DICOM

Conformance Statement
EPIQ Elite, Elite Advanced, E7, E5, CVx, CVxi Release 6.0.x
Affiniti 70, 50 and 30 Release 6.0.x
000737000000163 Rev A
April 6, 2020

© Koninklijke Philips Electronics N.V. 2020

All rights are reserved.
0.1 Revision History

Document Date of Issue Authors Description

Version
A April 6, 2020 ML, BG Initial Release

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 2
 1 CONFORMANCE STATEMENT OVERVIEW

Table 1.1 provides an overview of the supported network services.

Table 1.1
NETWORK SERVICES
User of Service
Networking SOP Classes Provider of Service (SCP)
(SCU)
Transfer
Ultrasound Image Storage Yes* Yes*
Ultrasound Image Storage (Retired) Yes* Yes*
Ultrasound Multiframe Image Storage Yes* Yes*
Ultrasound Multiframe Image Storage (Retired) Yes* Yes*
Secondary Capture Image Storage Yes* Yes*
Multi-frame True Color Secondary Capture
Yes* Yes*
Image Storage
CT Image Storage Yes* Yes*
Enhanced CT Image Storage Yes* Yes*
Digital Mammography X-Ray Image Storage –
Yes* Yes*
For Presentation
Digital Mammography X-Ray Image Storage –
Yes* Yes*
For Processing
MR Image Storage Yes* Yes*
Enhanced MR Image Storage Yes* Yes*
MR Spectroscopy Image Storage Yes* Yes*
Positron Emission Tomography Image Storage Yes* Yes*
X-Ray Angiographic Image Storage Yes* Yes*
Private 3D Presentation State Storage Yes* Yes*
Comprehensive SR Storage Yes* Yes***
Query/Retrieve
Study Root Query/Retrieve-FIND Yes** No
Study Root Query/Retrieve-MOVE Yes** No
Workflow Management
Storage Commitment Push Model Yes* No
Modality Worklist Information Model - FIND Yes* No
Modality Performed Procedure Step Yes* No
Print Management
Basic Grayscale Print Management Yes No
Basic Color Print Management Yes No

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 3
— This DICOM Conformance Statement reports the implementation of nine ultrasound systems: The EPIQ
and Affiniti families of products:
o EPIQ Elite, EPIQ Elite Advanced, EPIQ 7 and EPIQ 5, EPIQ CVx, EPIQ CVxi, Affiniti 70, Affiniti
50 and Affinit 30. Also referred to as EPIQ Elite, EPIQ Elite Advanced, 7, 5, CVx and CVxi; A70,
A50 and A30.

The Philips EPIQ and Affiniti Ultrasound systems implement the necessary DICOM® services to download
worklists from an information system, store Images and Structured Reports to a network storage device,
commit previously stored US images, store Images and Structured Reports to CD, DVD, or removable USB
Media storage devices, print to a networked DICOM printer device, receive previously stored ultrasound and
other modality images, and inform the information system about the work actually done.

* Purchasable option “Netlink DICOM 3.0”. DICOM Printing does not require an option.
** Requires option “Ultrasound Query Retrieve” or “Multi-Modality Query Retrieve”.
*** System will accept and can import and export SR objects with a study. No display of imported SR.

The SOP Classes are categorized as shown in Table 1.2:

Table 1.2
UID VALUES
UID Value UID NAME Category
1.2.840.10008.1.20.1 Storage Commitment Push Transfer
Model SOP Class
1.2.840.10008.3.1.2.3.3 Modality Performed Procedure Workflow Management
Step SOP Class
1.2.840.10008.5.1.1.9 Basic Grayscale Print Print Management
Management Meta SOP Class
1.2.840.10008.5.1.1.18 Basic Color Print Management Print Management
Meta SOP Class
1.2.840.10008.5.1.4.1.1.1.2 Digital Mammography X-Ray Transfer
Image Storage – For
Presentation
1.2.840.10008.5.1.4.1.1.1.2.1 Digital Mammography X-Ray Transfer
Image Storage – For
Processing
1.2.840.10008.5.1.4.1.1.2 CT Image Storage Transfer
1.2.840.10008.5.1.4.1.1.2.1 Enhanced CT Image Storage Transfer
1.2.840.10008.5.1.4.1.1.3.1 Ultrasound Multi-frame Image Transfer
Storage
1.2.840.10008.5.1.4.1.1.3 Ultrasound Multi-frame Image Transfer
Storage (Retired)
1.2.840.10008.5.1.4.1.1.4 MR Image Storage Transfer
1.2.840.10008.5.1.4.1.1.4.1 Enhanced MR Image Storage Transfer

®
DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital
communications of medical information.

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 4
 UID Value UID NAME Category
1.2.840.10008.5.1.4.1.1.4.2 MR Spectroscopy Storage Transfer
1.2.840.10008.5.1.4.1.1.6.1 Ultrasound Image Storage Transfer
1.2.840.10008.5.1.4.1.1.6 Ultrasound Image Storage Transfer
(Retired)
1.2.840.10008.5.1.4.1.1.7 Secondary Capture Image Transfer
Storage
1.2.840.10008.5.1.4.1.1.7.4 Multi-frame True Color Transfer
Secondary Capture Image
Storage
1.2.840.10008.5.1.4.1.1.128 Positron Emission Tomography Transfer
Image Storage
1.2.840.10008.5.1.4.1.1.12.1 X-Ray Angiographic Image Transfer
Storage
1.3.46.670589.2.5.1.1 Private 3D Presentation State Transfer
Storage
1.2.840.10008.5.1.4.1.1.88.33 Comprehensive SR Storage Transfer
1.2.840.10008.5.1.4.1.2.2.1 Study Root Query/Retrieve Query/Retrieve
Information Model – FIND
1.2.840.10008.5.1.4.1.2.2.2 Study Root Query/Retrieve Query/Retrieve
Information Model – MOVE
1.2.840.10008.5.1.4.31 Modality Worklist Information Workflow Management
Model – FIND

Table 1.3 specifies the Media Storage Application Profiles supported.

Table 1.3
MEDIA SERVICES

Media Storage Application Profile Write Files (FSC or FSU) Read Files (FSR)

STD-US-SC-SF&MF-CDR Yes / Yes Yes(1)

STD-US-SC-SF&MF-DVD Yes / Yes Yes(1)

STD-GEN-USB-JPEG Yes / Yes Yes(1)

(1) System will accept and can import and export SR objects with a study. No display of imported SR.

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 This page intentionally left blank.

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 6
 2 TABLE OF CONTENTS

1  CONFORMANCE STATEMENT OVERVIEW .......................................................................................... 3 

2  TABLE OF CONTENTS ........................................................................................................................... 7 
3  INTRODUCTION .................................................................................................................................... 11 
3.1  AUDIENCE ............................................................................................................................. 11 
3.2  REMARKS .............................................................................................................................. 11 
3.3  DEFINITIONS, TERMS AND ABBREVIATIONS ................................................................... 11 
3.4  REFERENCES ....................................................................................................................... 12 
4  NETWORKING ....................................................................................................................................... 14 
4.1  IMPLEMENTATION MODEL.................................................................................................. 14 
4.1.1  Application Data Flow ................................................................................................... 14 
4.1.2  Functional Definition of AEs ......................................................................................... 15 
4.1.2.1  Functional Definition of Storage Application Entity ............................................. 15 
4.1.2.2  Functional Definition of Workflow Application Entity .......................................... 16 
4.1.2.3  Functional Definition of Hardcopy Application Entity .......................................... 18 
4.1.3  Sequencing of Real-World Activities ............................................................................ 18 
4.2  AE SPECIFICATIONS............................................................................................................ 24 
4.2.1  Storage Application Entity Specification ....................................................................... 24 
4.2.1.1  SOP Classes ...................................................................................................... 24 
4.2.1.1.1  General ..................................................................................................... 25 
4.2.1.1.2  Number of Associations ............................................................................ 25 
4.2.1.1.3  Asynchronous Nature ............................................................................... 25 
4.2.1.1.4  Implementation Identifying Information ..................................................... 25 
4.2.1.2  Association Initiation Policy ................................................................................ 26 
4.2.1.2.1  Activity – Store Images and Structured Reports ....................................... 26 
4.2.1.2.1.1  Description and Sequencing of Activities ...................................... 26 
4.2.1.2.1.2  Proposed Presentation Contexts ................................................... 28 
4.2.1.2.1.3  SOP Specific Conformance ........................................................... 30 
4.2.1.2.1.3.1  Image and Comprehensive Structured Report Storage SOP
Classes 30 
4.2.1.2.1.3.2  SOP Specific Conformance for Storage Commitment Push
Model SOP Class ...................................................................................... 30 
4.2.1.3  Association Acceptance Policy ........................................................................... 31 
4.2.1.3.1.1  Activity – Receive Storage Commitment Response ...................... 31 
4.2.1.3.1.2  Description and Sequencing of Activities ...................................... 31 
4.2.1.3.1.3  Accepted Presentation Contexts ................................................... 31 
4.2.1.3.1.4  SOP Specific Conformance for Storage Commitment Push Model
SOP Class 32 
4.2.1.3.1.4.1  Storage Commitment Notifications (N-EVENT-REPORT) 32 
4.2.1.3.1.4.2  Storage Commitment Attributes (N-EVENT-REPORT) .... 32 
4.2.1.3.2  Activity – Query and Request Retrieval of Studies ................................... 33 
4.2.1.3.2.1  Description and Sequencing of Activities ...................................... 33 
4.2.1.3.2.2  Proposed Presentation Contexts ................................................... 39 
4.2.1.3.2.3  SOP Specific Conformance for SOP Classes ............................... 40 
4.2.1.3.2.3.1  Study Root Query Retrieve – FIND SOP Class................ 40 
4.2.1.3.2.3.2  Study Root Query Retrieve – MOVE SOP Class ............. 40 
4.2.1.3.2.4  Activity – Storage from a Remote Storage SCU ........................... 41 
4.2.1.3.2.5  Description and Sequencing of Activities ...................................... 41 
Accepted Presentation Contexts ........................................................................ 42 
4.2.2  Workflow Application Entity Specification..................................................................... 44 
4.2.2.1  SOP Classes ...................................................................................................... 44 

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 4.2.2.2  Association Policies ............................................................................................ 44 
4.2.2.2.1  General ..................................................................................................... 44 
4.2.2.2.2  Number of Associations ............................................................................ 44 
4.2.2.2.3  Asynchronous Nature ............................................................................... 44 
4.2.2.2.4  Implementation Identifying Information ..................................................... 44 
4.2.2.3  Association Initiation Policy ................................................................................ 45 
4.2.2.3.1  Activity – Worklist Update ......................................................................... 45 
4.2.2.3.1.1  Description and Sequencing of Activities ...................................... 45 
4.2.2.3.1.1.1  Worklist Update using Broad Query – using “Update Worklist”
45 
4.2.2.3.1.1.2  Worklist Update using Patient Query – using “Search” .... 46 
4.2.2.3.1.2  Proposed Presentation Contexts ................................................... 46 
4.2.2.3.1.3  SOP Specific Conformance for Modality Worklist ......................... 46 
4.2.2.3.2  Activity – Acquire Images.......................................................................... 49 
4.2.2.3.2.1  Description and Sequencing of Activities ...................................... 49 
4.2.2.3.2.2  Proposed Presentation Contexts ................................................... 50 
4.2.2.3.2.3  SOP Specific Conformance for MPPS .......................................... 51 
4.2.2.4  Association Acceptance Policy ........................................................................... 54 
4.2.3  Hardcopy Application Entity Specification .................................................................... 54 
4.2.3.1  SOP Classes ...................................................................................................... 54 
4.2.3.2  Association Policies ............................................................................................ 54 
4.2.3.2.1  General ..................................................................................................... 54 
4.2.3.2.2  Number of Associations ............................................................................ 54 
4.2.3.2.3  Asynchronous Nature ............................................................................... 55 
4.2.3.2.4  Implementation Identifying Information ..................................................... 55 
4.2.3.3  Association Initiation Policy ................................................................................ 55 
4.2.3.3.1  Activity – Film Images ............................................................................... 55 
4.2.3.3.1.1  Description and Sequencing of Activities ...................................... 55 
4.2.3.3.1.2  Proposed Presentation Contexts ................................................... 56 
4.2.3.3.1.3  SOP Specific Conformance for all Print SOP Classes .................. 57 
4.2.3.3.1.3.1  Printer SOP Class Operations (N-GET) ........................... 57 
4.2.3.3.1.3.2  Printer SOP Class Notifications (N-EVENT-REPORT) .... 58 
4.2.3.3.1.3.3  SOP Specific Conformance for the Film Session SOP Class
58 
4.2.3.3.1.3.4  Film Session SOP Class Operations (N-CREATE) .......... 59 
4.2.3.3.1.4  SOP Specific Conformance for the Film Box SOP Class .............. 59 
4.2.3.3.1.4.1  Film Box SOP Class Operations (N-CREATE) ................. 59 
4.2.3.3.1.4.2  Film Box SOP Class Operations (N-ACTION) .................. 61 
4.2.3.3.1.5  SOP Specific Conformance for the Image Box SOP Class .......... 61 
4.2.3.3.1.5.1  Image Box SOP Class Operations (N-SET) ..................... 61 
4.2.3.4  Association Acceptance Policy ........................................................................... 62 
4.2.4  Verification Application Entity specification .................................................................. 62 
4.2.4.1  SOP Class .......................................................................................................... 62 
4.2.4.2  Association Policies ............................................................................................ 63 
4.2.4.2.1  General ..................................................................................................... 63 
4.2.4.2.2  Number of Associations ............................................................................ 63 
4.2.4.2.3  Asynchronous Nature ............................................................................... 63 
4.2.4.2.4  Implementation Identifying Information ..................................................... 63 
4.2.4.3  Association Initiation Policy ................................................................................ 64 
4.2.4.3.1  Activity – Verify Remote SCP ................................................................... 64 
4.2.4.3.1.1  Description and Sequencing of Activities ...................................... 64 
4.2.4.3.1.2  Proposed Presentation Contexts ................................................... 64 
4.2.4.3.1.3  SOP Specific Conformance for Verification ................................... 65 
4.2.4.4  Association Acceptance Policy ........................................................................... 66 
4.2.4.4.1  Activity – Verification By Remote AE ........................................................ 66 
4.2.4.4.1.1  Description and Sequencing of Activities ...................................... 66 

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 4.2.4.4.1.2  Accepted Presentation Contexts ................................................... 67 
4.2.4.4.1.3  SOP Specific Conformance for Verification ................................... 67 
4.3  NETWORK INTERFACES ..................................................................................................... 67 
4.3.1  Physical Network Interface ........................................................................................... 67 
4.3.2  Additional Protocols ...................................................................................................... 68 
4.3.3  IPv4 and IPv6 Support.................................................................................................. 68 
4.4  CONFIGURATION ................................................................................................................. 68 
4.4.1  AE Title/Presentation Address Mapping....................................................................... 68 
4.4.1.1  Local AE Title ...................................................................................................... 68 
4.4.1.2  Remote AE Title/Presentation Address Mapping ............................................... 69 
4.4.1.2.1  Image Storage Configuration .................................................................... 69 
4.4.1.2.2  Structured Report Storage Configuration ................................................. 70 
4.4.1.2.3  Query Retrieve Configuration ................................................................... 71 
4.4.1.2.4  Advanced DICOM Device Association Configuration ............................... 71 
4.4.1.2.5  Serial Structured Report Storage Configuration ....................................... 72 
4.4.1.2.6  Workflow Configuration ............................................................................. 72 
4.4.1.2.7  Hardcopy ................................................................................................... 72 
4.4.2  Parameters ................................................................................................................... 72 
5  MEDIA STORAGE .................................................................................................................................. 73 
5.1  IMPLEMENTATION MODEL.................................................................................................. 73 
5.1.1  Application Data Flow ................................................................................................... 73 
5.1.2  Functional Definition of AEs ......................................................................................... 74 
5.1.2.1  Functional Definition of Media Application Entity................................................ 74 
5.1.3  Sequencing of Real-World Activities ............................................................................ 74 
5.1.4  File Meta Information Options ...................................................................................... 74 
5.2  AE SPECIFICATIONS............................................................................................................ 74 
5.2.1  Media Application Entity Specification.......................................................................... 74 
5.2.1.1  File Meta Information for the Application Entity .................................................. 74 
5.2.1.2  Real-World Activities........................................................................................... 75 
5.2.1.2.1  Activity – Export to Media ......................................................................... 75 
5.2.1.2.2  Activity – Import from Media ..................................................................... 75 
5.2.1.2.3  Activity – Update to Media ........................................................................ 75 
5.2.1.2.3.1  Media Storage Application Profiles................................................ 75 
5.2.1.2.3.2  Options .......................................................................................... 75 
6  TRANSFORMATION OF DICOM TO CDA ............................................................................................ 78 
7  SUPPORT OF CHARACTER SETS ...................................................................................................... 78 
8  SECURITY.............................................................................................................................................. 78 
8.1  GENERAL SECURITY ........................................................................................................... 78 
8.2  SUPPORTED DICOM SECURITY PROFILES ...................................................................... 78 
8.2.1  TLS Secure Transport Connection Profiles .................................................................. 78 
9  ANNEXES............................................................................................................................................... 80 
9.1  IOD CONTENTS .................................................................................................................... 80 
9.1.1  Created SOP Instances ................................................................................................ 80 
9.1.1.1  US or US Multiframe Image IOD ........................................................................ 80 
9.1.1.2  Secondary Capture IOD ..................................................................................... 81 
9.1.1.3  Multi-Frame True Color Secondary Capture IOD ............................................... 81 
9.1.1.4  Comprehensive Structured Report IOD.............................................................. 82 
9.1.1.5  Attribute Content by Module ............................................................................... 82 
9.1.1.5.1  Common Modules ..................................................................................... 82 
9.1.1.5.2  US or Multiframe Image Modules ............................................................. 86 
9.1.1.5.3  Secondary Capture Image Modules ......................................................... 92 
9.1.1.5.4  Comprehensive Structured Report Modules............................................. 95 
9.1.2  Usage of Attributes from Received IOD’s..................................................................... 98 

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 9.1.3  Attribute Mapping ......................................................................................................... 98 
9.1.4  Coerced/Modified Fields ............................................................................................... 99 
9.1.5  Attribute Anonymization................................................................................................ 99 
9.2  DATA DICTIONARY OF PRIVATE ATTRIBUTES .............................................................. 101 
9.3  CODED TERMINOLOGY AND TEMPLATES...................................................................... 101 
9.4  GRAYSCALE IMAGE CONSISTENCY................................................................................ 102 
9.5  STANDARD EXTENDED/SPECIALIZED/PRIVATE SOP CLASSES ................................. 102 
9.5.1  Ultrasound Image and Multi-frame Image SOP Classes ........................................... 102 
9.5.2  3D Presentation State Private SOP Class ................................................................. 103 
9.6  PRIVATE TRANSFER SYNTAXES ..................................................................................... 103 
A.1  STRUCTURED REPORTS .................................................................................................. 104 
A.1.1  Introduction ................................................................................................................. 104 
A.1.1.1  Measurements Linked to Images ..................................................................... 104 
A.1.2  Clinical Scope ............................................................................................................. 105 
A.2  APPLICATIONS THAT EXPORT STRUCTURED REPORTS FROM EPIQ AND AFFINITI105 
A.3  DICOM STRUCTURED REPORT EXPORT SPECIFICATIONS ........................................ 105 
A.3.1  Philips Healthcare Ultrasound Data Portal Website ................................................... 105 
A.4  PRIVATE TEMPLATE EXTENSIONS.................................................................................. 106 
A.4.1  TID5001: OB-GYN Patient Characteristics ................................................................ 106 
A.4.2  TID5008: Fetal Biometry Group ................................................................................. 107 
A.4.3  TID5101: Vascular Patient Characteristics................................................................. 107 
A.4.4  TID5202: Echocardiography Patient Characteristics ................................................. 107 
A.5  USER-DEFINED MEASUREMENTS AND CALCULATIONS ............................................. 108 
A.5.1  Description .................................................................................................................. 108 
A.5.1.1  Philips Generic DICOM Export Format............................................................. 108 
A.5.1.2  DICOM Template Compatible Export Format................................................... 108 
A.5.1.3  Private Template and Template Extensions ..................................................... 109 
A.5.1.3.1  TID5000: OB-GYN Ultrasound Procedure Report .................................. 109 
A.5.1.3.2  TID5100: Vascular Ultrasound Report .................................................... 109 
A.5.1.3.3  TID5200: Echocardiography Procedure Report...................................... 109 
A.5.1.3.4  TID995300: Pediatric Echocardiography Procedure Report .................. 109 
A.5.1.3.5  TID9900: User-defined concepts ............................................................ 109 
A.5.1.3.6  TID9901: User-defined concept .............................................................. 110 
A.5.1.3.7  TID9902: Fetal Heart Section ................................................................. 110 
A.5.1.3.8  TID 5009: Fetal Biophysical Profile Section............................................ 111 
A.5.1.3.9  TID 5016: Pelvis and Uterus Section ...................................................... 111 
B.1  BULK PRIVATE ATTRIBUTES ............................................................................................ 112 

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 10
 3 INTRODUCTION

3.1 AUDIENCE
This document is intended for hospital staff, health care system integrators, software designers or
implementers. It is assumed that the reader has a working understanding of DICOM.

3.2 REMARKS
DICOM, by itself, does not guarantee interoperability. However, the Conformance Statement facilitates a first-
level validation for interoperability between different applications supporting the same DICOM functionality.

This Conformance Statement is not intended to replace validation with other DICOM equipment to ensure
proper exchange of information intended.

The scope of this Conformance Statement is to facilitate communication between Philips equipment with non-
Philips equipment. The Conformance Statement should be read and understood in conjunction with the
DICOM Standard [DICOM]. However, by itself it is not guaranteed to ensure the desired interoperability and
successful interconnectivity.

The user should be aware of the following important issues:

— The comparison of different conformance statements is the first step towards assessing interconnectivity
between Philips equipment and non-Philips quipment.
— Test procedures should be defined to validate the desired level of connectivity.
— The DICOM standard will evolve to meet the users’ future requirements. Philips is actively involved in
developing the standard further and therefore reserves the right to make changes to its products or to
discontinue its delivery. This document is based on the 2019 version of the Standard, as listed in Section
3.4 References.
o Note: The Implementation Class UID and Implementation Version Name attribute contents may
differ from the information in this document when a sustaining software release is done that does
NOT change the DICOM features or functionality. This would be when the “x” portion of the
version on the cover page changes.

3.3 DEFINITIONS, TERMS AND ABBREVIATIONS

Definitions, terms and abbreviations used in this document are defined within the different parts of the DICOM
standard.

