dcmjs 0.47.1 → 0.48.0

package/build/dcmjs.es.js

@@ -12292,6 +12292,8 @@ var DerivedDataset = /*#__PURE__*/function () {
     o.ClinicalTrialTimePointID = options.ClinicalTrialTimePointID || "";
     o.ClinicalTrialCoordinatingCenterName = options.ClinicalTrialCoordinatingCenterName || "";
     o.ClinicalTrialSeriesID = options.ClinicalTrialSeriesID || "";
+
+    // TODO: Move ImageComments (0020,4000) to DerivedPixels since it is not part of the Enhanced SR IOD.
     o.ImageComments = options.ImageComments || "NOT FOR CLINICAL USE";
     o.ContentQualification = "RESEARCH";
     this.referencedDatasets = datasets; // list of one or more dicom-like object instances
@@ -13429,7 +13431,7 @@ var TID1500MeasurementReport = /*#__PURE__*/function () {
           CodeMeaning: "Language of Content Item and Descendants"
         }),
         ConceptCodeSequence: addAccessors({
-          CodeValue: "eng",
+          CodeValue: "en",
           CodingSchemeDesignator: "RFC5646",
           CodeMeaning: "English"
         }),
@@ -13456,9 +13458,9 @@ var TID1500MeasurementReport = /*#__PURE__*/function () {
           CodeMeaning: "Procedure reported"
         }),
         ConceptCodeSequence: addAccessors({
-          CodeValue: "1",
-          CodingSchemeDesignator: "99dcmjs",
-          CodeMeaning: "Unknown procedure"
+          CodeValue: "363679005",
+          CodingSchemeDesignator: "SCT",
+          CodeMeaning: "Imaging procedure"
         })
       }, {
         RelationshipType: "CONTAINS",
@@ -14005,33 +14007,259 @@ var TID300Measurement = /*#__PURE__*/function () {
   return TID300Measurement;
 }();
 
