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ID

11142

Descrição

CALGB: Post-Operative Chest CT Scan Form NCT00499330 Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2221FAA3-582D-4F78-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2221FAA3-582D-4F78-E044-0003BA3F9857

Palavras-chave

  1. 18/12/2014 18/12/2014 - Martin Dugas
  2. 09/01/2015 09/01/2015 - Martin Dugas
  3. 21/06/2015 21/06/2015 -
Transferido a

21 de junho de 2015

DOI

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Licença

Creative Commons BY-NC 3.0 Legacy

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    CALGB: Post-Operative Chest CT Scan Form NCT00499330

    Instructions: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice...

    Header
    Descrição

    Header

    CALGB Form
    Descrição

    Form ID CALGB

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3262252
    NCI Thesaurus ObjectClass
    C19464
    UMLS CUI-2
    C1516238
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ObjectClass-2
    C25442
    CALGB Study No
    Descrição

    Protocol ID CALGB

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1516238
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25442
    CALGB Patient ID
    Descrição

    Trial subject ID CALGB

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1516238
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25442
    Date of CT Scan
    Descrição

    DiagnosticComputedTomographyPerformedDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C17204
    UMLS 2011AA ObjectClass
    C0040405
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass-2
    C25482
    UMLS 2011AA ObjectClass-2
    C0348026
    Are data amended
    Descrição

    Data amended

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Hospital Name (or imaging center performing chest CT)
    Descrição

    TreatingHospitalName

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus ObjectClass
    C16696
    UMLS 2011AA ObjectClass
    C0019994
    NCI Thesaurus ObjectClass-2
    C25705
    UMLS 2011AA ObjectClass-2
    C1522326
    Patient demographics
    Descrição

    Patient demographics

    Patient Initials (Last, First Middle)
    Descrição

    Patient Initials

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Patient Hospital No.
    Descrição

    Medical Record Number

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1301894
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25261
    NCI Thesaurus Property-2
    C25198
    Institution/Affiliate
    Descrição

    Institution Name

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass-2
    C21541
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain
    C25191
    NCI Thesaurus ValueDomain-2
    C21541
    Participating Group
    Descrição

    Participating Group

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2347449
    NCI Thesaurus ObjectClass
    C25608
    NCI Thesaurus ObjectClass-2
    C17005
    NCI Thesaurus Property
    C25364
    Participating Group Study No.
    Descrição

    Study Number Participating Group

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Participating Group Patient ID
    Descrição

    Trial subject ID Participating Group

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Technique Factors
    Descrição

    Technique Factors

    KVp
    Descrição

    ChestComputedTomographyKilovoltPeakMeasurement

    Tipo de dados

    float

    Alias
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    NCI Thesaurus ObjectClass
    C17204
    UMLS 2011AA ObjectClass
    C0040405
    NCI Thesaurus ObjectClass-2
    C25389
    UMLS 2011AA ObjectClass-2
    C0817096
    NCI Thesaurus Property
    C48432
    UMLS 2011AA Property
    C1708610
    Pitch
    Descrição

    ChestComputedTomographyPitchMeasurement

    Tipo de dados

    float

    Alias
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    NCI Thesaurus ObjectClass
    C17204
    UMLS 2011AA ObjectClass
    C0040405
    NCI Thesaurus ObjectClass-2
    C25389
    UMLS 2011AA ObjectClass-2
    C0817096
    NCI Thesaurus Property
    C48442
    UMLS 2011AA Property
    C1704634
    mA
    Descrição

    ChestComputedTomographyAmpereMeasurement

    Tipo de dados

    float

    Alias
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    NCI Thesaurus ObjectClass
    C17204
    UMLS 2011AA ObjectClass
    C0040405
    NCI Thesaurus ObjectClass-2
    C25389
    UMLS 2011AA ObjectClass-2
    C0817096
    NCI Metathesaurus Property
    C0457243
    Scan Length (craniocaudal extent)
    Descrição

