Computed Tomography Structured Reporting in the Staging of Lymphoma: A Delphi Consensus Proposal

Abstract

Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports for lymphoma patients during the staging phase to improve communication between radiologists, members of multidisciplinary teams, and patients. A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology (SIRM), was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. The final SR version was divided into four sections: (a) Patient Clinical Data, (b) Clinical Evaluation, (c) Imaging Protocol, and (d) Report, including n = 13 items in the “Patient Clinical Data” section, n = 8 items in the “Clinical Evaluation” section, n = 9 items in the “Imaging Protocol” section, and n = 32 items in the “Report” section. Overall, 62 items were included in the final version of the SR. A dedicated section of significant images was added as part of the report. In the first Delphi round, all sections received more than a good rating (≥3). The overall mean score of the experts and the sum of score for structured report were 4.4 (range 1–5) and 1524 (mean value of 101.6 and standard deviation of 11.8). The Cα correlation coefficient was 0.89 in the first round. In the second Delphi round, all sections received more than an excellent rating (≥4). The overall mean score of the experts and the sum of scores for structured report were 4.9 (range 3–5) and 1694 (mean value of 112.9 and standard deviation of 4.0). The Cα correlation coefficient was 0.87 in this round. The highest overall means value, highest sum of scores of the panelists, and smallest standard deviation values of the evaluations in this round reflect the increase of the internal consistency and agreement among experts in the second round compared to first round. The accurate statement of imaging data given to referring physicians is critical for patient care; the information contained affects both the decision-making process and the subsequent treatment. The radiology report is the most important source of clinical imaging information. It conveys critical information about the patient’s health and the radiologist’s interpretation of medical findings. It also communicates information to the referring physicians and records this information for future clinical and research use. The present SR was generated based on a multi-round consensus-building Delphi exercise and uses standardized terminology and structures, in order to adhere to diagnostic/therapeutic recommendations and facilitate enrolment in clinical trials, to reduce any ambiguity that may arise from non-conventional language, and to enable better communication between radiologists and clinicians.

Complications Risk Assessment and Imaging Findings of Thermal Ablation Treatment in Liver Cancers: What the Radiologist Should Expect

“…However, inconsistencies with regard to content, style, and presentation can hamper information transfer and diminish the clarity of the reports, which can in turn adversely affect the extraction of the required key information by the referring physician. Therefore, FRT should be organized and re-orientated toward structured reports (SR) [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ]. According to the European Society of Radiology (ESR) paper on SR in radiology, the three main goals for moving from FTR to SR are quality, datafication/quantification and accessibility [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ].…”

“…Therefore, FRT should be organized and re-orientated toward structured reports (SR) [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ]. According to the European Society of Radiology (ESR) paper on SR in radiology, the three main goals for moving from FTR to SR are quality, datafication/quantification and accessibility [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ]. With regard to quality, this is correlated to standardization.…”

“…In this scenario, by using a dedicated report template, the radiologist has a list of predefined relevant items for the case at hand, ensuring that no important data is missed. This should not only guarantee a consistently high quality of final report, but also aid in the management of patients [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ].…”

Structured Reporting of Computed Tomography and Magnetic Resonance in the Staging of Pancreatic Adenocarcinoma: A Delphi Consensus Proposal

“…The use of templates in SR provides a checklist as to whether all relevant items for a specific procedure are addressed. Moreover, thanks to this "structure", SR allows the correlation of radiological data with other key clinical features, guiding to a precise diagnosis and personalized medicine [23][24][25][26][27][28].…”

Lymphoma: New Diagnosis and Current Treatment Strategies

“…The structured reporting of results is important for improving the communication between radiologists, members of multidisciplinary teams, and patients. The manuscript by Granata et al builds structured CT-based reports (SRs) for lymphoma patients in the staging phase [ 7 ]. The authors used a modified Delphi process to develop SRs and to assess the levels of agreement.…”