Clinical Report: Essential User Needs for Quantitative Imaging Reports in MS
Overview
This study used a Delphi panel of expert neurologists and radiologists to identify key user requirements for quantitative MRI reports (QReports) in multiple sclerosis (MS). Consensus was reached on the importance of specific measurements, visualization methods, and clinical workflow integration to enhance diagnosis, prognosis, and monitoring of MS.
Background
Multiple sclerosis is a chronic neurological disease characterized by progressive disability and diverse symptoms. MRI is critical for visualizing lesions and brain changes in MS, with automated segmentation techniques improving sensitivity and reproducibility over manual methods. Despite advances, quantitative radiological reports have seen limited clinical adoption, partly due to insufficient alignment with clinician needs. This study aimed to define essential user requirements for QReports to facilitate their clinical implementation.
Data Highlights
The Delphi panel included 77 respondents in the first round (49.6% response rate) comprising neurologists, neuroradiologists, biomedical engineers, and physicists, predominantly from academic hospitals. A second iteration with 62 respondents refined consensus on 19 key questions. Agreement thresholds were set at ≥75% for highly desirable features and ≥50% for desirable features. Topics covered QReport measurements, visualization, workflow, deployment, scanner compatibility, validation, quality control, and patient involvement.
Key Findings
High consensus on the need for QReports to include automated quantification of brain and lesion volumes contextualized with normative reference data.
Strong agreement that QReports should support clinical scenarios of diagnosis, prognosis, and monitoring with tailored information for each.
Desire for clear visualization formats that integrate lesion counts, volume changes, and brain atrophy metrics to aid clinical interpretation.
Importance of seamless integration of QReports into clinical workflows to facilitate routine use without disrupting existing practices.
Recognition of the need for validation, quality control, and standardization across scanners and sequences to ensure reliability.
Emerging interest in including spinal cord measurements and enhancing patient involvement in understanding QReport outputs.
Clinical Implications
Clinicians require QReports that provide accurate, reproducible quantitative data with intuitive visualization to support decision-making in MS care. Integration into existing clinical workflows and robust validation are critical for adoption. Addressing these user needs can improve diagnostic accuracy, disease monitoring, and personalized prognosis for MS patients.
Conclusion
This Delphi consensus highlights essential user requirements for quantitative MRI reports in MS, emphasizing measurement accuracy, visualization clarity, workflow integration, and validation. Aligning QReport development with these needs may enhance clinical implementation and ultimately improve patient management.
by David R. van Nederpelt, Zoe C. Mendelsohn, Lonneke Bos, Rozemarijn M. Mattiesing, Olga Ciccarelli, Jaume Sastre-Garriga, Ferran Prados Carrasco, Joost P. A. Kuijer, Hugo Vrenken, Joep Killestein, Menno M. Schoonheim, Bastiaan Moraal, Tarek Yousry, Giuseppe Pontillo, Àlex Rovira, Eva M. M. Strijbis, Bas Jasperse, Frederik Barkhof
