Image reporting method and system

• US 6,819,785 B1
• Filed: 08/09/2000
• Issued: 11/16/2004
• Est. Priority Date: 08/09/1999
• Status: Active Grant

• Current Assignee: Wake Forest University Health Sciences
• Original Assignee: Wake Forest University Health Sciences
• Inventors: Ahn, David K., Stelts, David R., Ge, Yaorong, Vining, David J.
• Primary Examiner(s): Mehta, Bhavesh M.
• Assistant Examiner(s): Carter, Aaron
• Application Number:
  US09/635,515
• Time in Patent Office: 1,560 Days
• Field of Search: 600/300, 128/922, 358/403-404, 382/128-134, 382/305, 382/180, 707/104.1
• US Class Current: 382/128
• CPC Class Codes: G06F 16/4393 Multimedia presentations, e.g. slide shows, multimedia albums
• CPC Class Codes: G06F 16/5838 using colour
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/04 Billing or invoicing
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G11B 2020/10944 Real-time recording or reproducing, e.g. for ensuring seamless playback of AV data
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: Y10S 128/922 including image analysis
• CPC Class Codes: Y10S 707/99945 Object-oriented database structure processing
• CPC Class Codes: Y10S 707/99948 Application of database or data structure, e.g. distributed, multimedia, or image

Abstract

A method and system are provided to report the findings of an expert'"'"'s analysis of image data. The method and system are based on a reporting system that forms the basis of an image management system that can efficiently and systematically generate image reports, facilitate data entry into searchable databases for data mining, and expedite billing and collections for the expert'"'"'s services. The expert identifies a significant finding on an image and attaches a location:description code to the location of that finding in order to create a significant finding and an entry into a database. Further descriptions of that finding, such as dimensional measurements, audio descriptions, 3D rendered snapshots, etc., may be automatically appended to the finding as secondary attributes of the finding within the database. At the end of the expert'"'"'s evaluation of the image(s), the system sorts the findings in the database and presents the findings by prioritized categories. The expert edits and approves a multimedia report, which may be delivered to an Internet server for immediate access, archived in the database, sent by automated voice, fax or e-mail to an end-user, or any combination thereof.

Claims

1. A computer implemented method for analysis of an image comprising the steps of:

displaying an actual image of an object in an image viewer to a user for analysis of the image;

associating image content information describing the image type with the image;

analyzing the image to identify a feature of interest of the object;

identifying a location of the feature using an input device to selectively mark a location on the actual image representing image coordinates of the identified feature;

associating a position descriptor with the location of the feature, the position descriptor representing image coordinates;

compiling a list of user-selectable items related to the image content information to present to the user;

selecting at least one item from the list, the item describing a characteristic of the feature; and

creating an image finding of the feature comprising the position descriptor and the at least one selected item.

2. A method according to claim 1 comprising associating a status of the viewer with the feature, the status comprising at least one of an orientation, a magnification, and a shading of the image, and wherein the image finding comprises the viewer status.

3. A method according to claim 1 wherein the at least one list item comprises a location-code which describes the location of the feature relative to an object depicted in the image.

4. A method according to claim 3 wherein the location-code represents an anatomical location.

5. A method according to claim 1 wherein the image content information comprises one or more of a CPT code and a ICD code.

6. A method according to claim 3 wherein the location-code is selected from a predefined lexicon of location-codes.

7. A method according to claim 3 wherein the at least one list item comprises a description-code which describes at least one property of the feature.

8. A method according to claim 7 wherein the description-code is selected from a predefined lexicon of description-codes.

9. A method according to claim 1 comprising associating at least one of a dimensional measurement, mean voxel value, standard deviation of voxel values, an audio description, a two-dimensional image, a three-dimensional rendered image, a video description, and a user-defined illustration with the finding.

10. A method according to claim 1, wherein the image content information denotes that at least one specific object is depicted within the image.

11. A method according to claim 7 wherein the property includes a pathology of the feature.

12. A method according to claim 1 wherein the selected item is entered using voice recognition.

13. A method according to claim 1 comprising the step of assigning a priority to the image finding to denote the importance of the image finding.

