Contrast ureteropyelography in theatre: standardised flowchart reporting

Area of Science:

• Urology
• Medical Imaging
• Radiology

Background:

• Urologists utilize retrograde contrast studies for diagnosing and guiding instrumentation of the ureters and pelvicalyceal systems.
• Standardization of diagnostic quality and reduction of radiation dose are critical for these procedures.
• Current practices lack standardized reporting, hindering multidisciplinary review.

Purpose of the Study:

• To develop and implement guidelines for standardizing the diagnostic quality of retrograde contrast studies.
• To reduce radiation dose for patients and healthcare professionals during these procedures.
• To integrate a reporting template with Picture Archiving and Communication System (PACS) for enhanced review.

Main Methods:

• Development of a set of guidelines including a reporting template and flowchart.
• Three cycles of audit were conducted to assess guideline implementation and impact.
• Independent review of image quality and screening times, with iterative refinement of guidelines.

Main Results:

• Significant improvements observed in the quality of retrograde contrast studies, including control, contrast, and post-procedure images.
• Mean screening time decreased from 5.0 minutes in phase 1 to 3.2 minutes in phase 3.
• In-theatre urologist reporting integrated with PACS in 93% of cases during phase 3.

Conclusions:

• Implementation of guidelines successfully improved the quality of retrograde contrast studies.
• The developed guidelines and reporting system effectively reduced screening times.
• A system for storing relevant images and urologist reports on PACS was established, facilitating multidisciplinary review.