Ramin Javan MD, Presenter: Nothing to Disclose

Mustafa Rifaat Bashir MD, Abstract Co-Author: Research support, Bracco Group Research support, Siemens AG Consultant, Bayer AG Consultant, Siemens AG

Decision support tools will likely become an integral part of many aspects of radiology in the near future, especially as part of the Imaging 3.0 movement by the ACR. In the field of breast imaging, standardized management and recommendations have been guided by the BI-RADS. Recently, an effort to standardize classification of liver lesions in the setting of cirrhosis has lead to the development of LI-RADS. 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 ideally 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 an 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 clipboard for insertion into the radiology report. A step-wise algorithm as well as a tabulated algorithm with the exact appearance as the LI-RADS v2013.1 is developed. This user interface functions based on the active/inactive state of each command point and includes features such as 'educational mode', 'image atlas' and allows for 'backtracking’ through the algorithm, lending more control to the user, which especially proves useful for training purposes and in practical situations.

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. The fundamentals behind the design of such tools can also be applied elsewhere, such as a PACS plug-in or a web-based application.

A PC-based stand-alone decision support tool was designed and implemented, for simplifying the use of the newest version of LI-RADS. 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.

Javan, R, Bashir, M, A Stand-alone Decision Support Tool for Managing Liver Lesions on CT and MRI Based on the LI-RADS v2013.1 Criteria.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13016093.html