title: Do MRI reports contain adequate preoperative staging information for end users to make appropriate treatment decisions for rectal cancer?
abstract: OBJECTIVE
  This study was designed to elicit end-user opinions regarding the importance and diagnostic accuracy of MRI for T-category, threatened or involved circumferential margin (CRMi), and lymph node involvement (LNi) for preoperative staging of rectal cancer and to determine completeness of MRI reports for these elements on a population based level.
  
  
  METHODS
  The first part of this study was a mailed survey of surgeons, radiation oncologists, and medical oncologists to elicit their opinions regarding the importance and diagnostic accuracy of T-category, CRMi, and LNi on MRI. The second part of the study was an audit of MRI reports issued for pre-operative staging of rectal cancer to assess the completeness of these reports for T-category, CRMi, and LNi.
  
  
  RESULTS
  Although T-category, CRMi, and LNi were considered essential by 97, 94, and 77 % of respondents, respectively, the MRI report audit showed that only 40 % of MRI reports captured all of these elements. The majority of end users reported moderate diagnostic accuracy on MRI for T-category and CRMi and low diagnostic accuracy for LNi (52.3, 43, and 48.5 % respectively). Multivariate analysis showed that specialty was the only independent predictor of correct reporting of the diagnostic accuracy for each of the MRI elements.
  
  
  CONCLUSIONS
  While end users consider T-category, CRMi and LNi essential for preoperative staging of rectal cancer, less than 40 % of MRI reports captured all of these elements. Therefore, strategies to improve communication between radiologists and end users are critical to improve the overall quality of care for rectal cancer patients.
authors.affiliation: Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada.
authors.forename: Eisar
authors.initials: E
authors.lastname: Al-Sukhni
authors.forename: David E
authors.initials: DE
authors.lastname: Messenger
authors.forename: J
authors.initials: J
authors.lastname: Charles Victor
authors.forename: Robin S
authors.initials: RS
authors.lastname: McLeod
authors.forename: Erin D
authors.initials: ED
authors.lastname: Kennedy
mesh_terms: D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008485:Medical Audit; D008495:Medical Oncology; D009367:Neoplasm Staging; D010819:Physician's Role; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000601:surgery