Discrepancies in Initial Clinical and Radiological Diagnoses of Vascular Malformations and the Role of the ISSVA Classification

Abstract

Objectives:. Diagnosing vascular anomalies can be difficult and incorrect diagnosis may result in diagnostic delay and suboptimal treatment. Adequate diagnosis and treatment of patients with vascular anomalies are best guaranteed by a multidisciplinary team of experts. The International Society for the Study of Vascular Anomalies (ISSVA) classification of vascular anomalies is important as it provides a common language in multidisciplinary settings to optimize the diagnostic process. We investigated the initial diagnostic process (clinical and radiological) of vascular anomalies and the contribution of the ISSVA classification to the comparability of clinical and radiological diagnoses. Methods:. Retrospectively, we evaluated medical records of pediatric patients diagnosed with vascular malformations >20 years and re-evaluated both the diagnostic process and the use of the ISSVA classification. Results:. Of the 157 patients evaluated, the percentage of concordant diagnoses between radiologists and clinicians and their adherence to the ISSVA classification increased over a 20-year period (from 38% to 76% and 50% to 60%, respectively). These concordant diagnoses correlated with adherence to the ISSVA classification with a stronger correlation observed in recent years. The proportion of concordant diagnoses stabilized at the end of the study period. Conclusions:. In this study, we found that the number of initial diagnoses of vascular malformations that concurred between clinicians and radiologists increased over time. Adherence to the same vascular terminology (ISSVA classification), close collaboration and clear communication between involved disciplines were essential, with an increased level of expertise in the vascular anomaly team also being important.