ID

1782

Description

RTOG-0522 IM: Local PET/CT Qualitative and Semi-Quantitative Assessment Form Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F7655132-1754-5B7C-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F7655132-1754-5B7C-E034-0003BA3F9857

Keywords

Versions (3)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 6/21/15 6/21/15 -
Uploaded on

September 19, 2012

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Head and Neck Cancer NCT00265941 - - RTOG-0522 IM: Local PET/CT Qualitative and Semi-Quantitative Assessment Form - 2311195v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: RTOG-0522 IM: Local PET/CT Qualitative and Semi-Quantitative Assessment Form
    1. No Instruction available.
Unnamed1
Description

Unnamed1

RTOG Study No.
Description

ProtocolRTOGIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C19778
UMLS 2011AA Property
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Case #
Description

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C19778
UMLS 2011AA ObjectClass
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C49152
UMLS 2011AA Property
C1706256
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Institution Name
Description

InstitutionName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Institution No.
Description

InstitutionIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Initials
Description

PatientInitialsName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
RTOG Patient ID
Description

PatientRadiationTherapyOncologyGroupIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C19778
UMLS 2011AA Property
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Unnamed2
Description

Unnamed2

Amended data
Description

DataAmendedInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Timepoint of PET/CT Imaging
Description

PositronEmissionTomographyAssessmentPeriodTime

Data type

text

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
Was PET/CT Imaging completed?
Description

MedicalImagingPositronEmissionTomographyCompleteInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16831
If no, provide reason
Description

MedicalImagingPositronEmissionTomographyNotCompleteReason

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16831
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25594
UMLS 2011AA Property
C1518422
NCI Thesaurus ValueDomain
C25638
UMLS 2011AA ValueDomain
C0392360
Other, specify
Description

MedicalImagingPositronEmissionTomographyNotCompleteSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16831
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25594
UMLS 2011AA Property
C1518422
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Date of PET/CT Exam (mm-dd-yyyy)
Description

PositronEmissionTomographyDiagnosticImagingAssessmentDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
Date of PET/CT Interpretation (mm-dd-yyyy)
Description

PositronEmissionTomographyExamResultAssessmentDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C25305
UMLS 2011AA ObjectClass
C0582103
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
CL282989
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Image Quality
Description

PositronEmissionTomographyImagingQualityType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16831
NCI Thesaurus Property
C25283
UMLS 2011AA Property
C0332306
Reason Image Inadequate
Description

PositronEmissionTomographyImagingInadequateAssessmentReason

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16831
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
CL124436
NCI Thesaurus ValueDomain
C25638
UMLS 2011AA ValueDomain
C0392360
SUVs cannot be calculated, specify (reason)
Description

PositronEmissionTomographyImagingStandardUptakeRatioInadequateAssessmentSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16831
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C44275
UMLS 2011AA Property
C1442989
NCI Metathesaurus Property
C0243144
NCI Thesaurus Property
C25712
UMLS 2011AA Property
C1522609
NCI Metathesaurus Property
CL124436
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Other, specify
Description

PositronEmissionTomographyImagingInadequateAssessmentSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16831
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
CL124436
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Semi-quantitative Assessment
Description

Semi-quantitative Assessment

Primary Tumor Site
Description

PositronEmissionTomographyPrimaryNeoplasmUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C8509
UMLS 2011AA ObjectClass
C0677930
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level I (Submandibular) Left
Description

PositronEmissionTomographySubmandibularLymphNodeLeftUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
C0229722
NCI Thesaurus Property
C25229
UMLS 2011AA Property
C0205091
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level II (Upper 1/3 Internal Jugular) Left
Description

PositronEmissionTomographyUpperJugularLymphNodeLeftUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
CL215314
NCI Thesaurus Property
C25229
UMLS 2011AA Property
C0205091
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level III (Mid 1/3 Internal Jugular) Left
Description

PositronEmissionTomographyMiddleJugularLymphNodeLeftUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
CL215316
NCI Thesaurus Property
C25229
UMLS 2011AA Property
C0205091
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level IV (Lower 1/3 Internal Jugular) Left
Description

PositronEmissionTomographyLowerJugularLymphNodeLeftUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
CL215315
NCI Thesaurus Property
C25229
UMLS 2011AA Property
C0205091
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level V (Posterior Triangle) Left
Description

