CONSIDER...technology that contains the following capabilities,which can mitigate the need for added stepsfor the radiologist

MULTIMEDIA-ENHANCED

RADIOLOGYREPORTING

PROCEDURE: CT Abdomen with contrast

CLINICAL INDICATION: Liver metastases (unknown primary tumor).

TECHNIQUE: CT scan of the abdomen with and without contrast was performed ont he volumetric 64 sliceCT scanner. The patient was scanned following the uncomplicated intravenous administration of 100 cc ofOmnipaque 300. 3-D coronal reformatted images were obtained from the axial source images.

COMPARISON: None

FINDINGS: The lung bases are clear. The heart size is normal, without pericardial thickening or effusion.There are several hypodense lesions on both lobes of the liver the largest with a diameter of 54.00 mm thatrepresent liver metastasis from unknown origin most probably.The spleen is normal in size and homogeneous in density. The stomach is partially collapsed, but is grosslyunremarkable. The pancreas as visualized is normal. The gallbladder and biliary tree are unremarkable andthere is no evidence for biliary dilatation. The adrenal glands are symmetric and normal.The kidneys are symmetrically unremarkable as well. The collecting system on the right is enlarged.The aorta is of normal caliber. Aortic calci�cations are present. There is no retroperitoneallymphadenopathy. The porta hepatis region is clear. The bowel and mesentery, as visualized, are equallyunremarkable.S/P total left hip replacement.The surrounding osseous structures are remarkable for mild degenerative spondylosis of the spine. Mildscoliosis of the lumbar spine No osteolytic or osteoblastic lesion is detected.

IMPRESSION:1. Several liver metastasis on both lobes from unknown origin.2. S/P total left hip replacement

Name: KING KEVIN ID: 201222091934Accession No.: 9275000235689 Report Date: 23/12/2005

Referring Physician: David Evans, MD 713-213-5479 davide@practice.com

Report Information

Midland Imaging

PROCEDURE: CT Chest.

CLINICAL INDICATION: Known left-sided squamous cell carcinoma of the lung post surgery with suspectedlung metastsis

TECHNIQUE: CT scan of the chest without contrast was performed on the GE volumetric 64 slice CT scanner.3-D coronal reformatted images were obtained from the axial source images.

COMPARISON: CT March 31 2012, CT June 23 2012

Name: DAVIS DOROTHY ID: 201201061940Accession No.: 9275000234567 Report Date: 28/09/2012

Referring Physician: David Evans, MD 713-213-5479 davide@practice.com

Report Information

450

400

350

300

250

200

150

100

50

0

F05 F04 F07

Volu

me

31/03/2012Baseline

28/09/2012Followup

07/08/2012

Date

23/06/2012Followup

Target LesionsName Target Description SeriesImageLong Diameter (mm)Short Diameter (mm)Volume (mm3)SUV Max (BW)

B06 (F04) Target Lesion (Lung) 3 99 13 5.4 407.8 --

B08 (F07) Target Lesion (Lung) 3 63 12.8 8.3 437.9 --

B07 (F05) Target Lesion (Lung) 3 71 7.9 5.7 228.1 --

Sum of target lesions (3): 33.7mm (Long)The automatic segmented lesions may not have been approved or adjusted

Change Over TimeName Target Baseline

2012-03-312012-06-23 2012-09-28 (Current)

F05 Target Volume (mm3)

Long (mm)

Short (mm)

109.4 (--)

7.1 (--)

3.5 (--)

165.4 (+51.2%)

7.3 (+4%)

5.1 (+43.9%)

140

228.1 (+108.5%)

7.9 (+12.2%)

5.7 (+62.6%)

170

Midland Imaging

2005-12-23, CT Abdomen

Study Information

Name Target Description Series Image Long Diameter (mm) Short Diameter (mm) Volume (mm3) SUV Max (BW)

Other Lesions

Signed ByJohn Jennings, MD

B01 Lesion (Liver) 5861 72 34.8 25.4 8888.7 --

B02 Lesion (Liver) 5861 67 54 44.7 49936.2 --

The automatic segmented lesions may not have been approved or adjusted.

