Rad Tech Minutes 2023-11-13-17

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Monday, November 13, 2023

Attendees: Andrei Leontiv (Visage), Wim Corbijn, (Philips), Chris Melo, (Philips), Ana Kostadinovska (Philips), Steve Nichols (GE), Antje Schroeder (Siemens), John Paulette (Rad AI), Kinson Ho (Tempus), Kevin O'Donnell (Canon), Sean Doyle (Hyperfine), Natalia Farish (ACR), Brian Bialecki (ACR), Chris Roth M.D., David Kwan (Insygnia), Lynn Felhofer (RAD TPM), TeRhonda McGee (RSNA), Jaime Dulkowski (RSNA), Chris Carr (RSNA)

Guests: Rob Ferre M.D., Rachel Liu M.D. (ACEP), Kevin Little (OSU)

  • A1: 8:45am-9:00am Administrative Time
  • S0: 9:00am-9:30am: Agenda work plan review
  • S1: 9:30am-10:30am: ACEP POCUS update (Steve Nichols)
    • See these slides: ACEP EBIW POCUS Workflow Update
    • This working group will continue to meet weekly; currently working on use cases, will especially like to consult with IHE as Vol 2 transactions will be identified to be used in the workflow. Steve and Kevin will continue to keep IHE RAD updated on progress. We can anticipate scheduling consultation tcons in the future with IHE RAD Tech.
  • S2: 10:45am-12:15pm: Maintenance
    • See full list of Maintenance topics
    • From Top Ten list:
      • CP-RAD-475 Extensions to RAD-107 for IMR (Kinson) - we reviewed and updated the content. This CP is approved as Completed and ready for ballot, pending updates agreed to during discussion
      • CP-RAD-523-03 Clarify display of DBT images (Steve) - we updated the text to clarify the requirements in a different section. This CP is approved as Completed and ready for ballot,
      • CP-RAD-501 WIA – RAD-129 fix in Expected Actions (Steve) - we reviewed and updated the content. Steve will make the recommended edit to the Enterprise Identity Table in RAD-14; we will review those updates this week to prepare this for ballot.
    • Other CPs ready for committee review:
      • CP-RAD-479-01 - RAD-60 - update reason codes reference to DICOM (Lynn) - reviewed and approved as Completed pending update to rationale.
  • A2: 1:15pm-1:30pm: Maintenance
    • Other CPs ready for committee review:
      • CP-RAD-463 - Add RDSR Display option in REM (Kevin) - status update: This is now separated into 2 CPs, including CP-RAD-525 Add EMR Extract option in REM. These 2 CPs remain Assigned & Kevin will bring back to RAD Tech for review in the future.
      • CP-RAD-496-01 - Missing arrow in SWF.b actor/transaction diagram (Lynn) - reviewed, updated, and approved as Completed.
  • S3: 1:30pm-3:00pm: Imaging Diagnostic Report (IDR)
    • Discussion of IDR use cases
    • During initial profile development, the most recent version of IDR will be kept in this folder in google drive. (Note: google drive is used for doc storage, NOT for editing)
    • Later, it is anticipated that this content will become a FHIR IG developed in this Github repository at https://github.com/IHE/RAD.IDR
  • S4: 3:15pm-4:45pm: Reject Analysis (RAM)
  • A3: 4:45pm-5:00pm: Administrative Time

Tuesday, November 14, 2023

Attendees: Andrei Leontiv, David Kwan, Wim Corbijn, Ana Kostadinovska, Brian Bialecki, Sean Doyle, Antje Schroeder, Wim Corbijn, Kinson Ho, Steve Nichols, Kevin O'Donnell, John Paulett, Yasunari Shiokawa-san (Salt, IHE-J), Jaime Dulkowski, TeRhonda McGee, Lynn Felhofer

Guests: David Goyard, Stephane, Nicolas Dehouck (Incepto), Natalia Farish, Kevin Little

