sup147_42.doc: Supplement 147: Second Generation Radiotherapy Page 288
Digital Imaging and Communications in Medicine (DICOM)
Supplement 147: Second Generation Radiotherapy
DICOM Standards Committee, Working Group 7, Radiation Therapy
1300 N. 17th Street, Suite 1752
Rosslyn, Virginia 22209 USA
VERSION: Sup 147 - Revision 42
March 28, 2014
Developed pursuant to DICOM Work Item 2007-06-B
This is a draft document. Do not circulate, quote, or reproduce it except with the approval of NEMA.
Table of Contents
Table of Contents 1
Foreword 11
Scope and Field of Application 11
Part 2 Addendum 12
Part 3 Addendum 13
7.12 Extension of the DICOM model of the real-world for Second Generation Radiotherapy Information Objects 13
7.12.1 RT Course 14
7.12.2 RT Physician Intent 15
7.12.3 Conceptual Volume 15
7.12.4 RT Segment Annotation 15
7.12.5 RT Radiation Set 15
7.12.6 RT Radiation 15
7.12.7 RT Radiation Record 15
7.12.8 RT Dose Image 16
7.12.9 RT Dose Histogram 16
7.12.10 RT Dose Samples 16
7.12.11 RT Treatment Phase 16
A.VV Second Generation Radiation Therapy 20
A.VV.1 Second Generation Radiation Therapy Objects 20
A.VV.1.1 Second Generation Radiation Therapy Common Information 20
A.VV.1.1.1 Second Generation Radiation Therapy Entity-Relationship Model 20
A.VV.1.2 RT Course Information Object Definition 24
A.VV.1.2.1 RT Course IOD Description 24
A.VV.1.2.2 RT Course IOD Entity-Relationship Model 24
A.VV.1.2.3 RT Course IOD Module Table 24
A.VV.1.3 RT Physician Intent Information Object Definition 25
A.VV.1.3.1 RT Physician Intent IOD Description 25
A.VV.1.3.2 RT Physician Intent IOD Entity-Relationship Model 25
A.VV.1.3.3 RT Physician Intent IOD Module Table 25
A.VV.1.4 RT Radiation Set Information Object Definition 25
A.VV.1.4.1 RT Radiation Set IOD Description 25
A.VV.1.4.2 RT Radiation Set IOD Entity-Relationship Model 25
A.VV.1.4.3 RT Radiation Set IOD Module Table 25
A.VV.1.5 RT Segment Annotation Information Object Definition 26
A.VV.1.5.1 RT Segment Annotation IOD Description 26
A.VV.1.5.2 RT Segment Annotation IOD Entity-Relationship Model 26
A.VV.1.5.3 RT Segment Annotation IOD Module Table 26
A.VV.1.6 Tomotherapeutic Radiation Information Object Definition 26
A.VV.1.6.1 Tomotherapeutic Radiation IOD Description 26
A.VV.1.6.2 Tomotherapeutic Radiation IOD Entity-Relationship Model 26
A.VV.1.6.3 Tomotherapeutic Radiation IOD Module Table 26
A.VV.1.7 C-Arm Photon Radiation Information Object Definition 26
A.VV.1.7.1 C-Arm Photon Radiation IOD Description 26
A.VV.1.7.2 C-Arm Photon Radiation IOD Entity-Relationship Model 26
A.VV.1.7.3 C-Arm Photon Radiation IOD Module Table 27
A.VV.1.8 C-Arm Electron Radiation Information Object Definition 27
A.VV.1.8.1 C-Arm Electron Radiation IOD Description 27
A.VV.1.8.2 C-Arm Electron Radiation IOD Entity-Relationship Model 27
A.VV.1.8.3 C-Arm Electron Radiation IOD Module Table 27
A.VV.1.9 Multiple Fixed Source Radiation Information Object Definition 27
A.VV.1.9.1 Multiple Fixed Source Radiation IOD Description 27
A.VV.1.9.2 Multiple Fixed Source Radiation IOD Entity-Relationship Model 27
A.VV.1.9.3 Multiple Fixed Source Radiation IOD Module Table 28
A.VV.1.10 Robotic Radiation Information Object Definition 28
A.VV.1.10.1 Robotic Radiation IOD Description 28
