SonoFlow: ultrasound reports from the frames you already saved

Ultrasound is the busiest modality in most Indian imaging centres, and it is also the one where the report takes the most retyping. The scan itself is quick. The radiologist (in India, very often the person holding the probe) freezes a frame, places the callipers and the machine shows the value on screen. Then the same numbers are written down a second time: read off the monitor or the saved frames, typed into a Word template or dictated to a transcriptionist, and checked again before the report is printed. On a day with forty or fifty ultrasound cases, that second round of typing is a real part of the radiologist's time.

The most common approach today is a set of templates, one per study type, with blanks where the measurements go. The advantage is that it needs no integration and every centre can do it. The disadvantage is that a person is still copying numbers from one screen to another, and that is where transposed digits, a left kidney entered as the right, or a femur length from an earlier frame creep in. SonoFlow is our ultrasound reporting module, built to remove that copying step while keeping the radiologist in charge of the report. So, let's look at why ultrasound reporting is slow, what SonoFlow does step by step, and what the radiologist should still check.

Why ultrasound reporting is slow

First, a few words about where the measurements live. On most machines, the radiologist measures on a frozen image and saves it. The saved frame (a DICOM image, sent to the PACS like any other) has the measurement drawn on it and the value printed in a corner. Some machines can also send the measurements as a DICOM Structured Report, a machine-readable list of values; Herman Oosterwijk notes in his article on DICOM SR for AI results that OB/GYN measurements were among the earliest uses of SR. In practice, many machines in Indian centres are not set up to send it, and older ones cannot. What almost every centre does have is the saved frames. (If DICOM objects are new to you, DICOM, explained for centre owners covers the basics.)

The report then has to be built from those frames. Three things make this slow.

1. Transcribing measurements. Every value on every frame is read and typed again. A routine abdomen has liver span, spleen size, both kidneys, perhaps the common bile duct and the prostate or uterus and ovaries. A pelvic or thyroid study has its own set.
2. OB worksheets. An obstetric scan carries a worksheet of its own: biparietal diameter, head circumference, abdominal circumference, femur length, the estimated fetal weight and gestational age calculated from them, liquor, placenta and presentation. The calculations are done by the machine, but the worksheet still has to be filled in for the report.
3. Growth charts. Where the referring obstetrician wants them, the measurements are plotted against reference curves so growth can be seen at a glance. Doing that by hand, or in a separate spreadsheet, is the step most centres simply skip.

None of this is difficult. It is repetitive, it happens on every case, and a typing error in a fetal measurement matters.

What SonoFlow does, step by step

SonoFlow works on the frames the centre already saves. The workflow is characterised as follows.

The report is structured because the worksheet is. Every OB report from the centre lists the same items in the same order, which referring doctors appreciate, and which makes it easy to compare this scan with the last one (we wrote about where templates earn their place in Structured reporting in radiology).

Why the radiologist still reviews and signs

A question I get often is whether this means the report writes itself. It does not, and we would not want it to. An ultrasound report is more than its measurements. The impression, the description of a lesion, the comment on fetal well-being and the advice to the referring doctor come from the person who did the scan. SonoFlow takes over the transcription; the clinical judgement stays where it was.

There is a practical reason as well. Reading values off an image is a machine task, and machine tasks can go wrong in quiet ways: a frame saved twice with different values, a measurement taken and then repeated, a label on the screen that does not match what was actually measured. A radiologist who knows what they measured will catch these in seconds. That is why every SonoFlow report is reviewed and signed by the radiologist, and why we built the review step to be fast rather than to be skipped.

What to check before you sign

When you review a SonoFlow report, start with the flagged values; they are flagged for a reason. Then, in my experience, four more checks take less than a minute and catch most problems.

1. Laterality. Right and left kidney, right and left ovary, right and left lobe of the thyroid.
2. Repeated measurements. If you measured something twice, make sure the value in the report is the one you meant to keep.
3. OB consistency. Gestational age by biometry against the dates in the history, and whether the growth chart looks like the patient in front of you.
4. The impression. It is yours. Read it as if you had typed it.

What this means for a centre

For a centre where ultrasound is most of the day's volume, the effect is simple: the radiologist spends less time typing numbers and more time on the scan and the impression. Getting started is mostly about connecting the machines. Before you do, it is worth checking three things: that every ultrasound machine can send its saved frames to a DICOM destination, that radiologists save a frame for every measurement they want in the report, and that the centre's internet line can carry the image traffic (our note on cloud PACS or on-premise has the bandwidth questions).

The practical upshot is that the slow part of ultrasound reporting was never the reading; it was the copying. Taking the copying away, and showing the radiologist exactly which values to look at, gives back time without taking the report out of the radiologist's hands.

Related reading

• Structured reporting in radiology — why consistent report structure helps referrers and comparisons.
• DICOM, explained for centre owners — how frames get from the machine to the system.
• Sharing scans with referring doctors — getting reports and images to obstetricians and physicians.

FAQ

What is SonoFlow?

SonoFlow is SOMATIQ's ultrasound reporting module. It reads the measurements off the saved ultrasound frames, fills the OB or general worksheet, flags values to check, draws OB growth charts and generates a structured report that the radiologist reviews and signs.

Does SonoFlow replace the radiologist?

No. SonoFlow removes the step of retyping measurements. The radiologist does the scan, reviews every value and the impression, and signs the report.

Do we need new ultrasound machines?

No. SonoFlow works from the frames the centre already saves. During setup, SOMATIQ connects the centre's existing ultrasound machines.

Does SonoFlow include a RIS-PACS?

Yes. Every SonoFlow subscription includes the full Somatiq Origin RIS-PACS for all modalities, with the worklist, browser viewer, AI reporting, voice dictation and WhatsApp delivery.