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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

  • Mariangela Dimarco
  • Roberto CannellaEmail author
  • Silvia Pellegrino
  • Dario Iadicola
  • Roberta Tutino
  • Francesco Allegra
  • Davide Castiglione
  • Giuseppe Salvaggio
  • Massimo Midiri
  • Giuseppe Brancatelli
  • Federica Vernuccio
Pancreas

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.

Keywords

Structured Reporting Pancreatic Ductal Adenocarcinoma Pancreatic Cancer Staging Computed Tomography 

Notes

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

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.

Informed consent

Informed consent was waived by the Institutional Review Board.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Mariangela Dimarco
    • 1
  • Roberto Cannella
    • 1
    Email author
  • Silvia Pellegrino
    • 1
  • Dario Iadicola
    • 2
  • Roberta Tutino
    • 2
  • Francesco Allegra
    • 1
  • Davide Castiglione
    • 1
  • Giuseppe Salvaggio
    • 1
  • Massimo Midiri
    • 1
  • Giuseppe Brancatelli
    • 1
  • Federica Vernuccio
    • 3
    • 4
    • 5
  1. 1.Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND)University Hospital of PalermoPalermoItaly
  2. 2.Department of Surgical, Oncological and Oral Sciences (Di. Chir. On. S.)University of PalermoPalermoItaly
  3. 3.Dipartimento Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G.D’Alessandro” (PROMISE), University of PalermoPalermoItaly
  4. 4.University Paris Diderot, Sorbonne Paris CitéParisFrance
  5. 5.I.R.C.C.S. Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS113MessinaItaly

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