PositronEmissionTomographyPosteriorTriangleLymphNodeLeftUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Metathesaurus ObjectClass
C0230073
NCI Thesaurus Property
C25229
UMLS 2011AA Property
C0205091
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Retropharyngeal Left
Description

PositronEmissionTomographyRetropharyngealLymphNodeLeftUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
C0229737
NCI Thesaurus Property
C25229
UMLS 2011AA Property
C0205091
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Other Location Left
Description

PositronEmissionTomographyOtherLymphNodeLeftUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus Property
C25229
UMLS 2011AA Property
C0205091
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level I (Submandibular) Right
Description

PositronEmissionTomographySubmandibularLymphNodeRightUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
C0229722
NCI Thesaurus Property
C25228
UMLS 2011AA Property
C0205090
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level II (Upper 1/3 Internal Jugular) Right
Description

PositronEmissionTomographyUpperJugularLymphNodeRightUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
CL215314
NCI Thesaurus Property
C25228
UMLS 2011AA Property
C0205090
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level III (Mid 1/3 Internal Jugular) Right
Description

PositronEmissionTomographyMiddleJugularLymphNodeRightUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
CL215316
NCI Thesaurus Property
C25228
UMLS 2011AA Property
C0205090
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level IV (Lower 1/3 Internal Jugular) Right
Description

PositronEmissionTomographyLowerJugularLymphNodeRightUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
CL215315
NCI Thesaurus Property
C25228
UMLS 2011AA Property
C0205090
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Level V (Posterior Triangle) Right
Description

PositronEmissionTomographyPosteriorTriangleLymphNodeRightUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Metathesaurus ObjectClass
C0230073
NCI Thesaurus Property
C25228
UMLS 2011AA Property
C0205090
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Retropharyngeal Right
Description

PositronEmissionTomographyRetropharyngealLymphNodeRightUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Metathesaurus ObjectClass
C0229737
NCI Thesaurus Property
C25228
UMLS 2011AA Property
C0205090
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
SUV (peak)
Description

StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement

Data type

double

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C44275
UMLS 2011AA ObjectClass
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass
C25712
UMLS 2011AA ObjectClass
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
Other location Right
Description

PositronEmissionTomographyOtherLymphNodeRightUptakeResultScale

Data type

text

Alias
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus Property
C25228
UMLS 2011AA Property
C0205090
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Metathesaurus Property
C0243144
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Other location, specify (Right)
Description

LymphadenopathyPositronEmissionTomographyAssessmentSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C17007
UMLS 2011AA Property
C0032743
NCI Thesaurus ObjectClass
C3206
UMLS 2011AA ObjectClass
C0024228
Other location, specify (Right)
Description

LymphadenopathyPositronEmissionTomographyAssessmentSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C17007
UMLS 2011AA Property
C0032743
NCI Thesaurus ObjectClass
C3206
UMLS 2011AA ObjectClass
C0024228
Part Iii Indicate Any Lymphadenopathy Seen With Pet
Description

Part Iii Indicate Any Lymphadenopathy Seen With Pet

Were there any distant metastases with PET findings?
Description

DistantMetastasisDetectedPositronEmissionTomographyInd-2

Data type

text

Alias
NCI Thesaurus ObjectClass
C25321
UMLS 2011AA ObjectClass
C0443203
NCI Thesaurus ObjectClass
C19151
UMLS 2011AA ObjectClass
C0027627
NCI Thesaurus Property
C17007
UMLS 2011AA Property
C0032743
NCI Thesaurus Property
C25481
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Specify site
Description

OtherHeadAndNeckDistantMetastasisSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Metathesaurus Property
CL031818
Comments
Description

Comments

COMMENTS
Description

ResearchCommentsText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
Signature of Nuclear Medicine M.D.
Description

NuclearMedicinePhysicianSignatureText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C25678
UMLS 2011AA Property
C1519316
NCI Thesaurus ObjectClass
C25741
UMLS 2011AA ObjectClass
C0031831
NCI Thesaurus ObjectClass
C16922
UMLS 2011AA ObjectClass
C0028582
Person Completing Form
Description

ResponsiblePersonName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25657
UMLS 2011AA ObjectClass
C1273518
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Form Completion Date, Original (mm-dd-yyyy)
Description

FormOriginalCompleteDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS 2011AA ObjectClass
C0376315
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25604
UMLS 2011AA Property
C0205313
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
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1 forms
  1. StudyEvent: RTOG-0522 IM: Local PET/CT Qualitative and Semi-Quantitative Assessment Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Unnamed1
ProtocolRTOGIdentifierNumber
Item
RTOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus Property)
C1514695 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
RadiationTherapyOncologyGroupPatientCaseIdentifierNumber
Item
Case #
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass)
C1514695 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property)
C1706256 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
InstitutionName
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
InstitutionIdentifierNumber
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientInitialsName
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
PatientRadiationTherapyOncologyGroupIdentifierNumber
Item
RTOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus Property)
C1514695 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item Group
Unnamed2
Item
Amended data
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
CL.1
Code List
Amended data
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Timepoint of PET/CT Imaging
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
CL.2
Code List
Timepoint of PET/CT Imaging
CL Item
Pre-treatment (Pre-treatment)
CL Item
Post-treatment (Post-treatment)
CL024863 (NCI Metathesaurus)
Item
Was PET/CT Imaging completed?
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16831 (NCI Thesaurus ObjectClass)
CL.3
Code List
Was PET/CT Imaging completed?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
If no, provide reason
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16831 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
CL.4
Code List
If no, provide reason
CL Item
Scheduling Problem (Scheduling problem)
CL Item
Equipment Failure (Equipment failure)
CL Item
Patient Refusal (Patient refusal)
CL Item
Medical Reason (Medical reason)
CL Item
Injection Site Complications (Injection site complications)
CL Item
Claustrophobia (Claustrophobia)
CL Item
Insurance (Insurance)
C16745 (NCI Thesaurus)
C0021672 (UMLS 2011AA)
CL Item
Equipment Not Available (Do not have required equipment)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
MedicalImagingPositronEmissionTomographyNotCompleteSpecify
Item
Other, specify
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16831 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
PositronEmissionTomographyDiagnosticImagingAssessmentDate
Item
Date of PET/CT Exam (mm-dd-yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
PositronEmissionTomographyExamResultAssessmentDate
Item
Date of PET/CT Interpretation (mm-dd-yyyy)
date
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C25305 (NCI Thesaurus ObjectClass)
C0582103 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL282989 (NCI Metathesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item
Image Quality
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16831 (NCI Thesaurus ObjectClass)
C25283 (NCI Thesaurus Property)
C0332306 (UMLS 2011AA Property)
CL.5
Code List
Image Quality
CL Item
Adequate (Adequate)
CL Item
Suboptimal (Suboptimal)
CL Item
Inadequate (Inadequate)
Item
Reason Image Inadequate
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16831 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL124436 (NCI Metathesaurus Property)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
CL.6
Code List
Reason Image Inadequate
CL Item
N/a (N/A)
CL Item
Entire Study Not Complete (Entire study not complete)
CL Item
Noisy Images (Noisy images)
CL Item
Patient Motion (Patient motion)
CL Item
Radiotracer Infiltration (Radiotracer infiltration)
CL Item
Suvs Cannot Be Calculated (SUVs cannot be calculated)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
PositronEmissionTomographyImagingStandardUptakeRatioInadequateAssessmentSpecify
Item
SUVs cannot be calculated, specify (reason)
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16831 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C44275 (NCI Thesaurus Property)
C1442989 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25712 (NCI Thesaurus Property)
C1522609 (UMLS 2011AA Property)
CL124436 (NCI Metathesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
PositronEmissionTomographyImagingInadequateAssessmentSpecify
Item
Other, specify
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16831 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL124436 (NCI Metathesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item Group
Semi-quantitative Assessment
Item
Primary Tumor Site
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C8509 (NCI Thesaurus ObjectClass)
C0677930 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.7
Code List
Primary Tumor Site
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level I (Submandibular) Left
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C0229722 (NCI Metathesaurus ObjectClass)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.8
Code List
Level I (Submandibular) Left
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level II (Upper 1/3 Internal Jugular) Left
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
CL215314 (NCI Metathesaurus ObjectClass)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.9
Code List
Level II (Upper 1/3 Internal Jugular) Left
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level III (Mid 1/3 Internal Jugular) Left
