MRT-Befundung hirneigener Tumoren: Was neuroonkologisch tätige Kliniker vom Radiologen erwarten

BACKGROUND AND OBJECTIVE: Structured reporting of MRI examinations using consensus-based content categories has the potential to improve interdisciplinary communication in neuro-oncology. Therefore, the aim of this study was to determine the essential reporting categories in the imaging of gliomas from a clinical perspective within the setting of a nationwide survey of members of medical societies working in neuro-oncology. MATERIALS AND METHODS: An online questionnaire was created based on an interdisciplinary developed catalog of possible MRI reporting elements. Subsequently, specialist members of the German Societies of Neurosurgery, Radiation Oncology, Hematology and Medical Oncology, Neurology, and Neuropathology were invited to evaluate the items with regard to their clinical relevance. RESULTS: A total of 171 specialists from Germany participated in the survey (81 neurosurgeons, 66 radiation therapists, and 24 other neuro-oncology experts). Number and anatomic extent of tumors in the contrast-enhanced T1 and 2D T2 sequences (98.8% vs. 97.1%) as well as newly diagnosed lesions at follow-up (T1 + contrast 98.2%; T2 94.7%) were overall most frequently considered crucial. In addition, the experts particularly rated the description of ependymal and/or leptomeningeal tumor dissemination (93.6%) and signs of mass effect including occlusive hydrocephalus and parenchymal mass shifts (> 75.0% each) as essential. Standard mention of intratumoral calcifications, hemorrhages, tumor vascular architecture, or advanced imaging modalities such as MR perfusion, diffusion, tractography, and proton spectroscopy were considered fundamental to their everyday practice by only a minority of neuro-oncology colleagues. CONCLUSION: A referring physician-oriented minimum content standard for MRI examinations in primary brain tumor patients should include as clinically relevant core elements the exact anatomic spread of the lesion(s), including ependymal and meningeal involvement, and the pertinent signs of mass effect.