Evidence-Based Reporting: A Method to Optimize Prostate MRI Communications With Referring Physicians

Objective: The purpose of this study was to develop an evidence-based method to optimize prostate MRI reports that would improve communication between urologists and radiologists.

Materials and methods: This quality improvement initiative was approved by the institutional Quality Improvement Review Committee. A structured report was developed containing essential components defined by local practice norms and Prostate Imaging Reporting and Data System (PI-RADS) lexicon version 2. Two hundred preintervention and 100 postintervention reports were retrospectively reviewed for essential components. Additionally, a sample of 40 reports generated before the intervention and 40 reports generated after the intervention that made use of the structured report were evaluated by a urologist and were scored on a 5-point scale for consistency, completeness, conciseness, clarity, likelihood to contact radiologist, and clinical impact. Variables were compared with ANOVA, chi-square, or Fisher exact test.

Results: Essential components of the report were utilization of the PI-RADSv2 lexicon, findings listed by lesion, reporting of pertinent positive and negative findings (extraprostatic extension, seminal vesicle, and neurovascular bundle invasion), and low word count. In postintervention reports, all essential measures were statistically improved except for mean report word count. The urologist indicated statistically improved consistency (before intervention, 2.7; after intervention, 3.5; χ² < 0.001), completeness (before intervention, 2.8; after intervention, 3.3; χ² < 0.001), clarity (before intervention, 2.9; after intervention, 3.3; χ² < 0.05), and clinical impact (before intervention, 2.8; after intervention, 3.8; χ² < 0.001) of the report with reduced perceived need to contact (before intervention, 3.2; after intervention, 2.1; χ² < 0.001) the interpreting radiologist for explanation.

Conclusion: The structured prostate MRI report resulted in improved communication with referring urologists as indicated by the increased perceived clinical impact of the report.