesor20SHIELDING i.e.BLOCK typeblocks.

300A 00F2 Total Block Tray Factor Import:ThisismappedtotheXiObeam'strayfactor.Ifnovaluesupplied,XiOwillusethedefaultXiOblocktrayvalue.Ifnodefaultblocktrayisdefined,XiOwillnotimporttheplanandexitwithanerrormessagethatthefollowingtag 300A,00F2 isinvalid.

300A 00F8 Block Type ThisismappedtoanXiOflagidentifying XiO’spolygontypewhereSHIELDING BLOCKandAPERTURE PORT.XiOallowsonlyoneAPERTUREperbeam.IfmorethanoneAPERTUREissentthentheimportwillbeabortedwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid: 300A,00F8 ".

300A 00FA Block Divergence AllblocksinXiOaredivergent PRESENT .IfABSENTornullvalueisreceivedtheuserwillbeforcedtoacknowledgethemessagethatthe'Blockforbeamnwillbeimportedasadivergentblock".



XiO 29



300A 00FC Block Number ThiswillbemappedtoXiO'sfirstavailablepolygonnumberforthisbeam.Ifthiswillcreatemorethan20polygonsforthisbeam,theimportwillbeabortedwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid:300A,00FC ".

300A 00FE Block Name Import:IfthereisaPortIDthisinformationisimportedotherwiseitisblank.

300A 00E1 Material ID Import:SeenoteforBlockTransmission.

300A 0100 Block Thickness Import:SeenoteforBlockTransmission.

300A 0102 Block Transmission Import:ThematerialID,BlockThicknessandBlockTransmissionareallcheckedtoverifythatvalidvaluesweresent.Ifanyofthesethreetagsarenotvalid,thenSFMdefaultsareusedforallofthem,andawarningmessageisdisplayed.IfanyofthesedefaultshavenotbeensetupinSFMthentheimportwillfailwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid: 300A,0102 ".

300A 0104 Block Number of Points Import:This isstoredasacheckagainsttheBlockData300A,0106 .

300A 0106 Block Data Import:ThisdataismappedtoanXiOpolygon.

300A 0108 Applicator ID Import:IftheXiOmachinedoesnothaveamatchingconeIDtheimportisabortedwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid: 300A,0108 ".

300A 0109 Applicator Type Import:NotUsed

300A 010A Applicator Description Import:NotUsed

300A 0110 Number of Control Points Import:Ifmorethantwocontrolpointsarepresentthentheimportwillbeabortedwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid:300A,0110 ".

300A 0114 Nominal Beam Energy Import:NotUsed;ThisissetbytheXiOtreatmentmachine.



30



300A 00B8 RT Beam Limiting Device Type Import:Thisischeckedagainstthevaluesentandstoredpreviously.Ifitisdifferent,orifitdoesn'tmatchtheXiOtreatmentmachineparameters,theimportisabortedwiththeerrormessage"DICOMPlanImportwasnotsuccessful.Thefollowingtagsareinvalid: 300A,00B8 ".

300A 011C Leaf/Jaw Positions Import:TheXiOmachine’sleaves/jawpositionsaremappedtothesevalues.

300A 011E Gantry Angle XiObeam'sgantryangleismappedtothisvalue.

300A 011F Gantry Rotation Direction Import:Thisissavedtemporarilyfordeterminingthedegreesofrotationforthisarcbeam

300A 0120 Beam Limiting Device Angle Import:Beam'scollimatorangleismappedfromthisvalue.

300A 0121 Beam Limiting Device Rotation Direction Import:OnlyNONEisaccepted.

300A 0122 Patient Support Angle Import:TheXiObeam'scouchangleismappedtothisvalue.

300A 0123 Patient Support Rotation Direction Import:OnlyNONEisaccepted.

300A 012C Isocenter Position Import:ThisismappedtotheXiObeamisocenter;ifNULL,notsent,orwillendupoutsidethepatientextenttheuserispromptedtoenteranisocenter.

XiO 31

Appendix 2 Export of CT Images, RT Structure Set, RT Plan RT Dose and RT Image from XiO (common module content except RT Ion)



0010 0010 Patient's Name ExportXiO’sDICOMPatientName; ifnotavailable,exportXiO’spatientname

0010 0020 Patient ID ExportXiO’sDICOMPatient’sID,ifnotavailable,exportXiOpatientID

0010 1000 Other Patient IDs IfstoredfromCT,exportthosevalues,elseexportXiO’spatientID.

0010 1001 Other Patient Names IfstoredfromCT,exportthosevalues,elseexportXiO’spatientname.

0010 0030 PatientBirthDateExport XiO’s birth date

0010 0040 Patient Sex ExportM formaleFforfemaleOforunknown



0020 000D Study Instance UID Exportuniqueidentifierfromtheimported,primaryimagestudy

0020 0010 Study ID ExportCT’svalue.Ifnotavailable,exportXiOstudysetID.

0008 0020 Study Date ExportCTStudy’screationdateIfnotavailableinXiOstudyset,exportnull.

0008 0030 Study Time ExportCTStudy’screationtimeIfnotavailableinXiOstudyset,exportnull.

0008 0050 Accession Number Exportoriginalimage’svaluableifavailable,otherwise1

Appendix 2 Export of CT Images, RT Structure Set, RT Plan RT Dose and RT Image from XiO (common module content except RT Ion)

32



0008 0090 Referring Physician’s Name ExportvaluefromCTimages

RT Series Module (C.8.8.1)


0008 0060 Modality ExportCT,RTSTRUCT,RTPLANRTDOSE orRTIMAGEdependingonmodalitybeingsent.

0020 000E Series Instance UID

0020 0011 SeriesNumberExport1



0008 0070 Manufacturer

ExportCMS,Inc.†

0008 1090 Manufacturer's Model Name ExportXiO

0018 1020 Software Versions ExportXiO'sSoftwareVersionNumber X.XX.XXformat

†CMSInc.hasbeensucceededasacorporationbyIMPACMedicalSystemsInc.;forsustaineddatacompatibilitywithDICOMreceiversthatmightusethenameforspecificimportfilteringorprocessing,wehaverefrainedfromchangingtheManufacturernameintheDICOMexportobjects.

SOP Common Module (C.12.1)


0008 0018 SOP Instance UID

0008 0005 Specific Character Set ExportISO_IR100

0008 0012 Instance Creation Date Export:InstanceDate

0008 0013 Instance Creation Time Export: InstanceTime

XiO 33

Appendix 3 Export of RT Structure Set

Structure Set Module (C.8.8.5)


3006 0002Structure Set Label ExportStructureSetlabel

3006 0004Structure Set Name Export XiO studyset name

3006 0008 StructureSetDate

3006 0009 StructureSetTime

3006 0010 ReferencedFrameOfReferenceSequence

0020 0052 Frame of Reference UID

3006 0020 StructureSetROISequence

3006 0022 ROI Number

3006 0022 Referenced Frame of Reference UID

3006 0026 ROI Name

3006 0036 ROI Generation Algorithm

ROI Contour Module (C.8.8.6)


3006 0039 ROI Contour Sequence

3006 0084 Referenced ROI Number

3006 002A ROI Display Color

3006 0040 Contour Sequence

3006 0016 Contour Image Sequence

3006 0042 Contour Geometric Type

3006 0046 Number of Contour Points

3006 0050 Contour Data

Appendix 3 Export of RT Structure Set

34

RT ROI Observations Module (C.8.8.8)


3006 0080 RT ROI Observation Sequence

>3006 0080 Observation Number

>3006 0084 Referenced ROI Number

>3006 0085 ROI Observation Label ExportXiO’scontourname

>3006 0088 ROI Observation Description ExportXiO’scontourname

>3006 00A4 RT ROI Interpreted Type EXTERNALORGANMARKERISOCENTER

>3006 00A6 ROI Interpreter ExportNull

>300C 300C ROI Physical Properties Sequence

>>3006 00B2 ROI Physical Property ExportREL_ELEC_DENSITY

>>3006 00B4 ROI Physical Property Value ExportElectronDensityvalue.

XiO 35

Appendix 4 Export of RT PLAN

Thefollowingmodules,whichmakeuptheDICOMRTPlanIOD,aresent.ElementsthatarenotsupportedforexportfromanXiOteletherapyplanarenotlisted.Forseveralelements,theSFMDICOMexportdatafunctionorpageismentioned.ForeachXiOtreatmentmachine,theusershouldtailortheconventionofXiOplandatatofitthereceivingsystem'srequirementsbyusingthesemenus.Theusercansetadifferentmachinename,definea"nowedge"ID,aconstantblockID e.g.,custom ,adefaulttolerancetablevalue,whattocallIMRTbeams "static"ordynamic" ,andsetupamappingofexportedwedgeIDsbasedonthewedgeangleandtoedirection.



