The Importance of Radiology and Pathology Communication in the Diagnosis and Staging of Cancer: Mammography as a Case Study. 5.4 Progress towards addressing the needs of radiology and pathology workflows


Both specialties recognize that there are gaps in their respective workflows in terms of optimal communication and discordance resolution. Each specialty is taking steps to address these issues and limitations. In pathology, there are standardized cancer reporting templates developed by the CAP Cancer Committee that may require additional modifications to report negative biopsy results. In addition, there are current efforts within the pathology field to adopt standardized pathology terminology. This effort has been jointly developed by the CAP Cancer committee and the Pathology Electronic Reporting Taskforce (PERT), and was funded in part by the Centers for Disease Control and Prevention National Program of Cancer Registries (CDC NPCR). Several pathology vendors have begun incorporating these eCC templates into their reporting systems. 19

The radiology community has also undertaken similar endeavors in terms of standardized reporting and transmission of results. Beginning in 1983, ACR and National Electrical Manufacturers Association (NEMA) published a set of standards for the format and transmission of digital images that have come to be known Digital Imaging and Communications in Medicine (DICOM). The implementation of DICOM standards for medical images is nearly universal in radiology systems. Additional efforts that seek to address the limitations of reporting in radiology are underway. The Radiological Society of North America (RSNA) has released a comprehensive lexicon of radiology terms including procedure names called RadLex. 20 This tool extends the use of consistent terminology across radiology subspecialties. 20,21 RSNA is also developing structured reporting templates for common procedures in all radiological subspecialties. These report templates are designed to integrate all evidence collected during the imaging procedure including clinical data, coded terminology, technical parameters, measurements, annotations, and key images. 22 The templates need to be further modified and tested for the purpose of documenting biopsies and submitting specimens to pathology.

In addition to the progress made within each field, individual academic medical centers such as KUMC (discussed previously) are beginning to develop programs that facilitate the collaboration between the two specialties in order to improve patient care outcomes. Another example of the collaboration between the two specialties is the UCLA model that is discussed in detail in the next section.

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