Neurologists prefer structured MRI reports when evaluating MS patients

Structured MRI reports of patients with multiple sclerosis (MS) are more helpful to neurologists and provide much more key information than nonstructured reports, according to a new study published by the American Journal of Roentgenology.

“[Structured reporting] could facilitate communication of MRI findings in MS, supporting clinicians with any level of experience in medical or therapeutic decisions in MS fields,” wrote Francesco Alessandrino, MD, department of radiology at Brigham and Women's Hospital in Boston, and colleagues.

The authors assessed brain and spinal cord MRI reports of patients with suspected or known MS before and after a structured reporting template was implemented at a high-volume neurology facility in June 2016. They studied 32 structured reports and 37 nonstructured reports, looking specifically for key features relevant for the management of MS. Three neurologists with varying years of experience also assessed each report.

Eleven key features were chosen for brain MRIs and three were chosen for spinal cord MRIs. Overall, structured brain MRI reports contained a mean of 10.25 of the 11 key features, and nonstructured brain MRI reports contained a mean of just 3.59 of the 11 key features. There was “no significant difference” in the number of key features found in structured spinal cord MRI reports and nonstructured spinal cord MRI reports.

All three neurologists said they could understand lesion load “significantly more often” when reading structured reports compared to nonstructured reports. “These findings may have important implications for patient management, because lesion load in the brain and total number of spinal cord lesions are known to be related to disability,” the authors wrote.

Two of the three neurologists reported that structured reports contained adequate information for decision-making more often than nonstructured reports. In addition, two of the three neurologists said they had to evaluate images “significantly more often” when reading nonstructured reports.

The authors noted that their study did have limitations. It was a single-center retrospective study, for example, and it was specialist answers that were evaluated and not the clinical data itself. Alessandrino et al. explained, however, that the study still showed the positive impact structured reporting can have on the evaluation of MRI reports.