Patent Description:
Medical imaging techniques are commonly used for diagnosis and/or follow-up in clinical medicine. Examples of medical imaging techniques include X-Ray, CT (computed tomography), MRI (magnetic resonance imaging), mammography, ultrasonography, etc..

Usually, a medical professional (typically a radiologist) analyses the images and dictates a medical imaging report. Methods and systems for generating a report are known in the art, for instance, <CIT> describes a teleradiology system having a report generation system that is template driven and provides access to macros specific to a study as well as previously dictated entries for particular fields to allow reuse of standard text in a contextual manner. <CIT> discloses a method for creating a radiological report from radiological images, including a fitting of a structural template with a radiological image and using landmark data and pathological data to populate empty fields of the report template. <CIT> describes a method for radiologists to report both normal and abnormal findings using frequently-repeated phrases. <CIT> discloses a method for creating a medical report that provides a link list to whole images captured in a time-series manner.

Traditionally, free dictation is used, whereby the radiologist dictates his observations in a self-chosen format, style, order, and language. With speech recognition, the radiologist is able to see a written transcript of his spoken report, and to make changes if required.

While dictating, the radiologist views the images. With modern techniques like CT and MRI, large sets of images are obtained, and radiologists typically use a computer mouse to scroll through the images. In a classic set-up, the radiologist uses one hand to operate the computer mouse (to scroll through the set of images), and the other hand to hold a dedication tool that records the words spoken by the radiologist (a "dictaphone").

Disadvantages of free dictation are well recognised and include a lack of standardisation and a high variability in report content, structure and quality.

In an attempt to overcome these limitations, structured reporting has been proposed as an alternative to free dictation.

Structured reporting has three essential characteristics: (<NUM>) the report has a structured format, with paragraphs and headings, (<NUM>) the report has a consistent organisation (e.g., each of the relevant anatomic areas are described in the report), and (<NUM>) a standard language is used. Using reports with a structured format and a consistent organization is sometimes called "itemised reporting" or "standardised reporting".

In practice, in order to make a standardised / itemised report, the radiologists starts with a predefined reporting template (suitable for the type of exam that has to be reported) and makes changes where needed. The template may be a normal report, a report where some findings have to be added, or a checklist that guides the radiologist. The radiologist analyses the images and changes the template report where needed. Usually, a two-monitor configuration is used. For example, images can be viewed on the right monitor, and the report is shown (and can be edited) on the left monitor (see below).

Structured reporting (SR) (and also standardized reporting) is highly controversial in radiology. While most experts acknowledge that making structured / standardized reports would be beneficial for quality of care, acceptance of systems proposed has been slow or even non-existent.

The reason is that SR systems tend to distract radiologists from their main task: looking at images and simultaneously dictating a report. From the point of view of the reporting radiologist, free dictation is usually preferred over itemised reporting, because, in free dictation, the cognitive process of scrolling through images, interpreting images, and outputting the interpretation as dictated text is highly effective. In itemised reporting, on the other hand, the radiologist has to look away from the images every time an item has to be checked and/or edited in the report template; as such the radiologist is forced to look away from the images and cognitive workflow is interrupted. Switching attention between multiple- screens can induce oculomotor distress, such as headaches, eyestrain, blurred vision and general discomfort over time. The present invention aims to overcome the problems of the art.

The present invention relates to method for assisting a user in generating an itemised medical report from at least one medical image in accordance with claim <NUM>. The at least one medical image is displayed in a display area of single computer display unit. In the same display area, a sub-region containing a checklist specific to the one or more images is displayed. Items from the checklist can be de-selected. This checklist comprises a list of selectable items, each item representing an organ, structure, or abnormality that has to be checked by the user. Linked to each item in the checklist is a default statement that is a pre-prepared statement indicative of the normality of the item. The default statement is not displayed by default as part of the checklist. The user can select an item from the checklist for providing comments by dictation thereon responsive to an observation in the radiological image. At the end of the image analysis, an editable itemised medical report is generated containing each item of the checklist as a heading and either the dictated comment or the default statement associated with the item as an observation. The editable itemised medical report is rapidly and accurately generated. Information is confined to a single screen reducing the look away time for the user. The user experiences reduced oculomotor distress and improved concentration.