14. A method according to claim 1 comprising the step of assigning a recommendation to the image finding to denote a recommended action to be taken with respect to the image finding.

15. A method according to claim 1 comprising the steps of creating at least one thumbnail image of the feature and associating the thumbnail image with the image finding.

16. A method according to claim 15 comprising the step of displaying the thumbnail image.

17. A method according to claim 1 comprising the step of displaying the image in at least one of a two-dimensional viewer and a three-dimensional viewer.

18. A method according to claim 17 wherein the image is formed by at least one of volume rendering, surface rendering, and rendering about a point.

19. A method according to claim 17 comprising the step of displaying multiple images simultaneously.

20. A method according to claim 1 wherein the image includes a digital image.

21. A method according to claim 1 wherein the image is part of a series of two-dimensional images associated with a three-dimensional body.

22. A method according to claim 1 comprising the step of identifying features in the image using computer analysis of the image to provide computer identified features.

23. A method according to claim 22 comprising the step of correlating the computer identified features with the feature.

24. A method according to claim 22 wherein the computer analysis includes computer assisted polyp detection.

25. A method according to claim 22 wherein the computer analysis includes a transbronchial needle aspiration targeting scheme.

26. A method according to claim 1 comprising creating a plurality of image findings.

27. A method according to claim 26 comprising the step of linking selected findings of the plurality of image findings to create a cumulative finding encompassing the plurality of image findings.

28. A method according to claim 26 comprising the step of linking related findings to associate the related findings to render the associated findings retrievable as a unit.

29. A method according to claim 26 comprising the steps of assigning a priority to at least one of the image findings and sorting the image findings according to priority.

30. A method according to claim 26 comprising the steps of assigning a location-code to at least one of the image findings and sorting the image findings according to location-code.

31. A method according to claim 26 comprising the step of assigning a description-code to at least one of the image findings and sorting the image findings according to the description-code.

32. A method according to claim 1 comprising the steps of

retrieving at least one prior finding from a previous analysis of an image and

linking the retrieved image finding to the image finding of the feature, whereby a set of findings is created describing a chronology of the image finding of the set feature.

33. A method according to claim 1 comprising the step of generating a report based on the image finding.

34. A method according to claim 1 comprising the step of recording a cine clip showing a time varying characteristic of the feature.

35. A method according to claim 33 wherein the report contains at least one of the image finding, a thumbnail image of an image finding, and a chronology of an image finding.

62. A method according to claim 1 including the steps of displaying a selected portion of the image and selecting of the displayed portion of the image to recall the associated diagnostic finding.

63. A method according to claim 1 wherein the image includes a plurality of views having differing perspectives of the feature.

67. A method according to claim 1 wherein the image content information includes an image content-code, denoting what the image data depicts, and includes reason-code, denoting a reason for creating the image data.

68. A method according to claim 67 comprising the step of ensuring that the image content-code and reason-code are compatible.

69. A method according to claim 1, wherein the list of user-selectable items is at least a subset of a comprehensive list of user selectable items.

70. A method according to claim 2, wherein the orientation comprises at least one of a translation state and a rotation state.

71. A method according to claim 2, wherein the magnification comprises a degree of image zoom.

72. A method according to claim 2, wherein the shading comprises at least one of a gray scale setting and opacity setting.

36. A computer implemented method for analysis of image data comprising the steps of:

displaying an actual image of an object in an image viewer to a user for analysis of the image;

analyzing the image to identify a feature of interest of the object;

identifying a location of the feature using an input device to selectively mark a location on the actual image representing image coordinates of the identified feature;

associating a status of the viewer with the feature, the status comprising at least one of an orientation, a magnification, and a shading of the image;

associating a position descriptor with the location of the feature, the position descriptor representing image coordinates;

associating a location-code with the feature, the location-code selected from a list presented to the user and describing the location of the feature relative to the object;

associating a description-code with the feature to describe a characteristic of the feature, the description-code selected from a list presented to the user; and

creating an image finding of the feature comprising the position descriptor, the location-code, the viewer status, and the description-code.

