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Structured CT reporting of pancreatic ductal adenocarcinoma: impact on completeness of information and interdisciplinary communication for surgical planning

Abstract

Purpose

With the rise in popularity of structured reports in radiology, we sought to evaluate whether free-text CT reports on pancreatic ductal adenocarcinoma (PDAC) staging at our institute met published guidelines and assess feedback of pancreatic surgeons comparing free-text and structured report styles with the same information content.

Methods

We retrospectively evaluated 298 free-text preoperative CT reports from 2015 to 2017 for the inclusion of key tumor descriptors. Two surgeons independently evaluated 50 free-text reports followed by evaluation of the same reports in a structured format using a 7-question survey to assess the usefulness and ease of information extraction. Fisher’s exact test and Chi-square test for independence were utilized for categorical responses and an independent samples t test for comparing mean ratings of report quality as rated on a 5-point Likert scale.

Results

The most commonly included descriptors in free-text reports were tumor location (99%), liver lesions (97%), and suspicious lymph nodes (97%). The most commonly excluded descriptors were variant arterial anatomy and peritoneal/omental nodularity, which were present in only 23% and 42% of the reports, respectively. For vascular involvement, a mention of the presence or absence of perivascular disease with the main portal vein was most commonly included (87%). Both surgeons’ rating of overall report quality was significantly higher for structured reports (p < 0.001).

Conclusion

Our results indicate that free-text reports may not include key descriptors for staging PDAC. Surgeons rated structured reports that presented the same information as free-text reports but in a template format superior for guiding clinical management, convenience of use, and overall report quality.

Graphical abstract

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Data availability

The data that support the findings of this study are available on request from the corresponding author, AZ.

Code availability

Statistical analysis was performed using Stata Statistical Software (Release 15, StataCorp LLC, College Station, TX).

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Correspondence to Atif Zaheer.

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The study was approved by the Johns Hopkins University Institutional Review Board for Human Research and complied with Health Insurance Portability and Accountability Act (HIPAA) regulations.

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Malik, R.F., Hasanain, A., Lafaro, K.J. et al. Structured CT reporting of pancreatic ductal adenocarcinoma: impact on completeness of information and interdisciplinary communication for surgical planning. Abdom Radiol 47, 704–714 (2022). https://doi.org/10.1007/s00261-021-03353-9

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  • DOI: https://doi.org/10.1007/s00261-021-03353-9

Keywords

  • Pancreatic ductal adenocarcinoma
  • CT
  • Structured reporting
  • Report quality
  • Radiology report