---
# System prepended metadata

title: FHIR SR - Liver
tags: [fhir-project]

---

---
title: FHIR SR - Liver
tags: fhir-project 
---

<font color="red">FHIR</font> SR - Bone Fracture
===

## Table of Contents
[TOC]

## 1. Introduction
![](https://i.imgur.com/CndhGEX.png =300x250)

This page is a sub-chapter of [FHIR Medical Imaging Structured](Reporthttps://hackmd.io/@victoriatjia/fhir-finding-report) which focus on define image finding form and diagnostic report template of liver

## 2. Methods
Step 1. Define the finding report template in excell table
![](https://i.imgur.com/WwutjzF.png)

Step 2. Define the value set of each field
Value set example:

<table>
<tr><th colspan="2" style="text-align
:center">Location (src: http://MISAC.org/codeSystem/massLocation)</th></tr>
<tr>
	<th style="text-align
:center">Code</th>
	<th style="text-align
:center">Desc</th>
</tr>
<tr>
	<td>LiverRightLobe</td>
	<td>Right lobe</td>
</tr>
<tr>
	<td>LiverLeftLobe</td>
	<td>Left lobe</td>
</tr>
<tr>
	<td>LiverCaudateLobe</td>
	<td>Caudate lobe</td>
</tr>
<tr>
	<td>LiverQuadrateLobe</td>
	<td>Quadrate lobe</td>
</tr>
<tr>
	<td>LiverSegmentalLocation</td>
	<td>Segmental location (specify)</td>
</tr>
<tr>
	<td>Other</td>
	<td>Other (specify)</td>
</tr>
</table>

<table>
<tr><th colspan="2" style="text-align
:center">Margin (src: http://MISAC.org/codeSystem/massMargin)</th></tr>
<tr>
	<th style="text-align
:center">Code</th>
	<th style="text-align
:center">Desc</th>
</tr>
<tr>
	<td>CircumscribedMargin</td>
	<td>Circumscribed Margin</td>
</tr>
<tr>
	<td>MicrolobulatedMargin</td>
	<td>Microlobulated Margin</td>
</tr>
<tr>
	<td>ObscuredMargin</td>
	<td>Obscured Margin</td>
</tr>
<tr>
	<td>IndistinctMargin</td>
	<td>Indistinct Margin</td>
</tr>
<tr>
	<td>SpiculatedMargin</td>
	<td>Spiculated Margin</td>
</tr>
</table>

Step 3. Convert finding template into FHIR Observation
```gherkin=
{
  "resourceType": "Observation",
  "status": "final",
  "code": {
    "coding": [ {
      "system": "http://MISAC.org/codeSystem/ObservationCodes",
      "code": "abnormalityMassObservation",
      "display": "Abnormality Mass observation"
    } ],
    "text": "Mass"
  },
  "subject": {
    "reference": "Patient/2"
  },
  /*LOCATION*/
  "bodySite": {
    "coding": [ {
      "system": "http://MISAC.org/codeSystem/massLocation",
      "code": "LiverLeftLobe",
      "display": "Left Lobe"
    } ],
    "text": "Left Lobe"
  },
  /*END LOCATION*/
  "derivedFrom": [ {
    "reference": "Observation/20"
  } ],
  "component": [ {
  /*SIZE*/
    "code": {
      "coding": [ {
        "system": "http://MISAC.org/codeSystem/massSize",
        "code": "mass.size",
        "display": "mass.size"
      } ]
    },
    "valueQuantity": {
      "value": 3.5,
      "unit": "cm",
      "system": "http://unitsofmeasure.org",
      "code": "cm"
    }
  /*END SIZE*/
  }, {
  /*SHAPE*/
    "code": {
      "coding": [ {
        "system": "http://MISAC.org/codeSystem/massShape",
        "code": "mass.shape",
        "display": "mass.shape"
      } ]
    },
    "valueCodeableConcept": {
      "coding": [ {
        "system": "http://snomed.info/sct",
        "code": "IrregularShapedLesion",
        "display": "Irregular shaped lesion"
      } ]
    }
  /*END SHAPE*/
  }, {
  /*MARGIN*/
    "code": {
      "coding": [ {
        "system": "http://MISAC.org/codeSystem/massMargin",
        "code": "mass.margin",
        "display": "mass.margin"
      } ]
    },
    "valueCodeableConcept": {
      "coding": [ {
        "system": "http://MISAC.org/codeSystem/massMargin",
        "code": "LiverCaudateLobe",
        "display": "Caudate Lobe"
      } ]
    }
  /*END MARGIN*/
  }, {
  /*DENSITY*/
    "code": {
      "coding": [ {
        "system": "http://MISAC.org/codeSystem/massDensity",
        "code": "mass.density",
        "display": "mass.density"
      } ]
    },
    "valueCodeableConcept": {
      "coding": [ {
        "system": "http://MISAC.org/codeSystem/massDensity",
        "code": "HighDensity",
        "display": "High Density"
      } ]
    }
  /*END DENSITY*/
  } ]
}
```

src: https://tzfhir1.ml/fhirvh/fhir/Observation/1453
	

## 4. References
- [Liver Observation LI-RADS](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/LIRADS/Chapter-7-The-LIRADS-observation.pdf)
- [Liver Diagnostic Report Code CT/MRI LI-RADS](https://www.acr.org/-/media/ACR/Images/Clinical-Resources/RADS/LI-RADS/LI-RADSv2018.JPG)
- [LI-RADS Structured Report Liver CT and MRI](https://pubs.rsna.org/doi/10.1148/rg.2021200205)
- [Liver HCC Finding report template](https://documents.cap.org/protocols/Liver.HCC_4.3.0.0.REL_CAPCP.pdf)
- [AI in assessment of hepatocellular carcinoma treatment response](https://www.researchgate.net/publication/350523686_Artificial_intelligence_in_assessment_of_hepatocellular_carcinoma_treatment_response)
- https://www.researchgate.net/figure/Example-report-template-for-a-treated-liver-lesion-based-on-LI-RADS-v2018_fig2_350523686
- https://www.researchgate.net/figure/Sample-MR-reports-a-Sample-with-LI-RADS-structured-template-b-Sample-free-text_fig2_344049425
- [Liver finding type](https://link.springer.com/book/10.1007/b137465?noAccess=true)


