CONCLUSIONES YRECOMENDACIONES.

Words which are non-contributory (which constitute “noise”) to my impression are highlighted in green. Additional highlighting (such as yellow or blue) corresponds to the impression about the topic.

topic0- advanced metastatic disease

evidence,vascular,bulky,calcification,images,metastasis,bone,lung,following,liver,mass,isovue,since,history,multidetecto r,contrast,130,complication,helical,apparent,pleural,dfov,delay,cc/s,hydronephrosis,hilum,axilla,pericardial,effusion,foci ,mesenteric,splenomegaly,minimal,spleen,definite,gallbladder,spine,due,mediastinum,approximate,2006,infusion,possi bly,subcentimeter,focus,retroperitoneal,2005,radiodensity,8-channel,quad topic1- MRI images,axial,t1-weighted,prior,following,t2-weighted,liver,sequences,foci,tesla,characteristic,fat- suppressed,multiple,1.5,coronal,mri,magnevist,vascular,prolonged,apparent,contrast,complication,evidence,relaxation,i ncluding,fat,focus,possibly,administration,echo,due,pleural,hydronephrosis,splenomegaly,impression,effusion,reason,fa st,multiphase,mass,enhancing,enhancement,axial/coronal,definite,approximate,comparison,history,suppression,spin,gr oss topic2- lymphadenopathy lymph,nodes,small,bilateral,subcentimeter,foci,node,iliac,periaortic,minimal,inguinal,lymphoma,mesenteric,pretracheal, axilla,comparison,prostate,scattered,subcarinal,spleen,bone,clinical,splenomegaly,evidence,pericardial,prevascular,nor mal,gallbladder,focus,thickening,window,focal,sclerotic,fat,paratracheal,periportal,history,aorticopulmonary,cll,moderat e,enlarged,femoral,top,scarring,size,peripancreatic,contrast,disease,hydronephrosis,baseline

topic3- lesion/mass characterization/followup examination

liver,lesion,may,small,lesions,findings,nodule,stable,mri,mass,contrast,evaluation,lobe,signal,lung,noted,tiny,area,appea rs,nonspecific,comparison,slightly,change,impression,nodules,clinically,represent,pelvic,increased,intensity,abdominal,w arranted,interval,adrenal,changed,significantly,given,larger,compared,upper,relate,breast,although,possibly,recommen ded,low,normal,correlation,spleen,anterior

vein,cava,vena,artery,liver,images,biliary,superior,phase,common,pancreas,intrahepatic,inferior,pancreatic,hepatic,rena l,duct,mass,arterial,venous,evidence,iliac,aorta,dilation,portal,thrombus,findings,early,dilatation,normal,celiac,mesenter ic,impression,aortic,stent,cancer,comparison,spleen,arteries,splenomegaly,veins,bile,kidneys,marked,splenic,large,head, subclavian,axis,porta

topic5- metastatic disease, comparison study

increasing,since,minimally,appearing,metastases,decreasing,masses,metastasis,mass,minimal,moderately,pleural,liver,p robably,lower,least,foci,approximate,effusion,lung,size,though,fat,gone,bilateral,bone,demonstrated,lobulated,contrast, length,2007,possibly,melanoma,near,administration,september,axilla,better,one,upper,periaortic,markedly,hydronephr osis,august,hilum,previously,april,wall,obscured,february

topic6- gastrointestinal tract

fluid,bowel,colon,contrast,small,collection,thickening,wall,evidence,distal,abdominal,images,findings,obstruction,absces s,gas,bladder,proximal,ascites,tube,level,stomach,oral,pneumoperitoneum,within,patient,cecum,see,hydronephrosis,an terior,urinary,sigmoid,rectum,loops,pelvic,resection,transverse,catheter,rectal,fat,clinical,tip,density,pain,ureter,descen ding,ileum,air,normal,mesenteric

topic7- chest imaging

lung,appearing,minimal,lower,pleural,since,infiltrate,effusion,bilateral,p.m,focal,evidence,atelectasis,multidetector,helic al,images,pericardial,decreasing,clinical,discussed,increasing,disease,axilla,mass,reviewed,radiodensity,scarring,cavity,sp lenomegaly,dfov,impression,inflammatory,probable,infiltrates,mid,gone,possibly,upper,due,catheter,bulky,thickening,p osterior,8 channel,findings,possible,exclude,hydronephrosis,tuesday,mediastinum

