Updating image set metadata - AWS HealthImaging

Updating image set metadata

Use the UpdateImageSetMetadata action to update image set metadata in AWS HealthImaging. You can use this asynchronous process to add, update, and remove image set metadata attributes, which are manifestations of DICOM normalization elements that are created during import. Using the UpdateImageSetMetadata action, you can also remove Series and SOP Instances to keep image sets in sync with external systems and to de-identify image set metadata. For more information, see UpdateImageSetMetadata in the AWS HealthImaging API Reference.

Note

Real-world DICOM imports require updating, adding, and removing attributes from the image set metadata. Keep the following points in mind when updating image set metadata:

  • Updating image set metadata creates a new version in the image set history. For more information, see Listing image set versions. To revert to a previous image set version ID, use the optional revertToVersionId parameter.

  • Updating image set metadata is an asynchronous process. Therefore, imageSetState and imageSetWorkflowStatus response elements are available to provide the respective state and status of an image set undergoing update. You cannot perform other write operations on a LOCKED image set.

  • If the UpdateImageSetMetadata action is not successful, call and review the message response element to see common errors.

  • DICOM element constraints are applied to metadata updates. The force request parameter allows you to update elements of non-primary image sets in cases where you want to override DICOM metadata constraints.

  • The Patient and Series level metadata elements can not be updated for primary image sets. The UpdateImageSet will not support --force to update StudyInstanceUID, SeriesInstanceUID, and SOPInstanceUID for primary image sets.

  • Set the force request parameter to force completion of the UpdateImageSetMetadata action on non-primary image sets. Setting this parameter allows the following updates to an image set:

    • Updating the Tag.StudyInstanceUID, Tag.SeriesInstanceUID, Tag.SOPInstanceUID, and Tag.StudyID attributes

    • Adding, removing, or updating instance level private DICOM data elements

  • The action of promoting an image set to primary will change the image set ID.

The following diagram represents image set metadata being updated in HealthImaging.

Diagram showing what updating image set metadata looks like in HealthImaging.
To update image set metadata

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CLI
AWS CLI

Example 1: To insert or update an attribute in image set metadata

The following update-image-set-metadata example inserts or updates an attribute in image set metadata.

aws medical-imaging update-image-set-metadata \
    --datastore-id 12345678901234567890123456789012 \
    --image-set-id ea92b0d8838c72a3f25d00d13616f87e \
    --latest-version-id 1 \
    --cli-binary-format raw-in-base64-out \
    --update-image-set-metadata-updates file://metadata-updates.json

Contents of metadata-updates.json

{
    "DICOMUpdates": {
        "updatableAttributes": "{\"SchemaVersion\":1.1,\"Patient\":{\"DICOM\":{\"PatientName\":\"MX^MX\"}}}"
    }
}

Output:

{
    "latestVersionId": "2",
    "imageSetWorkflowStatus": "UPDATING",
    "updatedAt": 1680042257.908,
    "imageSetId": "ea92b0d8838c72a3f25d00d13616f87e",
    "imageSetState": "LOCKED",
    "createdAt": 1680027126.436,
    "datastoreId": "12345678901234567890123456789012"
}

Example 2: To remove an attribute from image set metadata

The following update-image-set-metadata example removes an attribute from image set metadata.

aws medical-imaging update-image-set-metadata \
    --datastore-id 12345678901234567890123456789012 \
    --image-set-id ea92b0d8838c72a3f25d00d13616f87e \
    --latest-version-id 1 \
    --cli-binary-format raw-in-base64-out \
    --update-image-set-metadata-updates file://metadata-updates.json

Contents of metadata-updates.json

{
    "DICOMUpdates": {
        "removableAttributes": "{\"SchemaVersion\":1.1,\"Study\":{\"DICOM\":{\"StudyDescription\":\"CHEST\"}}}"
    }
}

Output:

{
    "latestVersionId": "2",
    "imageSetWorkflowStatus": "UPDATING",
    "updatedAt": 1680042257.908,
    "imageSetId": "ea92b0d8838c72a3f25d00d13616f87e",
    "imageSetState": "LOCKED",
    "createdAt": 1680027126.436,
    "datastoreId": "12345678901234567890123456789012"
}

Example 3: To remove an instance from image set metadata

The following update-image-set-metadata example removes an instance from image set metadata.