Abbreviations and terms are as follows:

AE Application Entity
AET Application Entity Title
ASCE Association Control Service Element
CD-R Compact Disk Recordable
CID Context ID. Reference to a DICOM code “context group” defined in DICOM PS3.16
CSE Customer Service Engineer
DICOM Digital Imaging and Communications in Medicine
FSC File-Set Creator
FSU File-Set Updater
FSR File-Set Reader

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 11
 GSDF Grayscale Standard Display Function
HIPAA United States “Healthcare Insurance Portability and Accountability Act of 1996”
IOD Information Object Definition
ISO International Standard Organization
LOINC Logical Observation Identifiers Names and Codes
MPPS Modality Performed Procedure Step
MWL Modality Worklist
R Required Key Attribute
O Optional Key Attribute
PDIR Patient Directory screen on EPIQ/Affiniti
PDU Protocol Data Unit
PDE Patient Data Entry screen on EPIQ/Affiniti
PS3.x Reference to part ‘x’ the DICOM 3.0 Standard
PSC Philips Support Connect. It is the primary interface on EPIQ/Affiniti for configuring DICOM
services. It is reached by pressing the “Support” key on the EPIQ/Affiniti control panel.
SCU Service Class User (DICOM client)
SCP Service Class Provider (DICOM server)
SOP Service-Object Pair
SNOMED Systematized Nomenclature of Medicine (SRT)
SPS Scheduled Procedure Step
SR Structured Report
TID Template ID. Reference to a DICOM Structured Report “template” defined in DICOM
PS3.16
U Unique Key Attribute
US Ultrasound
USB Universal Serial Bus

The following upper-case abbreviations represent specific Attributes. Refer to PS3.3 Section 8 for a
description:
CV Code Value (0008,0100)
CSD Coding Scheme Designator (0008,0102)
CM Code Meaning (0008,0104)
CSV Coding Scheme Version (0008,0103)

3.4 REFERENCES
[DICOM] Digital Imaging and Communications in Medicine (DICOM), NEMA PS 3.1-3.20, 2019, available free
at http://medical.nema.org/standard.html

Integrated Healthcare Enterprise (IHE) Radiology Technical Framework, Vol. 1, Integration Profiles, Revision
17.0 Final Text July 27, 2018

Integrated Healthcare Enterprise (IHE) Radiology Technical Framework, Vol. 2, Transactions, Revision 17.0
Final Text July 27, 2018

Integrated Healthcare Enterprise (IHE) Radiology Technical Framework, Vol. 3, Transactions continued,
Revision 17.0 Final Text July 27, 2018

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 12
Integrated Healthcare Enterprise (IHE) Cardiology Technical Framework, Vol. 1, Integration Profiles, Revision
5.0, Final Text, August 29, 2013

Integrated Healthcare Enterprise (IHE) Cardiology Technical Framework, Vol. 2, Transactions, Revision 5.0,
Final Text, August 29, 2013

Joint VA / DoD DICOM Conformance Requirements for Digital Acquisition Modalities, Version 3.0, September
28, 2005

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 13
 4 NETWORKING

4.1 IMPLEMENTATION MODEL

4.1.1 Application Data Flow

Local AE's Connected AE's

Receives Images, 
Reports, Commits; 
Returns 
Commitments
Send 
Images, Reports,
Commits; Query 
Images Storage 
Application  Sends images
Entity
Receive Retrieved 
Data

Receives queries

Update  Provides
Worklist Worklist
Items
Workflow 
Application 
Entity
Receives MPPS 
Acquire Create / Set
Images

Hardcopy 
Print Prints 
Application 
Images Film Sheets
Entity

DICOM Standard Interface

Figure 1: APPLICATION DATA FLOW DIAGRAM

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 14
Application Entities are:
 Storage Application Entity: Responsible for Storing images, Presentation States, and Structured Reports to
remote Storage SCPs and media, request commitment of instances and receiving commit responses from a
remote Storage Commitment SCP, performing Query and Retrieve requests to a remote Query/Retrieve SCP,
and accepting imports of images from remote Storage SCUs or media.
 Workflow Application Entity: Responsible for Modality Worklist queries of a remote Modality Worklist SCP
and Modality Performed Procedure Step notifications to a remote Modality Performed Procedure Step SCP.
 Hardcopy Application Entity: Responsible for making Print requests of remote Grayscale and Color Print
Meta-SCPs.
o Note: The ultrasound system uses one AE Title for all of its entities. See section 4.4.1.1 for where
and how to configure the local system’s AE Title.
Exam data is sent to all selected Store, Workflow, and Hardcopy destinations simultaneously in accordance with
system configuration of send “After Each Print/Acquire” or “At End of Exam”. If Send on Demand had been invoked,
images and Structured Reports modified since the last Send on Demand are sent at End Exam.

4.1.2 Functional Definition of AEs

4.1.2.1 Functional Definition of Storage Application Entity

The Storage Application Entity sends Images, Presentation States, and Structured Reports to a remote AE. It is
associated with the local real-world activity “Acquire” hardkeys and configured Touch Screen buttons on EPIQ/Affiniti.
To configure for auto export, the Acquisition buttons must be associated with the destination device(s) by configuring in
Touch screen “Utilities”, Setups, Acquisition/Capture, Archive/Printer. If not selected, the exams may be sent from
Review. Sending of images will occur automatically when configured to do so, either “After Each Print/Acquire” or “At
End of Exam” with or without “Send on Demand”. If configured to send “After Each Print/Acquire”, images are
transferred immediately after acquisition and Structured Reports are transferred when the exam is ended. If configured
for send “At End Exam”, images and Structured Reports are transferred when the exam is ended. Private
Presentation States are always transferred when the exam is ended.

While configured for send “At End Exam”, “Send on Demand” allows for sending acquired images and/or Structured
Report during an active exam without ending the exam or in-progress MPPS. Print images will be sent without
requiring a full print page to be filled. Send on Demand is invoked by clicking an icon located at the bottom center of
the system display after acquiring the first image of the study. If Send on Demand is invoked during an exam,
remaining images and the final Structured Report are transferred when the exam is ended.

The system can be configured to automatically end and send an exam after a specified time of system inactivity
without the user hitting “End Exam”.

An exam may be sent manually by user selection from the Patient Directory via “Review”, including exams that have
been imported or retrieved into EPIQ/Affiniti from other sources. Further, individually-selected images acquired on
EPIQ/Affiniti may be sent manually from image review.

The existence of a Network Store queue with associated network destination will activate the Storage AE. An activated
Network Store Queue will be represented by a green dot next to the Network Queue icon. An association request is
sent to the destination AE and upon successful negotiation of a Presentation Context, then the image transfer is
started. If certain transient network problems are detected, the Storage AE will automatically retry the storage job at
30-second intervals. Under other error conditions, the related queue is set to a “Failed” state, indicated by a Red dot
on the Network Queue Icon, and can be restarted by the user via the queue management interface. The user may
need to cancel the queue, and then restart manually. When configured for “Send at End Exam”, instances are not
necessarily sent in the order they are acquired. Typically, Structured Reports are sent first, followed by multi-frame
(loop) images, and then single frame images. When “Image Export Format” is selected as “Monochrome”, single frame
images that have color content (such as Color Flow, CPA, TDI, or elastography, or with Chroma applied), will export as
grayscale using Monochrome2 Photometric Interpretation. If the non-active region of a 2D/scrolling image has a
chroma map, it will be sent as monochrome.

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If the remote AE is configured for Storage Commitment and a selection is made to associate it with the appropriate
Storage Server, Storage Commitment N-ACTION requests are normally sent at the end of the exam. If instances are
sent during the exam, either by selecting send “After Each Print/Acquire” or by using “Send on Demand”, the “Storage
Commit image-by-image” selection determines when the associated Storage Commit N-ACTION requests are sent:

 If “Storage Commit image-by-image” is enabled, a storage association is initiated for C-STORE requests and
then released, followed by the initiation of a storage commit association for the associated N-ACTION
requests which is then released. This sequence is repeated for each storage event.

 If “Storage Commit image-by-image” is disabled, Storage Commit N-ACTION requests are sent at the end of
the exam after all C-STORE requests are sent to the Storage SCP associated with the Storage Commitment
SCP.

If a Storage Commitment N-EVENT-REPORT is successfully obtained for all instances acquired in the exam, this
information is recorded in the local database, placing a checkmark in the commit portion of the Patient Directory
display and signaling the Auto-delete function that the exam qualifies for deletion, if configured for Auto-Delete after
Commit. If not, no auto delete will occur even after successful commit notification is received.

Note: Storage Commitment will only complete successfully if all objects of the study are sent to the Storage device associated with the Storage Commit Server.
If other destinations are designated for storage of specific objects in the study, the Commit checkmark and auto delete will not occur.

The Storage AE is also responsible for accepting images for storage in EPIQ/Affiniti, through any of the following
mechanisms:

 Import from removable media

 Retrieve using the Query/Retrieve service
 Unsolicited push from a Storage SCU to EPIQ/Affiniti acting as a Storage SCP. This mechanism requires that
the Storage SCU AE Title and IP Address to have previously been configured as an acceptable DICOM
Storage Device.

The Storage Application Entity also support Query Retrieve functionality. See details in section 4.2.1.3.4, Query and
Request Retrieval of Studies. The functionality is found when an appropriate set of configurations is completed:

 A “DICOM Storage Server” device type is used to configure the AE Title, Port and IP Address of the server
that supports Study-Level Query Retrieve Find and Move.
 A second “DICOM Storage Server” device on the ultrasound system must be used to add the server’s sending
AE Title for the C-Store association initiated by the C-Move request sent to the Query Retrieve server. Without
this second device, the query will be succesful, but retrieve will fail because the ultrasound system will reject
any association request from an “unknown” AE Title.

To perform a query, the user selects the “Review” button on the touchscreen. Under “Source” – select the “Hard Drive”
selection to get the list of configured storage servers for the Query Retrieve server. That will open the query page.
Query options including automatic searching to each Series level or also to Image Level for each matching Study.
Note that Image level query for many studies will take longer.

4.1.2.2 Functional Definition of Workflow Application Entity

The Workflow Application Entity receives Modality Worklist (MWL) information from and sends Modality
Performed Procedure Step (MPPS) information to remote AEs. It is associated with the local real-world activities
“Update Worklist”, “Patient Search” and “Acquire Images”.
When either the “Update Worklist” or “Patient Search”, equivalent to IHE terms “Broad” and “Patient-based” queries in
local real-world activity is performed, the Workflow Application Entity queries a remote AE for worklist items and
provides the set of worklist items matching the query request.
 ”Update Worklist” is performed as a result of an operator request or can be is performed automatically at
specific time intervals or at the end of each exam. Default query criteria are Modality of US (ultrasound) and
Scheduled Procedure Step Start Date of the current date. Additional changes to Modality Worklist search

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 include customizing to search for a different AE Title, Station Name, System Location and Custom Modality.
These configuration options are found in the Advance settings for the MWL Device in DICOM Device setup.
 “Patient Search” is manually initiated. The user may search by Patient Last Name, Patient ID, Accession
#, Exam Date or Date Range, and/or Requested Procedure ID. A wildcard patient query can be performed
by entering a * in the Patient Name field. These critera are located in the Worklist Tab, Patient Search.
o Note: These two query options send messages to the Modality Worklist server which will provide all
matches for the query parameters. After a list from the worklist is displayed, the “Find” dialog will
seach only within the returned results. It is not another query.
If the Workflow AE establishes an Association to a remote AE, the server will transfer all matching worklist items via
the open Association. The results of a successful Worklist Update will overwrite the data in the Worklist display. There
is no queue management for Modality Worklist.

Modality Performed Procedure Steps are created and updated with the following real-world events:
 MPPS N-Create, Status = IN PROGRESS:
o Acquisition of images will result in automated creation of an MPPS Instance managed by a remote AE.
 MPPS N-Set, Status = COMPLETE
o Completion of the MPPS is performed as the result of an operator action of ending the exam.
 MPPS N-Set, Status = DISCONTINUED
o “Cancel Exam” causes the “Discontinued” status to be sent.
o Note: A “Paused” exam does not initiate an MPPS event.

Note: If the MPPS messages were not received by the MPPS server, they may be “re-sent” by selecting the
study in Review and selecting “Export”. In Export, select the MPPS server. The MPPS messages associated
with that study will be resent.
The Workflow AE performs the creation of a Modality Performed Procedure Step (MPPS) instance automatically
when the first image of a study is acquired. MPPS message queues are listed along with Image and Structured Report
queues in the Network status window.
The user may also change patient identification information while a MPPS is in progress. If this is done, the previous
MPPS is discontinued and a new MPPS is created with the changed patient information. The Storage AE is informed,
and if images acquired under the previous patient information have already been transferred (because send “After
Each Print/Acquire” or “Send On Demand”) the images are regenerated and sent again with updated patient
information and new DICOM UID’s.
Additional exams may be appended to an existing study. There are two fundamental methods to perform append:
 Append from Patient Directory: Select an Ended study from the Patient Directory and press choose “Append.”
Two options are available:
o “Add” (if less than 24 hours old), allows images to be added to the original Study, using the same
Study Instance UID, and a new Performed Procedure Step SOP Instance UID. If more than 24 hours
old, only “Create” will be available.
o “Create”, which will create a new Study Instance UID.
 Append from Image Review: Open the Study in Review from the Patient Directory and acquire an image.
Default behavior is selectable via a configuration screen for Append from Image Review – Create Study
Instance UID, either:

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 o “Add” (if less than 24 hours old), allows images to be added to the original Study using the same Study
Instance UID and a new Performed Procedure Step SOP Instance UID. If the Study being appended is
greater than 24 hours old, a new Study Instance UID is created.
o “Create”, which will create a new Study Instance UID.
For Exams appended by creating the image from Image Review and changing visualization of the existing images, for
example, changing chroma map, added images would have the same Acquisition DateTime value of the original
images in which the images were acquired. This is not the case for append from Patient Directory, which creates
completely new images with the current date and time.
Study Date on the Report page refers to the date of the Study in which the evidences were acquired. This is exported
as Study Date (0008,0020). This includes all Appended and Non-Appended exams. Refer to Study Date (0008,0020)
to determine the date of the original exam in which the evidences were acquired and refer to DICOM Performed
Procedure Step Start Date (0040,0244) for the date of Appended exam.
For Exams appended from Image Review, the Report footer has the statement “Appended: “followed by the date in
which the exam is started for Appending/Appended exams from Image Review.
The preceding append functions differ from the IHE Schedule Workflow Profile’s “Append Case”. In this case, a study
selected from a Modality Worklist Scheduled Procedure step is re-selected from the worklist. The same Study
Instance UID is used, but new Series Instances are created as well as new MPPS messages.
4.1.2.3 Functional Definition of Hardcopy Application Entity

The Hardcopy Application Entity prints images to a remote AE (Printer or print server). It is associated with the
”Acquire” local real-world activity, depending on configuration. The user action creates a Film Session containing one
or more Film Boxes and Image Boxes composed from images acquired by the user. The AE creates and sends fully
rendered pages according to the user’s selected formatting choices in a single Image Box per page. This Image Box
is rather large compared to sending individual Image Boxes to the printer.

If the user has both BW and Color DICOM printers configured and selected, and “Automatic Printer Choice” is enabled,
images containing color content (such as Color Flow, CPA, TDI, or elastography, or with Chroma applied) are sent to
the Color printer, and all others are sent to the BW printer. If both printers are configured and selected and “Automatic
Printer Choice” is disabled, each image will be printed to both printers.

The existence of a print queue will activate the Hardcopy AE. An association is established with the printer(s) and the
printer’s status determined. If the printer is operating normally, the film sheets will be printed. If the printer is not
operating normally, the print queue will set to a “Failed” state and can be restarted by the user via the queue
management interface.

4.1.3 Sequencing of Real-World Activities

The following sequence diagrams illustrate the order of network operations during a number of imaging scenarios. If
Modality Worklist is not being used, the user enters patient identification manually at the start of exam and the
Query/Receive Worklist steps do not occur.

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 FIGURE 2A:
SEND AFTER EACH PRINT/ACQUIRE, IMAGE-BY-IMAGE COMMIT DISABLED

Figures 2A through 2C illustrate exam acquisition with send “After Each Print/Acquire”, “At End Exam”, and “At End
Exam” with “Send on Demand”, respectively, with “Storage Commit image-by-image” disabled.

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 Storage Hardcopy Workflow Department  Printer Image 
Scheduler Manager

user update 
or query
1  Query Worklist

 2  Receive Worklist

 3  Acquire Images

4 Create MPPS on first image acquire

end exam
5 Store All Images, SR Documents, and Presentation States

end exam
6 Print All Film Sheets

cancel or 
end exam 7 Discontinue or Complete MPPS 

store 
completion 
8 Storage Commit Request 

commit
status 9  Accept Commitment Response
update

FIGURE 2B:
SEND AT END EXAM

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 FIGURE 2C:
SEND ON DEMAND, IMAGE-BY-IMAGE COMMIT DISABLED

Figures 2D and 2E illustrate exam acquisition with send “After Each Print/Acquire” and “At End Exam” with “Send on
Demand”, respectively, with “Storage Commit image-by-image” enabled.

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 Storage Hardcopy Workflow Department Printer Image
Scheduler Manager

user update
or query

1 Query Worklist

2 Receive Worklist

acquire or Accept
image Stage 3 Create MPPS upon first acquired image

4 Store Image

store
completion
5 Storage Commit Request

sheet full
6 Print Film Sheet

end exam
7 Print Film Sheet
end exam
8 Store SR Document and Presentation States

9 SR and Presentation States Storage Commit Requests

commit status
update 10 Accept Commitment Response

end exam 11 Complete or Discontinued MPPS

FIGURE 2D:
SEND AFTER EACH PRINT/ACQUIRE, IMAGE-BY-IMAGE COMMIT ENABLED

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 FIGURE 2E:
SEND ON DEMAND, IMAGE-BY-IMAGE COMMIT ENABLED

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4.2 AE SPECIFICATIONS
4.2.1 Storage Application Entity Specification

4.2.1.1 SOP Classes

EPIQ/Affiniti provides Standard Extended1 Conformance to the following SOP Classes:

Table 4.1
SOP CLASSES FOR AE STORAGE
SOP Class Name SOP Class UID SCU SCP
US Image Storage 1.2.840.10008.5.1.4.1.1.6.1 Yes Yes
US Image Storage (retired) 1.2.840.10008.5.1.4.1.1.6 Yes Yes
US Multiframe Image Storage 1.2.840.10008.5.1.4.1.1.3.1 Yes Yes
US Multiframe Image Storage (retired) 1.2.840.10008.5.1.4.1.1.3 Yes Yes
Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7 Yes Yes
Multi-frame True Color Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7.4 Yes Yes
CT Image Storage 1.2.840.10008.5.1.4.1.1.2 Yes Yes
Enhanced CT Image Storage 1.2.840.10008.5.1.4.1.1.2.1 Yes Yes
Digital Mammography X-Ray Image Storage – For Presentation 1.2.840.10008.5.1.4.1.1.1.2 Yes Yes
Digital Mammography X-Ray Image Storage – For Processing 1.2.840.10008.5.1.4.1.1.1.2.1 Yes Yes
MR Image Storage 1.2.840.10008.5.1.4.1.1.4 Yes Yes
Enhanced MR Image Storage 1.2.840.10008.5.1.4.1.1.4.1 Yes Yes
MR Spectroscopy Image Storage 1.2.840.10008.5.1.4.1.1.4.2 Yes Yes
Positron Emission Tomography Image Storage 1.2.840.10008.5.1.4.1.1.128 Yes Yes
X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.1 Yes Yes
Private 3D Presentation State Storage 1.3.46.670589.2.5.1.1 Yes Yes
Comprehensive SR Storage 1.2.840.10008.5.1.4.1.1.88.33 Yes Yes*
Storage Commitment Push Model 1.2.840.10008.1.20.1 Yes No
Study Root Query/Retrieve – FIND 1.2.840.10008.5.1.4.1.2.2.1 Yes No
Study Root Query/Retrieve – MOVE 1.2.840.10008.5.1.4.1.2.2.2 Yes No

Note: Use of Retired SOP Classes only is user configurable for the system on the PSC – Network/DICOM – DICOM
Settings – DICOM Storage Device – Advanced Settings configuration page. Image storage will use Retired SOP
Classes only when selected.

* System will accept and can import and export SR objects with a study. No display of imported SR.

1
See section 9.5 for information on the Standard Extended SOP Class

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4.2.1.1.1 General

The DICOM standard application context name for DICOM 3.0 is always proposed:

Table 4.2
DICOM APPLICATION CONTEXT FOR AE STORAGE
Application Context Name 1.2.840.10008.3.1.1.1

4.2.1.1.2 Number of Associations

EPIQ/Affiniti initiates one Association at a time for each destination to which a transfer request is being processed in
the active job queue list. Five storage destinations, one Structured Report storage destination, and one Storage
Commitment destination may be selected simultaneously, but only one job will be active at a time; the other(s) remain
pending until the active job is completed or failed.

Table 4.3
NUMBER OF ASSOCIATIONS INITIATED FOR AE STORAGE
Maximum number of simultaneous Associations 1

EPIQ/Affiniti accepts Associations for N-EVENT-REPORT notifications for the Storage Commitment Push Model SOP
Class. EPIQ/Affiniti will also accept Associations for C-STORE messages for receiving data in response to
Query/Retrieve C-MOVE requests or unsolicited images from a remote Storage SCU sending images to EPIQ/Affiniti.

Table 4.4
NUMBER OF ASSOCIATIONS ACCEPTED FOR AE STORAGE
Maximum number of simultaneous Associations 5

4.2.1.1.3 Asynchronous Nature

EPIQ/Affiniti does not support asynchronous communication (multiple outstanding transactions over a single
Association).

Table 4.5
ASYNCHRONOUS NATURE AS A SCU FOR AE STORAGE
Maximum number of outstanding asynchronous
1
transactions

4.2.1.1.4 Implementation Identifying Information

The implementation information for this Application Entity is:

Table 4.6
DICOM IMPLEMENTATION CLASS AND VERSION FOR AE STORAGE
Implementation Class UID 1.3.46.670589.14.10000.600
Implementation Version Name EPIQ-AFFIN_6.00

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4.2.1.2 Association Initiation Policy

4.2.1.2.1 Activity – Store Images and Structured Reports

4.2.1.2.1.1 Description and Sequencing of Activities

A user may select exams or individual images from Review and request them to be sent to multiple destinations (up to
five). Reports may not be selected individually, but are sent when “End Exam” is pressed, and when an entire exam is
selected for export from the Review Directory and exported to a Storage device with “Export Structured Report”
enabled. Each object (image, private presentation state, or structured report) is entered into the job queue. When
send “After Each Print/Acquire” is enabled, the acquired images are sent to the selected destinations immediately after
acquisition.

The Network Status icon reports the status of the job, Green is ok, Yellow exclamaition point is pending until a network
connection is available, and Red X indicates failed.

If the C-STORE response from the remote Application Entity contains a status other than Success, the Association is
aborted and the related Job is switched to a failed state. It can be restarted any time by user interaction. When a
system configured with selected network destinations is used without the network connected, it is considered in
“Portable” mode. Reconnecting the network cable will initiate transfer again.

If a device is configured for Storage Commitment service, the Storage AE will transmit a separate Storage
Commitment N-ACTION request for images and one for the report. The Storage AE can only receive an N-EVENT-
REPORT request in a separate subsequent association initiated by the SCP employing PDU 54H SCP/SCU Role
Negotiation of “SCP” in the SCP’s Association Request. It cannot receive N-EVENT-REPORT request messages on
the same association as the N-ACTION request.

Structured Reports will contain all supported measurements and calculations created by EPIQ/Affiniti even if they are
not selected for display in the on-system report. One Structured Report instance is created for each template that is
used. In this context, “template” refers to the DICOM Structured Report templates listed in PS3.16 of the DICOM
Standard.

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 Storage Image
AE Manager

acquire
image
(Acquire at least one image, make measurements)
1. Open Association

2. C-STORE (Images)
3. Close Association

end
exam

4. Open Association
5. C-STORE (Structured Report)
6. Close Association

store
completion
7. Open Association
8. N-ACTION (Storage Commitment Request for Images)
9. N-ACTION (Storage Commitment Request for SR)
10. Close Association
commit status
updated
11. Open Association
12. N-EVENT-REPORT (Storage Commitment Response - Images)
13. N-EVENT-REPORT (Storage Commitment Response - SRs)
14. Close Association

Figure 3
SEQUENCING OF ACTIVITY – SEND IMAGES AND STRUCTURED REPORT AFTER EACH PRINT/ACQUIRE

The sequence of interactions between the Storage AE and an Image Manager is illustrated in Figure 3 for the “Store”
configuration option “After Each Print/Acquire”. If the “At End Exam” configuration option is selected, no C-STORE is
sent at the Acquire Image event and instead all image C-STOREs are sent after end exam.

NOTES: Pausing an exam will close the current association. A new association will be created when resumed.
Similar behavior when the association times out.
The N-EVENT-REPORT must be sent over a separate association initiated by the Image Manager (see Section
4.2.1.3.1.1 on Activity – Receive Storage Commitment Response).

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4.2.1.2.1.2 Proposed Presentation Contexts

EPIQ/Affiniti is capable of proposing the Presentation Contexts shown in the following table:

Table 4.7
PROPOSED PRESENTATION CONTEXTS FOR ACTIVITY SEND IMAGES
Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List Role Neg.
US Image Storage 1.2.840.10008.5.1.4.1.1.6.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
US Image Storage 1.2.840.10008.5.1.4.1.1.6 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
(Retired) Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
US Multiframe Image 1.2.840.10008.5.1.4.1.1.3.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
RLE Lossless 1.2.840.10008.1.2.5
US Multiframe Image 1.2.840.10008.5.1.4.1.1.3 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
(Retired) JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
RLE Lossless 1.2.840.10008.1.2.5
Secondary Capture 1.2.840.10008.5.1.4.1.1.7 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Image Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Multi-frame True Color 1.2.840.10008.5.1.4.1.1.7.4 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Secondary Capture Explicit VR Little Endian 1.2.840.10008.1.2.1
Image Storage
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
RLE Lossless 1.2.840.10008.1.2.5
CT Image Storage 1.2.840.10008.5.1.4.1.1.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Enhanced CT Image 1.2.840.10008.5.1.4.1.1.2.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Digital Mammography X- 1.2.840.10008.5.1.4.1.1.1.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Ray Image Storage – Explicit VR Little Endian 1.2.840.10008.1.2.1
For Presentation JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70

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 Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List Role Neg.
Digital Mammography X- 1.2.840.10008.5.1.4.1.1.1.2.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Ray Image Storage – Explicit VR Little Endian 1.2.840.10008.1.2.1
For Processing
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
MR Image Storage 1.2.840.10008.5.1.4.1.1.4 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Enhanced MR Image 1.2.840.10008.5.1.4.1.1.4.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
MR Spectroscopy Image 1.2.840.10008.5.1.4.1.1.4.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Positron Emission 1.2.840.10008.5.1.4.1.1.128 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Tomography Image Explicit VR Little Endian 1.2.840.10008.1.2.1
Storage JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
X-Ray Angiographic 1.2.840.10008.5.1.4.1.1.12.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Image Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Private 3D Presentation 1.3.46.670589.2.5.1.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
State* Explicit VR Little Endian 1.2.840.10008.1.2.1
Comprehensive 1.2.840.10008.5.1.4.1.1.88.33 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Structured Report Explicit VR Little Endian 1.2.840.10008.1.2.1
Storage
Storage Commitment 1.2.840.10008.1.20.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
Push Model Explicit VR Little Endian 1.2.840.10008.1.2.1

*Intended for use only on Q-Station workstations and anywhere QLAB is installed.

