Impact of a standardized reporting format on the quality of MRI reports for rectal cancer staging

Abstract

Background and Aims: Besides providing a surgical roadmap, rectal MRI plays a major role in treatment planning. We recently started using a structured template for reporting rectal cancer via MRI. We study the impact of using this template at our hospital in terms of number of essential imaging parameters described in the reports as compared to the pre-template free-text reports. Methods: A structured rectal MRI reporting template was created in consensus with members of the colorectal tumour board and was introduced in the department, which included 14 essential parameters to be mentioned in the reports. We conducted a retrospective analysis of rectal MRI reports of 100 cases with histologically proven rectal cancer, comprising 50 consecutive free-text reports before the template was introduced and 50 consecutive structured reports after its introduction, checking for the presence or absence of inclusion of the 14 parameters. An anonymous online feedback survey was conducted as well after the introduction of the template for the members of the colorectal tumour board. Results: Overall, the total number of parameters reported increased from a median value of 10 (range 6-13) to 14 (range 12-14). The common unreported parameters prior to template introduction included T staging, presence or absence of restricted diffusion, anterior peritoneal reflection (APR) involvement, and presence or absence of extramural vascular invasion; these were reported in 16%, 22%, 30% and 50% respectively. These improved to 98-100% reporting after template introduction. Maximum improvement was in T staging (16% to 98%) (P < 0.0001), restricted diffusion on DWI (from 22% to 100%) (P < 0.0001) and APR involvement (from 30% to 100%) (P < 0.0001). The most common unreported parameter after template introduction was the “tumoral T2 signal intensity” (unreported in 4% cases). The results of the survey were as follows: 100% felt a decreased need to talk to the radiologist to clarify the report, 81.8% felt an improvement in the quality of reporting as compared to free style reports, and 91% felt that the new template is easier to interpret. Conclusion: The introduction of a structured template for rectal cancer significantly improved the quality of rectal MRI reports, along with the satisfaction of referring providers.

Structured reporting in radiology: a systematic review to explore its potential

“…Overview of articles with level A and B evidence which studied structured reporting in radiology. Presented is the level of evidence, control group, intervention, subspecialty/field, indication, modality and outcome(s) Level of evidence Control Intervention Subspecialty/field Indication Modality Outcome(s) Structured layout (SR level 1) — one template Dimarco et al (2020) [ 14 ] B Free text Structured itemized template with four parts and several key items Abdomen Pancreatic ductal adenocarcinoma CT Significant reduction of missing morphological and vascular features Improvement inter-reader agreement Gupta et al (2020) [ 15 ] B Free text Added 14 essential parameters Abdomen Rectal cancer staging MRI Significant report quality improvement Referring provider satisfaction improved McFarland (2020) [ 16 ] B Free text Free-form structured itemized templates Abdomen Various CT Less reporting errors potentially reducing The report word length did not differ Olthof et al (2020)[ 17 ] B Free text Additional template with key items for critical findings Neurology CNS metastasis MRI Automated insertion of context-dependent data and required elements is feasible Guideline adherence concerning critical findings improved Alessandrino et al (2019)[ 18 ] B Free te...…”

A Comparative Study on the Quality of MRI Reporting in Primary Rectal Cancer

“…Gupta et al conducted a study to determine how using a specific template for reporting rectal cancer via MRI impacted a hospital [ 7 ]. The researchers created a template that contained 14 necessary parameters to be included in the reports.…”

“…The survey showed that 100% of respondents felt less need to speak with the radiologist to clarify the report, 81.8% felt an improvement in the report's quality compared to free-style reports, and 91% felt that the new template was easier to interpret. The template increased the number of necessary imaging parameters mentioned in the reports, reducing the need for clarification, and improving the overall quality of reporting [ 7 ].…”

“…Quality reporting of the MRI is crucial for the accurate transfer of information among different specialties and hence a systematic, structured approach is recommended. Numerous studies have depicted that structured reporting via a pre-designed template improves the quality of MRI performed for rectal cancer in contrast to free text formats [ 6 , 7 ]. Template reporting ensures that key data points like EMVI, circumferential resection margin (CRM), and nodal status are recorded routinely.…”