Accordingly, presently claimed in claim <NUM> is a method for assisting a user in generating an itemised medical report from at least one medical image (<NUM>), comprising the steps of:.

The steps of receiving and replacing may be optionally repeated for some of the other items (210a', 210a", 210a'") in the checklist.

The method may further providing the option of removing one or more items (210a', 210a", 210a'", 210a'", 210a'") from the checklist (<NUM>) before generating the editable itemised medical report (<NUM>).

The selected sub-area (<NUM>) of the medical image (<NUM>) may be contextually related to the selected item (210b).

The method may further comprise the step of generating for display in the display area (<NUM>) a selectable information button (<NUM> - <FIG>) disposed adjacent to or at least partially overlapping with one or more of the one or more selectable items (<NUM>), wherein selection of the information button (<NUM>) generates for display in the display area (<NUM>) pre-defined reference information relevant to the item.

The method may further comprise the option to the user to link a tag (<NUM>) to a selected item in the checklist. The method may further comprising the option to the user to link a tag (<NUM>) to a selected item in the checklist, which tag is different from the dictated comment (510b), may be selectable from a pre-defined list or may be user-defined comment, and is linked to the selected item (210b).

The method may further comprise the steps of.

The sub-region (<NUM>) may be implemented as a user-moveable overlay.

The method may further comprise the steps (prior to the above steps) of:.

The method may further comprise the steps of generating at least one of the selectable checklists in the set of the checklists using patient-specific information.

At least some of the items in the checklist (<NUM>) may be organised into groups. Items in the checklist that are organised into a group may be displayed and made available for receiving a dictated comment after the user has indicated a selection of that group.

Further described herein is a computer program or a computer program product adapted to perform a method as described herein, comprising a computer-readable data carrier comprising said computer program or computer program product.

Before the present system and method of the invention are described, it is to be understood that this invention is not limited to particular systems and methods or combinations described, since such systems and methods and combinations may, of course, vary. It is also to be understood that the terminology used herein is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.

The terms "comprising", "comprises" and "comprised of' as used herein are synonymous with "including", "includes" or "containing", "contains", and are inclusive or open-ended and do not exclude additional, non-recited members, elements or method steps. It will be appreciated that the terms "comprising", "comprises" and "comprised of" as used herein comprise the terms "consisting of", "consists" and "consists of'.

The term "about" or "approximately" as used herein when referring to a measurable value such as a parameter, an amount, a temporal duration, and the like, is meant to encompass variations of +/-<NUM>% or less, preferably +/-<NUM>% or less, more preferably +/-<NUM>% or less, and still more preferably +/-<NUM>% or less of and from the specified value, insofar such variations are appropriate to perform in the disclosed invention. It is to be understood that the value to which the modifier "about" or "approximately" refers is itself also specifically, and preferably, disclosed.

In the following passages, different aspects of the invention are defined in more detail. Each aspect so defined may be combined with any other aspect or aspects unless clearly indicated to the contrary. In particular, any feature indicated as being preferred or advantageous may be combined with any other feature or features indicated as being preferred or advantageous. Furthermore, the particular features, structures or characteristics may be combined in any suitable manner, as would be apparent to a person skilled in the art from this disclosure, in one or more embodiments. For example, in the appended claims, any of the claimed embodiments can be used in any combination.

In the present description of the invention, reference is made to the accompanying drawings that form a part hereof, and in which are shown by way of illustration only of specific embodiments in which the invention may be practiced. Parenthesized or emboldened reference numerals affixed to respective elements merely exemplify the elements by way of example, with which it is not intended to limit the respective elements. It is to be understood that other embodiments may be utilised and structural or logical changes may be made without departing from the scope of the present invention. The following detailed description, therefore, is not to be taken in a limiting sense, and the scope of the present invention is defined by the appended claims.

