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Kocak B, Borgheresi A, Ponsiglione A, Andreychenko AE, Cavallo AU, Stanzione A, Doniselli FM, Vernuccio F, Triantafyllou M, Cannella R, Trotta R, Ghezzo S, Akinci D'Antonoli T, Cuocolo R. Explanation and Elaboration with Examples for CLEAR (CLEAR-E3): an EuSoMII Radiomics Auditing Group Initiative. Eur Radiol Exp 2024; 8:72. [PMID: 38740707 DOI: 10.1186/s41747-024-00471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
Overall quality of radiomics research has been reported as low in literature, which constitutes a major challenge to improve. Consistent, transparent, and accurate reporting is critical, which can be accomplished with systematic use of reporting guidelines. The CheckList for EvaluAtion of Radiomics research (CLEAR) was previously developed to assist authors in reporting their radiomic research and to assist reviewers in their evaluation. To take full advantage of CLEAR, further explanation and elaboration of each item, as well as literature examples, may be useful. The main goal of this work, Explanation and Elaboration with Examples for CLEAR (CLEAR-E3), is to improve CLEAR's usability and dissemination. In this international collaborative effort, members of the European Society of Medical Imaging Informatics-Radiomics Auditing Group searched radiomics literature to identify representative reporting examples for each CLEAR item. At least two examples, demonstrating optimal reporting, were presented for each item. All examples were selected from open-access articles, allowing users to easily consult the corresponding full-text articles. In addition to these, each CLEAR item's explanation was further expanded and elaborated. For easier access, the resulting document is available at https://radiomic.github.io/CLEAR-E3/ . As a complementary effort to CLEAR, we anticipate that this initiative will assist authors in reporting their radiomics research with greater ease and transparency, as well as editors and reviewers in reviewing manuscripts.Relevance statement Along with the original CLEAR checklist, CLEAR-E3 is expected to provide a more in-depth understanding of the CLEAR items, as well as concrete examples for reporting and evaluating radiomic research.Key points• As a complementary effort to CLEAR, this international collaborative effort aims to assist authors in reporting their radiomics research, as well as editors and reviewers in reviewing radiomics manuscripts.• Based on positive examples from the literature selected by the EuSoMII Radiomics Auditing Group, each CLEAR item explanation was further elaborated in CLEAR-E3.• The resulting explanation and elaboration document with examples can be accessed at https://radiomic.github.io/CLEAR-E3/ .
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Affiliation(s)
- Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey.
| | - Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126, Ancona, Italy
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Anna E Andreychenko
- Laboratory for Digital Public Health Technologies, ITMO University, St. Petersburg, Russian Federation
| | - Armando Ugo Cavallo
- Division of Radiology, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Fabio M Doniselli
- Neuroradiology Unit, Fondazione Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milano, Italy
| | - Federica Vernuccio
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnosis (Bi.N.D), University of Palermo, 90127, Palermo, Italy
| | - Matthaios Triantafyllou
- Department of Medical Imaging, University Hospital of Heraklion, 71110, Crete, Voutes, Greece
| | - Roberto Cannella
- Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Romina Trotta
- Department of Radiology - Fatima Hospital, Seville, Spain
| | | | - Tugba Akinci D'Antonoli
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
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Zhong J, Chen L, Xing Y, Lu J, Shi Y, Wang Y, Deng Y, Jiang R, Lu W, Wang S, Hu Y, Ge X, Ding D, Zhang H, Zhu Y, Yao W. Just give the contrast? Appraisal of guidelines on intravenous iodinated contrast media use in patients with kidney disease. Insights Imaging 2024; 15:77. [PMID: 38499879 PMCID: PMC10948651 DOI: 10.1186/s13244-024-01644-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/10/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE To appraise the quality of guidelines on intravenous iodinated contrast media (ICM) use in patients with kidney disease, and to compare the recommendations among them. METHODS We searched four literature databases, eight guideline libraries, and ten homepages of radiological societies to identify English and Chinese guidelines on intravenous ICM use in patients with kidney disease published between January 2018 and June 2023. The quality of the guidelines was assessed with the Scientific, Transparent, and Applicable Rankings (STAR) tool. RESULTS Ten guidelines were included, with a median STAR score of 46.0 (range 28.5-61.5). The guidelines performed well in "Recommendations" domain (31/40, 78%), while poor in "Registry" (0/20, 0%) and "Protocol" domains (0/20, 0%). Nine guidelines recommended estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 as the cutoff for referring patients to discuss the risk-benefit balance of ICM administration. Three guidelines further suggested that patients with an eGFR < 45 mL/min/1.73 m2 and high-risk factors also need referring. Variable recommendations were seen in the acceptable time interval between renal function test and ICM administration, and that between scan and repeated scan. Nine guidelines recommended to use iso-osmolar or low-osmolar ICM, while no consensus has been reached for the dosing of ICM. Nine guidelines supported hydration after ICM use, but their protocols varied. Drugs or blood purification therapy were not recommended as preventative means. CONCLUSION Guidelines on intravenous ICM use in patients with kidney disease have heterogeneous quality. The scientific societies may consider joint statements on controversial recommendations for variable timing and protocols. CRITICAL RELEVANCE STATEMENT The heterogeneous quality of guidelines, and their controversial recommendations, leave gaps in workflow timing, dosing, and post-administration hydration protocols of contrast-enhanced CT scans for patients with kidney diseases, calling for more evidence to establish a safer and more practicable workflow. KEY POINTS • Guidelines concerning iodinated contrast media use in kidney disease patients vary. • Controversy remains in workflow timing, contrast dosing, and post-administration hydration protocols. • Investigations are encouraged to establish a safer iodinated contrast media use workflow.
