Scholars@Duke
Christopher John Roth

Christopher John Roth

Professor of Radiology
Radiology, Neuroradiology
Box 3808 Med Ctr, Durham, NC 27710
Department of Radiology, Box 3808, Durham, NC 27710

Selected Publications

Proof-of-Concept Prompted Large Language Model for Radiology Procedure Request Routing.

Journal Article J Vasc Interv Radiol · July 2025 Featured Publication PURPOSE: To measure the accuracy and cost of a proof-of-concept prompted large language model (LLM) to route procedure requests to the appropriate phone number or pager at a single large academic hospital. MATERIALS AND METHODS: At a large academic hospita ... Full text Link to item Cite

Ocular Imaging Challenges, Current State, and a Path to Interoperability: A HIMSS-SIIM Enterprise Imaging Community Whitepaper.

Journal Article J Imaging Inform Med · June 2025 Featured Publication Office-based testing, enhanced by advances in imaging technology, is routinely used in eye care to non-invasively assess ocular structure and function. This type of imaging coupled with autonomous artificial intelligence holds immense opportunity to diagno ... Full text Link to item Cite

Celebrating 10 Years of the HIMSS-SIIM Enterprise Imaging Community and Enterprise Imaging Informatics.

Journal Article J Imaging Inform Med · December 2024 Featured Publication In response to the growing recognition of enterprise imaging as a critical component of healthcare's digital transformation, in 2014, the Healthcare Information and Management Systems Society (HIMSS) and the Society for Imaging Informatics in Medicine (SII ... Full text Link to item Cite

HIMSS-SIIM Enterprise Imaging Community White Papers: Reflections and Future Directions.

Journal Article J Imaging Inform Med · April 2024 Featured Publication Full text Link to item Cite

Implementation of Clinical Artificial Intelligence in Radiology: Who Decides and How?

Journal Article Radiology · December 2022 Featured Publication As the role of artificial intelligence (AI) in clinical practice evolves, governance structures oversee the implementation, maintenance, and monitoring of clinical AI algorithms to enhance quality, manage resources, and ensure patient safety. In this artic ... Full text Link to item Cite

How Image Exchange Breaks Down: the Image Library Perspective.

Journal Article J Digit Imaging · August 2022 Featured Publication While in the last decade there has been significant technical infrastructure development to support standards-based image exchange through organizations like Integrating the Healthcare Enterprise, Carequality, DICOM, and HL7 FHIR, the human operationalizat ... Full text Link to item Cite

Interactive Multimedia Reporting Technical Considerations: HIMSS-SIIM Collaborative White Paper.

Journal Article J Digit Imaging · August 2022 Featured Publication Despite technological advances in the analysis of digital images for medical consultations, many health information systems lack the ability to correlate textual descriptions of image findings linked to the actual images. Images and reports often reside in ... Full text Link to item Cite

Multi-institutional Experience with Patient Image Access Through Electronic Health Record Patient Portals.

Journal Article J Digit Imaging · April 2022 Featured Publication The objective is to determine patients' utilization rate of radiology image viewing through an online patient portal and to understand its impact on radiologists. IRB approval was waived. In this two-part, multi-institutional study, patients' image viewing ... Full text Link to item Cite

Data Sharing of Imaging in an Evolving Health Care World: Report of the ACR Data Sharing Workgroup, Part 1: Data Ethics of Privacy, Consent, and Anonymization.

Journal Article J Am Coll Radiol · December 2021 Radiology is at the forefront of the artificial intelligence transformation of health care across multiple areas, from patient selection to study acquisition to image interpretation. Needing large data sets to develop and train these algorithms, developers ... Full text Link to item Cite

Data Sharing of Imaging in an Evolving Health Care World: Report of the ACR Data Sharing Workgroup, Part 2: Annotation, Curation, and Contracting.

