Collaboration in Radiology Research

Dr Kirsten Gormly

I like asking questions, particularly clinical and practical questions that will impact daily practice. I was first invited to participate in a large international multicentre drug trial in rectal cancer in 2008. Principal investigator Professor Tim Price wanted to include a radiologist on the trials management committee as it involved a large amount of magnetic resonance imaging (MRI). This provided a golden opportunity to create an MRI audit substudy to capture the current state of MRI magnetic resonance rectal reporting and technique across Australia and New Zealand.

In November 2022, I attended my fourth Australasian Gastro-Intestinal Trials Group (AGITG) Annual Scientific Meeting (ASM). This meeting brings together oncologists, radiation oncologists, surgeons and scientists who present and discuss the latest in Australasian trials, current clinical dilemmas and future directions in gastrointestinal cancer. I first attended this meeting in 2015 and was overawed, humbled and inspired by the more than 400 people gathered, discussing the possible future of improved patient outcomes. However, I reported that only a third of MRI rectal scans in our cohort met image quality standards and included the required data for reporting (1). In addition, while most trials required imaging to stratify patients to test their new treatments, I was the only radiologist in the room.

Through the Abdominal Radiology Group of Australia and New Zealand (ARGANZ) I have engaged with AGITG and radiologists to encourage more collaboration. I finally had another radiologist join me at the 2022 ASM, who was similarly impressed and inspired. We have recently achieved formalisation of a radiologist member of the AGITG upper and lower gastrointestinal working groups, and I’m working with AGITG leaders to promote the inclusion of radiologists as investigators on trials that involve imaging.

We do, however, need more radiologists to step forward and engage with clinicians in this space. I read with interest, but not surprise, the recent article by Stewart & Sutherland looking at the rates of radiologist authorship on publications including images. Across four Australian journals only 12% of publications with images included a radiologist author (2). Australia typically has a greater divide between radiologists and treating clinicians in education and research, but we facilitate this by being absent from multidisciplinary collaborative conferences. You don’t need to be an expert to engage, as that is how you learn what is relevant and how to contribute.

While RANZCR is increasing the focus on trainee research, it is important we don’t always test imaging questions in a silo. I have been fortunate to be invited to contribute to a variety of clinical trial proposals and grant applications, often finding the imaging sections have been incorrectly worded and lacked the definition required to produce useful results. Having radiologist input during the development phase of a trial can improve the overall trial protocol, allow inclusion of additional imaging biomarkers which are unknown to the non-radiologists, and provide an opportunity for imaging substudies within large patient cohorts.

Being involved brings us to the table with our colleagues and reminds them how questions about imaging should be answered by radiologists. This will be one of our key value add areas in the future of radiology. I think there is great value in research collaboration, but we need to actively pursue opportunities. I encourage radiologists who like asking questions to engage with the clinicians and trials groups in your area of practice, be visible and get the dialogue flowing for the benefit of all.

Being involved brings us to the table with our colleagues, and reminds them how questions about imaging should be answered by radiologists. This will be one of our key value add areas in the future of radiology.

1. Gormly KL, Coscia C, Wells T, Tebbutt N, Harvey JA, Wilson K, Schmoll HJ, Price T. MRI rectal cancer in Australia and New Zealand: An audit from the PETACC-6 trial. J Med Imaging Radiat Oncol. 2016 Oct; 60(5): 607-615

2. Stewart M, Sutherland T. The publication of radiology images in non-radiology journals. J Med Imaging Radiat Oncol. 2022 Oct;66(7):966-968.