report42 Handbook

v3.3.1

screenshot1 screenshot1

Regulatory Information

report42 manufactured by

Manufactured by

Head Office
Circle Cardiovascular Imaging Inc.
250, 815 - 8th Avenue SW
Calgary, AB, T2P 3P2
Telephone: 1 (403) 338-1870
Fax: 1 (403) 338-1895

http://www.circlecvi.com

report42 regulatory auditor

1 About report42

report42 is designed to facilitate documentation and reporting of cardiac images. Fields with import function and with calculation algorithms allow for a fast and easy transition from quantitative information such as volumetric and signal intensity data to a structured report. report42 is based on societal recommendations on structured reporting for cardiovascular imaging (Douglas et al., Journal of the American College of Cardiology 2009;53:76-90.) and can be integrated into patient information storage systems.

When linked with cmr42 or cvi42®, it automatically imports image analysis results and classifies them based on user-editable normal value sets. Standard phrases can be defined for preparing the report. A graphical interface allows for using mouse-clicks to verify regional function tissue pathology and grade stenoses. Results are automatically translated into a narrated findings summary, but includes a graphic presentation of the results.

2 Intended Use

report42 is a web browser-based networked software application intended to use for reporting the results of the cardiovascular MR or CT image analysis performed with a post processing software application or PACS (Picture Archive Communication System) and RIS (Radiology Information System). It can be used as a standalone reporting software application by manually entering necessary information.

report42 shall only be used to report the Cardiovascular Magnetic Resonance Image analysis or Computed Tomography analysis.

report42 is not a diagnostic software application.

WARNING: Accuracy of reports

Please note that the users of report42 shall review the contents for accuracy prior to releasing the report.

3 Working with report42

3.1 Open report42

  1. In a desktop web browser:
    • report42 is a reporting tool base on web technologies and works in a standard web browser.
      • Open a web browser and navigate to the address of the report42 web server on your network.
      • Type in name and password.
  2. Within cvi42®/cmr42:
    • Configure the connection to report42
      • To access report42 from cvi42® you have to configure Reporting in Preferences → Reporting → Report server.
        cvi42 report config
      • Server type: select report42.
      • Server URL: enter the web address for your report42 server, including port (default is 4280).
      • Username and Password: These will be assigned to you by your administrator.
      • In the report module, click on the report42 tab
        cvi42 reporting module

3.2 How to Display a Report

The functionality is based on the definition of users and roles.

3.2.1 View the worklist within cvi42®

When opening a study in cvi42® you will be asked if you would like to create an instance in report42. If the instance has been created successfully, the report status will then be displayed in your patient list, if the attribute report42 has been selected. (Chapter Patient List).

3.2.2 View the worklist in report42

Go to the Report Module in cvi42® and click on the report42 tab. If an instance has been created the study can be selected from the work list. Clicking on the patient study opens the Report worksheet page.

3.2.3 How to push my report from cvi42® to report42

In the cvi42® modules, use the Add to Report button to automatically transfer the values to report42.

You are able to add images to your report by right-clicking in an image viewer and using the context menu's Add Frame to Report command.

3.2.4 Worklist Search

3.2.4.1 Search
report42 worklist search

This Filter allows you to search for attributes such as Name, Study Description, Report Status and Visit.

3.2.4.2 Advanced Search
report42 worklist advanced search

This Filter provides advanced search options that are

Any or All conditions may be matched by changing the Match term selection.

3.2.4.3 Bulk Export

An Export option allows for the export of single or multiple reports in CSV format for import into Excel or other table-oriented data aggregators. This option is available in the Advanced Search interface and exports all reports matching the current search criteria.

report42 worklist export

The default options produce standard-compliant CSV files. You can customize these options to better suit your analysis tool.

3.3 How to generate a report

3.3.1 How to use Free-Form Findings/Summary

3.3.2 How to use Structured Findings

3.3.3 How to use Z-Index Rulesets

3.3.4 How to create a Tissue Diagram (CMR)

The purpose of the diagrams is to quickly visualize myocardial injury of the left ventricle as well as function.