-var MM_UNIT = {
+/**
+ * Builds a DICOM SR ContentSequence block for geometric measurements
+ * that share the same structure across tools (Circle, Ellipse, Polyline, etc.)
+ */
+var TID320ContentItem = /*#__PURE__*/function () {
+  function TID320ContentItem(_ref) {
+    var graphicType = _ref.graphicType,
+      graphicData = _ref.graphicData,
+      _ref$use3DSpatialCoor = _ref.use3DSpatialCoordinates,
+      use3DSpatialCoordinates = _ref$use3DSpatialCoor === void 0 ? false : _ref$use3DSpatialCoor,
+      referencedSOPSequence = _ref.referencedSOPSequence,
+      referencedFrameOfReferenceUID = _ref.referencedFrameOfReferenceUID;
+    _classCallCheck(this, TID320ContentItem);
+    this.graphicType = graphicType;
+    this.graphicData = graphicData;
+    this.use3DSpatialCoordinates = use3DSpatialCoordinates;
+    this.referencedSOPSequence = referencedSOPSequence;
+    this.referencedFrameOfReferenceUID = referencedFrameOfReferenceUID;
+  }
+  _createClass(TID320ContentItem, [{
+    key: "contentItem",
+    value: function contentItem() {
+      var content = {
+        RelationshipType: "INFERRED FROM",
+        ValueType: this.use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
+        GraphicType: this.graphicType,
+        GraphicData: this.graphicData
+      };
+      if (this.use3DSpatialCoordinates) {
+        content.ReferencedFrameOfReferenceUID = this.referencedFrameOfReferenceUID;
+      } else {
+        content.ContentSequence = {
+          RelationshipType: "SELECTED FROM",
+          ValueType: "IMAGE",
+          ReferencedSOPSequence: this.referencedSOPSequence
+        };
+      }
+      return content;
+    }
+  }]);
+  return TID320ContentItem;
+}();
+
+var OpenPolyline = /*#__PURE__*/function (_TID300Measurement) {
+  _inherits(OpenPolyline, _TID300Measurement);
+  function OpenPolyline() {
+    _classCallCheck(this, OpenPolyline);
+    return _callSuper(this, OpenPolyline, arguments);
+  }
+  _createClass(OpenPolyline, [{
+    key: "getPoints",
+    value: function getPoints() {
+      throw new Error("getPoints() must be implemented by subclass");
+    }
+  }, {
+    key: "getConceptNameCodeSequence",
+    value: function getConceptNameCodeSequence() {
+      throw new Error("getConceptNameCodeSequence() must be implemented");
+    }
+  }, {
+    key: "getMeasuredValueSequence",
+    value: function getMeasuredValueSequence() {
+      return null;
+    }
+  }, {
+    key: "buildGraphicContent",
+    value: function buildGraphicContent() {
+      var _this$props = this.props,
+        _this$props$use3DSpat = _this$props.use3DSpatialCoordinates,
+        use3DSpatialCoordinates = _this$props$use3DSpat === void 0 ? false : _this$props$use3DSpat,
+        ReferencedSOPSequence = _this$props.ReferencedSOPSequence,
+        ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
+      var GraphicData = this.flattenPoints({
+        points: this.getPoints(),
+        use3DSpatialCoordinates: use3DSpatialCoordinates
+      });
+      return new TID320ContentItem({
+        graphicType: "POLYLINE",
+        graphicData: GraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
+    }
+  }, {
+    key: "contentItem",
+    value: function contentItem() {
+      var concept = this.getConceptNameCodeSequence();
+      var measuredValue = this.getMeasuredValueSequence();
+      return this.getMeasurement([{
+        RelationshipType: "CONTAINS",
+        ValueType: "NUM",
+        ConceptNameCodeSequence: concept,
+        MeasuredValueSequence: measuredValue,
+        ContentSequence: this.buildGraphicContent()
+      }]);
+    }
+  }]);
+  return OpenPolyline;
+}(TID300Measurement);
+
+var knownUnits = [
+// Standard UCUM units.
+{
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
   CodeValue: "mm",
+  CodeMeaning: "mm"
+}, {
   CodingSchemeDesignator: "UCUM",
   CodingSchemeVersion: "1.4",
-  CodeMeaning: "millimeter"
-};
-var MM2_UNIT = {
   CodeValue: "mm2",
+  CodeMeaning: "mm2"
+},
+// Units defined in https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_83.html
+{
   CodingSchemeDesignator: "UCUM",
   CodingSchemeVersion: "1.4",
-  CodeMeaning: "SquareMilliMeter"
-};
+  CodeValue: "[hnsf'U]",
+  CodeMeaning: "Hounsfield unit"
+},
+// Units defined in https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_84.html
+{
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "{counts}",
+  CodeMeaning: "Counts"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "{counts}/s",
+  CodeMeaning: "Counts per second"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "{propcounts}",
+  CodeMeaning: "Proportional to counts"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "{propcounts}/s",
+  CodeMeaning: "Proportional to counts per second"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "cm2",
+  CodeMeaning: "cm2"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "cm2/ml",
+  CodeMeaning: "cm2/ml"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "%",
+  CodeMeaning: "Percent"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "Bq/ml",
+  CodeMeaning: "Becquerels/milliliter"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "mg/min/ml",
+  CodeMeaning: "Milligrams/minute/milliliter"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "umol/min/ml",
+  CodeMeaning: "Micromole/minute/milliliter"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "ml/min/g",
+  CodeMeaning: "Milliliter/minute/gram"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "ml/g",
+  CodeMeaning: "Milliliter/gram"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "/cm",
+  CodeMeaning: "/Centimeter"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "umol/ml",
+  CodeMeaning: "Micromole/milliliter"
+},
+// Units defined in https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_85.html
+{
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "g/ml{SUVbw}",
+  CodeMeaning: "Standardized Uptake Value body weight"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "g/ml{SUVlbm}",
+  CodeMeaning: "Standardized Uptake Value lean body mass (James)"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "g/ml{SUVlbm(James128)}",
+  CodeMeaning: "Standardized Uptake Value lean body mass (James 128 multiplier)"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "g/ml{SUVlbm(Janma)}",
+  CodeMeaning: "Standardized Uptake Value lean body mass (Janma)"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "cm2/ml{SUVbsa}",
+  CodeMeaning: "Standardized Uptake Value body surface area"
+}, {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "g/ml{SUVibw}",
+  CodeMeaning: "Standardized Uptake Value ideal body weight"
+}];
+
+// Create unitCodeMap from knownUnits for efficient lookup
+var unitCodeMap = {};
+knownUnits.forEach(function (unit) {
+  unitCodeMap[unit.CodeValue] = unit;
+});
+var noUnitCodeValues = ["px", "px\xB2"];
 var NO_UNIT = {
   CodeValue: "1",
   CodingSchemeDesignator: "UCUM",
   CodingSchemeVersion: "1.4",
   CodeMeaning: "px"
 };
-var NO2_UNIT = NO_UNIT;
-var measurementMap = {
-  px: NO_UNIT,
-  mm: MM_UNIT,
-  mm2: MM2_UNIT,
-  "mm\xB2": MM2_UNIT,
-  "px\xB2": NO2_UNIT
+noUnitCodeValues.forEach(function (codeValue) {
+  unitCodeMap[codeValue] = NO_UNIT;
+});
+unitCodeMap["mm\xB2"] = {
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeValue: "mm2",
+  CodeMeaning: "mm2"
+};
+var MM_UNIT = {
+  CodeValue: "mm",
+  CodingSchemeDesignator: "UCUM",
+  CodingSchemeVersion: "1.4",
+  CodeMeaning: "millimeter"
 };
-
 /** Converts the given unit into the
  * specified coding values.
  * Has .measurementMap on the function specifying global units for measurements.
@@ -14040,67 +14268,53 @@ var unit2CodingValue = function unit2CodingValue(units) {
   if (!units) return NO_UNIT;
   var space = units.indexOf(" ");
   var baseUnit = space === -1 ? units : units.substring(0, space);
-  var codingUnit = measurementMap[units] || measurementMap[baseUnit];
+  var codingUnit = unitCodeMap[units] || unitCodeMap[baseUnit];
   if (!codingUnit) {
     log.error("Unspecified units", units);
     return MM_UNIT;
   }
   return codingUnit;
 };
-unit2CodingValue.measurementMap = measurementMap;
+unit2CodingValue.measurementMap = unitCodeMap;
 
-var Length$2 = /*#__PURE__*/function (_TID300Measurement) {
-  _inherits(Length, _TID300Measurement);
+var Length$2 = /*#__PURE__*/function (_OpenPolyline) {
+  _inherits(Length, _OpenPolyline);
   function Length() {
     _classCallCheck(this, Length);
     return _callSuper(this, Length, arguments);
   }
   _createClass(Length, [{
-    key: "contentItem",
-    value: function contentItem() {
+    key: "getPoints",
+    value: function getPoints() {
       var _this$props = this.props,
         point1 = _this$props.point1,
-        point2 = _this$props.point2,
-        _this$props$unit = _this$props.unit,
-        unit = _this$props$unit === void 0 ? "mm" : _this$props$unit,
-        _this$props$use3DSpat = _this$props.use3DSpatialCoordinates,
-        use3DSpatialCoordinates = _this$props$use3DSpat === void 0 ? false : _this$props$use3DSpat,
-        distance = _this$props.distance,
-        ReferencedSOPSequence = _this$props.ReferencedSOPSequence,
-        ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
-      var GraphicData = this.flattenPoints({
-        points: [point1, point2],
-        use3DSpatialCoordinates: use3DSpatialCoordinates
-      });
-      return this.getMeasurement([{
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "G-D7FE",
-          CodingSchemeDesignator: "SRT",
-          CodeMeaning: "Length"
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: unit2CodingValue(unit),
-          NumericValue: distance
-        },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYLINE",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
-      }]);
+        point2 = _this$props.point2;
+      return [point1, point2];
+    }
+  }, {
+    key: "getConceptNameCodeSequence",
+    value: function getConceptNameCodeSequence() {
+      return {
+        CodeValue: "410668003",
+        CodingSchemeDesignator: "SCT",
+        CodeMeaning: "Length"
+      };
+    }
+  }, {
+    key: "getMeasuredValueSequence",
+    value: function getMeasuredValueSequence() {
+      var _this$props2 = this.props,
+        distance = _this$props2.distance,
+        _this$props2$unit = _this$props2.unit,
+        unit = _this$props2$unit === void 0 ? "mm" : _this$props2$unit;
+      return {
+        MeasurementUnitsCodeSequence: unit2CodingValue(unit),
+        NumericValue: distance
+      };
     }
   }]);
   return Length;
-}(TID300Measurement);
+}(OpenPolyline);
 
 var CORNERSTONE_4_TAG = "cornerstoneTools@^4.0.0";
 
