Structured Reporting of Computed Tomography and Magnetic Resonance in the Staging of Pancreatic Adenocarcinoma: A Delphi Consensus Proposal

Abstract

Background: Structured reporting (SR) in radiology has been recognized recently by major scientific societies. This study aims to build structured computed tomography (CT) and magnetic resonance (MR)-based reports in pancreatic adenocarcinoma during the staging phase in order to improve communication between the radiologist and members of multidisciplinary teams. Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi process was used to develop the CT-SR and MRI-SR, assessing a level of agreement for all report sections. Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. Results: The final CT-SR version was built by including n = 16 items in the “Patient Clinical Data” section, n = 11 items in the “Clinical Evaluation” section, n = 7 items in the “Imaging Protocol” section, and n = 18 items in the “Report” section. Overall, 52 items were included in the final version of the CT-SR. The final MRI-SR version was built by including n = 16 items in the “Patient Clinical Data” section, n = 11 items in the “Clinical Evaluation” section, n = 8 items in the “Imaging Protocol” section, and n = 14 items in the “Report” section. Overall, 49 items were included in the final version of the MRI-SR. In the first round for CT-SR, all sections received more than a good rating. The overall mean score of the experts was 4.85. The Cα correlation coefficient was 0.85. In the second round, the overall mean score of the experts was 4.87, and the Cα correlation coefficient was 0.94. In the first round, for MRI-SR, all sections received more than a good rating. The overall mean score of the experts was 4.73. The Cα correlation coefficient was 0.82. In the second round, the overall mean score of the experts was 4.91, and the Cα correlation coefficient was 0.93. Conclusions: The CT-SR and MRI-SR are based on a multi-round consensus-building Delphi exercise derived from the multidisciplinary agreement of expert radiologists in order to obtain more appropriate communication tools for referring physicians.

Complications Risk Assessment and Imaging Findings of Thermal Ablation Treatment in Liver Cancers: What the Radiologist Should Expect

“…However, inconsistencies with regard to content, style, and presentation can hamper information transfer and diminish the clarity of the reports, which can in turn adversely affect the extraction of the required key information by the referring physician. Therefore, FRT should be organized and re-orientated toward structured reports (SR) [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ]. According to the European Society of Radiology (ESR) paper on SR in radiology, the three main goals for moving from FTR to SR are quality, datafication/quantification and accessibility [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ].…”

“…Therefore, FRT should be organized and re-orientated toward structured reports (SR) [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ]. According to the European Society of Radiology (ESR) paper on SR in radiology, the three main goals for moving from FTR to SR are quality, datafication/quantification and accessibility [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ]. With regard to quality, this is correlated to standardization.…”

“…In this scenario, by using a dedicated report template, the radiologist has a list of predefined relevant items for the case at hand, ensuring that no important data is missed. This should not only guarantee a consistently high quality of final report, but also aid in the management of patients [ 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ].…”

Structured Reporting in Radiological Settings: Pitfalls and Perspectives

“…In the assessment of pancreatic cancer [ 75 ], the multidisciplinary team should make the choice concerning the lesion resectability following the acquisition of a complete staging [ 76 , 77 ], based on CT and MRI studies [ 75 , 76 ]. The lesion resectability is related to the following three different features: anatomical (A), biological (B), and conditional (C).…”

“…Biological factors include potentially resectable diseases, based on anatomic criteria but with clinical findings suspicious for (but unproven) distant metastases or regional lymph nodes metastases, diagnosed by biopsy or positron emission tomography-computed tomography (PET-CT). Therefore, radiological templates should report features on the presence and degree of contact between the tumor and the vessels, such as irregularities of the vessel contours (including a “tear drop” deformity) or changes in caliber, since these are signs of vascular invasion [ 75 ]. Moreover, several additional findings, which are relevant for procedural planning, should be reported as the arterial variants and the origin of the right hepatic artery from the superior mesenteric artery (SMA) ( Figure 5 ) [ 77 , 78 ].…”