3.3.4.1 Choose One of the Two Diagram Options
  1. Polarmaps using the AHA segmentation. Start by selecting a diagram type:
    • Ischemic Heart Disease
    • Non-Ischemic Heart Disease
    • Legacy (Tissue Characteristics from report42 v2.0 and earlier)

    This presentation allows the user to depict:

    • Tissue Characteristics (left polarmap): Per segment as well as with their transmurality (50% or 100%)
    • Segmental Function (right polarmap)
    report42 heart polarmap diagram
  2. You may also use report42-specific diagrams providing more detailed information in multiple radial long axis and 3 short axis orientations. Unlike the AHA segmentation where slices are displayed in an all-in-one polar map view, the slices are displayed next to each other.

    This presentation allows the user to depict:

    • Tissue Characteristics (solid lined segments): Per segment as well as with their transmurality (50% or 100%)
    • Segmental Function (dotted lines)
    report42 heart diagram
3.3.4.2 Ischemic vs. Non-Ischemic HD

This will determine applicable tissue characteristics

report42 Ischemic HD

Ischemic

report42 Non-Ischemic HD

Non-Ischemic

3.3.4.3 How to apply tissue qualities

3.3.5 How to create an Axial Coronary Anatomy Diagram (CCT)

report42 axial coronary anatomy diagram

The purpose of the diagram is to quickly visualize quantitative stenosis grade and plaque type:

3.3.5.1 How to apply Stenosis Grade and Plaque

3.4 Edit Exam

report42 exam edit button

This section allows you to edit the header of your report, which will display the basic patient related information.

Changes in the Exam Edit screen are saved automatically as the user works.

3.4.1 Add Referring Physicians

3.5 Report Images

report42 report images button

Within cvi42® you have the option to add images to your report via contex menu → add frame to report. Only these images show up in the report.

cvi42® polar maps will be automatically added to the Report Image section if polarmaps are enabled at the time the module data is added to the report.

report42 exam images sample

3.6 Export Report

report42 report export buttonset

3.6.1 Configure Export Options

Click the configuration button (gear icon) to set your Export Preferences:

report42 export report

The Export Options configuration dialog allows you to change the format of the report before saving, sending, or viewing a report:

3.6.2 Hide Report Fields

Individual fields of a report can be hidden by clicking on the Eye icon.

  1. Select the drop down next to the eye icon
    report42 hide report field mode
    • Exam: allows to hide sections for the current report (Note that this is the only mode available to non-administrative users and will be used by default).
    • Protocol: available to administrators, this mode will save the selection to the current protocol.
  2. Toggle the field-visibility switch to hide/show report fields. Fields highlighted in red will be hidden from the onscreen and printed/exported reports. Fields highlighted in green will be visible.
  3. Click on the Eye icon again to return to report editing mode.
    report42 hide report field selections

3.6.3 Export Format

The Export Options dialog allows you to set the report format to PDF, HTML or Text before saving or viewing a report.

You can also change the current export format quickly without returning to this dialog by using the arrow-menu next to the Export button on the report page.

report42 export format quick select

3.7 Sending DICOM Reports to PACS

report42 send to pacs

If one or more PACS destinations have been configured in report42, the Send to PACS button will be available. Furthermore, if the minimum report state required to send reports to PACS has been reached, the button will be enabled.

Clicking the Send to PACS button will transfer a DICOM copy of the report to the PACS specified with the arrow-menu:

report42 select pacs

The format options for a DICOM report are the same as for PDF or HTML reports.

3.8 How to Tag a Report

Every report page has a section for adding and removing new tags. Tags are short metadata descriptions of the qualities of a report that can assist in future searches, but do not print on the final report.

report42 select pacs

Tags could describe patient conditions, actions taken in the study, study status, ownership, or anything else that isn't directly searchable in a typical field. For example:

Tags can be added to a study and created as you work by using the Plus icon in the Tags section.