@@ -14180,6 +14394,120 @@ Length$1.isValidCornerstoneTrackingIdentifier = function (TrackingIdentifier) {
 };
 MeasurementReport$3.registerTool(Length$1);
 
+/**
+ * Utility class for constructing DICOM SR Numeric (NUM) measurement items
+ * associated with a spatial coordinate (SCOORD) annotation.
+ *
+ * Each measurement produced by this builder includes:
+ *  - A NUM content item describing the measurement value
+ *  - A MeasuredValueSequence with its unit encoded in UCUM or another scheme
+ *  - A ContentSequence containing an INFERRED FROM reference linking the
+ *    measurement back to the SCOORD item using ReferencedContentItemIdentifier.
+ *
+ * This ensures that all derived measurements correctly reference the
+ * annotation from which they were computed.
+ */
+var MeasurementBuilder = /*#__PURE__*/function () {
+  function MeasurementBuilder() {
+    _classCallCheck(this, MeasurementBuilder);
+  }
+  _createClass(MeasurementBuilder, null, [{
+    key: "createNumericMeasurement",
+    value:
+    /**
+     * Creates a NUM (Numeric Measurement) content item for a DICOM SR.
+     *
+     * @param {string} codeValue - Code value representing the type of measurement.
+     * @param {string} codingScheme - Coding scheme designator (e.g., "SCT", "DCM").
+     * @param {string} codeMeaning - Human-readable meaning of the measurement code.
+     * @param {number|string} value - The numeric measurement value.
+     * @param {Object} unit - Unit definition object (UCUM or other coding scheme).
+     *
+     * @returns {Object} DICOM SR content item representing a numeric measurement.
+     */
+
+    function createNumericMeasurement(codeValue, codingScheme, codeMeaning, value, unit) {
+      var _ref = arguments.length > 5 && arguments[5] !== undefined ? arguments[5] : {},
+        _ref$scoordContentIte = _ref.scoordContentItem,
+        scoordContentItem = _ref$scoordContentIte === void 0 ? null : _ref$scoordContentIte;
+      var item = {
+        RelationshipType: "CONTAINS",
+        ValueType: "NUM",
+        ConceptNameCodeSequence: {
+          CodeValue: codeValue,
+          CodingSchemeDesignator: codingScheme,
+          CodeMeaning: codeMeaning
+        },
+        MeasuredValueSequence: {
+          MeasurementUnitsCodeSequence: unit2CodingValue(unit),
+          NumericValue: value
+        }
+      };
+      if (scoordContentItem) {
+        item.ContentSequence = scoordContentItem;
+      }
+      return item;
+    }
+  }, {
+    key: "createAreaMeasurement",
+    value: function createAreaMeasurement(area, areaUnit, _ref2) {
+      var scoordContentItem = _ref2.scoordContentItem;
+      return MeasurementBuilder.createNumericMeasurement("42798000", "SCT", "Area", area, areaUnit, {
+        scoordContentItem: scoordContentItem
+      });
+    }
+  }, {
+    key: "createRadiusMeasurement",
+    value: function createRadiusMeasurement(radius, radiusUnit, _ref3) {
+      var scoordContentItem = _ref3.scoordContentItem;
+      return MeasurementBuilder.createNumericMeasurement("131190003", "SCT", "Radius", radius, radiusUnit, {
+        scoordContentItem: scoordContentItem
+      });
+    }
+  }, {
+    key: "createMaxMeasurement",
+    value: function createMaxMeasurement(max, modalityUnit, _ref4) {
+      var scoordContentItem = _ref4.scoordContentItem;
+      return MeasurementBuilder.createNumericMeasurement("56851009", "SCT", "Maximum", max, modalityUnit, {
+        scoordContentItem: scoordContentItem
+      });
+    }
+  }, {
+    key: "createMinMeasurement",
+    value: function createMinMeasurement(min, modalityUnit, _ref5) {
+      var scoordContentItem = _ref5.scoordContentItem;
+      return MeasurementBuilder.createNumericMeasurement("255605001", "SCT", "Minimum", min, modalityUnit, {
+        scoordContentItem: scoordContentItem
+      });
+    }
+  }, {
+    key: "createMeanMeasurement",
+    value: function createMeanMeasurement(mean, modalityUnit, _ref6) {
+      var scoordContentItem = _ref6.scoordContentItem;
+      return MeasurementBuilder.createNumericMeasurement("373098007", "SCT", "Mean", mean, modalityUnit, {
+        scoordContentItem: scoordContentItem
+      });
+    }
+  }, {
+    key: "createStdDevMeasurement",
+    value: function createStdDevMeasurement(stdDev, modalityUnit, _ref7) {
+      var scoordContentItem = _ref7.scoordContentItem;
+      return MeasurementBuilder.createNumericMeasurement("386136009", "SCT", "Standard Deviation", stdDev, modalityUnit, {
+        scoordContentItem: scoordContentItem
+      });
+    }
+  }, {
+    key: "createPerimeterMeasurement",
+    value: function createPerimeterMeasurement(perimeter, unit, _ref8) {
+      var scoordContentItem = _ref8.scoordContentItem;
+      return MeasurementBuilder.createNumericMeasurement("131191004", "SCT", "Perimeter", perimeter, unit, {
+        scoordContentItem: scoordContentItem
+      });
+    }
+  }]);
+  return MeasurementBuilder;
+}();
+
 var Polyline$1 = /*#__PURE__*/function (_TID300Measurement) {
   _inherits(Polyline, _TID300Measurement);
   function Polyline() {
@@ -14200,63 +14528,56 @@ var Polyline$1 = /*#__PURE__*/function (_TID300Measurement) {
         perimeter = _this$props.perimeter,
         _this$props$unit = _this$props.unit,
         unit = _this$props$unit === void 0 ? "mm" : _this$props$unit,
+        modalityUnit = _this$props.modalityUnit,
+        min = _this$props.min,
+        max = _this$props.max,
+        mean = _this$props.mean,
+        stdDev = _this$props.stdDev,
         ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
       var GraphicData = this.flattenPoints({
         points: points,
         use3DSpatialCoordinates: use3DSpatialCoordinates
       });
-
-      // TODO: Add Mean and STDev value of (modality?) pixels
-      return this.getMeasurement([{
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "131191004",
-          CodingSchemeDesignator: "SCT",
-          CodeMeaning: "Perimeter"
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: unit2CodingValue(unit),
-          NumericValue: perimeter
-        },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYLINE",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
+      var measurementConfigs = [{
+        value: perimeter,
+        unit: unit,
+        builder: MeasurementBuilder.createPerimeterMeasurement
       }, {
