rtp-connect 1.8 → 1.9

data/lib/rtp-connect/plan_to_dcm.rb

@@ -1,657 +1,669 @@
-module RTP
-
-  class Plan < Record
-
-    attr_accessor :current_gantry
-    attr_accessor :current_collimator
-    attr_accessor :current_couch_angle
-    attr_accessor :current_couch_pedestal
-    attr_accessor :current_couch_lateral
-    attr_accessor :current_couch_longitudinal
-    attr_accessor :current_couch_vertical
-
-    # Converts the Plan (and child) records to a
-    # DICOM::DObject of modality RTPLAN.
-    #
-    # @note Only photon plans have been tested.
-    #   Electron beams beams may give an invalid DICOM file.
-    #   Also note that, due to limitations in the RTP file format, some original
-    #   values can not be recreated, like e.g. Study UID or Series UID.
-    # @param [Hash] options the options to use for creating the DICOM object
-    # @option options [Boolean] :dose_ref if set, Dose Reference & Referenced Dose Reference sequences will be included in the generated DICOM file
-    # @option options [String] :manufacturer the value used for the manufacturer tag (0008,0070) in the beam sequence
-    # @option options [String] :model the value used for the manufacturer's model name tag (0008,1090) in the beam sequence
-    # @option options [Symbol] :scale if set, relevant device parameters are converted from native readout format to IEC1217 (supported values are :elekta & :varian)
-    # @option options [String] :serial_number the value used for the device serial number tag (0018,1000) in the beam sequence
-    # @return [DICOM::DObject] the converted DICOM object
-    #
-    def to_dcm(options={})
-      #
-      # FIXME: This method is rather big, with a few sections of somewhat similar, repeating code.
-      # Refactoring and simplifying it at some stage might be a good idea.
-      #
-      require 'dicom'
-      original_level = DICOM.logger.level
-      DICOM.logger.level = Logger::FATAL
-      p = @prescriptions.first
-      # If no prescription is present, we are not going to be able to make a valid DICOM object:
-      logger.error("No Prescription Record present. Unable to build a valid RTPLAN DICOM object.") unless p
-      dcm = DICOM::DObject.new
-      #
-      # TOP LEVEL TAGS:
-      #
-      # Specific Character Set:
-      DICOM::Element.new('0008,0005', 'ISO_IR 100', :parent => dcm)
-      # Instance Creation Date
-      DICOM::Element.new('0008,0012', Time.now.strftime("%Y%m%d"), :parent => dcm)
-      # Instance Creation Time:
-      DICOM::Element.new('0008,0013', Time.now.strftime("%H%M%S"), :parent => dcm)
-      # SOP Class UID:
-      DICOM::Element.new('0008,0016', '1.2.840.10008.5.1.4.1.1.481.5', :parent => dcm)
-      # SOP Instance UID (if an original UID is not present, we make up a UID):
-      begin
-        sop_uid = p.fields.first.extended_field.original_plan_uid.empty? ? DICOM.generate_uid : p.fields.first.extended_field.original_plan_uid
-      rescue
-        sop_uid = DICOM.generate_uid
-      end
-      DICOM::Element.new('0008,0018', sop_uid, :parent => dcm)
-      # Study Date
-      DICOM::Element.new('0008,0020', Time.now.strftime("%Y%m%d"), :parent => dcm)
-      # Study Time:
-      DICOM::Element.new('0008,0030', Time.now.strftime("%H%M%S"), :parent => dcm)
-      # Accession Number:
-      DICOM::Element.new('0008,0050', '', :parent => dcm)
-      # Modality:
-      DICOM::Element.new('0008,0060', 'RTPLAN', :parent => dcm)
-      # Manufacturer:
-      DICOM::Element.new('0008,0070', 'rtp-connect', :parent => dcm)
-      # Referring Physician's Name:
-      DICOM::Element.new('0008,0090', "#{@md_last_name}^#{@md_first_name}^#{@md_middle_name}^^", :parent => dcm)
-      # Operator's Name:
-      DICOM::Element.new('0008,1070', "#{@author_last_name}^#{@author_first_name}^#{@author_middle_name}^^", :parent => dcm)
-      # Patient's Name:
-      DICOM::Element.new('0010,0010', "#{@patient_last_name}^#{@patient_first_name}^#{@patient_middle_name}^^", :parent => dcm)
-      # Patient ID:
-      DICOM::Element.new('0010,0020', @patient_id, :parent => dcm)
-      # Patient's Birth Date:
-      DICOM::Element.new('0010,0030', '', :parent => dcm)
-      # Patient's Sex:
-      DICOM::Element.new('0010,0040', '', :parent => dcm)
-      # Manufacturer's Model Name:
-      DICOM::Element.new('0008,1090', 'RTP-to-DICOM', :parent => dcm)
-      # Software Version(s):
-      DICOM::Element.new('0018,1020', "RubyRTP#{VERSION}", :parent => dcm)
-      # Study Instance UID:
-      DICOM::Element.new('0020,000D', DICOM.generate_uid, :parent => dcm)
-      # Series Instance UID:
-      DICOM::Element.new('0020,000E', DICOM.generate_uid, :parent => dcm)
-      # Study ID:
-      DICOM::Element.new('0020,0010', '1', :parent => dcm)
-      # Series Number:
-      DICOM::Element.new('0020,0011', '1', :parent => dcm)
-      # Frame of Reference UID (if an original UID is not present, we make up a UID):
-      begin
-        for_uid = p.site_setup.frame_of_ref_uid.empty? ? DICOM.generate_uid : p.site_setup.frame_of_ref_uid
-      rescue
-        for_uid = DICOM.generate_uid
-      end
-      DICOM::Element.new('0020,0052', for_uid, :parent => dcm)
-      # Position Reference Indicator:
-      DICOM::Element.new('0020,1040', '', :parent => dcm)
-      # RT Plan Label (max 16 characters):
-      plan_label = p ? p.rx_site_name[0..15] : @course_id
-      DICOM::Element.new('300A,0002', plan_label, :parent => dcm)
-      # RT Plan Name:
-      plan_name = p ? p.rx_site_name : @course_id
-      DICOM::Element.new('300A,0003', plan_name, :parent => dcm)
-      # RT Plan Description:
-      plan_desc = p ? p.technique : @diagnosis
-      DICOM::Element.new('300A,0004', plan_desc, :parent => dcm)
-      # RT Plan Date:
-      plan_date = @plan_date.empty? ? Time.now.strftime("%Y%m%d") : @plan_date
-      DICOM::Element.new('300A,0006', plan_date, :parent => dcm)
-      # RT Plan Time:
-      plan_time = @plan_time.empty? ? Time.now.strftime("%H%M%S") : @plan_time
-      DICOM::Element.new('300A,0007', plan_time, :parent => dcm)
-      # Approval Status:
-      DICOM::Element.new('300E,0002', 'UNAPPROVED', :parent => dcm)
-      #
-      # SEQUENCES:
-      #
-      # Tolerance Table Sequence:
-      if p && p.fields.first && !p.fields.first.tolerance_table.empty?
-        tt_seq = DICOM::Sequence.new('300A,0040', :parent => dcm)
-        tt_item = DICOM::Item.new(:parent => tt_seq)
-        # Tolerance Table Number:
-        DICOM::Element.new('300A,0042', p.fields.first.tolerance_table, :parent => tt_item)
-      end
-      # Structure set information:
-      if p && p.site_setup && !p.site_setup.structure_set_uid.empty?
