Varian System Server. DICOM Conformance Statement

Transcription

1 Varian System Server DICOM Conformance Statement P/N VA8005D3CS July 2007

2 General Information Abstract This document provides information about the DICOM Conformance of the Varian System Server product family, i.e. ARIA 8.0/8.1, Eclipse 8.0/8.1 and Acuity 8.0/8.1. Manufacturer and European Representative Manufacturer: Varian Medical Systems, Inc. Ltd Hansen Way, Bldg. 4A Palo Alto, CA , U.S.A. European Representative: Varian Medical Systems UK Ltd. Gatwick Road, Crawley West Sussex RH10 9RG United Kingdom Notice FDA 21 CFR 820 Quality System Regulations (CGMPs) ISO CE HIPAA Information in this document is subject to change without notice and does not represent a commitment on the part of Varian. Varian is not liable for errors contained in this document or for incidental or consequential damages in connection with the furnishing or use of this material. This document contains proprietary information protected by copyright. No part of this document may be reproduced, translated, or transmitted without the express written permission of Varian Medical Systems, Inc. Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the requirements specified within this federal regulation. Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the requirements specified ISO quality systems standards. Varian Medical Systems, Oncology Systems products meet the requirements of Council Directive MDD 93/42/EEC. Varian s products and services are specifically designed to include features that help our customers comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The software application uses a secure login process, requiring a user name and password, that supports role-based access. Users are assigned to groups, each with certain access rights, which may include the ability to edit and add data or may limit access to data. When a user adds or modifies data within the database, a record is maintained of the data that was changed, the users ID and the date and time the changes were made. This establishes an audit trail that can be examined by authorized system administrators. ii Varian System Server DICOM Conformance Statement, VA8005D3CS

3 General Information Trademarks ARIA, Eclipse, Varian and VMS are registered trademarks Acuity, ARIA, BrachyVision, Eclipse and On-Board Imager are trademarks of Varian Medical Systems, Inc. Microsoft, Windows NT and Windows are registered trademarks of Microsoft Corporation. All other trademarks or registered trademark are the property of their respective owners. Contacting Support If you have access to the Varian Intranet, you can download additional Varian internal documents from the PSE Web. To order additional hardcopies of documents, call your local office administrator If you cannot find the required information in this document nor on the PSE Web, please contact the appropriate service listed below. Web PSE Website North America National Technical Support (NTS), telephone support NTS Hardware Support PSE Europe European telephone support Eclipse & CadPlan support ARIA, VARiS Vision & technical support Brachy Help PSE ilab in Switzerland PSE Crawley Updates For updates to this document, please contact PSE ilab in Switzerland. Copyright 2007 Varian Medical Systems Inc., Oncology Systems All rights reserved. Edited in Switzerland. Varian System Server DICOM Conformance Statement, VA8005D3CS iii

4 General Information Document History July 07, 2007 Updated product names DAG March 28, March 16, 2007 February 19, January 17, 2007 October 19, 2006 October 19, 2006 September 7, 2006 September 1, August 4, 2006 Changes requested by document review. Ordered first three chapters according to DICOM Part 2. Adjustments prior to PDF creation Fixed heading styles. Document reformatted based on latest template PSE Service Manual C.dot. The strings of the elements in the footer are very long this time. As a result, nonbreaking spaces (shortcut: Ctrl+Shift+Spacebar) together with tabs had to be used in some cases to position the elements in the footer. Changes requested by document review Added B.1.2 Manual Import of DICOM Media Files Merged in relevant changes received from MBU. Minor enhancements on: SOP Specific Conformance for RT Structure Set Storage SOP Specific Conformance for RT Image Storage SOP Specific Conformance for RT Dose Storage Introduced chapter 2 to ensure standard numbering for easier readability Re-sequenced section 3.2 Remarks (start text should not sound kind of pessimistic). Initial Version DAU DAG DAU GABO DAU DAU DAU UBU UBU DAU iv Varian System Server DICOM Conformance Statement, VA8005D3CS

5 Contents Contents Contents... v List of Figures... viii List of Tables... viii 1. Conformance Statement Overview Table of Contents Introduction Revision History Audience Remarks Definitions, Terms and Abbreviations References Networking Implementation Model Application Data Flow Functional Definition of AE s Sequencing of Real World Activities AE Specifications RadOnc Client Application Entity File Daemon Application Entity DB Daemon Application Entity Network Interfaces Physical Network Interfaces Additional Protocols Configuration AE Title/Presentation Address Mapping Parameters Media Interchange Support of Character Sets Overview Display Behavior Security Security Profiles Association Level Security RadOnc Client File Daemon and DB Daemon Application Level Security RadOnc Client File Daemon and DB Daemon...63 Appendix A Specialization... 1 A.1 IOD Contents...1 A.1.1 Created SOP Instances...1 A.1.2 Usage of Attributes from received IOD s...1 A.1.3 Attribute Mapping...1 A.1.4 Coerced/Modified Fields...1 A.2 Data Dictionary of Private Attributes...1 A.2.1 Private Attributes used by all Application Entities...2 Varian System Server DICOM Conformance Statement, VA8005D3CS v

6 Contents A.2.2 Private Attributes used by DB Daemon Application Entity in Archive Service Mode...4 A.3 Coded Terminology and Templates...4 A.3.1 Context Groups...4 A.3.2 Template Specifications...4 A.3.3 Private Code Definitions...5 A.4 Grayscale Image Consistency...5 A.5 Standard Extended/Specialized/Private SOP Classes...5 A.5.1 Private LTArchive RT Treatment Record Storage SOP Class...5 A.6 Private Transfer Syntaxes...5 Appendix B Object Matching Criteria... 7 B.1 General Matching Criteria...7 B.1.1 Manual Import using RadOnc Client Query/Retrieve SCU...7 B.1.2 Manual Import of DICOM Media Files...8 B.1.3 Automatic Import using DB Daemon Storage SCP...8 B.2 IOD Specific Matching Criteria...8 B.2.1 RT Plan and RT Ion Plan...8 Appendix C IOD Details C.1 Supported IODs...11 C.1.1 Computed Radiography Image A C.1.2 Computed Tomography Image A C.1.3 Magnetic Resonance Image A C.1.4 Ultrasound Image A C.1.5 Secondary Capture Image A C.1.6 X-Ray Angiographic Image A C.1.7 Spatial Registration A C.1.8 Positron Emission Tomography Image A C.1.9 RT Image A C.1.10 RT Dose A C.1.11 RT Structure Set A C.1.12 RT Beams Treatment Record A C.1.13 RT Plan A C.1.14 RT Treatment Summary Record A C.1.15 RT Ion Plan A C.1.16 RT Ion Beams Treatment Record A C.2 Modules and Attributes...23 C.2.1 Patient C C.2.2 General Study C C.2.3 General Series C C.2.4 Frame of Reference C C.2.5 General Equipment C C.2.6 General Image C C.2.7 Image Plane C C.2.8 Image Pixel C C.2.9 Multi-Frame C C.2.10 CR Series C C.2.11 CR Image C C.2.12 CT Image C C.2.13 MR Image C C.2.14 SC Equipment C C.2.15 SC Image C C.2.16 X-Ray Image C C.2.17 RT Series C C.2.18 RT Image C C.2.19 RT Dose C C.2.20 RT DVH C C.2.21 Structure Set C vi Varian System Server DICOM Conformance Statement, VA8005D3CS

7 Contents C.2.22 ROI Contour C C.2.23 RT ROI Observations C C.2.24 RT General Plan C C.2.25 RT Prescription C C.2.26 RT Tolerance Tables C C.2.27 RT Patient Setup C C.2.28 RT Fraction Scheme C C.2.29 RT Beams C C.2.30 RT Brachy Application Setups C C.2.31 Approval C C.2.32 RT General Treatment Record C C.2.33 RT Treatment Machine Record C C.2.34 RT Beams Session Record C C.2.35 RT Treatment Summary Record C C.2.36 RT Ion Tolerance Tables C C.2.37 RT Ion Beams C C.2.38 PET Series C C.2.39 PET Image C C.2.40 Curve C C.2.41 Modality LUT C C.2.42 VOI LUT C C.2.43 SOP Common C C.2.44 Common Instance Reference C C.2.45 Spatial Registration Series C C.2.46 Spatial Registration C Appendix D Extended Interface D.1 RT Plan / RT Ion Plan D.2 RT Beams Treatment Record Varian System Server DICOM Conformance Statement, VA8005D3CS vii

8 List of Figures List of Figures Figure 4-1: SCU Role Application Data Flow Diagram...9 Figure 4-2: SCP Role Application Data Flow Diagram...10 Figure 4-3: Sequencing of Activities RadOnc Client Query/Retrieve...18 Figure 4-4: Sequencing of Activities RadOnc Client Print Images...28 Figure 4-5: Sequencing of Activities DB Daemon Handling Query Requests...47 Figure 4-6: Sequencing of Activities DB Daemon Handling Retrieval Requests...48 List of Tables Table 1-1: Network Services...2 Table 1-2: Media File SOP Classes...2 Table 4-1: SOP Classes for RadOnc Client Application Entity...13 Table 4-2: DICOM Application Context for RadOnc Client Application Entity...14 Table 4-3: Number of Associations initiated for RadOnc Client Application Entity...14 Table 4-4: DICOM Implementation Class and Version for RadOnc Client Application Entity...14 Table 4-5: Object Categories used by RadOnc Client Storage SCU Application Entity...15 Table 4-6: Proposed Presentation Contexts for RadOnc Client Storage SCU Application Entity...16 Table 4-7: RadOnc Client C-STORE Response Status Handling Behavior...16 Table 4-8: RadOnc Client Storage SCU Communication Failure Behavior...17 Table 4-9: Proposed Presentation Contexts for RadOnc Client Q/R SCU Application Entity...19 Table 4-10: RadOnc Client C-FIND Response Status Handling Behavior...20 Table 4-11: RadOnc Client Q/R C-FIND SCU Communication Failure Behavior...21 Table 4-12: Study Root Request Identifier for RadOnc Client Q/R C-FIND SCUU...22 Table 4-13: RadOnc Client C-MOVE Response Status Handling Behavior...23 Table 4-14: RadOnc Client Q/R C-MOVE SCU Communication Failure Behavior...24 Table 4-15: Study Root Request Identifier for RadOnc Client Q/R C-MOVE SCU...24 Table 4-16: Acceptable Presentation Contexts for RadOnc Client Temporary Storage SCP Application Entity and Receive Storage Request...25 Table 4-17: Response Status of RadOnc Client Temporary Storage SCP and Receive Storage Request...26 Table 4-18: Proposed Presentation Contexts for RadOnc Client Print SCU Application Entity...29 Table 4-19: Printer SOP Class N-EVENT-REPORT Behavior...30 Table 4-20: Basic Film Session SOP Class N-CREATE Request Attributes...30 Table 4-21: Basic Film Session SOP Class N-CREATE Response Status Handling Behavior...31 Table 4-22: Basic Film Session SOP Class N-DELETE Response Status Handling Behavior...31 Table 4-23: Basic Film Session SOP Class N-ACTION Response Status Handling Behavior...31 Table 4-24: Basic Film Box Session SOP Class N-CREATE Request Attributes...32 viii Varian System Server DICOM Conformance Statement, VA8005D3CS

9 List of Tables Table 4-25: Basic Film Box SOP Class N-CREATE Response Status Handling Behavior...33 Table 4-26: Basic Film Box SOP Class N-DELETE Response Status Handling Behavior...33 Table 4-27: Basic Film Box SOP Class N-ACTION Response Status Handling Behavior...33 Table 4-28: Basic Grayscale Image Box SOP Class N-SET Request Attributes...34 Table 4-29: Basic Grayscale Image Box SOP Class N-SET Response Status Handling Behavior...35 Table 4-30: SOP Classes for File Daemon Application Entity...36 Table 4-31: DICOM Application Context for File Daemon Application Entity...36 Table 4-32: Number of Associations accepted for File Daemon Application Entity...36 Table 4-33: DICOM Implementation Class and Version for File Daemon Application Entity...37 Table 4-34: DICOM Implementation Class and Version for Media Files...37 Table 4-35: Acceptable Presentation Contexts for File Daemon Application Entity and Receive Storage Request...37 Table 4-36: Response Status of File Daemon Storage SCP and Receive Storage Request...38 Table 4-37: SOP Classes for DB Daemon Application Entity...39 Table 4-38: DICOM Application Context for DB Daemon Application Entity...40 Table 4-39: Number of Associations accepted for DB Daemon Application Entity...40 Table 4-40: DICOM Implementation Class and Version for DB Daemon Application Entity...40 Table 4-41: Acceptable Presentation Contexts for DB Daemon Application Entity and Receive Storage Request...41 Table 4-42: Response Status of DB Daemon Storage SCP and Receive Storage Request...42 Table 4-43: Portal Dose Image Type Values and their Meaning...43 Table 4-44: Acceptable Presentation Contexts for DB Daemon Application Entity and Query/Retrieve...49 Table 4-45: Study Root C-FIND SCP Supported Elements for DB Daemon...52 Table 4-46: Response Status of DB Daemon Storage SCP and Receive Query Request...53 Table 4-47: Response Status of DB Daemon Storage SCP and Receive Retrieval Request...54 Table 4-48: AE Title Configuration Table...56 Table 4-49: Configuration Parameters Table...58 Table A-1: Coerced/Modified Fields...1 Table A-2: Private Creator Identification Strings...2 Table A-3: Private Attributes used in all Application Entities...4 Table A-4: Private Attributes used by DB Daemon Application Entity in Archive Service Mode...4 Table A-5: LTArchive RT Treatment Record Storage SOP Class...5 Table B-6: Patient Matching Criteria for Storage SCP of RadOnc Client Q/R SCU...8 Table B-7: Patient Matching Criteria for DB Daemon Storage SCP...8 Table B-8: RT Plan and RT Ion Plan Component Matching...10 Table C-9: Computed Radiography Image IOD Modules Support...11 Table C-10: Computed Tomography Image IOD Modules Support...12 Table C-11: Magnetic Resonance Image IOD Modules Support...13 Table C-12: Ultrasound Image IOD Modules Support...13 Varian System Server DICOM Conformance Statement, VA8005D3CS ix

10 List of Tables Table C-13: Secondary Capture Image IOD Modules Support...14 Table C-14: X-Ray Angiographic Image IOD Modules Support...15 Table C-15: Spatial Registration Image IOD Modules Support...16 Table C-16: Positron Emission Tomography Image IOD Modules Support...16 Table C-17: RT Image IOD Modules Support...17 Table C-18: RT Dose IOD Modules Support...18 Table C-19: RT Structure Set IOD Modules Support...18 Table C-20: RT Beams Treatment Record IOD Modules Support...19 Table C-21: RT Plan IOD Modules Support...20 Table C-22: RT Treatment Summary Record IOD Modules Support...20 Table C-23: RT Ion Plan IOD Modules Support...21 Table C-24: RT Ion Beams Treatment Record IOD Modules Support...22 Table D-25: RT Plan / RT Ion Plan Extended Interface XML Structure Table D-26: RT Beams Treatment Record Extended Interface XML Structure x Varian System Server DICOM Conformance Statement, VA8005D3CS

11 Conformance Statement Overview 1. Conformance Statement Overview The Varian System Server product family is a comprehensive suite of integrated applications which cover all aspects of radiotherapy. This includes especially treatment planning, virtual simulation, simulation, electronic chart and treatment review. To support those functions the following DICOM services for receiving and sending diagnostic imaging modalities as well as all radiotherapy objects are supported by all applications of this product family. Table 1-1 lists network services supported by the Varian System Server product family. SOP Classes User of Service (SCU) Provider of Service (SCP) Transfer Computed Radiography Image Storage Option (see Note 1) Option (see Note 4) CT Image Storage Option (see Note 1) Option (see Note 4) MR Image Storage Option (see Note 1) Option (see Note 4) Ultrasound Image Storage No Option (see Note 4) Secondary Capture Image Storage Option (see Note 1) Option (see Note 4) X-Ray Angiographic Image Storage No Option (see Note 4) Spatial Registration Storage No Option (see Note 4) Positron Emission Tomography Image Storage No Option (see Note 4) RT Image Storage Option (see Note 1) Option (see Note 4) RT Dose Storage Option (see Note 1) Option (see Note 4) RT Structure Set Storage Option (see Note 1) Option (see Note 4) RT Beams Treatment Record Storage LTArchive RT Treatment Record Storage Option (see Note 1) Option (see Note 4) Option (see Note 6) Option (see Note 6) RT Plan Storage Option (see Note 1) Option (see Note 4) RT Treatment Summary Record Storage Option (see Note 5) RT ION Plan Storage Option (see Note 1) Option (see Note 4) RT Ion Beams Treatment Record Storage Query/Retrieve No Option (see Note 1) Option (see Note 4) Study Root Query/Retrieve Information Model FIND Study Root Query/Retrieve Information Model MOVE Option (see Note 2) Option (see Note 5) Option (see Note 2) Option (see Note 5) Varian System Server DICOM Conformance Statement, VA8005D3CS 1 of 64

12 Conformance Statement Overview SOP Classes User of Service (SCU) Provider of Service (SCP) Print Management Basic Grayscale Print Management Meta SOP Class Option (see Note 3) No Table 1-1: Network Services Table 1-2 lists Media File SOP Classes supported for file based export and import by. SOP Classes DICOM Media File Export DICOM Media File Import Computed Radiography Image Storage Option (see Note 7) Option (see Note 8) CT Image Storage Option (see Note 7) Option (see Note 8) MR Image Storage Option (see Note 7) Option (see Note 8) Ultrasound Image Storage No Option (see Note 8) Secondary Capture Image Storage Option (see Note 7) Option (see Note 8) X-Ray Angiographic Image Storage No Option (see Note 8) Spatial Registration Storage Option (see Note 7) Option (see Note 8) Positron Emission Tomography Image Storage No Option (see Note 8) RT Image Storage Option (see Note 7) Option (see Note 8) RT Dose Storage Option (see Note 7) Option (see Note 8) RT Structure Set Storage Option (see Note 7) Option (see Note 8) RT Beams Treatment Record Storage Option (see Note 7) Option (see Note 8) RT Plan Storage Option (see Note 7) Option (see Note 8) RT Treatment Summary Record Storage Option (see Note 7) Option (see Note 8) RT Ion Plan Storage Option (see Note 7) Option (see Note 8) RT Ion Beams Treatment Record Storage Table 1-2: Media File SOP Classes Option (see Note 7) Option (see Note 8) Note 1 Note 2 Note 3 Note 4 Note 5 Note 6 Requires Storage SCU Export Filter and associated licenses or DB Daemon configured as Query/Retrieve SCP. Requires Query/Retrieve Import Filter and associated licenses. Requires DICOM printer configuration set up. Requires DB Daemon or File Daemon that is configured as Storage SCP. Requires DB Daemon that is configured as Query/Retrieve SCP. Requires DB Daemon that is configured for Archive Service Mode (Varian proprietary) 2 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

13 Conformance Statement Overview Note 7 Note 8 Requires DICOM Media File Export Filter. Requires DICOM Media File Import Filter. The following products are in the scope of this Conformance Statement: RadOnc Client (including Eclipse) DB Daemon File Daemon The Varian System Server product family runs on Microsoft Windows 2000 and Windows XP platforms. Varian System Server DICOM Conformance Statement, VA8005D3CS 3 of 64

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15 Table of Contents 2. Table of Contents The table of contents, the list of figures and the list of tables are located at the top of the document. Varian System Server DICOM Conformance Statement, VA8005D3CS 5 of 64

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17 Introduction 3. Introduction 3.1 Revision History The document history is located at the top of the document. 3.2 Audience This document is intended for the following groups of persons: Customers and hospital staff who want to use DICOM with Varian System Server applications System integrators of medical equipment Other vendors offering interfacing via DICOM Marketing and sales persons It is assumed, that the reader is familiar with the DICOM standard. The document is structured firmly along the template definition as specified in Part 2 of the DICOM standard. 3.3 Remarks The scope of this Conformance Statement is to facilitate communication with Varian System Server applications and other vendor s medical equipment. The Conformance Statement should be read and understood in conjunction with the DICOM standard [1]. The DICOM standard in the current version evolved in 1993 with DICOM 3.0. The definition of DICOM standard for radiotherapy data started in 1994 and has now reached a productive state. Nowadays DICOM is the primary choice for exchanging data with an open standard protocol for the majority of vendors and institutions. Varian Medical Systems is committed to this notion of standard-based cross-vendor interoperability as well as making use of the DICOM protocol among its own products. 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. Because the DICOM standard is subject to ongoing changes, enhancements and improvements, Varian Medical Systems reserves the right to advance their products by making use of upcoming DICOM features without prior announcement. 3.4 Definitions, Terms and Abbreviations This section provides the definitions of terms, acronyms, and abbreviations which are used throughout the document. An arrow sign ( ) left of a word indicates that it can be looked up in this table. AE ALWAYS Application Entity ( DICOM term) Attribute Always Present with a value Varian System Server DICOM Conformance Statement, VA8005D3CS 7 of 64

18 Introduction ANAP Daemon DB DICOM DIMSE DNS EMPTY IE IOD Management System Multi-frame Image NEMA PDU RadOnc SCU SCP SOP TCP/IP UID VNAP VR Attribute Not Always Present Collective term for Windows services accepting DICOM Associations Database Digital Imaging and Communications in Medicine, a standard on image communications in medical applications DICOM Message Service element Domain Name System Attribute is sent without a value Information Entity Information Object Definition ( DICOM term) Collective term including Daemon and RadOnc Client Image that contains multiple two-dimensional pixel planes National Electrical Manufacturers Association Protocol Data Unit ( DICOM term) Radiation Oncology Client Applications, including Eclipse Service Class User ( DICOM term) Service Class Provider ( DICOM term) Service-Object-Pair, a definition of an information object (like an image) and of a service (like storage) that can be performed for the object ( DICOM term) Transmission Control Protocol / Internet Protocol, a widely used computer networking protocol Unique Identifier used to identify an object by a worldwide unique identifier ( DICOM term) Value Not Always Present (attribute sent zero length if no value is present) Value Representation, a data encoding method in DICOM 3.5 References [1] Digital Imaging and Communications in Medicine (DICOM), Parts 1-18 (2006), National Electrical Manufacturers Association (NEMA) Rosslyn, VA United States of America 8 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

19 Networking 4. Networking 4.1 Implementation Model Application Data Flow Export object Storage SCU (RadOnc Client) Remote Store SCP receives object Search and Retrieve object Query/Retrieve SCU (RadOnc Client) Remote Q/R SCP receives Query or Retrieve command Import object Temporary Storage SCP (RadOnc Client) Remote Storage SCU sends requested objects Print images Print SCU (RadOnc Client) Remote DICOM Print SCP receives and prints selected images DICOM Standard Interface Figure 4-1: SCU Role Application Data Flow Diagram Varian System Server DICOM Conformance Statement, VA8005D3CS 9 of 64

20 Networking Figure 4-2: SCP Role Application Data Flow Diagram RadOnc Client Storage SCU Application Entity The Storage SCU Application Entity is invoked by the user from within a RadOnc Client Application to export selected images and RT objects or to export all objects of a whole patient to any configured remote Application Entity. RadOnc Client Query/Retrieve SCU Application Entity The Query/Retrieve Application Entity is invoked by the user from within a RadOnc Client Application to import images or RT objects from any configured remote Application Entity, typically a PACS. 10 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

21 Networking RadOnc Client Temporary Storage SCP Application Entity A temporary Storage SCP Application Entity is created by the Query/Retrieve SCU Application Entity to receive objects requested from a remote Query/Retrieve SCP. It is tightly coupled with the Query/Retrieve Application Entity. RadOnc Client Print SCU Application Entity The Print SCU Application Entity is invoked by the user from within a RadOnc Client Application to send a single image or any number of selected images to a DICOM printer. Various options for layout and scaling of these images can be selected. File/DB Daemon Storage SCP Application Entity Two different Storage SCPs are part of the Varian System Server product family. File Daemon provides a simple Storage SCP that saves any incoming object of known type as DICOM Media File to a configurable directory on the file system (see Table 1-1). A DICOM Media File header is therefore prepended to the incoming DICOM stream. DB Daemon can optionally be configured to work as Storage SCP. As opposed to File Daemon it is connected to the Varian System database and inserts received objects directly to the DB. File Daemon s and DB Daemon s Storage SCPs are invoked by a remote Storage SCU. DB Daemon Query/Retrieve SCP Application Entity DB Daemon can optionally be configured to work as Query/Retrieve SCP. It provides access to all DICOM objects stored on the Varian System database. DB Daemon s Query/Retrieve SCP is invoked by a remote Query/Retrieve SCU searching for and retrieving objects. DB Daemon Storage SCU Application Entity DB Daemon s Storage SCU is invoked by DB Daemon s Query/Retrieve SCP to transfer requested objects to a remote Storage SCP Functional Definition of AE s Functional Definition of RadOnc Client Application Entity The RadOnc Client Application Entity can serve as Storage SCU, Query/Retrieve SCU and Print SCU. Any of those SCUs mentioned above are invoked by user interaction. Storage SCU and Query/Retrieve SCU are available as DICOM Storage Service export filter and DICOM Query Retrieve Service import filter. Parameters for the desired remote AE have to be configured when setting up such a filter. Multiple different configurations of the same import or export filter can exist in parallel, allowing the user to quickly access any previously configured remote SCP. Storage SCU and Query/Retrieve SCU can handle objects of types listed in Table 1-1. The user can send images to any DICOM Printer SCP via the print menu entry. In the print dialog the user can select among various layout and display options. Connection Settings for any number of remote DICOM Print SCPs have to be configured in advance Functional Definition of File Daemon Application Entity The File Daemon Application Entity is running continuously as a service and is responsible for handling incoming association requests of other Application Entities. It accepts Storage requests of SOP Classes listed in Table 1-1. When receiving data, objects are stored as DICOM Varian System Server DICOM Conformance Statement, VA8005D3CS 11 of 64

22 Networking Media files in a configurable directory from which they can be imported into the DB via the RadOnc Client s import function later on. Multiple File Daemons can be running in parallel when configured as different Application Entities, listening on different TCP/IP ports Functional Definition of DB Daemon Application Entity The DB Daemon Application Entity is running continuously as a Windows service and is responsible for handling incoming association requests of other Application Entities. It accepts Storage and Query/Retrieve requests of SOP Classes listed in Table 1-1. Received objects are stored directly to the DB, queries for objects are answered based on objects stored in the DB, and requested objects are extracted from the DB and sent to the requestor. However, only copies of objects are exported, they will not be removed from the database. Storage SCP and Query/Retrieve SCP services can be configured and activated/deactivated separately and are designed to be supported in parallel by the same Application Entity which technically is identical to the same instance of the DB Daemon service. Multiple DB Daemons can be running in parallel when configured as different Application Entities, listening on different TCP/IP ports Sequencing of Real World Activities Not applicable because importing and exporting objects can happen in any sequence and independent of each other. 12 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

23 Networking 4.2 AE Specifications RadOnc Client Application Entity SOP Classes The RadOnc Client Application Entity provides Standard Conformance to the following SOP Classes. SOP Class Name SOP Class UID SCU SCP (Note 1) Computed Radiography Image Storage Yes Yes CT Image Storage Yes Yes MR Image Storage Yes Yes Secondary Capture Image Storage Yes Yes Spatial Registration Storage No Yes RT Image Storage Yes Yes RT Dose Storage Yes Yes RT Structure Set Storage Yes Yes RT Beams Treatment Record Storage No Yes RT Plan Storage Yes Yes RT Ion Plan Storage Yes Yes RT Ion Beams Treatment Record Storage Study Root Query/Retrieve Information Model FIND Study Root Query/Retrieve Information Model MOVE Basic Grayscale Print Management Meta SOP Class No Yes Yes No Yes No Yes No Table 4-1: SOP Classes for RadOnc Client Application Entity Note 1 Temporary Storage SCP used to receive Instances requested by Query/Retrieve SCU. Varian System Server DICOM Conformance Statement, VA8005D3CS 13 of 64

24 Networking Association Policies General The DICOM standard application context name for DICOM 3.0 is always proposed. Application Context Name Number of Associations Table 4-2: DICOM Application Context for RadOnc Client Application Entity RadOnc Client Application Entity initiates one Association at a time because this happens only through a user interface action. Only one Association can be handled at a time and no new Association will be initiated as long as another Association is still active. Maximum number of simultaneous Associations 1 Table 4-3: Number of Associations initiated for RadOnc Client Application Entity RadOnc Client Application Entity does not accept any Associations Asynchronous Nature RadOnc Client Application Entity does not support asynchronous communication Implementation Identifying Information The implementation information for this Application Entity is defined in the following table. Storage SCU Implementation Class UID Query/Retrieve SCU Implementation Class UID Print SCU Implementation Class UID Implementation Version Name Association Initiation Policy Activity Store (not used) Table 4-4: DICOM Implementation Class and Version for RadOnc Client Application Entity Description and Sequencing of Activities The user can select one or more objects to be exported. The Storage SCU will be invoked and attempts to initiate a new Association. If multiple objects shall be transferred then multiple C- STORE requests will be issued over the Association. Objects to be transferred are sorted among their category as defined in Table 4-5 and transferred in the following order (object categories as defined in Table 4-5): 1. Objects in category Plan 2. Objects in category Image 14 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

25 Networking 3. Objects in category Structure Set 4. Objects in category Dose 5. Objects in category Treatment Record Object Category SOP Class Name SOP Class UID Plan RT Plan Storage RT Ion Plan Storage Structure Set RT Structure Set Storage Dose RT Dose Storage Treatment Record RT Beams Treatment Record Storage RT Ion Beams Treatment Record Storage Image Remaining objects SOP Class * Proposed Presentation Contexts Table 4-5: Object Categories used by RadOnc Client Storage SCU Application Entity RadOnc Client Storage SCU is capable of proposing the Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Transfer Syntax Role Name UID Name UID Ext. Neg. Computed Radiography Image Storage DICOM Implicit VR Little Endian SCU None CT Image Storage DICOM Implicit VR Little Endian SCU None MR Image Storage DICOM Implicit VR Little Endian SCU None Secondary Capture Image Storage Spatial Registration Storage DICOM Implicit VR Little Endian SCU None DICOM Implicit VR Little Endian SCU None RT Image Storage RT Dose Storage RT Structure Set Storage RT Beams Treatment Record Storage RT Plan Storage DICOM Implicit VR Little Endian SCU None DICOM Implicit VR Little Endian SCU None DICOM Implicit VR Little Endian SCU None DICOM Implicit VR Little Endian SCU None DICOM Implicit VR Little Endian SCU None Varian System Server DICOM Conformance Statement, VA8005D3CS 15 of 64

26 Networking Presentation Context Table Abstract Syntax Transfer Syntax Role Name UID Name UID Ext. Neg. RT Ion Plan Storage DICOM Implicit VR Little Endian SCU None RT Ion Beams Treatment Record Storage DICOM Implicit VR Little Endian SCU None Table 4-6: Proposed Presentation Contexts for RadOnc Client Storage SCU Application Entity When requesting an Association, only the Presentation Contexts of a selection of Abstract Syntaxes will be proposed to the SCU, corresponding to the SOP Classes of objects to be transferred SOP Specific Conformance for all Storage SOP Classes The behavior of RadOnc Client Storage SCU when encountering status codes in a C-FIND response is summarized in Table 4-7 below. Service Status Further Meaning Error Code Behavior Refused Out of Resources A7xx Failure Warning Data Set does not match SOP Class Cannot understand Coercion of Data Elements Data Set does not match SOP Class Elements Discarded A9xx Cxxx B000 B007 B006 The user is informed that the C-STORE request has failed. Status (0000,0900) and Status Comment (0000,0902) are logged and displayed along with additional error information. The SCP has successfully stored the SOP Instance. The user is informed that the C- STORE request has been performed successfully with warnings. Status (0000,0900) and Status Comment (0000,0902) are logged and displayed along with additional information. Success Success 0000 The SCP has successfully stored the SOP Instance. If all SOP Instances that have been selected to be transferred together have been stored successfully the user gets a success message. * * Any other status code. Depending on the type of the Error Code it is either handled like a Failure or Warning. However, Error Codes other than listed above in this table should not occur, as they are not defined for C-STORE (see [1], PS 3.4, Table B.2-1). Table 4-7: RadOnc Client C-STORE Response Status Handling Behavior 16 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

27 Networking After sending all SOP Instances, either successfully or not, the Association is released using A- RELEASE and the results are presented to the user. All events required to extract the SOP Instances from the DB and send them to the SCP are logged. Timeout Exception Association aborted by the SCP or network layers Behavior The Association is released using A-RELEASE and the whole task of sending SOP Instances is aborted. The user is informed about the timeout and available information about it is logged. The whole task of sending SOP Instances is aborted. Table 4-8: RadOnc Client Storage SCU Communication Failure Behavior SOP Specific Conformance for RT Structure Set Storage See section SOP Specific Conformance for RT Dose Storage See section SOP Specific Conformance for RT Plan Storage See section Planned Verification Image Because the size of a verification image to be taken is not known in advance a width and height of zero pixels is assumed; as a consequence for RT Image Position (3002,0012), in Planned Verification Image Sequence (300A,00CA), the position of the image receptors center is used. This is because these coordinates are the same as those of the upper left hand corner of an image with zero number of pixels in x and y directions SOP Specific Conformance for RT Image Storage See section Activity Query/Retrieve Description and Sequencing of Activities The user invokes the DICOM Query/Retrieve Service import filter. At this time an Association is requested. When closing the dialog the Association is released again using A-RELEASE. Varian System Server DICOM Conformance Statement, VA8005D3CS 17 of 64

28 Networking Figure 4-3: Sequencing of Activities RadOnc Client Query/Retrieve A possible sequence of interactions between RadOnc Client Query/Retrieve SCU and a remote Query/Retrieve Server (e.g. retrieving SOP Instances of a patient) is illustrated in Figure 4-3: 1. The RadOnc Client Query/Retrieve SCU opens an Association with the Query/Retrieve Server. If it succeeds a temporary local Storage SCP is created. 2. A first C-FIND command with Query Level STUDY is issued containing, possibly empty, Patient Name and Patient ID. The result of this query is used to show a list of available patients matching the Patient Name and Patient ID query entered by the user. 3. The user selects a patient and again a C-FIND command with Query Level STUDY is issued containing the full Patient Name and Patient ID. This query is used to retrieve a list of all Studies of the selected patient. 18 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

29 Networking 4. The user selects a Study which triggers a C-FIND command with Query Level SERIES to get all Series that are contained in the selected Study. This step may be repeated for other Studies if user actions require retrieving information about another sub-tree of the object hierarchy. 5. The user selects a Series which triggers a C-FIND command with Query Level IMAGE to get all Series that are contained in the selected Series. This step may be repeated for other Series if user actions require retrieving information about another sub-tree of the object hierarchy. 6. The user selects one or more objects to be retrieved. When initiating retrieve operation a C- MOVE command for every SOP Instance to be retrieved is sent to the remote Query/Retrieve Server. 7. Upon receipt of a C-MOVE command the remote Query/Retrieve Server will open a new Association with the local Storage SCP. 8. For every C-MOVE command received from RadOnc Client Query/Retrieve SCU the remote Query/Retrieve Server will send via the remote Storage SCU a C-STORE command to the local Storage SCP. 9. When all objects have been transferred, whether successfully or not, and the user did not cancel the transfer then RadOnc Client Query/Retrieve SCU will release the Association using A-RELEASE and also shutdown it s temporary local Storage SCP. 10. The temporary local Storage SCP releases the Association using A-RELEASE if not already done by the remote Storage SCU Proposed Presentation Contexts RadOnc Client Query/Retrieve SCU is capable of proposing the Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Transfer Syntax Role Name UID Name UID Ext. Neg. Study Root Query/Retrieve information model FIND Study Root Query/Retrieve information model MOVE DICOM Implicit VR Little Endian DICOM Implicit VR Little Endian SCU None SCU None Table 4-9: Proposed Presentation Contexts for RadOnc Client Q/R SCU Application Entity Varian System Server DICOM Conformance Statement, VA8005D3CS 19 of 64

30 Networking SOP Specific Conformance for C-FIND SOP Classes The behavior of RadOnc Client Query/Retrieve SCU when encountering status codes in a C- FIND response is summarized in Table 4-10 below. Service Status Further Meaning Error Code Behavior Refused Out of Resources A7xx Failure Cancel Success Pending Data Set does not match SOP Class Cannot understand Matching terminated due to Cancel Request Matching is complete No final Identifier is supplied Matches are continuing Current Match is supplied and any Optional Keys were supported in the same manner as Required Keys. Matches are continuing Warning that one or more Optional Keys were not supported for existence and/or matching for this Identifier. A9xx Cxxx FE00 No results are displayed in the Query/Retrieve object browser. Cancel is handled like Failure, i.e. no results are displayed The SCP has completed the matches. Results are displayed in the Query/Retrieve object browser. FF00 FF01 * * Any other status code. The result transferred with this C-FIND Response is collected for display in the Query/Retrieve object browser once the C- FIND operation is completed. No results are displayed in the Query/Retrieve object browser. Table 4-10: RadOnc Client C-FIND Response Status Handling Behavior No C-CANCEL-FIND requests are ever issued. Relational-queries are not supported. Specific Character Set is not supported. It is not included in a query and will be ignored when present in the response. 20 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

31 Networking Exception Behavior Timeout The user is informed that the operation (C-FIND or C- MOVE) has timed out and can choose to retry the operation. Association aborted by the SCP or network layers When the Association is aborted during a C-MOVE operation the user is informed and failure details are displayed. The user can choose to retry the operation. Table 4-11: RadOnc Client Q/R C-FIND SCU Communication Failure Behavior Table 4-12 below lists the Attributes supported by the C-FIND SCU. Only a subset of the Attributes in this table will be sent in a specific C-FIND request, depending on Query Level and, if applicable, Modality. Name Tag VR Type Types of Matching Study Level Study Date (0008,0020) DA R U Study Time (0008,0030) TM R U Accession Number (0008,0050) SH R U Patient's Name (0010,0010) PN R U, S, W Patient ID (0010,0020) LO R U, S, W Study ID (0020,0010) SH R U Study Instance UID (0020,000D) UI U U, S Series Level Modality (0008,0060) CS R U Series Number (0020,0011) IS R U Series Instance UID (0020,000E) UI U U, S Composite Object Level (all modalities) Instance Number (0020,0013) IS R U SOP Instance UID (0008,0018) UI U U SOP Class UID (0008,0016) UI O U Composite Object Level (non-specific) Content Date (0008,0023) DA O U Content Time (0008,0033) TM O U Referenced SOP Class UID (0008,1150) UI O U Referenced SOP Instance UID (0008,1155) UI O U Varian System Server DICOM Conformance Statement, VA8005D3CS 21 of 64

32 Networking Name Tag VR Type Types of Matching Referenced Beam Number (300C,0006) IS O U Composite Object Level (RT (ION) Plan specific) Plan Label (300A,0002) SH O U Plan Date (300A,0006) DA O U Plan Time (300A,0007) TM O U Number of Beams (300A,0080) IS O U Composite Object Level (RT Dose specific) Referenced SOP Class UID (0008,1150) UI O U Referenced SOP Instance UID (0008,1155) UI O U Referenced Beam Number (300C,0006) IS O U Number of Frames (0028,0008) IS O U Composite Object Level (RT (ION) Beams Treatment Record specific) Referenced SOP Class UID (0008,1150) UI O U Referenced SOP Instance UID (0008,1155) UI O U Treatment Date (3008,0250) DA O U Treatment Time (3008,0251) TM O U Referenced Fraction Group Number (300C,0022) IS O U Table 4-12: Study Root Request Identifier for RadOnc Client Q/R C-FIND SCU The Types of Matching column in the above table should be read as follows: S L U W R Single Value Matching List of UID Matching Universal Matching Wild Card Matching Range Matching One or more matching types of the above list may be supported per Attribute. 22 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

33 Networking SOP Specific Conformance for C-MOVE SOP Classes The behavior of RadOnc Client Query/Retrieve SCU when encountering status codes in a C- MOVE response is summarized in the following table. Service Status Further Meaning Error Code Behavior Refused Failure Cancel Warning Success Pending Out of Resources Unable to calculate number of matches Out of Resources Unable to perform sub-operations Move Destination unknown Identifier does not match SOP Class Unable to Process Sub-operations terminated due to Cancel Indication Sub-operations complete One or more Failures Sub-operations complete No Failures Sub-operations are continuing A701 A702 A801 A900 Cxxx FE00 B000 None of the requested SOP Instances could be retrieved. The user will be informed about the failure and can choose to retry retrieval. Cancel is handled like Failure. Some or all SOP Instances have not been transmitted successfully. The user is informed and can choose to retry retrieval of the remaining SOP Instances All SOP Instances have successfully been transmitted. The user is informed that all objects have been retrieved successfully. FF00 * * Any other status code. Transferring requested SOP Instances is continuing. This message is ignored. Any other status code is handled like Failure. Table 4-13: RadOnc Client C-MOVE Response Status Handling Behavior After having received all requested SOP Instances or when the user aborts the operation the Association is released using A-RELEASE. All events occurring during querying and retrieving SOP Instances are logged. If any log entries are marked with internal category Warning or Error they will be shown to the user automatically. No C-CANCEL-MOVE requests are ever issued. Varian System Server DICOM Conformance Statement, VA8005D3CS 23 of 64

34 Networking Exception Behavior Timeout The user is informed that the operation (C-FIND or C- MOVE) has timed out and can choose to retry the operation. Association aborted by the SCP or network layers When the Association is aborted during a C-MOVE operation the user is informed and failure details are displayed. The user can choose to retry the operation. Table 4-14: RadOnc Client Q/R C-MOVE SCU Communication Failure Behavior Currently the same Attributes are used in a C-MOVE request as defined in Table 4-12 in section This is a known non-conformity and will be fixed with RadOnc Client Service Pack 1. The table below lists the Attributes that will be sent by the C-MOVE SCU if RadOnc Client Service Pack 1 or higher is applied. Only a subset of the Attributes in this table will be sent in a specific C-MOVE request, depending on Query Level. Name Tag VR Study Level Patient ID (0010,0020) LO Study Instance UID (0020,000D) UI Series Level Series Instance UID (0020,000E) UI Composite Object Level SOP Instance UID (0008,0018) UI Table 4-15: Study Root Request Identifier for RadOnc Client Q/R C-MOVE SCU Activity Receive Storage Request Description and Sequencing of Activities For a sequence diagram and complete sequencing of activities in the Query/Retrieve context see Figure 4-3. Received Instances are saved to temporary files and will be converted to the internal data model and imported into DB in a separate step Accepted Presentation Contexts RadOnc Client Temporary Storage SCP Application Entity accepts Presentation Contexts shown in the following table. 24 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

35 Networking Presentation Context Table Abstract Syntax Transfer Syntax Role Ext. Neg. Name UID Name UID All Storage SOP All Storage SOP Classes in Table 4-1 Classes in Table 4-1 DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian SCP None Table 4-16: Acceptable Presentation Contexts for RadOnc Client Temporary Storage SCP Application Entity and Receive Storage Request SOP Specific Conformance for all Storage SOP Classes RadOnc Client Temporary Storage SCP Application Entity conforms to storage service classes at level 0 (local) where not stated otherwise. Therefore it is guaranteed that at least all Type 1 Attributes are stored in the DB. Other Attributes are mainly supported but may be discarded in certain cases Presentation Context Acceptance Criterion RadOnc Client Temporary Storage SCP accepts all Presentation Contexts for all SOP Classes and Transfer Syntaxes supported by RadOnc Client Temporary Storage SCP. If more than one proposed Presentation Context is supported by the same Abstract Syntax all of them will be accepted Transfer Syntax Selection Policies If offered a choice of Transfer Syntaxes in a Presentation Context, RadOnc Client Temporary Storage SCP will select the first Transfer Syntax that is listed in the Presentation Context. RadOnc Client Temporary Storage SCP will accept duplicate Presentation Contexts, that is, if it is offered multiple Presentation Contexts, each of which offers acceptable Transfer Syntaxes, it will accept all Presentation Contexts, applying the same rule for selecting a Transfer Syntax for each as described above. Varian System Server DICOM Conformance Statement, VA8005D3CS 25 of 64

36 Networking Response Status RadOnc Client Temporary Storage SCP will behave as described in the Table below when generating the C-STORE response command message. Service Status Further Meaning Error Code Reason Refused Failure Warning Out of Resources A700 Failed to save incoming DICOM stream to temporary file. Out of Resources A7xx Never sent Invalid object instance Data Set does not match SOP Class Invalid C-STORE request Coercion of Data Elements Data Set does not match SOP Class 0117 Failed to read SOP Common Module. A9xx C000 B000 B007 Never sent Received invalid C-STORE request. Never sent Never sent Elements Discarded B006 Never sent Success 0000 Instance successfully stored in temporary file. Table 4-17: Response Status of RadOnc Client Temporary Storage SCP and Receive Storage Request Note 1 An Error Code of 0000 (Success) does not mean that the Instance has successfully been imported to the DB. It only means that it has been received and stored successfully to a temporary file SOP Specific Conformance for RT Image Storage Data Handling See section Import Preconditions If an RT Image references an RT Plan, this RT Plan must already be available on the DB or be retrieved during the same import session, otherwise connection between RT Image and RT Plan will not be preserved SOP Specific Conformance for certain Image Storage SOP Classes See section SOP Specific Conformance for RT Structure Set Storage Data Handling See section of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

37 Networking Import Preconditions To be able to import an RT Structure Set to the DB the images referenced in Contour Image Sequence (3006,0016) must already be available on the DB or be retrieved during the same import session SOP Specific Conformance for RT Dose Storage See section SOP Specific Conformance for RT Plan Storage See section SOP Specific Conformance for RT Beams Treatment Record Storage and RT Ion Beams Treatment Record Storage See section Activity Print Images Description and Sequencing of Activities The user selects any number of images to be sent to a hardcopy device. On the RadOnc print client the user may select between different image layouts, scaling and additional information to be printed together with the selected images. Structures and additional information like measurements, labels, etc. will always be burned in. Finally the RadOnc Client will compose one single image for every page to be printed and send this image to the hardcopy device. Varian System Server DICOM Conformance Statement, VA8005D3CS 27 of 64

38 Networking RadOnc Print SCU Printer 1. Open Association 2. N-CREATE (Film Session) 3. N-CREATE (Film Box) 4. N-Set (Image Box) 5a. A-ACTION (Film Box) 5b. N-ACTION (Film Session) 6. Print Sheets 7. N-EVENT-REPORT (Printer) 8a. N-DELETE (Film Box) 8b. N-DELETE (Film Session) 9. Release Association Figure 4-4: Sequencing of Activities RadOnc Client Print Images A possible sequence of interactions between RadOnc Client Print SCU and a remote Query/Retrieve Server (e.g. retrieving SOP Instances of a patient) is illustrated in Figure 4-4: 1. The RadOnc Client Print SCU opens a connection with the Printer. 2. N-CREATE on the Film Session SOP Class creates a Film Session. 3. N-CREATE on the Film Box SOP Class creates a Film Box linked to the Film Session. A single Image Box will be created as the result of this operation. 4. N-SET on the Image Box SOP Class transfers the contents of the film sheet to the printer. 5. If Collate option is not selected then 5a will be executed else 5b. a. N-ACTION on the Film Box SOP Class instructs the printer to print the Film Box. b. N-ACTION on the Film Session SOP Class instructs the printer to print the Film Box. 28 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

39 Networking 6. The printer prints the requested number of sheets. 7. The Printer asynchronously reports its status via N-EVENT-REPORT notification (Printer SOP Class). The printer can send this message at any time. RadOnc Client Print SCU does not require the N-EVENT-REPORT to be sent. RadOnc Client Print SCU is capable of receiving an N-EVENT-REPORT notification at any time during an Association. If the Printer reports a status of Warning or Failure, the user is informed. 8. If Collate option is not selected then 8a will be executed else 8b. a. N-DELETE on the Film Box SOP Class deletes the complete Film Box SOP Instance hierarchy. b. N-DELETE on the Film Session SOP Class deletes the complete Film Session SOP Instance hierarchy. 9. RadOnc Client Print SCU closes the Association to the Printer Proposed Presentation Contexts RadOnc Client Print SCU is capable of proposing the Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Transfer Syntax Role Ext. Neg. Name UID Name UID Basic Grayscale Print Management Meta SOP Class DICOM Implicit VR Little Endian SCU None Table 4-18: Proposed Presentation Contexts for RadOnc Client Print SCU Application Entity SOP Specific Conformance for Printer SOP Class RadOnc Client Print SCU supports the following DIMSE operations and notifications for the Printer SOP Class: N-EVENT-REPORT Details of the supported attributes and status handling behavior are defined in the following subsections Printer SOP Class Notifications (N-EVENT-REPORT) RadOnc Client Print SCU is capable of receiving an N-EVENT-REPORT request at any time during an Association. The behavior when receiving Event Types within an N-EVENT-REPORT is summarized in the following table. Varian System Server DICOM Conformance Statement, VA8005D3CS 29 of 64

40 Networking Event Type Name Event Type ID Attribute Name Tag Behavior Normal 1 Message is ignored. Warning 2 Failure 3 Printer Status (2110,0010) Printer Status Info (2110,0020) Printer Name (2110,0020) Printer Status (2110,0010) Printer Status Info (2110,0020) Printer Name (2110,0020) A warning message is displayed to the user containing a human-readable interpretation of Printer Status and Printer Status Info An error message is displayed to the user containing a human-readable interpretation of Printer Status and Printer Status Info Table 4-19: Printer SOP Class N-EVENT-REPORT Behavior The N-EVENT-REPORT response will always return a Service Status of SUCCESS with Error Code SOP Specific Conformance for Basic Film Session SOP Class RadOnc Client Print SCU supports the following DIMSE operations and notifications for the Basic Film Session SOP Class: N-CREATE N-DELETE N-ACTION Details of the supported attributes and status handling behavior are defined in the following subsections Basic Film Session SOP Class Operations (N-CREATE) The Attributes supplied in an N-CREATE request are listed in the following table. Attribute Name Tag VR Value Presence of Value Source Number of Copies (2000,0010) IS Unrestricted ALWAYS User Medium Type (2000,0030) CS BLUE FILM, CLEAR FILM or PAPER ALWAYS Table 4-20: Basic Film Session SOP Class N-CREATE Request Attributes User 30 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

41 Networking The behavior of RadOnc Client Print SCU when encountering status codes in an N-CREATE response is summarized in the following table. Service Status Further Meaning Error Code Behavior Success Success 0000 The SCP has completed the operation successfully. * * Any other status code. The reason for failure is displayed and the user can choose to retry. Table 4-21: Basic Film Session SOP Class N-CREATE Response Status Handling Behavior Basic Film Session SOP Class Operations (N-DELETE) The behavior of RadOnc Client Print SCU when encountering status codes in an N-DELETE response is summarized in the following table. Service Status Further Meaning Error Code Behavior Success Success 0000 The SCP has completed the operation successfully. * * Any other status code. Will be ignored. Table 4-22: Basic Film Session SOP Class N-DELETE Response Status Handling Behavior Basic Film Session SOP Class Operations (N-ACTION) An N-ACTION request with Action Type ID 1 is issued to instruct the Print SCP to print the contents of the Film Session. The Action Reply argument in an N-ACTION response is not evaluated. The behavior of RadOnc Client Print SCU when encountering status codes in an N-ACTION response is summarized in the following table. Service Status Further Meaning Error Code Behavior Success Success 0000 The SCP has completed the operation successfully. * * Any other status code. The reason for failure is displayed and the user can choose to retry. Table 4-23: Basic Film Session SOP Class N-ACTION Response Status Handling Behavior SOP Specific Conformance for Basic Film Box SOP Class RadOnc Client Print SCU supports the following DIMSE operations and notifications for the Varian System Server DICOM Conformance Statement, VA8005D3CS 31 of 64

42 Networking Basic Film Box SOP Class: N-CREATE N-DELETE N-ACTION Details of the supported attributes and status handling behavior are defined in the following subsections Basic Film Box SOP Class Operations (N-CREATE) The Attributes supplied in an N-CREATE request are listed in the following table. Attribute Name Tag VR Value Presence of Value Source Image Display Format Referenced Film Session Sequence >Referenced SOP Class UID >Referenced SOP Instance UID (2010,0010) ST STANDARD, ROW, COL, SLIDE, SUPERSLICE or CUSTOM (2010,0500) SQ Reference to parent Basic Film Session ALWAYS ALWAYS User Auto (0008,1150) UI ALWAYS Auto (0008,1155) UI ALWAYS Auto Film Orientation (2010,0040) CS PORTRAIT or LANDSCAPE Film Size ID (2010,0050) CS 8INX10IN, 8_5INX11IN, 10INX12IN, 10INX14IN, 11INX14IN, 11INX17IN, 14INX14IN, 14INX17IN, 24CMX24CM, 24CMX30CM, A4 or A3 ALWAYS ALWAYS User User Magnification Type (2010,0060) CS NONE ALWAYS User Min Density (2010,0120) US ANAP User Max Density (2010,0130) US ANAP User Configuration Information (2010,0150) ST ANAP User Smoothing Type (2010,0080) CS ANAP User Table 4-24: Basic Film Box Session SOP Class N-CREATE Request Attributes The behavior of RadOnc Client Print SCU when encountering status codes in an N-CREATE response is summarized in the following table. 32 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

43 Networking Service Status Further Meaning Error Code Behavior Success Success 0000 The SCP has completed the operation successfully. * * Any other status code. The reason for failure is displayed and the user can choose to retry. Table 4-25: Basic Film Box SOP Class N-CREATE Response Status Handling Behavior Basic Film Box SOP Class Operations (N-DELETE) The behavior of RadOnc Client Print SCU when encountering status codes in an N-DELETE response is summarized in the following table. Service Status Further Meaning Error Code Behavior Success Success 0000 The SCP has completed the operation successfully. * * Any other status code. Will be ignored. Table 4-26: Basic Film Box SOP Class N-DELETE Response Status Handling Behavior Basic Film Box SOP Class Operations (N-ACTION) An N-ACTION request with Action Type ID 1 is issued to instruct the Print SCP to print the contents of the Film Session. The Action Reply argument in an N-ACTION response is not evaluated. The behavior of RadOnc Client Print SCU when encountering status codes in an N-ACTION response is summarized in the following table. Service Status Further Meaning Error Code Behavior Success Success 0000 The SCP has completed the operation successfully. * * Any other status code. The reason for failure is displayed and the user can choose to retry. Table 4-27: Basic Film Box SOP Class N-ACTION Response Status Handling Behavior SOP Specific Conformance for Basic Grayscale Image Box SOP Class RadOnc Client Print SCU supports the following DIMSE operations and notifications for the Basic Image Box SOP Class: N-SET Varian System Server DICOM Conformance Statement, VA8005D3CS 33 of 64

44 Networking Details of the supported attributes and status handling behavior are defined in the following subsections Basic Grayscale Image Box SOP Class (N-SET) The Attributes supplied in an N-CREATE request are listed in the following table. Attribute Name Tag VR Value Presence of Value Source Image Position (2020,0010) US 1 ALWAYS Auto Basic Grayscale Image Sequence (2020,0110) SQ ALWAYS User >Samples Per Pixel (0028,0002) US 1 ALWAYS Auto >Photometric Interpretation (0028,0004) CS MONOCHROME2 ALWAYS Auto >Rows (0028,0010) US ALWAYS Auto >Columns (0028,0011) US ALWAYS Auto >Pixel Aspect Ratio (0028,0034) IS ANAP Auto >Bits Allocated (0028,0100) US 8 or 12 ALWAYS User >Bits Stored (0028,0101) US 8 or 16 ALWAYS Auto >High Bit (0028,0102) US 11 or 15 ALWAYS Auto >Pixel Representation >Pixel Data (7FE0,0010) OW or OB (0028,0103) US 0000H (unsigned integer) ALWAYS Auto ALWAYS Auto Smoothing Type (2010,0080) CS ANAP User Min Density (2010,0120) US ANAP User Max Density (2010,0130) US ANAP User Configuration Information (2010,0150) ST ANAP User Table 4-28: Basic Grayscale Image Box SOP Class N-SET Request Attributes The behavior of RadOnc Client Print SCU when encountering status codes in an N-SET response is summarized in the following table. Service Status Further Meaning Error Code Behavior 34 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

