Impact of structured reporting on interpretability of PSMA PET/CT in prostate cancer staging-towards standardised clinical implementation.

Authors

Gloria Biechele, Moritz Schnitzer, Romy Göbel, Niels Bauer, Sarah Takayama Fouladgar, Felix Herr, Mirlind Zaganjori, Adrien Holzgreve, Konrad Klimek, Rudolf Werner, Clemens Cyran, Jens Ricke, Johannes Rübenthaler, Thomas Geyer

Published in

European radiology experimental. Volume 10. Issue 1. Aug 10, 2026. Epub Aug 10, 2026.

Abstract

This study assessed the impact of structured reporting (SR) compared with conventional free-text reporting (FTR) on report quality for PSMA PET/CT for diagnosis and staging of prostate cancer (PC) using a dedicated template.
Fifty consecutive patients were included. Original clinical FTRs were compared with SRs retrospectively generated for the same examinations using template-based online software featuring clickable decision trees. Two readers specialised in urology and radioligand therapy independently assessed reports with regard to completeness, ease of information extraction, linguistic and overall report quality.
FTR achieved higher scores for overall report quality compared with SR (mean 5.46 versus 4.71; p < 0.0001) and was associated with fewer missing key features (present in 36% of FTR versus 54% of SR; p = 0.005). Information was rated sufficient to guide decision-making regarding surgery versus conservative therapy in 91% of FTR compared to 76% of SR (p = 0.018). Information extraction was rated easy in 69% of FTR compared to 50% of SRs (p = 0.007). FTR received higher scores for linguistic quality (mean 5.69 versus 5.09; p < 0.001). The key clinical questions were answered equally between reporting formats (p = 0.68).
In PSMA PET/CT reporting, FTR consistently achieved higher ratings than template-based SR, with respect to overall report quality, clinical usefulness for management decisions, information retrieval, and linguistic quality. These findings underline that the performance of SR strongly depends on template design, implementation workflow, and local reporting expertise, and that SR tools require careful, indication-specific validation.
Question Does SR improve the quality, completeness, interpretability, and clinical usefulness of PSMA PET/CT reports for PC staging compared with FTR? Findings FTR were rated superior to SR regarding clinical decision-making, completeness, report quality, and information retrieval. Relevance statement In PSMA PET/CT, report format directly affects the usability of imaging findings for therapeutic decision-making. The effectiveness of SR appears dependent on local reporting expertise and clinical context, underscoring the need for prospective, indication-specific validation before routine clinical implementation.

PMID:
42573660
Bibliographic data and abstract were imported from PubMed on 10 Aug 2026.

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