The present invention relates to method for assisting a user in generating an itemised medical report from at least one medical image. The method may be computer implemented, or implemented in a system or apparatus.

The at least one medical image (<NUM>) is displayed in a display area (<NUM>) of single computer display unit (<NUM>) as shown, for instance in <FIG>. In the same display area (<NUM>), a sub-region (<NUM>) containing a checklist (<NUM>) specific to the one or more images is displayed. This checklist comprises a list of selectable items (<NUM>), each item representing an organ, structure, or abnormality that has to be checked by the user. The user is typically a radiologist or trainee radiologist. As an example, for a CT scan of the abdomen, the items (<NUM>) in the checklist (<NUM>) may represent organs to be checked, for instance "liver", "pancreas", "spleen", "stomach", "kidneys", etc. It is noted that a single computer display unit (<NUM>) typically receives one set of data (e.g. image) signals through a single connecting cable. Where two computer display units are described herein, each display unit typically independently receives one set of data (e.g. image) signals through a single connecting cable i.e. there are two sets of data signals and two connecting cables in total.

Linked to each item in the checklist is a default statement (<FIG>, 510a', 510a", 510a‴, 510aʺʺ) that is a statement indicative of the normality of the item. It is a standard medical finding (of normality) which does not need further annotations nor explanations by the user. It is a pre-prepared statement. The statement is stored in a database. The default statement (510a', 510a", 510a‴, 510aʺʺ) is not displayed by default as part of the checklist (<NUM>). The default statement (510a', 510a", 510a‴, 510aʺʺ) is visible in the editable itemised medical report (<NUM>) eventually generated. It is understood that if an item in the checklist is not user-selected for providing a comment, the default statement (510a', 510a", 510a'", 510aʺʺ) is intended to appear in the editable itemised medical report (<NUM>).

For the example of <FIG>, the default statement linked to "liver" may state, for instance: "Normal size of the liver. Homogeneous aspect of the parenchyma, with normal density. No focal lesions. The portal and hepatic branches are patent. No bile duct dilatation". The default statement indicates that the liver is normal. The default statement (510a') is hidden text linked to each item is not displayed by default in the image display area during routine workflow. The default statement (510a') may be displayed by a simple action of the user e.g., mouseover as shown in <FIG>.

In some instances, the radiologist may not want to report on one or more items in the checklist (for example because the anatomical structure corresponding to an item in the checklist is not well seen on the images of a particular patient). In one embodiment of the invention, one or more item(s) can be removed from the checklist by a simple action (see figure). The selectable item (<NUM>) may be removable by providing and displaying next to the selectable item a "remove" icon which when selected removes the selectable item from display. For instance, in <FIG>, each selectable item (210a', 210a", 210a‴, 210a"") is provided with an adjacent "remove" icon (212a', 212a", 212a‴, 212a"") that is a cross (X). When an item is selected (e.g. <FIG>, 210b), for instance using a pointing device (e.g. mouse, digit), the item becomes active and the user can input user comments (<FIG>, 510b) related to the selected item (210b), for instance by dictation. The comments are typically visual observations pertinent to the medical image. The checklist (<NUM>) generated for display in the display area (<NUM>) may be updated with a visual marking (<NUM>) indicating the selected item (210b). The visual marking is a different marking from a non-selected item (e.g. 210a', 210a", 210a‴ in <FIG>). The item may be selected before or after input of report information. The inputted user comments (<FIG>, 510b) are stored in a storage medium (<NUM>) and linked to selected item (210b); it replaces the default statement (510aʺʺ). The other items of the checklist (210a', 210a", 210a‴) remain linked to the default statement (510a', 510a", 510a‴) i.e. to pre-prepared statement indicative of the normality of the item (<FIG>).

An exemplary workflow using the invention is as follows.