300A 0002 RT Plan Label ExportPlanID basedoncombinationofCourseID ifpresent plussavedplanID.Ifplanwasintemporarystatuswhenexported,thelabelwillbeprecededbyTemp.

300A 0003 RT Plan Name Export:IfthisisapermanentplansendplanIDorifitisatemporaryplanwithnopermanentplanreferencesendTemporaryplannumberTemporary_ TemporaryPlan# .Ifitisatemporaryplanwithapermanentplanreference,sendTemporary_ TemporaryPlan# _ PlanId .

300A 0004 RT Plan Description ExportPlanDescription

300A 0006 RT Plan Date ExportPlansavedondate

300A 0007 RT Plan Time ExportPlansavedontime

300A 000A RT Plan Intent ExportPlanintentfieldfromXiOifthere,otherwisenotexported.

300A 000C RT Plan Geometry ExportPATIENTunlessnoRTSRUCTURESETisbeingexportedatthesametime;forthatcase,exportTREATMENT_DEVICE


36

RT Prescription Module (C.8.8.10)


300A 0010 Dose Reference Sequence OnlyexportifPrescriptionSiteandPrescriptionDosearedefinedforatleastonefractiongroup.Onlygroupsthatcontainbothpiecesofinformationareexported.

300A 0012 Dose Reference Number Thenumberoffractionsplanned setsthisvalue thenumberoffractionsforeachfractiongroupisuniqueandthereforeusedhereandastheToleranceTableNumber .

300A 0014 Dose Reference Structure Type Export“SITE”

300A 0016 Dose Reference Description ExportXiO’sRx prescription Sitename forthefractiongroup.

300A 0020 Dose Reference Type Export“TARGET”

300A 0026 Target Prescription Dose ExportXiO’sRx prescription TotalDose

RT Tolerance Tables Module (C.8.8.11)


300A 0040 Tolerance Table Sequence OnlyexportifTolerancetablenameisdefinedforatleastonefractiongroup.

300A 0042 Tolerance Table Number Exportnumberoffractionsforthegroup.

300A 0043 Tolerance Table Label ExportXiO’sToleranceTableName.


XiO 37

RT Fraction Scheme Module (C.8.8.13)


300A 0070 Fraction Group Sequence AnybeamswiththesamenumberoffractionsinanXiOplanwillbeexportedaspartofthesamefractiongroup.

300A 0071 Fraction Group Number ExportnumberoftheFractionGroup

300A 0078 Number of Fractions Planned Exportnumberoffractionsforthesebeams.

300A 0080 Number of Beams Exportnumberofbeamsthatarepartofthisfractiongroup.

300A 00A0 Number of Brachy Application Setups Export0

300C 0004 Referenced Beam Sequence

300A 0082 Beam Dose Specification Point ExportWeightPointCoordinatesinmillimetercoordinatestofirstdecimalplace.

300A 0084 Beam Dose Export:Ifplandoseiscalculated,exportdoseperfractioninGyattheweightpoint tothethirddecimalplace .

300A 0086 Beam Meterset Exporttotalmetersetvalueforthisbeam MUortime

300C 0006 Referenced Beam Number ExportXiOBeamnumber anintegervaluebetween1and99 .

300C 0050 Referenced Dose Reference Sequence ExportedonlyifRxSiteandRxTotalDosearepresentinXiOforthebeam’sfractiongroup.

300C 0051 Referenced Dose Reference Number Exportthenumberoffractionsforthisgroup


38



300A 00B0 Beam Sequence

300A 00C0 Beam Number ExportXiOBeamnumber anintegerbetween1and99

300A 00C2 Beam Name ExportFieldIDifpresentinthebeam,otherwiseexportXiO’sbeamdescription upto24characters

300A 00C3 Beam Description ExportXiObeamdescription unlesstreatmentbeamisDynamicConformalArcforaVarianmachine– inthiscasesetautomaticallyto"DMLC_ARC"

300A 00C4 Beam Type Export:Ifbeamisrotationalarcbeamordynamicconformalbeam,putDYNAMIC.IfSegMLC i.e.IMRTbeam beam,exportDYNAMICorSTATICdependingonvaluechosenforstep‐and‐shootontheDICOMExportDatapageinSFM.

300A 00C6 Radiation Type Export:ELECTRONorPHOTON

300A 00B2 Treatment Machine Name ExportmachineIDfromXiO'sSFMExportcustomizationpage.ThismaybeadifferentmachinenamethanisusedonXiO.

0008 1040 Institutional Department Name ExportXiOClinicName

300A 00B3 Primary Dosimeter Unit ExportunitsidentifiedinXiO forthismachine.

300C 00A0 Reference Tolerance Table Number ExportTolerancetablenumberwhichwillequalthenumberoffractionsforthebeam.

300A 00B4 Source-Axis Distance ExportmachinereferencedistancedefinedinXiOforthismachine.

300A 00B6 Beam Limiting Device Sequence Export: aminimumoftwoanduptothreecollimatorsequenceswillbesentforeachbeam‐anXjawpair,aYjawpairandMLC,ifoneexists.MLCXisonlyMLCtypecurrentlyavailableinXiO.Foranelectronbeam,createtheX,YjawvaluesfromtheXiOconeID.Thatis,fora6x10cone,reportasymmetricjawvalueas60 mm andasymmetricYjawvalueas100 mm .


XiO 39



300A 00B8 RT Beam Limiting Device Type Export:StartwiththeXjawandexportsettingsaccordingtoplan asymmetricversussymmetric .CreateasecondsequencewiththeYjawandfinishwiththeMLCXifoneisinthebeam.XiOwillexport3deviceswhenthereisanMLC,evenforjawreplacementMLCs.

300A 00BA Source to Beam Limiting Device Distance Exportbeam'ssourcetocollimatordistancefortheX,YorMLCcollimatorasappropriate.

300A 00BC Number of Leaf/Jaw Pairs Export1ifnotMLC,ifMLC,exportvaluefromXiO'sMLCconfigurationfile.

300A 00BE Leaf Position Boundaries ExportvaluesfromXiO'sMLCconfigurationfile.

300A 006A Referenced Patient Setup number Willbe1unlessanSSDorExtendedSSDbeamisusedintheplan.Inthiscase,itwillbe1or2dependingonthePatientSetupSequenceorderforISOCENTRICorFIXED_SSD.

300A 00CE Treatment Delivery Type ExportTREATMENT

3002 0050 Primary Fluence Mode Sequence SequenceonlysentiftheenergyinthemachinemodelhasbeenexplicitlyupdatedtoindicatethatitsfluenceisSTANDARDorNON_STANDARD.Otherwise,sequenceisnotexported.

3002 0051 Fluence Mode

Ifsequenceissent,exportSTANDARDorNON_STANDARDasstoredintheXiOmachinemodelforthisenergy.

3002 0052 Fluence Mode ID

IfFluenceModeisNON_STANDARD,exportvaluestoredinFluenceModeIDforthismachineforthisenergy.

300A 00D0 Number of Wedges Export1ifwedgeexists;ifwedgeIDexistsinSFM,export1ifthereareparametersfor"nowedge."Otherwiseexport0.Export0foranelectronbeamNote:Althoughtheremaybenophysicalwedgeinthebeam,anentryfornowedgeinXiO'sexportwedge mappingtablemeansthattheuserwishestoreportawedgeIDanyway.

300A 00D1 Wedge Sequence

300A 00D2 Wedge Number Export1ifawedgeexistsoriftheuserhasentereda"NONE"tomaptonowedge;otherwise0.


40



300A 00D3 Wedge Type ThefollowingXiOwedgetermsareexportedasthefollowingDICOMterms:

XiOMOTORIZED MOTORIZEDXiOFIXED STANDARDXiODYNAMIC DYNAMICXiOVIRTUAL DYNAMICForNONE STANDARD

300A 00D4 Wedge ID ExportwedgeIDfromSFMWedgeMappingtableifitexists;otherwiseexportXiOwedgeID.

300A 00D5 Wedge Angle ExportwedgeanglefromSFMWedgemappingtableifoneexists;otherwise,exportnullfornowedgeorSTANDARDwedge,andwedgeangleformotorized,virtualordynamicwedge.

