Scribd
Upload
35 views15 pages

BT RADS Full Guide 2018 - 02 - 01

Uploaded by

pandeyutsav962
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
35 views15 pages

BT RADS Full Guide 2018 - 02 - 01

Uploaded by

pandeyutsav962
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 15

BT-RADS Implementation

Brent Weinberg MD, PhD


Michael Hoch MD

V 1.02
Updated 2018/02/01
Standardized Brain Tumor MR Reporting
• Problem: • Goals:
• Variability in reporting MRIs in • Simple system which can easily be
brain tumor patients limits implemented
usefulness to • Maximize consistency across
• Referring clinicians section
• Patients • Minimize ambiguity of report
• Proposed solution outcomes
• Standardized report for brain • Easily understandable reports
tumor reports
• Impression categories tied to • Legend at end to assist the reader
expected management decisions
Associated management
Score Title Subscore Description
recommendation

New baseline, incomplete study, or otherwise


0 Not scored Continued follow-up, no change
unable to categorize

Improvement in imaging findings suspected to


1a - Improvement reflect decreasing tumor burden and/or Continued follow-up, no change
improving treatment effect
Imaging
1
improvement
Improvement in imaging findings potentially
1b – Medication effect due to effect from medications such as Continued follow-up, no change
increasing steroids or initiating avastin

2 No change No appreciable change from the prior Continued follow-up, no change

Worsening imaging findings favored to


3a – Favor treatment effect represent treatment effects, including radiation Decreased time interval of follow-up
therapy and medications

Worsening imaging findings favored to


Imaging
3 3b – Indeterminate represent an indeterminate mix of treatment Decreased time interval of follow-up
worsening
effect and tumor worsening

Worsening imaging findings favored to Consider change in management vs.


3c – Favor tumor progression
represent increasing burden of tumor Decreased time interval of follow-up

Worsening of imaging findings highly suspicious


4 Imaging worsening Consider change in management
for tumor progression
Flow Chart
Detailed categorization criteria
0: Not Scored
• Baseline study (initial diagnostic MRI or most recent post-op MRI)
• Non-tumor findings obscure diagnosis (e.g. infection)
• Non-diagnostic study or otherwise unable to classify

*Designated if any of the above 3 criteria are met


1a: Improvement
• Decreased enhancing component
• Unchanged or decreased FLAIR component
• No new enhancing or FLAIR lesions
• Unchanged or decreased mass effect
• Clinically stable or improved

-OR-

• All of the above


• On Avastin with response confirmed by 4-week follow up
*All criteria for one scenario should be met
1b: Medication Effect
• Decreased enhancing component
• Unchanged or decreased FLAIR component
• No new enhancing or FLAIR lesions
• Unchanged or decreased mass effect
• Clinically stable or improved
• On increasing doses of steroids or first post-Avastin imaging with
decreased enhancement only

*All criteria should be met


2: No Change
• Unchanged enhancing component
• Unchanged FLAIR component
• No new enhancing or FLAIR lesions
• Unchanged mass effect
• Clinically stable

*All criteria should be met


3a: Favor Treatment Effect
• Imaging worsening within 12 weeks of completing most recent CRT
• One or both of the following:
• Increased enhancing component
• Increased FLAIR component
• No new enhancing or FLAIR lesions outside of XRT treatment zone
• Increased mass effect
• Clinically stable

*All criteria should be met


3b: Indeterminate
• Imaging worsening outside 12 weeks of completing CRT
• One of the following:
• Increased enhancing component
• Increased FLAIR component and increasing mass effect
• No new enhancing or FLAIR lesions outside of XRT treatment zone
• Clinically stable

*All criteria should be met


3c: Favor Tumor Progression
• Increased enhancing component less than 25%
• Increased FLAIR component less than 25%
• No new enhancing or FLAIR lesions outside XRT treatment zone
• Increased mass effect
• Clinically worse

-OR-

• New indeterminate lesion outside of XRT treatment zone (e.g. FLAIR


lesion without enhancement)
*All criteria for one scenario should be met
4: Progression
• Progressive increase in enhancing or FLAIR component over multiple studies over time
• Progressive increase in mass effect over multiple studies over time
• Progressive clinical deterioration

-OR-

• Increased enhancing component greater than 25%


• Increased FLAIR component greater than 25%
• Increased mass effect
• Clinically worse

-OR-

• New definitive lesion outside of XRT treatment zone (e.g. Enhancing lesion)

*All criteria for one scenario should be met


Initial Reporting Template
Follow-Up Reporting Template

You might also like