45 Networking Service Status Further Meaning Error Code Behavior Success Success 0000 The SCP has completed the operation successfully. * * Any other status code. The reason for failure is displayed and the user can choose to retry. Table 4-29: Basic Grayscale Image Box SOP Class N-SET Response Status Handling Behavior Association Acceptance Policy The RadOnc Client Application Entity does not accept Associations File Daemon Application Entity SOP Classes The File Daemon Application Entity provides Standard Conformance to the following SOP Classes. SOP Class Name SOP Class UID SCU SCP Computed Radiography Image Storage No Yes CT Image Storage No Yes Ultrasound Multi-frame Image No Yes Storage (Retired) Ultrasound Multi-frame Image Storage No Yes MR Image Storage No Yes Nuclear Medicine Image Storage (Retired) No Yes Ultrasound Image Storage No Yes (Retired) Ultrasound Image Storage No Yes Secondary Capture Image Storage No Yes Standalone Overlay Storage (Retired) No Yes Standalone Curve Storage (Retired) No Yes X-Ray Angiographic Image Storage No Yes Nuclear Medicine Image Storage No Yes Spatial Registration Storage No Yes Positron Emission Tomography Image Storage No Yes Varian System Server DICOM Conformance Statement, VA8005D3CS 35 of 64

46 Networking SOP Class Name SOP Class UID SCU SCP RT Image Storage No Yes RT Dose Storage No Yes RT Structure Set Storage No Yes RT Beams Treatment Record Storage No Yes RT Plan Storage No Yes RT Ion Plan Storage No Yes RT Ion Beams Treatment Record Storage Association Policies General No Yes Table 4-30: SOP Classes for File Daemon Application Entity The DICOM standard application context name for DICOM 3.0 is always proposed. Application Context Name Number of Associations Table 4-31: DICOM Application Context for File Daemon Application Entity The File Daemon Application Entity accepts all association requests that request one of the supported SOP Classes. It does not place any limitations on the number of concurrent associations or on who may connect to it, unless the Permit Trusted Application Entities only option is enabled. If enabled, only Association request of the defined Application Entities will be accepted. Maximum number of simultaneous Associations Unrestricted Table 4-32: Number of Associations accepted for File Daemon Application Entity File Daemon Application Entity does not initiate any Associations Asynchronous Nature File Daemon Application Entity does not support asynchronous communication Implementation Identifying Information The implementation information for this Application Entity is defined in the following table. 36 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

47 Networking Storage SCU Implementation Class UID Echo SCU Implementation Class UID Implementation Version Name (not used) Table 4-33: DICOM Implementation Class and Version for File Daemon Application Entity File Daemon Application Entity stores all received IODs as DICOM Media Files. The implementation information that is used for those files is defined in the following table. DICOM Media File Implementation UID Implementation Version Name Association Initiation Policy (not used) Table 4-34: DICOM Implementation Class and Version for Media Files The File Daemon Application Entity does not initiate Associations Association Acceptance Policy Unless the Permit Trusted Application Entities only option is enabled, the File Daemon Application Entity accepts all association requests that request one of the supported SOP Classes; otherwise it restricts access to the user-configured Application Entities Activity Receive Storage Request Description and Sequencing of Activities All Instances received will be stored as DICOM Media File on the local file system on a configurable location. For the Implementation UID of the created DICOM Media File the DICOM Media File Implementation UID as defined in Table 4-33 is used. DICOM Media Files are written using the same Transfer Syntax as has been used to transfer the incoming Instance Accepted Presentation Contexts File Daemon Application Entity accepts Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Transfer Syntax Role Name UID Name UID Ext. Neg. All Storage SOP All Storage SOP Classes Classes in Table 4-30 in Table 4-30 DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian SCP None Table 4-35: Acceptable Presentation Contexts for File Daemon Application Entity and Receive Storage Request SOP Specific Conformance for Storage SOP Classes File Daemon Application Entity conforms to storage service classes at level 2 (full). Therefore it Varian System Server DICOM Conformance Statement, VA8005D3CS 37 of 64

48 Networking is guaranteed that all Type 1, Type 2, and Type 3 Attributes defined in the Information Object Definition associated with the SOP Class, as well as any Standard Extended attributes (including Private Attributes) included in the SOP Instance, will be stored Presentation Context Acceptance Criterion File Daemon will always accept any Presentation Context for the supported SOP Classes with the supported Transfer Syntaxes. More than one proposed Presentation Context will be accepted for the same Abstract Syntax if the Transfer Syntax is supported, whether or not it is the same as another Presentation Context Transfer Syntax Selection Policies If offered a choice of Transfer Syntaxes in a Presentation Context, File Daemon will select the first Transfer Syntax that is listed in the Presentation Context. File Daemon will accept duplicate Presentation Contexts, that is, if it is offered multiple Presentation Contexts, each of which offers acceptable Transfer Syntaxes, it will accept all Presentation Contexts, applying the same rule for selecting a Transfer Syntax for each as described above Response Status File Daemon will behave as described in the Table below when generating the C-STORE response command message. Service Status Further Meaning Error Code Reason Refused Out of Resources A7xx Never sent Failure Warning Data Set does not match SOP Class Invalid C-STORE request Coercion of Data Elements Data Set does not match SOP Class A9xx C000 B000 B007 Never sent SOP Common Module could not be read or output file could not be created. Never sent Never sent Elements Discarded B006 Never sent Success 0000 Instance successfully stored on file system Table 4-36: Response Status of File Daemon Storage SCP and Receive Storage Request 38 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

49 Networking DB Daemon Application Entity SOP Classes The DB Daemon Application Entity provides Standard Conformance to the following SOP Classes. SOP Class Name SOP Class UID SCU (Note 3) SCP Computed Radiography Image Storage Yes Yes CT Image Storage Yes Yes MR Image Storage Yes Yes Ultrasound Image Storage No Yes (Note 1) Secondary Capture Image Storage Yes Yes X-Ray Angiographic Image Storage No Yes (Note 1) Spatial Registration Storage Yes Yes Positron Emission Tomography Image Storage No Yes (Note 1) RT Image Storage Yes Yes RT Dose Storage Yes Yes RT Structure Set Storage Yes Yes RT Beams Treatment Record Storage LTArchive RT Treatment Record Storage Yes Yes Yes (Note 2) Yes (Note 2) RT Plan Storage Yes Yes RT Treatment Summary Record Storage Yes No RT Ion Plan Storage Yes Yes RT Ion Beams Treatment Record Storage Study Root Query/Retrieve Information Model FIND Study Root Query/Retrieve Information Model MOVE Yes Yes No Yes No Yes Table 4-37: SOP Classes for DB Daemon Application Entity Note 1 Note 2 Some SOP Instances will be converted to a different Modality when imported. For details see section This SOP Class is supported only if DB Daemon is configured as Archive Daemon. Varian System Server DICOM Conformance Statement, VA8005D3CS 39 of 64

50 Networking Note 3 The SCU role is supported only to perform C-STORE sub-commands upon a C- MOVE request Association Policies General The DICOM standard application context name for DICOM 3.0 is always proposed. Application Context Name Number of Associations Table 4-38: DICOM Application Context for DB Daemon Application Entity The DB Daemon Application Entity accepts all association requests that request one of the supported SOP Classes. It does not place any limitations on the number of concurrent associations or on who may connect to it, unless the Permit Trusted Application Entities only option is enabled. If enabled, only Association request of the defined Application Entities will be accepted. Maximum number of simultaneous Associations Unrestricted Table 4-39: Number of Associations accepted for DB Daemon Application Entity DB Daemon Application Entity does not initiate any Associations Asynchronous Nature DB Daemon Application Entity does not support asynchronous communication Implementation Identifying Information DB Daemon can be configured to work either in Vision Service mode or in Archive Service mode. The Archive Service mode is useful only in combination with Varian System Server LT Archive Client; therefore when in Archive Service mode it will accept only Association Open Requests from LT Archive Client. The implementation information for this Application Entity is defined in the following table. Implementation Class UID (Vision Service mode) Implementation Class UID (Archive Service mode) Implementation Version Name Association Initiation Policy (not used) Table 4-40: DICOM Implementation Class and Version for DB Daemon Application Entity The DB Daemon Application Entity does not initiate Associations. 40 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

51 Networking Association Acceptance Policy Unless the Permit Trusted Application Entities only option is enabled, the DB Daemon Application Entity accepts all association requests that request one of the supported SOP Classes; otherwise it restricts access to the user-configured Application Entities Activity Receive Storage Request Description and Sequencing of Activities All Instances received will be converted to the internal data model and stored to the DB. If conversion was not successful, the incoming DICOM stream will be stored as DICOM Media File on the local file system on a configurable location Accepted Presentation Contexts DB Daemon Application Entity accepts Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Transfer Syntax Role Name UID Name UID Ext. Neg. All Storage SOP All Storage SOP Classes Classes in Table 4-37 in Table 4-37 DICOM Implicit VR Little Endian DICOM Explicit VR Little Endian SCP None Table 4-41: Acceptable Presentation Contexts for DB Daemon Application Entity and Receive Storage Request SOP Specific Conformance for all Storage SOP Classes DB Daemon Application Entity conforms to storage service classes at level 0 (local) where not stated otherwise. Therefore it is guaranteed that at least all Type 1 Attributes are stored in the DB. Other Attributes are mainly supported but may be discarded in certain cases Presentation Context Acceptance Criterion DB Daemon will always accept any Presentation Context for the supported SOP Classes with the supported Transfer Syntaxes. More than one proposed Presentation Context will be accepted for the same Abstract Syntax if the Transfer Syntax is supported, whether or not it is the same as another Presentation Context Transfer Syntax Selection Policies If offered a choice of Transfer Syntaxes in a Presentation Context, DB Daemon will select the first Transfer Syntax that is listed in the Presentation Context. DB Daemon will accept duplicate Presentation Contexts, that is, if it is offered multiple Presentation Contexts, each of which offers acceptable Transfer Syntaxes, it will accept all Presentation Contexts, applying the same rule for selecting a Transfer Syntax for each as described above. Varian System Server DICOM Conformance Statement, VA8005D3CS 41 of 64

52 Networking Response Status DB Daemon will behave as described in the Table below when generating the C-STORE response command message. Service Status Further Meaning Error Code Reason Refused Out of Resources A7xx Never sent Failure Warning Data Set does not match SOP Class Invalid C-STORE request A9xx C000 Never sent Received invalid C-STORE request. Conversion failed C101 Converting Instance from DICOM to internal data model failed. Connection to Database failed Save to Database failed Coercion of Data Elements Data Set does not match SOP Class C102 C103 B000 B007 Connecting Instance to internal data model failed. Could not save Instance to DB. Reason is specified in Error Comment. Never sent Never sent Elements Discarded B006 Never sent Success 0000 Instance successfully stored into DB Table 4-42: Response Status of DB Daemon Storage SCP and Receive Storage Request SOP Specific Conformance for RT Image Storage Data Handling Image Type The following Defined Terms for Value 3 of Image Type (0008,0008) are supported: DRR PORTAL SIMULATOR RT Image Position Parameters As defined by the standard, it is assumed, that the Imager Position is defined by X-Ray Image Receptor Translation (3002,000D) and the image readout area by RT Image Position (3002,0012). When RT Image Position (3002,0012) is not present, it is assumed that the image is centered around the IEC Image receptor system. In the absence of RT Image Orientation (3002,0010), the interpretation goes along the definition in section C of Part 3 of [1]. 42 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

53 Networking Portal Dose RT Images of Image Type PORTAL are also used to represent portal doses, according to the DICOM Standard [1], PS 3, section A.17.3 (RT Image IOD Module Table), Note 2. The conversion between portal image pixel values and portal dose is defined by the Modality LUT Module through Rescale Intercept (0028,1052) and Rescale Slope (0028,1053). The unit depends on Rescale Slope (0028,1053). The following 2 types of portal doses are supported, distinguished by their specific values for Image Type (0008,0008): Image Type DERIVED\SECONDARY\PORTAL\CALCULA TED_DOSE ORIGINAL\PRIMARY\PORTAL\ACQUIRED_ DOSE Meaning Portal dose predicted by a treatment planning system, i.e. an estimate of the dose that will be perceived by the portal imaging device. Portal dose actually measured by the portal imaging device based on its calibration. Table 4-43: Portal Dose Image Type Values and their Meaning Frame of Reference UID RT Images that do not have a Frame of Reference UID (0020,0052) will be assigned a Frame of Reference UID. The following rules apply: 1. If other RT Images of the same Series are already on the DB, the Frame of Reference UID of an RT Image of this Series will be used. 2. If rule 1 does not apply, a new unrelated Frame of Reference UID will be generated and assigned Import Preconditions If an RT Image references an RT Plan, this RT Plan must already be available on the DB, otherwise connection between RT Image and RT Plan will be lost SOP Specific Conformance for certain Image Storage SOP Classes For SOP Classes listed in the following list DB Daemon Application Entity accepts the SOP Class, but may discard even Type 1 Attributes when storing those Instances to DB: Ultrasound Image Storage SOP Class X-Ray Angiographic Image Storage SOP Class Positron Emission Tomography Image Storage SOP Class To preserve consistency of those image Instances they are converted to SC Modality, inserted into a Series of Modality OT and new Instance UIDs are issued for each Series and Image Instance SOP Specific Conformance for RT Structure Set Storage Data Handling An RT Structure Set serves as a starting point for 3D patient model creation. The internal representation of such a 3D patient model uses constant plane separation. If referenced images in an RT Structure Set are not scanned with constant plane separation, the constructed 3D patient model will use interpolated planes where necessary. Varian System Server DICOM Conformance Statement, VA8005D3CS 43 of 64

54 Networking On import, the 3D patient model is constructed from images referenced in Contour Image Sequence (3006,0016) of the RT Structure Set Module. It is assumed, that this sequence contains all image references, which have been used to construct the 3D Volume, independent of the presence of any contours on those planes Import Preconditions To be able to import an RT Structure Set to the DB, all images referenced in Contour Image Sequence (3006,0016) must already be available on the DB SOP Specific Conformance for RT Dose Storage Data Width 16 bit and 32 bit dose data is supported. This means that Bits Allocated (0028,0100) and Bits Stored (0028,0101) may contain value 16 or 32. Dose Summation Type The following values for Dose Summation Type (3004,000A) are supported: PLAN FRACTION BEAM Values PLAN and FRACTION are handled identically, since only one Item in Fraction Group Sequence (300A,0070) is supported. Dose Units The following values for Dose Units (3004, 0002) are supported: RELATIVE GY Dose Plane Spacing If Grid Frame Offset Vector (3004,000C) is present, it must contain offset values yielding equally spaced dose planes. Therefore, those values follow option a. in C in Part 3 of [1]. RT Dose Instances having unequally spaced dose planes are not supported SOP Specific Conformance for RT Plan Storage Data Handling Beam Limiting Devices Two collimators (symmetric or asymmetric, in any combination) or a collimator in one direction and an MLC in the direction perpendicular to it must be defined. No more than one MLC is supported. Wedges No more than two wedges per beam are supported. 44 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

55 Networking Blocks In contrary to DICOM the Varian System Server data model can handle multiple closed contours for the same block. Thus, if there are several blocks related to a single beam in imported DICOM data, they are merged into one block object if the following Attributes contain equal values among several DICOM blocks: Block Name (300A,00FE) Block Divergence (300A,00FA) Block Type (300A,00F8) Material ID (300A,00E1) Control Point Parameter Changes Changes in the following Attributes in Control Point Sequence (300A,0111) are supported: Cumulative Meterset Weight (300A,0134) Wedge Position Sequence (300A,0116) Wedge Position (300A,0118) This change is supported only for MOTORIZED wedges in a static plan, having exactly 4 Control Points. Beam Limiting Device Position Sequence (300A,011A) Leaf/Jaw Positions (300A,011C) Gantry Angle (300A,011E) Beam Limiting Device Angle (300A,0120) Fraction Groups Only one Fraction Group is supported, therefore only the first item of Fraction Group Sequence (300A,0070) is imported, additional ones are discarded. Fluences Optimal and Total Actual Fluences are exported in Compensator Sequence (300A,00E3) in RT Beams Module. Compensator Type (3004,00EE) contains either privately Defined Term OPTIMAL (for Optimal Fluence) or TOTAL_ACTUAL (for Total Actual Fluence) Import Preconditions If an RT Plan references a Bolus, the corresponding RT Structure Set must already be available on the DB. If an RT Plan references an RT Structure Set, this RT Structure Set must already be available on the DB, otherwise connection between RT Plan and RT Structure Set will be lost Approval Status Requirements RT Plans with Approval Status (300E,0002) APPROVED get internal status Planning Approved when imported. For a good interoperability it is recommended that third-party applications sending RT Plans apply a validation that is at least as tight as RadOnc Client s / Daemon s before setting Approval Status to APPROVED. In RadOnc Client / Daemon the following requirements (among others) have to be fulfilled to be able to change the plan status to Planning Approved : Varian System Server DICOM Conformance Statement, VA8005D3CS 45 of 64

56 Networking Jaw positions shall be defined for all existing collimators. If a wedge is used collimator jaw openings shall be smaller than the wedge s dimension. Gantry Angle (300A,011E) shall be defined. Patient Support Angle (300A,0122) shall be defined. Patient Position (0018,5100) shall be present for non-verification plans. A block outline shall not intersect with itself. A block in a non-electron beam shall have a tray assigned (Block Tray ID (300A,00F5)) and defined Material ID (300A,00E1). Static electron fields shall have an applicator. If a treatment device (Treatment Machine Name (300A,00B2)) is assigned to a beam, then all beam parameters shall be within the machine s operating limits. All accessories in a beam shall be enabled for the selected Nominal Beam Energy (300A,0114) and treatment technique. The difference between start and stop angle for an Arc treatment beam shall be greater than or equal to 1 and less than or equal to 360 degrees. Dose Rate Set (300A,0115) shall be the same across all control points. This is an implementation restriction of Varian treatment machines. Nominal Beam Energy (300A,0114) shall be the same across all control points. This is an implementation restriction of Varian treatment machines SOP Specific Conformance for RT Beams Treatment Record Storage and RT Ion Beams Treatment Record Storage For RT Beams Treatment Record Storage and RT Ion Beams Treatment Record Storage this Application Entity conforms to storage service classes at level 2 (full). Therefore it is guaranteed that all Type 1, Type 2, and Type 3 Attributes defined in the Information Object Definition associated with the SOP Class, as well as any Standard Extended attributes (including Private Attributes) included in the SOP Instance, will be stored. 46 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

57 Networking Activity Handling Query and Retrieval Requests Description and Sequencing of Activities Figure 4-5: Sequencing of Activities DB Daemon Handling Query Requests A typical sequence of interactions between DB Daemon Query/Retrieve SCP and a remote Query/Retrieve SCU querying Instances is illustrated in Figure 4-5: 1. Remote AE opens Association to DB Daemon. 2. Remote AE sends one or more C-FIND Requests. 3. For every C-FIND Request DB Daemon generates a C-FIND Response containing matching results. 4. Remote AE releases Association. Varian System Server DICOM Conformance Statement, VA8005D3CS 47 of 64

58 Networking Figure 4-6: Sequencing of Activities DB Daemon Handling Retrieval Requests A typical sequence of interactions between DB Daemon Query/Retrieve SCP and a remote Query/Retrieve SCU retrieving Instances is illustrated in Figure 4-6: 1. Remote AE opens Association to DB Daemon Q/R SCP. 2. Remote AE sends a C-MOVE Request to retrieve one or more Instances. 3. DB Daemon Q/R SCP evaluates retrieve command, collects objects to send and hands them over to its Storage SCU for sending them to the desired C-MOVE destination. 4. DB Daemon Storage SCU sends one Instance to Remote Storage SCP and notifies DB Daemon Q/R SCP about success or failure of the operation. 5. DB Daemon Q/R SCP sends C-MOVE Response with Status PENDING to the Remote Q/R SCU to inform it about progress of transferring Instances. 6. DB Daemon Q/R SCP sends final C-MOVE Response. 7. Remote Q/R SCU releases Association to DB Daemon Q/R SCP 8. DB Daemon Storage SCU releases Association to Remote Storage SCP, if Association has not already been released by Remote Storage SCP. 48 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

59 Networking Accepted Presentation Contexts DB Daemon Application Entity accepts Presentation Contexts shown in the following table. Presentation Context Table Abstract Syntax Transfer Syntax Role Name UID Name UID Ext. Neg. Study Root Query/Retrieve Information Model FIND Study Root Query/Retrieve Information Model MOVE DICOM Implicit VR Little Endian SCP None DICOM Explicit VR Little Endian DICOM Implicit VR Little Endian SCP None DICOM Explicit VR Little Endian Table 4-44: Acceptable Presentation Contexts for DB Daemon Application Entity and Query/Retrieve SOP Specific Conformance for all Query/Retrieve SOP Classes Presentation Context Acceptance Criterion DB Daemon will always accept any Presentation Context for the supported SOP Classes with the supported Transfer Syntaxes. More than one proposed Presentation Context will be accepted for the same Abstract Syntax if the Transfer Syntax is supported, whether or not it is the same as another Presentation Context Transfer Syntax Selection Policies If offered a choice of Transfer Syntaxes in a Presentation Context, DB Daemon will select the first Transfer Syntax that is listed in the Presentation Context. DB Daemon will accept duplicate Presentation Contexts, that is, if it is offered multiple Presentation Contexts, each of which offers acceptable Transfer Syntaxes, it will accept all Presentation Contexts, applying the same rule for selecting a Transfer Syntax for each as described above SOP Specific Conformance for Study Root Query SOP Classes Matching Behavior DB Daemon Query/Retrieve SCP supports the following Additional Query Levels not defined in DICOM Standard [1]. They are not required for successfully querying Instances of any supported Modality and are listed only for completeness: PLAN DOSE TREATMENTRECORD TREATMENTSUMREC (which is equal to TREATMENTSUMMARYRECORD) The following table lists the supported types of Matching for a C-FIND request on any Query Level specified by Study Root Query/Retrieve. Varian System Server DICOM Conformance Statement, VA8005D3CS 49 of 64

60 Networking Name Tag VR Type Types of Matching Study Level (Query Level STUDY) Study Date (0008,0020) DA R S, U Study Time (0008,0030) TM R S, U Accession Number (0008,0050) SH R S, U, W Patient's Name (0010,0010) PN R S, U, W Patient ID (0010,0020) LO R S, U, W Study ID (0020,0010) SH R S, U, W Study Instance UID (0020,000D) UI U S, U Series Level (Query Level SERIES) Modality (0008,0060) CS R S, U, W Series Number (0020,0011) IS R S, U Series Instance UID (0020,000E) UI U S, U Composite Object Level (general) Instance Number (0020,0013) IS R S, U SOP Instance UID (0008,0018) UI U S, U SOP Class UID (0008,0016) UI O S, U Composite Object Level (Query Level IMAGE) Image Type (0008,0008) CS O S, U Content Date (0008,0023) DA O S, U Content Time (0008,0033) TM O S, U Referenced SOP Class UID (0008,1150) UI O S, U Referenced SOP Instance UID (0008,1155) UI O S, U Referenced Beam Number (300C,0006) IS O S, U Reference Image Type (3257,1010) CS O S, U (see Note 1) 50 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

61 Networking Name Tag VR Type Types of Matching Composite Object Level (Query Level PLAN) Plan Label (300A,0002) SH O S, U, W Plan Date (300A,0006) DA O S, U Plan Time (300A,0007) TM O NONE Number of Beams (300A,0080) IS O NONE Referenced RT Plan Sequence (300C,0002) SQ O NONE >Referenced SOP Class UID (0008,1150) UI O NONE >Referenced SOP Instance UID (0008,1155) UI O NONE >RT Plan Relationship (300A,0055) CS O NONE Composite Object Level (Query Level DOSE) Referenced SOP Class UID (0008,1150) UI O NONE Referenced SOP Instance UID (0008,1155) UI O S, U Referenced Beam Number (300C,0006) IS O S, U Number of Frames (0028,0008) IS O NONE Composite Object Level (Query Level TREATMENTRECORD) Referenced SOP Class UID (0008,1150) UI O NONE Referenced SOP Instance UID (0008,1155) UI O S, U Treatment Date (3008,0250) DA O S, U Treatment Time (3008,0251) TM O S, U Referenced Fraction Group Number (300C,0022) IS O S, U Treatment Session Beam Sequence (3008,0020) SQ O NONE >Referenced Beam Number (300C,0006) IS O NONE >Current Fraction Number (3008,0022) IS O NONE >Treatment Delivery Type (300A,00CE) CS O NONE >Treatment Termination Status (3008,002A) CS O NONE >Delivered Primary Meterset (3008,0036) DS O NONE >Treatment Date (3008,0250) DA O NONE >Treatment Time (3008,0251) TM O NONE >Referenced Calculated Dose Reference Sequence (3008,0090) SQ O NONE >>Referenced Dose Reference Number (300C,0051) IS O NONE >>Calculated Dose Reference Dose Value (3008,0076) DS O NONE Varian System Server DICOM Conformance Statement, VA8005D3CS 51 of 64

62 Networking Name Tag VR Type Types of Matching >Control Point Delivery Sequence (3008,0040) SQ O NONE >>Referenced Control Point Index (300C,00F0) IS O NONE >>Specified Meterset (3008,0042) DS O NONE >>Gantry Angle (300A,011E) DS O NONE >>Override Sequence (3008,0060) SQ O NONE >>>Override Parameter Pointer (3008,0062) AT O NONE Composite Object Level (Query Level TREATMENTSUMREC) Referenced SOP Class UID (0008,1150) UI O NONE Referenced SOP Instance UID (0008,1155) UI O S, U Current Treatment Status (3008,0200) CS O NONE Number of Fractions Delivered (3008,005A) IS O NONE Treatment Summary Calculated Dose Reference Sequence (3008,0050) SQ O NONE >Referenced Dose Reference Number (300C,0051) IS O NONE >Dose Reference Description (300A,0016) LO O NONE >Cumulative Dose to Dose Reference (3008,0052) DS O NONE Table 4-45: Study Root C-FIND SCP Supported Elements for DB Daemon Note 1 This Element is used only for performing the find operation and is never returned. The Types of Matching column in the above table should be read as follows. One or more matching types of the following list may be supported per Element: S L U W R NONE Single Value Matching List of UID Matching Universal Matching Wild Card Matching Range Matching No matching supported, but values for this Element are returned if available. 52 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

63 Networking Response Status DB Daemon will behave as described in the Table below when generating the C-FIND response command message. Service Status Further Meaning Error Code Reason Refused Out of Resources A7xx Never sent Failure Cancel Success Pending Identifier does not match SOP Class A900 Never sent Unable to process C000 Failed to parse query key. Matching terminated due to Cancel Request Matching is complete No final Identifier is supplied Matches are continuing Current Match is supplied and any Optional Keys were supported in the same manner as Required Keys. Matches are continuing Warning that one or more Optional Keys were not supported for existence and/or matching for this Identifier. FE00 Never sent 0000 Matching is complete, all results have been sent. FF00 FF01 Indicates that the search for further matches is continuing. This is returned when each successful match is returned and when further matches are forthcoming. This status code is also returned if not all Optional keys in the query identifier are supported. Never sent Table 4-46: Response Status of DB Daemon Storage SCP and Receive Query Request Varian System Server DICOM Conformance Statement, VA8005D3CS 53 of 64

64 Networking SOP Specific Conformance for Study Root Retrieval SOP Classes DB Daemon will behave as described in the Table below when generating the C-MOVE response command message. Service Status Further Meaning Error Code Reason Refused Failure Cancel Warning Success Pending Out of Resources Unable to calculate number of matches Out of Resources Unable to perform sub-operations Move Destination unknown Identifier does not match SOP Class A701 A702 A801 A900 Never sent Never sent Never sent Never sent Unable to process C000 Failed to parse query key. Sub-operations terminated due to Cancel Indication Sub-operations complete One or more Failures Sub-operations complete No Failures Sub-operations are continuing FE00 B FF00 Never sent Either the creating of the DICOM stream for at least one Instance failed, or storage of at least one Instance to the move destination failed. A Response with this Status Code is sent every time an Instance has been successfully converted to a DICOM stream and every time before an Instance is sent to the move destination. Table 4-47: Response Status of DB Daemon Storage SCP and Receive Retrieval Request SOP Specific Conformance for RT Structure Set Move SOP Instance UID Handling When an RT Structure Set Instance has been sent out its SOP Instance UID on the DB is changed to a new value to allow further editing of the object Data Handling Contours representing volumes are always defined on the (potentially interpolated) planes of the 3D patient model. An exported RT Structure Set will thus have ROI Contours not referencing an image at all, if there are contours on interpolated planes. All images used to construct the 3D patient model are referenced in Contour Image Sequence (3006,0016) of RT Structure Set Module, even if they do not have any contours defined on them. 54 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

65 Networking SOP Specific Conformance for RT Dose Move SOP Instance UID Handling When an RT Dose Instance has been sent out its SOP Instance UID on the DB is changed to a new value to allow further editing of the object Data Handling Data Width Only 32 bit dose data is supported. This means that Bits Allocated (0028,0100) and Bits Stored (0028,0101) will contain value 32. Dose Summation Type The following values for Dose Summation Type (3004,000A) are supported: FRACTION BEAM Dose Units The following values for Dose Units (3004, 0002) are supported: RELATIVE GY Dose Plane Spacing Only equally spaced dose planes are supported. Thus if Grid Frame Offset Vector (3004,000C) is present, it will contain offset values yielding equally spaced dose planes. The values follow the option a. in C in Part 3 of [1] SOP Specific Conformance for RT Plan Move Beam Limiting Devices On the DB a beam can have asymmetrical or symmetrical collimator jaw modes in X and Y directions. A beam can be in symmetrical jaw mode even if the physical collimator jaws in the same direction support asymmetry. A beam s collimator mode is exported in RT Beam Limiting Device Type (300A, 00B8). Other vendor s implementations may require that RT Beam Limiting Device Type represents the physical capabilities of the collimator jaws; in these cases asymmetrical jaw mode must be selected for those beams before exporting them. Blocks In contrary to DICOM the Varian System Server data model can handle multiple closed contours for the same block. Thus, if a block contains more than one closed contour it will be exported as multiple blocks each having exactly one closed contour SOP Specific Conformance for RT Image Move Curve Module Varian System Server DICOM Conformance Statement, VA8005D3CS 55 of 64

66 Networking The DICOM standard allows a maximum of 16 curves within the Curve Module (see [1] Part 5, section 7.6). If curves on RT Images exceed a certain complexity it may happen that up to 128 curves are used when an RT Image object is created. When this happens, a warning message will be logged, stating that the resulting IOD is not fully DICOM conformant. For additional curves exceeding the standard conformant amount of 16, group numbers in the range of FE are used. 4.3 Network Interfaces Physical Network Interfaces The application is indifferent to the physical medium over which TCP/IP executes; which is dependent on the underlying operating system and hardware Additional Protocols When host names rather than IP addresses are used in the configuration properties to specify presentation addresses for remote AEs, the application is dependent on the name resolution mechanism of the underlying operating system (e.g. DNS). 4.4 Configuration AE Title/Presentation Address Mapping Local AE Titles All local RadOnc Client Application Entities use the AE Title and TCP/IP port number configured via the Import/Export Configuration dialog and DICOM Print Configuration dialog in a RadOnc Client application. The File Daemon and DB Daemon Application Entities use the AE Title and TCP/IP port numbers configured via the Daemon Configuration Wizard application. Application Entity Default AE Title Default TCP/IP Port RadOnc Client Storage SCU No Default Not Applicable RadOnc Client Query/Retrieve SCU No Default (configurable) RadOnc Client Print SCU No Default Not Applicable File Daemon No Default (configurable) DB Daemon No Default (configurable) Table 4-48: AE Title Configuration Table Remote AE Title/Presentation Address Mapping RadOnc Client Storage SCU For the Storage service class SCU, TCP/IP address, called AE title and port number of the destination are configurable as well as the calling AE title used by RadOnc. Multiple filter configurations can exist in the system at the same time. 56 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

67 Networking RadOnc Client Query/Retrieve SCU For the RadOnc Client Query/Retrieve SCU, TCP/IP address, called AE title and port number of the provider are configurable. The calling AE title of the local application, which is also the Move Destination AE title, is configurable too. The configurable Transfer Directory Path is the directory where the temporary objects are stored in. The local port is the port of the temporary Storage SCP for receiving the data. The temporary Storage SCP will accept only connection requests from the configured remote AE Title and IP Address. Multiple configurations can exist in the system at the same time RadOnc Client Print SCU For the RadOnc Client Print SCU, TCP/IP address, calling and called AE title and port number of the destination are configurable. By default no debug log is produced by the RadOnc Client Print SCU. It can be configured to produce an ASCII log containing its actions. Multiple configurations can exist in the system at the same time File Daemon For the File Daemon, AE Title, port number and the storage location of DICOM files are configurable. Calling AE title verification is configurable with remote AE Title and remote TCP/IP address. If multiple network adapters are available the TCP/IP address to be used is determined by the selected adapter. Multiple configurations can exist in the system at the same time DB Daemon For the DB Daemon, AE Title, port number and the temporary storage location of DICOM files are configurable. Calling AE title verification is configurable with remote AE Title, remote TCP/IP address and port number. The Remote TCP/IP Port is used only for a C-MOVE command as destination for sending requested Instances to. If multiple network adapters are available the TCP/IP address to be used is determined by the selected adapter. Multiple configurations can exist in the system at the same time Parameters The following table shows DICOM relevant configuration parameters. While some of them may be configured directly via a configuration dialog or a configuration application, other values can only be accessed via the Registry or can not be configured at all. Parameter General Parameters Configurable (Yes/No) Default Value Varian System Server DICOM Conformance Statement, VA8005D3CS 57 of 64

68 Networking Parameter Configurable (Yes/No) Default Value Max PDU Receive Size No Unlimited Max PDU Send Size No Bytes (32kB) Time-out waiting for a acceptance or rejection response to an Association request or Association Release request (Application Level Timeout) Yes RadOnc Client Storage SCU Specific Parameters 30s RadOnc Client Query/Retrieve SCU Specific Parameters RadOnc Client Print SCU Specific Parameters Time-out awaiting a Response to a DIMSE Request (Low-Level Timeout) Maximum number of simultaneously initiated Associations Yes No 1 300s File Daemon Specific Parameters Time-out awaiting a Response to a DIMSE Request (Low-Level Timeout) Connection timeout after which an Association will be released when idle. Maximum number of simultaneously accepted Associations Yes No No 240s 1h Unlimited Storage SOP Class support No Active DB Daemon Specific Parameters Time-out awaiting a Response to a DIMSE Request (Low-Level Timeout) Connection timeout after which an Association will be released when idle. Maximum number of simultaneously accepted Associations Yes No No 240s 1h Unlimited Storage SOP Class support Yes Active Query/Retrieve SOP Class support. Yes Active DB Daemon can be configured to work either in Vision Service Mode or Archive Service Mode. Yes Table 4-49: Configuration Parameters Table Vision Service Mode 58 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

69 Media Interchange 5. Media Interchange RadOnc Client Application Entity allows importing and exporting DICOM Media Files. Various import and export filters are available in the RadOnc Client application to read and create DICOM Media Files. The files fully conform to the Part 10 format. However, the Basic Directory IOD as defined in Media Interchange Application Profiles is not present. Varian System Server DICOM Conformance Statement, VA8005D3CS 59 of 64

70 Media Interchange (This page is intentionally left blank.) 60 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

71 Support of Character Sets 6. Support of Character Sets 6.1 Overview No dedicated support for Character Sets beyond the Default Character Repertoire is available. However, text fields containing characters not in the Default Character Repertoire when importing an Instance will appear unchanged when re-exporting the same Instance again. 6.2 Display Behavior Correct display of characters not in the Default Character Repertoire depends on available/configured operating system support. Varian System Server DICOM Conformance Statement, VA8005D3CS 61 of 64

72 Support of Character Sets (This page is intentionally left blank.) 62 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

73 Security 7. Security 7.1 Security Profiles No Security Profiles are supported. 7.2 Association Level Security RadOnc Client Storage SCU and Print SCU do not support Association Level Security. The temporary Storage SCP instantiated to receive Instances requested by Query/Retrieve SCU checks the following additional values when determining whether to accept Association Open Requests: Called AE Title Calling AE Title IP address of Association Request originator File Daemon and DB Daemon The File Daemon Application Entity and the DB Daemon Application Entity always check the following values when determining whether to accept Association Open Requests: Called AE Title The File Daemon Application Entity and the DB Daemon Application Entity can both be configured to check the following additional values when determining whether to accept Association Open Requests: Calling AE Title IP address of Association Request originator By default those additional checks are enabled when setting up a new DB Daemon configuration and disabled when setting up a new File Daemon configuration. 7.3 Application Level Security RadOnc Client A user logging on to a RadOnc Client application has to identify himself with username and password. Additionally, dedicated permissions to view patient data are required to use import/export functionality like Storage SCU and Query/Retrieve SCU as well as for DICOM Print SCU File Daemon and DB Daemon To set up a new Daemon configuration or to change an existing Daemon configuration local administrative credentials on the affected computer are required. Varian System Server DICOM Conformance Statement, VA8005D3CS 63 of 64

74 Security (This page is intentionally left blank.) 64 of 64 Varian System Server DICOM Conformance Statement, VA8005D3CS

75 Appendix A Specialization Appendix A Specialization A.1 IOD Contents A.1.1 Created SOP Instances IODs created by Varian System Server Application Entities are listed in Appendix C along with supported modules and mapping between Attributes and DB fields where applicable. A.1.2 Usage of Attributes from received IOD s Varian System Server Application Entities require all Type 1 Attributes to be present. A.1.3 Attribute Mapping Mapping Attributes between different SOP Classes is typically straight-forward and happens by means of commonly used fields on the DB. For details see Appendix C. A.1.4 Coerced/Modified Fields Fields may be coerced/modified by the following Application Entities: RadOnc Client Temporary Storage SCP DB Daemon Storage SCP Attributes that can be modified after importing an Instance are listed in the table below. Attribute Name Tag Condition Patient Module Patient's Name (0010,0010) Patient ID (0010,0020) Patient's Birth Date (0010,0030) Patient's Sex (0010,0040) Patient's Birth Time (0010,0032) Other Patient IDs (0010,1000) Ethnic Group (0010,2160) Patient Comments (0010,4000) Value will be changed when an already existing patient object on the DB, to which the Instance being imported is connected to, contains a different value than the Attribute of the Instance itself, when the related value on the DB is being updated. Table A-1: Coerced/Modified Fields A.2 Data Dictionary of Private Attributes All private Attributes in use in any Application Entity of the Varian System Server product family are listed in the following sub-chapter. The following table shows private creator identification strings for each private group. The placeholder ee is by default replaced by 10 when creating Instances, however, this is not Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 1 of 346

76 Appendix A Specialization guaranteed under all circumstances. Tag Private Creator Identification String (300B,00ee) IMPAC (3241,00ee) Varian Medical Systems VISION 3241 (3243,00ee) Varian Medical Systems VISION 3243 (3247,00ee) Varian Medical Systems VISION 3247 (3249,00ee) Varian Medical Systems VISION 3249 (3251,00ee) Varian Medical Systems VISION 3251 (3253,00ee) Varian Medical Systems VISION 3253 (3257,00ee) Varian Medical Systems VISION 3257 (3259,00ee) Varian Medical Systems VISION 3259 (3261,00ee) Varian Medical Systems VISION 3261 (3263,00ee) Varian Medical Systems VISION 3263 (3265,00ee) Varian Medical Systems VISION 3265 (3267,00ee) Varian Medical Systems VISION 3267 (3269,00ee) Varian Medical Systems VISION 3269 (3271,00ee) Varian Medical Systems VISION 3271 (3273,00ee) Varian Medical Systems VISION 3273 (3275,00ee) Varian Medical Systems VISION 3275 (3277,00ee) Varian Medical Systems VISION 3277 (3279,00ee) Varian Medical Systems VISION 3279 (3281,00ee) Varian Medical Systems VISION 3281 Table A-2: Private Creator Identification Strings A.2.1 Private Attributes used by all Application Entities The following table contains a list of private Attributes that are used throughout all Application Entities. Tag Name VR VM (300B,ee01) Distal Target Distance Tolerance FL 1 (300B,ee02) Maximum Collimated Field Diameter (Field Size) FL 1 (300B,ee04) Range (Planned Distal Target Distance) FL 1 (300B,ee08) Beam Line Data Table Version SH 1 (300B,ee0E) Nominal SOBP Width FL 1 (300B,ee11) Nominal SOBP Width Tolerance FL 1 (300B,ee17) Peek Range FL 1 (3241,ee00) Internal Image Id LO 2 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

77 Appendix A Specialization Tag Name VR VM (3241,ee02) Internal Pixel Offset IS (3241,ee03) Not Calibrated US (3241,ee04) Image Orientation (Patient) DS 6 (3241,ee05) Image Position (Patient) DS 6 (3241,ee06) Pixel Spacing DS 2 (3243,ee09) Beam Secondary Name SH 1 (3243,ee28) Related Referenced Beam Number IS 1 (3247,ee00) Session Termination Status SH 1 (3249,ee00) Maximum Treatment Time DS 1 (3249,ee10) Referenced Primary Dose Reference UID UI 1 (3251,ee00) Treatment Machine Note LO 1 (3253,ee00) Extended Interface Data OB 1 (3253,ee01) Extended Interface Length IS 1 (3253,ee02) Extended Interface Format LO 1 (3257,ee01) Plan Type CS 1 Enumerated Values: ALL_PLANS PREDECESSOR NOT_ PREDECESSOR (3257,ee10) Reference Image Type CS 1 Enumerated Values: ALL PRIMARY (3259,ee00) Additional Dose Value Sequence SQ 0..n (3259,ee02) Actual Session Dose DS 1 (3259,ee04) Daily Dose DS 1 (3259,ee06) Life Time Total Dose DS 1 (3261,ee2A) Treatment Session Beam Data OB 1 (3263,ee00) Overlap Type CS 1 Enumerated Values: OVERLAPPING NONOVERLAPPING (3263,ee01) Referenced Structure Set Relationship Sequence SQ 1 (3263,ee02) Structure Set Relationship CS 1 Defined Terms: PREDECESSOR ADDITION (3265,ee00) Total Number of Fractions SL 1 Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 3 of 346

78 Appendix A Specialization Tag Name VR VM (3265,ee01) Last treated Fraction SL 1 (3267,ee00) Referenced Patient Volume Id SH 1 (3271,ee00) Marker Subtype CS 1 Enumerated Values: MARKER POINT_MATCH REFERENCE_LINE (3273,ee00) RT Image Isocenter Position DS 3 (3273,ee01) RT Image Patient Position CS 1 (3275,ee00) Registration Sub Type LO 1 (3277,ee00) RT Motion Synchronization Sequence SQ 1 Table A-3: Private Attributes used in all Application Entities A.2.2 Private Attributes used by DB Daemon Application Entity in Archive Service Mode The following table contains a list of private Attributes that are used only in DB Daemon Application Entities running in Archive Service mode. Tag Name VR VM (3269,ee00) Prescribed Dose per Fraction DS 1 (3269,ee01) Prescribed Percentage DS 1 (3269,ee02) Plan Normalization Factor DS 1 (3279,ee00) LT Archive Primary Reference Image Flag CS 1 Enumerated Values: PRIMARY NOT_PRIMARY (3281,ee00) Image Remarks UT 1 Table A-4: Private Attributes used by DB Daemon Application Entity in Archive Service Mode A.3 Coded Terminology and Templates A.3.1 Context Groups Information will be published in a future version of this document. A.3.2 Template Specifications No standard templates are extended and no private templates are used. 4 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

79 Appendix A Specialization A.3.3 Private Code Definitions There are no private code definitions. A.4 Grayscale Image Consistency Not supported. A.5 Standard Extended/Specialized/Private SOP Classes A.5.1 Private LTArchive RT Treatment Record Storage SOP Class This LTArchive RT Treatment Record Storage SOP Class can only be created by the DB Daemon Application Entity working in Archive Service mode. Furthermore, only in this mode is this private SOP Class accepted. LTArchive RT Treatment Record Storage Table A-5: LTArchive RT Treatment Record Storage SOP Class The LT Archive RT Treatment Record Storage SOP Class is composed of the same Attributes as the standard RT Treatment Record Storage SOP Class. The only difference is that all elements have Type 3 and therefore may be missing. A.6 Private Transfer Syntaxes No private Transfer Syntaxes are used. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 5 of 346

80 Appendix A Specialization (This page is intentionally left blank.) 6 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

81 Appendix B Object Matching Criteria Appendix B Object Matching Criteria This chapter is relevant for all Application Entities of the Varian System Server product family that are importing Instances to the DB. The following sub-chapters describe how imported Instances are matched against already existing objects in the DB. B.1 General Matching Criteria The following Instance UIDs are always matched against those of already existing Instances in the DB: (0020,000D) Study Instance UID (0020,000E) Series Instance UID (0008,0018) SOP Instance UID Additionally, some Patient Attributes are used to search the related patient object on the DB. What Patient Attributes are used and how they are handled is described in the following subsections. If at least one of the above mentioned Instance UIDs and/or a matching patient is already present in the DB, then all instances in the path top-down from Patient Study Series Instance must be present up to the lowest level, where a match is found, and at least the patient must be present. Otherwise importing of the Instance is rejected with a DICOM Data Model consistency error message. If Study Instance UID or Series Instance UID of the imported SOP Instance is already present on the DB, the target patient is determined unambiguously. However, if the so found patient does not match the patient found by applying the matching criteria as laid out in the following sub-sections, a DICOM Data Model consistency error message is generated and importing the Instance is not possible. B.1.1 Manual Import using RadOnc Client Query/Retrieve SCU The target patient is determined unambiguously if Study Instance UID or Series Instance UID of the imported Instance is already present on the DB. In this case the patient determined by the above-mentioned UIDs is automatically selected as target patient and it cannot be changed by the user. If no patient can be determined from Study Instance UID or Series Instance UID of the imported Instance, the following algorithm is used to assist the user in selecting the right target patient. The following table describes how a list of patients is being collected to which an Instance shall finally be connected. Under certain circumstances the user will have the possibility to select another patient that is not part of the offered list. DICOM Attribute RadOnc Client Attributes Criteria 1 Criteria 2 (see Note 1) (see Note 2) Patient ID (0010,0020) Patient's Name (0010,0010) Patient's Birth Date (0010,0030) Patient ID 1 Patient Last Name Patient First Name Patient Birth Date X X X X Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 7 of 346

82 Appendix B Object Matching Criteria Note 1 Note 2 Table B-6: Patient Matching Criteria for Storage SCP of RadOnc Client Q/R SCU These are the default matching criteria for finding possible target patients. If no patient was found by applying Matching Criteria 1, then the matching criteria of this column are used to look for possible target patients. Patient First Name and Patient Birth Date will match any value on the DB if empty in the DICOM Instance. B.1.2 Manual Import of DICOM Media Files The same matching criteria apply as for manual import using RadOnc Client Query/Retrieve SCU, see B.1.1. B.1.3 Automatic Import using DB Daemon Storage SCP DB Daemon can be configured to use all, some or none of the matching criteria shown in the following table for searching the target Patient object. Importing the Instance will not be possible if multiple possible target Patient objects are found. DICOM Attribute RadOnc Client Attributes Matching Criteria Patient ID (0010,0020) Other Patient IDs (0010,1000) Patient's Name (0010,0010) Patient's Birth Date (0010,0030) Patient ID 1 Patient ID 2 Patient Last Name Patient First Name Patient Birth Date Configurable Configurable Configurable Configurable Configurable Table B-7: Patient Matching Criteria for DB Daemon Storage SCP Patient ID 2, Patient First Name and Patient Birth Date will match any value on the DB if empty in the DICOM Instance. B.2 IOD Specific Matching Criteria B.2.1 B RT Plan and RT Ion Plan Treatment Machine and Add-ons The table below specifies the matching criteria used to associate various items of a plan to a corresponding item in the DB. 8 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

83 Appendix B Object Matching Criteria Item DICOM Attribute Matching Criteria on DB Remarks Machine Applicator Treatment Machine Name (300A,00B2) Manufacturer (0008,0070) Manufacturer s Model Name (0018,1090) Device Serial Number (0018,1000) Applicator ID (300A,0108) Machine ID See Note 1 Applicator ID These three attributes have to match if Treatment Machine Name was not found in DB. Bolus Various Not applicable Is created from DICOM data during Import. Compensat or MLC Wedge Range Shifter Lateral Spreading Device Various Not applicable Is created from DICOM data during Import. RT Beam Limiting Device Type (300A,00B8) Number of Leaf/Jaw Pairs (300A,00BC) Leaf Position Boundaries (300A,00BE) Wedge Type (300A,00D3) Wedge Angle (300A,00D5) Wedge Orientation (300A,00D8) Wedge ID (300A,00D4) Range Shifter ID (300A,0318) Range Shifter Type (300A,0320) Lateral Spreading Device ID (300A,0336) Lateral Spreading Device Type (300A,0338) MLC Rotation Number of Leafs per bank Leaf Width Wedge Type, Motorized Flag Wedge Angle Wedge Direction Wedge ID MLCX = Rotation 0 deg MLCY = Rotation 90 deg Wedge Type to distinguish between STANDARD or DYNAMIC, Motorized Flag for MOTORIZED This attribute is only used if more than one wedge is found where all other attributes match. Range Shifter ID See Note 2 Range Shifter Type Lateral Spreader ID See Note 2 Lateral Spreader Type Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 9 of 346

84 Appendix B Object Matching Criteria Item DICOM Attribute Matching Criteria on DB Remarks Range Modulator Range Modulator ID Range Modulator ID See Note 2 Range Modulator Type Range Modulator Type Snout Snout ID (300A,030F) Snout ID See Note 2 Table B-8: RT Plan and RT Ion Plan Component Matching Note 1 Note 2 Optional mapping of Treatment Machine Name (DICOM) to a different internal Machine ID may apply. Mapping of external (DICOM) to internal ID of this beam line modifier may apply (configured in file DicomIonPlanIdMapping.xml). B Reference Points RT Prescription and RT Fraction Scheme Modules define primarily different reference points. During import they are converter to a RefPoint and must finally be connected to a Volume. Under some conditions, a Dose Reference Point (RT Prescription Module) and a Beam Dose Specification Point (RT Fraction Scheme Module) can be merged into one RefPoint. The matching algorithm is outlined below: 1. If Referenced Primary Dose Reference UID (3249,1010) is defined for all beams in Referenced Beam Sequence (300C,0004) (RT Fraction Scheme Module), and is equal in all beams as well as Dose Reference UID (300A,0013) (RT Prescription Module), then this Reference Point shall be used. 2. If Referenced Dose Reference Number (300C,0051) (RT Fraction Scheme Module) and the predecessor of the RT Plan can be determined, Dose Reference Number (300A,0012) (RT Prescription Module) is used to match against the DICOM sequence number of the primary reference point of the predecessor plan. 3. If Dose Reference Structure Type (300A,0014) (RT Prescription Module) has the value COORDINATES, those coordinates will be compared with those in Beam Dose Specification Point (300A,0082) (RT Fraction Scheme). If they are the same, these Reference Points can be merged. 4. If Dose Reference Structure Type (300A,0014) (RT Prescription Module) has the value SITE (no coordinates given), Dose Reference Type (300A,0020) shall be TARGET. If the dose for the last Control Point calculated by Cumulative Dose Reference Coefficient (300A,010C) (RT Beams Module) is the same as Beam Dose (300A,0084) (RT Fraction Scheme Module), then affected reference points can be merged. 5. If Beam Dose Specification Point (300A,0082) and Beam Dose (300A,0084) (RT Fraction Scheme Module) are either not given or empty (i.e. only Beam Meterset (300A,0086) is given), then this Beam Dose Specification Point can be merged with a Dose Reference Point that has Dose Reference Type (300A,0020) (RT Prescription Module) with value TARGET. If there exist more than one such Dose Reference Point the first one found will be taken. 10 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

85 Appendix C IOD Details C.1 Supported IODs For better reference with DICOM Standard [1], section titles of the following sub-sections are decorated with section number of DICOM Standard Part 3 where the corresponding IOD Module table can be found. C.1.1 Computed Radiography Image A.2.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series General Series C M CR Series C M Export only Clinical Trial Series C U Not supported Equipment General Equipment C M Image General Image C M Image Pixel C M Contrast/Bolus C C Not supported Device C U Not supported CR Image C M Overlay Plane C.9.2 U Not supported Curve (Retired) C.10.2 U Modality Lut C.11.1 U Import only VOI LUT C.11.2 U SOP Common C.12.1 M Table C-9: Computed Radiography Image IOD Modules Support Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 11 of 346

86 C.1.2 Computed Tomography Image A.3.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series General Series C M Clinical Trial Series C U Not supported Frame of Reference Frame of Reference C M Equipment General Equipment C M Image General Image C M Image Plane C M Image Pixel C M Contrast/Bolus C C Not supported CT Image C M Overlay Plane C.9.2 U Not supported VOI LUT C.11.2 U SOP Common C.12.1 M Table C-10: Computed Tomography Image IOD Modules Support C.1.3 Magnetic Resonance Image A.4.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series General Series C M Clinical Trial Series C U Not supported Frame of Reference Frame of Reference C M Equipment General Equipment C M Image General Image C M Image Plane C M Image Pixel C M 12 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

87 IE Module Reference Usage Presence Contrast/Bolus C C Not supported MR Image C M Overlay Plane C.9.2 U Not supported VOI LUT C.11.2 U SOP Common C.12.1 M Table C-11: Magnetic Resonance Image IOD Modules Support C.1.4 Ultrasound Image A.6.4 Patient Study Series Frame of Reference IE Module Reference Usage Presence Patient C M Clinical Trial Subject C U Not supported General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported General Series C M Clinical Trial Series C U Not supported Frame of Reference C M US Frame of Reference C C Not supported Synchronization C U Not supported Equipment General Equipment C M Image General Image C M Image Pixel C M Contrast/Bolus C C Not supported Palette Color Lookup Table C.7.9 C Not supported US Region Calibration C U Not supported US Image C M Not supported Overlay Plane C.9.2 U Not supported VOI LUT C.11.2 U SOP Common C.12.1 M Table C-12: Ultrasound Image IOD Modules Support Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 13 of 346

88 C.1.5 Secondary Capture Image A IE Module Reference Usage Presence Patient Study Series Equipment Image Patient C M Clinical Trial Subject C U Not supported General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported General Series C M Clinical Trial Series C U Not supported General Equipment C M SC Equipment C M General Image C M Image Pixel C M SC Image C M Overlay Plane C.9.2 U Not supported Modality LUT C.11.1 U Import only VOI LUT C.11.2 U SOP Common C.12.1 M Table C-13: Secondary Capture Image IOD Modules Support C.1.6 X-Ray Angiographic Image A.14.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series General Series C M Clinical Trial Series C U Not supported Equipment General Equipment C M Image General Image C M Image Pixel C M Contrast/Bolus C C Not supported Cine C C Not supported Multi Frame C C Not supported 14 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

89 IE Module Reference Usage Presence Frame Pointers C U Not supported Mask C C Not supported Display Shutter C U Not supported Device C U Not supported Intervention C U Not supported X-Ray Image C M X-Ray Acquisition C M Not supported X-Ray Collimator C U Not supported X-Ray Table C C Not supported XA Positioner C M Not supported DX Detector C U Not supported Overlay Plane C.9.2 U Not supported Multi Frame Overlay C.9.3 U Not supported Curve (Retired) C.10.2 U Modality LUT C.11.1 C / U VOI LUT C.11.2 U SOP Common C.12.1 M Table C-14: X-Ray Angiographic Image IOD Modules Support C.1.7 Spatial Registration A.39.3 Patient Study Series IE Module Reference Usage Presence Patient C M Clinical Trial Subject C U Not supported General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported General Series C M Clinical Trial Series C U Not supported Spatial Registration Series C.20.1 Frame of Reference Frame of Reference C M Equipment General Equipment C M Spatial Registration Spatial Registration C.20.2 M Common Instance Reference C.12.2 M M Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 15 of 346

90 IE Module Reference Usage Presence SOP Common C.12.1 M Table C-15: Spatial Registration Image IOD Modules Support C.1.8 Positron Emission Tomography Image A.21.3 Patient Study Series IE Module Reference Usage Presence Patient C M Clinical Trial Subject C U Not supported General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported General Series C M Clinical Trial Series C U Not supported PET Series C M Partially supported PET Isotope C M Not supported PET Multi-gated Acquisition NM/PET Patient Orientation Frame of Reference Frame of Reference C M Equipment General Equipment C M Image General Image C M Image Plane C M Image Pixel C M C C Not supported C M Not supported PET Image C M Partially supported Overlay Plane C.9.2 U Not supported VOI LUT C.11.2 U Acquisition Context C U Not supported SOP Common C.12.1 M Table C-16: Positron Emission Tomography Image IOD Modules Support 16 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

