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Wintermark, Max (1, * ); Li, Ying (1, *); Ding, Victoria Y. (2, *); Xu, Yingding (1); Jiang, Bin (1); Ball, Robyn L. (2); Zeineh, Michael (1, *); Gean, Alisa (3); Sanelli, Pina (4)

(1) Department of Radiology, Neuroradiology Division, Stanford University , Stanford, California. (2) Department of Medicine, Quantitative Sciences Unit, Stanford University , Stanford, California. (3) Department of Radiology, Neuroradiology Section, University of California , Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California. (4) Department of Radiology, Northwell Hofstra School of Medicine , Northwell Health, Manhasset, New York.

Address correspondence to: Max Wintermark, MD, MAS, MBA, Department of Radiology, Neuroradiology Division, Stanford University, 300 Pasteur Drive, Room S047, Stanford, CA 94305-5105 [email protected]

Introduction

Traumatic brain injury (TBI) is a complex, multi-faceted condition. Each year more than 2.5 million persons in the United States seek medical care for TBI. According to the U.S. Centers for Disease Control and Prevention, an estimated 2% of the United States population now lives with TBI-caused disabilities, at an annual cost of about $77 billion.1,2

Imaging is critical in the identification and treatment of these patients. The goals of imaging include (1) detecting injuries that may require immediate surgical or procedural intervention, (2) detecting injuries that may benefit from early medical therapy or vigilant neurologic supervision, and (3) determining the prognosis of patients to tailor rehabilitative therapy or discharge planning. There is inconsistent use of terminology in radiology reporting, however, thus leading to variations in clinical practice.3–6 Thus, the challenge remains for physicians to understand the inconsistent terminology among radiologists to guide appropriate management and treatment decisions.3–6

The common data elements (CDEs) were developed for TBI to promote the use of consistent terminology and definitions in characterizing intracranial injuries across all imaging studies, as well as all clinical aspects of TBI.7,8 The CDEs include an extensive list of the injuries that can be identified with definitions of terms used to describe these injuries on the images. To date, CDEs are not commonly adopted in radiology reporting unlike other imaging classification schemes such as the Breast Imaging and Reporting Data System (BI-RADS), perhaps because CDEs are not associated with specific patient care or treatment decisions.

The existing classification schemes,...

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