Updates: National Radiology Data Registry

Participation in ACR® registries helps your facility benchmark your performance to peers on measures important for patient care and carrying out quality improvement. Learn about critical updates to several of the registries that comprise the ACR National Radiology Data Registry (NRDR®), including the Dose Index Registry (DIR), 3D Printing Registry (3DP) and Lung Cancer Screening Registry (LCSR).

DIR-Fluoroscopy Paper Receives Recognition

The DIR-Fluoroscopy (DIR-Fluoro) pilot team received the 2023 People’s Choice Award from the Journal of Vascular and Interventional Radiology for the paper: Patient Radiation Doses in IR Procedures: The American College of Radiology Dose Index Registry-Fluoroscopy Pilot.

The People’s Choice Award recognizes articles that garner the most readership interest, measured by the number of downloads from when the pre-proof version is posted online through three months after print publication. The paper detailed the DIR-Fluoro pilot study, a collaborative effort that collected data from 70,377 fluoroscope-guided procedures mapped to the ACR Common™ collection of common radiology terms and semantic structures from March 2018 through December 2019.

“This study, conducted with 50 fluoroscopes from 10 sites, demonstrates how this data can be used to prioritize procedures for radiation optimization and provides valuable insights into our practices, paving the way for improved patient care and safety,” says lead author A. Kyle Jones, PhD, DIR Steering Committee Chair and a professor in the Departments of Imaging Physics and Interventional Radiology at the University of Texas MD Anderson Cancer Center.
A webinar series launching this fall about participating in the DIR-Fluoro module will include case studies on how participation can help your practice deliver optimum patient care. Watch the DIR page for details.

Now Available: DIR Module-Specific Registry Administrator Role

DIR participants can now designate a registry administrator for each DIR module: CT, Fluoroscopy, Digital Radiography and Nuclear Medicine (the latter two are in the pilot phase). This change allows facilities to designate a module-specific point person to receive NRDR communications. For example, the registry administrator for CT will receive DIR CT updates and notices, and the registry administrator for Fluoro will receive DIR-Fluoro updates and notices.

The following NRDR Support Knowledge Base articles provide information about creating and managing user accounts and profiles:

• Invite New Users to Create a NRDR Account.
• Manage User Profiles.

Check out these related DIR resources:

• Visit NRDR Publications to view papers published with analysis support from the NRDR team.
• The DIR Startup Guide.
• Benefits of DIR Participation.

3D Printing Registry Streamlines Data Entry and Submission

The 3DP Registry committee has worked diligently over the past year to implement new data submission strategies to minimize the staff time required to submit data to the registry. This work was pursued to advance the goals of the joint ACR-Radiological Society of North America registry to characterize the clinical indications, resource utilization and clinical impact of 3DP. The intended outcome is to develop benchmarks based on current practice, enable quality improvement and provide CMS with data required for reimbursement considerations.

New enhancements include:

• Streamlined data collection: As of fall 2023, data submission requirements for each 3DP case were significantly simplified by trading generality for efficiency. For example, the previous version of the registry data system allowed for multiple clinical indications, imaging modalities and printing technologies to be described for a given case. The registry update simply requires the most fundamental indication, imaging exam and printer type, resulting in a shorter, easier case report form. See the 3DP Registry Data Dictionary to learn more about the simplified requirements.
• New data upload template: 3DP Registry participants have a new option for data submission. As of May 2024, facilities can populate a template (a spreadsheet file) with data for multiple cases to upload to the registry. For facilities that already collect the required case data in other systems, this upload mechanism will enable automated data gathering for registry submission. Facilities can also continue to submit individual case data through the online form. See the 3D Printing (3DP) Registry Data Submission Overview for details.

“We’ve been fortunate to have a dedicated core group of practices that have submitted thousands of 3DP cases since the inception of the registry in 2020,” says 3DP Registry Committee Co-Chair Kenneth C. Wang, MD, PhD, a radiologist at the Baltimore VA Medical Center and an adjunct associate professor at the University of Maryland. “Their feedback has led to improvements in the data submission process, and we invite all practices performing 3D printing at the point of care to join the registry. Participants gain access to data, which provides insights into their own practice of 3DP, allows practitioners to demonstrate value within their own institutions, and also enables them to gauge their own methods and workflows against those of the broader registry community.”

Check out these related 3DP resources:

• Video of Dr. Wang describing the benefits of 3DP Registry participation.
• 3DP Registry Startup Guide.

LCSR Adds Incidental Pulmonary Nodule Management Module

The LCSR is expanding to incorporate a module that will provide insight into the management of actionable incidental pulmonary nodules (IPNs): Those nodules that warrant ongoing observation, additional diagnostic testing or treatment. The ACR received a grant award focused on developing diagnostic performance feedback for physicians participating in quality improvement registries for the IPN module planning phase.

Alongside lung cancer screening, the management of IPNs presents a significant opportunity for the early detection of lung cancer. However, many reports indicate that radiologists did not adequately complete recommended follow-ups for patients with actionable IPNs within the identified time frame, potentially leading to delayed cancer diagnoses. The IPN module aims to address this issue by providing facilities with feedback on the effectiveness of their IPN follow-up tracking processes. This will equip LCSR participants with crucial data for quality improvement and enhanced patient care opportunities.

Ella A. Kazerooni, MD, MS, FACR, and Ben C. Wandtke, MD, MS, are co-leading the planning and development of this module, building on the IPN measure developed by the Recommendations Follow-Up Improvement Collaborative and the Closing the Recommendations Follow-up on Actionable Incidental Findings initiative. These measures are likely to form the basis for performance measurement in the IPN module.

Most recently, the IPN planning grant team is soliciting input from relevant ACR committees (e.g., LCSR, LCS Steering, Incidental Finding and Lung-RADS®) about including topics such as critical data fields in the module and about standardizing terminology for IPN management with Fleischner Society guidelines serving as the basis. Fleischner Society criteria provide guidelines for the management and follow-up of incidental findings on chest imaging, including pulmonary nodules. By aligning with these criteria, the IPN registry can ensure consistency and standardization in reporting and managing IPNs, thereby facilitating communication and collaboration among healthcare providers and researchers.

Read the Voice of Radiology blog post, Harnessing the Value of Clinical Registries, to learn more about the LCSR expansion.