View Code Sequence (0054,0220)

6.4.6.1. View Code Sequence (0054,0220)#

Recommended. SHOULD be specified, if known. Only one value is allowed.

The projection of the anatomic region of interest on an image receptor.

Note

Use one of the lateral projections for photographs of the buccal (cheek) region.

Buccal projection is not present in SNOMED-CT, but there are various lateral projections. Buccal (intended site) SCT 763825005 in the anatomic region sequence is enough to specify un-ambiguosly that this photograph is a buccal view.

Allowed values: - **CID 4062**: VL View - **CID 4063**: VL Dental View

Table CID 4062. VL View#

code scheme designator

code value

code meaning

notes

SCT

399033003

frontal

SCT

399173006

left lateral

For left buccal photographs

SCT

260421001

left lateral oblique

SCT

399198007

right lateral projection

For right buccal photographs

SCT

260424009

right lateral oblique

SCT

399182000

oblique projection

SCT

260454004

45 degree projection

SCT

260427002

oblique lateral

Mandatory for IV24, IV25, IV26, IV27

SCT

399255003

submentovertical

Mandatory for EV36

SCT

260461000

vertex

Mandatory for EV37

SCT

410514004

Unknown (qualifier value)

This code is used when the photograph is taken without specific attention to the projection, prioritizing image detail over projection accuracy. In cases where the :ref:ViewModifierCodeSequence is required, it must be included. Since the :ref:ViewModifierCodeSequence also requires the parent :ref:ViewCodeSequence, the sequence cannot be omitted, and the value ‘Unknown’ SHALL be used.
Table CID 4063. VL Dental View#

code scheme designator

code value

code meaning

notes

SCT

260499007

Occlusal projection (qualifier value)

6.4.6.2. View Modifier Code Sequence (0054,0222)#

Photographs in orthodontics are not always taken directly: sometimes there is a device between the patient and the camera lens, like a mirror, to be able to see specific regions.

Table CID 4064. VL View Modifier#

code scheme designator

code value

code meaning

notes

SCT

789135000

Mirrored visible image uncorrected

SCT

789134001

Mirrored visible image uncorrected flipped horizontally

Light from anatomy is reflected on a mirror before reaching camera lens. Image has been flipped horizontally by image acquisition device.

SCT

789132002

Mirrored visible image uncorrected flipped horizontally and vertically

Light from anatomy is reflected on a mirror before reaching camera lens. Image has been flipped horizontally and vertically by image acquisition device.

SCT

789133007

Mirrored visible image uncorrected flipped vertically

Light from anatomy is reflected on a mirror before reaching camera lens. Image has been flipped vertically by image acquisition device.
Table CID 4065. VL Dental View Modifier#

code scheme designator

code value

code meaning

notes

SCT

789131009

Close up photographic view of teeth with no set magnification or distance

SCT

787610003

Photographic image corrected intraoral mirrored visible record

SCT

789310004

Mirrored photographic image of teeth corrected flipped horizontally

SCT

789311000

Mirrored photographic image of teeth corrected flipped vertically

SCT

789312007

Mirrored photographic image of teeth corrected flipped vertically and horizontally

SCT

787612006

Photographic image extraoral with 45 degree view

SCT

787611004

Photographic image extraoral with mandible postured forward

SCT

789313002

Photographic image of anterior teeth

SCT

789314008

Photographic image of face with lips in relaxed position

SCT

787607005

Photographic image with lips closed

SCT

789130005

Photographic image with mouth partially opened position and teeth apart

6.4.6.3. Storing Orthodontic Image Type in DICOM: Implementation Specification#

This specification describes the requirements for storing the image type of an orthodontic photograph as a code in a DICOM Visible Light (VL) object. While the orthodontic image can be fully represented using a combination of various DICOM attributes, there exist many situations where it is more convenient to encode the image type in a single code.

6.4.6.3.1. Requirements#

  1. ViewCodeSequence Usage

    • The DICOM attribute ViewCodeSequence (Tag: (0054,0220)) SHALL be used to encode the image type for orthodontic photographs.

    • Only a single Item SHALL be present in the ViewCodeSequence for each image type code.

  2. Context Identifier (CID) and Private Extension

    • The ContextIdentifier (Tag: (0008,010F)) of the code item in ViewCodeSequence SHALL be set to the value 4063 (CID 4063, “VL Dental View”) for standard codes.

    • For private or proprietary codes, the ContextIdentifier SHALL be set to 4063 with extension attributes as described below.

  3. Context Group Extension Attributes

    • If a code is not part of the standard CID 4063, the following attributes SHALL be present in the code item:

      • ContextGroupExtensionFlag (Tag: (0008,010B)) = 'Y'

      • ContextGroupLocalVersion (Tag: (0008,0107)) = the current date in YYYYMMDD format

      • ContextGroupExtensionCreatorUID (Tag: (0008,010D)) = a UID identifying the entity responsible for the code (see below)

    • The ContextGroupExtensionCreatorUID: - SHALL be set by the application or site generating the code.

  4. Code Triplet

    • Each code item in ViewCodeSequence SHALL include: - CodeValue (Tag: (0008,0100)): The code identifier (max 16 chars, or use Long/URN Code Value as appropriate) - CodingSchemeDesignator (Tag: (0008,0102)): The coding scheme (e.g., 99ORG for private codes) - CodeMeaning (Tag: (0008,0104)): Human-readable meaning of the code

  5. Setting and Retrieving the Code

    • When setting the image type code, the implementation SHALL: - Set or update the code item in ViewCodeSequence matching both ContextIdentifier and ContextGroupExtensionFlag. - If no such item exists, append a new item.

    • When retrieving the image type code, the implementation SHALL: - Return the first item in ViewCodeSequence where ContextIdentifier and ContextGroupExtensionFlag match the expected values.

  6. Interoperability

    • Receivers of the DICOM object SHOULD recognize and preserve private extension codes, including all extension attributes.

    • Receivers MAY ignore codes with unknown ContextGroupExtensionCreatorUID, but SHALL keep them.

  7. Example

code = Dataset()
code.CodeValue = 'EV20'
code.CodingSchemeDesignator = '99OPOR'
code.CodeMeaning = 'Extraoral, Full Face, Full Smile, Centric Relation'
code.ContextIdentifier = '4063'
code.ContextGroupExtensionFlag = 'Y'
code.ContextGroupLocalVersion = '20240625'
code.ContextGroupExtensionCreatorUID = '1.2.826.0.1.3680043.10.1234'

ds.ViewCodeSequence = Sequence([code])

  1. Compliance

    • Implementations SHALL follow this specification for all orthodontic photographs requiring non-standard image type codes.

    • Implementations SHOULD provide a mechanism for the application to specify the ContextGroupExtensionCreatorUID.

    • Implementations MAY provide a fallback UID for development or testing, but SHALL warn the user.

6.4.6.3.2. References#

  • DICOM PS3.3, PS3.16 (2025a)

  • DICOM Change Proposal CP-1570

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