Journal Article J Am Coll Radiol · December 2021 A core principle of ethical data sharing is maintaining the security and anonymity of the data, and care must be taken to ensure medical records and images cannot be reidentified to be traced back to patients or misconstrued as a breach in the trust betwee ... Full text Link to item Cite

Integrating Al Algorithms into the Clinical Workflow.

Journal Article Radiol Artif Intell · November 2021 Featured Publication Integration of artificial intelligence (AI) applications within clinical workflows is an important step for leveraging developed AI algorithms. In this report, generalizable components for deploying AI systems into clinical practice are described that were ... Full text Link to item Cite

Electronic Health Record Closed-Loop Communication Program for Unexpected Nonemergent Findings.

Journal Article Radiology · October 2021 Featured Publication Background Reliance on examination reporting of unexpected imaging findings does not ensure receipt of findings or appropriate follow-up. A closed-loop communication system should include provider and patient notifications and be auditable through the elec ... Full text Link to item Cite

Multispecialty Enterprise Imaging Workgroup Consensus on Interactive Multimedia Reporting Current State and Road to the Future: HIMSS-SIIM Collaborative White Paper.

Journal Article J Digit Imaging · June 2021 Featured Publication Diagnostic and evidential static image, video clip, and sound multimedia are captured during routine clinical care in cardiology, dermatology, ophthalmology, pathology, physiatry, radiation oncology, radiology, endoscopic procedural specialties, and other ... Full text Link to item Cite

The Importance of Body Part Labeling to Enable Enterprise Imaging: A HIMSS-SIIM Enterprise Imaging Community Collaborative White Paper.

Journal Article J Digit Imaging · February 2021 Featured Publication In order for enterprise imaging to be successful across a multitude of specialties, systems, and sites, standards are essential to categorize and classify imaging data. The HIMSS-SIIM Enterprise Imaging Community believes that the Digital Imaging Communica ... Full text Link to item Cite

User Governance

Chapter · January 1, 2021 According to the HIMSS-SIIM Enterprise Imaging Community, enterprise imaging governance is “the decision-making body, framework, and process to oversee and develop strategies for the enterprise imaging program, technology, information, clinical use, and av ... Full text Cite

Moving Radiology Workflow to the Electronic Health Record: Quantitative and Qualitative Experience From a Large Academic Medical Center.

Journal Article Acad Radiol · February 2020 Featured Publication RATIONALE AND OBJECTIVES: To objectively and subjectively evaluate a large, academic radiology department's transition to electronic health record (EHR) centered workflow. MATERIALS AND METHODS: Multiple metrics were compared from before and after the move ... Full text Link to item Cite

Image-Rich Radiology Reports: A Value-Based Model to Improve Clinical Workflow.

Journal Article J Am Coll Radiol · January 2017 Featured Publication PURPOSE: To determine the value of image-rich radiology reports (IRRR) by evaluating the interest and preferences of referring physicians, potential impact on clinical workflow, and the willingness of radiologists to create them. METHODS: Referring physici ... Full text Link to item Cite

A Foundation for Enterprise Imaging: HIMSS-SIIM Collaborative White Paper.

Journal Article J Digit Imaging · October 2016 Featured Publication Care providers today routinely obtain valuable clinical multimedia with mobile devices, scope cameras, ultrasound, and many other modalities at the point of care. Image capture and storage workflows may be heterogeneous across an enterprise, and as a resul ... Full text Link to item Cite

Enterprise Imaging Governance: HIMSS-SIIM Collaborative White Paper.

Journal Article J Digit Imaging · October 2016 Featured Publication Enterprise imaging governance is an emerging need in health enterprises today. This white paper highlights the decision-making body, framework, and process for optimal enterprise imaging governance inclusive of five areas of focus: program governance, tech ... Full text Link to item Cite

Orders- Versus Encounters-Based Image Capture: Implications Pre- and Post-Procedure Workflow, Technical and Build Capabilities, Resulting, Analytics and Revenue Capture: HIMSS-SIIM Collaborative White Paper.

