RSNA 2013 

Abstract Archives of the RSNA, 2013


Challenges in Radiology Reporting for Serial Tumor Assessment Using RECIST

Scientific Informal (Poster) Presentations

Presented on December 5, 2013
Presented as part of LL-INS-THB: Informatics - Thursday Posters and Exhibits (12:45pm - 1:15pm)


Rony Kampalath MD, Presenter: Nothing to Disclose
Apostolia Maria Tsimberidou MD, PhD, Abstract Co-Author: Research funded, Teva Pharmaceutical Industries Ltd Research funded, sanofi-aventis Group Research funded, Celgene Corporation Advisory Board, Teva Pharmaceutical Industries Ltd Advisory Board, sanofi-aventis Group Consultant, CTI Consulting
Roland Bassett, Abstract Co-Author: Nothing to Disclose
David Joseph Vining MD, Abstract Co-Author: Royalties, Bracco Group CEO, VisionSR Stockholder, VisionSR


The purpose of this project was to conduct an audit of radiology reports to determine if radiologists at a major cancer hospital properly used Response Evaluation Criteria in Solid Tumors (RECIST) for the serial assessment of tumor response to anticancer treatments.


Institutional Review Board (IRB) approval was granted for this retrospective data review. We analyzed baseline and subsequent computed tomography (CT) reports from 112 patients with advanced cancer treated in Phase I clinical trials at the MD Anderson Cancer Center to determine if radiologists (1) reported tumor measurements in their reports, (2) saved relevant annotated images in the institution’s PACS system for later comparison of those metrics, and (3) whether there was correlation of tumor measurements between the serial CT examinations for each patient.


We analyzed radiology reports from 112 consecutive patients enrolled in Phase I clinical trials. Six patients were excluded due to the absence of follow up exams, and 9 were excluded due to no measurements being reported in the baseline studies. We then audited the baseline and subsequent CT reports from the remaining 97 patients (194 total reports) which revealed that radiologists reported tumor measurements in 92% of all cases but saved the relevant annotated images in PACS in only 34% of baseline and 42% of follow up examinations. A total of 314 (3.2/patient) tumors were measured and reported in the baseline examinations, of which 113 (35%) had measurements reported for the same lesions in subsequent examinations.


The consistent use of RECIST in radiology reporting is critical as the accurate and timely assessment of tumor response determines whether cancer patients enrolled in clinical trials are to continue treatments with an experimental agent(s). However, our study reveals that radiologists at a major cancer hospital failed to accurately apply RECIST. Potential solutions include better training of radiologists in how to utilize RECIST, quality audits to identify reporting deficiencies, and possibly the application of structured reporting methods to facilitate the continuity of radiological information for serial tumor assessment.  


Conventional radiology reporting for the application of RECIST needs to be improved with better training of radiologists and/or the use of structured reporting solutions.

Cite This Abstract

Kampalath, R, Tsimberidou, A, Bassett, R, Vining, D, Challenges in Radiology Reporting for Serial Tumor Assessment Using RECIST.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL.