Michigan Medicine, Ann Arbor, MI, USA.
Michigan Radiology Quality Collaborative, Ann Arbor, MI, USA.
Abdom Radiol (NY). 2018 Dec;43(12):3493-3502. doi: 10.1007/s00261-018-1609-x.
To determine the need for a standardized renal mass reporting template by analyzing reports of indeterminate renal masses and comparing their contents to stated preferences of radiologists and urologists.
The host IRB waived regulatory oversight for this multi-institutional HIPAA-compliant quality improvement effort. CT and MRI reports created to characterize an indeterminate renal mass were analyzed from 6 community (median: 17 reports/site) and 6 academic (median: 23 reports/site) United States practices. Report contents were compared to a published national survey of stated preferences by academic radiologists and urologists from 9 institutions. Descriptive statistics and Chi-square tests were calculated.
Of 319 reports, 85% (271; 192 CT, 79 MRI) reported a possibly malignant mass (236 solid, 35 cystic). Some essential elements were commonly described: size (99% [269/271]), mass type (solid vs. cystic; 99% [268/271]), enhancement (presence vs. absence; 92% [248/271]). Other essential elements had incomplete penetrance: the presence or absence of fat in solid masses (14% [34/236]), size comparisons when available (79% [111/140]), Bosniak classification for cystic masses (54% [19/35]). Preferred but non-essential elements generally were described in less than half of reports. Nephrometry scores usually were not included for local therapy candidates (12% [30/257]). Academic practices were significantly more likely than community practices to include mass characterization details, probability of malignancy, and staging. Community practices were significantly more likely to include management recommendations.
Renal mass reporting elements considered essential or preferred often are omitted in radiology reports. Variation exists across radiologists and practice settings. A standardized template may mitigate these inconsistencies.
通过分析不确定肾肿块的报告并将其内容与放射科医生和泌尿科医生的既定偏好进行比较，确定是否需要标准化的肾肿块报告模板。
本多机构符合 HIPAA 规定的质量改进工作由机构审查委员会豁免了监管监督。从 6 家社区（中位数：每家 17 份报告）和 6 家学术（中位数：每家 23 份报告）美国实践中分析了用于描述不确定肾肿块的 CT 和 MRI 报告。将报告内容与来自 9 个机构的学术放射科医生和泌尿科医生发表的全国性偏好调查进行比较。计算了描述性统计数据和卡方检验。
在 319 份报告中，85%（271 份；192 份 CT，79 份 MRI）报告了可能为恶性的肿块（236 份实体瘤，35 份囊性瘤）。一些基本要素通常被描述：大小（99%[269/271]）、肿块类型（实性与囊性；99%[268/271]）、增强（存在与不存在；92%[248/271]）。其他基本要素的描述并不完整：实性肿块中是否存在脂肪（14%[34/236]）、有大小比较时（79%[111/140]）、囊性肿块的 Bosniak 分类（54%[19/35]）。首选但非必要的要素通常在不到一半的报告中描述。局部治疗候选者通常不包括肾切除术评分（12%[30/257]）。与社区实践相比，学术实践更有可能包括肿块特征描述、恶性概率和分期。社区实践更有可能包括管理建议。
放射科报告中经常省略被认为是必要或首选的肾肿块报告要素。放射科医生和实践环境之间存在差异。标准化模板可能会减轻这些不一致性。
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