Tools of the Trade - Radiologists' Tools

In this concept, we will see what a clinical workflow looks like. As you watch me inspect an MR study of a brain, think of where an AI technology would fit in here and how I would interact with it.

We have observed the use of a clinical-grade medical image viewer system used by a clinician to analyze a radiological study. Note the following things that happened in this walkthrough:

• Inspection of several MR pulse sequences side-by-side, drawing upon the fact that tissues present differently in different types of series
• Measurement of a lesion was taken. Note how exactly the measurement was done - through taking two linear measurements of the largest diameters. This is a fairly standard way of taking measurements of lesions
• Image inspection tools were used - zoom, pan and window center/width adjustments
• The analysis ended with a “report” - a formal description of important findings on the image. Such a report would be converted into text, stored in EHR over HL7 and presented to the ordering physician when they review the results of the test

Note some challenges that were immediately seen as well:

• It is not that easy or practical to measure volumes of tumors. Such measurement was substituted by several linear measurements
• I was looking for a change of the tumor over time, but it was not really easy to see what exactly changed as images belonged to different studies and were not exactly matching up, spatially