Radiology reporting in rectal cancer using MRI: adherence to national template for structured reporting

2021 ◽  
pp. 028418512110572
Author(s):  
Gustav Alvfeldt ◽  
Peter Aspelin ◽  
Lennart Blomqvist ◽  
Nina Sellberg
Keyword(s):  
Rectal Cancer ◽  
Qualitative Content Analysis ◽  
Cancer Staging ◽  
Free Text ◽  
Reporting Practice ◽  
Key Factor ◽  
Content Coverage ◽  
Magnetic Resonance Imaging Mri ◽  
National Workshop ◽  
Completeness Of Reporting

Background In 2014, a national workshop program was initiated and a reporting template and manual for rectal cancer primary staging using magnetic resonance imaging (MRI) was introduced and made available by the national Swedish Colorectal Cancer Registry. Purpose To evaluate the effect of the national template program by identify if there was a gap between the content in Swedish MRI reports from 2016 and the national reporting template from 2014. The aim was to explore and compare differences in content in reporting practice in different hospitals in relation to the national reporting template, with focus on: (i) identifying any implementational differences in reporting styles; and (ii) evaluating if reporting completeness vary based on such implementational differences. Material and Methods A total of 250 MRI reports from 10 hospitals in four healthcare regions in Sweden were collected. Reports were analyzed using qualitative content analysis with a deductive thematic coding scheme based on the national reporting template. Results Three different implemented reporting styles were identified with variations of content coverage in relation to the template: (i) standardized and structured protocol (reporting style A); (ii) standardized semi-structured free-text (reporting style B); and (iii) regular free-text (reporting style C). The relative completeness of reporting practice of rectal cancer staging in relation to the national reporting template were 92.9% for reporting style A, 77.5% for reporting style B, and 63.9% for reporting style C. Conclusion The implementation of template-based reporting according to reporting style A is a key factor to conform to evidence-based practice for rectal cancer reporting using MRI.

scholarly journals MSBC-Net: Automatic Rectal Cancer Segmentation from MR Scans

2021 ◽  
Author(s):  
Ping Meng ◽  
Chao Sun ◽  
Yi Li ◽  
Long Zhou ◽  
Xinyu Zhao ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Wall ◽  
Region Of Interest ◽  
Cancer Staging ◽  
Medical Image Segmentation ◽  
Research Progress ◽  
Dice Similarity Coefficient ◽  
Boundary Constraints ◽  
Segmentation Strategy ◽  
Magnetic Resonance Imaging Mri

<div>Accurate segmentation of rectal cancer and rectal wall based on high-resolution T2-weighted magnetic resonance imaging (MRI-HRT2) is the basis of rectal cancer staging. However, complex imaging background, highly characteristics variation and poor contrast hindered the research progress of the automatic rectal cancer segmentation. In this study, a multi-task learning network, namely mask segmentation with boundary constraints (MSBC-Net), is proposed to overcome these limitations and to obtain accurate segmentation results by locating and segmenting rectal cancer and rectal wall automatically. Specifically, at first, a region of interest (RoI)-based segmentation strategy is designed to enable end-to-end multi-task training, where a sparse object detection module is used to automatically localize and classify rectal cancer and rectal wall to mitigate the problem of background interference, and a mask and boundary segmentation block is used to finely segment the RoIs; second, a modulated deformable backbone is introduced to handle the variable features of rectal cancer, which effectively improves the detection performance of small objects and adaptability of the proposed model. Moreover, the boundary head is fused into the mask head to segment the ambiguous boundary of the target and constrain the mask head to obtain more refined segmentation results. In total, 592 annotated rectal cancer patients in MRI-HRT2 are enrolled, and the comprehensive results show that the proposed MSBC-Net outperforms state-of-the-art methods with a dice similarity coefficient (DSC) of 0.801 (95\% CI, 0.791-0.811), which can be well extended to other medical image segmentation tasks with high potential clinical applicability.</div>

scholarly journals MSBC-Net: Automatic Rectal Cancer Segmentation from MR Scans

2021 ◽  
Author(s):  
Ping Meng ◽  
Chao Sun ◽  
Yi Li ◽  
Long Zhou ◽  
Xinyu Zhao ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Wall ◽  
Region Of Interest ◽  
Cancer Staging ◽  
Medical Image Segmentation ◽  
Research Progress ◽  
Dice Similarity Coefficient ◽  
Boundary Constraints ◽  
Segmentation Strategy ◽  
Magnetic Resonance Imaging Mri

