rad-june12-noumeir-ED-KIN-SINR by dandanhuanghuang

VIEWS: 3 PAGES: 21

									    DICOM SR:
    Evidence Documents
    Key Image Notes
    Simple Image and Numeric Reports

Rita Noumeir, Ph.D.
Professor, University of Quebec
Evidence Documents
                       Evidence Documents
                        Value proposition


• Measurements and coded data
   – DICOM SR document
• Created by either Acquisition Modality or
  Evidence Creator
• Produced during acquisition or post-
  processing workflows
• Interpreted along with the images
                                   Evidence Documents
                                        Workflow

            Header:

            Report Type:   OB / Gyn
                           …..
            Findings:        BPD
                             ...
                             …..

                                       Query / Retrieve

            Image Refs.:


        Evidence Document Stored


Storage Commitment
                    Evidence Documents
                         Examples


•   Mammography CAD
•   Chest CAD
•   OB-Gyn Ultrasound Measurements
•   Vascular Ultrasound Measurements
•   Vascular Intervention Results
•   Echocardiography Measurements
Key Image Notes
                                          Key Image Notes
                                          Value proposition


• There is more to teamwork than images and reports
• With IHE, it is possible to attach « electronic post-it™ » to
  images to increase informal but critical communication
  between:
   – The Technologist and the Radiologist about specific examination
     events
   – The Radiologist and the Technologist about image quality issues
   – The Radiologist and other department clinicians (surgeon,
     orthopedist,..)
   – The Radiologist and collegues about selecting images for conferences
   – The Radiologist to the Referring Provider, …..etc.

• Query for the KIN using title codes
                              Key Image Notes
                                 Use cases


• “Dave, you read that 3000 slice MR study last
  night. Can you highlight the 5 most important
  images for me”
   – Thinking… “#$@%!%# You”, says “Sure”

• “Dr. Channin, I just reviewed 40 cases and
  marked my questions on yellow stickies. Can you
  review those”

• Tech to radiologist: “The patient wouldn’t hold
  still”
                   for referring physician
                   Here you can
                   see the renal
                   osteopathy.




For teaching
Fibroosteoclasia
Note1                                                   Note2
for referring physician                                 for referring physician
Here you can see the                                    This is the hematoma.
renal rupture.
                           Different notes on different images
        Note1                                                    Note2
        for refering physician                                   for refering physician
        Here you can see the                                     This is the hematoma.
        renal rupture.
                                           Note3
                                           for referring physician
                                           Hematoma everywhere
                                                                           Same note on different images




Note3                    Note3                    Note3                              Note3
for refering physician   for refering physician   for refering physician             for refering physician
Hematoma everywhere      Hematoma everywhere      Hematoma everywhere                Hematoma everywhere
                                 Key Image Notes
                                  Titles & Codes

                                                Codes
                                  Of Interest
Defined by DICOM. May be
  extended                        Rejected for Quality Reasons
                                  For Referring Provider
The note title defines the        For Surgery
  semantics of the reason of      For Teaching
  significance.                   For Conference
                                  For Therapy
Key Image Notes can be queried
                                  For Patient
  by code.
                                  For Peer Review
                                  For Research
The user comments are meant to
  be informal.                    Quality Issue
                                  For Reporting
Simple Image & Numeric
        Report
                                         Simple Image &
                                         Numeric Report
Can you make a report like this:


Institution Identification
Patient Identification
Study Identification
   Technique Identification
Discussion
   The liver is normal. There is a focal area of decreased
   attenuation adjacent to the falciform ligt., likely representing
   focal fat (image 22). The spleen, both kidneys, the … are
   normal.
Impression
   CT of the abdomen within normal limits
Signature
                                     Simple Image &
                                     Numeric Report
Or like this:

Discussion
   Comparison is made to the prior study of 4/11/99. The left
   paratracheal lymph node (image 8, image 11) now measures
   2.5x2.7x3.1 cm increasing from 2.0x2.1x2.6 previously. No
   other mediastinal, upper abdominal or axillary adenopathy is
   identified. No focal pulmonary lesions are seen. The yadda,
   yadda, yadda are normal.
Impression
   Worsening L Paratracheal adenopathy.
Signature
            Simple Image & Numeric Report
                  Value proposition


• Reports’ content is more than words…
• Based on DICOM SR
• Allows to include without transcription:
   – measurements
   – image links
   – structured content
• Integrated with the imaging workflow
• Friendly to XML implementations
• Easy to export with HL7
                  Simple Image & Numeric Report
                   Pattern – Simple Image Report
                           Document Title                     Observation
                                                                Context
                                                     1        (See section
                             1-n     CONTAINS                   5.3.2.3)

                          Section Heading                     Observation
                                                                Context
                                                     0-1      (See section
                                     CONTAINS                   5.3.2.3)
          0-n                               0-n                      0-n
         Report Text               Image Reference           Coded Entry

                INFERRED                                              INFERRED
                FROM                                                  FROM
                0-n                                                   0-n
        Image Reference                                    Image Reference


• Minimal Structure : Coded Title and Headings
• Full image links from specific sections of report
• Observation Context (who, what, when) may be section specific
                 Simple Image & Numeric Report
                            Pattern

                                       HAS OBS           Observation
                    Document Title
                                       CONTEXT             Context
                                                   1     (See section
                       1-n     CONTAIN                     5.3.2.3)
                               S
                                      HAS OBS            Observation
                    Section Heading
                                      CONTEXT              Context
                                                   0-1   (See section
                              CONTAIN                      5.3.2.3)
                              S
    0-n                 0-n                  0-n                   0-n
   Report Text       Image Reference     Measurement        Coded Entry

             INFERRED                                          INFERRED
             FROM                                              FROM
   0-n                        0-n           0-n                       0-n
  Image Reference      Measurement        Image Reference       Measurement



Simply adds Measurements to Simple Image Reports
Simple Image
 & Numeric
   Report

      an
 illustration
                              Evidence Documents
                                 Key Image Notes
                          Simple Image & Numeric Report
Evidence Documents                 Simple Image & Numeric Report
Header:                                        Header:     Radiology Report

Report Type:   OB / Gyn                        Report Type:     OB / Gyn
               …..                                              …..

Findings:        BPD                           Findings:       BPD
                 ...                                           ...
                 …..                                           …..
                             Interpretation
                                               Impressions:    Gestational
                                                                Age
Image Refs.:
                                                                 ...

                                                Image Refs.:




      Key Image Notes

								
To top