# The LELEX initiative to enhance cancer imaging communication: development of a consensus-based structured reporting template and lexicon for general oncologic imaging

## TL;DR

The LELEX initiative created a standardized system for cancer imaging reports to improve communication and clinical decision-making.

## Contribution

A multidisciplinary consensus-based structured reporting template and lexicon for oncologic imaging was developed.

## Key findings

- A structured report using the LELEX lexicon was rated higher in precision than traditional free-text reports.
- Over 88% of panelists found the structured report better for guiding clinical decisions.
- Consensus was reached on all components of the lexicon and the structured report template.

## Abstract

The Laudo Estruturado e Léxico em Oncologia (LELEX, Lexicon and
Structured Reporting in Oncology) initiative was established to develop a
standardized lexicon and structured reporting system applicable across
cancer types.

The São Paulo Radiology Society and Brazilian Society of Medical
Oncology assembled a 27-member multidisciplinary consensus panel that
included radiologists, medical and radiation oncologists, surgeons, and a
patient representative. A literature review identified relevant oncologic
reporting frameworks to guide the creation of a draft template and lexicon
by the LELEX executive committee. Panelists were surveyed to assess current
reporting practices and preferences between free-text and structured
reports. Consensus (i.e., agreement by more than 80% of panelists) on the
final lexicon and reporting system was reached through post-survey panel
discussions.

Compared with a traditional free-text report, a structured report
incorporating the LELEX lexicon received significantly higher ratings for
precision and was deemed better for guiding clinical decisions by > 88%
of panelists. In post-survey discussions, consensus was achieved for all
lexicon components, including diagnostic certainty terms, lesion count
descriptors, and longitudinal comparison language. The structured report
template was also agreed upon by the panel members.

The LELEX initiative established a consensus-driven structured reporting
system and lexicon for general oncologic imaging baseline and follow-up
assessments.