According to some embodiments of the invention, improved systems and methods for medical imaging report input are provided. A zero footprint software extension is provided that interfaces with supported hardware devices, such as dictation devices. The extension may be agnostic to different medical facilities and different medical imaging systems. Radiologists may quickly populate medical imaging reports with existing structured data included in the EMRs or other forms, such as medical orders. Radiologists may also use voice recognition technology in conjunction with the dictation devices to fill in diagnoses and other relevant information in the medical imaging reports. The functionality of the dictation devices may be configured by the radiologists to meet their preferences and needs, either generally or with respect to a specific medical imaging report.