topic8- renal tumor imaging

kidney,renal,pancreas,mass,adrenal,cysts,enhancing,images,nephrectomy,prior,bilateral,masses,pole,cyst,cystic,includin g,multiple,lesion,solid,small,mid,vhl,lower,lesions,contrast,complex,foci,cell,upper,carcinoma,head,size,tail,evaluate,foll owing,partial,pancreatic,focus,rcc,gland,multiphase,phase,1.5,s/p,compare,characterize,patient,imaging,impression,kid neys

topic9- [this topic appears very unfocused]

images,foci,evidence,due,contrast,lung,minimal,calcification,vascular,possibly,pleural,effusion,following,bone,bilateral,li ver,fat,focus,hydronephrosis,pericardial,mass,multiple,apparent,complication,intra-

abdominal,material,subcentimeter,small,splenomegaly,kidney,infusion,clinical,definite,2002,portions,exclude,diagnosis, gallbladder,helical,spleen,since,multidetector,lower,tract,prior,probable,130,probably,focal,hilum

topic10- [this topic appears very unfocused]

gross,evidence,lung,bulky,bone,images,vascular,calcification,liver,mass,reason,contrast,impression,spine,foci,following, axilla,administration,enteric,ascites,isovue,metastasis,hilum,pleural,300,minimal,since,helical,multidetector,complicatio n,mesenteric,apparent,cc/s,effusion,splenomegaly,pericardial,hydronephrosis,delay,mediastinum,gallbladder,retroperit oneal,untoward,focus,possibly,due,2011,fat,130,clinician,ordering

topic11- head and neck imaging

neck,thick,body,level,artifacts,near,limit,due,shoulders,minimal,bilateral,dental,fillings,presumed,supraclavicular,partiall y,fossa,maxillary,2.5,cervical,upper,foci,thyroid,mass,dfov,antrum,mucosal,spine,thickening,evidence,enhancing,retenti on,since,paratracheal,jugular,side,bulky,sinus,detail,internal,contrast,obscure,small,opacification,scattered,vein,lympho ma,calcification,air,portions

topic12- outside hospital review outside,patient,images,marked,reason,review,name,clinical,findings,information,addendum,contrast,scrollable,workstat ion,re- windowable,evidently,medical,read,vascular,cardiac,cris,entered,clinician,ordering,systems,administration,separately,hi story,reported,lung,following,non- cardiac,2007,enteric,cancer,hospital,2008,scan,possible,melanoma,lightspeed,siemens,dictation,administered,center,he art,work,including,2010,remainder

topic13- brain mri

axial,brain,signal,within,enhancement,mri,findings,noted,normal,technique,sagittal,postcontrast,lobe,images,impressio n,imaging,enhancing,performed,identified,contrast,frontal,stable,lesion,posterior,post,history,small,sinuses,mass,exami nation,coronal,flair,abnormal,comparison,pre,clinical,lateral,spine,lesions,matter,thoracic,abnormality,orbits,bilaterally, paranasal,echo,cells,abnormalities,tumor,air

topic14- tumor follow-up imaging

stable,size,interval,mass,small,prior,normal,measures,increased,lesions,within,images,pelvic,contrast,performed,adrena l,see,nodules,pleural,hepatic,impression,lymphadenopathy,masses,oral,lymph,mediastinal,nodule,comparison,pulmona ry,dated,lung,retroperitoneal,today,compare,lobe,axillary,increase,anterior,diameter,multiple,glands,spleen,axial,liver,e ffusion,changes,large,soft,nodes,gland

topic15- pulmonary imaging

lobe,upper,lower,pulmonary,lung,pleural,findings,new,middle,images,consolidation,comparison,disease,impression,effu sion,opacity,nodular,mediastinal,technique,portions,patient,bronchiectasis,prior,contrast,artery,reason,atelectasis,bilat eral,infection,scan,thickening,pericardial,opacities,glass,ground,hilar,groundglass,scarring,interstitial,airspace,noncontra st,small,limited,areas,history,bronchus,base,including,increased,axillary

topic16- [this topic appears very unfocused]

