# Structured, coded radiology reports for cancer response instead of free text

Source: https://onco.cc/ideas/idea-data-structured-radiology-response/  
OnCo record `idea-data-structured-radiology-response` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Radiologists would record tumour measurements and response in tick-box, coded form rather than prose, so progression is machine-readable across every scan.

## Summary

Response assessment (RECIST, PERCIST) is documented in free text that machines cannot reliably parse. Structured reporting templates with coded lesion measurements (RSNA RadReport, DICOM SR) and a response field would make progression a first-class data element for registries and RWE. The proposal mandates structured oncology follow-up reporting in publicly funded imaging and funds template integration in reporting software.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Structured response reporting will raise machine-derivable progression dates from under 30 percent to over 90 percent of follow-up scans and make real-world PFS as reliable as trial PFS.
- Rationale: Structured reporting has improved completeness in prostate MRI (PI-RADS) and lung nodules (Lung-RADS); response assessment is the missing oncology template.
- Proposed test: Deploy a structured response template at three centres; compare agreement of derived progression dates with trial-style central review in 500 patients against free-text NLP extraction.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Data silos): AACR Project GENIE: https://www.aacr.org/professionals/research/aacr-project-genie/

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/), [Imaging](https://onco.cc/fronts/imaging/)
- technologies: [CT (computed tomography)](https://onco.cc/technologies/ct/), [MRI](https://onco.cc/technologies/mri/), [PET/CT](https://onco.cc/technologies/pet-ct/)
- terms: [Progression-free survival (PFS)](https://onco.cc/terms/pfs/), [RECIST](https://onco.cc/terms/recist/)
- bottlenecks: [Data silos](https://onco.cc/bottlenecks/b-data-silos/), [Weak real-world evidence and registries](https://onco.cc/bottlenecks/b-real-world-evidence/)

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