Department of Clinical Radiology, Lincoln Wing, Leeds Teaching Hospitals NHS Trust, St James' University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, St James's Institute of Oncology, St James's University Hospital, University of Leeds, Leeds, LS9 7TF, UK.
Eur Radiol. 2019 Sep;29(9):5121-5128. doi: 10.1007/s00330-019-06028-8. Epub 2019 Feb 22.
Rectal cancer staging with magnetic resonance imaging (MRI) allows accurate assessment and preoperative staging of rectal cancers. Therefore, complete MRI reports are vital to treatment planning. Significant variability may exist in their content and completeness. Template-style reporting can improve reporting standards, but its use is not widespread. Given the implications for treatment, we have evaluated current clinical practice amongst specialist gastrointestinal (GI) radiologists to measure the quality of rectal cancer staging MRI reports.
Sixteen United Kingdom (UK) colorectal cancer multi-disciplinary teams (CRC-MDTs) serving a population over 5 million were invited to submit up to 10 consecutive rectal cancer primary staging MRI reports from January 2016 for each radiologist participating in the CRC-MDT. Reports were compared to a reference standard based on recognised staging and prognostic factors influencing case management RESULTS: Four hundred ten primary staging reports were submitted from 41 of 42 (97.6%) eligible radiologists. Three hundred sixty reports met the inclusion criteria, of these, 81 (22.5%) used a template. Template report usage significantly increased recording of key data points versus non-template reports for extra-mural venous invasion (EMVI) status (98.8% v 51.6%, p < 0.01) and circumferential resection margin (CRM) status (96.3% v 65.9%, p < 0.01). Local tumour stage (97.5% v 93.5%, NS) and nodal status (98.8% v 96.1%, NS) were reported and with similar frequency.
Rectal cancer primary staging reports do not meet published standards. Template-style reports have significant increases in the inclusion of key tumour descriptors. This study provides further support for their use to improve reporting standards and outcomes in rectal cancer.
• MRI primary staging of rectal cancer requires detailed tumour descriptions as these alter the neoadjuvant and surgical treatments. • Currently, rectal cancer MRI reports in clinical practice do not provide sufficient detail on these tumour descriptors. • The use of template-style reports for primary staging of rectal cancer significantly improves report quality compared to free-text reports.
磁共振成像（MRI）在直肠癌分期中可对直肠癌进行准确评估和术前分期。因此，完整的 MRI 报告对于治疗计划至关重要。其内容和完整性可能存在显著差异。模板式报告可以提高报告标准，但尚未广泛使用。鉴于其对治疗的影响，我们评估了英国（UK）胃肠病学（GI）放射科专家目前在直肠癌分期 MRI 报告中的临床实践，以衡量直肠癌分期 MRI 报告的质量。
邀请了 16 个英国（UK）结直肠癌多学科团队（CRC-MDT）为服务超过 500 万人口的人群服务，要求每个参与 CRC-MDT 的放射科医生提交 2016 年 1 月以来的连续 10 份直肠癌症原发分期 MRI 报告。报告与基于影响病例管理的公认分期和预后因素的参考标准进行了比较。
42 名符合条件的放射科医生中有 41 名（97.6%）提交了 410 份原发分期报告。360 份报告符合纳入标准，其中 81 份（22.5%）使用了模板。与非模板报告相比，模板报告在记录关键数据点方面显著增加了外膜静脉侵犯（EMVI）状态（98.8%对 51.6%，p<0.01）和环周切缘（CRM）状态（96.3%对 65.9%，p<0.01）。局部肿瘤分期（97.5%对 93.5%，无显著性差异）和淋巴结状态（98.8%对 96.1%，无显著性差异）也有报告，且频率相似。
直肠癌原发分期报告未达到已发表的标准。模板式报告在纳入关键肿瘤描述方面有显著增加。本研究进一步支持使用模板式报告来提高直肠癌的报告标准和结果。
MRI 对直肠癌的分期需要详细的肿瘤描述，因为这些描述会改变新辅助和手术治疗。
目前，临床实践中的直肠癌 MRI 报告在这些肿瘤描述符方面提供的细节不够充分。
与自由文本报告相比，使用模板式报告进行直肠癌原发分期可显著提高报告质量。
