Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30775
Title: Synoptic CT scan reporting of pancreatic adenocarcinoma to align with international consensus guidelines on surgical resectability: a Victorian pilot.
Austin Authors: Pilgrim, Charles H C;Maciejewska, Anna;Ayres, Nadia;Ellis, Sam;Goodwin, Mark D ;Zalcberg, John R;Haydon, Andrew
Affiliation: School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
Southern Melbourne Integrated Cancer Service (funded by the Victorian Government), Melbourne, Victoria, Australia
Department of Medical Oncology, Alfred Health, Melbourne, Victoria, Australia
Hepatopancreaticobiliary Surgery, The Alfred Hospital, Melbourne, Victoria, Australia
North Eastern Melbourne Integrated Cancer Service (funded by the Victorian Government), Melbourne, Victoria, Australia
Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia
Department of Radiology, The Alfred Hospital, Melbourne, Victoria, Australia
Radiology
The University of Melbourne, Melbourne, Victoria, Australia
Issue Date: 24-Aug-2022
Date: 2022
Publication information: ANZ Journal of Surgery; 92(10): 2565-2570
Abstract: Non-metastatic pancreatic ductal adenocarcinoma (PDAC) is classified as resectable (R), borderline resectable (BR) or locally advanced (LA). International Consensus Guidelines on these definitions exist, but have not been integrated into everyday Australian practice. The anatomical features on CT imaging lend themselves to synoptic reporting which should enhance completeness, comparability and consistency. We developed and tested a synoptic report for PDAC derived from the International Consensus Guidelines at two metropolitan pancreatic cancer services to standardize CT reporting in the region. Consecutive scans with suspected PDAC discussed at multidisciplinary meetings were reported using the template between October 2020 and September 2021. A purpose-built database captured data regarding resectability and image-quality parameters. Ninety-five scans were reviewed, 57.9% (N = 55) of which conformed to high-quality pancreatic CT protocols. Of suboptimal scans, meaningful synoptic reports were able to be issued for a further 24/40 (due to metastases in 9, and unequivocal resectability status in 15). Of 79 classifiable scans, 20% were metastatic, 51% deemed resectable, 16% locally advanced and 13% borderline resectable. PDAC lends itself to synoptic reporting given the specific anatomical considerations that classify resectability. This relies, however, on high-quality CT imaging and it was surprising that over 40% of scans reviewed were of suboptimal quality. Despite this, resectability status according to the International Consensus Guidelines was designated for 83% of scans. Optimal treatment algorithms for LA, BR and resectable disease vary widely underscoring the critical importance of accurately differentiating these anatomic subtypes of PDAC, and thus support further implementation of a synoptic report of this nature.
URI: https://ahro.austin.org.au/austinjspui/handle/1/30775
DOI: 10.1111/ans.17999
ORCID: 0000-0003-2193-7305
0000-0002-1476-0591
Journal: ANZ Journal of Surgery
PubMed URL: 36054233
Type: Journal Article
Subjects: CT scan
PDAC
pancreas cancer
synoptic report
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