Presentation Contexts are proposed for each Storage device based on selected options. Contexts are proposed for
images for all Storage devices, unless the user selects “Implicit Little Endian Only” in the Advanced Configuration tab
for the configured device. Then only Implicit Little Endian is negotiated for that device, provided the study contains no
JPEG Lossy compressed loops. The Implicit Little Endian Only selection will override the Single Frame Compression
setting, resulting in only uncompressed export. RLE Lossless and JPEG Lossless are only negotiated for Image
Presentation Contexts if configured for use by the user. JPEG Extended 12-bit Lossy will only be negotiated if images
are present that require that transfer syntax, this is not selectable by the user.

Storage Commitment N-ACTION requests are only sent to the device that is configured as the Storage Commitment
server. Storage Commitment always works in conjunction with a designated Storage SCP configured to receive
storage of the objects to be committed.

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4.2.1.2.1.3 SOP Specific Conformance

4.2.1.2.1.3.1 Image and Comprehensive Structured Report Storage SOP Classes

4.2.1.2.1.3.1.1 Storage (C-STORE)

All Image and Comprehensive Structured Report Storage SOP Classes supported by the Storage AE exhibit the same
behavior, except where stated, and are described together in this section.

Table 4.8 describes C-Store response behavior.

Table 4.8
STORAGE C-STORE RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
Success Success 0000 The SCP successfully stored the SOP Instance. If all SOP
Instances succeed, the job is marked as complete.
* * Any other The Association is aborted using A-ABORT and the transfer fails.
status code. The status is logged.

The behavior of Storage AE during communication failure is summarized in Table 4.9.

Table 4.9
STORAGE COMMUNICATION FAILURE BEHAVIOR
Exception Behavior
The Association is aborted using A-ABORT and the
Timeout
transfer fails. The status is logged.
The Association is aborted using A-ABORT and the
Association aborted by the SCP or network layers
transfer fails. The status is logged.

A green dot on the Network Queue Icon indicates an active queue. A red x indicates failure. A yellow asterisk
indicates network connection lost. By using the Queue Manager, the user can restart a failed transfer. Open the
Queue Manager by clicking on the Network Queue Icon. Select the failed transfer and click Retry.

The contents of US Image, US Multiframe Storage and Comprehensive Structured Report Storage SOP Instances
conform to the DICOM IOD definitions described in Section 9.1.

4.2.1.2.1.3.2 SOP Specific Conformance for Storage Commitment Push Model SOP Class

4.2.1.2.1.3.2.1 Storage Commitment Notifications (N-ACTION)

The Storage AE will request storage commitment for the configured device. If “Storage Commit image-by-image” is
selected, Storage Commitment is requested automatically by the system immediately after the instance is stored (but
not necessarily one-to-one with each storage request).

Table 4.10 summarizes the behavior of Storage AE when receiving response status codes.

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 Table 4.10
STORAGE COMMITMENT N-ACTION RESPONSE STATUS HANDLING BEHAVIOR

Service Status Further Meaning Error Code Behavior

Success Success 0000 The system waits for the N-Event-Report.
* * Any other status code. The commit status remains unchanged for all objects.

Table 4.11 summarizes the behavior of Storage AE during communication failure.

Table 4.11
STORAGE COMMITMENT N-ACTION COMMUNICATION FAILURE BEHAVIOR
Exception Behavior
Timeout Same as non-success status in Table 4.10.
Association aborted by the SCP or network layers Same as non-success status in Table 4.10.

The Storage AE will request storage commitment using the attributes described in Table 4.12.

Table 4.12
STORAGE COMMITMENT N-ACTION-REQUEST MESSAGE CONTENTS
Action Type Action Attribute Tag Requirement Type
Name Type ID SCU
Request 1 Transaction UID (0008,1195) 1
Storage Storage Media File-Set ID (0088,0130) 3
Commitment
Storage Media File-Set UID (0088,0140) 3
Referenced SOP Sequence (0008,1199) 1
>Referenced SOP Class UID (0008,1150) 1
>Referenced SOP Instance UID (0008,1155) 1
>Storage Media File-Set ID (0088,0130) 3
>Storage Media File-Set UID (0088,0140) 3

If Storage Commit Auto-Retry is enabled, the N-ACTION request is retried if the N-ACTION has completed
successfully but no N-EVENT-RESPONSE received within the configured “no-response” period. Further, the N-
ACTION request is retried if N-EVENT-RESPONSE is received with one or more instances that fail commit; in that
case, C-STORE requests are also resent for all instances that failed to commit.

4.2.1.3 Association Acceptance Policy

4.2.1.3.1.1 Activity – Receive Storage Commitment Response

4.2.1.3.1.2 Description and Sequencing of Activities

The Storage AE accepts associations for pending responses to a Storage Commitment Request only using SCP/SCU
Role Negotiation of “SCP” explicitly stating that the association is initiated by the SCP to the SCU.

4.2.1.3.1.3 Accepted Presentation Contexts

Table 4.13 summarizes Presentation Contexts that the Storage AE accepts.

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 Table 4.13
ACCEPTABLE PRESENTATION CONTEXTS FOR
ACTIVITY RECEIVE STORAGE COMMITMENT RESPONSE
Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.
Storage Implicit VR Little Endian 1.2.840.10008.1.2
Commitment Push 1.2.840.10008.1.20.1 SCU None
Model Explicit VR Little Endian 1.2.840.10008.1.2.1

4.2.1.3.1.4 SOP Specific Conformance for Storage Commitment Push Model SOP Class

4.2.1.3.1.4.1 Storage Commitment Notifications (N-EVENT-REPORT)

The Storage AE can receive an N-EVENT-REPORT notification received from the SCP via an association requested
by the SCP with reverse-role negotiation.

Upon receipt of an N-EVENT-REPORT the timer associated with the Transaction UID will be canceled. Table 4.14
summarizes the behavior of Storage AE when receiving Event Types within the N-EVENT-REPORT.

Table 4.14
STORAGE COMMITMENT N-EVENT-REPORT BEHAVIOR
Event Type Name Event Behavior
Type ID
Storage Commitment Request The commit status is set to complete for each object.
1
Successful
Storage Commitment Request The commit status remains incomplete. The commit
2
Complete – Failures Exist comment for each object is logged.

The reasons for returning specific status codes in an N-EVENT-REPORT response are summarized in Table 4.15.

Table 4.15
STORAGE COMMITMENT N-EVENT-REPORT RESPONSE STATUS REASONS

Service Status Further Meaning Error Code Reasons

Success Success 0000 The storage commitment result has been successfully received.

4.2.1.3.1.4.2 Storage Commitment Attributes (N-EVENT-REPORT)

Table 4.16 lists the attributes that are supported within the N-EVENT-REPORT.

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 Table 4.16
STORAGE COMMITMENT N-EVENT-REPORT MESSAGE CONTENTS
Event Type Event Attribute Tag Requirement Type
Name Type ID SCU
Storage 1 Transaction UID (0008,1195) None
Commitment Retrieve AE Title (0008,0054) None
Request
Successful Storage Media File-Set ID (0088,0130) None
Storage Media File-Set UID (0088,0140) None
Referenced SOP Sequence (0008,1199) None
>Referenced SOP Class UID (0008,1150) None
>Referenced SOP Instance UID (0008,1155) None
>Retrieve AE Title (0008,0054) None
>Storage Media File-Set ID (0088,0130) None
>Storage Media File-Set UID (0088,0140) None
Storage 2 Transaction UID (0008,1195) None
Commitment Retrieve AE Title (0008,0054) None
Request
Complete – Storage Media File-Set ID (0088,0130) None
Failures Exist Storage Media File-Set UID (0088,0140) None
Referenced SOP Sequence (0008,1199) None
>Referenced SOP Class UID (0008,1150) None
>Referenced SOP Instance UID (0008,1155) None
>Retrieve AE Title (0008,0054) None
>Storage Media File-Set ID (0088,0130) None
>Storage Media File-Set UID (0088,0140) None
Failed SOP Sequence (0008,1198) None
>Referenced SOP Class UID (0008,1150) None
>Referenced SOP Instance UID (0008,1155) None
>Failure Reason (0008,1197) None

4.2.1.3.2 Activity – Query and Request Retrieval of Studies

4.2.1.3.2.1 Description and Sequencing of Activities

The user may set a filter in Review when selecting a configured Query Retrieve device in the “Source” dropdown, to
specify the criteria used in querying the Query/Retrieve SCP. When the user initiates the query, the system sends a
Study Root C-FIND request using the filter parameters set by the user. The user may then select from the query
results one or more of the studies to initiate a Study Root C-MOVE request for the selected exam(s).

Additional Query options are user selectable for the initial query and after query results are displayed.

The initial query is only at the Study level. The user may select Series level to be automatically performed for each
Study level returned. The user may also select that each series is automatically queried for contents as well.

Each additional level of query selected at the main query page will increast the time required for result display.

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See section 4.4 Configuration for details on configuring EPIQ and Affiniti systems to support Query Retrieve.

Storage Image
AE Manager
Default Study
level Query
a. Open Association*
b. Close Association*

1. Open Association

2. C-FIND-RQ (STUDY)

3. C-FIND-RSP(s)
4. Close Association

* Empty Association is done for internal application logic

Figure 4a
DEFAULT STUDY LEVEL QUERY SEQUENCE DIAGRAM

The Default Query, at Study Level, settings are for Any Patient Name, indicated by the “*” wildcard in the “Last Name”
field and the “Date Range” left with no entered values, in the “Query Retrieve Filter Parameters”

The result will be all Patient’s for any date, up to the displayable limit.

The query parameters that may be selected for Study level queries are:

 Patient Last Name and First Name

 Patient ID
 Accession Number
 Date Range
 Today and 1-7 days before.

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 Storage Image
AE Manager
Plus sign on
a Patient
Response a. Open Association*
b. Close Association*

1. Open Association

2. C-FIND-RQ (STUDY, for selected Study UID)

3. C-FIND-RSP

4. C-FIND-RQ (SERIES – for the Study UID in the response)

5. C-FIND-RSP (including Series Instance UID)

6. C-FIND-RQ (IMAGE – for each image in the Series)

7. C-FIND-RSP(s)

8. Close Association

* Empty Association is done for internal application logic

Figure 4b
PLUS SIGN QUERY SEQUENCE DIAGRAM

The list of returned Patient Names includes a “+” plus sign next to it. If the plus sign is clicked for a patient, the result
will be to send additional Queries for all Series for that patient, and all Image objects associated with that patient.

When completed, the entry in the display will show the Modality, Number of Images, number of Series and Series
Description.

This feature allows for immediate display of information for a single patient to determine the appropriateness of the
study for Retrieval to the system.

The net effect of using the Plus sign is to query to the image level directly, and only for one selected result. If not the
correct study, re-perform the Study level query.

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 Storage Image
AE Manager
Series Level
Query
Checked a. Open Association*
b. Close Association*

1. Open Association

2. C-FIND-RQ (STUDY, with possible additional filters)

3. C-FIND-RSP (Matching Studies, including their Series UIDs)

4. C-FIND-RQ (SERIES – for each Study response)

5. C-FIND-RSP (Each series for each study)
6. Close Association

* Empty Association is done for internal application logic

Figure 4c
SERIES LEVEL QUERY SEQUENCE DIAGRAM

When the “Series Level Query” box is checked, the system performs Study and Series level queries automatically for
each response matching the query parameters.

In addition to the query filter parameters listed for Default Study Level query, the user may make the following choices
for Modality:

 All 2
 Ultrasound
 CT
 MR
 Mammography
 PET
 X-Ray Angiography

2
The “All” selection will return all available modality data associated with the patient. However, the system will only
allow import of the list of modality images listed here. A study that contains an unsupported modality will fail to import.

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 Storage Image
AE Manager

Query
Image Count a. Open Association*
b. Close Association*

1. Open Association

2. C-FIND-RQ (STUDY)

3. C-FIND-RSP (s)

4. C-FIND-RQ (SERIES – for each Study response to check modality)

5. C-FIND-RSP (s)

6. C-FIND-RQ (IMAGE – for each Series response to get Image count)

7. C-FIND-RSP (s)

8. Close Association

* Empty Association is done for internal application logic

Figure 4d
QUERY IMAGE COUNT QUERY SEQUENCE DIAGRAM

When “Query Image Count” is selected, the query behavior is like previous versions of Query Retrieve. For each
Study response, each series contained in each series will be queried for all Images in each Series response.

Notes:

1. This behavior will take more time depending on the number of Study responses.
2. Structured Reports will not be included in the Series counts. Structured Reports are not imported into the
system.

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 Storage Image
AE Manager

QR SCP
Retrieve AE, Port
a Study
1. Open Association
2. C-MOVE-RQ (STUDY)
3. C-MOVE-RSP (s) (For each image object in the study)
Repeat
for # of
images Store SCU
AE

4. Open Association
5. C-STORE (images)

Study 6. Close C-Move Association

appears in
Review as
7. Close C-Store Association
Imported

Figure 4e
STUDY LEVEL RETRIEVE SEQUENCE DIAGRAM

Pressing “Retrieve” for a Default Study Level query will result in sending a C-MOVE-RQ message for that Study to the
Image Manager. It will respond with the matching C-MOVE-RSP messages for that Study, and will close the
association.

The Image Manager will then open an association with the ultrasound system to perform C-STORE operations to store
the images to the system for the images listed in the C-MOVE-RSP messages.

Once the transfers are completed, the study will appear in “Review” on the system’s “Hard Drive” selection under
“Source” and have the status “IMPORTED”.

Note again, Structured Reports are included in the Import but will not be displayed with the studies in Review. They will
be included in a subsequent export of the study.

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 Storage Image
AE Manager

QR SCP
Retrieve AE, Port
a Study
1. Open Association
2. C-MOVE-RQ (SERIES)
3. C-MOVE-RSP (s) (For each image object in the series)
Repeat
for # of
images Store SCU
AE

4. Open Association
5. C-STORE (images)

Study 6. Close C-Move Association

appears in
Review as
7. Close C-Store Association
Imported

After completing a Series Level query, not pressing the “plus” sign, and selecting Retrieve, the system will send a C-
MOVE-RQ message containing the SERIES for retrieval. A C-MOVE-RSP for each image in that series will be
returned identifying each object for the Image Manager to send to the system using C-STORE-RQ messages.

As with Study Level Retrieve, the study will appear on the system in “Review” when Source is “Hard Drive” with Status
of IMPORTED.

Figure 4f
SERIES LEVEL RETRIEVE SEQUENCE DIAGRAM

4.2.1.3.2.2 Proposed Presentation Contexts

Table 4.17
PROPOSED PRESENTATION CONTEXTS FOR ACTIVITY QUERY AND RETRIEVE

Presentation Context Table

Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List Role Neg.
Study Root Query/Retrieve (C- 1.2.840.10008.5.1.4.1.2.2.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
FIND) Explicit VR Little Endian 1.2.840.10008.1.2.1
Study Root Query/Retrieve (C- 1.2.840.10008.5.1.4.1.2.2.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None
MOVE) Explicit VR Little Endian 1.2.840.10008.1.2.1

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4.2.1.3.2.3 SOP Specific Conformance for SOP Classes

4.2.1.3.2.3.1 Study Root Query Retrieve – FIND SOP Class

Table 4.18
QUERY/RETRIEVE MESSAGE CONTENTS
Request Attribute Tag Value
Type
C-FIND Query/Retrieve Level (0008,0052) STUDY, SERIES, IMAGE
Modality (0008,0060) User Set, US by default
Patient Name (0010,0010) User Set, Wildcard (‘*’) by
default
Patient ID (0010,0020) User Set or empty
Accession Number (0008,0050) User Set or empty
Study Date (0008,0020) User Set, available as date
range

The system actually performs a number of C-FIND requests at multiple levels in the DICOM object hierarchy to get the
data it requires to display a study. The “message” displayed above is the effective combination of the C-FIND requests
that are made to get the data in the next table (below).

Table 4.19
C-FIND MESSAGE RESULTS (ATTRIBUTES) REQUESTED
Attribute Tag
Study Date (0008,0020)
Study Time (0008,0030)
Accession Number (0008,0050)
Modality (0008,0060)
Patient Name (0010,0010)
Patient ID (0010,0020)
Study Instance UID (0020,000D)
Series Instance UID (0020,000E)
Study ID (0020,0010)

4.2.1.3.2.3.2 Study Root Query Retrieve – MOVE SOP Class

After examining the results of the user-initiated Query, the user may select one or more Studies from the query results
list and request that the contents of the selected Studies be retrieved. A C-MOVE message is sent to the
Query/Retrieve SCP requesting that the selected items be stored back to this system.

Table 4.20
QUERY/RETRIEVE MESSAGE CONTENTS
Request Type Attribute Tag Value
Command Set
C-MOVE
Move Destination (0000,0600) AE of system

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 Request Type Attribute Tag Value
Data Set
Query/Retrieve Level (0008,0052) STUDY, SERIES
Study Instance UID (0020,000D) (Study UID to Send)
Series Instance UID (0020,000E) (Series UID to Send)

4.2.1.3.2.4 Activity – Storage from a Remote Storage SCU

4.2.1.3.2.5 Description and Sequencing of Activities

The Storage AE accepts associations for storage from remote Storage SCUs. There are two distinct scenarios in
which images are transferred from a remote Storage SCU to EPIQ/Affiniti:

 Fulfillment of a Query/Retrieve C-MOVE request by the Query/Retrieve SCP

 Unsolicited push of images from a remote Storage SCU

In order for EPIQ/Affiniti to accept associations from a remote Storage SCU, the AE Title of the remote Storage SCU
must be configured as a “Storage device” in EPIQ/Affiniti. Studies of images that are received through this mechanism
will appear in the Patient Directory, marked as “Imported”.

Note: A device may store an image per association – separate associations for each image.

Storage Image
AE Manager

Study
appears in 1. Open Association
Review as
Imported 2. C-STORE (images)
3. Close Association

Figure 4g
STORAGE FROM REMOTE STORAGE SCU SEQUENCE DIAGRAM

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Accepted Presentation Contexts

Table 4.21 summarizes Presentation Contexts that the Storage AE accepts for this activity.

Table 4.21
ACCEPTABLE PRESENTATION CONTEXTS FOR
ACTIVITY STORAGE FROM A REMOTE SCU

Presentation Context Table

Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.
US Image Storage 1.2.840.10008.5.1.4.1.1.6.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
US Image Storage 1.2.840.10008.5.1.4.1.1.6 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
(retired) Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
US Multiframe Image 1.2.840.10008.5.1.4.1.1.3.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
US Multiframe Image 1.2.840.10008.5.1.4.1.1.3 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Storage (retired) Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Secondary Capture 1.2.840.10008.5.1.4.1.1.7 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Image Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Multi-frame True Color 1.2.840.10008.5.1.4.1.1.7.4 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Secondary Capture Explicit VR Little Endian 1.2.840.10008.1.2.1
Image Storage JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
CT Image Storage 1.2.840.10008.5.1.4.1.1.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Enhanced CT Image 1.2.840.10008.5.1.4.1.1.2.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 42
 Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.
Digital Mammography 1.2.840.10008.5.1.4.1.1.1.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
X-Ray Image Storage – Explicit VR Little Endian 1.2.840.10008.1.2.1
For Presentation
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Digital Mammography 1.2.840.10008.5.1.4.1.1.1.2.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
X-Ray Image Storage – Explicit VR Little Endian 1.2.840.10008.1.2.1
For Processing
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
MR Image Storage 1.2.840.10008.5.1.4.1.1.4 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Enhanced MR Image 1.2.840.10008.5.1.4.1.1.4.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
MR Spectroscopy 1.2.840.10008.5.1.4.1.1.4.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Image Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Positron Emission 1.2.840.10008.5.1.4.1.1.128 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Tomography Image Explicit VR Little Endian 1.2.840.10008.1.2.1
Storage JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
X-Ray Angiographic 1.2.840.10008.5.1.4.1.1.12.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
Image Storage Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Comprehensive 1.2.840.10008.5.1.4.1.1.88.33 Implicit VR Little Endian 1.2.840.10008.1.2 SCP* None
Structured Report Explicit VR Little Endian 1.2.840.10008.1.2.1
Storage JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
RLE Lossless 1.2.840.10008.1.2.5
Private 3D Presentation 1.3.46.670589.2.5.1.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None
State Explicit VR Little Endian 1.2.840.10008.1.2.1

* System will accept and can import and export SR objects with a study. No display of imported SR.

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 43
4.2.2 Workflow Application Entity Specification

4.2.2.1 SOP Classes

EPIQ/Affiniti provides Standard Conformance to the following SOP Classes:

Table 4.13
SOP CLASSES FOR AE WORKFLOW

SOP Class Name SOP Class UID SCU SCP

MWL Information Model – FIND 1.2.840.10008.5.1.4.31 Yes No

Modality Performed Procedure Step 1.2.840.10008.3.1.2.3.3 Yes No

4.2.2.2 Association Policies

4.2.2.2.1 General

The DICOM standard application context name for DICOM 3.0 is always proposed:

Table 4.23
DICOM APPLICATION CONTEXT FOR AE WORKFLOW

Application Context Name 1.2.840.10008.3.1.1.1

4.2.2.2.2 Number of Associations

EPIQ/Affiniti initiates one Association at a time for a Worklist request.

Table 4.24
NUMBER OF ASSOCIATIONS INITIATED FOR AE WORKFLOW

Maximum number of simultaneous Associations 1

4.2.2.2.3 Asynchronous Nature

EPIQ/Affiniti does not support asynchronous communication.

Table 4.25
ASYNCHRONOUS NATURE AS A SCU FOR AE WORKFLOW

Maximum number of outstanding asynchronous transactions 1

4.2.2.2.4 Implementation Identifying Information

The implementation information for this Application Entity is:

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 44
 Table 4.26
DICOM IMPLEMENTATION CLASS AND VERSION FOR AE WORKFLOW

Implementation Class UID 1.3.46.670589.14.10000.600

Implementation Version Name EPIQ-AFFIN_6.00

4.2.2.3 Association Initiation Policy

4.2.2.3.1 Activity – Worklist Update

4.2.2.3.1.1 Description and Sequencing of Activities

The Worklist Update activity is capable of updating the modality worklist using either a Broad Query or a Patient
Query, as described later in this section. A possible sequence of interactions between the Workflow AE and a
Departmental Scheduler (e.g. a device such as a RIS or HIS which supports the MWL SOP Class as an SCP) is
illustrated in Figure 5:

Figure 5
SEQUENCING OF ACTIVITY – WORKLIST UPDATE

4.2.2.3.1.1.1 Worklist Update using Broad Query – using “Update Worklist”

In Broad Query, the Modality Worklist SCP is queried based on a set of pre-defined query attributes (see Table 4.30
Column “BQ” for DICOM Attributes corresponding to each parameter):

 Scheduled Date = today’s date

 Station Name = this system’s name or a user-specified value
 Station Location = this system’s location or a user-specified value
 AE Title = this system’s AE Title or a user-specified value
 Modality = “US” or a user- specified value

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The user may configure one of the following schemes for updating the worklist using Broad Query:
 The worklist may be updated when the user presses “Update Worklist” on the patient data entry screen
 The worklist may be updated automatically each time an exam is ended
 The worklist may be updated periodically at a configurable time interval between 15 and 120 minutes in 15
minute increments
The user at may cancel a worklist update anytime between sending the update request and receiving the final
response.

