ARRS 2022 Abstracts


E1278. Structured CT Reporting of Pancreatic Ductal Adenocarcinoma: Impact on Report Quality, Interdisciplinary Communication and Surgical Planning
  1. Rubab Malik; Johns Hopkins University School of Medicine
  2. Alina Hasanain; Johns Hopkins University School of Medicine
  3. Kelly Lafaro; Johns Hopkins University School of Medicine
  4. Jin He; Johns Hopkins University School of Medicine
  5. Amol Narang; Johns Hopkins University School of Medicine
  6. Elliot Fishman; Johns Hopkins University School of Medicine
  7. Atif Zaheer; Johns Hopkins University School of Medicine
The use of CT for pancreatic ductal adenocarcinoma (PDAC) allows for preoperative staging to guide clinical management. With the rise in popularity of structured reports in radiology, we sought to evaluate whether free-text CT reports on PDAC staging at our institute met published guidelines and to assess feedback of pancreatic surgeons comparing free-text and structured report styles with the same information content.

Materials and Methods:
A total of 298 free-text preoperative CT reports for PDAC staging from 2015–2017 were retrospectively evaluated for the inclusion of 45 key tumor descriptors based on published reporting guidelines. Two pancreatic surgeons were recruited to independently evaluate 50 reports in the free-text format followed by evaluation of the same reports in a structured format after a 3-week period using a 7-question survey to assess the usefulness and ease of information extraction for the requesting surgeons. Fisher’s exact test and Chi-square test for independence were utilized for categorical responses and an independent samples t-test was utilized to compare mean ratings of report quality as rated on a 5-point Likert scale.

The most commonly included descriptors in the free-text reports were tumor location (99%), liver lesions (97%), and suspicious lymph nodes (97%). The most commonly excluded descriptors were variant arterial anatomy (23%) and peritoneal/omental nodularity (42%). For vascular involvement, a mention of the presence or absence of perivascular disease with the main portal vein was most commonly included (87%), with the presence or absence of perivascular disease of the superior mesenteric vessels included in about 70% of free-text reports. For both surgeons, change in format from free-text to structured report increased the percentage of reports that were rated as optimal for the treatment planning decisions and the mean rating of overall report quality on a 5-point Likert scale for structured reports was significantly higher than for free-text reports (p < 0.001).

To our knowledge, this is the first attempt strictly comparing surgeons’ feedback on preoperative PDAC reporting with the same information/content presented in a traditional narrative free-text report format and structured report format using the standardized template published by an expert consensus on PDAC staging. Our results indicate that free-text reports may not include key descriptors for staging PDAC. We found that surgeons rated structured reports that presented the same information as free-text reports but in a template format as superior for guiding clinical management, convenience of use, and overall report quality.