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European Radiology
Published in: European Radiology 4/2022

Open Access 01-04-2022 | Magnetic Resonance Imaging | Experimental

Structured reporting in radiology: a systematic review to explore its potential

Authors: J. Martijn Nobel, Koos van Geel, Simon G. F. Robben

Published in: European Radiology | Issue 4/2022

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Abstract

Objectives

Structured reporting (SR) in radiology reporting is suggested to be a promising tool in clinical practice. In order to implement such an emerging innovation, it is necessary to verify that radiology reporting can benefit from SR. Therefore, the purpose of this systematic review is to explore the level of evidence of structured reporting in radiology. Additionally, this review provides an overview on the current status of SR in radiology.

Methods

A narrative systematic review was conducted, searching PubMed, Embase, and the Cochrane Library using the syntax ‘radiol*’ AND ‘structur*’ AND ‘report*’. Structured reporting was divided in SR level 1, structured layout (use of templates and checklists), and SR level 2, structured content (a drop-down menu, point-and-click or clickable decision trees). Two reviewers screened the search results and included all quantitative experimental studies that discussed SR in radiology. A thematic analysis was performed to appraise the evidence level.

Results

The search resulted in 63 relevant full text articles out of a total of 8561 articles. Thematic analysis resulted in 44 SR level 1 and 19 level 2 reports. Only one paper was scored as highest level of evidence, which concerned a double cohort study with randomized trial design.

Conclusion

The level of evidence for implementing SR in radiology is still low and outcomes should be interpreted with caution.

