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The following is a summary of “Do MRI structured reports with FIGO classifications of leiomyomas contain adequate information for clinical decision making?” published in the April 2025 issue of International Journal of Gynecology & Obstetrics by Tordjman et al. 

Researchers conducted a retrospective study to assess whether structured reports (SR) of pelvic magnetic resonance imaging (MRI) scans using the PALM-COEIN (the International Federation of Gynecology & Obstetrics) uterine leiomyomas classification (SR-FIGO) provided sufficient information for clinical decision-making compared to narrative reports (NR).  

They compared 3 reporting templates for pelvic MRI scans: NR, SR without the PALM-COEIN FIGO classification of leiomyomas, and SR-FIGO, 19 key features (KF) relevant to leiomyoma management were assessed across report types using the Kruskal-Wallis test. A gynecologist and a gynecologist-in-training evaluated the reports and MRI scans to determine whether sufficient information was provided for decisions on treatment type (observation/medical treatment/surgery/uterine artery embolization), surgical approach (hysteroscopic/laparoscopic/robotic/open), surgery type (myomectomy/hysterectomy), need for MRI scan review, and time spent reviewing MRI scans. The responses from the gynecologist and gynecologist-in-training were compared across report types using the χ² test.  

The results showed significant differences in the number of KF among report types (P < 0.001), SR-FIGO had the most KF, followed by SR and NR. Pairwise comparisons revealed significant differences between NR and SR (P = 0.001) and NR and SR-FIGO (P = 0.001) but not between SR and SR-FIGO (P = 0.063). Significant differences in responses to question 1 were observed between the gynecologist and gynecologist-in-training for SR (P = 0.007) and SR-FIGO (P = 0.024), with the gynecologist more often deeming SR and SR-FIGO as providing sufficient information for treatment decisions.  

Investigators concluded that x SR provided more information than NR, further research was needed to determine if incorporating the PALM-COEIN FIGO classification in SR improved gynecologists’ clinical decision-making abilities. 

Source: obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70163