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Published on: June 23, 2015
Reporting ADPK Disease Phenotypes on Abdominal Scans
Zhongxiu Hu1, Elizabeth G Lane1, Grace C Lo1
1Department of Radiology, Weill Cornell Medicine, New York, New York, USA.
Introduction:
Kidney and liver volumes from abdominal magnetic resonance imaging (MRI) and computed tomography (CT) scans are critical biomarkers recommended by Kidney Disease: Improving Global Outcomes (KDIGO) for autosomal dominant polycystic kidney disease (ADPKD) progression and response to therapy. The purpose of this study was to determine how often these biomarkers are included in radiology reports as well as their reproducibility.
Methods:
Outside abdominal MRI (n = 102) and CT (n = 43) studies were reviewed retrospectively and independently by 2 observers for prevalence of reporting ADPKD-relevant findings with discrepancies resolved by 2 radiologists. These 2 radiologists independently reevaluated all examinations to assess interobserver reproducibility.
Results:
Outside reports (n = 145; males: 46%; median age: 47 [interquartile range: 35-61] years) by 122 radiologists from 88 institutions included kidney volumes in only 30 (21%) reports. Out of 140 imaging examinations that included the entire liver, 1 (1%) outside report provided liver volume. Comparison of outside and study radiologists' kidney volume measurements showed a median absolute difference of 15%, using the ellipsoidal method and 8% using model-assisted contouring. Additional positive findings not mentioned in 145 outside reports included umbilical hernia (n = 44), hepatic steatosis (n = 3), inguinal hernia (n = 4), pancreatic cyst (n = 6) and severe inferior vena cava (IVC) compression by cysts (n = 2).
Conclusion:
Radiologists report reliably on complex cysts, calcifications, ascites, and abdominal aortic aneurysms in ADPKD. However, the clinical utility of these reports can be improved more reliably by including kidney volume and other important imaging features of ADPKD recommended by clinical guidelines.
Insights
Radiology reports for autosomal dominant polycystic kidney disease (ADPKD) often omit kidney and liver volumes, crucial biomarkers. Including these volumes and other key findings in reports will improve clinical utility for ADPKD management.
Area of Science:
- Radiology and Medical Imaging
- Nephrology and Urology
- Genetics and Genomics
Background:
- Kidney and liver volumes are vital biomarkers for monitoring autosomal dominant polycystic kidney disease (ADPKD) progression and treatment response, as per KDIGO guidelines.
- Accurate reporting of these biomarkers in radiological assessments is essential for effective patient management.
Purpose of the Study:
- To evaluate the frequency of reporting kidney and liver volumes in radiology reports for ADPKD.
- To assess the reproducibility of kidney volume measurements by radiologists.
Main Methods:
- Retrospective review of 145 abdominal MRI and CT studies by two independent observers.
- Discrepancy resolution by two senior radiologists and assessment of interobserver reproducibility for kidney volume measurements.
Main Results:
- Kidney volumes were reported in only 21% of outside reports, and liver volume in only 1% of relevant examinations.
- Kidney volume measurements showed a median absolute difference of 15% (ellipsoidal method) and 8% (model-assisted contouring) between outside and study radiologists.
- Other ADPKD-relevant findings like IVC compression were frequently underreported.
Conclusions:
- Current radiology reports for ADPKD often lack essential biomarkers like kidney and liver volumes.
- Improving the inclusion of recommended imaging features in reports can enhance their clinical utility for ADPKD management.