4.2.2.3.1.1.2 Worklist Update using Patient Query – using “Search”

In Patient Query, the Modality Worklist SCP is queried based on a set of query attributes provided by the user at the
time of the query (see Table 4.30 Column “PQ” for DICOM Attributes corresponding to each parameter):

 Modality = “US” or the custom value defined for Broad Query

 Any combination of
o Patient Last Name = wildcard or matching leading letters
o Patient ID = exact match
o Accession Number = exact match (no wildcard per VA specialization)
o Requested Procedure ID = exact match (no wildcard per VA specialization)
o Scheduled Date = exact match or matching a date range around today

Patient Query is performed manually when specifically requested by the user. The user may cancel a worklist update
anytime between sending the update request and receiving the final response.

4.2.2.3.1.2 Proposed Presentation Contexts

EPIQ/Affiniti will propose Presentation Contexts as shown in the following table:

Table 4.27
PROPOSED PRESENTATION CONTEXTS FOR ACTIVITY WORKLIST UPD
Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.
Modality Worklist Implicit VR Little Endian 1.2.840.10008.1.2
1.2.840.10008.5.1.
Information Model – SCU None
4.31 Explicit VR Little Endian 1.2.840.10008.1.2.1
FIND

4.2.2.3.1.3 SOP Specific Conformance for Modality Worklist

Table 4.28 summarizes the behavior of EPIQ/Affiniti when encountering status codes in a MWL C-FIND response.

A message “query failed” will appear on the user interface if EPIQ/Affiniti receives any other SCP response status than
“Success” or “Pending.”

Table 4.28
MODALITY WORKLIST C-FIND RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
Success Matching is complete 0000 The system replaced the worklist from the response.

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 Service
Further Meaning Error Code Behavior
Status
The Association is aborted using A-ABORT. The worklist
Refused Out of Resources A700
is not replaced.
Identifier does not match
Failed A900 Same as “Refused” above.
SOP Class
Failed Unable to Process C000 – CFFF Same as “Refused” above.
Matching terminated due to
Cancel FE00 The retrieved items are ignored.
Cancel request
Pending Matches are continuing FF00 Continue.
Matches are continuing –
Warning that one or more
Pending FF01 Continue.
Optional Keys were not
supported
Any other
* * Same as “Refused” above.
status code.

Table 4.29 summarizes the behavior of EPIQ/Affiniti during communication failure.

Table 4.29
MODALITY WORKLIST COMMUNICATION FAILURE BEHAVIOR
Exception Behavior
Timeout Same as Service Status “Refused” in the table above.
Association aborted by the SCP or network layers Same as Service Status “Refused” in the table above.

Table 4.30 describes the EPIQ/Affiniti Worklist Matching Keys and requested attributes. Unexpected attributes
returned in a C-FIND response are ignored.

Non-matching responses returned by the SCP due to unsupported optional matching keys are ignored.

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 Table 4.30
WORKLIST MATCHING KEYS
Module Name Tag VR BQ PQ R D IOD M SD
Attribute Name
SOP Common
Specific Character Set (0008,0005) CS x
Scheduled Procedure Step
Scheduled Procedure Step Sequence (0040,0100) SQ x
> Scheduled Station AE Title (0040,0001) AE (S) x
> Scheduled Procedure Step Start Date (0040,0002) DA S x x x
> Scheduled Procedure Step Start Time (0040,0003) TM x x
> Modality (0008,0060) CS S, (S) x x x x x
> Scheduled Procedure Step Description (0040,0007) LO x x x x 2
> Scheduled Protocol Code Sequence (0040,0008) SQ x x x
>>Code Value (0008,0100) SH x x x
>>Coding Scheme Designator (0008,0102) SH x x x
>>Code Meaning (0008,0104) LO x x x x 3
> Scheduled Station Name (0040,0010) SH (S) x
> Scheduled Procedure Step Location (0040,0011) SH (S) x
> Pre-Medication (0040,0012) LO x x
> Scheduled Procedure Step ID (0040,0009) SH x x x
> Requested Contrast Agent (0032,1070) LO x x
Requested Procedure
Requested Procedure ID (0040,1001) SH x x x xnote3 xnote3
Requested Procedure Priority (0040,1003) SH x x
Patient Transport Arrangements (0040,1004) LO x x
Requested Procedure Description (0032,1060) LO x xnote1 x x 1
Study Instance UID (0020,000D) UI x x x
Referenced Study Sequence (0008,1110) SQ x x x
>Referenced SOP Class UID (0008,1150) UI x x x
>Referenced SOP Instance UID (0008,1155) UI x x x
Requested Procedure Code Sequence (0032,1064) SQ x xnote2 xnote2
>>Code Value (0008,0100) SH x x x
>>Coding Scheme Designator (0008,0102) SH x x x
>>Code Meaning (0008,0104) LO x x x x
Names of Intended Recipients of Results (0040,1010) PN x x x
Imaging Service Request
Accession Number (0008,0050) SH x x x x x
Requesting Physician (0032,1032) PN x x
Visit Relationship
Referenced Patient Sequence (0008,1120) SQ x x
>Referenced SOP Class UID (0008,1150) UI x x
>Referenced SOP Instance UID (0008,1155) UI x x
Visit Admission
Referring Physician's Name (0008,0090) PN x x x
Admitting Diagnosis Description (0008,1080) LO x x
Patient Identification
Patient’s Name (0010,0010) PN x x x x x
Patient ID (0010,0020) LO x x x x x
Other Patient IDs (0010,1000) LO x x x
Patient Demographic
Patient’s Birth Date (0010,0030) DA x x x x
Patient’s Sex (0010,0040) CS x x x x
Patient Size (0010,1020) DS x x x
Ethnic Group (0010,2160) SH x x
Patient’s Weight (0010,1030) DS x x x
Patient Comments (0010,4000) LT x x x
Patient Medical
Medical Alerts (0010,2000) LO x x
Allergies (0010,2110) LO x x

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 Module Name Tag VR BQ PQ R D IOD M SD
Attribute Name
Additional Patient’s History (0010,21B0) LT x x
Pregnancy Status (0010,21C0) US x x
Special Needs (0038,0050) LO x x
Note 1: If present, Requested Procedure Description (0032,1060) is displayed as Study Description.
Note 2: Requested Procedure Code Sequence (0032,1064) is exported as Procedure Code Sequence (0008,1032)
Note 3: Additionally mapped to “Study ID” (0020,0010) in Composite Objects

The above table should be read as follows:

Module Name: The name of the associated module for supported worklist attributes.
Attribute Name: Attributes supported to build a Worklist Request Identifier.
Tag: DICOM tag for this attribute.
VR: DICOM VR for this attribute.
BQ: Matching keys for Broad Query Worklist Update. An "S" indicates that EPIQ/Affiniti supplies
an attribute value for Single Value Matching or additional specific attributes indicated by “(S)”.
Criteria are specified in PSC - Network/DICOM - DICOM Settings - Worklist device -
Advanced Settings dialog.
PQ: Interactive Query Key for Patient Query Worklist Update. An “x” indicates that EPIQ/Affiniti
supplies this attribute as matching key. Criteria are specified in the Search dialog accessed
from Patient Data Entry screen Worklist tab.
R: Return keys. An "x" indicates that EPIQ/Affiniti supplies this attribute as a Return Key with
zero length for Universal Matching.
D: Displayed keys. An “x” indicates that this worklist attribute is displayed to the user in the
Patient Data Entry screen or Worklist Directory.
IOD: An "x" indicates that this Worklist attribute is included into all Object Instances created during
performance of the related Procedure Step.
M: An “x” indicates that this Worklist attribute is included in MPPS N-CREATE and/or N-SET
requests.
SD: A numeric value in this column indicates the attribute is a possible value of Study Description
(0008,1030). Starting with attribute marked “1”, the first non-empty attribute value found
becomes the value of Study Description in exported objects. See Study Description
(0008,1030) in Table 9.6.

4.2.2.3.2 Activity – Acquire Images

4.2.2.3.2.1 Description and Sequencing of Activities

An Association to the configured MPPS SCP system is established immediately after the first image is acquired to
send the MPPS N-CREATE message with status of “IN PROGRESS”.

The “End Exam” button causes a “COMPLETED” status in the N-SET message. An exam for which an MPPS
Instance is sent with a status of “COMPLETED” can no longer be updated. The only exception is when a scheduled
study is reselected from Modality Worklist to append additional images. A new set of MPPS messages will be
generated for the append study.

The “Cancel Exam” button causes a “DISCONTINUED” message. An exam for which an MPPS Instance is sent with a
state of “DISCONTINUED” can also no longer be updated.

The system supports creation of “unscheduled cases” by allowing MPPS Instances to be communicated for locally
registered Patients.

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The system performs a single Performed Procedure Step at a time per Scheduled Procedure Step.

EPIQ/Affiniti will initiate an Association to issue an:

— N-CREATE request according to the Create Modality Performed Procedure Step SOP Instance operation or a
— N-SET request to finalize the contents and state of the MPPS according to the Set Modality Performed Procedure
Step Information operation.

Workflow Department
AE Scheduler

start exam,
acquire image

1 Open Association

2 N-CREATE (MPPS) - IN PROGRESS

3 Close Association

cancel exam
4 Open Association

5 N-SET (MPPS) - DISCONTINUED

6 Close Association

end exam
7 Open Association

8 N-SET (MPPS) - COMPLETED

9 Close Association

Figure 6
SEQUENCING OF ACTIVITY – ACQUIRE IMAGES

A possible sequence of interactions between the Workflow AE and a Departmental Scheduler (e.g. a device such as a
RIS or HIS which supports the MPPS SOP Class as an SCP) is illustrated in Figure 6.
Note: The Cancel and End Exam commands are mutually exclusive. They are both represented here for illustration
purposes only. Actual workflow uses one or the other for a given exam. No PPS message for “Paused” exam.

4.2.2.3.2.2 Proposed Presentation Contexts

EPIQ/Affiniti will propose Presentation Contexts as shown in the following table:

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 Table 4.31
PROPOSED PRESENTATION CONTEXTS FOR REAL-WORLD ACTIVITY ACQUIRE IMAGES
Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.

Modality Performed 1.2.840.10008.3.1. Implicit VR Little Endian 1.2.840.10008.1.2

SCU None
Procedure Step 2.3.3 Explicit VR Little Endian 1.2.840.10008.1.2.1

4.2.2.3.2.3 SOP Specific Conformance for MPPS

Table 4.32 summarizes the behavior of EPIQ/Affiniti when encountering status codes in an MPPS N-CREATE or N–
SET response.

Table 4.32
MPPS N-CREATE / N-SET RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
The SCP has completed the
Success Success 0000
operation successfully.
Processing Failure – Performed Procedure Step
Failure 0110 The Association is aborted.
Object may no longer be updated
Warning Attribute Value Out of Range 0116H The error message is displayed.
Any other
* * Same as “Failure” above.
status code.

Table 4.33 summarizes the behavior of EPIQ/Affiniti during communication failure.

Table 4.33
MPPS COMMUNICATION FAILURE BEHAVIOR
Exception Behavior
Timeout Same as “Failure” above.
Association aborted by the SCP or network layers Same as “Failure” above.

Table 4.34 provides a description of the MPPS N-CREATE and N-SET request identifiers. Empty cells in the N-
CREATE and N-SET columns indicate that the attribute is not sent.

Table 4.14
MPPS N-CREATE / N-SET REQUEST IDENTIFIER
Attribute Name Tag VR N-CREATE N-SET
Sent only if replacement Sent only if replacement
Specific Character Set (0008,0005) CS
character set is used. character set is used.
Modality (0008,0060) CS US
Referenced Patient Sequence (0008,1120) SQ Zero length

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 Attribute Name Tag VR N-CREATE N-SET
From Modality Worklist or
Patient’s Name (0010,0010) PN
user input.
From Modality Worklist or
Patient ID (0010,0020) LO
user input.
From Modality Worklist or
Patient’s Birth Date (0010,0030) DA
user input.
From Modality Worklist or
Patient’s Sex (0010,0040) CS
user input.
From Requested
Procedure ID from MWL,
Study ID (0020,0010) SH
else System Generated
<yyyymmdd.hhmmss>
From Ultrasound System
Performed Station AE Title (0040,0241) AE
Configuration; see 4.4.2
From Ultrasound System
Performed Station Name (0040,0242) SH
Configuration; see 4.4.2
From Ultrasound System
Performed Location (0040,0243) SH
Configuration; see 4.4.2
Performed Procedure Step Start
(0040,0244) DA Actual start date
Date
Performed Procedure Step Start
(0040,0245) TM Actual start time
Time
Mapped from Requested Mapped from Requested
Procedure Code Sequence (0008,1032) SQ Procedure Code Sequence Procedure Code Sequence
(0032,1064) from MWL (0032,1064) from MWL
Performed Procedure Step End
(0040,0250) DA Zero length Actual end date
Date
Performed Procedure Step End
(0040,0251) TM Zero length Actual end time
Time
COMPLETED or
Performed Procedure Step Status (0040,0252) CS IN PROGRESS
DISCONTINUED
Auto generated
Performed Procedure Step ID (0040,0253) SH
<yyyymmdd.hhmmss>
Mapped from Scheduled
Performed Procedure Step Procedure Description
(0040,0254) LO Same
Description (0040,0007) from MWL or
user entered
Performed Procedure Type
(0040,0255) LO Zero length
Description
Zero length OR
corresponding to built-in
Performed Protocol Code Staged Protocols OR
(0040,0260) SQ Same
Sequence mapped from MWL
Scheduled Protocol Code
Sequence (0040,0008)

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 Attribute Name Tag VR N-CREATE N-SET
Scheduled Step Attributes
(0040,0270) SQ
Sequence
From MWL or user
> Accession Number (0008,0050) SH entered. MWL value may
be edited.
One item per item in the
MWL Reference Study
> Referenced Study Sequence (0008,1110) SQ
Sequence. Absent if
unscheduled.
Same value as in of the
>> Referenced SOP Class UID (0008,1150) UI Reference Study
Sequence in the MWL
Same value as in of the
>> Referenced SOP Instance UID (0008,1155) UI Reference Study
Sequence in the MWL
Same value as in MWL
> Study Instance UID (0020,000D) UI attribute or system
generated
> Requested Procedure Same value as in MWL
(0032,1060) LO
Description attribute
> Scheduled Procedure Step Same value as in MWL
(0040,0007) LO
Description attribute
> Scheduled Protocol Code Same value as in MWL
(0040,0008) SQ
Sequence attribute
Same value as in MWL
> Scheduled Procedure Step ID (0040,0009) SH
attribute
Same value as in MWL
> Requested Procedure ID (0040,1001) SH
attribute
One item per acquired
Performed Series Sequence (0040,0340) SQ Zero length
series
> Retrieve AE Title (0008,0054) AE
Study Description derived
> Series Description (0008,103E) LO
from MWL or user entered
> Performing Physician’s Name (0008,1050) PN Empty
MWL Scheduled Performing
Physician’s Name
> Operator’s Name (0008,1070) PN (0040,0006)
From PDE “Exam
Performed By” field
One item per referenced
> Referenced Image Sequence (0008,1140) SQ
image instance
SOP Class UID of acquired
>> Referenced SOP Class UID (0008,1150) UI
instance
SOP Instance UID of
>> Referenced SOP Instance UID (0008,1155) UI
acquired instance
> Protocol Name (0018,1030) LO See Table 9.9

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 Attribute Name Tag VR N-CREATE N-SET
> Series Instance UID (0020,000E) UI System generated
> Referenced Non-Image
One item per referenced
Composite SOP Instance (0040,0220) SQ
non-image instance
Sequence
SOP Class UID of acquired
>> Referenced SOP Class UID (0008,1150) UI
instance
SOP Instance UID of
>> Referenced SOP Instance UID (0008,1155) UI
acquired instance

4.2.2.4 Association Acceptance Policy

The Workflow Application Entity does not accept Associations.

4.2.3 Hardcopy Application Entity Specification

4.2.3.1 SOP Classes

EPIQ/Affiniti provides Standard Conformance to the following SOP Classes:

Table 4.35
SOP CLASSES FOR AE HARDCOPY

SOP Class Name SOP Class UID SCU SCP

Basic Grayscale Print Management Meta 1.2.840.10008.5.1.1.9 Yes No

Basic Color Print Management Meta 1.2.840.10008.5.1.1.18 Yes No

4.2.3.2 Association Policies

4.2.3.2.1 General

The DICOM standard application context name for DICOM 3.0 is always proposed:

Table 4.36
DICOM APPLICATION CONTEXT FOR AE HARDCOPY

Application Context Name 1.2.840.10008.3.1.1.1

4.2.3.2.2 Number of Associations

EPIQ/Affiniti initiates one Association at a time for each configured hardcopy device. Multiple hardcopy devices can be
configured.

Table 4.37
NUMBER OF ASSOCIATIONS INITIATED FOR AE HARDCOPY
2 (number of configured
Maximum number of simultaneous Associations
hardcopy devices)

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4.2.3.2.3 Asynchronous Nature

EPIQ/Affiniti does not support asynchronous communication (multiple outstanding transactions over a single
Association).

Table 4.38
ASYNCHRONOUS NATURE AS A SCU FOR AE HARDCOPY
Maximum number of outstanding asynchronous transactions 1

4.2.3.2.4 Implementation Identifying Information

The implementation information for this Application Entity is:

Table 4.39
DICOM IMPLEMENTATION CLASS AND VERSION FOR AE HARDCOPY
Implementation Class UID 1.3.46.670589.14.10000.600
Implementation Version Name EPIQ-AFFIN_6.00

4.2.3.3 Association Initiation Policy

4.2.3.3.1 Activity – Film Images

4.2.3.3.1.1 Description and Sequencing of Activities

The system composes images onto film sheets and sends print requests to job queue.

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 Hardcopy
Printer
AE

1. Open Association

2. N-GET (Printer)

3. N-CREATE (Film Session)

4. N-CREATE (Film Box)

5. N-SET (Image Box)

6. N-ACTION (Film Box)

7. Print film sheets

8. N-DELETE (Film Box)

9. N-DELETE (Film Session)

10. Close Association

Figure 7
SEQUENCING OF ACTIVITY – PRINT IMAGES

Figure 7 illustrates a typical sequence of DIMSE messages sent over an association between Hardcopy AE and a
Printer. Two DICOM Printers may be simultaneously configured, one for BW and one for Color prints.

If both BW and Color printers are configured and selected, the user may choose to automatically send BW prints only
to the BW printer and color prints only to the color printer. This feature may only be used while configured for “After
Each Print/Acquire”.

When using the “Send on Demand” feature with print, page(s) that have not been exported will be sent, according to
the formatting configuration. If less than a full page is sent, then the remaining space on the page will be left blank.

Status of the print-job is reported through the Printer Queue Manager icon. Only one job will be active at a time for
each separate hardcopy device. If any Response from the remote Application contains a status other than Success,
the Association is aborted and the related Job is switched to a failed state. It can be restarted any time by user
interaction.

4.2.3.3.1.2 Proposed Presentation Contexts

Table 4.40 shows the Presentation Contexts EPIQ/Affiniti is capable of proposing.

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 Table 4.40
PROPOSED PRESENTATION CONTEXTS FOR ACTIVITY FILM IMAGES
Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.
Basic Grayscale Implicit VR Little Endian 1.2.840.10008.1.2
1.2.840.10008.5.1.
Print Management SCU None
1.9 Explicit VR Little Endian 1.2.840.10008.1.2.1
Meta

Basic Color Print 1.2.840.10008.5.1. Implicit VR Little Endian 1.2.840.10008.1.2

SCU None
Management Meta 1.18 Explicit VR Little Endian 1.2.840.10008.1.2.1

4.2.3.3.1.3 SOP Specific Conformance for all Print SOP Classes

Table 4.41 summarizes the general behavior of all Hardcopy AE during communication failure. This behavior is
common for all SOP Classes supported by Hardcopy AE.

Table 4.41
COMMUNICATION FAILURE BEHAVIOR
Exception Behavior
Timeout The Association is aborted and reported as “Failed.”
Association aborted by the SCP or network layers ”Network Communication Failure” is reported.

Details of the supported attributes and status handling behavior are described in the following subsections.

4.2.3.3.1.3.1 Printer SOP Class Operations (N-GET)

Hardcopy AE uses the Printer SOP Class N-GET operation to obtain information about the current printer status.
Table 4.42 lists the attributes obtained via N-GET.

Table 4.42
PRINTER SOP CLASS N-GET RESPONSE ATTRIBUTES
Presence
Attribute Name Tag VR Value Source
of Value
Printer Status (2110,0010) CS Provided by Printer ALWAYS Printer
Printer Status
(2110,0020) CS Provided by Printer ALWAYS Printer
Info

The Printer Status information is evaluated as follows:

1. If Printer status (2110,0010) is NORMAL, the print-job continues to be printed.

2. If Printer status (2110,0010) is FAILURE, the print-job is marked as failed.
3. If Printer status (2110,0010) is WARNING, the print-job continues to be printed.
Table 4.43 summarizes the behavior of Hardcopy AE when encountering status codes in an N-GET response.

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 Table 4.43
PRINTER SOP CLASS N-GET RESPONSE STATUS HANDLING BEHAVIOR
Service Further
Error Code Behavior
Status Meaning
The request to get printer status information was
Success Success 0000
success.
Any other status
* * Same as Timeout above.
code.

4.2.3.3.1.3.2 Printer SOP Class Notifications (N-EVENT-REPORT)

Hardcopy AE is capable of receiving an N-EVENT-REPORT request at any time during an association.

Table 4.44 summarizes the behavior of Hardcopy AE when receiving Event Types within the N-EVENT-REPORT.

Table 4.44
PRINTER SOP CLASS N-EVENT-REPORT BEHAVIOUR
Event Type Event Type Behavior
Name ID
Normal 1 The print-job continues to be printed.
The print-job. For user-recoverable warnings, the job fails and a 1-hour retry period
Warning 2
starts, retrying every 20 seconds.
Failure 3 The print-job is marked as failed.
* * Status code of 0113H

Table 4.45 summarizes the reasons for returning specific status codes in an N-EVENT-REPORT response.

Table 4.45
PRINTER SOP CLASS N-EVENT-REPORT RESPONSE STATUS REASONS
Service Further Error
Reasons
Status Meaning Code
Success Success 0000 The notification event has been successfully received.
No Such Event
Failure 0113H An invalid Event Type ID was supplied in the N-EVENT-REPORT request.
Type
An internal error occurred during processing of the N-EVENT-REPORT. A
Processing
Failure 0110H short description of the error will be returned in Error Comment
Failure
(0000,0902).

4.2.3.3.1.3.3 SOP Specific Conformance for the Film Session SOP Class

Hardcopy AE supports the following DIMSE operations for the Film Session SOP Class:

— N-CREATE
Details of the supported attributes and status handling behavior are described in the following subsections.

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 4.2.3.3.1.3.4 Film Session SOP Class Operations (N-CREATE)

Table 4.46 lists the attributes supplied in an N-CREATE Request.

Table 4.46
FILM SESSION SOP CLASS N-CREATE REQUEST ATTRIBUTES
Presence
Attribute Name Tag VR Value Source
of Value
Number of
(2000,0010) IS Default 1. User defined in Device Configuration. ALWAYS USER
Copies
Print Priority (2000,0020) CS HIGH ALWAYS AUTO
Medium Type (2000,0030) CS BLUE FILM, CLEAR FILM or PAPER* ALWAYS USER
Film Destination (2000,0040) CS MAGAZINE or PROCESSOR* ALWAYS USER
Film Session
(2000,0050) LO Philips Medical Systems ALWAYS AUTO
Label
*Dependent on the specific printer selected

Table 4.47 summarizes the behavior of Hardcopy AE when encountering status codes in an N-CREATE response.

Table 4.47
FILM SESSION SOP CLASS N-CREATE RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
The SCP has completed the operation
Success Success 0000
successfully.
Attribute Value Out of
Warning 0116H System continues operations.
Range
Warning Attribute List Error 0107H Same as above.
Any other status The Association is aborted and the print-job
* *
code. fails.

4.2.3.3.1.4 SOP Specific Conformance for the Film Box SOP Class

Hardcopy AE supports the following DIMSE operations for the Film Box SOP Class:

— N-CREATE
— N-ACTION

Details of the supported attributes and status handling behavior are described in the following subsections.

4.2.3.3.1.4.1 Film Box SOP Class Operations (N-CREATE)

Table 4.48 lists the attributes supplied in an N-CREATE Request.

