Radiologic Evaluation and Structured Reporting Form for Extrahepatic Bile Duct Cancer: 2019 Consensus Recommendations from the Korean Society of Abdominal Radiology

Lee, Dong Hoon; Kim, Bohyun; Lee, Eun Sun; Kim, Hyoung Jung; Min, Ji Hye; Lee, Jeong Min; Choi, Moon Hyung; Seo, Nieun; Choi, Sang Hyun; Kim, Seong Hyun; Lee, Seung Soo; Park, Yang Shin; Chung, Yong Eun

doi:10.3348/kjr.2019.0803

Cited by 25 publications

(27 citation statements)

References 142 publications

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“…Fourth, this study considered only DBSs, and the results may not be applicable to other sites of biliary strictures. Fifth, although diffusion-weighted imaging (DWI) can help radiologists characterize bile duct lesions and detect extra-bile duct lesions ( 26 ), DWI was not used in this study because some patients had not undergone this imaging, or the image quality was poor. Sixth, compared to MRCP alone, contrast-enhanced CT brings additional contrast agent dose and x-ray exposure.…”

Section: Discussionmentioning

confidence: 99%

MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

Wang

Zhang

et al. 2021

Front. Oncol.

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ObjectiveTo determine whether contrast-enhanced computed tomography (CT) can promote the identification of malignant and benign distal biliary strictures (DBSs) compared to the use of magnetic resonance cholangiopancreatography (MRCP) alone and to identify imaging findings of malignant DBSs.Materials and MethodsA total of 168 consecutive patients with confirmed DBSs were reviewed. MRCP alone and MRCP combined with CT images were blindly analyzed by two radiologists (e.g., stricture pattern, margins), and malignant or benign DBSs were identified based on surgical findings, endoscopy findings, or follow-up. The diagnostic accuracy of the two reviewers using MRCP alone and MRCP combined with CT were evaluated. MRCP and CT features of malignant and benign DBSs were compared using multiple logistic regression analysis to identify independent malignant risk factors.ResultsMRCP combined with CT examination could improve the diagnostic accuracy, which increased from 70.2% to 81.5% in Doctor A and from 85.1% to 89.3% in Doctor B. The multiple logistic regression model revealed that stricture length [odds ratio (OR) 1.070, P=0.016], angle of the DBS (OR 1.061, P<0.001), double duct sign (OR 4.312, P=0.003) and low density in the arterial phase (OR 0.319, P=0.018) were associated with malignant DBS. A scoring model incorporating these four factors was established; at a threshold value of 1.75, and the sensitivity and specificity for the detection of malignant DBSs were 73.5 and 85.9%, respectively.ConclusionsCompared to the use of MRCP alone, MRCP combined with contrast-enhanced CT can improve the accuracy of DBS diagnosis. The scoring model accurately predicts malignant DBSs and helps make treatment decisions.

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Section: Discussionmentioning

confidence: 99%

MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

Wang

Zhang

et al. 2021

Front. Oncol.

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“…Contrast series data set is used as well to reproduce angiography images to delineate tumoral vascular invasion [25]. MDCT cholangiography assesses globally the biliary obstruction regarding the biliary tree, vessels, and solid abdominal organs (liver, pancreas, and duodenum), a feature that does not exist at ERCP and PTC [29,30].…”

Section: Discussionmentioning

confidence: 99%

Validity of MDCT cholangiography in differentiating benign and malignant biliary obstruction

Alsowey

Salem

Amin

2021

Egypt J Radiol Nucl Med

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Background MDCT cholangiography can be utilized to identify variant biliary anatomy to guide preoperative planning of biliary surgery, and determine the cause and level of biliary obstruction. Early tumor detection and staging of biliary cancer are key factors for a possible cure by surgical resection. Between December 2019 and October 2020, 69 patients with clinically suspected biliary obstruction were enrolled in the study, subjected to clinical assessment (full history taking and clinical examination) and imaging assessment by MDCT cholangiography. Our findings were correlated to standard reference examinations including operative/ERCP/biopsy and histopathology findings. Results The most affected age was between 60 and 70 years old, and males were more affected. The commonest clinical presentation was yellowish discoloration of the skin and sclera followed by biliary colic. Right hypochondrial tenderness was the main clinical finding on clinical examination. Our patients were categorized according to the etiology of biliary obstruction into 7 groups: malignant stricture 52.2% (36 patients), calcular 24.6% (17 patients), iatrogenic 5.8% (4 patients), portahepatis lesions 5.8% (4 patients), benign stricture 4.3% (3 patients), inflammatory 4.3% (3 patients), and congenital 1.4% (1 patient). The malignant group shows dominant mass, moderate biliary obstruction, and arterial and venous enhancement. The overall sensitivity was 94% for malignancy. Conclusion MDCT cholangiography is non-invasive, fast, and highly sensitive and specific in the diagnosis of different causes and levels of biliary obstruction and is useful in the characterization of the lesion in cases of malignant obstruction and differentiating it from benign stricture. It can be used as an effective alternative to ERCP or PTC.

