Curtis P. Langlotz, MD, PhD

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RadLex Unified Terminology for Radiology

• Curtis P. Langlotz, MD, PhD
• Chair, RSNA RadLex Steering Committee
• Associate Professor of Radiology
• University of Pennsylvania

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What is RadLex?

• 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

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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,
  ASSR-intervertebral disks, Fleischner glossaries,
  ...
• Coding schemes ICD, CPT, LOINC

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

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

• 26 participating organizations
• 9 committees
• 92 radiologist participants
• 5,308 anatomic concepts (so far)

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RadLex 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

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Organizational Structure
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Key Collaborating Organizations

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

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Lexicon Development Process
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What is a RadLex Term?

• Unique numeric ID
• Name
• Narrative definition
• Source(s)
• Links to related terms/lexicons
• Comments
• Sample image(s)

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RadLex 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

1. Findings
2. Relationships
3. Uncertainty
4. Conclusions
5. Recommendations
6. Teaching attributes

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Relationships in RadLex

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

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Status of RadLex 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 RadLex 1.0 at RSNA 2006

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For More Information

• Visit the RadLex web site
• http//www.rsna.org/radlex
• Attend a RadLex-related session at RSNA
• See poster nearby
• Visit the RadLex kiosk at InfoRad
• Join our mailing list

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Questions for DICOM

• How to unify relationship with SNOMED?
• Best structure to work with RadLex? WG8?

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Opening Screen
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