ArticleThe British journal of radiology2023
Pearls and pitfalls of structured staging and reporting of rectal cancer on MRI: an international multireader study.
Article in The British journal of radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- MST-Net: a multi-scale spatial transformation network for automated T2/T3 staging of rectal cancer on preoperative T2-weighted MRI.Insights into imaging · 2026Article
- Value of the DeepSeek-R1 large language model in extracting structured data from magnetic resonance imaging reports of rectal cancer and assisting in tumor staging.Quantitative imaging in medicine and surgery · 2026Article
- MRI to guide clinical management of rectal cancer: updated consensus recommendations from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR)-PART I primary staging.European radiology · 2026Article
- Diagnostic Performance and Misclassification Patterns of Preoperative MRI in Rectal Cancer: A Real-World Study.Diagnostics (Basel, Switzerland) · 2026Article
- Diagnostic accuracy of magnetic resonance imaging for rectal cancer: is it time to reassess the gold standard?Annals of coloproctology · 2026Article
- Advancing MRI diagnostic practices in rectal cancer: exploring the impact of web-based multi-reader study participation.Abdominal radiology (New York) · 2026Article
- Predictive Utility of Structured MRI Reporting for Rectal Cancer Outcomes.Diagnostics (Basel, Switzerland) · 2025Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate uniformity and pitfalls in structured radiological staging of rectal cancer.
methodsTwenty-one radiologists (12 countries) staged 75 rectal cancers on MRI using a structured reporting template. Interobserver agreement (IOA) was calculated as the percentage agreement between readers (categorical variables) and Krippendorff's α (continuous variables). Agreement with an expert consensus served as a surrogate standard of reference to estimate diagnostic accuracy. Polychoric correlation coefficients were used to assess correlations between diagnostic confidence and accuracy (=agreement with expert consensus).
resultsUniformity to diagnose high-risk (≥cT3 ab) versus low-risk (≤cT3 cd) cT-stage, cN0 versus cN+, lateral nodes and tumour deposits, MRF and sphincter involvement, and solid versus mucinous tumours was high with IOA > 80% in the majority of cases (and >80% agreement with expert consensus). Results for assessing extramural vascular invasion, cT-stage (cT1-2/cT3/cT4a/cT4b), cN-stage (cN0/N1/N2), relation to the peritoneal reflection, extent of sphincter involvement (internal/intersphincteric/external) and morphology (solid/annular/semi-annular) were considerably poorer. IOA was high (α = 0.72-0.84) for tumour height/length and extramural invasion depth, but low for tumour-MRF distance and number of (suspicious) nodes (α = 0.05-0.55). There was a significant positive correlation between diagnostic confidence and accuracy (=agreement with expert consensus) (p < 0.001-p = 0.003).
conclusions- Several staging items lacked sufficient reproducibility.- Results for cT- and N-staging g improved when using a dichotomized stratification.- Considering the significant correlation between diagnostic confidence and accuracy, a confidence level may be incorporated into structured reporting for specific items with low reproducibility. ADVANCES IN KNOWLEDGE: Although structured reporting aims to achieve uniformity in reporting, several items lack sufficient reproducibility and might benefit from dichotomized assessment and incorporating confidence levels.
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