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Heye T, Segeroth M, Franzeck F, Vosshenrich J. Turning radiology reports into epidemiological data to track seasonal pulmonary infections and the COVID-19 pandemic. Eur Radiol 2024; 34:3624-3634. [PMID: 37982834 PMCID: PMC11166749 DOI: 10.1007/s00330-023-10424-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/18/2023] [Accepted: 10/16/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES To automatically label chest radiographs and chest CTs regarding the detection of pulmonary infection in the report text, to calculate the number needed to image (NNI) and to investigate if these labels correlate with regional epidemiological infection data. MATERIALS AND METHODS All chest imaging reports performed in the emergency room between 01/2012 and 06/2022 were included (64,046 radiographs; 27,705 CTs). Using a regular expression-based text search algorithm, reports were labeled positive/negative for pulmonary infection if described. Data for regional weekly influenza-like illness (ILI) consultations (10/2013-3/2022), COVID-19 cases, and hospitalization (2/2020-6/2022) were matched with report labels based on calendar date. Positive rate for pulmonary infection detection, NNI, and the correlation with influenza/COVID-19 data were calculated. RESULTS Between 1/2012 and 2/2020, a 10.8-16.8% per year positive rate for detecting pulmonary infections on chest radiographs was found (NNI 6.0-9.3). A clear and significant seasonal change in mean monthly detection counts (102.3 winter; 61.5 summer; p < .001) correlated moderately with regional ILI consultations (weekly data r = 0.45; p < .001). For 2020-2021, monthly pulmonary infection counts detected by chest CT increased to 64-234 (23.0-26.7% per year positive rate, NNI 3.7-4.3) compared with 14-94 (22.4-26.7% positive rate, NNI 3.7-4.4) for 2012-2019. Regional COVID-19 epidemic waves correlated moderately with the positive pulmonary infection CT curve for 2020-2022 (weekly new cases: r = 0.53; hospitalizations: r = 0.65; p < .001). CONCLUSION Text mining of radiology reports allows to automatically extract diagnoses. It provides a metric to calculate the number needed to image and to track the trend of diagnoses in real time, i.e., seasonality and epidemic course of pulmonary infections. CLINICAL RELEVANCE Digitally labeling radiology reports represent previously neglected data and may assist in automated disease tracking, in the assessment of physicians' clinical reasoning for ordering radiology examinations and serve as actionable data for hospital workflow optimization. KEY POINTS • Radiology reports, commonly not machine readable, can be automatically labeled with the contained diagnoses using a regular-expression based text search algorithm. • Chest radiograph reports positive for pulmonary infection moderately correlated with regional influenza-like illness consultations (weekly data; r = 0.45; p < .001) and chest CT reports with the course of the regional COVID-19 pandemic (new cases: r = 0.53; hospitalizations: r = 0.65; p < 0.001). • Rendering radiology reports into data labels provides a metric for automated disease tracking, the assessment of ordering physicians clinical reasoning and can serve as actionable data for workflow optimization.
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Affiliation(s)
- Tobias Heye
- Department of Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Martin Segeroth
- Department of Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Fabian Franzeck
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Jan Vosshenrich
- Department of Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
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2
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Gertz RJ, Dratsch T, Bunck AC, Lennartz S, Iuga AI, Hellmich MG, Persigehl T, Pennig L, Gietzen CH, Fervers P, Maintz D, Hahnfeldt R, Kottlors J. Potential of GPT-4 for Detecting Errors in Radiology Reports: Implications for Reporting Accuracy. Radiology 2024; 311:e232714. [PMID: 38625012 DOI: 10.1148/radiol.232714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Background Errors in radiology reports may occur because of resident-to-attending discrepancies, speech recognition inaccuracies, and large workload. Large language models, such as GPT-4 (ChatGPT; OpenAI), may assist in generating reports. Purpose To assess effectiveness of GPT-4 in identifying common errors in radiology reports, focusing on performance, time, and cost-efficiency. Materials and Methods In this retrospective study, 200 radiology reports (radiography and cross-sectional imaging [CT and MRI]) were compiled between June 2023 and December 2023 at one institution. There were 150 errors from five common error categories (omission, insertion, spelling, side confusion, and other) intentionally inserted into 100 of the reports and used as the reference standard. Six radiologists (two senior radiologists, two attending physicians, and two residents) and GPT-4 were tasked with detecting these errors. Overall error detection performance, error detection in the five error categories, and reading time were assessed using Wald χ2 tests and paired-sample t tests. Results GPT-4 (detection rate, 82.7%;124 of 150; 95% CI: 75.8, 87.9) matched the average detection performance of radiologists independent of their experience (senior radiologists, 89.3% [134 of 150; 95% CI: 83.4, 93.3]; attending physicians, 80.0% [120 of 150; 95% CI: 72.9, 85.6]; residents, 80.0% [120 of 150; 95% CI: 72.9, 85.6]; P value range, .522-.99). One senior radiologist outperformed GPT-4 (detection rate, 94.7%; 142 of 150; 95% CI: 89.8, 97.3; P = .006). GPT-4 required less processing time per radiology report than the fastest human reader in the study (mean reading time, 3.5 seconds ± 0.5 [SD] vs 25.1 seconds ± 20.1, respectively; P < .001; Cohen d = -1.08). The use of GPT-4 resulted in lower mean correction cost per report than the most cost-efficient radiologist ($0.03 ± 0.01 vs $0.42 ± 0.41; P < .001; Cohen d = -1.12). Conclusion The radiology report error detection rate of GPT-4 was comparable with that of radiologists, potentially reducing work hours and cost. © RSNA, 2024 See also the editorial by Forman in this issue.
