Department of Radiology, Memorial Sloan Kettering Cancer Center, 1265 York Ave, New York, NY 10065.
Radiology Department, Royal North Shore Hospital, Saint Leonards, Australia.
AJR Am J Roentgenol. 2023 Dec;221(6):760-772. doi: 10.2214/AJR.23.29096. Epub 2023 Jul 12.
Imaging reports that consistently document all disease sites with a potential to increase surgical complexity or morbidity can facilitate ovarian cancer treatment planning. The aims of this study were to compare simple structured reports and synoptic reports from pretreatment CT examinations in patients with advanced ovarian cancer in terms of completeness of documenting involvement of clinically relevant anatomic sites as well as to evaluate physician satisfaction with synoptic reports. This retrospective study included 205 patients (median age, 65 years) who underwent contrast-enhanced abdominopelvic CT before primary treatment of advanced ovarian cancer from June 1, 2018, to January 31, 2022. A total of 128 reports generated on or before March 31, 2020, used a simple structured report (free text organized into sections); 77 reports generated on or after April 1, 2020, used a synoptic report (a list of 45 anatomic sites relevant to ovarian cancer management, each of which was classified in terms of disease absence versus presence). Reports were reviewed for completeness of documentation of involvement of the 45 sites. For patients who underwent neoadjuvant chemotherapy based on diagnostic laparoscopy findings or underwent primary debulking surgery with suboptimal resection, the EMR was reviewed to identify surgically established sites of disease that were unresectable or challenging to resect. Gynecologic oncology surgeons were electronically surveyed. The mean report turnaround time was 29.8 minutes for simple structured reports versus 54.5 minutes for synoptic reports ( < .001). A mean of 17.6 of 45 sites (range, four to 43 sites) were mentioned by simple structured reports versus 44.5 of 45 sites (range, 39-45) for synoptic reports ( < .001). Forty-three patients had surgically established unresectable or challenging-to-resect disease; involvement of anatomic site(s) with such disease was mentioned in 37% (11/30) of simple structured reports versus 100% (13/13) of synoptic reports ( < .001). All eight surveyed gynecologic oncology surgeons completed the survey. A synoptic report improved completeness of pretreatment CT reports in patients with advanced ovarian cancer, including for established sites of unresectable or challenging-to-resect disease. The findings indicate the role of disease-specific synoptic reports in facilitating referrer communication and potentially guiding clinical decision-making.
影像学报告一致记录所有有潜在增加手术复杂性或发病率的疾病部位,可以促进卵巢癌的治疗计划。本研究的目的是比较术前 CT 检查中简单的结构化报告和摘要报告,以评估其在记录与临床相关解剖部位的受累情况的完整性,并评估医生对摘要报告的满意度。这项回顾性研究纳入了 205 名年龄中位数为 65 岁的患者,他们于 2018 年 6 月 1 日至 2022 年 1 月 31 日在接受高级卵巢癌的初始治疗前进行了对比增强的腹盆腔 CT 检查。共有 128 份报告是在 2020 年 3 月 31 日之前生成的,使用了简单的结构化报告(按节组织的自由文本);77 份报告是在 2020 年 4 月 1 日之后生成的,使用了摘要报告(45 个与卵巢癌管理相关的解剖部位列表,每个部位根据疾病的有无进行分类)。报告的完整性被审查,以记录 45 个部位的受累情况。对于根据诊断性腹腔镜检查结果接受新辅助化疗或接受初步减瘤手术但切除不充分的患者,对 EMR 进行了回顾,以确定不可切除或难以切除的手术部位。妇科肿瘤外科医生接受了电子调查。简单的结构化报告的平均报告周转时间为 29.8 分钟,而摘要报告的平均报告周转时间为 54.5 分钟(<0.001)。简单的结构化报告平均提及了 45 个部位中的 17.6 个(范围为 4 到 43 个部位),而摘要报告平均提及了 45 个部位中的 44.5 个(范围为 39-45 个部位)(<0.001)。43 名患者存在经手术证实的不可切除或难以切除的疾病;在 30 例简单结构化报告中,有 37%(11/30)提及了涉及这种疾病的解剖部位,而在 13 例摘要报告中,100%(13/13)提及了这种解剖部位(<0.001)。所有 8 名接受调查的妇科肿瘤外科医生都完成了调查。摘要报告提高了高级卵巢癌患者术前 CT 报告的完整性,包括对不可切除或难以切除疾病部位的记录。这些发现表明,特定疾病的摘要报告在促进转诊医生的沟通和潜在指导临床决策方面发挥了作用。