Impact of a Structured Reporting Template on Adherence to Prostate Imaging Reporting and Data System Version 2 and on the Diagnostic Performance of Prostate MRI for Clinically Significant Prostate Cancer

Shaish, Hiram; Feltus, Whitney; Steinman, Jonathan; Hecht, Elizabeth M.; Wenske, Sven; Ahmed, Firas S.

doi:10.1016/j.jacr.2018.01.034

Cited by 34 publications

(13 citation statements)

References 24 publications

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“…However, word count did not drop moving from NR to SR and since the same urologists that selected the essential reporting items subsequently performed the subjective quality analysis, the latter could have been partly biased. Moving from a hybrid NR/SR to a full SR based on PI-RADS lexicon and rules, Shaish and colleagues observed a significant improvement of adherence to PI-RADS score rules (88.4% versus 32.9%, p < 0.001) [30]. Nevertheless, a survey of specialty societies found that while 54% of the urologists prefer structured reporting for prostate MRI, 53% of the radiologists still indicated a preference towards hybrid NR/SR solutions [31].…”

Section: Prostate Cancermentioning

confidence: 99%

State of the art in abdominal MRI structured reporting: a review

et al. 2020

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In the management of several abdominal disorders, magnetic resonance imaging (MRI) has the potential to significantly improve patient’s outcome due to its diagnostic accuracy leading to more appropriate treatment choice. However, its clinical value heavily relies on the quality and quantity of diagnostic information that radiologists manage to convey through their reports. To solve issues such as ambiguity and lack of comprehensiveness that can occur with conventional narrative reports, the adoption of structured reporting has been proposed. Using a checklist and standardized lexicon, structured reports are designed to increase clarity while assuring that all key imaging findings related to a specific disorder are included. Unfortunately, structured reports have their limitations too, such as risk of undue report simplification and poor template plasticity. Their adoption is also far from widespread, and probably the ideal balance between radiologist autonomy and report consistency of has yet to be found. In this article, we aimed to provide an overview of structured reporting proposals for abdominal MRI and of works assessing its value in comparison to conventional free-text reporting. While for several abdominal disorders there are structured templates that have been endorsed by scientific societies and their adoption might be beneficial, stronger evidence confirming their imperativeness and added value in terms of clinical practice is needed, especially regarding the improvement of patient outcome.

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Section: Prostate Cancermentioning

confidence: 99%

State of the art in abdominal MRI structured reporting: a review

et al. 2020

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“…All prostate MRIs were interpreted by one of 14 fellowship-trained abdominal radiologists with 5-25 years of experience. All radiologists adhered to PI-RADS v2.0 rules and lexicon as detailed in our previously published structured reporting template (20). At the time of the template change, all radiologists were reminded of the suggested cut-off range for csPCa as detailed in PI-RADS (750-900 um 2 /s).…”

Section: Mri Interpretationmentioning

confidence: 99%

Impact of mandated prospectively reported apparent diffusion coefficient values on the rates of positivity for clinically significant prostate cancer by PI-RADS score

et al. 2020

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Background Prior research has shown that retrospectively measured apparent diffusion coefficient (ADC) of prostate magnetic resonance imaging (MRI) lesions is associated with clinically significant prostate cancer (csPCa) on targeted biopsy suggesting that ADC should be measured and reported prospectively. Purpose To assess the impact of mandatory prospective measurement of ADC on the rates of positivity across PI-RADS scores for csPCa. Material and Methods Consecutive patients who underwent ultrasound (US)-MRI fusion prostate biopsy from August 2018 to July 2019 and who had prospectively reported ADC were compared to control patients who did not. Rates of positivity by PI-RADS category were computed and compared using Chi-square. Multivariable regression was performed. Results In total, 126 patients (median age 65 years) with 165 prostate lesions (19, 51, 70, and 25 PI-RADS 2, 3, 4, and 5, respectively) and prospectively reported ADC values were compared to 113 control patients (median age 66 years) with 157 prostate lesions (17, 42, 64, and 34 PI-RADS 2, 3, 4, and 5, respectively). Rates of positivity across PI-RADS scores were similar between the two cohorts; 11%, 25%, 55%, and 76% and 0%, 21%, 56%, and 62% for PI-RADS 2, 3, 4, and 5 in the test and control cohorts, respectively (Chi-square P = 0.78). Multivariate logistic regression showed no significant association between the presence of prospectively measured ADC and csPCa (odds ratio 1.1, 95% confidence interval 0.7–1.7, P = 0.82). Conclusion Prospective ADC measurement may not impact PI-RADS category assignments or positivity rates for csPCa under current guidelines. Future versions of PI-RADS may need to incorporate ADC into scoring rules to realize their potential.

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“…14,21 Report accuracy, too, may benefit: the use of a checklist-style report was found to decrease the missed non-fracture findings by residents reading cervical spine computed tomograms, and a report with dropdown options improved adherence to prostate imaging reporting and data system (PI-RADS) in patients with prostate cancer. 22,23 Nevertheless, structured templates have also received several criticisms. Reports with incomplete sentences have more typographical errors due to the limitations of voice recognition software.…”

Section: Discussionmentioning

confidence: 99%

The value of structured radiology reports to categorize intracranial metastases following radiation therapy

et al. 2019

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Purpose Radiology descriptions of intracranial metastases following radiotherapy are often imprecise. This study sought to improve such reports by creating and disseminating a structured template that encourages discrete categorization of intracranial lesions. Methods Following initiation of the structured template, a retrospective review assessed patients with intracranial metastases that underwent radiotherapy, comparing ‘pre-template’ with ‘post-template’ reports. A total of 139 patients were included; 94 patients (67.6%) were imaged pre-template, 45 (32.4%) post-template. Reports were assessed for discrete versus non-specific descriptions of lesions: ‘(presumed) new metastases’, ‘treated metastases’, and ‘indeterminate lesions’. Non-specific language was subdivided based on the type of lesion(s) described: e.g. ‘stable enhancing foci’ was deemed a non-specific description of ‘treated metastases’. Results Non-specific descriptions of lesions were used in 25/94 reports (26.6%) pre-template, and eight reports (17.8%) post-template. No significant difference was found in the frequency of inappropriate/ambiguous descriptions of intracranial lesions following template initiation ( P = 0.52). However, only 27/45 (60.0%) of the reports in the post-template time period used the structured report; the other reports were written as free prose. Of the reports that did use the structured template, the authors used significantly less ambiguous language structured template ( P = 0.02). Conclusion When utilized, a structured report template resulted in decreased non-specific descriptions and improved discrete characterization of intracranial metastases in patients treated with radiation. However, the frequency of non-specific language usage before and after template initiation was unchanged, probably due to poor compliance with template utilization.

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Impact of a Structured Reporting Template on Adherence to Prostate Imaging Reporting and Data System Version 2 and on the Diagnostic Performance of Prostate MRI for Clinically Significant Prostate Cancer

Cited by 34 publications

References 24 publications

State of the art in abdominal MRI structured reporting: a review

State of the art in abdominal MRI structured reporting: a review

Impact of mandated prospectively reported apparent diffusion coefficient values on the rates of positivity for clinically significant prostate cancer by PI-RADS score

The value of structured radiology reports to categorize intracranial metastases following radiation therapy

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