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Radiology Studies
Daniel J. Vreeman, PT, DPT, MSc
Associate Research Professor, Indiana University School of Medicine
Associate Director for Terminology Services, Regenstrief Institute, Inc
@djvreeman
2016
Overview
1. Overview of Radiology content in LOINC
2. LOINC Radiology Model (How we name
imaging studies)
3. Evolution via collaboration with RSNA
LOINC Diagnostic
Imaging (Radiology)
In diagnostic imaging,
LOINC provides codes for:
Ordered (and returned) imaging study
Sections within a report
Measurements or observations made
This is our
Modality
# LOINC Terms
CT
725
Mammography
145
MRI
870
Nuclear Medicine
522
Ultrasound
509
XR
2000
Fluoroscopy
646
Measurements / Observations
38261-4
38264-8
53626-8
8294-1
LOINC Code
Component
Property Measured
Pt
Timing
Shoulder
System
Doc
Scale
XR
Method
Component Structure
1st Subpart - View
Views descriptor
# of views
Views, Multisection,
Views for leg length
,
3, greater than 3
Beam orientation
AP, lateral
Body position
Prone
Component Structure
1st Subpart - Interventional
Examples
Guidance for biopsy:Find:Pt:Breast:Doc:Mam
Guidance for anesthetic block injection:Find:Pt:Celiac plexus:Doc:CT
Guidance for drainage:Find:Pt:Extremity:Doc:US
Component Structure
2nd Subpart - Challenge/Precondition
<timing/existence><substance given><route>
Timing/existence
Substance given
contrast, adenosine,
Tc-99m Sestamibi
Route
IV, PO
System
The anatomic area being visualized
Examples
24627-2
Chest CT
24590-2
Brain MRI
25011-8
System Structure
System^Super System
Super System
Patient is the default
Used to indicate:
blood product unit, bone marrow donor, fetus
Method
Modality
<modality><modality subtype>
Modality
CT, MR, XR
Subtype
Portable studies
General rule: only create when the
image produced by a portable study
is different than the normal study.
Classic example:
Portable chest x-ray studies are typically taken at a
shorter distance than those taken in the radiology
department. We have separate codes for these.
Angiography Abbreviations
LOINC uses these methods: XR.fluor.angio (soon to
be RF.angio), MR.angio, and CT.angio
MRA and CTA can refer to studies of arteries, veins, or
both. Included as synonyms of MR.angio and CT.angio.
MRV and CTV are synonyms where the method is
MR.angio or CT.angio and the system contains Vein
or Veins.
Side note: these are broken in current release
Evolving Conventions
Collaboration with RSNA to develop a
unified LOINC + RadLex Playbook
terminology
Overall Goal:
Produce a single unified source of
names and codes for radiology
procedures with a cooperative
governance process.
Main Deliverables
Developing a Unified Model for Radiology
Procedure Names
Mapping the attribute-values between each
terminology (i.e. LOINC Parts to RadLex RIDs)
Mapping between RadLex RPIDs and LOINC codes
Creating new LOINC codes where needed
Process
Model unification reviewed all modalities
Attributes can employ a syntax
Have made excellent progress on resolving issues
(always a few remaining edge cases)
Developed a User Guide covering all attributes:
definitions, usage notes, and identifying weird stuff
Mapping focus progressing through modalities
LOINC-speak
Method
Anatomy
System
View
Component
Component
Guidance
Component
Pharmaceutical
Challenge*
Subject
Super System
Pharmaceutical
Modality
Pharmaceutical.Substance Given
Modality.Subtype
Pharmaceutical.Route
Anatomy
Anatomic Location.Region Imaged
Pharmaceutical.Timing
Guidance
Guidance for.Presence
Anatomic Location.Laterality.Presence
Guidance for.Approach
Anatomic Location.Laterality
Guidance for.Action
View
Guidance for.Object
View.Aggregation
View.View type
Subject
View.Maneuver
Feedback Welcome
Body Region
Lots of discussion!
Content Changes
Changes underway in each release
CT, MR, US, NM and PT done!
Last release:
200 new terms
1500 terms edited
LOINCLongC
PartNumber PartName
ommonName
PartType
24628-0
Chest CT W
contrast IV
LP200088-5
Rad.Pharmaceutical.Timing
24628-0
Chest CT W
contrast IV
LP200085-1
Rad.Pharmaceutical.Substanc
e Given
24628-0
Chest CT W
contrast IV
LP200078-6
24628-0
Chest CT W
contrast IV
24628-0
24628-0
PartSeq
RID
Order
PreferredName
RPID
LongName
1 RID49853 W
RPID18
CT Chest w IV
Contrast
Contrast
RPID18
CT Chest w IV
Contrast
Rad.Pharmaceutical.Route
IV
1 RID11160 intravenous
RPID18
CT Chest w IV
Contrast
LP199962-4
Rad.Anatomic
Location.Region Imaged
Chest
1 RID1243
Thorax
RPID18
CT Chest w IV
Contrast
Chest CT W
contrast IV
LP200067-9
Rad.Modality
CT
RPID18
CT Chest w IV
Contrast
Chest CT W
contrast IV
LP200088-5
Rad.Pharmaceutical.Timing
1 RID49853 W
RPID18
CT Chest w IV
Contrast