-        #
-        # Referenced Structure Set Sequence:
-        #
-        ss_seq = DICOM::Sequence.new('300C,0060', :parent => dcm)
-        ss_item = DICOM::Item.new(:parent => ss_seq)
-        # Referenced SOP Class UID:
-        DICOM::Element.new('0008,1150', '1.2.840.10008.5.1.4.1.1.481.3', :parent => ss_item)
-        DICOM::Element.new('0008,1155', p.site_setup.structure_set_uid, :parent => ss_item)
-        # RT Plan Geometry:
-        DICOM::Element.new('300A,000C', 'PATIENT', :parent => dcm)
-      else
-        # RT Plan Geometry:
-        DICOM::Element.new('300A,000C', 'TREATMENT_DEVICE', :parent => dcm)
-      end
-      #
-      # Patient Setup Sequence:
-      #
-      ps_seq = DICOM::Sequence.new('300A,0180', :parent => dcm)
-      ps_item = DICOM::Item.new(:parent => ps_seq)
-      # Patient Position:
-      begin
-        pat_pos = p.site_setup.patient_orientation.empty? ? 'HFS' : p.site_setup.patient_orientation
-      rescue
-        pat_pos = 'HFS'
-      end
-      DICOM::Element.new('0018,5100', pat_pos, :parent => ps_item)
-      # Patient Setup Number:
-      DICOM::Element.new('300A,0182', '1', :parent => ps_item)
-      # Setup Technique (assume Isocentric):
-      DICOM::Element.new('300A,01B0', 'ISOCENTRIC', :parent => ps_item)
-      #
-      # Dose Reference Sequence:
-      #
-      create_dose_reference(dcm, plan_name) if options[:dose_ref]
-      #
-      # Fraction Group Sequence:
-      #
-      fg_seq = DICOM::Sequence.new('300A,0070', :parent => dcm)
-      fg_item = DICOM::Item.new(:parent => fg_seq)
-      # Fraction Group Number:
-      DICOM::Element.new('300A,0071', '1', :parent => fg_item)
-      # Number of Fractions Planned (try to derive from total dose/fraction dose, or use 1 as default):
-      begin
-        num_frac = p.dose_ttl.empty? || p.dose_tx.empty? ? '1' : (p.dose_ttl.to_i / p.dose_tx.to_f).round.to_s
-      rescue
-        num_frac = '0'
-      end
-      DICOM::Element.new('300A,0078', num_frac, :parent => fg_item)
-      # Number of Brachy Application Setups:
-      DICOM::Element.new('300A,00A0', '0', :parent => fg_item)
-      # Referenced Beam Sequence (items created for each beam below):
-      rb_seq = DICOM::Sequence.new('300C,0004', :parent => fg_item)
-      #
-      # Beam Sequence:
-      #
-      b_seq = DICOM::Sequence.new('300A,00B0', :parent => dcm)
-      if p
-        # If no fields are present, we are not going to be able to make a valid DICOM object:
-        logger.error("No Field Record present. Unable to build a valid RTPLAN DICOM object.") unless p.fields.length > 0
-        p.fields.each_with_index do |field, i|
-          # Fields with modality 'Unspecified' (e.g. CT or 2dkV) must be skipped:
-          unless field.modality == 'Unspecified'
-            # If this is an electron beam, a warning should be printed, as these are less reliably converted:
-            logger.warn("This is not a photon beam (#{field.modality}). Beware that DICOM conversion of Electron beams are experimental, and other modalities are unsupported.") if field.modality != 'Xrays'
-            # Reset control point 'current value' attributes:
-            reset_cp_current_attributes
-            # Beam number and name:
-            beam_number = field.extended_field ? field.extended_field.original_beam_number : (i + 1).to_s
-            beam_name = field.extended_field ? field.extended_field.original_beam_name : field.field_name
-            # Ref Beam Item:
-            rb_item = DICOM::Item.new(:parent => rb_seq)
-            # Beam Dose (convert from cGy to Gy):
-            field_dose = field.field_dose.empty? ? '' : (field.field_dose.to_f * 0.01).round(4).to_s
-            DICOM::Element.new('300A,0084', field_dose, :parent => rb_item)
-            # Beam Meterset:
-            DICOM::Element.new('300A,0086', field.field_monitor_units, :parent => rb_item)
-            # Referenced Beam Number:
-            DICOM::Element.new('300C,0006', beam_number, :parent => rb_item)
-            # Beam Item:
-            b_item = DICOM::Item.new(:parent => b_seq)
-            # Optional method values:
-            # Manufacturer:
-            DICOM::Element.new('0008,0070', options[:manufacturer], :parent => b_item) if options[:manufacturer]
-            # Manufacturer's Model Name:
-            DICOM::Element.new('0008,1090', options[:model], :parent => b_item) if options[:model]
-            # Device Serial Number:
-            DICOM::Element.new('0018,1000', options[:serial_number], :parent => b_item) if options[:serial_number]
-            # Treatment Machine Name (max 16 characters):
-            DICOM::Element.new('300A,00B2', field.treatment_machine[0..15], :parent => b_item)
-            # Primary Dosimeter Unit:
-            DICOM::Element.new('300A,00B3', 'MU', :parent => b_item)
-            # Source-Axis Distance (convert to mm):
-            DICOM::Element.new('300A,00B4', "#{field.sad.to_f * 10}", :parent => b_item)
-            # Beam Number:
-            DICOM::Element.new('300A,00C0', beam_number, :parent => b_item)
-            # Beam Name:
-            DICOM::Element.new('300A,00C2', beam_name, :parent => b_item)
-            # Beam Description:
-            DICOM::Element.new('300A,00C3', field.field_note, :parent => b_item)
-            # Beam Type:
-            beam_type = case field.treatment_type
-              when 'Static' then 'STATIC'
-              when 'StepNShoot' then 'STATIC'
-              when 'VMAT' then 'DYNAMIC'
-              else logger.error("The beam type (treatment type) #{field.treatment_type} is not yet supported.")
-            end
-            DICOM::Element.new('300A,00C4', beam_type, :parent => b_item)
-            # Radiation Type:
-            rad_type = case field.modality
-              when 'Elect' then 'ELECTRON'
-              when 'Xrays' then 'PHOTON'
-              else logger.error("The radiation type (modality) #{field.modality} is not yet supported.")
-            end
-            DICOM::Element.new('300A,00C6', rad_type, :parent => b_item)
-            # Treatment Delivery Type:
-            DICOM::Element.new('300A,00CE', 'TREATMENT', :parent => b_item)
-            # Number of Wedges:
-            DICOM::Element.new('300A,00D0', (field.wedge.empty? ? '0' : '1'), :parent => b_item)
-            # Number of Compensators:
-            DICOM::Element.new('300A,00E0', (field.compensator.empty? ? '0' : '1'), :parent => b_item)
-            # Number of Boli:
-            DICOM::Element.new('300A,00ED', (field.bolus.empty? ? '0' : '1'), :parent => b_item)
-            # Number of Blocks:
-            DICOM::Element.new('300A,00F0', (field.block.empty? ? '0' : '1'), :parent => b_item)
-            # Final Cumulative Meterset Weight:
-            DICOM::Element.new('300A,010E', 1, :parent => b_item)
-            # Referenced Patient Setup Number:
-            DICOM::Element.new('300C,006A', '1', :parent => b_item)
-            #
-            # Beam Limiting Device Sequence:
-            #
-            create_beam_limiting_devices(b_item, field)
-            #
-            # Block Sequence (if any):
-            # FIXME: It seems that the Block Sequence (300A,00F4) may be
-            # difficult (impossible?) to reconstruct based on the RTP file's
-            # information, and thus it is skipped altogether.
-            #
-            #
-            # Applicator Sequence (if any):
-            #
-            unless field.e_applicator.empty?
-              app_seq = DICOM::Sequence.new('300A,0107', :parent => b_item)
-              app_item = DICOM::Item.new(:parent => app_seq)
-              # Applicator ID:
-              DICOM::Element.new('300A,0108', field.e_field_def_aperture, :parent => app_item)
-              # Applicator Type:
-              DICOM::Element.new('300A,0109', "ELECTRON_#{field.e_applicator.upcase}", :parent => app_item)
-              # Applicator Description:
-              DICOM::Element.new('300A,010A', "Appl. #{field.e_field_def_aperture}", :parent => app_item)
-            end
-            #
-            # Control Point Sequence:
-            #
-            # A field may have 0 (no MLC), 1 (conventional beam with MLC) or 2n (IMRT) control points.
-            # The DICOM file shall always contain 2n control points (minimum 2).
-            #
-            cp_seq = DICOM::Sequence.new('300A,0111', :parent => b_item)
-            if field.control_points.length < 2
-              # When we have 0 or 1 control point, use settings from field, and insert MLC settings if present:
-              # First CP:
-              cp_item = DICOM::Item.new(:parent => cp_seq)
-              # Control Point Index:
-              DICOM::Element.new('300A,0112', "0", :parent => cp_item)
-              # Nominal Beam Energy:
-              DICOM::Element.new('300A,0114', "#{field.energy.to_f}", :parent => cp_item)
-              # Dose Rate Set:
-              DICOM::Element.new('300A,0115', field.doserate, :parent => cp_item)
-              # Gantry Angle:
-              DICOM::Element.new('300A,011E', field.gantry_angle, :parent => cp_item)
-              # Gantry Rotation Direction:
-              DICOM::Element.new('300A,011F', (field.arc_direction.empty? ? 'NONE' : field.arc_direction), :parent => cp_item)
-              # Beam Limiting Device Angle:
-              DICOM::Element.new('300A,0120', field.collimator_angle, :parent => cp_item)
-              # Beam Limiting Device Rotation Direction:
-              DICOM::Element.new('300A,0121', 'NONE', :parent => cp_item)
-              # Patient Support Angle:
-              DICOM::Element.new('300A,0122', field.couch_pedestal, :parent => cp_item)
-              # Patient Support Rotation Direction:
-              DICOM::Element.new('300A,0123', 'NONE', :parent => cp_item)
-              # Table Top Eccentric Angle:
-              DICOM::Element.new('300A,0125', field.couch_angle, :parent => cp_item)
-              # Table Top Eccentric Rotation Direction:
-              DICOM::Element.new('300A,0126', 'NONE', :parent => cp_item)
-              # Table Top Vertical Position:
-              couch_vert = field.couch_vertical.empty? ? '' : (field.couch_vertical.to_f * 10).to_s
-              DICOM::Element.new('300A,0128', couch_vert, :parent => cp_item)
-              # Table Top Longitudinal Position:
-              couch_long = field.couch_longitudinal.empty? ? '' : (field.couch_longitudinal.to_f * 10).to_s
-              DICOM::Element.new('300A,0129', couch_long, :parent => cp_item)
-              # Table Top Lateral Position:
-              couch_lat = field.couch_lateral.empty? ? '' : (field.couch_lateral.to_f * 10).to_s
-              DICOM::Element.new('300A,012A', couch_lat, :parent => cp_item)
-              # Isocenter Position (x\y\z):
-              if p.site_setup
-                DICOM::Element.new('300A,012C', "#{(p.site_setup.iso_pos_x.to_f * 10).round(2)}\\#{(p.site_setup.iso_pos_y.to_f * 10).round(2)}\\#{(p.site_setup.iso_pos_z.to_f * 10).round(2)}", :parent => cp_item)
-              else
-                logger.warn("No Site Setup record exists for this plan. Unable to provide an isosenter position.")
