The resources in this toolkit will help radiologists and other imaging professionals provide consistent and high-quality imaging according to best practices.
Diagnostic Imaging Priority Level Coding – Definitions and Examples
Find the Ontario Health reference guide for CT and MRI priority level coding definitions, and representative examples. Definitions include Priority, Clinical Indication for Scan, and Specified Date Procedures.
Priority level coding supports CT and MRI bookings according to clinical urgency. This data is collected through the Access to Care Wait-Time Information System and is used for wait time reporting.
If you have any questions about these documents, please email Access to Care.
Structured Radiology Reporting Templates
Structured radiology reporting templates facilitate clinical decision-making as well as communication between radiologists, referring physicians and patients.
Structured reports help ensure the information is complete, accurate and presented in a format and using language that is standard, clear and understandable. Structure should always be used for radiology reports, at minimum following guidelines such as those from the American College of Radiology (ACR, 2014).
The following templates were developed or endorsed by Ontario Health (Cancer Care Ontario). These complete, comprehensive and evidence-based templates – developed with multidisciplinary input – provide full clinical guidance for all possible information needed by referring clinicians, including options and nomenclature. Use them as a guide, along with clinical judgement and current evidence. Adjust or adapt specific content according to local clinical needs and practical implementation considerations.
A guide on the requirements for creating strong, evidence-based structured reports. Also serves as a resource for assessing the quality of radiology reporting templates for use.
The Standardized Ultrasound Reporting for Ovarian-Adnexal Masses is a risk stratification and management system that was adapted from the American College of Radiology’s Ovarian-Adnexal Reporting and Data System (O-RADS) to reflect the Ontario health care context. The use of a standardized lexicon for describing ovarian-adnexal lesions improves accuracy in assigning risk of malignancy and promotes appropriate patient management based on their level of risk. This will ensure that people with potentially malignant lesions are referred to a gynecologic oncologist, while those with low-risk lesions will avoid unnecessary additional investigations and interventions such as ongoing surveillance ultrasounds, magnetic resonance imaging (MRI), and surgery.
Included in the O-RADS reporting documents are:
- Explanatory Notes, which are a comprehensive resource that defines the standardized lexicon, explains how to use the risk stratification and management system, and provides radiologist reporting guidance and sample reports for the Ontario health care context.
- Ultrasound Worksheet for adnexal lesions.
- Risk Categorization and Management Quick Reference, which is an abbreviated version of the explanatory notes.
Please email the Cancer Integration and Disease Advisory Program for a copy of the documents at OH-CCO_CIDAPInfo@ontariohealth.ca.
These 4 products help improve the standardization and quality of thyroid ultrasound reporting in Ontario.
Biopsy Addendum Template (optional).
For radiologists to add to a biopsy report, providing recommendations for next steps, depending on biopsy results and TI-RADS category of a nodule.
Provides contextual and practical information related to the worksheet and templates.
Ontario Lung Screening Program
Find a collection of resources for radiologists at Lung Cancer Screening Information for Healthcare Providers.
- Radiology Quality Assurance Program Manual
- LDCT Lung Cancer Screening Reporting Template
- LDCT Lung-RADS® Version 1.1 Assessment Categories
- Lung Cancer Screening Reporting Template Explanatory Notes
- Recommendations for the Management of Actionable Incidental Findings
MRI for rectal and anal cancer
Find a collection of resources from the Society of Abdominal Radiology (SAR) on MRI imaging for the clinical management of rectal and anal cancer patients at Rectal and Anal Cancer DFP. There you will find the MRI Primary Rectal Cancer Staging Template and the User’s Guide to Synoptic MRI Staging Template.
Ontario Health (Cancer Care Ontario) endorses the use of the SAR template, which builds on the initial Cancer Services Innovation Partnership template (Cancer Care Ontario and Canadian Cancer Society). The template will be regularly updated through processes.
Links to the earlier versions (2015, updated from 2012) of the template and accompanying documents follow for reference purposes.
Ontario Health (Cancer Care Ontario) endorses the use of the Pancreatic Cancer Radiology Reporting Template (Figure PANC-A, 5 of 8) in the NCCN Clinical Practice Guidelines in Oncology for Pancreatic Adenocarcinoma V.1.2018.
Available from National Comprehensive Cancer Network (login credentials required to access template).
Measuring pulmonary nodules
The Fleischner Society has released a statement with recommendations for measuring pulmonary nodules with CT. The recommendations include technical requirements, directions to accurately measure nodules at workstation and directions on how to report changes in nodule size.
Note: The American College of Radiology has several resources, including templates available on their website. These may be helpful, but have not been explicitly reviewed or endorsed by Ontario Health.