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Introduction to Change Log

The following is a summary of changes since AIM version 3, revision 11. As of this writing, the current AIM version is 4, revision 43.

Download the AIM 3.0 model from http://gforge.nci.nih.gov/frs/download.php/8794/AIM_v3_rv11_load.zip.

The most significant change from version 3.0 to foundation of the AIM model is the use of ISO 21090 data types, a caBIG® mandate, and the introduction of AIM Statements. An AIM Statement describes a relationship of a finding found on an image or series of images. It represents a relationship between the subject and object entities in the AIM foundation model.

Why Use AIM Statements?

The AIM 3.0 model reflects relationships between classes using containment of a source class by a target class, and inheritance such as IS-A relationships. The expressive power of the model is limited by these two types of relationships. No other types of relationships in the AIM 3.0 model are possible and not all necessary relationships are present. For instance, there is no direct relationship between instances of the AnatomicEntity class, e.g. right-upper lobe of lung, and the ImagingObservation class, e.g. mass. Such classes can be indirectly linked to each other only via the Annotation class.

The desire to improve the expressiveness of the AIM model and specific use cases prompted us to create a flexible model of AIM statements. Use cases that led us to change the AIM model from the containment association approach to explicitly stated relationships between two classes follow.

A. Justin Kirby at the NCI's Cancer Imaging Program has a use case for storing information from a mammography case report form (CRF). The CRF has "Associated Findings" or imaging observation characteristics that are associated with the entire breast and are not specific to a mass. Dr. David Channin at Guthrie Clinic also has a similar use case.

B. Dr. Lior Weizman, a research fellow working with Dr. Daniel Rubin, wants to associate calculation results with a DICOM segmentation object.

C. Several AIM users want to capture imaging observations and calculations related directly to image markup.

D. A user wants to capture a measurement of a liver volume from a CT scan to facilitate clinical assessment of liver disorders, to improve decision making in liver transplant surgery and to avoid donor-recipient graft mismatch.

Adding an association relationship between the AnatomicEntity and ImagingObservationCharacteristic resolved the CRF issue. Adding an association between segmentation and calculation satisfied Dr. Weizman's comment. Applying the same approach could satisfy use cases C and D.

As the AIM model is used by an increasing number of users, additional requests will arise that add relationships between classes or create new classes to store other important information related to AIM. Managing and rearranging associations with classes will be too complex to manage without the AIM Statement class and its subclasses. 

Summary of changes between AIM 3.0 to 4.0 models

AIM 4.0 has eighty new classes. We renamed twelve classes and deleted four classes. This document describes changes from the AIM 3.0 to AIM 4.0 foundation information model.

AIM 4.0 uses ISO 21090 data types

AIM 3.0 Data TypeISO 21090
booleanBL
CalculationResultIdentifierNot Applicable
ComparisonOperatorsNot Applicable
DateTS
DoubleREAL
IntegerINT or II
StringST or Uid

Four attributes in AIM are now mapped to a single ISO 21090 CD data type.

AIM 3.0 Data TypeISO 21090
codeValueCD
codeMeaningCD
codingSchemeDesignatorCD
codingSchemeVersionCD

Descriptions of the new classes

AnnotationCollection

The AIM 3.0 model does not support a collection concept. In AIM 3.0, each AIM annotation is stored as a single AIM XML document or AIM DICOM SR.  A typical imaging study generates more than one AIM annotation. Managing AIM annotations of the same study becomes an extra activity that AIM implementers have to deal with. The AIM 4.0 foundation model has adopted the ability to store the same type of related AIM annotations as a single source. AIM has two types of annotations: image annotation and annotation-of-annotation. Image annotations annotate images. Annotation-of-annotations annotate other annotations, including image annotations and annotation-of-annotations. AIM 4.0 foundation, therefore, has a mechanism to manage collections of the same type of AIM annotations.

The AnnotationCollection abstract class is the parent of ImageAnnotationCollection and AnnotationofAnnotationCollection. It provides the general concept that AIM may contain one or more instances of the same type. It associates with two optional classes used to capture information about a person, software, or software manufacturer that is generating AIM instances.

ImageAnnotationCollection

This class is one of two root classes in the model. It inherits all AnnotationCollection properties. This class signifies that all members of a collection are of the ImageAnnotaton type.

AnnotationofAnnotationCollection

This class is the second root class in the model. It inherits all AnnotationCollection properties and signifies that all members of a collection are of type AnnotatonOfAnnotation.

AnnotationOfAnnotationStatement can be used to create statements about image annotations and annotation-of-annotations.

AnnotationStatement

Relationships in the AIM 3.0 model are represented by inheritance or IS-A relationships and association relationships. These two expressions do not always precisely represent what AIM users want to state in annotations. AIM 4.0 foundation introduces subject-predicate-object statement constructs, called AIM statements, to precisely define relationships between two entities: a subject and an object. A subject and an object can come from a set of particular classes in the AIM model. The introduction of AIM statements requires structural and class name changes from the AIM 3.0 model. The following classes in AIM 3.0 model were renamed and can be used as subjects and objects in AIM 4.0 foundation.

  • Annotation was renamed as AnnotationEntity.
  • AnnatomicEntity was renamed as ImagingPhysicalEntity.
  • ImagingObservation was renamed as ImagingObservationEntity.
  • Inference was renamed as InferenceEntity.
  • AnnotationRole was renamed as AnnotationRoleEntity.
  • GeometricShape was renamed as GeometricShapeEntity.
  • TextAnnotation was renamed as TextAnnotationEntity.
  • ImageReference was renamed as ImageReferenceEntity.
  • DICOMImageReference was renamed as DICOMImageReferenceEntity.
  • WebImageReference was renamed as UriImageReferenceEntity.
  • Calculation was renamed to CalculationEntity.

The classes above are derived from the Entity class. Prior relationships between many classes in the AIM 3.0 model have been deleted; see section 4 below for more information. Instead, an AIM statement can be created using the above classes as the subject and object of an AIM statement. The naming convention used to create an AIM statement is a concatenation between subject, predicate, and object. The current predicates in AIM are as follows.

  • Excludes
  • Has
  • IsComparedWith
  • IsCompriseOf
  • IsFoundIn
  • IsIdentifiedBy
  • References
  • Uses

AnnotationStatement class is the parent of ImageAnnotationStatement and AnnotationOfAnnotationStatement classes. It represents a general concept about a statement used to describe a finding that is addressed on an image or images in a series. A statement concept expresses the most granular information that an AIM annotation can have. An AIM annotation presents its content in a collection of semantic statements. Statements describe things found, measured, and/or graphically annotated on an image. There are three types of statements: AnnotationStatement, AnnotationOfAnnotationStatement and ImageAnnotationStatement

The AnnotationStatement class has nine different subtypes of annotation statements that can be applied to both AnnotationOfAnnotationStatement and ImageAnnotationStatement. The classes derived from AnnotationStatement are in the AIM 4.0 foundation UML diagram section called AnnotationStatement (common to both types of annotations).

A Statement class represents relationships via the use of the predicates listed above, inserted between subject and object. Subject and object associations can link to ImagingPhysicalEntity, ImagingObservationEntity, InferenceEntity, ReferencedAnnotationEntity, GeometricShapeEntity, TextAnnotationEntity, UriImageReferenceEntity, SegmentationEntity, DICOMImageReferenceEntity, ImageAnnotation, or AnnotationOfAnnotation. Not all combinations between these classes are valid AIM statements. See the AnnotationStatement, AnnotationOfAnnotationStatement, and ImageAnnotationStatement sections in the AIM 4.0 UML diagram for all valid AIM statements.