-                DICOM::Element.new('300A,012C', '', :parent => cp_item)
-              end
-              # Source to Surface Distance:
-              add_ssd(field.ssd, cp_item)
-              # Cumulative Meterset Weight:
-              DICOM::Element.new('300A,0134', '0', :parent => cp_item)
-              # Beam Limiting Device Position Sequence:
-              if field.control_points.length > 0
-                create_beam_limiting_device_positions(cp_item, field.control_points.first, options)
-              else
-                create_beam_limiting_device_positions_from_field(cp_item, field, options)
-              end
-              # Referenced Dose Reference Sequence:
-              create_referenced_dose_reference(cp_item) if options[:dose_ref]
-              # Second CP:
-              cp_item = DICOM::Item.new(:parent => cp_seq)
-              # Control Point Index:
-              DICOM::Element.new('300A,0112', "1", :parent => cp_item)
-              # Cumulative Meterset Weight:
-              DICOM::Element.new('300A,0134', '1', :parent => cp_item)
-            else
-              # When we have multiple (2 or more) control points, iterate each control point:
-              field.control_points.each { |cp| create_control_point(cp, cp_seq, options) }
-              # Make sure that hte cumulative meterset weight of the last control
-              # point is '1' (exactly equal to final cumulative meterset weight):
-              cp_seq.items.last['300A,0134'].value = '1'
-            end
-            # Number of Control Points:
-            DICOM::Element.new('300A,0110', b_item['300A,0111'].items.length, :parent => b_item)
-          end
-        end
-        # Number of Beams:
-        DICOM::Element.new('300A,0080', fg_item['300C,0004'].items.length, :parent => fg_item)
-      end
-      # Restore the DICOM logger:
-      DICOM.logger.level = original_level
-      return dcm
-    end
-
-
-    private
-
-
-    # Adds an angular type value to a Control Point Item, by creating the
-    # necessary DICOM elements.
-    # Note that the element is only added if there is no 'current' attribute
-    # defined, or the given value is different form the current attribute.
-    #
-    # @param [DICOM::Item] item the DICOM control point item in which to create the elements
-    # @param [String] angle_tag the DICOM tag of the angle element
-    # @param [String] direction_tag the DICOM tag of the direction element
-    # @param [String, NilClass] angle the collimator angle attribute
-    # @param [String, NilClass] direction the collimator rotation direction attribute
-    # @param [Symbol] current_angle the instance variable that keeps track of the current value of this attribute
-    #
-    def add_angle(item, angle_tag, direction_tag, angle, direction, current_angle)
-      if !self.send(current_angle) || angle != self.send(current_angle)
-        self.send("#{current_angle}=", angle)
-        DICOM::Element.new(angle_tag, angle, :parent => item)
-        DICOM::Element.new(direction_tag, (direction.empty? ? 'NONE' : direction), :parent => item)
-      end
-    end
-
-    # Adds a Table Top Position element to a Control Point Item.
-    # Note that the element is only added if there is no 'current' attribute
-    # defined, or the given value is different form the current attribute.
-    #
-    # @param [DICOM::Item] item the DICOM control point item in which to create the element
-    # @param [String] tag the DICOM tag of the couch position element
-    # @param [String, NilClass] value the couch position
-    # @param [Symbol] current the instance variable that keeps track of the current value of this attribute
-    #
-    def add_couch_position(item, tag, value, current)
-      if !self.send(current) || value != self.send(current)
-        self.send("#{current}=", value)
-        DICOM::Element.new(tag, (value.empty? ? '' : value.to_f * 10), :parent => item)
-      end
-    end
-
-    # Adds a Dose Rate Set element to a Control Point Item.
-    # Note that the element is only added if there is no 'current' attribute
-    # defined, or the given value is different form the current attribute.
-    #
-    # @param [String, NilClass] value the doserate attribute
-    # @param [DICOM::Item] item the DICOM control point item in which to create an element
-    #
-    def add_doserate(value, item)
-      if !@current_doserate || value != @current_doserate
-        @current_doserate = value
-        DICOM::Element.new('300A,0115', value, :parent => item)
-      end
-    end
-
-    # Adds a Nominal Beam Energy element to a Control Point Item.
-    # Note that the element is only added if there is no 'current' attribute
-    # defined, or the given value is different form the current attribute.
-    #
-    # @param [String, NilClass] value the energy attribute
-    # @param [DICOM::Item] item the DICOM control point item in which to create an element
-    #
-    def add_energy(value, item)
-      if !@current_energy || value != @current_energy
-        @current_energy = value
-        DICOM::Element.new('300A,0114', "#{value.to_f}", :parent => item)
-      end
-    end
-
-    # Adds an Isosenter element to a Control Point Item.
-    # Note that the element is only added if there is a Site Setup record present,
-    # and it contains a real (non-empty) value. Also, the element is only added if there
-    # is no 'current' attribute defined, or the given value is different form the current attribute.
-    #
-    # @param [SiteSetup, NilClass] site_setup the associated site setup record
-    # @param [DICOM::Item] item the DICOM control point item in which to create an element
-    #
-    def add_isosenter(site_setup, item)
-      if site_setup
-        # Create an element if the value is new or unique:
-        if !@current_isosenter
-          iso = "#{(site_setup.iso_pos_x.to_f * 10).round(2)}\\#{(site_setup.iso_pos_y.to_f * 10).round(2)}\\#{(site_setup.iso_pos_z.to_f * 10).round(2)}"
-          if iso != @current_isosenter
-            @current_isosenter = iso
-            DICOM::Element.new('300A,012C', iso, :parent => item)
-          end
-        end
-      else
-        # Log a warning if this is the first control point:
-        unless @current_isosenter
-          logger.warn("No Site Setup record exists for this plan. Unable to provide an isosenter position.")
-        end
-      end
-    end
-
-    # Adds a Source to Surface Distance element to a Control Point Item.
-    # Note that the element is only added if the SSD attribute contains
-    # real (non-empty) value.
-    #
-    # @param [String, NilClass] value the SSD attribute
-    # @param [DICOM::Item] item the DICOM control point item in which to create an element
-    #
-    def add_ssd(value, item)
-      DICOM::Element.new('300A,0130', "#{value.to_f * 10}", :parent => item) if value && !value.empty?
-    end
-
-    # Creates a control point item in the given control point sequence, based
-    # on an RTP control point record.
-    #
-    # @param [ControlPoint] cp the RTP ControlPoint record to convert
-    # @param [DICOM::Sequence] sequence the DICOM parent sequence of the item to be created
-    # @param [Hash] options the options to use for creating the control point
-    # @option options [Boolean] :dose_ref if set, a Referenced Dose Reference sequence will be included in the generated control point item
-    # @return [DICOM::Item] the constructed control point DICOM item
-    #
-    def create_control_point(cp, sequence, options={})
-      cp_item = DICOM::Item.new(:parent => sequence)
-      # Some CP attributes will always be written (CP index, BLD positions & Cumulative meterset weight).
-      # The other attributes are only written if they are different from the previous control point.
