Methods, frameworks and systems for validating DICOM (Digital Imaging and Communications in Medicine) SR (Structured Reporting) XML (Extensible Markup Language) documents against DICOM SR templates, using XSLT (Extensible Stylesheet Language Transformations) technology alone or as a complement to XML Schema, are disclosed. A framework of generating XSLT stylesheets from XML representation of DICOM SR templates is developed. Also a mechanism and method of automatic generating XSLT stylesheets for validating SR document contents are provided. In addition, a mechanism and method of flexibly adapting in different DICOM SR XML formats is provided.