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“…At worst, the resulting communication errors can lead to incorrect diagnosis, delayed initiation of adequate treatment, or adverse patient outcomes [8]. Recently, the use of structured reporting (SR) has been recommended by several medical societies [8][9][10][11][12][13][14][15][16]. SR could offer several advantages over conventional narrative reporting, including a higher standardization of reporting style and lexicon, greater consistency and reproducibility of reports, full integration with hospital IT systems (along with the possibility of performing large-scale data mining), shorter reporting time, potential reduction of errors, and improved communication with other radiologists and referring clinicians [8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the use of structured reporting (SR) has been recommended by several medical societies [8][9][10][11][12][13][14][15][16]. SR could offer several advantages over conventional narrative reporting, including a higher standardization of reporting style and lexicon, greater consistency and reproducibility of reports, full integration with hospital IT systems (along with the possibility of performing large-scale data mining), shorter reporting time, potential reduction of errors, and improved communication with other radiologists and referring clinicians [8][9][10][11][12][13][14][15][16]. To this regard, oncologists have been shown to prefer SR over conventional narrative reporting owing to its ability to convey information in a clearer and more standardized manner, and Shoeppe et al reported that SR of CT examinations for primary staging in patients with diffuse large B-cell lymphoma adds clinical value compared to narrative reporting by increasing completeness of reports, facilitating information extraction, and improving patient management [16].…”

Section: Introductionmentioning

confidence: 99%

Computed Tomography Structured Reporting in the Staging of Lymphoma: A Delphi Consensus Proposal

Granata

Pradella

Cozzi

et al. 2021

JCM

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Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports for lymphoma patients during the staging phase to improve communication between radiologists, members of multidisciplinary teams, and patients. A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology (SIRM), was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. The final SR version was divided into four sections: (a) Patient Clinical Data, (b) Clinical Evaluation, (c) Imaging Protocol, and (d) Report, including n = 13 items in the “Patient Clinical Data” section, n = 8 items in the “Clinical Evaluation” section, n = 9 items in the “Imaging Protocol” section, and n = 32 items in the “Report” section. Overall, 62 items were included in the final version of the SR. A dedicated section of significant images was added as part of the report. In the first Delphi round, all sections received more than a good rating (≥3). The overall mean score of the experts and the sum of score for structured report were 4.4 (range 1–5) and 1524 (mean value of 101.6 and standard deviation of 11.8). The Cα correlation coefficient was 0.89 in the first round. In the second Delphi round, all sections received more than an excellent rating (≥4). The overall mean score of the experts and the sum of scores for structured report were 4.9 (range 3–5) and 1694 (mean value of 112.9 and standard deviation of 4.0). The Cα correlation coefficient was 0.87 in this round. The highest overall means value, highest sum of scores of the panelists, and smallest standard deviation values of the evaluations in this round reflect the increase of the internal consistency and agreement among experts in the second round compared to first round. The accurate statement of imaging data given to referring physicians is critical for patient care; the information contained affects both the decision-making process and the subsequent treatment. The radiology report is the most important source of clinical imaging information. It conveys critical information about the patient’s health and the radiologist’s interpretation of medical findings. It also communicates information to the referring physicians and records this information for future clinical and research use. The present SR was generated based on a multi-round consensus-building Delphi exercise and uses standardized terminology and structures, in order to adhere to diagnostic/therapeutic recommendations and facilitate enrolment in clinical trials, to reduce any ambiguity that may arise from non-conventional language, and to enable better communication between radiologists and clinicians.

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Radiologic Evaluation and Structured Reporting Form for Extrahepatic Bile Duct Cancer: 2019 Consensus Recommendations from the Korean Society of Abdominal Radiology

Cited by 25 publications

References 142 publications

MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

Validity of MDCT cholangiography in differentiating benign and malignant biliary obstruction

Computed Tomography Structured Reporting in the Staging of Lymphoma: A Delphi Consensus Proposal

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