-      # Control Point Index:
-      DICOM::Element.new('300A,0112', "#{cp.index}", :parent => cp_item)
-      # Beam Limiting Device Position Sequence:
-      create_beam_limiting_device_positions(cp_item, cp, options)
-      # Source to Surface Distance:
-      add_ssd(cp.ssd, cp_item)
-      # Cumulative Meterset Weight:
-      DICOM::Element.new('300A,0134', cp.monitor_units.to_f, :parent => cp_item)
-      # Referenced Dose Reference Sequence:
-      create_referenced_dose_reference(cp_item) if options[:dose_ref]
-      # Attributes that are only added if they carry an updated value:
-      # Nominal Beam Energy:
-      add_energy(cp.energy, cp_item)
-      # Dose Rate Set:
-      add_doserate(cp.doserate, cp_item)
-      # Gantry Angle & Rotation Direction:
-      add_angle(cp_item, '300A,011E', '300A,011F', cp.gantry_angle, cp.gantry_dir, :current_gantry)
-      # Beam Limiting Device Angle & Rotation Direction:
-      add_angle(cp_item, '300A,0120', '300A,0121', cp.collimator_angle, cp.collimator_dir, :current_collimator)
-      # Patient Support Angle & Rotation Direction:
-      add_angle(cp_item, '300A,0122', '300A,0123', cp.couch_pedestal, cp.couch_ped_dir, :current_couch_pedestal)
-      # Table Top Eccentric Angle & Rotation Direction:
-      add_angle(cp_item, '300A,0125', '300A,0126', cp.couch_angle, cp.couch_dir, :current_couch_angle)
-      # Table Top Vertical Position:
-      add_couch_position(cp_item, '300A,0128', cp.couch_vertical, :current_couch_vertical)
-      # Table Top Longitudinal Position:
-      add_couch_position(cp_item, '300A,0129', cp.couch_longitudinal, :current_couch_longitudinal)
-      # Table Top Lateral Position:
-      add_couch_position(cp_item, '300A,012A', cp.couch_lateral, :current_couch_lateral)
-      # Isocenter Position (x\y\z):
-      add_isosenter(cp.parent.parent.site_setup, cp_item)
-      cp_item
-    end
-
-    # Creates a beam limiting device sequence in the given DICOM object.
-    #
-    # @param [DICOM::Item] beam_item the DICOM beam item in which to insert the sequence
-    # @param [Field] field the RTP field to fetch device parameters from
-    # @return [DICOM::Sequence] the constructed beam limiting device sequence
-    #
-    def create_beam_limiting_devices(beam_item, field)
-      bl_seq = DICOM::Sequence.new('300A,00B6', :parent => beam_item)
-      # The ASYMX item ('backup jaws') doesn't exist on all models:
-      if ['SYM', 'ASY'].include?(field.field_x_mode.upcase)
-        bl_item_x = DICOM::Item.new(:parent => bl_seq)
-        DICOM::Element.new('300A,00B8', "ASYMX", :parent => bl_item_x)
-        DICOM::Element.new('300A,00BC', "1", :parent => bl_item_x)
-      end
-      # The ASYMY item is always created:
-      bl_item_y = DICOM::Item.new(:parent => bl_seq)
-      # RT Beam Limiting Device Type:
-      DICOM::Element.new('300A,00B8', "ASYMY", :parent => bl_item_y)
-      # Number of Leaf/Jaw Pairs:
-      DICOM::Element.new('300A,00BC', "1", :parent => bl_item_y)
-      # MLCX item is only created if leaves are defined:
-      # (NB: The RTP file doesn't specify leaf position boundaries, so we
-      # have to set these based on a set of known MLC types, their number
-      # of leaves, and their leaf boundary positions.)
-      if field.control_points.length > 0
-        bl_item_mlcx = DICOM::Item.new(:parent => bl_seq)
-        DICOM::Element.new('300A,00B8', "MLCX", :parent => bl_item_mlcx)
-        num_leaves = field.control_points.first.mlc_leaves.to_i
-        DICOM::Element.new('300A,00BC', num_leaves.to_s, :parent => bl_item_mlcx)
-        DICOM::Element.new('300A,00BE', "#{RTP.leaf_boundaries(num_leaves).join("\\")}", :parent => bl_item_mlcx)
-      end
-      bl_seq
-    end
-
-    # Creates a beam limiting device positions sequence in the given DICOM object.
-    #
-    # @param [DICOM::Item] cp_item the DICOM control point item in which to insert the sequence
-    # @param [ControlPoint] cp the RTP control point to fetch device parameters from
-    # @return [DICOM::Sequence] the constructed beam limiting device positions sequence
-    #
-    def create_beam_limiting_device_positions(cp_item, cp, options={})
-      dp_seq = DICOM::Sequence.new('300A,011A', :parent => cp_item)
-      # The ASYMX item ('backup jaws') doesn't exist on all models:
-      if ['SYM', 'ASY'].include?(cp.parent.field_x_mode.upcase)
-        dp_item_x = DICOM::Item.new(:parent => dp_seq)
-        DICOM::Element.new('300A,00B8', "ASYMX", :parent => dp_item_x)
-        DICOM::Element.new('300A,011C', "#{cp.dcm_collimator_x1(options[:scale])}\\#{cp.dcm_collimator_x2(options[:scale])}", :parent => dp_item_x)
-      end
-      # Always create one ASYMY item:
-      dp_item_y = DICOM::Item.new(:parent => dp_seq)
-      # RT Beam Limiting Device Type:
-      DICOM::Element.new('300A,00B8', "ASYMY", :parent => dp_item_y)
-      # Leaf/Jaw Positions:
-      DICOM::Element.new('300A,011C', "#{cp.dcm_collimator_y1(options[:scale])}\\#{cp.dcm_collimator_y2(options[:scale])}", :parent => dp_item_y)
-      # MLCX:
-      dp_item_mlcx = DICOM::Item.new(:parent => dp_seq)
-      # RT Beam Limiting Device Type:
-      DICOM::Element.new('300A,00B8', "MLCX", :parent => dp_item_mlcx)
-      # Leaf/Jaw Positions:
-      DICOM::Element.new('300A,011C', cp.dcm_mlc_positions(options[:scale]), :parent => dp_item_mlcx)
-      dp_seq
-    end
-
-    # Creates a beam limiting device positions sequence in the given DICOM object.
-    #
-    # @param [DICOM::Item] cp_item the DICOM control point item in which to insert the sequence
-    # @param [Field] field the RTP treatment field to fetch device parameters from
-    # @return [DICOM::Sequence] the constructed beam limiting device positions sequence
-    #
-    def create_beam_limiting_device_positions_from_field(cp_item, field, options={})
-      dp_seq = DICOM::Sequence.new('300A,011A', :parent => cp_item)
-      # ASYMX:
-      dp_item_x = DICOM::Item.new(:parent => dp_seq)
-      DICOM::Element.new('300A,00B8', "ASYMX", :parent => dp_item_x)
-      DICOM::Element.new('300A,011C', "#{field.dcm_collimator_x1}\\#{field.dcm_collimator_x2}", :parent => dp_item_x)
-      # ASYMY:
-      dp_item_y = DICOM::Item.new(:parent => dp_seq)
-      DICOM::Element.new('300A,00B8', "ASYMY", :parent => dp_item_y)
-      DICOM::Element.new('300A,011C', "#{field.dcm_collimator_y1}\\#{field.dcm_collimator_y2}", :parent => dp_item_y)
-      dp_seq
-    end
-
-    # Creates a dose reference sequence in the given DICOM object.
-    #
-    # @param [DICOM::DObject] dcm the DICOM object in which to insert the sequence
-    # @param [String] description the value to use for Dose Reference Description
-    # @return [DICOM::Sequence] the constructed dose reference sequence
-    #
-    def create_dose_reference(dcm, description)
-      dr_seq = DICOM::Sequence.new('300A,0010', :parent => dcm)
-      dr_item = DICOM::Item.new(:parent => dr_seq)
-      # Dose Reference Number:
-      DICOM::Element.new('300A,0012', '1', :parent => dr_item)
-      # Dose Reference Structure Type:
-      DICOM::Element.new('300A,0014', 'SITE', :parent => dr_item)
-      # Dose Reference Description:
-      DICOM::Element.new('300A,0016', description, :parent => dr_item)
-      # Dose Reference Type:
-      DICOM::Element.new('300A,0020', 'TARGET', :parent => dr_item)
-      dr_seq
-    end
-
-    # Creates a referenced dose reference sequence in the given DICOM object.
-    #
-    # @param [DICOM::Item] cp_item the DICOM item in which to insert the sequence
-    # @return [DICOM::Sequence] the constructed referenced dose reference sequence
-    #
-    def create_referenced_dose_reference(cp_item)
-      # Referenced Dose Reference Sequence:
-      rd_seq = DICOM::Sequence.new('300C,0050', :parent => cp_item)
-      rd_item = DICOM::Item.new(:parent => rd_seq)
-      # Cumulative Dose Reference Coeffecient:
-      DICOM::Element.new('300A,010C', '', :parent => rd_item)
-      # Referenced Dose Reference Number:
-      DICOM::Element.new('300C,0051', '1', :parent => rd_item)
-      rd_seq
-    end
-
-    # Resets the types of control point attributes that are only written to the
-    # first control point item, and for following control point items only when
-    # they are different from the 'current' value. When a new field is reached,
-    # it is essential to reset these attributes, or else we could risk to start
-    # the field with a control point with missing attributes, if one of its first
-    # attributes is equal to the last attribute of the previous field.
-    #
-    def reset_cp_current_attributes
-      @current_gantry = nil
-      @current_collimator = nil
-      @current_couch_pedestal = nil
-      @current_couch_angle = nil
-      @current_couch_vertical = nil
-      @current_couch_longitudinal = nil
-      @current_couch_lateral = nil
-      @current_isosenter = nil
-    end
-
-  end
-
+module RTP
+
+  class Plan < Record
+
+    attr_accessor :current_gantry
+    attr_accessor :current_collimator
+    attr_accessor :current_couch_angle
+    attr_accessor :current_couch_pedestal
+    attr_accessor :current_couch_lateral
+    attr_accessor :current_couch_longitudinal
+    attr_accessor :current_couch_vertical
+
+    # Converts the Plan (and child) records to a
+    # DICOM::DObject of modality RTPLAN.
