Radiologist and multidisciplinary team clinician opinions on the quality of MRI rectal cancer staging reports: how are we doing?

Published on Aug 1, 2019in Clinical Radiology2.118
· DOI :10.1016/J.CRAD.2019.04.015
P. J. Brown1
Estimated H-index: 1
(Leeds Teaching Hospitals NHS Trust),
P.J. Brown2
Estimated H-index: 2
(Leeds Teaching Hospitals NHS Trust)
+ 5 AuthorsDamian Tolan18
Estimated H-index: 18
(Leeds Teaching Hospitals NHS Trust)
AIM To evaluate the current opinion of magnetic resonance imaging (MRI) reports amongst specialist clinicians involved in colorectal cancer multidisciplinary teams (CRC MDTs). MATERIALS AND METHODS Active participants at 16 UK CRC MDTs across a population of 5.7 million were invited to complete a questionnaire, this included 22 closed and three open questions. Closed questions used ordinal (Likert) scales to judge the subjective inclusion of tumour descriptors and impressions on the clarity and consistency of the MRI report. Open (free-text) questions allowed overall feedback and suggestions. RESULTS A total of 69 participants completed the survey (21 radiologists and 48 other CRC MDT clinicians). Both groups highlighted that reports commonly omit the status of the circumferential resection margin (CRM; 83% versus 81% inclusion, other clinicians and radiologists, respectively, p>0.05), presence or absence of extra-mural venous invasion (EMVI; 67% versus 57% inclusion, p>0.05), and lymph node status (90% inclusion in both groups). Intra-radiologist agreement across MRI examinations is reported as 75% by other clinicians. Free-text comments included suggestions for template-style reports. CONCLUSION Both groups recognise a proportion of MRI reports are suboptimal with key tumour descriptors omitted. There are also concerns around the presentation style of MRI reports and inter- and intra-radiologist report variability. The widespread implementation of standardised report templates may improve completeness and clarity of MRI reports for rectal cancer and thus clinical management and outcomes in rectal cancer.
📖 Papers frequently viewed together
7 Citations
45 Citations
117 Citations
#1P.J. Brown (Leeds Teaching Hospitals NHS Trust)H-Index: 2
#2H. Rossington (St James's University Hospital)H-Index: 2
Last. Damian Tolan (Leeds Teaching Hospitals NHS Trust)H-Index: 18
view all 8 authors...
Purpose Rectal cancer staging with magnetic resonance imaging (MRI) allows accurate assessment and preoperative staging of rectal cancers. Therefore, complete MRI reports are vital to treatment planning. Significant variability may exist in their content and completeness. Template-style reporting can improve reporting standards, but its use is not widespread. Given the implications for treatment, we have evaluated current clinical practice amongst specialist gastrointestinal (GI) radiologists to...
12 CitationsSource
#1Marc J. Gollub (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 36
#2Supreeta Arya (ACTREC: Tata Memorial Hospital)H-Index: 16
Last. Mukesh G. Harisinghani (Harvard University)H-Index: 55
view all 19 authors...
Purpose To propose guidelines based on an expert-panel-derived unified approach to the technical performance, interpretation, and reporting of MRI for baseline and post-treatment staging of rectal carcinoma.
46 CitationsSource
#1Regina G. H. Beets-Tan (NKI-AVL: Netherlands Cancer Institute)H-Index: 77
#2Doenja M. J. Lambregts (NKI-AVL: Netherlands Cancer Institute)H-Index: 18
Last. Lennart Blomqvist (Karolinska University Hospital)H-Index: 29
view all 19 authors...
Objectives To develop guidelines describing a standardised approach regarding the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer.
360 CitationsSource
#1Dhakshinamoorthy Ganeshan (University of Texas MD Anderson Cancer Center)H-Index: 18
#2Phuong-Anh T. Duong (Emory University)H-Index: 9
Last. Isaac R. Francis (UM: University of Michigan)H-Index: 72
view all 10 authors...
Radiology reports are vital for patient care as referring physicians depend upon them for deciding appropriate patient management. Traditional narrative reports are associated with excessive variability in the language, length, and style, which can minimize report clarity and make it difficult for referring clinicians to identify key information needed for patient care. Structured reporting has been advocated as a potential solution for improving the quality of radiology reports. The Association...
72 CitationsSource
OBJECTIVE. When considering organ preservation in patients with rectal cancer with good tumor response, assessment of a node-negative status after chemoradiation therapy (CRT) is important. DWI is a very sensitive technique to detect nodes. The study aim was to test the hypothesis that the absence of nodes at DWI after CRT is concordant with a ypN0 status. MATERIALS AND METHODS. A retrospective study was performed of 90 patients with rectal cancer treated with CRT followed by restaging MRI at 1....