-        // TODO: This feels weird to repeat the GraphicData
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "G-A166",
-          CodingSchemeDesignator: "SRT",
-          CodeMeaning: "Area" // TODO: Look this up from a Code Meaning dictionary
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: unit2CodingValue(areaUnit),
-          NumericValue: area
-        },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYLINE",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
-      }]);
+        value: area,
+        unit: areaUnit,
+        builder: MeasurementBuilder.createAreaMeasurement
+      }, {
+        value: max,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMaxMeasurement
+      }, {
+        value: min,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMinMeasurement
+      }, {
+        value: mean,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMeanMeasurement
+      }, {
+        value: stdDev,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createStdDevMeasurement
+      }];
+      var scoordContentItem = new TID320ContentItem({
+        graphicType: "POLYLINE",
+        graphicData: GraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
+      var measurements = measurementConfigs.filter(function (config) {
+        return config.value !== undefined;
+      }).map(function (config, index) {
+        return config.builder(config.value, config.unit, {
+          scoordContentItem: index === 0 ? scoordContentItem : null
+        });
+      });
+      return this.getMeasurement(measurements);
     }
   }]);
   return Polyline;
@@ -14372,54 +14693,46 @@ var Bidirectional$2 = /*#__PURE__*/function (_TID300Measurement) {
         points: [shortAxis.point1, shortAxis.point2],
         use3DSpatialCoordinates: use3DSpatialCoordinates
       });
+      var longAxisContentSequence = new TID320ContentItem({
+        graphicType: "POLYLINE",
+        graphicData: longAxisGraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
+      var shortAxisContentSequence = new TID320ContentItem({
+        graphicType: "POLYLINE",
+        graphicData: shortAxisGraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
       return this.getMeasurement([{
         RelationshipType: "CONTAINS",
         ValueType: "NUM",
         ConceptNameCodeSequence: {
-          CodeValue: "G-A185",
-          CodingSchemeDesignator: "SRT",
+          CodeValue: "103339001",
+          CodingSchemeDesignator: "SCT",
           CodeMeaning: "Long Axis"
         },
         MeasuredValueSequence: {
           MeasurementUnitsCodeSequence: unit2CodingValue(unit),
           NumericValue: longAxisLength
         },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYLINE",
-          GraphicData: longAxisGraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
+        ContentSequence: longAxisContentSequence
       }, {
         RelationshipType: "CONTAINS",
         ValueType: "NUM",
         ConceptNameCodeSequence: {
-          CodeValue: "G-A186",
-          CodingSchemeDesignator: "SRT",
+          CodeValue: "103340004",
+          CodingSchemeDesignator: "SCT",
           CodeMeaning: "Short Axis"
         },
         MeasuredValueSequence: {
           MeasurementUnitsCodeSequence: unit2CodingValue(unit),
           NumericValue: shortAxisLength
         },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYLINE",
-          GraphicData: shortAxisGraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
+        ContentSequence: shortAxisContentSequence
       }]);
     }
   }]);
@@ -14604,36 +14917,52 @@ var Ellipse$1 = /*#__PURE__*/function (_TID300Measurement) {
         ReferencedSOPSequence = _this$props.ReferencedSOPSequence,
         area = _this$props.area,
         areaUnit = _this$props.areaUnit,
+        max = _this$props.max,
+        min = _this$props.min,
+        mean = _this$props.mean,
+        stdDev = _this$props.stdDev,
+        modalityUnit = _this$props.modalityUnit,
         ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
       var GraphicData = this.flattenPoints({
         points: points,
         use3DSpatialCoordinates: use3DSpatialCoordinates
       });
-      return this.getMeasurement([{
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "G-D7FE",
-          CodingSchemeDesignator: "SRT",
-          CodeMeaning: "AREA"
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: unit2CodingValue(areaUnit),
-          NumericValue: area
-        },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "ELLIPSE",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
-      }]);
+      var measurementConfigs = [{
+        value: area,
+        unit: areaUnit,
+        builder: MeasurementBuilder.createAreaMeasurement
+      }, {
+        value: max,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMaxMeasurement
+      }, {
+        value: min,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMinMeasurement
+      }, {
+        value: mean,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMeanMeasurement
+      }, {
+        value: stdDev,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createStdDevMeasurement
+      }];
+      var scoordContentItem = new TID320ContentItem({
+        graphicType: "ELLIPSE",
+        graphicData: GraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
+      var measurements = measurementConfigs.filter(function (config) {
+        return config.value !== undefined;
+      }).map(function (config, index) {
+        return config.builder(config.value, config.unit, {
+          scoordContentItem: index === 0 ? scoordContentItem : null
+        });
+      });
+      return this.getMeasurement(measurements);
     }
   }]);
   return Ellipse;
@@ -14831,7 +15160,14 @@ var Circle$1 = /*#__PURE__*/function (_TID300Measurement) {
         areaUnit = _this$props$areaUnit === void 0 ? "mm2" : _this$props$areaUnit,
         _this$props$unit = _this$props.unit,
         unit = _this$props$unit === void 0 ? "mm" : _this$props$unit,
-        ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
+        max = _this$props.max,
+        min = _this$props.min,
+        mean = _this$props.mean,
+        stdDev = _this$props.stdDev,
+        radiusUnit = _this$props.radiusUnit,
+        modalityUnit = _this$props.modalityUnit,
+        ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID,
+        radius = _this$props.radius;
 
