IMG-06. Pediatric Brain Tumor Reporting and Data System (pBT-RADS), a structured reporting system for improving pediatric brain tumor care

Currently, there are no standards for clinical radiology reporting in Pediatric Neuro-Oncology. To determine the satisfaction among stakeholders regarding our current reporting methods, which do not include a specific structured template, we conducted a survey regarding the current state of neuro-oncologic imaging reporting at our institution. The initial survey involved 18 clinicians including pediatric neuro-oncologists, neurosurgeons, radiation oncologists, and neuroradiologists using a 5-point Likert scale with 5 representing the most positive response and 1 representing the least positive response. The median score for clear communication of results was 4 (interquartile range of 3-4). However, the median score for maintaining consistency was 3 (IQR 2-4), and the median score for refraining from ambiguity was 3 (IQR 4-3). Additionally, respondents endorsed the desire to have a structured format for both findings and an impression, particularly which would correlate with patient management. The Brain Tumor Reporting and Data System (BT-RADS) was developed to maximize consistency between reading radiologists and clarity of reports. However, currently the application of BT-RADS in the pediatric population has not been explored and may be limited due to the unique pathology and imaging features of pediatric brain tumors. Here, we introduce a pediatric brain tumor reporting and data system (pBT-RADS), which is adapted from BT-RADS, accounts for factors specific to pediatric tumors, and incorporates RAPNO criteria. We discuss specific pediatric tumors where using BT-RADS is limited, such as medulloblastoma, craniopharyngioma, and pediatric high and low grade gliomas, and how our proposed pBT-RADS addresses these issues. Future evaluation and implementation of pBT-RADS in practice will further refine our template and will allow us to determine the acceptance and utility in routine clinical use.