Current Practice vs. Guideline Based Imaging in Abdominal Radiology in the German Speaking Area: Results of an Online Survey

Abstract

Purpose: The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines.

Materials and Methods: We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics.

Results: 90 of all participants, who filled out the survey covering more than 80 % of the questions, were included in the statistical evaluation. 27 % of all participants were registered radiologists while 73 % represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium.

Conclusion: The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging.

Key Points:

• In German speaking countries indications for abdominal radiological examinations are performed with a high compliance to published guidelines.

• There is a significant heterogeneity regarding the acquisition of different contrast phases for parenchymal abdominal organs.

• There is an urgent need to publish radiological recommendations and guidelines based on current radiological literature for radiological abdominal imaging.

Citation Format:

• Schreyer AG, Wessling J, Grenacher L. Versorgungsrealität vs. leitliniengerechte Bildgebung in der Abdominalradiologie im deutschsprachigen Raum: Ergebnisse einer Online-Umfrage. Fortschr Röntgenstr 2016; 188: 1 – 12

Zusammenfassung

Ziel: In einer Online-Umfrage der Arbeitsgemeinschaft Abdominal- und Gastrointestinaldiagnostik der Deutsche Röntgengesellschaft (DRG) sollte ein aktuelles Abbild der gegenwärtig durchgeführten abdominalradiologischen Untersuchungstechniken in Deutschland erstellt und die Ergebnisse den aktuellen Leitlinien zu diesen Themenbereichen gegenübergestellt und kritisch bewertet werden.

Material und Methoden: Den Mitgliedern der DRG, die zu der Umfrage in Newslettern und E-mails eingeladen wurden, stand für 76 Tage eine Online-Umfrage mit insgesamt 65 Fragen und einer Bearbeitungszeit von über 15 Minuten pro Fragebogen zur technischen Durchführung von abdominalradiologischen Fragestellungen offen. Die Ergebnisse der Umfrage wurden mit deskriptiven statistischen Methoden ausgewertet.

Ergebnisse: Insgesamt beantworteten 90 Teilnehmer die Fragebogen über 80 %, die für die Auswertung berücksichtigt werden konnten. Die Umfrage wurde von 27 % niedergelassenen- und 73 % Klinikradiologen durchgeführt, wobei die meisten Teilnehmer in leitenden Positionen waren. Eingeteilt nach Organregionen (Ösophagus, Magen, Pankreas, Leber, Dünndarm, Dickdarm) wurden Angaben zu präferierten akquirierten Kontrastmittelphasen, Arten der oralen und intravenösen Kontrastierung und Auswertemöglichkeiten gemacht.

Schlussfolgerung: Die Ergebnisse der Umfrage zeigen, dass die meisten befragten Radiologen eine leitlinienkonforme Untersuchungstechnik verwenden, wobei die Mehrheit der Leitlinien keinerlei konkrete Angaben zur radiologisch technischen Untersuchungsdurchführung machen. Daher fallen eine beträchtliche Heterogenität der akquirierten Kontrastmittelphasen sowie eine Diversität der möglichen technischen Parameter auf. Es sollte daher angestrebt werden, eine aktuelle evidenzbasierte Empfehlungszusammenstellung für radiologische Untersuchungen zu entwickeln und zu erstellen.

Key words

abdomen - CT - diagnostic radiology - MR-imaging

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