30 CitationsSource
#1Simon King ('JHCH': John Hunter Hospital)H-Index: 1
#2Margaret Dimech (Royal College of Pathologists of Australasia)H-Index: 3
Last. Susan Johnstone ('JHCH': John Hunter Hospital)H-Index: 1
view all 3 authors...
Summary We examined whether introduction of a structured macroscopic reporting template for rectal tumour resection specimens improved the completeness and efficiency in collecting key macroscopic data elements. Fifty free text (narrative) macroscopic reports retrieved from 2012 to 2014 were compared with 50 structured macroscopic reports from 2013 to 2015, all of which were generated at John Hunter Hospital, Newcastle, NSW. The six standard macroscopic data elements examined in this study were ...
13 CitationsSource
#1Caro E. Sluijter (Radboud University Nijmegen)H-Index: 4
Last. Lucy I. H. OverbeekH-Index: 14
view all 5 authors...
Pathology reporting is evolving from a traditional narrative report to a more structured synoptic report. Narrative reporting can cause misinterpretation due to lack of information and structure. In this systematic review, we evaluate the impact of synoptic reporting on completeness of pathology reports and quality of pathology evaluation for solid tumours. Pubmed, Embase and Cochrane databases were systematically searched to identify studies describing the effect of synoptic reporting implement...
56 CitationsSource
#1Luc A. Heijnen (UM: Maastricht University)H-Index: 14
#2Monique Maas (UM: Maastricht University)H-Index: 34
Last. Geerard L. Beets (NKI-AVL: Netherlands Cancer Institute)H-Index: 70
view all 8 authors...
Purpose This study aims to explore the influence of chemoradiation treatment (CRT) on rectal cancer nodes and to generate hypotheses why nodal restaging post-CRT is more accurate than at primary staging.
42 CitationsSource
#1Yoshihiko Kono (Jichi Medical University)H-Index: 3
#2Kazutomo Togashi (Jichi Medical University)H-Index: 21
Last. Yoshikazu Yasuda (Jichi Medical University)H-Index: 24
view all 8 authors...
Abstract Although size criteria have been proposed to identify lymph node metastases in patients with rectal cancer, size may not be an accurate predictor. Specimens from consecutive rectal cancer patients who underwent curative-intent radical surgery were examined. The long and short axes of lymph nodes were measured on the glass slides using micrometer calipers. The pathologic diagnosis was used as the reference. The diagnostic accuracy of metastatic status according to lymph node size was eva...
7 CitationsSource
#1Y L Woods (Ninewells Hospital)H-Index: 1
#2S Mukhtar (Ninewells Hospital)H-Index: 1
Last. Frank A. Carey (Ninewells Hospital)H-Index: 21
view all 6 authors...
Aims The main purpose of the study was to present a baseline audit of reporting of colorectal cancers resection specimens in Scotland, audited against the Royal College of Pathologists (RCPath) standards (2007) and NHS Quality Improvement Scotland (NHS QIS) standards. Methods 50 consecutive rectal and 50 consecutive colonic cancer cases from 2011 were audited from 10 Scottish health boards involved in colorectal cancer reporting (n=953). The rates of reporting of serosal involvement, extramural ...
13 CitationsSource
Cited By2
#1Anna H. Zhao (Brigham and Women's Hospital)H-Index: 1
#2Shanna A. Matalon (Brigham and Women's Hospital)H-Index: 6
Last. Ramin Khorasani (Brigham and Women's Hospital)H-Index: 41
view all 6 authors...
Purpose Assess the impact of a multifaceted intervention to improve the completeness of structured MRI reports for patients undergoing initial staging for rectal cancer. Methods This Institutional Review Board-approved retrospective study was performed at a large academic hospital. MRI reports for initial staging of rectal cancer in 2017 and 2019 were analyzed pre- and post-implementation of multiple quality improvement interventions in 2018, including harmonizing MRI protocols across the instit...
#1Gustav Alvfeldt (KI: Karolinska Institutet)
#2Peter Aspelin (KI: Karolinska Institutet)H-Index: 42
Last. Nina Sellberg (KI: Karolinska Institutet)H-Index: 2
view all 4 authors...
BackgroundMagnetic resonance imaging (MRI) is the first-line imaging modality for local staging of rectal cancer. The radiology report should deliver all relevant available imaging information to g...