37. A method according to claim 36 wherein the location-code represents an anatomical location.

38. A method according to claim 36 wherein the list of location-codes is compiled from a predefined lexicon of location-codes.

39. A method according to claim 36 wherein the characteristic describes at least one physical property of the feature.

40. A method according to claim 36 wherein the list of description-codes is compiled from a predefined lexicon of description-codes.

41. A method according to claim 36 comprising the step of associating a content-code with the image, the content-code denoting that at least one specific object is depicted within the image, and wherein the description-code list is assembled to contain description-codes that are consistent with the content-code.

42. A method according to claim 38 comprising the step of associating a content-code with the image, the content-code denoting that at least one specific object is depicted within the image and wherein the location-code list is assembled to contain location-codes that are consistent with the content-code.

43. A method according to claim 36 wherein the characteristic includes a pathology of the feature.

44. A method according to claim 36 comprising associating at least one of a dimensional measurement, mean voxel value, standard deviation of voxel values, an audio description, a two-dimensional image, a three-dimensional rendered image, a video description, and a user-defined illustration with the finding.

45. A method according to claim 36 comprising the step of creating at least one thumbnail image of the feature and associating the thumbnail image with the image finding.

46. A method according to claim 45 comprising the step of displaying the thumbnail image wherein selection of the thumbnail image recalls the associated image finding.

47. A method according to claim 36 comprising the step of displaying the image includes display in at least one of a two-dimensional viewer and a three-dimensional viewer.

48. A method according to claim 47 wherein the image is formed by at least one of volume rendering, surface rendering, and rendering about a point.

49. A method according to claim 47 comprising the step of displaying multiple images simultaneously.

50. A method according to claim 36 wherein the image data includes a digital image.

51. A method according to claim 36 wherein the image data includes a series of two-dimensional images associated with a three-dimensional body.

52. A method according to claim 36 comprising the step of identifying features in the image using computer analysis of the image to provide computer identified features.

53. A method according to claim 52 comprising the step of correlating the computer identified features with the feature.

54. A method according to claim 36 comprising creating a plurality of image findings.

55. A method according to claim 54 comprising the step of generating a report based on the image findings.

56. A method according to claim 36 comprising the step of recording a cine clip showing a time varying characteristic of the feature.

57. A method according to claim 55 wherein the step of generating the report comprises incorporating a cumulative finding by linking selected findings of the plurality of image findings to create the cumulative finding encompassing the plurality of image findings.

58. A method according to claim 55 wherein the step of generating the report comprises incorporating a primary finding by linking related findings to associate the related findings to create the primary finding.

59. A method according to claim 55 wherein the step of generating the report comprises the step of assigning a priority to at least one of the image findings and sorting image findings according to priority.

60. A method according to claim 55 wherein the step of generating the report comprises the step of sorting image findings according to at least one of the location-code and the description-code.

61. A method according to claim 55 wherein the step of generating the report comprises incorporating a chronology of an image finding by

retrieving at least one previous finding associated with the feature from a previous analysis and

linking the retrieved image finding to the image finding of the feature whereby the chronology of the image finding of the feature is created.

64. A method according to claim 55 wherein the step of generating the report comprises computing a selected statistical measure of the report generation process.

65. A method according to claim 64 wherein the statistical measure includes at least one of total review time, time per finding, number of findings, and diagnostic accuracy.

66. A method according to claim 55 comprising generating billing information to create a bill for the report.

73. A method according to claim 36, wherein the orientation comprises at least one of a translation state and a rotation state.

74. A method according to claim 36, wherein the magnification comprises a degree of image zoom.

75. A method according to claim 36, wherein the shading comprises at least one of a gray scale setting and opacity setting.

76. A system for analyzing an image, comprising:

a display for displaying an actual image of an object in an image viewer to a user for analysis of the image;

a content information retriever for retrieving image content information describing the image type and for associating the content information with the image;

an input device for marking a location on the actual image representing image coordinates of an image feature;

a list compiler for compiling a list of user-selectable items related to the image content information and for presentation the list to the user; and

an image finding generator for creating an image finding of the feature comprising the image coordinates of the image feature and at least one item selected by the user from the list.