    ChestComputedTomographyScanLengthMeasurement

    Tipo de dados

    float

    Unidades de medida
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C17204
    UMLS 2011AA ObjectClass
    C0040405
    NCI Thesaurus ObjectClass-2
    C25389
    UMLS 2011AA ObjectClass-2
    C0817096
    NCI Thesaurus Property
    C17999
    UMLS 2011AA Property
    C0441633
    NCI Thesaurus Property-2
    C25334
    UMLS 2011AA Property-2
    C1444754
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    cm
    Rotation Time
    Descrição

    ChestComputedTomographyRevolutionTimeMeasurement

    Tipo de dados

    float

    Unidades de medida
    • seconds
    Alias
    NCI Thesaurus ObjectClass
    C17204
    UMLS 2011AA ObjectClass
    C0040405
    NCI Thesaurus ObjectClass-2
    C25389
    UMLS 2011AA ObjectClass-2
    C0817096
    NCI Thesaurus Property
    C25207
    UMLS 2011AA Property
    C0040223
    NCI Thesaurus Property-2
    C48439
    UMLS 2011AA Property-2
    C0035868
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    seconds
    Residual gross tumor
    Descrição

    GrossTumorResidualRemainingInd-2

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus ObjectClass-2
    C43566
    UMLS 2011AA ObjectClass-2
    C0439806
    NCI Thesaurus Property
    C37895
    UMLS 2011AA Property
    C1609982
    NCI Thesaurus Property-2
    C25649
    UMLS 2011AA Property-2
    C1527428
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Greatest diameter of largest residual gross tumor mass (on the lung window settings)
    Descrição

    LargestMalignantNeoplasmLongestDiameterMeasurement

    Tipo de dados

    float

    Unidades de medida
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus ObjectClass-2
    C25550
    UMLS 2011AA ObjectClass-2
    C0443228
    NCI Thesaurus Property
    C25285
    UMLS 2011AA Property
    C1301886
    NCI Thesaurus Property-2
    C25558
    UMLS 2011AA Property-2
    C1522425
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    cm
    Are any non-calcified lung nodules or masses present
    Descrição

    LungNon-CalcifiedNodulePresentInd-2

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C25594
    UMLS 2011AA ObjectClass
    C1518422
    NCI Thesaurus ObjectClass-2
    C12468
    UMLS 2011AA ObjectClass-2
    C0024109
    NCI Thesaurus ObjectClass-3
    C25441
    UMLS 2011AA ObjectClass-3
    C0175895
    NCI Thesaurus ObjectClass-4
    C3280
    UMLS 2011AA ObjectClass-4
    C0028259
    NCI Thesaurus Property
    C25626
    UMLS 2011AA Property
    C0150312
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Evaluation of lesions
    Descrição

    Evaluation of lesions

    Lesion Number
    Descrição

    LesionSiteNumber

    Tipo de dados

    float

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    Lesion Anatomic Site
    Descrição

    Lesion Site, Primary

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS CUI-1
    C0449695
    NCI Thesaurus ObjectClass
    C3824
    NCI Thesaurus Property
    C25341
    Table position of section that best shows lesion
    Descrição

    BestComputedTomographyCoordinatePerformedText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C17204
    UMLS 2011AA ObjectClass
    C0040405
    NCI Thesaurus ObjectClass-2
    C25432
    UMLS 2011AA ObjectClass-2
    C1522427
    NCI Thesaurus ObjectClass-3
    C44465
    UMLS 2011AA ObjectClass-3
    C1707511
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    Maximum diameter of tumor using the lung window settings
    Descrição

    ChestComputedTomographyNeoplasmMaximumDiameterLengthMeasurement

    Tipo de dados

    text

    Unidades de medida
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus ObjectClass-2
    C17204
    UMLS 2011AA ObjectClass-2
    C0040405
    NCI Thesaurus ObjectClass-3
    C25389
    UMLS 2011AA ObjectClass-3
    C0817096
    NCI Thesaurus Property
    C25285
    UMLS 2011AA Property
    C1301886
    NCI Thesaurus Property-2
    C25564
    UMLS 2011AA Property-2
    C0806909
    NCI Thesaurus Property-3
    C25334
    UMLS 2011AA Property-3
    C1444754
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    cm
    Present on previous CT scan
    Descrição

