Abstract

ObjectiveTo create a structured computed tomography (CT) report for the systematic evaluation of pancreatic ductal adenocarcinoma (PDAC), based on the opinions of clinicians and surgeons.Materials and MethodsThis was a prospective study in which we applied a 21-item questionnaire to experts in pancreatic diseases in order to create a model of a structured abdominal CT report. The questionnaire addressed the location and size of PDACs, as well as their effects on adjacent structures and on the vasculature, together with metastases. We used a Likert scale to determine which of those parameters should be included in the model.ResultsA total of 18 experts (12 surgeons and 6 clinicians) from 9 institutions completed the questionnaire. All of the experts agreed that the following (if present) should be described in the CT report on a PDAC: the degree of enhancement; the diameter and location of the lesion; pancreatic duct obstruction; biliary dilatation; pancreatic atrophy; liver metastases; peritoneal nodules; ascites; lymph node enlargement; and invasion of adjacent structures. More than 80% of the experts agreed that the report should also describe the relationship between the PDAC and the surrounding vasculature.ConclusionWe have developed a template for a CT report on patients with PDAC, based on the opinions of experts involved in the treatment of such patients.

Highlights

  • Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death in the United States[1]

  • Surgery provides the possibility of cure for PDAC[3], curative or radical surgery is possible in only a small fraction of patients with the disease

  • By having specialists in pancreatic diseases complete a questionnaire covering several aspects of the computed tomography (CT) scan for the evaluation of patients with PDAC, it was possible to devise a model of a structured tomography report that meets the expectations of those professionals and improves communication among the various specialists involved in the care of this population of patients

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Summary

Introduction

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death in the United States[1]. In Brazil, it accounts for approximately 2% of all malignancies and 4% of all cancer deaths[2]. When a PDAC is located in the pancreatic head, it is resectable in 15– 20% of cases, compared with only 10% when it is located in the body or tail[4]. Many consider PDAC to be incurable, radical surgery offers a five-year survival rate of approximately 20%, compared with an overall rate of less than 5%(5). Survival is longer and quality of life is better among patients who undergo resection than among those who undergo other, nonradical, forms of treatment[5]

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