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 Table 4.48
FILM BOX SOP CLASS N-CREATE REQUEST ATTRIBUTES
Presence
Attribute Name Tag VR Value Source
of Value
STANDARD\1,1 3 or
Image Display CUSTOM\xxx depending on printer.
(2010,0010) ST ALWAYS AUTO/USER
Format Default is displayed, and is user editable. Edit
only when a valid substitute value is known.
Referenced Film
Session (2010,0500) SQ ALWAYS AUTO
Sequence
>Referenced
(0008,1150) UI 1.2.840.10008.5.1.1.1 ALWAYS AUTO
SOP Class UID
>Referenced
SOP Instance (0008,1155) UI From created Film Session SOP Instance ALWAYS AUTO
UID
Film Orientation (2010,0040) CS PORTRAIT or LANDSCAPE ALWAYS USER
Depends on configuration file selected.
Film Size ID (2010,0050) CS ALWAYS USER
DICOM Defined Terms plus US_LETTER.
Magnification
(2010,0060) CS Default Value = NONE, depending on printer ANAP AUTO
Type
Min Density (2010,0120) US Default value displayed, user editable ALWAYS AUTO/USER
Max Density (2010,0130) US Default value displayed, user editable ALWAYS AUTO/USER
Trim (2010,0140) CS NO ALWAYS AUTO
Configuration Default value displayed, user editable. Edit only
(2010,0150) ST ALWAYS AUTO/USER
Information when a valid substitute value is known.

Table 4.49 summarizes the behavior of Hardcopy AE when encountering status codes in an N-CREATE response.

Table 4.49
FILM BOX SOP CLASS N-CREATE RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
The SCP has completed the operation
Success Success 0000
successfully.
Requested Max Density outside of The N-CREATE operation is considered
Warning B605H
printer’s operating range successful but the status meaning is logged.
Any other
* * The Association is aborted and the job failed.
status code.

3
EPIQ/Affiniti performs page compositing of n-up prints (i.e., 2x2, 2,3, etc.) internally and prints the pages as a single
Image Box per page; hence STANDARD\1,1

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 4.2.3.3.1.4.2 Film Box SOP Class Operations (N-ACTION)

The Hardcopy AE issues an N-ACTION Request to instruct the Print SCP to print the contents of the Film Box.

Table 4.50 summarizes the behavior of Hardcopy AE when encountering status codes in an N-ACTION response.

Table 4.50
FILM BOX SOP CLASS N-ACTION RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
The SCP has completed the operation
Success Success 0000 successfully. The film has been accepted
for printing.
Film Box SOP Instance hierarchy does not
The Association is aborted and the job is
Warning contain Image Box SOP Instances (empty B603H
failed.
page)
Unable to create Print Job SOP Instance;
Failure C602 Same as B603H above.
print queue is full.
Any other
* * Same as B603H above.
status code.

4.2.3.3.1.5 SOP Specific Conformance for the Image Box SOP Class

Hardcopy AE supports the following DIMSE operations for the Image Box SOP Class:

— N-SET

Details of the supported attributes and status handling behavior are described in the following subsections.

4.2.3.3.1.5.1 Image Box SOP Class Operations (N-SET)

Table 4.51 lists the attributes supplied in an N-SET Request.

Table 4.51
IMAGE BOX SOP CLASS N-SET REQUEST ATTRIBUTES
Presence
Attribute Name Tag VR Value Source
of Value
Image Position (2020,0010) US 1 ALWAYS AUTO
Polarity (2020,0020) CS NORMAL ALWAYS AUTO
Basic Grayscale
(2020,0110) SQ Used for BW (Monochrome2) print ALWAYS* AUTO
Image Sequence
Basic Color Image
(2020,0111) SQ Used for Color (RGB) print ALWAYS* AUTO
Sequence
1 for Monochrome2
>Samples Per Pixel (0028,0002) US ALWAYS AUTO
3 for RGB
>Photometric MONOCHROME2
(0028,0004) CS ALWAYS AUTO
Interpretation RGB
Planar Configuration (0028,0006) US Always “01”, only used for RGB print. ANAP AUTO

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 Presence
Attribute Name Tag VR Value Source
of Value
Printer
Depends on film size, number of rows for
>Rows (0028,0010) US ALWAYS Configuration
entire sheet of film
File
Printer
Depends on film size, number of columns
>Columns (0028,0011) US ALWAYS Configuration
for entire sheet of film
File
>Bits Allocated (0028,0100) US 8 ALWAYS AUTO
>Bits Stored (0028,0101) US 8 ALWAYS AUTO
>High Bit (0028,0102) US 7 ALWAYS AUTO
>Pixel
(0028,0103) US 0 ALWAYS AUTO
Representation
>Pixel Data (7FE0,0010) OW Pixels of rendered film sheet. ALWAYS AUTO
* Mutually exclusive attributes

Table 4.52 summarizes the behavior of Hardcopy AE when encountering status codes in an N-SET response.

Table 4.52
IMAGE BOX SOP CLASS N-SET RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
The SCP has completed the operation
Success Success 0000
successfully.
Insufficient memory in printer to store The Association is aborted and the job is
Failure C605
the image. failed.
Any other status
* * Same as C605 above.
code.

4.2.3.4 Association Acceptance Policy

The Hardcopy Application Entity does not accept Associations.

4.2.4 Verification Application Entity specification

4.2.4.1 SOP Class

EPIQ/Affiniti provides Standard Conformance to the following SOP Class:

Table 4.53
SOP CLASSES FOR AE VERIFICATION

SOP Class Name SOP Class UID SCU SCP

Verification 1.2.840.10008.1.1 Yes Yes

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4.2.4.2 Association Policies

4.2.4.2.1 General

The DICOM standard application context name for DICOM 3.0 is always proposed:

Table 4.54
DICOM APPLICATION CONTEXT FOR AE VERIFICATION

Application Context Name 1.2.840.10008.3.1.1.1

4.2.4.2.2 Number of Associations

EPIQ/Affiniti initiates one Association at a time for a Verification request.

Table 4.55
NUMBER OF ASSOCIATIONS INITIATED FOR AE VERIFICATION
Up to 10, one for each configured
Maximum number of simultaneous Associations
remote device

Table 4.56
NUMBER OF ASSOCIATIONS ACCEPTED FOR AE VERIFICATION
Unlimited, however, calling AE
Maximum number of simultaneous Associations must be already configured in
EPIQ/Affiniti.

4.2.4.2.3 Asynchronous Nature

EPIQ/Affiniti does not support asynchronous communication (multiple outstanding transactions over a single
Association).

Table 4.57
ASYNCHRONOUS NATURE AS A SCU FOR AE VERIFICATION

Maximum number of outstanding asynchronous transactions 1

4.2.4.2.4 Implementation Identifying Information

The implementation information for this Application Entity is:

Table 4.58
DICOM IMPLEMENTATION CLASS AND VERSION FOR AE VERIFICATION

Implementation Class UID 1.3.46.670589.14.10000.600

Implementation Version Name EPIQ-AFFIN_6.00

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4.2.4.3 Association Initiation Policy

4.2.4.3.1 Activity – Verify Remote SCP

4.2.4.3.1.1 Description and Sequencing of Activities

The user selecting the “Verify” button on the Device configuration page initiates the verification request to the device
whose data has just been configured. This tool allows the user to ensure all data (AE Title, Port and IP Address) was
correctly entered and the remote device may be contacted. It uses C-Echo and verifies the remote device supports all
configured SOP Classes. Any SOP Classes requested that are not supported will report “failed”. Operations may
continue, but objects of the type that are not supported will not be exported.

EPIQ/Affiniti initiates an Association in order to issue:

— C-ECHO request according to the Verification SOP Class.

Verification Verification
SCU SCP

1. Open Association

2. C-ECHO Request

3. C-ECHO Response

4. Close Association

Figure 8a
SEQUENCING OF ACTIVITY – ISSUE VERIFY

4.2.4.3.1.2 Proposed Presentation Contexts

EPIQ/Affiniti will propose Presentation Contexts as shown in the following table:

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 Table 4.59
PROPOSED PRESENTATION CONTEXTS FOR ACTIVITY VERIFICATION
Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.
Implicit VR Little Endian 1.2.840.10008.1.2
Verification 1.2.840.10008.1.1 SCU None
Explicit VR Little Endian 1.2.840.10008.1.2.1

4.2.4.3.1.3 SOP Specific Conformance for Verification

When Verification of a remote AE is requested in PSC – Network/DICOM – DICOM Settings, the Association
Negotiation Request message contents for each DICOM device will include Presentation Contexts for the following
SOP Classes:

Table 4.60
SOP CLASS VERIFICATION BY DICOM DEVICE
Device Type SOP Classes Requested Additional Notes
DICOM Storage Server Storage SOP Classes from Table 4.7 If SR export to a Storage Server is
Study Root Query/Retrieve – FIND desired & supported, select Export
Study Root Query/Retrieve – MOVE SR before in Advanced settings.
An additional “Storage Server” entry is needed Storage Commitment requires
to allow the ultrasound system to “know” the configuration of both a Storage
AE Title of the Q/R Servers “sending” SCU. server and a Storage Commitment
Otherwise, storage associations from the QR server, and association of the
server will be rejected. Storage server to the Storage
Verification Commitment server in the PSC –
Network/DICOM – DICOM Selection
page.
DICOM Commit Server Storage Commitment Push Model Storage Commitment requires
Verification configuration of both a Storage
server and a Storage Commitment
server, and association of the
Storage server to the Storage
Commitment server in the PSC –
Network/DICOM – DICOM Selection
page.
DICOM PPS Server Modality Performed Procedure Step To activate this server, it must be
Verification selected in the PSC –
Network/DICOM – DICOM Selection
page.
DICOM Worklist Server Modality Worklist To activate this server, it must be
Verification selected in the PSC –
Network/DICOM – DICOM Selection
page.

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 Device Type SOP Classes Requested Additional Notes
DICOM Structured Report Comprehensive Structured Report Configuration of this device is only
Server Storage required if SRs are to be exported to
Verification a dedicated Structured Report
Server Storage SCP.
To activate this server, it must be
selected in the PSC –
Network/DICOM – DICOM Selection
page.
Note: SR exports to this configured
server ONLY occur at End of the
Exam.
DICOM BW Printer Basic Grayscale META Print All BW printers configure this entry.
Verification If the printer supports both BW and
Color, then this must be configured
to allow BW on that printer.

DICOM Color Printer Basic Color META Print May be the same printer if color is
Verification also supported.

Table 4.61 summarizes the behavior of EPIQ/Affiniti when receiving status codes in a C-ECHO response.

Table 4.61
VERIFICATION C-ECHO RESPONSE STATUS HANDLING BEHAVIOR
Service
Further Meaning Error Code Behavior
Status
Success 0000 Device Status is set to: Verified
Refused Out of Resources A700 Device Status is set to: Not Verified
Failed Unable to Process C000 – CFFF Device Status is set to: Not Verified
* * Any other status code. Device Status is set to: Not Verified

Results of a user-initiated Verify are reported as one of three outcomes:

 Successfully Verified – All SOP Classes proposed by EPIQ/Affiniti were accepted

 Verify Failed – Server could not be reached OR remote AE is not running OR no SOP Classes proposed by
EPIQ/Affiniti were accepted OR C-ECHO did not return “Success”
 Partially Verified – Verification SOP Class and at least one other proposed SOP Class were accepted AND C-
ECHO returned “Success” AND at least one proposed SOP Class was not accepted

4.2.4.4 Association Acceptance Policy

4.2.4.4.1 Activity – Verification By Remote AE

4.2.4.4.1.1 Description and Sequencing of Activities

The system listens on the port configured on the Global System Configuration screen for Verification requests initiated
by other remote devices. The calling device AE must already be configured as a remote device in EPIQ/Affiniti or the
association is rejected.

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 Figure 8b
SEQUENCING OF ACTIVITY – VERIFICATION BY REMOTE AE

4.2.4.4.1.2 Accepted Presentation Contexts

EPIQ/Affiniti will accept Presentation Contexts as shown in the following table:

Table 4.62
ACCEPTABLE PRESENTATION CONTEXTS FOR
ACTIVITY VERIFICATION BY REMOTE AE
Presentation Context Table
Abstract Syntax Transfer Syntax
Ext.
Name UID Name List UID List
Role Neg.
Implicit VR Little Endian 1.2.840.10008.1.2
Verification 1.2.840.10008.1.1 SCP None
Explicit VR Little Endian 1.2.840.10008.1.2.1

4.2.4.4.1.3 SOP Specific Conformance for Verification

The association request will be rejected if the remote AE is not configured on EPIQ/Affiniti

4.3 NETWORK INTERFACES

4.3.1 Physical Network Interface

EPIQ/Affiniti supports both wired and wireless network interface as follows:

Table 4.63
SUPPORTED PHYSICAL NETWORK INTERFACES
Ethernet 10/100/1000 BaseT, RJ-45; Manual or AutoDetect Speed, Full or Half Duplex
Wireless 802.11 g/n/ac using optionally provided wireless adapter or internal wireless adapter.

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If both wired and wireless networks are configured, EPIQ/Affiniti will select the best available network automatically as
followed:

 The Wired network has priority and it will be used if available

 The Wireless network will be automatically used if the wired network is not available.

4.3.2 Additional Protocols

EPIQ/Affiniti supports the following additional protocols:

 Dynamic Host Configuration Protocol (DHCP): If enabled by the user, DHCP is used to acquire network
configuration parameters, such as IP address, subnet mask, gateway address, and DNS server addresses
from the DHCP server.
 Domain Name System (DNS): If configured, DNS is used to lookup server network addresses specified by
hostname
 Wi-Fi Protected Access II (WPA2) Personal (PSK): Wireless encryption method with shared-key
authentication. Provides reasonable wireless security in small to medium wireless network environments.
 Wi-Fi Protected Access II (WPA2) Enterprise: Wireless encryption method with centralized authentication.
Provides very good wireless security in medium to large wireless network environments with centralized
authentication server support.
4.3.3 IPv4 and IPv6 Support

EPIQ/Affiniti supports IPv4 and IPv6 internet protocols.

When IPv4 is used

 EPIQ/Affiniti’s network address may be specified as either static IP addresses or DHCP
 Remote servers’ network addresses may be specified as either IP address or DNS hostname

When IPv6 is used

 EPIQ/Affiniti’s network address must be generated automatically as link local address, router discovery
address, or assigned by DHCP. Static IPv6 address entry is not supported.
 Remote server’s network addresses must be specified by DNS hostname; fixed IPv6 address entry is not
supported.
 IPv6 versions of DHCP client, DNS client, ICMP, etc. are supported while IPv6 is being used.
 IPv6 may be disabled if name resolution to an IPv4 device is problematic in a dual-protocol IPv4/IPv6 network.

4.4 CONFIGURATION
4.4.1 AE Title/Presentation Address Mapping

Philips Support Connect, or PSC, is the primary interface on EPIQ/Affiniti for configuring DICOM services. It is
reached by pressing the “Support” key on the EPIQ/Affiniti control panel.

Additional acquisition and export settings are configured in the Setups interface. This interface is found on the
touchsceen by selecting Utilities – Setups – Acquisition/Capture. Ensure correct settings are made in “Archive/Print” to
associate the selected Acquisition Button(s) to the selected configured devices and continue to the Touchscreen
button selections as well. Please note to check each touchscreen button individually.

4.4.1.1 Local AE Title

All local AEs use the same AE Title and TCP/IP Port configured via the PSC – Network/DICOM – DICOM Settings,
“This System” screen. The system listens on the configured Port for Verification requests from remote AE’s, Storage

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Commitment N-Event reports, and images received from remote Storage SCP’s. In addition, TLS security for incoming
DICOM communication may be enabled, optional encryption enabled/disabled, and certificates imported, selected, or
removed from this interface.

4.4.1.2 Remote AE Title/Presentation Address Mapping

Remote AE’s may be configured on the PSC – Network/DICOM – DICOM Settings screen. The screen is organized
into DICOM Devices, each specified by

 The Device Type which indicates the services for which the device is to be used
 A Device Name given by the user in order to reference the device elsewhere in the EPIQ/Affiniti user interface
 AE Title for the remote AE
 Port for the remote AE
 Network address, specified either by IPv4 IP address or a Hostname that is resolved by DNS
 TLS security for outgoing DICOM communication may be enabled, optional encryption enabled/disabled, and
certificates imported, selected, or removed
 Additional settings specific to each device type

The following Device Types may be configured:

Table 4.64
CONFIGURABLE DICOM DEVICES
Device Type Supported SOPs
Storage SOP Classes defined in Section 4.1.2.1
Study Root Query Retrieve-FIND See details in 4.4.1.2.3
DICOM Storage Server Study Root Query Retrieve-MOVE
Note: Used to make an entry for any Remote AE that will make an
association with the system. Examples include: QR ‘sending’ AE, any
system that will “Store” to the ultrasound system.
DICOM Commit Server Storage Commitment Push Model
DICOM MPPS Server Modality Performed Procedure Step
DICOM Worklist Server Modality Worklist FIND
DICOM Structured Report Server Comprehensive Structured Report Storage
DICOM BW Printer Basic Grayscale Print Meta
DICOM Color Printer Basic Color Print Meta

To configure a single server that supports multiple services, such as image store, storage commitment, and MPPS, a
separate “Device” entry must be configured for each service using the correct device type, an appropriate AE Title,
Port, and network address. Select the first completed entry and choose “Copy” then select the next “Service” and fill in
the appropriate info. For clarity in the Export UI, use “Device Name” to indicate the function.

To configure Storage Commitment, define a Storage Server to which objects to be committed will be stored and a
Storage Commitment server (which may or may not be the same physical computer). Then, on the DICOM Selection
screen, associate this Storage Server with the associated Storage Commitment server. See section

Configuration specific to particular Device Types is described below.

4.4.1.2.1 Image Storage Configuration

Multiple remote Storage SCPs can be defined and up to five may be selected simultaneously for export. For automatic
export of acquired images during an exam if set to send “After Each Print/Acquire” or at the end of an exam if set to
send “At End of Exam”, a destination device must be enabled in Setups – Acquisition/Capture – Archive/Print screen.

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This screen allows each capture control to be separately configured for export destination. If a destination device is
not enabled for a capture control, any images acquired through that capture control will not be automatically sent to
that destination device. However, all acquired images are saved and may be sent from Review.

Each Storage Server includes a set of Advanced Settings allowing for device-specific control of the data to be stored to
that device. These settings include:

 Compression to be used for single-frame images

 Compression to be used for multi-frame images
 Whether to send images in Monochrome or Color photometric interpretations
 Whether to limit export to Implicit VR Little Endian transfer syntax. Generally used only with devices that do
not understand any other transfer syntax.
 Whether to send Structured Reports to this destination
 Whether to send Native Data of various imaging modes to this device. Native Data should not be selected
unless the data will be displayed by a workstation using Philips’ QLAB analysis software (or imported back to
an EPIQ/Affiniti with similar subproduct configuration and licensed options) which is able to understand this
data, as the datasets are large and could possibly affect data transfer performance.
 Whether to send Volume data and Philips Proprietary 3D Presentation State to this device. If not enabled, the
device would still receive 2D representations of acquired volumes.
 Association Timeout settings (see 4.4.1.2.3)
 Whether to send Pixel Spacing (0028,0030) with single-mode images to this device. This is in addition to US
Region Calibration that automatically sent with all images. Use for allowing measurements to be made on
DICOM viewers that don’t understand Ultrasound Region Calibration.

In addition, there is a global setting to use the retired Ultrasound SOP Classes 1.2.840.10008.5.1.4.1.1.3 and
1.2.840.10008.5.1.4.1.1.6 instead of the current standard Ultrasound SOP Classes 1.2.840.10008.5.1.4.1.1.3.1 and
1.2.840.10008.5.1.4.1.1.6.1.

4.4.1.2.2 Structured Report Storage Configuration

Most PACS, DICOM Storage Server devices, support Strutured Report. If so, and that PACS is where Stuctured
Reports are intended to be sent, then select “Export Structured Reports” in Advanced Settings. If sending a Structured
Report during an exam is needed, the also select “Export structured report with send on demand” needs to be
selected.

For Structured Reports to be sent automatically at end exam, the storage destination must be selected for either the
Acquire 1 or Acquire 2, (or Acquire 3 for Affiniti) keys in Setups – Acquisition/Capture – Archive/Print.

If SR support is confirmed using “Verify” and measurements are made during the exam, one or more Structured
Reports will be sent to the device. In Support > Network/DICOM > DICOM Settings > Structured Report Global
Settings, you may select which Structured Reports to send. Additionally, Link Measurements to Images allows for
inclusion of coordinate data with the SR.

A DICOM Structured Report Server device is a Storage SCP that only supports and receives reports. To enable this
method, create a Structured Report server in PSC – Network/DICOM – DICOM Settings and then select it as the
active Structured Report server in PSC – Network/DICOM – DICOM Selection.

OB-GYN study types generate OB-GYN Ultrasound Procedure Reports, Vascular or Abdominal study measurements
generate a Vascular Ultrasound Report, and the Adult Echo Study generates an Echocardiography Procedure Report.
Two types of Pediatric Echo Reports are available depending on configuration: DICOM-standard Pediatric, Fetal, and
Congenital Cardiac Ultrasound Report or Philips proprietary Pediatric Echo Report.

Note that there may be more than one report instance per exam, so long as they are from different study types. If no
separate Structured Report server is configured and the SOP Class fails negotiation on the configured Storage server,
then no SR objects will be created, however, a failed job will remain in the queue. This will need to be manually
removed.

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User Defined measurements will be sent in a Structured report. No Structured Report is sent for General
measurements.

4.4.1.2.3 Query Retrieve Configuration

EPIQ and Affiniti ultrasound systems use the DICOM Device type of “DICOM Storage Server” to perform Query
Retrieve configuration.

For the remote system that is performing the role of Query Retrieve SCP, a “Storage Device” entry is completed using
the AE Title, IP Address/Hostname and Port for the QR server. When the configuration entry is complete and saved,
the system will automatically perform a DICOM Verification. The results need to show support for the Query Retrieve
Study Root – Find and Move SOP Classes, indicated by ‘Passed’.

The Query Retrieve system will usually use a different AE Title when performing the resulting C-Store to the ultrasound
system. In order for EPIQ and Affiniti to allow that connection to succeed, the SCU Client AE Title for the server needs
to be added to the ultrasound system.

In order to accomplish this, an additional “Storage Device” entry is used. In this entry, the sending AE Title and IP
Address/Hostname are required, but since the client will not use a specific port, the user may enter “9999” in order for
the form to be completed. Since there is no verification required for a “sending” port, deselect the “Automatically
perform DICOM Verification after Saving?” box. Or, if left checked, expect it to fail. That is not an error.

Now, when the retrieve of data is requested, the system is aware of the sending SCU’s AE Title and will not reject the
incoming storage association.

4.4.1.2.4 Advanced DICOM Device Association Configuration

Configuration Settings for all DICOM devices.

Max PDU (Protocol Data Unit) Size

o The maximum PDU size in bytes

ARTIM (Association Request/Reject/Release) Timeout

o as defined by DICOM PS 3.8

Network Reply Timeout

o If there is no response from the SCP within this time period, the Network/Reply timer expires. The system will
send a DICOM A-RELEASE Request.

Idle Association Timeout

o Association inactivity timeout.

Storage Commit image-by-image

A configuration option is provided in Setups to control when Storage Commitment N-ACTION requests are issued
relative to image acquisition:

o Storage Commit Image-by-Image enabled: Storage Commit N-ACTION requests are issued immediately after
instances are stored to the Storage SCP associated with Storage Commit when using send “After Each
Print/Acquire” or “Send on Demand”. A consequence of this selection is that separate associations are initiated
and released for C-STORE requests to the Storage SCP and N-ACTION requests to the Storage Commitment
SCP.

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 o Storage Commit Image-by-Image disabled: Storage Commit N-ACTION requests are issued at end exam
after storage is performed. This selection reduces the number of associations used for send “After Each
Print/Acquire” and “Send on Demand”.

Additional Configuration Settings for Storage Commit Devices.

There is an option provided for user if automatic retry of Commit job is required or not.

Number of retry attempts before abandoning storage commitment

o Maximum number of retries the system would perform before setting the job to failed state. Factory default
value is provided.

Retry delay after failed storage commit (minutes)

o Time interval before a retry attempt when storage commit has failed. Factory default value is provided.

Retry delay after no response from storage commit server (hours)

o Time interval before a retry attempt when no response has been received from the storage commit server.
Factory default value is provided.

4.4.1.2.5 Serial Structured Report Storage Configuration

Serial Report data is a non-DICOM representation of Structured Reports which may additionally be exported via a USB
– RS-232 adapter cable to a null-modem RS-232 cable to a serial port configured for 115200 baud, 8 bits, No Parity, 1
Stop Bit and Xon-Xoff Flow Control. Output will be an XML representation of the DICOM Structured Report object.

4.4.1.2.6 Workflow Configuration

Multiple Worklist servers may be defined, but only a single Worklist server can be selected at a time on the PSC –
Network/DICOM – DICOM Selection page. See 4.2.2.3.1 for the specification of query criteria for worklist queries.

