Radiologists are still the best physicians for interpreting images, but improvements can be made in the reports they provide to referring doctors, according to a survey of Dutch and Belgian physicians.
Survey results indicate itemized reporting with standardized language is in the near future, and radiologists should learn how to report during their training.
Despite the numerous studies on radiology reports, a dearth of data remains on whether clinicians really need a report, if the availability of clinical information improves the quality of the report, and if reports are clear enough, according to the study authors (Radiology, April 2011, Vol. 259:1, pp. 184-195).
Dr. Jan Bosmans and colleagues from the radiology department at Antwerp University Hospital in Belgium asked a total of 3,884 clinicians and 292 radiologists to participate via email in two Internet surveys, one called "Clinicians' Opinions, Views, and Expectations Concerning the Radiology Report (COVER)," and the other "Radiologists' Opinions, Views, and Expectations Concerning the Radiology Report (ROVER)."
A total of 873 forms, or 21%, were completed. Respondents were asked 46 questions such as the following:
- Is the radiology report important for the clinician?
- Is there a need to provide clinical information and formulate an unequivocal clinical question?
- Is the recipient satisfied with the report?
- Is the recipient satisfied with the structure and style of the radiology report?
- Should radiologists receive instruction on how to make a good report?
General practitioners agreed more than specialists that the radiology report is important for the clinician (83% versus 41.4%). The majority also said clinicians are not better able to interpret an imaging study in their own discipline than radiologists. In addition, 42.8% of specialists and 84% of general practitioners said radiology reports often mention important issues the clinician would not have noticed on the images. More than two-thirds (61.5%) of radiologists shared that viewpoint.
Regarding itemized reports, most clinicians (84.5%) would like to receive a report consisting of templates with separate headings for every organ system. More than half of radiologists (55.3%) thought itemized reports were a good idea.
Despite clinicians' and radiologists' repeated confirmation of their preference for itemized reporting based on fixed templates, it is not the standard way of reporting, according to Bosmans.
"Both in Flanders and in the Netherlands, including in our own institution, itemized reporting is the exception rather than the rule," the authors wrote. "One can therefore safely assume that respondents who declared themselves in favor of itemized reporting did so on the basis of a theoretical concept rather than of personal experience."
Lastly, nearly all clinicians (92.4%) and radiologists (94.7%) think learning to report should be an obligatory and well-structured part of future radiologists' training.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
