RegionOfInterest
type: StructureDefinition
node role: treeRoot
id:
  v: RegionOfInterest
text:
  status:
    v: generated
  div: A derivative of the RIM Observation class that represents a region of interest on an image, using an overlay shape. RegionOfInterest is used to make reference to specific regions in images, e.g., to specify the site of a physical finding by "circling" a region in a schematic picture of a human body. The units of the coordinate values in RegionOfInterest.value are in pixels, expressed as a list of integers. The origin is in the upper left hand corner, with positive X values going to the right and positive Y values going down. The relationship between a RegionOfInterest and its referenced ObservationMedia or ExternalObservation is specified by traversing the entryRelationship or reference class, respectively, where typeCode equals "SUBJ". A RegionOfInterest must reference exactly one ObservationMedia or one ExternalObservation. If the RegionOfInterest is the target of a <renderMultimedia> reference, then it shall only reference an ObservationMedia and not an ExternalObservation. An XML attribute "ID" of type XML ID, is added to RegionOfInterest within the CDA Schema. This attribute serves as the target of a renderMultiMedia reference (see renderMultiMedia). All values of attributes of type XML ID must be unique within the document (per the W3C XML specification).
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/logical-target
  value: boolean
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/data-absent-reason
      value: code
        v: not-applicable
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/xml-namespace
  value: uri
    v: urn:hl7-org:v3
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/xml-name
  value: string
    v: regionOfInterest
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/logical-container
  value: uri
    v: http://hl7.org/cda/stds/core/StructureDefinition/ClinicalDocument
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/type-profile-style
  value: code
    v: cda
url:
  v: http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
version:
  v: 1.0.1
name:
  v: RegionOfInterest
title:
  v: RegionOfInterest (CDA Class)
status:
  v: active
experimental:
  v: false
date:
  v: 2025-10-10T09:58:30+10:00
publisher:
  v: HL7
description:
  v: A derivative of the RIM Observation class that represents a region of interest on an image, using an overlay shape. RegionOfInterest is used to make reference to specific regions in images, e.g., to specify the site of a physical finding by "circling" a region in a schematic picture of a human body. The units of the coordinate values in RegionOfInterest.value are in pixels, expressed as a list of integers. The origin is in the upper left hand corner, with positive X values going to the right and positive Y values going down. The relationship between a RegionOfInterest and its referenced ObservationMedia or ExternalObservation is specified by traversing the entryRelationship or reference class, respectively, where typeCode equals "SUBJ". A RegionOfInterest must reference exactly one ObservationMedia or one ExternalObservation. If the RegionOfInterest is the target of a renderMultimedia reference, then it shall only reference an ObservationMedia and not an ExternalObservation. An XML attribute "ID" of type XML ID, is added to RegionOfInterest within the CDA Schema. This attribute serves as the target of a renderMultiMedia reference (see renderMultiMedia). All values of attributes of type XML ID must be unique within the document (per the W3C XML specification).
fhir version:
  v: 5.0.0
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
  name:
    v: RIM Mapping
kind:
  v: logical
abstract:
  v: false
type:
  v: http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
base definition:
  v: http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
  link: http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
derivation:
  v: specialization
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
    value: string
      v: 1.0.1
  element:
    id:
      v: RegionOfInterest
    path:
      v: RegionOfInterest
    short:
      v: Base for all types and resources
    definition:
      v: Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
    min:
      v: 1
    max:
      v: 1
    base:
      path:
        v: Base
      min:
        v: 0
      max:
        v: *
    is modifier:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: n/a
  element:
    id:
      v: RegionOfInterest.nullFlavor
    path:
      v: RegionOfInterest.nullFlavor
    representation:
      v: xmlAttr
    label:
      v: Exceptional Value Detail
    definition:
      v: If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: ANY.nullFlavor
      min:
        v: 0
      max:
        v: 1
    type:
      code:
        v: code
      profile:
        v: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
        link: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
    binding:
      strength:
        v: required
      value set:
        v: http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
        link: http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
  element:
    id:
      v: RegionOfInterest.realmCode
    path:
      v: RegionOfInterest.realmCode
    definition:
      v: When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: InfrastructureRoot.realmCode
      min:
        v: 0
      max:
        v: *
    type:
      code:
        v: http://hl7.org/cda/stds/core/StructureDefinition/CS
  element:
    id:
      v: RegionOfInterest.typeId
    path:
      v: RegionOfInterest.typeId
    definition:
      v: When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: InfrastructureRoot.typeId
      min:
        v: 0
      max:
        v: 1
    type:
      code:
        v: http://hl7.org/cda/stds/core/StructureDefinition/II
    constraint:
      key:
        v: II-1
      severity:
        v: error
      human:
        v: An II instance must have either a root or an nullFlavor.
      expression:
        v: root.exists() or nullFlavor.exists()
      source:
        v: http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
        link: http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
  element:
    id:
      v: RegionOfInterest.typeId.nullFlavor
    path:
      v: RegionOfInterest.typeId.nullFlavor
    representation:
      v: xmlAttr

