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Standardising reporting of cervical lymphadenopathy in paediatric neck ultrasound: a pilot study using an
Lyndsay Fraser1, Katie O'Neill, Richard Locke
1Departments of Otolaryngology, Royal Hospital for Sick Children, Dalnair St, Glasgow G3 8SJ, United Kingdom. LyndsayFraser@doctors.org.uk
Insights
A new reporting protocol significantly improved the quality of ultrasound reports for pediatric cervical lymphadenopathy. This standardization enhances diagnostic consistency for this common childhood condition.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Otolaryngology
Background:
- Cervical lymphadenopathy is a frequent pediatric condition with diverse causes.
- Ultrasound is a valuable initial imaging tool, but its effectiveness is limited by operator dependency and inconsistent reporting.
- Variability in ultrasound report content necessitates standardized approaches for accurate diagnosis.
Purpose of the Study:
- To evaluate the impact of an evidence-based reporting protocol on the content of pediatric cervical lymphadenopathy ultrasound reports.
- To compare the consistency and completeness of ultrasound reporting before and after protocol implementation.
- To establish a standardized reporting framework for pediatric neck ultrasounds.
Main Methods:
- A prospective pilot study was conducted over two 8-month periods.
- Ultrasound reports for pediatric cervical lymphadenopathy were audited before and after introducing a new reporting protocol.
- Key ultrasonographic features were identified through a literature search and incorporated into the protocol.
Main Results:
- A statistically significant improvement was observed in reporting key features, including nodal distribution, shape, echogenicity, calcification, necrosis, and vascular patterns (p < 0.05).
- The frequency of reporting specific ultrasonographic characteristics increased post-protocol implementation.
- Analysis of 23 pre-protocol and 26 post-protocol reports demonstrated enhanced reporting quality.
Conclusions:
- Implementation of a standardized reporting protocol streamlined ultrasound reporting for pediatric cervical lymphadenopathy.
- The developed protocol can serve as a model for other departments to improve standardization and aid in teaching.
- This initiative addresses the lack of national guidelines for pediatric neck ultrasound reporting.
Objectives:
Cervical lymphadenopathy is common in children and can arise from a wide range of aetiologies. Ultrasound can be a useful imaging tool for initial investigation but is known to be operator dependent. We aimed to compare the content of ultrasound reporting in this clinical scenario before and after the introduction of an evidence-based reporting protocol.
Methods:
We performed a prospective 8-month pilot study assessing the content of ultrasound reports generated from scans to investigate suspected cervical lymphadenopathy in children referred to our tertiary referral otolaryngology service. We found wide variation in report content and inconsistent reporting of certain radiological features. In response to this we performed a literature search to identify key, clinically relevant ultrasonographic features for cervical lymphadenopathy and then in consultation with our radiology colleagues, devised a protocol to facilitate the reporting of these key features. Content of reports was then prospectively re-audited over a further 8-month period.
Results:
23 reports were assessed before and 26 after introduction of the reporting protocol. Fisher's exact test was used to analyse the data. We found a statistically significant (p < 0.05) improvement in the frequency of reporting of various key features such as nodal distribution, shape, echogenicity, calcification, necrosis and vascular pattern.
Conclusions:
The introduction of a standardised protocol has helped to streamline the reporting of ultrasounds to investigate cervical lymphadenopathy within our department. In the absence of any national guidelines on the reporting of paediatric neck ultrasound in this scenario, we propose that our protocol could be used by other departments to improve standardisation and as a teaching aid.