aws medical-imaging update-image-set-metadata \
    --datastore-id 12345678901234567890123456789012 \
    --image-set-id ea92b0d8838c72a3f25d00d13616f87e \
    --latest-version-id 1 \
    --cli-binary-format raw-in-base64-out \
    --update-image-set-metadata-updates file://metadata-updates.json

Contents of metadata-updates.json

{
    "DICOMUpdates": {
        "removableAttributes": "{\"SchemaVersion\": 1.1,\"Study\": {\"Series\": {\"1.1.1.1.1.1.12345.123456789012.123.12345678901234.1\": {\"Instances\": {\"1.1.1.1.1.1.12345.123456789012.123.12345678901234.1\": {}}}}}}"
    }
}

Output:

{
    "latestVersionId": "2",
    "imageSetWorkflowStatus": "UPDATING",
    "updatedAt": 1680042257.908,
    "imageSetId": "ea92b0d8838c72a3f25d00d13616f87e",
    "imageSetState": "LOCKED",
    "createdAt": 1680027126.436,
    "datastoreId": "12345678901234567890123456789012"
}

Example 4: To revert an image set to a previous version

The following update-image-set-metadata example shows how to revert an image set to a prior version. CopyImageSet and UpdateImageSetMetadata actions create new versions of image sets.

aws medical-imaging update-image-set-metadata \
    --datastore-id 12345678901234567890123456789012 \
    --image-set-id 53d5fdb05ca4d46ac7ca64b06545c66e \
    --latest-version-id 3 \
    --cli-binary-format raw-in-base64-out \
    --update-image-set-metadata-updates '{"revertToVersionId": "1"}'

Output:

{
    "datastoreId": "12345678901234567890123456789012",
    "imageSetId": "53d5fdb05ca4d46ac7ca64b06545c66e",
    "latestVersionId": "4",
    "imageSetState": "LOCKED",
    "imageSetWorkflowStatus": "UPDATING",
    "createdAt": 1680027126.436,
    "updatedAt": 1680042257.908
}

Example 5: To add a private DICOM data element to an instance

The following update-image-set-metadata example shows how to add a private element to a specified instance within an image set. The DICOM standard permits private data elements for communication of information that cannot be contained in standard data elements. You can create, update, and delete private data elements with the UpdateImageSetMetadata action.

aws medical-imaging update-image-set-metadata \
    --datastore-id 12345678901234567890123456789012 \
    --image-set-id 53d5fdb05ca4d46ac7ca64b06545c66e \
    --latest-version-id 1 \
    --cli-binary-format raw-in-base64-out \
    --force \
    --update-image-set-metadata-updates file://metadata-updates.json

Contents of metadata-updates.json

{
    "DICOMUpdates": {
        "updatableAttributes": "{\"SchemaVersion\": 1.1,\"Study\": {\"Series\": {\"1.1.1.1.1.1.12345.123456789012.123.12345678901234.1\": {\"Instances\": {\"1.1.1.1.1.1.12345.123456789012.123.12345678901234.1\": {\"DICOM\": {\"001910F9\": \"97\"},\"DICOMVRs\": {\"001910F9\": \"DS\"}}}}}}}"
    }
}

Output:

{
    "latestVersionId": "2",
    "imageSetWorkflowStatus": "UPDATING",
    "updatedAt": 1680042257.908,
    "imageSetId": "53d5fdb05ca4d46ac7ca64b06545c66e",
    "imageSetState": "LOCKED",
    "createdAt": 1680027126.436,
    "datastoreId": "12345678901234567890123456789012"
}

Example 6: To update a private DICOM data element to an instance

The following update-image-set-metadata example shows how to update the value of a private data element belonging to an instance within an image set.

aws medical-imaging update-image-set-metadata \
    --datastore-id 12345678901234567890123456789012 \
    --image-set-id 53d5fdb05ca4d46ac7ca64b06545c66e \
    --latest-version-id 1 \
    --cli-binary-format raw-in-base64-out \
    --force \
    --update-image-set-metadata-updates file://metadata-updates.json

Contents of metadata-updates.json

{
    "DICOMUpdates": {
        "updatableAttributes": "{\"SchemaVersion\": 1.1,\"Study\": {\"Series\": {\"1.1.1.1.1.1.12345.123456789012.123.12345678901234.1\": {\"Instances\": {\"1.1.1.1.1.1.12345.123456789012.123.12345678901234.1\": {\"DICOM\": {\"00091001\": \"GE_GENESIS_DD\"}}}}}}}"
    }
}

