Development of a methodology for structured reporting of information in echocardiography

In order to conduct research relying on ultrasound images, it is necessary to access a large number of relevant cases represented by images and their interpretation. DICOM standard defines the structured reporting information object. Templates are tree-like structures which offer structural guidance in report construction.

Laying the foundations of a structured reporting methodology in echocardiography, through the generation of a consistent set of DICOM templates.

We developed an information system with the ability of managing echocardiographic images and structured reports. In order to perform a complete description of the cardiac structures, we used 1900 coded concepts organized into 344 contexts by their semantic meaning in a variety of cardiac diseases.

We developed 30 templates, with up to 10 nesting levels. The list of templates has a pyramid-like architecture. Two templates are used for reporting every measurement and description: "EchoMeasurement" and "EchoDescription". Intermediate level templates specify how to report the features of echoDoppler findings: "Spectral Curve", "Color Jet", "Intracardiac mass". Templates for every cardiovascular structure include the previous ones. "Echocardiography Procedure Report" includes all other templates. The templates were tested in reporting echo features of 100 patients by analyzing 500 DICOM images.

The benefits of these templates has been proven during the testing process, through the quality of the echocardiography report, the ability to argue and to link every diagnostic feature to a defining image and by opening up opportunities for education, research. In the future, our template-based reporting methodology might be extended to other imaging modalities.