/// <inheritdoc/>
        public async Task <FhirTransactionRequestEntry> BuildAsync(FhirTransactionContext context, CancellationToken cancellationToken)
        {
            EnsureArg.IsNotNull(context, nameof(context));
            EnsureArg.IsNotNull(context.ChangeFeedEntry, nameof(context.ChangeFeedEntry));
            EnsureArg.IsNotNull(context.Request, nameof(context.Request));

            IResourceId patientId = context.Request.Patient.ResourceId;

            ChangeFeedEntry changeFeedEntry = context.ChangeFeedEntry;

            Identifier imagingStudyIdentifier = ImagingStudyIdentifierUtility.CreateIdentifier(changeFeedEntry.StudyInstanceUid);

            ImagingStudy existingImagingStudy = await _fhirService.RetrieveImagingStudyAsync(imagingStudyIdentifier, cancellationToken);

            ImagingStudy imagingStudy = (ImagingStudy)existingImagingStudy?.DeepCopy();

            FhirTransactionRequestMode requestMode = FhirTransactionRequestMode.None;

            if (existingImagingStudy == null)
            {
                imagingStudy = new ImagingStudy()
                {
                    Status  = ImagingStudy.ImagingStudyStatus.Available,
                    Subject = patientId.ToResourceReference(),
                };

                imagingStudy.Identifier.Add(imagingStudyIdentifier);
                requestMode = FhirTransactionRequestMode.Create;
            }

            SynchronizeImagingStudyProperties(context, imagingStudy);

            if (requestMode != FhirTransactionRequestMode.Create &&
                !existingImagingStudy.IsExactly(imagingStudy))
            {
                requestMode = FhirTransactionRequestMode.Update;
            }

            Bundle.RequestComponent request = requestMode switch
            {
                FhirTransactionRequestMode.Create => ImagingStudyPipelineHelper.GenerateCreateRequest(imagingStudyIdentifier),
                FhirTransactionRequestMode.Update => ImagingStudyPipelineHelper.GenerateUpdateRequest(imagingStudy),
                _ => null,
            };

            IResourceId resourceId = requestMode switch
            {
                FhirTransactionRequestMode.Create => new ClientResourceId(),
                _ => existingImagingStudy.ToServerResourceId(),
            };

            return(new FhirTransactionRequestEntry(
                       requestMode,
                       request,
                       resourceId,
                       imagingStudy));
        }