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
Summary
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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