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Affiliation(s)
- Roman Johannes Gertz
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Thomas Dratsch
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Alexander Christian Bunck
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Simon Lennartz
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Andra-Iza Iuga
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Martin Gunnar Hellmich
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Thorsten Persigehl
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Lenhard Pennig
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Carsten Herbert Gietzen
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Philipp Fervers
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - David Maintz
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Robert Hahnfeldt
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Jonathan Kottlors
- From the Institute of Diagnostic and Interventional Radiology (R.J.G., T.D., A.C.B., S.L., A.I.I., T.P., L.P., C.H.G., P.F., D.M., R.H., J.K.) and Institute of Medical Statistics and Bioinformatics (M.G.H.), Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
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Beekman KM, Kuijer PPFM, Maas M. Imaging of Overuse Injuries of the Ankle and Foot in Sport and Work. Radiol Clin North Am 2023; 61:307-318. [PMID: 36739147 DOI: 10.1016/j.rcl.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Overuse injuries of the ankle and foot are common injuries both in sport and in a work-related context. After clinical assessment, imaging is key for early diagnosis. In this overview article, we focus on imaging techniques, protocols, and imaging findings of overuse injuries of the ankle and foot; we emphasize the important role of structured reporting; and we discuss clinical symptoms, epidemiology, and risk factors in sports and in a work-related context.
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Affiliation(s)
- Kerensa M Beekman
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - P Paul F M Kuijer
- Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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6
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Saba L, Loewe C, Weikert T, Williams MC, Galea N, Budde RPJ, Vliegenthart R, Velthuis BK, Francone M, Bremerich J, Natale L, Nikolaou K, Dacher JN, Peebles C, Caobelli F, Redheuil A, Dewey M, Kreitner KF, Salgado R. State-of-the-art CT and MR imaging and assessment of atherosclerotic carotid artery disease: the reporting-a consensus document by the European Society of Cardiovascular Radiology (ESCR). Eur Radiol 2023; 33:1088-1101. [PMID: 36194266 PMCID: PMC9889425 DOI: 10.1007/s00330-022-09025-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 02/04/2023]
Abstract
The European Society of Cardiovascular Radiology (ESCR) is the European specialist society of cardiac and vascular imaging. This society's highest priority is the continuous improvement, development, and standardization of education, training, and best medical practice, based on experience and evidence. The present intra-society consensus is based on the existing scientific evidence and on the individual experience of the members of the ESCR writing group on carotid diseases, the members of the ESCR guidelines committee, and the members of the executive committee of the ESCR. The recommendations published herein reflect the evidence-based society opinion of ESCR. The purpose of this second document is to discuss suggestions for standardized reporting based on the accompanying consensus document part I. KEY POINTS: • CT and MR imaging-based evaluation of carotid artery disease provides essential information for risk stratification and prediction of stroke. • The information in the report must cover vessel morphology, description of stenosis, and plaque imaging features. • A structured approach to reporting ensures that all essential information is delivered in a standardized and consistent way to the referring clinician.
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Affiliation(s)
- Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Christian Loewe
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Weikert
- Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH164SB, UK
- Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, UK
| | - Nicola Galea
- Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Ricardo P J Budde
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Rozemarijn Vliegenthart
- Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Birgitta K Velthuis
- Department of Radiology, Utrecht University Medical Center, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Jens Bremerich
- Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Luigi Natale
- Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, Rome, Italy
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tübingen, Germany
| | - Jean-Nicolas Dacher
- Department of Radiology, Normandie University, UNIROUEN, INSERM U1096 - Rouen University Hospital, F 76000, Rouen, France
| | - Charles Peebles
- Department of Cardiothoracic Radiology, University Hospital Southampton, Southampton, UK
| | - Federico Caobelli
- University Clinic of Nuclear Medicine Inselspital Bern, University of Bern, Bern, Switzerland
| | - Alban Redheuil
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Department of Cardiovascular and Thoracic, Imaging and Interventional Radiology, Institute of Cardiology, APHP, Pitié-Salpêtrière University Hospital, Paris, France
- Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146, CNRS 7371, Paris, France
| | - Marc Dewey
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1371, 10117 Berlin, Germany
| | - Karl-Friedrich Kreitner
- Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz Langenbeckstraße 1, 55131, Mainz, Germany
| | - Rodrigo Salgado
- Department of Radiology, Antwerp University Hospital & Antwerp University, Holy Heart Lier, Berlaar, Belgium.
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Kohli A, Castillo S, Thakur U, Chhabra A. Structured Reporting in Musculoskeletal Radiology. Semin Musculoskelet Radiol 2021; 25:641-645. [PMID: 34861708 DOI: 10.1055/s-0041-1736412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Musculoskeletal (MSK) radiologists are predominantly consultants in the service departments of health care. Unlike the manufacturing industry, quality controls are difficult to institute in a service industry and more variability is expected. Structured reporting is a unique way to institute quality standards, and by using the checklist approach with uniform terminology, it can lead to more homogeneity and consistency of reporting, concise lexicon use within and across practices, minimization of errors, enhancement of divisional and departmental branding, improvement of interdisciplinary communications, and future data mining. We share our experience from more than a decade of structured reporting in the domain of MSK radiology, our practice standards, and how reporting has evolved in our MSK practice. Further discussions include future directions aided by machine learning approaches with augmented reality and the possibility of virtual fellowship and training using consistent lexicons and structured reporting.
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Affiliation(s)
- Ajay Kohli
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas.,Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Texas
| | - Samantha Castillo
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Uma Thakur
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas.,Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Texas
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