[Reporting initiatives. An update on treatment in radiology]

The written radiological report is the most important means of communication between the radiologist and the referring medical doctor. There is no universal definition of a radiological report concerning its structure and content. The majority of clinicians and radiologists prefer structured reporting rather than free text reports of findings. Structured reporting does not increase the quality of a radiological report but has many advantages in research, teaching and quality management. Using standard RadLex terms facilitates translation and ontological assignment of a report. The Reporting Initiative of the Radiological Society of North America (RSNA) offers free and freely available extensively validated best practices radiology report templates in the new management of radiology report templates (MRRT) format according to the guidelines of the Integrating the Healthcare Enterprise (IHE).

Therapy response evaluation of malignant lymphoma in a multicenter study: comparison of manual and semiautomatic measurements in CT

PURPOSE

Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting.

MATERIALS AND METHODS

MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST.

RESULTS

Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6%. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements.

CONCLUSION

Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6% in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach.

KEY POINTS

► Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients ► Manual lymph node evaluation with uni-dimensional parameters is inferior to semi-automatic analysis in a multicenter setting ► Semi-automatic quantitative software tools should be introduced in clinical study evaluation.

[Registration and monitoring of radiation exposure from radiological imaging]

Strategies for reducing radiation exposure are an important part of optimizing medical imaging and therefore a relevant quality factor in radiology. Regarding the medical radiation exposure, computed tomography has a special relevance. The use of the integrating the healthcare enterprise (IHE) radiation exposure monitoring (REM) profile is the upcoming standard for organizing and collecting exposure data in radiology. Currently most installed base devices do not support this profile generating the required digital imaging and communication in medicine (DICOM) dose structured reporting (SR). For this reason different solutions had been developed to register dose exposure measurements without having the dose SR object.Registration and analysis of dose-related parameters is required for constantly optimizing examination protocols, especially computed tomography (CT) examinations based on the latest research results in order to minimize the individual radiation dose exposure from medical imaging according to the principle as low as reasonably achievable (ALARA).

[IT systems in radiology and IT systems for radiologists]

Radiology plays an important role in introduction and use of information technology (IT) systems in the daily clinical routine. The radiology information system (RIS) and picture archiving and communication system (PACS) are the main systems used in a digital radiology department. In this article the basic principles and functions of these systems and trends in development are described.