4 Admin

Access to the Administrative section of report42 is limited by a user's Role and the corresponding Permissions.

4.1 System

4.1.1 Users

report42 allows you to define multiple user and roles. You can Add a new user or Edit existing users.

report42 add user

Note: By default, report42 is configured to allow user and role management to take place entirely in cvi42® v5.5+. If cvi42® meets the minimum required version, you can do all of your user and role administration there. User details will automatically be synchronized to report42 when that user signs in, and their password will always be managed in cvi42®.

It is possible to link older local report42 accounts to cvi42® so that all user management will take place in cvi42®. It is also possible to have a mix of local report42-only users and users managed by cvi42®.

report42 edit list

The link icon indicates that a user is sourced and managed from cvi42®.

Users sourced from cvi42® do not need to be added manually, they will appear in this list as they log in using their cvi42® credentials and will be granted the same roles.

A user is able to interact with the system in different ways, depending on what roles they are assigned. The following matrix shows which of the default roles can access which features and administrative sections:

Permission/Role Viewer Technician Analyst Reporter Data Administrator User Administrator System Administrator PACS Administrator
View Not Read Exams
(formerly Waiting)
Create Not Read Exams
(formerly Waiting)
Edit Not Read Exams
(formerly Waiting)
View In Progress Exams
(formerly Complete)
Create In Progress Exams
(formerly Complete)
Edit In Progress Exams
(formerly Complete)
View Preliminary Exams
Create Preliminary Exams
Edit Preliminary Exams
View Finalized Exams
Create Finalized Exams
Edit Finalized Exams
View Addendum Exams
Create Addendum Exams
Edit Addendum Exams
Delete Exams
Bulk Export
Create/Edit System Tag
Delete System Tag
Add/Remove System Tag to Study
Edit Role Tag
Admin Users
Admin Roles
Admin Language
Admin Disease Clusters
Admin Indications
Admin Protocols
Admin PACS
View Audit
Admin HL7
Admin Site of Service
Admin Staff
Admin Form List Options
Admin Sequences
Admin Study Descriptions
Admin Referring Physicians
Admin Patient History
Admin Normal Ranges
Admin Findings/Summary Text
Admin Z-Index

4.1.2 Roles

Add or customized existing Roles to suit the needs of a particular organization.

4.1.3 Language

The system is able to operate in several languages. The language setting will take effect for every user of the system when they next log in.

Be aware that all content entered in the Report Content admin section is linked to the language in use when it was first created. If edits or additions are made and the language is subsequently changed, you will find your content missing.

4.1.4 Disease Clusters, Indications, and Protocols

Indication Driven Workflow was introduced in cvi42® version 5.6. For implementations using this workflow, the configuration of disease clusters, indications, protocols, and sequences is managed in cvi42®, so report42 will display the following message:

report42 config settings moved

For implementations not using the indication driven workflow, disease clusters, indications and protocols are managed in report42. report42 comes with a predefined disease, indication, and protocol hierarchy. To edit, go to their respective Admin sections.

4.1.4.1 Desease Clusters

Use the Desease Clusters section to view, add, or edit disease clusters.

report42 disease clusters
4.1.4.2 Indications
4.1.4.3 Protocols

Protocols are used to define the structure of a report and are assigned to indications. Specifically, the protocol determines which report sections and sequences are used to address the respective indication.

4.1.5 PACS configuration

Here you may configure the DICOM PACS entities that report42 may send reports to, as well as the method of packaging reports as DICOM data.

report42 admin pacs configuration
4.1.5.1 Adding and Editing PACS configuration

Use the Add New StoreSCU button to add a new PACS host to receive DICOM reports, or edit an existing host conifguration using the Pencil icon.

report42 admin pacs add

4.1.6 Audit

Here you may search through the audit log for changes to the system and edits to report contents.