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Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Liwei Chen
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Junjie Lu
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Yuping Shi
- Department of Nephrology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yibin Wang
- Department of Urology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yi Deng
- University of Washington School of Pharmacy, Seattle, WA, 98105, USA
| | - Run Jiang
- Department of Pharmacovigilance, Shanghai Hansoh BioMedical Co., Ltd, Shanghai, 201203, China
| | - Wenjie Lu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Silian Wang
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 200025, China.
| | - Ying Zhu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
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Kocak B, Akinci D'Antonoli T, Ates Kus E, Keles A, Kala A, Kose F, Kadioglu M, Solak S, Sunman S, Temiz ZH. Self-reported checklists and quality scoring tools in radiomics: a meta-research. Eur Radiol 2024:10.1007/s00330-023-10487-5. [PMID: 38180530 DOI: 10.1007/s00330-023-10487-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/11/2023] [Accepted: 11/24/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE To evaluate the use of reporting checklists and quality scoring tools for self-reporting purposes in radiomics literature. METHODS Literature search was conducted in PubMed (date, April 23, 2023). The radiomics literature was sampled at random after a sample size calculation with a priori power analysis. A systematic assessment for self-reporting, including the use of documentation such as completed checklists or quality scoring tools, was conducted in original research papers. These eligible papers underwent independent evaluation by a panel of nine readers, with three readers assigned to each paper. Automatic annotation was used to assist in this process. Then, a detailed item-by-item confirmation analysis was carried out on papers with checklist documentation, with independent evaluation of two readers. RESULTS The sample size calculation yielded 117 papers. Most of the included papers were retrospective (94%; 110/117), single-center (68%; 80/117), based on their private data (89%; 104/117), and lacked external validation (79%; 93/117). Only seven papers (6%) had at least one self-reported document (Radiomics Quality Score (RQS), Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD), or Checklist for Artificial Intelligence in Medical Imaging (CLAIM)), with a statistically significant binomial test (p < 0.001). Median rate of confirmed items for all three documents was 81% (interquartile range, 6). For quality scoring tools, documented scores were higher than suggested scores, with a mean difference of - 7.2 (standard deviation, 6.8). CONCLUSION Radiomic publications often lack self-reported checklists or quality scoring tools. Even when such documents are provided, it is essential to be cautious, as the accuracy of the reported items or scores may be questionable. CLINICAL RELEVANCE STATEMENT Current state of radiomic literature reveals a notable absence of self-reporting with documentation and inaccurate reporting practices. This critical observation may serve as a catalyst for motivating the radiomics community to adopt and utilize such tools appropriately, thereby fostering rigor, transparency, and reproducibility of their research, moving the field forward. KEY POINTS • In radiomics literature, there has been a notable absence of self-reporting with documentation. • Even if such documents are provided, it is critical to exercise caution because the accuracy of the reported items or scores may be questionable. • Radiomics community needs to be motivated to adopt and appropriately utilize the reporting checklists and quality scoring tools.
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Affiliation(s)
- Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey.
| | - Tugba Akinci D'Antonoli
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Ece Ates Kus
- Department of Neuroradiology, Klinikum Lippe, Lemgo, Germany
| | - Ali Keles
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Ahmet Kala
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Fadime Kose
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Mehmet Kadioglu
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Sila Solak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Seyma Sunman
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Zisan Hayriye Temiz
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
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