A.VV.1.10.2 Robotic Radiation IOD Entity-Relationship Model 28
A.VV.1.10.3 Robotic Radiation IOD Module Table 28
A.VV.1.11 Multi-Axial Radiation Information Object Definition 28
A.VV.1.11.1 Multi-Axial Radiation IOD Description 28
A.VV.1.11.2 Multi-Axial Radiation IOD Entity-Relationship Model 28
A.VV.1.11.3 Multi-Axial Radiation IOD Module Table 28
A.VV.1.12 RT Dose Image Information Object Definition 29
A.VV.1.12.1 RT Dose Image IOD Description 29
A.VV.1.12.2 RT Dose Image IOD Entity-Relationship Model 29
A.VV.1.12.3 RT Dose Image IOD Module Table 29
A.VV.1.12.4 RT Dose Image IOD Content Constraints 29
A.VV.1.12.5 RT Dose Image Functional Group Macros 29
A.VV.1.13 RT Dose Histogram Information Object Definition 30
A.VV.1.13.1 RT Dose Histogram IOD Description 30
A.VV.1.13.2 RT Dose Histogram IOD Entity-Relationship Model 30
A.VV.1.13.3 RT Dose Histogram IOD Module Table 30
A.VV.1.14 RT Dose Samples Information Object Definition 30
A.VV.1.14.1 RT Dose Samples IOD Description 30
A.VV.1.14.2 RT Dose Samples IOD Entity-Relationship Model 30
A.VV.1.14.3 RT Dose Samples IOD Module Table 30
A.VV.1.15 Tomotherapeutic Radiation Record Information Object Definition 31
A.VV.1.15.1 Tomotherapeutic Radiation Record IOD Description 31
A.VV.1.15.2 Tomotherapeutic Radiation Record IOD Entity-Relationship Model 31
A.VV.1.15.3 Tomotherapeutic Radiation Record IOD Module Table 31
A.VV.1.16 C-Arm Photon Radiation Record Information Object Definition 31
A.VV.1.16.1 C-Arm Photon Radiation Record IOD Description 31
A.VV.1.16.2 C-Arm Photon Radiation Record IOD Entity-Relationship Model 31
A.VV.1.16.3 C-Arm Photon Radiation Record IOD Module Table 31
A.VV.1.17 C-Arm Electron Radiation Record Information Object Definition 32
A.VV.1.17.1 C-Arm Electron Radiation Record IOD Description 32
A.VV.1.17.2 C-Arm Electron Radiation Record IOD Entity-Relationship Model 32
A.VV.1.17.3 C-Arm Electron Radiation Record IOD Module Table 32
A.VV.1.18 Multiple Fixed Source Radiation Record Information Object Definition 32
A.VV.1.18.1 Multiple Fixed Source Record Radiation IOD Description 32
A.VV.1.18.2 Multiple Fixed Source Radiation Record IOD E-R Model 32
A.VV.1.18.3 Multiple Fixed Source Radiation Record IOD Module Table 32
A.VV.1.19 Robotic Radiation Record Information Object Definition 32
A.VV.1.19.1 Robotic Radiation Record IOD Description 32
A.VV.1.19.2 Robotic Radiation Record IOD Entity-Relationship Model 32
A.VV.1.19.3 Robotic Radiation Record IOD Module Table 32
A.VV.1.20 Multi-Axial Radiation Record Information Object Definition 33
A.VV.1.20.1 Multi-Axial Radiation Record IOD Description 33
A.VV.1.20.2 Multi-Axial Radiation Record IOD Entity-Relationship Model 33
A.VV.1.20.3 Multi-Axial Radiation Record IOD Module Table 33
C.AA Second Generation Radiotherapy Modules 34
C.AA.1 Second Generation Radiotherapy Definitions 34
C.AA.1.1 Control Points 34
C.AA.1.1.1 Verification Control Points 34
C.AA.1.2 Nominal Energy 34
C.AA.1.3 Fractionation, Fractionation Scheme 34
C.AA.1.4 Treatment RT Radiation Set 34
C.AA.1.5 Meterset 35
C.AA.1.6 Radiation Dose Point 35
C.AA.1.7 Treatment Phase 35
C.AA.2 Second Generation Radiotherapy General-Purpose Macros 36
C.AA.2.1 RT Entity Labeling Macro 36
