Abstract
Background and Aims: Besides providing a surgical roadmap, rectal MRI plays a major role in treatment
planning. We recently started using a structured template for reporting rectal cancer
via MRI. We study the impact of using this template at our hospital in terms of number
of essential imaging parameters described in the reports as compared to the pre-template
free-text reports. Methods: A structured rectal MRI reporting template was created in consensus with members
of the colorectal tumour board and was introduced in the department, which included
14 essential parameters to be mentioned in the reports. We conducted a retrospective
analysis of rectal MRI reports of 100 cases with histologically proven rectal cancer,
comprising 50 consecutive free-text reports before the template was introduced and
50 consecutive structured reports after its introduction, checking for the presence
or absence of inclusion of the 14 parameters. An anonymous online feedback survey
was conducted as well after the introduction of the template for the members of the
colorectal tumour board. Results: Overall, the total number of parameters reported increased from a median value of
10 (range 6-13) to 14 (range 12-14). The common unreported parameters prior to template
introduction included T staging, presence or absence of restricted diffusion, anterior
peritoneal reflection (APR) involvement, and presence or absence of extramural vascular
invasion; these were reported in 16%, 22%, 30% and 50% respectively. These improved
to 98-100% reporting after template introduction. Maximum improvement was in T staging
(16% to 98%) (P < 0.0001), restricted diffusion on DWI (from 22% to 100%) (P < 0.0001)
and APR involvement (from 30% to 100%) (P < 0.0001). The most common unreported parameter
after template introduction was the “tumoral T2 signal intensity” (unreported in 4%
cases). The results of the survey were as follows: 100% felt a decreased need to talk
to the radiologist to clarify the report, 81.8% felt an improvement in the quality
of reporting as compared to free style reports, and 91% felt that the new template
is easier to interpret. Conclusion: The introduction of a structured template for rectal cancer significantly improved
the quality of rectal MRI reports, along with the satisfaction of referring providers.
Keywords
Cancer - rectal - reporting - structured - template
