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However, its role in contrast-enhanced ultrasound (CEUS) for testicular tumors remains underexplored. This study evaluates urologist-perceived clarity, completeness, and clinical usefulness of SR compared to free-text reporting (FTR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and materials<\/jats:title>\n                    <jats:p>In this retrospective, single-center study, 65 male patients with suspected testicular tumors underwent CEUS at LMU University Hospital. Reports were initially documented as FTRs by an experienced radiologist and later converted into SRs using Smart Reporting software. Four board-certified urologists independently assessed both formats using a structured questionnaire. Completeness, readability, trust, and impact on clinical decision-making were evaluated. Statistical analysis included McNemar\u2019s test and the Wilcoxon signed-rank test, with \u03b1\u2009=\u20090.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SRs significantly improved readability (97.3% vs. 10.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and information extraction (98.8% vs. 91.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, completeness (56.9% vs. 60.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.427) and clinical decision support (85.7% vs. 84.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.152) were comparable. Trust in SRs was lower than in FTRs (4.92 vs. 5.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), likely due to missing diagnostic parameters and retrospective SR generation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SR was associated with improved reporting clarity and consistency but did not outperform FTR in completeness or clinical decision-making. Interdisciplinary collaboration in template development and the integration of classification systems could improve SR\u2019s diagnostic value. Future prospective, multicenter studies should assess real-time SR implementation and its potential impact on reporting quality, communication, and outcome-based endpoints in prospective settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance\/application<\/jats:title>\n                    <jats:p>Structured reporting in multiparametric testicular ultrasound including CEUS improved perceived readability and facilitated information access for referring clinicians. However, SR showed no clear advantage over free-text reporting regarding completeness or clinical decision-making. The lower clinician trust in SR highlights the need for clinically tailored templates developed in interdisciplinary collaboration. The broader clinical value of SR in testicular imaging should be confirmed in prospective real-time studies incorporating outcome-based and workflow-related endpoints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12894-026-02159-5","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:05:31Z","timestamp":1777003531000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Structured reporting of B-mode, color Doppler, and CEUS in testicular tumor assessment: a reader study with urologist ratings"],"prefix":"10.1186","volume":"26","author":[{"given":"Moritz Ludwig","family":"Schnitzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Biechele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Eckermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix L.","family":"Herr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dascalescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Heimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Schwarze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Marcon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Lenhart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Waldbillig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Baier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk-Andre","family":"Clevert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias Frank","family":"Fr\u00f6lich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"R\u00fcbenthaler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Geyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"issue":"3","key":"2159_CR1","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.eururo.2023.04.010","volume":"84","author":"A Patrikidou","year":"2023","unstructured":"Patrikidou A, Cazzaniga W, Berney D, Boormans J, de Angst I, Di Nardo D. u. a. 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The need for informed consent was waived by the Ethics Committee of the Medical Faculty, Ludwig Maximilian University (LMU) Munich. All data were collected in accordance with the principles of the Declaration of Helsinki\/Edinburgh 2022.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Matthias Frank Froelich reports a relationship with Smart Reporting GmbH that includes: former employment and equity. The other authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"108"}}