Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Am J Surg. 2020 Feb;219(2):304-308. doi: 10.1016/j.amjsurg.2019.11.012. Epub 2019 Nov 11.
Magnetic resonance imaging (MRI) is essential for the multidisciplinary treatment of rectal cancer. However, baseline experience of surgical residents with MRI is unknown. Therefore, a needs assessment survey was conducted to examine confidence with pelvic MRI for residents entering Complex General Surgical Oncology (CSGO) fellowships.
A multi-institutional survey evaluated incoming CGSO fellows' experience with pelvic MRI for rectal cancer in residency. Additionally, confidence was assessed for essential components of pelvic MRI including T- and N-stage, circumferential resection margin (CRM), extramural venous invasion (EMVI), and pelvic anatomy.
Of the twenty-four incoming fellows who completed the survey (response rate = 44%), 20 reported frequent use of pelvic MRI for rectal cancer in residency, but 16 reported rarely/never interpreting images themselves for staging or operative planning. Most respondents reported low confidence for T-stage, N-stage, CRM, EMVI, as well as pelvic anatomy, particularly for lateral and posterior pelvis.
The development of a pelvic MRI curriculum for residents entering CGSO fellowships could enhance their clinical training in the multidisciplinary management of patients with rectal cancer.
磁共振成像(MRI)对于直肠癌的多学科治疗至关重要。然而,外科住院医师对 MRI 的基础经验尚不清楚。因此,进行了一项需求评估调查,以检查即将进入复杂普通外科肿瘤学(CSGO)奖学金的住院医师对 MRI 检查骨盆的信心。
一项多机构调查评估了即将进入 CSGO 的住院医师在 residency 期间对 MRI 检查骨盆直肠癌的经验。此外,还评估了对包括 T 期和 N 期、环周切缘(CRM)、外膜静脉侵犯(EMVI)和骨盆解剖在内的 MRI 检查骨盆的基本组成部分的信心。
在完成调查的二十四名即将进入的住院医师中(应答率为 44%),有 20 名报告在 residency 期间经常使用 MRI 检查骨盆直肠癌,但有 16 名报告很少/从未自己解释过图像以进行分期或手术计划。大多数受访者对 T 期、N 期、CRM、EMVI 以及骨盆解剖结构,尤其是骨盆的侧面和后部,报告的信心较低。
为进入 CSGO 奖学金的住院医师制定骨盆 MRI 课程可以增强他们在直肠癌多学科管理方面的临床培训。