1. Very few of the SNOMED codes in CID 12001 Ultrasound Protocol Types, and none of the codes in 12002 Ultrasound Protocol Stage Types, actually exist in SNOMED. While these non-existent codes do no harm (yet), it is inappropriate for DICOM to assert them as SNOMED codes, and in fact SNOMED could use them for other concepts. [For the record, these terms were added in CP230.] 2. The codes as listed in DICOM for “Transthoracic echocardiography” and “Epicardial echocardiography” conflict with the actual codes in SNOMED, and with each other. (For the record, TTE in SNOMED is P5-B3004 but is listed in DICOM as P5-B3003 – which is the code for a different concept in SNOMED, and ECE in SNOMED is P5-B3007 but is listed in DICOM as P5-B3004). SNOMED has assigned new codes to resolve the conflict and potential ambiguity. 3. SNOMED had assigned other codes for Exercise stress echocardiography (P5-B3009), Contrast echocardiography (P5-B3008) and Fetal echocardiography (P5-B3001). SNOMED has agreed to reassign these concepts with the codes published in DICOM (P5-B3050, P5-B3090, and P5-B8215, respectively). 4. The various Stress Protocol names in CID 12001 are pre-coordinated with the term “echocardiography”, e.g., “Bruce treadmill stress echocardiography”. For other uses in stress testing we simply use a protocol name without the modality term, e.g., “Bruce protocol” (SNOMED P2-7131A). It would simplify applications if there were a common set of protocol names used across all modalities, without having to map to a different code for each modality. The pre-coordinated terms are therefore replaced by the terms of CID 3261 Stress Protocols. 5. Similarly, the various Stage names in CID 12002 are pre-coordinated with the term “image acquisition”, e.g., “Peak-stress image acquisition”. For other staged modality protocols (stress testing) we simply use a stage name, as some modalities do not acquire images. The pre-coordinated terms are therefore replaced by the terms of CID 3207 Stress Test Procedure Phases (copied from Sup128_FZ). 6. Various Stage names in CID 12002 are pre-coordinated with very specific terms for test conditions, e.g., “Image acquisition at dobutamine 50 mcg/kg/min plus atropine”. It is not clear that this is a useful or practical type of concept to be selected or entered on the imaging modality. For other uses in stress testing we rely on the protocol definition or other reporting mechanism to convey the details of the stage test conditions (see Supplement 128). These terms are retired. Sections of documents affected
Add to new table to PS 3.6 Annex A Table A-3 CONTEXT GROUP UID VALUES Context UID Context Group Name Identifier
Modify CID 12001 and CID 12002 in PS 3.16 Annex B
CID 12001 Ultrasound Protocol Types Context ID 12001 Ultrasound Protocol Types Type: Extensible Version: 2002090420081027 Coding Scheme Code Value Code Meaning Designator (0008,0100) (0008,0104) (0008,0102) P5-B3000 Echocardiography P5-B3003 P5-B3012 Transthoracic echocardiography P5-B3004P0-05F95 Epicardial echocardiography SRT P5-B301F Limited M-mode only echocardiography SRT P5-B303F Limited Doppler only echocardiography SRT P5-B3051 Maximal stress echocardiography SRT P5-B3052 Submaximal echocardiography SRT P5-B3053 Treadmill exercise stress echocardiography SRT P5-B3054 Bruce treadmill stress echocardiography SRT P5-B3055 Modified Bruce treadmill stress echocardiography SRT P5-B3056 Naughton treadmill stress echocardiography SRT P5-B3058 Bicycle exercise stress echocardiography SRT P5-B3060 Echocardiography with administered drug stress SRT P5-B3061 Dobutamine echocardiography SRT P5-B3062 High dose dobutamine stress echocardiography SRT P5-B3063 Low dose dobutamine stress echocardiography SRT P5-B3065 Arbutamine echocardiography SRT P5-B3066 Dipyridamole stress echocardiography SRT P5-B3070 Cardiac pacing echocardiography SRT P5-B3081 Adult echocardiography P5-B3082 P5-B300F Pediatric echocardiography P5-B3083 P5-B300C Intraoperative echocardiography SRT P5-B3084 Upright echocardiography SRT P5-B3085 Supine echocardiography SRT P5-B3091 Contrast left ventricular opacification echocardiography SRT P5-B3092 Contrast perfusion echocardiography SRT P5-B3093 Contrast Doppler enhancement echocardiography SRT P5-B3191 2D complete echocardiography SRT P5-B3192 Limited 2D only echocardiography Include CID 3261 Stress Protocols In a prior version of this context group, Transthoracic echocardiography was assigned the code P5- B3003 and Epicardial echocardiography was assigned the code P5-B3004; these codes conflict with other SNOMED code assignments. In addition, the prior version used many codes that are not actually in SNOMED. Receiving applications should be aware of this change, and the possibility of misinterpretation of SOP Instances that may include the deprecated codes; see Annex J.
