highly suggestive of
less likely unlikely
“How sure are you?”
Referring physicians often ask the radiologist
D. M. Panicek, et al. AJR Am J Roentgenol. 2016;207(1):2-3.
● In 2009, began using a well-defined and agreed-on lexicon of certainty terms
● The lexicon terms are used consistently throughout the body and the
○ Posted on each PACS workstation
○ Displayed on the home page
○ Printed at the bottom of each radiology report
Consistent with > 90%
Suspicious for / Probable / Probably ~ 75%
Possible / Possibly ~ 50%
Less likely ~ 25%
Unlikely < 10%
Consistent With (> 90%)
“ Patchy consolidation in the right lung is consistent
with pneumonia in this patient with fever and
Suspicious for / Probable / Probably (~75%)
A 2-cm nodule in the right adrenal gland is
suspicious for metastasis. A subcentimeter left
adrenal nodule is probably an adenoma.
● “Suspicious for” generally is used when discussing a malignant entity
● “Probable / probably” is used for a benign entity
Possible / Possibly (~50%)
A small lung nodule is possibly a granuloma or
possibly a metastasis.
Less Likely (~25%)
Two small sclerotic osseous lesions are probably
bone islands; blastic metastases seem less likely.
Unlikely (< 10%)
Small sclerotic lesion in ischium is probably a bone
island; the lesion is unlikely to represent metastatic