European Radiology

, Volume 28, Issue 10, pp 4274–4280 | Cite as

Improvement of radiology reporting in a clinical cancer network: impact of an optimised multidisciplinary workflow

  • A. W. OlthofEmail author
  • J. Borstlap
  • W. W. Roeloffzen
  • P. M. C. Callenbach
  • P. M. A. van Ooijen



To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria.


Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting.


The essential information included in the requests and the reports improved significantly after implementation of the interventions. In the requests, mentioning start date increased from 2% to 49%; date of baseline CT from 7% to 64%; nadir date from 1% to 41%. In the reports, structured layout increased from 14% to 86%; mentioning target lesions from 18% to 80% and non-target lesions from 11% to 80%; measurements stored in PACS increased from 76% to 97%; labelled key images from 38% to 95%; all p values < 0.001.


The combination of implementation of an optimised workflow, subspecialisation and structured reporting led to significantly better quality radiology reporting for oncology patients receiving chemotherapy. The applied multifactorial approach can be used within other radiology subspeciality areas as well.

Key points

Undeveloped subspecialisation makes adherence to RECIST guidelines difficult in general hospitals.

A clinical cancer network provides opportunities to improve healthcare.

Optimised workflow, subspecialisation and structured reporting substantially improve request and report quality.

Good interdisciplinary communication between oncologists, radiologists and others contributes to quality improvement.


Quality assurance, healthcare Radiology information systems Medical oncology Interdisciplinary communication Health facility merger 



Picture Archiving and Communication System


Plan Do Check Act


Response Evaluation Criteria in Solid Tumours



The authors thank the administrative staff, the technicians, the PACS administrators, the radiologists and the oncologists for participating in the project.


The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is P.M.A. van Ooijen MSc PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because patient data were anonymously used for the study and no interventions took place for the study.

Ethical approval

Institutional Review Board approval was not required because of the retrospective nature of the study.


• retrospective

• observational

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • A. W. Olthof
    • 1
    Email author
  • J. Borstlap
    • 1
  • W. W. Roeloffzen
    • 2
  • P. M. C. Callenbach
    • 3
  • P. M. A. van Ooijen
    • 4
    • 5
  1. 1.Department of RadiologyTreant Health Care GroupHoogeveenThe Netherlands
  2. 2.Department of OncologyTreant Health Care GroupHoogeveenThe Netherlands
  3. 3.Research BureauTreant Health Care GroupHoogeveenThe Netherlands
  4. 4.Department of RadiologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
  5. 5.Center for Medical Imaging North East Netherlands (CMI-NEN)University of Groningen, University Medical Center GroningenGroningenThe Netherlands

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