91 C.1.9 RT Image A.17.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series RT Series C M Clinical Trial Series C U Not supported Frame of Reference Frame of Reference C M Equipment General Equipment C M Image General Image C M Image Pixel C M Contrast/Bolus C C Not supported Cine C C Not supported Multi Frame C C Not supported RT Image C M Modality LUT C.11.1 U VOI LUT C.11.2 U Approval C U Curve (Retired) C.10.2 U SOP Common C.12.1 M Extended Interface Extended Interface N/A U Private Table C-17: RT Image IOD Modules Support C.1.10 RT Dose A.18.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series RT Series C M Clinical Trial Series C U Not supported Frame of Reference Frame of Reference C M Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 17 of 346

92 IE Module Reference Usage Presence Equipment General Equipment C M Dose General Image C C Export only Image Plane C C Image Pixel C C Multi-Frame C C Export only Overlay Plane C.9.2 U Not supported Multi-Frame Overlay C.9.3 U Not supported Modality LUT C.11.1 U Not supported RT Dose C M RT DVH C U Export only Structure Set C C Not supported ROI Contour C C Not supported RT Dose ROI C C Not supported SOP Common C.12.1 M Table C-18: RT Dose IOD Modules Support C.1.11 RT Structure Set A.19.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series RT Series C M Clinical Trial Series C U Not supported Equipment General Equipment C M Structure Set Structure Set C M ROI Contour C M RT ROI Observations C M Approval C U Not supported SOP Common C.12.1 M Table C-19: RT Structure Set IOD Modules Support 18 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

93 C.1.12 RT Beams Treatment Record A.29.3 When importing a RT Beams Treatment Record IOD, also the complete DICOM stream will be stored, thus all modules and attributes, including private elements, are preserved. However, not all modules are supported during conversion to and from the internal data model and thus data from those modules are not accessible via DB tables. Patient Study Series IE Module Reference Usage Presence Patient C M Clinical Trial Subject C U Not supported General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported RT Series C M Clinical Trial Series C U Not supported Equipment General Equipment C M Treatment Record RT General Treatment Record C RT Patient Setup C U Not supported RT Treatment Machine Record Measured Dose Reference Record Calculated Dose Reference Record RT Beams Session Record RT Treatment Summary Record C M M C U Not supported C U Not supported C SOP Common C.12.1 M M C U Not supported Table C-20: RT Beams Treatment Record IOD Modules Support C.1.13 RT Plan A.20.3 IE Module Reference Usage Presence Patient Patient C M Clinical Trial Subject C U Not supported Study General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported Series RT Series C M Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 19 of 346

94 IE Module Reference Usage Presence Clinical Trial Series C U Not supported Frame of Reference Frame of Reference C M Equipment General Equipment C M Plan RT General Plan C M RT Prescription C U RT Tolerance Tables C U RT Patient Setup C U RT Fraction Scheme C U RT Beams C C RT Brachy Application Setups C Approval C U SOP Common C.12.1 M Extended Interface Extended Interface N/A U Private Table C-21: RT Plan IOD Modules Support C C.1.14 RT Treatment Summary Record A.31.3 Patient Study Series IE Module Reference Usage Presence Patient C M Export only Clinical Trial Subject C U Not supported General Study C M Export only Patient Study C U Not supported Clinical Trial Study C U Not supported RT Series C M Export only Clinical Trial Series C U Not supported Equipment General Equipment C M Export only Treatment Record RT General Treatment Record RT Treatment Summary Record C M Export only C M Export only SOP Common C.12.1 M Export only Table C-22: RT Treatment Summary Record IOD Modules Support 20 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

95 C.1.15 RT Ion Plan A.49.2 Patient Study Series IE Module Reference Usage Presence Patient C M Clinical Trial Subject C U Not supported General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported RT Series C M Clinical Trial Series C U Not supported Frame of Reference Frame of Reference C M Equipment General Equipment C M Plan RT General Plan C M RT Prescription C U RT Ion Tolerance Tables C RT Patient Setup C U RT Fraction Scheme C U RT Ion Beams C C Approval C U SOP Common C.12.1 M Extended Interface Extended Interface N/A U Private Table C-23: RT Ion Plan IOD Modules Support U C.1.16 RT Ion Beams Treatment Record A.50.2 When importing an RT Ion Beams Treatment Record IOD to the DB, also the complete DICOM stream will be stored, thus all modules and attributes, including private elements, are preserved. However, not all modules are supported during conversion to and from the internal data model and thus data from those modules is not accessible via DB tables. IE Module Reference Usage Presence Patient Study Series Patient C M Clinical Trial Subject C U Not supported General Study C M Patient Study C U Not supported Clinical Trial Study C U Not supported RT Series C M Clinical Trial Series C U Not supported Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 21 of 346

96 IE Module Reference Usage Presence Equipment General Equipment C M Treatment Record RT General Treatment Record C RT Patient Setup C U Not supported RT Treatment Machine Record Measured Dose Reference Record Calculated Dose Reference Record RT Beams Session Record RT Treatment Summary Record C M M C U Not supported C U Not supported C M C U Not supported Curve C.10.2 U Not supported SOP Common C.12.1 M Table C-24: RT Ion Beams Treatment Record IOD Modules Support 22 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

97 C.2 Modules and Attributes For better reference with DICOM Standard [1], section titles of the following sub-sections are decorated with section number of DICOM Standard Part 3 where the corresponding Module Attribute table can be found. The first four columns in the following tables contain definitions from the DICOM standard. References in those columns refer to the DICOM standard and not to this document. The Handling column describes for each Attribute whether it is supported and to which database attribute it maps. A value of indicates that an Attribute is unknown and therefore ignored by the application. A value of *** Not Used *** indicates that an Attribute is validated, but its value is not saved on the database. C.2.1 Patient C Patient s Name (0010,0010) 2 Patient's full name. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Patient.LastName, Patient.FirstName, Patient.MiddleName, Patient.Honorific, Patient.NameSuffix) Elements of the patient name are separately stored in above attributes. Patient ID (0010,0020) 2 Primary hospital identification number or code for the patient. Patient.PatientId) Used as the primary patient identification on the user interface. Case-insensitive searches are performed if user selects a patient by ID. Issuer of Patient ID (0010,0021) 3 Identifier of the Assigning Authority that issued the Patient ID. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 23 of 346

98 Patient's Birth Date (0010,0030) 2 Birth date of the patient. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Patient.DateOfBirth) Date and Time are both stored in the same datetime attribute internally. Patient's Sex (0010,0040) 2 Sex of the named patient. Enumerated Values: M = male Patient.Sex) F = female Import: O = other F: Female, M: Male, O: Other Female : F, Male : M, anything else: O Referenced Patient Sequence > Referenced SOP Class UID > Referenced SOP Instance UID (0008,1120) 3 A sequence that provides reference to a Patient SOP Class/Instance pair. Only a single Item shall be permitted in this Sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Patient Sequence (0008,1120) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Patient Sequence (0008,1120) is sent. Patient's Birth Time (0010,0032) 3 Birth time of the Patient. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Patient.DateOfBirth) Date and Time are both stored in the same datetime attribute internally. 24 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

99 Other Patient IDs (0010,1000) 3 Other identification numbers or codes used to identify the patient. Patient.PatientId2) Import: Only the first item of the multi-valued tag is imported. Other Patient Names (0010,1001) 3 Other names used to identify the patient. Ethnic Group (0010,2160) 3 Ethnic group or race of the patient. Patient.Race) Patient Comments (0010,4000) 3 User-defined additional information about the patient. Patient.Comment) Patient Identify Removed (0012,0062) 3 The true identity of the patient has been removed from the Attributes and the Pixel Data Enumerated Values: YES NO Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 25 of 346

100 De-identification Method De-identification Method Code Sequence (0012,0063) 1C A description or label of the mechanism or method use to remove the patient's identity. May be multi-valued if successive de-identification steps have been performed. Note: This may be used to describe the extent or thoroughness of the de- identification, for example whether or not the deidentification is for a "Limited Data Set" (as per HIPAA Privacy Rule). Required if Patient Identity Removed (0012,0062) is present and has a value of YES and De-identification Method Code Sequence (0012,0064) is not present. (0012,0064) 1C A code describing the mechanism or method use to remove the patient's identity. One or more Items shall be present. Multiple items are used if successive de-identification steps have been performed Required if Patient Identity Removed (0012,0062) is present and has a value of YES and De-identification Method (0012,0063) is not present. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. 26 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

101 C.2.2 General Study C Study Instance UID (0020,000D) 1 Unique identifier for the Study. Study.StudyUID) Study Date (0008,0020) 2 Date the Study started. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Study.CreationDate) Date and Time are both stored in the same datetime attribute internally. Study Time (0008,0030) 2 Time the Study started. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Study.CreationDate) Date and Time are both stored in the same datetime attribute internally. Referring Physician s Name Referring Physician Identification Sequence (0008,0090) 2 Name of the patient's referring physician Roundtrip is supported but internal representation is different from DICOM. (Stored in: Study.ReferringPhysicianName) Name components separated by a <tab> character internally. (0008,0096) 3 Identification of the patient's referring physician. Only a single item shall be permitted in this sequence. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 27 of 346

102 > Person Identification Code Sequence (0040,1101) 1 A coded entry which identifies a person. The Code Meaning attribute, though it will be encoded with a VR of LO, may be encoded according to the rules of the PN VR (e.g. caret '^' delimiters shall separate name components), except that a single component (i.e. the whole name unseparated by caret delimiters) is not permitted. Name component groups for use with multi-byte character sets are permitted, as long as they fit within the 64 characters (the length of the LO VR). One or more Items may be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Person s Address (0040,1102) 3 Person's mailing address > Person s Telephone Numbers (0040,1103) 3 Person's telephone number(s) > Institution Name (0008,0080) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Code Sequence (0008,0082) is present. > Institution Address (0008,0081) 3 Mailing address of the institution or organization to which the identified individual is responsible or accountable. 28 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

103 > Institution Code Sequence (0008,0082) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Name (0008,0080) is present. Only a single Item shall be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Study ID (0020,0010) 2 User or equipment generated Study identifier. Study.StudyId) Accession Number (0008,0050) 2 A RIS generated number that identifies the order for the Study. Study Description (0008,1030) 3 Institution-generated description or classification of the Study (component) performed. Physician(s) of Record (0008,1048) 3 Names of the physician(s) who are responsible for overall patient care at time of Study (see Section C for Performing Physician) Study.AccessionNumber) Study.Comment) Import: Ignored Names of all Doctors who are the patient's primary oncologists. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 29 of 346

104 Physician(s) of Record Identification Sequence > Person Identification Code Sequence (0008,1049) 3 Identification of the physician(s) who are responsible for overall patient care at time of Study. One or more items shall be included in this sequence. If more than one Item, the number and order shall correspond to the value of Physician(s) of Record (0008,1048), if present. (0040,1101) 1 A coded entry which identifies a person. The Code Meaning attribute, though it will be encoded with a VR of LO, may be encoded according to the rules of the PN VR (e.g. caret '^' delimiters shall separate name components), except that a single component (i.e. the whole name unseparated by caret delimiters) is not permitted. Name component groups for use with multi-byte character sets are permitted, as long as they fit within the 64 characters (the length of the LO VR). One or more Items may be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Person s Address (0040,1102) 3 Person's mailing address > Person s Telephone Numbers (0040,1103) 3 Person's telephone number(s) 30 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

105 > Institution Name (0008,0080) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Code Sequence (0008,0082) is present. > Institution Address (0008,0081) 3 Mailing address of the institution or organization to which the identified individual is responsible or accountable. > Institution Code Sequence (0008,0082) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Name (0008,0080) is present. Only a single Item shall be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Name of Physician(s) Reading Study Physician(s) Reading Study Identification Sequence (0008,1060) 3 Names of the physician(s) reading the Study. (0008,1062) 3 Identification of the physician(s) reading the Study. One or more items shall be included in this sequence. If more than one Item, the number and order shall correspond to the value of Name of Physician(s) Reading Study (0008,1060), if present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 31 of 346

106 > Person Identification Code Sequence (0040,1101) 1 A coded entry which identifies a person. The Code Meaning attribute, though it will be encoded with a VR of LO, may be encoded according to the rules of the PN VR (e.g. caret '^' delimiters shall separate name components), except that a single component (i.e. the whole name unseparated by caret delimiters) is not permitted. Name component groups for use with multi-byte character sets are permitted, as long as they fit within the 64 characters (the length of the LO VR). One or more Items may be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Person s Address (0040,1102) 3 Person's mailing address > Person s Telephone Numbers (0040,1103) 3 Person's telephone number(s) > Institution Name (0008,0080) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Code Sequence (0008,0082) is present. > Institution Address (0008,0081) 3 Mailing address of the institution or organization to which the identified individual is responsible or accountable. 32 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

107 > Institution Code Sequence (0008,0082) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Name (0008,0080) is present. Only a single Item shall be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Referenced Study Sequence > Referenced SOP Class UID > Referenced SOP Instance UID Procedure Code Sequence (0008,1110) 3 A sequence that provides reference to a Study SOP Class/Instance pair. The sequence may have zero or more Items. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Study Sequence (0008,1110) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Study Sequence (0008,1110) is sent. (0008,1032) 3 A Sequence that conveys the type of procedure performed. One or more Items may be included in this Sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 33 of 346

108 > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. C.2.3 General Series C Modality (0008,0060) 1 Type of equipment that originally acquired the data used to create the images in this Series. See C for Defined Terms. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Series.SeriesModality) Import: Modalities PT, RF and XA will be mapped to OT Series Instance UID (0020,000E) 1 Unique identifier of the Series. Series.SeriesUID) Import: For objects where the modality is mapped to OT, the instance UID is being updated. 34 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

109 Series Number (0020,0011) 2 A number that identifies this Series. Series.SeriesNumber) Import: Will also be used create the name of the series as displayed in the UI. Laterality (0020,0060) 2C Laterality of (paired) body part examined. Required if the body part examined is a paired structure and Image Laterality (0020,0062) or Frame Laterality (0020,9072) are not sent. Enumerated Values: R = right L = left Note: Some IODs support Image Laterality (0020,0062) at the Image level or Frame Laterality(0020,9072) at the Frame level in the Frame Anatomy functional group macro, which can provide a more comprehensive mechanism for specifying the laterality of the body part(s) being examined. Series Date (0008,0021) 3 Date the Series started. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Series.CreationDate) Date and Time are both stored in the same datetime attribute internally. Series Time (0008,0031) 3 Time the Series started. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Series.CreationDate) Date and Time are both stored in the same datetime attribute internally. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 35 of 346

110 Performing Physician s Name (0008,1050) 3 Name of the physician(s) administering the Series. Performing Physician Identification Sequence > Person Identification Code Sequence (0008,1052) 3 Identification of the physician(s) administering the Series. One or more items shall be included in this sequence. If more than one Item, the number and order shall correspond to the value of Performing Physicians' Name (0008,1050), if present. (0040,1101) 1 A coded entry which identifies a person. The Code Meaning attribute, though it will be encoded with a VR of LO, may be encoded according to the rules of the PN VR (e.g. caret '^' delimiters shall separate name components), except that a single component (i.e. the whole name unseparated by caret delimiters) is not permitted. Name component groups for use with multi-byte character sets are permitted, as long as they fit within the 64 characters (the length of the LO VR). One or more Items may be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Person s Address (0040,1102) 3 Person's mailing address 36 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

111 > Person s Telephone Numbers (0040,1103) 3 Person's telephone number(s) > Institution Name (0008,0080) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Code Sequence (0008,0082) is present. > Institution Address (0008,0081) 3 Mailing address of the institution or organization to which the identified individual is responsible or accountable. > Institution Code Sequence (0008,0082) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Name (0008,0080) is present. Only a single Item shall be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Protocol Name (0018,1030) 3 User-defined description of the conditions under which the Series was performed. Note: This attribute conveys series-specific protocol identification and may or may not be identical to the one presented in the Performed Protocol Code Sequence (0040,0260). Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 37 of 346

112 Series Description (0008,103E) 3 User provided description of the Series Series.Comment) Operators Name (0008,1070) 3 Name(s) of the operator(s) supporting the Series. Operator Identification Sequence > Person Identification Code Sequence (0008,1072) 3 Identification of the operator(s) supporting the Series. One or more items shall be included in this sequence. If more than one Item, the number and order shall correspond to the value of Operators' Name (0008,1070), if present. (0040,1101) 1 A coded entry which identifies a person. The Code Meaning attribute, though it will be encoded with a VR of LO, may be encoded according to the rules of the PN VR (e.g. caret '^' delimiters shall separate name components), except that a single component (i.e. the whole name unseparated by caret delimiters) is not permitted. Name component groups for use with multi-byte character sets are permitted, as long as they fit within the 64 characters (the length of the LO VR). One or more Items may be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. 38 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

113 > Person s Address (0040,1102) 3 Person's mailing address > Person s Telephone Numbers (0040,1103) 3 Person's telephone number(s) > Institution Name (0008,0080) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Code Sequence (0008,0082) is present. > Institution Address (0008,0081) 3 Mailing address of the institution or organization to which the identified individual is responsible or accountable. > Institution Code Sequence (0008,0082) 1C Institution or organization to which the identified individual is responsible or accountable. Shall not be present if Institution Name (0008,0080) is present. Only a single Item shall be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Referenced Performed Procedure Step Sequence (0008,1111) 3 Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). The Sequence shall have zero or one Item. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 39 of 346

114 > Referenced SOP Class UID > Referenced SOP Instance UID Related Series Sequence > Study Instance UID > Series Instance UID (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Performed Procedure Step Sequence (0008,1111) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Performed Procedure Step Sequence (0008,1111) is sent. (0008,1250) 3 Identification of Series significantly related to this Series. Zero or more Items may be present. Notes: 1. For example, for a combined CT and PET acquisition, the CT images and PET images would be in separate series that could cross- reference each other with multiple purpose of reference codes meaning same anatomy, simultaneously acquired and same indication. 2. The related series may have different Frames of Reference and hence require some sort of registration before spatial coordinates can be directly compared. 3. This attribute is not intended for conveying localizer reference information, for which Referenced Image Sequence (0008,1140) should be used. (0020,000D) 1 Instance UID of Study to which the related Series belongs (0020,000E) 1 Instance UID of Related Series > Purpose of Reference Code Sequence (0040,A170) 2 Describes the purpose for which the reference is made. Zero or more Items may be present. When absent, implies that the reason for the reference is unknown. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. 40 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

115 >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Body Part Examined (0018,0015) 3 Text description of the part of the body examined. Defined Terms: SKULL, CSPINE, TSPINE, LSPINE, SSPINE, COCCYX, CHEST, CLAVICLE, BREAST, ABDOMEN, PELVIS, HIP, SHOULDER, ELBOW, KNEE, ANKLE, HAND, FOOT, EXTREMITY, HEAD, HEART, NECK, LEG, ARM, JAW Note: Some IODs support the Anatomic Region Sequence (0008,2218), which can provide a more comprehensive mechanism for specifying the body part being examined. Series.BodyPartExamined) Values HEAD, HEART, NECK, LEG, ARM, JAW are not fully supported. Objects imported with these values will be displayed correctly. But the user will not be able to create a new object with such a defined term. Patient Position (0018,5100) 2C Patient position descriptor relative to the equipment. Required for CT and MR images; shall not be present if Patient Orientation Code Sequence (0054,0410) is present; may be present otherwise. See C for Defined Terms and further explanation. Series.PatientOrientation) Smallest Pixel Value in Series Largest Pixel Value in Series (0028,0108) 3 The minimum value of all images in this Series. (0028,0109) 3 The maximum value of all images in this Series. Request Attributes Sequence (0040,0275) 3 Sequence that contains attributes from the Imaging Service Request. The sequence may have one or more Items. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 41 of 346

116 > Requested Procedure ID (0040,1001) 1 Identifier that identifies the Requested Procedure in the Imaging Service Request. > Reason for the Requested Procedure > Reason for Requested Procedure Code Sequence (0040,1002) 3 Reason for requesting this procedure. (0040,100A) 3 Coded Reason for requesting this procedure. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Scheduled Procedure Step ID (0040,0009) 1 Identifier that identifies the Scheduled Procedure Step. > Scheduled Procedure Step Description > Scheduled Protocol Code Sequence (0040,0007) 3 Institution-generated description or classification of the Scheduled Procedure Step to be performed. (0040,0008) 3 Sequence describing the Scheduled Protocol following a specific coding scheme. This sequence contains one or more Items. 42 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

117 >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >> Protocol Context Sequence (0040,0440) 3 Sequence that specifies the context for the Scheduled Protocol Code Sequence Item. One or more items may be included in this sequence. >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >>> Content Item Modifier Sequence (0040,0441) 3 Sequence that specifies modifiers for a Protocol Context Content Item. One or more items may be included in this sequence. See Section C >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 43 of 346

118 >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Performed Procedure Step ID (0040,0253) 3 User or equipment generated identifier of that part of a Procedure that has been carried out within this step. Performed Procedure Step Start Date Performed Procedure Step Start Time Performed Procedure Step Description Performed Protocol Code Sequence (0040,0244) 3 Date on which the Performed Procedure Step started. (0040,0245) 3 Time on which the Performed Procedure Step started. (0040,0254) 3 Institution-generated description or classification of the Procedure Step that was performed. (0040,0260) 3 Sequence describing the Protocol performed for this Procedure Step. One or more Items may be included in this Sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. 44 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

119 > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Protocol Context Sequence (0040,0440) 3 Sequence that specifies the context for the Performed Protocol Code Sequence Item. One or more items may be included in this sequence. >> Value Type (0040,A040) 1 The type of the value encoded in this name-value Item. Defined Terms: DATETIME DATE TIME PNAME UIDREF TEXT CODE NUMERIC. >> Concept Name Code Sequence (0040,A043) 1 Coded concept name of this name-value Item. >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 45 of 346

120 >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >> DateTime (0040,A120) 1C Datetime value for this name-value Item. Required if Value Type (0040,A040) is DATETIME. >> Date (0040,A121) 1C Date value for this name-value Item. Required if Value Type (0040,A040) is DATE. >> Time (0040,A122) 1C Time value for this name-value Item. Required if Value Type (0040,A040) is TIME. >> Person Name (0040,A123) 1C Person name value for this name-value Item. Required if Value Type (0040,A040) is PNAME. >> UID (0040,A124) 1C UID value for this name-value Item. Required if Value Type (0040,A040) is UIDREF. >> Text Value (0040,A160) 1C Text value for this name-value Item. Required if Value Type (0040,A040) is TEXT. >> Concept Code Sequence (0040,A168) 1C Coded concept value of this name-value Item. Required if Value Type (0040,A040) is CODE. >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. 46 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

121 >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >> Numeric Value (0040,A30A) 1C Numeric value for this name-value Item. Required if Value Type (0040,A040) is NUMERIC. >> Measurement Units Code Sequence (0040,08EA) 1C Units of measurement for a numeric value in this namevalue Item. Required if Value Type (0040,A040) is NUMERIC. >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >> Content Item Modifier Sequence (0040,0441) 3 Sequence that specifies modifiers for a Protocol Context Content Item. One or more items may be included in this sequence. See Section C Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 47 of 346

122 >>> Value Type (0040,A040) 1 The type of the value encoded in this name-value Item. Defined Terms: DATETIME DATE TIME PNAME UIDREF TEXT CODE NUMERIC. >>> Concept Name Code Sequence (0040,A043) 1 Coded concept name of this name-value Item. >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >>> DateTime (0040,A120) 1C Datetime value for this name-value Item. Required if Value Type (0040,A040) is DATETIME. >>> Date (0040,A121) 1C Date value for this name-value Item. Required if Value Type (0040,A040) is DATE. 48 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

123 >>> Time (0040,A122) 1C Time value for this name-value Item. Required if Value Type (0040,A040) is TIME. >>> Person Name (0040,A123) 1C Person name value for this name-value Item. Required if Value Type (0040,A040) is PNAME. >>> UID (0040,A124) 1C UID value for this name-value Item. Required if Value Type (0040,A040) is UIDREF. >>> Text Value (0040,A160) 1C Text value for this name-value Item. Required if Value Type (0040,A040) is TEXT. >>> Concept Code Sequence (0040,A168) 1C Coded concept value of this name-value Item. Required if Value Type (0040,A040) is CODE. >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >>> Numeric Value (0040,A30A) 1C Numeric value for this name-value Item. Required if Value Type (0040,A040) is NUMERIC. >>> Measurement Units Code Sequence (0040,08EA) 1C Units of measurement for a numeric value in this namevalue Item. Required if Value Type (0040,A040) is NUMERIC. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 49 of 346

124 >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Comments on the Performed Procedure Step (0040,0280) 3 User-defined comments on the Performed Procedure Step. C.2.4 Frame of Reference C Frame of Reference UID Position Reference Indicator (0020,0052) 1 Uniquely identifies the frame of reference for a Series. See C for further explanation. (0020,1040) 2 Part of the patient's anatomy used as a reference, such as the iliac crest, orbital- medial, sternal notch, symphysis pubis, xiphoid, lower coastal margin, external auditory meatus. See C for further explanation. Slice.FrameOfReferenceUID, DoseMatrix.FrameOfReferenceUID) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix) *** Not Used *** 50 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

125 C.2.5 General Equipment C Manufacturer (0008,0070) 2 Manufacturer of the equipment that produced the composite instances. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ReferingEquipment) Stored together with manufacturers model name. Institution Name (0008,0080) 3 Institution where the equipment that produced the composite instances is located. Institution Address (0008,0081) 3 Mailing address of the institution where the equipment that produced the composite instances is located. Import: Used to find machine If ReferingEquipment is empty then Machine.Manufacturer is used. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ReferingEquipment) Import: ignored. If Slice.ReferingEquipment is empty then Hospital.Id is used Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 51 of 346

126 Station Name (0008,1010) 3 User defined name identifying the machine that produced the composite instances. Institutional Department Name Manufacturer s Model Name (0008,1040) 3 Department in the institution where the equipment that produced the composite instances is located. (0008,1090) 3 Manufacturer's model name of the equipment that produced the composite instances. Import: Attribute is read, but cannot be exported. (Stored as-is in: Slice.StationName) Images: Machine.Id Other objects: Id of Workstation from where object is beeing exported Attribute is written, but not supported during import. (Value read from: Department.DepartmentId) Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ReferingEquipment) Stored together with manufacturer. Import: Used to find machine If Slice.ReferingEquipment is empty then Machine.MachineModel 52 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

127 Device Serial Number (0018,1000) 3 Manufacturer's serial number of the equipment that produced the composite instances. Stored together with manufacturers model name and manufacturer Import: Used to find machine Software Version(s) (0018,1020) 3 Manufacturer's designation of software version of the equipment that produced the composite instances. If Slice.ReferingEquipment is empty then Machine.ManufacturerSerNo Attribute is processed during export only. The value of Slice.ReferingEquipment will be used to calculate the contents during export. Export only: Images: If Slice.ReferingEquipment is empty then Machine.SoftwareVersion Spatial Resolution (0018,1050) 3 The inherent limiting resolution in mm of the acquisition equipment for high contrast objects for the data gathering and reconstruction technique chosen. If variable across the images of the series, the value at the image center. Date of Last Calibration (0018,1200) 3 Date when the image acquisition device calibration was last changed in any way. Multiple entries may be used for additional calibrations at other times. See C for further explanation. Other objects: Version of the Vision software *** Not Used *** *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 53 of 346

128 Time of Last Calibration (0018,1201) 3 Time when the image acquisition device calibration was last changed in any way. Multiple entries may be used. See C for further explanation. *** Not Used *** Pixel Padding Value (0028,0120) 3 Value of pixels not present in the native image added to an image to pad to rectangular format. See C for further explanation. Note: The Value Representation of this Attribute is determined by the value of Pixel Representation (0028,0103). Import only C.2.6 General Image C Instance Number (0020,0013) 2 A number that identifies this image. Note: This Attribute was named Image Number in earlier versions of this Standard. Slice.SliceNumber) Used for Image and Acquired Dose. Not used for Calculated Dose. Import: Will also be used to create the Image ID as displayed in the UI. 54 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

129 Patient Orientation (0020,0020) 2C Patient direction of the rows and columns of the image. Required if image does not require Image Orientation (Patient) (0020,0037) and Image Position (Patient) (0020,0032). See C for further explanation. Note: IOD's may have attributes other than Patient Orientation, Image Orientation, or Image Position (Patient) to describe orientation in which case this attribute will be zero length. Content Date (0008,0023) 2C The date the image pixel data creation started. Required if image is part of a series in which the images are temporally related. Note: This Attribute was formerly known as Image Date. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Image.PatientOrientation) Used for Image and Acquired Dose. Not used for Calculated Dose. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.CreationDate, DoseMatrix.CreationDate) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix) Date and Time are both stored in the same datetime attribute internally. Content Time (0008,0033) 2C The time the image pixel data creation started. Required if image is part of a series in which the images are temporally related. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.CreationDate, DoseMatrix.CreationDate) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix) Date and Time are both stored in the same datetime attribute internally. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 55 of 346

130 Image Type (0008,0008) 3 Image identification characteristics. See C for Defined Terms and further explanation. Slice.SliceCharacteristics) Content depends on image modality if Slice.SliceCharacteristics is not defined. Portal Dose: Tag value for acquired portal dose: ORIGINAL\PRIMARY\PORTAL\ACQUIRE D_DOSE Tag value for calculated portal dose: DERIVED\SECONDARY\PORTAL\CALC ULATED_DOSE Acquisition Number (0020,0012) 3 A number identifying the single continuous gathering of data over a period of time that resulted in this image. Acquisition Date (0008,0022) 3 The date the acquisition of data that resulted in this image started Acquisition Time (0008,0032) 3 The time the acquisition of data that resulted in this image started On export, content of this tag may be generated depending on image type. SliceCT.AcquisitionNumber) Used only for CT Images 56 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

131 Acquisition Datetime (0008,002A) 3 The date and time that the acquisition of data that resulted in this image started. Note: The synchronization of this time with an external clock is specified in the Synchronization Module in Acquisition Time Synchronized (0018,1800). Referenced Image Sequence (0008,1140) 3 A sequence that references other images significantly related to this image (e.g. post-localizer CT image or Mammographic biopsy or partial view images). One or more Items may be included in this sequence. > Referenced SOP Class UID > Referenced SOP Instance UID (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. > Referenced Frame Number > Purpose of Reference Code Sequence (0008,1160) 1 Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Note: This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames. (0040,A170) 3 Describes the purpose for which the reference is made. Only a single Item shall be permitted in this sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 57 of 346

132 >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Derivation Description (0008,2111) 3 A text description of how this image was derived. See C for further explanation. Derivation Code Sequence (0008,9215) 3 A coded description of how this image was derived. See C for further explanation. One or more Items may be included in this Sequence. More than one Item indicates that successive derivation steps have been applied. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Source Image Sequence > Referenced SOP Class UID (0008,2112) 3 A Sequence that identifies the set of Image SOP Class/Instance pairs of the Images that were used to derive this Image. Zero or more Items may be included in this Sequence. See C for further explanation. (0008,1150) 1 Uniquely identifies the referenced SOP Class. 58 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

133 > Referenced SOP Instance UID (0008,1155) 1 Uniquely identifies the referenced SOP Instance. > Referenced Frame Number > Purpose of Reference Code Sequence (0008,1160) 1 Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Note: This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames. (0040,A170) 3 Describes the purpose for which the reference is made, that is what role the source image or frame(s) played in the derivation of this image. Only a single Item shall be permitted in this sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 59 of 346

134 > Spatial Locations Preserved Referenced Instance Sequence > Referenced SOP Class UID > Referenced SOP Instance UID (0028,135A) 3 Whether or not the spatial locations of all pixels are preserved during the processing of the source image that resulted in the current image Enumerated Values: YES NO Note: This applies not only to images with a known relationship to a 3D space, but also to projection images. For example, a projection radiograph such as a mammogram that is processed by a point image processing operation such as contrast enhancement, or a smoothing or edge enhancing convolution, would have a value of YES for this attribute. A projection radiograph that had been magnified or warped geometrically would have a value of NO for this attribute. This attribute is typically of importance in relating images with Presentation Intent Type (0008,0068) values of FOR PROCESSING and FOR PRESENTATION. (0008,114A) 3 A sequence which provides reference to a set of non-image SOP Class/Instance pairs significantly related to this Image, including waveforms that may or may not be temporally synchronized with this image. One or more Items may be included in this sequence. (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. > Purpose of Reference Code Sequence (0040,A170) 1 Code describing the purpose of the reference to the Instance(s). Only a single Item shall be permitted in this sequence. 60 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

135 >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Images in Acquisition (0020,1002) 3 Number of images that resulted from this acquisition of data Image Comments (0020,4000) 3 User-defined comments about the image Image.Comment, DoseMatrix.CreationNote) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix) Quality Control Image (0028,0300) 3 Indicates whether or not this image is a quality control or phantom image. Enumerated Values: YES NO If this Attribute is absent, then the image may or may not be a quality control or phantom image. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 61 of 346

136 Burned In Annotation Lossy Image Compression Lossy Image Compression Ratio Lossy Image Compression Method (0028,0301) 3 Indicates whether or not image contains sufficient burned in annotation to identify the patient and date the image was acquired. Enumerated Values: YES NO If this Attribute is absent, then the image may or may not contain burned in annotation. (0028,2110) 3 Specifies whether an Image has undergone lossy compression. Enumerated Values: 00 = Image has NOT been subjected to lossy compression. 01 = Image has been subjected to lossy compression. See C (0028,2112) 3 Describes the approximate lossy compression ratio(s) that have been applied to this image. See C for further explanation. May be multivalued if successive lossy compression steps have been applied. Notes: 1. For example, a compression ratio of 30:1 would be described in this Attribute with a single value of For historical reasons, the lossy compression ratio may also be described in Derivation Description (0008,2111). (0028,2114) 3 A label for the lossy compression method(s) that have been applied to this image. See C for further explanation. May be multivalued if successive lossy compression steps have been applied; the value order shall correspond to the values of Lossy Image Compression Ratio (0028,2112). Note: For historical reasons, the lossy compression method may also be described in Derivation Description (0008,2111). Export only for Portal Dose: of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

137 Icon Image Sequence (0088,0200) 3 This icon image is representative of the Image. > Samples per Pixel (0028,0002) 1 Number of samples (planes) in this image. See C for further explanation. > Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. See C for further explanation. > Rows (0028,0010) 1 Number of rows in the image. > Columns (0028,0011) 1 Number of columns in the image. > Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See PS 3.5 for further explanation. > Bits Stored (0028,0101) 1 Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. See PS 3.5 for further explanation. > High Bit (0028,0102) 1 Most significant bit for pixel sample data. Each sample shall have the same high bit. See PS 3.5 for further explanation. > Pixel Representation (0028,0103) 1 Data representation of the pixel samples. Each sample shall have the same pixel representation. Enumerated Values: 0000H = unsigned integer. 0001H = 2's complement > Pixel Data (7FE0,0010) 1C A data stream of the pixel samples that comprise the Image. See C for further explanation. Required if Pixel Data Provider URL (0028,7FE0) is not present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 63 of 346

138 > Planar Configuration (0028,0006) 1C Indicates whether the pixel data are sent color-by-plane or color-by-pixel. Required if Samples per Pixel (0028,0002) has a value greater than 1. See C for further explanation. > Pixel Aspect Ratio (0028,0034) 1C Ratio of the vertical size and horizontal size of the pixels in the image specified by a pair of integer values where the first value is the vertical pixel size, and the second value is the horizontal pixel size. Required if the aspect ratio is not 1 and the Image Plane Module or the Pixel Measures Macro is not applicable to this Image. See C > Smallest Image Pixel Value (0028,0106) 3 The minimum actual pixel value encountered in this image. > Largest Image Pixel Value (0028,0107) 3 The maximum actual pixel value encountered in this image. > Red Palette Color Lookup Table Descriptor US or > Green Palette Color Lookup Table Descriptor US or > Blue Palette Color Lookup Table Descriptor US or (0028,1101) 1C Specifies the format of the Red Palette Color Lookup Table Data (0028,1201) Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1102) 1C Specifies the format of the Green Palette Color Lookup Table Data (0028,1202) Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1103) 1C Specifies the format of the Blue Palette Color Lookup Table Data (0028,1203) Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. 64 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

139 > Red Palette Color Lookup Table Data > Green Palette Color Lookup Table Data > Blue Palette Color Lookup Table Data (0028,1201) 1C Red Palette Color Lookup Table Data. Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1202) 1C Green Palette Color Lookup Table Data. Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1203) 1C Blue Palette Color Lookup Table Data. Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. > ICC Profile (0028,2000) 3 An ICC Profile encoding the transformation of devicedependent color stored pixel values into PCS-Values. See Section C When present, defines the color space of color Pixel Data (7FE0,0010) values, and the output of Palette Color Lookup Table. Data (0028, ). Note: The profile applies only to the Pixel Data (7FE0,0010) attribute at the same level of the dataset and not to any icons nested within sequences, which may or may not have their own ICC profile specified. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 65 of 346

140 Presentation LUT Shape Irradiation Event UID (2050,0020) 3 When present, specifies an identity transformation for the Presentation LUT such that the output of all grayscale transformations, if any, are defined to be in P-Values. Enumerated Values are: IDENTITY = output is in P-Values - shall be used if Photometric Interpretation (0028,0004) is MONOCHROME2 or any color photometric interpretation. INVERSE = output after inversion is in P- Values - shall be used if Photometric Interpretation (0028,0004) is MONOCHROME1. When this attribute is used with a color photometric interpretation then the luminance component is in P-Values. (0008,3010) 3 Unique identification of the irradiation event(s) associated with the acquisition of this image. See C Image Remarks (3281,1000) 3 66 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

141 C.2.7 Image Plane C Pixel Spacing (0028,0030) 1 Physical distance in the patient between the center of each pixel, specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing in mm. Image Orientation (Patient) (0020,0037) 1 The direction cosines of the first row and the first column with respect to the patient. See C for further explanation. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ResolutionX, Slice.ResolutionY, Image.ImageResX, Image.ImageResY, DoseMatrix.ResX, DoseMatrix.ResY) Storage location depends on object type (Image in table Slice and Image / Portal Dose in table DoseMatrix) Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.Transformation, DoseMatrix.Transformation) Attribute is imported to Image.Transformation but not exported from there. Slice/Image.Transformation combines the Image Orientation and Image Position attributes. Storage location depends on object type (Image in table Slice and Image / Portal Dose in table DoseMatrix) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 67 of 346

142 Image Position (Patient) (0020,0032) 1 The x, y, and z coordinates of the upper left hand corner (center of the first voxel transmitted) of the image, in mm. See C for further explanation. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.Transformation, DoseMatrix.Transformation) Attribute is imported to Image.Transformation but not exported from there. Slice/Image.Transformation combines the Image Orientation and Image Position attributes. Storage location depends on object type (Image in table Slice and Image / Portal Dose in table DoseMatrix) Slice Thickness (0018,0050) 2 Nominal slice thickness, in mm. SliceCT.Thickness) Used for CT Images only. Slice Location (0020,1041) 3 Relative position of exposure expressed in mm. C for further explanation. Slice.Position) Is displayed as "Slice-Position (z-value)" in Technical tab of properties page. Does not affect any other coordinate values. 68 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

143 C.2.8 Image Pixel C Samples per Pixel (0028,0002) 1 Number of samples (planes) in this image. See C for further explanation. Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. See C for further explanation. Import: For Portal Dose and RT Dose warning, if value is not 1 1 Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 Rows (0028,0010) 1 Number of rows in the image. Image.ImageSizeY, DoseMatrix.SizeY) Storage location depends on object type (Image in table Image / Portal Dose in table DoseMatrix) Columns (0028,0011) 1 Number of columns in the image. Image.ImageSizeX, DoseMatrix.SizeX) Storage location depends on object type (Image in table Image / Portal Dose in table DoseMatrix) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 69 of 346

144 Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See PS 3.5 for further explanation. Bits Stored (0028,0101) 1 Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. See PS 3.5 for further explanation. High Bit (0028,0102) 1 Most significant bit for pixel sample data. Each sample shall have the same high bit. See PS 3.5 for further explanation. Slice.BitsAllocated) Portal Dose: 16 RT Dose: 32 Other: variable Slice.BitsStored) The same value as Bits Allocated if undefined. Slice.HighBit) Bits Allocated - 1 if undefined. 70 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

145 Pixel Representation (0028,0103) 1 Data representation of the pixel samples. Each sample shall have the same pixel representation. Enumerated Values: 0000H = unsigned integer. 0001H = 2's complement Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.PixelOffset) Import: Import of Portal Dose or RT Dose is rejected if value is other then 0000H. Both values supported, but for RT Image, Portal Dose and RT Dose it is always 0000H Pixel Data (7FE0,0010) 1C A data stream of the pixel samples that comprise the Image. See C for further explanation. Required if Pixel Data Provider URL (0028,7FE0) is not present. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.FileName, DoseMatrix.DoseMatrixFile) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix). Actual contents of the tag are stored in a physical file. On the DB a filename is tracked. Pixels will never be modified on the storage system. Modifications are temporary on the display only. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 71 of 346

146 Planar Configuration (0028,0006) 1C Indicates whether the pixel data are sent color-by-plane or color-by-pixel. Required if Samples per Pixel (0028,0002) has a value greater than 1. See C for further explanation. Pixel Aspect Ratio (0028,0034) 1C Ratio of the vertical size and horizontal size of the pixels in the image specified by a pair of integer values where the first value is the vertical pixel size, and the second value is the horizontal pixel size. Required if the aspect ratio is not 1 and the Image Plane Module or the Pixel Measures Macro is not applicable to this Image. See C Smallest Image Pixel Value Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ResolutionX, Slice.ResolutionY, DoseMatrix.ResX, DoseMatrix.ResY) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix). (0028,0106) 3 The minimum actual pixel value encountered in this image. Largest Image Pixel Value (0028,0107) 3 The maximum actual pixel value encountered in this image. Red Palette Color Lookup Table Descriptor US or Green Palette Color Lookup Table Descriptor US or (0028,1101) 1C Specifies the format of the Red Palette Color Lookup Table Data (0028,1201) Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1102) 1C Specifies the format of the Green Palette Color Lookup Table Data (0028,1202) Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. 72 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

147 Blue Palette Color Lookup Table Descriptor US or Red Palette Color Lookup Table Data Green Palette Color Lookup Table Data Blue Palette Color Lookup Table Data (0028,1103) 1C Specifies the format of the Blue Palette Color Lookup Table Data (0028,1203) Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1201) 1C Red Palette Color Lookup Table Data. Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1202) 1C Green Palette Color Lookup Table Data. Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. (0028,1203) 1C Blue Palette Color Lookup Table Data. Required if Photometric Interpretation (0028,0004) has a value of PALETTE COLOR or Pixel Presentation (0008,9205) at the image level equals COLOR or MIXED. See C for further explanation. ICC Profile (0028,2000) 3 An ICC Profile encoding the transformation of devicedependent color stored pixel values into PCS-Values. See Section C When present, defines the color space of color Pixel Data (7FE0,0010) values, and the output of Palette Color Lookup Table. Data (0028, ). Note: The profile applies only to the Pixel Data (7FE0,0010) attribute at the same level of the dataset and not to any icons nested within sequences, which may or may not have their own ICC profile specified. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 73 of 346

148 Pixel Data Provider URL (0028,7FE0) 1C A URL of a provider service that supplies the pixel data of the Image. Required if the image is to be transferred in one of the following presentation contexts identified by Transfer Syntax UID: (DICOM JPIP Referenced Transfer Syntax) (DICOM JPIP Referenced Deflate Transfer Syntax) C.2.9 Multi-Frame C Number of Frames (0028,0008) 1 Number of frames in a Multi-frame Image. See C for further explanation. DoseMatrix.SizeZ) Supported only for RT Dose Frame Increment Pointer (0028,0009) 1 Contains the Data Element Tag of the attribute that is used as the frame increment in Multi-frame pixel data. See C for further explanation. RT Dose: Grid Frame Offset Vector tag (3004, 000C) C.2.10 CR Series C of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

149 Body Part Examined (0018,0015) 2 Text description of the part of the body examined. Defined Terms: SKULL CSPINE TSPINE LSPINE SSPINE COCCYX CHEST CLAVICLE BREAST ABDOMEN PELVIS HIP SHOULDER ELBOW KNEE ANKLE HAND FOOT EXTREMITY HEAD HEART NECK LEG ARM JAW Series.BodyPartExamined) Values HEAD, HEART, NECK, LEG, ARM, JAW are not fully supported. Objects imported with these values will be displayed correctly. But the user will not be able to create a new object with such a defined term. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 75 of 346

150 View Position (0018,5101) 2 Radiographic view associated with Patient Position (0018,5100). Defined Terms: AP = Anterior/Posterior PA = Posterior/Anterior LL = Left Lateral RL = Right Lateral RLD = Right Lateral Decubitus LLD = Left Lateral Decubitus RLO = Right Lateral Oblique LLO = Left Lateral Oblique Filter Type (0018,1160) 3 Label for the type of filter inserted into the x-ray beam Collimator/Grid Name (0018,1180) 3 Label describing any grid inserted. Focal Spot(s) (0018,1190) 3 Size of the focal spot in mm. For devices with variable focal spot or multiple focal spots, small dimension followed by large dimension. Plate Type (0018,1260) 3 Label of the type of storage phosphor plates used in this series Phosphor Type (0018,1261) 3 Label of type of phosphor on the plates 76 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

151 C.2.11 CR Image C Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. Shall have one of the following Enumerated Values: MONOCHROME1 MONOCHROME2 Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 KVP (0018,0060) 3 Peak kilo voltage output of the x-ray generator used Plate ID (0018,1004) 3 The ID or serial number of the sensing plate upon which the image was acquired Distance Source to Detector (0018,1110) 3 Distance in mm from source to detector center. Note: This value is traditionally referred to as Source Image Receptor Distance (SID). Distance Source to Patient (0018,1111) 3 Distance in mm from source to isocenter (center of field of view). Note: This value is traditionally referred to as Source Object Distance (SOD). Exposure Time (0018,1150) 3 Time of x-ray exposure in msec X-ray Tube Current (0018,1151) 3 X-ray Tube Current in ma. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 77 of 346

152 Exposure (0018,1152) 3 The exposure expressed in mas, for example calculated from Exposure Time and X-ray Tube Current. Exposure in uas (0018,1153) 3 The exposure expressed in As, for example calculated from Exposure Time and X-ray Tube Current. Imager Pixel Spacing (0018,1164) 3 Physical distance measured at the front plane of the Image Receptor housing between the center of each pixel. Specified by a numeric pair - row spacing value (delimiter) column spacing value - in mm. In the case of CR, the front plane is defined to be the external surface of the CR plate closest to the patient and radiation source. Pixel Spacing (0028,0030) 1C Physical distance in the patient between the center of each pixel, specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing in mm. See Pixel Spacing Calibration Type (0028,0402) 3 The type of correction for the effect of geometric magnification or calibration against an object of known size, if any. See Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ResolutionX, Slice.ResolutionY, Image.ImageResX, Image.ImageResY, Slice.CalibratedFlag) Import: Overrides the data 'Pixel Spacing' if available. will essentially get the same values as 'Pixel Spacing' 78 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

153 Pixel Spacing Calibration Description (0028,0404) 1C A free text description of the type of correction or calibration performed. Notes: 1. In the case of correction, the text might include description of the assumptions made about the body part and geometry and depth within the patient. 2. in the case of calibration, the text might include a description of the fiducial and where it is located (e.g., "XYZ device applied to the skin over the greater trochanter"). 3. Though it is not required, the Device Module may be used to describe the specific characteristics and size of the calibration device. Required if Pixel Spacing Calibration Type (0028,0402) is present. Generator Power (0018,1170) 3 Power in kw to the x-ray generator. Acquisition Device Processing Description Acquisition Device Processing Code (0018,1400) 3 Describes device-specific processing associated with the image (e.g. Organ Description) (0018,1401) 3 Code representing the device-specific processing associated with the image (e.g. CR Organ Filtering code) Cassette Orientation (0018,1402) 3 Orientation of cassette, used to properly position the image for display. Enumerated Values: LANDSCAPE PORTRAIT Cassette Size (0018,1403) 3 Size of cassette. Defined Terms: 18CMX24CM 8INX10IN 24CMX30CM 10INX12IN 30CMX35CM 30CMX40CM 11INX14IN 35CMX35CM 14INX14IN 35CMX43CM 14INX17IN Exposures on Plate (0018,1404) 3 Total number of x-ray exposures that have been made on the plate identified in Plate ID (0018,1004) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 79 of 346

154 Relative X-ray Exposure (0018,1405) 3 Relative x-ray exposure on the plate. Meaning of values is implementation specific. May be used to adjust the dynamic range of the plate digitizer (scanner). Sensitivity (0018,6000) 3 Read out sensitivity. Anatomic Region Sequence (0008,2218) 3 Sequence that identifies the anatomic region of interest in this Instance (i.e. external anatomy, surface anatomy, or general region of the body). Only a single Item shall be permitted in this sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Anatomic Region Modifier Sequence (0008,2220) 3 Sequence of Items that modifies the anatomic region of interest of this Instance One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. 80 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

155 >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Primary Anatomic Structure Sequence (0008,2228) 3 Sequence of Items that identifies the primary anatomic structure(s) of interest in this Instance. One or more Items may be included in this Sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Primary Anatomic Structure Modifier Sequence (0008,2230) 3 Sequence of Items that modifies the primary anatomic structure of interest in this Instance. One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 81 of 346

156 >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. C.2.12 CT Image C Image Type (0008,0008) 1 Image identification characteristics. See C for specialization. Slice.SliceCharacteristics) Content depends on image modality if Slice.SliceCharacteristics is not defined. Portal Dose: Tag value for acquired portal dose: ORIGINAL\PRIMARY\PORTAL\ACQUIRE D_DOSE Tag value for calculated portal dose: DERIVED\SECONDARY\PORTAL\CALC ULATED_DOSE On export, content of this tag may be generated depending on image type. 82 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

157 Samples per Pixel (0028,0002) 1 Number of samples (planes) in this image. See C for specialization. Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. See C for specialization. Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See C for specialization. Bits Stored (0028,0101) 1 Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. See C for specialization. Import: For Portal Dose and RT Dose warning, if value is not 1 1 Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 Slice.BitsAllocated) Portal Dose: 16 RT Dose: 32 Other: variable Slice.BitsStored) The same value as Bits Allocated if undefined. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 83 of 346

158 High Bit (0028,0102) 1 Most significant bit for pixel sample data. Each sample shall have the same high bit. See C for specialization. Rescale Intercept (0028,1052) 1 The value b in relationship between stored values (SV) and Hounsfield (HU). HU = m*sv+b Slice.HighBit) Bits Allocated - 1 if undefined. SliceCT.RescaleIntercept) Rescale Slope (0028,1053) 1 m in the equation specified in Rescale Intercept (0028,1052). SliceCT.RescaleSlope) KVP (0018,0060) 2 Peak kilo voltage output of the x-ray generator used SliceCT.KVP) Acquisition Number (0020,0012) 2 A number identifying the single continuous gathering of data over a period of time which resulted in this image SliceCT.AcquisitionNumber) Scan Options (0018,0022) 3 Parameters of scanning sequence. SliceCT.ScanOptions) Data Collection Diameter Reconstruction Diameter (0018,0090) 3 The diameter in mm of the region over which data were collected (0018,1100) 3 Diameter in mm of the region from within which data were used in creating the reconstruction of the image. Data may exist outside this region and portions of the patient may exist outside this region. SliceCT.DataCollectionDiameter) SliceCT.ReconstructionDiameter) 84 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

159 Distance Source to Detector (0018,1110) 3 Distance in mm from source to detector center. Note: This value is traditionally referred to as Source Image Receptor Distance (SID). SliceCT.SourceDetectorDist) Distance Source to Patient (0018,1111) 3 Distance in mm from source to isocenter (center of field of view). Note: This value is traditionally referred to as Source Object Distance (SOD). SliceCT.SourcePatientDist) Gantry/Detector Tilt (0018,1120) 3 Nominal angle of tilt in degrees of the scanning gantry. Not intended for mathematical computations. Table Height (0018,1130) 3 The distance in mm of the top of the patient table to the center of rotation; below the center is positive. SliceCT.GantryTilt) Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.CouchVrt) Internally sign is different as we store value in IEC. Display on UI depends on selected scale. Table Top Longitudinal Position Table Top Lateral Position (300A,0129) 3 Slice.CouchLng) Extended Standard Attribute used to track table position. (300A,012A) 3 Slice.CouchLat) Extended Standard Attribute used to track table position. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 85 of 346

160 Patient Support Angle (300A,0122) 3 Slice.PatientSupportAngle) Extended Standard Attribute used to track table position. Rotation Direction (0018,1140) 3 Direction of rotation of the source when relevant, about nearest principal axis of equipment. Enumerated Values: CW = clockwise CC = counter clockwise SliceCT.RotationDirection) Exposure Time (0018,1150) 3 Time of x-ray exposure in msec SliceCT.ExposureTime) X-ray Tube Current (0018,1151) 3 X-ray Tube Current in ma. SliceCT.XRayTubeCurrent) Exposure (0018,1152) 3 The exposure expressed in mas, for example calculated from Exposure Time and X-ray Tube Current. Exposure in uas (0018,1153) 3 The exposure expressed in As, for example calculated from Exposure Time and X-ray Tube Current. SliceCT.Exposure) Filter Type (0018,1160) 3 Label for the type of filter inserted into the x-ray beam. SliceCT.FilterType) Generator Power (0018,1170) 3 Power in kw to the x-ray generator. SliceCT.GeneratorPower) 86 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

161 Focal Spot(s) (0018,1190) 3 Size of the focal spot in mm. For devices with variable focal spot or multiple focal spots, small dimension followed by large dimension. Convolution Kernel (0018,1210) 3 A label describing the convolution kernel or algorithm used to reconstruct the data Revolution Time (0018,9305) 3 The time in seconds of a complete revolution of the source around the gantry orbit. SliceCT.FocalSpot) SliceCT.ConvolutionKernel) Single Collimation Width (0018,9306) 3 The width of a single row of acquired data (in mm). Note: Adjacent physical detector rows may have been combined to form a single effective acquisition row. Total Collimation Width (0018,9307) 3 The width of the total collimation (in mm) over the area of active x-ray detection. Note: This will be equal the number of effective detector rows multiplied by single collimation width. Table Speed (0018,9309) 3 The distance in mm that the table moves in one second during the gathering of data that resulted in this image. Table Feed per Rotation (0018,9310) 3 Motion of the table (in mm) during a complete revolution of the source around the gantry orbit. Spiral Pitch Factor (0018,9311) 3 Ratio of the Table Feed per Rotation (0018,9310) to the Total Collimation Width (0018,9307). Exposure Modulation Type (0018,9323) 3 A label describing the type of exposure modulation used for the purpose of limiting the dose. Defined Terms: NONE Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 87 of 346

162 Estimated Dose Saving (0018,9324) 3 A percent value of dose saving due to the use of Exposure Modulation Type (0018,9323). A negative percent value of dose savings reflects an increase of exposure. CTDIvol (0018,9345) 3 Computed Tomography Dose Index (CTDIvol), im mgy according to IEC , Ed.2.1 (Clause ), The Volume CTDIvol. It describes the average dose for this image for the selected CT conditions of operation. Anatomic Region Sequence (0008,2218) 3 Sequence that identifies the anatomic region of interest in this Instance (i.e. external anatomy, surface anatomy, or general region of the body). Only a single Item shall be permitted in this sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Anatomic Region Modifier Sequence (0008,2220) 3 Sequence of Items that modifies the anatomic region of interest of this Instance One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. 88 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

163 >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Primary Anatomic Structure Sequence (0008,2228) 3 Sequence of Items that identifies the primary anatomic structure(s) of interest in this Instance. One or more Items may be included in this Sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Primary Anatomic Structure Modifier Sequence (0008,2230) 3 Sequence of Items that modifies the primary anatomic structure of interest in this Instance. One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 89 of 346

164 >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. C.2.13 MR Image C Image Type (0008,0008) 1 Image identification characteristics. See C for specialization. Slice.SliceCharacteristics) Content depends on image modality if Slice.SliceCharacteristics is not defined. Portal Dose: Tag value for acquired portal dose: ORIGINAL\PRIMARY\PORTAL\ACQUIRE D_DOSE Tag value for calculated portal dose: DERIVED\SECONDARY\PORTAL\CALC ULATED_DOSE On export, content of this tag may be generated depending on image type. 90 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

165 Samples per Pixel (0028,0002) 1 Number of samples (planes) in this image. See C for specialization. Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. See C for specialization. Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See C for specialization. Import: For Portal Dose and RT Dose warning, if value is not 1 1 Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 Slice.BitsAllocated) Portal Dose: 16 RT Dose: 32 Other: variable Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 91 of 346