ImageAnnotationStatement

This class is a parent class of AIM statements that can only be applied to ImageAnnotation.

AnnotationOfAnnotationStatement

This class is a parent class of AIM statements that can only be applied to AnnotationOfAnnotation.

Entity

The Entity abstract class represents the existence of a thing, concept, observation, calculation, measurement, or graphical drawing in AIM. It is a parent class of all entities that are subjects and objects of AIM statements.

MarkupEntity

This abstract class represents graphical drawing and textual description that can be placed on an image.

CompactCalculaitonResult

The result of a calculation captured in a string format. The type attribute of the base class defines the data format in which the string is captured.

A string value of a calculation and its type are determined by the type attribute in this class, which inherits from the CalculationResult class. A type can be an array, binary, histogram, matrix, scalar, URI, or vector. An encoding method is applied to the content of the value attribute. A compression method attribute can be used to define the compression algorithm of the value attribute to reduce the size of the value attribute.

ExtendedCalculationResult

This class stores a result of a calculation explicitly with the precise location of each element in the result. It supports sparse matrix type results.

Algorithm

The class provides well-defined instructions for arriving at results.

Parameter

The class represents a set of structured data to be used in the calculation or computation of an algorithm.

AdjudicationObservation

An observation is made about the comparison between two or more performers’ clinical results (i.e., “adjudication”). It describes a specific time point or all previous time points as well as those explicitly called out. 

AuditTrail

It is used to capture any activity, in coded terms, that requires an entry in the audit trail log, including general and time point lesion observations, time point observations, etc.

SegmentationEntity

This is an abstract class representing the result of a segmentation process where digital images are segmented into a set of pixels. These pixels are stored in a separate file from the original images. Segmentation typically represents a region of interest.

TaskContextEntity

This class contains identifying and descriptive attributes of the reading session and the reading subtask that result in clinical environment or trial results. The class consists of the overall task and the specific subtask. A task represents a unit of overall work, e.g. "Read all of the available time points for the subjects". It may have one or more subtasks. It can be used to capture planned (scheduled) and to record performed tasks.

ThreeDimensionGeographicShapeEntity

This abstract class represents three-dimensional coordinates of a graphical drawing that can be placed on an image to identify a region of interest (ROI).

TaskContextEntity

This abstract class represents two-dimensional coordinates of a graphical drawing that can be placed on an image to identify a region of interest (ROI).

TwoDimensionPoint

This class was originally named Point. A point is defined by a single pixel denoted by a single (column,row) pair.

TwoDimensionCircle

This class was originally named Circle. A circle is defined by two (column,row) pairs. The first point is the central pixel. The second point is a pixel on the perimeter of the circle.

TwoDimensionEllipse

This class was originally named Ellipse. An ellipse is defined by four pixel (column,row) pairs; the first two points specify the endpoints of the major axis and the second two points specify the endpoints of the minor axis of an ellipse.

TwoDimensionPolyline

This class was originally named Polyline. A polyline is defined by a series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon.

TwoDimensionMultipoint

This class was originally named Multipoint. A multipoint is defined by multiple pixels each denoted by a (column,row) pair.

ThreeDimensionPoint

This class contains a single location denoted by a single (x,y,z) triplet.

 

2.25 ThreeDimensionMultipoint

This class contains multiple locations each denoted by an (x,y,z) triplet. The points need not be coplanar.

 

2.26 ThreeDimensionPolyline

This class stores a series of connected line segments with ordered vertices denoted by (x,y,z) triplets; the points need not be coplanar.

 

2.27 ThreeDimensionPolygon

This class stores a series of connected line segments with ordered vertices denoted by (x,y,z) triplets, where the first and last vertices shall be the same forming a polygon; the points shall be coplanar.

 

2.28 ThreeDimensionEllipse

An ellipse is defined by four (x,y,z) triplets; the first two triplets specify the endpoints of the major axis and the second two triplets specify the endpoints of the minor axis.

 

2.29 ThreeDimensionEllipsoid

A three-dimensional geometric surface whose plane sections are either ellipses or circles and contains three intersecting orthogonal axes, “a”, “b”, and “c”. The ellipsoid is defined by six (x,y,z) triplets; the first and second triplets specify the endpoints of axis “a”, the third and fourth triplets specify the endpoints of axis “b”, and the fifth and sixth triplets specify the endpoints of axis “c”.

 

2.30 ImagePlane

The class contains common imaging attributes in the DICOM Image Plane module. DICOM modalities that share the same module are CT, MR, RT, and PET.

 

2.31 GeneralImage

General Image specifies the Attributes that identify and describe an image within a particular series.

 

Classes derived from Annotation Statement -- common to both ImageAnnotation and AnnotationOfAnnotation:

 

2.32 CalculationEntityReferencesCalculationEntityStatement

A calculation result can reference another calculation result without using its referenced calculation outcome.

 

A use case:

A user wants to store measurement results of left and right ventricular parameters from a cardiac MRI study.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create a calculation result to store the left ventricular measurement.
  4. Create a calculation result to store the right ventricular measurement.
  5. Create CalculationEntityReferencesCalculationEntityStatement. It links left and right ventricular measurements.

 

2.33 CalculationEntityUsesCalculationEntityStatement

A calculation result can use another calculation result for its own computation purposes.

 

A use case:

A user wants to store mean and standard deviation measurement results from a region of interest in a CT study.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create a markup, which is a region of interest of type polygon.
  4. Create a calculation result to store the mean value.
  5. Create a calculation result to store the standard deviation (SD) result. Note that the mean value is used to calculate SD.
  6. Create CalculationEntityUsesCalculationEntityStatement. It uses SD calculation result as a subject and mean calculation result as an object of the statement.

 

2.34 ImagingObservationEntityHasCalculationEntityStatement

An image observation can have a calculation result associated with it.

 

A use case:

A user wants to measure a mass found on an image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create an imaging observation containing mass, RID3874, RadLex.
  4. Create a makeup of type line measurement. The line measurement has a length as a result.
  5. Create a calculation result to store the length of the mass.
  6. Create ImagingObservationEntityHasCalculationEntityStatement to link between the imaging observation (subject) and calculation results (object).

 

2.35 ImagingObservationEntityIsFoundInImagingPhysicalEntityStatement

An image observation can be found in an imaging physical entity.

 

A use case:

A user wants to state that a mass is found on the left upper lobe of the lung.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series and image instances.
  3. Create an imaging observation containing mass, RID3874, RadLex.
  4. Create an imaging physical entity containing left upper lobe, RID1327, RadLex.
  5. Create ImagingObservationEntityIsFoundInImagingPhysicalEntityStatement to link the imaging observation (subject) and imaging physical entity (object).

 

2.36 ImagingPhysicalEntityHasCalculationEntityStatement

An imaging physical entity can have a calculation result.

 

A use case:

A user wants to store a diagnostic measurement of liver size.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create an imaging physical entity containing liver, RID58, RadLex.
  4. Create a calculation result to store the size of the liver.
  5. Create ImagingPhysicalEntityHasCalculationEntityStatement to link the imaging physical entity (subject) with the calculation result (object).

 

2.37 ImagingPhysicalEntityHasImagingObservationEntityStatement

An image physical entity can have an imaging observation.

 

A use case:

A user wants to state that there is a mass in the left upper lobe of a patient.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series and image instances.
  3. Create an imaging physical entity containing left upper lobe, RID1327, RadLex.
  4. Create an imaging observation containing mass, RID3874, RadLex.
  5. Create ImagingPhysicalEntityHasImagingObservationEntityStatement to link imaging physical entity (subject) with imaging observation (object).

