Skip to main content
SpringerLink
Log in

Structured vs narrative reporting of pelvic MRI for fibroids: clarity and impact on treatment planning

  • Urogenital
  • Published:
European Radiology Aims and scope Submit manuscript

An Urogenital to this article was published on 04 May 2018

Abstract

Objectives

To evaluate clarity and usefulness of MRI reporting of uterine fibroids using a structured disease-specific template vs. narrative reporting for planning of fibroid treatment by gynaecologists and interventional radiologists.

Methods

This is a HIPAA-compliant, IRB-approved study with waiver of informed consent. A structured reporting template for fibroid MRIs was developed in collaboration between gynaecologists, interventional and diagnostic radiologists. The study population included 29 consecutive women who underwent myomectomy for fibroids and pelvic MRI prior to implementation of structured reporting, and 42 consecutive women with MRI after implementation of structured reporting. Subjective evaluation (on a scale of 1-10, 0 not helpful; 10 extremely helpful) and objective evaluation for the presence of 19 key features were performed.

Results

More key features were absent in the narrative reports 7.3 ± 2.5 (range 3-12) than in structured reports 1.2 ± 1.5 (range 1-7), (p < 0.0001). Compared to narrative reports, gynaecologists and radiologists deemed structured reports both more helpful for surgical planning (p < 0.0001) (gynaecologists: 8.5 ± 1.2 vs. 5.7 ± 2.2; radiologists: 9.6 ± 0.6 vs. 6.0 ± 2.9) and easier to understand (p < 0.0001) (gynaecologists: 8.9 ± 1.1 vs. 5.8 ± 1.9; radiologists: 9.4 ± 1.3 vs. 6.3 ± 1.8).

Conclusion

Structured fibroid MRI reports miss fewer key features than narrative reports. Moreover, structured reports were described as more helpful for treatment planning and easier to understand.

Key Points

• Structured reports missed only 1.2 ± 1.5 out of 19 key features, as compared to narrative reports that missed 7.3 ± 2.5 key features for planning of fibroid treatment.

• Structured reports were more helpful and easier to understand by clinicians.

• Structured template can provide essential information for fibroids treatment planning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

NR:

Narrative Reports

SR:

Structured Reports

UFE:

Uterine Fibroid Embolization

IR:

Interventional Radiologist

GYN:

Gynaecologist

References

  1. Ellenbogen PH (2013) Imaging 3.0: what is it? J Am Coll Radiol 10(4):229

    Article  PubMed  Google Scholar 

  2. Hinkey PM (1922) Standardization of roentgen-ray reports. AJR Am J Roentgenol 9:422–425

    Google Scholar 

  3. Ryan GL, Syrop CH, Van Voorhis BJ (2005) Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol 48(2):312–324

    Article  PubMed  Google Scholar 

  4. Wallach EE, Vlahos NF (2004) Uterine myomas: an overview of development, clinical features, and management. Obstet Gynecol 104(2):393–406

    Article  PubMed  Google Scholar 

  5. Khan AT, Shehmar M, Gupta JK (2014) Uterine fibroids: current perspectives. Int J Womens Health 6:95–114

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bolan C, Caserta MP (2016) MR imaging of atypical fibroids. Abdom Radiol NY 41(12):2332–2349

    Article  PubMed  Google Scholar 

  7. Munro MG, Crithcley HOD, Broder MS et al (2011) FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 113(1):3–13

    Article  PubMed  Google Scholar 

  8. Deshmukh SP, Gonsalves CF, Guglielmo FF, Mitchell DG (2012) Role of MR imaging of uterine leiomyomas before and after embolization. Radiogr Rev Publ Radiol Soc N Am Inc 32(6):E251–E281

    Google Scholar 

  9. Nikolaidis P, Siddiqi AJ, Carr JC, Vogelzang RL, Miller FH, Chrisman HB, Nemcek AA Jr, Omary RA (2005) Incidence of nonviable leiomyomas on contrast material-enhanced pelvic MR imaging in patients referred for uterine artery embolization. J Vasc Interv Radiol 16(11):1465–1471

    Article  PubMed  Google Scholar 

  10. Desai P, Patel P (2011) Fibroids, Infertility and Laparoscopic Myomectomy. J Gynecol Endosc Surg 2(1):36–42

    Article  PubMed  PubMed Central  Google Scholar 

  11. Murase E, Siegelman ES, Outwater EK et al (1999) Uterine leiomyomas: histopathologic features, MR imaging findings, differential diagnosis, and treatment. Radiographics 19(5):1179–1197

    Article  PubMed  CAS  Google Scholar 

  12. Verma SK, Bergin D, Gonsalves CF, Mitchell DG, Lev-Toaff AS, Parker L (2008) Submucosal fibroids becoming endocavitary following uterine artery embolization: risk assessment by MRI. AJR Am J Roentgenol 190(5):1220–1226

    Article  PubMed  Google Scholar 

  13. Katsumori T, Akazawa K, Mihara T (2005) Uterine artery embolization for pedunculated subserosal fibroids. AJR Am J Roentgenol 184(2):399–402