166 Scanning Sequence (0018,0020) 1 Description of the type of data taken. Enumerated Values: SE = Spin Echo IR = Inversion Recovery GR = Gradient Recalled EP = Echo Planar RM = Research Mode Note: Multi-valued, but not all combinations are valid (e.g. SE/GR, etc.). SliceMR.ScanningSequence) Sequence Variant (0018,0021) 1 Variant of the Scanning Sequence. Defined Terms: SK = segmented k-space MTC = magnetization transfer contrast SS = steady state TRSS = time reversed steady state SP = spoiled MP = MAG prepared OSP = oversampling phase NONE = no sequence variant SliceMR.SequenceVariant) 92 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

167 Scan Options (0018,0022) 2 Parameters of scanning sequence. *** Not Used *** Defined Terms: PER = Phase Encode Reordering RG = Respiratory Gating CG = Cardiac Gating PPG = Peripheral Pulse Gating FC = Flow Compensation PFF = Partial Fourier - Frequency PFP = Partial Fourier - Phase SP = Spatial Presaturation FS = Fat Saturation MR Acquisition Type (0018,0023) 2 Identification of data encoding scheme. *** Not Used *** Enumerated Values: 2D = frequency x phase 3D = frequency x phase x phase Repetition Time (0018,0080) 2C The period of time in msec between the beginning of a pulse sequence and the beginning of the succeeding (essentially identical) pulse sequence. Required except when Scanning Sequence (0018,0020) is EP and Sequence Variant (0018,0021) is not SK. Echo Time (0018,0081) 2 Time in ms between the middle of the excitation pulse and the peak of the echo produced (kx=0). In the case of segmented k-space, the TE(eff) is the time between the middle of the excitation pulse to the peak of the echo that is used to cover the center of k-space (i.e.-kx=0, ky=0). *** Not Used *** *** Not Used *** Echo Train Length (0018,0091) 2 Number of lines in k-space acquired per excitation per image. *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 93 of 346

168 Inversion Time (0018,0082) 2C Time in msec after the middle of inverting RF pulse to middle of excitation pulse to detect the amount of longitudinal magnetization. Required if Scanning Sequence (0018,0020) has values of IR. Trigger Time (0018,1060) 2C Time, in msec, between peak of the R wave and the peak of the echo produced. In the case of segmented k-space, the TE(eff) is the time between the peak of the echo that is used to cover the center of k- space. Required for Scan Options (0018,0022) which include heart gating (e.g. CG, PPG, etc.) Sequence Name (0018,0024) 3 User defined name for the Scanning Sequence (0018,0020) and Sequence Variant (0018,0021) combination. *** Not Used *** *** Not Used *** Angio Flag (0018,0025) 3 Angio Image Indicator. Primary image for Angio processing. Enumerated Values: Y = Image is Angio N = Image is not Angio Number of Averages (0018,0083) 3 Number of times a given pulse sequence is repeated before any parameter is changed Imaging Frequency (0018,0084) 3 Precession frequency in MHz of the nucleus being addressed Imaged Nucleus (0018,0085) 3 Nucleus that is resonant at the imaging frequency. Examples: 31P, 1H Echo Number(s) (0018,0086) 3 The echo number used in generating this image. In the case of segmented k-space, it is the effective Echo Number. Magnetic Field Strength (0018,0087) 3 Nominal field strength of MR magnet, in Tesla Spacing Between Slices (0018,0088) 3 Spacing between slices, in mm. The spacing is measured from the center-tocenter of each slice. 94 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

169 Number of Phase Encoding Steps (0018,0089) 3 Total number of lines in k-space in the 'y' direction collected during acquisition. Percent Sampling (0018,0093) 3 Fraction of acquisition matrix lines acquired, expressed as a percent. Percent Phase Field of View (0018,0094) 3 Ratio of field of view dimension in phase direction to field of view dimension in frequency direction, expressed as a percent. Pixel Bandwidth (0018,0095) 3 Reciprocal of the total sampling period, in hertz per pixel. Nominal Interval (0018,1062) 3 Average R-R interval used for the scans, in msec Beat Rejection Flag (0018,1080) 3 Beat length sorting has been applied. Enumerated Values: Y = yes N = No Low R-R Value (0018,1081) 3 R-R interval low limit for beat rejection, in msec High R-R Value (0018,1082) 3 R-R interval high limit for beat rejection, in msec Intervals Acquired (0018,1083) 3 Number of R-R intervals acquired. Intervals Rejected (0018,1084) 3 Number of R-R intervals rejected. PVC Rejection (0018,1085) 3 Description of type of PVC rejection criteria used. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 95 of 346

170 Skip Beats (0018,1086) 3 Number of beats skipped after a detected arrhythmia. Heart Rate (0018,1088) 3 Beats per minute. Cardiac Number of Images (0018,1090) 3 Number of images per cardiac cycle. Trigger Window (0018,1094) 3 Percent of R-R interval, based on Heart Rate (0018,1088), prescribed as a window for a valid/usable trigger. Reconstruction Diameter (0018,1100) 3 Diameter in mm. of the region from within which data were used in creating the reconstruction of the image. Data may exist outside this region and portions of the patient may exist outside this region. Receive Coil Name (0018,1250) 3 Receive coil used. Transmit Coil Name (0018,1251) 3 Transmit coil used. Acquisition Matrix (0018,1310) 3 Dimensions of the acquired frequency /phase data before reconstruction. Multi-valued: frequency rows\frequency columns\phase rows\phase columns. In-plane Phase Encoding Direction (0018,1312) 3 The axis of phase encoding with respect to the image. Enumerated Values: ROW = phase encoded in rows. COL = phase encoded in columns. Flip Angle (0018,1314) 3 Steady state angle in degrees to which the magnetic vector is flipped from the magnetic vector of the primary field. SAR (0018,1316) 3 Calculated whole body Specific Absorption Rate in watts/kilogram. 96 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

171 Variable Flip Angle Flag (0018,1315) 3 Flip angle variation applied during image acquisition. Enumerated Values: Y = yes N = no db/dt (0018,1318) 3 The rate of change of the gradient coil magnetic flux density with time (T/s). Temporal Position Identifier Number of Temporal Positions (0020,0100) 3 Temporal order of a dynamic or functional set of Images. (0020,0105) 3 Total number of temporal positions prescribed. Temporal Resolution Anatomic Region Sequence (0020,0110) 3 Time delta between Images in a dynamic or functional set of Images. (0008,2218) 3 Sequence that identifies the anatomic region of interest in this Instance (i.e. external anatomy, surface anatomy, or general region of the body). Only a single Item shall be permitted in this sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 97 of 346

172 > Anatomic Region Modifier Sequence (0008,2220) 3 Sequence of Items that modifies the anatomic region of interest of this Instance One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Primary Anatomic Structure Sequence (0008,2228) 3 Sequence of Items that identifies the primary anatomic structure(s) of interest in this Instance. One or more Items may be included in this Sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. 98 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

173 > Primary Anatomic Structure Modifier Sequence (0008,2230) 3 Sequence of Items that modifies the primary anatomic structure of interest in this Instance. One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. C.2.14 SC Equipment C Conversion Type (0008,0064) 1 Describes the kind of image conversion. Defined Terms : DV = Digitized Video DI = Digital Interface DF = Digitized Film WSD = Workstation SD = Scanned Document SI = Scanned Image DRW = Drawing SYN = Synthetic Image Slice.ConversionType) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix - 99 of 346

174 Modality (0008,0060) 3 Source equipment for the image. This type definition shall override the definition in the General Series Module. See C for Defined Terms. Secondary Capture Device ID (0018,1010) 3 User defined identification of the device that converted the image Roundtrip is supported but internal representation is different from DICOM. (Stored in: Series.SeriesModality) Import: Modalities PT, RF and XA will be mapped to OT Secondary Capture Device Manufacturer Secondary Capture Device Manufacturer s Model Name Secondary Capture Device Software Version(s) Video Image Format Acquired (0018,1016) 3 Manufacturer of the Secondary Capture Device (0018,1018) 3 Manufacturer's model number of the Secondary Capture Device (0018,1019) 3 Manufacturer's designation of software version of the Secondary Capture Device (0018,1022) 3 Original format of the captured video image (e.g. NTSC, PAL, Videomed-H) Digital Image Format Acquired (0018,1023) 3 Additional information about digital interface used to acquire the image C.2.15 SC Image C of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

175 Date of Secondary Capture Time of Secondary Capture (0018,1012) 3 The date the Secondary Capture Image was captured. (0018,1014) 3 The time the Secondary Capture Image was captured. Nominal Scanned Pixel Spacing (0018,2010) 3 Physical distance on the media being digitized or scanned between the center of each pixel, specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing in mm. Shall be consistent with Pixel Aspect Ratio (0028,0034), if present. Pixel Spacing (0028,0030) 1C Physical distance in the patient between the center of each pixel, specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing in mm. See Pixel Spacing Calibration Type Pixel Spacing Calibration Description (0028,0402) 3 The type of correction for the effect of geometric magnification or calibration against an object of known size, if any. See (0028,0404) 1C A free text description of the type of correction or calibration performed. Notes: 1. In the case of correction, the text might include description of the assumptions made about the body part and geometry and depth within the patient. 2. in the case of calibration, the text might include a description of the fiducial and where it is located (e.g., "XYZ device applied to the skin over the greater trochanter"). 3. Though it is not required, the Device Module may be used to describe the specific characteristics and size of the calibration device. Required if Pixel Spacing Calibration Type (0028,0402) is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

176 C.2.16 X-Ray Image C Frame Increment Pointer Lossy Image Compression (0028,0009) 1C Required if Multi-Frame Image. Contains the Data Element Tag of the attribute that is used as the Frame increment in Multi-frame image pixel data (See C.7.6.6). Specialized for X- Ray as Enumerated Value: H = Frame Time (0018,1063); H = Frame Time Vector (0018,1065). (0028,2110) 1C Specifies whether an Image has undergone lossy compression. Enumerated Values: 00 = Image has NOT been subjected to lossy compression. 01 = Image has been subjected to lossy compression. See C Required if Lossy Compression has been performed on the Image. Export only for Portal Dose: of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

177 Image Type (0008,0008) 1 Image identification characteristics. See C for specialization. Slice.SliceCharacteristics) Content depends on image modality if Slice.SliceCharacteristics is not defined. Portal Dose: Tag value for acquired portal dose: ORIGINAL\PRIMARY\PORTAL\ACQUIRE D_DOSE Tag value for calculated portal dose: DERIVED\SECONDARY\PORTAL\CALC ULATED_DOSE Pixel Intensity Relationship (0028,1040) 1 The relationship between the Pixel sample values and the X- Ray beam intensity. See Section C Samples per Pixel (0028,0002) 1 Number of samples (color planes) in this image shall have a value of 1. On export, content of this tag may be generated depending on image type. Warning if value is other than LIN Import: For Portal Dose and RT Dose warning, if value is not 1 1 Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

178 Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. Only MONOCHROME2 may be used. Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. See Section C Bits Stored (0028,0101) 1 Number of bits stored for each pixel sample. See Section C High Bit (0028,0102) 1 Most significant bit for pixel sample data. See Section C Pixel Representation (0028,0103) 1 Data representation of the pixel samples. Shall have the value: 0000H = Unsigned Integer. Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 Slice.BitsAllocated) Portal Dose: 16 RT Dose: 32 Other: variable Slice.BitsStored) The same value as Bits Allocated if undefined. Slice.HighBit) Bits Allocated - 1 if undefined. 104 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

179 Scan Options (0018,0022) 3 Parameters of scanning sequence. See Section C Anatomic Region Sequence (0008,2218) 3 Sequence that identifies the anatomic region of interest in this Instance (i.e. external anatomy, surface anatomy, or general region of the body). Only a single Item shall be permitted in this sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Anatomic Region Modifier Sequence (0008,2220) 3 Sequence of Items that modifies the anatomic region of interest of this Instance One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

180 >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Primary Anatomic Structure Sequence (0008,2228) 3 Sequence of Items that identifies the primary anatomic structure(s) of interest in this Instance. One or more Items may be included in this Sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Primary Anatomic Structure Modifier Sequence (0008,2230) 3 Sequence of Items that modifies the primary anatomic structure of interest in this Instance. One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. 106 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

181 >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. R Wave Pointer (0028,6040) 3 Marks the location(s) of the R Wave in the cardiac cycles by referencing frame numbers; frame numbers begin with 1. Referenced Image Sequence (0008,1140) 1C A sequence which provides reference to a set of Image SOP Class/Instance identifying other images significantly related to this image. Shall be present if Image Type (0008,0008) Value 3 is BIPLANE A or BIPLANE B. May be present otherwise. One or more items may be included in this sequence.. See Section C > Referenced SOP Class UID > Referenced SOP Instance UID (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. > Referenced Frame Number > Purpose of Reference Code Sequence (0008,1160) 1 Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Note: This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames. (0040,A170) 2 Describes the purpose for which the reference is made. Onlya single Item shall be permitted in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

182 >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Derivation Description Acquisition Device Processing Description (0008,2111) 3 A text description of how this image was derived. See C for further explanation. (0018,1400) 3 Indicates any visual processing performed on the images prior to exchange. See Section C Frame Label Vector (0018,2002) 3 A multi-valued attribute that contains a descriptive label for each of the image frames. The number of values shall equal the number of frames. Frame Dimension Pointer (0028,000A) 3 Contains the Data Element Tags of one or more attributes that vary or increment for the frames of a multi-frame image. See C Shall not be present if it would contain only one value and that value would be Frame Time (0018,1063) or Frame Time Vector (0018,1065). Calibration Image (0050,0004) 3 Indicates whether a reference object (phantom) of known size is present in the image and was used for calibration. Enumerated Values: YES NO Device is identified using the Device module. See C C.2.17 RT Series C of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

183 Modality (0008,0060) 1 Type of equipment that originally acquired the data. Enumerated Values: RTIMAGE = RT Image RTDOSE = RT Dose RTSTRUCT = RT Structure Set RTPLAN = RT Plan RTRECORD = RT Treatment Record See C Series.SeriesModality) Series Instance UID (0020,000E) 1 Unique identifier of the series. Series.SeriesUID) Series Number (0020,0011) 2 A number that identifies this series. Series.SeriesNumber) Import: Will also be used create the name of the series as displayed in the UI. Series Description (0008,103E) 3 User provided description of the series. Series.Comment) Referenced Performed Procedure Step Sequence > Referenced SOP Class UID (0008,1111) 3 Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). One or more items may be included in this sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Performed Procedure Step Sequence (0008,1111) is sent. *** Not Implement *** *** Not Implement *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

184 > Referenced SOP Instance UID Request Attributes Sequence > Requested Procedure ID (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Performed Procedure Step Sequence (0008,1111) is sent. (0040,0275) 3 Sequence that contains attributes from the Imaging Service Request. The sequence may have one or more Items. (0040,1001) 1 Identifier that identifies the Requested Procedure in the Imaging Service Request. *** Not Implement *** *** Not Implement *** *** Not Implement *** > Reason for the Requested Procedure > Reason for Requested Procedure Code Sequence (0040,1002) 3 Reason for requesting this procedure. (0040,100A) 3 Coded Reason for requesting this procedure. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Scheduled Procedure Step ID (0040,0009) 1 Identifier that identifies the Scheduled Procedure Step. *** Not Implement *** 110 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

185 > Scheduled Procedure Step Description > Scheduled Protocol Code Sequence (0040,0007) 3 Institution-generated description or classification of the Scheduled Procedure Step to be performed. (0040,0008) 3 Sequence describing the Scheduled Protocol following a specific coding scheme. This sequence contains one or more Items. *** Not Implement *** *** Not Implement *** >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. *** Not Implement *** >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. *** Not Implement *** >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. *** Not Implement *** >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. *** Not Implement *** >> Protocol Context Sequence (0040,0440) 3 Sequence that specifies the context for the Scheduled Protocol Code Sequence Item. One or more items may be included in this sequence. >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

186 >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >>> Content Item Modifier Sequence (0040,0441) 3 Sequence that specifies modifiers for a Protocol Context Content Item. One or more items may be included in this sequence. See Section C >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Performed Procedure Step ID (0040,0253) 3 User or equipment generated identifier of that part of a Procedure that has been carried out within this step. *** Not Implement *** Performed Procedure Step Start Date Performed Procedure Step Start Time Performed Procedure Step Description (0040,0244) 3 Date on which the Performed Procedure Step started. *** Not Implement *** (0040,0245) 3 Time on which the Performed Procedure Step started. *** Not Implement *** (0040,0254) 3 Institution-generated description or classification of the Procedure Step that was performed. *** Not Implement *** 112 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

187 Performed Protocol Code Sequence (0040,0260) 3 Sequence describing the Protocol performed for this Procedure Step. One or more Items may be included in this Sequence. *** Not Implement *** > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. *** Not Implement *** > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. *** Not Implement *** > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. *** Not Implement *** > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. *** Not Implement *** > Protocol Context Sequence (0040,0440) 3 Sequence that specifies the context for the Performed Protocol Code Sequence Item. One or more items may be included in this sequence. >> Value Type (0040,A040) 1 The type of the value encoded in this name-value Item. Defined Terms: DATETIME DATE TIME PNAME UIDREF TEXT CODE NUMERIC. >> Concept Name Code Sequence (0040,A043) 1 Coded concept name of this name-value Item. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

188 >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >> DateTime (0040,A120) 1C Datetime value for this name-value Item. Required if Value Type (0040,A040) is DATETIME. >> Date (0040,A121) 1C Date value for this name-value Item. Required if Value Type (0040,A040) is DATE. >> Time (0040,A122) 1C Time value for this name-value Item. Required if Value Type (0040,A040) is TIME. >> Person Name (0040,A123) 1C Person name value for this name-value Item. Required if Value Type (0040,A040) is PNAME. >> UID (0040,A124) 1C UID value for this name-value Item. Required if Value Type (0040,A040) is UIDREF. >> Text Value (0040,A160) 1C Text value for this name-value Item. Required if Value Type (0040,A040) is TEXT. >> Concept Code Sequence (0040,A168) 1C Coded concept value of this name-value Item. Required if Value Type (0040,A040) is CODE. >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. 114 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

189 >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >> Numeric Value (0040,A30A) 1C Numeric value for this name-value Item. Required if Value Type (0040,A040) is NUMERIC. >> Measurement Units Code Sequence (0040,08EA) 1C Units of measurement for a numeric value in this namevalue Item. Required if Value Type (0040,A040) is NUMERIC. >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >> Content Item Modifier Sequence (0040,0441) 3 Sequence that specifies modifiers for a Protocol Context Content Item. One or more items may be included in this sequence. See Section C Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

190 >>> Value Type (0040,A040) 1 The type of the value encoded in this name-value Item. Defined Terms: DATETIME DATE TIME PNAME UIDREF TEXT CODE NUMERIC. >>> Concept Name Code Sequence (0040,A043) 1 Coded concept name of this name-value Item. >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >>> DateTime (0040,A120) 1C Datetime value for this name-value Item. Required if Value Type (0040,A040) is DATETIME. >>> Date (0040,A121) 1C Date value for this name-value Item. Required if Value Type (0040,A040) is DATE. 116 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

191 >>> Time (0040,A122) 1C Time value for this name-value Item. Required if Value Type (0040,A040) is TIME. >>> Person Name (0040,A123) 1C Person name value for this name-value Item. Required if Value Type (0040,A040) is PNAME. >>> UID (0040,A124) 1C UID value for this name-value Item. Required if Value Type (0040,A040) is UIDREF. >>> Text Value (0040,A160) 1C Text value for this name-value Item. Required if Value Type (0040,A040) is TEXT. >>> Concept Code Sequence (0040,A168) 1C Coded concept value of this name-value Item. Required if Value Type (0040,A040) is CODE. >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. >>> Numeric Value (0040,A30A) 1C Numeric value for this name-value Item. Required if Value Type (0040,A040) is NUMERIC. >>> Measurement Units Code Sequence (0040,08EA) 1C Units of measurement for a numeric value in this namevalue Item. Required if Value Type (0040,A040) is NUMERIC. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

192 >>>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >>>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >>>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >>>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. C.2.18 RT Image C Samples per Pixel (0028,0002) 1 Number of samples (planes) in this image. See C for specialization. Import: For Portal Dose and RT Dose warning, if value is not of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

193 Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. See C for specialization. Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See C for specialization. Bits Stored (0028,0101) 1 Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. See C for specialization. High Bit (0028,0102) 1 Most significant bit for each pixel sample. Each sample shall have the same high bit. See C for specialization. Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 Slice.BitsAllocated) Portal Dose: 16 RT Dose: 32 Other: variable Slice.BitsStored) The same value as Bits Allocated if undefined. Slice.HighBit) Bits Allocated - 1 if undefined. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

194 Pixel Representation (0028,0103) 1 Data representation of the pixel samples. Each sample shall have the same pixel representation. See C for specialization. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.PixelOffset) Import: Import of Portal Dose or RT Dose is rejected if value is other then 0000H. Pixel Intensity Relationship Pixel Intensity Relationship Sign (0028,1040) 3 The relationship between the Pixel sample values and the X- Ray beam intensity. Enumerated Values: LIN = Linearly proportional to X-Ray beam intensity LOG = Logarithmically proportional to X- Ray beam intensity See C for further explanation. (0028,1041) 1C The sign of the relationship between the Pixel sample values stored in Pixel Data (7FE0,0010) and the X-Ray beam intensity. Required if Pixel Intensity Relationship (0028,1040) is present. Enumerated Values; 1 = Lower pixel values correspond to less X-Ray beam intensity -1 = Higher pixel values correspond to less X-Ray beam intensity See C for further explanation. Both values supported, but for RT Image, Portal Dose and RT Dose it is always 0000H 120 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

195 RT Image Label (3002,0002) 1 User-defined label for RT Image. Image.ImageId, DoseMatrix.DoseMatrixId) Storage location depends on object type (RT Image in table Image / Portal Dose in table DoseMatrix) Used as Image ID. RT Image Name (3002,0003) 3 User-defined name for RT Image. Image.ImageName, DoseMatrix.DoseMatrixName) Storage location depends on object type (RT Image in table Image / Portal Dose in table DoseMatrix) RT Image Description Used as Image Name. (3002,0004) 3 User-defined description of RT Image. SliceRT.AcqNote) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

196 Operators Name (0008,1070) 2 Name of operator(s) acquiring or creating RT Image. Slice.CreationUserName, DoseMatrix.CreationUserName) Storage location depends on object type (RT Image in table Image / Portal Dose in table DoseMatrix) Image Type (0008,0008) 1 Image identification characteristics (see Section C ). RT Images shall use one of the following Defined Terms for Value 3: DRR = digitally reconstructed radiograph PORTAL = digital portal image or portal film image SIMULATOR = conventional simulator image RADIOGRAPH = radiographic image BLANK = image pixels set to background value FLUENCE = fluence map Import: Only the first value of the multi-value attribute will be imported. Slice.SliceCharacteristics) Content depends on image modality if Slice.SliceCharacteristics is not defined. Portal Dose: Tag value for acquired portal dose: ORIGINAL\PRIMARY\PORTAL\ACQUIRE D_DOSE Tag value for calculated portal dose: DERIVED\SECONDARY\PORTAL\CALC ULATED_DOSE On export, content of this tag may be generated depending on image type. 122 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

197 Conversion Type (0008,0064) 2 Describes the kind of image conversion. Defined Terms: DV = Digitized Video DI = Digital Interface DF = Digitized Film WSD = Workstation Slice.ConversionType) Reported Values Origin (3002,000A) 2C Describes the origin of the parameter values reported in the image. Required if Value 3 of Image Type (0008,0008) is SIMULATOR or PORTAL. Enumerated Values: OPERATOR = manually entered by operator PLAN = planned parameter values ACTUAL = electronically recorded SliceRT.ReportedValuesOrigin) Portal Dose: Ignored on import, exported with value PLAN. RT Image Plane (3002,000C) 1 Describes whether or not image plane is normal to beam axis. Enumerated Values: NORMAL = image plane normal to beam axis NON_NORMAL = image plane non-normal to beam axis Import: Only NORMAL is allowed Always NORMAL X-Ray Image Receptor Translation X-Ray Image Receptor Angle (3002,000D) 3 Position in (x,y,z) coordinates of origin of IEC X-RAY IMAGE RECEPTOR System in the IEC GANTRY coordinate system (mm). See Note 2. (3002,000E) 2 X-Ray Image Receptor Angle i.e. orientation of IEC X-RAY IMAGE RECEPTOR coordinate system with respect to IEC GANTRY coordinate system (degrees). See C Import: 1st/2nd value to IDU Lat/Lng positions, 3rd must equal SAD - SID. 1st/2nd/3rd values: IDUPosLat/IDUPosLng/(SAD - SID). SliceRT.IDURtn) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

198 RT Image Orientation Image Plane Pixel Spacing (3002,0010) 2C The direction cosines of the first row and the first column with respect to the IEC XRAY IMAGE RECEPTOR coordinate system. Required if RT Image Plane (3002,000C) is NON_NORMAL. May be present otherwise. (3002,0011) 2 Physical distance (in mm) between the center of each image pixel, specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing. See C *** Not Used *** Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ResolutionX, Slice.ResolutionY, DoseMatrix.ResX, DoseMatrix.ResY) Storage location depends on object type (RT Image in table Slice / Calculated Dose in table DoseMatrix, values scaled by SID/SAD / Acquired Dose in table Slice, values scaled by SID/SAD) RT Image Position (3002,0012) 2 The x and y coordinates (in mm) of the upper left hand corner of the image, in the IEC X-RAY IMAGE RECEPTOR coordinate system. This is the center of the first pixel transmitted. See C SliceRT.RTImagePositionX, SliceRT.RTImagePositionY) Radiation Machine Name (3002,0020) 2 User-defined name identifying radiation machine used in acquiring or computing image (i.e. name of conventional simulator, electron accelerator, X-ray device, or machine modeled when calculating DRR). *** Not Used *** Primary Dosimeter Unit (300A,00B3) 2 Measurement unit of machine dosimeter. Enumerated Values: MU = Monitor Unit MINUTE = minute SliceRT.PrimaryDosimeterUnit) Radiation Machine SAD (3002,0022) 2 Radiation source to Gantry rotation axis distance of radiation machine used in acquiring or computing image (mm). Roundtrip is supported but internal representation is different from DICOM. (Stored in: SliceRT.SAD) 124 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

199 Radiation Machine SSD (3002,0024) 3 Source to patient surface distance (in mm) of radiation machine used in acquiring or computing image. RT Image SID (3002,0026) 2 Distance from radiation machine source to image plane (in mm) along radiation beam axis. See C Source to Reference Object Distance Referenced RT Plan Sequence > Referenced SOP Class UID > Referenced SOP Instance UID (3002,0028) 3 Source to reference object distance (in mm), as used for magnification calculation of RADIOGRAPH and SIMULATOR images. (300C,0002) 3 Introduces sequence of one Class/Instance pair describing RT Plan associated with image. Only a single item shall be permitted in this sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced RT Plan Sequence (300C,0002) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced RT Plan Sequence (300C,0002) is sent. SliceRT.IDUSID) Same value as SAD if SID is undefined. SOP Class of RT Plan or RT ION Plan. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Fractionation.PlanUID) Plan UID of the Plan where this image is a reference image. Import: used to identify the field to which the image is a reference image. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

200 Referenced Beam Number (300C,0006) 3 Uniquely identifies the corresponding N- segment treatment beam specified by Beam Number (300A,00C0) within Beam Sequence in RT Beams Module within the RT Plan referenced in Referenced RT Plan Sequence (300C,0002). Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.FieldNumber) FieldNumber of the Field where this image is associated to. Referenced Fraction Group Number (300C,0022) 3 Identifier of Fraction Group within RT Plan referenced in Referenced RT Plan Sequence (300C,0002). Fraction Number (3002,0029) 3 Fraction Number of fraction during which image was acquired, within Fraction Group referenced by Referenced Fraction Group Number (300C,0022) within RT Plan referenced in Referenced RT Plan Sequence (300C,0002). Start Cumulative Meterset Weight (300C,0008) 3 Cumulative Meterset Weight within Beam referenced by Referenced Beam Number (300C,0006) at which image acquisition starts. Import: Used to identify the field to which the images is associated to. Image.RefDicomSeqNumber) Image.FractionNumber) SliceRT.StartCumulativeMeterset) Import: Not imported if beam referenced by Referenced Beam Number (300C,0006) has Treatment Delivery Type (300A,0007) OPEN_PORTFILM or TRMT_PORTFILM. 126 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

201 End Cumulative Meterset Weight (300C,0009) 3 Cumulative Meterset Weight within Beam referenced by Referenced Beam Number (300C,0006) at which image acquisition ends. SliceRT.EndCumulativeMeterset) Import: Not imported if beam referenced by Referenced Beam Number (300C,0006) has Treatment Delivery Type (300A,0007) OPEN_PORTFILM or TRMT_PORTFILM. Exposure Sequence (3002,0030) 3 Introduces sequence of Exposure parameter sets, corresponding to exposures used in generating the image. One or more items may be included in this sequence. See C Only 1 item supported > Referenced Frame Number (0008,1160) 1C Identifies corresponding image frame in multi-frame image. Required if Exposure Sequence (3002,0030) is sent, there is more than one item in Exposure Sequence (3002,0030), and image is a multi-frame image. > KVP (0018,0060) 2C Peak kilo voltage output (kv) of X-ray generator used to acquire image. Required if Value 3 of Image Type (0008,0008) is PORTAL, SIMULATOR or RADIOGRAPH and Exposure Sequence (3002,0030) is sent. SliceRT.Energy) > X-ray Tube Current (0018,1151) 2C Imaging device X-ray Tube Current (ma). Required if Value 3 of Image Type (0008,0008) is SIMULATOR or RADIOGRAPH and Exposure Sequence (3002,0030) is sent. SliceRT.XRayTubeCurrent) > Exposure Time (0018,1150) 2C Time of X-ray exposure (msec). Required if Value 3 of Image Type (0008,0008) is SIMULATOR or RADIOGRAPH and Exposure Sequence (3002,0030) is sent. SliceRT.ExposureTime) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

202 > Meterset Exposure > Diaphragm Position > Beam Limiting Device Sequence >> RT Beam Limiting Device Type (3002,0032) 2C Treatment machine Meterset duration over which image has been acquired, specified in Monitor units (MU) or minutes as defined by Primary Dosimeter Unit (300A,00B3). Required if Value 3 of Image Type (0008,0008) is PORTAL and Exposure Sequence (3002,0030) is sent. (3002,0034) 3 Positions of diaphragm jaw pairs (in mm) in IEC BEAM LIMITING DEVICE coordinate axis in the IEC order X1, X2, Y1, Y2. (300A,00B6) 3 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions for given exposure. One or more items may be included in this sequence. (300A,00B8) 1C Type of beam limiting device (collimator). Required if Beam Limiting Device Sequence (300A,00B6) is sent. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction SliceRT.MetersetExposure) SliceRT.BladeX1, SliceRT.BladeX2, SliceRT.BladeY1, SliceRT.BladeY2) Supported values: X, Y, ASYMX, ASYMY >> Source to Beam Limiting Device Distance (300A,00BA ) 3 Radiation source to beam limiting device (collimator) distance (mm). *** Not Used *** >> Number of Leaf/Jaw Pairs (300A,00BC ) 1C Number of leaf (element) or jaw pairs (equal to 1 for standard beam limiting device jaws). Required if Beam Limiting Device Sequence (300A,00B6) is sent. 1 (see Leaf/Jaw Positions below) 128 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

203 >> Leaf Position Boundaries (300A,00BE ) 2C Boundaries (in mm) of beam limiting device (collimator) leaves (elements) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), i.e. X-axis for MLCY, Y- axis for MLCX. Contains N+1 values, where N is the Number of Leaf/Jaw Pairs (300A,00BC), starting from Leaf (Element) Pair 1. Required if RT Beam Limiting Device Type (300A,00B8) is MLCX or MLCY. *** Not Used *** >> Leaf/Jaw Positions > Applicator Sequence (300A,011C) 1C Positions of beam limiting device (collimator) leaf or jaw (element) pairs (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), e.g. X- axis for MLCX, Y-axis for MLCY). Contains 2N values, where N is the Number of Leaf/Jaw Pairs (300A,00BC), in IEC leaf (element) subscript order 101, 102,... 1N, 201, 202,... 2N. Required if Beam Limiting Device Sequence (300A,00B6) is sent. (300A,0107) 3 Introduces sequence of Applicators associated with Beam. Only a single item shall be permitted in this sequence. SliceRT.CollX1, SliceRT.CollX2, SliceRT.CollY1, SliceRT.CollY2) >> Applicator ID (300A,0108) 1C User or machine supplied identifier for Applicator. Required if Applicator Sequence (300A,0107) is sent. >> Applicator Type (300A,0109) 1C Type of Applicator. Required if Applicator Sequence (300A,0107) is sent. Defined Terms: ELECTRON_SQUARE = square electron applicator ELECTRON_RECT = rectangular electron applicator ELECTRON_CIRC = circular electron applicator ELECTRON_SHORT = short electron applicator ELECTRON_OPEN = open (dummy) electron applicator INTRAOPERATIVE = intraoperative (custom) applicator STEREOTACTIC = stereotactic applicator Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

204 >> Applicator Description (300A,010A) 3 User-defined description for Applicator. > Number of Blocks (300A,00F0) 1C Number of shielding blocks associated with Beam. Required if Exposure Sequence (3002,0030) is sent. > Block Sequence (300A,00F4) 2C Introduces sequence of blocks associated with Beam. Required if Number of Blocks (300A,00F0) is non-zero. One or more items may be included in this sequence. Value is always set to 0 (Zero) >> Block Tray ID (300A,00F5) 3 User-supplied identifier for block tray. >> Source to Block Tray Distance (300A,00F6) 2C Radiation Source to attachment edge of block tray assembly (mm). Required if Block Sequence (300A,00F4) is sent. >> Block Type (300A,00F8) 1C Type of block. Required if Block Sequence (300A,00F4) is sent. Enumerated Values: SHIELDING = blocking material is inside contour APERTURE = blocking material is outside contour >> Block Divergence >> Block Mounting Position (300A,00FA) 2C Indicates presence or otherwise of geometrical divergence. Required if Block Sequence (300A,00F4) is sent. Enumerated Values: PRESENT = block edges are shaped for beam divergence ABSENT = block edges are not shaped for beam divergence (300A,00FB) 3 Indicates on which side of the Block Tray the block is mounted. Enumerated Values: PATIENT_SIDE = the block is mounted on the side of the Block Tray which is towards the patient. SOURCE_SIDE = the block is mounted on the side of the Block Tray which is towards the radiation source. 130 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

205 >> Block Number (300A,00FC) 1C Identification Number of the Block. The value of Block Number (300A,00FC) shall be unique within the Beam in which it is created. Required if Block Sequence (300A,00F4) is sent. >> Block Name (300A,00FE) 3 User-defined name for block. >> Material ID (300A,00E1) 2C User-supplied identifier for material used to manufacture Block. Required if Block Sequence (300A,00F4) is sent. >> Block Thickness (300A,0100) 3 Physical thickness of block (in mm) parallel to radiation beam axis. >> Block Number of Points (300A,0104) 2C Number of (x,y) pairs defining the block edge. Required if Block Sequence (300A,00F4) is sent. >> Block Data (300A,0106) 2C A data stream of (x,y) pairs which comprise the block edge. The number of pairs shall be equal to Block Number of Points (300A,0104), and the vertices shall be interpreted as a closed polygon. Coordinates are projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm). Required if Block Sequence (300A,00F4) is sent. Fluence Map Sequence (3002,0040) 1C A Sequence of data describing the fluence map attributes for a radiotherapy beam. Only one item may be included in this sequence. Required if the third value of Image Type (0008,0008) is FLUENCE. > Fluence Data Source (3002,0041) 1 Source of fluence data. Enumerated Values: CALCULATED = Calculated by a workstation MEASURED = Measured by exposure to a film or detector. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

206 > Fluence Data Scale (3002,0042) 3 The meterset corresponding with a fluence map cell value of 1.0 expressed in units specified by Primary Dosimeter Units (300A,00B3). This is the meterset value used for treatment, not the meterset used to expose the film as defined by Meterset Exposure (3002,0032). Gantry Angle (300A,011E) 3 Treatment machine gantry angle, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Beam Limiting Device Angle Patient Support Angle Table Top Eccentric Axis Distance (300A,0120) 3 Treatment machine beam limiting device (collimator) angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). (300A,0122) 3 Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). (300A,0124) 3 Distance (positive) from the IEC PATIENT SUPPORT vertical axis to the IEC TABLE TOP ECCENTRIC vertical axis (mm). SliceRT.GantryAngle) SliceRT.CollRtn) Slice.PatientSupportAngle) Table Top Eccentric Angle Table Top Vertical Position Table Top Longitudinal Position Table Top Lateral Position (300A,0125) 3 Table Top (non-isocentric) angle, i.e. orientation of IEC TABLE TOP ECCENTRIC coordinate system with respect to IEC PATIENT SUPPORT system (degrees). (300A,0128) 3 Table Top Vertical position in IEC TABLE TOP coordinate system (mm). (300A,0129) 3 Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). (300A,012A) 3 Table Top Lateral position in IEC TABLE TOP coordinate system (mm). Slice.TableTopEccentricAngle) Slice.CouchVrt) Slice.CouchLng) Slice.CouchLat) 132 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

207 Isocenter Position (300A,012C) 3 Isocenter coordinates (x,y,z), in mm. Specifies the location of the machine isocenter in the patient-based coordinate system associated with the Frame of Reference. It allows transformation from the equipment-based IEC coordinate system to the patient-based coordinate system. Patient Position (0018,5100) 1C Patient position descriptor relative to the patient support device. Required if Isocenter Position (300A,012C) is present. May be present otherwise. See Section C for Defined Terms and further explanation. Note: The orientation of the patient relative to the patient support device is denoted in the same manner as in the RT Patient Setup module. It defines the relation of the patient-based DICOM coordinate system identified by the frame of reference module of the RT Image to the IEC coordinate system and together with the Isocenter Position (300A,012C) allows the RT Image to be placed into the patient frame of reference. It also allows a system using an RT Image to verify that the patient is setup in a similar position relative to the patient support device. Currently this data can be found in the private tag (3273,1000). See below for a description. Currently this data can be found in the private tag (3273,1001). See below for a description. RT Image Isocenter Position RT Image Patient Position (3273,1000) 3 The isocenter position in the FOR as defined in the FOR module. For DRRs, this is typically the FOR of the diagnostic image and the isocenter coordinate correspond to those of the associated beam. For treatment / simulator images, the acquisition systems create the FOR and define it's origin (typically the isocenter position of the first image acquired). (3273,1001) 3 The patient position at the time, when the image was taken (or created in case of DRRs). SliceRT.IsoCenterPositionX, SliceRT.IsoCenterPositionY, SliceRT.IsoCenterPositionZ) Series.PatientOrientation) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

208 LT Archive Primary Reference Image Flag (3279,1000) 3 If present indicates if image is primary reference image of beam referenced by Referenced RT Plan Sequence (300C,0002) and Referenced Beam Number (300C,0006). If absent then it is not a primary reference image. Enumerated Values: PRIMARY NOT_PRIMARY Field.RefImageSer) Only used by DB Daemon when configured in Archive Service Mode. Used to remember primary reference image status. Status will be set to PRIMARY if the reference image serial number of field 'points' to the RT Image. C.2.19 RT Dose C Samples per Pixel (0028,0002) 1C Number of samples (planes) in this image. See C for specialization. Required if Pixel Data (7FE0,0010) is present. Import: For Portal Dose and RT Dose warning, if value is not 1 1 Photometric Interpretation (0028,0004) 1C Specifies the intended interpretation of the pixel data. See C for specialization. Required if Pixel Data (7FE0,0010) is present. Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 134 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

209 Bits Allocated (0028,0100) 1C Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. See C for specialization. Required Pixel Data (7FE0,0010) is present. Bits Stored (0028,0101) 1C Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. See C for specialization. Required if Pixel Data (7FE0,0010) is present. High Bit (0028,0102) 1C Most significant bit for each pixel sample. Each sample shall have the same high bit. See C for specialization. Required if Pixel Data (7FE0,0010) is present. Slice.BitsAllocated) Portal Dose: 16 RT Dose: 32 Other: variable Slice.BitsStored) The same value as Bits Allocated if undefined. Slice.HighBit) Bits Allocated - 1 if undefined. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

210 Pixel Representation (0028,0103) 1C Data representation of the pixel samples. Each sample shall have the same pixel representation. See C for specialization. Required Pixel Data (7FE0,0010) is present. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.PixelOffset) Import: Import of Portal Dose or RT Dose is rejected if value is other then 0000H. Both values supported, but for RT Image, Portal Dose and RT Dose it is always 0000H Dose Units (3004,0002) 1 Units used to describe dose. Enumerated Values: GY = Gray DoseMatrix.Unit) RELATIVE = dose relative to implicit reference value GY <--> Absolute Dose RELATIVE <--> RelativeDose Dose Type (3004,0004) 1 Type of dose. Import: Defined Terms: Not used PHYSICAL = physical dose EFFECTIVE = physical dose after correction for biological PHYSICAL effect using user- defined modeling technique ERROR = difference between desired and planned dose 136 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

211 Instance Number (0020,0013) 3 A number that identifies this object instance. Slice.SliceNumber) Used for Image and Acquired Dose. Not used for Calculated Dose. Dose Comment (3004,0006) 3 User-defined comments for dose data. *** Not Used *** Import: Will also be used to create the Image ID as displayed in the UI. Normalization Point (3004,0008) 3 Coordinates (x, y, z) of normalization point in the patient based coordinate system described in C (mm). See C Dose Summation Type Referenced RT Plan Sequence (3004,000A) 1 Type of dose summation. Defined Terms: PLAN = dose calculated for entire RT Plan FRACTION = dose calculated for a single Fraction Group within RT Plan BEAM = dose calculated for one or more Beams within RT Plan BRACHY = dose calculated for one or more Brachy Application Setups within RT Plan CONTROL_POINT = dose calculated for one or more Control Points within a Beam (300C,0002) 1C Introduces sequence of one Class/Instance pair describing RT Plan associated with dose. Required if Dose Summation Type (3004,000A) is PLAN, FRACTION, BEAM, BRACHY or CONTROL_POINT. Only a single item shall be permitted in this sequence. See Note 1. Import: BEAM, FRACTION, PLAN BEAM, FRACTION Because only one fraction is supported FRACTION and PLAN are synonyms. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

212 > Referenced SOP Class UID > Referenced SOP Instance UID > Referenced Fraction Group Sequence >> Referenced Fraction Group Number >> Referenced Beam Sequence (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced RT Plan Sequence (300C,0002) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced RT Plan Sequence (300C,0002) is sent. (300C,0020) 1C Introduces sequence of one Fraction Group containing beams or brachy application setups contributing to dose. Required if Dose Summation Type (3004,000A) is FRACTION, BEAM, BRACHY or CONTROL_POINT. Only a single item shall be permitted in this sequence. See Note 1. (300C,0022) 1C Uniquely identifies Fraction Group specified by Fraction Group Number (300A,0071) in Fraction Group Sequence of RT Fraction Scheme Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002). Required if Referenced Fraction Group Sequence (300C,0020) is sent. (300C,0004) 1C Introduces sequence of Beams in current Fraction Group contributing to dose. Required if Dose Summation Type (3004,000A) is BEAM or CONTROL_POINT. One or more items may be included in this sequence. Import: Ignored (RT Plan) or (RT ION Plan) Attribute is processed during export only. The value of Fractionation.PlanUID will be used to calculate the contents during export. PlanUID, which could be found as (parent of) the primary context object of the DoseMatrix. Import: Value ignored Always 1 Only 1 item is supported 138 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

213 >>> Referenced Beam Number >>> Referenced Control Point Sequence >>>> Referenced Start Control Point Index >>>> Referenced Stop Control Point Index (300C,0006) 1C Uniquely identifies Beam specified by Beam Number (300A,00C0) in Beam Sequence of RT Beams Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002). Required if Referenced Beam Sequence (300C,0004) is sent. (300C,00F2) 1C Sequence defining the Control Points in current Beam contributing to dose. Required if Dose Summation Type (3004,000A) is CONTROL_POINT. Only a single item shall be present in this sequence. (300C,00F4) 1 Identifies Control Point specified by Control Point Index (300A,0112) within Beam referenced by Referenced Beam Number (300C,0006). This is the first of the two Control Points from which the Dose contribution to the Control Point can be calculated. (300C,00F6) 1 Identifies Control Point specified by Control Point Index (300A,0112) within Beam referenced by Referenced Beam Number (300C,0006). This is the second of the two Control Points from which the Dose contribution to the Control Point can be calculated. The Control Point Index (300A,0112) referenced by Referenced Stop Control Point Index (300C,00F6) shall be the Control Point Index (300A,0112) immediately following the Control Point Index (300A,0112) referenced by Referenced Start Control Point Index (300C,00F4) within the Referenced Beam Number (300C,0006). Attribute is processed during export only. The value of Field.FieldNumber will be used to calculate the contents during export. Import:Sets the primary context to the Field with corresponding FieldNumber. FieldNumber of the primary context if it is a field. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

214 >> Referenced Brachy Application Setup Sequence (300C,000A) 1C Introduces sequence of Brachy Application Setups in current Fraction Group contributing to dose. Required if Dose Summation Type (3004,000A) is BRACHY. One or more items may be included in this sequence. Not supported: Import rejected if present. >>> Referenced Brachy Application Setup Number (300C,000C ) 1C Uniquely identifies Brachy Application Setup specified by Brachy Application Setup Number (300A,0234) in Brachy Application Setup Sequence (300A,0230) of RT Brachy Application Setups Module within RT Plan referenced in Referenced RT Plan Sequence (300C,0002). Required if Referenced Brachy Application Setup Sequence (300C,000A) is sent. *** Not Used *** Grid Frame Offset Vector (3004,000C) 1C An array which contains the dose image plane offsets (in mm) of the dose image frames in a multi-frame dose. Required if multi-frame pixel data are present and Frame Increment Pointer (0028,0009) points to Grid Frame Offset Vector (3004,000C). See C For import, frames must be equallyspaced in z direction. Dose Grid Scaling (3004,000E) 1 Scaling factor that when multiplied by the dose grid data found in the Pixel Data (7FE0,0010) attribute of the Image Pixel Module, yields grid doses in the dose units as specified by Dose Units (3004,0002). DoseMatrix.Scaler) Tissue Heterogeneity Correction (3004,0014) 3 Specifies a list of patient heterogeneity characteristics used for calculating dose. This Atttibute shall be multi-valued if beams used to compute the dose have differing correction techniques. Enumerated Values: IMAGE = image data ROI_OVERRIDE = one or more ROI densities override image or water values where they exist WATER = entire volume treated as water equivalent 140 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

215 C.2.20 RT DVH C Referenced Structure Set Sequence > Referenced SOP Class UID > Referenced SOP Instance UID DVH Normalization Point DVH Normalization Dose Value (300C,0060) 1 Introduces sequence of one class/instance pair describing Structure Set containing structures which are used to calculate Dose-Volume Histograms (DVHs). Only a single item shall be permitted in this sequence. See C Export only (0008,1150) 1 Uniquely identifies the referenced SOP Class (Storage RT Structure SOP Class UID) (0008,1155) 1 Uniquely identifies the referenced SOP Instance. Attribute is written, but not supported during import. (Value read from: Image.StructureSetUID) From the Planning Image. (3004,0040) 3 Coordinates (x, y, z) of common DVH normalization point in the patient based coordinate system described in C (mm). (3004,0042) 3 Dose Value at DVH Normalization Point (3004,0040) used as reference for individual DVHs when Dose Units (3004,0002) is RELATIVE. DVH Sequence (3004,0050) 1 Introduces sequence of DVHs. One or more items may be included in this sequence. > DVH Referenced ROI Sequence >> Referenced ROI Number (3004,0060) 1 Introduces sequence of referenced ROIs used to calculate DVH. (3006,0084) 1 Uniquely identifies ROI used to calculate DVH specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set referenced by referenced RT Plan in Referenced RT Plan Sequence (300C,0002) in RT Dose Module. *** Not Used *** *** Not Used *** Export only Only one item in this sequence Attribute is written, but not supported during import. (Value read from: Structure.DicomSeqNumber) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

216 >> DVH ROI Contribution Type (3004,0062) 1 Specifies whether volume within ROI is included or excluded in DVH. See C Enumerated Values: INCLUDED, EXCLUDED. Only INCLUDED is supported > DVH Type (3004,0001) 1 Type of DVH. Depends on user selection from export Enumerated Values: DIFFERENTIAL = differential dose-volume histogram CUMULATIVE = cumulative dose-volume histogram NATURAL = natural dose volume histogram wizard page > Dose Units (3004,0002) 1 Dose axis units. Depends on user selection from export Enumerated Values: GY = Gray RELATIVE = dose relative to reference value specified in DVH Normalization Dose Value (3004,0042) wizard page > Dose Type (3004,0004) 1 Type of dose. Only PHYSICAL is supported Defined Terms: PHYSICAL = physical dose EFFECTIVE = physical dose after correction for biological effect using user- defined modeling technique ERROR = difference between desired and planned dose > DVH Dose Scaling (3004,0052) 1 Scaling factor that when multiplied by the dose bin widths found in DVH Data (3004,0058), yields dose bin widths in the dose units as specified by Dose Units (3004,0002). Only 1.0 is supported 142 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

217 > DVH Volume Units > DVH Number of Bins (3004,0054) 1 Volume axis units. Depends on user selection from export Defined Terms: CM3 = cubic centimeters PERCENT = percent PER_U = volume per u with u(dose)=dose3/ 2. See C wizart page (3004,0056) 1 Number of bins n used to store DVH Data (3004,0058). Calculated value > DVH Data (3004,0058) 1 A data stream describing the dose bin widths Dn and associated volumes Vn in DVH Volume Units (3004,0054) in the order D1V1, D2V2,... DnVn. Note: DVH Data arrays may not be properly encoded if Explicit-VR transfer syntax is used and the VL of this attribute exceeds bytes. Calculated value > DVH Minimum Dose > DVH Maximum Dose (3004,0070) 3 Minimum calculated dose to ROI(s) described by DVH Referenced ROI Sequence (3004,0060). (3004,0072) 3 Maximum calculated dose to ROI(s) described by DVH Referenced ROI Sequence (3004,0060). Calculated value Calculated value > DVH Mean Dose (3004,0074) 3 Mean calculated dose to ROI(s) described by DVH Referenced ROI Sequence (3004,0060). Calculated value Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

218 C.2.21 Structure Set C Structure Set Label (3006,0002) 1 User-defined label for Structure Set. Structure.StructureSetLabel) Value is also imported to Structure.StructureName but not exported from there. Used as initial volume image ID. Structure Set Name (3006,0004) 3 User-defined name for Structure Set. *** Not Used *** Structure Set Description (3006,0006) 3 User-defined description for Structure Set. *** Not Used *** Instance Number (0020,0013) 3 A number that identifies this object instance. Structure Set Date (3006,0008) 2 Date at which Structure Set was last modified. *** Not Used *** Structure Set Time (3006,0009) 2 Time at which Structure Set was last modified. *** Not Used *** Referenced Frame of Reference Sequence (3006,0010) 3 Introduces sequence of items describing Frames of Reference in which the ROIs are defined. One or more items may be included in this sequence. See C Import: Used for finding related images. Unresolved external references are not stored. Generated from images associated to this structure set. 144 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

219 > Frame of Reference UID > Frame of Reference Relationship Sequence >> Related Frame of Reference UID >> Frame of Reference Transformation Type >> Frame of Reference Transformation Matrix >> Frame of Reference Transformation Comment (0020,0052) 1C Uniquely identifies Frame of Reference within Structure Set. Required if Referenced Frame of Reference Sequence (3006,0010) is sent. (3006,00C0) 3 Introduces sequence of transforms that relate other Frames of Reference to this Frame of Reference. (3006,00C2) 1C Frame of Reference Coordinate System to be transformed to the current Frame of Reference. Required if Frame of Reference Relationship Sequence (3006,00C0) is sent. (3006,00C4) 1C Type of Transformation. Required if Frame of Reference Relationship Sequence (3006,00C0) is sent. Defined Terms: HOMOGENEOUS (3006,00C6) 1C Four-by-four transformation Matrix from Related Frame of Reference to current Frame of Reference. Matrix elements shall be listed in row-major order. Required if Frame of Reference Relationship Sequence (3006,00C0) is sent. See C (3006,00C8) 3 Comment regarding the transformation between the related and current Frames of Reference. Slice.FrameOfReferenceUID) Import: used to identify the image to which the structure set will be assigned. *** Not Used *** *** Not Used *** *** Not Used *** *** Not Used *** *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

220 > RT Referenced Study Sequence >> Referenced SOP Class UID >> Referenced SOP Instance UID >> RT Referenced Series Sequence >>> Series Instance UID >>> Contour Image Sequence (3006,0012) 3 Introduces sequence of Studies containing series to be referenced. One or more items may be included in this sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if RT Referenced Study Sequence (3006,0012) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if RT Referenced Study Sequence (3006,0012) is sent. (3006,0014) 1C Introduces sequence of items describing series of images within the referenced study which are used in defining the Structure Set. Required if RT Referenced Study Sequence (3006,0012) is sent. One or more items may be included in this sequence. (0020,000E) 1C Unique identifier for the series containing the images. Required if RT Referenced Series Sequence (3006,0014) is sent. (3006,0016) 1C Introduces sequence of items describing images in a given series used in defining the Structure Set (typically CT or MR images). Required if RT Referenced Series Sequence (3006,0014) is sent. One or more items may be included in this sequence. Import: Used for finding related images. Unresolved external references are not stored. Generated from images associated to this structure set (Study Component Mangement SOP Class) Study.StudyUID) Import: Used for finding related images. Unresolved external references are not stored. Generated from images associated to this structure set. Series.SeriesUID) Import: Used for finding related images. Unresolved external references not stored. Generated from images associated to this structure set. 146 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

221 >>>> Referenced SOP Class UID >>>> Referenced SOP Instance UID >>>> Referenced Frame Number Structure Set ROI Sequence (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. (0008,1160) 1 Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Note: This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames. (3006,0020) 3 Introduces sequence of ROIs for current Structure Set. One or more items may be included in this sequence. > ROI Number (3006,0022) 1C Identification number of the ROI. The value of ROI Number (3006,0022) shall be unique within the Structure Set in which it is created. Required if Structure Set ROI Sequence (3006,0020) is sent. Structure.DicomSeqNumber) Default StructureId is constructed based on ROI Number of the ROI Name is not propperly defined. > Referenced Frame of Reference UID (3006,0024) 1C Uniquely identifies Frame of Reference in which ROI is defined, specified by Frame of Reference UID (0020,0052) in Referenced Frame of Reference Sequence (3006,0010). Required if Structure Set ROI Sequence (3006,0020) is sent. Slice.FrameOfReferenceUID) > ROI Name (3006,0026) 2C User-defined name for ROI. Required if Structure Set ROI Sequence (3006,0020) is sent. Structure.StructureId) If undefined on import, the ROI Number is used to construct a reasonable StructureId. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

222 > ROI Description (3006,0028) 3 User-defined description for ROI. Structure.Comment) > ROI Volume (3006,002C) 3 Volume of ROI (cubic centimeters). *** Not Used *** > ROI Generation Algorithm > ROI Generation Description > Overlapping Status Referenced Structure Set Sequence > Referenced SOP Class UID > Referenced SOP Instance UID (3006,0036) 2C Type of algorithm used to generate ROI. Required if Structure Set ROI Sequence (3006,0020) is sent. Defined Terms: AUTOMATIC = calculated ROI SEMIAUTOMATIC = ROI calculated with user assistance MANUAL = user-entered ROI (3006,0038) 3 User-defined description of technique used to generate ROI. *** Not Used *** (3263,1000) 2 (3263,1001) 3 Introduces sequence of related SOP Class/Instance pairs describing related instances of structure sets. One or more items may be included in this sequence. Structure.GenerationAlgorithm) (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. 148 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

223 > Structure Set Relationship (3263,1002) 3 Relationship of referenced structure set with respect to current structure set. Required if Referenced Structure Set Sequence (3263,1002) is sent. Only value ADDITION is supported. Defined Terms: PREDECESSOR = structure set used in derivation of current structure set ADDITION = structure set, for which the current structure set is an addition C.2.22 ROI Contour C ROI Contour Sequence > Referenced ROI Number (3006,0039) 1 Introduces sequence of Contour Sequences defining ROIs. One or more items may be included in this sequence. (3006,0084) 1 Uniquely identifies the referenced ROI described in the Structure Set ROI Sequence (3006,0020). Structure.DicomSeqNumber) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

