Structured reporting of computed tomography in the polytrauma patient assessment: a Delphi consensus proposal

Abstract

Objectives To develop a structured reporting (SR) template for whole-body CT examinations of polytrauma patients, based on the consensus of a panel of emergency radiology experts from the Italian Society of Medical and Interventional Radiology. Methods A multi-round Delphi method was used to quantify inter-panelist agreement for all SR sections. Internal consistency for each section and quality analysis in terms of average inter-item correlation were evaluated by means of the Cronbach’s alpha (Cα) correlation coefficient. Results The final SR form included 118 items (6 in the “Patient Clinical Data” section, 4 in the “Clinical Evaluation” section, 9 in the “Imaging Protocol” section, and 99 in the “Report” section). The experts’ overall mean score and sum of scores were 4.77 (range 1–5) and 257.56 (range 206–270) in the first Delphi round, and 4.96 (range 4–5) and 208.44 (range 200–210) in the second round, respectively. In the second Delphi round, the experts’ overall mean score was higher than in the first round, and standard deviation was lower (3.11 in the second round vs 19.71 in the first round), reflecting a higher expert agreement in the second round. Moreover, Cα was higher in the second round than in the first round (0.97 vs 0.87). Conclusions Our SR template for whole-body CT examinations of polytrauma patients is based on a strong agreement among panel experts in emergency radiology and could improve communication between radiologists and the trauma team.

Machine Learning and Radiomics Analysis for Tumor Budding Prediction in Colorectal Liver Metastases Magnetic Resonance Imaging Assessment

“…So, patients with liver metastases with tumor budding and/or KRAS mutational status [39,40] respond poorly to anti-EGFR therapy [32]. In the context of personalized medicine, this is evident as the possibility to predict several prognostic markers allows us to identify the best treatment for a specific patient [41][42][43][44][45][46]. Radiomics analysis could be a promising tool to evaluate a lesion "virtually", with the possibility to analyze the whole tumor during the disease history to obtain those markers which can affect the treatment choice [47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65].…”

Future Perspectives on Radiomics in Acute Liver Injury and Liver Trauma

“…The diagnostic power of CT is also reduced by the attenuation of liver parenchyma at CT due to steatosis or cirrhosis, so the diagnosis is more challenging [ 155 , 156 ]. As a delayed diagnosis can be significant for patients’ survival, a radiomic model is one of the solutions to the problem [ 157 , 158 , 159 , 160 ].…”

Dose Reduction Strategies for Pregnant Women in Emergency Settings

“…In fact, US and MRI should be preferred during pregnancy. However, in a critical setting, such as trauma, when the benefits outweigh the potential risks to the fetus, CT should be performed, although the study protocol should be optimized [21,55,57,78,98,[112][113][114][115][116][117][118][119][120][121][122][123]. In addition, examination in anatomical regions far from the fetus, such as those on the chest, skull, or extremities, can typically be performed safely at any stage during pregnancy, with adequate bundle collimation [10,39].…”