Multimedia-Enhanced Radiology Reports Improve Target Lesion Selection and Measurement Concordance, and Are More Efficient in Genitourinary Cancer Trials
Thursday, September 15, 2016 — Poster Session II
- LB Machado
- SM Steinberg
- AB Apolo
- LR Folio
Purpose: Radiology reports often lack necessary measurements of target lesions needed for oncology clinical trials. When available, they are often discrepant from records used to calculate therapeutic response. This study assessed the clinical value and efficiency of hyperlinked tumor measurements in multimedia-enhanced radiology reports (MERRs) within PACS and the inclusion of a radiologist extender in the process of assessing tumor burden. Materials and Methods: We assessed 489 target lesions in 232 CT scans from 71 patients with metastatic genitourinary cancer enrolled in two therapeutic trials. We analyzed target lesion selection and measurement concordance between oncology records (used to calculate therapeutic response) and radiology reports: MERRs and text-only within PACS. We also estimated time to extract measurements from MERRs vs. text-only reports. For statistical tests we used Wilcoxon signed rank, Wilcoxon rank sum test, and Fisher’s method to combine P values from the paired and unpaired results. Fisher’s exact test was used to compare overall measurement concordance. Results: Concordance on target lesion selection was greater in MERRs (78%) than in text-only reports (52%) (P = 0.0050). There was also improved overall measurement concordance with MERRs (68%) compared to text-only reports (38%; P < 0.0001). Lesion measurements extracted from MERRs were found more quickly per patient than measurements in text only reports (P=0.032; overall mean extraction time was 1.3 vs. 3.3 minutes/lesion). Conclusion: Hyperlinked MERRs improved concordance of target lesion selection and measurement with measurements used to calculate tumor response compared to text-only reports, and finding measurements was almost three times faster.
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