v: Exceptional Value Detail

v: If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

v: 0

v: 1

path:
  v: ANY.nullFlavor
min:
  v: 0
max:
  v: 1

code:
  v: code
profile:
  v: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
  link: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple

strength:
  v: required
value set:
  v: http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
  link: http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor

id:
  v: RegionOfInterest.typeId.assigningAuthorityName
path:
  v: RegionOfInterest.typeId.assigningAuthorityName
representation:
  v: xmlAttr
label:
  v: Assigning Authority Name
definition:
  v: A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: II.assigningAuthorityName
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
    link: http://hl7.org/cda/stds/core/StructureDefinition/st-simple

id:
  v: RegionOfInterest.typeId.displayable
path:
  v: RegionOfInterest.typeId.displayable
representation:
  v: xmlAttr
label:
  v: Displayable
definition:
  v: Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: II.displayable
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/bl-simple
    link: http://hl7.org/cda/stds/core/StructureDefinition/bl-simple

id:
  v: RegionOfInterest.typeId.root
path:
  v: RegionOfInterest.typeId.root
representation:
  v: xmlAttr
label:
  v: Root
definition:
  v: Identifies the type as an HL7 Registered model
min:
  v: 1
max:
  v: 1
base:
  path:
    v: II.root
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/oid
    link: http://hl7.org/cda/stds/core/StructureDefinition/oid
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/uuid
    link: http://hl7.org/cda/stds/core/StructureDefinition/uuid
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/ruid
    link: http://hl7.org/cda/stds/core/StructureDefinition/ruid
fixed: string
  v: 2.16.840.1.113883.1.3

id:
  v: RegionOfInterest.typeId.extension
path:
  v: RegionOfInterest.typeId.extension
representation:
  v: xmlAttr
label:
  v: Extension
definition:
  v: A character string as a unique identifier within the scope of the identifier root.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: II.extension
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
    link: http://hl7.org/cda/stds/core/StructureDefinition/st-simple

id:
  v: RegionOfInterest.templateId
path:
  v: RegionOfInterest.templateId
definition:
  v: When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
min:
  v: 0
max:
  v: *
base:
  path:
    v: InfrastructureRoot.templateId
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/II

id:
  v: RegionOfInterest.ID
path:
  v: RegionOfInterest.ID
representation:
  v: xmlAttr
min:
  v: 0
max:
  v: 1
base:
  path:
    v: RegionOfInterest.ID
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: id
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/xs-ID
    link: http://hl7.org/cda/stds/core/StructureDefinition/xs-ID

id:
  v: RegionOfInterest.classCode
path:
  v: RegionOfInterest.classCode
representation:
  v: xmlAttr
min:
  v: 1
max:
  v: 1
base:
  path:
    v: RegionOfInterest.classCode
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
    link: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
default value: code
  v: ROIOVL
fixed: code
  v: ROIOVL
binding:
  strength:
    v: required
  value set:
    v: http://terminology.hl7.org/ValueSet/v3-ActClassROI
    link: http://terminology.hl7.org/ValueSet/v3-ActClassROI

id:
  v: RegionOfInterest.moodCode
path:
  v: RegionOfInterest.moodCode
representation:
  v: xmlAttr
min:
  v: 1
max:
  v: 1
base:
  path:
    v: RegionOfInterest.moodCode
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
  profile:
    v: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
    link: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
default value: code
  v: EVN
fixed: code
  v: EVN
binding:
  strength:
    v: required
  value set:
    v: http://hl7.org/cda/stds/core/ValueSet/CDAActMood
    link: http://hl7.org/cda/stds/core/ValueSet/CDAActMood

id:
  v: RegionOfInterest.id
path:
  v: RegionOfInterest.id
min:
  v: 1
max:
  v: *
base:
  path:
    v: RegionOfInterest.id
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/II

id:
  v: RegionOfInterest.code
path:
  v: RegionOfInterest.code
min:
  v: 1
max:
  v: 1
base:
  path:
    v: RegionOfInterest.code
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/CS
binding:
  strength:
    v: required
  value set:
    v: http://terminology.hl7.org/ValueSet/v3-ROIOverlayShape|2.0.0
    link: 2.0
    link: .0

id:
  v: RegionOfInterest.value
path:
  v: RegionOfInterest.value
min:
  v: 1
max:
  v: *
base:
  path:
    v: RegionOfInterest.value
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/INT

id:
  v: RegionOfInterest.subject
path:
  v: RegionOfInterest.subject
min:
  v: 0
max:
  v: 1
base:
  path:
    v: RegionOfInterest.subject
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Subject

id:
  v: RegionOfInterest.specimen
path:
  v: RegionOfInterest.specimen
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.specimen
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Specimen

id:
  v: RegionOfInterest.performer
path:
  v: RegionOfInterest.performer
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.performer
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Performer2

id:
  v: RegionOfInterest.author
path:
  v: RegionOfInterest.author
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.author
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Author