+    #
+    # @note Only photon plans have been tested.
+    #   Electron beams beams may give an invalid DICOM file.
+    #   Also note that, due to limitations in the RTP file format, some original
+    #   values can not be recreated, like e.g. Study UID or Series UID.
+    # @param [Hash] options the options to use for creating the DICOM object
+    # @option options [Boolean] :dose_ref if set, Dose Reference & Referenced Dose Reference sequences will be included in the generated DICOM file
+    # @option options [String] :manufacturer the value used for the manufacturer tag (0008,0070) in the beam sequence
+    # @option options [String] :model the value used for the manufacturer's model name tag (0008,1090) in the beam sequence
+    # @option options [Symbol] :scale if set, relevant device parameters are converted from native readout format to IEC1217 (supported values are :elekta & :varian)
+    # @option options [String] :serial_number the value used for the device serial number tag (0018,1000) in the beam sequence
+    # @return [DICOM::DObject] the converted DICOM object
+    #
+    def to_dcm(options={})
+      #
+      # FIXME: This method is rather big, with a few sections of somewhat similar, repeating code.
+      # Refactoring and simplifying it at some stage might be a good idea.
+      #
+      require 'dicom'
+      original_level = DICOM.logger.level
+      DICOM.logger.level = Logger::FATAL
+      p = @prescriptions.first
+      # If no prescription is present, we are not going to be able to make a valid DICOM object:
+      logger.error("No Prescription Record present. Unable to build a valid RTPLAN DICOM object.") unless p
+      dcm = DICOM::DObject.new
+      #
+      # TOP LEVEL TAGS:
+      #
+      # Specific Character Set:
+      DICOM::Element.new('0008,0005', 'ISO_IR 100', :parent => dcm)
+      # Instance Creation Date
+      DICOM::Element.new('0008,0012', Time.now.strftime("%Y%m%d"), :parent => dcm)
+      # Instance Creation Time:
+      DICOM::Element.new('0008,0013', Time.now.strftime("%H%M%S"), :parent => dcm)
+      # SOP Class UID:
+      DICOM::Element.new('0008,0016', '1.2.840.10008.5.1.4.1.1.481.5', :parent => dcm)
+      # SOP Instance UID (if an original UID is not present, we make up a UID):
+      begin
+        sop_uid = p.fields.first.extended_field.original_plan_uid.empty? ? DICOM.generate_uid : p.fields.first.extended_field.original_plan_uid
+      rescue
+        sop_uid = DICOM.generate_uid
+      end
+      DICOM::Element.new('0008,0018', sop_uid, :parent => dcm)
+      # Study Date
+      DICOM::Element.new('0008,0020', Time.now.strftime("%Y%m%d"), :parent => dcm)
+      # Study Time:
+      DICOM::Element.new('0008,0030', Time.now.strftime("%H%M%S"), :parent => dcm)
+      # Accession Number:
+      DICOM::Element.new('0008,0050', '', :parent => dcm)
+      # Modality:
+      DICOM::Element.new('0008,0060', 'RTPLAN', :parent => dcm)
+      # Manufacturer:
+      DICOM::Element.new('0008,0070', 'rtp-connect', :parent => dcm)
+      # Referring Physician's Name:
+      DICOM::Element.new('0008,0090', "#{@md_last_name}^#{@md_first_name}^#{@md_middle_name}^^", :parent => dcm)
+      # Operator's Name:
+      DICOM::Element.new('0008,1070', "#{@author_last_name}^#{@author_first_name}^#{@author_middle_name}^^", :parent => dcm)
+      # Patient's Name:
+      DICOM::Element.new('0010,0010', "#{@patient_last_name}^#{@patient_first_name}^#{@patient_middle_name}^^", :parent => dcm)
+      # Patient ID:
+      DICOM::Element.new('0010,0020', @patient_id, :parent => dcm)
+      # Patient's Birth Date:
+      DICOM::Element.new('0010,0030', '', :parent => dcm)
+      # Patient's Sex:
+      DICOM::Element.new('0010,0040', '', :parent => dcm)
+      # Manufacturer's Model Name:
+      DICOM::Element.new('0008,1090', 'RTP-to-DICOM', :parent => dcm)
+      # Software Version(s):
+      DICOM::Element.new('0018,1020', "RubyRTP#{VERSION}", :parent => dcm)
+      # Study Instance UID:
+      DICOM::Element.new('0020,000D', DICOM.generate_uid, :parent => dcm)
+      # Series Instance UID:
+      DICOM::Element.new('0020,000E', DICOM.generate_uid, :parent => dcm)
+      # Study ID:
+      DICOM::Element.new('0020,0010', '1', :parent => dcm)
+      # Series Number:
+      DICOM::Element.new('0020,0011', '1', :parent => dcm)
+      # Frame of Reference UID (if an original UID is not present, we make up a UID):
+      begin
+        for_uid = p.site_setup.frame_of_ref_uid.empty? ? DICOM.generate_uid : p.site_setup.frame_of_ref_uid
+      rescue
+        for_uid = DICOM.generate_uid
+      end
+      DICOM::Element.new('0020,0052', for_uid, :parent => dcm)
+      # Position Reference Indicator:
+      DICOM::Element.new('0020,1040', '', :parent => dcm)
+      # RT Plan Label (max 16 characters):
+      plan_label = p ? p.rx_site_name[0..15] : @course_id
+      DICOM::Element.new('300A,0002', plan_label, :parent => dcm)
+      # RT Plan Name:
+      plan_name = p ? p.rx_site_name : @course_id
+      DICOM::Element.new('300A,0003', plan_name, :parent => dcm)
+      # RT Plan Description:
+      plan_desc = p ? p.technique : @diagnosis
+      DICOM::Element.new('300A,0004', plan_desc, :parent => dcm)
+      # RT Plan Date:
+      plan_date = @plan_date.empty? ? Time.now.strftime("%Y%m%d") : @plan_date
+      DICOM::Element.new('300A,0006', plan_date, :parent => dcm)
+      # RT Plan Time:
+      plan_time = @plan_time.empty? ? Time.now.strftime("%H%M%S") : @plan_time
+      DICOM::Element.new('300A,0007', plan_time, :parent => dcm)
+      # Approval Status:
+      DICOM::Element.new('300E,0002', 'UNAPPROVED', :parent => dcm)
+      #
+      # SEQUENCES:
+      #
+      # Tolerance Table Sequence:
+      if p && p.fields.first && !p.fields.first.tolerance_table.empty?
+        tt_seq = DICOM::Sequence.new('300A,0040', :parent => dcm)
+        tt_item = DICOM::Item.new(:parent => tt_seq)
+        # Tolerance Table Number:
+        DICOM::Element.new('300A,0042', p.fields.first.tolerance_table, :parent => tt_item)
+      end
+      # Structure set information:
+      if p && p.site_setup && !p.site_setup.structure_set_uid.empty?