While scrolling through the images, the radiologist may detect one or several abnormalities in the stack of images. During image viewing, the radiologist starts to dictate user comments about a specific item that appears abnormal. At the end of the dictation, he indicates (e.g. by speech or by clicking on the item) which is the corresponding item in the checklist (210b), and gives a command (e.g. via speech or using button on microphone) to paste the dictated text (user comments) to the text field linked to that item. Alternatively, the "abnormal" item in the checklist may be "activated" (selected) before the dictation starts. The checklist (<NUM>) generated for display in the display area (<NUM>) is now updated with a visual marking (<NUM>) indicating the selected item (<FIG>, 210b) with a different marking from a non-selected item (210a', 210a", 210a‴). Once an item has been selected, it may retain a distinguishing visual marking to indicate that a user comment has been provided thereon.

The dictated comment (510b) relevant for the selected item is stored and linked to the selected item (210b) in the checklist. The other items of the checklist (210a', 210a", 210a‴) remain linked to the respective default statements (510a', 510a", 510a‴) i.e. to the pre-prepared statement indicative of the normality of the item (<FIG>).

Although not displayed in the display area (<NUM>), the dictated comment (510b) is now linked to the selected item (210b), and will be used instead of the default statement (510aʺʺ) for the eventual itemised medical report (<FIG>, <NUM>). It is an aspect of the invention that the dictated comment (510b) is simultaneously displayed dynamically on a second computer display unit as shown, for instance, in <FIG>.

If needed the radiologist repeats the procedure described above for other items in the checklist.

Upon receiving an input from the radiologist or other user, an editable itemised medical report is generated (<FIG>, <NUM>). This report contains all items in the checklist (210a', 210a", 210a‴, 210b) except those removed by the radiologist. For each item that has not been selected by the user, the default statement (510a', 510a", 510a‴) is used for the report. For each item that has been selected by the user, the default statement (510aʺʺ) is replaced by the dictated user comments (510b) provided by the user. In the example of <FIG>, the medical imaging report would have the format as shown in <FIG>. For items <NUM> to <NUM>, the default statement (510a', 510a", 510a‴) is used in the report. For Item <NUM>, the dictated text (510b) is used.

A more concrete example is given as follows, illustrated in <FIG>. A radiologist has to make a report of a CT study of the upper abdomen. As a simplification, it is assumed that the report has to contain comments on the following four organs only: liver, pancreas, spleen, kidneys. According to the description above, the radiologist scrolls through the images and the <NUM> relevant organs are included as items in the checklist (see <FIG>). While the radiologist considers the liver, pancreas, and spleen to be normal, he detects an abnormality in one of the kidneys and wants to describe the abnormality using dictation. The radiologist selects the item "kidneys" (<FIG>, 210b) either before or after the actual dictation and dictates the following sentence "The left kidney is normal. The right kidney contains several cysts and areas of parenchymal loss. " In this example, the radiologist does not detect any further abnormalities. During the process or after receiving an input from the radiologist indicating that the dictation is finished, the method provides an editable itemised medical report as shown in <FIG>.

The invention provides a solution for the current lack of implementation of itemised reporting in clinical practice. The report generated according to the method of the invention is a well-structured itemised report. However, unlike in solutions described in previous art, this report can be generated with minimal distraction of the user (radiologist). The only distraction from the ideal cognitive workflow (consisting of combined image viewing and dictating) is the need to give an indication to which organ in the checklist the dictated text has to be linked. Moreover, the invention saves time for the radiologist: his dictation does not have to include a description of normal organs (these descriptions are automatically generated); as such he can focus on the dictation of what is abnormal.

The invention makes use of a checklist that is displayed within the same display area (<NUM>) as the medical images (<NUM>), thus reducing the "look away time" for the radiologist, and that, at the same time, represents an itemised report. There may be a reduction in oculomotor distress, such as headaches, eyestrain, blurred vision and general discomfort over time. While displaying a full itemised standard report within the same area as the images would not be practical for the radiologist, the checklist as described above allows to combine the best of both worlds: the advantages of itemised reporting can be obtained with minimal or no workflow interruption.