Journal Article J Digit Imaging · October 2016 Featured Publication The decision to implement an orders-based versus an encounters-based imaging workflow poses various implications to image capture and storage. The impacts include workflows before and after an imaging procedure, electronic health record build, technical in ... Full text Link to item Cite

The Current State and Path Forward For Enterprise Image Viewing: HIMSS-SIIM Collaborative White Paper.

Journal Article J Digit Imaging · October 2016 Featured Publication Clinical specialties have widely varied needs for diagnostic image interpretation, and clinical image and video image consumption. Enterprise viewers are being deployed as part of electronic health record implementations to present the broad spectrum of cl ... Full text Open Access Link to item Cite

Workflow Challenges of Enterprise Imaging: HIMSS-SIIM Collaborative White Paper.

Journal Article J Digit Imaging · October 2016 Featured Publication With the advent of digital cameras, there has been an explosion in the number of medical specialties using images to diagnose or document disease and guide interventions. In many specialties, these images are not added to the patient's electronic medical r ... Full text Link to item Cite

ACR Appropriateness Criteria Head Trauma.

Journal Article J Am Coll Radiol · June 2016 Neuroimaging plays an important role in the management of head trauma. Several guidelines have been published for identifying which patients can avoid neuroimaging. Noncontrast head CT is the most appropriate initial examination in patients with minor or m ... Full text Link to item Cite

ACR Appropriateness Criteria Myelopathy.

Journal Article J Am Coll Radiol · January 2016 Patients presenting with myelopathic symptoms may have a number of causative intradural and extradural etiologies, including disc degenerative diseases, spinal masses, infectious or inflammatory processes, vascular compromise, and vertebral fracture. Patie ... Full text Link to item Cite

ACR Appropriateness Criteria Imaging in the Diagnosis of Thoracic Outlet Syndrome.

Journal Article J Am Coll Radiol · May 2015 Thoracic outlet syndrome is a clinical entity characterized by compression of the neurovascular bundle, and may be associated with additional findings such as venous thrombosis, arterial stenosis, or neurologic symptoms. The goal of imaging is to localize ... Full text Link to item Cite

Use of apparent diffusion coefficient values for diagnosis of pediatric posterior fossa tumors.

Journal Article Neuroradiol J · April 2014 We prospectively compared the ability of neuroradiologists to diagnose medulloblastoma with novice raters using only apparent diffusion coefficient (ADC) values measured on ADC maps. One hundred and three pediatric patients with pre-operative magnetic reso ... Full text Link to item Cite

Evaluation of MRI acquisition workflow with lean six sigma method: case study of liver and knee examinations.

Journal Article AJR Am J Roentgenol · August 2010 OBJECTIVE: The purpose of this investigation was to assess workflow for medical imaging studies, specifically comparing liver and knee MRI examinations by use of the Lean Six Sigma methodologic framework. The hypothesis tested was that the Lean Six Sigma f ... Full text Link to item Cite

Implementation of graphic user interface screen capture solution for workflow assessment of abdominal MR examinations valuable tool to analyze discrepancies in expected and experienced MR table time.

Journal Article Acad Radiol · October 2009 RATIONALE AND OBJECTIVES: The aim of this study was to assess if graphical user interface screen-capture software applied to a magnetic resonance (MR) hardware console could nonintrusively allow the analysis of discrepancies between expected and experience ... Full text Link to item Cite

A novel application of the MIRC repository in medical education.

Journal Article J Digit Imaging · June 2005 Medical students on the radiology elective in our institution create electronic presentations to present to each other as part of the requirements for the rotation. Access was given to previous students' presentations via the web-based system, Medical Imag ... Full text Link to item Cite

Quadriceps fat pad signal intensity and enlargement on MRI: prevalence and associated findings.

Journal Article AJR Am J Roentgenol · June 2004 OBJECTIVE: The purpose of this investigation was to characterize the MRI appearance of the quadriceps fat pad and to correlate the findings with other knee abnormalities, anatomic measurements of the extensor mechanism, and findings from history and at phy ... Full text Link to item Cite