    LesionPriorComputedTomographyPresentIndicator

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25626
    UMLS 2011AA Property
    C0150312
    NCI Thesaurus Property-2
    C17204
    UMLS 2011AA Property-2
    C0040405
    NCI Thesaurus Property-3
    C25629
    UMLS 2011AA Property-3
    C0332152
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    Longest Diameter of Lesion(s)
    Descrição

    Longest Diameter of Lesion

    Tipo de dados

    float

    Unidades de medida
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS CUI-1
    C0221198
    NCI Thesaurus Property
    C25285
    UMLS CUI-2
    C1301886
    NCI Thesaurus Property-2
    C25558
    UMLS CUI-3
    C1522425
    NCI Thesaurus ValueDomain
    C25209
    NCI Thesaurus ValueDomain-2
    C25285
    cm
    Lymph Nodes
    Descrição

    Lymph Nodes

    Indicate stations of all enlarged lymph nodes
    Descrição

    LungLymphNodeSwellingAssessmentSite

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C12468
    UMLS 2011AA ObjectClass
    C0024109
    NCI Thesaurus ObjectClass-2
    C12745
    UMLS 2011AA ObjectClass-2
    C0024204
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus Property-2
    C3399
    UMLS 2011AA Property-2
    C0038999
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    Was a pre-operative PET scan performed
    Descrição

    PriorTreatmentPositronEmissionTomographyInterpretationAvailableInd-2

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C17007
    UMLS 2011AA ObjectClass
    C0032743
    NCI Thesaurus ObjectClass-2
    C25629
    UMLS 2011AA ObjectClass-2
    C0332152
    NCI Thesaurus ObjectClass-3
    C15368
    NCI Thesaurus Property
    C25429
    UMLS 2011AA Property
    C0470187
    NCI Thesaurus Property-2
    C41255
    UMLS 2011AA Property-2
    C0459471
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Date of PET scan (If yes,)
    Descrição

    PatientPre-studyChestPositronEmissionTomographyEligibilityDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C17007
    UMLS 2011AA Property
    C0032743
    NCI Thesaurus Property-2
    C25389
    UMLS 2011AA Property-2
    C0817096
    NCI Thesaurus Property-3
    C25171
    UMLS 2011AA Property-3
    C0013893
    NCI Thesaurus Property-4
    C38010
    UMLS 2011AA Property-4
    C1527048
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    Pet Scan Results
    Descrição

    Pet Scan Results

    Site of lesion
    Descrição

    PositronEmissionTomographyMedicalImagingLungNeoplasmAssessmentAnatomicSite

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C17007
    UMLS 2011AA ObjectClass
    C0032743
    NCI Thesaurus ObjectClass-2
    C16831
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus Property-2
    C3200
    UMLS 2011AA Property-2
    C0020445
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    Nodal lesion, specify
    Descrição

    PositronEmissionTomographyMedicalImagingLungNeoplasmAssessmentSpecify

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C17007
    UMLS 2011AA ObjectClass
    C0032743
    NCI Thesaurus ObjectClass-2
    C16831
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus Property-2
    C3200
    UMLS 2011AA Property-2
    C0020445
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    SUV Max
    Descrição

    StandardUptakeValuePositronEmissionTomographyAssessmentMaximumMeasurement

    Tipo de dados

    float

    Alias
    NCI Thesaurus ObjectClass
    C17007
    UMLS 2011AA ObjectClass
    C0032743
    NCI Thesaurus ObjectClass-2
    C44275
    UMLS 2011AA ObjectClass-2
    C1442989
    NCI Metathesaurus ObjectClass
    C0243144
    NCI Thesaurus ObjectClass-3
    C25712
    UMLS 2011AA ObjectClass-3
    C1522609
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    NCI Thesaurus ValueDomain-2
    C25564
    UMLS 2011AA ValueDomain-2
    C0806909
    SUV Mean
    Descrição

