Abstract Details

Title The Importance of Neuroradiology Input at a Neuroinflammatory Multidisciplinary Team (MDT) Meeting: Influencing and Optimising the Management of Patients with Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) S2 - Advances in MS Imaging (2:08 PM-2:16 PM)

Poster/Presentation
Number 002

Objective

To assess the rate and clinical significance of discrepancies between original MRI reports and the report following MDT review.

Background Management of patients with multiple sclerosis (MS) in the era of disease modifying therapies (DMT) relies heavily on magnetic resonance imaging (MRI). As clinicians, decisions are influenced by the reporting prowess of neuroradiologists, however imaging can be reported by general radiologists. We developed a monthly neuroinflammatory MDT, beginning in June 2018, with neuroradiology to obtain second opinions on complex cases, with >600 cases reviewed to date.

Design/Methods A pilot, 1-month, retrospective study was performed. Data included demographics, original scan authors (neuroradiology or non-neuroradiology), the nature and frequency of reporting revisions made, and subsequent changes in management/investigation strategies. We analysed the data focusing on the frequency of scan report revisions and the subsequent impact in clinical management of our patients.

Results Thirty-one cases were analysed. Of these, 61% had a confirmed diagnosis of MS whilst 39% were under ongoing investigation. Mean patient age was 48 years. Of the 31 cases, 71% were originally reported by a general radiologist and 29% by a neuroradiologist. Following neuroradiology review at the MDT, 13 cases (42%) had the original report amended; of these, 77% were originally authored by a non-neuroradiologist. Of scan reports authored by a general radiologist, 46% were amended following this specialist review. The most frequently occurring revision was identification of additional, originally unreported brain lesions. Of the 13 report revisions, 46.2% resulted in a change in clinical management, e.g. DMT commencement/escalation and, in one case, consideration of plasma exchange.

Conclusions

This study shows that there is a significant rate of discrepancy in MRI reporting in MS cases, between general and neuroradiologists. This has clear implications for management, confirming the importance of dedicated MDTs with specialist neuroradiology input for complex neurological conditions.

Authors/Disclosures
Stephen J. Ramsay, MB (UK) (Royal Victoria Hospital, Belfast Health and Social Care Trust) PRESENTER	Dr. Ramsay has nothing to disclose.
	No disclosure on file
Rebecca Robinson, MRCP, MB BCh BAO	Dr. Robinson has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Aidan G. Droogan, BSc, MBB (Belfast HSC Trust (RVH))	Dr. Droogan has nothing to disclose.
Stella E. Hughes, MD	Dr. Hughes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Hughes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Hughes has received personal compensation in the range of $500-$4,999 for serving as a Meeting Chair with Merck. Dr. Hughes has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Biogen. Dr. Hughes has received personal compensation in the range of $500-$4,999 for serving as a Meeting Chair with Roche. Dr. Hughes has received personal compensation in the range of $500-$4,999 for serving as a Conference Delegate with Roche.
Fiona Kennedy, MB, Bch, BAO	Dr. Kennedy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Kennedy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Kennedy has received personal compensation in the range of $500-$4,999 for serving as a Meeting chair with Neuraxpharm. Dr. Kennedy has received personal compensation in the range of $500-$4,999 for serving as a Meeting chair with Roche. Dr. Kennedy has received personal compensation in the range of $0-$499 for serving as a Meeting chair with Merck. Dr. Kennedy has received personal compensation in the range of $500-$4,999 for serving as a Conference delegate with Sanofi. Dr. Kennedy has received personal compensation in the range of $500-$4,999 for serving as a Conference delegate with Novartis. Dr. Kennedy has received personal compensation in the range of $500-$4,999 for serving as a Conference delegate with Roche.
Gavin V. McDonnell, MD (Belfast Trust)	Dr. McDonnell has nothing to disclose.

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