Simple fluoroscopy

Simple fluoroscopy is real time imaging (usually on TV monitors/image intensifiers) of a body part or system. Only rarely is it an imaging process alone (without some interventional procedure). Fluoroscopy is most often used to guide or direct a primary procedure/purpose. The usual convention in clinical practice is to ignore the fluoroscopic element and refer to a procedure entirely by the primary component, e.g., angiography. However, this is unacceptable in SNOMED CT, where the imaging component must be explicitly described.

• FSN: Fluoroscopy of X (procedure)

• PT: Fluoroscopy of X

• SYN: Fluoroscopy - X

  • For example,

    • 169005008 | Fluoroscopy of esophagus (procedure)

      • FSN: Fluoroscopy of esophagus (procedure)

      • PT: Fluoroscopy of esophagus

Fluoroscopic X is not necessarily interpreted as X using fluoroscopic guidance (procedure). When modeling a procedure using fluoroscopic guidance, the use of fluoroscopic x in the FSN is not sufficient; the FSN must explicitly state using fluoroscopic guidance if that is the intent.

The following naming pattern can be used for direct observation:

• FSN: X using fluoroscopic guidance (procedure)

• PT: Fluoroscopy guided X

• SYN: X using fluoroscopic guidance

  • For example,

Such procedures are subtypes of Fluoroscopy (procedure). See also .

Angiography and angiogram , as terms on their own, refer to visualization of a blood vessel or vascular structure not specified as an artery or a vein and could refer to either or both. So for clarity, a blood vessel site (X) and the phrase with contrast must be included in the concept description.

• FSN: Fluoroscopic angiography of X with contrast (procedure)

• PT: Fluoroscopic angiography of X with contrast

• SYN: Fluoroscopic angiogram of X with contrast

• FSN: Fluoroscopic angiography of X artery with contrast (procedure)

• PT: Fluoroscopic angiography of X artery with contrast

• SYN: Fluoroscopic arteriography of X with contrast

• SYN: Fluoroscopic arteriogram of X with contrast

• FSN: Fluoroscopic venography of X with contrast (procedure)

• PT: Fluoroscopic venography of X with contrast

• SYN: Fluoroscopic venogram of X with contrast

  • For example,

• FSN: Fluoroscopic arthrography of X (procedure)

• PT: Fluoroscopic arthrography of X

• SYN: Fluoroscopic arthrogram of X

  • For example,

Single photon emission computerized tomography (procedure)

• FSN: Single photon emission computed tomography of X (procedure)

• PT: Single photon emission computed tomography of X

• SYN: SPECT of X

  • For example,

    • 709549003 | Single photon emission computed tomography of heart (procedure)|

      • FSN: Single photon emission computed tomography of heart (procedure)

      • PT: Single photon emission computed tomography of heart

      • SYN: SPECT of heart

Modeling new content requests

Requests for new imaging-related content must clearly specify an imaging action; for example, computed tomography, plain X-ray, fluoroscopy, etc.

Radiographic imaging is a broad term that encompasses several types of imaging studies that use ionizing radiation for visualization of internal parts of the body using X-ray techniques (for example, computed tomography) and is therefore a grouping concept. New content requests using the phrase Radiographic imaging of and/or submissions requesting a Method (attribute) of 278110001 |Radiographic imaging - action (qualifier value)| are not acceptable for the international edition of SNOMED CT.

Approved naming pattern

FSN: Plain X-ray of (procedure) PT: Plain X-ray of

The X is capitalized, and the description case sensitivity is Only initial character case insensitive.

The following are acceptable synonyms:

• Plain film of X

• Plain radiography of X

The terms radiologic and radiologic guidance are not permitted for any new descriptions, neither FSN nor synonyms. Neither are the following patterns permitted for any new descriptions:

• Radiography of X

  • For example,

    • Radiography of hand (procedure)

• X-ray of X

363680008 | Radiographic imaging procedure (procedure)| is at the top-level of the hierarchy of imaging procedures utilizing ionizing radiation for X-ray techniques. This concept has been retained along with a small number of high usage subtypes that are modeled with method 278110001 |Radiographic imaging - action (qualifier value)|.

