Development and Implementation of a Synoptic MRI Report for Preoperative Staging of Rectal Cancer on a Population-Based Level

Abstract

A synoptic MRI report for preoperative staging of rectal cancer was successfully developed and pilot tested in the province of Ontario, Canada.

Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

“…We used a modified Delphi method to develop the proposed consensus recommendation. We started with a comprehensive summary of the relevant data and evidences in the literature using 1) thorough PubMed MEDLINE search of original research articles; 2) review of existing recommendations/guides on structural reporting of rectal MRI, including the User's guide for the synoptic MRI report for rectal cancer supported by Cancer Care Ontario and the Canadian Cancer Society (56), Proforma-based reporting by a British group (8), Radiology reporting template of the Radiological Society of North America (7), recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology consensus meeting (9), and radiology experts review of the European Registration of Cancer Care (EURECCA) consensus (10); 3) review of general management or staging guidelines for rectal cancer, including the National Comprehensive Cancer Network (NCCN) 2016 guidelines of the United States (11), EURECCA consensus of Europe (12), and the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) staging manuals (131415); and 4) review of relevant articles included in the bibliography of the aforementioned recommendations and guides. We made a list of candidate issues, which were deemed potentially essential for the reporting of rectal cancer MRI.…”

“…However, using these terms alone in official radiology reports is not recommended because there are no cohesive definitions for these terms. The definitions of these terms have been inconsistent in published literature (5716171819). These terms should be accompanied by objective measurements of the tumor distances from fixed reference anatomical structures for clarity, if they are to be included in the report.…”

“…Neoadjuvant radiation therapy decreases the risk of local tumor recurrence and may increase patient survival following rectal cancer surgery (1234). In order to help achieve a systematic assessment and reporting of findings on rectal MRI in rectal cancer patients, several recommendations and guides for structured reporting of rectal MRI have been proposed (5678910). These guides generally follow similar principles but do not concur completely.…”

A structured approach to reporting rectal cancer with magnetic resonance imaging

“…Signal intensity, border contour, and shape are more important features than size alone. The suggested short axis size thresholds of 0.8 and 1 cm for mesorectal and extramesorectal nodes, respectively, has good specificity (>95%) but poor sensitivity [18,19]. Involved lymph nodes are most often found at the level of the tumor.…”

“…A synoptic MRI report was developed based on a metaanalysis of the literature by analyzing the sensitivity and specificity of rectal MRI for the parameters including CRM, T-category, and lymph node metastases [18][19][20]. A condensed version of the essential elements of the synoptic MRI report is provided in Table 2, designed to answer key questions from the surgical oncologist summarized in Table 3 adapted from [14].…”