77. A system according to claim 76, comprising a viewer status recorder for associating a status of the viewer with the feature, the status comprising at least one of an orientation, a magnification, and a shading of the image.

78. A system according to claim 77, wherein the orientation comprises at least one of a translation state and a rotation state.

79. A system according to claim 77, wherein the magnification comprises a degree of image zoom.

80. A system according to claim 77, wherein the shading comprises at least one of a gray scale setting and opacity setting.

81. A system according to claim 76, wherein the list items comprise a location-code which describes the location of the feature relative to an object depicted in the image.

82. A system according to claim 81, wherein the location-code represents an anatomical location.

83. A system according to claim 81, wherein the location-code is selected from a predefined lexicon of location-codes.

84. A system according to claim 81, comprising a finding sorter for sorting a plurality of image findings according to location-code.

85. A system according to claim 76, wherein the list items comprise a description-code which describes at least one property of the feature.

86. A system according to claim 85, comprising a finding sorter for sorting a plurality of image findings according to description-code.

87. A system according to claim 85, wherein the description-code is selected from a predefined lexicon of description-codes.

88. A system according to claim 85, wherein the property includes a pathology of the feature.

89. A system according to claim 76, wherein the image content information comprises one or more of a CPT code and a ICD code.

90. A system according to claim 76, comprising a finding annotator for associating at least one of a dimensional measurement, mean voxel value, standard deviation of voxel values, an audio description, a two-dimensional image, a three-dimensional rendered image, a video description, and a user-defined illustration with the finding.

91. A system according to claim 76, comprising a voice recognition unit for entering the selected item.

92. A system according to claim 76, wherein the finding generator is configured to associate a priority with the image finding to denote the importance of the image finding.

93. A system according to claim 92, wherein the finding generator is configured to sort the image findings according to priority.

94. A system according to claim 76, wherein the finding generator is configured to associate a recommendation with the image finding to denote a recommended action to be taken with respect to the image finding.

95. A system according to claim 76, comprising a thumbnail generator for creating at least one thumbnail image of the feature and associating the thumbnail image with the image finding.

96. A system according to claim 76, wherein the viewer comprises at least one of a two-dimensional viewer and a three-dimensional viewer.

97. A system according to claim 76, comprising a renderer for generating the image by at least one of volume rendering, surface rendering, and rendering about a point.

98. A system according to claim 76, comprising an image analyzer for identifying features in the image using computer analysis of the image to provide computer identified features.

99. A system according to claim 98, wherein the image analyzer is configured to correlate the computer identified features with the feature.

100. A system according to claim 94, wherein the image analyzer is configured to perform computer assisted polyp detection.

101. A system according to claim 94, wherein the image analyzer is configured to perform a transbronchial needle aspiration targeting scheme.

102. A system according to claim 76, comprising a finding compositor for linking selected findings of a plurality of image findings to create a cumulative finding comprising the plurality of image findings.

103. A system according to claim 76, comprising a file loader for retrieving at least one prior finding from a previous analysis of an image and for linking the retrieved image finding to the image finding of the feature, whereby a set of findings is created describing a chronology of the image finding of the feature.

104. A system according to claim 76, comprising a report generator for generating a report based on the image finding.

105. A system according to claim 104, wherein the report contains at least one of the image finding, a thumbnail image of the image finding, and a chronology of the image finding.

106. A system according to claim 76, wherein the list of user-selectable items is at least a subset of a comprehensive list of user selectable items.

107. A system according to claim 76, comprising a communication interface for communication with at least one of the Internet, an e-mail system, a fax, a telephone, a wireless communications system, a pager, a cell phone, a hospital information system, a radiology information system, and a picture archiving and communication system.

