Pancreatic Ductal Adenocarcinoma Radiology Reporting Template: Consensus Statement of the Society of Abdominal Radiology and the American Pancreatic Association

Al-Hawary, Mahmoud M.; Francis, Isaac R.; Chari, Suresh T.; Fishman, Elliot K.; Hough, David M.; Lu, David; Macari, Michael; Megibow, Alec J.; Miller, Frank H.; Mortelé, Koenraad J.; Merchant, Nipun B.; Minter, Rebecca M.; Tamm, Eric P.; Sahani, Dushyant V.; Simeone, Diane M.

doi:10.1053/j.gastro.2013.11.004

Cited by 281 publications

(223 citation statements)

References 33 publications

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“…Bile duct dilatation was defined as dilatation of both the extrahepatic bile duct (>8 mm) and the intrahepatic bile duct (>2 mm). The criteria for vascular invasion were venous thrombus, vessel occlusion, focal narrowing, or contour deformity, and more than half of the perimeter in contact with the tumour [14,15]. Lymph node enlargements were defined as short axis>1 cm, abnormal round morphology, or central necrosis [14].…”

Section: Image Analysismentioning

confidence: 99%

“…The criteria for vascular invasion were venous thrombus, vessel occlusion, focal narrowing, or contour deformity, and more than half of the perimeter in contact with the tumour [14,15]. Lymph node enlargements were defined as short axis>1 cm, abnormal round morphology, or central necrosis [14]. Criteria of vascular invasion and lymph node enlargements were adopted from the pancreas cancer evaluation [14,15].…”

Section: Image Analysismentioning

confidence: 99%

“…Lymph node enlargements were defined as short axis>1 cm, abnormal round morphology, or central necrosis [14]. Criteria of vascular invasion and lymph node enlargements were adopted from the pancreas cancer evaluation [14,15]. Hepatic metastasis was defined as a hepatic nodule with hypervascularity or peripheral enhancement without classic features of hemangioma or focal nodular hyperplasia.…”

Section: Image Analysismentioning

confidence: 99%

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Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients

Kim

et al. 2015

Eur Radiol

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Section: Image Analysismentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

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Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients

Kim

et al. 2015

Eur Radiol

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“…The use of standardized descriptions of radiographic anatomy, as might be used in templated radiology reports, also can help to facilitate research and allow for comparison of stage-specific treatment results between different institutions. 3 Reporting of the imaging findings for patients with pancreatic cancer should include descriptions of the primary tumor's size and location, the extent of the circumferential interface (tumor-vessel interface) between the tumor and major vessels (in degrees), the presence or absence of vessel occlusion, variant vascular anatomy, an anatomic assessment of local tumor resectability (resectable, borderline resectable [ Fig. 1A], or locally advanced [see Fig.…”

Section: Radiologic Reportingmentioning

confidence: 99%

“…Furthermore, no data from prospective trials have been generated to guide the evaluation, diagnosis, or management of patients with this stage of disease, so essentially all decision-making is directed by low-level data or consensus. [3][4][5][6][7][8] Herein we describe current thinking regarding the classification, definition, diagnosis, and management of patients with borderline resectable PDAC and discuss ongoing controversies relevant to this disease stage.…”

mentioning

confidence: 99%

Diagnosis and Management of Borderline Resectable Pancreatic Adenocarcinoma

Schwarz¹,

Katz²

2015

Hematology/Oncology Clinics of North America

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Efficacy of Perioperative Chemotherapy for Resectable Pancreatic Adenocarcinoma

et al. 2021

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IMPORTANCE Clinical outcomes after curative treatment of resectable pancreatic ductal adenocarcinoma (PDA) remain suboptimal. To assess the potential of early control of systemic disease with multiagent perioperative chemotherapy, we conducted a prospective trial. OBJECTIVE To determine 2-year overall survival (OS) using perioperative chemotherapy for resectable PDA. DESIGN, SETTING, AND PARTICIPANTSThis was a randomized phase 2 trial of perioperative chemotherapy with a pick-the-winner design. It was conducted across the National Clinical Trials Network, including academic and community centers all across the US. Eligibility required patients with Zubrod Performance Score of 0 or 1, confirmed tissue diagnosis of PDA, and resectable disease per Intergroup criteria.INTERVENTIONS Perioperative (12 weeks preoperative, 12 weeks postoperative) chemotherapy with either fluorouracil, irinotecan, and oxaliplatin (mFOLFIRINOX, arm 1) or gemcitabine/nab-paclitaxel (arm 2). MAIN OUTCOMES AND MEASURESThe primary outcome was 2-year overall survival (OS), using a pick-the-winner design; for 100 eligible patients, accrual up to 150 patients was planned to account for cases deemed ineligible at central radiology review. RESULTSFrom 2015 to 2018, 147 patients were enrolled; 43 patients (29%) had ineligible disease, beyond resectability criteria, at central radiology review. There were 102 eligible and evaluable patients, 55 in arm 1 and 47 in arm 2, of whom the median (range) age was 66 (44-76) and 64 (46-76) years, respectively; 36 patients (65%) in arm 1 and 24 (51%) in arm 2 were men. In arm 1, 34 (62%) had Zubrod Performance Score of 0, while in arm 2, 31 (66%) did; and 44 (80%) in arm 1 and 39 (83%) in arm 2 had head tumors. Of 102 patients, 84% and 85% completed preoperative chemotherapy, 73% and 70% underwent resection, and 49% and 40% completed all treatment. Adverse events were expected hematologic toxic effects, fatigue, and gastrointestinal toxicities. Two-year OS was 47% (95% CI, 31%-61%) for arm 1 and 48% (95% CI, 31%-63%) for arm 2; median OS was 23.2 months (95% CI, 17.6-45.9 months) and 23.6 months (95% CI, 17.8-31.7 months). Neither arm's 2-year OS estimate was significantly higher than the a priori threshold of 40%. Median disease-free survival after resection was 10.9 months in arm 1 and 14.2 months in arm 2.CONCLUSIONS AND RELEVANCE This phase 2 randomized clinical trial did not demonstrate an improved OS with perioperative chemotherapy, compared with historical data from adjuvant trials in resectable pancreatic cancer. Two-year OS was 47% with mFOLFIRINOX and 48% with gemcitabine/nab-paclitaxel for all eligible patients starting treatment for resectable PDA. The trial also demonstrated adequate safety and high resectability rates with perioperative chemotherapy, and challenges in quality control for resectability criteria.

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Pancreatic Ductal Adenocarcinoma Radiology Reporting Template: Consensus Statement of the Society of Abdominal Radiology and the American Pancreatic Association

Cited by 281 publications

References 33 publications

Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients

Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients

Diagnosis and Management of Borderline Resectable Pancreatic Adenocarcinoma

Efficacy of Perioperative Chemotherapy for Resectable Pancreatic Adenocarcinoma

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