224 > ROI Display Color (3006,002A) 3 RGB triplet color representation for ROI, specified using the range > Contour Sequence (3006,0040) 3 Introduces sequence of Contours defining ROI. One or more items may be included in this sequence. >> Contour Number (3006,0048) 3 Identification number of the contour. The value of Contour Number (3006,0048) shall be unique within the Contour Sequence (3006,0040) in which it is defined. No semantics or ordering shall be inferred from this attribute. >> Attached Contours >> Contour Image Sequence >>> Referenced SOP Class UID (3006,0049) 3 List of Contour Number (3006,0048) defining lowernumbered contour(s) to which the current contour is connected. (3006,0016) 3 Introduces sequence of images containing the contour. One or more items may be included in this sequence. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Material.Color2D) Import: Attribute is processed during import only. It is represented by Structure.MaterialSer on the database. Import: Color is used to search for matching Material. If none is found, a new Material with given color will be created. (0008,1150) 1 Uniquely identifies the referenced SOP Class. >>> Referenced SOP Instance UID (0008,1155) 1 Uniquely identifies the referenced SOP Instance. 150 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

225 >>> Referenced Frame Number >> Contour Geometric Type (0008,1160) 1 Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Note: This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames. (3006,0042) 1C Geometric type of contour. Required if Contour Sequence (3006,0040) is sent. See C Enumerated Values: POINT = single point OPEN_PLANAR = open contour containing coplanar points OPEN_NONPLANAR = open contour containing noncoplanar points CLOSED_PLANAR = closed contour (polygon) containing coplanar points Import: Contour is wrapping if type is POINT or CLOSED_PLANAR Contour is open if type is OPEN_PLANAR In the remaining cases a warning will be generated POINT if Contour contains only one point OPEN_PLANAR if Contour has nore then one point and Contour is open CLOSED_PLANAR in the remaining cases >> Contour Slab Thickness >> Contour Offset Vector (3006,0044) 3 Thickness of slab (in mm) represented by contour, where the Contour Data (3006,0050) defines a plane in the center of the slab, offset by the Contour Offset Vector (3006,0045) if it is present. See C (3006,0045) 3 Vector (x,y,z) in the the patient based coordinate system described in C which is normal to plane of Contour Data (3006,0050), describing direction and magnitude of the offset (in mm) of each point of the central plane of a contour slab from the corresponding original point of Contour Data (3006,0050). See C OPEN_NONPLANAR is not supported *** Not Used *** *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

226 >> Number of Contour Points (3006,0046) 1C Number of points (triplets) in Contour Data (3006,0050). Required if Contour Sequence (3006,0040) is sent. Header information in a binary file. >> Contour Data (3006,0050) 1C Sequence of (x,y,z) triplets defining a contour in the patient based coordinate system described in C (mm). Required if Contour Sequence (3006,0040) is sent. See C and C Note: Contour Data may not be properly encoded if Explicit-VR transfer syntax is used and the VL of this attribute exceeds bytes. Read from or written to contour points in a binary file. C.2.23 RT ROI Observations C RT ROI Observations Sequence > Observation Number > Referenced ROI Number (3006,0080) 1 Introduces sequence of observations related to ROIs defined in the ROI Module. One or more items may be included in this sequence. (3006,0082) 1 Identification number of the Observation. The value of Observation Number (3006,0082) shall be unique within the RT ROI Observations Sequence (3006,0080). (3006,0084) 1 Uniquely identifies the referenced ROI described in the Structure Set ROI Sequence (3006,0020). Increasing unique number, starting with 1. Structure.DicomSeqNumber) > ROI Observation Label (3006,0085) 3 User-defined label for ROI Observation. PatientVolume.VolumeId) Also stored in PatientVolume.VolumeName 152 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

227 > ROI Observation Description (3006,0088) 3 User-defined description for ROI Observation. PatientVolume.Comment) > RT Related ROI Sequence >> Referenced ROI Number >> RT ROI Relationship > RT ROI Identification Code Sequence (3006,0030) 3 Introduces sequence of significantly related ROIs, e.g. CTVs contained within a PTV. One or more items may be included in this sequence. (3006,0084) 1C Uniquely identifies the related ROI described in the Structure Set ROI Sequence (3006,0020). Required if RT Related ROI Sequence (3006,0030) is sent. (3006,0033) 3 Relationship of referenced ROI with respect to referencing ROI. Defined Terms: SAME = ROIs represent the same entity ENCLOSED = referenced ROI completely encloses referencing ROI ENCLOSING = referencing ROI completely encloses referenced ROI (3006,0086) 3 Introduces sequence containing Code used to identify ROI. If this sequence is included, only one item shall be present. Baseline Context ID Number = 96. See Section 5.3 for further explanation. *** Not Used *** *** Not Used *** *** Not Used *** >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. VolumeCode.VolumeCode) >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. VolumeCode.VolumeCodeTable) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

228 >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Attribute is written, but not supported during import. (Value read from: VolumeCode.Description) Import: Warning, if it does not match with object found on database. > Related RT ROI Observations Sequence >> Observation Number (3006,00A0) 3 Introduces sequence of related ROI Observations. One or more items may be included in this sequence. (3006,0082) 1C Uniquely identifies a related ROI Observation. Required if Related RT ROI Observations Sequence (3006,00A0) is sent. *** Not Used *** *** Not Used *** 154 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

229 > RT ROI Interpreted Type (3006,00A4) 2 Type of ROI. See C Defined Terms: EXTERNAL = external patient contour PTV = Planning Target Volume (as defined in ICRU50) CTV = Clinical Target Volume (as defined in ICRU50) GTV = Gross Tumor Volume (as defined in ICRU50) TREATED_VOLUME = Treated Volume (as defined in ICRU50) IRRAD_VOLUME = Irradiated Volume (as defined in ICRU50) BOLUS = patient bolus to be used for external beam therapy AVOIDANCE = region in which dose is to be minimized ORGAN = patient organ MARKER = patient marker or marker on a localizer REGISTRATION = registration ROI ISOCENTER = treatment isocenter to be used for external beam therapy CONTRAST_AGENT = volume into which a contrast agent has been injected CAVITY = patient anatomical cavity BRACHY_CHANNEL = brachytherapy channel BRACHY_ACCESSORY = brachytherapy accessory device BRACHY_SRC_APP = brachytherapy source applicator BRACHY_CHNL_SHLD = brachytherapy channel shield SUPPORT = external patient support device FIXATION = external patient fixation or immobilisation device DOSE_REGION = ROI to be used as a dose reference CONTROL = ROI to be used in control of dose optimization and calculation Import: Attribute is processed during import only. It is represented by Structure.StructureTypeSer on the database. Attribute is processed during export only. The value of StructureType.StructureTypeIndex, PatientVolume.VolumeTypeSer, VolumeType. The Defined Terms map to a Structure with following StructureType: BOLUS: Bolus BRACHY_CHANNEL: BrachyShape MARKER: Reference Line REGISTRATION: Match Anatomy GTV, CTV, PTV, AVOIDANCE, EXTERNAL, ORGAN: PatientVolume All other Defined Terms: User For Defined Terms that map to StructureType "PatientVolume" the Structure is connected to a PatientVolume with following VolumeType: GTV: GTV CTV: CTV PTV: PTV AVOIDANCE: Avoidance or Avoid. EXTERNAL: BODY ORGAN: Organ or Org Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

230 > ROI Interpreter (3006,00A6) 2 Name of person performing the interpretation. *** Not Used *** > Material ID (300A,00E1) 3 User-supplied identifier for ROI material. *** Not Used *** > ROI Physical Properties Sequence >> ROI Physical Property (3006,00B0) 3 Introduces sequence describing physical properties associated with current ROI interpretation. One or more items may be included in this sequence. (3006,00B2) 1C Physical property specified by ROI Physical Property Value (3006,00B4). Required if ROI Physical Properties Sequence (3006,00B0) is sent. Defined Terms: REL_MASS_DENSITY = mass density relative to water REL_ELEC_DENSITY = electron density relative to water EFFECTIVE_Z = effective atomic number EFF_Z_PER_A = effective ratio of atomic number to mass (AMU-1) Structure.ROIPhysicalProperty) The entire sequence is retained on an import/export cycle, but only RES_MASS_DENSITY is supported. If the sequence length exceeds the storage capability a warning is issued and the last element(s) may be missing after a re-export. Only RES_MASS_DENSITY is supported, other values are ignore. 156 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

231 >> ROI Physical Property Value (3006,00B4) 1C User-assigned value for physical property. Required if ROI Physical Properties Sequence (3006,00B0) is sent. Attribute is processed during export only. The value of Structure.MaterialCTValue will be used to calculate the contents during export. Contains HU value relative to water. Import: HU = 1000 * Value Value = 1 + HU / 1000 > Marker Subtype (3271,1000) 3 Specific type of marker. Used only if RT ROI Interpreted Type has value MARKER. Enumerated Values: MARKER = position of physical marker POINT_MATCH = point used for matching REFERENCE_LINE = line amphasizing anatomical structure The Defined Terms map to a Structure with following StructureType: MARKER: Marker POINT_MATCH: Point Match REFERENCE_LINE: Reference Line Attribute will be written only if value is one of the above listed. In this case RT ROI Interpretated Type will contain value MARKER Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

232 C.2.24 RT General Plan C RT Plan Label (300A,0002) 1 User-defined label for treatment plan. PlanSetup.PlanSetupId) Used as Plan ID. RT Plan Name (300A,0003) 3 User-defined name for treatment plan. PlanSetup.PlanSetupName) Used as Plan Name. RT Plan Description (300A,0004) 3 User-defined description of treatment plan. PlanSetup.Comment) Instance Number (0020,0013) 3 A number that identifies this object instance. Operators Name (0008,1070) 2 Name of operator(s) creating treatment plan. PlanSetup.CreationUserName) Import: Only the first operators name will be used. RT Plan Date (300A,0006) 2 Date treatment plan was last modified. Import: Attribute is read, but cannot be exported. (Stored as-is in: PlanSetup.CreationDate) Attribute is written, but not supported during import. (Value read from: PlanSetup.HstryDateTime) 158 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

233 RT Plan Time (300A,0007) 2 Time treatment plan was last modified. Import: Attribute is read, but cannot be exported. (Stored as-is in: PlanSetup.CreationDate) Attribute is written, but not supported during import. (Value read from: PlanSetup.HstryDateTime) Treatment Protocols (300A,0009) 3 Planned treatment protocols. Plan Intent (300A,000A) 3 Intent of this plan. Defined Terms: CURATIVE = curative therapy on patient PALLIATIVE = palliative therapy on patient PROPHYLACTIC = preventative therapy on patient VERIFICATION = verification of patient plan using phantom MACHINE_QA = Quality assurance of the delivery machine (independently of a specific patient) RESEARCH = Research project SERVICE = Machine repair or maintenance operation Roundtrip is supported but internal representation is different from DICOM. (Stored in: Course.Intent, PlanSetup.UsageType) CURATIVE, PALLIATIVE map to Course.Intent VERIFICATION maps to PlanSetup.UsageType If plan is a verification plan, value VERIFICATION is exported independent of Course status Treatment Sites (300A,000B) 3 Planned treatment sites. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

234 RT Plan Geometry (300A,000C) 1 Describes whether RT Plan is based on patient or treatment device geometry. See C Defined Terms: PATIENT = RT Structure Set exists TREATMENT_DEVICE = RT Structure Set does not exist Export only: Take PATIENT, when a structure set can be identified for Export as defined in (300A,0060). Referenced Structure Set Sequence (300C,0060) 1C Introduces sequence of one Class/Instance pair describing instance of RT Structure Set on which the RT Plan is based. Only a single item shall be permitted in this sequence. Required if RT Plan Geometry (300A,000C) is PATIENT. Import: Checks whether referenced structure set is already in the system. If so, a context from the representing Volume Image to the PlanSetup is created. > Referenced SOP Class UID > Referenced SOP Instance UID Referenced Dose Sequence (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Structure Set Sequence (300C,0060) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Structure Set Sequence (300C,0060) is sent. (300C,0080) 3 Introduces sequence of related SOP Class/Instance pairs describing related instances of RT Dose (for grids and named/unnamed point doses). One or more items may be included in this sequence. See Note 1. Volume Image having a context to the PlanSetup represents the plan structure set Image.StructureSetUID) Import: Stored in Image.StructureSetUID Read from Image.StructureSetUID, which is the UID of the actual structure set that is referenced by the plan. 160 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

235 > Referenced SOP Class UID > Referenced SOP Instance UID Referenced RT Plan Sequence > Referenced SOP Class UID > Referenced SOP Instance UID > RT Plan Relationship (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced RT Dose Sequence (300C,0080) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced RT Dose Sequence (300C,0080) is sent. (300C,0002) 3 Introduces sequence of related SOP Class/Instance pairs describing related instances of RT Plan. One or more items may be included in this sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced RT Plan Sequence (300C,0002) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced RT Plan Sequence (300C,0002) is sent. (300A,0055) 1C Relationship of referenced plan with respect to current plan. Required if Referenced RT Plan Sequence (300C,0002) is sent. Defined Terms: PRIOR = plan delivered prior to current treatment ALTERNATIVE = alternative plan prepared for current treatment PREDECESSOR = plan used in derivation of current plan VERIFIED_PLAN = plan which is verified using the current plan. This value shall only be used if Plan Intent (300A,000A) is present and has a value of VERIFICATION. Only one item is supported in this sequence Fractionation.PredecessorPlanUID) This value will be dropped on import if the referenced predecessor plan along with a different successor plan already exist on the DB. In this case a warning will be displayed to the user. Only value PREDECESSOR is supported. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

236 Beam Line Data Table Version (300B,1008) 3 Version Number that is set for Look-up Table (and/or for each beam tune in Look-up Table in future) FieldProton.BeamlineDataTableVers) Used only in RT Ion Plans. Export fails if this value is not the same for all beams. C.2.25 RT Prescription C Prescription Description (300A,000E) 3 User-defined description of treatment prescription. *** Not Used *** Dose Reference Sequence > Dose Reference Number > Dose Reference UID (300A,0010) 3 Introduces sequence of Dose References. One or more items may be included in this sequence. (300A,0012) 1C Identification number of the Dose Reference. The value of Dose Reference Number (300A,0012) shall be unique within the RT Plan in which it is created. Required if Dose Reference Sequence (300A,0012) is sent. (300A,0013) 3 A unique identifier for a Dose Reference that can be used to link the same entity across multiple RT Plan objects. DoseContribution.DicomSeqNumber) RefPoint.RefPointUID) 162 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

237 > Dose Reference Structure Type > Dose Reference Description (300A,0014) 1C Structure type of Dose Reference. Import: Required if Dose Reference Sequence (300A,0010) is sent. Supported values: COORDINATES, SITE. Defined Terms: POINT = dose reference point specified as ROI VOLUME = dose reference volume specified as ROI COORDINATES = point specified by Dose Reference Point Coordinates (300A,0018) SITE = dose reference clinical site Item is ignored if value is POINT or VOLUME. COORDINATE: If RefPointLocation exists in the Image which has context to the plan SITE: Otherwise (300A,0016) 3 User-defined description of Dose Reference. RefPoint.RefPointId) > Referenced ROI Number > Dose Reference Point Coordinates > Nominal Prior Dose (3006,0084) 1C Uniquely identifies ROI representing the dose reference specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set in Referenced Structure Set Sequence (300C,0060) in RT General Plan Module. Required if Dose Reference Structure Type (300A,0014) is POINT or VOLUME and Dose Reference Sequence (300A,0010) is sent. (300A,0018) 1C Coordinates (x,y,z) of Reference Point in the patient based coordinate system described in C (mm). Required if Dose Reference Structure Type (300A,0014) is COORDINATES and Dose Reference Sequence (300A,0010) is sent. (300A,001A) 3 Dose (in Gy) from prior treatment to this Dose Reference (e.g. from a previous course of treatment). *** Not Used *** Roundtrip is supported but internal representation is different from DICOM. (Stored in: RefPointLocation.Location) *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

238 > Dose Reference Type (300A,0020) 1C Type of Dose Reference. Required if Dose Reference Sequence (300A,0010) is sent. Defined Terms: TARGET = treatment target (corresponding to GTV, PTV, or CTV in ICRU50) ORGAN_AT_RISK = Organ at Risk (as defined in ICRU50) Import: TARGET is mapped to PTV ORGAN_AT_RISK is mapped to AVOIDANCE. If PatientVolume.Type is PTV, CTV or GTV then TARGET else ORGAN_AT_RISK. > Constraint Weight (300A,0021) 3 Relative importance of satisfying constraint, where high values represent more important constraints. Import: Attribute is processed during import only. It is represented by RefPoint.TotalDoseLimit on the database. > Delivery Warning Dose > Delivery Maximum Dose > Target Minimum Dose > Target Prescription Dose (300A,0022) 3 The dose (in Gy) which when reached or exceeded should cause some action to be taken. (300A,0023) 3 The maximum dose (in Gy) which can be delivered to the dose reference. (300A,0025) 3 Minimum permitted dose (in Gy) to Dose Reference if Dose Reference Type (300A,0020) is TARGET. (300A,0026) 3 Prescribed dose (in Gy) to Dose Reference if Dose Reference Type (300A,0020) is TARGET. *** Not Used *** Import: If Dose Reference Type is neither TARGET nor ORGAN_AT_RISK then written to RefPoint.TotalDoseLimit otherwise ignored. Value is read from: RefPoint.TotalDoseLimit Total planned dose 164 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

239 > Target Maximum Dose > Referenced Patient Volume Id > Target Underdose Volume Fraction > Organ at Risk Full-volume Dose > Organ at Risk Limit Dose > Organ at Risk Maximum Dose > Organ at Risk Overdose Volume Fraction (300A,0027) 3 Maximum permitted dose (in Gy) to Dose Reference if Dose Reference Type (300A,0020) is TARGET. Roundtrip supported if Dose Reference Type is TARGET. (Stored as-is in: RefPoint.TotalDoseLimit) (3267,1000) 3 PatientVolume.VolumeId) (300A,0028) 3 Maximum permitted fraction (in percent) of Target to receive less than the Target Prescription Dose if Dose Reference Type (300A,0020) is TARGET and Dose Reference Structure Type (300A,0014) is VOLUME. See C (300A,002A) 3 Maximum dose (in Gy) to entire Dose Reference if Dose Reference Type (300A,0020) is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) is VOLUME. (300A,002B) 3 Maximum permitted dose (in Gy) to any part of Dose Reference if Dose Reference Type (300A,0020) is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) is VOLUME. (300A,002C) 3 Maximum dose (in Gy) to non-overdosed part of Dose Reference if Dose Reference Type (300A,0020) is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) is VOLUME. (300A,002D) 3 Maximum permitted fraction (in percent) of the Organ at Risk to receive more than the Organ at Risk Maximum Dose if Dose Reference Type (300A,0020) is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) is VOLUME. *** Not Used *** Stored in: RefPoint.TotalDoseLimit Import: Only if Dose Reference Type is ORGAN_AT_RISK Only if Dose Reference Type is not TARGET *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

240 C.2.26 RT Tolerance Tables C Tolerance Table Sequence > Tolerance Table Number > Tolerance Table Label > Gantry Angle Tolerance > Beam Limiting Device Angle Tolerance > Beam Limiting Device Tolerance Sequence (300A,0040) 3 Introduces sequence of tolerance tables to be used for delivery of treatment plan. One or more items may be included in this sequence. See Note 1. (300A,0042) 1C Identification number of the Tolerance Table. The value of Tolerance Table Number (300A,0042) shall be unique within the RT Plan in which it is created. Required if Tolerance Table Sequence (300A,0040) is sent. Import: Matched against Referenced Tolerance Table Number in RT Beams Module (300A,0043) 3 User-defined label for Tolerance Table. Attribute is written, but not supported during import. (Value read from: Tolerance.ToleranceId) (300A,0044) 3 Maximum permitted difference (in degrees) between planned and delivered Gantry Angle. (300A,0046) 3 Maximum permitted difference (in degrees) between planned and delivered Beam Limiting Device Angle. (300A,0048) 3 Introduces sequence of beam limiting device (collimator) tolerances. One or more items may be included in this sequence. Taken from ToleranceLimit where ParameterName = GantryRtn Taken from ToleranceLimit where ParameterName = CollRtn 166 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

241 >> RT Beam Limiting Device Type >> Beam Limiting Device Position Tolerance (300A,00B8) 1C Type of beam limiting device (collimator). All values are supported. Required if Beam Limiting Device Tolerance Sequence (300A,0048) is sent. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction (300A,004A) 1C Maximum permitted difference (in mm) between planned and delivered leaf (element) or jaw positions for current beam limiting device (collimator). Required if Beam Limiting Device Tolerance Sequence (300A,0048) is sent. Only for Dose Dynamic or Arc Dynamic MLC: Taken from attributes DoseDynamicLeafTolerance or ArcDynamicLeafTolerance of MLC associated to field. > Patient Support Angle Tolerance > Table Top Eccentric Angle Tolerance (300A,004C) 3 Maximum permitted difference (in degrees) between planned and delivered Patient Support Angle. (300A,004E) 3 Maximum permitted difference (in degrees) between planned and delivered Table Top Eccentric Angle. Collimator: For X: ToleranceLimit where ParameterName = CollX For ASYMX: ToleranceLimit where ParameterName = CollX1/X2 For Y: ToleranceLimit where ParameterName = CollY For ASYMY: ToleranceLimit where ParameterName = CollY1/Y2 Taken from ToleranceLimit where ParameterName = PatientSupportAngle Taken from ToleranceLimit where ParameterName = TableTopEccentricAngle Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

242 > Table Top Vertical Position Tolerance > Table Top Longitudinal Position Tolerance > Table Top Lateral Position Tolerance (300A,0051) 3 Maximum permitted difference (in mm) between planned and delivered Table Top Vertical Position. (300A,0052) 3 Maximum permitted difference (in mm) between planned and delivered Table Top Longitudinal Position. (300A,0053) 3 Maximum permitted difference (in mm) between planned and delivered Table Top Lateral Position. Taken from ToleranceLimit where ParameterName = CouchVrt Taken from ToleranceLimit where ParameterName = CouchLng Taken from ToleranceLimit where ParameterName = CouchLat C.2.27 RT Patient Setup C Patient Setup Sequence > Patient Setup Number > Patient Setup Label (300A,0180) 1 Introduces sequence of patient setup data for current plan. One or more items may be included in this sequence. (300A,0182) 1 Identification number of the Patient Setup. The value of Patient Setup Number (300A,0182) shall be unique within the RT Plan in which it is created. Import: Required to find related beam FieldGroupNumber of related beam (300A,0183) 3 The user-defined label for the patient setup. 168 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

243 > Patient Position (0018,5100) 1C Patient position descriptor relative to the equipment. Required if Patient Additional Position (300A,0184) is not present. See Section C for Defined Terms and further explanation. Roundtrip is supported but internal representation is different from DICOM. (Stored in: PlanSetup.TreatmentOrientation) Only plans having the same Patient Position for all beams are accepted for import. Additionally to the Terms defined in the DICOM standard, we support the value 'FAFSIT' for 'Face First - Sitting'. > Patient Additional Position > Referenced Image Setup Sequence (300A,0184) 1C User-defined additional description of patient position. Required if Patient Position (0018,5100) is not present. (300A,0401) 3 Introduces sequence of setup verification images for this patient setup. One or more items may be included in this sequence. See C >> Setup Image Comment >> Referenced SOP Class UID >> Referenced SOP Instance UID (300A,0402) 3 Comment on the Setup Image. (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. >> Referenced Frame Number (0008,1160) 1 Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Note: This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

244 > Fixation Device Sequence >> Fixation Device Type >> Fixation Device Label (300A,0190) 3 Introduces sequence of Fixation Devices used in Patient Setup. One or more items may be included in this sequence. (300A,0192) 1C Type of Fixation Device used during in Patient Setup. Required if Fixation Device Sequence (300A,0190) is sent. Defined Terms: BITEBLOCK HEADFRAME MASK MOLD CAST HEADREST BREAST_BOARD BODY_FRAME VACUUM_MOLD WHOLE_BODY_POD RECTAL_BALLOON (300A,0194) 2C User-defined label identifier for Fixation Device. Required if Fixation Device Sequence (300A,0190) is sent. >> Fixation Device Description >> Fixation Device Position (300A,0196) 3 User-defined description of Fixation Device. (300A,0198) 3 Position/Notch number of Fixation Device. >> Fixation Device Pitch Angle (300A,0199) 3 The Fixation Device Pitch Angle, i.e. orientation of PITCHED FIXATION DEVICE coordinate system with respect to IEC PATIENT SUPPORT coordinate system (degrees). Pitching is the rotation around IEC PATIENT SUPPORT X-axis. 170 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

245 >> Fixation Device Roll Angle (300A,019A) 3 The Fixation Device Roll Angle, i.e. orientation of ROLLED FIXATION DEVICE coordinate system with respect to IEC PITCHED FIXATION DEVICE coordinate system (degrees). Rolling is the rotation around IEC PATIENT SUPPORT Y- axis. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. > Shielding Device Sequence >> Shielding Device Type (300A,01A0) 3 Introduces sequence of Shielding Devices used in Patient Setup. One or more items may be included in this sequence. (300A,01A2) 1C Type of Shielding Device used in Patient Setup. Required if Shielding Device Sequence (300A,01A0) is sent. Defined Terms: GUM EYE GONAD >> Shielding Device Label >> Shielding Device Description >> Shielding Device Position (300A,01A4) 2C User-defined label for Shielding Device. Required if Shielding Device Sequence (300A,01A0) is sent. (300A,01A6) 3 User-defined description of Shielding Device. (300A,01A8) 3 Position/Notch number of Shielding Device. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

246 > Setup Technique (300A,01B0) 3 Setup Technique used in Patient Setup. Defined Terms: ISOCENTRIC FIXED_SSD TBI BREAST_BRIDGE SKIN_APPOSITION > Setup Technique Description (300A,01B2) 3 User-defined description of Setup Technique. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.Note) > Setup Device Sequence >> Setup Device Type >> Setup Device Label (300A,01B4) 3 Introduces sequence of devices used for patient alignment in Patient Setup. One or more items may be included in this sequence. (300A,01B6) 1C Type of Setup Device used for Patient alignment. Required if Setup Device Sequence (300A,01B4) is sent. Defined Terms: LASER_POINTER DISTANCE_METER TABLE_HEIGHT MECHANICAL_PTR ARC (300A,01B8) 2C User-defined label for Setup Device used for patient alignment. Required if Setup Device Sequence (300A,01B4) is sent. >> Setup Device Description (300A,01BA ) 3 User-defined description for Setup Device used for patient alignment. 172 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

247 >> Setup Device Parameter >> Setup Reference Description > Table Top Vertical Setup Displacement > Table Top Longitudinal Setup Displacement > Table Top Lateral Setup Displacement (300A,01BC ) 2C Setup Parameter for Setup Device in appropriate IEC coordinate system. Units shall be mm for distances and degrees for angles. Required if Setup Device Sequence (300A,011B4) is sent. (300A,01D0) 3 User-defined description of Setup Reference used for patient alignment. (300A,01D2) 3 Vertical Displacement in IEC TABLE TOP coordinate system (in mm) relative to initial Setup Position, i.e. vertical offset between patient positioning performed using setup and treatment position. (300A,01D4) 3 Longitudinal Displacement in IEC TABLE TOP coordinate system (in mm) relative to initial Setup Position, i.e. longitudinal offset between patient positioning performed using setup and treatment position. (300A,01D6) 3 Lateral Displacement in IEC TABLE TOP coordinate system (in mm) relative to initial Setup Position, i.e. lateral offset between patient positioning performed using setup and treatment position. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

248 C.2.28 RT Fraction Scheme C Fraction Group Sequence > Fraction Group Number > Fraction Group Description (300A,0070) 1 Introduces sequence of Fraction Groups in current Fraction Scheme. One or more items may be included in this sequence. (300A,0071) 1 Identification number of the Fraction Group. The value of Fraction Group Number (300A,0071) shall be unique within the RT Plan in which it is created. Import: Only the first item is imported. Additional ones will be ignored and a warning will be issued. Always only one item. Attribute is written, but not supported during import. (Value read from: Fractionation.DicomSeqNumber) (300A,0072) 3 The user defined description for the fraction group. > Referenced Dose Sequence >> Referenced SOP Class UID >> Referenced SOP Instance UID > Referenced Dose Reference Sequence (300C,0080) 3 Introduces sequence of related SOP Class/Instance pairs describing related instances of RT Dose (for grids, isodose curves and named/unnamed point doses). One or more items may be included in this sequence. See Note 1. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Dose Sequence (300C,0080) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Dose Sequence (300C,0080) is sent. (300C,0050) 3 Introduces sequence of Dose References for the current Fraction Group. One or more items may be included in this sequence. 174 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

249 >> Referenced Dose Reference Number >> Constraint Weight >> Delivery Warning Dose >> Delivery Maximum Dose >> Target Minimum Dose >> Target Prescription Dose >> Target Maximum Dose >> Target Underdose Volume Fraction >> Organ at Risk Full-volume Dose (300C,0051) 1C Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) within Dose Reference Sequence (300A,0010) in RT Prescription Module. Required if Referenced Dose Reference Sequence (300C,0050) is sent. (300A,0021) 3 Relative importance of satisfying constraint, where high values represent more important constraints. (300A,0022) 3 The dose (in Gy) which when reached or exceeded should cause some action to be taken. (300A,0023) 3 The maximum dose (in Gy) which can be delivered to the dose reference. (300A,0025) 3 Minimum permitted dose (in Gy) to Dose Reference if Dose Reference Type (300A,0020) of referenced Dose Reference is TARGET. (300A,0026) 3 Prescribed dose (in Gy) to Dose Reference if Dose Reference Type (300A,0020) of referenced Dose Reference is TARGET. (300A,0027) 3 Maximum permitted dose (in Gy) to Dose Reference if Dose Reference Type (300A,0020) of referenced Dose Reference is TARGET. (300A,0028) 3 Maximum permitted fraction (in percent) of Target to receive less than the Target Prescription Dose (300A,0027) if Dose Reference Type (300A,0020) of referenced Dose Reference is TARGET and Dose Reference Structure Type (300A,0014) of referenced Dose Reference is VOLUME. (300A,002A) 3 Maximum dose (in Gy) to entire Dose Reference if Dose Reference Type (300A,0020) of referenced Dose Reference is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) of referenced Dose Reference is VOLUME. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

250 >> Organ at Risk Limit Dose >> Organ at Risk Maximum Dose >> Organ at Risk Overdose Volume Fraction > Number of Fractions Planned > Number of Fraction Pattern Digits Per Day > Repeat Fraction Cycle Length (300A,002B) 3 Maximum permitted dose (in Gy) to any part of Dose Reference if Dose Reference Type (300A,0020) of referenced Dose Reference is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) of referenced Dose Reference is VOLUME. (300A,002C) 3 Maximum dose (in Gy) to non-overdosed part of Dose Reference if Dose Reference Type (300A,0020) of referenced Dose Reference is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) of referenced Dose Reference is VOLUME. (300A,002D) 3 Maximum permitted fraction (in percent) of Organ at Risk to receive more than the Organ at Risk Maximum Dose if Dose Reference Type (300A,0020) of referenced Dose Reference is ORGAN_AT_RISK and Dose Reference Structure Type (300A,0014) of referenced Dose Reference is VOLUME. (300A,0078) 2 Total number of treatments (Fractions) prescribed for current Fraction Group. (300A,0079) 3 Number of digits in Fraction Pattern (300A,007B) used to represent one day. See Note 2. (300A,007A) 3 Number of weeks needed to describe treatment pattern. See Note 2. Fractionation.NoFractions) Fractionation.FractionPerDay) *** Not Used *** > Fraction Pattern (300A,007B) 3 String of 0's (no treatment) and 1's (treatment) describing treatment pattern. Length of string is 7 x Number of Fraction Pattern Digits Per Day x Repeat Fraction Cycle Length. Pattern shall start on a Monday. See Note 2. > Number of Beams (300A,0080) 1 Number of Beams in current Fraction Group. If Number of Beams is greater then zero, Number of Brachy Application Setups (300A,00A0) shall equal zero. *** Not Used *** Number of items in Referenced Beam Sequence 176 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

251 > Referenced Beam Sequence >> Referenced Beam Number >> Beam Dose Specification Point (300C,0004) 1C Introduces sequence of treatment beams in current Fraction Group. Required if Number of Beams (300A,0080) is greater than zero. One or more items may be included in this sequence. (300C,0006) 1C Uniquely identifies Beam specified by Beam Number (300A,00C0) within Beam Sequence (300A,00B0) in RT Beams Module. Required if Referenced Beam Sequence (300C,0004) is sent. (300A,0082) 3 Coordinates (x,y,z) of point at which Beam Dose is specified in the patient based coordinate system described in C (mm). See Note 3. >> Beam Dose (300A,0084) 3 Dose (in Gy) at Beam Dose Specification Point (300A,0082) due to current Beam. One item for every treatment field belonging to the current plan Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.FieldNumber) Import: Used to identify an existing beam. Coordinates of the primary reference point. Import: Used for reference point identification, as is described in detail on a different location within this document. Value read from: Field.BeamDosePointLocation FieldRefPoint.FieldDose) Dose per fraction of the primary reference point. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

252 >> Beam Meterset (300A,0086) 3 Machine setting to be delivered for current Beam, specified in Monitor Units (MU) or minutes as defined by Primary Dosimeter Unit (300A,00B3) (in RT Beams Module) for referenced Beam. See Note 4. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.MU, Field.MUpGy) Import: If Beam Dose > 0 then Field.MUpGy = Beam Meterset / Beam Dose. Otherwise Field.MU = Beam Meterset. >> Maximum Treatment Time > Number of Brachy Application Setups > Referenced Brachy Application Setup Sequence (3249,1000) 3 The maximum treatment time, which should not be exceeeded. This items serves as a secondary safety limit besides the Beam Meterset value (300A,0086) itself. Units in [min]. (300A,00A0) 1 Number of Brachy Application Setups in current Fraction Group. If Number of Brachy Application Setups is greater then zero, Number of Beams (300A,0080) shall equal zero. (300C,000A) 1C Introduces sequence of treatment Brachy Application Setups in current Fraction Group. Required if Number of Brachy Application Setups (300A,00A0) is greater than zero. One or more items may be included in this sequence. Field.MUpGy * (FieldRefPoint.FieldDose of primary reference point) Field.TreatmentTime) >> Referenced Brachy Application Setup Number (300C,000C ) 1C Uniquely identifies Brachy Application Setup specified by Brachy Application Setup Number (300A,0234) within Brachy Application Setup Sequence (300A,0230) in RT Brachy Application Setups Module. Required if Referenced Brachy Application Setup Sequence (300C,000A) is sent. Sequential numbers starting from of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

253 >> Brachy Application Setup Dose Specification Point >> Brachy Application Setup Dose > Prescribed Dose per Fraction > Prescribed Percentage > Plan Normalization Factor (300A,00A2) 3 Coordinates (x,y,z) of point in the patient based coordinate system described in C at which Brachy Application Setup Dose (300A,00A4) is specified (mm). (300A,00A4) 3 Dose (in Gy) at Brachy Application Setup Dose Specification Point (300A,00A2) due to current Brachy Application Setup. *** Not Used *** *** Not Used *** (3269,1000) 3 Fractionation.PrescribedDose) Only used by DB Daemon when configured in Archive Service Mode. (3269,1001) 3 PlanSetup.PrescribedPercentage) Only used by DB Daemon when configured in Archive Service Mode. (3269,1002) 3 PlanSetup.PlanNormFactor) Only used by DB Daemon when configured in Archive Service Mode. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

254 C.2.29 RT Beams C Beam Sequence (300A,00B0) 1 Introduces sequence of treatment beams for current RT Plan. One or more items may be included in this sequence. > Beam Number (300A,00C0) 1 Identification number of the Beam. The value of Beam Number (300A,00C0) shall be unique within the RT Plan in which it is created. See Note 1. Field.FieldNumber) > Beam Name (300A,00C2) 3 User-defined name for Beam. See Note 1. Radiation.RadiationId) Used as Field ID. > Beam Seconary Name (3243,1009) 3 User-defined secondary name for Beam. Radiation.RadiationName) Used as Field Name. > Beam Description (300A,00C3) 3 User-defined description for Beam. See Note 1. Radiation.Comment) 180 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

255 > Beam Type (300A,00C4) 1 Motion characteristic of Beam. See Note 5. Enumerated Values: STATIC = All Control Point Sequence (300A,0111) attributes remain unchanged between consecutive pairs of control points with changing Cumulative Meterset Weight (300A,0134). DYNAMIC = One or more Control Point Sequence (300A,0111) attributes change between one or more consecutive pairs of control points with changing Cumulative Meterset Weight (300A,0134). Treatment Beams: Import: Used in deciding value for Field.Technique. Depends on Field.Technique and control point parameters. Port Film Beams: STATIC > Radiation Type (300A,00C6) 2 Particle type of Beam. Defined Terms: PHOTON ELECTRON NEUTRON PROTON Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.EnergyModeSer) Treatment Beams: PHOTON = X ELECTRON = E NEUTRON is not supported PROTON = P Port Film Beams: PHOTON Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

256 > High-Dose Technique Type (300A,00C7) 1C Type of high-dose treatment technique. Defined Terms: NORMAL = Standard treatment TBI = Total Body Irradiation HDR = High Dose Rate Required if treatment technique requires a dose that would normally require overriding of treatment machine safety controls. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.Technique) Treatment Beams: Mapping to application technique names: TBI = TOTAL HDR = HTDSE SRS = SRS STATIC or SRS ARC NORMAL (import only) = STATIC or ARC > Treatment Machine Name (300A,00B2) 2 User-defined name identifying treatment machine to be used for beam delivery. See Note 2. Port Film Beams: NORMAL if High-DoseTechnique of related beam is defined. Import: Used for lookup only. Value read from database. Value stored in: Machine.MachineId Import: Affects Radiation.ResourceSer if matching treatment machine was found. > Manufacturer (0008,0070) 3 Manufacturer of the equipment to be used for beam delivery. Import: Used for lookup only. Value read from database. Value stored in: Machine.ManufacturerName 182 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

257 > Institution Name (0008,0080) 3 Institution where the equipment is located that is to be used for beam delivery. > Institution Address (0008,0081) 3 Mailing address of the institution where the equipment is located that is to be used for beam delivery. Attribute is written, but not supported during import. (Value read from: Hospital.HospitalName) > Institutional Department Name > Manufacturer s Model Name > Device Serial Number (0008,1040) 3 Department in the institution where the equipment is located that is to be used for beam delivery. (0008,1090) 3 Manufacturer's model name of the equipment that is to be used for beam delivery. (0018,1000) 3 Manufacturer's serial number of the equipment that is to be used for beam delivery. Attribute is written, but not supported during import. (Value read from: Department.DepartmentId) Import: Used for lookup only. Value read from database. Value stored in: Machine.MachineModel Import: Used for lookup only. Value read from database. Value stored in: Machine.MachineSerialNo > Primary Dosimeter Unit (300A,00B3) 3 Measurement unit of machine dosimeter. See C Enumerated Values: MU for any external beam MU = Monitor Unit Import: MINUTE = minute Must be MU for an external beam, otherwise import is not possible. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

258 > Referenced Tolerance Table Number (300C,00A0) 3 Uniquely identifies Tolerance Table specified by Tolerance Table Number (300A,0042) within Tolerance Table Sequence in RT Tolerance Tables Module. These tolerances are to be used for verification of treatment machine settings. Import: find item with same Tolerance Table Number within RT Tolerance Tables Module and find tolerance object where Tolerance.Id = Tolerance Table Label. If no such tolerance table is found a warning will be generated. FieldObject.ToleranceSer > Source-Axis Distance > Beam Limiting Device Sequence (300A,00B4) 3 Radiation source to Gantry rotation axis distance of the equipment that is to be used for beam delivery (mm). (300A,00B6) 1 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) sets. One or more items may be included in this sequence. Port Film: Value of related beam Import: Used for lookup only. Value read from database. Value stored in: ExternalBeam.SAD Import: Generates a warning if SAD does not match. 184 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

259 >> RT Beam Limiting Device Type (300A,00B8) 1 Type of beam limiting device (collimator). Import: Enumerated Values: Only one mlc is supported. X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction MLCX, MLCY: Rotation as defined in Administration task. ASYMX/ASYMY is not set if the field is symmetrical, even if the treatment machine supports asymmetrical jaws. >> Source to Beam Limiting Device Distance (300A,00BA ) 3 Radiation source to beam limiting device (collimator) distance of the equipment that is to be used for beam delivery (mm). Import: Used for lookup only. Value read from database. Value stored in: MLCLevel.SourceToLevelDist Import: compare with SourceToLevelDst >> Number of Leaf/Jaw Pairs (300A,00BC ) 1 Number of leaf (element) or jaw pairs (equal to 1 for standard beam limiting device jaws). Import: Used for lookup only MLC: MLCBank.NumberOfLeaves Collimator: 1 Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

260 >> Leaf Position Boundaries > Referenced Patient Setup Number > Referenced Reference Image Sequence >> Referenced SOP Class UID (300A,00BE ) 2C Boundaries of beam limiting device (collimator) leaves (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), i.e. X-axis for MLCY, Y- axis for MLCX. Contains N+1 values, where N is the Number of Leaf/Jaw Pairs (300A,00BC), starting from Leaf (Element) Pair 1. Required if Beam Limiting Device Sequence (300A,00B6) is sent and RT Beam Limiting Device Type (300A,00B8) is MLCX or MLCY. See Note 3. (300C,006A) 3 Uniquely identifies Patient Setup to be used for current beam, specified by Patient Setup Number (300A,0182) within Patient Setup Sequence of RT Patient Setup Module. (300C,0042) 3 Introduces sequence of reference images used for validation of current beam. One or more items may be included in this sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Reference Image Sequence (300C,0042) is sent. Import: Verified against various MLCLevel parameters to verify that the imported plan was created for a machine configured with an identical MLC as the one assigned during import. MLC definition is being converted into the DICOM notion of leaf position boundaries. Import: Used to identify an item of Patient Setup Sequence Field.FieldNumber This sequence is only supported on export. On import all items will be silently ignored. References the primary reference image if one is defined and all portal dose images having a context to the field. Import: ignored Class UID of Image 186 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

261 >> Referenced SOP Instance UID >> Reference Image Number >> Start Cumulative Meterset Weight >> End Cumulative Meterset Weight (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Reference Image Sequence (300C,0042) is sent. (300A,00C8) 1C Uniquely identifies Reference Image within Referenced Reference Image Sequence (300A,0042). Required if Referenced Reference Image Sequence (300A,0042) is sent. (300C,0008) 3 Cumulative Meterset Weight within current Beam at which image acquisition starts. (300C,0009) 3 Cumulative Meterset Weight within current Beam at which image acquisition ends. Import: ignored Class UID of image, depends on image modality. Import: ignored unique number starting from 1 > Planned Verification Image Sequence (300A,00CA ) 3 Introduces sequence of planned verification images to be acquired during current beam. One or more items may be included in this sequence. See C Import: First item is used to update IDU positions on the field. If more items are present a warning will be generated. Verification images scheduled for next treatment session are exported. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

262 >> Start Cumulative Meterset Weight (300C,0008) 3 Cumulative Meterset Weight within current Beam at which image acquisition will start. Attribute is processed during export only. The value of SequenceImage.AcqAdjustment will be used to calculate the contents during export. Export only: AcqAdjustment * (Final Cumulative Meterset Weigth) >> Meterset Exposure >> End Cumulative Meterset Weight (3002,0032) 3 Meterset duration over which image is to be acquired, specified in Monitor units (MU) or minutes as defined by Primary Dosimeter Unit (300A,00B3). (300C,0009) 3 Cumulative Meterset Weight within current Beam at which image acquisition will end. Port Film Beams: Not Used >> RT Image Plane (3002,000C) 3 Describes whether or not image plane is normal to beam axis. Enumerated Values: NORMAL = image plane normal to beam axis NON_NORMAL = image plane non-normal to beam axis Import: Generate warning if not NORMAL. NORMAL >> X-Ray Image Receptor Angle (3002,000E) 3 X-Ray Image Receptor Angle i.e. orientation of IEC X-RAY IMAGE RECEPTOR coordinate system with respect to IEC GANTRY coordinate system (degrees). See C Import: Attribute is read, but cannot be exported. (Stored as-is in: Field.IDURtn) Import: If value is not 0.0 then generate warning of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

263 >> RT Image Orientation >> RT Image Position (3002,0010) 3 The direction cosines of the first row and the first column with respect to the IEC XRAY IMAGE RECEPTOR coordinate system. (3002,0012) 3 The x and y coordinates (in mm) of the upper left hand corner of the image, in the IEC X-RAY IMAGE RECEPTOR coordinate system. This is the center of the first pixel transmitted. Field.IDUPosLat, Field.IDUPosLng) First value: IDUPosLat Second value: IDUPosLng Because of unknown target imager size an image size of 0.0 is assumed and thus RT Image Position has to be interpreted as IEC Image Receptor system translation (and not image cropping). >> RT Image SID (3002,0026) 3 Radiation machine source to image plane distance (mm). Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.IDUPosVrt) Import: Field.IDUPosVrt = SAD - SID SID = SAD - Field.IDUPosVrt Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

264 >> Imaging Device- Specific Acquisition Parameters (300A,00CC ) 3 User-specified device-specific parameters that describe how the imager will acquire the image. Attribute is processed during export only. The value of SequenceImage.AcquisitionMode will be used to calculate the contents during export. Export only: Depends on configuration of SequenceImage template. >> Referenced Reference Image Number (300C,0007) 3 Uniquely identifies Reference Image to which planned verification image is related, specified by Reference Image Number (300A,00C8) within Referenced Reference Image Sequence (300A,0042). > Treatment Delivery Type (300A,00CE ) 3 Delivery Type of treatment. Import: Defined Terms: Only TREATMENT, otherwise beam is TREATMENT = normal patient treatment ignored. OPEN_PORTFILM = portal image acquisition with open field TRMT_PORTFILM = portal image acquisition with treatment port CONTINUATION = continuation of interrupted treatment TREATMENT Port Film: OPEN_PORTFILM or TRMT_PORTFILM > Referenced Dose Sequence >> Referenced SOP Class UID >> Referenced SOP Instance UID (300C,0080) 3 Introduces sequence of related SOP Class/Instance pairs describing related instances of RT Dose (for grids, isodose curves, and named/unnamed point doses). One or more items may be included in this sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Dose Sequence (300C,0080) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Dose Sequence (300C,0080) is sent. *** Not Used *** *** Not Used *** *** Not Used *** 190 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

265 > Number of Wedges (300A,00D0) 1 Number of wedges associated with current Beam. Beams: Maximum of two wedges supported. Port Film: 0. Wedge Sequence is not used. > Wedge Sequence (300A,00D1) 1C Introduces sequence of treatment wedges. Required if Number of Wedges (300A,00D0) is non-zero. One or more items may be included in this sequence. >> Wedge Number (300A,00D2) 1C Identification number of the Wedge. The value of Wedge Number (300A,00D2) shall be unique within the Beam in which it is created. Required if Wedge Sequence (300A,00D1) is sent. Import: Used for lookup only. Value read from database. Value stored in: FieldAddOn.DicomSeqNumber >> Wedge Type (300A,00D3) 2C Type of wedge (if any) defined for Beam. Import: Required if Wedge Sequence (300A,00D1) is sent. Used for lookup only. Defined Terms: STANDARD = standard (static) wedge Value read from database. DYNAMIC = moving beam limiting device (collimator) jaw simulating wedge MOTORIZED = single wedge which can be removed from beam remotely Value stored in: StandardWedge.MotorizedFlag. Internal representation is different from DICOM. STANDARD if it is a standard wedge type with MotorizedFlag cleared MOTORIZED if it is a standard wedge type with MotorizedFlag set DYNAMIC if it is a dynamic wedge type Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

266 >> Wedge ID (300A,00D4) 3 User-supplied identifier for Wedge. Import: Used for lookup only. Value read from database. Value stored in: AddOn.AddOnId Used as the primary wedge identification on the UI. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. >> Wedge Angle (300A,00D5) 2C Nominal wedge angle (degrees). Required if Wedge Sequence (300A,00D1) is sent. >> Wedge Factor (300A,00D6) 2C Nominal wedge factor under machine calibration conditions at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Control Point Sequence (300A,0111). Required if Wedge Sequence (300A,00D1) is sent. Import: Written to FieldAddOn.CustomCode Read from FieldAddOn.CustomCode if defined else AddOn.InternalCode. Import: Used for lookup only. Value read from database. Value stored in: Wedge.WedgeAngle Import: ignored depends on Energy Mode and Add-On Material 192 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

267 >> Wedge Orientation >> Source to Wedge Tray Distance > Number of Compensators > Total Compensator Tray Factor > Compensator Sequence (300A,00D8) 2C Orientation of wedge, i.e. orientation of IEC WEDGE FILTER coordinate system with respect to IEC BEAM LIMITING DEVICE coordinate system (degrees). Required if Wedge Sequence (300A,00D1) is sent. (300A,00DA ) 3 Radiation source to wedge tray attachment edge distance (in mm) for current wedge. Import: Used for lookup only. Value read from database. Value stored in: Wedge.ThinEdgeToX1Flag, Wedge.ThinEdgeToX2Flag, Wedge.ThinEdgeToY1Flag, Wedge.ThinEdgeToY2Flag. Internal representation is different from DICOM. Import: Used for lookup only. Value read from database. Value stored in: Slot.SourceSlotDist (300A,00E0) 1 Number of compensators associated with current Beam. Port Film: 0. Compensator Sequence is not used. (300A,00E2) 3 Compensator Tray transmission factor (between 0 and 1), at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Control Point Sequence (300A,0111). (300A,00E3) 1C Introduces sequence of treatment compensators. Required if Number of Compensators (300A,00E0) is non-zero. One or more items may be included in this sequence. Import: ignored depends on Energy Mode and Add-On Material Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

268 >> Compensator Number >> Compensator Type (300A,00E4) 1C Identification number of the Compensator. The value of Compensator Number (300A,00E4) shall be unique within the Beam in which it is created. Required if Number of Compensators (300A,00E0) is non-zero. (300A,00EE ) 3 Type of compensator (if any). Defined Terms: STANDARD = physical (static) compensator DYNAMIC = moving Beam Limiting Device (collimator) simulating physical compensator Import: Not used Number unique within sequence, starting from 1. Import: DYNAMIC silently ignored. >> Material ID (300A,00E1) 2C User-supplied identifier for material used to manufacture Compensator. Required if Number of Compensators (300A,00E0) is non-zero. Additionanl Defined Terms: TOTAL_ACTUAL and OPTIMAL: both used to transfer fluences in an RT Plan object. Fluences are export only and will be AddOnMaterial.AddOnMaterialId) >> Compensator ID (300A,00E5) 3 User-supplied identifier for compensator. Compensator.CompensatorId) >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. Import: Written to FieldAddOn.CustomCode Read from FieldAddOn.CustomCode if defined else AddOn.InternalCode. 194 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

269 >> Source to Compensator Tray Distance >> Compensator Divergence >> Compensator Mounting Position (300A,00E6) 2C Radiation source to compensator tray attachment edge distance (in mm) for current compensator. Required if Compensator Sequence (300A,00E3) is sent. (300A,02E0) 3 Indicates presence or absence of geometrical divergence of the compensator. Enumerated Values: PRESENT = the compensator is shaped according to the beam geometrical divergence. ABSENT = the compensator is not shaped according to the beam geometrical divergence. (300A,02E1) 3 Indicates on which side of the Compensator Tray the compensator is mounted. Enumerated Values: PATIENT_SIDE = the compensator is mounted on the side of the Compensator Tray which is towards the patient. SOURCE_SIDE = the compensator is mounted on the side of the Compensator Tray which is towards the radiation source. DOUBLE_SIDED = the compensator has a shaped (i.e. nonflat) surface on both sides of the Compensator Tray. Import: Used for lookup only. Value read from database. Value stored in: Slot.SourceSlotDist. Internal representation is different from DICOM. Import: Used for lookup only. Value read from database. Value stored in: Compensator.DivergingFlag Mapping of enumarated value is: PRESET <--> true ABSENT <--> false Export only: For proton beams: always SOURCE_SIDE >> Compensator Rows (300A,00E7) 1C Number of rows in the compensator. Required if Compensator Sequence (300A,00E3) is sent. Matrix.SizeY) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

270 >> Compensator Columns (300A,00E8) 1C Number of columns in the compensator. Required if Compensator Sequence (300A,00E3) is sent. Matrix.SizeX) >> Compensator Pixel Spacing (300A,00E9) 1C Physical distance (in mm) between the center of each pixel projected onto machine isocentric plane. Specified by a numeric pair - adjacent row spacing (delimiter) adjacent column spacing. Required if Compensator Sequence (300A,00E3) is sent. Read from or written to Res in a TransmissionMatrix >> Compensator Position (300A,00EA ) 1C The x and y coordinates of the upper left hand corner (first pixel transmitted) of the compensator, projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm). Required if Compensator Sequence (300A,00E3) is sent. Position of voxel (0/0/0) of the compensator thickness matrix in object space coordinates. >> Compensator Transmission Data (300A,00EB ) 1C A data stream of the pixel samples which comprise the compensator, expressed as broad-beam transmission values (between 0 and 1) along a ray line passing through the pixel, at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Control Point Sequence (300A,0111). The order of pixels sent is left to right, top to bottom, i.e., the upper left pixel is sent first followed by the remainder of the first row, followed by the first pixel of the 2nd row, then the remainder of the 2nd row and so on) when viewed from the radiation source. Required if Compensator Sequence (300A,00E3) is sent and Material ID (300A,00E1) is zero- length. See C Note: Compensator Transmission Data may not be properly encoded if Explicit-VR transfer syntax is used and the VL of this attribute exceeds bytes. Written to and read from Transmission Matrix having a context to Compensator. 196 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

271 >> Compensator Thickness Data (300A,00EC ) 1C A data stream of the pixel samples which comprise the compensator, expressed as thicknesses (in mm). The order of pixels sent is left to right, top to bottom, i.e., the upper left pixel is sent first followed by the remainder of the first row, followed by the first pixel of the 2nd row, then the remainder of the 2nd row and so on) when viewed from the radiation source. Required if Compensator Sequence (300A,00E3) is sent and Material ID (300A,00E1) is nonzero length. See C and C Note: Compensator Thickness Data may not be properly encoded if Explicit- VR transfer syntax is used and the VL of this attribute exceeds bytes. Written to and read from Transmission Matrix having a context to Compensator. >> Source to Compensator Distance (300A,02E2) 1C A data stream of the pixel samples which comprise the distance from the radiation source to the compensator surface closest to the radiation source (in mm). The order of pixels sent is left to right, top to bottom (upper left pixel, followed by the remainder of row 1, followed by the remainder of the columns). Required if Compensator Sequence (300A,00E3) is sent, Material ID (300A,00E1) is non-zero length, and Compensator Mounting Position (300A,02E1) is DOUBLE_SIDED. See C *** Not Used *** > Number of Boli (300A,00ED ) 1 Number of boli associated with current Beam. Port Film: 0. Bolus Sequence is not used. > Referenced Bolus Sequence (300C,00B0) 1C Introduces sequence of boli associated with Beam. Required if Number of Boli (300A,00ED) is non-zero. One or more items may be included in this sequence. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

272 >> Referenced ROI Number (3006,0084) 1C Uniquely identifies ROI representing the Bolus specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set in Referenced Structure Set Sequence (300C,0060) in RT General Plan Module. Required if Referenced Bolus Sequence (300C,00B0) is sent. Structure.DicomSeqNumber) Bolus is modelled as a structure. >> Bolus ID (300A,00DC ) 3 User-supplied identifier for the Bolus. >> Bolus Description (300A,00DD ) 3 User-defined description for the Bolus. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. > Number of Blocks (300A,00F0) 1 Number of shielding blocks associated with Beam. Port Film: 0. Block Sequence is not used. > Total Block Tray Factor (300A,00F2) 3 Total block tray transmission for all block trays (between 0 and 1) at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Control Point Sequence (300A,0111). Import: ignored Depends on Energy Mode and Add-On Material of tray. > Block Sequence (300A,00F4) 1C Introduces sequence of blocks associated with Beam. Required if Number of Blocks (300A,00F0) is non-zero. One or more items may be included in this sequence. 198 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

