Surgeon oriented reporting template for magnetic resonance imaging and endoanal ultrasound of anal fistulas enhances surgical decision-making

Abstract

In this editorial, a commentary on the article by Sudoł-Szopińska et al has been provided. Successful treatment of anal fistula (AF) relies on accurate diagnosis. Magnetic resonance imaging (MRI) and endoanal ultrasound (EUS) are important for the AF diagnosis. Previously, colorectal surgeons found that AF reports in MRI and EUS issued by radiologists were not appropriate for decision-making and management. To address this issue, a new AF reporting template in MRI and EUS has been developed. The new reporting template has several strengths: (1) It was based on the Delphi study of consensus statements, generated by numerous experts, including 69 colorectal surgeons from different countries, disciplines, and centers; and (2) Fourteen evidence-based statements were discussed repeatedly for 12 months and anonymously voted on in 3 rounds, achieving a consensus on 12 of 14 statements (85.7%). The reporting template comprises six features, each detailing several items related to AF classification and management, with illustrative diagrams of the anatomy. The use of this new reporting template would assist radiologists in reporting in a standardized manner and would be suitable for surgeons in decision-making and management, thereby improving treatment quality and avoiding or reducing complications.