Title: Pilot feasibility study to determine the utility of direct access and quantitative magnetic
resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or
ductal gallstone presentations.
Version: 3 Date: 11 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The pandemic severely affected recruitment, and although the study managed to complete data
collection on 27 patients, the interruptions in recruitment limit the representativeness of the
sample. The impact of this limitation on the study's generalizability needs to be considered when
interpreting the results.
-The exclusion of MRCP scans due to reduced image quality highlights a limitation in the current
technology's applicability in an acute setting, where patient conditions or technical constraints
may compromise image acquisition. This could reduce the utility of quantitative MRCP in
certain clinical contexts.
-Although quantitative MRCP measurements (e.g., biliary volume and common bile duct
diameter) were analyzed, the clinical relevance of these parameters in guiding acute management
remains unclear. The study does not assess whether these measurements improve patient
outcomes (e.g., faster resolution of symptoms, fewer complications), which is the ultimate test
of any diagnostic tool's utility.
-The study did not compare the diagnostic accuracy of quantitative MRCP versus traditional
qualitative MRCP, nor did it assess the impact of direct MRCP on clinical decision-making
or patient management. A direct comparison between these approaches would be helpful
in understanding whether quantitative MRCP offers additional diagnostic value beyond the
traditional MRCP interpretation.
-Although the study mentions the possibility of discomfort or failure with MRCP due to
claustrophobia, it does not explore the failure rates associated with the traditional ultrasound
approach (e.g., pain, difficulty obtaining images). Including data on ultrasound-related
challenges would provide a more balanced comparison of the two diagnostic strategies and give
a clearer picture of the strengths and weaknesses of both approaches.
-The study presents promising early findings regarding the potential role of AI-assisted MRCP
in automating and standardizing measurements, but it does not explore the actual clinical utility
of these measurements in guiding management decisions. Further studies are needed to assess
whether these quantitative data truly impact clinical decisions, or if they merely add complexity
without improving patient outcomes.
Title: Pilot feasibility study to determine the utility of direct access and quantitative magnetic
resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or
ductal gallstone presentations.
Version: 3 Date: 11 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The pandemic severely affected recruitment, and although the study managed to complete data
collection on 27 patients, the interruptions in recruitment limit the representativeness of the
sample. The impact of this limitation on the study's generalizability needs to be considered when
interpreting the results.
-The exclusion of MRCP scans due to reduced image quality highlights a limitation in the current
technology's applicability in an acute setting, where patient conditions or technical constraints
may compromise image acquisition. This could reduce the utility of quantitative MRCP in
certain clinical contexts.
-Although quantitative MRCP measurements (e.g., biliary volume and common bile duct
diameter) were analyzed, the clinical relevance of these parameters in guiding acute management
remains unclear. The study does not assess whether these measurements improve patient
outcomes (e.g., faster resolution of symptoms, fewer complications), which is the ultimate test
of any diagnostic tool's utility.
-The study did not compare the diagnostic accuracy of quantitative MRCP versus traditional
qualitative MRCP, nor did it assess the impact of direct MRCP on clinical decision-making
or patient management. A direct comparison between these approaches would be helpful
in understanding whether quantitative MRCP offers additional diagnostic value beyond the
traditional MRCP interpretation.
-Although the study mentions the possibility of discomfort or failure with MRCP due to
claustrophobia, it does not explore the failure rates associated with the traditional ultrasound
approach (e.g., pain, difficulty obtaining images). Including data on ultrasound-related
challenges would provide a more balanced comparison of the two diagnostic strategies and give
a clearer picture of the strengths and weaknesses of both approaches.
-The study presents promising early findings regarding the potential role of AI-assisted MRCP
in automating and standardizing measurements, but it does not explore the actual clinical utility
of these measurements in guiding management decisions. Further studies are needed to assess
whether these quantitative data truly impact clinical decisions, or if they merely add complexity
without improving patient outcomes.
Please review this paper.
user
Title: Pilot feasibility study to determine the utility of direct access and quantitative magnetic
resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or
ductal gallstone presentations.
Version: 3 Date: 11 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The pandemic severely affected recruitment, and although the study managed to complete data
collection on 27 patients, the interruptions in recruitment limit the representativeness of the
sample. The impact of this limitation on the study's generalizability needs to be considered when
interpreting the results.
-The exclusion of MRCP scans due to reduced image quality highlights a limitation in the current
technology's applicability in an acute setting, where patient conditions or technical constraints
may compromise image acquisition. This could reduce the utility of quantitative MRCP in
certain clinical contexts.
-Although quantitative MRCP measurements (e.g., biliary volume and common bile duct
diameter) were analyzed, the clinical relevance of these parameters in guiding acute management
remains unclear. The study does not assess whether these measurements improve patient
outcomes (e.g., faster resolution of symptoms, fewer complications), which is the ultimate test
of any diagnostic tool's utility.
-The study did not compare the diagnostic accuracy of quantitative MRCP versus traditional
qualitative MRCP, nor did it assess the impact of direct MRCP on clinical decision-making
or patient management. A direct comparison between these approaches would be helpful
in understanding whether quantitative MRCP offers additional diagnostic value beyond the
traditional MRCP interpretation.
-Although the study mentions the possibility of discomfort or failure with MRCP due to
claustrophobia, it does not explore the failure rates associated with the traditional ultrasound
approach (e.g., pain, difficulty obtaining images). Including data on ultrasound-related
challenges would provide a more balanced comparison of the two diagnostic strategies and give
a clearer picture of the strengths and weaknesses of both approaches.
-The study presents promising early findings regarding the potential role of AI-assisted MRCP
in automating and standardizing measurements, but it does not explore the actual clinical utility
of these measurements in guiding management decisions. Further studies are needed to assess
whether these quantitative data truly impact clinical decisions, or if they merely add complexity
without improving patient outcomes.
assistant