300A 00D6 Wedge Factor ExportXiOwedgecorrectionfactorasreportedattheweightpointonthesourceindexForNONEexport1.0

300A 00D8 Wedge Orientation ForFixed,VirtualandEDWwedgesexportoffsetofwedgeheelwithrespecttoIECBEAMLIMITINGDEVICEcoordinatesystemasfollows

XiOHeelIn 180XiOHeelout 0

XiOHeelLeft 270XiOHeelRight 90

ForNONEwedgeexport0ForMOTORIZED,export0

300A 00DA Source to Wedge Tray Distance ExportwedgetraydistanceparameterfromSFMmachinefile.ForNONEdo notexport.

300A 00E0 Number of Compensators Export1ifcompensatorexitsotherwise0ForXiO'sEllisandLucitetypes,export0.

300A 00E2 Total Compensator Tray Factor ExportCompensatorTrayFactorUsedinbeam.

300A 00E3 Compensator Sequence

300A 00E4 Compensator Number Export1


XiO 41



300A 00E1 Material ID ExportcompensatormaterialfromXiO'streatmentmachineparametersforcompensators

300A 00E5 Compensator ID Exportcompensatortype:Huestis,ParScientific,decimal,fromXiO'streatmentmachineparametersforcompensators

300A 00E6 Source to Compensator Tray Distance Exportbeam'sSourcetocompensatorfiltertrayvaluefromXiO'streatmentmachineparameters

300A 00E7 Compensator Rows ExportnumberofcompensatordatapointsintheXjawdimension

300A 00E8 Compensator Columns ExportnumberofcompensatordatapointsintheYjawdimension

300A 00E9 Compensator Pixel Spacing Export:CalculatefromPointsPer/cminCompensatordataandprojecttotheisocenterplane

300A 00EA Compensator Position Forsymmetricbeamexport ‐W/2, L/2 ForAsymmetricexport –LW, UL whereW width ,L length ,LW leftwidth andUL upperlength aretheXiOnamesfortheXandYjawsofthemachine

300A 00EC Compensator Thickness Data XiOexportsonce‐smearedcompensatorphysicalthicknessesateachgridlocation.

300A 02E1 Compensator Mounting Position ExportPATIENT_SIDEorSOURCE_SIDEassetbythecompensatordetailsinSourceFileMaintenance.

300A 00ED Number of Boli ExportnumberofboliusedinthisbeamNote:Ifbeamisnot100%bolusedor100%unbolused,errormessagewillbeissuedandthenon‐bolusedbeamonlywillbeexported.TheusermustcreateasecondbeamwiththedesiredbolusedplancontributionforDICOMtorecognizeit

300A 00B0 Referenced Bolus Sequence Exportallplanbolusnumbersturnedonforthisbeamasasequence

3006 0084 Referenced ROI Number ExportXiO'splanBolusNumber


42



300A 00F0 Number of Blocks Exporttotalnumberofportsandblocksinthebeam XiOmaximumis20

300A 00F2 Total Block Tray Factor ExportTrayfactorforbeamshownintheXiO'ssourceindex

300A 00F4 Block Sequence

300A 00F5 BlockTrayIDExporttraydescriptionifdefinedinXiO,otherwisenull

300A 00F6 Source to Block Tray Distance ExportsourcetoblocktraydistancefromXiO'streatmentmachineparameters

300A 00F8 Block Type IfXiOpolygonflagsaysport,thenexportAPERTUREotherwiseSHIELDING

300A 00FA Block Divergence PRESENTiscurrentlytheonlysupportedtypeonXiOforphotonandelectron

300A 00FC Block Number Exportpolygonnumber 1‐20

300A 00FE Block Name ExportuniversalBlockIDfromXiOSFMDICOMdataexportparameterspageifavaluehasbeendefined;otherwisethereisnoexportofthistag

300A 00E1 Material ID ExportmapBlockmaterialforthisblockifithasbeendefinedfortheapertureorblock,otherwisevalueisnull

300A 0100 Block Thickness ExportFFTblockthicknessvalueifavailable,otherwisenull

300A 0102 Block Transmission ExportBlocktransmissionasgivenbyHVLvalueinaClarksoncalculatedbeam,otherwisenull

300A 0104 Block Number of Points Exporttotalpolygoncoordinatescount

300A 0106 Block Data Exportdatastreamofpolygoncoordinates

300A 0107 Applicator Sequence

300A 0108 Applicator ID ExporttheXiOconedescription aconesizeincentimeters

300A 0109 Applicator Type Export:ELECTRON_OPEN


XiO 43



300A 010A Applicator Description ExportXiOConedescription

300A 010E Final Cumulative Meterset Weight Export:1.0

300A 0110 Number of Control Points Exportnumberofcontrolpoints.XiOFixedandrotationbeamswithnoMOTORIZEDwedgeorSegmentedMLC IMRT willhave2controlpoints;ArotationalbeamhasonlytheMU/minutesandgantryanglechanginginvalue;arotationalbeamisdifferentiatedbythedesignationofbeamtypeDYNAMICAMOTORIZEDWEDGEbeamwillhave4controlpoints:CP0toCP1incrementthecumulativemetersetweighttotheamountneededforthewedgedbeam;setwedgepositionasIN.CP1toCP2,changewedgepositionfromINtoOUTwithnoincrementincumulativemetersetweight.ReportthecumulativemetersetweightvalueagainatCP2.CP2toCP3incrementcumulativemetersetweightforopenpartofthebeam.Foranarcwithmotorizedwedge,alsouse4controlpoints:0‐1:definearadiatingarcwithwedgeIN1‐2:defineanon‐radiatingsegmentwhereonlythewedgemovedINtoOUT2‐3definea reverse radiatingarcwithwedgeOUT.ADYNAMICCONFORMALbeamwillhaveacontrolpointateveryexportangleincrement selectedinSFM pluscontrolpoint0.Forexample,a120°arcwillhave121controlpoints.ADYNAMICCONFORMALbeamwithamotorizedwedgewillhavetwiceasmanycontrolpoints.ThefirsthalfofthecontrolpointswillreportthearcwiththeWEDGEsettoOUT,thesecondwiththeWEDGEsettoIN.

300A 0111 Control Point Sequence

300A 0112 Control Point Index


44



300A 0134 CumulativeMetersetWeightExportCumulativeMeterset Weight CMW ForafixedbeamMOTORIZEDWEDGE,CMWatCP1willbe MUwedged/totalMU /FinalCumulativeMetersetWeightForaDynamicConformalArcbeamwithamotorizedwedge,XiOwillexportthetreatmentasasinglebeamdescribingtwoarcs.ThevalueofFinalCumulativeMetersetWeightvalueisreachedattheendofthesetwoarcs.Thetwoarcsaredescribedbythesamenumberofcontrolpoints.ThefirsthalfofthecontrolpointsreportsthecumulativemetersetweighttoreachtheOPENfieldMU,thesecondhalfaccumulatesthemetersetweightsneededtoaddtheWEDGEfieldMU.

300A 0114 Nominal Beam Energy Export:machineenergyatControlPoint0

300C 0050 Referenced Dose Reference Sequence ExportedonlyifDoseReferenceSequence 300A,0010 isexportedforthefractiongroup.

300C 0051 Referenced Dose Reference Number Exportnumberoffractionsforthebeam

300A 0115 Dose Rate Set OnlyexportedfornondynamicIMRTbeamsifDoseRateisdefinedforthefractiongroup.FordynamicIMRTbeams,thedoserateusedforsegmentationisexported.Inallcases,onlyencodedforcontrolpoint0.

300A 0116 Wedge Position Sequence Export:usedifwedgeisinthebeam

300C 00C0 Referenced Wedge Number Export:1ifwedgeinbeam

300A 0118 Wedge Position ForFIXED,NONE,EDWandVW,putINForMotorizedWEDGE,atControlPoint0and1,setWedgePositiontoIN.Atcontrolpoint2and3setthewedgePositiontoOUT

300A 011A Beam Limiting Device Position Sequence

300A 00B8 RT Beam Limiting Device Type Exportcollimatortagappropriately.Aminimumoftwoanduptothreecollimatorsequenceswillbesentforeachbeam‐ anXjawpair,aYjawpairandMLC,ifoneexists.MLCXisonlycurrentlyavailableMLCinXiO


XiO 45



300A 011C Leaf/Jaw Positions Export X,YandMLCjawpositionsinIEC1217coordinatesystem

300A 011E Gantry Angle ExportIECgantryanglevalue

300A 011F Gantry Rotation Direction Forrotation arc beam,exportgantryincreasingdirectionvaluefromSFMbeamfile.For DYNAMICCONFORMALbeam,exportcurrentvaluebasedonnextgantryposition.Forlastcontrolpoint,enter"none."