FSN: Dual energy X-ray absorptiometry of X (procedure)

PT: Dual energy X-ray absorptiometry of X

SYN: DXA of X

SYN: DEXA of X

• For example,

  • 428313006 | Dual energy X-ray absorptiometry of mandible (procedure)|

    • FSN: Dual energy X-ray absorptiometry of mandible (procedure)

    • PT: Dual energy X-ray absorptiometry of mandible

Computed tomography

• FSN: Computed tomography of X (procedure)

• PT: CT of X

• SYN: Computed tomography of X

• For example,

  • 241566009 | Computed tomography of elbow (procedure)|

    • FSN: Computed tomography of elbow (procedure)

    • PT: CT of elbow

    • SYN: Computed tomography of elbow

This naming pattern is used when an anatomical location is specified, but the blood vessel is not explicit.

• FSN: Computed tomography angiography of X with contrast (procedure)

• PT: CT angiography of X with contrast

• SYN: Computed tomography angiography of X with contrast

  • For example,

• FSN: Computed tomography angiography of [artery] with contrast (procedure)

• PT: CT angiography of [artery] with contrast

• SYN: CT arteriography of [body structure] with contrast

• SYN: Computed tomography arteriography of [body structure] with contrast

• FSN: Computed tomography venography of X with contrast (procedure)

• PT: CT venography of X with contrast

• SYN: CT venogram of X with contrast

• SYN: Computed tomography venography of X with contrast

• FSN: Computed tomography arthrography of X (procedure)

• PT: CT arthrography of X

• SYN: CT arthrogram of X

• SYN: Computed tomography arthrography of X

Concepts which describe adjacent structures, imaged in one procedure, are acceptable.

For example,

• 432672003 | Magnetic resonance imaging of pelvis and hip (procedure)|

There are numerous procedures where the imaging component is considered a supplemental or secondary technique to help accomplish the primary goal. The pattern is:

Procedure using guidance

• FSN: Y using guidance (procedure)

• PT: guided Y

• SYN: Y using guidance

Computed tomography guided procedure

• FSN: Y using computed tomography guidance (procedure)

• PT: CT guided Y

• SYN: Y using computed tomography guidance

  • For example,

    • 431864000 | Injection using computed tomography guidance (procedure)|

      • FSN: Injection using computed tomography guidance (procedure)

• FSN: Y using fluoroscopic guidance (procedure)

• PT: Fluoroscopy guided Y

• SYN: Y using fluoroscopic guidance

  • For example,

(See also )

• FSN: Y using magnetic resonance imaging guidance (procedure)

• PT: MRI guided Y

• SYN: Y using magnetic resonance imaging guidance

  • For example,

• FSN: Y using ultrasonographic guidance (procedure)

• PT: Ultrasonography guided Y

• SYN: Y using ultrasonographic guidance

• SYN: Y using ultrasound guidance

• FSN: Y using plain X-ray guidance (procedure)

• PT: Plain X-ray guided Y

• SYN: Y using plain X-ray guidance

  • For example,

Magnetic resonance imaging

Descriptions:

• FSN: Magnetic resonance imaging of X (procedure)

• PT: MRI of X

• SYN: Magnetic resonance imaging of X

  • For example,

    • 6007000 | Magnetic resonance imaging of chest (procedure)|

      • FSN: Magnetic resonance imaging of chest (procedure)

      • PT: MRI of chest

Descriptions:

• FSN: Magnetic resonance angiography of X (procedure)

• PT: Magnetic resonance angiography of X

• SYN: Magnetic resonance angiogram of X

• SYN: MR angiography of X

Descriptions:

• FSN: Magnetic resonance venography of X (procedure)

• PT: Magnetic resonance venography of X

• SYN: Magnetic resonance venogram of X

• SYN: MR venography of X

Descriptions:

• FSN: Magnetic resonance arthrography of X (procedure)

• PT: Magnetic resonance arthrography of X

• SYN: Magnetic resonance arthrogram of X

• SYN: MR arthrography of X

Descriptions:

• FSN: Magnetic resonance spectroscopy of X (procedure)

• PT: Magnetic resonance spectroscopy of X

• SYN: MR spectroscopy of X

  • For example,

There are very few imaging procedures which are truly multi-modality procedures. Two procedures are usually conducted in parallel, rather than as one. Positron emission tomography with computed tomography (PET/CT) and Single photon emission computed tomography with computed tomography (SPECT/CT), however, are produced by one piece of equipment, possibly by a single technician, but with multiple imaging energies.