108. A system for analyzing an image, comprising:

display means for displaying an actual image of an object in an image viewer to a user for analysis of the image;

content information retrieval means for retrieving image content information describing the image type and for associating the content information with the image;

input means for marking a location on the actual image representing image coordinates of an image feature;

list compilation means for compiling a list of user-selectable items related to the image content information for presentation to the user; and

finding creation means for creating an image finding of the feature comprising the image coordinates of the image feature and at least one item selected by the user from the list.

109. A system according to claim 108, comprising a viewer status association means for associating a status of the viewer with the feature, the status comprising at least one of an orientation, a magnification, and a shading of the image.

110. A system according to claim 109, wherein the orientation comprises at least one of a translation state and a rotation state.

111. A system according to claim 109, wherein the magnification comprises a degree of image zoom.

112. A system according to claim 109, wherein the shading comprises at least one of a gray scale setting and opacity setting.

113. A system according to claim 108, wherein the list items comprise a location-code which describes the location of the feature relative to an object depicted in the image.

114. A system according to claim 113, wherein the location-code represents an anatomical location.

115. A system according to claim 113, wherein the location-code is selected from a predefined lexicon of location-codes.

116. A system according to claim 113, comprising a sorting means for sorting a plurality of image findings according to location-code.

117. A system according to claim 108, wherein the list items comprise description-codes which describes at least one property of the feature.

118. A system according to claim 117, comprising a sorting means for sorting a plurality of image findings according to description-code.

119. A system according to claim 117, wherein the description-code is selected from a predefined lexicon of description-codes.

120. A system according to claim 117, wherein the property includes a pathology of the feature.

121. A system according to claim 108, wherein the image content information comprises one or more of a CPT code and a ICD code.

122. A system according to claim 108, an annotation association means for associating at least one of a dimensional measurement, mean voxel value, standard deviation of voxel values, an audio description, a two-dimensional image, a three-dimensional rendered image, a video description, and a user-defined illustration with the finding.

123. A system according to claim 108, comprising a voice recognition unit for entering the selected item.

124. A system according to claim 108, wherein the finding creation means is configured to associate a priority with the image finding to denote the importance of the image finding.

125. A system according to claim 124, wherein the finding creation means is configured to sort the image findings according to priority.

126. A system according to claim 108, wherein the finding creation means is configured to associate a recommendation with the image finding to denote a recommended action to be taken with respect to the image finding.

127. A system according to claim 108, comprising a thumbnail creation means for creating at least one thumbnail image of the feature and associating the thumbnail image with the image finding.

128. A system according to claim 108, wherein the viewer comprises at least one of a two-dimensional viewer and a three-dimensional viewer.

129. A system according to claim 108, comprising a rendering means for rendering the image by at least one of volume rendering, surface rendering, and rendering about a point.

130. A system according to claim 108, comprising an image analysis means for analyzing the image to identify features in the image using computer analysis of the image to provide computer identified features.

131. A system according to claim 130, wherein the image analysis means is configured to correlate the computer identified features with the feature.

132. A system according to claim 130, wherein the image analysis means is configured to perform computer assisted polyp detection.

133. A system according to claim 130, wherein the image analysis means is configured to perform a transbronchial needle aspiration targeting scheme.

134. A system according to claim 108, comprising a finding linking means for linking selected findings of a plurality of image findings to create a cumulative finding comprising the plurality of image findings.

135. A system according to claim 108, comprising a file retrieval means for retrieving at least one prior finding from a previous analysis of an image and for linking the retrieved image finding to the image finding of the feature, whereby a set of findings is created describing a chronology of the image finding of the feature.

136. A system according to claim 108, comprising a report creation means for generating a report based on the image finding.

137. A system according to claim 136, wherein the report contains at least one of the image finding, a thumbnail image of the image finding, and a chronology of the image finding.

138. A system according to claim 108, wherein the list of user-selectable items is at least a subset of a comprehensive list of user selectable items.

139. A system according to claim 108, comprising a communication means for communication with at least one of the Internet, an e-mail system, a fax, a telephone, a wireless communications system, a pager, a cell phone, a hospital information system, a radiology information system, and a picture archiving and communication system.

