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

            ChangeFeedEntry changeFeedEntry = context.ChangeFeedEntry;

            Identifier   imagingStudyIdentifier = ImagingStudyIdentifierUtility.CreateIdentifier(changeFeedEntry.StudyInstanceUid);
            ImagingStudy imagingStudy           = await _fhirService.RetrieveImagingStudyAsync(imagingStudyIdentifier, cancellationToken);

            // Returns null if imagingStudy does not exists for given studyInstanceUid
            if (imagingStudy == null)
            {
                return(null);
            }

            string imagingStudySource = imagingStudy.Meta.Source;

            ImagingStudy.SeriesComponent   series   = ImagingStudyPipelineHelper.GetSeriesWithinAStudy(changeFeedEntry.SeriesInstanceUid, imagingStudy.Series);
            ImagingStudy.InstanceComponent instance = ImagingStudyPipelineHelper.GetInstanceWithinASeries(changeFeedEntry.SopInstanceUid, series);

            // Return null if the given instance is not present in ImagingStudy
            if (instance == null)
            {
                return(null);
            }

            // Removes instance from series collection
            series.Instance.Remove(instance);

            // Removes series from ImagingStudy if its instance collection is empty
            if (series.Instance.Count == 0)
            {
                imagingStudy.Series.Remove(series);
            }

            if (imagingStudy.Series.Count == 0 && _dicomWebEndpoint.Equals(imagingStudySource, System.StringComparison.Ordinal))
            {
                return(new FhirTransactionRequestEntry(
                           FhirTransactionRequestMode.Delete,
                           ImagingStudyPipelineHelper.GenerateDeleteRequest(imagingStudy),
                           imagingStudy.ToServerResourceId(),
                           imagingStudy));
            }

            return(new FhirTransactionRequestEntry(
                       FhirTransactionRequestMode.Update,
                       ImagingStudyPipelineHelper.GenerateUpdateRequest(imagingStudy),
                       imagingStudy.ToServerResourceId(),
                       imagingStudy));
        }