# Imaging-guided procedure modeling

Imaging guidance can be modeled using the *Has intent (attribute)*. The concept 429892002 |Guidance intent (qualifier value)|, a child of 363675004 |Intents (nature of procedure values) (qualifier value)|, is the value for the Has intent (attribute) for imaging-guided procedures.

* For example,
  * 432666003 |Biopsy of brain using computed tomography guidance (procedure)| has two relationship groups:
    * Group 1:
      * Method (attribute) of Biopsy - action (qualifier value)
      * Procedure Site - Direct (attribute) of Brain structure (body structure)
    * Group 2:
      * Procedure Site - Direct (attribute) of Brain structure (body structure)
      * Method (attribute) of Computed tomography imaging - action (qualifier value)
      * Has intent (attribute) of Guidance intent (qualifier value)

{% hint style="info" %}
**Biopsy of brain using CT guidance**

432666003 |Biopsy of brain using computed tomography guidance (procedure)| is subsumed by 702707005 |Biopsy of head (procedure)| and by 34227000 |Computerized axial tomography of brain (procedure)|.
{% endhint %}

Where the procedure involves a device and/or morphology as the object of the action for which imaging guidance is being performed, that morphology, device, and/or anatomic structure in/on which the procedure is being performed are all the direct object of the imaging action. The direct device or direct morphology is included in the imaging role group.

* For example,
  * In Aspiration of cyst using ultrasonic guidance (procedure), the Ultrasound imaging role group will include a Direct morphology (attribute) of Cyst (morphologic abnormality).

<figure><img src="https://4060284305-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FuoSxuN6wQMDYcvuq2wNX%2Fuploads%2FrKbrXqkKs6dbpb8AS1QM%2Fimage.png?alt=media&#x26;token=c6990bf5-8fb4-4838-8033-db64df9a4408" alt=""><figcaption></figcaption></figure>

### Fluoroscopic guidance <a href="#fluoroscopic-guidance" id="fluoroscopic-guidance"></a>

*X* *using fluoroscopic guidance (procedure)* is a subtype of Fluoroscopy (procedure).

* For example,
  * 710291004 |Endoscopy using fluoroscopic guidance (procedure)| has the following relationship groups
    * Group 1:
      * Using device (attribute) of Endoscopic device (physical object)
      * Method (attribute) of Inspection - action (qualifier value)
    * Group 2:
      * Method (attribute) of Fluoroscopic imaging - action (qualifier value)
      * Has intent (attribute) of Guidance intent (qualifier value)

{% hint style="info" %}
See also [*Clinical imaging procedure naming conventions* section](https://docs.snomed.org/snomed-ct-specifications/snomed-ct-editorial-guide/readme/authoring/domain-specific-modeling/procedure/index-1/index)
{% endhint %}

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