 

2.38 AnnotationEntityHasPerformedTaskContextStatement

The class is used to record an activity or a performed task used to create an AIM instance. The AIM instance may contain zero or more performed tasks. Either the ImageAnnotation or AnnotationOfAnnotation class can be a subject of this statement.

 

A use case:

A user wants to record activities performed to create an AIM instance.

 

Working with AIM:

For example, a user wants to record lesion activity.

  1. Create ImageAnnotation.
  2. Create GeometricShapeEntity and record user makeup.
  3. Create TaskContextEntity and fill in the required information; e.g., task name and subtask. The task information must be related to markup activity.
  4. Create AnnotationEntityHasPerformedTaskContextStatement to link ImageAnnotation (subject) with TaskContextEntity (object).

 

2.39 AnnotationEntityHasPlannedTaskContextStatement

The class is used to record a planned activity or task. The task is used to inform users or computer programs of what activity needs to be performed in order to create an AIM instance. The instance may be created from one or more planned tasks. Either the ImageAnnotation or AnnotationOfAnnotation class can be a subject of this statement.

 

A use case:

A user wants to plan or define activities to be performed in order to create an AIM instance. For example, users want to create a planned activity to guide imaging interpreters in creating an AIM instance.

 

Working with AIM:

  1. Create ImageAnnotation.
  2. Create TaskContextEntityand fill in the required information; e.g., task name and subtask. Both subtasks below have the same task information; e.g., search for a lesion in an organ.
    1. Identify an imaging observation found on an image.
    2. Identify an anatomic entity location associated with the imaging observation.
  3. Create AnnotationEntityHasPerformedTaskContextStatement to link ImageAnnotation (subject) with TaskContextEntity (object).

 

Classes derived from AnnotationOfAnnotationStatement:

 

2.40 AnnotationOfAnnotationHasAnnotationOfAnnotationStatement

An instance of AnnotationOfAnnotation has another instance of AnnotationOfAnnotation. An AnnotationOfAnnotation may be used to compare, evaluate or reference one or more instances of AnnotationOfAnnotation and/or ImageAnnotation.

 

A use case:

An adjudicator wants to compare a result in an annotation-of-annotation instance with another image annotation instance.

 

Assumption:

  1. There is an annotation-of-annotation instance with an additional image annotation instance of the same lesion.
  2. There is a system capable of reading and extracting information from the annotation-of-annotation instance and image annotation.

 

Working with AIM:

  1. Create a new annotation-of-annotation instance.
  2. Extract calculation result from annotation-of-annotation and other information to display to the user.
  3. Create AnnotationOfAnnotationHasAnnotationOfAnnotationStatement to link the newly created annotation-of-annotation first (subject) with the existing annotation-of-annotation (object).
  4. Compare the results of the existing annotation-of-annotation with the user’s own measurement and evaluation.
  5. Create and store the calculation entity after comparing the difference between the two sizes from existing annotation-of-annotation and new measurements.
  6. Create an inference entity to store the result, such as smaller or larger to the question: "Is the size getting larger or smaller?"
  7. Create AnnotationOfAnnotationHasCalculationEntityStatement to associate the annotation-of-annotation (subject) with the calculation entity (object).

 

 

2.41 AnnotationOfAnnotationHasAnnotationRoleEntityStatement

A given instance of type AnnotationOfAnnotation can have an assigned role. Examples of roles can be baseline, follow-up, referenced case, etc. They are captured in the model as coded terms in the AnnotationRoleEntity class. Some of these roles have been defined in the DICOM standard part 16, Content Mapping Resource. For example:

Baseline Category:

DCM 112074 Target Lesion at Baseline

DCM 112075 Non-Target Lesion at Baseline

DCM 112076 Non-Lesion at Baseline

 

A use case:

A user wants to assign a baseline role to an annotation-of-annotation consisting of image annotations of a non-target lesion.

 

Assumption:

  1. Image annotations for a non-target lesion were created earlier.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create an annotation role entity containing Baseline Category, 112016, DCM.
  3. The annotation-of-annotation has a statement referencing image annotations with the non-target lesion.
  4. Create AnnotationOfAnnotationHasAnnotationRoleEntityStatement to link the annotation-of-annotation (subject) to the annotation role entity (object).

       

2.42 AnnotationOfAnnotationHasCalculationEntityStatement

An instance of AnnotationOfAnnotation can have one or more calculation results. The instance can reference one calculation at a time in a statement. For example, if there are three calculation results, there must be three AnnotationOfAnnotationHasCalculationEntityStatements.

 

A use case:

An adjudicator wants to compute an average size of the mass from the three markups created by three readers.

 

Assumptions:

  1. Three image annotations for a target lesion were created earlier from three different readers.
  2. There is a system capable of reading and extracting information from the three annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create three AnnotationOfAnnotationHasImageAnnotationStatements linking annotation-of-annotation (subjects) to image annotations (objects).
  3. Extract the mass size from each image annotation and calculate an average.
  4. Create CalculationEntity and store the average result calculation and other required information.
  5. Create AnnotationOfAnnotationHasCalculationEntityStatement to link the annotation-of-annotation (subject) to the calculation entity (object).

 

2.43 AnnotationOfAnnotationHasImageAnnotationStatement

An instance of AnnotationOfAnnotation can reference existing image annotations. Results from image annotations can be used for further analysis, computation, comparison, reference, etc.

 

A use case:

An adjudicator wants to annotate a study read by three different readers.

 

Assumption:

  1. Three image annotations for a target lesion were created earlier from three different readers.
  2. There is a system capable of reading and extracting information from the three annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create three AnnotationOfAnnotationHasImageAnnotationStatements to link the annotation-of-annotation (subject) with each instance of image annotation (object).
  3. The adjudicator may want to create additional imaging physical entity statements and imaging observation entity statements, etc.

 

2.44 AnnotationOfAnnotationHasImagingObservationEntityStatement

An instance of AnnotationOfAnnotation can have one or more imaging observations associated with the instance. AnnotationOfAnnotationHasImagingObservationEntityStatement expresses a relationship between the instance of AnnotationOfAnnotation and an imaging observation.

 

A use case:

An adjudicator wants to annotate imaging observations on a study read by three different readers.

 

Assumption:

  1. Three image annotations for a target lesion were created earlier from three different readers.
  2. There is a system capable of reading and extracting information from the three annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create three AnnotationOfAnnotationHasImageAnnotationStatements linking annotation-of-annotation (subject) to image annotations (objects).
  3. Create an ImagingObservationEntity and store the related question, the imaging observation result, and optional information. See ImagingObservationEntity.
  4. Create an AnnotationOfAnnotationHasImagingObservationEntityStatement to link annotation-of-annotation (subject) to the imaging observation entity (object).

 

2.45 AnnotationOfAnnotationHasImagingPhysicalEntityStatement

An instance of AnnotationOfAnnotation can reference an imaging physical entity, an anatomical part, or a physical object that can be identified on an image.

 

A use case:

An adjudicator wants to annotate an imaging physical entity on a study read by three different readers.

 

Assumption:

  1. Three image annotations for a target lesion were created earlier by three different readers.
  2. There is a system capable of reading and extracting information from the three annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create three AnnotationOfAnnotationHasImageAnnotationStatements linking annotation-of-annotation (subject) to image annotations (objects).
  3. Create ImagingPhysicalEntity and store the related question, the imaging physical entity result, and optional information. See ImagingPhysicalEntity.
  4. Create an AnnotationOfAnnotationHasImagingPhysicalEntityStatement to link the annotation-of-annotation (subject) to the imaging physical entity (object).