Key Points

• Structured reporting is increasingly being used in radiology, especially in abdominal and neuroradiological CT and MRI reports.
• SR can be subdivided into structured layout (SR level 1) and structured content (SR level 2), in which the first is defined as being a template in which the reporter has to report; the latter is an IT-based manner in which the content of the radiology report can be inserted and displayed into the report.
• Despite the extensive amount of research on the subject of structured reporting, the level of evidence is low.
Literature
1.
Liu D, Zucherman M, Tulloss WB Jr (2006) Six characteristics of effective structured reporting and the inevitable integration with speech recognition. J Digit Imaging 19:98–104PubMedPubMedCentralCrossRef
2.
3.
Powell DK, Silberzweig JE (2015) state of structured reporting in radiology, a survey. Acad Radiol 22:226–33PubMedCrossRef
4.
Radiological Society of North America (2020) RadReport template library. Radiological Society of North America, Oak Brook (IL), USA. Available via https://​radreport.​org. Accessed 15 Dec 2020.
5.
European Society of Radiology (ESR) (2018) ESR paper on structured reporting in radiology. Insights Imaging 9:1–7CrossRef
6.
Schwartz LH, Seymour L, Litière S et al (2016) RECIST 1.1 – standardisation and disease-specific adaptations: perspectives from the RECIST Working Group. Eur J Cancer 62:138–145PubMedPubMedCentralCrossRef
7.
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722PubMedCrossRef
8.
An JY, Unsdorfer KML, Weinreb JC (2019) BI-RADS, C-RADS, CAD-RADS, LI-RADS, Lung-RADS, NI-RADS, O-RADS, PI-RADS, TI-RADS: reporting and data systems. Radiographics 39:1435–1436PubMedCrossRef
9.
10.
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535
11.
Mays N, Pope C, Popay J (2005) Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. J Health Serv Res Policy 10(Suppl 1):6–20PubMedCrossRef
12.
Lucas PJ, Baird J, Arai L, Law C, Roberts HM (2007) Worked examples of alternative methods for the synthesis of qualitative and quantitative research in systematic reviews. BMC Med Res Methodol 7:4
13.
Siwek J, Gourlay ML, Slawson DC, Shaughnessy AF (2002) How to write an evidence-based clinical review article. Am Fam Physician 65:251–258PubMed
14.
Dimarco M, Cannella R, Pellegrino S et al (2020) Impact of structured report on the quality of preoperative CT staging of pancreatic ductal adenocarcinoma: assessment of intra- and inter-reader variability. Abdom Radiol (NY) 45:437–448CrossRef
15.
Gupta NA, Mahajan S, Sumankumar A, Saklani A, Engineer R, Baheti AD (2020) Impact of a standardized reporting format on the quality of MRI reports for rectal cancer staging. Indian J Radiol Imaging 30:7–12PubMedPubMedCentralCrossRef
16.
McFarland JA, Elkassem AMA, Casals L, Smith GD, Smith AD, Gunn AJ (2021) Objective comparison of errors and report length between structured and freeform abdominopelvic computed tomography reports. Abdom Radiol (NY) 46:387–393CrossRef
17.
Olthof AW, Leusveld ALM, de Groot JC, Callenbach PMC, van Ooijen PMA (2020) Contextual structured reporting in radiology: implementation and long-term evaluation in improving the communication of critical findings. J Med Syst 44(9):148
18.
Alessandrino F, Cristiano L, Cinnante CM et al (2019) Value of structured reporting in neuromuscular disorders. Radiol Med (Torino) 124:628–635CrossRef
19.
Benson J, Burgstahler M, Zhang L, Rischall M (2019) The value of structured radiology reports to categorize intracranial metastases following radiation therapy. Neuroradiol J 32:267–272PubMedPubMedCentralCrossRef
20.
Gore A, Hoch MJ, Shu H-KG, Olson JJ, Voloschin AD, Weinberg BD (2019) Institutional implementation of a structured reporting system: our experience with the brain tumor reporting and data system. Acad Radiol 26:974–980PubMedCrossRef
21.
Liu Y, Feng Z, Qin S, Yang J, Han C, Wang X (2019) Structured reports of pelvic magnetic resonance imaging in primary endometrial cancer: potential benefits for clinical decision-making. PLoS One 14(3):e0213928
22.
Wetterauer C, Winkel DJ, Federer-Gsponer JR et al (2019) Structured reporting of prostate magnetic resonance imaging has the potential to improve interdisciplinary communication. PLoS One 14(2):e0212444
23.
Bink A, Benner J, Reinhardt J et al (2018) Structured reporting in neuroradiology: Intracranial tumors. Front Neurol 9:32
24.
Griffin AS, Mitsky J, Rawal U, Bronner AJ, Tessler FN, Hoang JK (2018) Improved quality of thyroid ultrasound reports after implementation of the ACR thyroid imaging reporting and data system nodule lexicon and risk stratification System. J Am Coll Radiol 15:743–748PubMedCrossRef
25.
Magnetta MJ, Donovan AL, Jacobs BL, Davies BJ, Furlan A (2018) Evidence-based reporting: a method to optimize prostate MRI communications with referring physicians. AJR Am J Roentgenol 210:108–112PubMedCrossRef
26.
Olthof AW, Borstlap J, Roeloffzen WW, Callenbach PMC, van Ooijen PMA (2018) Improvement of radiology reporting in a clinical cancer network: impact of an optimised multidisciplinary workflow. Eur Radiol 28:4274–4280PubMedCrossRef
27.
