Structured Reporting in Neuroradiology: Intracranial Tumors

Abstract

Purpose: The aim of this pilot study was to assess the clinical feasibility, diagnostic yield, advantages, and disadvantages of structured reporting for routine MRI-reading in patients with primary diagnosis of intracranial tumors as compared to traditional neuroradiological free text reporting.

Methods: A structured MRI reporting template was developed covering pathological, anatomical, and functional aspects in an itemized fashion. Retrospectively, 60 consecutive patients with first diagnosis of an intracranial tumor were selected from the radiology information system/PACS system. Structured reporting was performed by a senior neuroradiologist, blinded to clinical and radiological data. Reporting times were measured per patient. The diagnostic content was compared to free text reporting which was independently performed on the same MRI exams by two other neuroradiologists. The comparisons were categorized per item as: "congruent," "partially congruent," "incongruent," or "not mentioned in free-style report."

Results: Tumor-related items: congruent findings were found for all items (17/17) with congruence rates ranging between 98 and 39% per item. Four items achieved congruence rates ≥90%, 5 items >80%, and 9 items ≥70%. Partially congruent findings were found for all items in up to 50% per item. Incongruent findings were present in 7/17 items in up to 5% per item. Free text reports did not mention 12 of 17 items (range 7-43% per item). Non-tumor-related items, including brain atrophy, microangiopathy, vascular pathologies, and various extracranial pathologies, which were not mentioned in free-text reports between 18 and 85% per item. Mean reporting time for structured reporting was 7:49 min (3:12-17:06 min).

Conclusion: First results showed that expert structured reporting ensured reliable detection of all relevant brain pathologies along with reproducible documentation of all predefined diagnostic items, which was not always the case for free text reporting. A mean reporting time of 8 min per patient seems clinically feasible.

Keywords: MRI; intracranial; neuroradiology; quantitative data; structured reporting; tumor.

Figure 1

Screen view Structured reporting with 2D size measurements, upper row, axial: fluid-attenuated inversion recovery, native T1w, ceT1w, DSC-Perfusion, lower row, axial: diffusion weighted imaging, susceptibility weighted imaging, coronal: ceT1w, T2w.

Figure 2

Results ordered by topic and within the topics location, measurements and T2w/fluid-attenuated inversion recovery signal changes by congruence.

Figure 3

Results ordered by rank (highest to lowest percentages in the category “congruent”).