300A 0120 Beam Limiting Device Angle ExportXiOcollimatorvalue

300A 0121 Beam Limiting Device Rotation Direction Export:NONE

300A 0122 Patient Support Angle ExportXiOtableangle

300A 0123 Patient Support Rotation Direction Export:NONE

300A 0125 Table Top Eccentric Angle Export0

300A 0126 Table Top Eccentric Rotation Direction ExportNONE

300A 012C Isocenter Position Export:mapXiObeamisocentervalueinDICOMcoordinatesystem

300A 012E Surface Entry Point ExportXiObeamentrypointinDICOMcoordinateForrotationalordynamicconformalbeam,donotexport

300A 0130 Source to Surface Distance ExportSSDofthebeaminDICOMcoordinatesystem.ForRotationalanddynamicconformalbeams,donotexport

RT Patient Setup Module (Part 3 C8.8.12)


300A 0180 Patient Setup Sequence Export:Twosequence entriesiftheplanusesanSSDorextendedSSDbeamintheplan.Otherwiseonesequence.

300A 0182 Patient Setup NumberExport1or2


46

RT Patient Setup Module (Part 3 C8.8.12)


300A 01B0 Setup Technique Export:ISOCENTRICorFIXED_SSDdependingonthebeamsusedintheplan.

0018 5100 Patient PositionIfnorecordoforiginalCTImagePatientPositionandpatientplanningpositioniseFOOTIN,SendFFS.ElseifthereisnorecordoforiginalCTImagePatientPositionandpatientplanningpositioniseHEADIN,SendHFS.ElseifpatientplanningpositioniseFOOTIN,sendoriginalCTImagePatientPositionexceptthefirstcharacterisreplacedwith"F".Elseifplanishead‐ineHEADIN,sendoriginalCTImagePatientPositionexceptthefirstcharacterisreplacedwith"H".

Approval Module (C.8.8.16)


300E 0002 Approval Status Export:SendAPPROVED ifplanisapproved ;otherwisesendUNAPPROVED.

300E 0004 Review Date Export:IfApprovalStatus 300E,0002 isAPPROVED,sendtheplan’slastmodificationdate.

300E 0005 Review Time Export:IfApprovalStatus 300E,0002 isAPPROVED,sendtheplan’slastreviewtimeofday.

300E 0008 Reviewer Name Export:IfApprovalStatus 300E,0002 isAPPROVED,sendphysician’sname.

XiO 47

Appendix 5 Export of RT DOSE

Thefollowingmodules,whichmakeuptheDICOMRTDOSEIOD,aresent.ElementsthatarenotsupportedforexportfromanXiOteletherapyplanarenotlisted.

RT Dose Module


0028 0002 Number of Samples Export1

0020 0013 Instance Number Export1

0028 0004 Photometric Representation ExportMONOCHROME2

0028 0100 Bits Allocated Export16

0028 0101 Bits Stored Export16

0028 0102 High Bit Export15

0028 0103 Pixel Representation Export0

3004 0002 Dose Units ExportGY

3004 0004 Dose Type ExportPHYSICAL

3004 000A Dose Summation Type ExportPLAN

300C 0002 Referenced RT Plan Sequence

0008 1150 Referenced SOP Class UID Export1.2.840.10008.5.1.4.1.1.481.2

0008 1155 Referenced SOP Instance UID ExporttheSOPInstanceUIDfortheRTPLANobjectthatwasexportedatthesametimeasthisdoseobject

3004 000C Grid Frame Offset Vector FirstvalueiszeroandmonotonicallyincreasingintheDICOMpatientZdirection.Thevaluesinthevectorarerelativetothez‐valueof“ImagePosition Patient ” 0020,0032

3004 000E Dose Grid Scaling

48

XiO 49

Appendix 6 Secondary Capture and RT IMAGE Export of DRR and Intensity Map

Thefollowingelements,whichmakeuptheDICOMSecondaryCaptureIOD,aresentforaDRR.ElementsthatarenotsupportedforexportfromanXiOteletherapyplanarenotlisted.

Secondary Capture (DRR and Intensity Map Fluence)


0008 0005 Specific Character Set ExportISO_IR100

0008 0008 Image Type DERIVED\SECONDARY

0008 0016 SOP Class UID 1.2.840.10008.5.1.4.1.1.7

0008 0018 SOP Instance UID

0008 0020 Study Date ExportCTcreationdateifavailable;ifnotavailable,exportnull.

0008 0030 Study Time ExportCTcreationtimeifavailable;ifnotavailable,exportnull.

0008 0050 Accession Number Exportnull

0008 0060 Modality CT

0008 0064 Conversion Type WSD

0008 0070 Manufacturer CMS,Inc.†

0008 0090 Referring Physicians Name ExportvaluestoredinCTimages.

0008 1090 Manufacturer Model Name XiO

0008 2111 Derivation Description Export:“XiO\ patientID\ savedplanID \beamnumber\BEV”

0020 000D Study Instance UID

0020 000E Series Instance UID

0020 0010 Study ID ExportXiO’sstudysetID

0020 0011 Series Number Export0

0020 0013 Instance Number Export1


50

Secondary Capture (DRR and Intensity Map Fluence)


0020 0020 Patient Orientation SeeAppendix6 forreportedvaluesalgorithm

0028 0002 Samples Per Pixel 1

0028 0004 Photometric Interpretation MONOCHROME2

0028 0010 Rows

0028 0011 Columns

0028 0100 Bits Allocated

0028 0101 Bits Stored

0028 0102 High Bit

0028 0103 Pixel Representation 0

0028 0106 Smallest Image Pixel Value

0028 0107 Largest Image Pixel Value

0028 1050 Window Center

0028 1051 Window Width

7FE0 0010 Pixel Data


Thefollowingelements,whichmakeuptheDICOMRTIMAGEIOD,aresentforaDRRimage;exportedtagvalueswillbethesameasthoseexportedforSecondaryCaptureDRRexceptwherenotedbelow.

RT IMAGE (DRR)


0008 0008 Image Type DERIVED\SECONDARY\DRR

0008 0060 Modality RTIMAGE

0028 0004 Photometric Interpretation MONOCHROME2

3002 0002 RT Image Label ExporttheBeamDescriptionifavailable.Otherwise,exportBeamN whereNisthebeamnumberfromXiO’scurrentplanMOSAIQ usesthefirst5charactersofthistagtotrytomatchtheDRRautomaticallywithaFieldID.


XiO 51

RT IMAGE (DRR)


3002 000C RT Image Plane NORMAL

3002 000D X-ray Image Receptor Translation ExportX,YshiftofthecenteroftheDRRfromthebeamisocenter. ValueofZwillbezero i.e. attheisocenterplane

3002 000E X-ray Image Receptor Angle Export 0.0

3002 0011 Image Plane Pixel Spacing Exportpairofvaluesthatarethesame squarepixels .Calculatedasimagewidthatisocenterdividedbythenumberofcolumns

3002 0012 RT Image Position Exportthetopleftcorneroftheimagewherethecenteroftheimageis 0,0

3002 0020 Radiation Machine Name ExportXiO'sDICOMexporttreatmentmachinename usethesamemappingcodeasRTPLANexport ;ifnotpresent,exportXiO’streatmentmachinename

300A 00B3 Primary Dosimeter Unit IfCobaltunit,exportMINUTE,otherwiseexportMU.Ifnothingcanbefound,exportnull

3002 0022 Radiation Machine SAD ExportSADofthetreatmentmachinebeingusedforthisbeamusethesamemappingcodeasRTPLANexport

3002 0026 RT Image SID ExportSADvalueofthetreatmentmachineforthisbeam

300A 011E Gantry Angle Exportbeam’sgantryangle

300A 0120 Beam Limiting Device Angle Exportbeam’scollimatorangle

300A 0122 Patient Support Angle Exportbeam’scouchangle

300A 0125 Table Top Eccentric Angle Export0 notusedinXiO

300A 0012C Isocenter Position


52

RT IMAGE (DRR)


0018 5100 Patient Position IfplanisFeetFirstreadtheCTpatientpositionvalue,convertandexportthevalueasfollows:

HFSFFSHFPFFPFFSFFSFFPFFP

IfplanisHeadFirst,readtheCTpatientpositionvalue,convertandexportthevalueasfollows:

FFSHFSFFPHFPHFSHFSHFPHFP

300C 0002 Referenced RT Plan Sequence OnlyexportedifRTPLANorRTIONPLANisbeingexportedwiththeRTIMAGE.

0008 1150 Referenced SOP Class UID IfbeamisProtonbeam,export1.2.840.10008.5.1.4.1.1.481.8. RTIONPLAN Elseexport1.2.840.10008.5.1.4.1.1.481.5 RTPLAN .

