Background: Magnetic 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 guide treatment. Purpose: To explore and describe if there was a gap between the contents in MRI reports for primary staging of rectal cancer in Sweden in 2010 compared to evidence-based practice. Material and Methods: A total of 243 primary MRI staging reports from 2010, collected from 10 hospitals in four healthcare regions in Sweden, were analyzed using content analysis with a deductive thematic coding scheme based on evidence-based practice. Focus was on: (i) most frequently reported findings; (ii) correlation to key prognostic findings; and (iii) identifying if any findings being reported were beyond the information defined in evidence-based practice. Results: Most frequently reported findings were spread through the bowel wall or not, local lymph node description, tumor length, and distance of tumor from anal verge. These items accounted for 35% of the reporting content. Of all reported content, 86% correlated with the evidence-based practice. However, these included more information than was generally found in the reports. When adjusting for omitted information, 48% of the reported content were accounted for. Of the reported content, 20% correlated to key pathological prognostic findings. Six types of findings were reported beyond the evidence-based practice, representing 14% of the total reporting content. Conclusion: There was a gap between everyday practice and evidence-based practice in 2010. This indicates a need for national harmonization and implementation of standardized structured reporting templates.

Background In 2014, a national workshop program was initiated and a reporting template and manual for rectal cancer primary staging using magnetic resonance imaging (MRI) was introduced and made available by the national Swedish Colorectal Cancer Registry. Purpose To evaluate the effect of the national template program by identify if there was a gap between the content in Swedish MRI reports from 2016 and the national reporting template from 2014. The aim was to explore and compare differences in content in reporting practice in different hospitals in relation to the national reporting template, with focus on: (i) identifying any implementational differences in reporting styles; and (ii) evaluating if reporting completeness vary based on such implementational differences. Material and Methods A total of 250 MRI reports from 10 hospitals in four healthcare regions in Sweden were collected. Reports were analyzed using qualitative content analysis with a deductive thematic coding scheme based on the national reporting template. Results Three different implemented reporting styles were identified with variations of content coverage in relation to the template: (i) standardized and structured protocol (reporting style A); (ii) standardized semi-structured free-text (reporting style B); and (iii) regular free-text (reporting style C). The relative completeness of reporting practice of rectal cancer staging in relation to the national reporting template were 92.9% for reporting style A, 77.5% for reporting style B, and 63.9% for reporting style C. Conclusion The implementation of template-based reporting according to reporting style A is a key factor to conform to evidence-based practice for rectal cancer reporting using MRI.

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