       // Combine all lengths to save the perimeter
       // @ToDO The permiter has to be implemented
@@ -14841,58 +15177,50 @@ var Circle$1 = /*#__PURE__*/function (_TID300Measurement) {
         points: points,
         use3DSpatialCoordinates: use3DSpatialCoordinates
       });
-
-      // TODO: Add Mean and STDev value of (modality?) pixels
-
-      return this.getMeasurement([{
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "G-A197",
-          CodingSchemeDesignator: "SRT",
-          CodeMeaning: "Perimeter" // TODO: Look this up from a Code Meaning dictionary
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: unit2CodingValue(unit),
-          NumericValue: perimeter
-        },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "CIRCLE",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
+      var measurementConfigs = [{
+        value: perimeter,
+        unit: unit,
+        builder: MeasurementBuilder.createPerimeterMeasurement
       }, {
-        // TODO: This feels weird to repeat the GraphicData
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "G-A166",
-          CodingSchemeDesignator: "SRT",
-          CodeMeaning: "Area" // TODO: Look this up from a Code Meaning dictionary
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: unit2CodingValue(areaUnit),
-          NumericValue: area
-        },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "CIRCLE",
-          GraphicData: GraphicData,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
-      }]);
+        value: area,
+        unit: areaUnit,
+        builder: MeasurementBuilder.createAreaMeasurement
+      }, {
+        value: radius,
+        unit: radiusUnit,
+        builder: MeasurementBuilder.createRadiusMeasurement
+      }, {
+        value: max,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMaxMeasurement
+      }, {
+        value: min,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMinMeasurement
+      }, {
+        value: mean,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createMeanMeasurement
+      }, {
+        value: stdDev,
+        unit: modalityUnit,
+        builder: MeasurementBuilder.createStdDevMeasurement
+      }];
+      var scoordContentItem = new TID320ContentItem({
+        graphicType: "CIRCLE",
+        graphicData: GraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
+      var measurements = measurementConfigs.filter(function (config) {
+        return config.value !== undefined;
+      }).map(function (config, index) {
+        return config.builder(config.value, config.unit, {
+          scoordContentItem: index === 0 ? scoordContentItem : null
+        });
+      });
+      return this.getMeasurement(measurements);
     }
   }]);
   return Circle;
@@ -15029,11 +15357,17 @@ var Point$1 = /*#__PURE__*/function (_TID300Measurement) {
         _this$props$use3DSpat = _this$props.use3DSpatialCoordinates,
         use3DSpatialCoordinates = _this$props$use3DSpat === void 0 ? false : _this$props$use3DSpat,
         ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
-      var GraphicData = this.flattenPoints({
-        // Allow storing another point as part of an indicator showing a single point
-        points: points.slice(0, 2),
-        use3DSpatialCoordinates: use3DSpatialCoordinates
-      });
+
+      // Point must contain exactly one coordinate
+      var point = points[0];
+      var GraphicData = use3DSpatialCoordinates ? [point.x, point.y, point.z] : [point.x, point.y];
+      var graphicContentSequence = new TID320ContentItem({
+        graphicType: "POINT",
+        graphicData: GraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
       return this.getMeasurement([{
         RelationshipType: "CONTAINS",
         ValueType: "NUM",
@@ -15042,19 +15376,16 @@ var Point$1 = /*#__PURE__*/function (_TID300Measurement) {
           CodingSchemeDesignator: "DCM",
           CodeMeaning: "Center"
         },
-        //MeasuredValueSequence: ,
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POINT",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
+        // MeasuredValueSequence is required for NUM items per TID 300/1501
+        MeasuredValueSequence: {
+          NumericValue: 0,
+          MeasurementUnitsCodeSequence: {
+            CodeValue: "1",
+            CodingSchemeDesignator: "UCUM",
+            CodeMeaning: "no units"
           }
-        }
+        },
+        ContentSequence: graphicContentSequence
       }]);
     }
   }]);
@@ -15063,7 +15394,7 @@ var Point$1 = /*#__PURE__*/function (_TID300Measurement) {
 
 var ARROW_ANNOTATE$1 = "ArrowAnnotate";
 var CORNERSTONEFREETEXT$1 = "CORNERSTONEFREETEXT";
-var ArrowAnnotate$1 = /*#__PURE__*/function () {
+var ArrowAnnotate$2 = /*#__PURE__*/function () {
   function ArrowAnnotate() {
     _classCallCheck(this, ArrowAnnotate);
   }
@@ -15134,10 +15465,10 @@ var ArrowAnnotate$1 = /*#__PURE__*/function () {
   }]);
   return ArrowAnnotate;
 }();
-ArrowAnnotate$1.toolType = ARROW_ANNOTATE$1;
-ArrowAnnotate$1.utilityToolType = ARROW_ANNOTATE$1;
-ArrowAnnotate$1.TID300Representation = Point$1;
-ArrowAnnotate$1.isValidCornerstoneTrackingIdentifier = function (TrackingIdentifier) {
+ArrowAnnotate$2.toolType = ARROW_ANNOTATE$1;
+ArrowAnnotate$2.utilityToolType = ARROW_ANNOTATE$1;
+ArrowAnnotate$2.TID300Representation = Point$1;
+ArrowAnnotate$2.isValidCornerstoneTrackingIdentifier = function (TrackingIdentifier) {
   if (!TrackingIdentifier.includes(":")) {
     return false;
   }
@@ -15150,7 +15481,7 @@ ArrowAnnotate$1.isValidCornerstoneTrackingIdentifier = function (TrackingIdentif
   }
   return toolType === ARROW_ANNOTATE$1;
 };
-MeasurementReport$3.registerTool(ArrowAnnotate$1);
+MeasurementReport$3.registerTool(ArrowAnnotate$2);
 
