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  1. PO
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    <p>Don't know exacly what you need, but this (very long code) will return a dictionary (of dictionaries...) grouped as you said (i.e. <code>PatientID/StudyID/SeriesID/InstanceID</code>):</p> <pre><code>var byPatient = new Dictionary&lt;string, Dictionary&lt;string, Dictionary&lt;string, Dictionary&lt;string, InstanceInformation&gt;&gt;&gt;&gt;(); foreach (var patientGroup in instances.GroupBy(x =&gt; x.PatientID)) { var byStudy = new Dictionary&lt;string, Dictionary&lt;string, Dictionary&lt;string, InstanceInformation&gt;&gt;&gt;(); byPatient.Add(patientGroup.Key, byStudy); foreach (var studyGroup in patientGroup.GroupBy(x =&gt; x.StudyID)) { var bySeries = new Dictionary&lt;string, Dictionary&lt;string, InstanceInformation&gt;&gt;(); byStudy.Add(studyGroup.Key, bySeries); foreach (var seriesIdGroup in studyGroup.GroupBy(x =&gt; x.SeriesID)) { var byInstance = new Dictionary&lt;string, InstanceInformation&gt;(); bySeries.Add(seriesIdGroup.Key, byInstance); foreach (var inst in seriesIdGroup) { byInstance.Add(inst.InstanceID, inst); } } } } </code></pre> <p><strong>P.S.</strong><br> I've considered <code>InstanceID</code> as unique among all instances. </p> <p>Otherwise, the last dictionary level should be: <code>Dictionary&lt;string, List&lt;InstanceInformation&gt;&gt;</code></p> <p><strong>EDIT:</strong></p> <p>Reading your last comment, I think you don't need a real <code>GroupBy</code>, but rather an <code>OrderBy().ThenBy()...</code></p> <pre><code>foreach (var el in instances.OrderBy(x =&gt; x.PatientID) .ThenBy(x =&gt; x.StudyID) .ThenBy(x =&gt; x.SeriesID) .ThenBy(x =&gt; x.InstanceID)) { // it yields: // Pat1 Std1 Srs1 Inst1 // Pat1 Std1 Srs1 Inst2 // Pat1 Std1 Srs2 Inst1 // Pat1 Std2 Srs2 Inst2 // ... } </code></pre>
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    1. COI think this is as close to what I need so far - I just am currently trying to figure out how I would iterate through the results. Say for instance if I wanted to output it as Patient1/Study1/Series1/1, Patient1/Study1/Series1/2 etc.
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    2. COReading your comment, I think you don't need a group by, check my edit ;)
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    3. COThe Dictionary seemed to work for what I needed - it took a bit of code to actually iterate through it, some nesting foreachs that used KeyValuePairs, but it got the job done. I appreciate it digEmAll.
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