ESOI-ESUR multicentre validation of a structured MRI report for cervical cancer staging

To compare an International Federation of Gyneology and Obstetrics (FIGO)-anchored structured MRI report with conventional narrative reporting for cervical cancer staging by evaluating referring clinicians' satisfaction.

In this prospective multicentre crossover study (January-June 2024), consecutive patients with biopsy-proven cervical cancer at any FIGO stage underwent staging MRI at five European centres. For each patient, one narrative and one structured report were produced and independently evaluated by gynaecologists and radiation oncologists using a 12-item questionnaire (5-point Likert scale): five general items (Q1-Q5) for both formats and seven feature-specific items (Q6-Q12) for structured reports only. The primary endpoint was the proportion of structured-report evaluations with an overall score ≥ 20 (target ≥ 80%). Paired comparisons used the Wilcoxon signed-rank test with matched-pairs rank-biserial correlation (r) as effect size.

One hundred patients were evaluated, yielding 200 report evaluations. Of 100 structured report evaluations, 98.0% (95% Clopper-Pearson CI: 93.0-99.8%) achieved an overall score ≥ 20, exceeding the 80% threshold, vs 78.0% (95% CI: 68.6-85.7%) for narrative reports. Structured reports scored significantly higher on all five general items and on the overall score (all p < 0.05), with the largest effects for readability (r = 0.95) and brevity (r = 0.85). The advantage was consistent across reader type, disease stage, and centre, with the strongest effect in locally advanced disease. Q6 (cervical stromal invasion) had the lowest feature-specific satisfaction (73.7% scoring ≥ 4), prompting template revision.

A structured MRI report for cervical cancer staging significantly outperformed narrative reporting across all quality domains in a multicentre crossover design.

Question Cervical cancer management is highly stage-dependent, yet evidence on clinician-centred benefit of structured vs narrative MRI staging reports in routine practice is scarce. Findings In a multicentre crossover study, a FIGO-anchored structured MRI report significantly outperformed narrative reporting on all five general quality domains. Clinical relevance A structured MRI report standardises the communication of staging features that drive cervical cancer management and is preferred by referring clinicians over narrative reporting across specialties, disease stages, and European centres.