Agreement Between Multidisciplinary Sarcoma Tumor Board and Radiologists’ Assessment and Recommendations

Purpose: Measure frequency in which a radiologist makes a recommendation when interpreting a sarcoma case and if the recommendation was performed. Measure agreement between interpreting radiologists' and sarcoma tumor board’s (STB) assessment of disease and clinical recommendations.

Methods/Materials: Retrospective review of 500 adult STB cases from August 2020 to July 2021 at University of Miami Hospital and Clinics (UM). Exclusion criteria included the absence of documented STB occurrence, assessment or plan, absence of medical imaging or radiology report, and STB postponement.

Data variables include patient clinical status (treatment versus surveillance), interpreting radiologist and STB disease assessment (stable or progressive disease; partial or complete response), radiologist and STB recommendation (none; surgical/radiation oncology referral; normal or short term follow-up; systemic therapy change; other), and performance of the interpreting radiologist’s recommendation.

Agreement between the interpreting radiologist and STB disease assessments and recommendations was performed using kappa statistic.

Results: 283 cases were eligible after excluding 217 cases.

There was substantial agreement of disease assessment between radiologists and STBs (κ = 0.65). Radiologists were more likely to interpret progressive/recurrent disease than STBs.

There was slight agreement of clinical recommendations between radiologists and STBs (κ = 0.18). Radiologists were less likely to make recommendations compared to STBs (34% versus 65%).

Conclusions: Interaction with STBs may improve patient care compared to care driven by radiology alone. In our study, 44 of 283 disease assessments were discordant between radiologists and STBs, potentially contributing to treatment delay, unnecessary workup, or even incorrect treatment.

If radiology recommendations were made, radiologists more likely recommended short-term follow-up. STBs more frequently made recommendations for surgical/radiation referrals. Experience from STB involvement may improve radiology reporting while improving concordance of disease response and clinical recommendations.