+        #
+        # Referenced Structure Set Sequence:
+        #
+        ss_seq = DICOM::Sequence.new('300C,0060', :parent => dcm)
+        ss_item = DICOM::Item.new(:parent => ss_seq)
+        # Referenced SOP Class UID:
+        DICOM::Element.new('0008,1150', '1.2.840.10008.5.1.4.1.1.481.3', :parent => ss_item)
+        DICOM::Element.new('0008,1155', p.site_setup.structure_set_uid, :parent => ss_item)
+        # RT Plan Geometry:
+        DICOM::Element.new('300A,000C', 'PATIENT', :parent => dcm)
+      else
+        # RT Plan Geometry:
+        DICOM::Element.new('300A,000C', 'TREATMENT_DEVICE', :parent => dcm)
+      end
+      #
+      # Patient Setup Sequence:
+      #
+      ps_seq = DICOM::Sequence.new('300A,0180', :parent => dcm)
+      ps_item = DICOM::Item.new(:parent => ps_seq)
+      # Patient Position:
+      begin
+        pat_pos = p.site_setup.patient_orientation.empty? ? 'HFS' : p.site_setup.patient_orientation
+      rescue
+        pat_pos = 'HFS'
+      end
+      DICOM::Element.new('0018,5100', pat_pos, :parent => ps_item)
+      # Patient Setup Number:
+      DICOM::Element.new('300A,0182', '1', :parent => ps_item)
+      # Setup Technique (assume Isocentric):
+      DICOM::Element.new('300A,01B0', 'ISOCENTRIC', :parent => ps_item)
+      #
+      # Dose Reference Sequence:
+      #
+      create_dose_reference(dcm, plan_name) if options[:dose_ref]
+      #
+      # Fraction Group Sequence:
+      #
+      fg_seq = DICOM::Sequence.new('300A,0070', :parent => dcm)
+      fg_item = DICOM::Item.new(:parent => fg_seq)
+      # Fraction Group Number:
+      DICOM::Element.new('300A,0071', '1', :parent => fg_item)
+      # Number of Fractions Planned (try to derive from total dose/fraction dose, or use 1 as default):
+      begin
+        num_frac = p.dose_ttl.empty? || p.dose_tx.empty? ? '1' : (p.dose_ttl.to_i / p.dose_tx.to_f).round.to_s
+      rescue
+        num_frac = '0'
+      end
+      DICOM::Element.new('300A,0078', num_frac, :parent => fg_item)
+      # Number of Brachy Application Setups:
+      DICOM::Element.new('300A,00A0', '0', :parent => fg_item)
+      # Referenced Beam Sequence (items created for each beam below):
+      rb_seq = DICOM::Sequence.new('300C,0004', :parent => fg_item)
+      #
+      # Beam Sequence:
+      #
+      b_seq = DICOM::Sequence.new('300A,00B0', :parent => dcm)
+      if p
+        # If no fields are present, we are not going to be able to make a valid DICOM object:
+        logger.error("No Field Record present. Unable to build a valid RTPLAN DICOM object.") unless p.fields.length > 0
+        p.fields.each_with_index do |field, i|
+          # Fields with modality 'Unspecified' (e.g. CT or 2dkV) must be skipped:
+          unless field.modality == 'Unspecified'
+            # If this is an electron beam, a warning should be printed, as these are less reliably converted:
+            logger.warn("This is not a photon beam (#{field.modality}). Beware that DICOM conversion of Electron beams are experimental, and other modalities are unsupported.") if field.modality != 'Xrays'
+            # Reset control point 'current value' attributes:
+            reset_cp_current_attributes
+            # Beam number and name:
+            beam_number = field.extended_field ? field.extended_field.original_beam_number : (i + 1).to_s
+            beam_name = field.extended_field ? field.extended_field.original_beam_name : field.field_name
+            # Ref Beam Item:
+            rb_item = DICOM::Item.new(:parent => rb_seq)
+            # Beam Dose (convert from cGy to Gy):
+            field_dose = field.field_dose.empty? ? '' : (field.field_dose.to_f * 0.01).round(4).to_s
+            DICOM::Element.new('300A,0084', field_dose, :parent => rb_item)
+            # Beam Meterset:
+            DICOM::Element.new('300A,0086', field.field_monitor_units, :parent => rb_item)
+            # Referenced Beam Number:
+            DICOM::Element.new('300C,0006', beam_number, :parent => rb_item)
+            # Beam Item:
+            b_item = DICOM::Item.new(:parent => b_seq)
+            # Optional method values:
+            # Manufacturer:
+            DICOM::Element.new('0008,0070', options[:manufacturer], :parent => b_item) if options[:manufacturer]
+            # Manufacturer's Model Name:
+            DICOM::Element.new('0008,1090', options[:model], :parent => b_item) if options[:model]
+            # Device Serial Number:
+            DICOM::Element.new('0018,1000', options[:serial_number], :parent => b_item) if options[:serial_number]
+            # Treatment Machine Name (max 16 characters):
+            DICOM::Element.new('300A,00B2', field.treatment_machine[0..15], :parent => b_item)
+            # Primary Dosimeter Unit:
+            DICOM::Element.new('300A,00B3', 'MU', :parent => b_item)
+            # Source-Axis Distance (convert to mm):
+            DICOM::Element.new('300A,00B4', "#{field.sad.to_f * 10}", :parent => b_item)
+            # Beam Number:
+            DICOM::Element.new('300A,00C0', beam_number, :parent => b_item)
+            # Beam Name:
+            DICOM::Element.new('300A,00C2', beam_name, :parent => b_item)
+            # Beam Description:
+            DICOM::Element.new('300A,00C3', field.field_note, :parent => b_item)
+            # Beam Type:
+            beam_type = case field.treatment_type
+              when 'Static' then 'STATIC'
+              when 'StepNShoot' then 'STATIC'
+              when 'VMAT' then 'DYNAMIC'
+              else logger.error("The beam type (treatment type) #{field.treatment_type} is not yet supported.")
+            end
+            DICOM::Element.new('300A,00C4', beam_type, :parent => b_item)
+            # Radiation Type:
+            rad_type = case field.modality
+              when 'Elect' then 'ELECTRON'
+              when 'Xrays' then 'PHOTON'
+              else logger.error("The radiation type (modality) #{field.modality} is not yet supported.")
+            end
+            DICOM::Element.new('300A,00C6', rad_type, :parent => b_item)
+            # Treatment Delivery Type:
+            DICOM::Element.new('300A,00CE', 'TREATMENT', :parent => b_item)
+            # Number of Wedges:
+            DICOM::Element.new('300A,00D0', (field.wedge.empty? ? '0' : '1'), :parent => b_item)
+            # Number of Compensators:
+            DICOM::Element.new('300A,00E0', (field.compensator.empty? ? '0' : '1'), :parent => b_item)
+            # Number of Boli:
+            DICOM::Element.new('300A,00ED', (field.bolus.empty? ? '0' : '1'), :parent => b_item)
+            # Number of Blocks:
+            DICOM::Element.new('300A,00F0', (field.block.empty? ? '0' : '1'), :parent => b_item)
+            # Final Cumulative Meterset Weight:
+            DICOM::Element.new('300A,010E', 1, :parent => b_item)
+            # Referenced Patient Setup Number:
+            DICOM::Element.new('300C,006A', '1', :parent => b_item)
+            #
+            # Beam Limiting Device Sequence:
+            #
+            create_beam_limiting_devices(b_item, field)
+            #
+            # Block Sequence (if any):
+            # FIXME: It seems that the Block Sequence (300A,00F4) may be
+            # difficult (impossible?) to reconstruct based on the RTP file's
+            # information, and thus it is skipped altogether.
+            #
+            #
+            # Applicator Sequence (if any):
+            #
+            unless field.e_applicator.empty?
+              app_seq = DICOM::Sequence.new('300A,0107', :parent => b_item)
+              app_item = DICOM::Item.new(:parent => app_seq)
+              # Applicator ID:
+              DICOM::Element.new('300A,0108', field.e_field_def_aperture, :parent => app_item)
+              # Applicator Type:
+              DICOM::Element.new('300A,0109', "ELECTRON_#{field.e_applicator.upcase}", :parent => app_item)
+              # Applicator Description:
+              DICOM::Element.new('300A,010A', "Appl. #{field.e_field_def_aperture}", :parent => app_item)
+            end
+            #
+            # Control Point Sequence:
+            #
+            # A field may have 0 (no MLC), 1 (conventional beam with MLC) or 2n (IMRT) control points.
+            # The DICOM file shall always contain 2n control points (minimum 2).
+            #
+            cp_seq = DICOM::Sequence.new('300A,0111', :parent => b_item)
+            if field.control_points.length < 2
+              # When we have 0 or 1 control point, use settings from field, and insert MLC settings if present:
+              # First CP:
+              cp_item = DICOM::Item.new(:parent => cp_seq)
+              # Control Point Index:
+              DICOM::Element.new('300A,0112', "0", :parent => cp_item)
+              # Nominal Beam Energy:
+              DICOM::Element.new('300A,0114', "#{field.energy.to_f}", :parent => cp_item)
+              # Dose Rate Set:
+              DICOM::Element.new('300A,0115', field.doserate, :parent => cp_item)
+              # Gantry Angle:
+              DICOM::Element.new('300A,011E', field.gantry_angle, :parent => cp_item)
+              # Gantry Rotation Direction:
+              DICOM::Element.new('300A,011F', (field.arc_direction.empty? ? 'NONE' : field.arc_direction), :parent => cp_item)
+              # Beam Limiting Device Angle:
+              DICOM::Element.new('300A,0120', field.collimator_angle, :parent => cp_item)
+              # Beam Limiting Device Rotation Direction:
+              DICOM::Element.new('300A,0121', 'NONE', :parent => cp_item)
+              # Patient Support Angle:
+              DICOM::Element.new('300A,0122', field.couch_pedestal, :parent => cp_item)
+              # Patient Support Rotation Direction:
+              DICOM::Element.new('300A,0123', 'NONE', :parent => cp_item)
+              # Table Top Eccentric Angle:
+              DICOM::Element.new('300A,0125', field.couch_angle, :parent => cp_item)
+              # Table Top Eccentric Rotation Direction:
+              DICOM::Element.new('300A,0126', 'NONE', :parent => cp_item)
+              # Table Top Vertical Position:
+              couch_vert = field.couch_vertical.empty? ? '' : (field.couch_vertical.to_f * 10).to_s
+              DICOM::Element.new('300A,0128', couch_vert, :parent => cp_item)
+              # Table Top Longitudinal Position:
+              couch_long = field.couch_longitudinal.empty? ? '' : (field.couch_longitudinal.to_f * 10).to_s
+              DICOM::Element.new('300A,0129', couch_long, :parent => cp_item)
+              # Table Top Lateral Position:
+              couch_lat = field.couch_lateral.empty? ? '' : (field.couch_lateral.to_f * 10).to_s
+              DICOM::Element.new('300A,012A', couch_lat, :parent => cp_item)
+              # Isocenter Position (x\y\z):
+              if p.site_setup
+                DICOM::Element.new('300A,012C', "#{(p.site_setup.iso_pos_x.to_f * 10).round(2)}\\#{(p.site_setup.iso_pos_y.to_f * 10).round(2)}\\#{(p.site_setup.iso_pos_z.to_f * 10).round(2)}", :parent => cp_item)
+              else
+                logger.warn("No Site Setup record exists for this plan. Unable to provide an isosenter position.")