C.AA.2.1.1 RT Entity Labeling Macro Attribute Description 36
C.AA.2.2 RT Entity Long Labeling Macro 36
C.AA.2.3 RT Item State Macro 37
C.AA.2.3.1 RT Item State Macro Attribute Description 37
C.AA.2.4 RT Operation State Macro 38
C.AA.2.5 Conceptual Volume Macro 40
C.AA.2.5.1 Conceptual Volume Macro Attribute Description 41
C.AA.2.6 Conceptual Volume Segmentation Reference and Combination Macro 41
C.AA.2.6.1 Conceptual Volume Combination and Segmentation Macro Attribute Description 46
C.AA.2.9 Radiation Fraction Pattern Macro 52
C.AA.2.9.1 Radiation Fraction Pattern Macro Attribute Description 52
C.AA.2.10 Treatment Device Identification Macro 54
C.AA.2.11 Device Model Macro 54
C.AA.2.12 RT Patient Support Devices Macro 54
C.AA.2.13 Patient Support Position Macro 55
C.AA.2.14 Device Identification Macro 56
C.AA.2.15 RT Accessory Device Identification Macro 57
C.AA.2.16 Control Point General Attributes Macro 58
C.AA.2.16.1 Control Point Attribute Concept 59
C.AA.2.17 External Beam Control Point General Attributes Macro 61
C.AA.2.17.1 External Beam Control Point General Attributes Macro Attribute Description 62
C.AA.2.18 External Beam Sub-Control Point General Attributes Macro 62
C.AA.2.18.1 RT Beam Limiting Device Definition Macro Attribute Description 62
C.AA.2.18.1.1 Sub-Control Point Attribute Requirements 62
C.AA.2.18.1.2 Cumulative Meterset 63
C.AA.2.19 Beam Mode Macro 63
C.AA.2.19.1 Beam Mode 65
C.AA.2.20 RT Beam Limiting Device Definition Macro 65
C.AA.2.20.1 RT Beam Limiting Device Definition Macro Attribute Description 67
C.AA.2.21 RT Beam Limiting Device Positions Macro 67
C.AA.2.22 Wedges Definition Macro 68
C.AA.2.23 Wedge Positions Macro 69
C.AA.2.24 Compensators Definition Macro 69
C.AA.2.24.1 Compensators Definition Macro Attributes Description 72
C.AA.2.25 Blocks Definition Macro 73
C.AA.2.25.1 Blocks Definition Macro Attribute Description 74
C.AA.2.26 Accessory Holder Definition Macro 75
C.AA.2.26.1 Accessory Holder Description 75
C.AA.2.27 General Accessories Definition Macro 77
C.AA.2.28 Boluses Definition Macro 78
C.AA.2.28.1 Bolus Definition Macro Attribute Description 78
C.AA.2.29 Outline Definition Macro 79
C.AA.2.30 RT Tolerance Set Macro 80
C.AA.2.30.1 RT Tolerance Set Attribute Description 81
C.AA.2.30.1.2 Patient Support Position Tolerance Sequence 81
C.AA.2.31 Patient to Equipment Relationship Macro 81
C.AA.2.31.1 Patient to Equipment Relationship Macro Attributes Description 82
C.AA.2.32 RT Treatment Position Macro 83
C.AA.2.33 User Content Identification Macro 84
C.AA.2.33.1 User Content Identification Macro Attribute Description 85
C.AA.2.34 RT Treatment Phase Macro 85
C.AA.2.34.1 RT Treatment Phase Macro Attribute Description 85
C.AA.2.35 RT Treatment Phase Interval Macro 86
C.AA.2.35.1 Referenced Treatment Phases 87
C.AA.A1 Enhanced RT Series Module 88
C.AA.A1.1 Enhanced RT Series Attribute Description 88
C.AA.A1.1.1 Modality 88
C.AA.A2 Radiotherapy Common Instance Module 89
C.AA.A3 RT Course Module 89
C.AA.A3.1 RT Course Attribute Description 91
C.AA.A3.1.1 RT Course Scope Indicator 91
C.AA.A3.1.2 Delivered Radiation Dose Sequence 92
C.AA.A3.1.3 RT Course State Sequence 92
C.AA.A4 RT Prescription Reference Module 92
C.AA.A4.1 RT Prescription Reference Attribute Description 93