<div>Accurate segmentation of rectal cancer and rectal wall based on high-resolution T2-weighted magnetic resonance imaging (MRI-HRT2) is the basis of rectal cancer staging. However, complex imaging background, highly characteristics variation and poor contrast hindered the research progress of the automatic rectal cancer segmentation. In this study, a multi-task learning network, namely mask segmentation with boundary constraints (MSBC-Net), is proposed to overcome these limitations and to obtain accurate segmentation results by locating and segmenting rectal cancer and rectal wall automatically. Specifically, at first, a region of interest (RoI)-based segmentation strategy is designed to enable end-to-end multi-task training, where a sparse object detection module is used to automatically localize and classify rectal cancer and rectal wall to mitigate the problem of background interference, and a mask and boundary segmentation block is used to finely segment the RoIs; second, a modulated deformable backbone is introduced to handle the variable features of rectal cancer, which effectively improves the detection performance of small objects and adaptability of the proposed model. Moreover, the boundary head is fused into the mask head to segment the ambiguous boundary of the target and constrain the mask head to obtain more refined segmentation results. In total, 592 annotated rectal cancer patients in MRI-HRT2 are enrolled, and the comprehensive results show that the proposed MSBC-Net outperforms state-of-the-art methods with a dice similarity coefficient (DSC) of 0.801 (95\% CI, 0.791-0.811), which can be well extended to other medical image segmentation tasks with high potential clinical applicability.</div>

scholarly journals Rectal cancer staging using MRI: adherence in reporting to evidence-based practice

2020 ◽  
Vol 61 (11) ◽  
pp. 1463-1472
Author(s):  
Gustav Alvfeldt ◽  
Peter Aspelin ◽  
Lennart Blomqvist ◽  
Nina Sellberg
Keyword(s):  
Rectal Cancer ◽  
Evidence Based Practice ◽  
Imaging Modality ◽  
Anal Verge ◽  
Cancer Staging ◽  
Evidence Based ◽  
Mri Staging ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Local Lymph Node

Background Magnetic resonance imaging (MRI) is the first-line imaging modality for local staging of rectal cancer. The radiology report should deliver all relevant available imaging information to guide treatment. Purpose To explore and describe if there was a gap between the contents in MRI reports for primary staging of rectal cancer in Sweden in 2010 compared to evidence-based practice. Material and Methods A total of 243 primary MRI staging reports from 2010, collected from 10 hospitals in four healthcare regions in Sweden, were analyzed using content analysis with a deductive thematic coding scheme based on evidence-based practice. Focus was on: (i) most frequently reported findings; (ii) correlation to key prognostic findings; and (iii) identifying if any findings being reported were beyond the information defined in evidence-based practice. Results Most frequently reported findings were spread through the bowel wall or not, local lymph node description, tumor length, and distance of tumor from anal verge. These items accounted for 35% of the reporting content. Of all reported content, 86% correlated with the evidence-based practice. However, these included more information than was generally found in the reports. When adjusting for omitted information, 48% of the reported content were accounted for. Of the reported content, 20% correlated to key pathological prognostic findings. Six types of findings were reported beyond the evidence-based practice, representing 14% of the total reporting content. Conclusion There was a gap between everyday practice and evidence-based practice in 2010. This indicates a need for national harmonization and implementation of standardized structured reporting templates.

scholarly journals Evolutions in rectal cancer MRI staging and risk stratification in The Netherlands

2021 ◽  
Author(s):  
Nino Bogveradze ◽  
Najim el Khababi ◽  
Niels W. Schurink ◽  
Joost J. M. van Griethuysen ◽  
Shira de Bie ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
High Risk ◽  
The Netherlands ◽  
Risk Stratification ◽  
Risk Classification ◽  
Teaching Hospitals ◽  
Free Text ◽  
Mri Staging ◽  
Radiological Staging ◽  
Completeness Of Reporting