Multiple MPPS servers may be defined, but only a single MPPS server can be selected at a time on the PSC –
Network/DICOM – DICOM Selection page. No other configuration is required for MPPS servers.

4.4.1.2.7 Hardcopy

Multiple remote Print SCPs can be defined, but no more than one Grayscale and one Color Print SCP may be selected
at a time.

Automatic sending of color images to the color printer and BW images to the BW printer is selectable in Setups –
Acquisition/Capture – Acquisition/Capture – Send Images/Clips – Automatic Printer Choice.

4.4.2 Parameters

The following parameters apply to all local-system Application Entities. The system must be power-cycled after
changing any of these values:

Table 4.65
Configuration Parameters Table
Parameter Configurable Default Value
(Yes/No)
General Parameters
AE Title for all AE’s Yes AETitle

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 Parameter Configurable Default Value
(Yes/No)
General Parameters
Listening Port Yes 104*
Station Name Yes <empty>
Station Location Yes <empty>
Hostname Yes <generatedName>
MAX PDU Size Yes 32768
Max Simultaneous Associations No 5
ARTIM Timeout Yes 60
*If standard DICOM. If Secure DICOM, default port automatically changes to 2762.

5 MEDIA STORAGE

5.1 IMPLEMENTATION MODEL

5.1.1 Application Data Flow

Export to
Media
FSC
FSU
Media
Application Media
FSR* Storage
Entity
Medium
Import from
Media

Figure 9
APPLICATION DATA FLOW DIAGRAM FOR MEDIA STORAGE

The Media Application Entity exports Images, 3D Presentation States and Structured Reports to a Storage medium. It
is associated with the local real-world activity “Export to Media”. “Export to Media” is performed upon user request for
selected studies, performed procedures, or instances (images, 3D Volumes, 3D Presentation States, and Structured
Reports).

Throughout this section, the term “Media” refers to any of the media listed below which is in use.

EPIQ/Affiniti will support the use of most writable media including CD-R, CD-RW, DVD-R, DVD+R, DVD-RW,
DVD+RW and removable USB Storage Device. DICOM structure will be the same regardless of media used.
Note that although –R or +R media may be erased multiple times using “erase”, the space may not be
recovered. If a –R or +R media is “Erased”, the previously written data is no longer available, and only the

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 remaining unwritten space on the media is available for use. This restriction does not apply to + / - RW media.
Erasing + / - RW media allows the entire disk’s space to be used.
If a –R or +R is erased, it is not usable again for DICOM exports due to reliability concerns associated with DVD
media. Only DVD+RW/-RW can be erased and used again for DICOM export.
5.1.2 Functional Definition of AEs

5.1.2.1 Functional Definition of Media Application Entity

Using “Export to… Media” will pass the currently selected studies, exams, or individually selected images to the Media
Application Entity. The SOP Instances associated with the selection will be collected into one or more export jobs.
The contents of each export job will be written to the installed media. If the capacity of a disk is exceeded, the user is
provided a dialog, stating capacity exceeded and to insert another disk.

5.1.3 Sequencing of Real-World Activities

At least one image must exist and be selected before the Media Application Entity can be invoked. The operator can
insert new media at any time. If no writable media is available, the Media queue management Icon will be Yellow.

5.1.4 File Meta Information Options

The implementation information written to the File Meta Header in each file is:

Table 5.1
DICOM IMPLEMENTATION CLASS AND VERSION FOR MEDIA STORAGE

Implementation Class UID 1.3.46.670589.14.10000.600

Implementation Version Name EPIQ-AFFIN_6.00

5.2 AE SPECIFICATIONS
5.2.1 Media Application Entity Specification

The Media Application Entity provides standard conformance to the DICOM Interchange Option of the Media Storage
Service Class. The Application Profiles and roles are listed in DICOM PS 3.10 and PS 3.11.

Table 5.2
MEDIA APPLICATION PROFILES, ACTIVITIES, AND ROLES
Application Profiles Supported Real World Activity Roles SC Option

STD-US-SC-SF&MF-CDR FSC
STD-US-SC-SF&MF-DVD Export to….Media
FSC, FSU
STD-GEN-USB-JPEG Interchange
STD-US-SC-SF&MF-CDR
Send to Hard Disk
STD-US-SC-SF&MF-DVD FSR
(import)
STD-GEN-USB-JPEG

5.2.1.1 File Meta Information for the Application Entity

The File-Set ID (0004,1130) included in the File Meta Header of the DICOMDIR is the same as the volume label of the
media.

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5.2.1.2 Real-World Activities

5.2.1.2.1 Activity – Export to Media

The Media Application Entity acts as an FSC using the interchange option when requested to export SOP Instances
from the local database to media.

The contents of the export job will be written together with a corresponding DICOMDIR to media. The user can cancel
an export job in the job queue. Writing in multi-session format to CDs and DVDs is not supported; any CD or DVD with
DICOM data on it will be viewed as read-only and additional information will not be written to the media. USB media
can be written many times.

5.2.1.2.2 Activity – Import from Media

The Media Application Entity acts as an FSR using the interchange option when requested to import SOP Instances
from media to the local database.

The Patient Directory user interface displays the contents of removable media. Exams selected by the user are
transferred from the media to the system for review. Objects transferred to the system retain their original SOP
Instance UIDs. Patient Directory must be set to display the contents of the Hard Disk before the imported exam
information may be displayed.

Note: Structured Reports may not be read back into EPIQ/Affiniti.

5.2.1.2.3 Activity – Update to Media

The Media Application Entity acts as an FSU using the interchange option when requested to export SOP Instances
from the local database to media upon which DICOM data already resides.

The system user selects exams from the system’s directory for transfer to media that already contains data. The
DICOMDIR is updated allowing access to original and new data.

DVD/CD +RW media may be erased at any time, removing all previously recorded data.

5.2.1.2.3.1 Media Storage Application Profiles

See Table 5.2 for supported Application Profiles.

5.2.1.2.3.2 Options

The Media Application Entity supports the SOP Classes and Transfer Syntaxes listed in Table 5.3.

Table 5.3
IODS, SOP CLASSES AND TRANSFER SYNTAXES FOR REMOVABLE ¬MEDIA

Transfer Syntax
Information Object Definition SOP Class UID Transfer Syntax
UID

Media Storage Directory Storage 1.2.840.10008.1.3.10 Explicit VR Little Endian 1.2.840.10008.1.2.1

US Image Storage 1.2.840.10008.5.1.4.1.1.6.1 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
US Image Storage (Retired) 1.2.840.10008.5.1.4.1.1.6 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70

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 Transfer Syntax
Information Object Definition SOP Class UID Transfer Syntax
UID
US Multiframe Image Storage 1.2.840.10008.5.1.4.1.1.3.1 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Baseline Lossy 1.2.840.10008.1.2.4.50
Compression
US Multiframe Image Storage (Retired)* 1.2.840.10008.5.1.4.1.1.3 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Baseline Lossy 1.2.840.10008.1.2.4.50
Compression
Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Multi-frame True Color Secondary Capture 1.2.840.10008.5.1.4.1.1.7.4 Explicit VR Little Endian 1.2.840.10008.1.2.1
Image Storage JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
CT Image Storage 1.2.840.10008.5.1.4.1.1.2 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Enhanced CT Image Storage 1.2.840.10008.5.1.4.1.1.2.1 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Digital Mammography X-Ray Image 1.2.840.10008.5.1.4.1.1.1.2 Explicit VR Little Endian 1.2.840.10008.1.2.1
Storage – For Presentation JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Digital Mammography X-Ray Image 1.2.840.10008.5.1.4.1.1.1.2.1 Explicit VR Little Endian 1.2.840.10008.1.2.1
Storage – For Processing JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
MR Image Storage 1.2.840.10008.5.1.4.1.1.4 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Enhanced MR Image Storage 1.2.840.10008.5.1.4.1.1.4.1 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
MR Spectroscopy Image Storage 1.2.840.10008.5.1.4.1.1.4.2 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Extended 12-bit Lossy 1.2.840.10008.1.2.4.51
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
Positron Emission Tomography Image 1.2.840.10008.5.1.4.1.1.128 Explicit VR Little Endian 1.2.840.10008.1.2.1
Storage JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70
X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.1 Explicit VR Little Endian 1.2.840.10008.1.2.1
JPEG Lossy Baseline 1.2.840.10008.1.2.4.50
JPEG Lossless Baseline 1.2.840.10008.1.2.4.70

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 Transfer Syntax
Information Object Definition SOP Class UID Transfer Syntax
UID
Comprehensive Structured Report Storage 1.2.840.10008.5.1.4.1.1.88.33 Explicit VR Little Endian 1.2.840.10008.1.2.1

Private 3D Presentation State** 1.3.46.670589.2.5.1.1 Explicit VR Little Endian 1.2.840.10008.1.2.1

** For import to Philips QLAB, Xcelera or IntelliSpace for CardioVascular workstations only.

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 6 TRANSFORMATION OF DICOM TO CDA

EPIQ/Affiniti exports a CDA file format which complies with the HL7 CDA-R2 schema.

7 SUPPORT OF CHARACTER SETS

All EPIQ/Affiniti DICOM applications support the following values of Specific Character Set (0008,0005):

ISO_IR 100 (Latin Alphabet No. 1 supplementary set)

ISO_IR 144 (Cyrillic)
GB18030 (Chinese)

8 SECURITY

8.1 GENERAL SECURITY

EPIQ/Affiniti incorporates an internal firewall that only accepts incoming traffic on the designated listening port, as
configured in PSC – Network/DICOM – DICOM Settings. The port is only opened if one or more servers are defined.

8.2 SUPPORTED DICOM SECURITY PROFILES

8.2.1 TLS Secure Transport Connection Profiles

Basic TLS Secure Transport Connection Profile and the AES TLS Secure Transport Connection Profile are supported
using Transport Layer Security Version 1.2 protocol with the following features:

Supported TLS Feature Mechanism

Entity Authentication RSA based certificates

Exchange of Master Secrets RSA

Data Integrity SHA-1 or SHA-2 based certificates

Privacy (Cyphersuite Options) TLS_RSA_WITH_AES_128_CBC_SHA (preferred)

TLS_RSA_WITH_3DES_EDE_CBC_SHA

TLS authentication may be used with or without TLS encryption – default is with TLS encryption.

For outgoing TLS requests where EPIQ/Affiniti acts as a TLS Client, the received server RSA certificate is validated by
verifying its digital signature against a certificate in the local Trusted Certificate Authorities store whose Subject
matches the Issuer of the received certificate. If requested by the TLS Server, EPIQ/Affiniti will then send the
certificate configured for “This System” from the local Personal store.

For incoming TLS connection requests where EPIQ/Affiniti acts as a TLS Server, the certificate configured for “This
System” is sent from the Personal store to the client as specified in the TLS protocol. EPIQ/Affiniti always requests a
client certificate from the TLS Client.

Certificates are locally managed. The site administrator may import certificates from media to the Trusted Certificate
Authority store for verifying incoming certificates; these may be either CA certificates or self-signed end-entity

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certificates. The site administrator may also import certificates from media to the Personal store along with the
certificates private key for certificates representing ‘This System’. A wide variety of certificate file formats are
supported, including

 Base 64 Text: PEM format (.pem, .crt), usually unencrypted but may be encrypted. If encrypted, the
encryption password must be provided when importing.

 ASN.1 Binary: BER, DER, CER formats (.der, .cer, .crt)

 PKCS#12: Encrypted Container for certificates with private keys (.pfx, .p12). This format is used primarily for
the “This System” certificate with corresponding private key. The encryption password must be provided when
importing.

 PKCS#7: Container for multiple certificates. If there is only one certificate in the container, then the certificate
is saved to the user-specified store name. If there are multiple certificates in the container, then the Issuer and
Subject names of each certificate are compared; if the names are the same, the certificate is stored in the
Trusted Certificate Authority store, else in the Intermediate Certificate Authority store.

The site administrator may also remove previously-imported certificates.

The incoming TCP port defaults to port 2762 when TLS security is enabled; this port may be changed by the user if
desired.

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 9 ANNEXES

9.1 IOD CONTENTS

9.1.1 Created SOP Instances

Table 9.1 specifies the attributes of an Ultrasound or Ultrasound Multiframe Image transmitted by the EPIQ/Affiniti
storage application.

Table 9.2 specifies the attributes of a Secondary Capture Image transmitted by the EPIQ/Affiniti storage application.

Table 9.3 specifies the attributes of a Multi-frame True Color Secondary Capture image transmitted by the EPIQ/Affiniti
storage application.

Table 9.4 specifies the attributes of a Comprehensive Structured Report transmitted by the EPIQ/Affiniti storage
application. Please note that there are differences between which Structured Report Templates are used in each
product.

The following tables use a number of abbreviations. The abbreviations used in the “Presence of …” column are:

VNAP Value Not Always Present

ANAP Attribute Not Always Present
ALWAYS Always Present
ALWAYSUA Always Present, unless anonymized
EMPTY Attribute is sent without a value

The abbreviations used in the “Source” column:

MWL the attribute value source Modality Worklist

USER the attribute value source is from User input
AUTO the attribute value is generated automatically
MPPS the attribute value is the same as the Modality Performed Procedure Step service
CONFIG the attribute value source is a configurable parameter

9.1.1.1 US or US Multiframe Image IOD

Table 9.1
IOD OF CREATED US OR US MULTIFRAME SOP INSTANCES
IE Module Reference Presence of Module
Patient Patient Table 9.5 ALWAYS
General Study Table 9.6 ALWAYS
Study
Patient Study Table 9.7 ALWAYS
Series General Series Table 9.9 ALWAYS
Equipment General Equipment Table 9.10 ALWAYS
General Image Table 9.11 ALWAYS
Image Pixel Table 9.12 ALWAYS
Image
Cine Table 9.13 Only if Multi-frame
Multi-frame Table 9.14 Only if Multi-frame

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 IE Module Reference Presence of Module
US Region Calibration Table 9.15 ANAP
US Image Table 9.16 ALWAYS
VOI LUT Table 9.17 Only if Single frame
SOP Common Table 9.18 ALWAYS

9.1.1.2 Secondary Capture IOD

Table 9.2
IOD OF CREATED SECONDARY CAPTURE SOP INSTANCES
IE Module Reference Presence of Module
Patient Patient Table 9.5 ALWAYS
General Study Table 9.6 ALWAYS
Study
Patient Study Table 9.7 ALWAYS
Series General Series Table 9.9 ALWAYS
General Equipment Table 9.10 ALWAYS
Equipment
SC Equipment Table 9.21 ALWAYS
General Image Table 9.19 ALWAYS
Image Pixel Table 9.20 ALWAYS
Image All attributes are
SC Image N.A. optional and are not
present
SOP Common Table 9.23 ALWAYS

9.1.1.3 Multi-Frame True Color Secondary Capture IOD

Table 9.3
IOD OF CREATED MULTI-FRAME TRUE COLOR SECONDARY CAPTURE SOP INSTANCES
IE Module Reference Presence of Module
Patient Patient Table 9.5 ALWAYS
General Study Table 9.6 ALWAYS
Study
Patient Study Table 9.7 ALWAYS
Series General Series Table 9.9 ALWAYS
General Equipment Table 9.10 ALWAYS
Equipment
SC Equipment Table 9.21 ALWAYS
General Image Table 9.19 ALWAYS
Image Pixel Table 9.20 ALWAYS
Cine Table 9.13 ALWAYS
Image Multi-frame Table 9.14 ALWAYS
SC Multi-frame Image Table 9.22 ALWAYS
All attributes are
SC Multi-frame Vector N.A. conditional and are not
present

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 IE Module Reference Presence of Module
SOP Common Table 9.23 ALWAYS

9.1.1.4 Comprehensive Structured Report IOD

Table 9.4
IOD OF CREATED COMPREHENSIVE STRUCTURED REPORT SOP INSTANCES
IE Module Reference Presence of Module
Patient Patient Table 9.5 ALWAYS
General Study Table 9.6 ALWAYS
Study
Patient Study Table 9.7 ALWAYS
Series SR Document Series Table 9.24 ALWAYS
Equipment General Equipment Table 9.10 ALWAYS
SR Document General Table 9.25 ALWAYS
Document SR Document Content Table 9.26 ALWAYS
SOP Common Table 9.27 ALWAYS

9.1.1.5 Attribute Content by Module

9.1.1.5.1 Common Modules

Table 9.5
PATIENT MODULE OF CREATED SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
MWL/
Patient’s Name (0010,0010) PN Same attribute of MWL or PDE input ALWAYS
USER
MWL/
From MWL, user input or system
Patient ID (0010,0020) LO ALWAYS USER/
generated. Maximum 64 characters.
AUTO
MWL/
Patient’s Birth Date (0010,0030) DA Same attribute of MWL or PDE input VNAP
USER
MWL/
Patient’s Sex (0010,0040) CS Same attribute of MWL or PDE input* VNAP
USER
Other Patient IDs (0010,1000) LO Same attribute of MWL VNAP MWL
Ethnic Group (0010,2160) SH Same attribute of MWL VNAP MWL
Same attribute of MWL or PDE input
MWL/
Patient Comments (0010,4000) LT MWL input limited to 3500 characters VNAP
USER
PDE input limited to 100 characters
* In English

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 Table 9.6
GENERAL STUDY MODULE OF CREATED SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Same value as in MWL or auto MWL/
Study Instance UID (0020,000D) UI ALWAYS
generated AUTO
Study Date (0008,0020) DA Study’s Start Date (0040,0244). ALWAYSUA AUTO
Study Time (0008,0030) TM Study’s Start Time (0040,0245). ALWAYS AUTO
Only Last, First and Middle names MWL/
Referring Physician’s Name (0008,0090) PN VNAP
from MWL, or PDE input. USER
MWL Requested Procedure ID MWL/
Study ID (0020,0010) SH ALWAYSUA
(0040,1001) or auto-generated AUTO
Same attribute of MWL or user PDE MWL/
Accession Number (0008,0050) SH VNAP
input. USER
The first available attribute (provided
in the MWL response) from the
following list:
Requested Procedure Description
(0032,1060) MWL/
Study Description (0008,1030) LO Scheduled Procedure Step VNAP
USER
Description (0040,0007)
Scheduled Protocol Code Sequence
>Code Meaning
(0040,0008),(0008,0104)
or user input
When user manually makes entry in
Physician(s) of Record (0008,1048) PN ANAP USER
“Physician of Record” in PDE.
Names of Intended When present in MWL, displayed in
(0040,1010) PN ANAP MWL
Recipients of Results PDE, “Physician of Record”.
One item per item in the MWL
Referenced Study
(0008,1110) SQ Referenced Study Sequence. ANAP MWL
Sequence
Absent if unscheduled.
>Referenced SOP Class Same value as in of the Referenced
(0008,1150) UI VNAP MWL
UID Study Sequence in the MWL
>Referenced SOP Instance Same value as in of the Referenced
(0008,1155) UI VNAP MWL
UID Study Sequence in the MWL
MWL Requested Procedure Code
Procedure Code Sequence (0008,1032) SQ Sequence (0032,1064) ANAP MWL
Absent if unscheduled.
>Code Value (0008,0100) SH Same value as MWL attribute VNAP MWL
>Coding Scheme
(0008,0102) SH Same value as MWL attribute VNAP MWL
Designator
>Coding Scheme Version (0008,0103) SH Same value as MWL attribute VNAP MWL
>Code Meaning (0008,0104) LO Same value as MWL attribute VNAP MWL

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 Table 9.7
PATIENT STUDY MODULE OF CREATED SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
Admitting Diagnosis
(0008,1080) LO Same attribute as MWL attribute VNAP MWL
Description
Same value as MWL attribute or PDE MWL/
Patient Size (0010,1020) DS VNAP
input USER
Same value as MWL attribute or PDE MWL/
Patient’s Weight (0010,1030) DS VNAP
input USER

Table 9.8
PATIENT MEDICAL MODULE OF CREATED SOP INSTANCES*
Presence
Attribute Name Tag VR Value Source
of Value
Medical Alerts (0010,2000) LO Same value as MWL attribute VNAP MWL
Allergies (0010,2110) LO Same value as MWL attribute VNAP MWL
Additional Patient’s History (0010,21B0) LT Same value as MWL attribute VNAP MWL
Pregnancy Status (0010,21C0) US Same value as MWL attribute ANAP MWL
Special Needs (0038,0050) LO Same value as MWL attribute VNAP MWL
*Note: These attributes extend the standard US Image and US Multiframe Image IODs

Table 9.9
GENERAL SERIES MODULE OF CREATED IMAGE SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Modality (0008,0060) CS “US” ALWAYS AUTO
Presentation Intent Type (0008,0068) CS This attribute is defined for the DX ALWAYS AUTO
Series. It is added here as an
extension to the General Series for
Ultrasound.
“FOR PRESENTATION” if this is
Series 1, containing the standard
ultrasound images. “FOR
PROCESSING” if this is Series 4,
containing Ultrasound Multiframe 3D
volumes, intended only for
processing by Philips 3D viewers.
Series Instance UID (0020,000E) UI Auto-generated ALWAYS AUTO
Series Number (0020,0011) IS A number unique within the Study. ALWAYS AUTO
Series Date (0008,0021) DA Date of first image in series. ALWAYSUA AUTO
Series Time (0008,0031) TM Time of first image in series. ALWAYS AUTO

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 Presence of
Attribute Name Tag VR Value Source
Value
“Free Form”
”Exercise 2 Stage”
“Exercise 3 Stage”
Protocol Name (0018,1030) LO “Pharmacological 4 Stage” ALWAYS AUTO
“Wall Motion and Contrast”
“Quantitative 4 Stage”
user defined
Same Source as Study Description MWL/
Series Description (0008,103E) LO ANAP
(0008,1030) when from MWL. USER
MWL Scheduled Performing
MWL/
Operators’ Name (0008,1070) PN Physician’s Name (0040,0006) VNAP
USER
From PDE “Exam Performed By” field
Referenced Performed Identifies the MPPS SOP Instance
(0008,1111) SQ ALWAYS MPPS
Procedure Step Sequence this image is related to
>Referenced SOP Class PPS SOP Class =
(0008,1150) UI ALWAYS MPPS
UID “1.2.840.10008.3.1.2.3.3”
>Referenced SOP Instance PPS Instance UID of the PPS
(0008,1155) UI ALWAYS MPPS
UID generating this image
Requesting Physician (0032,1032) PN Same value as MWL attribute ANAP MWL
Referenced Patient
(0008,1120) SQ ANAP MWL
Sequence
RETIRED Detached Patient
>Referenced SOP Class
(0008,1150) UI Management SOP Class = ALWAYS MWL
UID
“1.2.840.10008.3.1.2.1.1”
>Referenced SOP Instance Instance UID of the generating this
(0008,1155) UI ALWAYS MWL
UID image
>Requested Procedure
(0032,1060) LO Same value as MWL attribute VNAP MWL
Description
>Requested Contrast Same value as MWL attribute in
(0032,1070) LO ANAP MWL
Agent Scheduled Procedure Step Sq
Auto-generated=Study ID or value AUTO /
>Requested Procedure ID (0040,1001) SH ALWAYS
from MWL. One item. MWL
>Requested Procedure
(0040,1003) SH Same value as MWL attribute ANAP MWL
Priority
>Patient Transport
(0040,1004) LO Same value as MWL attribute ANAP MWL
Arrangements
>Scheduled Procedure Auto-generated=Study ID or value AUTO /
(0040,0009) SH ALWAYS
Step ID from MWL. One item. MWL
>Scheduled Procedure
(0040,0007) LO Same value as MWL attribute VNAP MWL
Step Description
>Scheduled Protocol Code
(0040,0008) SQ Same value as MWL attribute VNAP MWL
Sequence
>Pre-Medication (0040,0012) LO Same value as MWL attribute ANAP MWL

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 Presence of
Attribute Name Tag VR Value Source
Value
Performed Procedure Step
(0040,0253) SH Auto-generated=Study ID One item. ALWAYSUA AUTO
ID
Performed Procedure Step
(0040,0244) DA See Table 9.6 ALWAYSUA AUTO
Start Date
Performed Procedure Step
(0040,0245) TM See Table 9.6 ALWAYS AUTO
Start Time
MWL Scheduled Procedure Step
Performed Procedure Step USER /
(0040,0254) LO Description (0040,0007) or PDE input VNAP
Description MWL
if any.
Zero length, or mapped from MWL
Performed Protocol Code
(0040,0260) SQ Scheduled Protocol Code Sequence VNAP MWL
Sequence
(0040,0008)
Comments on the Mapped from MWL Requested
(0040,0280) ST ANAP MWL
Performed Procedure Step Procedure Description (0032,1060)

Table 9.10
GENERAL EQUIPMENT MODULE OF CREATED SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Manufacturer (0008,0070) LO Philips Medical Systems ALWAYS AUTO
From Setups configuration*
Institution Name (0008,0080) LO VNAP CONFIG
(requires power cycle after change)
Station Name (0008,1010) SH From Setups configuration VNAP CONFIG
Manufacturer’s A string indicating the product, level, and clinical
(0008,1090) LO ALWAYS AUTO
Model Name specialty. Example: EPIQ 7C
Decimal representation of system “Chip ID”
Device Serial found in PSC>System Management>System
(0018,1000) LO ALWAYS AUTO
Number Information. Also used as component of system
generated private UIDs.
A string indicating the model name and software
Software Version(s) (0018,1020) LO ALWAYS AUTO
build version. Example: EPIQ 7C_4.0.0.1234
* Always cycle system power after changing Institution Name prior to sending data.

