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. 2015 Oct;28(5):528-36.
doi: 10.1007/s10278-015-9787-3.

Conversion of Radiology Reporting Templates to the MRRT Standard

Charles E Kahn Jr  1 , Brad Genereaux  2 , Curtis P Langlotz  3
Affiliations

Conversion of Radiology Reporting Templates to the MRRT Standard

Charles E Kahn Jr et al. J Digit Imaging. 2015 Oct.

Abstract

In 2013, the Integrating the Healthcare Enterprise (IHE) Radiology workgroup developed the Management of Radiology Report Templates (MRRT) profile, which defines both the format of radiology reporting templates using an extension of Hypertext Markup Language version 5 (HTML5), and the transportation mechanism to query, retrieve, and store these templates. Of 200 English-language report templates published by the Radiological Society of North America (RSNA), initially encoded as text and in an XML schema language, 168 have been converted successfully into MRRT using a combination of automated processes and manual editing; conversion of the remaining 32 templates is in progress. The automated conversion process applied Extensible Stylesheet Language Transformation (XSLT) scripts, an XML parsing engine, and a Java servlet. The templates were validated for proper HTML5 and MRRT syntax using web-based services. The MRRT templates allow radiologists to share best-practice templates across organizations and have been uploaded to the template library to supersede the prior XML-format templates. By using MRRT transactions and MRRT-format templates, radiologists will be able to directly import and apply templates from the RSNA Report Template Library in their own MRRT-compatible vendor systems. The availability of MRRT-format reporting templates will stimulate adoption of the MRRT standard and is expected to advance the sharing and use of templates to improve the quality of radiology reports.

Keywords: Infrastructure; Integrating the Healthcare Enterprise (IHE); MRRT; Radiology reporting; Reporting; Standards; Structured reporting.

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Figures

Fig. 1
Fig. 1
Part of the RELAX NG encoding of the CT Brain report template, showing the “Findings” section. Note that blocks such as “Extra-axial spaces” are incorporated by reference; the <ref> tag points to the block of RELAX NG code enclosed by the corresponding <define> tag
Fig. 2
Fig. 2
Schematic diagram depicts the semi-automated process of converting the reporting templates into MRRT. The manual editing and editorial review steps required expertise in radiology and/or HTML5
Fig. 3
Fig. 3
Portion of the XSLT stylesheet used to transform a RELAX NG reporting template into MRRT
Fig. 4
Fig. 4
MRRT header section for the CT Brain reporting template. Note the Dublin Core metadata
Fig. 5
Fig. 5
Conversion of RELAX NG to MRRT. Corresponding portions of the template for CT Brain show how the RELAX NG code for the report element “Cerebellum” has been converted. The upper panel shows the RELAX NG encoding, in which the data element incorporate a <choice> tag that allows either the element “Normal” or free text. The RadLex IDs for the terms Cerebellum (RID6815) and Normal (RID13173) are shown. The lower panel shows the <head> and <body> sections of the corresponding MRRT document. Note that the RadLex code for “Cerebellum” is preserved in the <coded_content> section of the document header, but not the encoding for “Normal.”
Fig. 6
Fig. 6
A portion of a schema for MRRT, written in RELAX NG compact syntax, used to validate the syntax of converted templates
Fig. 7
Fig. 7
MRRT encoding of part of the Findings section of the CT Brain reporting template
Fig. 8
Fig. 8
The MRRT-encoded CT Brain reporting template, as rendered in a web browser. MRRT uses HTML5 to allow viewing of data-entry elements in a web browser but does not require that a clinical reporting system support web browser capabilities
See this image and copyright information in PMC

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