Abstract Purpose To analyze how the MRI reporting of rectal cancer has evolved (following guideline updates) in The Netherlands. Methods Retrospective analysis of 712 patients (2011–2018) from 8 teaching hospitals in The Netherlands with available original radiological staging reports that were re-evaluated by a dedicated MR expert using updated guideline criteria. Original reports were classified as “free-text,” “semi-structured,” or “template” and completeness of reporting was documented. Patients were categorized as low versus high risk, first based on the original reports (high risk = cT3-4, cN+, and/or cMRF+) and then based on the expert re-evaluations (high risk = cT3cd-4, cN+, MRF+, and/or EMVI+). Evolutions over time were studied by splitting the inclusion period in 3 equal time periods. Results A significant increase in template reporting was observed (from 1.6 to 17.6–29.6%; p < 0.001), along with a significant increase in the reporting of cT-substage, number of N+ and extramesorectal nodes, MRF invasion and tumor-MRF distance, EMVI, anal sphincter involvement, and tumor morphology and circumference. Expert re-evaluation changed the risk classification from high to low risk in 18.0% of cases and from low to high risk in 1.7% (total 19.7%). In the majority (17.9%) of these cases, the changed risk classification was likely (at least in part) related to use of updated guideline criteria, which mainly led to a reduction in high-risk cT-stage and nodal downstaging. Conclusion Updated concepts of risk stratification have increasingly been adopted, accompanied by an increase in template reporting and improved completeness of reporting. Use of updated guideline criteria resulted in considerable downstaging (of mainly high-risk cT-stage and nodal stage). Graphic abstract

scholarly journals Structured Reporting of Rectal Cancer Staging and Restaging: A Consensus Proposal

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2135
Author(s):  
Vincenza Granata ◽  
Damiano Caruso ◽  
Roberto Grassi ◽  
Salvatore Cappabianca ◽  
Alfonso Reginelli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Correlation Coefficient ◽  
Clinical Decision Making ◽  
Intraclass Correlation ◽  
Clinical Decision ◽  
Cancer Staging ◽  
Structured Reporting ◽  
Quality Analysis ◽  
Promising Tool ◽  
Structured Reports

Background: Structured reporting (SR) in oncologic imaging is becoming necessary and has recently been recognized by major scientific societies. The aim of this study was to build MRI-based structured reports for rectal cancer (RC) staging and restaging in order to provide clinicians all critical tumor information. Materials and Methods: A panel of radiologist experts in abdominal imaging, called the members of the Italian Society of Medical and Interventional Radiology, was established. The modified Delphi process was used to build the SR and to assess the level of agreement in all sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess the internal consistency of each section and to measure the quality analysis according to the average inter-item correlation. The intraclass correlation coefficient (ICC) was also evaluated. Results: After the second Delphi round of the SR RC staging, the panelists’ single scores and sum of scores were 3.8 (range 2–4) and 169, and the SR RC restaging panelists’ single scores and sum of scores were 3.7 (range 2–4) and 148, respectively. The Cα correlation coefficient was 0.79 for SR staging and 0.81 for SR restaging. The ICCs for the SR RC staging and restaging were 0.78 (p < 0.01) and 0.82 (p < 0.01), respectively. The final SR version was built and included 53 items for RC staging and 50 items for RC restaging. Conclusions: The final version of the structured reports of MRI-based RC staging and restaging should be a helpful and promising tool for clinicians in managing cancer patients properly. Structured reports collect all Patient Clinical Data, Clinical Evaluations and relevant key findings of Rectal Cancer, both in staging and restaging, and can facilitate clinical decision-making.

scholarly journals Accuracy of High-Resolution MRI with Lumen Distention in Rectal Cancer Staging and Circumferential Margin Involvement Prediction

2014 ◽  
Vol 15 (1) ◽  
pp. 37 ◽  
Author(s):  
Elsa Iannicelli ◽  
Sara Di Renzo ◽  
Mario Ferri ◽  
Emanuela Pilozzi ◽  
Marco Di Girolamo ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
High Resolution ◽  
Cancer Staging ◽  
Circumferential Margin ◽  
Margin Involvement ◽  
Rectal Cancer Staging ◽  
High Resolution Mri

Hospital end-of-life care: families’ free-text notes

2020 ◽  
pp. bmjspcare-2020-00239
Author(s):  
Sandra Kurkowski ◽  
Johannes Radon ◽  
Annika R Vogt ◽  
Martin Weber ◽  
Stephanie Stiel ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Qualitative Content Analysis ◽  
Free Text ◽  
Life Care ◽  
Quality Aspects ◽  
Care Of The Dying

BackgroundPalliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients’ loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones’ perspectives on need for improvements.AimTo identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire.DesignWithin the validation study of the questionnaire ‘Care of the Dying Evaluation’ (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring.Setting/participantsLoved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017.Results993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient’s and/or loved one’s will, involvement in decision-making at the end of life (patient’s volition) and having the possibility to say goodbye.ConclusionsIt is important for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients’ will and to be emotionally supported.Trial registration numberThis study was registered at the German Clinical Trials Register (DRKS00013916).