    StandardUptakeValuePositronEmissionTomographyAssessmentMeanMeasurement

    Tipo de dados

    float

    Alias
    NCI Thesaurus ObjectClass
    C17007
    UMLS 2011AA ObjectClass
    C0032743
    NCI Thesaurus ObjectClass-2
    C44275
    UMLS 2011AA ObjectClass-2
    C1442989
    NCI Metathesaurus ObjectClass
    C0243144
    NCI Thesaurus ObjectClass-3
    C25712
    UMLS 2011AA ObjectClass-3
    C1522609
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    NCI Thesaurus ValueDomain-2
    C53319
    UMLS 2011AA ValueDomain-2
    C0444504
    What tests were performed to rule out possible distant metastases present on PET scan?
    Descrição

    DiagnosticProcedureLungDistantMetastasisPresentPerformedText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C18020
    UMLS 2011AA ObjectClass
    C0430022
    NCI Thesaurus Property
    C25626
    UMLS 2011AA Property
    C0150312
    NCI Thesaurus Property-2
    C12468
    UMLS 2011AA Property-2
    C0024109
    NCI Thesaurus Property-3
    C18206
    UMLS 2011AA Property-3
    C1269798
    NCI Thesaurus Property-4
    C38000
    UMLS 2011AA Property-4
    C0884358
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    Footer
    Descrição

    Footer

    Completed by (Last name, First name)
    Descrição

    Person Completing Form

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1550483
    NCI Thesaurus ObjectClass
    C25657
    NCI Thesaurus Property
    C25364
    Date Form Originally Completed
    Descrição

    Form Completion Date

    Tipo de dados

    date

    Alias
    NCI Thesaurus ObjectClass
    C19464
    UMLS CUI-1
    C1549507
    NCI Thesaurus Property
    C25250
    NCI Thesaurus Property-2
    C25604
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25367

    Similar models

    Instructions: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice...

