from AJR

1. worrisome for
compatible with
may be
highly suggestive of
suggestive of
consistent with
suspicious for
possible
less likely unlikely

2. “How sure are you?”
Referring physicians often ask the radiologist
D. M. Panicek, et al. AJR Am J Roentgenol. 2016;207(1):2-3.

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
impression
○ Posted on each PACS workstation
○ Displayed on the home page
○ Printed at the bottom of each radiology report

4. Certainty Terms
Radiologist’s
certainty
Consistent with > 90%
Suspicious for / Probable / Probably ~ 75%
Possible / Possibly ~ 50%
Less likely ~ 25%
Unlikely < 10%

5. Consistent With (> 90%)
“ Patchy consolidation in the right lung is consistent
with pneumonia in this patient with fever and
cough.
”

6. 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

7. Possible / Possibly (~50%)
A small lung nodule is possibly a granuloma or
possibly a metastasis.
“
”

8. Less Likely (~25%)
Two small sclerotic osseous lesions are probably
bone islands; blastic metastases seem less likely.
“
”

9. Unlikely (< 10%)
Small sclerotic lesion in ischium is probably a bone
island; the lesion is unlikely to represent metastatic
renal cancer.
“
”