MRI for rectal cancer: Staging, mrCRM, EMVI, lymph node staging and post-treatment response

2021 ◽  
Author(s):  
David D.B. Bates ◽  
Maria El Homsi ◽  
Kevin Chang ◽  
Neeraj Lalwani ◽  
Natally Horvat ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Treatment Response ◽  
Cancer Staging ◽  
Post Treatment ◽  
Lymph Node Staging ◽  
Rectal Cancer Staging

scholarly journals Comparison of MRI and colonoscopy in determining tumor height in rectal cancer

2017 ◽  
Vol 6 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Lotte Jacobs ◽  
David B Meek ◽  
Joost van Heukelom ◽  
Thomas L Bollen ◽  
Peter D Siersema ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Intraclass Correlation ◽  
Rectal Tumor ◽  
Height Measurement ◽  
Treatment Allocation ◽  
Large Variability ◽  
Magnetic Resonance Imaging Mri ◽  
Preoperative Work Up ◽  
Work Up

Background and aim Endoscopy and magnetic resonance imaging (MRI) are used routinely in the diagnostic and preoperative work-up of rectal cancer. We aimed to compare colonoscopy and MRI in determining rectal tumor height. Methods Between 2002 and 2012, all patients with rectal cancer with available MRIs and endoscopy reports were included. All MRIs were reassessed for tumor height by two abdominal radiologists. To obtain insight in techniques used for endoscopic determination of tumor height, a survey among regional endoscopists was conducted. Results A total of 211 patients with rectal cancer were included. Tumor height was significantly lower when assessed by MRI than by endoscopy with a mean difference of 2.5 cm (95% CI: 2.1–2.8). Although the agreement between tumor height as measured by MRI and endoscopy was good (intraclass correlation coefficient (ICC) 0.7 (95% CI: 0.7–0.8)), the 95% limits of agreement varied from –3.0 cm to 8.0 cm. In 45 patients (21.3%), tumors were regarded as low by MRI and middle–high by endoscopy. MRI inter- and intraobserver agreements were excellent with an ICC of 0.8 (95% CI: 0.7–0.9) and 0.9 (95% CI: 0.9–1.0), respectively. The survey showed no consensus among endoscopists as to how to technically measure tumor height. Conclusion This study showed large variability in rectal tumor height as measured by colonoscopy and MRI. Since MRI measurements showed excellent inter- and intraobserver agreement, we suggest using tumor height measurement by MRI for diagnostic purposes and treatment allocation.

scholarly journals PRE- AND POSTOPERATIVE IMAGING METHODS IN COLORECTAL CANCER

2018 ◽  
Vol 31 (2) ◽  
Author(s):  
Gleim Dias de SOUZA ◽  
Luciana Rodrigues Queiroz SOUZA ◽  
Ronaldo Mafia CUENCA ◽  
Vinícius Martins VILELA ◽  
Bruno Eduardo de Morais SANTOS ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tnm Classification ◽  
Great Majority ◽  
Cancer Staging ◽  
Screening Tools ◽  
Screening Tests ◽  
Surgical Evaluation ◽  
Pre Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
American Society

ABSTRACT Introduction: Among the screening tests for colorectal cancer, colonoscopy is currently considered the most sensitive and specific technique. However, computed tomography colonography (CTC), magnetic resonance imaging (MRI), and transrectal ultrasonography have gained significant ground in the clinical practice of pre-treatment, screening and, more recently, post-treatment and surgical evaluation. Objective: To demonstrate the high accuracy of CT and MRI for pre and postoperative colorectal cancer staging. Methods: Search and analysis of articles in Pubmed, Scielo, Capes Periodicals and American College of Radiology with headings “colorectal cancer” and “colonography”. Weew selected 30 articles that contained radiological descriptions, management or statistical data related to this type of neoplasia. The criteria for radiological diagnosis were the American College of Radiology. Results : The great majority of patients with this subgroup of neoplasia is submitted to surgical procedures with the objective of cure or relief, except those with clinical contraindication. CTC colonography is not the most commonly used technique for screening; however, it is widely used for treatment planning, assessment of the abdomen for local complications or presence of metastasis, and post-surgical evaluation. MRI colonography is an alternative diagnostic method to CT, recommended by the American Society of Gastrointestinal Endoscopy. Although there are still no major studies on the use of MRI for screening, the high resolution examination has now shown good results for the American Joint Committee on Cancer TNM classification. Conclusion: MRI and CT represent the best means for colorectal neoplasm staging. The use of these methods as screening tools becomes beneficial to decrease complications and discomfort related to colonoscopy.

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