273 >> Block Tray ID (300A,00F5) 3 User-supplied identifier for block tray. Import: Used for lookup only. Value read from database. Value stored in: AddOn.AddOnId. Internal representation is different from DICOM. AddOnId of the tray to which the block is connected. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. Import: Written to FieldAddOn.CustomCode Read from FieldAddOn.CustomCode if defined else AddOn.InternalCode. >> Source to Block Tray Distance (300A,00F6) 2C Radiation Source to attachment edge of block tray assembly (mm). Required if Block Sequence (300A,00F4) is sent. Import: Used for lookup only. Value read from database. Value stored in: Slot.SourceSlotDist. Internal representation is different from DICOM. SourceSlotDistance of the slot to which the block is assigned. >> Block Type (300A,00F8) 1C Type of block. Required if Block Sequence (300A,00F4) is sent. See C Enumerated Values: SHIELDING = blocking material is inside contour APERTURE = blocking material is outside contour Block.BlockType) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

274 >> Block Divergence >> Block Mounting Position (300A,00FA) 2C Indicates presence or otherwise of geometrical divergence. Required if Block Sequence (300A,00F4) is sent. Enumerated Values: PRESENT = block edges are shaped for beam divergence ABSENT = block edges are not shaped for beam divergence (300A,00FB) 3 Indicates on which side of the Block Tray the block is mounted. Enumerated Values: PATIENT_SIDE = the block is mounted on the side of the Block Tray which is towards the patient. SOURCE_SIDE = the block is mounted on the side of the Block Tray which is towards the radiation source. Block.DivergingFlag) Mapping of enumarated value is: PRESET <--> true ABSENT <--> false Export only for proton beams: SOURCE_SIDE >> Block Number (300A,00FC) 1C Identification number of the Block. The value of Block Number (300A,00FC) shall be unique within the Beam in which it is created. Required if Block Sequence (300A,00F4) is sent. Block.DicomSeqNumber) If a block consists of multiple structures, the block is brocken up into simpler blocks having just one delemitting line. New block numbers will be generated in such a case. >> Block Name (300A,00FE) 3 User-defined name for block. Block.BlockId) 200 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

275 >> Material ID (300A,00E1) 2C User-supplied identifier for material used to manufacture Block. Required if Block Sequence (300A,00F4) is sent. >> Block Thickness (300A,0100) 2C Physical thickness of block (in mm) parallel to radiation beam axis. Required if Block Sequence (300A,00F4) is sent and Material ID (300A,00E1) is non-zero length. See C >> Block Transmission >> Block Number of Points (300A,0102) 2C Transmission through the block (between 0 and 1) at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Control Point Sequence (300A,0111). Required if Block Sequence (300A,00F4) is sent and Material ID (300A,00E1) is zero length. See C (300A,0104) 2C Number of (x,y) pairs defining the block edge. Required if Block Sequence (300A,00F4) is sent. AddOnMaterial.AddOnMaterialId) Import: The attribute is used to identify the appropriate AddOnMaterial to link to the block. Block.BlockThickness) Import: Warning occurs if imported block thickness does not correspond to AddOnMaterial.Thickness. Export only: depends on Energy Mode and Add-On Material Import: number of points is determined by the contenets of the block data itself. Number of points in the contour describing the block. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

276 >> Block Data (300A,0106) 2C A data stream of (x,y) pairs which comprise the block edge. The number of pairs shall be equal to Block Number of Points (300A,0104), and the vertices shall be interpreted as a closed polygon. Coordinates are projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm). Required if Block Sequence (300A,00F4) is sent. See Note 4. The contour describing the block. Contours are stored in file, which is referenced by Structure.FileName. > Applicator Sequence (300A,0107) 3 Introduces sequence of Applicators associated with Beam. Only a single item shall be permitted in this sequence. Port Film: Applicator Sequence is not used. >> Applicator ID (300A,0108) 1C User or machine supplied identifier for Applicator. Required if Applicator Sequence (300A,0107) is sent. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. >> Applicator Type (300A,0109) 1C Type of Applicator. Required if Applicator Sequence (300A,0107) is sent. Defined Terms: ELECTRON_SQUARE = square electron applicator ELECTRON_RECT = rectangular electron applicator ELECTRON_CIRC = circular electron applicator ELECTRON_SHORT = short electron applicator ELECTRON_OPEN = open (dummy) electron applicator INTRAOPERATIVE = intraoperative (custom) applicator STEREOTACTIC = stereotactic applicator Import: Used for lookup only. Value read from database. Value stored in: AddOn.AddOnId Import: Written to FieldAddOn.CustomCode Read from FieldAddOn.CustomCode if defined else AddOn.InternalCode. Export only: ELECTRON_SQUARE if RectangularFlag is set ELECTRON_RECT if RectangularFlag is set and FieldSizeX <> FieldSizeY ELECTRON_CIRC if RectangularFlag is set and FieldSizeX is defined ELECTRON_OPEN in all other cases 202 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

277 >> Applicator Description (300A,010A) 3 User-defined description for Applicator. Attribute is written, but not supported during import. (Value read from: AddOn.Comment) > Final Cumulative Meterset Weight (300A,010E) 1C Value of Cumulative Meterset Weight (300A,0134) for final Control Point in Control Point Sequence (300A,0111). Required if Cumulative Meterset Weight is non-null in Control Points specified within Control Point Sequence (300A,0111). See C Import: Used to calculate Field.WedgeDose if a motorized wedge is present. MetersetWeight from last control point of field > Number of Control Points (300A,0110) 1 Number of control points in Beam. Port Film: 2 > RT Motion Synchronization Sequence (3277,1000) 3 Introduces sequence of Motion Synchronization. One or more items may be included in this sequence. Only first item of sequence is imported Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

278 >> Respiratory Motion Compensation Technique (0018,9170) 1 Technique applied to reduce respiratory motion artifacts. Defined Terms: NONE BREATH_HOLD REALTIME= image acquisition shorter than respiratory cycle GATING = Prospective gating TRACKING = prospective through-plane or in-plane motion tracking PHASE_ORDERING = prospective phase ordering PHASE_RESCANNING = prospective techniques, such as real-time averaging, diminishing variance and motion adaptive gating RETROSPECTIVE = retrospective gating CORRECTION = retrospective image correction UNKNOWN = technique not known Field.MotionCompTechnique) 204 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

279 >> Respiratory Signal Source > Control Point Sequence >> Control Point Index >> Cumulative Meterset Weight (0018,9171) 1 Signal source from which respiratory motion is derived. Defined Terms: NONE BELT NASAL_PROBE CO2_SENSOR NAVIGATOR = MR navigator and organ edge detection MR_PHASE = phase (of center k-space line) ECG = baseline demodulation of the ECG SPIROMETER = Signal derived from flow sensor EXTERNAL_MARKER = Signal determined from external motion surrogate INTERNAL_MARKER = Signal determined from internal motion surrogate IMAGE = Signal derived from an image UNKNOWN = Signal source not known (300A,0111) 1 Introduces sequence of machine configurations describing treatment beam. Two or more items may be included in this sequence. See C and C (300A,0112) 1C Index of current Control Point, starting at 0 for first Control Point. Required if Control Point Sequence (300A,0111) is sent. (300A,0134) 2C Cumulative weight to current control point. Cumulative Meterset Weight for the first item in Control Point Sequence shall always be zero. Cumulative Meterset Weight for the final item in Control Point Sequence shall always be equal to Final Cumulative Meterset Weight. Required if Control Point Sequence (300A,0111) is sent. See C Field.MotionCompSource) Roundtrip supported. ControlPoint.MetersetWeight) Port Film: First control point: 0 Last control point: 100 Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

280 >> Referenced Dose Reference Sequence >>> Referenced Dose Reference Number >>> Cumulative Dose Reference Coefficient >> Referenced Dose Sequence (300C,0050) 3 Introduces a sequence of Dose References for current Beam. One or more items may be included in this sequence. (300C,0051) 1C Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module. Required if Referenced Dose Reference Sequence (300C,0050) is sent. (300A,010C) 2C Coefficient used to calculate cumulative dose contribution from this Beam to the referenced Dose Reference at the current Control Point. Required if Referenced Dose Reference Sequence (300C,0050) is sent. See C (300C,0080) 1C Sequence describing related instances of RT Dose (for grids, isodose curves, and named/unnamed point doses). One or more items may be included in this sequence. Required if RT Dose is being sent, and Dose Summation Type (3004,000A) equals CONTROL_POINT. DoseContribution.DicomSeqNumber) Import: Value of last control point is written to FieldRefPoint.FieldDose. Calculated by following formula: (FieldRefPoint.FieldDose / field dose) * (cumulative meterset weight / final cumulative meterset) >>> Referenced SOP Class UID >>> Referenced SOP Instance UID (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. 206 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

281 >> Nominal Beam Energy (300A,0114) 3 Nominal Beam Energy at control point (MV/MeV). EnergyMode.Energy) Import: Data is used to match against appropriate machine setting. >> Dose Rate Set (300A,0115) 3 Dose Rate to be set on treatment machine for segment beginning at current control point (e.g. MU/min). Port Film: SequenceImage.DevEnergy if defined, else if related beam is a photon beam then value of related beam else default energy of ExternalBeam. Field.DoseRate) Field.DoseRate >> Wedge Position Sequence (300A,0116) 3 A Sequence of Items describing Wedge Positions for the current control point. Required for first item of Control Point Sequence if Number of Wedges (300A,00D0) is non-zero, and in subsequent control points if Wedge Position (300A,0118) changes during Beam. See C The number of items in this sequence shall equal the value of Number of Wedges (300A,00D0). Port Film: SequenceImage.DevDoseRate if defined, else if related beam is a photon beam then value of related beam else default dose rate of ExternalBeam. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

282 >>> Referenced Wedge Number (300C,00C0 ) 1C Uniquely references Wedge described by Wedge Number (300A,00D2) in Wedge Sequence (300A,00D1). Required if Wedge Position Sequence (300A,0116) is sent. FieldAddOn.DicomSeqNumber) >>> Wedge Position (300A,0118) 1C Position of Wedge at current Control Point. Field.WedgeDose is used to calculate the meterset at which the position of a motorized wedge has to change. >> Beam Limiting Device Position Sequence >>> RT Beam Limiting Device Type Required if Wedge Position Sequence (300A,0116) is sent. Enumerated Values: IN OUT (300A,011A) 1C Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions. Required for first item of Control Point Sequence, or if Beam Limiting Device changes during Beam. One or more items may be included in this sequence. (300A,00B8) 1C Type of beam limiting device (collimator). The value of this attribute shall correspond to RT Beam Limiting Device Type (300A,00B8) defined in an item of Beam Limiting Device Sequence (300A,00B6). Required if Beam Limiting Device Position Sequence (300A,011A) is sent. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction ExternalBeam.MaxNoOfAddOn is being used to store whether the initial position of a motorized wedge is IN or OUT. 0, NULL: initially OUT 1: initially IN Collimator: Type X / Y or ASYMX / ASYMY depending on value of Field.CollMode MLC: MLCX if MLC.Rotation = 0 MLCY if MLC.Rotation = of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

283 >>> Leaf/Jaw Positions (300A,011C) 1C Positions of beam limiting device (collimator) leaf (element) or jaw pairs (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), e.g. X- axis for MLCX, Y-axis for MLCY. Contains 2N values, where N is the Number of Leaf/Jaw Pairs (300A,00BC) in Beam Limiting Device Sequence (300A,00B6). Values shall be listed in IEC leaf (element) subscript order 101, 102,... 1N, 201, 202,... 2N. Required if Beam Limiting Device Position Sequence (300A,011A) is sent. See Note 2. Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPoint.CollX1, ControlPoint.CollX2, ControlPoint.CollY1, ControlPoint.CollY2, Field.CollX1, Field.CollX2, Field.CollY1, Field.CollY2, ControlPoint Collimator: If VFC ControlPoint objects are available (depending on treatment technique) then use ControlPoint. Otherwise use Field IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. MLC: ControlPoint.PlanPosition1A/B to PlanPosition60A/B Port Film: MLC (only if SequenceImage.DevGeometry = 0 (planned field positions)): If MLC does not change or it is a Before Image of an Arc field: MLC positions of first control point. If it is an After Image of an Arc field: MLC positions of last control point. All other cases: CIAO positions Collimator (depends on value of SequenceImage.DevGeometry): 0: Coll of related field. 1: SequenceImage.DevColl<..> 2: SequenceImage.JawState3: ExternalBeam.OpenColl<..> Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

284 >> Gantry Angle (300A,011E) 1C Gantry angle of radiation source, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for first item of Control Point Sequence, or if Gantry Angle changes during Beam. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.GantryRtn, ControlPoint.GantryRtn, Field.Technique, Field.StopAngle) Value from Field or ControlPoint depending on technique. In case of last control point of an Arc field Field.StopAngle IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. >> Gantry Rotation Direction (300A,011F) 1C Direction of Gantry Rotation when viewing gantry from isocenter, for segment following Control Point. Required for first item of Control Point Sequence, or if Gantry Rotation Direction changes during Beam. See C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation Port Film: If it is an After Image of an Arc treatment: value of last control point of related beam. Else: value of first control point of related beam. Field.GantryRtnDirection) Value must not change between control points. Port Film: NONE 210 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

285 >> Beam Limiting Device Angle >> Beam Limiting Device Rotation Direction >> Patient Support Angle (300A,0120) 1C Beam Limiting Device angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for first item of Control Point Sequence, or if Beam Limiting Device Angle changes during Beam. (300A,0121) 1C Direction of Beam Limiting Device Rotation when viewing beam limiting device (collimator) from radiation source, for segment following Control Point. Required for first item of Control Point Sequence, or if Beam Limiting Device Rotation Direction changes during Beam. See C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation (300A,0122) 1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for first item of Control Point Sequence, or if Patient Support Angle changes during Beam. Field.CollRtn) IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. Export only: NONE Value must not change between control points. Field.PatientSupportAngle) Value must not change between control points. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

286 >> Patient Support Rotation Direction (300A,0123) 1C Direction of Patient Support Rotation when viewing table from above, for segment following Control Point. Required for first item of Control Point Sequence, or if Patient Support Rotation Direction changes during Beam. See C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation Export only: NONE Value must not change between control points. IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. >> Table Top Eccentric Axis Distance >> Table Top Eccentric Angle >> Table Top Eccentric Rotation Direction (300A,0124) 3 Distance (positive) from the IEC PATIENT SUPPORT vertical axis to the IEC TABLE TOP ECCENTRIC vertical axis (mm). (300A,0125) 1C Table Top (non-isocentric) angle, i.e. orientation of IEC TABLE TOP ECCENTRIC coordinate system with respect to IEC PATIENT SUPPORT coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Eccentric Angle changes during Beam. (300A,0126) 1C Direction of Table Top Eccentric Rotation when viewing table from above, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Eccentric Rotation Direction changes during Beam. See C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation Port Film: Value of first control point of related beam Export only: always 0.0. Value must not change between control points. Export only: NONE Value must not change between control points. 212 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

287 >> Table Top Vertical Position >> Table Top Longitudinal Position >> Table Top Lateral Position (300A,0128) 2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Vertical Position changes during Beam. See C (300A,0129) 2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Longitudinal Position changes during Beam. See C (300A,012A) 2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Lateral Position changes during Beam. See C >> Virtual SAD (3243,101A) 3 The virtual SAD for this control point. This SAD denotes the physical focus of the beam if it is different than the nominal Source Axis Distance (300A,00B4). >> Table Top Roll Angle Field.CouchVrt) Value must not change between control points. Field.CouchLng) Value must not change between control points. Field.CouchLat) Value must not change between control points. (3243,1016) 3 Table Top Roll Angle. Not yet part of the IEC system. *** Not Used *** >> Table Top Pitch Angle (3243,1017) 3 Table Top Pitch Angle. Not yet part of the IEC system. *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

288 >> Isocenter Position >> Surface Entry Point (300A,012C) 2C Isocenter coordinates (x,y,z) in the patient based coordinate system described in C (mm). Required for first item of Segment Control Point Sequence, or if Segment Isocenter Position changes during Beam. (300A,012E) 3 Patient surface entry point coordinates (x,y,z) in the patient based coordinate system described in C (mm). Field.IsoCenterPositionX, Field.IsoCenterPositionY, Field.IsoCenterPositionZ) This is the Isocenter position in relation to the 3D image of the PlanSetup Value must not change between control points. >> Source to Surface Distance (300A,0130) 3 Source to Patient Surface distance (mm). Field.SSD) Value must not change between control points. 214 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

289 C.2.30 RT Brachy Application Setups C Brachy Treatment Technique Brachy Treatment Type Treatment Machine Sequence (300A,0200) 1 Type of brachytherapy treatment technique. Enumerated Values: INTRALUMENARY INTRACAVITARY INTERSTITIAL CONTACT INTRAVASCULAR PERMANENT See C (300A,0202) 1 Type of brachytherapy treatment. Import: Defined Terms: MANUAL = manually positioned HDR = High dose rate MDR = Medium dose rate LDR = Low dose rate PDR = Pulsed dose rate (300A,0206) 1 Introduces single item sequence describing treatment machine to be used for treatment delivery. Only one item may be included in this sequence. PlanSetup.TreatmentTechnique) Attribute is read, but cannot be exported. (Stored as-is in: BrachyUnit.DoseRateMode) Unless MachineModel is MANUAL Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

290 > Treatment Machine Name (300A,00B2) 2 User-defined name identifying treatment machine to be used for treatment delivery. > Manufacturer (0008,0070) 3 Manufacturer of the equipment to be used for treatment delivery. > Institution Name (0008,0080) 3 Institution where the equipment is located that is to be used for treatment delivery. > Institution Address (0008,0081) 3 Mailing address of the institution where the equipment is located that is to be used for treatment delivery. > Institutional Department Name (0008,1040) 3 Department in the institution where the equipment is located that is to be used for treatment delivery. Machine.MachineId) Import: used to identify the right brachy unit. for seeds the machine name "Manual seeds" is used. Machine.ManufacturerName) Import: used to identify the right brachy unit. for seeds empty. Hospital.HospitalName) Hospital.HospitalLocation) *** Not Used *** 216 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

291 > Manufacturer s Model Name > Device Serial Number (0008,1090) 3 Manufacturer's model name of the equipment that is to be used for treatment delivery. (0018,1000) 3 Manufacturer's serial number of the equipment that is to be used for treatment delivery. Source Sequence (300A,0210) 1 Introduces sequence of Sources to be used within Application Setups. One or more items may be included in this sequence. > Source Number (300A,0212) 1 Identification number of the Source. The value of Source Number (300A,0212) shall be unique within the RT Plan in which it is created. > Source Type (300A,0214) 1 Type of Source. Defined Terms: POINT LINE CYLINDER SPHERE Machine.MachineModel) Import: used to identify the right brachy unit. for seeds empty. Machine.MachineSerialNo) Import: used to identify the right brachy unit. for seeds empty. All unique RadioActiveSource connected to BrachyFields in the PlanSetup Import: Attribute is read, but cannot be exported. (Stored as-is in: RadioactiveSource.SourceNumber) Sequential number starting at 1. RadioactiveSourceModel.SourceType) Import: used to identify the right radioactive source. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

292 > Source Manufacturer > Active Source Diameter > Active Source Length (300A,0216) 3 Manufacturer of Source. RadioactiveSourceModel.ManufacturerNa me) Import: used to identify the right radioactive source. (300A,0218) 3 Diameter of active Source (mm). Roundtrip is supported but internal representation is different from DICOM. (Stored in: RadioactiveSourceModel.ActiveSize) X-Component of the size. (300A,021A) 3 Length of active Source (mm). Roundtrip is supported but internal representation is different from DICOM. (Stored in: RadioactiveSourceModel.ActiveSize) Z-Component of the size > Material ID (300A,00E1) 3 User-supplied identifier for encapsulation material of active Source. > Source Encapsulation Nominal Thickness > Source Encapsulation Nominal Transmission (300A,0222) 3 Nominal thickness of wall of encapsulation (mm). See C (300A,0224) 3 Nominal transmission through wall of encapsulation (between 0 and 1). See C of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

293 > Source Isotope Name > Source Isotope Half Life > Source Strength Units > Reference Air Kerma Rate (300A,0226) 1 Name of Isotope. Import: Attribute is read, but cannot be exported. (Stored as-is in: RadioactiveSource.RadioactiveSourceId) Attribute is written, but not supported during import. (Value read from: RadioactiveSourceModel.RadioactiveSour cemodelname) (300A,0228) 1 Half-life of Isotope (days). RadioactiveSourceModel.HalfTime) Import: used to identify the right radioactive source. (300A,0229) 1C Measurement unit of Source Strength. Required if the source is not a gamma- emitting (photon) source. May be present otherwise. Enumerated Values: AIR_KERMA_RATE = Air Kerma Rate if Source is Gamma emitting Isotope. DOSE_RATE_WATER = Dose Rate in Water if Source is Beta emitting Isotope. (300A,022A) 1 Air Kerma Rate in air of Isotope specified at Air Kerma Rate Reference Date (300A,022C) and Air Kerma Rate Reference Time (300A,022E) (in Gy h-1 at 1 m). Value shall be zero for non-gamma sources. RadioactiveSource.SourceStrength) Import: used to identify the right radioactive source. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

294 > Source Strength (300A,022B) 1C Source Strength of Isotope at Source Strength Reference Date (300A,022C) and Source Strength Reference Time (300A,022E), in units specified in Source Strength Units (300A,0229). Required if the source is not a gamma- emitting (photon) source. See C > Source Strength Reference Date > Source Strength Reference Time Application Setup Sequence > Application Setup Type > Application Setup Number (300A,022C) 1 Reference date for Reference Air Kerma Rate (300A,022A) or Source Strength (300A,022B) of Isotope. (300A,022E) 1 Reference time for Air Kerma Rate (300A,022A) or Source Strength (300A,022B) of Isotope. (300A,0230) 1 Introduces sequence of Application Setups for current RT Plan. One or more items may be included in this sequence. (300A,0232) 1 Type of Application Setup. Defined Terms: FLETCHER_SUIT DELCLOS BLOEDORN JOSLIN_FLYNN CHANDIGARH MANCHESTER HENSCHKE NASOPHARYNGEAL OESOPHAGEAL ENDOBRONCHIAL SYED_NEBLETT ENDORECTAL PERINEAL (300A,0234) 1 Identification number of the Application Setup. The value of Application Setup Number (300A,0234) shall be unique within the RT Plan in which it is created. BrachyField.PlannedTreatmDateTime) BrachyField.PlannedTreatmDateTime) PlanSetup.ApplicationSetupType) Additional Varian defined term: UNDEFINED Sequential number starting at 1. > Application Setup Name > Application Setup Manufacturer (300A,0236) 3 User-defined name for Application Setup. PlanSetup.PlanSetupId) (300A,0238) 3 Manufacturer of Application Setup. Empty string 220 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

295 > Template Number (300A,0240) 3 Identification number of the Template. The value of Template Number (300A,0240) shall be unique within the Application Setup in which it is created. *** Not Used *** > Template Type (300A,0242) 3 User-defined type for Template Device. *** Not Used *** > Template Name (300A,0244) 3 User-defined name for Template Device. *** Not Used *** > Referenced Reference Image Sequence >> Referenced SOP Class UID >> Referenced SOP Instance UID > Total Reference Air Kerma > Brachy Accessory Device Sequence >> Brachy Accessory Device Number >> Brachy Accessory Device ID (300C,0042) 3 Introduces sequence of reference images used for validation of current Application Setup. One or more items may be included in this sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Reference Image Sequence (300C,0042) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Reference Image Sequence (300C,0042) is sent. (300A,0250) 1 Total Reference Air Kerma for current Application Setup, i.e. the product of Air Kerma Rate of all Sources in all Channels with their respective Channel Times ( Gy at 1 m). Value shall be zero for non-gamma sources. (300A,0260) 3 Introduces sequence of Brachy Accessory Devices associated with current Application Setup. One or more items may be included in this sequence. (300A,0262) 2C Identification number of the Brachy Accessory Device. The value of Brachy Accessory Device Number (300A,0262) shall be unique within the Application Setup in which it is created. Required if Brachy Accessory Device Sequence (300A,0260) is sent. (300A,0263) 2C User or machine supplied identifier for Brachy Accessory Device. Required if Brachy Accessory Device Sequence (300A,0260) is sent. Total of all RadioactiveSourceStrengths multiplied with dwell times *** Not Used *** *** Not Used *** *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

296 >> Brachy Accessory Device Type >> Brachy Accessory Device Name (300A,0264) 1C Type of Brachy Accessory Device. *** Not Used *** Required if Brachy Accessory Device Sequence (300A,0260) is sent. Defined Terms: SHIELD DILATATION MOLD PLAQUE FLAB (300A,0266) 3 User-defined name for Brachy Accessory Device. *** Not Used *** >> Material ID (300A,00E1) 3 User-supplied identifier for material of Brachy Accessory Device. See Note. *** Not Used *** >> Brachy Accessory Device Nominal Thickness >> Brachy Accessory Device Nominal Transmission >> Referenced ROI Number > Channel Sequence (300A,026A) 3 Nominal thickness of Brachy Accessory Device (mm). See C (300A,026C) 3 Nominal Transmission through Brachy Accessory Device (between 0 and 1). See C (3006,0084) 2C Uniquely identifies ROI representing the Brachy Accessory specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set referenced by Referenced RT Structure Set Sequence (300C,0060) in RT General Plan Module. Required if Brachy Accessory Device Sequence (300A,0260) is sent. See C (300A,0280) 1 Introduces sequence of Channels for current Application Setup. One or more items may be included in this sequence. *** Not Used *** *** Not Used *** *** Not Used *** 222 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

297 >> Channel Number (300A,0282) 1 Identification number of the Channel. The value of Channel Number (300A,0282) shall be unique within the Application Setup in which it is created. Channel.ChannelNumber) >> Channel Length (300A,0284) 2 Length of Channel (mm). See C BrachyField.ApplicatorLength) >> Channel Total Time (300A,0286) 1 Total amount of time between first and final Control Points of the Brachy Control Point Sequence (300A,02D0) for current Channel (sec). Channel Total Time calculation is based upon the Reference Air Kerma Rate (300A,022A) of the Referenced Source Number (300C,000E). Total time of dwells >> Source Movement Type (300A,0288) 1 Type of Source movement. See C Defined Terms: STEPWISE FIXED OSCILLATING UNIDIRECTIONAL BrachyUnit.SourceMovementType) >> Number of Pulses >> Pulse Repetition Interval >> Source Applicator Number >> Source Applicator ID (300A,028A) 1C Number of Pulses per fraction for current Channel. Required if Brachy Treatment Type (300A,0202) is PDR. (300A,028C) 1C Pulse repetition interval (sec) for current Channel. Required if Brachy Treatment Type (300A,0202) is PDR. (300A,0290) 3 Identification number of the Source Applicator. The value of Source Applicator Number (300A,0290) shall be unique within the Channel in which it is created. (300A,0291) 2C User or machine supplied identifier for Source Applicator. Required if Source Applicator Number (300A,0290) is sent. Fractionation.NoFractions) BrachyUnit.PulsInterval) 1 Radiation.RadiationId) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

298 >> Source Applicator Type (300A,0292) 1C Type of Source Applicator. Required if Source Applicator Number (300A,0290) is sent. Defined Terms: FLEXIBLE RIGID Roundtrip is supported but internal representation is different from DICOM. (Stored in: BrachyApplicator.BrachyApplicatorTypeInf o) if BrachyField has BrachyApplicator otherwise RIGID >> Source Applicator Name (300A,0294) 3 User-defined name for Source Applicator. Radiation.RadiationName) >> Source Applicator Length (300A,0296) 1C Length of Source Applicator (mm), defined as the distance between the connector of the applicator and the distal-most position of the source. Required if Source Applicator Number (300A,0290) is sent. BrachyField.ApplicatorLength) >> Source Applicator Manufacturer (300A,0298) 3 Manufacturer of Source Applicator. *** Not Used *** >> Material ID (300A,00E1) 3 User-supplied identifier for material of Source Applicator wall. See Note. *** Not Used *** >> Source Applicator Wall Nominal Thickness >> Source Applicator Wall Nominal Transmission >> Source Applicator Step Size (300A,029C) 3 Nominal Thickness of Source Applicator wall (mm). See C (300A,029E) 3 Nominal Transmission through Source Applicator wall (between 0 and 1). See C (300A,02A0) 1C Distance of path along channel (in mm) between adjacent (potential) dwell positions. Required if Source Movement Type (300A,0288) is STEPWISE. *** Not Used *** *** Not Used *** BrachyField.StepSize) 224 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

299 >> Referenced ROI Number >> Transfer Tube Number >> Transfer Tube Length >> Channel Shield Sequence >>> Channel Shield Number >>> Channel Shield ID (3006,0084) 2C Uniquely identifies ROI representing the Source Applicator specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set referenced by Referenced RT Structure Set Sequence (300C,0060) in RT General Plan Module. Required if Source Applicator Number (300A,0290) is sent. See C (300A,02A2) 2 Identification number of the Transfer Tube. The value of Transfer Tube Number (300A,02A2) shall be unique within the Channel in which it is created. (300A,02A4) 2C Length of Transfer Tube of current afterloading Channel (mm). Required if value Transfer Tube Number (300A,02A2) is non-null. (300A,02B0) 3 Introduces sequence of Channel Shields associated with current Channel. One or more items may be included in this sequence. See C (300A,02B2) 1C Identification number of the Channel Shield. The value of Channel Shield Number (300A,02B2) shall be unique within the Channel in which it is created. Required if Channel Shield Sequence (300A,02B0) is sent. (300A,02B3) 2C User or machine supplied identifier for Channel Shield. Required if Channel Shield Sequence (300A,02B0) is sent. Structure.DicomSeqNumber) *** Not Used *** *** Not Used *** *** Not Used *** *** Not Used *** *** Not Used *** >>> Channel Shield Name (300A,02B4) 3 User-defined name for Channel Shield. *** Not Used *** >>> Material ID (300A,00E1) 3 User-supplied identifier for material of Channel Shield. See Note. *** Not Used *** >>> Channel Shield Nominal Thickness (300A,02B8) 3 Nominal Thickness of Channel Shield (mm). See C *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

300 >>> Channel Shield Nominal Transmission (300A,02BA ) 3 Nominal Transmission of Channel Shield (between 0 and 1). See C *** Not Used *** >>> Referenced ROI Number >> Referenced Source Number >> Number of Control Points >> Final Cumulative Time Weight >> Brachy Control Point Sequence >>> Control Point Index (3006,0084) 2C Uniquely identifies ROI representing the Channel Shield specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set referenced by Referenced RT Structure Set Sequence (300C,0060) in RT General Plan Module. Required if Channel Shield Sequence (300A,02B0) is sent. See C (300C,000E) 1 Uniquely identifies the referenced Source within the Source Sequence (300A,0210) for current Application Setup. (300A,0110) 1 Number of control points in Channel. For an N-segment Channel there will be 2N (stepwise movement) or N+1 (continuous movement) control points. (300A,02C8) 1C Value of Cumulative Time Weight (300A,02D6) for final Control Point in Brachy Control Point Sequence (300A,02D0). Required if Cumulative Time Weight (300A,02D6) is non-null in Control Points specified within Brachy Control Point Sequence (300A,02D0). See C (300A,02D0) 1 Introduces sequence of machine configurations describing this Channel. Two or more items may be included in this sequence. See C (300A,0112) 1 Index of current Control Point, starting at 0 for first Control Point. *** Not Used *** Import: Attribute is read, but cannot be exported. (Stored as-is in: RadioactiveSource.SourceNumber) 1 2 * BrachyField.NumberOfSources Cumulative dwell time in BrachyField 226 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

301 >>> Cumulative Time Weight >>> Control Point Relative Position >>> Control Point 3D Position >>> Brachy Referenced Dose Reference Sequence >>>> Referenced Dose Reference Number >>>> Cumulative Dose Reference Coefficient (300A,02D6) 2 Cumulative time weight to current Control Point (where the weighting is proportional to time values delivered). Cumulative Time Weight for first item in Brachy Control Point Sequence (300A,02D0) is always zero. See C and C (300A,02D2) 1 Distance between current Control Point Position and the distal-most possible Source position in current Channel (mm). See C (300A,02D4) 3 Coordinates (x, y, z) of Control Point in the patient based coordinate system described in C (mm). See C (300C,0055) 3 Introduces a sequence of Dose References for current Channel. One or more items may be included in this sequence. (300C,0051) 1C Uniquely identifies Dose Reference described in Dose Reference Sequence. (300A,0010) within RT Prescription Module of current RT Plan. Required if Brachy Referenced Dose Reference Sequence (300C,0055) is sent. (300A,010C) 1C Coefficient used to calculate cumulative dose contribution from this Source to the referenced Dose Reference at the current Control Point. Required if Brachy Referenced Dose Reference Sequence (300C,0055) is sent. See C Note: Material ID (300A,00E1) may also be specified within a referenced ROI, if an ROI is used to describe the object. Cumulative dwell time before current control point Roundtrip is supported but internal representation is different from DICOM. (Stored in: SourcePosition.DwellPosition) Current center of source position in DICOM space *** Not Used *** *** Not Used *** *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

302 C.2.31 Approval C of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

303 Approval Status (300E,0002) 1 Approval status at the time the SOP Instance was created. Enumerated Values: APPROVED = Reviewer recorded that object met an implied criterion UNAPPROVED = No review of object has been recorded REJECTED = Reviewer recorded that object failed to meet an implied criterion Roundtrip is supported but internal representation is different from DICOM. (Stored in: PlanSetup.Status, Image.ImageStatus) Plan Import: APPROVED -> Planning Approved REJECTED -> Rejected UNAPPROVED -> Unapproved Plan Treatment Approved -> APPROVED Rejected -> REJECTED Retired -> APPROVED (if plan has treated fractions) Retired -> UNAPPROVED (otherwise) Unapproved -> UNAPPROVED Else, no approval module is written Image Import: APPROVED -> Approved REJECTED -> Action Required If no approval module avaliable -> New Image Approved -> APPROVED Action Required -> REJECTED New -> Approval module not written Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

304 Review Date (300E,0004) 2C Date on which object was reviewed. Required if Approval Status (300E,0002) is APPROVED or REJECTED. Review Time (300E,0005) 2C Time at which object was reviewed. Required if Approval Status (300E,0002) is APPROVED or REJECTED. Reviewer Name (300E,0008) 2C Name of person who reviewed object. Required if Approval Status (300E,0002) is APPROVED or REJECTED. PlanSetup.StatusDate, Image.ApprovalDate) Depending on object type, the data is stored in PlanSetup or Image. Attribute is written, but not supported during import. (Value read from: PlanSetup.StatusDate, Image.ApprovalDate) Depending on object type, the data is stored in PlanSetup or Image. PlanSetup.StatusUserName, Image.ApprovalUserName) Depending on object type, the data is stored in PlanSetup or Image. C.2.32 RT General Treatment Record C Instance Number (0020,0013) 1 Instance number identifying this particular instance of the object. Export only: Always set to value of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

305 Treatment Date (3008,0250) 2 Date when current fraction was delivered, or Date last fraction was delivered in case of RT Treatment Summary Record IOD. See Note. Treatment Time (3008,0251) 2 Time when current fraction was delivered (begun), or Time last fraction was delivered (begun) in case of RT Treatment Summary Record IOD. See Note. Referenced RT Plan Sequence > Referenced SOP Class UID > Referenced SOP Instance UID Referenced Treatment Record Sequence (300C,0002) 2 A sequence which provides reference to a RT Plan SOP Class/Instance pair. Only a single Item shall be permitted in this Sequence. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced RT Plan Sequence (300C,0002) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced RT Plan Sequence (300C,0002) is sent. (3008,0030) 3 A sequence which provides reference to RT Treatment Record SOP Class/Instance pairs to which the current RT Treatment Record is significantly related. The sequence may contain one or more items. TreatmentFieldHstry.TreatmentDateTime) Date/Time of the last history object exported. TreatmentFieldHstry.TreatmentDateTime) Date/Time of the last history object exported. Plan to which this treatment record belongs Import: If this tag does not contain the RT Plan Storage UID then a warning will be generated. RT Plan Storage UID. Fractionation.PlanUID) Import: UID is used for identifying the referenced plan. *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

306 > Referenced SOP Class UID > Referenced SOP Instance UID (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Treatment Record Sequence (3008,0030) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Treatment Record Sequence (3008,0030) is sent. *** Not Used *** *** Not Used *** C.2.33 RT Treatment Machine Record C Treatment Machine Sequence > Treatment Machine Name (300A,0206) 1 Introduces sequence describing treatment machine used for treatment delivery. Only a single Item shall be permitted in this Sequence. (300A,00B2) 2 User-defined name identifying treatment machine used for treatment delivery. Machine.MachineId) Import: Used to identify the treatment machine. > Manufacturer (0008,0070) 2 Manufacturer of the equipment used for treatment delivery. Machine.ManufacturerName) Import: Used to identify the treatment machine. If the machine cannot be found using the machine name. 232 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

307 > Institution Name (0008,0080) 2 Institution where the equipment is located that was used for treatment delivery. > Institution Address (0008,0081) 3 Mailing address of the institution where the equipment is located that was used for treatment delivery. Attribute is written, but not supported during import. (Value read from: Hospital.HospitalName) > Institutional Department Name > Manufacturer s Model Name > Device Serial Number (0008,1040) 3 Department in the institution where the equipment is located that was used for treatment delivery. (0008,1090) 2 Manufacturer's model name of the equipment used for treatment delivery. (0018,1000) 2 Manufacturer's serial number of the equipment used for treatment delivery. Attribute is written, but not supported during import. (Value read from: Department.DepartmentId) Machine.MachineModel) Import: Used to identify the treatment machine. If the machine cannot be found using the machine name. Machine.MachineSerialNo) Import: Used to identify the treatment machine. If the machine cannot be found using the machine name. C.2.34 RT Beams Session Record C Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

308 Operators Name (0008,1070) 2 Name of operator administering treatment session. TreatmentFieldHstry.UserName1) Referenced Fraction Group Number Number of Fractions Planned Primary Dosimeter Unit Treatment Session Beam Sequence > Referenced Beam Number > Treatment Session Beam extended interface (300C,0022) 3 Identifier of Fraction Group within referenced RT Plan. Import: Attribute is read, but cannot be exported. (Stored as-is in: Fractionation.DicomSeqNumber) (300A,0078) 2 Total number of treatments (Fractions) planned for current Fraction Group. (300A,00B3) 1 Measurement unit of machine dosimeter. Enumerated Values: MU = Monitor Unit MINUTE = minute (3008,0020) 1 Introduces sequence of Beams administered during treatment session. The sequence may contain one or more items. (300C,0006) 3 References Beam specified by Beam Number (300A,00C0) in Beam Sequence (300A,00B0) in RT Beams Module within referenced RT Plan. (3261,102A) XML blob for the RT Beams Session Record Extended Interface Import: Attribute is read, but cannot be exported. (Stored as-is in: TreatmentFieldHstry.NoOfFractions) Attribute is written, but not supported during import. (Value read from: Fractionation.NoFractions) TreatmentFieldHstry.FieldGroupNumber) Contains information in XML format about dose overrides, tray specifications and additional override user names. 234 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

309 > Beam Name (300A,00C2) 3 User-defined name for delivered Beam. TreatmentFieldHstry.FieldId) > Beam Seconary Name (3243,1009) User-defined secondary name for delivered Beam. TreatmentFieldHstry.FieldName) > Beam Description (300A,00C3) 3 User-defined description for delivered Beam. TFHNote.Value) A History Note. > Beam Type (300A,00C4) 1 Motion characteristic of delivered Beam. Enumerated Values: STATIC = all beam parameters remain unchanged during delivery DYNAMIC = one or more beam parameters changes during delivery > Radiation Type (300A,00C6) 1 Particle type of delivered Beam. Defined Terms: Roundtrip is supported but internal PHOTON, ELECTRON, NEUTRON, PROTON. representation is different from DICOM. (Stored in: TreatmentFieldHstry.RadiationType) PHOTON = 'X' ELECTRON = 'E' PROTON = 'P' Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

310 > High-Dose Technique Type (300A,00C7) 1C Type of high-dose treatment technique. Defined Terms: NORMAL = Standard treatment TBI = Total Body Irradiation HDR = High Dose Rate Required if treatment technique requires a dose that would normally require overriding of treatment machine safety controls. > Technique (3243,1006) 3 Treatment Technique of this Beam for PROTON beams. Defined Terms: DOUBLESCATTERING SINGLESCATTERING UNIFORM_SCANNING MODULAT_SCANNING STATIC Note, that the definition of DYNAMIC in (300A,00C4) is completely independent from the definitions in here. Required if RadiationType (300A,00C6) is PROTON > Referenced Verification Image Sequence >> Referenced SOP Class UID (300C,0040) 3 Introduces sequence of verification images obtained during delivery of current beam. The sequence may contain one or more items. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Verification Image Sequence (300C,0040) is sent. Import: Attribute is processed during import only. It is represented by TreatmentFieldHstry.NoOfImage on the database. Number of items in this sequence is assigned to NoOfImage *** Not Used *** 236 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

311 >> Referenced SOP Instance UID (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Verification Image Sequence (300C,0040) is sent. >> Start Meterset (3008,0078) 3 Cumulative Meterset Weight within Beam referenced by Referenced Beam Number at which image acquisition starts. >> End Meterset (3008,007A) 3 Cumulative Meterset Weight within Beam referenced by Referenced Beam Number at which image acquisition ends. *** Not Used *** > Referenced Measured Dose Reference Sequence >> Referenced Dose Reference Number >> Referenced Measured Dose Reference Number (3008,0080) 3 Introduces sequence of doses measured during treatment delivery for current Beam. The sequence may contain one or more items. (300C,0051) 1C Uniquely references Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module of referenced RT Plan. Required if Referenced Measured Dose Reference Sequence (3008,0080) is sent and Referenced Measured Dose Reference Number (3008,0082) is not sent. It shall not be present otherwise. (3008,0082) 1C Uniquely references Measured Dose Reference specified by Measured Dose Reference Number (3008,0064) in Measured Dose Reference Sequence (3008,0010). Required if Referenced Measured Dose Reference Sequence (3008,0080) is sent and Referenced Dose Reference Number (300C,0051) is not sent. It shall not be present otherwise. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

312 >> Measured Dose Value > Referenced Calculated Dose Reference Sequence >> Referenced Dose Reference Number >> Referenced Calculated Dose Reference Number >> Calculated Dose Reference Dose Value > Source-Axis Distance (3008,0016) 1C Measured Dose in units specified by Dose Units (3004,0002) in sequence referenced by Measured Dose Reference Sequence (3008,0010) or Dose Reference Sequence (300A,0010) in RT Prescription Module of referenced RT Plan as defined above. Required if Referenced Measured Dose Reference Sequence (3008,0080) is sent. (3008,0090) 3 Introduces sequence of doses estimated for each treatment delivery. The sequence may contain one or more items. (300C,0051) 1C Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module of referenced RT Plan. Required if Referenced Calculated Dose Reference Sequence (3008,0090) is sent and Referenced Calculated Dose Reference Number (3008,0092) is not sent. (3008,0092) 1C Uniquely identifies Calculated Dose Reference specified by Calculated Dose Reference Number (3008,0072) within Calculated Dose Reference Sequence (3008,0070). Required if Referenced Calculated Dose Reference Sequence (3008,0090) is sent and Referenced Dose Reference Number (300C,0051) is not sent. (3008,0076) 1C Calculated Dose (Gy). Required if Referenced Calculated Dose Reference Sequence (3008,0090) is sent. (300A,00B4) 3 Radiation source to gantry rotation axis distance of the equipment that was used for beam delivery (mm). DoseContribution.DicomSeqNumber) Dose Contribution object of the Reference Point of the plan this treatment record is referencing. DoseContribution.DicomSeqNumber) RefPointHstry.ActualDose) Attribute is written, but not supported during import. (Value read from: ExternalBeam.SAD) 238 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

313 > Beam Limiting Device Leaf Pairs Sequence (3008,00A0) 1 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) leaf pair values. The sequence may contain one or more items. Roundtrip is supported but internal representation is different from DICOM. (Stored in: TFHAddOn.AddOnId, TreatmentFieldHstry.CollMode) >> RT Beam Limiting Device Type (300A,00B8) 1 Type of beam limiting device (collimator). Import: Enumerated Values: Only one mlc is supported. X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction MLCX, MLCY: Rotation as defined in Administration task. >> Number of Leaf/Jaw Pairs (300A,00BC ) 1 Number of leaf (element) or jaw pairs (equal to 1 for standard beam limiting device jaws). Export of MLC: Number of Leafes of the MLC object Collimator: 1 > Referenced Patient Setup Number (300C,006A) 3 Uniquely identifies Patient Setup used within current beam, specified by Patient Setup Number (300A,0182) within Patient Setup Sequence (300A,0180) of RT Treatment Record. *** Not Used *** > Number of Wedges (300A,00D0) 1 Number of wedges associated with current delivered Beam. At most, two wedges are supported. > Recorded Wedge Sequence (3008,00B0) 1C Introduces sequence of treatment wedges present during delivered Beam. Required if Number of Wedges (300A,00D0) is nonzero. The sequence may contain one or more items. At most, two wedges are supported. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

314 >> Wedge Number (300A,00D2) 3 Identification number of the Wedge. The value of Wedge Number (300A,00D2) shall be unique within the wedge sequence. TreatmentFieldHstry.WedgeNumber1, TreatmentFieldHstry.WedgeNumber2, FieldAddOn.DicomSeqNumber) On Import uses the DicomSeqNumber to find the correct wedge. >> Wedge Type (300A,00D3) 2C Type of wedge defined for delivered Beam. Required if Recorded Wedge Sequence (3008,00B0) is sent. Defined Terms: STANDARD = standard (static) wedge DYNAMIC = moving Beam Limiting Device (collimator) jaw simulating wedge MOTORIZED = single wedge which can be removed from beam remotely Roundtrip is supported but internal representation is different from DICOM. (Stored in: TFHAddOn.AddOnSubType) Import: Angle, Orientation and Wedge Type are used to find an existing Wedge on the Treatment Machine used for delivery of the treatment. If a machine override was performed or the wedge could not be found on the plan using the DicomSeqNumber. Mapping VFC to DICOM: StandardWedge - STANDARD MotorizedStandardWedge - MOTORIZED DynamicWedge - DYNAMIC EnhancedDynamicWedge - DYNAMIC >> Wedge ID (300A,00D4) 3 User-supplied identifier for wedge. TFHAddOn.AddOnId) Allows for multiple AddOns per TreatmentFieldHstry record. 240 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

315 >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. >> Wedge Angle (300A,00D5) 3 Nominal wedge angle delivered (degrees). TreatmentFieldHstry.WedgeAngle, TreatmentFieldHstry.WedgeAngle2) Import: Angle, Orientation and Wedge Type are used to find an existing Wedge on the Treatment Machine used for delivery of the treatment. If a machine override was performed or the wedge could not be found on the plan using the DicomSeqNumber. >> Wedge Orientation > Number of Compensators > Recorded Compensator Sequence (300A,00D8) 3 Orientation of wedge, i.e. orientation of IEC WEDGE FILTER coordinate system with respect to IEC BEAM LIMITING DEVICE coordinate system (degrees). (300A,00E0) 2 Number of compensators associated with current delivered Beam. (3008,00C0) 3 Introduces sequence of treatment compensators associated with current Beam. The sequence may contain one or more items. TreatmentFieldHstry.WedgeDirection, TreatmentFieldHstry.WedgeDirection2) Import: Angle, Orientation and Wedge Type are used to find an existing Wedge on the Treatment Machine used for delivery of the treatment. If a machine override was performed or the wedge could not be found on the plan using the DicomSeqNumber. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

316 >> Referenced Compensator Number (300C,00D0 ) 1C Uniquely identifies compensator specified by Compensator Number (300A,00E4) within Beam referenced by Referenced Beam Number (300C,0006). Required if Recorded Compensator Sequence (3008,00C0) is sent. Compensator.DicomSeqNumber) On Import uses the DicomSeqNumber to find the correct compensator. >> Compensator Type (300A,00EE ) 2C Type of compensator (if any). Required if Recorded Compensator Sequence (3008,00C0) is sent. Defined Terms: STANDARD = physical (static) compensator DYNAMIC = moving Beam Limiting Device (collimator) simulating compensator Import: Attribute is read, but cannot be exported. (Stored as-is in: TFHAddOn.AddOnSubType) >> Compensator ID (300A,00E5) 3 User-supplied identifier for compensator. TFHAddOn.AddOnId) >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. > Number of Boli (300A,00ED ) 2 Number of boli used with current Beam. > Referenced Bolus Sequence >> Referenced ROI Number (300C,00B0) 3 Introduces sequence of boli associated with Beam. The sequence may contain one or more items. (3006,0084) 1C Uniquely identifies ROI representing the bolus specified by ROI Number (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set IOD referenced by referenced RT Plan in Referenced RT Plan Sequence (300C,0002) in RT General Treatment Record Module. Required if Referenced Bolus Sequence (300C,00B0) is sent. *** Not Used *** *** Not Used *** >> Bolus ID (300A,00DC ) 3 User-supplied identifier for the Bolus. 242 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

317 >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. > Number of Blocks (300A,00F0) 2 Number of shielding blocks or Electron Inserts associated with Beam. > Recorded Block Sequence (3008,00D0) 3 Introduces sequence of blocks associated with current Beam. The sequence may contain one or more items. TFHAddOn.AddOnId) >> Block Tray ID (300A,00F5) 3 User-supplied identifier for block tray or Electron Insert. AddOn.AddOnId) Import: used to find the corresponding tray attached to the field by ID. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. >> Referenced Block Number (300C,00E0) 3 Uniquely identifies block specified by Block Number (300A,00FC) within Beam referenced by Referenced Beam Number (300C,0006). Block.DicomSeqNumber) Import: used to find the corresponding block attached to the field by ID. Only done if Block could not be found by the tray ID. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

318 >> Block Name (300A,00FE) 2C User-defined name for block. Required if Recorded Block Sequence (3008,00D0) is sent. TFHAddOn.AddOnId) Import: used to find the corresponding block attached to the field by ID. Only done if Block could not be found by DicomSeqNumber or tray ID. > Applicator Sequence (300A,0107) 3 Introduces sequence of Applicators associated with Beam. Only a single item shall be permitted in this sequence. >> Applicator ID (300A,0108) 1C User or machine supplied identifier for Applicator. Required if Applicator Sequence (300A,0107) is sent. >> Accessory Code (300A,00F9) 3 An identifier for the accessory intended to be read by a device such as a bar-code reader. >> Applicator Type (300A,0109) 1C Type of Applicator. Required if Applicator Sequence (300A,0107) is sent. Defined Terms: ELECTRON_SQUARE = square electron applicator ELECTRON_RECT = rectangular electron applicator ELECTRON_CIRC = circular electron applicator ELECTRON_SHORT = short electron applicator ELECTRON_OPEN = open (dummy) electron applicator INTRAOPERATIVE = intraoperative (custom) applicator STEREOTACTIC = stereotactic applicator TFHAddOn.AddOnId) TFHAddOn.AddOnSubType) >> Applicator Description (300A,010A) 3 User-defined description for Applicator. *** Not Used *** 244 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

319 > Current Fraction Number (3008,0022) 2 Fraction number for this beam administration. TreatmentFieldHstry.FractionNumber) The IOD is rejected, if the fraction number is undefined. > Treatment Delivery Type (300A,00CE ) 2 Delivery Type of treatment. Defined Terms: TREATMENT = normal patient treatment OPEN_PORTFILM = portal image acquisition with open field TRMT_PORTFILM = portal image acquisition with treatment port CONTINUATION = continuation of interrupted treatment Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.ContinuationFlag) Import: Attribute is processed during import only. It is represented by TreatmentFieldHstry.PIFlag on the databas Mapping: TREATMENT: 0 CONTIUNATION: 1 OPEN_PORTFILM: 2 TRMT_PORTFILM: 3 > Related Referenced Beam Number (3243,1028) 3 Only allowed, if Treatment Delivery Type (300A,00CE) id OPEN_PORTFILM or TRMT_PORTFILM Beam number of related beam for which this image has been taken. > Treatment Termination Status (3008,002A) 1 Conditions under which treatment was terminated. Enumerated Values: NORMAL = treatment terminated normally OPERATOR = operator terminated treatment MACHINE = machine terminated treatment UNKNOWN = status at termination unknown TreatmentFieldHstry.TerminationStatus) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

320 > Treatment Termination Code > Treatment Machine Note > Treatment Verification Status (3008,002B) 3 Treatment machine termination code. This code is dependent upon the particular application and equipment. (3251,1000) 3 A textual description which can be supplied by the treatment machine for describe technical details. (3008,002C) 2 Conditions under which treatment was verified by a verification system. Enumerated Values: VERIFIED = treatment verified VERIFIED_OVR = treatment verified with at least one out-ofrange value overridden NOT_VERIFIED = treatment verified manually TreatmentFieldHstry.BeamOffCode) The type of the entry denotes a MachineNote. Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.OverrideFlag, TreatmentFieldHstry.RVFlag) Bit 0 of the RVFlag denotes whether the treatment record was VERIFIED or not. Bit 1 of the RVFlag denotes whether the treatment record was recorded (through IT Daemon) or import (DICOM import in any application). DICOM <-> RVFlag / OverrideFlag: Recorded (ITDaemon): VERIFIED <-> 1 / false VERIFIED_OVR <-> 1 / true NOT_VERIFIED <-> 0 / false Imported: VERIFIED <-> 3 / false VERIFIED_OVR <-> 3 / true NOT_VERIFIED <-> 1 / false 246 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

321 > Specified Primary Meterset > Specified Secondary Meterset (3008,0032) 3 Desired machine setting of primary meterset. *** Not Used *** (3008,0033) 3 Desired machine setting of secondary meterset. *** Not Used *** > Delivered Primary Meterset > Delivered Secondary Meterset (3008,0036) 3 Machine setting actually delivered as recorded by primary meterset. (3008,0037) 3 Machine setting actually delivered as recorded by secondary meterset. Import: Attribute is read, but cannot be exported. (Stored as-is in: TreatmentFieldHstry.ActualMU) If defined this value is stored in ActualMU and not the one derived from DeliveredMeterset (3008,0044) of the first and last control point (see there). *** Not Used *** > Specified Treatment Time > Delivered Treatment Time > Number of Control Points > Control Point Delivery Sequence (3008,003A) 3 Treatment Time set (sec). (3008,003B) 3 Treatment Time actually delivered (sec). Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.TreatmentTime) (300A,0110) 1 Number of control points delivered. (3008,0040) 1 Introduces sequence of beam control points for current treatment beam. The sequence may contain one or more items. See C Generally only the first and last control point is included, if a motorized wedge is present then four control points are included. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

322 >> Referenced Control Point Index >> Treatment Control Point Date >> Treatment Control Point Time (300C,00F0) 3 Uniquely identifies Control Point specified by Control Point Index (300A,0112) within Beam referenced by Referenced Beam Number (300C,0006). (3008,0024) 1 Date administration of treatment beam began. Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.TreatmentDateTime) Import: Value of control point with index = 0. Value set to all control points. (3008,0025) 1 Time administration of treatment beam began. Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.TreatmentDateTime) Import: Value of control point with index = 0. Value set to all control points. 248 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

323 >> Specified Meterset (3008,0042) 2 Desired machine setting for current control point. See C TreatmentFieldHstry.PlannedMU) Import: Value of last control point is assigned to PlannedMU >> Delivered Meterset (3008,0044) 1 Machine setting actually delivered at current control point. See C First control point: 0 Control points 1 and 2 of treatment with motorized wedge: PlannedMU * wedge dose Last control point: PlannedMU Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.ActualMU) Import: ActualMU = Delivered Meterset of last control point - Delivered Meterset of first control point. If Delivered Primary Meterset (3008,0036) is defined ActualMU is overridden by that value (see there). First control point: 0 Remaining control points: Minimum of Specified Meterset and ActualMU Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

324 >> Dose Rate Set (300A,0115) 2 Dose Rate set on treatment machine for segment beginning at current control point (meterset/min). Attribute is processed during export only. The value of Field.DoseRate will be used to calculate the contents during export. Planned dose rate as specified by the field associated with the treatment record. >> Dose Rate Delivered (3008,0048) 2 Dose Rate actually delivered for segment beginning at current control point (meterset/min). TreatmentFieldHstry.DoseRate) Import: Value of control point with index 0. >> Nominal Beam Energy (300A,0114) 3 Nominal Beam Energy at control point. Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.NominalEnergy) Import: Value of control point with index 0. >> Nominal Beam Energy Unit (300A,0015) 1C Units used for Nominal Beam Energy (300A,0114). Required if Nominal Beam Energy (300A,0114) is sent. Defined Terms: MV = Megavolt MEV = Mega electron-volt If Radiation Type (300A,00C6) is PHOTON, Nominal Beam Energy Unit (300A,0015) shall be MV. If Radiation Type (300A,00C6) is ELECTRON, Nominal Beam Energy Unit (300A,0015) shall be MEV. Roundtrip is supported but internal representation is different from DICOM. (Stored in: TreatmentFieldHstry.NominalEnergy) Import: Assume MV for photon, MeV for electron treatments. Photon treatments always exported in MV. Electron treatments always exported in MeV. 250 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