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
CL215316 (NCI Metathesaurus ObjectClass)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.10
Code List
Level III (Mid 1/3 Internal Jugular) Left
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level IV (Lower 1/3 Internal Jugular) Left
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
CL215315 (NCI Metathesaurus ObjectClass)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.11
Code List
Level IV (Lower 1/3 Internal Jugular) Left
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level V (Posterior Triangle) Left
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C0230073 (NCI Metathesaurus ObjectClass)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.12
Code List
Level V (Posterior Triangle) Left
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Retropharyngeal Left
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C0229737 (NCI Metathesaurus ObjectClass)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.13
Code List
Retropharyngeal Left
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Other Location Left
text
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.14
Code List
Other Location Left
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level I (Submandibular) Right
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C0229722 (NCI Metathesaurus ObjectClass)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.15
Code List
Level I (Submandibular) Right
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level II (Upper 1/3 Internal Jugular) Right
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
CL215314 (NCI Metathesaurus ObjectClass)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.16
Code List
Level II (Upper 1/3 Internal Jugular) Right
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level III (Mid 1/3 Internal Jugular) Right
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
CL215316 (NCI Metathesaurus ObjectClass)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.17
Code List
Level III (Mid 1/3 Internal Jugular) Right
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level IV (Lower 1/3 Internal Jugular) Right
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
CL215315 (NCI Metathesaurus ObjectClass)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.18
Code List
Level IV (Lower 1/3 Internal Jugular) Right
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Level V (Posterior Triangle) Right
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C0230073 (NCI Metathesaurus ObjectClass)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.19
Code List
Level V (Posterior Triangle) Right
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
Item
Retropharyngeal Right
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C0229737 (NCI Metathesaurus ObjectClass)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.20
Code List
Retropharyngeal Right
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
StandardUptakeValuePositronEmissionTomographyAssessmentMeasurement
Item
SUV (peak)
double
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass)
C1442989 (UMLS 2011AA ObjectClass)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass)
C1522609 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
Item
Other location Right
text
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0243144 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.21
Code List
Other location Right
CL Item
Definitely Abnormal (Definitely abnormal)
CL Item
Definitely Normal (Definitely normal)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Imaged, Cannot Evaluate (Not imaged, cannot evaluate)
CL Item
Probably Abnormal (Probably abnormal)
CL Item
Probably Normal (Probably normal)
LymphadenopathyPositronEmissionTomographyAssessmentSpecify
Item
Other location, specify (Right)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus Property)
C17007 (NCI Thesaurus Property)
C0032743 (UMLS 2011AA Property)
C3206 (NCI Thesaurus ObjectClass)
C0024228 (UMLS 2011AA ObjectClass)
LymphadenopathyPositronEmissionTomographyAssessmentSpecify
Item
Other location, specify (Right)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus Property)
C17007 (NCI Thesaurus Property)
C0032743 (UMLS 2011AA Property)
C3206 (NCI Thesaurus ObjectClass)
C0024228 (UMLS 2011AA ObjectClass)
Item Group
Part Iii Indicate Any Lymphadenopathy Seen With Pet
Item
Were there any distant metastases with PET findings?
text
C25321 (NCI Thesaurus ObjectClass)
C0443203 (UMLS 2011AA ObjectClass)
C19151 (NCI Thesaurus ObjectClass)
C0027627 (UMLS 2011AA ObjectClass)
C17007 (NCI Thesaurus Property)
C0032743 (UMLS 2011AA Property)
C25481 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.22
Code List
Were there any distant metastases with PET findings?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
OtherHeadAndNeckDistantMetastasisSpecify
Item
Specify site
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
CL031818 (NCI Metathesaurus Property)
Item Group
Comments
ResearchCommentsText
Item
COMMENTS
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
NuclearMedicinePhysicianSignatureText
Item
Signature of Nuclear Medicine M.D.
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C16922 (NCI Thesaurus ObjectClass)
C0028582 (UMLS 2011AA ObjectClass)
ResponsiblePersonName
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
FormOriginalCompleteDate
Item
Form Completion Date, Original (mm-dd-yyyy)
date
C19464 (NCI Thesaurus ObjectClass)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25604 (NCI Thesaurus Property)
C0205313 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
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