UCLA includes images in web-based reporting system

Communicating radiology reports to referring physicians can be a time-consuming process that inhibits radiologist workflow. Frequently, a report contains no images to aid the clinician.

Researchers at the University of California, Los Angeles have come up with an open source prototype web-based image documentation and reporting system based on the concept of a classic wet-read. The system was reported in a recent issue of Radiographics (Jul-Aug;27(4):1201-1211).

"By integrating radiologic standards such as DICOM, ACS, and PACS with web-based HTTP, PHP, and MySQL technologies, we have built a widely accessible application that can more effectively communicate and document imaging data," said Corey Arnold of UCLA's Medical Imaging Informatics Group.

Images are displayed in native DICOM format with a Java applet, which allows accurate presentation along with use of various image manipulation tools, Arnold said.

"The web-based infrastructure consists of a server that stores imaging studies and reports, with web browsers that download and install necessary client software on demand," he said.

Application logic is designed around a set of PHP hypertext preprocessor modules accessible with an application programming interface.

Arnold said an ideal system should not only facilitate communication between radiologist and clinician, but could also serve as a repository of medical data and images, allowing retrieval of teaching files, research, and other applications, such as quality control.

The system includes a web-based interface that requires no additional software installation on user computers and has annotation and reporting capabilities currently unavailable in a web-accessible form.

"These features may provide increased convenience and utility to users who currently rely on limited communication mechanisms as well as methods that poorly document information passed to clinicians," Arnold said.

With the UCLA system, users can tag images with standard UMLS, ACR, or RadLex lexicons, which can be used in turn to support indexing and data mining applications.

The system's modular architecture allows lexicons to be modified and different ontologies to be mapped together. The UCLA system also provides image export capabilities to standard formats, as well as the ability to generate DICOM Structured Reporting objects.

"Although our current PACS cannot accept outside DICOM SR objects, this feature was implemented for future applications and allows interoperability with any other system implementing the standard," Arnold said.