Presentation Authors: Christian Wetterauer*, David Jean Winkel, Joel Federer-Gsponer, Armin Halla, Svetozar Subotic, Alexander Deckart, Hans Helge Seifert, Daniel Boll, Jan Ebbing, Basel, Switzerland
Introduction: The communication of imaging findings is essential for patient care. Referring physicians depend on adequate information transfer in clinical decision making and subsequent treatment. Traditional radiology reports contain non-structured free text using narrative language. The associated variability can hamper the information transfer and diminish the clarity of the report. This study investigates how the use of structured reports (SRs) of prostate magnetic resonance imaging (MRI) can improve interdisciplinary communication as compared to the use of non-structured reports (NSRs).
Methods: A total of 100 cases (50 NSRs and 50 SRs) describing just one prostatic lesion were presented to four urologists with expert level experience in prostate cancer surgery or targeted MRI TRUS fusion biopsy. The readers had to plot the tumor location in a 2-dimensional prostate diagram and answer a questionnaire focusing on information on clinically relevant key features and the structure of the report. The accuracy of the tumor position in the prostate diagram was evaluated by using a newly established and validated scoring system distinguishing major and minor mistakes
Results: The overall rate of major mistakes (10 vs. 54%) and minor mistakes (22 vs. 74%) was significantly lower (p < 0.01) for SRs as compared to NSRs. The mean total score for accuracyfor the use of SRs was significantly higher as compared to NSRs 28.46 (range 13.33 - 30.0) vs. 21.75 (range 0.0 - 30.0), p < 0.01. The rate of radiologist re-consultations was significantly (p < 0.01) lower for SRs as compared to NSRs (19% vs. 85%). SRs were also rated significantly better in regard to determining the clinical tumor stage as compared to NSRs (p < 0.01) and more valuable for further clinical decision making and surgical planning (p < 0.01). SRs achieved significantly (p < 0.01) higher ratings for quality of the summary (4.4 vs. 2.5) and overall satisfaction (4.5 vs. 2.3) as compared to NSRs.
Conclusions: Interdisciplinary communication can be improved by the use of structured reporting of prostate MRI. Urologist are enabled to assess the exact location of single prostate cancer lesions more accurately. Therefore, structured reporting can help to facilitate clinical decision making and surgical planning. Furthermore, structured reporting of prostate MRI leads to a higher satisfaction level of the referring physician.