0008 1155 Referenced SOP Instance UID ExportinstanceofPlanobject RTorRTION

300C 0006 Referenced Beam Number Exportthebeamnumber

Thefollowingelements,whichmakeuptheDICOMRTIMAGEIOD,aresentforanIntensityMapimage;exportedtagvalueswillbethesameasthoseexportedforRTIMAGE DRR exceptwherenotedbelow:

RT IMAGE (Intensity Map Fluence)


0008 0008 ImageType DERIVED\SECONDARY\FLUENCE

3002 0040 Fluence Map Sequence

3002 0041 Fluence Data Source ExportCALCULATED

3002 0042 Fluence Data Scale ExportMUfromthebeam

XiO 53

Appendix 7 DRR and Intensity Map Patient Orientation tag (0020,0020) Reported Values

Head First plan, patient is supine

BeamatIEC0 L\F

Beamangle0 angle 45 beamgantryanglebetweenzeroandfortyfivedegrees LP\F

Beamangle45 angle 90 beamgantryanglefrom45degreesuptoninetydegrees PL\F

BeamatIEC90 P\F

Beamangle90 angle 135 beamgantryanglebetween90and135degrees PR\F

Beamangle135 angle 180 beamgantryanglefrom136degreesupto180degrees RP\F

BeamatIEC180 R\F

Beamangle180 angle 225 beamgantryanglebetween180and225degrees RA\F

Beamangle225 angle 270 beamgantryanglefrom226degreesupto270degrees AR\F

BeamatIEC270 A\F

Beamangle270 angle 315 beamgantryanglebetween270and315degrees AL\F

Beamangle315 angle 360 beamgantryanglefrom316degreesupto360degrees LA\F

Feet First plan, patient is supine

BeamatIEC0 R\H

Beamangle0 angle 45 beamgantryanglebetweenzeroandfortyfivedegrees RP\H

Beamangle45 angle 90 beamgantryanglefrom45degreesuptoninetydegrees PR\H

BeamatIEC90 P\H

Beamangle90 angle 135 beamgantryanglebetween90and135degrees PL\H

Beamangle135 angle 180 beamgantryanglefrom136degreesupto180degrees LP\H

BeamatIEC180 L\H

Beamangle180 angle 225 beamgantryanglebetween180and225degrees LA\H

Beamangle225 angle 270 beamgantryanglefrom226degreesupto270degrees AL\H

BeamatIEC270 A\H

Appendix 7 DRR and Intensity Map Patient Orientation tag (0020,0020) Reported Values

54

Beamangle270 angle 315 beamgantryanglebetween270and315degrees AR\H

Beamangle315 angle 360 beamgantryanglefrom316degreesupto360degrees RA\H

Head First plan, patient is prone

BeamatIEC0 R\F

Beamangle0 angle 45 beamgantryanglebetweenzeroandfortyfivedegrees RA\F

Beamangle45 angle 90 beamgantryanglefrom45degreesuptoninetydegrees AR\F

BeamatIEC90 A\F

Beamangle90 angle 135 beamgantryanglebetween90and135degrees AL\F

Beamangle135 angle 180 beamgantryanglefrom136degreesupto180degrees LA\F

BeamatIEC180 L\F

Beamangle180 angle 225 beamgantryanglebetween180and225degrees LP\F

Beamangle225 angle 270 beamgantryanglefrom226degreesupto270degrees PL\F

BeamatIEC270 P\F

Beamangle270 angle 315 beamgantryanglebetween270and315degrees PR\F

Beamangle315 angle 360 beamgantryanglefrom316degreesupto360degrees RP\F

Feet first plan, patient is prone

BeamatIEC0 L\H

Beamangle0 angle 45 beamgantryanglebetweenzeroandfortyfivedegrees LA\H

Beamangle45 angle 90 beamgantryanglefrom45degreesuptoninetydegrees AL\H

BeamatIEC90 A\H

Beamangle90 angle 135 beamgantryanglebetween90and135degrees AR\H

Beamangle135 angle 180 beamgantryanglefrom136degreesupto180degrees RA\H

BeamatIEC180 R\H

Beamangle180angle 225 beamgantryanglebetween180and225degrees RP\H

Beamangle225 angle 270 beamgantryanglefrom226degreesupto270degrees PR\H

XiO 55

BeamatIEC270 P\H

Beamangle270 angle 315 beamgantryanglebetween270and315degrees PL\H

Beamangle315 angle 360 beamgantryanglefrom316degreesupto360degrees LP\H

XiO 56

Appendix 8 DICOM RT Ion Plan Export/Import (available only with PROTON planning license)

AnRTIonPlanobjectwillcontaintheelementslistedbelow.TheimportmappingisIGNOREunlessotherwisespecified.DataitemsdescribedasNULLarezero‐lengthitems.

SOP Common Module (Part 3 C12.1) (See also Part 3 C12.1.1.2)


0008 0005 Specific Character Set Export:ISO_IR100

0008 0012 Instance Creation Date Export:InstanceDate

0008 0013 Instance Creation Time Export:InstanceTime

0008 0014 Instance Creator UID Export:2.16.840.1.114337

0008 0016 SOP Class UID Export:RTIonPlanStorageImport:ProcessonlyifRTIonPlanStorageorelsepasstoRTPlan import

0008 0018 SOP Instance UID Export:PlanInstanceUIDReferencedbelow SOPInstanceUID

Patient Module (Part 3 C7.1.1)


0010 0010 Patient's Name Export:NameImport:Presentedasinformationduringimport.Warningissuedifnotthesameasthepatientinmemory;usercanoverrideandcontinue.

0010 0020 Patient's ID Export:SendDICOMpatientIDifoneexists;otherwise,sendthepatientIDassociatedwiththeplan.Import:Presentedasinformationduringimport.Warningissuedifnotthesameasthepatientinmemory;usercanoverrideandcontinue.

0010 0030 Patient's Birth Date Export:Dateofbirth.

XiO 57

Patient Module (Part 3 C7.1.1)

0010 0040 Patient's Sex Export:SendM,F,orOgendermappedtoM/F/O

0010 1000 Other Patient's IDs Export:PatientID.

General Study Module (Part 3 C7.2.1)


0008 0020 Study Date Export:OriginalStudydateImport:onlypresentedasinformationduringimport

0008 0030 Study Time Export:OriginalStudytimeImport:onlypresentedasinformationduringimport

0008 0050 Accession Number Export:OriginalDICOMaccessionnumber

0008 1030 Study Description Export:StudyDescription

0020 000D Study Instance UID Regardlessofvalueexported,auniqueUIDsharedacrossallIODsexportedsimultaneouslyisgeneratedandreferencedbelowas SU .Export:OriginalStudyInstanceUIDifoneexists,otherwisesendSU

0020 0010 Study ID Export:OriginalstudyIDifitexists,otherwiseexportstudysetID.

RT Series Module General Series Module (Defined: Part 3 C7.3.1

Defined: Part 3 C8.8


0020 000E Series Instance UID ExportSeriesinstanceUID StudyInstanceUID .1.1

0020 0011 Series Number Export:NULL


58

RT Series Module General Series Module (Defined: Part 3 C7.3.1

Defined: Part 3 C8.8 See also: Part 3 C7.3.1.1)


0008 0060 Modality Export:RTPLAN

0020 000E Series Instance UID ExportSeriesinstanceUID StudyInstanceUID .1.1


Frame of Reference Module (Part 3 C7.4.1 See also Part 3 C7.4.1.1.1)


0020 0052 Frame of Reference UID Export:CT’soriginalframeofreferenceUID ifavailable;elsegenerateauniqueUID.

Frame of Reference Module (Part 3 C7.4.1 See also Part 3 C7.4.1.1.2)


0020 1040 Position Reference Indicator Export:Sendoriginalpositionofreference.

General Equipment Module (Part 3 C7.5.1)


0008 0070 Manufacturer Export:"CMS,Inc."†

Import:IfVarian,continueimport,otherwisestop.

0008 1010 Station Name XiOworkstationhostnameatthetimeofSOPInstanceUIDgeneration.Export:StationName

0008 1090 Manufacturer's Model Name Export:"XiO"

0018 1020 Software Version(s) Export:XiO'sSoftwareVersionNumber x.xx.xxformat .