140. A system for analyzing an image, comprising:

a display for displaying an actual image of an object in an image viewer to a user for analysis of the image;

an input device for marking a location on the actual image representing image coordinates of an image feature;

a viewer status recorder for associating a status of the viewer with the feature, the status comprising at least one of an orientation, a magnification, and a shading of the image;

a location-code list compiler for compiling a list of user-selectable location-codes describing the location of the feature relative to the object;

a description-code list compiler for compiling a list of user-selectable description-codes describing a characteristic of the feature; and

an image finding generator for creating an image finding of the feature comprising the image coordinates of the image feature, the viewer status, at least one location-code selected by the user from the location-code list, and at least one description-code selected by the user from the description-code list.

141. A system according to claim 140, wherein the location-code represents an anatomical location.

142. A system according to claim 140, wherein the list of location-codes is compiled from a predefined lexicon of location-codes.

143. A system according to claim 140, wherein at least one of the location-code list and the description-code list is at least a subset of a comprehensive list of user selectable items.

144. A system according to claim 140, comprising a content-code retriever for retrieving a content-code, denoting what the image data depicts, and for retrieving a reason-code, denoting a reason for creating the image data.

145. A system according to claim 140 wherein the characteristic describes at least one physical property of the feature.

146. A system according to claim 140, wherein the characteristic includes a pathology of the feature.

147. A system according to claim 140, wherein the list of description-codes is compiled from a predefined lexicon of description-codes.

148. A system according to claim 140, comprising a content-code retriever for retrieving a content-code and associating the content-code with the image, the content-code denoting that at least one specific object is depicted within the image, and wherein the location-code list is assembled to contain location-codes that are consistent with the content-code.

149. A system according to claim 140, comprising a content-code retriever for retrieving a content-code and associating the content-code with the image, the content-code denoting that at least one specific object is depicted within the image, and wherein the description-code list is assembled to contain description-codes that are consistent with the content-code.

150. A system according to claim 140, comprising a finding annotator for associating at least one of a dimensional measurement, mean voxel value, standard deviation of voxel values, an audio description, a two-dimensional image, a three-dimensional rendered image, a video description, and a user-defined illustration with the finding.

151. A system according to claim 140, comprising a thumbnail generator for creating at least one thumbnail image of the feature and associating the thumbnail image with the image finding.

152. A system according to claim 140, wherein the viewer comprises at least one of a two-dimensional viewer and a three-dimensional viewer.

153. A system according to claim 152, comprising a rendering means for rendering the image by at least one of volume rendering, surface rendering, and rendering about a point.

154. A system according to claim 140, comprising an image analyzer for identifying features in the image using computer analysis of the image to provide computer identified features.

155. A system according to claim 154, wherein the image analyzer is configured to correlate the computer identified features with the feature.

156. A system according to claim 140, comprising a report generator for generating a report based on the image finding.

157. A system according to claim 156, comprising a finding linking means for linking selected findings of a plurality of image findings to create a cumulative finding comprising the plurality of image findings.

158. A system according to claim 156, wherein the report generator is configured to assign a priority to at least one of a plurality of image findings and to sort the image findings according to priority.

159. A system according to claim 156, wherein the report generator is configured to sort image findings according to at least one of the location-code and the description-code.

160. A system according to claim 156, comprising a file loader for retrieving at least one prior finding from a previous analysis of an image and for linking the retrieved image finding to the image finding of the feature, whereby a set of findings is created describing a chronology of the image finding of the feature.

161. A system according to claim 156, wherein the report generator is configured to compute a selected statistical measure of the report generation process.

162. A system according to claim 161, wherein the statistical measure includes at least one of total review time, time per finding, number of findings, and diagnostic accuracy.

163. A system according to claim 140, comprising a bill generator for creating a bill based on the diagnostic finding.

164. A system according to claim 140, wherein the finding generator is configured to associate a recommendation with the image finding to denote a recommended action to be taken with respect to the image finding.

165. A system according to claim 140, wherein the orientation comprises at least one of a translation state and a rotation state.