+                DICOM::Element.new('300A,012C', '', :parent => cp_item)
+              end
+              # Source to Surface Distance:
+              add_ssd(field.ssd, cp_item)
+              # Cumulative Meterset Weight:
+              DICOM::Element.new('300A,0134', '0', :parent => cp_item)
+              # Beam Limiting Device Position Sequence:
+              if field.control_points.length > 0
+                create_beam_limiting_device_positions(cp_item, field.control_points.first, options)
+              else
+                create_beam_limiting_device_positions_from_field(cp_item, field, options)
+              end
+              # Referenced Dose Reference Sequence:
+              create_referenced_dose_reference(cp_item) if options[:dose_ref]
+              # Second CP:
+              cp_item = DICOM::Item.new(:parent => cp_seq)
+              # Control Point Index:
+              DICOM::Element.new('300A,0112', "1", :parent => cp_item)
+              # Cumulative Meterset Weight:
+              DICOM::Element.new('300A,0134', '1', :parent => cp_item)
+            else
+              # When we have multiple (2 or more) control points, iterate each control point:
+              field.control_points.each { |cp| create_control_point(cp, cp_seq, options) }
+              # Make sure that hte cumulative meterset weight of the last control
+              # point is '1' (exactly equal to final cumulative meterset weight):
+              cp_seq.items.last['300A,0134'].value = '1'
+            end
+            # Number of Control Points:
+            DICOM::Element.new('300A,0110', b_item['300A,0111'].items.length, :parent => b_item)
+          end
+        end
+        # Number of Beams:
+        DICOM::Element.new('300A,0080', fg_item['300C,0004'].items.length, :parent => fg_item)
+      end
+      # Restore the DICOM logger:
+      DICOM.logger.level = original_level
+      return dcm
+    end
+
+
+    private
+
+
+    # Adds an angular type value to a Control Point Item, by creating the
+    # necessary DICOM elements.
+    # Note that the element is only added if there is no 'current' attribute
+    # defined, or the given value is different form the current attribute.
+    #
+    # @param [DICOM::Item] item the DICOM control point item in which to create the elements
+    # @param [String] angle_tag the DICOM tag of the angle element
+    # @param [String] direction_tag the DICOM tag of the direction element
+    # @param [String, NilClass] angle the collimator angle attribute
+    # @param [String, NilClass] direction the collimator rotation direction attribute
+    # @param [Symbol] current_angle the instance variable that keeps track of the current value of this attribute
+    #
+    def add_angle(item, angle_tag, direction_tag, angle, direction, current_angle)
+      if !self.send(current_angle) || angle != self.send(current_angle)
+        self.send("#{current_angle}=", angle)
+        DICOM::Element.new(angle_tag, angle, :parent => item)
+        DICOM::Element.new(direction_tag, (direction.empty? ? 'NONE' : direction), :parent => item)
+      end
+    end
+
+    # Adds a Table Top Position element to a Control Point Item.
+    # Note that the element is only added if there is no 'current' attribute
+    # defined, or the given value is different form the current attribute.
+    #
+    # @param [DICOM::Item] item the DICOM control point item in which to create the element
+    # @param [String] tag the DICOM tag of the couch position element
+    # @param [String, NilClass] value the couch position
+    # @param [Symbol] current the instance variable that keeps track of the current value of this attribute
+    #
+    def add_couch_position(item, tag, value, current)
+      if !self.send(current) || value != self.send(current)
+        self.send("#{current}=", value)
+        DICOM::Element.new(tag, (value.empty? ? '' : value.to_f * 10), :parent => item)
+      end
+    end
+
+    # Adds a Dose Rate Set element to a Control Point Item.
+    # Note that the element is only added if there is no 'current' attribute
+    # defined, or the given value is different form the current attribute.
+    #
+    # @param [String, NilClass] value the doserate attribute
+    # @param [DICOM::Item] item the DICOM control point item in which to create an element
+    #
+    def add_doserate(value, item)
+      if !@current_doserate || value != @current_doserate
+        @current_doserate = value
+        DICOM::Element.new('300A,0115', value, :parent => item)
+      end
+    end
+
+    # Adds a Nominal Beam Energy element to a Control Point Item.
+    # Note that the element is only added if there is no 'current' attribute
+    # defined, or the given value is different form the current attribute.
+    #
+    # @param [String, NilClass] value the energy attribute
+    # @param [DICOM::Item] item the DICOM control point item in which to create an element
+    #
+    def add_energy(value, item)
+      if !@current_energy || value != @current_energy
+        @current_energy = value
+        DICOM::Element.new('300A,0114', "#{value.to_f}", :parent => item)
+      end
+    end
+
+    # Adds an Isosenter element to a Control Point Item.
+    # Note that the element is only added if there is a Site Setup record present,
+    # and it contains a real (non-empty) value. Also, the element is only added if there
+    # is no 'current' attribute defined, or the given value is different form the current attribute.
+    #
+    # @param [SiteSetup, NilClass] site_setup the associated site setup record
+    # @param [DICOM::Item] item the DICOM control point item in which to create an element
+    #
+    def add_isosenter(site_setup, item)
+      if site_setup
+        # Create an element if the value is new or unique:
+        if !@current_isosenter
+          iso = "#{(site_setup.iso_pos_x.to_f * 10).round(2)}\\#{(site_setup.iso_pos_y.to_f * 10).round(2)}\\#{(site_setup.iso_pos_z.to_f * 10).round(2)}"
+          if iso != @current_isosenter
+            @current_isosenter = iso
+            DICOM::Element.new('300A,012C', iso, :parent => item)
+          end
+        end
+      else
+        # Log a warning if this is the first control point:
+        unless @current_isosenter
+          logger.warn("No Site Setup record exists for this plan. Unable to provide an isosenter position.")
+        end
+      end
+    end
+
+    # Adds a Source to Surface Distance element to a Control Point Item.
+    # Note that the element is only added if the SSD attribute contains
+    # real (non-empty) value.
+    #
+    # @param [String, NilClass] value the SSD attribute
+    # @param [DICOM::Item] item the DICOM control point item in which to create an element
+    #
+    def add_ssd(value, item)
+      DICOM::Element.new('300A,0130', "#{value.to_f * 10}", :parent => item) if value && !value.empty?
+    end
+
+    # Creates a control point item in the given control point sequence, based
+    # on an RTP control point record.
+    #
+    # @param [ControlPoint] cp the RTP ControlPoint record to convert
+    # @param [DICOM::Sequence] sequence the DICOM parent sequence of the item to be created
+    # @param [Hash] options the options to use for creating the control point
+    # @option options [Boolean] :dose_ref if set, a Referenced Dose Reference sequence will be included in the generated control point item
+    # @return [DICOM::Item] the constructed control point DICOM item
+    #
+    def create_control_point(cp, sequence, options={})
+      cp_item = DICOM::Item.new(:parent => sequence)
+      # Some CP attributes will always be written (CP index, BLD positions & Cumulative meterset weight).
+      # The other attributes are only written if they are different from the previous control point.
+      # Control Point Index:
+      DICOM::Element.new('300A,0112', "#{cp.index}", :parent => cp_item)
+      # Beam Limiting Device Position Sequence:
+      create_beam_limiting_device_positions(cp_item, cp, options)
+      # Source to Surface Distance:
+      add_ssd(cp.ssd, cp_item)
+      # Cumulative Meterset Weight:
+      DICOM::Element.new('300A,0134', cp.monitor_units.to_f, :parent => cp_item)
+      # Referenced Dose Reference Sequence:
+      create_referenced_dose_reference(cp_item) if options[:dose_ref]
+      # Attributes that are only added if they carry an updated value:
+      # Nominal Beam Energy:
+      add_energy(cp.energy, cp_item)
+      # Dose Rate Set:
+      add_doserate(cp.doserate, cp_item)
+      # Gantry Angle & Rotation Direction:
+      add_angle(cp_item, '300A,011E', '300A,011F', cp.gantry_angle, cp.gantry_dir, :current_gantry)
+      # Beam Limiting Device Angle & Rotation Direction:
+      add_angle(cp_item, '300A,0120', '300A,0121', cp.collimator_angle, cp.collimator_dir, :current_collimator)
+      # Patient Support Angle & Rotation Direction:
+      add_angle(cp_item, '300A,0122', '300A,0123', cp.couch_pedestal, cp.couch_ped_dir, :current_couch_pedestal)
+      # Table Top Eccentric Angle & Rotation Direction:
+      add_angle(cp_item, '300A,0125', '300A,0126', cp.couch_angle, cp.couch_dir, :current_couch_angle)
+      # Table Top Vertical Position:
+      add_couch_position(cp_item, '300A,0128', cp.couch_vertical, :current_couch_vertical)
+      # Table Top Longitudinal Position:
+      add_couch_position(cp_item, '300A,0129', cp.couch_longitudinal, :current_couch_longitudinal)
+      # Table Top Lateral Position:
+      add_couch_position(cp_item, '300A,012A', cp.couch_lateral, :current_couch_lateral)
+      # Isocenter Position (x\y\z):
+      add_isosenter(cp.parent.parent.site_setup, cp_item)
+      cp_item
+    end
+
+    # Creates a beam limiting device sequence in the given DICOM object.
