Standardizing MR defecography referral and reporting: a multidisciplinary Delphi consensus

Abstract Purpose Dynamic magnetic resonance defecography (MRD) is a key imaging modality for comprehensive evaluation of pelvic floor dysfunction, enabling detailed multiplanar anatomical and functional assessment without ionizing radiation. However, despite its established clinical role, MRD reporting is heterogeneous among centers, hindering standardized interpretation, multidisciplinary communication, and comparison across studies. This modified Delphi consensus study aimed to develop a standardized referral dataset and structured reporting framework for MRD. Methods A multidisciplinary panel of 20 Italian experts (radiologists, colorectal surgeons, gynecologists, urologists, gastroenterologists, physiatrists, and a methodologist) conducted a three-round Delphi process to develop consensus-based templates for MRD referral and reporting. Consensus was set at ≥75% agreement. A total of 36 items were evaluated, covering technical parameters, anatomical/functional findings, and reporting format. Results Consensus was achieved for 21 items (58%), including technical parameters, standardized measurements (anorectal angle, pubococcygeal line), and clinically relevant descriptors (prolapse, dyssynergia, rectocele, rectal inertia). A structured referral template was also developed to improve information transfer from clinicians to radiologists. Both tools were unanimously endorsed. Conclusions This modified Delphi consensus study provides a multidisciplinary framework for standardized MRD referral and reporting. The proposed reporting template may facilitate greater consistency in image interpretation, reporting terminology, and multidisciplinary communication. These recommendations may serve as a foundation for the harmonization of MRD practice and future validation studies in pelvic floor imaging.

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Journal
La radiologia medica
Published
2026-09-21
DOI
https://doi.org/10.1007/s11547-026-02279-w
Primary Topic
Pelvic floor disorders treatments
Type
article
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article

Standardizing MR defecography referral and reporting: a multidisciplinary Delphi consensus

Tommaso Simoncini, Daria Schettini, Marco Ranucci, Marco Torella et al.
La radiologia medica
Pelvic floor disorders treatments
article

Standardizing MR defecography referral and reporting: a multidisciplinary Delphi consensus

Tommaso Simoncini, Daria Schettini, Marco Ranucci, Marco Torella, Nicoletta G. Gandolfo, Gabriele Naldini, Elisabetta Costantini, Silvia Cornaglia, Ugo Grossi, Anna Colarieti, Alfonso Reginelli, Gianfranco Lamberti, Edda Battaglia, Vittorio Luigi Piloni, Francesca Maccioni, Marco Oderda, Arcangelo Picciariello, Angelo Stuto, Giampiero Capobianco, Paolo Tonello, Elsa Beltrami, Mara Scabini, Mara Falco, Raffaella Ferrando, Daniela Lo Sasso, Marco Estienne, Pietro Biondetti, Fausto Pittarello
article en

Abstract

Abstract Purpose Dynamic magnetic resonance defecography (MRD) is a key imaging modality for comprehensive evaluation of pelvic floor dysfunction, enabling detailed multiplanar anatomical and functional assessment without ionizing radiation. However, despite its established clinical role, MRD reporting is heterogeneous among centers, hindering standardized interpretation, multidisciplinary communication, and comparison across studies. This modified Delphi consensus study aimed to develop a standardized referral dataset and structured reporting framework for MRD. Methods A multidisciplinary panel of 20 Italian experts (radiologists, colorectal surgeons, gynecologists, urologists, gastroenterologists, physiatrists, and a methodologist) conducted a three-round Delphi process to develop consensus-based templates for MRD referral and reporting. Consensus was set at ≥75% agreement. A total of 36 items were evaluated, covering technical parameters, anatomical/functional findings, and reporting format. Results Consensus was achieved for 21 items (58%), including technical parameters, standardized measurements (anorectal angle, pubococcygeal line), and clinically relevant descriptors (prolapse, dyssynergia, rectocele, rectal inertia). A structured referral template was also developed to improve information transfer from clinicians to radiologists. Both tools were unanimously endorsed. Conclusions This modified Delphi consensus study provides a multidisciplinary framework for standardized MRD referral and reporting. The proposed reporting template may facilitate greater consistency in image interpretation, reporting terminology, and multidisciplinary communication. These recommendations may serve as a foundation for the harmonization of MRD practice and future validation studies in pelvic floor imaging.

La radiologia medica
University of Pisa (IT), Marche Polytechnic University (IT), Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT), University of Parma (IT), Piaggio (Italy) (IT), Humanitas University (IT), University of Padua (IT), University of Salento (IT), University of Sassari (IT), University of Pavia (IT), Policlinico Umberto I (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Fondazione Ricerca Molinette (IT), IRCCS Policlinico San Donato (IT), Ospedale Koelliker (IT), Humanitas Castelli (IT), Humanitas Gavazzeni (IT), University of Campania "Luigi Vanvitelli" (IT), Policlinico Abano Terme (IT), Villa Torri Hospital (IT), IRCCS Humanitas Research Hospital (IT), University of Turin (IT), University of Palermo (IT)
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Pelvic floor disorders treatments
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