166. A system according to claim 140, wherein the magnification comprises a degree of image zoom.

167. A system according to claim 140, wherein the shading comprises at least one of a gray scale setting and opacity setting.

168. A system for analyzing an image, comprising:

display means for displaying an actual image of an object in an image viewer to a user for analysis of the image;

input means for marking a location on the actual image representing image coordinates of an image feature;

viewer status association means for associating a status of the viewer with the feature, the status comprising at least one of an orientation, a magnification, and a shading of the image;

location-code list compilation means for compiling a list of user-selectable location-codes describing the location of the feature relative to the object;

description-code compilation means for compiling a list of user-selectable description-codes describing a characteristic of the feature; and

finding creation means for creating an image finding of the feature, comprising the image coordinates of the image feature, the viewer status, at least one location-code selected by the user from the location-code list, and at least one description-code selected by the user from the description-code list.

169. A system according to claim 168, wherein the orientation comprises at least one of a translation state and a rotation state.

170. A system according to claim 168, wherein the magnification comprises a degree of image zoom.

171. A system according to claim 168, wherein the shading comprises at least one of a gray scale setting and opacity setting.

172. A system according to claim 168, wherein the location-code represents an anatomical location.

173. A system according to claim 168, wherein the list of location-codes is compiled from a predefined lexicon of location-codes.

174. A system according to claim 168, wherein at least one of the location-code list and the description-code list is at least a subset of a comprehensive list of user selectable items.

175. A system according to claim 168, comprising a content-code retriever for retrieving a content-code, denoting what the image data depicts, and for retrieving a reason-code, denoting a reason for creating the image data.

176. A system according to claim 168, wherein the characteristic describes at least one physical property of the feature.

177. A system according to claim 168, wherein the characteristic includes a pathology of the feature.

178. A system according to claim 168, wherein the list of description-codes is compiled from a predefined lexicon of description-codes.

179. A system according to claim 168, comprising a content-code retrieval means for retrieving a content-code and associating the content-code with the image, the content-code denoting that at least one specific object is depicted within the image, and wherein the location-code list is assembled to contain location-codes that are consistent with the content-code.

180. A system according to claim 168, comprising a content-code retrieval means for retrieving a content-code and associating the content-code with the image, the content-code denoting that at least one specific object is depicted within the image, and wherein the description-code list is assembled to contain description-codes that are consistent with the content-code.

181. A system according to claim 168, an annotation association means for associating at least one of a dimensional measurement, mean voxel value, standard deviation of voxel values, an audio description, a two-dimensional image, a three-dimensional rendered image, a video description, and a user-defined illustration with the finding.

182. A system according to claim 168, comprising a rendering means for rendering the image by at least one of volume rendering, surface rendering, and rendering about a point.

183. A system according to claim 168, comprising an image analyzer for identifying features in the image using computer analysis of the image to provide computer identified features.

184. A system according to claim 183, wherein the image analyzer is configured to correlate the computer identified features with the feature.

185. A system according to claim 168, comprising a report generator for generating a report based on the image finding.

186. A system according to claim 185, comprising a finding linking means for linking selected findings of a plurality of image findings to create a cumulative finding comprising the plurality of image findings.

187. A system according to claim 185, wherein the report generator is configured to assign a priority to at least one of a plurality of image findings and to sort the image findings according to priority.

188. A system according to claim 185, wherein the report generator is configured to sort image findings according to at least one of the location-code and the description-code.

189. A system according to claim 185, comprising a file loader for retrieving at least one prior finding from a previous analysis of an image and for linking the retrieved image finding to the image finding of the feature, whereby a set of findings is created describing a chronology of the image finding of the feature.

190. A system according to claim 185, wherein the report generator is configured to compute a selected statistical measure of the report generation process.

191. A system according to claim 190, wherein the statistical measure includes at least one of total review time, time per finding, number of findings, and diagnostic accuracy.

192. A system according to claim 168, comprising a bill generator for creating a bill based on the diagnostic finding.

193. A system according to claim 190, wherein the finding creation means is configured to associate a recommendation with the image finding to denote a recommended action to be taken with respect to the image finding.