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Multimedia Radiology Reports Are More Efficient in Tumor Burden Assessment

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Multimedia Radiology Reports Are More Efficient In Tumor Burden Assessment


Tumor burden assessment process in cancer patients under clinical trials is objective, requires identification and measurement over time of metastatic selected target lesions on cross sectional images. Most of the oncologists at the NIH Clinical Center use RECIST 1.1 (Response Evaluation Criteria In Solid Tumors) to assess therapeutic response. They used to either extract measurements buried in text only radiology reports or measure independently, resulting in inefficiency, duplicated efforts, hence discrepancies and errors.

We improved report content and tumor burden assessment using multimedia reporting and a radiologist assistant and show hyperlink usage in body CT radiology reports during our first year of experience with multimedia radiology reporting. 

Materials and Methods:

We estimated time needed to extract target lesion measurements from multimedia and text-only reports of CT scans from patients with metastatic genitourinary cancer enrolled in two therapeutic trials.

Also, we assessed radiologist hyperlink usage after our PACS upgrade in Feb 2015.


Hyperlink usage by radiologists in the year following the PACS upgrade that included hyperlink capability, increased from 5% in February 2015 to 88% in April 2016. Universal adoption by body radiologists support improved efficiency. 


Multimedia radiology reports that include hyperlinks that direct clinicians to annotated images, tables of measurements with automated assessment calculations that are exportable and graphs showing tumor burden over time, are more informative and efficient for radiologists and oncologists.

Radiologists quickly adopted universal use of hyperlinks in multimedia radiology reports, supporting time savings.



1.EisenhauerEA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumors: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228-247.
2.Kahn CE, Langlotz CP, Burnside ES, et al. Toward best practices in radiology reporting. Radiology 2009;252(3): 852-856.
3.Machado LB, Apolo AB, Steinberg SM, Folio LR. Multimedia-Enhanced Radiology Reports Improve Target Lesion Selection and Measurement Concordance, and Are More Efficient in Genitourinary Cancer Trials. Oral presentation. ARRS. April 19, 2016. LA,CA.
4.Folio LR, Choi MM, Solomon JM, et al. Automated Registration, Segmentation, and Measurement of Metastatic Melanoma Tumors in Serial CT Scans. Academic Radiology 2013;20(5):604-613.
5.Folio LR, Nelson CJ, Benjamin M, Ran A, Engelhard G, Bluemke DA. Survey Quantitative Radiology Reporting and Tumor Metrics: Survey of Oncologists and Radiologists. AJR 2015;205(3):W233-W243.


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