CID 12002 Ultrasound Protocol Stage Types Context ID 12002 Ultrasound Protocol Stage Types Type: Extensible Version: 2002090420081027 Coding Scheme Code Value Code Meaning Designator (0008,0100) (0008,0104) (0008,0102) Include CID 3207 Stress Test Procedure Phases Include CID12102 Temporal Periods Relating to Procedure or Therapy SRT P5-01000 Image acquisition procedure SRT P5-01101 Image acquisition after administration of contrast agent P5-01103P2-35000 Image acquisition during Cardiac pacing SRT P5-01104 Image acquisition at user-defined cardiac pacing rate P5-01111P2-71306 Image acquisition during Hand grip maneuver P5-01112R-40928 Image acquisition during Valsalva SRT P5-01113 Image acquisition during postural maneuver SRT P5-01120 Pre-procedure image acquisition SRT P5-01121 Preoperative image acquisition SRT P5-01130 Intra-procedure image acquisition SRT P5-01131 Intra-operative image acquisition SRT P5-01140 Post-procedure image acquisition SRT P5-01141 Post-operative image acquisition SRT P5-01142 Image acquisition following first cardiopulmonary SRT P5-01143 Image acquisition following second cardiopulmonary bypass SRT P5-01144 Image acquisition following third cardiopulmonary bypass SRT P5-01200 Image acquisition during stress procedure SRT P5-01201 Image acquisition at baseline SRT P5-01202 Pre-stress image acquisition SRT P5-01203 Mid-stress image acquisition SRT P5-01204 Peak-stress image acquisition SRT P5-01205 Image acquisition during recovery SRT P5-01300 Image acquisition after drug administration SRT P5-01310 Image acquisition at user-defined dobutamine dose SRT P5-01311 Image acquisition at low-dose dobutamine SRT P5-01312 Image acquisition at mid-dose dobutamine P5-01313 Image acquisition at peak dose dobutamine SRT P5-01314 Image acquisition at dobutamine 5 mcg/kg/min SRT P5-01315 Image acquisition at dobutamine 10 mcg/kg/min SRT P5-01316 Image acquisition at dobutamine 20 mcg/kg/min SRT P5-01317 Image acquisition at dobutamine 30 mcg/kg/min SRT P5-01318 Image acquisition at dobutamine 40 mcg/kg/min SRT P5-01319 Image acquisition at dobutamine 50 mcg/kg/min SRT P5-0131A Image at dobutamine 40 mcg/kg/min plus atropine SRT P5-0131B Image acquisition at dobutamine 50 mcg/kg/min plus atropine SRT P5-01323 Image acquisition at peak Arbutamine dose SRT P5-01333 Image acquisition at peak dipyridamole SRT P5-01341 Image acquisition after nitroglycerin SRT P5-01342 Image acquisition after amyl nitrite SRT P5-01343 Image acquisition after adenosine A prior version of this context group used many codes that are not actually in SNOMED. Although there is minimal possibility of misinterpretation with SOP Instances that may include the deprecated use, receiving applications should be aware of this change; see Annex J. Add CID 3207 (also defined in Supplement 128 Frozen Draft for Trial Use) Context ID 3207 Stress Test Procedure Phases Type: Extensible Version: 20081031 Code Value Code Meaning Scheme Designator
Modify CID 3261 (including modifications in Supplement 128 Frozen Draft for Trial Use)
CID 3261 Stress Protocols Context ID 3261 Stress Protocols Type: Extensible Version: 2002090420081027 Code Value Code Meaning P2-31102 Stress test using Bicycle Ergometer P2-31107 Pharmacologic Stress protocol P2-3110A Dipyridamole Stress protocol P2-31109 Adenosine Stress protocol P2-31108 Dobutamine Stress protocol P2-31011 Pharmacologic and exercise stress test P2-3110B Stress testusing cardiac pacing
For reference, CID 12102 from PS3.16-2008 (no change)
CID 12102 Temporal Periods Relating to Procedure or Therapy Context ID 12102 Temporal Periods Relating to Procedure or Therapy Type: Extensible Version: 20050110 Code Value Code Meaning (0008,0100) (0008,0104) Designator (0008,0102) Add the following rows to PS 3.16 Annex J SNOMED DICOM Microglossary Retired Codes Code Meaning Replacement (SNOMED)
“Stress test using Bicycle Ergometer”
“Stress testusing cardiac pacing”
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CONTENTS 1. OVERVIEW OF CHYTRIDIOMYCOSIS Catastrophic amphibian population crashes over the last 30 years have been caused by the spread of an emerging fungal disease, chytridiomycosis, caused by the chytrid fungus Batrachochytrium dendrobatidis . The arrival of this pathogen in naïve populations has caused about 122 extinctions worldwide, and is the worst example of a disease impacting