THE VALUE OFMULTIMEDIA-ENHANCED

RADIOLOGYREPORTING

THE VALUE OF

MERRPROVIDES GREATERVALUE TO RADIOLOGISTS

MERRFACILITIES

67% believe that using interactive MERR,

they would be more likely to review both report text and images with patients.

Midland Imaging

Name:Patient ID:History:Date of Birth:Study CT chest with contrastFacility:Physician: XXXXX XXXXXX, MDDate of Service: XX/XX/XXXX XX:XX:XX

PROCEDURE: CT chest with contrast

REASON FOR EXAM: Female, 59 years old. Congestion and a left upper lobe in�ltrate.

RADIATION DOSAGE: (if Supplied by Facility): CTDlvol=(30.34) mGy, DLP=(523.87) mGycm.

TECHNIQUE: High resolution transaxial imaging was preformed following intravenous administration of 100ml ofIsovue 300 contrast material. Multi planar coronal and sagittal images were reformatted.

COMPARISON: Prior CT scan 02/20/13 and radiographs 02/26/13

believe that using MERR, they would be more likely to provide patients access to both text reports and images.

66%

80%believed that MERR

would representan improvement

85%expressed interest in

having access to diagnostic images forradiology reports that

currently do notinclude images

AND HERE’S THE FINAL REPORT

For more information, visit carestream.com/vue-reporting

80%believed that MERR

would representan improvement

Improvedunderstanding of

radiology �ndings by correlating images to

text reports.

Time saved trying to understand �ndings without

supporting imaging.

Easier accessto images while

monitoring progression of a disease/condition.

Easier access to images while planning

treatment.

C O N C L U S I O N :

MERRPROVIDES GREATERVALUE TO RADIOLOGISTS

C O N C L U S I O N :

SOURCES:

Gelareh Sadigh, MD, Timothy Hertweck, BA, Cristine Kao, BSc, Paul Wood, BA,Danny Hughes, PhD, Travis S. Henry, MD, Richard Duszak Jr, MD, “Traditional Text-Only Versus Multimedia-Enhanced Radiology Reporting: Referring Physicians’ Perceptions of Value,” Journal of American College of Radiology, January 23, 2015.

jacr.org/article/S1546-1440(14)00737-6/abstract

79%of physicians are more

likely to recommend thattheir peers refer patients

to a facility withmultimedia reporting

80%of physicians

would preferentially refer patients to a facility with multimedia reporting

COMMONLY REPORTED ADVANTAGES OF MERR

80%of physicians

would preferentially refer patients to a facility with multimedia reporting

79%of physicians are more

likely to recommend thattheir peers refer patients

to a facility withmultimedia reporting

85%expressed interest in

having access to diagnostic images forradiology reports that

currently do notinclude images

Participants, on average, reportedproviding patients withcopies of text reports

of the time. 50%

66%

50%

86%

79%

66%

64%

MERR IS NOT WITHOUT ITS CONCERNS

Compared with text-only reports, most physicians (57%) reported that MERR would be of more value for studies with signi�cant positive �ndings.

More than half of physicians (53%) reported that MERR would be more valuable than text-only reports for conditions that require follow-up and monitoring of the progressionof a disease over a period of time.

28% of physicians said they had concerns about MERR implementation

MULTIMEDIA-ENHANCEDRADIOLOGY REPORTING (MERR)providing advantages to radiologists

across specialties

MULTIMEDIA-ENHANCEDRADIOLOGY REPORTING (MERR)providing advantages to radiologists

across specialties

Clinic work�ow does not allowviewing reports in such a fashion.

42%

Too time intensive.

53%

Automatically include key images into report

Automatically include hyperlinks to key diagnoses or anatomical markers

Take key measurements and automatically present comparisons and highlight major changes