Evaluation of the implementation of the sigmoid take‐off landmark in the Netherlands. (7th December 2021)

• Record Type: Journal Article
• Authors: Hazen, Sanne‐Marije J. A.; Sluckin, Tania C.; Horsthuis, Karin; Lambregts, Doenja M. J.; Beets‐Tan, Regina G. H.; Tanis, Pieter J.; Kusters, Miranda
• Other Names: Dinaux Anne M. investigator.; Lamme Bas investigator.; Musters Gijsbert D. investigator.; Bangert Fleur investigator.; Knöps Eva investigator.; Temmink Sofieke investigator.; Kint Peter A. M. investigator.; Coebergh van den Braak Robert R. J. investigator.; Schuivens Puck M. E. investigator.; Bemelman Willem A. investigator.; Borstlap Wernard A. A. investigator.; Haasnoot Pieter J. investigator.; Hompes Roel investigator.; Tuynman Jurriaan B. investigator.; Mulder Erik J. investigator.; The G. Y. M. investigator.; Prette Jeroen F. investigator.; Krielen Pepijn investigator.; Plate Joost D. J. investigator.; Nederend Joost investigator.; Ketelaers Stijn H. J. investigator.; Nordkamp Stefi investigator.; de Bie Shira H. investigator.; Nieuwenhuis Jonanne F. investigator.; Talsma A. Koen investigator.; van Tilborg G. F. A. J. B. investigator.; Verduin Wouter M. investigator.; van der Wolk Sander investigator.; van Rees Jan M. investigator.; Rothbarth Joost investigator.; de Groof E. Joline investigator.; Bradshaw Jennifer W. investigator.; van der Sande Marit E. investigator.; van der Zaag Edwin S. investigator.; Schaafsma Boudewijn E. investigator.; de Korte Fleur I. investigator.; Vogelij Clementine L. A. investigator.; Zeilstra Annette investigator.; Ankersmit Marjolein investigator.; Frietman Bas investigator.; Braak Sicco J. investigator.; van Egdom Laurentine. S. E. investigator.; Nonner Joost investigator.; Brandsma Amarins T. A. investigator.; Poelmann Floris B. investigator.; van Westreenen Henderik L. investigator.; Feshtali Shirin investigator.; Heesink Vera investigator.; Clermonts Stefan H. E. M. investigator.; Keizers Bas investigator.; Wijma Allard investigator.; van Elderen Saskia G. C. investigator.; Consten Esther C. J. investigator.; Hogewoning Anna investigator.; Jou‐Valencia Daniela investigator.; Paulusma Ida investigator.; van der Sluis Martsje investigator.; van den Hoek Sjoerd investigator.; Hakkenbrak Nadia A. G. investigator.; Barendse Renée M. investigator.; Gerritsen Arja. investigator.; Rombouts Anouk J. M. investigator.; Qaderi Seyed M. investigator.; de Wilt Johannes H. W. investigator.; Kroese Leonard F. investigator.; Olthof Pim B. investigator.; Zandvoort Herman J. A. investigator.; Dogan Kemal investigator.; Spillenaar Bilgen Ernst Jan investigator.; van der Burg Sjirk W. investigator.; Emmen Anouk investigator.; van Westerveld Paul P. investigator.; Kok Sylvia investigator.; Posma Lisanne A. E. investigator.; Tielbeek Jeroen A. W. investigator.; Derksen Tyche investigator.; van Woerden Victor investigator.; Blok Robin D. investigator.; Jonkers Jacoline investigator.; de Haas Robbert J. investigator.; Bakker Ilsalien. S. investigator.; Feitsma Eline A. investigator.; Furnée Edgar J. B. investigator.; Burghgraef Thijs A. investigator.; van Vugt S. T. investigator.; den Boer Frank C. investigator.; Corver Maaike investigator.; Hendrickx Sifrid investigator.; de Mey Dietrich J. L. investigator.; Vliegen Roy F. A. investigator.; Boerma Evert‐Jan G. investigator.; Poodt Ingrid G. M. investigator.; Martens Milou H. investigator.;
• Is Part Of: Colorectal disease. Volume 24:Number 3(2022)
• Page Start: 292
• Page End: 307
• Publication Date: 2021-12-07
• Subjects: implementation -- magnetic resonance imaging -- rectal cancer -- sigmoid cancer -- sigmoid take‐off; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.16005
• Languages: English
• ISSNs: 1462-8910

Abstract

Abstract: Aim: The sigmoid take‐off (STO), the point on imaging where the sigmoid sweeps ventral from the sacrum, was chosen as the definition of the rectum during an international Delphi consensus meeting and has been incorporated into the Dutch guidelines since October 2019. The aim of this study was to evaluate the implementation of this landmark 1 year after the guideline implementation and to perform a quality assessment of the STO training. Method: Dutch radiologists, surgeons, surgical residents, interns, PhD students and physician assistants were asked to complete a survey and classify 20 tumours on MRI as 'below', 'on' or 'above' the STO. Outcomes were agreement with the expert reference, inter‐rater variability and accuracy before and after the training. Results: Eighty‐six collaborators participated. Six radiologists (32%) and 11 surgeons (73%) used the STO as the standard landmark to distinguish between rectal and sigmoidal tumours during multidisciplinary meetings. Overall agreement with the expert reference improved from 53% to 70% ( p < 0.001) after the training. The positive predictive value for diagnosing rectal tumours was high before and after the training (92% vs. 90%); the negative predictive value for diagnosing sigmoidal tumours improved from 39% to 63%. Conclusion: Approximately half of the represented hospitals have implemented the new definition of rectal cancer 1 year after the implementation of the Dutch national guidelines. Overall baseline agreement with the expert reference and accuracy for the tumours around the STO was low, but improved significantly after training. These results highlight the added value of training in implementation of radiological landmarks to ensure unambiguous assessment.