4.1.7 Tags

Here you may add and edit report tags for use by all users or by users having specific roles. Tags are short metadata descriptions of the qualities of a report that can assist in future searches, but do not print on the final report.

report42 tags list

Tags could describe patient conditions, actions taken in the study, study status, ownership, or anything else that isn't directly searchable in a typical field.

Tags created for a user's personal use can only be edited by them in their user user profile page, accessible from the link (their full name) in the top-right of the report42 web page.

4.2 Report Content

4.2.1 Site of Service

The Site of Service information appears at the top of the first page of your report.

Here you can enter contact and accreditation information for your facility, as well as a logo. Logos can be quite large in terms of resolution (which will look sharper on printed reports), However you are advised to use a logo which is approximately square or roughly 2:3 (height:width) in dimension.

4.2.2 Staff

The Staff module allows you to define the list of people who operate your facility and participate in studies. These people can be added to a report in the Edit Exam page. Their names and all identifying information will appear on the exported reports. Staff are not necessarily users of report42 and are not granted access to the system. Refer to the Users module.

When editing staff, there are two options for the Type of Change:

4.2.3 Standard Form List Options

You are able to define parameter or options that offer different qualities: e.g. Image quality with a form list that offers the options good/moderate/bad.

These options will show up in the CMR Report page.

4.2.4 Sequences

Sequences like T1 mapping sequence or First Pass Perfusion can be defined.

These sequences will be added to the list in the Edit Exam page and will be added quickly to a report header to make it more descriptive.

Note: An indication driven workflow was introduced in cvi42® version 5.6. For implementations using this workflow, the configuration of sequences is managed in cvi42®; report42 will display the following message:

report42 configuration settings moved

4.2.5 Study Descriptions

Newly defined study descriptions will be displayed in a drop down list in Edit → Exam and will be part of your report header. Study descriptions will also be entered automatically when report data is transferred from cmr42 or cvi42®.

4.2.6 Referring Physician

You can create a list of referring physicians. Each referring physician can have multiple addresses to which a report might be returned.

They will be displayed in a checklist in Edit → Exam and if selected, will show up in the report header. Addresses will not be printed in report headers, they are there as a convenience for addressing returned reports.

Referring Physician names will also be entered automatically when transferred from cmr42 or cvi42®.

4.2.7 Patient History

This allows to define canned text, that will be displayed in list format for selection in Edit → Exam.

4.2.8 Normal ranges

report42 admin normal ranges
4.2.8.1 Export / Import Normal Ranges

To facilitate inter-center collaboration, administrators can import or export all/selected normal ranges in a readable PDF report or transferable JSON data format.

report42 admin normal ranges export format
4.2.8.2 Editing Normal Ranges
report42 admin normal range edit

Definition requires the following input:

4.2.8.3 Adding / Editing Normal Range Rules
report42 findings-summary text

To add a normal range rule, click the Plus button. To edit normal ranges, just start typing.

The normal range editor allows you to easily set up new ranges and classifications (normal/reduced/increased) which can be age and/or gender specific.

Click the Checkmark to save any unsaved changes.

4.2.9 Findings-Summary Text

report42 findings-summary text

Here you may add and edit to the text available in the Findings and Summary report modules.

4.2.10 Structured Findings

Structured Findings is a report section and can be used as an alternative to Findings.

report42 structured findings
Add Structured Findings Text

To facilitate inter-center collaboration, administrators can import and export all findings texts (including their normal range dependencies) or selected categories of findings.

4.2.11 Z-Index Rulesets

4.2.11.1 Editing Z-Index Rule Sets

Rulesets correspond to a particular paper used for z-scoring, and so must be set up to use the same BSA Calculation and the same z-scoring / normal-value regression function used by the paper's authors.

report42 z-score rulesets
4.2.11.2 Creating Z-Index Rules

Rules correspond to regression curve parameters found within a source paper and will represent a single measurement (length, volume, mass, etc.).

report42 z-score ruleset edit

Save the entry by clicking the checkmark.