ESGAR consensus statement on MR imaging in primary sclerosing cholangitis

Abstract Objectives To provide a consensus statement and recommendations on MR imaging in primary sclerosing cholangitis (PSC). Methods The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) convened a multinational European panel of experts selected based on a literature review and their leadership in the field. A modified Delphi process was adopted to draft a list of statements. For each statement, the panelists indicated the level of agreement using a 5-point Likert scale, where 1 means “no agreement,” 2 means “poor agreement,” 3 means “slight agreement,” 4 means “fair agreement,” and 5 means “complete agreement.” The median score for each statement was collected. The level of evidence was reported according to the Oxford Centre for Evidence-Based Medicine. Descriptive statistics were used to rate agreement levels and the consensus’ internal reliability. Results The 12 voting committee members were from Italy ( n = 4, 33.4%), Austria ( n = 2, 16.7%), Sweden ( n = 1, 8.3%), France ( n = 1, 8.3%), the United States ( n = 1, 8.3%), Switzerland ( n = 1, 8.3%), and Belgium ( n = 2, 16.7%). The final questionnaire consisted of 55 statements. The agreement reached by the expert panel was complete for 23 statements (41.8%), fair for 16 (29.1%), slight for 15 (27.2%), and poor for 1 (1.9%). Statements that received complete agreement were used to structure a reporting template. Conclusions This statement paper recommends how and when to perform MRI in PSC patients. A structured reporting template has been created to improve quality care and communication among radiologists and clinicians. Key Points Question A standard MR protocol and the most common imaging features to be reported are fundamental for the correct evaluation of primary sclerosing cholangitis (PSC) patients. Findings Twelve expert radiologists reported which are the most important imaging features and how and when to perform MR in PSC patients. Clinical relevance The identified statements reported in this paper and the structured reporting template are useful for radiologists and clinicians to help correctly manage PSC patients. Graphical Abstract