Do MRI Structured Reports with FIGO classifications of Fibroids Contain Adequate Information for Clinical Decision Making?
Do MRI Structured Reports with FIGO classifications of Fibroids Contain Adequate Information for Clinical Decision Making?
Laura Tordjman MD; Haleh Amirian MD; Sara Shir; Julieta Aristiazabal MD; Stephanie Delgado MD; Patricia Castillo MD; Prasoon Mohan, MD; Francesco Alessandrino MD1
To evaluate if structured reports with FIGO classifications of fibroids (SR-FIGO) of MRI in uterine fibroids contain adequate information for clinical decision-making compared with non-structured reports (NSR).
In this HIPAA-compliant, IRB-approved study for which informed consent was waived, three reporting templates for fibroid MRIs were compared: two SR developed in collaboration between gynecologists, interventional and diagnostic radiologists, and one NR for presence of 19 key features deemed relevant for management of fibroids. Kruskal-Wallis test was used to evaluate the distribution of key features across the different report types. A gynecologist evaluated the reports and the MRIs to assess: 1. presence of sufficient information to decide on treatment (observation/medical treatment/surgery/uterine artery embolization); 2. surgical approach (hysteroscopic/laparoscopic/robotic/open); 3. type of surgery (myomectomy/hysterectomy); 4. necessity to review the MRIs; 5. time spent reviewing the MRIs. The gynecologist’s response to questions 1-5 among the three different reports were compared with Chi-square test.
Title, Disclosures, Purpose
Materials and Methods
Twenty NR, 20 SR, and 20 SR-FIGO were reviewed. The number of key features contained in each report type (mean±SD) were significantly different (p<0.001):SR-FIGO had highest number of key features (16.95±0.19), followed by SR (16.15±0.29), and NR (9.8±0.58). In pairwise comparison, significant difference was observed between NR and SR (p=0.001), NR and SR-FIGO (p=0.001), whereas no significant difference was observed comparing number of key features contained in SR versus SR-FIGO (p=0.063). Gynecologist’s evaluation of the reports did not show any significant difference in answer to questions 1-5 among the three different reports (p-value range: 0.05-0.34).
Results
SR of MRI in patients with fibroids provides more information compared to NR; however, it is unclear if including the FIGO classification of fibroids in SR changes the gynecologist’s clinical decision-making ability. Further studies can help clarifying if SR-FIGO may be more helpful in clinical decision-making depending on referring gynecologist’s experience.