Output:

{
    "latestVersionId": "2",
    "imageSetWorkflowStatus": "UPDATING",
    "updatedAt": 1680042257.908,
    "imageSetId": "53d5fdb05ca4d46ac7ca64b06545c66e",
    "imageSetState": "LOCKED",
    "createdAt": 1680027126.436,
    "datastoreId": "12345678901234567890123456789012"
}

Example 7: To update a SOPInstanceUID with the force parameter

The following update-image-set-metadata example shows how to update a SOPInstanceUID, using the force parameter to override the DICOM metadata constraints.

aws medical-imaging update-image-set-metadata \
        --datastore-id 12345678901234567890123456789012 \
        --image-set-id 53d5fdb05ca4d46ac7ca64b06545c66e \
        --latest-version-id 1 \
        --cli-binary-format raw-in-base64-out \
        --force \
        --update-image-set-metadata-updates file://metadata-updates.json

Contents of metadata-updates.json

{
    "DICOMUpdates": {
        "updatableAttributes": "{\"SchemaVersion\":1.1,\"Study\":{\"Series\":{\"1.3.6.1.4.1.5962.99.1.3633258862.2104868982.1369432891697.3656.0\":{\"Instances\":{\"1.3.6.1.4.1.5962.99.1.3633258862.2104868982.1369432891697.3659.0\":{\"DICOM\":{\"SOPInstanceUID\":\"1.3.6.1.4.1.5962.99.1.3633258862.2104868982.1369432891697.3659.9\"}}}}}}}"
    }
}

Output:

{
    "latestVersionId": "2",
    "imageSetWorkflowStatus": "UPDATING",
    "updatedAt": 1680042257.908,
    "imageSetId": "53d5fdb05ca4d46ac7ca64b06545c66e",
    "imageSetState": "LOCKED",
    "createdAt": 1680027126.436,
    "datastoreId": "12345678901234567890123456789012"
}

Java
SDK for Java 2.x

    /**
     * Update the metadata of an AWS HealthImaging image set.
     *
     * @param medicalImagingClient - The AWS HealthImaging client object.
     * @param datastoreId          - The datastore ID.
     * @param imageSetId           - The image set ID.
     * @param versionId            - The version ID.
     * @param metadataUpdates      - A MetadataUpdates object containing the updates.
     * @param force                - The force flag.
     * @throws MedicalImagingException - Base exception for all service exceptions thrown by AWS HealthImaging.
     */
    public static void updateMedicalImageSetMetadata(MedicalImagingClient medicalImagingClient,
                                                     String datastoreId,
                                                     String imageSetId,
                                                     String versionId,
                                                     MetadataUpdates metadataUpdates,
                                                     boolean force) {
        try {
            UpdateImageSetMetadataRequest updateImageSetMetadataRequest = UpdateImageSetMetadataRequest
                    .builder()
                    .datastoreId(datastoreId)
                    .imageSetId(imageSetId)
                    .latestVersionId(versionId)
                    .updateImageSetMetadataUpdates(metadataUpdates)
                    .force(force)
                    .build();

            UpdateImageSetMetadataResponse response = medicalImagingClient.updateImageSetMetadata(updateImageSetMetadataRequest);

            System.out.println("The image set metadata was updated" + response);
        } catch (MedicalImagingException e) {
            System.err.println(e.awsErrorDetails().errorMessage());
            throw e;
        }
    }

Use case #1: Insert or update an attribute.

                final String insertAttributes = """
                        {
                          "SchemaVersion": 1.1,
                          "Study": {
                            "DICOM": {
                              "StudyDescription": "CT CHEST"
                            }
                          }
                        }
                        """;
                MetadataUpdates metadataInsertUpdates = MetadataUpdates.builder()
                        .dicomUpdates(DICOMUpdates.builder()
                                .updatableAttributes(SdkBytes.fromByteBuffer(
                                        ByteBuffer.wrap(insertAttributes
                                                .getBytes(StandardCharsets.UTF_8))))
                                .build())
                        .build();

                updateMedicalImageSetMetadata(medicalImagingClient, datastoreId, imagesetId,
                        versionid, metadataInsertUpdates, force);

Use case #2: Remove an attribute.