 function iota$1(n) {
   var result = new Array(n);
@@ -18999,62 +19330,48 @@ function fillSegmentation(segmentation, inputLabelmaps3D) {
   console.warn("No generateSegmentation adapater for cornerstone version ".concat(cornerstoneToolsVersion, ", exiting."));
 }
 
-var CobbAngle$1 = /*#__PURE__*/function (_TID300Measurement) {
-  _inherits(CobbAngle, _TID300Measurement);
+var CobbAngle$1 = /*#__PURE__*/function (_OpenPolyline) {
+  _inherits(CobbAngle, _OpenPolyline);
   function CobbAngle() {
     _classCallCheck(this, CobbAngle);
     return _callSuper(this, CobbAngle, arguments);
   }
   _createClass(CobbAngle, [{
-    key: "contentItem",
-    value: function contentItem() {
+    key: "getPoints",
+    value: function getPoints() {
       var _this$props = this.props,
         point1 = _this$props.point1,
         point2 = _this$props.point2,
         point3 = _this$props.point3,
-        point4 = _this$props.point4,
-        rAngle = _this$props.rAngle,
-        use3DSpatialCoordinates = _this$props.use3DSpatialCoordinates,
-        ReferencedSOPSequence = _this$props.ReferencedSOPSequence,
-        ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
-      var GraphicData = this.flattenPoints({
-        points: [point1, point2, point3, point4],
-        use3DSpatialCoordinates: use3DSpatialCoordinates
-      });
-      return this.getMeasurement([{
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "285285000",
-          CodingSchemeDesignator: "SCT",
-          CodeMeaning: "Cobb angle"
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: {
-            CodeValue: "deg",
-            CodingSchemeDesignator: "UCUM",
-            CodingSchemeVersion: "1.4",
-            CodeMeaning: "\xB0"
-          },
-          NumericValue: rAngle
+        point4 = _this$props.point4;
+      return [point1, point2, point3, point4];
+    }
+  }, {
+    key: "getConceptNameCodeSequence",
+    value: function getConceptNameCodeSequence() {
+      return {
+        CodeValue: "285285000",
+        CodingSchemeDesignator: "SCT",
+        CodeMeaning: "Cobb angle"
+      };
+    }
+  }, {
+    key: "getMeasuredValueSequence",
+    value: function getMeasuredValueSequence() {
+      var rAngle = this.props.rAngle;
+      return {
+        MeasurementUnitsCodeSequence: {
+          CodeValue: "deg",
+          CodingSchemeDesignator: "UCUM",
+          CodingSchemeVersion: "1.4",
+          CodeMeaning: "\xB0"
         },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYLINE",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
-      }]);
+        NumericValue: rAngle
+      };
     }
   }]);
   return CobbAngle;
-}(TID300Measurement);
+}(OpenPolyline);
 
 var COBB_ANGLE = "CobbAngle";
 var CobbAngle = /*#__PURE__*/function () {
@@ -19336,7 +19653,7 @@ var Cornerstone = {
   Bidirectional: Bidirectional$1,
   EllipticalRoi: EllipticalRoi,
   CircleRoi: CircleRoi,
-  ArrowAnnotate: ArrowAnnotate$1,
+  ArrowAnnotate: ArrowAnnotate$2,
   MeasurementReport: MeasurementReport$3,
   Segmentation: Segmentation$1,
   CobbAngle: CobbAngle,
@@ -19347,17 +19664,46 @@ var Cornerstone = {
 // This is a custom coding scheme defined to store some annotations from Cornerstone.
 // Note: CodeMeaning is VR type LO, which means we only actually support 64 characters
 // here this is fine for most labels, but may be problematic at some point.
-var CORNERSTONEFREETEXT = "CORNERSTONEFREETEXT";
+// CodeValue must be ≤ 16 characters (SH VR constraint)
+var FREE_TEXT_CODE_VALUE = "CS3DTEXT";
+
+// Private coding scheme designator for dcmjs
+var CodingSchemeDesignator$1 = "99dcmjs";
 
-// Cornerstone specified coding scheme for storing findings
-var CodingSchemeDesignator$1 = "CORNERSTONEJS";
+// Legacy code value for backward compatibility (deprecated, exceeds SH VR limit)
+var CORNERSTONEFREETEXT = "CORNERSTONEFREETEXT";
 var CodingScheme = {
   CodingSchemeDesignator: CodingSchemeDesignator$1,
   codeValues: {
+    FREE_TEXT_CODE_VALUE: FREE_TEXT_CODE_VALUE,
+    // Legacy support - kept for reading old files
     CORNERSTONEFREETEXT: CORNERSTONEFREETEXT
   }
 };
 