XiO 59


RT Series (Part 3 C8.8)


0008 0060 Modality Export:RTPLAN

0008 1070 Operator’s Name Export:Loginusername

0020 000E Series Instance UID Export: StudyInstanceUID .1.1


RT General Plan (Part 3 C8.8.9)


0008 1070 Operator’s Name Export:Loginusername

0008 1150 Referenced SOP Class UID Export:RTStructureSetStorage

0008 1155 Referenced SOP Instance UID Export:SOPInstanceUIDofexportedStructureSet

300A 0002 RT Plan Label ExportPlanID basedoncombinationofCourseID ifpresent plussavedplanID.Ifplanwasintemporarystatuswhenexported,thelabelwillbeprecededbyTemp.Import:Thisdatawillbepresentedintheplanindexasahelptotheuser,andwillbeusedtocreatethetemporaryXiOfilename.

300A 0003 RT Plan Name Export:IfthisisapermanentplansendplanIDorifitisatemporaryplanwithnopermanentplanreferencesendTemporaryplannumberTemporary_ TemporaryPlan# .Ifitisatemporary planwithapermanentplanreference,sendTemporary_ TemporaryPlan# _ PlanId .

300A 0004 RT Plan Description Export:Plandescription

300A 0006 RT Plan Date Export:Plan Modification DateImport:Thisdatawillbepresentedintheplanindexasahelptotheuser.


60

RT General Plan (Part 3 C8.8.9)


300A 0007 RT Plan Time Export:PlanModificationTimeImport:Thisdatawillbepresentedintheplanindexasahelptotheuser.

300A 000A Plan Intent ExportPlanintentfieldfromXiOifthere isone,otherwisenotexported.

300A 000C RT Plan Geometry Export:IfStructureSetwassent, send“PATIENT”orelsesendthe“TREATMENT_DEVICE”.

300C 0060 Referenced Structure Set Sequence Export:SendifStructureSetwassentwiththeRTIonPlan.

RT Prescription Module (C.8.8.10)


300A 0010 Dose Reference Sequence Export:OnlyexportifPrescriptionSiteandPrescriptionDosearedefinedforatleastonefractiongroup.Onlygroupsthatcontainbothpiecesofinformationareexported.

300A 0012 Dose Reference Number Export:Thenumberoffractionsplannedsetsthisvalue thenumberoffractionsforeachfractiongroupisuniqueandthereforeusedhereandastheToleranceTableNumber .Import:notused

300A 0014 Dose Reference Structure Type Export“SITE”

300A 0016 Dose Reference Description ExportXiO’sRx prescription Sitenameforthefractiongroup.Import:systemimportsthefirstDoseReferenceDescriptionasaprescription Rx site

300A 0020 Dose Reference Type Export“TARGET”

300A 0026 Target Prescription Dose ExportXiO’sRx prescription TotalDoseImport:notimported

XiO 61

RT Patient Setup (Part 3 C8.8.12)


300A 0180 Patient Setup Sequence Export:Always

0018 5100 Patient PositionExport:IfplanhasanIBAbeamanditsPatientSupportType300A,0350 is“CHAIR”,thenexportSITTING:ElseifthereisnorecordoforiginalCTImagePatientPositionandpatientplanningpositioniseFOOTIN,SendFFS.ElseifthereisnorecordoforiginalCTImagePatientPositionandpatientplanningpositioniseHEADIN,SendHFS.ElseifpatientplanningpositioniseFOOTIN,sendoriginalCTImagePatientPositionexceptthefirstcharacterisreplacedwith"F".Elseifplanishead‐ineHEADIN,sendoriginalCTImagePatientPositionexceptthefirstcharacterisreplacedwith"H".

300A 0182 Patient Setup NumberExport:1

300A 01B0 Setup Technique Export:ISOCENTRICImport:assumesISOCENTRIC

RT Fraction Scheme (Part 3 C8.8.13)


300A 0070 Fraction Group Sequence Export:Always

300A 0071 Fraction Group Number Export:fractiongroupnumber.Groupsarecreatedbasedoncommonnumberoffractionsforeachbeamandgroupnumbersareassignedsequentially.

300A 0078 Number of Fractions Planned Export:Numberoffractions fromanybeamingroupbecausetheyareallequal.

300A 0080 Number of Beams Export:Numberof beamsincurrentgroup.

300A 00A0 Number of Brachy Application Setups Export:0

300C 0004 Referenced Beam Sequence Export:Always

300A 0082 Beam Dose Specification Point ExportDoseSpecificationPointCoordinatesinmillimetercoordinatestofirstdecimalplace.


62

RT Fraction Scheme (Part 3 C8.8.13)


300A 0084 Beam Dose Export:Ifplandoseiscalculated,exportdoseperfractioninGyatthedosespecificationpoint.

300A 0086 Beam Meterset Export:Numberofmonitorunitsperfraction,iftheyareavailable.Import:tagvalueisignored. SpotbeammonitorunitissetbytheFinalCumulativeMetersetWeighttag 300A,010E .

300C 0006 Referenced Beam Number Export:Beamnumber

300C 0050 Referenced Dose Reference Sequence ExportedonlyifRxSiteandRxTotalDosearepresentinXiOforthebeam’sfractiongroup.

300C 0051 Referenced Dose Reference Number Exportthenumberoffractionsforthisgroup

Approval Module (Part 3 C.8.8.16)


300E 0002 Approval Status Export:SendAPPROVED ifplanisapproved ;otherwisesendUNAPPROVED.Import:planwillbesettoUNAPPROVED

300E 0004 Review Date Export:IfApprovalStatus 300E,0002 isAPPROVED,sendtheplan’slastmodificationdate.

300E 0005 Review Time Export:IfApprovalStatus 300E,0002 isAPPROVED,sendtheplan’slastreviewtimeofday.

300E 0008 Reviewer Name Export:IfApprovalStatus 300E,0002 isAPPROVED,sendphysician’sname.

XiO 63

RT Ion Beams Module (Part 3 C.8.8.25)


300A 03A2 Ion Beam Sequence Export:Sendforeachprotonbeamthatisactiveandcalculable.Import:Readall

0008 1040 Institutional Department Name Export:XiOClinicName

300A 00B2 Treatment Machine Name Export:SendtheDICOMmachineIDifoneisassigned;otherwisesendtheXiO‐assignedmachineID.Import:XiOmachineID

300A 00B3 Primary Dosimeter Unit Export:MU

300A 00C0 Beam Number Export:BeamnumberImport:ThiswillbemappedtoanXiObeamnumber anintegerbetween1and99 .

300A 00C2 Beam Name ExportFieldIDifpresentinthebeam,otherwiseexportXiO’sbeamdescription upto24characters Import:ThiswillbeusedastheXiOfieldIDandbeamdescriptionunlessBeamDescription 300A,00C3 exists.

300A 00C3 Beam Description Export:Beamdescription upto24characters Import:Thefirst24characterswillbeusedastheXiObeamdescription.

300A 00C4 Beam Type Export:IfBeam Spreadingtype is“spotScanning”andManufactureris“IBA”,sendSTATIC.Else,ifBeamSpreadingtypeis“spotscanning”andManufactureris“Varian”,sendDYNAMIC.ElsesendSTATIC.

300A 00C6 Radiation Type Export:PROTONImport:SkipbeamifnotPROTON.

300A 00CE Treatment Delivery Type Export:TREATMENT

300A 00D0 Number of Wedges Export:Ifbeamhasawedgedcompensator,send1;otherwisesend0.

300A 00E0 Number of Compensators Export:0

300A 00ED Number of Boli Export:0


64



300A 00F0 Number of Blocks Export:Ifbeamhasa port,send1;otherwisesend0.Import:Read

300A 010E Final Cumulative Meterset Weight Export:Time/MUresults.Import:importasfinalMUforbeam

300A 0110 Number of Control Points Export:SeeIonControlPointSequence 300A,03A8 .

300A 02EA Ion Range Compensator Sequence Export: Ifthereisarangecompensatoronthebeam.Import:notread.

300A 02E0 Compensator Divergence Export:"ABSENT"

300A 02E1 Compensator Mounting Position Export:"SOURCE_SIDE"

300A 02E4 Isocenter to Compensator Tray Distance Export:ThedistancefromtheCompensatortotheIsocenter.

300A 02E5 Compensator Column Offset Export:Thecolumnoffsetissentifitisnotsettozero.

300A 02E8 Compensator Milling Tool Diameter Export:CompensatorMillingToolDiameter

300A 02EB Compensator Description Export:TheRange compensatordescription ifitisdefined.

300A 0308 Scan Mode Export:Ifthebeamis spotscanning,sendMODULATED.IftheScanMode SFM isspecifiedasUniform,sendUNIFORM.Otherwise,sendNONE.Import:skipbeamifnotMODULATED.

300A 030A Virtual Source-Axis Distances Export:Ifthebeamisspotscanning,sendtheverticalandhorizontalscanreferencedistances;otherwise,sendmachinereferencedistance.

