CDE Detailed Report
Disease: content
Subdomain Name: Imaging Diagnostics
CRF: welcome
Displaying 1 - 37 of 37
Subdomain Name: Imaging Diagnostics
CRF: welcome
Displaying 1 - 37 of 37
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C08245 | Imaging slice count | ImgSliceCt | Count representing the total number of single image planes captured during imaging acquisition | Count representing the total number of single image planes captured during imaging acquisition | # of Slices | Numeric Values |
Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C14965 | Imaging artifacts indicator | ImgArtifactInd | Indicator of any obvious artifacts in the image | Indicator of any obvious artifacts in the image | Are there any obvious artifacts? | Yes;No | Yes;No | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C02497 | Imaging scanner model name | ImgScannerModelName | Name of model of imaging scanner | Name of model of imaging scanner | Symphony;Trio;Achieva;Signa;Other, specify;Skyra | Symphony;Trio;Achieva;Signa;Other, specify;Skyra | Alphanumeric | Duhaime AC, Gean AD, Haacke EM, Hicks R, Wintermark M, Mukherjee P, Brody D, Latour L, Riedy G; Common Data Elements Neuroimaging Working Group Members, Pediatric Working Group Members. Common data elements in radiologic imaging of traumatic brain injury. Arch Phys Med Rehabil. 2010 Nov;91(11):1661-6. [DOI: 10.1016/j.apmr.2010.07.238] ; Haacke, E.M., Duhaime, A.C., Gean, A.D., Riedy, G., Wintermark, M., Mukherjee, P., Brody, D.L., DeGraba, T., Duncan, T.D., and Elovic, E. (2010). Common data elements in radiologic imaging of traumatic brain injury. Journal of Magnetic Resonance Imaging 32, 516-543, DOI:10.1002/jmri.22259 | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C18718 | Imaging scanner strength value type other text | ImgScannerStrgthValTypOTH | The free-text field related to 'Imaging scanner strength value type', specifying other text. Type of value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | The free-text field related to 'Imaging scanner strength value type', specifying other text. Type of value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | Other, specify | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 2.10 | 2024-03-18 15:21:17.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
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| C10568 | Imaging radio frequency coil channel count | ImgRFCoilChannelCt | Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | Record the number of coils for the applicable receiver coils. | 1;8;16;32 channels;Other, specify | Single coil;8 channels;16 channels;32 channels;Other, specify | Alphanumeric |
No references available |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C14966 | Imaging artifact type | ImgArtifactTyp | The artifacts present on the scan | The artifacts present on the scan | If yes, specify the artifacts | Excessive movement;Poor gray/white contrast;For DTI: Excessive table movement;Other, specify | Excessive movement;Poor gray/white contrast;For DTI: Excessive table movement;Other, specify | Alphanumeric |
Only answered if Yes is answered for "Are there any obvious artifacts?" |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Multiple Pre-Defined Values Selected |
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| C02499 | Imaging pulse sequence type | ImgPulseSeqTyp | Type of imaging pulse sequence used | Type of imaging pulse sequence used | Pulse Sequence;Sequence Type | MPRAGE;SPGR;GRE;FLASH;SWI;DTI;FLAIR;SPACE/VISTA;TSE/FSE;Other, specify | MPRAGE;SPGR;GRE;FLASH;SWI;DTI;FLAIR;SPACE/VISTA;TSE/FSE;Other, specify | Alphanumeric |
Choose all that apply. For each pulse sequence checked, record the scan parameters in the table in question #6 - Scan parameters;In this row, for each column list each pulse sequence checked in question #3 (e.g., MPRAGE, FLAIR, DTI etc.) |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:47:35.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Multiple Pre-Defined Values Selected |
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| C19063 | Imaging neurologic other data collected other text | ImgNeuroOtherDataCollectedOTH | The free-text field related to 'Imaging neurologic other data collected type' specifying other text. Other types of neuroimaging data that may have been collected during this scan visit | The free-text field related to 'Imaging neurologic other data collected type' specifying other text. Other types of neuroimaging data that may have been collected during this scan visit | Other, specify | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
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| C10570 | Imaging contrast agent used indicator | ImgContrastAgentUsedInd | Indicator of whether an imaging contrast agent was used for the scan | Indicator as to whether or not an imaging contrast agent was used for the scan | Were contrast agents used? | Yes;No | Yes;No | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-03-18 15:21:17.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C15572 | Imaging diffusion direction count | ImgDiffusionDirCt | Count of diffusion directions in the associated diffusion imaging study | Count of diffusion directions in the associated diffusion imaging study | # OF GRADIENT DIRECTIONS | Numeric Values |
For DTI only |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C08236 | Imaging scanner software name | ImgScannerSftwrName | Name of the scanner software that runs the imaging camera | Name of the scanner software that runs the imaging camera | Camera Software | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
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| C19064 | Imaging functional magnetic resonance imaging task other text | ImgFMRITaskOTH | The free-text field related to 'Imaging functional magnetic resonance imaging task type' specifying other text. Tasks performed during a functional magnetic resonance imaging (fMRI) scan | The free-text field related to 'Imaging functional magnetic resonance imaging task type' specifying other text. Tasks performed during a functional magnetic resonance imaging (fMRI) scan | Other, specify | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
