Study/Serie/Object with Structured Report

[email]erik_campos@entelchile.net[/email] wrote:[color=blue]
> I'm dealing with this situation:
>
> I have a study, with two or more series (different modalities).
>
> How many structured reports the reporting station should create? only
> one with references to both series of images or two reports for each
> series of images. Should a final report be included with the final
> conclusion?
>
> How should I link the series with reports. I know they both must have
> the same study information, but what about the case in which I have
> more than one report and more that one serie.
>[/color]
There seems to be an implicit assumption in your question that series
of different modalities in the same study must be different requested
procedures requiring different reports. While these different series
may well reflect multiple different requested procedures, it is the
requested procedures, not the series themselves which would drive what
reports need to be generated. That said, just as a DICOM study can
contain series from different modalities, so too can a single report
cover multiple different requested procedures AND the series which make
up the evidence documents for those requested procedures. Recognize too
that you can have cases where there is only a single series for which
multiple requested procedures apply to different subsets of images in
the series. Or, you can have multiple series and corresponding subsets
of images from the each of the series apply to different requested
procedures.

The "classic" group procedure case fits this model. Consider a CT study
from the shoulders to the pelvis consisting of a "without contrast" and
a "with contrast" series. Three requested procedures need to be
reported for the chest, abdomen, and pelvis regions. For each of the
regions, images from both the "with" and "without" series need to be
reported. You can come up with other scenarios which more closely
resemble your question --i.e. your example could be for CT&PET or CT&MR
series of the same anatomic region all contained in a single study. In
any case, the principle is the same. It is the requested procedures
which drive the reporting requirements not the organizational structure
of the images as generated by the acquisition procedure(s).

Whether you generate a single report for all the requested procedures
(and series) covered in a study; or generate multiple reports, one for
each requested procedure, the SR is supposed to contain references to
a) the performed procedures which generated the images, b) the
requested procedures which caused the acquisitions procedures to be
performed and c) the evidence documents (ie the images and subsequent
analytic objects) evaluated in the performance of the report.

The system receiving the report is likely going to be the one which
will determine whether or not you need to generate multiple reports or
a single report. If there is an automated system receiving the
report(s) it is my guess that the receiving system is going to want a
report for each procedure. However, if the receiving system is able to
pull a list of requested procedures out of the single report, you could
do only one; but for the most part, its a one-to-one world out there.

Back to your original question - a single study with multiple series
from different modalities - which set of images do you reference when
you are generating multiple reports. Although with a modality worklist,
it is not THAT difficult to make one of those studies come into being,
one does have to go through some hoops to make it happen. It is not
something the modalities would tend to do all on their own. The fact
that the series from different modalities are being combined into a
single study implies someone either wanted them reported together; or,
if they did in fact, want them reported separately, they want both
series to be visible to the interpreting physician as a reference when
reporting each one separately.

In this latter case, even though the "other" series does not contain
the images of the current procedure being reported, the images from
that other series are contributing to the conclusions the interpreting
physician is drawing. So, it is my opinion you should reference the
full set of images in the study for both reports even when you are
generating separate reports.

So if you for example had a CT&MR study of the head, there should be a
CT requested procedure and an MR requested procedure. Each SR generated
would reference the full set of images but the CT report would
reference only the CT requested procedure and the MR report would
reference only the MR requested procedure.

I didn't understand your question about the referencing the final
reports in the final conclusion.