C.AA.A4.1.1 RT Item State Macro Meanings 93
C.AA.A5 RT Treatment Phase Module 93
C.AA.A5.1 RT Treatment Phase Attribute Description 94
C.AA.A5.1.1 RT Item State Macro Meanings 94
C.AA.A6 RT Radiation Set Reference Module 94
C.AA.A6.1 RT Radiation Set Reference Attribute Description 99
C.AA.A6.1.1 RT Item State Macro Meanings 99
C.AA.A6.1.2 Radiation Set Start Delay 99
C.AA.A7 RT Course Associated Instance Reference Module 102
C.AA.B1 RT Physician Intent Module 102
C.AA.B1.1 RT Physician Intent Attribute Description 104
C.AA.B1.1.1 RT Physician Intent Sequence 104
C.AA.B1.1.2 RT Protocol Code Sequence 104
C.AA.B1.1.3 RT Diagnostic Image Set Sequence 104
C.AA.B2 RT Prescription Module 104
C.AA.B2.1 RT Prescription Attribute Description 112
C.AA.B2.1.1 Anatomy Property Type Code Sequence 112
C.AA.B2.1.2 Dosimetric Objective Parameter Sequence 112
C.AA.B2.1.3 Dosimetric Objective Parameter Sequence Examples 114
C.AA.B2.1.4 Conceptual Volume Sequence 114
C.AA.B2.1.5 Prescription Anatomy Type 114
C.AA.B2.1.6 Radiobiological Structural Type 115
C.AA.B2.1.7 Dosimetric Objective Priority 115
C.AA.B2.1.8 Fraction-Based Relationship Sequence 115
C.AA.B2.2 Dosimetric Objective Scope 116
C.AA.B3 RT Treatment Phase Intent Module 117
C.AA.C1 RT Radiation Set Module 117
C.AA.C1.1 RT Radiation Set Attribute Description 118
C.AA.C1.1.1 Radiation Set Type 118
C.AA.C1.1.2 Radiation Sequence 118
C.AA.C2 RT Dose Contribution Module 119
C.AA.C2.1 RT Dose Contribution Attribute Description 123
C.AA.C2.1.1 Meterset to Dose Mapping Sequence 123
C.AA.C2.1.2 Conceptual Volume Sequence 123
C.AA.C2.1.3 Primary Dose Value Indicator 124
C.AA.C2.2 Radiation Verification Control Point Description 124
C.AA.C2.2.1 Referenced Control Point 124
C.AA.C2.2.2 Distance Parameters 124
C.AA.C2.2.3 Radiation Dose Value 124
C.AA.D1 RT Segment Annotation Module 124
C.AA.D1.1 RT Segment Annotation Description 128
C.AA.D1.1.1 Segmentation SOP Instance Reference Sequence 128
C.AA.D1.1.2 Alternate Segmented Property Type Code Sequence 129
C.AA.D1.1.3 Segmented Property Type Code Sequence 130
C.AA.D1.1.4 Segmented RT Accessory Device Sequence 130
C.AA.D1.1.5 Direct Segment Reference Sequence 130
C.AA.D1.1.6 Combination Segment Reference Sequence 131
C.AA.D1.1.7 Segment Properties Sequence 131
C.AA.E1 RT Delivery Device Common Module 131
C.AA.E1.1 RT Delivery Device Common Module Attribute Description 132
C.AA.E1.1.3 Equipment Frame of Reference UID 133
C.AA.E2 RT Radiation Common Module 134
C8.A.E2.1 RT Radiation Common Attribute Description 134
C.AA.E2.1.1 Radiotherapy Procedure Technique Sequence 134
C.AA.E2.1.2 RT Treatment Position Macro 135
C.AA.E2.1.3 RT Radiation Data Scope 135
C.AA.E2.1.4 Treatment Times 135
C.AA.E2.1.5 Treatment Machine Mode Sequence 135
C.AA.F1 Tomotherapeutic Delivery Device Module 135
C.AA.F1.1 Tomotherapeutic Delivery Device Attribute Description 136
C.AA.F1.1.1 Leaf Slot Definition 136
C.AA.F2 Tomotherapeutic Beam Module 136
C.AA.G1 C-Arm Photon-Electron Delivery Device Module 138
C.AA.G2 C-Arm Photon-Electron Beam Module 139
C.AA.G2.1 C-Arm Photon-Electron Beam Attribute Description 140
C.AA.G2.1.1 Radiation Particle 140
C.AA.H1 Multiple Fixed Source Delivery Device Module 140
