Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, the Netherlands.
Eur Radiol. 2022 Oct;32(10):6637-6645. doi: 10.1007/s00330-022-08840-1. Epub 2022 May 18.
Enlarged lateral lymph nodes (LLNs) are associated with increased (lateral) local recurrence rates. Size and anatomical location should therefore always be reported by radiologists and discussed during multidisciplinary meetings. The objective was to investigate how often LLNs are mentioned in MRI reports in a tertiary referral centre.
A single - centre, retrospective study of 202 patients treated for primary rectal cancer between 2012 and 2020, with at least a T2 tumour located within 12cm of the anorectal junction. The radiology reports were written by 30-40 consultant radiologists. MRI scans were independently re-assessed by an expert radiologist. The primary outcome was how often the presence or absence of LLNs was mentioned in the initial report.
Primary MRI reports explicitly mentioned the presence or absence of LLNs in 89 (44%) cases. Of the 43 reports with present LLNs, only one (1%) reported on all features such as size, location or malignant features. Expert review revealed 17 LLNs which were ≥ 7 mm (short-axis); two of these were not mentioned in the original reports. In 14/43 (33%) cases, LLNs were discussed during the primary multidisciplinary meeting, while 17/43 (40%) restaging MRI reports failed to report on the previously visible LLN. Reporting LLNs increased significantly with higher N-stage (p = .010) and over time (p = .042).
Though improving with time, there is still limited consistency in reporting LLNs. Only 44% of primary MRI reports mentioned LLNs and relevant features of those LLNs were seldomly reported. Given the importance of this information for subsequent treatment; increased awareness, proper training and the use of templates are needed.
• Comprehensive reporting of lateral lymph nodes in primary MRI reports was limited to less than 50%. • Lateral lymph nodes are not always discussed during primary multidisciplinary meetings or mentioned in restaging reports. • Improvements in the awareness and knowledge of lateral lymph nodes are needed to ensure adequate multidisciplinary treatment decisions.
增大的侧方淋巴结（LLNs）与增加的（侧方）局部复发率相关。因此，放射科医生应始终报告淋巴结的大小和解剖位置，并在多学科会议上进行讨论。本研究旨在调查在一家三级转诊中心，放射科医生在 MRI 报告中提及 LLNs 的频率。
对 2012 年至 2020 年间接受原发性直肠癌治疗的 202 名患者进行了单中心回顾性研究，这些患者至少有一处 T2 肿瘤位于肛直肠交界处 12cm 以内。放射学报告由 30-40 名顾问放射科医生撰写。MRI 扫描由一名专家放射科医生独立重新评估。主要结局是初始报告中提及 LLNs 存在或不存在的频率。
原发性 MRI 报告明确提及 LLNs 存在或不存在的情况分别为 89 例（44%）和 113 例（56%）。在 43 份有可见 LLNs 的报告中，仅有 1 份（1%）报告了所有特征，如大小、位置或恶性特征。专家审查发现了 17 个≥7mm（短轴）的 LLNs，其中 2 个在原始报告中未提及。在 43 例中有 LLNs 的病例中，有 14 例（33%）在初次多学科会议上进行了讨论，而在 43 例中有 LLNs 的病例中，有 17 例（40%）重新分期的 MRI 报告未能报告之前可见的 LLN。随着 N 分期的升高（p=0.010）和时间的推移（p=0.042），LLNs 的报告显著增加。
尽管随着时间的推移有所改善，但在报告 LLNs 方面仍存在一致性有限的问题。只有不到 50%的原发性 MRI 报告提及了 LLNs，而这些 LLNs 的相关特征很少被报告。鉴于这些信息对后续治疗的重要性，需要提高认识、适当培训和使用模板。
在原发性 MRI 报告中对侧方淋巴结的全面报告限于不到 50%。
侧方淋巴结并非总是在初次多学科会议上进行讨论，也不会在重新分期报告中提及。
需要提高对侧方淋巴结的认识和知识，以确保做出充分的多学科治疗决策。
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