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| C10576 | Imaging in plane resolution axis 1 measurement | ImgInPlaneRsltnAxis1Measr | Measurement of axis 1 of in-plane spatial resolution used in imaging acquisition | Measurement of axis 1 of in-plane spatial resolution used in imaging acquisition | IN-PLANE RESOLUTION MATRIX | Numeric Values |
This value should be captured in millimeters by millimeters (mm X mm). Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:47:41.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
square millimeter | |||||||||
| C17748 | Imaging neurologic other data collected indicator | ImgNeuroOtherDataCollectedInd | The indicator whether other types of neuroimaging data were collected during this scan visit | The indicator whether other types of neuroimaging data were collected during this scan visit | Were any other types of neuroimaging data collected during this scan visit? | Yes;No | Yes;No | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C08238 | Imaging repetition gap duration | ImgRepetitionGapDur | Duration between successive pulse sequences, in milliseconds, applied to the same slice during imaging acquisition | Duration between successive pulse sequences, in milliseconds, applied to the same slice during imaging acquisition | TR | Numeric Values |
This value should be captured in milliseconds (ms) Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:47:45.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
millisecond | |||||||||
| C10685 | Imaging slice orientation type | ImgSliceOrientTyp | Type of slice orientation used in imaging acquisition | Type of slice orientation used in imaging acquisition | ORIENTATION | Axial;Coronal;Sagittal | Axial;Coronal;Sagittal | Alphanumeric |
Answer for each sequence performed. Choose only one |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:47:40.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C17749 | Imaging neurologic other data collected type | ImgNeuroOtherDataCollectedTyp | Other types of neuroimaging data that may have been collected during this scan visit | Other types of neuroimaging data that may have been collected during this scan visit | If yes, indicate the other types of neuroimaging data collected | Magnetic Resonance Spectroscopy(MRS);Functional MRI(fMRI);Other, specify | Magnetic Resonance Spectroscopy(MRS);Functional MRI(fMRI);Other, specify | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C08239 | Imaging echo duration | ImgEchoDur | Duration between the application of the 90 degree pulse and the peak of the echo signal, in milliseconds, during the spin echo and inversion recovery pulse sequences in imaging acquisition | Duration between the application of the 90 degree pulse and the peak of the echo signal, in milliseconds, during the spin echo and inversion recovery pulse sequences in imaging acquisition | TE | Numeric Values |
This value should be captured in milliseconds (ms). Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.20 | 2024-03-18 15:21:17.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
millisecond | |||||||||
| C10837 | Imaging gap between slices measurement | ImgGapBetwnSlicesMeasr | Measurement of the gap between slices used in imaging acquisition | Measurement of the gap between slices used in imaging acquisition | GAP | Numeric Values |
This value should be captured in millimeters (mm). Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
millimeter | |||||||||
| C17750 | Imaging functional magnetic resonance imaging task type | ImgFMRITaskTyp | Tasks performed during a functional magnetic resonance imaging (fMRI) scan | Tasks performed during a functional magnetic resonance imaging (fMRI) scan | Specify tasks | Finger tapping;N-back;Other, specify | Finger tapping;N-back;Other, specify | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Multiple Pre-Defined Values Selected |
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| C08240 | Imaging flip angle measurement | ImgFlipAngleMeasr | Measurement of the angle, in degrees, over which the radio frequency changes proton spin angle | Measurement of the angle, in degrees over which the radio frequency changes proton spin angle | FLIP ANGLE | Numeric Values |
This value should be captured in degrees. Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-03-18 15:21:17.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
degree | |||||||||
| C10927 | Imaging inversion time duration | ImgInversionTimeDur | Duration of the time period between the 180 degree inversion pulse and the 90 degree excitation pulse in an Inversion Recovery pulse sequence | Duration of the time period between the 180 degree inversion pulse and the 90 degree excitation pulse in an Inversion Recovery pulse sequence | TI | Numeric Values |
This value should be captured in milliseconds (ms). Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:47:46.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
millisecond | |||||||||
| C18691 | Imaging artifact other text | ImgArtifactOTH | The free-text field related to 'Imaging artifact type' specifying other text. The artifacts present on the scan | The free-text field related to 'Imaging artifact type' specifying other text. The artifacts present on the scan | Other, specify | Alphanumeric |
Only answered if Yes is answered for "Are there any obvious artifacts?" |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
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| C08241 | Imaging field of view axis 1 measurement | ImgFieldViewAxis1Measr | Measurement of axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Measurement of axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters | FIELD OF VIEW | Numeric Values |
This value should be captured in millimeters by millimeters (mm X mm). Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:47:41.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
millimeter | |||||||||
| C14961 | Imaging excitation number | ImgExcitationNum | Number of times each line of k-space data is acquired during the scan | Number of times each line of k-space data is acquired during the scan | NEX | Numeric Values |
Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