 

2.46 AnnotationOfAnnotationHasInferenceEntityStatement

An instance of AnnotationOfAnnotation can have a conclusion derived by interpreting images and/or other supplemental information related to the images. The conclusion is stored in InferenceEntity.

 

A use case:

An adjudicator wants to provide a medical conclusion to a study read by three different readers.

 

Assumption:

  1. Three image annotations for a target lesion were created earlier from three different readers.
  2. There is a system capable of reading and extracting information from the three annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create three AnnotationOfAnnotationHasImageAnnotationStatements linking annotation-of-annotation (subject) to image annotations (object).
  3. Create an InferenceEntity and store the related question and medical conclusion. See InferenceEntity.
  4. Create AnnotationOfAnnotationHasInferenceEntityStatement to link the annotation-of-annotation (subject) to the inference entity (object).

 

2.47 AnnotationOfAnnotationIsComparedWithAnnotationOfAnnotationStatement

An instance of AnnotationOfAnnotation can be compared to another instance of AnnotationOfAnnotation. AIM users can further create CalculationEntityIsComparedWithCalculationEntityStatement to compare a calculation result from the subject AnnotationOfAnnotation instance with a calculation result from the object AnnotationOfAnnotation.

 

A use case:

An adjudicator wants to compare annotation-of-annotations’ calculation results from two different time points--baseline and first follow-up.

 

Assumption:

1. There are two annotation-of-annotations from two time points, baseline and the first follow-up.

2. There is a system capable of reading and extracting information from the annotations for further computational and manipulation purposes.

 

Working with AIM:

1. Create an annotation-of-annotation instance.

2. Create two AnnotationOfAnnotationHasAnnotationOfAnnotationStatements linking a newly created annotation-of-annotation (subject) to the two existing annotation-of-annotations (objects).

3. Create an AnnotationOfAnnotationIsComparedWithAnnotationOfAnnotationStatement to link baseline (subject) and follow-up (object) instances.

4. Extract a calculation result from the baseline and the first follow-up annotation-of-annotation instances.

5. Compare results.

6. Create and store the calculation entity if comparing the difference between two sizes.

7. Create an inference entity to store the result, such as smaller or larger, to the question "Is the size getting larger or smaller?"

8. Create an AnnotationOfAnnotationHasCalculationEntityStatement to associate the annotation-of-annotation (subject) with the calculation entity (object).

9. Create an AnnotationOfAnnotationHasInferenceEntityStatement to associate the annotation-of-annotation (subject) with an inference entity (object).

 

2.48 AnnotationOfAnnotationIsComparedWithImageAnnotationStatement

An instance of AnnotationOfAnnotation can be compared with an instance of ImageAnnotation. AIM users can further create a CalculationEntityIsComparedWithCalculationEntityStatement to compare a calculation result from the subject AnnotationOfAnnotation instance with a calculation result from the object ImageAnnotation.

 

A use case:

An adjudicator wants to compare an annotation-of-annotation calculation result from the baseline and an image annotation created by a reader from the first follow-up.

 

Assumption:

  1. There is an annotation –f-annotation from the first time point and an image annotation from the first follow-up.
  2. There is a system capable of reading and extracting information from the annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create an AnnotationOfAnnotationHasAnnotationOfAnnotationStatement linking the annotation-of-annotation (subject) to the baseline annotation-of-annotation (object).
  3. Create an AnnotationOfAnnotationHasImageAnnotationStatement linking the annotation-of-annotation (subject) to the first follow-up image annotation (object).
  4. Create AnnotationOfAnnotationIsComparedWithImageAnnotationStatement to link the baseline annotation-of-annotation (subject) with the follow-up image annotation (object).
  5. Extract a calculation result from the baseline annotation-of-annotation and first follow-up image annotation.
  6. Compare results.
  7. Create and store the calculation entity if comparing the difference between two sizes.
  8. Create an inference entity to store the result, such as smaller or larger,to the question "Is the size getting larger or smaller?"
  9. Create an AnnotationOfAnnotationHasCalculationEntityStatement to associate the annotation-of-annotation (subject) with a calculation entity (object).
  10. Create an AnnotationOfAnnotationHasInferenceEntityStatement to associate the annotation-of-annotation (subject) with inference entity (object).

 

2.49 CalculationEntityIsComparedWithCalculationEntityStatement

When an AIM user wants to compare two calculation results, the user can use CalculationEntityIsComparedWithCalculationEntityStatement to identify a subject and object of calculation results.

 

This statement should not exist alone. There should be a statement such as AnnotationOfAnnotationIsComparedWithAnnotationOfAnnotationStatement or AnnotationOfAnnotationIsComparedWithImageAnnotationStatement existing alongside the CalculationEntityIsComparedWithCalculationEntityStatement.

 

A use case:

An adjudicator wants to compare an annotation-of-annotation calculation result from the baseline and an image annotation created by a reader from the first follow-up.

 

Assumption:

  1. There is an annotation-of-annotation from the first time point and image annotation from the first follow-up.
  2. There is a system capable of reading and extracting information from the annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create AnnotationOfAnnotationHasAnnotationOfAnnotationStatement linking the annotation-of-annotation (subject) to the baseline annotation-of-annotation (object).
  3. Create an AnnotationOfAnnotationHasImageAnnotationStatement linking the annotation-of-annotation to the first follow-up image annotation (object).
  4. Create an AnnotationOfAnnotationIsComparedWithImageAnnotationStatement to link the baseline annotation-of-annotation (subject) with the follow-up image annotation (object).
  5. Create CalculationEntityIsComparedWithCalculationEntityStatement to link the calculation from the baseline annotation-of-annotation (subject) with the calculation from the image annotation (object).
  6. Extract a calculation result from the baseline annotation-of-annotation and the first follow-up image annotation.
  7. Compare the results.
  8. Create and store the calculation entity if comparing the difference between two sizes.
  9. Create an inference entity to store the result, such as smaller or larger, to the question "Is the size getting larger or smaller?"
  10. Create an AnnotationOfAnnotationHasCalculationEntityStatement to associate the annotation-of-annotation (subject) with a calculation entity (object).
  11. Create an AnnotationOfAnnotationHasInferenceEntityStatement to associate the annotation-of-annotation (subject) with an inference entity (object).

 

2.50 ImageAnnotationHasAnnotationRoleEntityStatement

This class is used to assign an annotation role to an image annotation. For example, an image annotation can be a baseline in one study but a follow-up in another study.

 

A use case:

A user wants to assign a baseline role to an image annotation of a non-target lesion.

 

Assumption:

  1. An image annotation for a non-target lesion was created earlier.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create an annotation role entity containing Baseline Category, 112016, DCM.
  3. Create an AnnotationOfAnnotationHasImageAnnotationStatement to link an annotation-of-annotation (subject) with an image annotation (object).
  4. Create an ImageAnnotationHasAnnotationRoleEntityStatement to link the image annotation (subject) to the annotation role entity (object).

 

2.51 ImageAnnotationIsComparedWithImageAnnotationStatement

An instance of ImageAnnotation is compared with another instance of ImageAnnotation. AIM users can further create CalculationEntityIsComparedWithCalculationEntityStatement to compare a calculation result from the subject ImageAnnotation instance with a calculation result from the object ImageAnnotation.