325 >> Wedge Position Sequence (300A,0116) 3 Introduces sequence of Wedge positions for current control point. The sequence may contain one or more items. >>> Referenced Wedge Number (300C,00C0 ) 1C Uniquely identifies wedge specified by Wedge Number (300A,00D2) within Beam referenced by Referenced Beam Number (300C,0006). Required if Wedge Position Sequence (300A,0116) is sent. Attribute is written, but not supported during import. (Value read from: TreatmentFieldHstry.WedgeNumber1, TreatmentFieldHstry.WedgeNumber2) >>> Wedge Position (300A,0118) 1C Position of Wedge at current control point. Import: Required if Wedge Position Sequence (300A,0116) is sent. Enumerated Values: IN, OUT. Attribute is processed during import only. It is represented by ExternalBeam.MaxNoOfAddOn on the database. MaxNoOfAddOn is used to denote whether the wedge is initially moved in or out. >> Beam Limiting Device Position Sequence (300A,011A) 1C Introduces sequence of beam limiting device (collimator) jaw or leaf (element) positions. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if beam limiting device (collimator) changes during beam administration. The sequence may contain one or more items. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

326 >>> RT Beam Limiting Device Type >>> Leaf/Jaw Positions (300A,00B8) 1C Type of beam limiting device. The value of this attribute shall correspond to RT Beam Limiting Device Type (300A,00B8) defined in an element of Beam Limiting Device Leaf Pairs Sequence (3008,00A0). Required if Beam Limiting Device Position Sequence (300A,011A) is sent. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction (300A,011C) 1C Positions of beam limiting device (collimator) leaf (element) or jaw pairs (mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), e.g. X- axis for MLCX, Y-axis for MLCY. Contains 2N values, where N is the Number of Leaf/Jaw Pairs (300A,00BC) defined in element of Beam Limiting Device Leaf Pairs Sequence (3008,00A0). Values shall be in IEC leaf subscript order 101, 201, 102, 202, à 1N, 2N. Required if Beam Limiting Device Position Sequence (300A,011A) is sent. TreatmentFieldHstry.CollX1, TreatmentFieldHstry.CollX2, TreatmentFieldHstry.CollY1, TreatmentFieldHstry.CollY2) MLC: Import: Ignored if Beam Limiting Device Type is MLCX or MLCY. Planned MLC leaf positions specified in control points of associated treatment field. 252 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

327 >> Gantry Angle (300A,011E) 1C Treatment machine gantry angle, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Gantry Angle changes during beam administration. TreatmentFieldHstry.GantryRtn, TreatmentFieldHstry.StopAngle) Import: GantryRtn = value of control point 0. StopAngle = value of last control point in sequence if gantry angle changes. >> Gantry Rotation Direction (300A,011F) 1C Direction of Gantry Rotation when viewing gantry from isocenter, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040), or if Gantry Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation GantryRtn is assigned to first control point. If StopAngle is defined then value is assigned to second control point. TreatmentFieldHstry.GantryRtnDirection) Import: Value of control point with index 0. >> Beam Stopper Position (3008,0230) 3 Position of Beam Stopper during beam administration. Enumerated Values: EXTENDED = Beam Stopper extended RETRACTED = Beam Stopper retracted UNKNOWN = Position unknown Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

328 >> Beam Limiting Device Angle >> Beam Limiting Device Rotation Direction >> Patient Support Angle >> Patient Support Rotation Direction (300A,0120) 1C Beam Limiting Device (collimator) angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if beam limiting device (collimator) angle changes during beam delivery. (300A,0121) 1C Direction of Beam Limiting Device Rotation when viewing beam limiting device (collimator) from radiation source, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Beam Limiting Device Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation (300A,0122) 1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Patient Support Angle changes during beam administration. (300A,0123) 1C Direction of Patient Support Rotation when viewing table from above, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040), or if Patient Support Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation TreatmentFieldHstry.CollRtn) Import: Value of control point with index 0. Import: Warning if value of control point with index 0 is not NONE. NONE. TreatmentFieldHstry.PatientSupportAngle ) Import: Value of control point with index 0. Import: Warning if value of control point with index 0 is not NONE. NONE. 254 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

329 >> Table Top Eccentric Axis Distance >> Table Top Eccentric Angle >> Table Top Eccentric Rotation Direction >> Table Top Vertical Position (300A,0124) 3 Distance (positive) from the IEC PATIENT SUPPORT vertical axis to the IEC TABLE TOP ECCENTRIC vertical axis (mm). (300A,0125) 1C Table Top (non-isocentric) angle, i.e. orientation of IEC TABLE TOP ECCENTRIC coordinate system with respect to IEC PATIENT SUPPORT coordinate system (degrees). Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Eccentric Angle changes during beam administration. (300A,0126) 1C Direction of Table Top Eccentric Rotation Direction when viewing table from above, for segment beginning at current Control Point. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Eccentric Rotation Direction changes during beam administration. Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation (300A,0128) 2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Vertical Position changes during beam administration. Attribute is written, but not supported during import. (Value read from: ExternalBeam.TableTopEccentricDist) Import: Warning if value in control point with index 0 is not equal to the value of the external beam. Import: Warning if not Import: Warning if value of control point with index 0 is not NONE. NONE. TreatmentFieldHstry.CouchVrt) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

330 >> Table Top Longitudinal Position >> Table Top Lateral Position >> Table Top Roll Angle >> Table Top Pitch Angle >> Corrected Parameter Sequence >>> Parameter Sequence Pointer >>> Parameter Item Index >>> Parameter Pointer >>> Correction Value (300A,0129) 2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Longitudinal Position changes during beam administration. (300A,012A) 2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). This value is interpreted as an absolute, rather than relative, Table setting. Required for Control Point 0 of Control Point Delivery Sequence (3008,0040) or if Table Top Lateral Position changes during beam administration. (3243,1016) 3 Table Top Roll Angle (ot yet part of the IEC system). (3243,1017) 3 Table Top Pitch Angle (not yet part of the IEC system). (3008,0068) 3 Introduces a sequence of items describing any corrections made to any attributes prior to delivery of the next control point. The sequence may contain one or more items. (3008,0061) 1 Contains the Data Element Tag of the parent sequence containing the attribute that was corrected. The value is limited in scope to the Treatment Session Beam Sequence (3008,0020) and all nested sequences therein. (3008,0063) 1 Contains the sequence item index (starting at 1) of the corrected attribute within its parent sequence. (3008,0065) 1 Contains the Data Element Tag of the attribute that was corrected. (3008,006A) 1 The value applied to the attribute that was referenced by the Parameter Sequence Pointer (3008,0061), Parameter Item Index (3008,0063) and Parameter Pointer (3008,0065). TreatmentFieldHstry.CouchLng) TreatmentFieldHstry.CouchLat) 256 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

331 >> Override Sequence >>> Override Parameter Pointer >>> Parameter Sequence Pointer >>> Parameter Item Index (3008,0060) 3 Introduces sequence of parameters that were overridden during the administration of the beam segment immediately prior to the current control point. The sequence may contain one or more items. (3008,0062) 2C Contains the Data Element Tag of the attribute that was overridden. Required if Override Sequence (3008,0060) is sent. (3008,0061) 3 Contains the Data Element Tag of the parent sequence containing the attribute that was overridden. The value is limited in scope to the Treatment Session Beam Sequence (3008,0020) and all nested sequences therein. (3008,0063) 3 Contains the sequence item index (monotonically increasing from 1) of the overridden attributes within its parent sequence. The value is limited in scope to the Treatment Session Beam Sequence (3008,0020) and all nested sequences therein. Import: TreatmentFieldHistory.<Parameter>Overri deflag are set according to this value. Values are set according to which TreatmentFieldHistory.<Parameter>Overri deflag is set. >>> Operators Name (0008,1070) 2C Name of operator who authorized override. Import: Required if Override Sequence (3008,0060) is sent. TreatmentFieldHistory.ApproavlUserNam e The name from TreatmentFieldHistory.UserName2 and the first four names of TreatmentFieldHistory.UserName3 >>> Override Reason (3008,0066) 3 User-defined description of reason for override of parameter specified by Override Parameter Pointer (3008,0062). *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

332 C.2.35 RT Treatment Summary Record C Current Treatment Status (3008,0200) 1 Status of the Treatment at the time the Treatment Summary was created. Enumerated Values: NOT_STARTED, ON_TREATMENT, ON_BREAK, SUSPENDED, STOPPED, COMPLETED. See C Attribute is processed during export only. The value of PlanSetup.Status will be used to calculate the contents during export. NOT_STARTED: Treatment not started or just Port Images or Port Films recorded COMPLETED: Status of plan is 'Completed' ON_TREATMENT: if Status of some Sessions are 'Active' or 'Partially Completed - Active' ON_BREAK: Not supported SUSPENDED: Status of plan is Rejected STOPPED: Status of plan is Completed Early Treatment Status Comment First Treatment Date (3008,0202) 3 Comment on current treatment status. (3008,0054) 2 Date of delivery of the first treatment. Attribute is processed during export only. The value of TreatmentFieldHstry.TreatmentDateTime will be used to calculate the contents during export. Minimal TreatmentDateTime of all treatment records belonging to the current plan. 258 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

333 Most Recent Treatment Date (3008,0056) 2 Date of delivery of the most recent administration. *** Not Used *** Total Number of Fractions Fraction Group Summary Sequence > Referenced Fraction Group Number > Fraction Group Type > Number of Fractions Planned > Number of Fractions Delivered > Fraction Status Summary Sequence >> Referenced Fraction Number (3265,1000) 3 Total number of Fractions planned for the current plan, all its former plans and all its successor plans. (3008,0220) 3 Introduces sequence describing current state of planned vs. delivered fraction groups. The sequence may contain one or more items. (300C,0022) 3 References Fraction Group Number (300A,0071) in Fraction Group Sequence (300A,0070) in the referenced RT Plan. (3008,0224) 2C Indicates type of fraction group. Required if Fraction Group Summary Sequence (3008,0220) is sent. Enumerated Values: EXTERNAL_BEAM, BRACHY. (300A,0078) 2C Number of fractions planned for this fraction group. Required if Fraction Group Summary Sequence (3008,0220) is sent. (3008,005A) 2C Number of fractions delivered as of Treatment Summary Report. Required if Fraction Group Summary Sequence (3008,0220) is sent. (3008,0240) 3 Introduces sequence describing status of fractions in Fraction Group. The sequence may contain one or more items. (3008,0223) 1C Identifies fraction. Required if Fraction Status Summary Sequence (3008,0240) is sent. Number of planned fractions Contains exactly one item. Attribute is written, but not supported during import. (Value read from: Fractionation.DicomSeqNumber) EXTERNAL_BEAM Attribute is written, but not supported during import. (Value read from: Fractionation.NoFractions) Number of completed fractions Attribute is written, but not supported during import. (Value read from: TreatmentFieldHstry.FractionNumber) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

334 >> Treatment Date (3008,0250) 2C Date when fraction was delivered. Required if Fraction Status Summary Sequence (3008,0240) is sent. >> Treatment Time (3008,0251) 2C Time when fraction was delivered. Required if Fraction Status Summary Sequence (3008,0240) is sent. Attribute is processed during export only. The value of TreatmentFieldHstry.TreatmentDateTime will be used to calculate the contents during export. Most recent value of TreatmentDateTime of all Treatment Records (that do not originate from Port Images or Port Films or whose termination status is not NORMAL ) belonging to the current plan treating the fraction number specified in (3008, 0223). Attribute is processed during export only. The value of TreatmentFieldHstry.TreatmentDateTime will be used to calculate the contents during export. Most recent value of TreatmentDateTime of all Treatment Records (that do not originate from Port Images or Port Films or whose termination status is not NORMAL ) belonging to the current plan treating the fraction number specified in (3008, 0223). 260 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

335 >> Treatment Termination Status Treatment Summary Measured Dose Reference > Referenced Dose Reference Number (3008,002A) 2C Conditions under which treatment was terminated. Required if Fraction Status Summary Sequence (3008,0240) is sent. Enumerated Values: NORMAL = treatment terminated normally OPERATOR = operator terminated treatment MACHINE = machine terminated treatment for other than NORMAL condition UNKNOWN = status at termination unknown (3008,00E0) 3 Introduces sequence of references to Measured Dose References. The sequence may contain one or more items. (300C,0051) 3 Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module of referenced RT Plan referenced in Referenced RT Plan Sequence (300C,0002) of RT General Treatment Record Module. Attribute is processed during export only. The value of TreatmentFieldHstry.TerminationStatus will be used to calculate the contents during export. NORMAL if all fields in the current fraction have Treatment Records (not originating from Port Images or Port Films) that have TerminationStatus = NORMAL. > Dose Reference Description (300A,0016) 3 User-defined description of Dose Reference. > Cumulative Dose to Dose Reference Treatment Summary Calculated Dose Reference (3008,0052) 1C Cumulative Dose delivered to Dose Reference (Gy). Required if Treatment Summary Dose Reference Sequence (3008,00E0) is sent. (3008,0050) 3 Introduces sequence of references to Calculated Dose References. The sequence may contain one or more items. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

336 > Referenced Dose Reference Number > Dose Reference Description > Cumulative Dose to Dose Reference Additional Dose Value Sequence > Referenced Dose Reference Number > Actual Session Dose (300C,0051) 3 Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module of referenced RT Plan referenced in Referenced RT Plan Sequence (300C,0002) of RT General Treatment Record Module. Attribute is written, but not supported during import. (Value read from: DoseContribution.DicomSeqNumber) (300A,0016) 3 User-defined description of Dose Reference. Attribute is written, but not supported during import. (Value read from: RefPoint.RefPointId) Of the Reference Point associated with the Dose Contribution. (3008,0052) 1C Cumulative Dose delivered to Dose Reference (Gy). Required if Treatment Summary Dose Reference Sequence (3008,0050) is sent. (3259,1000) 3 Introduces sequence of actual session dose. The sequence may contain one or more items. (300C,0051) 3 Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module of referenced RT Plan referenced in Referenced RT Plan Sequence (300C,0002) of RT General Treatment Record Module. Attribute is written, but not supported during import. (Value read from: RefPointDeliveredDose.TotDeliveredDose ) Of the Reference Point associated with the Dose Contribution. Attribute is written, but not supported during import. (Value read from: DoseContribution.DicomSeqNumber) (3259,1002) 1C Delivered session dose of actual session Total dose delivered on currently active Required if Actual Session Dose Sequence is sent. session for the Reference Point. 262 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

337 > Daily Dose (3259,1004) 1C Total dose of current day Total dose delivered today. Required if Actual Session Dose Sequence is sent. > Life Time Total Dose (3259,1006) 2C Total Dose of RefPoint over all Plans Total dose ever delivered to Reference Point associated with the current Dose Contribution. C.2.36 RT Ion Tolerance Tables C Ion Tolerance Table Sequence > Tolerance Table Number > Tolerance Table Label > Gantry Angle Tolerance > Beam Limiting Device Angle Tolerance > Beam Limiting Device Tolerance Sequence (300A,03A0) 1 Introduces sequence of ion tolerance tables to be used for delivery of treatment plan. One or more items shall be included in this sequence. See Note 1. (300A,0042) 1 Identification number of the Tolerance Table. The value of Tolerance Table Number (300A,0042) shall be unique within the RT Ion Plan in which it is created. Import: Matched against Referenced Tolerance Table Number in RT Beams Module (300A,0043) 3 User-defined label for Tolerance Table. Attribute is written, but not supported during import. (Value read from: Tolerance.ToleranceId) (300A,0044) 3 Maximum permitted difference (in degrees) between planned and delivered Gantry Angle. (300A,0046) 3 Maximum permitted difference (in degrees) between planned and delivered Beam Limiting Device Angle. (300A,0048) 3 Introduces sequence of beam limiting device (collimator) tolerances. One or more items may be included in this sequence. Taken from ToleranceLimit where ParameterName = GantryRtn Taken from ToleranceLimit where ParameterName = CollRtn Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

338 >> RT Beam Limiting Device Type >> Beam Limiting Device Position Tolerance (300A,00B8) 1 Type of beam limiting device (collimator). All values are supported. Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction (300A,004A) 1 Maximum permitted difference (in mm) between planned and delivered leaf (element) or jaw positions for current beam limiting device (collimator). Only for Dose Dynamic or Arc Dynamic MLC: Taken from attributes DoseDynamicLeafTolerance or ArcDynamicLeafTolerance of MLC associated to field. > Patient Support Angle Tolerance > Table Top Vertical Position Tolerance (300A,004C) 3 Maximum permitted difference (in degrees) between planned and delivered Patient Support Angle. (300A,0051) 3 Maximum permitted difference (in mm) between planned and delivered Table Top Vertical Position. Attribute Name Tag Type Description Collimator: For X: ToleranceLimit where ParameterName = CollX For ASYMX: ToleranceLimit where ParameterName = CollX1/X2 For Y: ToleranceLimit where ParameterName = CollY For ASYMY: ToleranceLimit where ParameterName = CollY1/Y2 Taken from ToleranceLimit where ParameterName = PatientSupportAngle Taken from ToleranceLimit where ParameterName = CouchVrt 264 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

339 > Table Top Longitudinal Position Tolerance > Table Top Lateral Position Tolerance > Table Top Pitch Angle Tolerance > Table Top Roll Angle Tolerance > Snout Position Tolerance > Distal Target Distance Tolerance > Nominal SOBP Width Tolerance (300A,0052) 3 Maximum permitted difference (in mm) between planned and delivered Table Top Longitudinal Position. (300A,0053) 3 Maximum permitted difference (in mm) between planned and delivered Table Top Lateral Position. (300A,004F) 3 Maximum permitted difference (in degrees) between planned and delivered Table Top Pitch Angle. (300A,0050) 3 Maximum permitted difference (in degrees) between planned and delivered Table Top Roll Angle. (300A,004B) 3 Maximum permitted difference (in mm) between planned and delivered Snout Position. (300B,1001) 3 Maximum permitted difference (in mm) between planned and delivered Distal Target Distance. (300B,1011) 3 Maximum permitted difference (in mm) between planned and delivered Nominal SOBP Width. Taken from ToleranceLimit where ParameterName = CouchLng Taken from ToleranceLimit where ParameterName = CouchLat Taken from ToleranceLimit where ParameterName = PatientSupportPitchAngle Taken from ToleranceLimit where ParameterName = PatientSupportRollAngle Taken from ToleranceLimit where ParameterName = SnoutPosition Taken from ToleranceLimit where ParameterName = DistalRange Taken from ToleranceLimit where ParameterName = SOBPWidth C.2.37 RT Ion Beams C Ion Beam Sequence (300A,03A2) 1 Introduces sequence of setup and/or treatment beams for current RT Ion Plan. One or more items shall be included in this sequence. > Beam Number (300A,00C0) 1 Identification number of the Beam. The value of Beam Number (300A,00C0) shall be unique within the RT Ion Plan in which it is created. See section C Field.FieldNumber) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

340 > Beam Name (300A,00C2) 1 User-defined name for Beam. See section C > Beam Description (300A,00C3) 3 User-defined description for Beam. See section C Radiation.RadiationId) Used as Field ID. Radiation.Comment) > Beam Type (300A,00C4) 1 Motion characteristic of Beam. Only STATIC is supported Enumerated Values: STATIC = all beam parameters remain unchanged during delivery DYNAMIC = one or more beam parameters changes during delivery > Radiation Type (300A,00C6) 1 Particle type of Beam. Attribute Name Tag Type Description Defined Terms: PHOTON PROTON ION Treatment Beams: PHOTON is not supported PROTON = P ION is not supported > Radiation Mass Number > Radiation Atomic Number > Radiation Charge State (300A,0302) 1C Mass number of radiation. Required if Radiation Type (300A,00C6) is ION (300A,0304) 1C Atomic number of radiation. Required if Radiation Type (300A,00C6) is ION (300A,0306) 1C Charge state of radiation. Required if Radiation Type (300A,00C6) is ION Port Film: PHOTON *** Not Used *** *** Not Used *** *** Not Used *** 266 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

341 > Scan Mode (300A,0308) 1 The method of beam scanning to be used during treatment. Defined Terms: NONE = No beam scanning is performed. UNIFORM = The beam is scanned between control points to create a uniform lateral fluence distribution across the field. MODULATED = The beam is scanned between control points to create a modulated lateral fluence distribution across the field. Technique.TechniqueId) NONE <-- SINGLESCATTERING (upon export) NONE <--> DOUBLESCATTERING UNIFORM <--> UNIFORM_SCANNING MODULATED <--> MODULATED_SCANNING > Treatment Machine Name (300A,00B2) 2 User-defined name identifying treatment machine to be used for beam delivery. See section C Import: Used for lookup only. Value read from database. Value stored in: Machine.MachineId Import: Affects Radiation.ResourceSer if matching treatment machine was found. > Manufacturer (0008,0070) 3 Manufacturer of the equipment to be used for beam delivery. > Institution Name (0008,0080) 3 Institution where the equipment is located that is to be used for beam delivery. > Institution Address (0008,0081) 3 Mailing address of the institution where the equipment is located that is to be used for beam delivery. Import: Used for lookup only. Value read from database. Value stored in: Machine.ManufacturerName Attribute is written, but not supported during import. (Value read from: Hospital.HospitalName) *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

342 > Institutional Department Name > Manufacturer s Model Name > Device Serial Number (0008,1040) 3 Department in the institution where the equipment is located that is to be used for beam delivery. (0008,1090) 3 Manufacturer's model name of the equipment that is to be used for beam delivery. (0018,1000) 3 Manufacturer's serial number of the equipment that is to be used for beam delivery. Attribute is written, but not supported during import. (Value read from: Department.DepartmentId) Import: Used for lookup only. Value read from database. Value stored in: Machine.MachineModel Import: Used for lookup only. Value read from database. Value stored in: Machine.MachineSerialNo > Primary Dosimeter Unit (300A,00B3) 1 Measurement unit of machine dosimeter. Enumerated Values: MU for any external beam MU = Monitor Unit Import: NP = number of particles Must be MU for an external beam, otherwise import is not possible. 268 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

343 > Referenced Tolerance Table Number (300C,00A0) 3 Uniquely identifies Tolerance Table Attribute Name Tag Type Description specified by Tolerance Table Number (300A,0042) within Tolerance Table Sequence in RT Ion Tolerance Tables Module. These tolerances are to be used for verification of treatment machine settings. Import: find item with same Tolerance Table Number within RT Tolerance Tables Module and find tolerance object where Tolerance.Id = Tolerance Table Label. If no such tolerance table is found a warning will be generated. FieldObject.ToleranceSer > Virtual Source- Axis Distances > Ion Beam Limiting Device Sequence (300A,030A) 1 Distance (in mm) from virtual source position to gantry rotation axis or nominal isocenter position (fixed beam-lines) of the equipment to be used for beam delivery. Specified by a numeric pair - the VSAD in the IEC Gantry X direction followed by the VSAD in the IEC Gantry Y direction. The VSAD is commonly used for designing apertures in contrast to the effective source-axis-distance (ESAD) that is commonly used with the inverse square law for calculating the dose decrease with distance. See section C (300A,03A4) 3 Introduces sequence of beam limiting device (collimator) jaw or leaf (element) sets. One or more items may be included in this sequence. Port Film: Value of related beam FieldProton.VirtualSADX, FieldProton.VirtualSADY) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

344 >> RT Beam Limiting Device Type (300A,00B8) 1 Type of beam limiting device (collimator). Import: Enumerated Values: Only one mlc is supported. X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction MLCX, MLCY: Rotation as defined in Administration task. ASYMX/ASYMY is not set if the field is symmetrical, even if the treatment machine supports asymmetrical jaws. >> Isocenter to Beam Limiting Device Distance >> Number of Leaf/Jaw Pairs (300A,00BB) 2 Isocenter to beam limiting device (collimator) distance (in mm) of the equipment that is to be used for beam delivery. See section C (300A,00BC) 1 Number of leaf (element) or jaw pairs (equal to 1 for standard beam limiting device jaws). MLCLevel.SourceToLevelDist) Import: Validated against SourceToLevelDistance. Warning if not matching the machine configuration. Import: Used for lookup only MLC: MLCBank.NumberOfLeaves Collimator: of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

345 >> Leaf Position Boundaries > Referenced Patient Setup Number > Referenced Reference Image Sequence (300A,00BE) 1C Boundaries of beam limiting device (collimator) leaves (in mm) in IEC BEAM LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), i.e. X-axis for MLCY, Y Attribute Name Tag Type Description axis for MLCX. Contains N+1 values, where N is the Number of Leaf/Jaw Pairs (300A,00BC), starting from Leaf (Element) Pair 1. Required if RT Beam Limiting Device Type (300A,00B8) is MLCX or MLCY. See section C (300C,006A) 3 Uniquely identifies Patient Setup to be used for current beam, specified by Patient Setup Number (300A,0182) within Patient Setup Sequence of RT Patient Setup Module. (300C,0042) 3 Introduces sequence of reference images used for validation of current beam. One or more items may be included in this sequence. Roundtrip is supported but internal representation is different from DICOM. (Stored in: MLCLeaf.OffsetX, MLCLeaf.Width) Import: Validated against MLC configuration. Import: Used to identify an item of Patient Setup Sequence Field.FieldNumber This sequence is only supported on export. On import all items will be silently ignored. References the primary reference image if one is defined and all portal dose images having a context to the field. >> Referenced SOP Class UID >> Referenced SOP Instance UID (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. >> Reference Image Number (300A,00C8) 1 Uniquely identifies Reference Image within Referenced Reference Image Sequence (300C,0042). Import: ignored unique number starting from 1 Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

346 > Treatment Delivery Type > Referenced Dose Sequence (300A,00CE) 1 Delivery Type of treatment. Defined Terms: TREATMENT = normal patient treatment OPEN_PORTFILM = portal image acquisition with open field (the source of radiation is specified by Radiation Type (300A,00C6)) TRMT_PORTFILM = portal image acquisition with treatment port (the source of radiation is specified by Radiation Type (300A,00C6)) CONTINUATION = continuation of interrupted treatment SETUP = no treatment beam is applied for this RT Beam. To be used for specifying the gantry, couch, and other machine positions where X-ray set-up images or measurements shall be taken. (300C,0080) 3 Introduces sequence of related SOP Class/Instance pairs describing related instances of RT Dose (for grids, isodose curves, and named/unnamed point doses). One or more items may be included in this sequence. Import: Only TREATMENT, otherwise beam is ignored. TREATMENT Port Film: OPEN_PORTFILM or TRMT_PORTFILM *** Not Used *** *** Not Used *** >> Referenced SOP Class UID >> Referenced SOP Instance UID (0008,1150) 1 Uniquely identifies the referenced SOP Class. (0008,1155) 1 Uniquely identifies the referenced SOP Instance. > Number of Wedges (300A,00D0) 1 Number of wedges associated with current Attribute Name Tag Type Description beam. Beams: Maximum of two wedges supported. Port Film: 0. Wedge Sequence is not used. 272 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

347 > Total Wedge Tray Water-Equivalent Thickness > Ion Wedge Sequence (300A,00D7) 3 Shift of the wedge tray induced on the range of the ion beam as measured in water (in mm). *** Not Used *** (300A,03AA) 1C Introduces sequence of treatment wedges. Required if Number of Wedges (300A,00D0) is non-zero. The number of items shall be identical to the value of Number of Wedges (300A,00D0). >> Wedge Number (300A,00D2) 1 Identification number of the Wedges. The value of Wedge Number (300A,00D2) shall be unique within the Beam in which it was created. >> Wedge Type (300A,00D3) 2 Typer of wedge (if any) defined for Beam. Defined Terms: STANDARD = standard (static) wedge MOTORIZED = single wedge that can be removed from beam remotely. PARTIAL_STANDARD = wedge does not extend across the whole field and is operated manually. PARTIAL_MOTORIZ = wedge does not extend across the whole field and can be removed from beam remotely. >> Wedge ID (300A,00D4) 3 User-supplied identifier for Wedge. >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. >> Wedge Angle (300A,00D5) 2 Nominal wedge angle (degrees). Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

348 >> Wedge Orientation >> Isocenter to Wedge Tray Distance > Number of Compensators > Total Compensator Tray Water-Equivalent Thickness > Ion Range Compensator Sequence >> Compensator Number (300A,00D8) 2 Orientation of wedge, i.e. orientation of IEC WEDGE FILTER coordinate system with respect to the IEC BEAM LIMITING DEVICE coordinate systems (degrees). (300A,00D9) 1 Isocenter to downstream edge of wedge tray (mm). See section C (300A,00E0) 1 Number of compensators associated with current Beam. (300A,02E3) 3 Water-Equivalent thickness of the compensator tray (in mm) parallel to radiation beam axis. (300A,02EA) 1C Introduces sequence of compensators. Required if Number of Compensators (300A,00E0) is non-zero. The number of items shall be identical to the value of Number of Compensators (300A,00E0). Attribute Name Tag Type Description (300A,00E4) 1 Identification number of the Compensator. The value of Compensator Number (300A,00E4) shall be unique within the Beam in which it is created. >> Material ID (300A,00E1) 2 User-supplied identifier for material used to manufacture Compensator. Port Film: 0. Compensator Sequence is not used. Import: Not used Number unique within sequence, starting from 1. AddOnMaterial.AddOnMaterialId) >> Compensator ID (300A,00E5) 3 User-supplied identifier for the compensator. Compensator.CompensatorId) 274 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

349 >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. Import: Written to FieldAddOn.CustomCode Read from FieldAddOn.CustomCode if defined else AddOn.InternalCode. >> Isocenter to Compensator Tray Distance >> Compensator Divergence (300A,02E4) 1C Isocenter to compensator tray attachment edge distance (in mm) for current range compensator. Required if Compensator Mounting Position (300A,02E1) is not DOUBLE_SIDED. See section C (300A,02E0) 1 Indicates presence or absence of geometrical divergence of the range compensator. Enumerated Values: PRESENT = the range compensator is shaped according to the beam geometrical divergence. ABSENT = the range compensator is not shaped according to the beam geometrical divergence. Attribute is processed during export only. The value of ExternalBeam.SAD, Slot.SourceSlotDist, ControlPointProton.SnoutPosition will be used to calculate the contents during export. SAD - (SourceSlotDist - SnoutPosition + MaxCompThickness) Import: Used for lookup only. Value read from database. Value stored in: Compensator.DivergingFlag Mapping of enumarated value is: PRESET <--> true ABSENT <--> false Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

350 >> Compensator Mounting Position (300A,02E1) 1 Indicates on which side of the Compensator Tray the compensator is mounted. Enumerated Values: PATIENT_SIDE = the Compensator is mounted on the side of the Compensator Tray that is towards the patient. SOURCE_SIDE = the Compensator is mounted on the side of the Compensator Tray that is towards the radiation source. DOUBLE_SIDED = the Compensator has a shaped (i.e. non-flat) surface on both sides of the Compensator Tray. Export only: For proton beams: always SOURCE_SIDE >> Compensator Rows >> Compensator Columns (300A,00E7) 1 Number of rows in the range compensator. Matrix.SizeY) (300A,00E8) 1 Number of columns in the range compensator. Matrix.SizeX) >> Compensator Pixel Spacing >> Compensator Position >> Compensator Column Offset (300A,00E9) 1 Physical distance (in mm) between the center of each pixel projected onto machine isocentric plane. Specified by a numeric pair - adjacent row spacing followed by adjacent column spacing. (300A,00EA) 1 The x and y coordinates of the upper left hand corner (first pixel transmitted) of the range compensator, projected onto the Attribute Name Tag Type Description machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm). (300A,02E5) 1C The offset distance (in mm) applied to the x coordinate of the Compensator Position (300A,00EA) for even numbered rows. Required if the compensator pattern is hexogonal. Read from or written to Res in a TransmissionMatrix Position of voxel (0/0/0) of the compensator thickness matrix in object space coordinates. Compensator.ColumnOffset) 276 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

351 >> Compensator Thickness Data >> Isocenter to Compensator Distances >> Compensator Relative Stopping Power Ratio >> Compensator Milling Tool Diameter (300A,00EC) 1 A data stream of the pixel samples that comprise the range compensator, expressed as physical thickness (in mm), either parallel to radiation beam axis if Compensator Divergence (300A,02E0) equals ABSENT, or divergent according to the beam geometrical divergence if Compensator Divergence (300A,02E0) equals PRESENT. The order of pixels sent is left to right, top to bottom (upper left pixel, followed by the remainder of row 1, followed by the remainder of the rows). (300A,02E6) 1C A data stream of the pixel samples that comprise the distance from the isocenter to the compensator surface closest to the radiation source (in mm). The order of pixels sent is left to right, top to bottom (upper left pixel, followed by the remainder of row 1, followed by the remainder of the rows). Required if Material ID (300A,00E1) is non-zero length, and Compensator Mounting Position (300A,02E1) is DOUBLE_SIDED. See sections C and C (300A,02E7) 3 Compensator Linear Stopping Power Ratio, relative to water, at the beam energy specified by the Nominal Beam Energy (300A,0114) of the first Control Point of the Ion Control Point Sequence (300A,03A8). (300A,02E8) 3 The diameter (in mm) of the milling tool to be used to create the compensator. The diameter is expressed as the actual physcial size and not a projected size at isocenter. Written to and read from Transmission Matrix having a context to Compensator. CompensatorProximalEnd data of MetallicCompensator.TransmissionMatrix.Volume Compensator.CompStoppingPowerRatio) Compensator.CompMillingToolDiameter) > Number of Boli (300A,00ED) 1 Number of boli associated with current Beam. Port Film: 0. Bolus Sequence is not used. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

352 > Referenced Bolus Sequence >> Referenced ROI Number (300C,00B0) 1C Introduces sequence of boli associated with Beam. Required if Number of Boli (300A,00ED) is non-zero. The number of items shall be identical to the value of Number of Boli (300A,00ED). (3006,0084) 1 Uniquely identifies ROI representing the Bolus specified by ROI Number Attribute Name Tag Type Description (3006,0022) in Structure Set ROI Sequence (3006,0020) in Structure Set Module within RT Structure Set in Referenced Structure Set Sequence (300C,0060) in RT General Plan Module. >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. Structure.DicomSeqNumber) Bolus is modelled as a structure. > Number of Blocks (300A,00F0) 1 Number of shielding blocks associated with Beam. Port Film: 0. Block Sequence is not used. > Total Block Tray Water-Equivalent Thickness > Ion Block Sequence (300A,00F3) 3 Water-Equivalent thickness of the block tray (in mm) parallel to radiation beam axis. (300A,03A6) 1C Introduces sequence of blocks associated with Beam. Required if Number of Blocks (300A,00F0) is non-zero. The number of items shall be identical to the value of Number of Blocks (300A,00F0). >> Block Tray ID (300A,00F5) 3 User-supplied identifier for block tray. Import: Used for lookup only. Value read from database. Value stored in: AddOn.AddOnId. Internal representation is different from DICOM. AddOnId of the tray to which the block is connected. 278 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

353 >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. Import: Written to FieldAddOn.CustomCode Read from FieldAddOn.CustomCode if defined else AddOn.InternalCode. >> Isocenter to Block Tray Distance (300A,00F7) 1 Isocenter to downstream edge of block tray (mm). Required if Block Sequence (300A,00F4) is sent. See section C Attribute is processed during export only. The value of ExternalBeam.SAD, Slot.SourceSlotDist, ControlPointProton.SnoutPosition will be used to calculate the contents during export. SAD - (SourceSlotDist - SnoutPosition) >> Block Type (300A,00F8) 1 Type of block. See section C Enumerated Values: SHIELDING = blocking material is inside contour APERTURE = blocking material is outside contour Block.BlockType) >> Block Divergence >> Block Mounting Position (300A,00FA) 1 Indicates presence or otherwise of geometrical divergence. Enumerated Values: PRESENT = block edges are shaped for beam divergence ABSENT = block edges are not shaped for beam divergence (300A,00FB) 1 Indicates on which side of the Block Tray the block is mounted. Enumerated Values; PATIENT_SIDE = the block is mounted on the side of the Block Tray that is towards the patient. SOURCE_SIDE = the block is mounted on the side of the Block Tray that is towards the radiation source. Block.DivergingFlag) Mapping of enumarated value is: PRESET <--> true ABSENT <--> false Export only for proton beams: SOURCE_SIDE Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

354 >> Block Number (300A,00FC) 1 Identification number of the Block. The Attribute Name Tag Type Description value of Block Number (300A,00FC) shall be unique within the Beam in which it is created. Block.DicomSeqNumber) If a block consists of multiple structures, the block is brocken up into simpler blocks having just one delemitting line. New block numbers will be generated in such a case. >> Block Name (300A,00FE) 3 User-defined name for block. Block.BlockId) >> Material ID (300A,00E1) 2 User-supplied identifier for material used to manufacture Block. >> Block Thickness (300A,0100) 1 Physical thickness of block (in mm) parallel to radiation beam axis. See section C >> Block Number of Points AddOnMaterial.AddOnMaterialId) Import: The attribute is used to identify the appropriate AddOnMaterial to link to the block. Block.BlockThickness) Import: Warning occurs if imported block thickness does not correspond to AddOnMaterial.Thickness. (300A,0104) 1 Number of (x,y) pairs defining the block edge. Import: number of points is determined by the contenets of the block data itself. Number of points in the contour describing the block. 280 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

355 >> Block Data (300A,0106) 1 A data stream of (x,y) pairs that comprise the block edge. The number of pairs shall be equal to Block Number of Points (300A,0104), and the vertices shall be interpreted as a closed polygon. Coordinates are projected onto the machine isocentric plane in the IEC BEAM LIMITING DEVICE coordinate system (mm). > Snout Sequence (300A,030C) 3 Introduces sequence of Snouts associated with Beam. Only a single item shall be permitted in this sequence. The contour describing the block. Contours are stored in file, which is referenced by Structure.FileName. >> Snout ID (300A,030F) 1 User or machine supplied identifier for Snout. AddOn.AddOnId) >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. > Applicator Sequence (300A,0107) 3 Introduces sequence of Applicators associated with Beam. Only a single item shall be permitted in this sequence. >> Applicator ID (300A,0108) 1 User or machine supplied identifier for Applicator. See section C FieldAddOn.CustomCode) If FieldAddOn.CustomCode is not defined then AddOn.InternalCode is exported. Not used by applications currently. Import: Used for lookup only. Value read from database. Value stored in: AddOn.AddOnId Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

356 >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. >> Applicator Type (300A,0109) 1 Type of applicator. Defined Terms: ION_SQUARE = square ion applicator ION_RECT = rectangluar ion applicator ION_CIRC = circular ion applicator ION_SHORT = short ion applicator ION_OPEN = open (dummy) ion applicator INTEROPERATIVE = interoperative (custom) applicator STEREOTACTIC = stereotactic applicator Attribute Name Tag Type Description Import: Written to FieldAddOn.CustomCode Read from FieldAddOn.CustomCode if defined else AddOn.InternalCode. Attribute is processed during export only. The value of Applicator.RectangularFlag, Applicator.FieldSizeX, Applicator.FieldSizeY will be used to calculate the contents during export. >> Applicator Description > Number of Range Shifters > Range Shifter Sequence (300A,010A) 3 User-defined description for Applicator. Attribute is written, but not supported during import. (Value read from: AddOn.Comment) (300A,0312) 1 Number of range shifters associated with current beam. (300A,0314) 1C Introduces sequence of range shifters associated with Beam. Required if Number of Range Shifters (300A,0312) is non-zero. The number of items shall be identical to the value of Number of Range Shifters (300A,0312). >> Range Shifter Number (300A,0316) 1 Identification number of the Range Shifter. The value of Range Shifter Number (300A,0316) shall be unique within the Beam in which it is created. FieldAddOn.DicomSeqNumber) 282 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

357 >> Range Shifter ID (300A,0318) 1 User or machine supplied identifier for Range Shifter. >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. AddOn.AddOnId) Attribute is written, but not supported during import. (Value read from: FieldAddOn.CustomCode) If FieldAddOnCustomCode is not defined then AddOn.InternalCode is exported. >> Range Shifter Type >> Range Shifter Description > Number of Lateral Spreading Devices > Lateral Spreading Device Sequence (300A,0320) 1 Type of Range Shifter. Defined Terms: ANALOG = Device is variable thickness and is composed of opposing sliding wedges, water column or similar mechanism. BINARY = Device is composed of different thickness materials that can be moved in or out of the beam in various stepped combinations. RangeShifter.RangeShifterType) (300A,0322) 3 User defined description of Range Shifter. Attribute is written, but not supported during import. (Value read from: AddOn.Comment) Cannot be set with applications currently. (300A,0330) 1 Number of lateral spreading devices associated with current beam. (300A,0332) 1C Introduces sequence of lateral spreading devices associated with Beam. Required if Number of Lateral Spreading Devices (300A,0330) is nonzero. The number of items shall be identical to the value of Number of Lateral Spreading Devices (300A,0330). Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

358 >> Lateral Spreading Device Number >> Lateral Spreading Device ID (300A,0334) 1 Identification number of the Lateral Spreading Device. The value of Lateral Spreading Device Number (300A,0334) shall be unique within the Beam in which it is created. (300A,0336) 1 User or machine supplied identifier for Lateral Spreading Device. FieldAddOn.DicomSeqNumber) AddOn.AddOnId) >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. Attribute is written, but not supported during import. (Value read from: FieldAddOn.CustomCode) If FieldAddOnCustomCode is not defined then AddOn.InternalCode is exported. >> Lateral Spreading Device Type >> Lateral Spreading Device Description > Number of Range Modulators > Range Modulator Sequence (300A,0338) 1 Type of Lateral Spreading Device. Attribute Name Tag Type Description Defined Terms: SCATTERER = metal placed into the beam path to scatter charged particles laterally. MAGNET = nozzle configuration of magnet devices to expand beam laterally. (300A,033A) 3 User-defined description for lateral spreading device. (300A,0340) 1 Number of range modulators associated with current beam. (300A,0342) 1C Introduces sequence of range modulators associated with Beam. Required if Number of Range Modulators (300A,0340) is nonzero. The number of items shall be identical to the value of Number of Range Modulators (300A,0340). ProtonLateralSpreader.ProtonLatSpreaderType) Attribute is written, but not supported during import. (Value read from: AddOn.Comment) 284 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

359 >> Range Modulator Number >> Range Modulator ID (300A,0344) 1 Identification number of the Range Modulator. The value of Range Modulator Number (300A,0344) shall be unique within the Beam in which it is created. (300A,0346) 1 User or machine supplied identifier for Range Modulator. FieldAddOn.DicomSeqNumber) AddOn.AddOnId) >> Accessory Code (300A,00F9) 3 An accessory identifier to be read by a device such as a bar code reader. Attribute is written, but not supported during import. (Value read from: FieldAddOn.CustomCode) If FieldAddOnCustomCode is not defined then AddOn.InternalCode is exported. >> Range Modulator Type (300A,0348) 1 Type of Range Modulator. Defined Terms: FIXED = fixed modulation width and weights using ridge filter or constant speed wheel with constant beam current WHL_FIXEDWEIGHTS = selected wheel/track (Range Modulator ID) is spinning at constant speed. Modulation width is adjusted by switching constant beam current on and off at wheel steps indicated by Range Modulator Gating Values. WHL_MODWEIGHTS = selected wheel/track (Range Modulator ID) is spinning at constant speed. Weight per wheel step is adjusted by modulating beam current according to selected Beam Current Modulation ID (300A,034C). Only one item in the Range Modulator Sequence (300A,0342) can have a Range Modulator Type (300A,0348) of WHL_MODWEIGHTS. RangeModulator.RangeModulatorType) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

360 >> Range Modulator Description >> Beam Current Modulation ID > Patient Support Type (300A,034A) 3 User-defined description of Range Modulator. Attribute Name Tag Type Description (300A,034C) 1C User-supplied identifier for the beam current modulation pattern. Required if Range Modulator Type (300A,0348) is WHL_MODWEIGHTS (300A,0350) 1 Defined terms: TABLE = Treatment delivery system table CHAIR = Treatment delivery system chair See section C Attribute is written, but not supported during import. (Value read from: AddOn.Comment) Attribute is written, but not supported during import. (Value read from: FieldProton.BeamCurrModulationId) PatientSupportDevice.PatSupportType) > Patient Support ID (300A,0352) 3 User-specified identifier for manufacturer specific patient support devices. PatientSupportDevice.PatSupportId) > Patient Support Accessory Code > Fixation Light Azimuthal Angle > Fixation Light Polar Angle > Final Cumulative Meterset Weight (300A,0354) 3 A Patient Support accessory identifier to be read by a device such as a bar code reader. (300A,0356) 3 Azimuthal angle (degrees) of the fixation light coordinate around IEC BEAM LIMITING DEVICE Y-axis. Used for eye treatments. See section C (300A,0358) 3 Polar angle (degrees) of the fixation light coordinate. Used for eye treatments. See section C (300A,010E) 1C Value of Cumulative Meterset Weight (300A,0134) for final Control Point in Ion Control Point Sequence (300A,03A8). Required if Cumulative Meterset Weight is nonnull in Control Points specified within Ion Control Point Sequence. See section C PatientSupportDevice.PatSupportAccessoryCode) *** Not Used *** *** Not Used *** Import: Used to calculate Field.WedgeDose if a motorized wedge is present. MetersetWeight from last control point of field 286 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

361 > Number of Control Points > RT Motion Synchronization Sequence >> Respiratory Motion Compensation Technique (300A,0110) 1 Number of control points in Beam. Value shall be greater than or equal to 2. (3277,1000) 3 Introduces sequence of Motion Synchronization. One or more items may be included in this sequence. (0018,9170) 1 Technique applied to reduce respiratory motion artifacts. Port Film: 2 Only first item of sequence is imported Field.MotionCompTechnique) *** Not Implemented *** >> Respiratory Signal Source (0018,9171) 1 Signal source from which respiratory motion is derived. Field.MotionCompSource) > Ion Control Point Sequence >> Control Point Index >> Cumulative Meterset Weight >> Referenced Dose Reference Sequence (300A,03A8) 1 Introduces sequence of machine configurations describing Ion treatment beam. The number of items shall be identical to the value of Number of Control Points (300A,0110). (300A,0112) 1 Index of current Control Point, starting at 0 for first Control Point. (300A,0134) 2 Cumulative weight to current control point. Cumulative Meterset Weight for the first item in Control Point Sequence shall always be zero. Cumulative Meterset Weight for the final item in Ion Control Point Sequence shall always be equal to Final Cumulative Meterset Weight. (300C,0050) 3 Introduces a sequence of Dose References for current Beam. One or more items may be included in this sequence. Roundtrip supported. ControlPoint.MetersetWeight) Port Film: First control point: 0 Last control point: 100 Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

362 >>> Referenced Dose Reference Number >>> Cumulative Dose Reference Coefficient >> Nominal Beam Energy (300C,0051) 1 Uniquely identifies Dose Reference specified by Dose Reference Number (300A,0012) in Dose Reference Sequence (300A,0010) in RT Prescription Module. (300A,010C) 2 Coefficient used to calculate cumulative dose contribution from this Beam to the referenced Dose Reference at the current Control Point. (300A,0114) 1C Nominal Beam Energy at control point in MeV per nucleon. Defined at nozzle entrance before all Beam Modifiers. Attribute Name Tag Type Description Required for first item of Control Point Sequence, or if Nominal Beam Energy changes during Beam, and KVp (0018,0060) is not present. DoseContribution.DicomSeqNumber) Import: Value of last control point is written to FieldRefPoint.FieldDose. Calculated by following formula: (FieldRefPoint.FieldDose / field dose) * (cumulative meterset weight / final cumulative meterset) EnergyMode.Energy) Import: Data is used to match against appropriate machine setting. >> KVP (0018,0060) 1C Peak kilo voltage output of the setup X-Ray generator to be used. Required for first item of Control Point Sequence, or if KVp changes during setup, and Nominal Beam Energy (300A,0114) is not present. >> Meterset Rate (300A,035A) 3 Specifies the speed of delivery of the specified dose in units specified by Primary Dosimeter Unit (300A,00B3) per minute. Port Film: SequenceImage.DevEnergy if defined, else if related beam is a photon beam then value of related beam else default energy of ExternalBeam. Field.DoseRate) 288 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

363 >> Ion Wedge Position Sequence >>> Referenced Wedge Number (300A,03AC) 1C Introduces sequence of Wedge positions for current control point. Required for first item of Ion Control Point Sequence if Number of Wedges (300A,00D0) is non-zero, and in subsequent control points if Wedge Position (300A,0118) or Wedge Thin Edge Position (300A,00DB) changes during beam. The number of items shall be identical to the value of Number of Wedges (300A,00D0). (300C,00C0) 1 Uniquely references Wedge described by Wedge Number (300A,00D2) in Wedge Sequence (300A,00D1). >>> Wedge Position (300A,0118) 1 Position of Wedge at current Control Point. Enumerated Values: IN OUT >>> Wedge Thin Edge Position >> Range Shifter Settings Sequence (300A,00DB) 1C Closest distance from the central axis of the beam along a wedge axis to the thin edge as projected to the machine isocentric plane (mm). Value is positive is the wedge does not cover the central axis, negative if it does. Required if Wedge Type (300A,00D3) of the wedge referenced by Referenced Wedge Number (300C,00C0) is PARTIAL_STANDARD or PARTIAL_MOTORIZ. See section C (300A,0360) 1C Introduces sequence of Range Shifter settings for the current control point. One or more items shall be included in this sequence. Required for first item of Control Point Sequence if Number of Range Shifters (300A,0312) is non-zero, or if Range Shifter Setting (300A,0362) Attribute Name Tag Type Description changes during Beam. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

364 >>> Referenced Range Shifter Number >>> Range Shifter Setting >>> Isocenter to Range Shifter Distance >>> Range Shifter Water Equivalent Thickness >> Lateral Spreading Device Settings Sequence (300C,0100) 1 Uniquely references Range Shifter described by Range Shifter Number (300A,0316) in Range Shifter Sequence (300A,0314). (300A,0362) 1 Machine specific setting attribute for the range shifter. The specific encoding of this value should be documented in a Conformance Statement. See section C (300A,0364) 3 Isocenter to downstream edge of range shifter (mm) at current control point. See section C (300A,0366) 3 Water equivalent thickness (in mm) of the range shifter at the central axis for the beam energy incident upon the device. (300A,0370) 1C Introduces sequence of Lateral Spreading Device settings for the current control point. One or more items shall be included in this sequence. Required for first item of Control Point Sequence if Number of Lateral Spreading Devices (300A,0330) is nonzero, or if Lateral Spreading Device Setting (300A,0372) changes during Beam. Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeShifter1DcmSeqNumb, ControlPointProton.RangeShifter2DcmSeqNumb, ControlPointProton.RangeShifter3DcmSeqNumb) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeShifter1Setting, ControlPointProton.RangeShifter2Setting, ControlPointProton.RangeShifter3Setting) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.IsoToRangeShifter1Dist, ControlPointProton.IsoToRangeShifter2Dist, ControlPointProton.IsoToRangeShifter3Dist) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeShifter1WeT, ControlPointProton.RangeShifter2WeT, ControlPointProton.RangeShifter3WeT) 290 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

365 >>> Referenced Lateral Spreading Device Number >>> Lateral Spreading Device Setting >>> Isocenter to Lateral Spreading Device Distance >>> Lateral Spreading Device Water Equivalent Thickness >> Range Modulator Settings Sequence (300C,0102) 1 Uniquely references Lateral Spreading Device described by Lateral Spreading Device Number (300A,0334) in Lateral Spreading Device Sequence (300A,0332). (300A,0372) 1 Machine specific setting attribute for the lateral spreading device. The specific encoding of this value should be documented in a Conformance Statement. See section C (300A,0374) 3 Isocenter to downstream edge of Lateral Spreading Device (mm) at current control point. See section C (300A,033C) 3 Water equivalent thickness (in mm) of the lateral spreading device at the central axis for the beam energy incident upon the device. (300A,0380) 1C Introduces sequence of Range Modulator Settings for current control point. One or more items shall be included in this sequence. Required for first item of Control Point Sequence if Number of Range Modulators (300A,0340) is non-zero, or if Range Modulator Setting changes during Beam. Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.LatSpreadDev1DcmSeqNumb, ControlPointProton.LatSpreadDev2DcmSeqNumb, ControlPointProton.LatSpreadDev3DcmSeqNumb) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.LateralSpreadDev1Setting, ControlPointProton.LateralSpreadDev2Setting, ControlPointProton.LateralSpreadDev3Setting) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.IsoToLatSpreadDev1Dist, ControlPointProton.IsoToLatSpreadDev2Dist, ControlPointProton.IsoToLatSpreadDev3Dist) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.LateralSpreadDev1WeT, ControlPointProton.LateralSpreadDev2WeT, ControlPointProton.LateralSpreadDev3WeT) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

366 >>> Referenced Range Modulator Number >>> Range Modulator Gating Start Value >>> Range Modulator Gating Stop Value >>> Range Modulator Gating Start Water Equivalent (300C,0104) 1 Uniquely references Range Modulator Attribute Name Tag Type Description Number described by Range Modulator Number (300A,0344) in Range Modulator Sequence (300A,0342). (300A,0382) 1C Start position defines the range modulator position at which the beam is switched on. Required if Range Modulator Type (300A,0348) of the range modulator referenced by Referenced Range Modulator Number (300C,0104) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS (300A,0384) 1C Stop position defines the range modulator position at which the beam is switched off. Required if Range Modulator Type (300A,0348) of the range modulator referenced by Referenced Range Modulator Number (300C,0104) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS (300A,0386) 3 If Range Modulator Type (300A,0348) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS: Water equivalent thickness (in mm) of the range modulator at the position specified by Range Modulator Gating Start Value (300A,0382). If Range Modulator Type (300A,0348) is FIXED: Minimum water equivalent thickness (in mm) of the range modulator. Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeMod1DicomSeqNumb, ControlPointProton.RangeMod2DicomSeqNumb) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeMod1InterruptStart, ControlPointProton.RangeMod2InterruptStart) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeMod1InterruptStop, ControlPointProton.RangeMod2InterruptStop) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeMod1WeTStart, ControlPointProton.RangeMod2WeTStart) 292 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

367 >>> Range Modulator Gating Stop Water Equivalent >>> Isocenter to Range Modulator Distance >> Beam Limiting Device Position Sequence >>> RT Beam Limiting Device Type >>> Leaf/Jaw Positions (300A,0388) 3 If Range Modulator Type (300A,0348) is WHL_MODWEIGHTS or WHL_FIXEDWEIGHTS: Water equivalent thickness (in mm) of the range modulator at the position specified by Range Modulator Gating Stop Value (300A,0384). If Range Modulator Type (300A,0348) is FIXED: Maximum water equivalent thickness (in mm) of the range modulator. (300A,038A) 3 Isocenter to downstream edge of range modulator (mm) at current control point. See section C (300A,011A) 1C Introduces sequence of beam limiting Sequence device (collimator) jaw or leaf (element) positions. Required if Ion Beam Limiting Device Sequence (300A,03A4) is included and for first item of Control Point Sequence, or if Beam Limiting Device changes during Beam. One or more items shall be included in this sequence. (300A,00B8) 1 Type of beam limiting device (collimator). The value of this attribute shall correspond to RT Beam Limiting Device Type (300A,00B8) defined in an item of Ion Beam Limiting Device Sequence (300A,03A4). Enumerated Values: X = symmetric jaw pair in IEC X direction Y = symmetric jaw pair in IEC Y direction ASYMX = asymmetric jaw pair in IEC X direction ASYMY = asymmetric pair in IEC Y direction MLCX = multileaf (multi-element) jaw pair in IEC X direction MLCY = multileaf (multi-element) jaw pair in IEC Y direction. (300A,011C) 1 Positions of beam limiting device (collimator) leaf (element) or jaw pairs (in mm) in IEC BEAM Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.RangeMod1WeTStop, ControlPointProton.RangeMod1WeTStop) Roundtrip is supported but internal representation is different from DICOM. (Stored in: ControlPointProton.IsocenterToRangeMod1Dist, ControlPointProton.IsocenterToRangeMod2Dist) Collimator: Type X / Y or ASYMX / ASYMY depending on value of Field.CollMode MLC: MLCX if MLC.Rotation = 0 MLCY if MLC.Rotation = 90 Roundtrip is supported but internal representation is Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

