# Series metadata image laterality

**URL:** <https://discourse.slicer.org/t/series-metadata-image-laterality/31659>\
**Category:** Support\
**Created:** [September 12, 2023, 4:15pm UTC](https://discourse.slicer.org/t/series-metadata-image-laterality/31659 "2023-09-12T16:15:01Z")\
**Posts on this page:** 3\
**Page:** 1

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**Author:** ![SOFIA\_R](https://sea2.discourse-cdn.com/flex002/user_avatar/discourse.slicer.org/sofia_r/32/66469_2.png) [@SOFIA\_R](https://discourse.slicer.org/u/SOFIA_R)\
**Post date:** [September 12, 2023, 4:15pm UTC](https://discourse.slicer.org/t/series-metadata-image-laterality/31659/1 "2023-09-12T16:15:01Z")

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Hello, I am currently making segmentations in a Tomosynthesis series of images and I would like to know which series is the left breast or the right breast. That’s when I looked for the series metadata. Then I found “PatientOrientation” which says for example “[2] P, FL”. Is that related to left and right? Or which one of the metadata is the one that provides me the laterality of the image? Thank you.

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**Author:** ![pieper](https://sea2.discourse-cdn.com/flex002/user_avatar/discourse.slicer.org/pieper/32/8_2.png) [@pieper](https://discourse.slicer.org/u/pieper)\
**Post date:** [September 12, 2023, 4:50pm UTC](https://discourse.slicer.org/t/series-metadata-image-laterality/31659/2 "2023-09-12T16:50:16Z")

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It may vary depending on how the vendor implemented the standard, but PatientOrientation should describe only the relationship of the patient to the scanner ([Patient Position Attribute – DICOM Standard Browser](https://dicom.innolitics.com/ciods/cr-image/general-series/00185100)), while Laterality ([Laterality Attribute – DICOM Standard Browser](https://dicom.innolitics.com/ciods/cr-image/general-series/00200060)) should be used to describe which side of the body is being imaged.

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**Author:** ![David\_Clunie](https://sea2.discourse-cdn.com/flex002/user_avatar/discourse.slicer.org/david_clunie/32/10689_2.png) [@David\_Clunie](https://discourse.slicer.org/u/David_Clunie)\
**Post date:** [September 14, 2023, 4:06pm UTC](https://discourse.slicer.org/t/series-metadata-image-laterality/31659/3 "2023-09-14T16:06:17Z")

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The laterality information (which breast) is distinct from the orientation information (which direction the rows and columns of the image point relative to the patient).

For the [Breast Tomosynthesis IOD](https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_A.55.html), which is of the enhanced multi-frame family, such anatomical information is in the [Frame Anatomy Sequence in Frame Laterality](https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.7.6.16.2.html#sect_C.7.6.16.2.8), which is usually in the Shared [Functional Group Sequence](https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_A.55.4.html), since all frames in a single instance are (usually) of the same breast.

I.e., it is not in the top level dataset, and not in Laterality or [Image Laterality](https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_C.8.11.2.html) (the later being used for ordinary, non-tomographic [mammography images](https://dicom.nema.org/medical/dicom/current/output/chtml/part03/sect_A.27.html)).

There are examples in IDC such as [this one](https://viewer.imaging.datacommons.cancer.gov/viewer/1.2.826.0.1.3680043.8.498.11387662677066579919319049302075478647), and you can use the Tag Browser in OHIF to see the Frame Laterality.