+/**
+ * Checks if the given code value is the free text annotation code value
+ * @param {string} codeValue - The code value to check
+ * @returns {boolean} True if the code value matches the free text annotation code (CS3DTEXT)
+ */
+var isFreeTextCodeValue = function isFreeTextCodeValue(codeValue) {
+  return codeValue === CodingScheme.FREE_TEXT_CODE_VALUE;
+};
+
+/**
+ * Checks if the given code value is the legacy free text code value
+ *
+ * NOTE:
+ * This is kept only for backward compatibility when reading old DICOM SRs.
+ * New SRs must NOT use this legacy code value.
+ *
+ * @param {string} codeValue - The code value to check
+ * @returns {boolean} True if the code value matches the legacy free text code (CORNERSTONEFREETEXT)
+ */
+var isLegacyFreeTextCodeValue = function isLegacyFreeTextCodeValue(codeValue) {
+  return codeValue === CodingScheme.CORNERSTONEFREETEXT;
+};
+
 var FINDING = {
   CodingSchemeDesignator: "DCM",
   CodeValue: "121071"
@@ -19407,14 +19753,17 @@ var MeasurementReport$2 = /*#__PURE__*/function () {
       var _defaultState$finding = defaultState.findingSites,
         findingSites = _defaultState$finding === void 0 ? [] : _defaultState$finding,
         finding = defaultState.finding;
-      var cornersoneFreeTextCodingValue = CodingScheme.codeValues.CORNERSTONEFREETEXT;
+
+      // Check finding sites for new or legacy free text annotation codes
       var freeTextLabel = findingSites.find(function (fs) {
-        return fs.CodeValue === cornersoneFreeTextCodingValue;
+        return isFreeTextCodeValue(fs.CodeValue) || isLegacyFreeTextCodeValue(fs.CodeValue);
       });
       if (freeTextLabel) {
         return freeTextLabel.CodeMeaning;
       }
-      if (finding && finding.CodeValue === cornersoneFreeTextCodingValue) {
+
+      // Check finding for new or legacy free text annotation codes
+      if (finding && (isFreeTextCodeValue(finding.CodeValue) || isLegacyFreeTextCodeValue(finding.CodeValue))) {
         return finding.CodeMeaning;
       }
     }
@@ -20888,10 +21237,13 @@ var EllipticalROI = /*#__PURE__*/function () {
           y: bottom[1]
         });
       }
-      var _ref = cachedStats["imageId:".concat(referencedImageId)] || {},
-        area = _ref.area;
+      var stats = cachedStats["imageId:".concat(referencedImageId)] || {};
       return {
-        area: area,
+        area: stats.area,
+        mean: stats.mean,
+        max: stats.max,
+        min: stats.min,
+        stdDev: stats.stdDev,
         points: points,
         trackingIdentifierTextValue: trackingIdentifierTextValue$3,
         finding: finding,
@@ -20922,6 +21274,42 @@ EllipticalROI.isValidCornerstoneTrackingIdentifier = function (TrackingIdentifie
 };
 MeasurementReport$2.registerTool(EllipticalROI);
 
+var ArrowAnnotate$1 = /*#__PURE__*/function (_OpenPolyline) {
+  _inherits(ArrowAnnotate, _OpenPolyline);
+  function ArrowAnnotate() {
+    _classCallCheck(this, ArrowAnnotate);
+    return _callSuper(this, ArrowAnnotate, arguments);
+  }
+  _createClass(ArrowAnnotate, [{
+    key: "getPoints",
+    value: function getPoints() {
+      return this.props.points;
+    }
+  }, {
+    key: "getConceptNameCodeSequence",
+    value: function getConceptNameCodeSequence() {
+      return addAccessors({
+        CodeValue: "111010",
+        CodingSchemeDesignator: "DCM",
+        CodeMeaning: "label"
+      });
+    }
+  }, {
+    key: "getMeasuredValueSequence",
+    value: function getMeasuredValueSequence() {
+      return {
+        NumericValue: 0,
+        MeasurementUnitsCodeSequence: {
+          CodeValue: "1",
+          CodingSchemeDesignator: "UCUM",
+          CodeMeaning: "no units"
+        }
+      };
+    }
+  }]);
+  return ArrowAnnotate;
+}(OpenPolyline);
+
 var ARROW_ANNOTATE = "ArrowAnnotate";
 var trackingIdentifierTextValue$2 = "".concat(CORNERSTONE_3D_TAG, ":").concat(ARROW_ANNOTATE);
 var codeValues = CodingScheme.codeValues,
@@ -21007,9 +21395,9 @@ var ArrowAnnotate = /*#__PURE__*/function () {
       };
 
       // If freetext finding isn't present, add it from the tool text.
-      if (!finding || finding.CodeValue !== codeValues.CORNERSTONEFREETEXT) {
+      if (!finding || !isFreeTextCodeValue(finding.CodeValue) && !isLegacyFreeTextCodeValue(finding.CodeValue)) {
         finding = {
-          CodeValue: codeValues.CORNERSTONEFREETEXT,
+          CodeValue: codeValues.FREE_TEXT_CODE_VALUE,
           CodingSchemeDesignator: CodingSchemeDesignator,
           CodeMeaning: data.text
         };
@@ -21022,7 +21410,7 @@ var ArrowAnnotate = /*#__PURE__*/function () {
 }();
 ArrowAnnotate.toolType = ARROW_ANNOTATE;
 ArrowAnnotate.utilityToolType = ARROW_ANNOTATE;
-ArrowAnnotate.TID300Representation = Point$1;
+ArrowAnnotate.TID300Representation = ArrowAnnotate$1;
 ArrowAnnotate.isValidCornerstoneTrackingIdentifier = function (TrackingIdentifier) {
   if (!TrackingIdentifier.includes(":")) {
     return false;
@@ -21657,6 +22045,13 @@ var Polygon$1 = /*#__PURE__*/function (_TID300Measurement) {
         points: points,
         use3DSpatialCoordinates: use3DSpatialCoordinates
       });
+      var graphicContentSequence = new TID320ContentItem({
+        graphicType: "POLYGON",
+        graphicData: GraphicData,
+        use3DSpatialCoordinates: use3DSpatialCoordinates,
+        referencedSOPSequence: ReferencedSOPSequence,
+        referencedFrameOfReferenceUID: ReferencedFrameOfReferenceUID
+      }).contentItem();
       return this.getMeasurement([{
         RelationshipType: "CONTAINS",
         ValueType: "NUM",
@@ -21669,18 +22064,7 @@ var Polygon$1 = /*#__PURE__*/function (_TID300Measurement) {
           MeasurementUnitsCodeSequence: unit2CodingValue(unit),
           NumericValue: perimeter
         },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYGON",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
+        ContentSequence: graphicContentSequence
       }, {
         RelationshipType: "CONTAINS",
         ValueType: "NUM",
@@ -21693,18 +22077,7 @@ var Polygon$1 = /*#__PURE__*/function (_TID300Measurement) {
           MeasurementUnitsCodeSequence: unit2CodingValue(areaUnit),
           NumericValue: area
         },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYGON",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
+        ContentSequence: graphicContentSequence
       }]);
     }
   }]);
@@ -21919,58 +22292,44 @@ var TID1500 = {
   TID1501MeasurementGroup: TID1501MeasurementGroup
 };
 