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| C18700 | Imaging matrix size value other text | ImgMatrixSizeValOTH | The free-text field related to 'Imaging matrix size value', specifying other text. Value representing the imaging matrix size in millimeters | The free-text field related to 'Imaging matrix size value', specifying other text. Value representing the imaging matrix size in millimeters | Other, specify | Alphanumeric |
Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 2.00 | 2022-07-01 16:00:38.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 50 |
Free-Form Entry |
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| C08242 | Imaging acquisition duration | ImgAcquisitionDur | Duration of the imaging scan in minutes | Duration of the imaging scan in minutes | DURATION | Numeric Values |
This value should be captured in minutes. Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
minute | |||||||||
| C14962 | Imaging acquisition entire brain coverage indicator | ImgAcqEntireBrnCoverageInd | Indicator of whether the imaging acquisition covered the entire brain | Indicator of whether the imaging acquisition covered the entire brain | Covers entire brain? | Yes;No | Yes;No | Alphanumeric |
Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C18708 | Imaging pulse sequence type other text | ImgPulseSeqTypOTH | The free-text field related to 'Imaging pulse sequence type', specifying other text. Type of imaging pulse sequence used | The free-text field related to 'Imaging pulse sequence type', specifying other text. Type of imaging pulse sequence used | Other, specify | Alphanumeric |
Choose all that apply. For each pulse sequence checked, record the scan parameters in the table in question #6 - Scan parameters;In this row, for each column list each pulse sequence checked in question #3 (e.g., MPRAGE, FLAIR, DTI etc.) |
No references available | Adult;Pediatric | Supplemental | 2.00 | 2022-07-01 14:55:04.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
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| C08243 | Imaging matrix size value | ImgMatrixSizeVal | Value representing the imaging matrix size in millimeters | Value representing the imaging matrix size in millimeters | MATRIX SIZE | 64 x 64;128 x 128;512 x 512;Other, specify;256 x 256 | 64 x 64;128 x 128;512 x 512;Other, specify;256 x 256 | Alphanumeric |
Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
millimeter | |||||||
| C14963 | Imaging field maps acquisition indicator | ImgFildMapsAcqInd | Indicator of whether field maps were acquired during the acquisition | Indicator of whether field maps were acquired during the acquisition | FIELD MAPS ACQUIRED? | Yes;No;Not applicable | Yes;No;Not applicable | Alphanumeric |
Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C02495 | Imaging scanner strength value type | ImgScannerStrgthValTyp | Type of value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | Type of value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | Field strength | 1.5T;3.0T;4.0T;7.0T;Other, specify | 1.5T;3.0T;4.0T;7.0T;Other, specify | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:47:31.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C18716 | Imaging scanner manufacturer name other text | ImgScannerManufNameOTH | The free-text field related to 'Imaging scanner manufacturer name', specifying other text. Name of manufacturer of imaging scanner | The free-text field related to 'Imaging scanner manufacturer name', specifying other text. Name of manufacturer of imaging scanner | Other, specify | Alphanumeric |
Include type of scanner and manufacturer |
No references available | Adult;Pediatric | Supplemental | 2.00 | 2022-06-28 13:09:35.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
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| C08244 | Imaging slice thickness value | ImgSliceThicknessVal | Value of the thickness of the slice measured in millimeters (mm) | Value of the thickness of the slice measured in millimeters (mm) | SLICE THICKNESS | Numeric Values |
This value should be captured in millimeters (mm). Answer for each sequence performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Free-Form Entry |
0 | 99 | millimeter | |||||||
| C14964 | Sedation used indicator | SedationUsedInd | Indicator of whether the participant was administered any sedation | Indicator of whether the participant was administered any sedation | Was any sedation administered? | Yes;No | Yes;No | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:47:29.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C02496 | Imaging scanner manufacturer name | ImgScannerManufName | Name of manufacturer of imaging scanner | Name of manufacturer of imaging scanner | Scanner | Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify | Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify | Alphanumeric |
Include type of scanner and manufacturer |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations |
Single Pre-Defined Value Selected |
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| C18717 | Imaging scanner model other text | ImgScannerModelOTH | The free-text field related to 'Imaging scanner model name' specifying other text. Name of model of imaging scanner | The free-text field related to 'Imaging scanner model name' specifying other text. Name of model of imaging scanner | Alphanumeric | Duhaime AC, Gean AD, Haacke EM, Hicks R, Wintermark M, Mukherjee P, Brody D, Latour L, Riedy G; Common Data Elements Neuroimaging Working Group Members, Pediatric Working Group Members. Common data elements in radiologic imaging of traumatic brain injury. Arch Phys Med Rehabil. 2010 Nov;91(11):1661-6. [DOI: 10.1016/j.apmr.2010.07.238] ; Haacke, E.M., Duhaime, A.C., Gean, A.D., Riedy, G., Wintermark, M., Mukherjee, P., Brody, D.L., DeGraba, T., Duncan, T.D., and Elovic, E. (2010). Common data elements in radiologic imaging of traumatic brain injury. Journal of Magnetic Resonance Imaging 32, 516-543, DOI:10.1002/jmri.22259 | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Magnetic Resonance (MR) Localization Imaging | Imaging Diagnostics | Assessments and Examinations | 4000 |
Free-Form Entry |