    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de dados
    Alias
    Item Group
    Header
    Form ID CALGB
    Item
    CALGB Form
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3262252 (UMLS CUI-1)
    C19464 (NCI Thesaurus ObjectClass)
    C1516238 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25442 (NCI Thesaurus ObjectClass-2)
    Protocol ID CALGB
    Item
    CALGB Study No
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1516238 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25442 (NCI Thesaurus Property-2)
    Trial subject ID CALGB
    Item
    CALGB Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1516238 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25442 (NCI Thesaurus Property-2)
    DiagnosticComputedTomographyPerformedDate
    Item
    Date of CT Scan
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C17204 (NCI Thesaurus ObjectClass)
    C0040405 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C25482 (NCI Thesaurus ObjectClass-2)
    C0348026 (UMLS 2011AA ObjectClass-2)
    Data amended
    Item
    Are data amended
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    TreatingHospitalName
    Item
    Hospital Name (or imaging center performing chest CT)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C16696 (NCI Thesaurus ObjectClass)
    C0019994 (UMLS 2011AA ObjectClass)
    C25705 (NCI Thesaurus ObjectClass-2)
    C1522326 (UMLS 2011AA ObjectClass-2)
    Item Group
    Patient demographics
    Patient Initials
    Item
    Patient Initials (Last, First Middle)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Medical Record Number
    Item
    Patient Hospital No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1301894 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25261 (NCI Thesaurus Property)
    C25198 (NCI Thesaurus Property-2)
    Institution Name
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C25191 (NCI Thesaurus ValueDomain)
    C21541 (NCI Thesaurus ValueDomain-2)
    Participating Group
    Item
    Participating Group
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2347449 (UMLS CUI-1)
    C25608 (NCI Thesaurus ObjectClass)
    C17005 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    Study Number Participating Group
    Item
    Participating Group Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Trial subject ID Participating Group
    Item
    Participating Group Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Item Group
    Technique Factors
    ChestComputedTomographyKilovoltPeakMeasurement
    Item
    KVp
    float
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    C17204 (NCI Thesaurus ObjectClass)
    C0040405 (UMLS 2011AA ObjectClass)
    C25389 (NCI Thesaurus ObjectClass-2)
    C0817096 (UMLS 2011AA ObjectClass-2)
    C48432 (NCI Thesaurus Property)
    C1708610 (UMLS 2011AA Property)
    ChestComputedTomographyPitchMeasurement
    Item
    Pitch
    float
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    C17204 (NCI Thesaurus ObjectClass)
    C0040405 (UMLS 2011AA ObjectClass)
    C25389 (NCI Thesaurus ObjectClass-2)
    C0817096 (UMLS 2011AA ObjectClass-2)
    C48442 (NCI Thesaurus Property)
    C1704634 (UMLS 2011AA Property)
    ChestComputedTomographyAmpereMeasurement
    Item
    mA
    float
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    C17204 (NCI Thesaurus ObjectClass)
    C0040405 (UMLS 2011AA ObjectClass)
    C25389 (NCI Thesaurus ObjectClass-2)
    C0817096 (UMLS 2011AA ObjectClass-2)
    C0457243 (NCI Metathesaurus Property)
    ChestComputedTomographyScanLengthMeasurement
    Item
    Scan Length (craniocaudal extent)
    float
    C17204 (NCI Thesaurus ObjectClass)
    C0040405 (UMLS 2011AA ObjectClass)
    C25389 (NCI Thesaurus ObjectClass-2)
    C0817096 (UMLS 2011AA ObjectClass-2)
    C17999 (NCI Thesaurus Property)
    C0441633 (UMLS 2011AA Property)
    C25334 (NCI Thesaurus Property-2)
    C1444754 (UMLS 2011AA Property-2)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    ChestComputedTomographyRevolutionTimeMeasurement
    Item
    Rotation Time
    float
    C17204 (NCI Thesaurus ObjectClass)
    C0040405 (UMLS 2011AA ObjectClass)
    C25389 (NCI Thesaurus ObjectClass-2)
    C0817096 (UMLS 2011AA ObjectClass-2)
    C25207 (NCI Thesaurus Property)
    C0040223 (UMLS 2011AA Property)
    C48439 (NCI Thesaurus Property-2)
    C0035868 (UMLS 2011AA Property-2)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    GrossTumorResidualRemainingInd-2
    Item
    Residual gross tumor
    boolean
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C43566 (NCI Thesaurus ObjectClass-2)
    C0439806 (UMLS 2011AA ObjectClass-2)
    C37895 (NCI Thesaurus Property)