  • A1: 8:45am-9:00am Administrative Time
  • S1: 9:00am-10:30am: Appropriateness of TID 1500 for AI Results (Antje, Sean)
    • Refer to this presentation with notes from Antje
    • Sean pointed out the issue encoding with being unable to encode classification (i.e. confidence, certainty...) of findings within TID 1500. Oncology has use cases that can inform this work for us. Kevin noted that AI cannot necessarily apply a certainty value to a finding, but AI can report how close the current result is to its training set. The AIR profile has open issue #34 with an initial write-up on this topic. We will likely need to convene a working group to address this.
    • Brian questioned whether using TID 1500 is the right solution; perhaps consider using FHIR R5 Observation / ImagingSelection, instead. There was some discussion of this future direction, but Andrei asked that that discussion of this future consideration be deferred and that we spend the time i this session specifically on how to get guidance for current challenges on encoding AI results in TID 1500.
    • David G. reported that they have chosen DICOM SR for encoding AI Results because a goal is to have the AI output in the PACS. The problem they have encountered that the PACS will not accept and enable viewing and editing of the SR content. Brian noted that an additional challenge is when there are many AI-related SRs in the PACS, which are relevant for the radiologist.
    • Sean reported that the main challenge workflow issue
    • Antje recommended perhaps making the TID 4xxx (Mammo CAD SR) templates more general.
    • Kevin pointed to the AI Result Tree encoding specification and examples in the AIR Profile
    • Encoding of results status -- Kevin pointed to Open Issue #32 in AIR.
    • Examples:
      • Sean pointed out that good examples are really valuable. He suggested a Github repository of examples.
      • Antje said targeted examples that demonstrate key features (AI outputs / primitives) would be good to produce.
    • Post discussion actions to address. Create ad-hoc working groups to address these topics.:
      • Looking into alternatives for derived measurements (temporal, spacial)
      • Flavors of certainty
      • Workflow (accept...reject...). Perhaps keep a library of patterns of usage of AI algorithms.
      • Be sure to engage with the AIGI task force in Europe (Marc Kammerer and others)
      • Bring this topic up at the RAD meeting at RSNA. For future RAD Tech meetings, include an update from these working groups as a sub-topic for maintenance.
  • S2: 10:45am-12:15pm: Imaging Diagnostic Report (IDR)
      • Discuss and add details to the Concepts section in Vol e
      • Discussion of HL7 V2 export option (see notes in IDR open issue #2). We will provide guidance in the profile in a hybrid environment section in Vol 1 concepts, but not a named option.
  • A2: 1:00pm-1:30pm: Administrative Time
    • Connectathon-related...
      • Summary of RAD testing at 2023 Connectathon
      • 2024 Connectathons: Feb 19-23 @ RSNA Headquarters in Oak Brook and June 3-7 in Trieste, Italy
  • S3: 1:30pm-3:00pm: Reject Analysis
    • Discussion of Open Issues in the document
    • Work on actor requirements
  • S4: 3:15pm-4:45pm: Imaging Diagnostic Report (IDR)
  • A3: 4:45pm-5:00pm: Administrative Time

Wednesday, November 15, 2023

Attendees: John Paulett, Kevin O'Donnell, Steve Nichols, Ana Kostadinovska, Wim Corbijn, Antje Schroeder, Kinson Ho, David Kwan, Kevin O'Donnell, Lynn Felhofer, Jaime Dulkowski, TeRhonda McGee, Chris Carr

Guests: Jason Malobicky (Rad AI), Natalia Farish, Charles Parisot

  • A1: 8:45am-9:00am Administrative Time
  • S1: 9:00am-10:30am: Imaging Diagnostic Report (IDR)
    • Discussion of Vol 1 concepts with focus on the structure of the FHIR resources
  • S2: 10:45am-12:45pm: Maintenance
    • Review New Submitted CPs
      • Discussion of the WIA/WIC option for XCA-I (Steve, Charles)
    • Review / update Assessment of RAD profiles for promotion or retirement
      • TO DO for RAD Tech -- communicate candidate FT profiles to national deployment committees as a 'last call' for CPs
      • Include review of (old) criteria on the wiki for Final Text Process and retirement
      • Discussion -- how to help new audience consumer RAD profiles. WIKI content is too technical for this audience. C
    • If time, see Thurs maintenance topics
  • A2: 1:00pm-1:30pm: Administrative Time
  • S3: 1:30pm-2:45pm: Imaging Diagnostic Report (IDR)
  • S4: 3:00pm-4:00pm: Imaging Diagnostic Report (IDR) - Clinical Consult
  • S5: 4:00pm-4:45pm: Reject Analysis
  • A3: 4:45pm-5:00pm: Administrative Time
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