A majority of musculoskeletal (MSK) radiologists are not familiar with the International Society for the Study of Vascular Anomalies (ISSVA) classification system, according to a recent study published in Current Problems in Diagnostic Radiology.

The ISSVA classifications, last updated in 2014, help radiologists diagnose and classify soft tissue vascular anomalies (VAs). The authors surveyed members of the Society of Skeletal Radiology about ISSVA classification via email, and 130 radiologists responded. Overall, the data showed that just 17 percent of MSK radiologists used the ISSVA classification system. Though more academic radiologists answered the survey than nonacademic radiologists, “no significant difference” was found between the two groups.

“We believe that this represents a missed opportunity, because while practice styles vary among different hospitals or institutions, adherence to a common classification system and nomenclature has the potential to decrease ambiguity in a multidisciplinary setting and improve patient care for complex diseases such as VAs,” wrote Shivani Ahlawat, MD, of the Johns Hopkins Medical Institutions in Baltimore, and colleagues. “Management of VA requires a multidisciplinary approach but a shared or common language used by the various subspecialties involved in the diagnosis and treatment of these challenging lesions.”

The data also revealed that 74 percent of respondents classified a hemangioma as a type of vascular malformation, “which is inherently discordant with the ISSVA classification system.” Radiologists with more than 5 years of experience did worse when answering that question than their less experienced counterparts. “This trend may be attributable to changes in radiology residency training increasing familiarity of newer graduates with the ISSVA classification,” Ahlawat et al. wrote.

The authors concluded that further research should focus on “best practices for broadening adoption of the ISSVA system.”