In order to appreciate the difference with the current art, the classic process to make an itemised report in the case described above will be illustrated and compared with the workflow according to the invention. As mentioned above, medical images and templates for reporting are classically displayed on separate display areas (see <FIG>). This is done to allow maximum magnification of the images, which may be required for detection of subtle abnormalities. As illustrated in <FIG>, displaying both the itemised report and the images in the same display would be impractical. Both the images and the text of the report would be displayed at suboptimal size, and the left screen would be left unused.

Moreover, in order to link dictated text to a specific item in the itemised report, the radiologist has to try to find the relevant paragraph in the report, which is obviously more complicated than finding the relevant item in a checklist.

It is an aspect of the invention that the checklist is displayed in the same display area as the medical images. Because of the nature of a checklists, which comprises a list of items rather than extensive text or paragraphs, the checklist does not significantly interfere with optimal magnification of the medical images. Moreover, when an abnormality is detected, the relevant item in the checklist can be readily identified.

<FIG> further illustrates differences between current art and the present method in terms of interruption of the cognitive process of the radiologist. <FIG> illustrates the current art for standardized (or itemised) reporting. The radiologist starts with a template containing a normal report (left screen) and a screen displaying images (right screen). In step <NUM>, the radiologist analyzes the images and detects an abnormality. In step two, the radiologist has to look away from the screen displaying the images and try to find the relevant paragraph in the standard report. Also in step <NUM>, the radiologist has to indicate that he wants to dictate an observation in the standard report under the item "kidneys". In order to do so, he has to put the cursor of the dictation tool in the right place in the text field. Furthermore, he has to remove the standard text provided in the template. All this together represents a major workflow interruption. Finally, in step three, the radiologist describes the abnormality using dictation.

By comparison a workflow according to the present method is illustrated in <FIG>. Step <NUM> is identical as above. In step two, the radiologist simply clicks on the item "kidneys" in the checklist. This is immediately followed by the dictation (step <NUM>). The workflow interruption is negligible.

In clinical practice, there is usually more than one abnormality to be reported. Modern CT and MRI scanners produce hundreds of images per exam and small anatomical structures are displayed with exquisite detail. It is not uncommon that five or ten variants or abnormalities are reported during viewing images of a single study. It is obvious that in such a situation the invention provides a huge advantage in terms of workflow optimization.

According to one embodiment of the invention, the default statement (510a', 510a", 510a‴, 510aʺʺ) can be displayed before dictation in a display area separate from the image display area (eg on a separate screen as illustrated below).

In a further embodiment of the invention, the editable itemised medical report is displayed outside of the display area (<NUM>) of single computer display unit (<NUM>) as shown, for instance in <FIG>; the editable itemised medical report is displayed is displayed on a second computer display unit. The editable itemised medical report may be updated during the reporting process, i.e., default statement is replaced by the text dictated by the radiologist in the report.

In a further embodiment of the invention, the radiologist can select a sub-area (<NUM>) of the medical image (<NUM>); the image part contained in the selected sub-area can be copy/pasted or dragged (<NUM>) into the corresponding item in the checklist (instead of just clicking on the item) as illustrated, for instance, in <FIG>. The selected sub-area (<NUM>) of the medical image (<NUM>) may be contextually related to the selected item (210b). As such, two functions are combined: (<NUM>) the item (in the checklist) is selected and (<NUM>) the selected image part is linked to the selected item. This allows the radiologist to produce an itemised report illustrated with relevant images showing the abnormalities that are described. The image can be displayed in the report adjacent to the corresponding dictation (see <FIG>). All this can be done without any additional workflow interruption for the radiologist.

Another embodiment of the invention further comprises the step of generating for display in the display area (<NUM>) a selectable information button (<NUM> - <FIG>) disposed adjacent to or at least partially overlapping with one or more of the one or more selectable items (<NUM>), wherein selection of the information button (<NUM>) generates for display in the display area (<NUM>) pre-defined reference information relevant to the item.

