Indexing Imaging Reports for Data Sharing: A Study of Mapping Using RadLex Playbook and LOINC.

New use cases and the need for quality control and imaging data sharing in health studies require the capacity to align them to reference terminologies. We are interested in mapping the local terminology used at our center to describe imaging procedures to reference terminologies for imaging procedures (RadLex Playbook and LOINC/RSNA Radiology Playbook). We performed a manual mapping of the 200 most frequent imaging report titles at our center (i.e. 73.2% of all imaging exams). The mapping method was based only on information explicitly stated in the titles. The results showed 57.5% and 68.8% of exact mapping to the RadLex and LOINC/RSNA Radiology Playbooks, respectively. We identified the reasons for the mapping failure and analyzed the issues encountered.

Feasibility of Natural Language Processing-Assisted Auditing of Critical Findings in Chest Radiology.

OBJECTIVE: Time-sensitive communication of critical imaging findings like pneumothorax or pulmonary embolism to referring physicians is essential for patient safety. The definitive communication is the radiology free-text report. Quality assurance initiatives require that institutions audit these communications, a time-intensive manual task. We propose using a rule-based natural language processing system to improve the process for auditing critical findings communications. METHODS: We present a pilot assessment of the feasibility of using an automated critical finding identification system to assist quality assurance teams' evaluation of critical findings communication compliance. Our assessment is based on chest imaging reports. Critical findings are identified in radiology reports using pyConTextNLP, an open source Python implementation of the ConText algorithm. RESULTS: In our test set, there were 75 reports with critical findings and 591 reports without critical findings. pyConTextNLP correctly identified 69 of the positive cases with 8 false-positives for a sensitivity of 0.92 and a specificity of 0.99. DISCUSSION: Natural language processing can provide valuable assistance to auditing critical findings communications.

Migrating to the Modern PACS: Challenges and Opportunities.

With progressive advancements in picture archiving and communication system (PACS) technology, radiology practices frequently look toward system upgrades and replacements to further improve efficiency and capabilities. The transition between PACS has the potential to derail the operations of a radiology department. Careful planning and attention to detail from radiology informatics leaders are imperative to ensure a smooth transition. This article is a review of the architecture of a modern PACS, highlighting areas of recent innovation. Key considerations for planning a PACS migration and important issues to consider in data migration, change management, and business continuity are discussed. Beyond the technical aspects of a PACS migration, the human factors to consider when managing the cultural change that accompanies a new informatics tool and the keys to success when managing technical failures are explored. Online supplemental material is available for this article. ©RSNA, 2018.

The future of radiology augmented with Artificial Intelligence: A strategy for success.

The rapid development of Artificial Intelligence/deep learning technology and its implementation into routine clinical imaging will cause a major transformation to the practice of radiology. Strategic positioning will ensure the successful transition of radiologists into their new roles as augmented clinicians. This paper describes an overall vision on how to achieve a smooth transition through the practice of augmented radiology where radiologists-in-the-loop ensure the safe implementation of Artificial Intelligence systems.

Integration of a Zero-footprint Cloud-based Picture Archiving and Communication System with Customizable Forms for Radiology Research and Education.

RATIONALE AND OBJECTIVES: The purpose of this study was to integrate web-based forms with a zero-footprint cloud-based Picture Archiving and Communication Systems (PACS) to create a tool of potential benefit to radiology research and education. MATERIALS AND METHODS: Web-based forms were created with a front-end and back-end architecture utilizing common programming languages including Vue.js, Node.js and MongoDB, and integrated into an existing zero-footprint cloud-based PACS. RESULTS: The web-based forms application can be accessed in any modern internet browser on desktop or mobile devices and allows the creation of customizable forms consisting of a variety of questions types. Each form can be linked to an individual DICOM examination or a collection of DICOM examinations. CONCLUSIONS: Several uses are demonstrated through a series of case studies, including implementation of a research platform for multi-reader multi-case (MRMC) studies and other imaging research, and creation of an online Objective Structure Clinical Examination (OSCE) and an educational case file.

Bits and bytes: the future of radiology lies in informatics and information technology.

Advances in informatics and information technology are sure to alter the practice of medical imaging and image-guided therapies substantially over the next decade. Each element of the imaging continuum will be affected by substantial increases in computing capacity coincident with the seamless integration of digital technology into our society at large. This article focuses primarily on areas where this IT transformation is likely to have a profound effect on the practice of radiology. KEY POINTS: • Clinical decision support ensures consistent and appropriate resource utilization. • Big data enables correlation of health information across multiple domains. • Data mining advances the quality of medical decision-making. • Business analytics allow radiologists to maximize the benefits of imaging resources.

Imaging Informatics: 25 Years of Progress.

The science and applications of informatics in medical imaging have advanced dramatically in the past 25 years. This article provides a selective overview of key developments in medical imaging informatics. Advances in standards and technologies for compression and transmission of digital images have enabled Picture Archiving and Communications Systems (PACS) and teleradiology. Research in speech recognition, structured reporting, ontologies, and natural language processing has improved the ability to generate and analyze the reports of imaging procedures. Informatics has provided tools to address workflow and ergonomic issues engendered by the growing volume of medical image information. Research in computeraided detection and diagnosis of abnormalities in medical images has opened new avenues to improve patient care. The growing number of medical-imaging examinations and their large volumes of information create a natural platform for "big data" analytics, particularly when joined with high-dimensional genomic data. Radiogenomics investigates relationships between a disease's genetic and gene-expression characteristics and its imaging phenotype; this emerging field promises to help us better understand disease biology, prognosis, and treatment options. The next 25 years offer remarkable opportunities for informatics and medical imaging together to lead to further advances in both disciplines and to improve health.

Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives.

UNLABELLED: The number of computed tomography examinations has continuously increased over the last decades and accounts for a major part of the collective radiation dose from medical investigations. For purposes of quality assurance in modern radiology a systematic monitoring and analysis of dose related data from radiological examinations is mandatory. Various ways of collecting dose data are available today, for example the Digital Imaging and Communication in Medicine - Structured Report (DICOM-SR), optical character recognition and DICOM-modality performed procedure steps (MPPS). The DICOM-SR is part of the DICOM-standard and provides the DICOM-Radiation Dose Structured Report, which is an easily applicable and comprehensive solution to collect radiation dose parameters. This standard simplifies the process of data collection and enables comprehensive dose monitoring. Various commercial dose monitoring software devices with varying characteristics are available today. In this article, we discuss legal obligations, various ways to monitor dose data, current dose monitoring software solutions and future perspectives in regard to the EU Council Directive 2013/59/EURATOM. KEY POINTS: • Automated, systematic dose monitoring is an important element in quality assurance of radiology departments. • DICOM-RDSR-capable CT scanners facilitate the monitoring of dose data. • A variety of commercial and non-commercial dose monitoring software tools are available today. • Successful dose monitoring requires comprehensive infrastructure for monitoring, analysing and optimizing radiation exposure. Citation Format: • Boos J, Meineke A, Bethge OT et al. Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives. Fortschr Röntgenstr 2016; 188: 443 - 450.

[Digital oral-maxillofacial imaging: present and future].

Digital imaging has been widely used in the field of oral and maxillofacial radiology. The present work summarizes the use of digital imaging from the following aspects: ①The origin of digital oral and maxillofacial imaging; ②The influence of digital imaging on the work mode and work flow of oral and maxillofacial radiology; ③ Application of picture archiving and communication system(PACS)in oral and maxillofacial radiology; ④The influence of three dimensional medical data sets on diagnosis, prognosis and treatment plan; ⑤Digital imaging facilitates the development of telemedicine and internet-medicine; ⑥The significance of establishing a medical database or data center; ⑦Problems and challenges.

Manejo de la lesión renal focal incidental / Managing focal incidental renal lesions

La aparición de una lesión renal incidental ocurre con relativa frecuencia en la práctica radiológica diaria. Ante una lesión incidental deben conocerse las diferentes posibilidades diagnósticas dependiendo de si la lesión es de apariencia quística o sólida. El manejo de las lesiones quísticas viene determinado por la clasificación de Bosniak, mientras que el manejo de las lesiones sólidas trata de diferenciar entre el cáncer renal y tumores benignos, como el angiomiolipoma pobre en grasa y el oncocitoma. El radiólogo debe conocer las recomendaciones en el manejo de dichas lesiones y la utilidad de las diferentes técnicas por imagen e intervencionistas que se pueden realizar en función de las características de la lesión incidental y de las expectativas de vida del paciente (AU)

Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy (AU)

Modern Ultrasound Diagnostic Procedures in an Interdisciplinary Ultrasound Department: Challenge and Opportunities for Radiologists.

Interdisciplinary ultrasound departments are sources for modern and effective ultrasound diagnostic procedures. Radiologists have a very important role as part of these centers for the establishment of new diagnostic ultrasound modalities like contrast-enhanced ultrasound (CEUS), image fusion between US and computed tomography (CT) and magnetic resonance tomography (MRI), resulting in new interventional procedures. Data acquisition and the development of solutions for PACS are also important points.

An Audio/Video Reporting Workflow to Supplement Standardized Radiology Reports.

Radiology studies are inherently visual and the information contained within is best conveyed by visual methodology. Advanced reporting software allows the incorporation of annotated key images into text reports, but such features may be less effective compared with in-person consultations. The use of web technology and screen capture software to create retrievable on-demand audio/visual reports has not yet been investigated. This approach may preempt potential curbside consultations while providing referring clinicians with a more engaged imaging service. In this work, we develop and evaluate a video reporting tool that utilizes modern screen capture software and web technology. We hypothesize that referring clinicians would find that recorded on-demand video reports add value to clinical practice, education, and that such technology would be welcome in future practice. A total of 45 case videos were prepared by radiologists for 14 attending and 15 trainee physicians from emergency and internal medicine specialties. Positive survey feedback from referring clinicians about the video reporting system was statistically significant in all areas measured, including video quality, clinical helpfulness, and willingness to use such technology in the future. Trainees unanimously found educational value in video reporting. These results suggest the potential for video technology to re-establish the radiologist's role as a pivotal member of patient care and integral clinical educator. Future work is needed to streamline these methods in order to minimize work redundancy with traditional text reporting. Additionally, integration with an existing PACS and dictation system will be essential to ensuring ease of use and widespread adoption.