Poullos PD, Tseng JJ, Melcher ML et al (2018) Structured reporting of multiphasic CT for hepatocellular carcinoma: effect on staging and suitability for transplant. AJR Am J Roentgenol 210:766–774PubMedCrossRef
28.
Tersteeg JJC, Gobardhan PD, Crolla RMPH et al (2018) Improving the quality of MRI reports of preoperative patients with rectal cancer: effect of national guidelines and structured reporting. AJR Am J Roentgenol 210:1240–1244PubMedCrossRef
29.
Flusberg M, Ganeles J, Ekinci T et al (2017) Impact of a structured report template on the quality of CT and MRI reports for hepatocellular carcinoma diagnosis. J Am Coll Radiol 14:1206–1211PubMedCrossRef
30.
Franconeri A, Fang J, Carney B et al (2018) Structured vs narrative reporting of pelvic MRI for fibroids: clarity and impact on treatment planning. Eur Radiol 28:3009–3017PubMedCrossRef
31.
Pysarenko K, Recht M, Kim D (2017) Structured reporting: a tool to improve reimbursement. J Am Coll Radiol 14:662–664PubMedCrossRef
32.
Wildman-Tobriner B, Allen BC, Bashir MR et al (2017) Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians. Abdom Radiol (NY) 42:2243–2250CrossRef
33.
Wildman-Tobriner B, Allen BC, Davis JT et al (2017) Structured reporting of magnetic resonance enterography for pediatric Crohn’s disease: effect on key feature reporting and subjective assessment of disease by referring physicians. Curr Probl Diagn Radiol 46:110–114PubMedCrossRef
34.
Dickerson E, Davenport MS, Syed F et al; Michigan Radiology Quality Collaborative (2017) Effect of template reporting of brain MRIs for multiple sclerosis on report thoroughness and neurologist-rated quality: results of a prospective quality improvement project. J Am Coll Radiol 14(3):371–379.e1
35.
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 274:464–472PubMedCrossRef
36.
Sahni VA, Silveira PC, Sainani NI, Khorasani R (2015) Impact of a structured report template on the quality of MRI reports for rectal cancer staging. AJR Am J Roentgenol 205:584–588PubMedCrossRef
37.
Silveira PC, Dunne R, Sainani NI et al (2015) Impact of an information technology-enabled initiative on the quality of prostate multiparametric MRI reports. Acad Radiol 22:827–833PubMedPubMedCentralCrossRef
38.
Lin E, Powell DK, Kagetsu NJ (2014) Efficacy of a checklist-style structured radiology reporting template in reducing resident misses on cervical spine computed tomography examinations. J Digit Imaging 27:588–593PubMedPubMedCentralCrossRef
39.
Marcovici PA, Taylor GA (2014) Journal Club: structured radiology reports are more complete and more effective than unstructured reports. AJR Am J Roentgenol 203:1265–1271PubMedCrossRef
40.
Powell DK, Lin E, Silberzweig JE, Kagetsu NJ (2014) Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy. Acad Radiol 21:415–423PubMedCrossRef
41.
Fraser L, O’Neill K, Locke R et al (2013) Standardising reporting of cervical lymphadenopathy in paediatric neck ultrasound: a pilot study using an evidence-based reporting protocol. Int J Pediatr Otorhinolaryngol 77:1248–1251PubMedCrossRef
42.
Chung CY, Makeeva V, Yan J et al (2020) Improving billing accuracy through enterprise-wide standardized structured reporting with cross-divisional shared templates. J Am Coll Radiol 17:157–164PubMedCrossRef
43.
Hanna TN, Shekhani H, Maddu K, Zhang C, Chen Z, Johnson J-O (2016) Structured report compliance: effect on audio dictation time, report length, and total radiologist study time. Emerg Radiol 23:449–453PubMedCrossRef
44.
Hawkins CM, Hall S, Zhang B, Towbin AJ (2014) Creation and implementation of department-wide structured reports: an analysis of the impact on error rate in radiology reports. J Digit Imaging 27:581–587PubMedPubMedCentralCrossRef
45.
Larson DB, Towbin AJ, Pryor RM, Donnelly LF (2013) Improving consistency in radiology reporting through the use of department-wide standardized structured reporting. Radiology 267:240–250PubMedCrossRef
46.
Hawkins CM, Hall S, Hardin J, Salisbury S, Towbin AJ (2012) Prepopulated radiology report templates: a prospective analysis of error rate and turnaround time. J Digit Imaging 25:504–511PubMedPubMedCentralCrossRef
47.
Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H (2011) Improving communication of diagnostic radiology findings through structured reporting. Radiology 260:174–181PubMedPubMedCentralCrossRef
48.
Liu D, Berman GD, Gray RN (2003) The use of structured radiology reporting at a community hospital: a 4-year case study of more than 200,000 reports. Appl Radiol 32:23–26CrossRef
49.
Dabrowiecki A, Sadigh G, Duszak R (2020) Chest radiograph reporting: public preferences and perceptions. J Am Coll Radiol 17:1259–1268PubMedCrossRef
50.
Camilo DMR, Tibana TK, Adôrno IF et al (2019) Radiology report format preferred by requesting physicians: prospective analysis in a population of physicians at a university hospital. Radiol Bras 52:97–103PubMedPubMedCentralCrossRef
51.
Heye T, Gysin V, Boll DT, Merkle EM (2018) Journal Club: structured reporting: the voice of the customer in an ongoing debate about the future of radiology reporting. AJR Am J Roentgenol 211:964–970PubMedCrossRef
52.
