Key Images are… well, key!

As I discuss key images with vendor and healthcare provider staff, I have come to the realization that they are not well understood. Let’s see if we can correct that.

What are key images?

In most contexts, they are images within a medical imaging exams that the Radiologist reviewing the exam wishes to indicate for others, such as the referring physician and clinicians, that they are important in understanding the diagnosis.

In other context, they may represent important images for teaching purposes, quality control, surgical planning or other purposes.

In any case, they serve some importance over other images in the exam and the user wishes to communicate this. That’s why they are ‘key’.

Who creates key images and how?

In the digital world, any authorized user can mark an image as a key image on any system that supports this function. Typically, this function is restricted to authorized users like Radiologists on systems like PACS; however, they may also be created by Technologists/Radiographers on modality workstations or clinical imaging systems, like an Enterprise Viewer in an EMR.

Key images are normally created in one of two ways:

  • Manually by selecting an image and choosing a key image method
  • Automatically by creating some other form of markup or measurement on the image (implying that it has some importance)

The latter capability is important as getting Radiologists to take the time to mark images as key is often difficult. And if they are not created, the consumer does not benefit from them.

Special case: In systems that allow the user to create spine labels, these should not result in automatic key image creation.

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