    C1609982 (UMLS 2011AA Property)
    C25649 (NCI Thesaurus Property-2)
    C1527428 (UMLS 2011AA Property-2)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    LargestMalignantNeoplasmLongestDiameterMeasurement
    Item
    Greatest diameter of largest residual gross tumor mass (on the lung window settings)
    float
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C25550 (NCI Thesaurus ObjectClass-2)
    C0443228 (UMLS 2011AA ObjectClass-2)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS 2011AA Property)
    C25558 (NCI Thesaurus Property-2)
    C1522425 (UMLS 2011AA Property-2)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    LungNon-CalcifiedNodulePresentInd-2
    Item
    Are any non-calcified lung nodules or masses present
    boolean
    C25594 (NCI Thesaurus ObjectClass)
    C1518422 (UMLS 2011AA ObjectClass)
    C12468 (NCI Thesaurus ObjectClass-2)
    C0024109 (UMLS 2011AA ObjectClass-2)
    C25441 (NCI Thesaurus ObjectClass-3)
    C0175895 (UMLS 2011AA ObjectClass-3)
    C3280 (NCI Thesaurus ObjectClass-4)
    C0028259 (UMLS 2011AA ObjectClass-4)
    C25626 (NCI Thesaurus Property)
    C0150312 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    Item Group
    Evaluation of lesions
    LesionSiteNumber
    Item
    Lesion Number
    float
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    Lesion Site, Primary
    Item
    Lesion Anatomic Site
    text
    C13717 (NCI Thesaurus ValueDomain)
    C0449695 (UMLS CUI-1)
    C3824 (NCI Thesaurus ObjectClass)
    C25341 (NCI Thesaurus Property)
    BestComputedTomographyCoordinatePerformedText
    Item
    Table position of section that best shows lesion
    text
    C17204 (NCI Thesaurus ObjectClass)
    C0040405 (UMLS 2011AA ObjectClass)
    C25432 (NCI Thesaurus ObjectClass-2)
    C1522427 (UMLS 2011AA ObjectClass-2)
    C44465 (NCI Thesaurus ObjectClass-3)
    C1707511 (UMLS 2011AA ObjectClass-3)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    ChestComputedTomographyNeoplasmMaximumDiameterLengthMeasurement
    Item
    Maximum diameter of tumor using the lung window settings
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C17204 (NCI Thesaurus ObjectClass-2)
    C0040405 (UMLS 2011AA ObjectClass-2)
    C25389 (NCI Thesaurus ObjectClass-3)
    C0817096 (UMLS 2011AA ObjectClass-3)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS 2011AA Property)
    C25564 (NCI Thesaurus Property-2)
    C0806909 (UMLS 2011AA Property-2)
    C25334 (NCI Thesaurus Property-3)
    C1444754 (UMLS 2011AA Property-3)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    Item
    Present on previous CT scan
    text
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25626 (NCI Thesaurus Property)
    C0150312 (UMLS 2011AA Property)
    C17204 (NCI Thesaurus Property-2)
    C0040405 (UMLS 2011AA Property-2)
    C25629 (NCI Thesaurus Property-3)
    C0332152 (UMLS 2011AA Property-3)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    Code List
    Present on previous CT scan
    CL Item
    No, New Lesion (No, new lesion)
    CL Item
    Yes, Same Size As Previous Scan (Yes, same size as previous scan)
    CL Item
    Yes, Size Decreased From Previous Scan (Yes, size decreased from previous scan)
    CL Item
    Yes, Size Increased From Previous Scan (Yes, size increased from previous scan)
    Longest Diameter of Lesion
    Item
    Longest Diameter of Lesion(s)
    float
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS CUI-1)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS CUI-2)
    C25558 (NCI Thesaurus Property-2)
    C1522425 (UMLS CUI-3)
    C25209 (NCI Thesaurus ValueDomain)
    C25285 (NCI Thesaurus ValueDomain-2)
    Item Group
    Lymph Nodes
    Item
    Indicate stations of all enlarged lymph nodes
    text
    C12468 (NCI Thesaurus ObjectClass)
    C0024109 (UMLS 2011AA ObjectClass)
    C12745 (NCI Thesaurus ObjectClass-2)
    C0024204 (UMLS 2011AA ObjectClass-2)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C3399 (NCI Thesaurus Property-2)
    C0038999 (UMLS 2011AA Property-2)
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    Code List
    Indicate stations of all enlarged lymph nodes
    CL Item
    Left Hilar Node (Left hilar (10L))
    CL Item
    Left Lower Paratracheal Node (Left lower paratracheal (4L))
    CL Item
    Left Pulmonary Ligament (9l) (Left pulmonary ligament (9L))
    CL Item
    Left Upper Paratracheal Node (Left upper paratracheal (2L))
    CL Item
    Para-aortic Node (Para-aortic (6))
    CL Item
    Paraesophageal (Paraesophageal (8))
    C25344 (NCI Thesaurus)
    C0475302 (UMLS 2011AA)
    CL Item
    Pre-vascular (3a) (Pre-vascular (3A))
    CL Item
    Retrotracheal (3p) (Retrotracheal (3P))
