Objective

The majority of radiological reports are still written as free text and lack structure. Further evaluation of free-text reports is difficult to achieve without a great deal of manual effort, and is not possible in everyday clinical practice. This study aims to automatically capture clinical information and positive hit rates from narrative radiological reports of suspected urolithiasis using natural language processing (NLP).

Methods

Narrative reports of low dose computed tomography (CT) of the retroperitoneum from April 2016 to July 2018 (n = 1714) were analyzed using NLP. These free-text reports were automatically structured based on RadLex concepts. Manual feedback was used to test and train the NLP engine to further enhance the performance. The chi-squared test, phi coefficient, and logistic regression analysis were performed to determine the effect of clinical information on the positive hit rate of urolithiasis.

Results

Urolithiasis was affirmed in 72% of the reports; in 38% at least one stone was described in the kidneys, and in 45% at least one stone was described in the ureter. Clinical information, such as previous stone history and obstructive uropathy, showed a strong correlation with confirmed urolithiasis (p = 0.001). Previous stone history and the combination of obstructive uropathy and loin pain had the highest association with positive urolithiasis (p < 0.001).

Conclusion

Applying this NLP approach to already existing free-text reports allows the conversion of such reports into a structured form. This may be valuable for epidemiological studies, to evaluate the appropriateness of CT examinations, or to answer a variety of research questions.

中文翻译：

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在疑似尿路结石的患者中，采用自然语言处理技术来实现数据驱动的医学成像。

目的

大多数放射学报告仍以自由文本形式编写，缺乏结构。没有大量的人工就很难实现对自由文本报告的进一步评估，并且在日常临床实践中是不可能的。本研究旨在使用自然语言处理（NLP）从可疑尿路结石的叙述性放射学报告中自动捕获临床信息和阳性命中率。

方法

使用NLP分析了2016年4月至2018年7月（n = 1714）的腹膜后低剂量计算机断层扫描（CT）的报道。这些自由文本报告是根据RadLex概念自动构建的。手动反馈用于测试和训练NLP引擎，以进一步提高性能。进行卡方检验，phi系数和logistic回归分析，以确定临床信息对尿路结石阳性率的影响。

结果

尿石症在72％的报告中得到肯定；在38％的肾脏中至少有1个结石，在输尿管中至少有1个结石。临床信息，例如既往结石病史和阻塞性尿毒症，与确诊的尿路结石症有很强的相关性（p  = 0.001）。既往的结石病史以及阻塞性尿毒症和腰痛的合并与尿路结石阳性呈最高相关性（p  <0.001）。

结论

将这种NLP方法应用于现有的自由文本报告可以将此类报告转换为结构化形式。这对于流行病学研究，评估CT检查的适当性或回答各种研究问题可能是有价值的。