368 LIMITING DEVICE coordinate axis appropriate to RT Beam Limiting Device Type (300A,00B8), e.g. X-axis for MLCX, Y-axis for MLCY. Contains 2N values, where N is the Number of Leaf/Jaw Pairs (300A,00BC) in Ion Beam Limiting Device Sequence (300A,03A4). Values shall be listed in IEC leaf (element) subscript order 101, 102,... 1N, 201, 202,... 2N. See section C different from DICOM. (Stored in: ControlPoint.CollX1, ControlPoint.CollX2, ControlPoint.CollY1, ControlPoint.CollY2, Field.CollX1, Field.CollX2, Field.CollY1, Field.CollY2, ControlPoint Collimator: If VFC ControlPoint objects are available (depending on treatment technique) then use ControlPoint. Otherwise use Field IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. MLC: ControlPoint.PlanPosition1A/B to PlanPosition60A/B Port Film: MLC (only if SequenceImage.DevGeometry = 0 (planned field positions)): If MLC does not change or it is a Before Image of an Arc field: MLC positions of first control point. If it is an After Image of an Arc field: MLC positions of last control point. All other cases: CIAO positions Collimator (depends on value of SequenceImage.DevGeometry): 0: Coll of related field. 1: SequenceImage.DevColl<..> 294 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

369 2: SequenceImage.JawState3: ExternalBeam.OpenColl<..> >> Gantry Angle (300A,011E) 1C Gantry angle of radiation source, i.e. orientation of IEC GANTRY coordinate system with respect to IEC FIXED REFERENCE coordinate system Attribute Name Tag Type Description (degrees). Required for first item of Control Point Sequence, or if Gantry Angle changes during Beam. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Field.GantryRtn, ControlPoint.GantryRtn, Field.Technique, Field.StopAngle) Value from Field or ControlPoint depending on technique. In case of last control point of an Arc field Field.StopAngle IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. >> Gantry Rotation Direction (300A,011F) 1C Direction of Gantry Rotation when viewing gantry from isocenter, for segment following Control Point. Required for first item of Control Point Sequence, or if Gantry Rotation Direction changes during Beam. See section C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation Port Film: If it is an After Image of an Arc treatment: value of last control point of related beam. Else: value of first control point of related beam. Field.GantryRtnDirection) Value must not change between control points. Port Film: NONE Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

370 >> Source Off-Plane Angle >> Source Off-Plane Rotation Direction >> Beam Limiting Device Angle (300A,014A) 2C Gantry Pitch Angle of the radiation source, i.e. the rotation of the IEC GANTRY coordinate system about the X-axis of the IEC GANTRY coordinate system (degrees). Required for first item of Control Point Sequence, or if Gantry Pitch Rotation Angle changes during Beam. See C (300A,014C) 2C Direction of Gantry Pitch Angle when viewing along the positive X-axis of the IEC GANTRY coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Gantry Pitch Rotation Direction changes during Beam. See C and C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation (300A,0120) 1C Beam Limiting Device angle, i.e. orientation of IEC BEAM LIMITING DEVICE coordinate system with respect to IEC GANTRY coordinate system (degrees). Required for first item of Control Point Sequence, or if Beam Limiting Device Angle changes during Beam. *** Not Used *** *** Not Used *** Field.CollRtn) IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. 296 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

371 >> Beam Limiting Device Rotation Direction >> Scan Spot Tune ID >> Number of Scan Spot Positions >> Scan Spot Position Map (300A,0121) 1C Direction of Beam Limiting Device Rotation when viewing beam limiting device (collimator) from radiation source, for segment following Control Point. Required for first item of Control Point Sequence, or if Beam Limiting Device Rotation Direction changes during Beam. See section C Attribute Name Tag Type Description Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation (300A,0390) 1C User-supplied or machine code identifier for machine configuration to produce beam spot. This may be the nominal spot size or some other machine specific value. Required if Scan Mode (300A,0308) is MODULATED. (300A,0392) 1C Number of spot positions used to specify scanning pattern for current segment beginning at control point. Required if Scan Mode (300A,0308) is MODULATED. (300A,0394) 1C The x and y coordinates of the scan spots are defined as projected onto the machine isocentric plane in the IEC GANTRY coordinate system (mm). Required if Scan Mode (300A,0308) is MODULATED. Contains 2N values where N is the Number of Scan Spot Positions (300A,0392). Export only: NONE Value must not change between control points. AddOn.AddOnId) Of AddOn referenced by ControlPointProton.SpotAddOnSer Scanning is not yet supported by applications. ControlPointProton.NumberOfSpots) Scanning is not yet supported by applications. Contents of file referenced by ControlPointProton.SpotPositionListFile Scanning is not yet supported by applications. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

372 >> Scan Spot Meterset Weights >> Scanning Spot Size >> Number of Paintings >> Patient Support Angle (300A,0396) 1C A data set of meterset weights corresponding to scan spot positions. The order of weights matches the positions in Scan Spot Positions (300A,0394). The sum contained in all meterset weights shall match the difference of the cumulative meterset weight of the current control point to the following control point. Required if Scan Mode (300A,0308) is MODULATED. (300A,0398) 3 The Scanning Spot Size as calculated using the Full Width Half Maximum (FWHM). Specified by a numeric pair - the size measured in air at isocenter in IEC GANTRY X direction followed by the size in the IEC GANTRY Y direction (mm). (300A,039A) 1C The number of times the scan pattern given by Scan Spot Position Map (300A,0394) and Scan Spot Meterset Weights (300A,0396) shall be applied at the current control point. To obtain the meterset weight per painting, the values in the Scan Spot Meterset Weights (300A,0396) should be divided by the value of this attribute. Required if Scan Mode (300A,0308) is MODULATED. (300A,0122) 1C Patient Support angle, i.e. orientation of IEC PATIENT SUPPORT (turntable) coordinate system with respect to IEC FIXED REFERENCE coordinate system Attribute Name Tag Type Description (degrees). Required for first item of Control Point Sequence, or if Patient Support Angle changes during Beam. Contents of file referenced by ControlPointProton.SpotWeightListFile Scanning is not yet supported by applications. ControlPointProton.SpotSizeX, ControlPointProton.SpotSizeY) ControlPointProton.NumberOfPaintings) Scanning is not yet supported by applications. Field.PatientSupportAngle) Value must not change between control points. 298 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

373 >> Patient Support Rotation Direction >> Patient Support Pitch Angle >> Patient Support Pitching Direction (300A,0123) 1C Direction of Patient Support Rotation when viewing table from above, for segment following Control Point. Required for first item of Control Point Sequence, or if Patient Support Rotation Direction changes during Beam. See section C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation (300A,0140) 2C Table Top Pitch Angle, i.e. the rotation of the IEC TABLE TOP coordinate system about the X-axis of the IEC TABLE TOP coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Pitch Angle changes during Beam. See section C (300A,0142) 2C Direction of Table Top Pitch Rotation when viewing the table along the positive X-axis of the IEC TABLE TOP coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Pitch Rotation Direction changes during Beam. See C and C Enumerated Values: CW = clockwise CC = counter-clockwise NONE = no rotation Export only: NONE Value must not change between control points. IT Daemon If values are not defined then "IT undefined value" ( ) will be sent. Port Film: Value of first control point of related beam Field.TableTopPitchAngle) Value must not change between control points Export only: NONE Import: check for expected value NONE Value must not change between control points. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

374 >> Patient Support Roll Angle >> Patient Support Rolling Direction >> Head Fixation Angle >> Table Top Vertical Position (300A,0144) 2C Table Top Roll Angle, i.e. the rotation of the IEC TABLE TOP coordinate system about the Y-axis of the IEC TABLE TOP coordinate system (degrees). Required for first item of Control Point Sequence, or if Table Top Roll Angle changes during Beam. See section C (300A,0146) 2C Direction of Table Top Roll Rotation when viewing the table along the positive Y-axis of the IEC TABLE TOP coordinate system, for segment following Control Point. Required for first item of Control Point Sequence, or if Table Top Roll Rotation Direction changes during Beam. See C and C Enumerated Values: Attribute Name Tag Type Description CW = clockwise CC = counter-clockwise NONE = no rotation. (300A,0148) 3 Angle (in degrees) of the head fixation for eye treatments with respect to the Table Top Pitch Angle (300A,0140) coordinate system. Positive head fixation angle is the same direction as positive Table Top pitch. See section C (300A,0128) 2C Table Top Vertical position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Vertical Position changes during Beam. See section C Field.TableTopRollAngle) Value must not change between control points Export only: NONE Import: check for expected value NONE Value must not change between control points. *** Not Used *** Read from or written to HeadFixationAngle in a Proton Field Field.CouchVrt) Value must not change between control points. 300 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

375 >> Table Top Longitudinal Position >> Table Top Lateral Position (300A,0129) 2C Table Top Longitudinal position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Longitudinal Position changes during Beam. See section C (300A,012A) 2C Table Top Lateral position in IEC TABLE TOP coordinate system (mm). Required for first item of Control Point Sequence, or if Table Top Lateral Position changes during Beam. See section C Field.CouchLng) Value must not change between control points. Field.CouchLat) Value must not change between control points. >> Snout Position (300A,030D) 2C Axial position of the snout (in mm) measured from isocenter to the downstream side of the snout (without consideration of variable length elements such as blocks, MLC and/or compensators). Required for first item in Control Point Sequence, or if Snout Position changes during Beam. ControlPointProton.SnoutPosition) >> Isocenter Position >> Surface Entry Point > Maximum Collimated Field Diameter (Field Size) (300A,012C) 2C Isocenter coordinates (x,y,z) in the patient based coordinate system described in C (mm). Required for first item of Segment Control Point Sequence, or if Segment Isocenter Position changes during Beam. (300A,012E) 3 Patient surface entry point coordinates (x,y,z), along the central axis of the beam, in the patient based coordinate system described in C (mm). (300B,1002) 3 Maximum diameter [cm] of a circle centered around the beam axis, which contains collimated field. Calculated by TPS and used for machine setting calculation and clinical verification in TCS. Field.IsoCenterPositionX, Field.IsoCenterPositionY, Field.IsoCenterPositionZ) This is the Isocenter position in relation to the 3D image of the PlanSetup Value must not change between control points. *** Not Used *** Export only: The minimum of field size and the smallest aperture block outline coordinate. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

376 > Range (Planned Distal Target Distance) > Nominal SOBP Width (300B,1004) 3 FieldProton.DistalEndEnergy) (300B,100E) 3 FieldProton.SOBPWidth) C.2.38 PET Series C Series Date (0008,0021) 1 Date the Series started. See C for specialization. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Series.CreationDate) Date and Time are both stored in the same datetime attribute internally. Series Time (0008,0031) 1 Time the Series started. See C for specialization. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Series.CreationDate) Date and Time are both stored in the same datetime attribute internally. Units (0054,1001) 1 Pixel value units. See C for explanation. Import: Defined terms: CNTS, NONE, CM2, PCNT, CPS, BQML, MGMINML, UMOLMINML, MLMING, MLG, 1CM, UMOLML, PROPCNTS, PROPCPS, MLMINML, MLML, GML, STDDEV Attribute is read, but cannot be exported. (Stored as-is in: Image.WindowingModel) 302 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

377 Counts Source (0054,1002) 1 The primary source of counts. The primary source leads to the underlying image Units (0054,1001), as opposed to secondary sources which are used during reconstruction correction. Enumerated Values: EMISSION TRANSMISSION Series Type (0054,1000) 1 A multi-valued indicator of the type of Series. See C for explanation. Value 1 Enumerated Values: STATIC DYNAMIC GATED WHOLE BODY Value 2 Enumerated Values: IMAGE REPROJECTION *** Not Used *** *** Not Used *** Reprojection Method Number of R-R Intervals Number of Time Slots (0054,1004) 2C Method for projecting volumetric data onto planar projection. Required if Series Type (0054,1000), Value 2 is REPROJECTION. Defined terms: SUM MAX PIXEL (0054,0061) 1C The maximum number of R-R Intervals that may exist in this Series. Required if Series Type (0054,1000), Value 1 is GATED. (0054,0071) 1C The maximum number of Time Slots that may exist in this Series. Required if Series Type (0054,1000), Value 1 is GATED. *** Not Used *** *** Not Used *** *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

378 Number of Time Slices (0054,0101) 1C The maximum number of Time Slices that may exist in this Series. Required if Series Type (0054,1000), Value 1 is DYNAMIC. *** Not Used *** Number of Slices (0054,0081) 1 The maximum number of Slices that may exist in this Series. *** Not Used *** Corrected Image (0028,0051) 2 A value that indicates which, if any, corrections have been applied to the images in this series. Defined terms: DECY = decay corrected ATTN = attenuation corrected SCAT = scatter corrected DTIM = dead time corrected MOTN = gantry motion corrected (e.g. wobble, clamshell) PMOT = patient motion corrected CLN = count loss normalization (correction for count loss in gated Time Slots). RAN = randoms corrected RADL = non-uniform radial sampling corrected DCAL = sensitivity calibrated using dose calibrator NORM = detector normalization Randoms Correction Method *** Not Used *** (0054,1100) 3 Type of randoms correction processing. Defined terms: NONE = no randoms correction DLYD = delayed event subtraction SING = singles estimation 304 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

379 Attenuation Correction Method Scatter Correction Method (0054,1101) 3 A textual description of the attenuation correction processing. e.g. measured vs. calculated, transmission source type (ring, line, point), assumed patient geometry (polygon, ellipse, segmented, attenuation coefficient, skull thickness), postinjection transmission, smoothing. (0054,1105) 3 A textual description of the scatter correction processing. e.g. convolution- subtraction, dual energy window, model- based, use of attenuation data. Decay Correction (0054,1102) 1 The real-world event to which images in this Series were decay corrected. See C for explanation. Defined terms: NONE = no decay correction START = acquisition start time ADMIN = radiopharmaceutical administration time *** Not Used *** Reconstruction Diameter (0018,1100) 3 Diameter, in mm, of the region within which the data was used in creating the reconstruction of the image. Data may exist outside this region and portions of the patient may exist outside this region. Convolution Kernel (0018,1210) 3 Textual description of the convolution kernel(s) used to reconstruct the data (e.g. name, cutoff, radial/axial/angular, mathematical form, DC handling) Reconstruction Method Detector Lines of Response Used (0054,1103) 3 Textual description of reconstruction processing, e.g. 2D filtered backprojection, 2D iterative, 3D PROMIS, 3D FAVOR, 3D iterative. (0054,1104) 3 Textual description of which detector lines of response were used, mashed, or otherwise processed during tomographic reconstruction. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

380 Acquisition Start Condition Acquisition Start Condition Data (0018,0073) 3 Description of how the data collection was started. Defined terms: DENS = density (counts/sec) RDD = relative density difference (change in counts/sec) MANU = manual TIME = time AUTO = automatic, when ready TRIG = physiological trigger See C for explanation. (0018,0074) 3 Count density, change in count density, or physiological triggers causing data collection to start. Acquisition Termination Condition Acquisition Termination Condition Data (0018,0071) 3 Description of how the data collection for the series was stopped. Defined terms: CNTS = counts DENS = density (counts/sec) RDD = relative density difference (change in counts/sec) MANU = manual OVFL = data overflow TIME = time TRIG = physiological trigger See C for explanation. (0018,0075) 3 Number of counts, count density, change in count density, or physiological triggers causing the termination. 306 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

381 Field of View Shape (0018,1147) 3 Shape of the field of view of the PET camera. Defined Terms: CYLINDRICAL RING HEXAGONAL MULTIPLE PLANAR Field of View Dimension(s) (0018,1149) 3 Dimensions of the field of view, in mm. Transverse detector diameter followed by axial width. Gantry/Detector Tilt (0018,1120) 3 Angle of tilt in degrees of the gantry. See C for explanation. Gantry/Detector Slew Type of Detector Motion (0018,1121) 3 Angle of slew in degrees of the gantry. Positive slew is moving the gantry on the patient's left toward the patient's superior, when the patient is supine. (0054,0202) 3 Describes the detector motion during acquisition. Defined Terms: NONE = stationary gantry STEP AND SHOOT = Interrupted motion, acquire only while stationary CONTINUOUS = Gantry motion and acquisition are simultaneous and continuous WOBBLE = wobble motion CLAMSHELL = clamshell motion Collimator Type (0018,1181) 2 Collimator Type. Defined Terms: NONE = no collimator RING = transverse septa Collimator/Grid Name (0018,1180) 3 Label describing the collimator used. Axial Acceptance (0054,1200) 3 Maximum axial angle accepted, in degrees. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

382 Axial Mash (0054,1201) 3 Number of adjacent axial lines of response mashed together. See C for explanation. Transverse Mash (0054,1202) 3 Number of adjacent transverse lines of response mashed together. See C for explanation. Detector Element Size Coincidence Window Width Energy Window Range Sequence (0054,1203) 3 Size of an individual detector element, in mm. Transverse dimension followed by axial dimension. For a discrete crystal, this is the crystal size. For a continuous detector, this is the pixel bin size. (0054,1210) 3 The width of the coincidence timing window, in nsec. The maximum time difference accepted between two single events. (0054,0013) 3 Sequence of Repeating Items that describes the energy windows used for this Series. This sequence may contain zero or more items. See C for explanation. > Energy Window Lower Limit > Energy Window Upper Limit (0054,0014) 3 The lower limit of the energy window, in KeV. (0054,0015) 3 The upper limit of the energy window, in KeV. Secondary Counts Type (0054,1220) 3 Array defining the type of additional counts accumulated during acquisition. Defined terms: DLYD = delayed events SCAT = scattered events in secondary window SING = singles DTIM = events lost due to deadtime 308 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

383 C.2.39 PET Image C Image Type (0008,0008) 1 Image identification characteristics. See C for specialization. Slice.SliceCharacteristics) Content depends on image modality if Slice.SliceCharacteristics is not defined. Portal Dose: Tag value for acquired portal dose: ORIGINAL\PRIMARY\PORTAL\ACQUIRE D_DOSE Tag value for calculated portal dose: DERIVED\SECONDARY\PORTAL\CALC ULATED_DOSE Samples per Pixel (0028,0002) 1 Number of samples (planes) in this image. This value shall be 1. On export, content of this tag may be generated depending on image type. Import: For Portal Dose and RT Dose warning, if value is not 1 1 Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

384 Photometric Interpretation (0028,0004) 1 Specifies the intended interpretation of the pixel data. See C for specialization. Slice.PhotometricInterpretation) Import: Warning if value is not MONOCHROME2. Pixel data is always imported as if it were MONOCHROME2. MONOCHROME2 Bits Allocated (0028,0100) 1 Number of bits allocated for each pixel sample. Each sample shall have the same number of bits allocated. Enumerated values: 16. Bits Stored (0028,0101) 1 Number of bits stored for each pixel sample. Each sample shall have the same number of bits stored. The value shall be the same as the value in Bits Allocated (0028,0100). High Bit (0028,0102) 1 Most significant bit for pixel sample data. Each sample shall have the same high bit. Shall be one less than the value in Bits Stored (0028,0101). Slice.BitsAllocated) Portal Dose: 16 RT Dose: 32 Other: variable Slice.BitsStored) The same value as Bits Allocated if undefined. Slice.HighBit) Bits Allocated - 1 if undefined. 310 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

385 Rescale Intercept (0028,1052) 1 The value b in relationship between stored values (SV) and pixel value units (U) defined in Units (0054,1001): U = m*sv+b. The Rescale Intercept is always zero for PET images. Import: Attribute is read, but cannot be exported. (Stored as-is in: Slice.PixelOffset) Value must be 0, otherwise import will be rejected. Rescale Slope (0028,1053) 1 m in the equation specified in Rescale Intercept (0028,1052). Import: Attribute is read, but cannot be exported. (Stored as-is in: Slice.PixelSlope) Frame Reference Time (0054,1300) 1 The time that the pixel values in the image occurred. Frame Reference Time is the offset, in msec, from the Series reference time. See explanation in C Trigger Time (0018,1060) 1C Time interval, in msec, from the start of the trigger to the beginning of data acquisition for this image. Required if Series Type (0054,1000), Value 1 is GATED. Frame Time (0018,1063) 1C Nominal duration per individual frame, in msec. Required if Series Type (0054,1000), Value 1 is GATED. See C for explanation. Low R-R Value (0018,1081) 1C R-R interval lower limit for beat rejection, in msec. Required if Series Type (0054,1000), Value 1 is GATED and Beat Rejection Flag (0018,1080) is Y. High R-R Value (0018,1082) 1C R-R interval upper limit for beat rejection, in msec. Required if Series Type (0054,1000), Value 1 is GATED and Beat Rejection Flag (0018,1080) is Y. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

386 Lossy Image Compression (0028,2110) 1C Specifies whether an Image has undergone lossy compression. Enumerated values: 00 = Image has NOT been subjected to lossy compression. 01 = Image has been subjected to lossy compression. See C Required if Lossy Compression has been performed on the image. Image Index (0054,1330) 1 An index identifying the position of this image within a PET Series. See C for explanation. Acquisition Date (0008,0022) 2 The date the acquisition of data that resulted in this image started. See C for specialization. Acquisition Time (0008,0032) 2 The time the acquisition of data that resulted in this image started. See C for specialization. Actual Frame Duration (0018,1242) 2 Elapsed time of the data acquisition for this image, in msec. See C for explanation. Nominal Interval (0018,1062) 3 Average duration of accepted beats, in msec, of the R-R interval. Intervals Acquired (0018,1083) 3 Number of heartbeats that fall within Low R-R Value (0018,1081) and High R-R Value (0018,1082), and were therefore accepted and contribute coincidence events to this R-R Interval. Intervals Rejected (0018,1084) 3 Number of heartbeats that fall outside Low R-R Value (0018,1081) and High R-R Value (0018,1082), and do not contribute coincidence events to this R-R Interval. However, they may contribute coincidence events to other R-R Intervals. 312 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

387 Primary (Prompts) Counts Accumulated Secondary Counts Accumulated Slice Sensitivity Factor (0054,1310) 3 The sum of events that occur in the primary event channel. The counts include Trues +Scatter+ Randoms if Randoms Correction Method (0054,1100) is NONE; otherwise the counts are Trues +Scatter. (0054,1311) 3 Sum of counts accumulated in secondary channels. See C for explanation. (0054,1320) 3 The slice-to-slice sensitivity correction factor that was used to correct this image. The value shall be one if no slice sensitivity correction was applied. Decay Factor (0054,1321) 1C The decay factor that was used to scale this image. Required if Decay Correction (0054,1102) is other than NONE. If decay correction is applied, all images in the Series shall be decay corrected to the same time. Dose Calibration Factor Scatter Fraction Factor (0054,1322) 3 Factor that was used to scale this image from counts/sec to Bq/ml using a dose calibrator. The value shall be one if no dose calibration was applied. See C for explanation. (0054,1323) 3 An estimate of the fraction of acquired counts that were due to scatter and were corrected in this image. The value shall be zero if no scatter correction was applied. Dead Time Factor (0054,1324) 3 The average dead time correction factor that was applied to this image. The value shall be one if no dead time correction was applied. Anatomic Region Sequence (0008,2218) 3 Sequence that identifies the anatomic region of interest in this Instance (i.e. external anatomy, surface anatomy, or general region of the body). Only a single Item shall be permitted in this sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

388 > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Anatomic Region Modifier Sequence (0008,2220) 3 Sequence of Items that modifies the anatomic region of interest of this Instance One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Primary Anatomic Structure Sequence (0008,2228) 3 Sequence of Items that identifies the primary anatomic structure(s) of interest in this Instance. One or more Items may be included in this Sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. 314 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

389 > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Primary Anatomic Structure Modifier Sequence (0008,2230) 3 Sequence of Items that modifies the primary anatomic structure of interest in this Instance. One or more Items may be included in this Sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. Slice Progression Direction (0054,0500) 3 Describes the anatomical direction that slices are progressing as the slices are considered in order (as defined by the Slice Index. See section C for a definition of Slice Index). Meaningful only for cardiac images. When View Code Sequence (0054,0220) indicates a short axis view, then Enumerated Values are: APEX_TO_BASE BASE_TO_APEX Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

390 View Code Sequence (0054,0220) 3 Sequence that describes the projection of the anatomic region of interest. Only a single Item shall be permitted in this sequence. > Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. > Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. > Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. > Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > View Modifier Code Sequence (0054,0222) 2C View Modifier. Required if needed to fully specify the View. Only a single Item shall be permitted in this sequence. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. 316 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

391 C.2.40 Curve C.10.2 Curve Dimensions (50XX,0005) 1 Number of dimensions for these data. The dimensions may be any number from 1 to n. Only 2 dimensions supported. Import: if value is not 2 a warning will be issued and the curve data will be ignored. 2 Number of Points (50XX,0010) 1 Number of data points in this Curve For Labels: 1 For other curves: Number of contour points Type of Data (50XX,0020) 1 Type of data in this curve. See C for Defined Terms. Contour: ROI, POLY Label: LABEL Data Value Representation (50XX,0103) 1 Data representation of the curve data points. See C for Enumerated Values and further explanation. Curve Data OW or (50XX,3000) 1 Curve data. See C for further explanation. Import: All values are supported 0003H (floating point double) Curve Description (50XX,0022) 3 User-defined comments about the Curve Structure.Name or Label.LabelText, depending on Type of Data. Axis Units (50XX,0030) 3 Units of measure for the axes. See C for Defined Terms. Supports only PIXL\PIXL, but may be empty on import. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

392 Axis Labels (50XX,0040) 3 Text labels for each axis. One label for each axis. Used to identify the structure type assigned to a curve. This defines material and rendering options. If unavailable structure type 'USER' will be used. Minimum Coordinate Value (50XX,0104) 3 The minimum value in the set of data. One value for each dimension. Maximum Coordinate Value (50XX,0105) 3 The maximum value in the set of data. One value for each dimension. Curve Range (50XX,0106) 3 A minimum-maximum pair for each dimension for defining the range of the curve representation, in the same units as Axis Units. Curve Data Descriptor Coordinate Start Value Coordinate Step Value (50XX,0110) 1C Specifies the format of the Curve Data. Required if any dimensions of the data are described by interval spacing. See C for further explanation. (50XX,0112) 1C The starting point of a one dimensional data list. Required if Curve Data Descriptor is used. One value for each dimension. The Value Representation is given in Data Value Representation (50xx,0103). (50XX,0114) 1C The interval spacing between two successive points. Required if Curve Data Descriptor is used. One value for each dimension. The Value Representation is given in Data Value Representation (50xx,0103). Curve Label (50XX,2500) 3 A user defined text string which may be used to label or name this curve. Structure.StructureId) Will be shown as the ID of a structure on the GUI. If unavailable, curves will be named 'Curve_{n}' 318 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

393 Curve Referenced Overlay Sequence > Referenced SOP Class UID > Referenced SOP Instance UID (50XX,2600) 3 A Sequence which provides reference to a set of related overlays used to generate this curve. (0008,1150) 1C Uniquely identifies the referenced SOP Class. Required if Referenced Overlay Sequence (50xx,2600) is sent. (0008,1155) 1C Uniquely identifies the referenced SOP Instance. Required if Referenced Overlay Sequence (50xx,2600) is sent. > Referenced Overlay Group (50XX,2610) 1C The Group number of the related overlay. Required if Referenced Overlay Sequence (50xx,2600) is sent. C.2.41 Modality LUT C.11.1 Modality LUT Sequence > LUT Descriptor US or (0028,3000) 1C Defines a sequence of Modality LUTs. Only one Item may be present. Shall not be present if Rescale Intercept (0028,1052) is present. (0028,3002) 1C Specifies the format of the LUT Data in this Sequence. See C for further explanation. Required if the Modality LUT Sequence (0028,3000) is sent. Currently only linear mappings are supported > LUT Explanation (0028,3003) 3 Free form text explanation of the meaning of the LUT. > Modality LUT Type (0028,3004) 1C Specifies the output values of this Modality LUT. See C for further explanation. Required if the Modality LUT Sequence (0028,3000) is sent. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

394 > LUT Data US or (0028,3006) 1C LUT Data in this Sequence. Required if the Modality LUT Sequence (0028,3000) is sent. Rescale Intercept (0028,1052) 1C The value b in relationship between stored values (SV) and the output units specified in Rescale Type (0028,1054). Output units = m*sv + b. Required if Modality LUT Sequence (0028,3000) is not present. Shall not be present otherwise. Rescale Slope (0028,1053) 1C m in the equation specified by Rescale Intercept (0028,1052). Required if Rescale Intercept is present. Rescale Type (0028,1054) 1C Specifies the output units of Rescale Slope (0028,1053) and Rescale Intercept (0028,1052). See C for further explanation. Required if Rescale Intercept is present. Slice.PixelOffset, DoseMatrix.Offset) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix) Slice.PixelSlope, DoseMatrix.Scaler) Storage location depends on object type (Image in table Slice / Portal Dose in table DoseMatrix) Slice.RescaleType) Supported values: Gy/MU = Gray per MU (Varian definition) CU = Calibration Units (Varian definition) RD = Relative Dose (Varian definition) US = unspecified (for all other types on export) Images: US if unknown Portal Dose: All values are supported as listed above. 320 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

395 C.2.42 VOI LUT C.11.2 VOI LUT Sequence (0028,3010) 1C Defines a sequence of VOI LUTs. One or more Items shall be present. Required if Window Center (0028,1050) is not present. May be present otherwise. > LUT Descriptor US or (0028,3002) 1 Specifies the format of the LUT Data in this Sequence. See C for further explanation. Currently only linear mappings are supported > LUT Explanation (0028,3003) 3 Free form text explanation of the meaning of the LUT. > LUT Data US or (0028,3006) 1 LUT Data in this Sequence.. Window Center (0028,1050) 1C Window Center for display. See C for further explanation. Required if VOI LUT Sequence (0028,3010) is not present. May be present otherwise. Window Width (0028,1051) 1C Window Width for display. See C for further explanation. Required if Window Center (0028,1050) is sent. Window Center & Width Explanation (0028,1055) 3 Free form explanation of the meaning of the Window Center and Width. Multiple values correspond to multiple Window Center and Width values. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.AcqLevel) Only the first value of the multi-value field is read/written. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.AcqWindow) Only the first value of the multi-value field is read/written. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

396 VOI LUT Function (0028,1056) 3 Describes a VOI LUT function to apply to the values of Window Center (0028,1050) and Window Width (0028,1051). See C for further explanation. Defined terms: LINEAR SIGMOID When this attribute is not present, the interpretation of the values of Window Center (0028,1050) and Window Width (0028,1051) is linear as in C C.2.43 SOP Common C.12.1 SOP Class UID (0008,0016) 1 Uniquely identifies the SOP Class. See C for further explanation. See also PS 3.4. SOP Instance UID (0008,0018) 1 Uniquely identifies the SOP Instance. See C for further explanation. See also PS 3.4. The SOP Class UID is used to map the data to an appropriate object type. Slice.SliceUID, Fractionation.PlanUID, DoseMatrix.DoseUID, SpatialRegistrationIOD.SpatialRegistratio nuid, Structure.StructureUID) Storage location depends on the SOPClassUID and object type. Specific Character Set (0008,0005) 1C Character Set that expands or replaces the Basic Graphic Set. Required if an expanded or replacement character set is used. See C for Defined Terms. *** Not Used *** Supported character set depends on client operating system version. No character translation is performed other than reading/writing contents of DICOM string attributes in corresponding database attributes. Also no support for multiple character sets within a single attribute. 322 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

397 Instance Creation Date Instance Creation Time Instance Creator UID (0008,0012) 3 Date the SOP Instance was created. The date the DICOM file was created. (0008,0013) 3 Time the SOP Instance was created. The time the DICOM file was created. (0008,0014) 3 Uniquely identifies device which created the SOP Instance. *** Not Used *** Related General SOP Class UID Original Specialized SOP Class UID Coding Scheme Identification Sequence > Coding Scheme Designator > Coding Scheme Registry (0008,001A) 3 Uniquely identifies a Related General SOP Class for the SOP Class of this Instance. See PS 3.4. (0008,001B) 3 The SOP Class in which the Instance was originally encoded, but which has been replaced during a fall-back conversion to the current Related General SOP Class. See PS 3.4. (0008,0110) 3 Sequence of items that map values of Coding Scheme Designator (0008,0102) to an external coding system registration, or to a private or local coding scheme. One or more items may be present in the sequence. (0008,0102) 1 The value of a Coding Scheme Designator, used in this SOP Instance, which is being mapped. (0008,0112) 1C The name of the external registry where further definition of the identified coding scheme may be obtained. Required if coding scheme is registered. Defined term: HL7 > Coding Scheme UID (0008,010C) 1C The coding scheme UID identifier. Required if coding scheme is identified by an ISO 8824 object identifier compatible with the UI VR. > Coding Scheme External ID (0008,0114) 2C The coding scheme identifier as defined in an external registry. Required if coding scheme is registered and Coding Scheme UID (0008,010C) is not present. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

398 > Coding Scheme Name (0008,0115) 3 The coding scheme full common name > Coding Scheme Version > Responsible Organization Timezone Offset From UTC Contributing Equipment Sequence (0008,0103) 3 The coding scheme version associated with the Coding Scheme Designator (0008,0102). (0008,0116) 3 Name of the organization responsible for the Coding Scheme. May include organizational contact information. (0008,0201) 3 Contains the offset from UTC to the timezone for all DA and TM Attributes present in this SOP Instance. Encoded as an ASCII string in the format "&ZZZZ". The components of this string, from left to right, are & = "+" or "-", and ZZZZ = Hours and Minutes of offset. Notes: 1. This encoding is the same as described in PS 3.5 for the DT Value Representation. 2. This Attribute does not apply to values with a DT Value Representation, which may contain an explicitly encoded timezone. 3. The corrected time may cross a 24 hour boundary. For example, if Local Time = 1.00 a.m. and Offset = +0200, then UTC = p.m. (23.00) the day before. 4. The "+" sign may not be omitted. Time earlier than UTC is expressed as a negative offset. Note: For example: UTC = 5.00 a.m. Local Time = 3.00 a.m. Offset = The local timezone offset is undefined if this Attribute is absent. (0018,A001) 3 Sequence of Items containing descriptive attributes of related equipment which has contributed to the acquisition, creation or modification of the composite instance. One or more Items may be included in this Sequence. See C for further explanation. 324 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

399 > Purpose of Reference Code Sequence (0040,A170) 1 Describes the purpose for which the related equipment is being reference. Only a single Item shall be permitted in this sequence. See C for further explanation. >> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. >> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. >> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. >> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. > Manufacturer (0008,0070) 1 Manufacturer of the equipment that contributed to the composite instance. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ReferingEquipment) Stored together with manufacturers model name. Import: Used to find machine If ReferingEquipment is empty then Machine.Manufacturer is used. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

400 > Institution Name (0008,0080) 3 Institution where the equipment that contributed to the composite instance is located. > Institution Address (0008,0081) 3 Address of the institution where the equipment that contributed to the composite instance is located. > Station Name (0008,1010) 3 User defined name identifying the machine that contributed to the composite instance. > Institutional Department Name (0008,1040) 3 Department in the institution where the equipment that contributed to the composite instance is located. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ReferingEquipment) Import: ignored. If Slice.ReferingEquipment is empty then Hospital.Id is used Import: Attribute is read, but cannot be exported. (Stored as-is in: Slice.StationName) Images: Machine.Id Other objects: Id of Workstation from where object is beeing exported Attribute is written, but not supported during import. (Value read from: Department.DepartmentId) 326 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

401 > Manufacturer s Model Name (0008,1090) 3 Manufacturer's model name of the equipment that contributed to the composite instance. Roundtrip is supported but internal representation is different from DICOM. (Stored in: Slice.ReferingEquipment) Stored together with manufacturer. Import: Used to find machine > Device Serial Number (0018,1000) 3 Manufacturer's serial number of the equipment that contributed to the composite instance. If Slice.ReferingEquipment is empty then Machine.MachineModel Stored together with manufacturers model name and manufacturer Import: Used to find machine If Slice.ReferingEquipment is empty then Machine.ManufacturerSerNo Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

402 > Software Version(s) (0018,1020) 3 Manufacturer's designation of the software version of the equipment that contributed to the composite instance. Attribute is processed during export only. The value of Slice.ReferingEquipment will be used to calculate the contents during export. Export only: Images: If Slice.ReferingEquipment is empty then Machine.SoftwareVersion > Spatial Resolution (0018,1050) 3 The inherent limiting resolution in mm of the acquisition equipment for high contrast objects for the data gathering and reconstruction technique chosen. If variable across the images of the series, the value at the image center. > Date of Last Calibration > Time of Last Calibration > Contribution Date Time (0018,1200) 3 Date when the image acquisition device calibration was last changed in any way. Multiple entries may be used for additional calibrations at other times. See C for further explanation. (0018,1201) 3 Time when the image acquisition device calibration was last changed in any way. Multiple entries may be used. See C for further explanation. (0018,A002) 3 The Date & Time when the equipment contributed to the composite instance. Other objects: Version of the Vision software *** Not Used *** *** Not Used *** *** Not Used *** > Contribution Description (0018,A003) 3 Description of the contribution the equipment made to the composite instance. Instance Number (0020,0013) 3 A number that identifies this Composite object instance. 328 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

403 SOP Instance Status SOP Authorization Date and Time SOP Authorization Comment (0100,0410) 3 A flag that indicates the storage status of the SOP Instance. Not Specified (NS) implies that this SOP Instance has no special storage status, and hence no special actions need be taken. Original (OR) implies that this is the primary SOP instance for the purpose of storage, but that it has not yet been authorized for diagnostic use. Authorized Original (AO) implies that this is the primary SOP instance for the purpose of storage, which has been authorized for diagnostic use. Any copies of an Authorized Original should be given the status of Authorized Copy. Authorized Copy (AC) implies that this is a copy of an Authorized Original SOP Instance. Enumerated Values: NS, OR, AO, AC Note: Proper use of these flags is specified in Security Profiles. Implementations that do not conform to such Security Profiles may not necessarily handle these flags properly. (0100,0420) 3 The date and time when the SOP Instance Status (0100,0410) was set to AO. (0100,0424) 3 Any comments associated with the setting of the SOP Instance Status (0100,0410) to AO. Authorization Equipment Certification Number MAC Parameters Sequence (0100,0426) 3 The certification number issued to the Application Entity that set the SOP Instance Status (0100,0410) to AO. (4FFE,0001) 3 A sequence of one or more items that describe the parameters used to calculate a MAC for use in Digital Signatures. > MAC ID Number (0400,0005) 1 A number used to identify this MAC Parameters Sequence item. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

404 > MAC Calculation Transfer Syntax UID (0400,0010) 1 The Transfer Syntax UID used to encode the values of the Data Elements included in the MAC calculation. Only Transfer Syntaxes that explicitly include the VR and use Little Endian encoding shall be used. Notes: Certain Transfer Syntaxes, particularly those that are used with compressed data, allow the fragmentation of the pixel data to change. If such fragmentation changes, Digital Signatures generated with such Transfer Syntaxes could become invalid. > MAC Algorithm (0400,0015) 1 The algorithm used in generating the MAC to be encrypted to form the Digital Signature. Defined Terms: RIPEMD160 MD5 SHA1. Note: Digital Signature Security Profiles (see PS 3.15) may require the use of a restricted subset of these terms. > Data Elements Signed (0400,0020) 1 A list of Data Element Tags in the order they appear in the Data Set which identify the Data Elements used in creating the MAC for the Digital Signature. See Section C Digital Signatures Sequence (FFFA,FFFA ) 3 Sequence holding one or more Digital Signatures. > MAC ID Number (0400,0005) 1 A number used to identify which MAC Parameters Sequence item was used in the calculation of this Digital Signature. > Digital Signature UID (0400,0100) 1 A UID that can be used to uniquely reference this signature. 330 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

405 > Digital Signature DateTime (0400,0105) 1 The date and time the Digital Signature was created. The time shall include an offset (i.e., time zone indication) from Coordinated Universal Time. Note: This is not a certified timestamp, and hence is not completely verifiable. An application can compare this date and time with those of other signatures and the validity date of the certificate to gain confidence in the veracity of this date and time. > Certificate Type (0400,0110) 1 The type of certificate used in (0400,0115). Defined Term: X509_1993_SIG Note: Digital Signature Security Profiles (see PS 3.15) may require the use of a restricted subset of these terms. > Certificate of Signer (0400,0115) 1 A certificate that holds the identity of the entity producing this Digital Signature, that entity's public key or key identifier, and the algorithm and associated parameters with which that public key is to be used. Algorithms allowed are specified in Digital Signature Security Profiles (see PS 3.15). Notes: 1. As technology advances, additional encryption algorithms may be allowed in future versions. Implementations should take this possibility into account. 2. When symmetric encryption is used, the certificate merely identifies which key was used by which entity, but not the actual key itself. Some other means (e.g., a trusted third party) must be used to obtain the key. > Signature (0400,0120) 1 The MAC generated as described in Section and encrypted using the algorithm, parameters, and private key associated with the Certificate of the Signer (0400,0115). See Section C Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

406 > Certified Timestamp Type > Certified Timestamp Encrypted Attributes Sequence > Encrypted Content Transfer Syntax UID (0400,0305) 1C The type of certified timestamp used in the Certified Timestamp (0400,0310) Attribute. Required if Certified Timestamp (0400,0310) is present. Defined Terms: CMS_TSP û Internet X.509 Public Key Infrastructure Time Stamp Protocol Note: Digital Signature Security Profiles (see PS 3.15) may require the use of a restricted subset of these terms. (0400,0310) 3 A certified timestamp of the Digital Signature (0400,0120) Attribute Value, which shall be obtained when the Digital Signature is created. See Section C (0400,0500) 1C Sequence of Items containing encrypted DICOM data. One or more Items shall be present. Required if application level confidentiality is needed and certain recipients are allowed to decrypt all or portions of the Encrypted Attributes Data Set. See C (0400,0510) 1 Transfer Syntax used to encode the encrypted content. Only Transfer Syntaxes that explicitly include the VR and use Little Endian encoding shall be used. > Encrypted Content (0400,0520) 1 Encrypted data. See C HL7 Structured Document Reference Sequence (0040,A390) 1C Sequence of items defining mapping and/or access mechanism for HL7 Structured Documents referenced from the current SOP Instance. One or more Items may be included in this sequence. See C Required if HL7 Structured Documents are referenced within the Instance. > Referenced SOP Class UID (0008,1150) 1 Unique identifier for the class of HL7 Structured Document. > Referenced SOP Instance UID (0008,1155) 1 Unique identifier for the HL7 Structured Document as used in DICOM instance references. 332 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

407 > HL7 Instance Identifier (0040,E001) 1 Instance Identifier of the referenced HL7 Structured Document, encoded as a UID (OID or UUID), concatenated with a caret ("^") and Extension value (if Extension is present in Instance Identifier). > Retrieve URI (0040,E010) 3 Retrieval access path to HL7 Structured Document. Includes fully specified scheme, authority, path, and query in accordance with RFC 2396 C.2.44 Common Instance Reference C.12.2 Referenced Series Sequence > Series Instance UID > Referenced Instance Sequence >> Referenced SOP Class UID (0008,1115) 1 Sequence of Items each of which includes the Attributes of one Series. One or more Items shall be present. (0020,000E) 1 Unique identifier of the Series containing the referenced Instances. (0008,114A) 1 Sequence of Items each providing a reference to an Instance that is part of the Series defined by Series Instance UID (0020,000E) in the enclosing Item. One or more Items shall be present. SpatialRegistrationImage.SeriesUID) Only referenced images are handled. (0008,1150) 1 Uniquely identifies the referenced SOP Class. SpatialRegistrationImage.ImageClassUID ) Only referenced images are handled. Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

408 >> Referenced SOP Instance UID Studies Containing Other Referenced Instances > Study Instance UID > Referenced Series Sequence >> Series Instance UID >> Referenced Instance Sequence >>> Referenced SOP Class UID (0008,1155) 1 Uniquely identifies the referenced SOP Instance. SpatialRegistrationImage.ImageInstanceU ID) Only referenced images are handled. (0008,1200) 1C Sequence of items each identifying a Study other than the Study of which this Instance is a part, which Studies contain Instances that are referenced elsewhere in this Instance. One or more Items shall be present. Required if this Instance references Instances in other Studies. (0020,000D) 1 Unique identifier of the Study containing the referenced Instances. (0008,1115) 1 Sequence of Items each of which includes the Attributes of one Series. One or more Items shall be present. (0020,000E) 1 Unique identifier of the Series containing the referenced Instances. (0008,114A) 1 Sequence of Items each providing a reference to an Instance that is part of the Series defined by Series Instance UID (0020,000E) in the enclosing Item. One or more Items shall be present. SpatialRegistrationImage.StudyUID) Only referenced images are handled. SpatialRegistrationImage.SeriesUID) Only referenced images are handled. (0008,1150) 1 Uniquely identifies the referenced SOP Class. SpatialRegistrationImage.ImageClassUID ) Only referenced images are handled. 334 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

409 >>> Referenced SOP Instance UID (0008,1155) 1 Uniquely identifies the referenced SOP Instance. SpatialRegistrationImage.ImageInstanceU ID) Only referenced images are handled. C.2.45 Spatial Registration Series C.20.1 Modality (0008,0060) 1 Modality type. Enumerated Value: REG Series.SeriesModality) C.2.46 Spatial Registration C.20.2 Content Date (0008,0023) 1 The date the content creation started. SpatialRegistrationIOD.CreationDate) Content Time (0008,0033) 1 The time the content creation started. SpatialRegistrationIOD.CreationDate) Instance Number (0020,0013) 1 A number that identifies this instance SpatialRegistrationIOD.InstanceNumber) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

410 Content Label (0070,0080) 1 A label that is used to identify this registration. SpatialRegistrationIOD.SpatialRegistrationI ODId) Content Description (0070,0081) 2 A description of this registration. SpatialRegistrationIOD.Comment) Content Creator s Name Registration Sequence > Frame of Reference UID > Referenced Image Sequence (0070,0084) 2 Name of operator performing the registration (such as a technologist or physician). (0070,0308) 1 A sequence of one or more registration items. Each item defines a spatial registration to the referenced images in that item. All referenced images are in the same spatial frame of reference or atlas. (0020,0052) 1C Identifies a Frame of Reference that may or may not be an image set (e.g. atlas or physical space). See C for further explanation. Required if Referenced Image Sequence (0008,1140) is absent. May be present otherwise. (0008,1140) 1C Identifies the set of images registered in this sequence item. One or more items shall be present. Required if Frame of Reference UID (0020,0052) is absent. May be present otherwise. Roundtrip is supported but internal representation is different from DICOM. (Stored in: SpatialRegistrationIOD.CreationUserName) On import the prefix and suffix will be ommited. On export the content of CreationUserName will be parsed and every word will result in one of the name components in DICOM. SpatialRegistration.RegisteredFOR) 336 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

411 >> Referenced SOP Class UID >> Referenced SOP Instance UID (0008,1150) 1 Uniquely identifies the referenced SOP Class. SpatialRegistrationImage.ImageClassUID) (0008,1155) 1 Uniquely identifies the referenced SOP Instance. SpatialRegistrationImage.ImageInstanceUI D) >> Referenced Frame Number > Matrix Registration Sequence >> Frame of Reference Transformation Comment >> Registration Type Code Sequence (0008,1160) 1 Identifies the frame numbers within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Note: This Attribute may be multi-valued. Required if the Referenced SOP Instance is a multi-frame image and the reference does not apply to all frames. (0070,0309) 1 A sequence that specifies one spatial registration. Exactly one item shall be present (3006,00C8) 3 User description or comments about the Transformation Comment registration. (0070,030D) 2 Describes the information input into the registration process. Only one item may be present. SpatialRegistration.Comment) >>> Code Value (0008,0100) 1C See Section 8.1. Required if a sequence item is present. SpatialRegistration.RegTypeCodeValue) >>> Coding Scheme Designator (0008,0102) 1C See Section 8.2. Required if a sequence item is present. SpatialRegistration.RegTypeCodeDesignat or) Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

412 >>> Coding Scheme Version (0008,0103) 1C See Section 8.2. Required if a sequence item is present and the value of Coding Scheme Designator (0008,0102) is not sufficient to identify the Code Value (0008,0100) unambiguously. SpatialRegistration.RegTypeCodeVersion) >>> Code Meaning (0008,0104) 1C See Section 8.3. Required if a sequence item is present. SpatialRegistration.RegTypeCodeMeaning) >> Matrix Sequence (0070,030A) 1 One or more items shall be present. Each item specifies a transformation. The item order is significant and corresponds to matrix multiplication order. See C Import: Zero or more items are accepted. Always one item is exported which incorporates the combination of all matrices of the original sequence. >>> Frame of Reference Transformation Matrix >>> Frame of Reference Transformation Matrix Type >> Registration Sub Type (3006,00C6) 1 A 4x4 homogeneous transformation matrix that registers the referenced images to the local RCS. Matrix elements shall be listed in row-major order. See C (0070,030C) 1 Type of Frame of Reference Transformation Matrix (3006,00C6). Defined terms: RIGID RIGID_SCALE AFFINE See C (3275,1000) 3 Identifies the application or application context in which this registration object has been created. Roundtrip is supported but internal representation is different from DICOM. (Stored in: SpatialRegistration.Transformation) Import: Only RIGID is supported, import will be rejected if different value is found. RIGID. SpatialRegistration.RegSubType) 338 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

413 > Used Fiducials Sequence (0070,0314) 3 The fiducials used to determine the Frame of Reference Transformation Matrix. One or more Items may be present. *** Not Used *** >> Fiducial UID (0070,031A) 1 The UID that identifies the fiducial used as registration input. *** Not Used *** Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

414 (This page is intentionally left blank.) 340 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

415 Appendix D Extended Interface Appendix D Extended Interface The following IODs have private Attributes containing an XML data structure for transporting structured non-dicom data: RT Plan RT Ion Plan RT Beams Treatment Record The following sections specify Attributes containing the XML data and describe the structure of the XML data. D.1 RT Plan / RT Ion Plan The XML data structure for RT Plan and RT Ion Plan IODs is contained in private Extended Interface Module which is optional in RT Plan and RT Ion Plan IOD. The structure of the XML data structure is described in the following table. Node Name Min occurs Max occurs Data Type Node Description ExtendedVAPlanInterface 0 1 > Beams 0 1 >> Beam 0 Unbounded >>> ReferencedBeamNumber 1 1 int Beam identifier >>> BeamExtension 1 1 Additional items provided from Vision to expand the features of RT Beams. >>>> FieldType 1 1 string TREATMENT or SETUP >>>> RelatedTreatBeamNumber 0 1 int Relation from the image beams to the treatment and/or setup beams. >>>> FieldOrder 1 1 int Order in which the fields are shown Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

416 Appendix D Extended Interface Node Name Min occurs Max occurs Data Type Node Description >>>> GantryRtnExtendedStart 0 1 int When true, gantry angle position is in the extended range, which means it has an over travel (a Gantry can move most typical 400' and not only 360'). >>>> GantryRtnExtendedStop 0 1 int When true, gantry angle position is in the extended range, which means it has an over travel (a Gantry can move most typical 400' and not only 360'). >>>> MUSubtraction 0 1 int MUSubtraction defines whether some MUs have to be subtracted from the related treatment beam to take images in the before phase and/or after phase. >>>> FieldSetupPhotos 0 1 >>>>> FieldSetupPhoto 0 2 Two setup photos max >>>>>> SetupPhotoNumber 1 1 int Increasing number of setup photos. The value has to start from 1 and up. >>>>>> SetupPhotoFormat 1 1 string The format of the pixel information. Supported values are 'JPG' and 'BMP' >>>>>> SetupPhotoPicture 1 1 hex binary Pixel information of the photo in the corresponding format. >>>>>> PhotoModified 1 1 string Photo has been modified. PhotoModified may have true or false >>> CustomAddOns 0 1 >>>> CustomAddOn 0 4 >>>>> CustomAddOnType 1 1 string Three Add On Type to choose from: BLOCK COMPENSATOR TRAY >>>>> CustomCode 0 1 int Codes for accessory which may be custom made or factory made (in that case the internal code in equal the custom code.) 342 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

417 Appendix D Extended Interface Node Name Min occurs Max occurs Data Type Node Description >>>>> ReferencedAddOnNumber 0 1 int Reference to the identification number of the Block or Compensator. >>>>> TraySpecification 0 1 In case the CustomAddOn is a tray, it gets reported back through this node >>>>>> TrayID 1 1 string User-supplied identifier for tray. Max length is 16 characters. >>>>>> SourceTrayDistance 0 1 int The distance from source to slot. This information is needed to distinguish the slot > ToleranceTables 0 1 >> ToleranceTable 0 Unbounded Additional items provided from Vision to expand the features of Tolerance Tables with AutoSetup capabilities >>> ReferencedToleranceTableNumber 1 1 int Refers to the tolerance table in RT Tolerance Table module >>> ToleranceTableExtension 1 1 >>>> GantryRtnSetup 0 1 string Setup attributes may have following type: Automatic Manual Remote >>>> CollRtnSetup 0 1 string >>>> CollXSetup 0 1 string >>>> CollYSetup 0 1 string >>>> PatientSupportAngleSetup 0 1 string >>>> CouchLngSetup 0 1 string >>>> CouchVrtSetup 0 1 string >>>> CouchLatSetup 0 1 string >>>> TableTopEccentricAngleSetup 0 1 string Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

418 Appendix D Extended Interface Node Name Min occurs Max occurs Data Type Node Description > DoseReferences 0 1 >> DoseReference 0 Unbounded >>> ReferencedDoseReferenceNumber 1 1 int Reference to the identification number of the Dose Reference (300A,0012) in the RT Prescription module which is a representation of our reference point >>> DoseReferenceExtension 1 1 Additional items provided from Vision to expand the features of reference points. >>>> DailyDoseLimit 0 1 decimal Unit is [Gy] >>>> SessionDoseLimit 0 1 decimal Unit is [Gy] >>>> Breakpoints 0 1 >>>>> Breakpoint 0 Unbounded Breakpoint extensions, since DICOM has just one DeliveryWarningDose without a description this is needed. >>>>>> BreakpointDose 1 1 decimal Unit is [Gy] >>>>>> BreakpointWarning 1 1 string Text which describes the breakpoint. Max length is 254 characters Table D-25: RT Plan / RT Ion Plan Extended Interface XML Structure 344 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS

419 Appendix D Extended Interface D.2 RT Beams Treatment Record The XML data structure for RT Beams Session Record IOD is contained in RT Beams Session Record Module in private Treatment Session Beam Data Attribute with tag (3261,102A). The structure of the XML data structure is described in the following table. Node Name Min occurs Max occurs Data Type Node Description RTBeamSessionRecordExtendedIF 0 1 > DoseOverrides 0 1 >> DoseOverride 0 Unbound There may be as many DoseOverride nodes as Reference Points. >>> DoseOverrideType 1 1 string Type of dose overrides. Supported are: BREAKPOINT: Breakpoint dose limit overridden DAILYDOSE: Daily dose limit overridden SESSIONDOSE: Session dose limit overridden TOTALDOSE: >>> Dose 0 1 decimal Contains the specific overridden/authorized dose for DoseOverrideType BREAKPOINT at the Reference Point referenced by Dose Reference Number. Unit is [Gy] >>> DoseReferenceNumber 1 1 nonnegative int References the Reference Point on which the dose was applied. >>> OperatorsName 1 1 Operator Name who overrode/approved the specific doses. >>>> FamilyName 0 1 string Max length is 64 characters. >>>> GivenName 0 1 string Max length is 64 characters >>>> MiddleName 0 1 string Max length is 64 characters >>>> Prefix 0 1 string Max length is 64 characters Varian System Server DICOM Conformance Statement, VA8005D3CS Appendix of 346

420 Appendix D Extended Interface Node Name Min occurs Max occurs Data Type Node Description >>>> Suffix 0 1 string Max length is 64 characters > TraySpecifications 0 1 >> TraySpecification 1 Unbound As many nodes as tray applied for the treated beam. >>> TrayID 1 1 string That's the parameter which needs to be defined when a tray is defined/acquired. Max length is 16 characters >>> SourceTrayDistance 0 1 int Radiation Source to attachment edge of tray assembly (mm). > AdditionalOperators 0 1 >> OperatorsName 1 2 If the Show Sign Off Dialog is checked in ITAdmin -> MachineConfiguration -> Preferences, the Sign Off Dialog will be shown after closing the patient. Three OperatorsName may be entered in this dialog. The first OperatorsName will be sent through the standard attribute Operator Name (0008,1070) in the RT Beams Session Record module, the remaining two names if available will be sent here in the Extended Interface >>> FamilyName 0 1 string Max length is 64 characters. >>> GivenName 0 1 string Max length is 64 characters >>> MiddleName 0 1 string Max length is 64 characters >>> Prefix 0 1 string Max length is 64 characters >>> Suffix 0 1 string Max length is 64 characters Table D-26: RT Beams Treatment Record Extended Interface XML Structure 346 of Appendix Varian System Server DICOM Conformance Statement, VA8005D3CS