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Impact of structured report on the quality of preoperative CT staging of pancreatic ductal adenocarcinoma: assessment of intra- and inter-reader variability

  • Pancreas
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate whether a structured radiology report improves the completeness of preoperative CT staging of pancreatic ductal adenocarcinoma (PDA) compared to conventional free-text reports.

Methods

We retrospectively included 27 patients (mean age, 64 ± 11.1 years) referred for pancreatic preoperative CT scan for staging of PDA between 2015 and 2018 and in whom a diagnosis of pancreatic adenocarcinoma was ultimately confirmed. Four readers independently reported CT scans with both conventional free-text and structured reports. Differences in reported morphologic and vascular features with the two reports were assessed through McNemar Test. Intra-reader and inter-reader were calculated.

Results

A total of 216 reports were completed by four different readers including 108 free-text and 108 structured reports. Overall, 139 of 540 morphologic characteristics of PDA and 869 of 1188 vascular key features were only described in structured reports. Encasement of left gastric artery, gastroduodenal artery and splenic artery was described in up to 14.8% using free-text reports and in up to 29.6% using structured report, resulting in low-intra-reader agreement (k = 0.033–0.216). Inter-reader agreement improved with structured report compared to free-text one for left gastric artery (ICC = 0.844 vs. ICC = 0.493, respectively), gastroduodenal artery (ICC = 0.730 vs. ICC = 0.449, respectively), portal vein (ICC = 0.847 vs. ICC = 0.638, respectively), portal confluence (ICC = 0.848 vs. ICC = 0.422, respectively) superior mesenteric vein (ICC = 0.765 vs. ICC = 0.695, respectively), and splenic vein (ICC = 0.921 vs. ICC = 0.841, respectively).

Conclusion

Structured reports for PDA staging significantly reduces the number of missing morphological and vascular features of PDA and improves the inter-reader agreement compared to free-text reports.

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Funding

No funding was received for this study.

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Author notes

  1. Mariangela Dimarco and Roberto Cannella equally contributed to this work.

Authors and Affiliations

  1. Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University Hospital of Palermo, Via del Vespro 129, 90127, Palermo, Italy

    Mariangela Dimarco, Roberto Cannella, Silvia Pellegrino, Francesco Allegra, Davide Castiglione, Giuseppe Salvaggio, Massimo Midiri & Giuseppe Brancatelli

  2. Department of Surgical, Oncological and Oral Sciences (Di. Chir. On. S.), University of Palermo, Policlinico P. Giaccone. Via Liborio Giuffré 5, 90127, Palermo, Italy

    Dario Iadicola & Roberta Tutino

  3. Dipartimento Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G.D’Alessandro” (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127, Palermo, Italy

    Federica Vernuccio

  4. University Paris Diderot, Sorbonne Paris Cité, Paris, France

    Federica Vernuccio

  5. I.R.C.C.S. Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS113, 98124, Messina, Italy

    Federica Vernuccio

Authors
  1. Mariangela Dimarco
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  2. Roberto Cannella
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  3. Silvia Pellegrino
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  4. Dario Iadicola
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  6. Francesco Allegra
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  7. Davide Castiglione
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  8. Giuseppe Salvaggio
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  9. Massimo Midiri
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  10. Giuseppe Brancatelli
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  11. Federica Vernuccio
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Corresponding author

Correspondence to Roberto Cannella.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Dimarco, M., Cannella, R., Pellegrino, S. et al. Impact of structured report on the quality of preoperative CT staging of pancreatic ductal adenocarcinoma: assessment of intra- and inter-reader variability. Abdom Radiol 45, 437–448 (2020). https://doi.org/10.1007/s00261-019-02287-7

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