Structured vs. unstructured MRI reporting for lumbar spine degenerative conditions: a comparative evaluation using a...

Area of Science:

• Radiology
• Musculoskeletal Imaging
• Medical Reporting

Background:

• Evaluating degenerative musculoskeletal conditions of the lumbar spine is crucial for patient care.
• Current reporting methods include structured templates and free-narrative approaches, each with potential benefits and drawbacks.

Purpose of the Study:

• To compare the diagnostic performance and reporting efficiency of a structured reporting template versus a free-narrative approach for lumbar spine MRI.
• To assess diagnostic accuracy, reporting time, and diagnostic confidence.

Main Methods:

• A structured reporting template was developed through interdisciplinary consensus, covering key categories of lumbar spine pathology.
• Seventy-eight lumbar spine MRIs were interpreted by a radiology resident and a senior radiologist using both structured and free-narrative methods in a blinded fashion.
• Diagnostic accuracy, reporting time, and confidence were statistically compared against a gold standard established by a subspecialized radiologist.

Main Results:

• Structured reporting significantly reduced reporting time for the resident (8 vs. 21 minutes) and improved diagnostic confidence.
• The resident demonstrated higher accuracy in neuroforaminal stenosis and higher sensitivity for spinal canal stenosis and disc herniation with the structured approach.
• The senior radiologist performed better with free-narrative reports, particularly in specificity, indicating potential limitations of structured templates for experienced practitioners.

Conclusions:

• Structured reporting can enhance diagnostic confidence and efficiency for residents in early training stages for lumbar spine MRI interpretation.
• Experienced radiologists may not experience similar efficiency benefits, and free-narrative reports may retain advantages for identifying subtle findings.
• A balanced integration of structured and free-narrative reporting methods is recommended for optimal clinical practice in musculoskeletal radiology.