Machado Laura B, Apolo Andrea B, Steinberg Seth M, Folio Les R
1 Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 9000 Rockville Pike, Bldg 10, Bethesda, MD 20892.
2 Genitourinary Malignancies Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.
AJR Am J Roentgenol. 2017 Feb;208(2):W31-W37. doi: 10.2214/AJR.16.16845.
Radiology reports often lack the measurements of target lesions that are needed for oncology clinical trials. When available, the measurements in the radiology reports often do not match those in the records used to calculate therapeutic response. This study assessed the clinical value of hyperlinked tumor measurements in multimedia-enhanced radiology reports in the PACS and the inclusion of a radiologist assistant in the process of assessing tumor burden.
We assessed 489 target lesions in 232 CT examinations of 71 patients with metastatic genitourinary cancer enrolled in two therapeutic trials. We analyzed target lesion selection and measurement concordance between oncology records (used to calculate therapeutic response) and two types of radiology reports in the PACS: multimedia-enhanced radiology reports and text-only reports. For statistical tests, we used the Wilcoxon signed rank, Wilcoxon rank sum test, and Fisher method to combine p values from the paired and unpaired results. The Fisher exact test was used to compare overall measurement concordance.
Concordance on target lesion selection was greater for multimedia-enhanced radiology reports (78%) than the text-only reports (52%) (p = 0.0050). There was also improved overall measurement concordance with the multimedia-enhanced radiology reports (68%) compared with the text-only reports (38%) (p < 0.0001).
Compared with text-only reports, hyperlinked multimedia-enhanced radiology reports improved concordance of target lesion selection and measurement with the measurements used to calculate therapeutic response.
放射学报告常常缺少肿瘤学临床试验所需的靶病灶测量值。即便有测量值,放射学报告中的测量值往往与用于计算治疗反应的记录中的测量值不匹配。本研究评估了PACS中多媒体增强放射学报告里超链接肿瘤测量值的临床价值,以及在评估肿瘤负荷过程中纳入放射科助理的情况。
我们评估了71例转移性泌尿生殖系统癌患者参与两项治疗试验的232次CT检查中的489个靶病灶。我们分析了靶病灶的选择以及肿瘤学记录(用于计算治疗反应)与PACS中的两种放射学报告之间的测量一致性:多媒体增强放射学报告和纯文本报告。对于统计检验,我们使用Wilcoxon符号秩检验、Wilcoxon秩和检验以及Fisher方法来合并配对和非配对结果的p值。使用Fisher精确检验来比较总体测量一致性。
多媒体增强放射学报告在靶病灶选择上的一致性(78%)高于纯文本报告(52%)(p = 0.0050)。与纯文本报告(38%)相比,多媒体增强放射学报告在总体测量一致性方面也有所提高(68%)(p < 0.0001)。
与纯文本报告相比,超链接多媒体增强放射学报告在靶病灶选择和测量与用于计算治疗反应的测量值之间的一致性方面有所提高。