Automated Protocoling for MRI Exams—Challenges and Solutions

Abstract

Automated protocoling for MRI examinations is an amendable target for workflow automation with artificial intelligence. However, there are still challenges to overcome for a successful and robust approach. These challenges are outlined and analyzed in this work. Through a literature review, we analyzed limitations of currently published approaches for automated protocoling. Then, we assessed these limitations quantitatively based on data from a private radiology practice. For this, we assessed the information content provided by the clinical indication by computing the overlap coefficients for the sets of ICD-10-coded admitting diagnoses of different MRI protocols. Additionally, we assessed the heterogeneity of protocol trees from three different MRI scanners based on the overlap coefficient, on MRI protocol and sequence level. Additionally, we applied sequence name standardization to demonstrate its effect on the heterogeneity assessment, i.e., the overlap coefficient, of different protocol trees. The overlap coefficient for the set of ICD-10-coded admitting diagnoses for different protocols ranges from 0.14 to 0.56 for brain/head MRI exams and 0.04 to 0.57 for spine exams. The overlap coefficient across the set of sequences used at two different scanners increases when applying sequence name standardization (from 0.81/0.86 to 0.93). Automated protocoling for MRI examinations has the potential to reduce the workload for radiologists. However, an automated protocoling approach cannot be solely based on admitting diagnosis as it does not provide sufficient information. Moreover, sequence name standardization increases the overlap coefficient across the set of sequences used at different scanners and therefore facilitates transfer learning.