Interoperability
MADO 101: The Manifest Becomes Its Own Document
Manifest-based Access to DICOM Objects is a small profile with a large consequence: it takes the retrieve address out of the signed clinical report and makes the imaging manifest a document in its own right. Everything else in it follows from that one decision. This paper is the orientation layer for the engineers and architects who have to specify, procure or build against it, and it is written from the primary text rather than from the coverage. It covers the three actors and exactly what each one owes, both manifest encodings and why a producer has to implement both, the FHIR document opened entry by entry, the DICOM KOS document including the identifier chain that is not one order to one study, the single retrieve transaction and the obligations it does and does not carry, cross-community retrieval through XC-WADO, and where the European extensions currently disagree with the international profile. It sits on top of WP-02, IHE 101, and WP-05, DICOMweb 101, which covers the transaction MADO reuses.
What’s inside
- What was published and when: Trial Implementation in March 2026, revision 1.2 in August, and why the profile came out of a European joint action
- The architectural seam, drawn: where the retrieve address sits relative to the signature, before and after
- Three actors, one transaction, and the asymmetry in the conformance table that is easy to miss
- Everything the MADO manifest carries that the XDS-I.b manifest did not, and the retrieval economics that motivate it
- Both encodings and the bi-directional mapping, with the FHIR Bundle opened entry by entry
- The DICOM KOS manifest, the TID 1600 image library, and three worked cases where orders, procedure requests and studies do not map one to one
- RAD-107 in practice: what a responder actually owes, how the retrieve URL is formed, and the count mismatch every consumer has to handle
- Crossing a community boundary with XC-WADO, and the URL rewriting the previous generation left unspecified
- EHDS: Article 14, the staged dates through 26 March 2031, and what is authorised text versus a continuous build
- Where the IHE and HL7 Europe guides currently disagree, and nine expensive mistakes
PDF · 21 pages
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