9.1.1.5.2 US or Multiframe Image Modules

Table 9.11
GENERAL IMAGE MODULE OF CREATED US SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Instance Generated by device, increments from “1” in
(0020,0013) IS ALWAYS AUTO
Number* each series
Content Date (0008,0023) DA <yyyymmdd> ALWAYSUA AUTO

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 Presence of
Attribute Name Tag VR Value Source
Value
Content Time (0008,0033) TM <hhmmss> ALWAYS AUTO
Acquisition The date and time that the acquisition of data
(0008,002A) DT ALWAYSUA AUTO
DateTime that resulted in this image started.
“Uncompressed” for US Image; Numeric value
Derivation set from JPEG Quality Factor slider found in
(0008,2111) ST ALWAYS AUTO
Description Utilities > Setups > Acquisition/Capture >
Acquisition Compression
Source Image (0008,2112) SQ This sequence will be present only for 3D ANAP AUTO
Sequence images from motorized 3D transducers, or
freehand acquisition from single-array
transducers.
> Referenced (0008,1150) UI SOP Class UID of Ultrasound Multiframe ANAP AUTO
SOP Class UID Image
> Referenced (0008,1155) UI The value is the SOP Instance UID of the ANAP AUTO
SOP Instance associated 3D volume.
UID
This value links this image, intended for first-
order presentation, to a US Multiframe image in
Series 4, which is intended as source data for
proprietary 3D viewing applications.
> Purpose of (0040,A170) SQ ANAP AUTO
Reference Code
Sequence
>> Coding (0008,0102) SH “DCM” ANAP AUTO
Scheme
Designator
>> Code Value (0008,0100) SH “121324” ANAP AUTO
>> Code (0008,0104) LO “Source Image” (comment from DICOM PS ANAP AUTO
Meaning 3.16: “image used as the source for a derived
or compressed image”)
Set to “NO”.
Burned In
(0028,0301) CS Set to “YES” if “Burn Patient Information Into ALWAYS AUTO
Annotation
Images” is set.
Lossy Image
(0028,2110) CS “01” if image is lossy compressed, “00” if not. ALWAYS AUTO
Compression
For Lossy Compressed images, the following
Lossy Image Quality Factor value is sent:
Compression (0028,2112) DS Uncompressed, Lossless, Lossy Low, = 100 ANAP AUTO
Ratio Lossy Med = 95
Lossy High = 90
Lossy Image
For Lossy Compressed images, the attribute is
Compression (0028,2114) CS ANAP AUTO
set to “ISO_10918_1”
Method

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 Presence of
Attribute Name Tag VR Value Source
Value
ANAP
Provided as an extension to the Ultrasound (Mutually
Presentation LUT
(2050,0010) SQ Multiframe IOD. Present only for 3D volume exclusive AUTO
Sequence
objects in Series 4. with
(2050,0020)
> LUT US
(0028,3002) [256 / 0 / 16] ANAP AUTO
Description or SS
US [P0 / P1 ... P255]
or SS
> LUT Data (0028,3006) Array of 256 16-bit values mapping the output ANAP AUTO
or
OW range of the VOI LUT to P-values
Presentation LUT “IDENTITY” only if “Image Export Format” is
(2050,0020) CS ANAP AUTO
Shape GSDF.
* Instance Number will be mapped to View Number when studies with General Imaging Protocol Images are
configured to export shuffled. Images that are not part of the protocol will have the instance number offset by 10,000.

Table 9.12
IMAGE PIXEL MODULE OF CREATED US OR US MULTIFRAME SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Samples per
(0028,0002) US See US Image Module Table 9.16 ALWAYS AUTO
Pixel
Photometric
(0028,0004) CS See US Image Module Table 9.16 ALWAYS AUTO
Interpretation
Image height in pixels. Varies with export
resolution configuration, normal vs. quad size
Rows (0028,0010) US ALWAYS CONFIG
image, and full-screen vs. image area setting
and Normal vs MaxVue setting.
Image width in pixels. Varies with export
resolution configuration, normal vs. quad size
Columns (0028,0011) US ALWAYS CONFIG
image, and full-screen vs. image area setting
and Normal vs MaxVue setting.
Bits Allocated (0028,0100) US 8 Bits per pixel. ALWAYS AUTO
Bits Stored (0028,0101) US 8 Bits per pixel. ALWAYS AUTO
High Bit (0028,0102) US High bit is 7 ALWAYS AUTO
Pixel
(0028,0103) US “0” pixels are Unsigned Integers ALWAYS AUTO
Representation
OW /
Pixel Data (7FE0,0010) ALWAYS AUTO
OB
Planar
(0028,0006) US Present when image is RGB. Value is “0”. ANAP AUTO
Configuration

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 Table 9.13
CINE MODULE OF CREATED MULTIFRAME US OR SC SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
Frame Time (0018,1063) DS Frame time in milliseconds ANAP AUTO
Recommended (0008,2144) IS Display frame rate corresponding to Frame Time ANAP AUTO
Display Frame (0018,1063) value, in frames per second.
Rate
Cine Rate (0018,0040) IS Display frame rate corresponding to Frame Time ANAP AUTO
(0018,1063) value, in frames per second.

Table 9.14
MULTI-FRAME MODULE OF CREATED MULTIFRAME US OR SC SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
Number of
(0028,0008) IS # of frames in object ANAP AUTO
Frames
Frame Increment
(0028,0009) AT (0018,1063) Frame Time only ANAP AUTO
Pointer

Table 9.15
US REGION CALIBRATION MODULE OF CREATED US IMAGE OR US MULTIFRAME IMAGE SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
A sequence is present for each region on the
Sequence of
system display, except for ECG regions. Only
Ultrasound (0018,6011) SQ ANAP AUTO
when set for “Display Area”. No scaling for
Regions
“Full Screen” images, rendered 3D.
>Region Location
Min x0 (0018,6018) UL Top Left position of region. ALWAYS AUTO

>Region Location
Min y0 (0018,601A) UL Top Left position of region ALWAYS AUTO

>Region Location
Max x1 (0018,601C) UL Bottom Right position of region ALWAYS AUTO

>Region Location
Max y1 (0018,601E) UL Bottom Right position of region ALWAYS AUTO

Enumerated Value.
>Physical Units X
(0018,6024) US 2D Image = 0003H = CM ALWAYS AUTO
Direction
Mmode / Doppler = 0004H = SEC

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 Presence
Attribute Name Tag VR Value Source
of Value
Enumerated Value.
>Physical Units Y 2D Image = 0003H = CM
(0018,6026) US ALWAYS AUTO
Direction Mmode = 0003H = CM
Doppler = 0007H = CM / SEC
>Physical Delta X (0018,602C) FD The physical value per pixel increment ALWAYS AUTO
>Physical Delta Y (0018,602E) FD The physical value per pixel increment ALWAYS AUTO
>Reference Pixel
(0018,6020) SL The X pixel value of baseline, Doppler only ANAP AUTO
X0
>Reference Pixel
(0018,6022) SL The Y pixel value of baseline, Doppler only ANAP AUTO
Y0
Enumerated Value.
>Region Spatial 2D (tissue or flow) = 0001H
(0018,6012) US ALWAYS AUTO
Format M-Mode (tissue or flow) = 0002H
Spectral (CW or PW Doppler) = 0003H
Enumerated Value.
>Region Data Tissue = 0001H
(0018,6014) US ALWAYS AUTO
Type PW Spectral Doppler = 0003H
CW Spectral Doppler = 0004H
>Region Flags (0018,6016) UL Bit mask. See DICOM PS3.3 C.8.5.5.1.3: ALWAYS AUTO

Table 9.16
US IMAGE MODULE OF CREATED US IMAGE OR US MULTIFRAME IMAGE SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
ORIGINAL/PRIMARY/ < Analysis Type* > for
uncompressed,
DERIVED/PRIMARY/ < Analysis Type* > if
Image Type (0008,0008) CS ALWAYS CONFIG
compressed
ORIGINAL/PRIMARY/INVALID if non-image
like the Patient Data Entry (PDE) screen.
“1” for MONOCHROME2, only if “Export
Samples Per Monochrome” is selected, otherwise,
(0028,0002) US ALWAYS AUTO
Pixel
“3” for RGB or YBR_FULL_422
Uncompressed: “MONOCHROME2” or “RGB”
Photometric
(0028,0004) CS Lossy Compressed: “YBR_FULL_422” ALWAYS CONFIG
Interpretation
Lossless Compressed: “RGB”
Bits Allocated (0028,0100) US 8 Bits per pixel. ALWAYS AUTO
Bits Stored (0028,0101) US 8 Bits per pixel. ALWAYS AUTO
High Bit (0028,0102) US High bit is 7 ALWAYS AUTO

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 Presence
Attribute Name Tag VR Value Source
of Value
Planar
(0028,0006) US Always “0”, if color. ANAP AUTO
Configuration
Pixel
(0028,0103) US “0” Pixels are Unsigned integers ALWAYS AUTO
Representation
Frame Increment
(0028,0009) AT (0018,1063) “Frame Time” only; MF only. ANAP AUTO
Pointer
Image Type (0008,0008) CS See Table 9.11 ALWAYS CONFIG
Lossy Image “01” if image is lossy compressed,
(0028,2110) CS ALWAYS AUTO
Compression “00” if not.
Number of Stages (0008,2124) IS 1-n ANAP AUTO
Number of Views
(0008,212A) IS 1-n ANAP AUTO
in Stage
Ultrasound Color
(0028,0014) US 0 or 1 ALWAYS AUTO
Data Present
REST, PEAK, POST, IMPOST, BASE, LOW,
Stage Name (0008,2120) SH ANAP AUTO
user defined
Sequence of items describing the performed
Stage Code
(0040,000A) SQ Ultrasound Protocol Stage(s). See Baseline ANAP AUTO
Sequence
Context ID 12002 for possible contents.
Stage Number (0008,2122) IS 1-n ANAP AUTO
View Name** (0008,2127) SH LAX, SAX, AP4, AP2, AP3, user defined ANAP AUTO
View Number** (0008,2128) IS 1-n ANAP AUTO
Number of Event
(0008,2129) IS 1-n ANAP AUTO
Timers
Event Elapsed
(0008,2130) DS nnn msec. ANAP AUTO
Time(s)
Event Timer
(0008,2132) LO Timer ANAP AUTO
Name(s)
Sequence that describes the view of the patient
View Code anatomy in this image.
(0054,0220) SQ
Sequence Only a single Item shall be permitted in this
Sequence.
Acquisition The date and time that the acquisition of data ALWAYSU
(0008,002A) DT AUTO
DateTime that resulted in this image started. A
Trigger Time (0018,1060) DS nnn msec. ANAP AUTO
Heart Rate (0018,1088) IS Beats per minute ANAP AUTO
Transducer Data (0018,5010) LO Transducer name or code. ALWAYS AUTO
Processing
(0018,5020) LO Imaging optimization name. ALWAYS AUTO
Function

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* Analysis Type selection is determined by the analysis package associated with the transducer / preset selection.
** View name and View Number attributes are also in use by General Imaging Protocol

Table 9.17
VOI LUT MODULE OF CREATED US SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
Window Center (0028,1050) DS Fixed at 127 ANAP AUTO
Window Width (0028,1051) DS Fixed at 254 ANAP AUTO

Table 9.18
SOP COMMON MODULE OF CREATED US IMAGE OR US MULTIFRAME IMAGE SOP INSTANCES
Attribute Presence
Tag VR Value Source
Name of Value
1.2.840.10008.5.1.4.1.1.6.1 or
SOP Class 1.2.840.10008.5.1.4.1.1.6* for US Image
(0008,0016) UI ALWAYS AUTO
UID 1.2.840.10008.5.1.4.1.1.3.1 or
1.2.840.10008.5.1.4.1.1.3* for US Multiframe Image
SOP Instance
(0008,0018) UI Generated by device ALWAYS AUTO
UID
Specific Attribute only sent if an Extended or Replacement
(0008,0005) CS ANAP AUTO
Character Set Character Set is used
Instance
(0008,0012) DA <yyyymmdd> ALWAYSUA AUTO
Creation Date
Instance
(0008,0013) TM <hhmmss> ALWAYS AUTO
Creation Time
*Only if “Export Retired SOP Classes” is selected in Acquisition/Capture>Image Export>Format in Setups.

9.1.1.5.3 Secondary Capture Image Modules

Table 9.19
GENERAL IMAGE MODULE OF CREATED SECONDARY CAPTURE SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Instance Generated by device, increments from “1” in
(0020,0013) IS ALWAYS AUTO
Number* each Secondary Capture series
Content Date (0008,0023) DA <yyyymmdd> ALWAYSUA AUTO
Content Time (0008,0033) TM <hhmmss> ALWAYS AUTO
Image Type (0008,0008) CS DERIVED\SECONDARY ALWAYS AUTO
Acquisition
(0008,002A) DT The date and time of the image. ALWAYSUA AUTO
DateTime
Derivation “0” for SC Image or Numeric value for USMF
(0008,2111) ST ALWAYS AUTO
Description Image based on configuration setting
Burned In
(0028,0301) CS See SC Multi-Frame Image Module Table 9.22 ALWAYS AUTO
Annotation

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 Presence of
Attribute Name Tag VR Value Source
Value
Lossy Image
(0028,2110) CS “01” if image is lossy compressed, “00” if not. ALWAYS AUTO
Compression
For Lossy Compressed images, the following
Lossy Image Quality Factor value is sent:
Compression (0028,2112) DS Uncompressed, Lossless, Lossy Low, = 100 ANAP AUTO
Ratio Lossy Med = 95
Lossy High = 90
Lossy Image
For Lossy Compressed images, the attribute is
Compression (0028,2114) CS ANAP AUTO
set to “ISO_10918_1”
Method
* Instance Number will be mapped to View Number when studies with General Imaging Protocol Images are
configured to export shuffled. Images that are not part of the protocol will have the instance number offset by 10,000.

Table 9.20
IMAGE PIXEL MODULE OF CREATED SECONDARY CAPTURE SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Samples per Set to 1 or 3 for Secondary Capture Images,
(0028,0002) US ALWAYS AUTO
Pixel Set to 3 for Multi-frame True Color SC Images
Uncompressed: “MONOCHROME2” or “RGB”
Photometric
(0028,0004) CS Lossy Compressed: “YBR_FULL_422” ALWAYS AUTO
Interpretation
Lossless Compressed: “RGB”
Image height in pixels:
Rows (0028,0010) US 983 or 1050 for Secondary Capture Images ALWAYS CONFIG
983 for Multi-frame True Color SC Images
Image width in pixels:
Columns (0028,0011) US 1593 or 1920 for Secondary Capture Images ALWAYS CONFIG
1593 for Multi-frame True Color SC Images
Bits Allocated (0028,0100) US 8 Bits per pixel. ALWAYS AUTO
Bits Stored (0028,0101) US 8 Bits per pixel. ALWAYS AUTO
High Bit (0028,0102) US High bit is 7 ALWAYS AUTO
Pixel
(0028,0103) US “0” pixels are Unsigned Integers ALWAYS AUTO
Representation
OW /
Pixel Data (7FE0,0010) ALWAYS AUTO
OB
Planar
(0028,0006) US Present when image is RGB. Value is “0”. ANAP AUTO
Configuration

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 Table 9.21
SC EQUIPMENT MODULE OF CREATED SECONDARY CAPTURE SOP INSTANCES
Attribute Presence
Tag VR Value Source
Name of Value
Conversion
(0008,0064) CS WSD = Workstation ALWAYS AUTO
Type
Determined by the image modality being viewed at
Modality (0008,0060) CS ALWAYS AUTO
the time of acquisition.

Table 9.22
SC MULTI-FRAME IMAGE MODULE OF CREATED SECONDARY CAPTURE SOP INSTANCES
Attribute Presence
Tag VR Value Source
Name of Value
Burned In Set to “NO”. Set to “YES” if “Burn Patient Information
(0028,0301) CS ALWAYS AUTO
Annotation Into Images” is set.
Frame
Increment (0028,0009) AT (0018,1063) Frame Time only ALWAYS AUTO
Pointer

Table 9.23
SOP COMMON MODULE OF CREATED SECONDARY CAPTURE SOP INSTANCES
Attribute Presence
Tag VR Value Source
Name of Value
1.2.840.10008.5.1.4.1.1.7 for Secondary Capture
SOP Class Image
(0008,0016) UI ALWAYS AUTO
UID 1.2.840.10008.5.1.4.1.1.7.4 for Multi-frame True
Color Secondary Capture Image
SOP Instance
(0008,0018) UI Generated by device ALWAYS AUTO
UID
Specific Attribute only sent if an Extended or Replacement
(0008,0005) CS ANAP AUTO
Character Set Character Set is used
Instance
(0008,0012) DA <yyyymmdd> ALWAYSUA AUTO
Creation Date
Instance
(0008,0013) TM <hhmmss> ALWAYS AUTO
Creation Time

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9.1.1.5.4 Comprehensive Structured Report Modules

Table 9.24
SR DOCUMENT SERIES MODULE OF CREATED COMPREHENSIVE SR SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
Modality (0008,0060) CS “SR” ALWAYS AUTO
Series Date (0008,0021) DA Date of series creation. ALWAYS AUTO
Series Time (0008,0031) TM Time of series creation. ALWAYS AUTO
Series Instance
(0020,000E) UI Auto-generated ALWAYS AUTO
UID
Series Number (0020,0011) IS A number unique within the Study ALWAYS AUTO
Referenced
Performed Identifies the MPPS SOP Instance to which this
(0008,1111) SQ ALWAYS MPPS
Procedure Step image is related
Sequence
>Referenced
(0008,1150) UI PPS SOP Class = “1.2.840.10008.3.1.2.3.3” ALWAYS MPPS
SOP Class UID
> Referenced
PPS Instance UID of the PPS generating this
SOP Instance (0008,1155) UI ALWAYS MPPS
document
UID

Table 9.25
SR DOCUMENT GENERAL MODULE OF CREATED COMPREHENSIVE SR SOP INSTANCES
Presence of
Attribute Name Tag VR Value Source
Value
Instance Number (0020,0013) IS Unique number ALWAYS AUTO
Completion Flag (0040,A491) CS PARTIAL ALWAYS AUTO
Verification Flag (0040,A493) CS UNVERIFIED ALWAYS AUTO
Content Date (0008,0023) DA Date content created. ALWAYSUA AUTO
Content Time (0008,0033) TM Time content created. ALWAYS AUTO
Used when Send of Demand is used and Send
Predecessor
Structured Reports with Send on Demand is
Documents (0040,A360) SQ ANAP AUTO
selected. Will indicate the preceding SR sent in
Sequence
the study.
>Study Instance UID (0020,000D) UI Study’s UID ANAP AUTO
>Referenced Series
(0008,1115) SQ Identifies the Series containing the referenced SR ALWAYS AUTO
Sequence

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 Presence of
Attribute Name Tag VR Value Source
Value
>>Referenced SOP
(0008,1199) SQ SOP Instance UID for SR Series in the study ALWAYS AUTO
Sequence
>>> Referenced SOP Comprehensive SR SOP Class
(0008,1150) UI ALWAYS AUTO
Class 1.2.840.10008.5.1.4.1.1.88.33
>>> Referenced SOP SOP Instance UID of the preceding SR in the
(0008,1155) UI ALWAYS AUTO
Instance UID study
Identifies Requested Procedures being
Referenced Request
(0040,A370) SQ fulfilled (completely or partially) by creation of this ANAP AUTO
Sequence
Document.
MWL/
>Study Instance UID (0020,000D) UI Same value as in MWL or auto generated ALWAYS
AUTO
>Referenced Study 1 item per item in MWL, zero length if
(0008,1110) SQ ANAPVNAP MWL
Sequence unscheduled
>>Referenced SOP
(0008,1150) UI Identifies the Referenced SOP Class ANAP MWL
Class UID
>>Referenced SOP
(0008,1155) UI Instance UID ANAP MWL
Instance UID
MWL/
>Accession Number (0008,0050) SH Same attribute of MWL or user PDE input. VNAP
USER
>Placer Order
Order Number of Imaging Service Request
Number/Imaging (0040,2016) LO VNAP MWL
assigned by placer
Service Request
>Filler Order
Order Number of Imaging Service Request
Number/Imaging (0040,2017) LO VNAP MWL
assigned by filler
Service Request
>Requested
(0040,1001) SH 1 item per item in MWL, absent if unscheduled ANAP MWL
Procedure ID
>Requested
Procedure (0032,1060) LO 1 item per item in MWL, absent if unscheduled ANAP MWL
Description
>Requested
1 item per item in MWL, zero length if
Procedure Code (0032,1064) SQ VNAP MWL
unscheduled
Sequence
Performed Procedure Codes of the performed procedure, zero length if AUTO/
(0040,A372) SQ VNAP
Code Sequence unscheduled MWL

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 Table 9.26
SR DOCUMENT CONTENT MODULE OF CREATED COMPREHENSIVE SR SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
Content Template
(0040,A504) SQ ALWAYS AUTO
Sequence
The Root Content Item identifies TID 5000 (OB-
>Template Identifier (0040,DB00) CS GYN), 5100 (Vascular). 5200 (Echo), TID 5220 or ALWAYS AUTO
995300 (Ped Echo), TID 995400 (Small Parts)
>Mapping Resource (0008,0105) CS DCMR ALWAYS AUTO
Content Sequence (0040,A730) SQ ALWAYS AUTO
CONTAINS
>Relationship Type (0040,A010) CS HAS CONCEPT MOD ALWAYS AUTO
HAS PROPERTIES
Document Relationship See data at Philips Data Portal referenced in
ANAP AUTO
Macro Table Section A.3.1
Document Content See data at Philips Data Portal referenced in
ALWAYS AUTO
Macro Section A.3.1
CONTAINER, always first attribute of SR
Value Type (0040,A040) CS Additional values used: ALWAYS AUTO
TEXT, NUM, DATE, CODE, IMAGE, SCOORD
Concept Name Code
(0040,A043) SQ ALWAYS AUTO
Sequence
125000, 125100, 125200, 125195, 995300, or
>Code Value (0008,0100) ALWAYS AUTO
995400
>Coding Scheme
(0008,0102) DCM ALWAYS AUTO
Designator
“OB-GYN Ultrasound Procedure Report”,
“Vascular Ultrasound Procedure Report”,
“Adult Echocardiography Procedure Report”
>Code Meaning (0008,0104) ALWAYS AUTO
“Pediatric Ultrasound Procedure Report”
“Pediatric Echocardiography Procedure Report”
or “Small Parts Ultrasound Procedure Report”
Continuity of Content (0040,A050) CS SEPARATE ALWAYS AUTO
Spatial Coordinates
If and only if Value Type (0040,A040) = SCOORD ANAP AUTO
Macro
Order set of Column \ Row pairs defining positions
Graphic Data (0070,0022) ANAP AUTO
in a reference image
Graphic Type (0070,0023) Polyline ANAP AUTO
Numeric Measurement See data at Philips Data Portal referenced in
ALWAYS AUTO
Macro Section A.3.1
See data at Philips Data Portal referenced in
Code Macro ALWAYS AUTO
Section A.3.1

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 Table 9.27
SOP COMMON MODULE OF CREATED COMPOSITE SR SOP INSTANCES
Presence
Attribute Name Tag VR Value Source
of Value
SOP Class UID (0008,0016) UI 1.2.840.10008.5.1.4.1.1.88.33 ALWAYS AUTO
SOP Instance UID (0008,0018) UI Generated by device ALWAYS AUTO
Specific Character
(0008,0005) CS “None”, unless required by characters used ALWAYS CONFIG
Set

9.1.2 Usage of Attributes from Received IOD’s

The attributes of images imported to EPIQ/Affiniti are stored with Level 2 conformance, are used in the display of these
images, and are exported if the imported images are exported from EPIQ/Affiniti.

