�© American Roentgen Ray Society. OBJECTIVE. Despite patients' increasing interest in reading their own imaging results, little is known about how patients interpret the reporting terminology of radiologists. The purpose of this study was to survey patients and radiologists to improve understanding of how each group views commonly used phrases within the radiology report. SUBJECTS AND METHODS. Patients and radiologists were asked to assign a numerical likelihood of the presence of metastatic disease based on their understanding of radiology report phrasing. Commonly used qualifying phrases, such as “likely represents,” “concerning for,” and “cannot exclude” were evaluated to compare differences in interpretation between patients and radiologists. Potential responses for statistical likelihoods included 0–25%, 26–50%, 51–75%, 76–99%, and 100%. RESULTS. There was a significant difference between the two groups with respect to assigned statistical likelihoods for most phrases. Patients identified the phrase “probably meta-static disease” as conferring the highest likelihood of true malignancy, even though radiologists rated this phrase as conferring the sixth highest likelihood (p = 0.002). Radiologists consistently identified the phrase “diagnostic for metastatic disease” as conveying the highest likelihood of metastatic disease, whereas patients ranked this phrase as having the third highest numerical likelihood (p < 0.001). The phrase “cannot exclude cancer” was assigned the lowest numerical likelihood by both groups. CONCLUSION. Patients and radiologists have differing perceptions of the specific semantic meaning of the language in radiology reports. A variable interpretation of the radiologist's diagnostic confidence may lead to confusion and dissatisfaction with the report. Radiologists should consider that patients read their reports and should endeavor to use strategies to convey imaging results clearly and effectively.