    Article  PubMed  Google Scholar 

  14. Kim MD, Lee M, Jung DC, Park SI, Lee MS, Won JY, Lee DY, Lee KH (2012) Limited efficacy of uterine artery embolization for cervical leiomyomas. J Vasc Interv Radiol 23(2):236–240

    Article  PubMed  Google Scholar 

  15. Pelage JP, Cazejust J, Pluot E et al (2005) Uterine fibroid vascularization and clinical relevance to uterine fibroid embolization. Radiographics 25(Suppl 1):S99–S117

    Article  PubMed  Google Scholar 

  16. Brook OR, Brook A, Vollmer CM, Kent TS, Sanchez N, Pedrosa I (2015) Structured reporting of multiphasic CT for pancreatic cancer: potential effect on staging and surgical planning. Radiology 274(2):464–472

    Article  PubMed  Google Scholar 

  17. Yee J, Chang KJ, Dachman AH et al (2016) The Added Value of the CT Colonography Reporting and Data System. J Am Coll Radiol 13(8):931–935

    Article  PubMed  Google Scholar 

  18. Nörenberg D, Sommer WH, Thasler W et al (2017) Structured Reporting of Rectal Magnetic Resonance Imaging in Suspected Primary Rectal Cancer: Potential Benefits for Surgical Planning and Interdisciplinary Communication. Investig Radiol 52(4):232–239

    Article  Google Scholar 

  19. Ghoshhajra BB, Lee AM, Ferencik M et al (2013) Interpreting the interpretations: the use of structured reporting improves referring clinicians’ comprehension of coronary CT angiography reports. J Am Coll Radiol 10(6):432–438

    Article  PubMed  PubMed Central  Google Scholar 

  20. Anderson TJT, Lu N, Brook OR (2017) Disease-Specific Report Templates for Your Practice. J Am Coll Radiol. https://doi.org/10.1016/j.jacr.2016.12.019

  21. McLucas B (2008) Diagnosis, imaging and anatomical classification of uterine fibroids. Best Pract Res Clin Obstet Gynaecol 22(4):627–642

    Article  PubMed  Google Scholar 

  22. Naik SS, Hanbidge A, Wilson SR (2001) Radiology reports: examining radiologist and clinician preferences regarding style and content. AJR Am J Roentgenol 176(3):591–598

    Article  PubMed  CAS  Google Scholar 

  23. Johnson AJ (2002) Radiology report quality: a cohort study of point-and-click structured reporting versus conventional dictation. Acad Radiol 9(9):1056–1061

    Article  PubMed  Google Scholar 

  24. Hong Y, Kahn CE (2013) Content analysis of reporting templates and free-text radiology reports. J Digit Imaging 26(5):843–849

    Article  PubMed  PubMed Central  Google Scholar 

  25. Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H (2011) Improving communication of diagnostic radiology findings through structured reporting. Radiology 260(1):174–181

    Article  PubMed  PubMed Central  Google Scholar 

  26. Reiner BI, Knight N, Siegel EL (2007) Radiology reporting, past, present, and future: the radiologist’s perspective. J Am Coll Radiol 4(5):313–319

    Article  PubMed  Google Scholar 

  27. Kahn CE, Heilbrun ME, Applegate KE (2013) From guidelines to practice: how reporting templates promote the use of radiology practice guidelines. J Am Coll Radiol 10(4):268–273

    Article  PubMed  PubMed Central  Google Scholar 

  28. Toor SS, Tan KT, Simons ME et al (2008) Clinical failure after uterine artery embolization: evaluation of patient and MR imaging characteristics. J Vasc Interv Radiol 19(5):662–667

    Article  PubMed  Google Scholar 

  29. Samartine S, White L, McKeon D, Becker M (2015) Enhancing structured reporting: improving quality by tailoring the report to the clinical scenario. J Am Coll Radiol 12(8):845–847

    Article  PubMed  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding for this work.

Author information

Authors and Affiliations

  1. Department of Radiology, IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy

    Andrea Franconeri

  2. Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA

    Jieming Fang, Benjamin Carney, Laura Miller, Hye-Chun Hur, Louise P. King, Roa Alammari, Salomao Faintuch, Koenraad J. Mortele & Olga R. Brook

  3. Department of Radiology, King Abdulla Medical City, Makkah, Saudi Arabia

    Almamoon Justaniah

Authors
  1. Andrea Franconeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jieming Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benjamin Carney
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Almamoon Justaniah
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laura Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hye-Chun Hur
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Louise P. King
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Roa Alammari
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Salomao Faintuch
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Koenraad J. Mortele
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Olga R. Brook
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Olga R. Brook.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Olga Rachel Brook.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

Electronic supplementary material

ESM 1

(DOCX 7548 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Franconeri, A., Fang, J., Carney, B. et al. Structured vs narrative reporting of pelvic MRI for fibroids: clarity and impact on treatment planning. Eur Radiol 28, 3009–3017 (2018). https://doi.org/10.1007/s00330-017-5161-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-017-5161-9

Keywords

Search

Navigation