RadLex: Unified Terminology for Radiology

Curtis P. Langlotz, MD, PhDChair, RSNA RadLex Steering CommitteeAssociate Professor of RadiologyUniversity of Pennsylvania

RadLex: Unified Terminology for Radiology

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

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

Medical Lexicons: Completeness for Radiology

4%9%

14%9%

42%

71%

50%50%

52%

87%

63%63%

0%

25%

50%

75%

100%

ICD9 SNOMED UMLS

 FSG:eDict: LSVT:Mean

Langlotz & Caldwell, J Digit Imaging 15(1S):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 There is a need for a single source of common terminology for radiology.common terminology for radiology.

What is RadLex?

• 26 participating organizations

• 9 committees• 92 radiologist participants• 5,308 anatomic concepts (so

far)

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

RadLexSteering

Committee

RadLex MSKLexicon Development

Committee

Other RadLexLexicon Development

Committees…

RadLex TechnicalTask Force

RSNA RadLexStaff

Organizational Structure

Key Collaborating Organizations

• American College of Radiology (ACR)

• College of American Pathologists / Systematized Nomenclature for Medicine (CAP/SNOMED)

• DICOM/IHE

NCI Thesaurus

Iterative LexiconDevelopment Process

SNOMED-CT

RadLex Lexicon Development Committees

XMLRadLex base

content

OWL

OWL

RadLexProtégé

Database

SNOMED-CT

RadLexwebsite

UMLS Meta-Thesaurus

Lexicon Development Process

What is a RadLex Term?

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

RadLex Term Categories

1. Patient identifiers2. Clinical history3. Image acquisition,

processing, and display

4. Location on the image5. Image quality6. Anatomic location

7. Findings8. Relationships9. Uncertainty10.Conclusions11.Recommendation

s12.Teaching

attributes

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)

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

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

Questions for DICOM

• How to unify relationship with SNOMED?

• Best structure to work with RadLex? WG8?

Opening Screen

There are12 RadLex

term categories

Enter a search term

BOOP Search

Hierarchy expandsto show results

in context

Term details are shown