10 Chapter 1 above. Availability of a platform and infrastructure to facilitate research in this direction would thus be an important step forward. Moreover, it would create new opportunities for training and teaching, thereby promoting effective clinical dissemination and implementation of study outcomes. Aims of this thesis The overall aim of this thesis was to develop a practical web-based tool and research infrastructure to investigate and validate available diagnostic methods and staging templates on a large scale within the clinical context of rectal cancer. The main study goals and questions addressed in this thesis – using this newly developed webplatform – are as follows: 1. To investigate the clinical applicability and main pitfalls of the ESGAR structured reporting template for rectal cancer (Chapter 2), and to explore to what extent structured reporting is already successfully embedded in daily radiological reporting practice in the Netherlands (Chapter 4) 2. To test the use of our webplatform as a tool for virtual training and teaching and its potential impact on rectal cancer staging performance (Chapter 3) 3. To validate the diagnostic performance and reproducibility of different visual diagnostic grading systems to evaluate and predict response to neoadjuvant chemoradiotherapy (Chapters 5,6,7) Outline of this thesis Chapter 2 investigates the reproducibility and diagnostic performance in staging using the ESGAR structured reporting template, and aims to establish its main limitations and areas for improvement. Chapter 3 describes the outcomes and explores the impact of a virtual hands-on training course on MRI staging confidence and performance. Chapter 4 evaluates how the MRI reporting of rectal cancer has evolved in the Netherlands following guidelines updates and assesses how well-structured reporting templates have been adopted into clinical routine. Chapter 5 evaluates the pearls and pitfalls of MRI for yT-staging after chemoradiotherapy.
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