Structured Reporting - Health Imaging Hub ·  · 2011-12-05Structured Reporting Herman Oosterwijk, OTech, Inc. ... Agenda ©2008 OTech, Inc. • What are Structured Reports and benefits

Structured Reporting

Herman Oosterwijk, OTech, Inc.

Copyright © 2008 OTech Inc.

Agenda

©2008 OTech, Inc.

• What are Structured Reports and benefits

• DICOM Structured Reports

• General structure

• Typical applications: KON, US

• Conclusion

Reports

©2008 OTech, Inc.

• Diagnostic reports

• Traditional transcription

• Voice recognition with macro’s

• Applications such as MRS, Structured

• Measurements (US)

Issues

©2008 OTech, Inc.

• Transfer of information into a report (e.g. US)

• State of the art: paper forms, proprietary I/F’s, PDF

© 2008 OTech Inc.

Solution: DICOM SR

• Transfer of information into a report (e.g. US)

Image PACS

DICOM SR

EHR

(HL7 CDA)

©2008 OTech, Inc.

SR Objects

• DICOM IOD’s similar to images, etc.

• Reside at the Series level in the DICOM hierarchy

(modality “SR”) in study

• To be stored, archived, retrieved, queried as any

other DICOM object

• Do NOT contain any pixel, waveform, etc. data, at

the most they have thumbnails

• Contents is highly encoded: free text as much as

possible discouraged: excellent for data mining and

outcome research

©2008 OTech, Inc.

Sample

• Based on DICOM SR

• Allows to include

without transcription:

• Measurements

• Image links

• Structured content

©2008 OTech, Inc.

Common Applications

• Ultrasound: Measurements; “during exam”

• For OR and/or ER, physicians, and tech notes: Key

objects

• CAD: machine (AI) generates output

• Cath lab: Groups images, ECG’s, references,

reports; “during exam”

• Dose reports (image and MPPS insufficient info)

• Note: NO presentation (such as PDF)

©2008 OTech, Inc.

Advantages

• Eliminate cut/paste and/or OCR

• Higher data integrity

• Faster, more efficient

• Issues

• Support by PACS lacking: SOP Classes

• Support by viewers lacking

• Support by VR systems lacking

©2008 OTech, Inc.

Conformance Statement Example

• SOP Classes: SR supported?

• PACS should match modality

• Details?

©2008 OTech, Inc.

SOP Classes

• Basic Text SR IOD (“simplest report”)

• Minimal usage of coded entries

• Reference to SOP Instances restricted

• No by-reference Content Items

• Enhanced SR IOD (“some restrictions”)

• Based on Basic Text, extended to include measurements, spatial and temporal regions of interest

• Comprehensive SR IOD (“no restrictions”)

• Based on Enhanced, references to leaves not restricted; includes by-reference Content Items

©2008 OTech, Inc.

Example - Key Image Note

©2008 OTech, Inc.

Example - CAD System

©2008 OTech, Inc.

Example – Chest CAD

Top Level

©2008 OTech, Inc.

Node Code Meaning of Concept Name Code Meaning

or Example Value

TID

1 Chest CAD Report 4100

1.1 Image Library 4100

1.2 CAD Processing and Findings

Summary

All algorithms

succeeded; with findings

4101

1.3 Summary of Detections Succeeded 4100

1.4 Summary of Analyses Not Attempted 4100

Check Templates

• Templates are like “forms”

• Need to be checked to make sure all information

can be encoded

• Complete specifications are in conformance

statements and DICOM standard

• Similar to what is in DICOM image header

©2008 OTech, Inc.

Conclusion

• SR’s are increasingly supported (KON, SR’s, CAD)

by modalities

• PACS archives and viewers are lagging

• Support of SR can make a major impact on workflow

and data integrity

©2008 OTech, Inc.

©2008 OTech, Inc.

Remarks/Questions: [email protected]

DICOM, HL7 standard and proposals available at medical.nema.org and www.HL7.org

Books, e-learning, classes on DICOM and HL7: www.otechimg.com

What should a system administrator know: www.pacsadmin.org

Information resource: www.otpedia.com

Additional Information