300A 030C Snout Sequence

300A 030F Snout ID Export:SnoutID.Import:readsnoutID;skipbeamifnotvalid.

300A 0312 Number of Range Shifters Export:Ifaprotonbeamdegraderexists,send1;otherwisesend0.

XiO 65



300A 0314 Range Shifter Sequence Export:SendifNumberofRangeShifters 300A,0312 0.Import:ReadifNumberofRangeShifters 300A,0312 0.

300A 0316 Range Shifter Number Export:1

300A 0318 Range Shifter ID Export:SendprotonbeamdegraderID.Import:readprotonbeamdegraderID;skipbeamifnotvalid.

300A 0320 Range Shifter Type Export:Iftheprotonbeamisspotscanning,sendBINARY;otherwisesendANALOG.

300A 0330 Number of Lateral Spreading Devices Export:0

300A 0340 Number of Range Modulators Export:Ifbeamisspotscanningandaripplefilterexists,send1.Ifthebeamisnotspotscanning,send1.Otherwise,send0.

300A 0342 Range Modulator Sequence Export:sendifNumberofRangeModulators 300A,0340 0.Import:readifNumberofRangeModulators 300A,0340 0.

300A 0344 Range Modulator Number Export:1

300A 0346 Range Modulator ID Export:ForManufacturer“IBA”IfScanMode 300A,0308 isNONE,sendRF_Undefined.IfScanModeisUNIFORM,sendModulatorIDorPrescribedModulation.IfScanModeisMODULATED,senduserselectedRippleFilterIDForManufacturernotequaltoIBAIfScanModeisNONEorUNIFORM,sendModulatorIDorPrescribedModulationIfScanModeisMODULATED,sendtheripplefilterID.Import:readRippleFilterifscanmodeisMODUALTED.

300A 0348 Range Modulator Type Export:Ifbeamisspotscanning,sendFIXED;otherwise,sendWHL_FIXEDWEIGHTS.

300A 0350 Patient Support Type Export:Ifthecouchdefinitionischair,sendCHAIR;otherwisesendTABLE.Import:Useifvalueissent,otherwisedefaulttoTABLE.


66



300A 0352 Patient Support ID Export:SendthecouchIDifone exists,otherwise,donotsend.Import:importasbeam’scouchID;skipbeamifnotvalid.

300A 0356 Fixation Light Azimuthal Angle Export:IfgazedataexistsforanOcuProplan,sendtheazimuthalangle.

300A 0358 Fixation Light Polar Angle Export:IfgazedataexistsforanOcuProplan,sendthepolarangle.

300A 03A6 Ion Block Sequence Export:SendifNumberofBlocks 300A,00F0 is 0.Import:ReadifNumberofBlocks 300A,00F0 is 0.Ifmorethan1blockisdefined,onlythefirstblockwithaBlockType300A,00F8 ofAperture willbeprocessed.Ifanyblocks/aperturesarenotprocessed,awarningwillbedisplayed.

300A 00E1 Material ID Export:Exportcustomizedportmaterial.Import:Same

300A 00F7 Isocenter to Block Tray Distance Export:Sendisocenter toaperturedistanceplusportthickness.Import:Ignore

300A 00F8 Block Type Export:ApertureImport:IgnoreblocksthatarenotAPERTURES.

300A 00FA Block Divergence Export:AbsentImport:Ignore

300A 00FB Block Mounting Position Export:PATIENT_SIDEImport:Ignore

300A 00FC Block Number Export:1Import:Ignore

300A 00FE Block Name Export:Ifthisisdefinedexport,otherwisedonotexport.Import:Ifthisfieldisdefinedthenimport.

300A 0100 Block Thickness Export:Exportportthickness.Import:importblockthickness

300A 0104 Block Number of Points Export:Exportnumberofcoordinates.Import:importnumberofpoints

XiO 67



300A 0106 Block Data Export:Exportcoordinates.Import:importcoordinates

300A 03A8 Ion Control Point Sequence Export:IfBeamSpreadingtypeis“spotscanning”andManufactureris“IBA”,sendtwoseparatecontrolpoints.Specifybeginningandendofeachlayer.Layersthathavenodosecontributionarenotsent. Else,ifthebeamisspotscanning,sendalllayersthatareONplusoneControlPointafterthelastlayer.Forexample,forNlayers:NOTE:"sum"meansCumulativeMetersetWeight 300A,0134 CP#0 sum 0;containing1stlayerCP#1 sum after1stlayer;containing2ndlayerCP#2 sum after2ndlayer;containing3rdlayerCP#N‐1 sum after N‐1 thlayer;containingNthlayerCP#N sum afterNthlayer;containingnolayerElsesendtwoitems:i.e.CP#0 sum 0;containingdeliverysettingsCP#1 sum 1.0;containingnosettingsImport:Readall

300A 0015 Nominal Beam Energy Unit Export:MEV

300A 0112 Control Point Index Export:Startat0andincrementby1foreachsubsequentcontrolpoint.

300A 0114 Nominal Beam Energy Export:Ifbeamisspotscanning,sendtheEnergyvalueconvertedfromtheprescribedrange.E MeV prescribedrange/0.022 ^ 1.0/1.77 Import:Skipbeamifnotvalid.OtherwiseconvertincomingEnergytoprescribedrangeusingtheinverseoftheformulaabove.

300A 011E Gantry Angle Export:InfirstcontrolpointsendthegantryangleconvertedfromXiOtoIECcoordinatesystem.Import:Same,convertedfromIECtoXiOcoordinatesystem.

300A 011F Gantry Rotation Direction Export:Infirstcontrolpoint,sendNONE.

300A 0120 Beam Limiting Device Angle Export:Infirstcontrolpoint,send0.

300A 0121 Beam Limiting Device Rotation Direction Export:Infirstcontrolpoint,sendNONE.


68



300A 0122 Patient Support Angle Export:Infirstcontrolpoint,sendthecouchangleconvertedfromXiOtoIECcoordinatesystem.Ifachairisused,thisanglewillincludetheadditionofthechairmountangle.Import:SameconvertedfromIECtoXiOcoordinatesystem.

300A 0123 Patient Support Rotation Direction Export: Infirstcontrolpoint,sendNONE.

300A 0128 Table Top Vertical Position Export:Infirstcontrolpoint,ifsetsendthecouchpositionz‐coordinatetransformedtotheoriginalFrameofReference;otherwisesendNULL.Import:Infirstcontrolpoint,transformtoXiOpatientcoordinatesanduseasthecouchpositionz‐coordinate.

300A 0129 Table Top Longitudinal Position Export:Infirstcontrolpoint,sendNULL.

300A 012A Table Top Lateral Position Export:Infirstcontrolpoint,ifset,sendthe couchpositionx‐coordinatetransformedtooriginalFrameofReference;otherwisesendNULL.Import:Infirstcontrolpoint,transformtoXiOpatientcoordinatesanduseasthecouchpositionx‐coordinate.

300A 012C Isocenter Position Export:Infirst controlpoint,sendthebeamisocentertransformedtooriginalFrameofReference.Import:Samewithreversetransformifwithinpatientvolumeextents;otherwise,markforuseroverride.

300A 0134 Cumulative Meterset Weight Export:Ifbeamisspotscanning,sendsumofallspotweightsScanSpotMetersetWeights 300A,0396 sentthusfar beforecurrentcontrolpoint .Forexample:CP#0 0CP#1 sumof1stlayerCP#2 sumof1stand2ndlayersCP#3 sumof1st,2ndand3rdlayersCP#N sumofall 1stthroughNth layersOtherwise,send0forfirstcontrolpointand1.0forthesecondcontrolpoint.

XiO 69



300A 0140 Table Top Pitch Angle Export:Onlyforthefirstcontrolpoint.Send0ifitisaspot‐scanbeam.Else,ifbeamPatientSupportType 300A,0014 is“CHAIR”anditsManufactureris“IBA”,send0.ElsesendthepitchangleconvertedtoIEC.TheXiOpositivepitchangleisthesameasIEC.Import:forthefirstcontrolpoint,ifsent,converttoXiOangleandstoreasthebeam’sPitchAngle.Ifnotsent,settothenominalPitchAngleforthemachine.

300A 0142 Table Top Pitch Rotation Direction Export:Infirstcontrolpoint,sendNONE.Import:notused

300A 0144 Table Top Roll Angle Export:Infirstcontrolpoint, sendtabletoprollangleconvertedtoIEC.Note:Forhead‐firstplans,XiOPositiveRollAngleisintheoppositedirectionastheIEC.Forfeet‐firstplans,theXiOpositiverollangleisinthesamedirectionastheIEC.Import:forthefirstcontrolpoint,ifsent,converttoXiOangleandstoreasthebeam’sRollAngle.Ifnotsent,settothenominalRollAngleforthemachine.

