Abstract
BackgroundAccurate pre-operative imaging plays a vital role in patient selection for surgery and in allocating stage-appropriate therapies to patients diagnosed with pancreatic cancer (PC). This study aims to: (1) understand the current diagnosis and staging practices for PC; and (2) explore the factors (barriers and enablers) that influence the use of a pancreatic protocol computed tomography (PPCT) or magnetic resonance imaging (MRI) to confirm diagnosis and/or accurately stage PC.MethodsSemi-structured interviews were conducted with radiologists, surgeons, gastroenterologists, medical and radiation oncologists from the states of New South Wales (NSW) and Victoria, Australia. Interviews were conducted either in person or via video conferencing. All interviews were recorded, transcribed verbatim, de-identified and data were thematically coded according to the 12 domains explored within the Theoretical Domains Framework (TDF). Common belief statements were generated to compare the variation between participant responses.FindingsIn total, 21 clinicians (5 radiologists, 10 surgeons, 2 gastroenterologists, 4 medical and radiation oncologists) were interviewed over a four-month-period. Belief statements relevant to the TDF domains were generated. Across the 11 relevant domains, 20 themes and 30 specific beliefs were identified. All TDF domains, with the exception of social influences were identified by participants as relevant to protocol-based imaging using either a PPCT or MRI, with the domains of knowledge, skills and environmental context and resources being offered by most participants as being relevant in influencing their decisions.ConclusionsTo maximise outcomes and personalise therapy it is imperative that diagnosis and staging investigations using the most appropriate imaging modalities are conducted in a timely, efficient and effective manner. The results provide an understanding of specialists’ opinion and behaviour in relation to a PPCT or MRI and should be used to inform the design of future interventions to improve compliance with this practice.
Highlights
The results provide an understanding of specialists’ opinion and behaviour in relation to a pancreatic protocol computed tomography (PPCT) or magnetic resonance imaging (MRI) and should be used to inform the design of future interventions to improve compliance with this practice
Accurate pre-operative imaging plays a vital role in patient selection for surgery and in allocating stage-appropriate therapies to patients diagnosed with pancreatic cancer (PC) [1]
This study aims to: (1) understand the current diagnosis and staging practices for PC; and (2) explore the factors that influence the use of a PPCT or MRI to confirm diagnosis and/or accurately stage PC
Summary
Accurate pre-operative imaging plays a vital role in patient selection for surgery and in allocating stage-appropriate therapies to patients diagnosed with pancreatic cancer (PC) [1]. The recommended method of assessing operability is to use a high-quality multi-phase computed tomography (CT) scan that examines the abdominal area in the arterial and portal venous phase Such a CT scan can determine the proximity of the tumour to major vascular structures and the presence of locally advanced disease or intra and extra-abdominal metastases [2, 3]. In 2012, the Society of Abdominal Radiology and the American Pancreatic Association released a consensus statement describing a standardised reporting template for the accurate staging of PC to improve disease management. This statement was authored by a multi-institutional group of experts comprising radiologists, gastroenterologists, and hepatopancreatobiliary surgeons [4]. This study aims to: (1) understand the current diagnosis and staging practices for PC; and (2) explore the factors (barriers and enablers) that influence the use of a pancreatic protocol computed tomography (PPCT) or magnetic resonance imaging (MRI) to confirm diagnosis and/or accurately stage PC
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