    CL Item
    Right Hilar Node (Right hilar (10R))
    CL Item
    Right Lower Paratracheal Node (Right lower paratracheal (4R))
    CL Item
    Right Pulmonary Ligament (9r) (Right pulmonary ligament (9R))
    CL Item
    Right Upper Paratracheal Node (Right upper paratracheal (2R))
    CL Item
    Subaortic Node (Subaortic (5))
    CL Item
    Subcarinal Node (Subcarinal (7))
    PriorTreatmentPositronEmissionTomographyInterpretationAvailableInd-2
    Item
    Was a pre-operative PET scan performed
    boolean
    C17007 (NCI Thesaurus ObjectClass)
    C0032743 (UMLS 2011AA ObjectClass)
    C25629 (NCI Thesaurus ObjectClass-2)
    C0332152 (UMLS 2011AA ObjectClass-2)
    C15368 (NCI Thesaurus ObjectClass-3)
    C25429 (NCI Thesaurus Property)
    C0470187 (UMLS 2011AA Property)
    C41255 (NCI Thesaurus Property-2)
    C0459471 (UMLS 2011AA Property-2)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    PatientPre-studyChestPositronEmissionTomographyEligibilityDate
    Item
    Date of PET scan (If yes,)
    date
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C17007 (NCI Thesaurus Property)
    C0032743 (UMLS 2011AA Property)
    C25389 (NCI Thesaurus Property-2)
    C0817096 (UMLS 2011AA Property-2)
    C25171 (NCI Thesaurus Property-3)
    C0013893 (UMLS 2011AA Property-3)
    C38010 (NCI Thesaurus Property-4)
    C1527048 (UMLS 2011AA Property-4)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    Item Group
    Pet Scan Results
    Item
    Site of lesion
    text
    C17007 (NCI Thesaurus ObjectClass)
    C0032743 (UMLS 2011AA ObjectClass)
    C16831 (NCI Thesaurus ObjectClass-2)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C3200 (NCI Thesaurus Property-2)
    C0020445 (UMLS 2011AA Property-2)
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    Code List
    Site of lesion
    CL Item
    Lymph Node (Nodal lesion)
    C12745 (NCI Thesaurus)
    C0024204 (UMLS 2011AA)
    CL Item
    Other (Other lesion)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Lung (Primary Lung)
    C12468 (NCI Thesaurus)
    C0024109 (UMLS 2011AA)
    PositronEmissionTomographyMedicalImagingLungNeoplasmAssessmentSpecify
    Item
    Nodal lesion, specify
    text
    C17007 (NCI Thesaurus ObjectClass)
    C0032743 (UMLS 2011AA ObjectClass)
    C16831 (NCI Thesaurus ObjectClass-2)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C3200 (NCI Thesaurus Property-2)
    C0020445 (UMLS 2011AA Property-2)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    StandardUptakeValuePositronEmissionTomographyAssessmentMaximumMeasurement
    Item
    SUV Max
    float
    C17007 (NCI Thesaurus ObjectClass)
    C0032743 (UMLS 2011AA ObjectClass)
    C44275 (NCI Thesaurus ObjectClass-2)
    C1442989 (UMLS 2011AA ObjectClass-2)
    C0243144 (NCI Metathesaurus ObjectClass)
    C25712 (NCI Thesaurus ObjectClass-3)
    C1522609 (UMLS 2011AA ObjectClass-3)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    C25564 (NCI Thesaurus ValueDomain-2)
    C0806909 (UMLS 2011AA ValueDomain-2)
    StandardUptakeValuePositronEmissionTomographyAssessmentMeanMeasurement
    Item
    SUV Mean
    float
    C17007 (NCI Thesaurus ObjectClass)
    C0032743 (UMLS 2011AA ObjectClass)
    C44275 (NCI Thesaurus ObjectClass-2)
    C1442989 (UMLS 2011AA ObjectClass-2)
    C0243144 (NCI Metathesaurus ObjectClass)
    C25712 (NCI Thesaurus ObjectClass-3)
    C1522609 (UMLS 2011AA ObjectClass-3)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    C53319 (NCI Thesaurus ValueDomain-2)
    C0444504 (UMLS 2011AA ValueDomain-2)
    DiagnosticProcedureLungDistantMetastasisPresentPerformedText
    Item
    What tests were performed to rule out possible distant metastases present on PET scan?
    text
    C18020 (NCI Thesaurus ObjectClass)
    C0430022 (UMLS 2011AA ObjectClass)
    C25626 (NCI Thesaurus Property)
    C0150312 (UMLS 2011AA Property)
    C12468 (NCI Thesaurus Property-2)
    C0024109 (UMLS 2011AA Property-2)
    C18206 (NCI Thesaurus Property-3)
    C1269798 (UMLS 2011AA Property-3)
    C38000 (NCI Thesaurus Property-4)
    C0884358 (UMLS 2011AA Property-4)
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    Item Group
    Footer
    Person Completing Form
    Item
    Completed by (Last name, First name)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1550483 (UMLS CUI-1)
    C25657 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Form Completion Date
    Item
    Date Form Originally Completed
    date
    C19464 (NCI Thesaurus ObjectClass)
    C1549507 (UMLS CUI-1)
    C25250 (NCI Thesaurus Property)
    C25604 (NCI Thesaurus Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)

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