Positron emission tomography with computed tomography

• FSN: Positron emission tomography with computed tomography of X (procedure)

• PT: PET CT of X

• SYN: Positron emission tomography with computed tomography of X

  • For example,

    • 16554361000119106 | Positron emission tomography with computed tomography of brain (procedure)|

      • FSN: Positron emission tomography with computed tomography of brain (procedure)

      • PT: PET CT of brain

• FSN: Single photon emission computed tomography with computed tomography of X (procedure)

• PT: Single photon emission computed tomography with computed tomography of X

• SYN: SPECT CT of X

  • For example,

It may be important, from both clinical and administrative perspectives, to capture variations or modifications of imaging technique. The variations may impact correct acquisition and interpretation of images.

• Examples of modifications include:

  • Axial (qualifier value)

  • Skyline projection (qualifier value)

  • Decubitus (qualifier value)

It is essential to express when contrast is part of a procedure and that descriptions are constructed consistently.

• For example,

  • 702501008 | Computed tomography of knee with contrast (procedure)|

    • FSN: Computed tomography of knee with contrast (procedure)

    • PT: CT of knee with contrast

    • SYN: Computed tomography of knee with contrast

The descriptions for all procedure concepts that use contrast must explicitly state ‘with contrast.’ All procedures that use contrast, including 420040002 |Fluoroscopic angiography with contrast (procedure)| and all subtypes, must include the attribute 424361007 |Using substance (attribute)| and a value of 385420005 |Contrast media (substance)| or a subtype in the role group.

Where the value for the method imaging action is 278110001 |Radiographic imaging - action (qualifier value)| or a subtype, the value for 424361007 |Using substance (attribute)| must be 419098001 |Radiographic imaging contrast media (substance)| or a subtype to denote the radio-opaque nature of the substance.

• Exception: procedures which specify negative contrast which is non-radio-opaque

It is unnecessary to add the word media to contrast.

It is agreed that the linking word to associate the contrast use with the procedure is with - not for, or, etc.

Although considered a negation, this term is used in clinical records. Without contrast imaging procedures are acceptable.

For example,

• 566341000119106 | Computed tomography of ankle without contrast (procedure)|

  • FSN: Computed tomography of ankle without contrast (procedure)

  • PT: CT of ankle without contrast

  • SYN: Computed tomography of ankle without contrast

With and without and With or without imaging concepts are not acceptable due to ambiguity. Two concepts should be used to express these separately.

Ultrasonography

• FSN: Ultrasonography of X (procedure)

• PT: Ultrasonography of X

• SYN: Ultrasound scan of X

• SYN: Ultrasound of X

  • For example,

    • 709590000 | Ultrasonography of perineum (procedure)|

      • FSN: Ultrasonography of perineum (procedure)

      • PT: Ultrasonography of perineum

• FSN: Doppler ultrasonography of X (procedure)

• PT: Doppler ultrasonography of X

• SYN: Doppler ultrasound scan of X

  • For example,

An obstetric ultrasound may require a complex description. However, the same rules apply, as follows:

• FSN: Obstetric ultrasonography of X (procedure)

• PT: Obstetric ultrasonography of X

• SYN: Obstetric ultrasound scan of X

• SYN: Obstetric ultrasound of X

Almost all imaging procedures can be unambiguously expressed in a number of ways. There is a balance between flexibility in language and efficiency in terminology maintenance. Consequently, all variants for imaging modalities are not routinely included in SNOMED CT. Submissions for additional descriptions must be justified explicitly.

At a minimum, procedures are ordinarily expressed with the modality and body site. Existing content may have inconsistencies, but new content should following the naming conventions that follow.

Nuclear medicine imaging uses radionuclides or radioisotopes.

Radionuclide imaging

• FSN: Radionuclide imaging of X (procedure)

• PT: Radionuclide imaging of X

• SYN: Radioisotope imaging of X

  • For example,

    • 710313004 | Radionuclide imaging of peritoneal cavity (procedure)|

      • FSN: Radionuclide imaging of peritoneal cavity (procedure)

      • PT: Radionuclide imaging of peritoneal cavity

• FSN: Radionuclide imaging of X using Y (procedure)

• PT: Radionuclide imaging of X using Y

• SYN: Radioisotope imaging of X using Y

  • For example,

Positron emission tomography (procedure)

• FSN: Positron emission tomography of X (procedure)

• PT: PET of X

• SYN: Positron emission tomography of X

  • For example,

    • 702767007 | Positron emission tomography of whole body (procedure)|

      • FSN: Positron emission tomography of whole body (procedure)

      • PT: PET of whole body

      • SYN: Positron emission tomography of whole body