+    #
+    # @param [DICOM::Item] beam_item the DICOM beam item in which to insert the sequence
+    # @param [Field] field the RTP field to fetch device parameters from
+    # @return [DICOM::Sequence] the constructed beam limiting device sequence
+    #
+    def create_beam_limiting_devices(beam_item, field)
+      bl_seq = DICOM::Sequence.new('300A,00B6', :parent => beam_item)
+      # The ASYMX item ('backup jaws') doesn't exist on all models:
+      if ['SYM', 'ASY'].include?(field.field_x_mode.upcase)
+        bl_item_x = DICOM::Item.new(:parent => bl_seq)
+        DICOM::Element.new('300A,00B8', "ASYMX", :parent => bl_item_x)
+        DICOM::Element.new('300A,00BC', "1", :parent => bl_item_x)
+      end
+      # The ASYMY item is always created:
+      bl_item_y = DICOM::Item.new(:parent => bl_seq)
+      # RT Beam Limiting Device Type:
+      DICOM::Element.new('300A,00B8', "ASYMY", :parent => bl_item_y)
+      # Number of Leaf/Jaw Pairs:
+      DICOM::Element.new('300A,00BC', "1", :parent => bl_item_y)
+      # MLCX item is only created if leaves are defined:
+      # (NB: The RTP file doesn't specify leaf position boundaries, so we
+      # have to set these based on a set of known MLC types, their number
+      # of leaves, and their leaf boundary positions.)
+      if field.control_points.length > 0
+        bl_item_mlcx = DICOM::Item.new(:parent => bl_seq)
+        DICOM::Element.new('300A,00B8', "MLCX", :parent => bl_item_mlcx)
+        num_leaves = field.control_points.first.mlc_leaves.to_i
+        DICOM::Element.new('300A,00BC', num_leaves.to_s, :parent => bl_item_mlcx)
+        DICOM::Element.new('300A,00BE', "#{RTP.leaf_boundaries(num_leaves).join("\\")}", :parent => bl_item_mlcx)
+      end
+      bl_seq
+    end
+
+    # Creates a beam limiting device positions sequence in the given DICOM object.
+    #
+    # @param [DICOM::Item] cp_item the DICOM control point item in which to insert the sequence
+    # @param [ControlPoint] cp the RTP control point to fetch device parameters from
+    # @return [DICOM::Sequence] the constructed beam limiting device positions sequence
+    #
+    def create_beam_limiting_device_positions(cp_item, cp, options={})
+      dp_seq = DICOM::Sequence.new('300A,011A', :parent => cp_item)
+      # The ASYMX item ('backup jaws') doesn't exist on all models:
+      if ['SYM', 'ASY'].include?(cp.parent.field_x_mode.upcase)
+        dp_item_x = create_asym_item(cp, dp_seq, axis=:x, options)
+      end
+      # Always create one ASYMY item:
+      dp_item_y = create_asym_item(cp, dp_seq, axis=:y, options)
+      # MLCX:
+      dp_item_mlcx = DICOM::Item.new(:parent => dp_seq)
+      # RT Beam Limiting Device Type:
+      DICOM::Element.new('300A,00B8', "MLCX", :parent => dp_item_mlcx)
+      # Leaf/Jaw Positions:
+      DICOM::Element.new('300A,011C', cp.dcm_mlc_positions(options[:scale]), :parent => dp_item_mlcx)
+      dp_seq
+    end
+
+    # Creates an ASYMX or ASYMY item.
+    #
+    # @param [ControlPoint] cp the RTP control point to fetch device parameters from
+    # @param [DICOM::Sequence] dcm_parent the DICOM sequence in which to insert the item
+    # @param [Symbol] axis the axis for the item (:x or :y)
+    # @return [DICOM::Item] the constructed ASYMX or ASYMY item
+    #
+    def create_asym_item(cp, dcm_parent, axis, options={})
+      val1 = cp.send("dcm_collimator_#{axis.to_s}1", options[:scale])
+      val2 = cp.send("dcm_collimator_#{axis.to_s}2", options[:scale])
+      item = DICOM::Item.new(:parent => dcm_parent)
+      # RT Beam Limiting Device Type:
+      DICOM::Element.new('300A,00B8', "ASYM#{axis.to_s.upcase}", :parent => item)
+      # Leaf/Jaw Positions:
+      DICOM::Element.new('300A,011C', "#{val1}\\#{val2}", :parent => item)
+      item
+    end
+
+    # Creates a beam limiting device positions sequence in the given DICOM object.
+    #
+    # @param [DICOM::Item] cp_item the DICOM control point item in which to insert the sequence
+    # @param [Field] field the RTP treatment field to fetch device parameters from
+    # @return [DICOM::Sequence] the constructed beam limiting device positions sequence
+    #
+    def create_beam_limiting_device_positions_from_field(cp_item, field, options={})
+      dp_seq = DICOM::Sequence.new('300A,011A', :parent => cp_item)
+      # ASYMX:
+      dp_item_x = DICOM::Item.new(:parent => dp_seq)
+      DICOM::Element.new('300A,00B8', "ASYMX", :parent => dp_item_x)
+      DICOM::Element.new('300A,011C', "#{field.dcm_collimator_x1}\\#{field.dcm_collimator_x2}", :parent => dp_item_x)
+      # ASYMY:
+      dp_item_y = DICOM::Item.new(:parent => dp_seq)
+      DICOM::Element.new('300A,00B8', "ASYMY", :parent => dp_item_y)
+      DICOM::Element.new('300A,011C', "#{field.dcm_collimator_y1}\\#{field.dcm_collimator_y2}", :parent => dp_item_y)
+      dp_seq
+    end
+
+    # Creates a dose reference sequence in the given DICOM object.
+    #
+    # @param [DICOM::DObject] dcm the DICOM object in which to insert the sequence
+    # @param [String] description the value to use for Dose Reference Description
+    # @return [DICOM::Sequence] the constructed dose reference sequence
+    #
+    def create_dose_reference(dcm, description)
+      dr_seq = DICOM::Sequence.new('300A,0010', :parent => dcm)
+      dr_item = DICOM::Item.new(:parent => dr_seq)
+      # Dose Reference Number:
+      DICOM::Element.new('300A,0012', '1', :parent => dr_item)
+      # Dose Reference Structure Type:
+      DICOM::Element.new('300A,0014', 'SITE', :parent => dr_item)
+      # Dose Reference Description:
+      DICOM::Element.new('300A,0016', description, :parent => dr_item)
+      # Dose Reference Type:
+      DICOM::Element.new('300A,0020', 'TARGET', :parent => dr_item)
+      dr_seq
+    end
+
+    # Creates a referenced dose reference sequence in the given DICOM object.
+    #
+    # @param [DICOM::Item] cp_item the DICOM item in which to insert the sequence
+    # @return [DICOM::Sequence] the constructed referenced dose reference sequence
+    #
+    def create_referenced_dose_reference(cp_item)
+      # Referenced Dose Reference Sequence:
+      rd_seq = DICOM::Sequence.new('300C,0050', :parent => cp_item)
+      rd_item = DICOM::Item.new(:parent => rd_seq)
+      # Cumulative Dose Reference Coeffecient:
+      DICOM::Element.new('300A,010C', '', :parent => rd_item)
+      # Referenced Dose Reference Number:
+      DICOM::Element.new('300C,0051', '1', :parent => rd_item)
+      rd_seq
+    end
+
+    # Resets the types of control point attributes that are only written to the
+    # first control point item, and for following control point items only when
+    # they are different from the 'current' value. When a new field is reached,
+    # it is essential to reset these attributes, or else we could risk to start
+    # the field with a control point with missing attributes, if one of its first
+    # attributes is equal to the last attribute of the previous field.
+    #
+    def reset_cp_current_attributes
+      @current_gantry = nil
+      @current_collimator = nil
+      @current_couch_pedestal = nil
+      @current_couch_angle = nil
+      @current_couch_vertical = nil
+      @current_couch_longitudinal = nil
+      @current_couch_lateral = nil
+      @current_isosenter = nil
+    end
+
+  end
+
 end