id:
  v: RegionOfInterest.informant
path:
  v: RegionOfInterest.informant
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.informant
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Informant

id:
  v: RegionOfInterest.participant
path:
  v: RegionOfInterest.participant
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.participant
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Participant2

id:
  v: RegionOfInterest.entryRelationship
path:
  v: RegionOfInterest.entryRelationship
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.entryRelationship
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship

id:
  v: RegionOfInterest.reference
path:
  v: RegionOfInterest.reference
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.reference
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Reference

id:
  v: RegionOfInterest.precondition
path:
  v: RegionOfInterest.precondition
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.precondition
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Precondition

id:
  v: RegionOfInterest.sdtcPrecondition2
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/xml-namespace
  value: uri
    v: urn:hl7-org:sdtc
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/xml-name
  value: string
    v: precondition2
path:
  v: RegionOfInterest.sdtcPrecondition2
min:
  v: 0
max:
  v: *
base:
  path:
    v: RegionOfInterest.sdtcPrecondition2
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Precondition2

element:
  id:
    v: RegionOfInterest
  path:
    v: RegionOfInterest
  min:
    v: 1
  max:
    v: 1
element:
  id:
    v: RegionOfInterest.ID
  path:
    v: RegionOfInterest.ID
  representation:
    v: xmlAttr
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: id
    profile:
      v: http://hl7.org/cda/stds/core/StructureDefinition/xs-ID
      link: http://hl7.org/cda/stds/core/StructureDefinition/xs-ID
element:
  id:
    v: RegionOfInterest.classCode
  path:
    v: RegionOfInterest.classCode
  representation:
    v: xmlAttr
  min:
    v: 1
  max:
    v: 1
  type:
    code:
      v: code
    profile:
      v: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
      link: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
  default value: code
    v: ROIOVL
  fixed: code
    v: ROIOVL
  binding:
    strength:
      v: required
    value set:
      v: http://terminology.hl7.org/ValueSet/v3-ActClassROI
      link: http://terminology.hl7.org/ValueSet/v3-ActClassROI
element:
  id:
    v: RegionOfInterest.moodCode
  path:
    v: RegionOfInterest.moodCode
  representation:
    v: xmlAttr
  min:
    v: 1
  max:
    v: 1
  type:
    code:
      v: code
    profile:
      v: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
      link: http://hl7.org/cda/stds/core/StructureDefinition/cs-simple
  default value: code
    v: EVN
  fixed: code
    v: EVN
  binding:
    strength:
      v: required
    value set:
      v: http://hl7.org/cda/stds/core/ValueSet/CDAActMood
      link: http://hl7.org/cda/stds/core/ValueSet/CDAActMood
element:
  id:
    v: RegionOfInterest.id
  path:
    v: RegionOfInterest.id
  min:
    v: 1
  max:
    v: *
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/II
element:
  id:
    v: RegionOfInterest.code
  path:
    v: RegionOfInterest.code
  min:
    v: 1
  max:
    v: 1
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/CS
  binding:
    strength:
      v: required
    value set:
      v: http://terminology.hl7.org/ValueSet/v3-ROIOverlayShape|2.0.0
      link: 2.0
      link: .0
element:
  id:
    v: RegionOfInterest.value
  path:
    v: RegionOfInterest.value
  min:
    v: 1
  max:
    v: *
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/INT
element:
  id:
    v: RegionOfInterest.subject
  path:
    v: RegionOfInterest.subject
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/Subject
element:
  id:
    v: RegionOfInterest.specimen
  path:
    v: RegionOfInterest.specimen
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/Specimen
element:
  id:
    v: RegionOfInterest.performer
  path:
    v: RegionOfInterest.performer
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/Performer2
element:
  id:
    v: RegionOfInterest.author
  path:
    v: RegionOfInterest.author
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/Author
element:
  id:
    v: RegionOfInterest.informant
  path:
    v: RegionOfInterest.informant
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/Informant
element:
  id:
    v: RegionOfInterest.participant
  path:
    v: RegionOfInterest.participant
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: http://hl7.org/cda/stds/core/StructureDefinition/Participant2
element:
  id:
    v: RegionOfInterest.entryRelationship
  path:
    v: RegionOfInterest.entryRelationship
  min:
    v: 0

v: *

id:
  v: RegionOfInterest.reference
path:
  v: RegionOfInterest.reference
min:
  v: 0
max:
  v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Reference

id:
  v: RegionOfInterest.precondition
path:
  v: RegionOfInterest.precondition
min:
  v: 0
max:
  v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Precondition

id:
  v: RegionOfInterest.sdtcPrecondition2
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/xml-namespace
  value: uri
    v: urn:hl7-org:sdtc
extension:
  url:
    v: http://hl7.org/fhir/tools/StructureDefinition/xml-name
  value: string
    v: precondition2
path:
  v: RegionOfInterest.sdtcPrecondition2
min:
  v: 0
max:
  v: *
type:
  code:
    v: http://hl7.org/cda/stds/core/StructureDefinition/Precondition2