Rad Lex Unified Terminology for Radiology Curtis P

Rad. Lex: Unified Terminology for Radiology Curtis P. Langlotz, MD, Ph. D Chair, RSNA Rad. Lex Steering Committee Associate Professor of Radiology University of Pennsylvania

What is Rad. Lex? • A successor to the ACR Index for retrieving online teaching files • A set of terms for clinical reports in an electronic medical record • Common data elements to improve clinical imaging research

Medical Lexicons for Radiology • UMLS (National Library of Medicine) • SNOMED-CT (College of American Pathology) • ACR Index for Radiological Diagnoses (ACR) • NCI Thesaurus and Common Data Elements (CDEs) • Subspecialty lexicons: ACR BI-RADSTM, ASSRintervertebral disks, Fleischner glossaries, . . . • Coding schemes: ICD, CPT, LOINC

Medical Lexicons: Completeness for Radiology Langlotz & Caldwell, J Digit Imaging 15(1 S): 201, 2002

Shortcomings of Existing Medical Terminologies for Imaging • Image acquisition techniques – MRI pulse sequences, CT parameters, imaging protocols • Image features – Low signal, high attenuation, hypoechoic • Global assessments – BI-RADS assessment categories • Anatomy only visible in context – Tendons, abdominal spaces

Conclusion There is a need for a single source of common terminology for radiology.

What is Rad. Lex? • 26 participating organizations • 9 committees • 92 radiologist participants • 5, 308 anatomic concepts (so far)

Rad. Lex Key Features • Adopts existing concepts from widely accepted standards (e. g. , SNOMED, DICOM) • Fills gaps where radiology terms are absent • Serves as single source for radiology concepts and terms • Linked to existing term sets (e. g. CPT, ACR Index, UMLS) • Freely available, courtesy of RSNA

Organizational Structure Rad. Lex Steering Committee Rad. Lex Technical Task Force Rad. Lex MSK Lexicon Development Committee RSNA Rad. Lex Staff Other Rad. Lexicon Development Committees …

Key Collaborating Organizations • American College of Radiology (ACR) • College of American Pathologists / Systematized Nomenclature for Medicine (CAP/SNOMED) • DICOM/IHE

Lexicon Development Process L W O SNOMEDCT Rad. Lex base content XML Rad. Lex Protégé Database Rad. Lex web site SNOMEDCT OWL NCI Thesaurus Rad. Lexicon Development Committees Iterative Lexicon Development Process UMLS Meta. Thesaurus

What is a Rad. Lex Term? • Unique numeric ID • Name • Narrative definition • Source(s) • Links to related terms/lexicons • Comments • Sample image(s)

Rad. Lex Term Categories 1. Patient identifiers 2. Clinical history 3. Image acquisition, processing, and display 4. Location on the image 5. Image quality 6. Anatomic location 7. Findings 8. Relationships 9. Uncertainty 10. Conclusions 11. Recommendations 12. Teaching attributes

Relationships in Rad. Lex • Part of (anatomy) • Is a (pathology) • Branch of (vessels, nerves) • Contained in (body cavities and spaces) • Component of (assemblies, such as joints)

Status of Rad. Lex Project • Anatomy meetings were held this fall • Draft anatomic terms available for public comment soon • Meetings winter/spring 2006 to consider findings and pathology terms • Public comment summer/fall 2006 • Release of Rad. Lex 1. 0 at RSNA 2006

For More Information • Visit the Rad. Lex web site: – http: //www. rsna. org/radlex • Attend a Rad. Lex-related session at RSNA – See poster nearby • Visit the Rad. Lex kiosk at Info. Rad • Join our mailing list

Questions for DICOM • How to unify relationship with SNOMED? • Best structure to work with Rad. Lex? WG 8?

Opening Screen Enter a search term There are 12 Rad. Lex term categories

BOOP Search Hierarchy expands to show results in context Term details are shown