The method may further comprise an option to the user to link a tag (<NUM>) to a selected item (<NUM>) in the checklist. A tag is a label that may be selectable from a pre-defined list, or a user-defined comment that may be dictated or entered using a manual-input device (e.g. keyboard, touch screen). It is different from the dictated comment (510b). A tag may be linked to the selected item (<NUM>), for example, by the method receiving (from the user) a selection of one from a plurality of labels. If the user does not take make any selection action, a default label may be assigned to the item (<NUM>) in the checklist. A tag may be linked to the selected item (<NUM>), for example, by the method receiving (from the user) a selection of one from three labels: "normal" (N), "anatomical variant" (V), or "pathologic" (P). If the user does not take make any selection action, the label "N" could be assigned by default to the item (<NUM>) in the checklist. The method may further comprise a step of generating for display in the display area (<NUM>) a selectable descriptive button (<NUM>) disposed adjacent to or at least partially overlapping with one or more of the one or more selectable items (<NUM>), wherein selection of the descriptive button (<NUM>) provides a label (i.e. a tag) to the item in the checklist. For instance in <FIG>, a button "V" has been selected in relation the item "kidneys". This could mean that the dictation provided by the radiologist contains a description of an anatomical Variant.

Another embodiment of the invention further comprises the step of generating for display in the display area (<NUM>) a selectable descriptive button (<NUM>) disposed adjacent to or at least partially overlapping with one or more of the one or more selectable items (<NUM>), wherein selection of the descriptive button (<NUM>) provides a label to the item in the checklist. For instance in <FIG>, a button "V" has been selected in relation the item "kidneys". This could mean that the dictation provided by the radiologist contains a description of an anatomical Variant.

In a further embodiment of the invention, after selection of an item in the checklist (e.g. <FIG>, 210b), one or more descriptive terms are displayed and may be selected by the user (see <FIG>, <NUM>). Selection of a descriptive term automatically generates a corresponding text in the draft report. In the example below, the item in the checklist could be, for instance, "achilles tendon", and selection of the button displaying "moderate" would generate a standard text "There is moderate thickening of the Achilles tendon" in the report. Accordingly the method may further comprise the steps of.

A computing device or system may also be provided configured for performing the method as described herein. The system may comprise circuitry configured performing the method as described herein. Typically the circuitry comprises a processor and a memory.

A computer program is also provided having instructions which when executed by a computing device or system cause the computing device or system to perform the method as described herein.

A computer readable medium may also be provided having stored thereon a computer program as described herein.

Claim 1:
A method for assisting a user in generating an itemised medical report from at least one medical image (<NUM>), comprising the steps of:
- generating for display and displaying in a display area (<NUM>) of single computer display unit (<NUM>) at least one of the medical images (<NUM>);
- generating for display and displaying in the same display area (<NUM>), a sub-region (<NUM>) containing a checklist (<NUM>) specific to the one or more images, comprising a list of selectable items (<NUM>), wherein each item (210a', 210a", 210a'", 210a'", 210a‴) in the checklist is linked to a default statement (510a' , 510a", 510a‴, 510aʺʺ) which default statement is by default not displayed in the same display area (<NUM>) and is a pre-prepared statement specific to the item indicating a normal medical finding for insertion into the itemised medical report;
- receiving from the user a dictated text comment (510b) for linking with a user-selected item (210b) of the checklist;
- replacing the default statement (510a"") linked to the user-selected item (210b) with the dictated text comment (510b);
- receiving an input indicating a user-selected sub-area (<NUM>) of the medical image (<NUM>);
- updating and generating for display in the display area (<NUM>) the checklist (<NUM>) wherein a thumbnail image (<NUM>) of the selected sub-area (<NUM>) is provided adjacent to or at least partially overlapping with the selected item (210b); and
- generating an editable itemised medical report (<NUM>) containing items (210a', 210a", 210a'", 210a‴) of the checklist (<NUM>), and
- the default statement (510a', 510a", 510a'") linked to each item (210a', 210a", 210a'", 210a'") not selected by the user for comment, and
- dictated text comment (510b) linked to each item (210b) selected by the user,
wherein
- the editable itemised medical report (<NUM>) also comprises one or more thumbnail image(s) of the selected sub-area(s) (<NUM>) associated with the selected item(s) (210b).