 

A use case:

An adjudicator wants to compare image annotation calculation results from two different time points, baseline and the first follow-up.

 

Assumption:

  1. There are two image annotations from two time points--baseline and the first follow-up.
  2. There is a system capable of reading and extracting information from the annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create two AnnotationOfAnnotationHasImageAnnotationStatement annotation-of-annotation statements to link the annotation-of-annotation (subject) to each image annotation instance (object).
  3. Create an ImageAnnotationIsComparedWithImageAnnotationStatement to link baseline (subject) and follow-up (object) instances.
  4. Extract calculation results from the baseline and the first follow-up image annotation instances.
  5. Compare the results.
  6. Create and store the calculation entity if comparing the difference between two sizes.
  7. Create an inference entity to store the result, such as smaller or larger, to the question "Is the size getting larger or smaller?", PRV-SIZE01 and Private.
  8. Create an AnnotationOfAnnotationHasCalculationEntityStatement to associate the annotation-of-annotation (subject) with a calculation entity (object).
  9. Create an AnnotationOfAnnotationHasInferenceEntityStatement to associate the annotation-of-annotation (subject) with an inference entity (object).

 

2.52 ImageAnnotationIsComparedWithAnnotationOfAnnotationStatement

An instance of ImageAnnotation is compared with another instance of AnnotationOfAnnotation. AIM users can further create CalculationEntityIsComparedWithCalculationEntityStatement to compare a calculation result from the subject AnnotationOfAnnotation instance with a calculation result from the object ImageAnnotation.

 

A use case:

A user wants to compare an image annotation calculation result with an annotation-of-annotation calculation result created by an adjudicator.

 

Assumption:

  1. There is an image annotation with a calculation result.
  2. There is an annotation-of-annotation with a calculation result.
  3. There is a system capable of reading and extracting information from the annotations for further computational and manipulation purposes.

 

Working with AIM:

  1. Create an annotation-of-annotation instance.
  2. Create an AnnotationOfAnnotationHasAnnotationOfAnnotationStatement to link the annotation-of-annotation (subject) with the referenced annotation-of-annotation (object).
  3. Create an AnnotationOfAnnotationHasImageAnnotationStatement to link the annotation-of-annotation (subject) with the instance of image annotation (object).
  4. Create an ImageAnnotationIsComparedWithAnnotationOfAnnotationStatement to link the image annotation (subject) with the referenced annotation-of-annotation (object).
  5. Extract the calculation results from annotation-of-annotation and image annotation.
  6. Compare results.
  7. Create and store the calculation entity after comparing the difference between the two sizes.
  8. Create an inference entity to store the result, such as smaller or larger, to the question "Is the size getting larger or smaller?"
  9. Create an AnnotationOfAnnotationHasCalculationEntityStatement to associate the annotation-of-annotation (subject) with calculation entity (object).
  10. Create an AnnotationOfAnnotationHasInferenceEntityStatement to associate the annotation-of-annotation (subject) with inference entity (object).

 

Classes derived from ImageAnnotationStatement

 

2.53 DICOMImageReferenceEntityHasCalculationEntityStatement

A DICOM image can have a calculation associated with the image.

 

A use case:

A user wants to store a calculation result associated with a DICOM image. The calculation comes from a region of interest (ROI) of a mass. The user uses a freehand drawing tool to outline the mass region.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create DICOMImageReferenceEntity containing an image with a mass.
  3. Create ImageAnnotationHasDICOMImageReferenceEntityStatement to link the image annotation (subject) to the DICOM image reference entity (object).
  4. The user creates the ROI of the mass.
  5. Compute area of the mass.
  6. Create CalculationEntity and store the ROI result.
  7. Create DICOMImageReferenceEntityHasCalculationEntityStatement to link the DICOM image (subject) with the calculation entity (object).

 

2.54 DICOMImageReferenceEntityHasImagingObservationEntityStatement

A DICOM image, captured in DICOMImageReferenceEntity, can be associated with an imaging observation, captured in ImagingObservationEntity, to describe an observation on the image.

 

A use case:

A user wants to store an imaging observation associated with a DICOM image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create DICOMImageReferenceEntity containing an image with a mass.
  3. Create an ImageAnnotationHasDICOMImageReferenceEntityStatement to link the image annotation (subject) to the DICOM image reference entity (object).
  4. The user creates ROI of the mass.
  5. The user provides an imaging observation with the values of mass, RID3874, RadLex.
  6. Create ImagingObservationEntity and store the value above.
  7. Create DICOMImageReferenceEntityHasImagingObservationEntityStatement to link the DICOM image (subject) with the imaging observation entity (object).

 

2.55 DICOMImageReferenceEntityHasImagingPhysicalEntity

A DICOM image, captured in DICOMImageReferenceEntity, can associate with an image physical entity, captured in ImagingPhysicalEntity, to describe an observation on the image.

 

A use case:

A user wants to store an imaging physical entity associated with a DICOM image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create DICOMImageReferenceEntity containing an image with a mass.
  3. Create ImageAnnotationHasDICOMImageReferenceEntityStatement to link the image annotation (subject) to the DICOM image reference entity (object).    
  4. The user creates the ROI of the mass.
  5. The user provides an imaging physical entity with the values of left upper lobe, RID1327, RadLex.
  6. Create ImagingPhysicalEntity and store the value above.
  7. Create DICOMImageReferenceEntityHasImagingPhysicalEntity to link DICOM image (subject) with the imaging physical entity (object).

 

2.56 DICOMSegmentationEntityHasImagingObservationEntityStatement

A DICOM segmentation object can have an imaging observation to further describe the segmentation object.

 

A use case:

A user wants to associate a DICOM segmentation with an imaging observation.

 

Assumption:

  1. There is a system capable of creating a DICOM segmentation object based on a user ROI for a set of images in a series.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create DICOMImageReferenceEntity containing images with a mass.
  3. Create ImageAnnotationHasDICOMImageReferenceEntityStatement to link the image annotation (subject) to the DICOM image reference entity (object).    
  4. The user designates the ROI of the mass.
  5. The system creates a DICOM segmentation object.
  6. Create DICOMSegmentationEntity with the required information from step 5.
  7. The user provides an imaging observation with values of mass, RID3874, RadLex.
  8. Create ImagingObservationEntity and store the value above.
  9. Create DICOMSegmentationEntityHasImagingObservationEntityStatement to link DICOM segmentation entity (subject) with the imaging observation entity (object).

 

2.57 ImageAnnotationHasCalculationEntityStatement

An image annotation can have a calculation result associated with it.

 

A use case:

A user wants to compute and store a size of the mass from an image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a markup to measure the size of a mass.
  3. Extract the mass size.
  4. Create CalculationEntity and store the result and other required information from step 3.
  5. Create ImageAnnotationHasCalculationEntityStatement to link the image annotation (subject) to the calculation entity (object).

 

2.58 ImageAnnotationHasChildImageAnnotationStatement

An image annotation can have a child image annotation. This represents a hierarchical structure between images. A child image implicitly has a parent image. A use case of this type of statement is a diagnostic mammogram image that has another magnification image associated with the diagnostic image. Another use case is a whole slide image with a 10X magnification factor that may have a section of the image magnified and stored as a separate image. Both images can have a parent-child relationship.

 

A use case:

A user wants to link a mammography image with a corresponding magnification image.