Lather JD, Che Z, Saltzman B, Bieszczad J (2018) Structured reporting in the academic setting: what the referring clinician wants. J Am Coll Radiol 15:772–775PubMedCrossRef
53.
Travis AR, Sevenster M, Ganesh R, Peters JF, Chang PJ (2014) Preferences for structured reporting of measurement data. An institutional survey of medical oncologists, oncology registrars, and radiologists. Acad Radiol 21:785–796PubMedCrossRef
54.
Krupinski EA, Hall ET, Jaw S, Reiner B, Siegel E (2012) Influence of radiology report format on reading time and comprehension. J Digit Imaging 25:63–69PubMedCrossRef
55.
56.
Sistrom CL, Honeyman-Buck J (2005) Free text versus structured format: information transfer efficiency of radiology reports. AJR Am J Roentgenol 185:804–812PubMedCrossRef
57.
Naik SS, Hanbidge A, Wilson SR (2001) Radiology reports: examining radiologist and clinician preferences regarding style and content. AJR Am J Roentgenol 176:591–598PubMedCrossRef
58.
Johnson AJ, Chen MYM, Zapadka ME, Lyders EM, Littenberg B (2010) Radiology report clarity: a cohort study of structured reporting compared with conventional dictation. J Am Coll Radiol 7:501–506PubMedCrossRef
59.
Johnson AJ, Chen MYM, Shannon Swan J, Applegate KE, Littenberg B (2009) Cohort study of structured reporting compared with conventional dictation. Radiology 253:74–80PubMedCrossRef
60.
Aase A, Fabbrini AE, White KM, Averill S, Gravely A, Melzer AC (2020) Implementation of a standardized template for reporting of incidental pulmonary nodules: feasibility, acceptability, and outcomes. J Am Coll Radiol 17:216–223PubMedCrossRef
61.
Alper DP, Shinagare AB, Hashemi SR et al (2020) Effect of a report template-enabled quality improvement initiative on use of preferred phrases for communicating normal findings in structured abdominal CT and MRI reports. AJR Am J Roentgenol 214:835–842PubMedCrossRef
62.
Kim SH, Sobez LM, Spiro JE et al (2020) Structured reporting has the potential to reduce reporting times of dual-energy x-ray absorptiometry exams. BMC Musculoskelet Disord 21(1):248
63.
Tuncyurek O, Garces-Descovich A, Jaramillo-Cardoso A et al (2019) Structured versus narrative reporting of pelvic MRI in perianal fistulizing disease: impact on clarity, completeness, and surgical planning. Abdom Radiol (NY) 44:811–820CrossRef
64.
Armbruster M, Gassenmaier S, Haack M et al (2018) Structured reporting in petrous bone MRI examinations: impact on report completeness and quality. Int J Comput Assist Radiol Surg 13:1971–1980PubMedCrossRef
65.
Sabel BO, Plum JL, Czihal M et al (2018) Structured reporting of CT angiography runoff examinations of the lower extremities. Eur J Vasc Endovasc Surg 55:679–687PubMedCrossRef
66.
Schoeppe F, Sommer WH, Haack M et al (2018) Structured reports of videofluoroscopic swallowing studies have the potential to improve overall report quality compared to free text reports. Eur Radiol 28:308–315PubMedCrossRef
67.
Schöppe F, Sommer WH, Schmidutz F et al (2018) Structured reporting of x-rays for atraumatic shoulder pain: advantages over free text? BMC Med Imaging 18(1):20
68.
Shaish H, Feltus W, Steinman J, Hecht E, Wenske S, Ahmed F (2018) Impact of a structured reporting template on adherence to prostate imaging reporting and data system version 2 and on the diagnostic performance of prostate MRI for clinically significant prostate cancer. J Am Coll Radiol 15:749–754PubMedCrossRef
69.
Gassenmaier S, Armbruster M, Haasters F et al (2017) Structured reporting of MRI of the shoulder - improvement of report quality? Eur Radiol 27:4110–4119PubMedCrossRef
70.
Norenberg 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. Invest Radiol 52:232–239PubMedCrossRef
71.
Sabel BO, Plum JL, Kneidinger N et al (2017) Structured reporting of CT examinations in acute pulmonary embolism. J Cardiovasc Comput Tomogr 11:188–195PubMedCrossRef
72.
Walter WR, Goldberg-Stein S, Levsky JM, Cohen HW, Scheinfeld MH (2015) A default normal chest CT structured reporting field for coronary calcifications does not cause excessive false-negative reporting. J Am Coll Radiol 12:783–787PubMedPubMedCentralCrossRef
73.
Schweitzer W, Bartsch C, Ruder TD, Thali MJ (2014) Virtopsy approach: structured reporting versus free reporting for PMCT findings. J Forensic Radiol Imaging 2:28–33CrossRef
74.
Karim S, Fegeler C, Boeckler D, Schwartz LH, Kauczor H-U, von Tengg-Kobligk H (2013) Development, implementation, and evaluation of a structured reporting web tool for abdominal aortic aneurysms. JMIR Res Protoc 2(2):e30
75.
Barbosa F, Maciel LMZ, Vieira EM, Azevedo Marques PM, de, Elias J, Muglia VF, (2010) Radiological reports: a comparison between the transmission efficiency of information in free text and in structured reports. Clinics (Sao Paulo) 65:15–21CrossRef
76.
Hasegawa Y, Matsumura Y, Mihara N et al (2010) Development of a system that generates structured reports for chest x-ray radiography. Methods Inf Med 49:360–370PubMedCrossRef
Metadata
Title
Structured reporting in radiology: a systematic review to explore its potential
Authors
J. Martijn Nobel
Koos van Geel
Simon G. F. Robben
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08327-5

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