The usage of attributes received via Modality Worklist C-FIND is described in Section 4.2.2.3.1.3.

9.1.3 Attribute Mapping

Table 9.28 summarizes the relationships between attributes received via MWL, stored in acquired images and
communicated via MPPS. The format and conventions used in Table 9.28 relate to the corresponding table in IHE
Technical Framework, Rev. 11.0 07-24-2012, vol. II: Transactions.

Table 9.28
ATTRIBUTE MAPPING BETWEEN MODALITY WORKLIST, IMAGE AND MPPS
Modality Worklist Image IOD MPPS IOD
Patient’s Name Patient’s Name Patient’s Name
Patient ID Patient ID Patient ID
Patient’s Birth Date Patient’s Birth Date Patient’s Birth Date
Patient’s Sex Patient’s Sex Patient’s Sex
Patient’s Weight Patient’s Weight
Referring Physician’s Name Referring Physician’s Name
Scheduled Step Attributes
---- ----
Sequence
Study Instance UID Study Instance UID >Study Instance UID
Referenced Study Sequence Referenced Study Sequence >Referenced Study Sequence
Accession Number Accession Number >Accession Number
---- Request Attributes Sequence ----
Requested Procedure ID >Requested Procedure ID >Requested Procedure ID
Requested Procedure >Requested Procedure >Requested Procedure
Description Description Description
Scheduled Procedure Step ID >Scheduled Procedure Step ID >Scheduled Procedure Step ID

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 Modality Worklist Image IOD MPPS IOD
>Scheduled Procedure Step
>Scheduled Procedure Step
Description
Scheduled Procedure Step Description
Description > Series Description
> Performed Procedure Step
> Performed Procedure Step
Description
Description
Scheduled Protocol Code >Scheduled Protocol Code
----
Sequence Sequence
Performed Protocol Code Performed Protocol Code
----
Sequence Sequence
Study ID – Requested Procedure Study ID – Requested Procedure
----
ID from MWL, else generated ID from MWL, else generated
---- Performed Procedure Step ID Performed Procedure Step ID
Performed Procedure Step Start Performed Procedure Step Start
----
Date Date
Performed Procedure Step Start Performed Procedure Step Start
----
Time Time
Performed Procedure Step Performed Procedure Step
----
Description Description
---- ---- Performed Series Sequence
Requested Procedure Code
Procedure Code Sequence Procedure Code Sequence
Sequence
Referenced Performed
---- ----
Procedure Step Sequence
---- >Referenced SOP Class UID SOP Class UID
---- >Referenced SOP Instance UID SOP Instance UID
---- Protocol Name Protocol Name

9.1.4 Coerced/Modified Fields

The MWL AE will truncate attribute values received in the response to a MWL Query if the value length is longer than
the maximum length permitted by the attribute’s VR.

9.1.5 Attribute Anonymization

The EPIQ/Affiniti supports basic anonymization in that a set of identifying DICOM attributes that are stored to media
will be either removed or replaced with non-identifying data, according to the HIPAA guidelines for anonymization.

The option to de-identify is available at the time of export for the manual send to media workflows.

Table 9.29 contains a list of attributes containing patient identification and how EPIQ/Affiniti processing the attribute
value when DICOM de-identification is selected on export. This table is derived from DICOM 2007 PS3.15 Annex E,
Table E.1-1. Note most attributes are labeled ‘Keep’ because they are not classified as identifying by the United
States Health Insurance Portability and Accountability Act of 1996 (HIPAA) Safe-Harbor De-Identification Guidelines.

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 Table 9.29
DICOM ATTRIBUTES CONTAINING PATIENT IDENTIFYING INFORMATION

Attribute Name Tag Delete /

Replace?
Instance Creation Date (0008,0012) Delete
Instance Creation Time (0008,0013) Delete
SOP Instance UID (0008,0018) Replace
Study Date (0008,0020) Replace
Series Date (0008,0021) Delete
Content Date (0008,0023) Delete
Acquisition DateTime (0008,002A) Delete
Study Time (0080,0030) Replace
Series Time (0008,0031) Delete
Content Time (0008,0033) Delete
Accession Number (0008,0050) Delete
Institution Name (0008,0080) Delete
Referring Physician’s Name (0008,0090) Delete
Code Meaning (0008,0104) Delete
Station Name (0008,1010) Delete
Study Description (0008,1030) Delete
Series Description (0008,103E) Delete
Physicians of Record (0008,1048) Delete
Operators’ Name (0008,1070) Delete
Admitting Diagnosis Description (0008,1080) Delete
Referenced SOP Instance UID (0008,1155) Replace
Derivation Description (0008,2111) Delete
Patient’s Name (0010,0010) Replace
Patient ID (0010,0020) Replace
Patient’s Birth Date (0010,0030) Delete
Patient’s Sex (0010,0040) Delete
Other Patient IDs (0010,1000) Delete
Patient’s Size (0010,1020) Replace
Patient’s Weight (0010,1030) Replace
Pregnancy Status (0010,10C0) Replace
Medical Alerts (0010,2000) Delete
Alergies (0010,2110) Delete

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 Attribute Name Tag Delete /
Replace?
Ethnic Group (0010,2160) Delete
Additional Patient History (0010,21B0) Delete
Patient Comments (0010,4000) Delete
Device Serial Number (0018,1000) Delete
Protocol Name (0018,1030) Delete
Study Instance UID (0020,000D) Replace
Series Instance UID (0020,000E) Replace
Study ID (0020,0010) Delete
Requesting Physician (0032,1032) Delete
Scheduled Procedure Step Description (0040,0007) Delete
Performed Procedure Step Start Date (0040,0244) Delete
Performed Procedure Step Start Time (0040,0245) Delete
Performed Procedure Step ID (0040,0253) Delete
Performed Procedure Step Description (0040,0254) Delete
Comments on Performed Procedure Step (0040,0280) Delete
Names of Intended Recipients of Results (0040,1010) Delete

o EPIQ/Affiniti will replace the Patient Name with an unidentifiable string composed of a prefix ‘DeId-‘ and
followed by a unique numeric sequence,

o EPIQ/Affiniti will replace the Patient ID with a new generated unique ID.

o All noted Instance UIDs are modified because the Voyager generated instance UID’s are generated at the
time of the start of the procedure and suffixed with a date/time string noting the current date and time.
Because all manner of dates are considered identifying, the date and time portion of these strings is
replaced with a new date and time at the time of export. In this way we can be sure that they cannot be
linked back to the original date and time of the study. Referenced SOP instance UID links are maintained.

o The Study ID and Performed Procedure Step ID on EPIQ/Affiniti include date strings, and thus must be
removed.

9.2 DATA DICTIONARY OF PRIVATE ATTRIBUTES

Philips private attributes in groups 0x2001 and 0x200D may be included in objects created by EPIQ/Affiniti.

9.3 CODED TERMINOLOGY AND TEMPLATES

The Workflow AE is capable of supporting arbitrary coding schemes for Procedure and Protocol Codes. The contents
of Requested Procedure Code Sequence (0032,1064) and Scheduled Protocol Code Sequence (0040,0008) supplied
in Worklist Items will be mapped to Image IOD and MPPS attributes as described in Table 9.28.

Structured Reporting uses codes supplied by DCMR (DICOM Code Mapping Resource, PS 3-16), LOINC, SRT and
99PMSBLUS (Philips Private Codes for Ultrasound).

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9.4 GRAYSCALE IMAGE CONSISTENCY
The high-resolution display monitor is calibrated according to the Grayscale Standard Display Function (GSDF).

9.5 STANDARD EXTENDED/SPECIALIZED/PRIVATE SOP CLASSES

9.5.1 Ultrasound Image and Multi-frame Image SOP Classes

The US or US Multiframe Image Storage SOP Classes are extended to create a Standard Extended SOP Class by
addition of standard and private attributes to the created SOP Instances as documented in section 8.1 as well as the
standard attributes listed in Table 9.30.

Table 9.30
ULTRASOUND IMAGE EXTENDED ATTRIBUTES
Tag Attribute Name Added to
(0028,0030) Pixel Spacing Images with a single 2D region or dual 2D with same depth
Indicates that Pixel Data (7FE0,0010) contains 3D volume
(0008,0068) Presentation Intent Type
data
(0008,2112) Source Image Sequence Extended to use codes from CID 7205. See Table 9.31.
(0032,1032) Requesting Physician Added to image IODs for consistency with Structured
Reports.

Pixel Spacing (0028,0030) is added to the exported DICOM file when the user has configured this attribute to be
included and the image contains only one 2D calibration region and no Doppler or M-Mode calibration regions. This
attribute is system generated, if used:

 Contain the Pixel Spacing attribute: 2D still, 2D loop, 2D color still, 2D color loop, Mmode Preview Still, PW
Preview Still, CW Preview still, and Dual with same calibration on both images.

 Do NOT contain the Pixel Spacing attribute: Mmode live trace, Mmode frozen trace, PW live trace, PW
Frozen trace, CW live trace, CW frozen trace, Reports and dual images with different calibration on each
image.

Ultrasound Multi frame Image instances may be used to store 3D and 4D ultrasound volume information. The
presence of the Presentation Intent Type (0008,0068) value “FOR PRESENTATION” indicates that Pixel Data
(7FE0,0010) contains spatially related frames of a 3D volume rather than the normal temporally related frames. 3D
Temporal (a.k.a. 4D) volume information is stored using private attributes within a normal Ultrasound Multi frame
Image object.

The private attributes that are sent via network or media are dependent on settings for the specific destination, as
found in “Print/Network>Device Selection and either the “Media” tab or “Archive” tab and the “Advanced” button for the
highlighted archive device.

Table 9.31
SOURCE IMAGE SEQUENCE ITEM EXTENDED ATTRIBUTES
Attribute Name Tag Type VR Description Value
The set of Image SOP Class/Instance
Source Image
(0008,2112) 3 SQ pairs of the Images that were used to
Sequence
derive this image.

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 Attribute Name Tag Type VR Description Value
>Purpose of
Describes the purpose for which the
Reference Code (0040,A170) 3 SQ
reference is made.
Sequence
>> Code Value (0008,0100) 1 SH Code Value 121324
>>Code Meaning (0008,0104) 1 LO Code Meaning Source Image

9.5.2 3D Presentation State Private SOP Class

EPIQ Elite, Elite Advanced, 7, CVx (CVi) and some EPIQ 5 configurations may create instances of the following
Private SOP Class:

Table 9.32
PRIVATE SOP CLASS FOR 3D PRESENTATION STATE

SOP Class Name SOP Class UID SCU SCP

Private 3D Presentation State 1.3.46.670589.2.5.1.1 Yes No

9.6 PRIVATE TRANSFER SYNTAXES

There are no Private Transfer Syntaxes.

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 APPENDIX A – Structured Reports

A.1 STRUCTURED REPORTS

A.1.1 Introduction

EPIQ/Affiniti implement DICOM Structured Report Templates TID 5000 (OB-GYN Ultrasound Procedure Report), TID
5100 (Vascular Ultrasound Report), TID 5200 (Echocardiography Procedure Report), TID 5220 (Pediatric, Fetal and
Congenital Cardiac Ultrasound Reports), private TID 995300 (Ped Echo) based on supplement 78 version 2, May 8
2004, and private TID 995400 (Small Parts). See section A.2 for the DICOM Structured Report export capabilities for
each EPIQ/Affiniti model.

DICOM PS 3.17 of the DICOM Standard includes tree diagrams showing graphic examples of the structure of each
template.

Briefly, a Structured Report (SR) document will contain only the measurements, calculations and observations made
during the exam. Its exact structure is therefore determined by two main components, the measurements that are
available within the context of the template and its referenced Templates and Context groups, and those
measurements and calculations that are implemented on the system creating the report. Supplementing these
constraints are private and user defined measurements and calculations, which may be added if the Root Container
Template is extensible.

In EPIQ/Affiniti, the calculation packages contain a combination of template and user defined measurements and
calculations.

ROOT
Document Title
CONTAINER

0-1 0-1 0-N 0-1

CONTAINS CONTAINS CONTAINS CONTAINS
Patient Characteristics Procedure Summary Heading Image LIbrary
CONTAINER CONTAINER CONTAINER CONTAINER

1-N 1-N 0-N 0-N 1-N

CONTAINS CONTAINS
CONTAINS CONTAINS CONTAINS
Observations Observations
Observations Measurement Group Image Entry
NUM, CODE, NUM, CODE,
NUM, CODE, TEXT CONTAINER, CODE IMAGE
TEXT, DATE TEXT, DATE

0-n 1-N
CONTAINS
Fetus Summary CONTAINS, HAS PROP
CONTAINER Observations
NUM, CODE, TEXT

A.1.1.1 Measurements Linked to Images

Spatial Coordinates (as defined by TID 320 row 3) are included for measurement sub-results whose measurement
tools have been captured in an image (as defined by TID 300 row 13).
There are three special cases in which the Value Multiplicity for DTID 320 shall be greater than one:

a. If more than one image is captured of the same measurement tool, the sub-result will reference each image.
b. For a complex measurement tool (the Simpson’s Method of Disk Volume measurement) which with one user
action creates 22 unique spatial coordinates, the first 20 spatial coordinates shall be the Chord values, the

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 21st spatial coordinate shall be the ventricular length measurement, and the 22nd spatial coordinate shall be
the ventricular area measurement.
c. For Doppler velocity measurements made with a two-point or trace tool, there shall be two spatial coordinates
per measurement. The first shall be the single point associated with the velocity measurement, and the
second shall consist of all the points of the measurement tool.
A.1.2 Clinical Scope

The supported measurements are located in Calcs packages accessed with the “Measure” hard key on EPIQ/Affiniti.
Measurements for a given SR section may come from several calcs sidebars/touch screens.

A.2 APPLICATIONS THAT EXPORT STRUCTURED REPORTS FROM EPIQ AND AFFINITI

The following table describes the DICOM Structured Report export capabilities by application for the EPIQ Affiniti
families of ultrasound systems.

• “G”, including “Elite” “Elite Advanced”, is optimized for General Imaging, Shared Service, and Radiology use

• “C”, including “CVx”, “CVxi”, is optimized for Cardiology use

• “W”, is optimized for Women’s Healthcare use 

Adult  Pediatric 
Pediatric  Small Parts
OB/Gyn Vascular  Abdominal  TCD  Echo Fetal Echo Echo
Echo TID 995400
TID 5000 TID 5100 TID 5100  TID 5100  TID  125196 TID 995300
TID 5220 (Private) 
5200 (Private)
EPIQ *G 
EPIQ Elite*          
Affiniti *G 
EPIQ *C 
CVx*          
Affiniti *C
EPIQ *W 
Affiniti *W
    

Affiniti 30         
*=Any model

A.3 DICOM STRUCTURED REPORT EXPORT SPECIFICATIONS

A.3.1 Philips Healthcare Ultrasound Data Portal Website

Rather than list the thousands of DICOM export encodings in this document, the Philips Healthcare Ultrasound Data
Portal website (see link below) provides detailed DICOM export specifications for all Philips ultrasound products in a
convenient downloadable spreadsheet format. These spreadsheets allow users to quickly filter for specific areas of
interests such as application, template, label, or DICOM attribute. In addition to DICOM Structured Report
specifications, the link also provides many DICOM Structured Report example files and images for import and display
testing.

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To access the Philips Healthcare Ultrasound Data Portal,
 Using a browser, to navigate to the link below.
 Select the ultrasound product of interest.
 Provide an email address and press the submit button.
 Download “Philips_EPIQAffiniti_v6.0_DICOM_SR_Specification.xlsx”

Philip Ultrasound Data Portal Website Link: http://www.UltrasoundDataPortal.net.philips.com/portal/index.asp?pid=us

A.4 PRIVATE TEMPLATE EXTENSIONS

The PDE and Study Info data that is not already part of the DICOM templates is included using the following template
extensions, per the appropriate application.

A.4.1 TID5001: OB-GYN Patient Characteristics

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
9 > CONTAINS TEXT or DCID (99002) 1 U
DATE or General Study
NUM Info
10 > CONTAINS TEXT or DCID (99003) 1 U
DATE or OB Study Info
NUM
11 > CONTAINS TEXT or DCID (99004) 1 U
DATE or Gyn Study
NUM Info

Line 4.1 is used only with a user-defined table or equation.

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A.4.2 TID5008: Fetal Biometry Group

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
3 > CONTAINS NUM EV (18185-9 1 MC At least one of Units = EV (d,
, LN, row 2 and 3 UCUM, days)
“Gestational shall be
Age”) present
4 >> INFERRED CODE DCID (228) 1 U IF row 4.1 is DCID (12013)
FROM Equation or absent Gestational Age
Table Equations and
Tables
4.1 >> INFERRED TEXT DCID (228) 1 U IF row 4 is
FROM Equation or absent
Table
5 >> R- NUM 1-n U
INFERRED
FROM

A.4.3 TID5101: Vascular Patient Characteristics

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
7 > CONTAINS TEXT or DCID (99002) 1 U
DATE or General Study
NUM Info
8 > CONTAINS TEXT or DCID (99005) 1 U
DATE or Vascular
NUM Study Info
9 > CONTAINS TEXT or DCID (99006) 1 U
DATE or Abdominal
NUM Study Info

A.4.4 TID5202: Echocardiography Patient Characteristics

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
9 > CONTAINS TEXT or DCID (99002) 1 U
DATE or General Study
NUM Info
10 > CONTAINS TEXT or DCID (99007) 1 U
DATE or Adult Echo
NUM Study Info

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A.5 USER-DEFINED MEASUREMENTS AND CALCULATIONS

A.5.1 Description

EPIQ/Affiniti provides 2 different DICOM export formats for creating user defined measurements and calculations. The
DICOM Encoding format provides a way to create and export user-defined measurements and calculations or user-
defined OB authors to PACS using the existing DICOM SR templates. The Philips Generic export format allows users
to create measurements and calculations without specifying complete DICOM encoding attributes and will be exported
in a generic DICOM encoding format.

A.5.1.1 Philips Generic DICOM Export Format

For quickly creating exportable measurements and calculations without specific DICOM encodings, a generic structure
was created that does not assign specific codes to the individual measurements, rather uses the label given by the
user. This will allow all user-defined measurements to be treated in a uniform manner, without needing a per-site
dictionary of user-defined codes.

A.5.1.2 DICOM Template Compatible Export Format

EPIQ/Affiniti can also export user defined measurements, calculations and OB tables which are compatible with
existing DICOM standard templates. These DICOM objects are created with user configurable attributes for the
DICOM code scheme designator, code value and code meaning. For more information on the DICOM attributes
supported, see the Analysis section in the EPIQ and Affiniti Setups menu.

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 108
A.5.1.3 Private Template and Template Extensions

A.5.1.3.1 TID5000: OB-GYN Ultrasound Procedure Report

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
25 > CONTAINS INCLUDE TID (9902) 1 U
Fetal Heart
Section
26 > CONTAINS INCLUDE TID (9900) 1 U
User-defined
concepts

A.5.1.3.2 TID5100: Vascular Ultrasound Report

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
31 > CONTAINS INCLUDE TID (9900) 1 U
User-defined
concepts

A.5.1.3.3 TID5200: Echocardiography Procedure Report

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
22 > CONTAINS INCLUDE TID (9900) 1 U
User-defined
concepts

A.5.1.3.4 TID995300: Pediatric Echocardiography Procedure Report

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
… … … … … … … … …
22 > CONTAINS INCLUDE TID (9900) 1 U
User-defined
concepts

A.5.1.3.5 TID9900: User-defined concepts

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
1 CONTAINER DT (T9900- 1 M
01,
99PMSBLUS,
“User-defined
concepts”)
2 > CONTAINS INCLUDE TID (9901) 1-n MC One of row 2 $Type = DT
User-defined and 3 must be (T9900-02,
concept present 99PMSBLUS,
“Measurement”)
3 > CONTAINS INCLUDE TID (9901) 1-n MC One of row 2 $Type = DT
User-defined and 3 must be (T9900-03,
concept present 99PMSBLUS,
“Calculation”)

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 109
A.5.1.3.6 TID9901: User-defined concept

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
1 CONTAINER $Type 1 M
2 > HAS OBS INCLUDE DTID (1008) 1 MC IF this template
CONTEXT Subject is invoked more
Context, than once to
Fetus describe more
than one fetus
3 > HAS TEXT DT (T9900- 1 M
CONCEPT 04,
MOD 99PMSBLUS,
“Label”)
4 > HAS CODE DT (G-C171, 1 U DCID (244)
CONCEPT SRT, Laterality
MOD “Laterality”)
5 > CONTAINS INCLUDE TID (300) 1 1-n IFF $Type = $Measurement =
“Measurement” DCID (99008)
Results

$Derivation =
DCID (3627)
Measurement Type
6 > CONTAINS INCLUDE TID (300) 1 1 IFF $Type = $Measurement =
“Calculation” DT (T9900-05,
99PMSBLUS,
“Value”)
7 > CONTAINS NUM EV (18185-9 1 U $Units = EV (d,
, 1.4, UCUM, days)
LN,
“Gestational
Age”)
8 > INFERRED TEXT DCID (228) 1 U
FROM Equation or
Table

A.5.1.3.7 TID9902: Fetal Heart Section

NL Rel with VT Concept VM Req Condition Value Set

Parent Name Type Constraint
1 CONTAINER DT (99999, 1 M … …
99PMSBLUS,
“Fetal Heart”)
2 > HAS OBS INCLUDE DTID (1008) 1 MC IF this
CONTEXT Subject template is
Context. invoked more
Fetus than once to
describe more
than one fetus
3 > CONTAINS INCLUDE DTID (5008) 1-n M $Biometery
Fetal Type=MemberOf
Biometry (DCID (99001)
Group Fetal Heart)

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 110
A.5.1.3.8 TID 5009: Fetal Biophysical Profile Section

NL Rel with VT Concept Name VM Req Condition Value Set

Parent Type Constraint
1 CONTAINER DT 1 M
125006,DCM,”Biophysical
Profile”)
2 > HAS OBS INCLUDE DTID (1008) Subject 1 MC IF this template is
CONTEXT Context. Fetus invoked more than
once to describe
more than one
fetus
3 > CONTAINS NUM EV (11631-9,LN, “Gross 1 MC At least one of row Units = DT (“{0:2}”,
Body Movement”) 3-7 shall be present UCUM, “range 0:2”)
4 > CONTAINS NUM EV (11632-7,LN, “Fetal 1 MC At least one of row Units = DT (“{0:2}”,
Breathing”) 3-7 shall be present UCUM, “range 0:2”)
5 > CONTAINS NUM EV (11635-0,LN, “Fetal 1 MC At least one of row Units = DT (“{0:2}”,
Tone”) 3-7 shall be present UCUM, “range 0:2”)
6 > CONTAINS NUM EV (11635-5,LN, “Fetal 1 MC At least one of row Units = DT (“{0:2}”,
Heart Reactivity”) 3-7 shall be present UCUM, “range 0:2”)
7 > CONTAINS NUM EV (11630-1,LN, 1 MC At least one of row Units = DT (“{0:2}”,
“Amniotic Fluid Volume”) 3-7 shall be present UCUM, “range 0:2”)
8 > CONTAINS NUM DT (11634-3,LN, 1 U
”Bipohysical Profile Sum
Score”)

A.5.1.3.9 TID 5016: Pelvis and Uterus Section

NL Rel with VT Concept Name VM Req Condition Value Set

Parent Type Constraint
1 CONTAINER DT 125011,DCM,”Pelvis 1 M
and Uterus”)
2 > CONTAINS INCLUDE DTID (5016) LWH 1 U $GroupName = EV (T-
Volume Group 83000, SRT, ”Uterus”)
$Width = EV (11865-
3,LN,” Uterus Width”)
$Length = EV (11842-2,
LN,” Uterus Length”)
$Height = EV (11859-6,
LN,” Uterus Height”)
$Volume = EV (33192-6,
LN, ”Uterus Volume”)
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n U $Measurement = DCID
(12011) Ultrasound
Pelvis and Uterus
$Derivation = DCID
(3627) Measurement
Type

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 111
 B APPENDIX B – BULK PRIVATE TAGS

B.1 BULK PRIVATE ATTRIBUTES

The private attributes listed below are intended to provide awareness of large groups of private data from EPIQ/Affiniti
datasets

Attribute Name DICOM Tag VR Description

Private Data (200D,300E) OB Bulk data

Private Data (200D,300B) OB Bulk data

Private Data (200D,3CF3) OB Bulk data

***** End of Document *****

EPIQ Elite Elite Advanced E7 E5 CVx/i A70 A50 A30 Rel 6.0.x DICOM Conformance Statement 000737000000163 Rev A Page 112