 

Assumption:

  1. There is a DICOMImageReferenceEntity containing the original image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. User views a left mediolateral oblique (MLO)
  3. User creates a magnification view of the ROI and save it as a DICOM secondary captured image.
  4. Create DICOMImageReferenceEntity containing the secondary captured image.
  5. Create ImageAnnotationHasChildImageAnnotationStatement to link the image annotation (subject) to an instance of DICOMImageReferenceEntity containing secondary captured image (object).

 

2.59 ImageAnnotationHasDICOMImageReferenceEntityStatement

An instance of image annotation can have DICOM images of the same series.

 

A use case:

A user views a set of CT axial series.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create ImageAnnotationHasDICOMImageReferenceEntityStatement to link image annotation (subject) and DICOM image reference (object).

 

2.60 ImageAnnotationHasDICOMSegmentationEntityStatement

An image annotation can have one or more DICOM segmentation objects. An ImageAnnotationHasDICOMSegmentationEntityStatement statement represents a direct relationship between an image annotation and a DICOM segmentation entity. If the image annotation has three DICOM segmentation entities, there needs to be three ImageAnnotationHasDICOMSegmentationEntityStatements.

 

A use case:

A user found two nodules in a CT axial series. The user used a workstation to create two DICOM segmentation objects. The user annotated and stored the findings in AIM format with segmentation information.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. An image annotation has the set of CT images in the series. We need to create a statement that associates image annotation with DICOM images.

** Use : ImageAnnotationHasDICOMImageReferenceEntityStatement 

** The statement has the image annotation instance as subject and DICOM image reference instance as object.

  1. Create two DICOM segmentation entity instances. Each instance references DICOM segmentation object from step 2.
  2. Create two statements of type ImageAnnotationHasDICOMSegmentationEntityStatement. Each statement has the same image annotation (subject) but different DICOM segmentation entity (object).

 

2.61 ImageAnnotationHasImagingObservationEntityStatement

An image annotation can have an imaging observation associated with it.

 

A use case:

A user wants to state that a mass is found on an image. 

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create an imaging observation containing mass, RID3874, RadLex.
  4. Create ImageAnnotationHasImagingObservationEntityStatement to link the imaging annotation (subject) with imaging observation (object).

 

2.62 ImageAnnotationHasImagingPhysicalEntityStatement

An image annotation can have an imaging physical entity associated with it.

 

A use case:

A user wants to label the left upper lobe of lung on an image. 

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create an imaging physical entity containing left upper lobe, RID1327, RadLex.
  4. Create ImageAnnotationHasImagingPhysicalEntityStatement to link the imaging annotation (subject) and imaging physical entity (object).

 

2.63 ImageAnnotationHasInferenceEntityStatement

An image annotation can have a conclusion derived by interpreting images and/or other supplemental information related to the images.

 

A use case:

A user wants to provide medical conclusion for a study.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create InferenceEntity and store the related question and medical conclusion. See InferenceEntity.
  4. Create ImageAnnotationHasInferenceEntityStatement to link an image annotation (subject) to the inference entity (object).

 

2.64 ImageAnnotationHasTextAnnotationEntityStatement

An image annotation can have a text annotation associated with it.

 

A use case:

A user creates a text markup on an image from a set of CT axial series.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create a text markup on a mass.
  4. Create TextAnnotationEntity to store information in step 3.
  5. Create ImageAnnotationHasTextAnnotationEntityStatement to link the image annotation (subject) with the text annotation entity (object).

 

2.65 ImageAnnotationHasThreeDimensionGeometricShapeEntityStatement

One or more three-dimensional graphic drawings may be associated with an instance of an image annotation. ImageAnnotationHasThreeDimensionGeometricShapeEntityStatement represents a direct relationship between an instance of image annotation and a drawing. If you have two drawings on an image, you will need to create two statements.

 

A use case:

A user creates a three-dimensional markup on an image from a set of CT axial series.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create a three-dimensional polyline markup on a mass.
  4. Create ThreeDimensionPolyline to store information in step 3.
  5. Create ImageAnnotationHasThreeDimensionGeometricShapeEntityStatement to link the image annotation (subject) with the ThreeDimensionPolyline entity (object).

 

2.66 ImageAnnotationHasTwoDimensionGeometricShapeEntityStatement

An instance of image annotation may have one or more two-dimensional graphical drawings associate with it. ImageAnnotationHasTwoDimensionGeometricShapeEntityStatement represents a direct relationship between an instance of image annotation and a drawing. If you have two drawings on an image, create two statements.

 

A use case:

A user creates a two-dimensional markup on an image from a set of CT axial series.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create a two-dimension polyline markup on a mass.
  4. Create TwoDimensionPolyline to store information in step 3.
  5. Create ImageAnnotationHasTwoDimensionGeometricShapeEntityStatement to link the image annotation (subject) with the TwoDimensionPolyline entity (object).

 

2.67 ImageAnnotationHasUriImageReferenceEntityStatement

An image annotation can have a URI reference that directs to the actual storage location of the image used in the image annotation.

 

A use case:

A user views a set of CT axial series from URI sources.

 

Working with AIM:

1. Create an image annotation instance.

2. Create UriImageReferenceEntity for each image in the CT series.

3. Create ImageAnnotationHasUriImageReferenceEntityStatements to link the image annotation (subject) with each UriImageReferenceEntity (object).

 

2.68 ImagingObservationEntityIsIdentifiedByThreeDimensionGeometricShapeEntityStatement

An instance of imaging observation entity can be identified by one or more three-dimensional graphical drawings associate with it. ImageObservationEntityIsIdentifiedByThreeDimensionGeometricShapeEntityStatement represents a direct relationship between an instance of imaging observation entity and a markup. If you have two markups on an image, create two statements.

 

A use case:

A user creates a three-dimensional markup on an image from a set of CT axial series.

 

Working with AIM:

  1. Create an imaging observation entity instance.
  2. Create a DICOM image reference instance and its associated image study, image series and image instances using DICOMImageReferenceEntity.
  3. Create a three-dimensional polyline markup on a mass.
  4. Create ThreeDimensionPolyline to store information in step 3.
  5. Create ImagingObservationEntityIsIdentifiedByThreeDimensionGeometricShapeEntityStatement to link the imaging observation entity (subject) with the ThreeDimensionPolyline entity (object).

 

2.69 ImagingObservationEntityIsIdentifiedByTwoDimensionGeometricShapeEntityStatement

An instance of imaging observation entity can be identified one or more three-dimensional graphical drawings associated with it. ImageObservationEntityIsIdentifiedByThreeDimensionGeometricShapeEntityStatement represents a direct relationship between an instance of an imaging observation entity and a markup. If you have two markups on an image, create two statements.

 

A use case:

A user creates a three-dimensional markup on an image from a set of CT axial series.

 

Working with AIM:

  1. Create an imaging observation entity instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create a two-dimensional polyline markup on a mass.
  4. Create TwoDimensionPolyline to store information in step 3.
  5. Create ImagObservationIsIdentifiedByTwoDimensionGeometricShapeEntityStatement to link the imaging observation entity (subject) with the TwoDimensionPolyline entity (object).

 

2.70 ImagingObservationEntityIsIdentifiedByTextAnnotationEntityStatement

An imaging observation can be identified by a text annotation.

 

A use case:

A user wants to create a text markup for a mass found on an image. 

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances.
  3. Create an imaging observation containing mass, RID3874, RadLex.
  4. Create a text markup on a mass.
  5. Create a text annotation entity based on information from step 4.
  6. Create an ImagingObservationEntityIsIdentifiedByTextAnnotationEntityStatement to link the imaging observation (subject) with the text annotation entity (object).

