Time Efficiency and Feasibility of Lesion Dashboard Workflow for Computing RECIST (response Evaluation Criteria in Solid Tumors) Treatment Response Assessment.

e17675 Background: Lesion measurements in oncology research subjects are communicated in radiology reports and manually tabulated by clinical research associates (CRAs) in most clinical research centers. This workflow is inefficient, error prone and suffers from dissociating measurement and image data. We evaluate time efficiency and feasibility of Lesion Dashboard (LD), a software application that consumes a patient's structured measurements directly from the Picture Archiving Communication System (PACS), gives an image-integrated, longitudinal quantitative disease review and enables RECIST assessment. Methods: CT exams, reports and RECIST worksheets of 16 oncology research subjects on therapeutic clinical trials were obtained retrospectively. LD was developed presenting longitudinal measurements, collected by Lesion Tracker (LT), a PACS tool used by Radiology, and gives one-click access to pertinent image slices and reports. The images of the 16 patients were annotated with LT. Part 1: 4 CRAs tabulated measurements from the reports into worksheets, mimicking the traditional workflow. Part 2: 4 oncologists and 4 CRAs (same as in Part 1) completed RECIST assessment in LD and were surveyed thereafter. Time to complete a case was measured in both parts. Results: Completing RECIST assessment in LD required 77.8 seconds on average per patient case (oncologists: 107.9s; CRAs: 47.8s). In the traditional workflow, CRAs were less efficient per case (240.5s). The difference is significant for each CRA (paired t-test; P < .0001). On average per case, oncologists opened images of 2.0 lesions and 0.1 reports. In the survey, all 8 participants agreed that LD was intuitive and easy to use. All 4 oncologists strongly preferred LD over traditional workflow and strongly agreed that populating LD with LT data is a value-add to Radiology's service. Conclusions: LD creates a more efficient workflow for computing response assessment that is error-free due to automated propagation of measurement data and gives one-click access to image data. User survey results indicate that the new workflow is feasible and preferred compared to the traditional workflow.