C.AA.H1.1 Multiple Fixed Source Delivery Device Attribute Description 141
C.AA.H1.1.1 Radiation Source Angles 141
C.AA.H2 Multiple Fixed Source Beam Set Module 141
C.AA.J1 Robotic Delivery Device Module 142
C.AA.J2 Robotic Path Module 143
C.AA.L1 Multi-Axial Delivery Device Module 144
C.AA.L2.1 Multi Axial Delivery Device Attribute Description 145
C.AA.L1.1 Source-Axis Distance 145
C.AA.L2 Multi-Axial Beam Module 145
C.AA.L2.1 Multi Axial Beam Attribute Description 149
C.AA.L2.1.1 Multi-Axial Gantry Angles 149
C.AA.L2.1.2 Gantry Head Angles 149
C.AA.L2.1.3 Multi Axial Beam Delimiter Positions 149
C.AA.M1 Enhanced RT Dose Module 151
C.AA.M1.1 Enhanced RT Dose Attribute Description 157
C.AA.M1.1.1 Dose Scope 157
C.AA.M1.1.2 Radiation Absorption Model 157
C.AA.M2 RT Dose Image Module 158
C.AA.M2.1 RT Dose Image Attribute Description 159
C.AA.M2.1.1 Image Type and Frame Type 159
C.AA.M2.1.2 Dose Grid Geometry 159
C.AA.M2.1.3 Dose Grid Real World Values 159
C.AA.M3 RT Dose Image Functional Group Macros 160
C.AA.M3.1 RT Dose Image Frame Type Macro 160
C.AA.M4 RT Dose Histogram Module 160
C.AA.M4.1 RT Dose Histogram Attribute Description 162
C.AA.M4.1.1 Referenced Segmentation Properties Sequence 162
C.AA.M4.1.2 Dose Histogram Data 162
C.AA.M4.1.3 Dose Histogram Referenced Segment Sequence 162
C.AA.M5 Dose Samples Module 163
C.AA.M5.1 RT Dose Samples Attribute Description 163
C.AA.M5.1.1 Dose Samples Data 163
C.AA.P1 RT Radiation Record Common Module 163
C.AA.P1.1 RT Radiation Record Common Attribute Description 167
C.AA.P1.1.1 Control Point References 167
C.AA.P1.1.2 Referenced RT Patient Setup Sequence 167
C.AA.P2 RT Dose Record Common Module 167
C.AA.P2.1 RT Dose Record Common Module Attribute Description 169
C.AA.P2.1.1 Conceptual Volume Sequence 169
F.5.X Radiotherapy Directory Record Definition 173
C.7.5.1 General Equipment Module 174
C.7.6.3 Image Pixel Module 175
Part 4 Addendum 176
Part 6 Addendum 179
6 Registry of DICOM Data Elements 179
Annex A Registry of DICOM unique identifiers (UID) (Normative) 195
Part 16 Addendum 198
CID 9231 General Purpose Workitem Definition 198
CID SUP147001 Dosimetric Objective Value Types 199
CID SUP147002 Prescription Anatomy Categories 199
CID SUP147003 Radiotherapy Segment Categories 199
CID SUP147004 Radiotherapy Targets 200
CID SUP147005 RT Geometric Information 200
CID SUP147006 Fixation or Positioning Devices 201
CID SUP147007 Brachytherapy Devices 201
CID SUP147009 Segmentation Combination 202
CID SUP147010 Beam Limiting Device Types 202
CID SUP147011 Radiotherapy Robotic Paths 202
CID SUP147012 General External Radiotherapy Procedure Techniques 203
CID SUP147013 Tomotherapeutic Radiotherapy Procedure Techniques 203
CID SUP147014 Treatment RT Radiation Set Alteration Types 203
CID SUP147015 Treatment Termination Reasons 204
CID SUP147016 Compensator Device Types 204
CID SUP147017 Radiotherapy Treatment Machine Modes 205
CID SUP147018 Pre-Treatment RT Radiation Set Purpose 205
CID SUP147020 Instance Reference Purposes 205
CID SUP147021 Patient Setup Techniques 206
CID SUP147022 Fixation Device Types 206
CID SUP147023 Shielding Device Types 207
CID SUP147024 Setup Devices 207
CID SUP147025 RT Patient Support Devices 207
CID SUP147026 Dose Statistics 208