 

2.71 ImagingPhysicalEntityHasThreeDimensionGeometricShapeEntityStatement

An instance of imaging physical entity may have one or more three-dimensional drawings associate with it. ImagePhysicalEntityHasThreeDimensionGeometricShapeEntityStatement represents a direct relationship between an instance of an imaging physical entity and a markup. If you have two markups on an image, you create two statements.

 

A use case:

A user creates a three-dimensional markup on an image from a set of CT axial series.

 

Working with AIM:

  1. Create an imaging physical entity instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create an imaging physical entity containing left upper lobe, RID1327, RadLex.
  4. Create a three-dimensional polyline markup on a mass.
  5. Create ThreeDimensionPolyline to store information in step 3.
  6. Create ImagingPhysicalEntityHasThreeDimensionGeometricShapeEntityStatement to link the imaging physical entity (subject) with the ThreeDimensionPolyline entity (object).

 

2.72 ImagingPhysicalEntityHasTwoDimensionGeometricShapeEntityStatement

An instance of imaging physical entity may have one or more two-dimensional drawings associate with it. ImagePhysicalEntityHasTwoDimensionGeometricShapeEntityStatement represents a direct relationship between an instance of an imaging physical entity and a markup. If you have two markups on an image, you create two statements.

 

A use case:

A user creates a two-dimensional markup on an image from a set of CT axial series.

 

Working with AIM:

  1. Create an imaging physical entity instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create an imaging physical entity containing left upper lobe, RID1327, RadLex.
  4. Create a two-dimensional polyline markup on a mass.
  5. Create a TwoDimensionPolyline to store information in step 3.
  6. Create ImagingPhysicalEntityHasTwoDimensionGeometricShapeEntityStatement to link the imaging observation entity (subject) with the TwoDimensionPolyline entity (object).

 

2.73 ImagingPhysicalEntityHasTextAnnotationEntityStatement

An image physical entity can have a text annotation.

 

A use case:

A user creates a text markup to label the imaging physical entity from a set of CT axial series.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a DICOM image reference instance and its associated image study, image series, and image instances using DICOMImageReferenceEntity.
  3. Create an imaging physical entity containing left upper lobe, RID1327, RadLex.
  4. Create a text markup on a mass.
  5. Create TextAnnotationEntity to store information from step 4.
  6. Create ImagingPhysicalEntityHasTextAnnotationEntityStatement to link the imaging physical entity (subject) with the text annotation entity (object).

 

2.74 ThreeDimensionGeometricShapeEntityIsComprisedOfThreeDimensionGeometricShapeEntityStatement

Two or more drawings captured as ThreeDimensionGeometricShapeEntity instances have a direct relationship to other drawings when these drawings are placed on the same physical entity or thing.

 

A use case:

A user draws two different markups on the same lesion. This lesion is the same thing that appears on the same image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a markup of the first area of a mass.
  3. Create ThreeDimensionGeometricShapeEntity to store information in step 2.
  4. Calculate area from step 3 (optional).
  5. Create a markup of the second area of the same mass.
  6. Create a ThreeDimensionGeometricShapeEntity to store information in step 5.
  7. Calculate the area from step 5.
  8. Create ThreeDimensionGeometricShapeEntityIsComprisedOfThreeDimensionGeometricShapeEntityStatement to link the first markup (subject) to the second markup (object).

 

2.75 ThreeDimensionGeometricShapeEntityExcludesThreeDimensionGeometricShapeEntityStatement

Two or more graphical drawings captured as ThreeDimensionGeometricShapeEntity instances have a direct relationship with other drawings when these drawings are placed on the same physical entity or thing.

 

A use case:

A user draws two different markups on the same lesion. This lesion is the same thing that appears on the same image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a markup of the first area of a mass.
  3. Create ThreeDimensionGeometricShapeEntity to store information from step 2.
  4. Calculate the area from step 3 (optional).
  5. Create a markup of the second area of the same mass.
  6. Create ThreeDimensionGeometricShapeEntity to store information in step 5.
  7. Calculate the area from step 5.
  8. Create ThreeDimensionGeometricShapeEntityExcludesThreeDimensionGeometricShapeEntityStatement to link the first markup (subject) to the second markup (object).

 

2.76 TwoDimensionGeometricShapeEntityIsComprisedOfTwoDimensionGeometricShapeEntityStatement

Two or more graphical drawings captured as TwoDimensionGeometricShapeEntity instances have a direct relationship with other graphical drawings when these drawings are placed on the same physical entity or thing.

 

A use case:

A user draws two different markups on the same lesion. This lesion is the same thing that appears on the same image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a markup of the first area of a mass.
  3. Create TwoDimensionGeometricShapeEntity to store information from step 2.
  4. Calculate the area from step 3 (optional).
  5. Create a markup of the second area of the same mass.
  6. Create TwoDimensionGeometricShapeEntity to store information in step 5.
  7. Calculate the area from step 5.
  8. Create TwoDimensionGeometricShapeEntityIsComprisedOfTwoDimensionGeometricShapeEntityStatement to link the first markup (subject) to the second markup (object).

 

2.77 TwoDimensionGeometricShapeEntityExcludesTwoDimensionGeometricShapeEntityStatement

Two or more graphical drawings captured as TwoDimensionGeometricShapeEntity instances have a direct relationship with other drawings when these drawings are placed on the same physical entity or thing.

 

A use case:

A user draws two different markups on the same lesion. This lesion is the same thing that appears on the same image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a markup of the first area of a mass.
  3. Create TwoDimensionGeometricShapeEntity to store information from step 2.
  4. Calculate the area from step 3 (optional).
  5. Create a markup of the second area of the same mass.
  6. Create TwoDimensionGeometricShapeEntity to store information from step 5.
  7. Calculate the area from step 5.
  8. Create TwoDimensionGeometricShapeEntityExcludesTwoDimensionGeometricShapeEntityStatement to link the first markup (subject) to the second markup (object).

 

2.78 UriImageReferenceEntityHasImagingObservationEntityStatement

A URI image reference can have an imaging observation. It is used in conjunction with UriImageReferenceHasImagingPhysicalEntityStatement.

 

A use case:

A user wants to state that a mass is found on an image. 

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create UriImageReferenceEntity instance with the image location.
  3. Create an imaging observation containing mass, RID3874, RadLex.
  4. Create UriImageReferenceEntityHasImagingObservationEntityStatement to link the UriImageReferenceEntity (subject) with imaging observation (object).

 

2.79 UriImageReferenceEntityHasImagingPhysicalEntityStatement

An URI image reference can have an imaging physical entity associated with it.

 

A use case:

A user wants to label left upper lobe of lung on an image. 

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a UriImageReferenceEntity instance with the image location.
  3. Create an imaging physical entity containing left upper lobe, RID1327, RadLex.
  4. Create UriImageReferenceEntityHasImagingPhysicalEntityStatement to link the UriImageReferenceEntity (subject) with the imaging physical entity (object).

 

2.80 UriImageReferenceEntityHasCalculationEntityStatement

A URI image reference can have a calculation associated with it.

 

A use case:

A user wants to compute and store a size of the mass from an image.

 

Working with AIM:

  1. Create an image annotation instance.
  2. Create a UriImageReferenceEntity instance with the image location.
  3. Create a markup to measure the size of a mass.
  4. Create CalculationEntity and store the size of the mass.
  5. Create UriImageReferenceEntityHasCalculationEntityStatement to link the UriImageReferenceEntity (subject) with the calculation entity (object).

 

3. We renamed the following classes.

 

3.1 AnatomicEntity was renamed as ImagingPhysicalEntity.

ImagingPhysicalEntity is an entity or object that can be identified on an image. For medical imaging, it may represent anatomical location of an organ or body structure. Terms from controlled vocabulary such as RadLex, SNOMED CT, DCIOM, etc. are used to record the type of entity.

 

3.2 AnatomicEntityCharacteristic was renamed as ImagingPhysicalEntityCharacteristic.

An ImagingPhysicalEntityCharacteristic is a characteristic of imaging physical entities. It is in contradistinction to ImagingObservationCharacteristic. In a medical area, for example, "dilated" might be an imaging physical entity characteristic of the "colon" imaging physical entity.

 

3.3 ImagingObservation was renamed as ImagingObservationEntity.

An ImagingObservationEntity is the description of things that are seen in an image. "Mass", "Pleural Effusion", "Foreign Body", and "Artifact", are all examples of imaging observation entity.

 

3.4 Inference was renamed as InferenceEntity.

A conclusion derived by interpreting images and/or other supplemental information related to the images such as medical history, geographic history, etc.

 

3.5 AnnotationRole was renamed as AnnotationRoleEntity.

AnnotationRoleEntity describes the role of referenced annotation.

 

3.6 ImageReference was renamed as ImageReferenceEntity.

ImageReference is an abstract class that references the image which is being annotated.

 

3.7 WebImageReference was renamed as UriImageReferenceEntity.

UriImageReferenceEntity is a source image for the annotation. It can be accessed via Intranet, Internet, local computer and/or file sharing systems.

 

3.8 DICOMImageReference was renamed as DICOMImageReferenceEntity.

DICOMImageReferenceEntity is a source image for the annotation.

 

3.9 Annotation was renamed as AnnotationEntity.

AnnotationEntity captures information that can be described, measured, calculated, and drawn on images either by a human or machine observer.

 

3.10 TextAnnotation was renamed as TextAnnotationEntity.

TextAnnotationEntity represents the text and the markup of text intended to be rendered on the image.

 

3.11 GeometricShape was renamed as GeometricShapeEntity.

GeometricShapeEntity is the shape of a region of interest (ROI).

 

3.12 Segmentation was renamed to DICOMSegmentation.

DICOMSegmentation is a multi-frame image representing a classification of pixels in one or more referenced images. Segmentations are either binary or fractional. See DICOM part 3 Segmentation IOD for more information.

 

3.13 PresentationState was renamed to ReferencedDICOMObject.

ReferencedDICOMObject is a collection of related DICOM objects created from the image(s), e.g. presentation state, SR document, radiotherapy objects, waveform, encapsulated document, etc. 

 

The old association between PresentationState and DICOMImageReferenceEntity was removed. It was replaced by an association between ReferencedDICOMObject and ImageStudy.

 

4. Four classes were deleted since AIM statements and new classes cover the concepts represented by the deleted classes.

 

4.1 ReferencedGeometricShape is represented by ImagingObservationEntityIsIdentifiedByGeometricShapeEntityStatement.

4.2 AimStatus is represented by AuditTrail.

4.3 ReferencedAnnotation is represented by AnnotationOfAnnotationHasAnnotationRoleEntityStatement and ImageAnnotationHasAnnotationRoleEntityStatement.

4.4 ReferencedCalculation is represented by CalculationEntityReferencesCalculationEntityStatement.

 

5. New attributes have been added to the following classes.

 

5.1 Inference

    - questionTypeCode is used to collect coded entry data that describes the question being asked that is related to the typeCode attribute.

    - isPresent, a Boolean value indicating whether or not an inference exists in the observed images.

    - label, a human readable description of the Inference.

- questionIndex is used to store an index value that identifies the order of the question in an AIM Template.

- comment is a free text about inference.

 

5.2 GeometricShapeEntity

    - label is a human readable description of the geometric shape.

    - description is a free text about the geometric shape, not intended for rendering.

- questionTypeCode is used to collect coded entry data that describes the question being asked that is related to the typeCode attribute.

- questionIndex is used to store an index value that identifies the order of the question in an AIM Template.

- interpolationMethod is used to create new data points from a discrete set of data points, such as linear, polynomial, spline and piecewise constant interpolation.

- comment is free text about a geometric shape entity.

 

5.3 ImageSeries

    - modality is the equipment used to acquire images of subjects or  things, such as human and animal bodies.

 

5.4 CalculationEntity

 - questionTypeCode is used to collect coded entry data that describes the question being asked that is related to the typeCode attribute.

 - imageIdentifierReference is a number that refers to an existing image identifier from ImageReference.

- questionIndex is used to store an index value that identifies the order of the question in an AIM Template.

 

5.5 ImageStudy

   - procedureDescription is information about the procedure being performed on a subject.

 

5.6 Scale

   - type represents different types of scales that are Nominal, Ordinal or Ratio.

 

5.7 AnnotationRole

   - questionTypeCode is used to collect coded entry data that describes the question being asked that is related to the typeCode attribute.

 

5.8 ImageReference

   - imageIdentifier is a unique number within an ImageAnnotation object that uniquely identifies this object.

 

5.9 ImagingObservation

   - imageIdentifierReference is a number that refers to an existing image identifier from ImageReference.  

- questionIndex is used to store an index value that identifies the order of the question in an AIM template.

 

5.10 Annotation

   - templateUid is a UID that references to an AIM template used to capture semantic meaning of pixel data, markup and calculation.

 

5.11 CalculationResult

  - dataType is coded entry data used to describe or capture a type of parameter. A coded data type can be a primitive programming data type such as integer, double, etc. as well as other data types such as URI.

 

5.12 Equipment

  - deviceSerialNumber is manufacturer’s serial number of the equipment that produced the sources.

 

5.13 ImagingPhysicalEntity

- questionIndex is used to store an index value that identifies the order of the question in an AIM Template.

 

5.14 Quantile

- bins is a number representing the dividing ordered data into an equal-sized data subsets. For example, maxValue is 100. It's divided by four. Four is the value for the bins.

- selectedBin is an integer value of the selected bin.

- minValue is a minimum value of the lowest value in a range.

- maxValue is a maximum value of the largest value in a range.

 

5.15 CharacteristicQuantification

- comment is free text about characteristic quantification.

- valueLabel is a value that associates with the label.

- valueDescription is a human readable description.

 

5.16 ImagingPhysicalEntity

- comment is free text about imaging physical entity.

 

5.17 ImagingPhysicalEntityCharacteristic

- comment is free text about imaging physical entity characteristic.

 

 

6. Attribute name change.

 

6.1 typeCode attribute replaces a set of coded term attributes as a single attribute in a class. The replaced attributes include:

-          codeValue

-          codeMeaning

-          codingSchemeDesignator

-          codingSchemeVersion

 

These attributes are mapped to a single CD ISO 21090 data type. The effected AIM classes include:

-          AnnotationEntity (formerly known as Annotation)

-          AnnotationRoleEntity (formerly known as AnnotationRole)

-          CalculationEntity (formerly known as Calculation)

-          ImagingPhysicalEntity (formerly known as AnatomicEntity)

-          ImagingPhysicalEntityCharacteristic (formerly known as AnatomicEntityCharacteristic)

-          ImagingObservationEntity (formerly known as ImagingObservation)

-          ImagingObservationEntityCharacteristic (formerly known as ImagingObservationCharacteristic)

-          InferenceEntity (formerly known as Inference)

-          NonQuantifiable

 

6.2 The name attribute in CharacteristicQuantification has been change

 

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