                final String removeAttributes = """
                        {
                          "SchemaVersion": 1.1,
                          "Study": {
                            "DICOM": {
                              "StudyDescription": "CT CHEST"
                            }
                          }
                        }
                        """;
                MetadataUpdates metadataRemoveUpdates = MetadataUpdates.builder()
                        .dicomUpdates(DICOMUpdates.builder()
                                .removableAttributes(SdkBytes.fromByteBuffer(
                                        ByteBuffer.wrap(removeAttributes
                                                .getBytes(StandardCharsets.UTF_8))))
                                .build())
                        .build();

                updateMedicalImageSetMetadata(medicalImagingClient, datastoreId, imagesetId,
                        versionid, metadataRemoveUpdates, force);

Use case #3: Remove an instance.

                final String removeInstance = """
                        {
                          "SchemaVersion": 1.1,
                          "Study": {
                            "Series": {
                              "1.1.1.1.1.1.12345.123456789012.123.12345678901234.1": {
                                "Instances": {
                                  "1.1.1.1.1.1.12345.123456789012.123.12345678901234.1": {}
                                }
                              }
                            }
                          }
                        }      
                        """;
                MetadataUpdates metadataRemoveUpdates = MetadataUpdates.builder()
                        .dicomUpdates(DICOMUpdates.builder()
                                .removableAttributes(SdkBytes.fromByteBuffer(
                                        ByteBuffer.wrap(removeInstance
                                                .getBytes(StandardCharsets.UTF_8))))
                                .build())
                        .build();

                updateMedicalImageSetMetadata(medicalImagingClient, datastoreId, imagesetId,
                        versionid, metadataRemoveUpdates, force);

Use case #4: Revert to a previous version.

                // In this case, revert to previous version.
                String revertVersionId = Integer.toString(Integer.parseInt(versionid) - 1);
                MetadataUpdates metadataRemoveUpdates = MetadataUpdates.builder()
                        .revertToVersionId(revertVersionId)
                        .build();
                updateMedicalImageSetMetadata(medicalImagingClient, datastoreId, imagesetId,
                        versionid, metadataRemoveUpdates, force);
Note

There's more on GitHub. Find the complete example and learn how to set up and run in the AWS Code Examples Repository.

JavaScript
SDK for JavaScript (v3)
import { UpdateImageSetMetadataCommand } from "@aws-sdk/client-medical-imaging";
import { medicalImagingClient } from "../libs/medicalImagingClient.js";

/**
 * @param {string} datastoreId - The ID of the HealthImaging data store.
 * @param {string} imageSetId - The ID of the HealthImaging image set.
 * @param {string} latestVersionId - The ID of the HealthImaging image set version.
 * @param {{}} updateMetadata - The metadata to update.
 * @param {boolean} force - Force the update.
 */
export const updateImageSetMetadata = async (
  datastoreId = "xxxxxxxxxx",
  imageSetId = "xxxxxxxxxx",
  latestVersionId = "1",
  updateMetadata = "{}",
  force = false,
) => {
  try {
    const response = await medicalImagingClient.send(
      new UpdateImageSetMetadataCommand({
        datastoreId: datastoreId,
        imageSetId: imageSetId,
        latestVersionId: latestVersionId,
        updateImageSetMetadataUpdates: updateMetadata,
        force: force,
      }),
    );
    console.log(response);
    // {
    //     '$metadata': {
    //     httpStatusCode: 200,
    //         requestId: '7966e869-e311-4bff-92ec-56a61d3003ea',
    //         extendedRequestId: undefined,
    //         cfId: undefined,
    //         attempts: 1,
    //         totalRetryDelay: 0
    // },
    //     createdAt: 2023-09-22T14:49:26.427Z,
    //     datastoreId: 'xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx',
    //     imageSetId: 'xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx',
    //     imageSetState: 'LOCKED',
    //     imageSetWorkflowStatus: 'UPDATING',
    //     latestVersionId: '4',
    //     updatedAt: 2023-09-27T19:41:43.494Z
    // }
    return response;
  } catch (err) {
    console.error(err);
  }
};

Use case #1: Insert or update an attribute and force the update.

    const insertAttributes = JSON.stringify({
      SchemaVersion: 1.1,
      Study: {
        DICOM: {
          StudyDescription: "CT CHEST",
        },
      },
    });

    const updateMetadata = {
      DICOMUpdates: {
        updatableAttributes: new TextEncoder().encode(insertAttributes),
      },
    };

    await updateImageSetMetadata(
      datastoreID,
      imageSetID,
      versionID,
      updateMetadata,
      true,
    );

Use case #2: Remove an attribute.

