F.3.3 Example 3: Lung Nodule Detection, Temporal Differencing with Findings

The patient in Example 2 returns for another chest radiograph. A more comprehensive chest CAD device processes the current chest radiograph, and analyses are performed that determine some temporally related content items for Composite Features. Portions of the prior chest CAD report (Example 2) are incorporated into this report. In the current chest radiograph the lung nodule has increased in size.

PRIOR PROJECTION CHEST [pic]
CURRENT PROJECTION CHEST [pic]

Figure F.3-8: Chest radiographs as Described in Example 3

Italicized entries ( xxx ) in the following table denote references to or by-value inclusion of content tree items reused from the prior Chest CAD SR instance (Example 2).

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1 Chest CAD Report 4100

While the Image Library contains references to content tree items reused from the prior Chest CAD SR instance, the images are actually used in the chest CAD analysis and are therefore not italicized as indicated above.

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.1 Image Library 4100
1.1.1 IMAGE 1 4020
1.1.1.1 Image View Postero-anterior 4020
1.1.1.2 Study Date 20000101 4020
1.1.2 IMAGE 2 4020
1.1.2.1 Image View Postero-anterior 4020
1.1.2.2 Study Date 19990101 4020

The CAD processing and findings consist of one composite feature, comprised of single image findings, one from each year. The temporal relationship allows a quantitative temporal difference to be calculated:

Node Code Meaning of Concept Name Code Meaning or Example Value TID
1.2 CAD Processing and Findings Summary All algorithms succeeded; with findings 4101
1.2.1 Composite Feature Abnormal Opacity 4102
1.2.1.1 Composite Feature Modifier Nodule 4102
1.2.1.2 Rendering Intent Presentation Required: … 4102
1.2.1.3 Algorithm Name “Nodule Change” 4019
1.2.1.4 Algorithm Version “V2.3 4019
1.2.1.5 Composite Type Target content items are related temporally 4103
1.2.1.6 Scope of Feature Feature detected on multiple images 4103
1.2.1.7 Certainty of Feature 85% 4103
1.2.1.8 Difference in size 2 cm 4103
1.2.1.8.1 Reference to Node 1.2.1.9.8 4103
1.2.1.8.2 Reference to Node 1.2.1.10.8 4103
1.2.1.9 Single Image Finding Abnormal Opacity 4104
1.2.1.9.1 Single Image Finding Modifier Nodule 4104
1.2.1.9.2 Rendering Intent Presentation Required: … 4104
1.2.1.9.3 Tracking Identifier “Watchlist #1” 4108
1.2.1.9.4 Algorithm Name “Lung Nodule Detector” 4019
1.2.1.9.5 Algorithm Version “V1.3 4019
1.2.1.9.6 Center POINT 4107
1.2.1.9.6.1 Reference to Node 1.1.1 4107
1.2.1.9.7 Outline POLYLINE 4107
1.2.1.9.7.1 Reference to Node 1.1.1 4107
1.2.1.9.8 Diameter 4 cm 1400
1.2.1.9.8.1 Path POLYLINE 1400
1.2.1.9.8.1.1 Reference to Node 1.1.1 1400
1.2.1.10 Single Image Finding Abnormal Opacity 4104
1.2.1.10.1 Single Image Finding Modifier Nodule 4104
1.2.1.10.2 Rendering Intent Presentation Required: … 4104
1.2.1.10.3 [Observation Context content items] 4022
1.2.1.10.4 Algorithm Name “Lung Nodule Detector” 4019
1.2.1.10.5 Algorithm Version “V1.3 4019
1.2.1.10.6 Center POINT 4107
1.2.1.10.6.1 Reference to Node 1.1.2 4107
1.2.1.10.7 Outline POLYLINE 4107
1.2.1.10.7.1 Reference to Node 1.1.2 4107
1.2.1.10.8 Diameter 2 cm 1400
1.2.1.10.8.1 Path POLYLINE 1400
1.2.1.10.8.1.1 Reference to Node 1.1.2 1400
1.3 Summary of Detections Succeeded 4100
1.3.1 Successful Detections 4015
1.3.1.1 Detection Performed Nodule 4017
1.3.1.1.1 Algorithm Name “Lung Nodule Detector” 4019
1.3.1.1.2 Algorithm Version “V1.3 4019
1.3.1.1.3 Reference to node 1.1.1 4017
1.4 Summary of Analyses Succeeded 4100
1.4.1 Successful Analyses 4016
1.4.1.1 Analysis Performed “Temporal correlation” 4018
1.4.1.1.1 Algorithm Name “Nodule Change” 4019
1.4.1.1.2 Algorithm Version “V2.3 4019
1.4.1.1.3 Reference to node 1.1.1 4018
1.4.1.1.4 Reference to node 1.1.2 4018