# Advancing MRI diagnostic practices in rectal cancer: exploring the impact of web-based multi-reader study participation

## TL;DR

This study shows that participating in web-based validation studies improves MRI diagnostic practices for rectal cancer among radiologists.

## Contribution

The study demonstrates that web-based multi-reader studies can influence real-world MRI diagnostic practices through education and collaboration.

## Key findings

- 52% of radiologists reported improved personal diagnostic practices after participating in web-based studies.
- 36% observed institutional changes in MRI rectal cancer staging practices.
- Key changes included increased use of DWI and structured reporting templates.

## Abstract

To explore the impact of participation in web-based validation studies on personal and institutional diagnostic practices for MRI rectal cancer (re)staging.

An online questionnaire was distributed to radiologists who had participated in one or more previously conducted and published multi-reader validation studies focused on rectal cancer staging and response evaluation. The questionnaire included general questions about the web-based platform used for these studies, as well as study-specific questions addressing the tools under investigation, such as diffusion-weighted imaging (DWI), different MRI response grading systems, and the sigmoid take-off (STO).

Among 25 respondents from 14 countries, 52% reported significant improvements in their personal reporting practice as a result of their study participation; 36% also observed a significant impact on local diagnostic practices in their institution after discussing the study results with their colleagues. Key reported effects included increased use of DWI for restaging, increased use of the STO to discern rectal from sigmoid cancer, enhanced confidence in using diagnostic tools and grading systems, greater adoption of structured reporting templates, and more frequent integration of organ-preserving treatment considerations into radiological assessments. Respondents also emphasized the importance of receiving feedback to maximize the educational benefits of participating in such studies.

Web-based validation studies can positively influence radiologists’ reporting practices, fostering the adoption of novel diagnostic tools through education and collaborative knowledge sharing. Future studies should focus on incorporating consistent feedback mechanisms and integrating specific training modules to maximize the impact of these platforms on clinical practice.

The online version contains supplementary material available at 10.1007/s00261-025-05104-6.