-var Calibration = /*#__PURE__*/function (_TID300Measurement) {
-  _inherits(Calibration, _TID300Measurement);
+var Calibration = /*#__PURE__*/function (_OpenPolyline) {
+  _inherits(Calibration, _OpenPolyline);
   function Calibration() {
     _classCallCheck(this, Calibration);
     return _callSuper(this, Calibration, arguments);
   }
   _createClass(Calibration, [{
-    key: "contentItem",
-    value: function contentItem() {
+    key: "getPoints",
+    value: function getPoints() {
       var _this$props = this.props,
         point1 = _this$props.point1,
-        point2 = _this$props.point2,
-        _this$props$unit = _this$props.unit,
-        unit = _this$props$unit === void 0 ? "mm" : _this$props$unit,
-        _this$props$use3DSpat = _this$props.use3DSpatialCoordinates,
-        use3DSpatialCoordinates = _this$props$use3DSpat === void 0 ? false : _this$props$use3DSpat,
-        distance = _this$props.distance,
-        ReferencedSOPSequence = _this$props.ReferencedSOPSequence,
-        ReferencedFrameOfReferenceUID = _this$props.ReferencedFrameOfReferenceUID;
-      var GraphicData = this.flattenPoints({
-        points: [point1, point2],
-        use3DSpatialCoordinates: use3DSpatialCoordinates
-      });
-      return this.getMeasurement([{
-        RelationshipType: "CONTAINS",
-        ValueType: "NUM",
-        ConceptNameCodeSequence: {
-          CodeValue: "102304005",
-          CodingSchemeDesignator: "SCT",
-          CodeMeaning: "Calibration Ruler"
-        },
-        MeasuredValueSequence: {
-          MeasurementUnitsCodeSequence: unit2CodingValue(unit),
-          NumericValue: distance
-        },
-        ContentSequence: {
-          RelationshipType: "INFERRED FROM",
-          ValueType: use3DSpatialCoordinates ? "SCOORD3D" : "SCOORD",
-          GraphicType: "POLYLINE",
-          GraphicData: GraphicData,
-          ReferencedFrameOfReferenceUID: use3DSpatialCoordinates ? ReferencedFrameOfReferenceUID : undefined,
-          ContentSequence: use3DSpatialCoordinates ? undefined : {
-            RelationshipType: "SELECTED FROM",
-            ValueType: "IMAGE",
-            ReferencedSOPSequence: ReferencedSOPSequence
-          }
-        }
-      }]);
+        point2 = _this$props.point2;
+      return [point1, point2];
+    }
+  }, {
+    key: "getConceptNameCodeSequence",
+    value: function getConceptNameCodeSequence() {
+      return {
+        CodeValue: "102304005",
+        CodingSchemeDesignator: "SCT",
+        CodeMeaning: "Calibration Ruler"
+      };
+    }
+  }, {
+    key: "getMeasuredValueSequence",
+    value: function getMeasuredValueSequence() {
+      var _this$props2 = this.props,
+        distance = _this$props2.distance,
+        _this$props2$unit = _this$props2.unit,
+        unit = _this$props2$unit === void 0 ? "mm" : _this$props2$unit;
+      return {
+        MeasurementUnitsCodeSequence: unit2CodingValue(unit),
+        NumericValue: distance
+      };
     }
   }]);
   return Calibration;
-}(TID300Measurement);
+}(OpenPolyline);
 
 // To be implemented:
 // - Cornerstone Probe
@@ -22032,6 +22391,7 @@ var TID300 = {
   TID300Measurement: TID300Measurement,
   Point: Point$1,
   Length: Length$2,
+  ArrowAnnotate: ArrowAnnotate$1,
   CobbAngle: CobbAngle$1,
   Bidirectional: Bidirectional$2,
   Polyline: Polyline$1,
@@ -22581,7 +22941,7 @@ var ContentItem = /*#__PURE__*/_createClass(function ContentItem(options) {
   if (!(options.name instanceof CodedConcept)) {
     throw new Error("Option 'name' must have type CodedConcept.");
   }
-  this.ConceptNameCodeSequence = [options.name];
+  this.ConceptNameCodeSequence = addAccessors([options.name]);
   if (options.valueType === undefined) {
     throw new Error("Option 'valueType' is required for ContentItem.");
   }
@@ -22619,7 +22979,7 @@ var CodeContentItem = /*#__PURE__*/function (_ContentItem) {
     if (!(options.value instanceof CodedConcept)) {
       throw new Error("Option 'value' must have type CodedConcept.");
     }
-    _this.ConceptCodeSequence = [options.value];
+    _this.ConceptCodeSequence = addAccessors([options.value]);
     return _this;
   }
   return _createClass(CodeContentItem);
@@ -22919,6 +23279,7 @@ var ScoordContentItem = /*#__PURE__*/function (_ContentItem10) {
     if (options.graphicData[0] instanceof Array) {
       options.graphicData = [].concat.apply([], options.graphicData);
     }
+    _this10.GraphicType = options.graphicType;
     _this10.GraphicData = options.graphicData;
     options.pixelOriginInterpretation = options.pixelOriginInterpretation || PixelOriginInterpretations.VOLUME;
     if (!(typeof options.pixelOriginInterpretation === "string" || options.pixelOriginInterpretation instanceof String)) {