First Name

Last Name

Company

Email

Modality CTMRIX-rayUltrasoundPET/CTPET/MRDEXAEchocardiographyFluorescence

Other modality

Body part Chest-abdomen-pelvisPelvisLiver/SpleenKidney/RenalProstateHead-neckSkull/Facial StructuresNeckThyroidLumbar SpineCervical SpineThoracic SpineCardiacShoulderHumerusClavicle/CollarboneRibElbowForearmWristHandHipFemurKneeAnkleFootLower-limb/leg

Other body parts

Protocol Name / Type

Contrast YESNO

Manufacturer Any manufacturerSiemensGEToshibaPhilipsHitachiSamsung

Radiology reports YESNO

Source location AnywhereUSAEuropeSouth AmericaAsiaAfrica

Metadata requirements AgeGenderDate of the examRaceSlice thicknessSeries descriptionOther

Other metadata details

Total exams

EHR data YESNO

EHR data details

Approximate Budget

Other requirements or details

Comments