    // Attribute key and value must match the existing attribute.
    const remove_attribute = JSON.stringify({
      SchemaVersion: 1.1,
      Study: {
        DICOM: {
          StudyDescription: "CT CHEST",
        },
      },
    });

    const updateMetadata = {
      DICOMUpdates: {
        removableAttributes: new TextEncoder().encode(remove_attribute),
      },
    };

    await updateImageSetMetadata(
      datastoreID,
      imageSetID,
      versionID,
      updateMetadata,
    );

Use case #3: Remove an instance.

    const remove_instance = JSON.stringify({
      SchemaVersion: 1.1,
      Study: {
        Series: {
          "1.1.1.1.1.1.12345.123456789012.123.12345678901234.1": {
            Instances: {
              "1.1.1.1.1.1.12345.123456789012.123.12345678901234.1": {},
            },
          },
        },
      },
    });

    const updateMetadata = {
      DICOMUpdates: {
        removableAttributes: new TextEncoder().encode(remove_instance),
      },
    };

    await updateImageSetMetadata(
      datastoreID,
      imageSetID,
      versionID,
      updateMetadata,
    );

Use case #4: Revert to an earlier version.

    const updateMetadata = {
      revertToVersionId: "1",
    };

    await updateImageSetMetadata(
      datastoreID,
      imageSetID,
      versionID,
      updateMetadata,
    );
Note

There's more on GitHub. Find the complete example and learn how to set up and run in the AWS Code Examples Repository.

Python
SDK for Python (Boto3)
class MedicalImagingWrapper:
    def __init__(self, health_imaging_client):
        self.health_imaging_client = health_imaging_client


    def update_image_set_metadata(
        self, datastore_id, image_set_id, version_id, metadata, force=False
    ):
        """
        Update the metadata of an image set.

        :param datastore_id: The ID of the data store.
        :param image_set_id: The ID of the image set.
        :param version_id: The ID of the image set version.
        :param metadata: The image set metadata as a dictionary.
            For example {"DICOMUpdates": {"updatableAttributes":
            "{\"SchemaVersion\":1.1,\"Patient\":{\"DICOM\":{\"PatientName\":\"Garcia^Gloria\"}}}"}}
        :param: force: Force the update.
        :return: The updated image set metadata.
        """
        try:
            updated_metadata = self.health_imaging_client.update_image_set_metadata(
                imageSetId=image_set_id,
                datastoreId=datastore_id,
                latestVersionId=version_id,
                updateImageSetMetadataUpdates=metadata,
                force=force,
            )
        except ClientError as err:
            logger.error(
                "Couldn't update image set metadata. Here's why: %s: %s",
                err.response["Error"]["Code"],
                err.response["Error"]["Message"],
            )
            raise
        else:
            return updated_metadata

The following code instantiates the MedicalImagingWrapper object. 

    client = boto3.client("medical-imaging")
    medical_imaging_wrapper = MedicalImagingWrapper(client)

Use case #1: Insert or update an attribute.

            attributes = """{
                    "SchemaVersion": 1.1,
                    "Study": {
                        "DICOM": {
                            "StudyDescription": "CT CHEST"
                        }
                    }
                }"""
            metadata = {"DICOMUpdates": {"updatableAttributes": attributes}}

            self.update_image_set_metadata(
                data_store_id, image_set_id, version_id, metadata, force
            )

Use case #2: Remove an attribute.

            # Attribute key and value must match the existing attribute.
            attributes = """{
                    "SchemaVersion": 1.1,
                    "Study": {
                        "DICOM": {
                            "StudyDescription": "CT CHEST"
                        }
                    }
                }"""
            metadata = {"DICOMUpdates": {"removableAttributes": attributes}}

            self.update_image_set_metadata(
                data_store_id, image_set_id, version_id, metadata, force
            )

Use case #3: Remove an instance.

            attributes = """{
                    "SchemaVersion": 1.1,
                    "Study": {
                        "Series": {
                            "1.1.1.1.1.1.12345.123456789012.123.12345678901234.1": {
                                "Instances": {
                                    "1.1.1.1.1.1.12345.123456789012.123.12345678901234.1": {}
                                }
                            }
                        }
                    }
                }"""
            metadata = {"DICOMUpdates": {"removableAttributes": attributes}}

            self.update_image_set_metadata(
                data_store_id, image_set_id, version_id, metadata, force
            )

Use case #4: Revert to an earlier version.

            metadata = {"revertToVersionId": "1"}

            self.update_image_set_metadata(
                data_store_id, image_set_id, version_id, metadata, force
            )
Note

There's more on GitHub. Find the complete example and learn how to set up and run in the AWS Code Examples Repository.