normal,last,lymphadenopathy,prior,lobe,similar,contrast,examination,since,features,lymph,measuring,lower,enhancem ent,liver,minimal,nodule,nodes,comparison,lung,small,postoperative,loops,iliac,bone,pleural,increased,bowel,upper,lesi ons,tiny,hypodensity,thickening,identified,technique,indication,short,axis,near,anterior,thyroid,along,spine,nodules,pos terior,evidence,aorta,axillary,region,bladder

topic17- [this topic appears very unfocused]

unremarkable,noted,structures,within,skeletal,new,scan,performed,findings,technique,intravenous,prior,lobe,stable,ora l,liver,reason,nodules,contrast,pleural,axillary,imaged,thoracic,spleen,hilar,impression,pancreas,multiple,nodule,otherwi se,effusion,pulmonary,see,patient,fluid,mediastinal,cts,comparison,pericardial,visualized,example,free,adrenals,kidneys, retroperitoneal,current,isovue-300,130,information,hepatic

topic18- musculoskeletal MRI

subcutaneous,soft,tissue,fat,mass,thigh,lytic,lesion,rib,posterior,skin,muscle,wall,femur,masses,proximal,increased,asso ciated,metastases,anterior,lower,aspect,edema,joint,hip,femoral,upper,bone,sarcoma,lateral,fracture,calf,iliac,metastas is,thighs,medial,muscles,distal,melanoma,head,history,extension,bilateral,marrow,knee,extending,tissues,breast,compa rison,thickening

findings,include,evidence,mri,liver,prior,scans,mass,intravenous,lesions,change,lesion,present,impression,compare,imag es,comparison,renal,metastases,previous,abdominal,hepatic,multiple,technique,gadolinium,changes,consistent,see,sinc e,adrenal,example,injection,splenic,size,indication,made,enlargement,reason,difference,retroperitoneal,magnevist,perf ormed,masses,mediastinal,nodule,including,entered,node,developing,cris

Second-level sub-topics of document-level topic #77:

kidney,images,abdomen,e.g,prior,mass,pancreas,following,cysts,adrenal,liver,foci,renal,contrast,approximate,including,f ocus,cyst,bilateral,masses,size,enhancing,for,also,given,possibly,mid,2.5,vascular,without,due,nephrectomy,please,1.5,f rom,few,multiphase,subcentimeter,least,comparison,patient,dualphase,length,apparent,complication,obtained,upper,st udy,lower,vhl

Impression: This topic appears to be about abdominal masses. However, in some of the images, it is not completely certain if the image has a mass (some of the masses may be small, and it would need the report to direct us as to where to look).

Topic 77-01,

appearing,minimal,p.m,fluid,increasing,reviewed,catheter,discussed,since,lower,e.g,decreasing,pleural,for,atelectasis,ca va,vena,bilateral,radiodensity,patient,and/or,tuesday,thickening,chest,minimally,tip,findings,colon,effusion,lung,effusio ns,venous,moderate,report,gone,bowel,exclude,possible,obtained,clinical,gas,superior,edema,contrast,possibly,abscess, can,upper,wednesday,s/p

Impression: The words in this topic are not focused on a particular topic, and the images do not strongly correlate with the words. For example, words like fluid, increasing, catheter, decreasing, pleural, atelectasis, tip, effusion, edema, and abscess (highlighted in yellow) suggest that this topic may be focusing on free fluid in the chest or abdomen, however, none of the images show free fluid. The majority of the images are demonstrating an intraabdominal mass.

Topic 77-02,

bulky,pelvis,bone,gross,since,liver,abdomen,calcification,vascular,study,lung,mass,isovue,dfov,without,contrast,adminis tration,impression,metastasis,chest,for,images,mesenteric,axilla,following,hilum,cc/s,helical,multidetector,ascites,enteri c,reason,apparent,complication,pleural,splenomegaly,pericardial,hydronephrosis,delay,effusion,mediastinum,obtained, 300,spine,gallbladder,report,130,retroperitoneal,spleen,e.g

Impression: The images in this topic heading suggest this topic heading focuses on bulky tumor. However, the words in this topic are not strongly focused on tumor.

Topic 77-03,

abdomen,chest,pelvis,foci,images,calcification,vascular,small,since,bone,minimal,lung,lymph,report,without,following,li ver,obtained,contrast,pleural,nodes,apparent,complication,bilateral,pericardial,infusion,hydronephrosis,bulky,effusion,a xilla,mass,subcentimeter,spleen,130,hilum,multidetector,splenomegaly,helical,metastasis,gallbladder,cc/s,delay,definite ,due,few,history,spine,isovue,focus,mesenteric

Impression: As in topic 77-02, the images in this topic heading suggest this topic heading focuses on tumor. However, the words in this topic are not strongly focused on tumors.

