Structured prostate MRI reports boost clinical impact

BI-RADS, developed by the American College of Radiology, changed how radiologists and specialists communicate with its implementation in the 1980s. A group of researchers aimed to develop a structured prostate MRI report to improve communication between radiologists and referring urologists.

The study—led by Michael J. Magnetta, MS, MD, with the department of diagnostic radiology at the Univeristy of Pittsburgh Medical Center—was published online Nov. 1 in the American Journal of Roentgenology.

“Although PI-RADS [Prostate Imaging Reporting and Data System] provides a standardized report lexicon and assessment category to assign risk of clinically significant prostate carcinoma, interobserver agreement has been shown to be moderate at best, and no recommendation has yet been developed for the findings that must be included in the final report to appropriately guide management,” wrote Magnetta et al. “These deficiencies may lead to reduced clarity of findings, increase the likelihood of urologists to contact the interpreting radiologist for clarification and degrade the clinical impact of the radiology report.”

Researchers retroactively reviewed 200 preintervention and 100 sequential postintervention reports that included at least one prostatic lesion, nodule or mass. Additionally, urologists evaluated 40 reports generated before the intervention and 40 after using a five-point scale for consistency, completeness, conciseness, clarity, likelihood to contact radiologist, and clinical impact.

According to the survey results from urologists, researchers found that urologists found four essential components in reports: risk of cancer reported using PI-RADSv2 assessment category, findings section organized by lesion, descriptions of pertinent positive and negative findings for staging, and low word count.

Reports showed lesion signal intensity, imaging parameters and reporting of incidental cysts or calcifications were not as significant.

“These results are important because they suggest that evidence-based collaborative reporting contributes to improved communication between radiologists and referring providers, solidifying the clinical practice and quantitative value of radiology,” Magnetta and colleagues wrote.

The study was limited by its size. It also depended on urologists to design the structured reports while also grading results, which may have led to some sample biases. Still, the authors concluded, “the structured prostate MRI report resulted in improved communication with referring urologists as indicated by the increased perceived clinical impact of the report.”