Multi-institutional analysis of CT and MRI reports evaluating indeterminate renal masses: comparison to a national survey investigating desired report elements

Eric M. Hu, Andrew Zhang, Stuart G. Silverman, Ivan M. Pedrosa, Zhen J. Wang, Andrew D. Smith, Hersh Chandarana, Ankur Doshi, Atul B. Shinagare, Erick M. Remer, Samuel D. Kaffenberger, David C. Miller, Matthew S. Davenport

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine the need for a standardized renal mass reporting template by analyzing reports of indeterminate renal masses and comparing their contents to stated preferences of radiologists and urologists. Methods: The host IRB waived regulatory oversight for this multi-institutional HIPAA-compliant quality improvement effort. CT and MRI reports created to characterize an indeterminate renal mass were analyzed from 6 community (median: 17 reports/site) and 6 academic (median: 23 reports/site) United States practices. Report contents were compared to a published national survey of stated preferences by academic radiologists and urologists from 9 institutions. Descriptive statistics and Chi-square tests were calculated. Results: Of 319 reports, 85% (271; 192 CT, 79 MRI) reported a possibly malignant mass (236 solid, 35 cystic). Some essential elements were commonly described: size (99% [269/271]), mass type (solid vs. cystic; 99% [268/271]), enhancement (presence vs. absence; 92% [248/271]). Other essential elements had incomplete penetrance: the presence or absence of fat in solid masses (14% [34/236]), size comparisons when available (79% [111/140]), Bosniak classification for cystic masses (54% [19/35]). Preferred but non-essential elements generally were described in less than half of reports. Nephrometry scores usually were not included for local therapy candidates (12% [30/257]). Academic practices were significantly more likely than community practices to include mass characterization details, probability of malignancy, and staging. Community practices were significantly more likely to include management recommendations. Conclusions: Renal mass reporting elements considered essential or preferred often are omitted in radiology reports. Variation exists across radiologists and practice settings. A standardized template may mitigate these inconsistencies.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Apr 17 2018

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Kidney
Health Insurance Portability and Accountability Act
Penetrance
Research Ethics Committees
Chi-Square Distribution
Quality Improvement
Radiology
Fats
Surveys and Questionnaires
Radiologists
Neoplasms
Urologists
Therapeutics

Keywords

  • Multi-institutional
  • Renal cancer
  • Renal cell carcinoma
  • Renal mass
  • Structured reporting

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Multi-institutional analysis of CT and MRI reports evaluating indeterminate renal masses : comparison to a national survey investigating desired report elements. / Hu, Eric M.; Zhang, Andrew; Silverman, Stuart G.; Pedrosa, Ivan M.; Wang, Zhen J.; Smith, Andrew D.; Chandarana, Hersh; Doshi, Ankur; Shinagare, Atul B.; Remer, Erick M.; Kaffenberger, Samuel D.; Miller, David C.; Davenport, Matthew S.

In: Abdominal Radiology, 17.04.2018, p. 1-10.

Research output: Contribution to journalArticle

Hu, EM, Zhang, A, Silverman, SG, Pedrosa, IM, Wang, ZJ, Smith, AD, Chandarana, H, Doshi, A, Shinagare, AB, Remer, EM, Kaffenberger, SD, Miller, DC & Davenport, MS 2018, 'Multi-institutional analysis of CT and MRI reports evaluating indeterminate renal masses: comparison to a national survey investigating desired report elements', Abdominal Radiology, pp. 1-10. https://doi.org/10.1007/s00261-018-1609-x
Hu, Eric M. ; Zhang, Andrew ; Silverman, Stuart G. ; Pedrosa, Ivan M. ; Wang, Zhen J. ; Smith, Andrew D. ; Chandarana, Hersh ; Doshi, Ankur ; Shinagare, Atul B. ; Remer, Erick M. ; Kaffenberger, Samuel D. ; Miller, David C. ; Davenport, Matthew S. / Multi-institutional analysis of CT and MRI reports evaluating indeterminate renal masses : comparison to a national survey investigating desired report elements. In: Abdominal Radiology. 2018 ; pp. 1-10.
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abstract = "Purpose: To determine the need for a standardized renal mass reporting template by analyzing reports of indeterminate renal masses and comparing their contents to stated preferences of radiologists and urologists. Methods: The host IRB waived regulatory oversight for this multi-institutional HIPAA-compliant quality improvement effort. CT and MRI reports created to characterize an indeterminate renal mass were analyzed from 6 community (median: 17 reports/site) and 6 academic (median: 23 reports/site) United States practices. Report contents were compared to a published national survey of stated preferences by academic radiologists and urologists from 9 institutions. Descriptive statistics and Chi-square tests were calculated. Results: Of 319 reports, 85{\%} (271; 192 CT, 79 MRI) reported a possibly malignant mass (236 solid, 35 cystic). Some essential elements were commonly described: size (99{\%} [269/271]), mass type (solid vs. cystic; 99{\%} [268/271]), enhancement (presence vs. absence; 92{\%} [248/271]). Other essential elements had incomplete penetrance: the presence or absence of fat in solid masses (14{\%} [34/236]), size comparisons when available (79{\%} [111/140]), Bosniak classification for cystic masses (54{\%} [19/35]). Preferred but non-essential elements generally were described in less than half of reports. Nephrometry scores usually were not included for local therapy candidates (12{\%} [30/257]). Academic practices were significantly more likely than community practices to include mass characterization details, probability of malignancy, and staging. Community practices were significantly more likely to include management recommendations. Conclusions: Renal mass reporting elements considered essential or preferred often are omitted in radiology reports. Variation exists across radiologists and practice settings. A standardized template may mitigate these inconsistencies.",
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AU - Pedrosa, Ivan M.

AU - Wang, Zhen J.

AU - Smith, Andrew D.

AU - Chandarana, Hersh

AU - Doshi, Ankur

AU - Shinagare, Atul B.

AU - Remer, Erick M.

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AU - Davenport, Matthew S.

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