Topic 77-04,

increasing,e.g,metastases,masses,metastasis,minimally,since,appearing,decreasing,fat,subcutaneous,foci,lung,and/or,ap proximate,chest,possibly,least,lower,size,bilateral,mass,moderately,pleural,effusion,upper,pelvis,lesion,though,focus,on e,thigh,exclude,minimal,can,due,lytic,probably,liver,soft,lobulated,side,wall,1.5,tissue,posterior,length,melanoma,some, about

Impression: A number of the images and several words (highlighted in yellow) assigned to this topic show multifocal masses, so it is suspected that this topic may be focusing on multifocal metastatic disease.

Topic 77-05,

images,axial,t1-weighted,without,prior,liver,following,t2-weighted,tesla,fat-

suppressed,multiple,sequences,e.g,characteristic,obtained,1.5,foci,fat,abdomen,for,prolonged,coronal,including,relaxati on,hydronephrosis,mri,magnevist,splenomegaly,complication,apparent,vascular,pleural,impression,report,effusion,cont rast,reason,study,mass,administration,since,focus,multiphase,definite,echo,defect,gross,filling,ascites,into

Impression: The majority of these words are focused on the acquisition of MRI (they are highlighted in blue), however none of the images are MRI images.

Topic 77-06,

neck,thick,minimal,bilateral,body,foci,level,near,artifacts,lymph,study,small,nodes,shoulders,due,limit,since,dental,mass ,fillings,presumed,partially,e.g,decreasing,2.5,fossa,untoward,maxillary,supraclavicular,antrum,upper,cervical,dfov,mini mally,scattered,bulky,axilla,thickening,periaortic,mucosal,increasing,vascular,chest,subcentimeter,thyroid,appearing,len gth,lymphoma,pelvis,iliac

Impression: A number words in this topic seem to refer to head and neck imaging (highlighted in blue), however, only two of the images assigned to this topic are of the head/neck. A number of other words seem to focus on

lymphadenopathy (highlighted in yellow), however here again the images to not conclusively support this topic heading. It is possible that this topic is focused on patients with lymphoma who require head and neck imaging with body imaging, however, the images do not conclusively support this.

Topic 77-07,

gross,images,bulky,bone,lung,calcification,mass,e.g,into,pelvis,exam,vascular,clinician,cris,ordering,entered,spine,since, minimal,for,liver,reason,also,without,from,impression,reconstructed,data,axilla,pleural,ascites,fat,intra-

abdominal,2012,mesenteric,effusion,administration,hilum,splenomegaly,contrast,helical,untoward,enteric,pericardial,h ydronephrosis,multidetector,obtained,following,abdomen,complication

Impression: The words in this topic are not focused. The images grouped with this topic also lack focus, though many appear to contain tumors.

Topic 77-08, contrast,study,pelvis,definite,administration,abdomen,not,portions,partially,calcification,due,material,images,fat,multip le,limit,only,well,vascular,enteric,tract,opacified,intra- abdominal,request,minimal,kidneys,limited,paucity,obtained,mass,gallbladder,chest,foci,clinical,hydronephrosis,indicat ed,comparison,clinically,report,artifacts,splenomegaly,following,possibly,detail,effusion,patient,multidetector,though,a dvise,helical

Impression: Like topic 77-09, the words in this topic are not focused. The images grouped with this topic also lack focus, though many appear to contain tumors.

Topic 77-09,

lung,chest,pleural,images,bilateral,minimal,effusion,lower,obtained,pericardial,multidetector,helical,axilla,study,report, mass,infiltrate,for,scarring,since,bulky,and/or,clinical,splenomegaly,dfov,cavity,e.g,impression,decreasing,infiltrates,foca l,mediastinum,disease,atelectasis,hydronephrosis,small,reason,upper,untoward,history,probable,appearing,calcification ,lobe,8-channel,supine,scattered,prone,bone,intervals

Impression: The majority of the images assigned to this topic contain liver tumors. However, the words assigned to this topic don’t seem to reflect the focus on liver tumors.

Sentence-level topics: