• Huy M Do, Lillian G Spear, Moozhan Nikpanah, S Mojdeh Mirmomen, Laura B Machado, Alexandra P Toscano, Baris Turkbey, Mohammad Hadi Bagheri, James L Gulley, and Les R Folio.
• Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10, 9000 Rockville Pike, Bethesda, MD 20892, USA. Electronic address: huy.do@nih.gov.
• Acad Radiol. 2020 Jan 1; 27 (1): 96-105.

Rationale And ObjectivesOur primary aim was to improve radiology reports by increasing concordance of target lesion measurements with oncology records using radiology preprocessors (RP). Faster notification of incidental actionable findings to referring clinicians and clinical radiologist exam interpretation time savings with RPs quantifying tumor burden were also assessed.Materials And MethodsIn this prospective quality improvement initiative, RPs annotated lesions before radiologist interpretation of CT exams. Clinical radiologists then hyperlinked approved measurements into interactive reports during interpretations. RPs evaluated concordance with our tumor measurement radiologist, the determinant of tumor burden. Actionable finding detection and notification times were also deduced. Clinical radiologist interpretation times were calculated from established average CT chest, abdomen, and pelvis interpretation times.ResultsRPs assessed 1287 body CT exams with 812 follow-up CT chest, abdomen, and pelvis studies; 95 (11.7%) of which had 241 verified target lesions. There was improved concordance (67.8% vs. 22.5%) of target lesion measurements. RPs detected 93.1% incidental actionable findings with faster clinician notification by a median time of 1 hour (range: 15 minutes-16 hours). Radiologist exam interpretation times decreased by 37%.ConclusionsThis workflow resulted in three-fold improved target lesion measurement concordance with oncology records, earlier detection and faster notification of incidental actionable findings to referring clinicians, and decreased exam interpretation times for clinical radiologists. These findings demonstrate potential roles for automation (such as AI) to improve report value, worklist prioritization, and patient care.Published by Elsevier Inc.

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