Example availability

Can't find what you need? Request a code example using the Provide feedback link on the right sidebar of this page.

You can move SOP Instances between image sets, resolve metadata element conflicts, and add or remove instances from the primary image sets using the CopyImageSet, UpdateImageSetMetadata, and DeleteImageSet APIs.

You can remove an image set from the primary collection with the DeleteImageSet action.

To update the metadata of a primary image set

  1. Use the CopyImageSet action to create a non-primary image set that is a copy of the primary image set you want to modify. Let's say this returns 103785414bc2c89330f7ce51bbd13f7a as the non-primary image set ID.

    
          aws medical-imaging copy-image-set --datastore-id 
          a8d19e7875e1532d9b5652f6b25e12c9 --source-image-set-id 
          0778b83b36eced0b76752bfe32192fb7 --copy-image-set-information 
          '{"sourceImageSet": {"latestVersionId": "1" }}' --region us-west-2

  2. Use the UpdateImageSetMetadata action to make changes on the non-primary image set (103785414bc2c89330f7ce51bbd13f7a). For example, changing the PatientID.

    aws medical-imaging update-image-set-metadata \
    --region us-west-2 \
    --datastore-id a8d19e7875e1532d9b5652f6b25e12c9 \
    --image-set-id 103785414bc2c89330f7ce51bbd13f7a \
    --latest-version-id 1 \
    --cli-binary-format raw-in-base64-out \
    --update-image-set-metadata-updates '{
    "DICOMUpdates": {
      "updatableAttributes": "{\"SchemaVersion\":1.1,\"Patient\":
      {\"DICOM\":{\"PatientID\":\"1234\"}}}"
    }
  }'

  3. Delete the primary image set that you are modifying.

    aws medical-imaging delete-image-set --datastore-
          id a8d19e7875e1532d9b5652f6b25e12c9 --image-set-
          id 0778b83b36eced0b76752bfe32192fb7

  4. Use the CopyImageSet action with the argument --promoteToPrimary to add the updated image set to the primary collection.

    aws medical-imaging copy-image-set --datastore-
          id a8d19e7875e1532d9b5652f6b25e12c9 --source-image-set-
          id 103785414bc2c89330f7ce51bbd13f7a --copy-image-set-information 
          '{"sourceImageSet": {"latestVersionId": "2" }}' --region us-west-2 --
          promote-to-primary

  5. Delete the non-primary image set.

    aws medical-imaging delete-image-set --datastore-
          id a8d19e7875e1532d9b5652f6b25e12c9 --image-set-
          id 103785414bc2c89330f7ce51bbd13f7a

To make a non-primary image set primary

  1. Use the UpdateImageSetMetadata action to resolve conflicts with existing Primary image sets.

    aws medical-imaging update-image-set-metadata \
    --region us-west-2 \
    --datastore-id a8d19e7875e1532d9b5652f6b25e12c9 \
    --image-set-id 103785414bc2c89330f7ce51bbd13f7a \
    --latest-version-id 1 \
    --cli-binary-format raw-in-base64-out \
    --update-image-set-metadata-updates '{
    "DICOMUpdates": {
      "updatableAttributes": "{\"SchemaVersion\":1.1,\"Patient\":{\"DICOM\":
      {\"PatientID\":\"1234\"}}}"
    }
  }'

  2. When the conflicts are resolved, use the CopyImageSet action with the argument --promoteToPrimary to add the image set to the primary image set collection.

    aws medical-imaging copy-image-set --datastore-
          id a8d19e7875e1532d9b5652f6b25e12c9 --source-image-set-
          id 103785414bc2c89330f7ce51bbd13f7a --copy-image-set-information 
          '{"sourceImageSet": {"latestVersionId": "2" }}' --region us-west-2 --
          promote-to-primary

  3. After confirming that the CopyImageSet action was successful, delete the source non-primary image set.

    aws medical-imaging delete-image-set --datastore-
          id a8d19e7875e1532d9b5652f6b25e12c9 --image-set-
          id 103785414bc2c89330f7ce51bbd13f7a