Ramin Javan MD, Presenter: Nothing to Disclose

Claude B. Sirlin MD, Abstract Co-Author: Research Grant, Bayer AG Research Grant, General Electric Company Research Grant, Bracco Group Contract, Isis Pharmaceuticals, Inc Contract, Pfizer Inc Speakers Bureau, Bayer AG Consultant, Bayer AG Medical Advisory Board, Bayer AG Consultant, Merck & Co, Inc Medical Advisory Board, General Electric Company

Mustafa Rifaat Bashir MD, Abstract Co-Author: Research Grant, Bracco Group Research Grant, Siemens AG

A simple Windows-based prototype of a stand-alone decision support tool was designed and implemented, for simplifying the use of the LI-RADS criteria. We hope that this tool encourages the widespread use of this recently developed scheme by radiologists and aids in bringing consistency to the recommendations made to clinicians.

Decision support is likely to be incorporated into many aspects of radiology in the near future. With the current boom in health IT and government’s emphasis on meaningful use, emerging decision support tools can utilize a vast array of patient data to allow for better decision making and enabling evidence-based radiology. For many years, standardized management and recommendations for mammography have been guided by the BI-RADS lexicon and criteria. Recently, a similar system has been developed with the support of the American College of Radiology (ACR), for classification of liver lesions in the setting of cirrhosis. This method aims to add consistency to radiologists’ interpretations and provides a lexicon of terms, decision algorithms, and an atlas of imaging findings.

A decision support tool must be simple, user friendly, intuitive, and preferably work in a step-wise fashion, minimizing the possibility of confusing the user with an excessive number of choices, features, and definitions. Microsoft Visual Basic 2010 was implemented for creating a prototype application that allows the user to arrive at the appropriate LI-RADS category and therefore a standardized recommendation, which can then be copied to the Windows operating system clipboard for insertion into the Radiology report. The flowcharts and definitions that are used are also available under separate tabs.

Presumably, decision support tools can successfully be implemented from decision flowcharts in any aspect of radiology. Ideally, an application can be created once the decision tree is provided as its input, as long as the flowchart data and the 'conditional' boxes or 'if' statements are indicated, similar to a programmer's flowchart. The fundamentals behind the design of such a tool can also be applied elsewhere, such as a PACS plug-in or a web-based application.

Javan, R, Sirlin, C, Bashir, M, A Stand-Alone Decision Support Tool for Managing Liver Lesions on CT and MRI, based on the ACR-supported LI-RADS 1.0 Criteria.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12022119.html