1 Department of Oncological Surgery, Amphia Hospital, Molengracht 21, 4818CK Breda, The Netherlands.
2 Department of Radiology, Amphia Hospital, Breda, The Netherlands.
AJR Am J Roentgenol. 2018 Jun;210(6):1240-1244. doi: 10.2214/AJR.17.19054. Epub 2018 Mar 23.
Since the implementation of new guidelines for rectal cancer in The Netherlands in April 2014, clinical stage as seen at preoperative MRI indicates whether neoadjuvant therapy is necessary before rectal cancer surgery. Therefore, the importance of correct MRI interpretation has increased. The aim of this study was to evaluate the completeness of MRI reports of rectal cancer and the effect of implementation of the new guidelines and standardized reporting on the completeness of these reports.
Data were collected from all patients who consecutively underwent rectal cancer surgery at one hospital between January 2011 and July 2017. Data were extracted from electronic patient records.
The study included 492 MRI examinations. Before implementation of the new guidelines, a median of 4 of 10 items (interquartile range [IQR], 3-6 items) were described in each MRI report. After implementation of the new guidelines, the number of items described improved significantly (median, 7 items; IQR, 6-8 items; p < 0.001). Implementation of a standardized report led to further significant improvement (median, 9 items; IQR, 9-10 items; p < 0.001). The items scored most frequently were distance between the tumor and the anal verge (85.6%) and length of the tumor (87.6%). The items scored least were presence or absence of extramural venous invasion (21.1%) and morphologic features of the tumor (24.6%).
Implementation of a standardized protocol and a standardized reporting system for MRI in preoperative staging of rectal cancer results in a more complete MRI report.
自 2014 年 4 月荷兰实施新的直肠癌指南以来，术前 MRI 所见的临床分期表明直肠癌手术前是否需要新辅助治疗。因此，正确解读 MRI 的重要性增加了。本研究旨在评估直肠癌 MRI 报告的完整性，以及新指南的实施和标准化报告对这些报告完整性的影响。
数据来自 2011 年 1 月至 2017 年 7 月期间在一家医院连续接受直肠癌手术的所有患者。数据从电子患者记录中提取。
本研究共纳入 492 例 MRI 检查。在新指南实施前，每份 MRI 报告中描述的 10 项内容中有中位数 4 项（四分位距 [IQR]，3-6 项）。新指南实施后，描述的项目数量显著增加（中位数 7 项；IQR，6-8 项；p<0.001）。实施标准化报告进一步显著改善（中位数 9 项；IQR，9-10 项；p<0.001）。评分最高的项目是肿瘤距肛门缘的距离（85.6%）和肿瘤长度（87.6%）。评分最低的项目是有无壁外静脉侵犯（21.1%）和肿瘤的形态特征（24.6%）。
在直肠癌术前分期中实施标准化协议和标准化 MRI 报告系统可使 MRI 报告更完整。