300A 0146 Table Top Roll Rotation Direction Export:Infirstcontrolpoint,sendNONE.Import:notused

300A 014A Gantry Pitch Angle Export:Infirstcontrolpoint,send0.

300A 014C Gantry Pitch Rotation Direction Export:Infirstcontrolpoint,sendNONE.

300A 030D Snout Position Export:Infirstcontrolpoint,sendthenozzletoisocenterdistance.Import:Inthefirstcontrolpoint,settheairgaptothisvalueminusthedifferencebetweenthemachinereferencedistanceandthesource‐to‐skindistanceandthenaddedtothethicknessesoftherangeshifter,ripplefilter,andaperture allthatapplies .Ifanyofthesethicknessesis applicable,thedeviceisattachedtothesnout.

300A 0360 Range Shifter Setting Sequence Export:SendinfirstcontrolpointifNumberofRangeShifters300A,0312 0.

300A 0362 Range Shifter Setting Export:IfBeamSpreadingtypeis“spotscanning”andManufactureris“IBA”,Send1.Else,sameasRangeShifterWaterEquivalentThickness300A,0366 .


70



300A 0364 Isocenter to Range Shifter Distance Export:Sendtheisocentertodegraderdistance.

300A 0366 Range Shifter Water Equivalent Thickness Export:Ifbeamisspotscanning,sendthedegraderwaterequivalentthickness.Fornon‐spotscanningbeams,exportthemaximumrangeminustheprescribedrange.

300C 0100 Referenced Range Shifter Number Export:1

300A 0380 Range Modulator Settings Sequence Export:SendinfirstcontrolpointifNumberofRangeModulators 300A,0340 0.

300A 0386 Range Modulator Gating Start Water Equivalent Thickness Export:Sendwaterequivalentthickness rangemodulatoroffsetis0 .

300A 0388 Range Modulator Gating Stop Water Equivalent Thickness Export:Sendwaterequivalentthickness rangemodulatoroffsetisthenumberofelements–1 .

300A 038A Isocenter to Range Modulator Distance Export:Sendtheisocentertomodulatordistance.

300C 0104 Referenced Range Modulator Number Export:1

300A 0390 Scan Spot Tune ID Export:Ifthebeamisspotscanning,sendthetuneID sigmavalue .Import:Same;Skipbeamifnotvalid.

300A 0392 Number of Scan Spot Positions Export:Ifbeamisspotscanning,sendnumberofspotswithnon‐zeroweight.Import:Determinesnumberofspotpositionsandweightstoread.

300A 0394 Scan Spot Position Map Export:Ifbeamisspotscanning,sendthex/ypositioninbeamcoordinatesofeachspotwithnon‐zeroweight.Import:Spotpositionsarereadandusedifwithinscan/fieldextents widthandlength specifiedinSFM Skipbeamifnotvalid. .Theyarenotfittoarectilineargrid.Dosewillcalculatebutthespotweightswillnotbeindividuallyeditable.

XiO 71



300A 0396 Scan Spot Meterset Weights Export:Ifbeamisspotscanning andmanufacturerisVarian,sendspotweightscorrespondingtothespotsinScanSpotPositionMap 300A,0394 .Ifbeamisspotscanningandthemanufactureris“IBA”,Forthecontrolpointthatspecifiesthebeginningofanenergylayer,sendthespotweightsthatcorrespondtothespotsinScanSpotPositionMap 300A,0394 .Forthecontrolpointthatspecifiestheendofanenergylayer,sendspotweightsof“0”foreachspotonScanSpotPositionMap300A,0394 .Import:Same;Skipbeamifnotvalid.

300A 0398 Scanning Spot Size Export:Ifbeamisspotscanning,sendspotsize.

300A 039A Number of Paintings Export:Ifbeamisspotscanning,sendnumberofpaintings.Import:Same.

300A 03AC Ion Wedge Position Sequence Export:SendinfirstcontrolpointifNumberofWedges300A,00D0 0.

300A 00DB Wedge Thin Edge Position Export:Sendinsertiondistanceforwedge.

300A 0118 Wedge Position Export: IN.

300C 00C0 Referenced Wedge Number Export:1

300A 03AA Ion Wedge Sequence Export:SendifNumberofWedges 300A,00D0 0.

300A 00D2 Wedge Number Export:1.

300A 00D3 Wedge Type Export:PARTIAL_STANDARD

300A 00D4 Wedge ID Export:Send Wedge_XXwhereXXisthewedgeangleinvaluestated in 300A,00D5 field.

300A 00D5 Wedge Angle Export:Sendwedgeangle.

300A 00D8 Wedge Orientation Export:Sendwedgeorientationangle.

300A 00D9 Isocenter to Wedge Tray Distance Export:Send isocentertowedgetraydistance.


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300B 0010 MOSAIQ Private Creator Export:"IMPAC"ifitisnotaspot‐scanbeam.

300B 1002 Maximum Collimated Field Diameter Export:Ifitisnotaspot‐scanbeam,orifitisSpotScanningandmanufactureris“IBA”thensendthemaximumfielddiameter.

300B 1004 Planned Distal Target Distance Export:IfBeamSpreadingtypeis“SpotScanning”andmanufacturerisIBA,senddistallayerprescribedrange.Else,ifitisnotaspot‐scanbeam,sendprescribedrange.

300B 100E Nominal SOBP Width Export:IfBeamSpreadingtypeis“SpotScanning”andmanufacturerisIBA,senddifferencebetweentheprescribedrangesforthefirstandlastlayers.Else,ifitisnotaspot‐scanbeam,sendtheprescribedmodulation.

300C 006A Referenced Patient Setup Number Export:1

4429 0011 ACCEL Private Creator Export:IfOcuProgazedataorseatedtreatmentdataexists,sendION_PRIVATE11.

4429 110C Fixation Light Position Export:Ifeyeplanning gazedataexistssendthex,y,andzcoordinatesofthefixationposition.

4429 110D Reference Fixation Light Azimuthal Angle Export:ifeyeplanninggazedataexists,exporttheReferenceazimuthalanglereceivedfromFocal.

4429 110E Reference Fixation Light Polar Angle Export:ifeyeplanninggazedataexists,exporttheReferencepolaranglereceivedfromFocal.

4429 110F Chair Back Angle Export:sendchairbackangle

4429 1110 Chair Mount Offset Angle Export:sendchairmountangle

300D 0010 IBA Private Creator Export:ifscan modeisNONE,sendvalueofIBA;otherwisedonotexporttag.

300D 1002 Scattered Mode

Export:ifscanmodeisNONE,exportSINGLEorDOUBLEdependingonthevaluesetinthetreatmentmachine;otherwisedonotexporttag.

XiO 73

Appendix 9 Private Data Elements

BelowisalistingoftheValueRepresentationandValueMultiplicityfortheprivatetagsmentionedinAppendix7forRTIONPLAN.

Table 9.1 Private Creator Identification (IMPAC)

Tag Attribute Name VR VM

300B 0010 MOSAIQ Private creator LO 1

300B 1002 Maximum Collimated Field Diameter

FL 1

300B 1004 Planned Distal Target Distance FL 1

300B 100E Nominal SOBP Width FL 1

Table 9.2 Private Creator Identification (ION_PRIVATE11)


4429 0011 ACCEL Private Creator LO 1

4429 110C Fixation Light Position FL 3

4429 110D Reference Fixation Light Azimuthal Angle

FL 1

4429 110E Reference Fixation Light Polar Angle

FL 1

4429 110F Chair Back Angle FL 1

4429 1110 Chair Mount Offset Angle FL 1

Table 9.3 Private Creator Identification (IBA)


300D 0010 IBA Private Creator LO 1

300D 1002 Scattered Mode SH 1

Manufacturer Elekta Business Area Software Systems IMPAC Medical Systems, Inc. 13723 Riverport Drive Suite 100 Maryland Heights, MO 63043 USA Phone: +1.800.878.4267 Fax: +1 314 812 4491

European Union Authorized Representative

Elekta Limited Linac House, Fleming Way Crawley, West Sussex RH10 9RR, United Kingdom Phone: +44 129 365 4242 Fax: +44 1293 47134

www.elekta.com Human Care Makes the Future Possible

Documents

XiO® DICOM Conformance Statementcf20ec46-9397-4d97... · XiO 1 1. Overview The following is the DICOM Conformance Statement for the XiO product as of release 5.10. XiO is a 3‐dimensional