Radiation protection and optimisation of imaging procedures depends on many different issues. Appropriate coding systems are one of those requirements. Coding is relevant in all parts of the radiological workflow (Image 1): - starting with the ordering, which relays on correct clinical informations and questions, - procedure descriptions should be harmonized or comparable to support further analytics and benchmarking, - for reporting lexica are required for a standardized terminology and analytics - finally, correct coding supports optimisation of billing. An overview on the european should...

A systematic review of existing coding systems has been conducted. This has been added by a preliminary survey across different countries in Europe. For ordering and documentation of procedures there are different systems available: LOINC, SnoMed, RadLex, ICD (International Classification of Diseases), UMLS, NICIP and others. Findings and Diseases are almost handled using ICD and RadlLex. Meanwhile there are specific reporting systems for different organs available, e.g. BI-RADS, PI-RADS, LI-RADS and others. The quality of processes is measured using several items, e.g. dose values as...

The limitations of existing codings systems and their usage are a hurdle for implementation of e.g. dose registers, which would provide data for benckmarking and improvements in dose protection. An initiative in Europe to improve consistency and harmonisation should be encouraged. IHE and DICOM provides tools and concepts for mapping such systems, this would support different languages and individual (national) specifications to respect the differences in healthcare systems, but implement a harmonized system for an european data comparison.

Contact auothor: Peter Mildenberger, MD. Dept. of Radiology University Medical Center Mainz (Germany) [email protected]

1. Langlotz, Caldwell. J Digit Imaging 15: 201 (2002) 2. www.rsna.org