CID SUP147027 Fixed Beam Limiting Device Types 208
CID SUP147028 Radiotherapy Wedge Types 208
CID SUP147030 General Accessory Device Types 209
CID SUP147031 Radiotherapy Bolus Device Types 209
CID SUP147032 Radiotherapy Block Device Types 209
CID SUP147033 Radiotherapy Accessory No-Slot Holder Device Types 210
CID SUP147034 Radiotherapy Accessory Slot Holder Device Types 210
CID SUP147035 Effective Dose Method Code Definition 210
CID SUP147036 Purpose of Referenced Dose Calculation Annotation Object 211
CID SUP147037 Dose Data Source Measurement Definition 211
CID SUP147039 Dose Histogram Spatial Unit Definition 211
CID SUP147040 Segmented RT Accessory Devices 212
CID SUP147041 Dose Algorithm Class 212
CID SUP147042 Energy Unit 213
CID SUP147043 RT Item States 213
CID SUP147044 RT Operation States 213
CID SUP147045 Multi-Source Radiation Technique 214
CID SUP147046 Robotic Radiation Technique 214
CID SUP147047 Radiotherapy Procedure Techniques 214
CID SUP147048 Revised value 215
CID SUP147049 Radiotherapy General Workitem Definition 215
CID SUP147050 Beam Mode Type Definition 215
CID SUP147051 Delivery Rate Unit Definition 216
CID SUP147052 Radiation Particle 216
CID SUP147053 Regulatory Device Identifier Type 216
CID SUP147054 Treatment Delivery Device Type 217
CID SUP147055 Dosimeter Unit Definition 217
CID SUP147056 Treatment Session Sign-Off 217
CID SUP147060 Single Dose-related Dosimetric Objectives 217
CID SUP147061 Percentage and Dose-related Dosimetric Objectives 218
CID SUP147062 Volume and Dose-related Dosimetric Objectives 218
CID SUP147063 Dimensionless and Dose-related Dosimetric Objectives 218
CID SUP147064 Coded Dosimetric Objectives 219
CID SUP147065 Radiotherapy Dose Real World Units 219
CID 9241 RADIOTHERAPY GENERAL Radiotherapy Treatment Workitem Definition 220
CID 9242 RADIOTHERAPY ACQUISITION Radiotherapy Acquisition Workitem Definition 220
CID 9243 RADIOTHERAPY REGISTRATION Radiotherapy Registration Workitem Definition 220
Annex C Acquisition and Protocol Context Templates (Normative) 221
TID SUP147001 RT Prescription Annotation 221
TID SUP147003 RT Segment Annotation Properties 223
TID SUP147004 Patient Support Position Parameters 223
Annex D Dicom controlled terminology definitions (normative) 225
Part 17 Addendum 242
Annex Z Second Generation RT (Informative) 242
ZZ.1 Introduction 242
ZZ.2 Entity Descriptions 246
ZZ.2.1 RT Course 246
ZZ.2.2 RT Physician Intent 248
ZZ.2.3 RT Segment Annotation 251
ZZ.2.4 RT Radiation Set 251
ZZ.2.5 RT Radiation 252
ZZ.2.6 RT Dose Image 253
ZZ.2.7 RT Dose Histogram 254
ZZ.2.8 RT Dose Samples 255
ZZ.2.9 RT Radiation Record 256
ZZ.3 Notes on RT Course 257
ZZ.3.1 Introduction 257
ZZ.3.2 Evolution of an RT Course SOP Instance 257
ZZ.3.3 Elements of the RT Course 258
ZZ.3.3.1. Physician Intent 258
ZZ.3.3.2. Treatment Phase 258
ZZ.3.3.3. Radiation Sets 258
ZZ.3.3.4 Clinical State Information 259
ZZ.4 Notes on Second-Generation IODs 260
ZZ.4.1 RT Radiation Set IOD 260
ZZ.4.1.1 General Notes 260
ZZ.4.1.2. Fractionation 260
ZZ.4.1.2. Meterset and other parameters resolution 260
ZZ.4.2 RT Radiation IODs 260
ZZ.4.2.1 Control Points 260
ZZ.4.2.2 Sub-Control Points 260
ZZ.4.3 RT Segment Annotation IOD 260
ZZ.4.3.1 Conceptual Volume 260
ZZ.4.3.2 Segment 261