Marcal Leonardo P, Fox Patricia S, Evans Douglas B, Fleming Jason B, Varadhachary Gauri R, Katz Matthew H, Tamm Eric P
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
Abdom Imaging. 2015 Oct;40(7):2391-7. doi: 10.1007/s00261-015-0420-1.
To assess the completeness and clarity of current free-form radiology reports for pancreatic cancer staging by evaluating them against the elements of the RSNA CT oncology primary pancreas mass dictation template.
This retrospective study was approved by our Institutional Review Board (IRB). 295 free-form computed tomography (CT) reports for baseline staging of pancreatic cancer (PC) generated between August 2008 and December 2010 were evaluated by one of two radiologists with expertise in pancreatic cancer imaging. Reports which indicated that metastatic disease was present were excluded. The completeness and clarity of the reports were analyzed against the elements of the RSNA CT pancreas mass dictation template. Fisher's exact tests were used to analyze differences by year and type of radiologist.
Primary lesion location, size, and effect on bile duct (BD) were provided in 93.9% (277/295), 69.8% (206/295), and 67.5% (199/295) of reports, respectively. Standard terms to describe vascular involvement were used in 47.5% (140/295) of reports. In 20.3% (60/295), the resectability status could not be defined based on the report alone. In 36.9% (109/295) of reports, review of CT images was necessary to understand vascular involvement. Radiologists expert in pancreatic oncology had a higher proportion of reports using standardized terminology and reports in which vascular involvement was understood without revisiting the images.
Free-form reports were more likely to use ambiguous terminology and/or require review of the actual images for understanding resectability status. The use of a standardized reporting template may improve the usefulness of pancreatic cancer staging reports.
通过对照美国放射学会（RSNA）CT肿瘤学原发性胰腺肿块听写模板的要素，评估当前胰腺癌分期的自由格式放射学报告的完整性和清晰度。
本回顾性研究经我们机构审查委员会（IRB）批准。由两名胰腺癌影像专家之一对2008年8月至2010年12月期间生成的295份胰腺癌（PC）基线分期的自由格式计算机断层扫描（CT）报告进行评估。排除表明存在转移性疾病的报告。对照RSNA CT胰腺肿块听写模板的要素分析报告的完整性和清晰度。采用Fisher精确检验分析年份和放射科医生类型的差异。
分别有93.9%（277/295）、69.8%（206/295）和67.5%（199/295）的报告提供了原发病变位置、大小及对胆管（BD）的影响。47.5%（140/295）的报告使用了描述血管受累的标准术语。20.3%（60/295）的报告无法仅根据报告确定可切除性状态。36.9%（109/295）的报告需要复查CT图像以了解血管受累情况。胰腺癌影像专家的报告中使用标准化术语的比例更高，且无需复查图像就能理解血管受累情况的报告比例更高。
自由格式报告更可能使用模糊术语和/或需要复查实际图像以了解可切除性状态。使用标准化报告模板可能会提高胰腺癌分期报告的实用性。
