## 4 Discussion  
Effective communication between neuroradiologists and neurologists is crucial in clinical practice, with direct repercussions on healthcare quality. In this study, we evaluated for the first time the impact of the content and structure of neuroradiiological reports on the clinical choices of neurologists specialized in MS care. Clinicians were asked not only their opinion on conventional MRI biomarkers but also on the clinical significance of software-derived quantitative information, so far used almost uniquely in research settings. Our results suggest that including accurate quantitative information in neuroradiiological \begin{table}
\begin{tabular}{c c c} \hline \hline
**Answers** & **Number of Answers (Percentages)** & **Median Value (Range)** \\ \hline _Do you think that finding this type of information in a structured report could be helpful in the management of MS patients?_ & \\ \hline Yes & 61 (98.4\%) & n.a. \\ No & 1 (1.6\%) & n.a. \\ \hline \multicolumn{4}{c}{**If yes:**_Which aspect would be more affected?_} \\ \hline Prognostic evaluation & 52 (83.9\%) & \\ Choice of therapy & 0 (0.0\%) & \\ Start/switch of therapy & 46 (74.2\%) & n.a. \\ Start/switch of symptomatic drug therapy & 12 (19.4\%) & n.a. \\ Start/switch of rehabilitation therapy & 10 (16.1\%) & \\ Other (follow-up) & 1 (1.6\%) & \\ \hline \multicolumn{4}{c}{_These tools provide different quantitative information. Which of the following do you think could be most helpful in the clinical management of MS patients, compared with a structured report?_} \\ \hline T2w/FLAIR lesion load & 33 (53.2\%) & \\ T1w hypointensities (“black holes”) volume & 29 (46.8\%) & \\ Enhancing lesions volume & 14 (22.6\%) & \\ Whole brain volume and normative percentile & 43 (69.4\%) & n.a. \\ Gray matter volume and normative percentile & 34 (54.8\%) & \\ White matter volume and normative percentile & 19 (30.6\%) & \\ Cortical gray matter volume (by cerebral lobe) & 16 (25.8\%) & \\ Regional T2w/FLAIR lesion load volume & 25 (40.3\%) & \\ \hline \multicolumn{4}{c}{_Do you think that finding graphs that summarize this quantitative information in a report could be helpful in your clinical practice?_} \\ \hline Yes & 59 (95.2\%) & 4 (2–5) \\ No & 3 (4.8\%) & \\ \hline \multicolumn{4}{c}{_Do you think that finding annotated images that summarize this quantitative information in a report could be helpful in your clinical practice with MS patients?_} \\ \hline Yes & 54 (87.1\%) & 4 (2–5) \\ No & 8 (12.9\%) & \\ \hline \multicolumn{4}{c}{_Do you think that having some or all this information might have an impact on your clinical management of MS patients?_} \\ \hline Yes, I think that it would help me manage MS patients better & 57 (91.9\%) & n.a. \\ No, I think that these tools have only research applications & 5 (8.1\%) & \\ \hline \multicolumn{4}{c}{_Which of the following do you perceive as more reliable?_} \\ \hline A radiologist writing a report without quantitative tools & 0 (0.0\%) & \\ A radiologist writing a report containing only information & 4 (6.5\%) & \\ obtained by a quantitative tool & n.a. \\ A radiologist writing a report containing some information & \\ obtained by a quantitative tool, integrated & 58 (93.5\%) & \\ by her/his experience & \\ \hline \multicolumn{4}{c}{_Do you think that the integration of quantitative information processed by a software in radiological reports could reduce variability in reporting and/or can help standardize descriptive reports as well?_} \\ \hline Yes & 59 (95.2\%) & \\ No & 3 (4.8\%) & 4 (3–5) \\ \hline \hline \end{tabular}
\end{table} 
Table 4: _Cont._reports is highly relevant to clinicians. Furthermore, the use of software for medical imaging quantification in radiological assessment of MS patients is considered helpful not only to standardize radiological reports but also to inform neurologists' clinical decision-making, a result expected given the increasing use of this software but to date not available in the literature.