Pathak Priya, Hacker-Prietz Amy, Myneni Revathi, Zheng Lei, He Jin, Fishman Elliot K, Zaheer Atif, Narang Amol K
Department of Radiation Oncology, Johns Hopkins School of Medicine, Baltimore, USA.
Department of Radiation Oncology, Johns Hopkins Kimmel Cancer Center, Baltimore, USA.
Abdom Radiol (NY). 2025 May;50(5):2270-2279. doi: 10.1007/s00261-024-04646-5. Epub 2024 Nov 12.
To evaluate the feasibility of implementation of structured reporting in the setting of a high-volume pancreatic multidisciplinary clinic (PMDC) and to assess its value by comparing the accuracy of structured reports with expert imaging reviews.
A single institutional prospective cohort study was conducted during March 2022 to May 2024 to understand the feasibility of implementation of structured reporting (SR) for all patients who were seen in our weekly PMDC. Descriptive and regression analyses were performed to find an association between SR and difference in vascular involvement of the primary pancreatic tumor between the radiology report and expert radiologist review (gold standard) during PMDC.
Among 466 patients seen in the PMDC, 426 (91.4%) had reports generated prior to PMDC. Of this, 294 reports met the inclusion criteria. The usage of SR increased from 58.3% in Mar 2022 to 87.8% in June 2024. Majority of the reports that used SR (n = 226, 76.9%), were performed for initial staging (n = 197, 67.0%) of PC. The median years of experience of reading radiologists that used non-SR was 14 (IQR: 8-27) years, while it was 9 (IQR - 9-15) years for those who used SR (p = 0.030). Of note, as compared to the radiology report, increased vascular involvement was noted in PMDC review 62.5% (20 out of 32) of the time with non-SRs, whereas increased vascular involvement during PMDC review was noted in only 36.6% (48 out of 132) of the time with SRs. On multivariable analysis, using SR lowered the odds of increase in vascular involvement during PMDC review by 0.29 times (95CIs 0.11-0.79; p = 0.015).
SR is feasible and superior to the free-text reporting with respect to the accuracy of peri-pancreatic vascular involvement. While its use cannot replace the PMDC radiology review, it can nonetheless be an indispensable tool in clinical management, particularly in a non-PMDC setting.
评估在高流量胰腺多学科诊所（PMDC）环境中实施结构化报告的可行性，并通过比较结构化报告与专家影像评估的准确性来评估其价值。
于2022年3月至2024年5月进行了一项单机构前瞻性队列研究，以了解对我们每周PMDC中所有患者实施结构化报告（SR）的可行性。进行描述性和回归分析，以发现SR与PMDC期间放射学报告和专家放射科医生评估（金标准）之间原发性胰腺肿瘤血管受累差异之间的关联。
在PMDC就诊的466例患者中，426例（91.4%）在PMDC之前已有报告。其中，294份报告符合纳入标准。SR的使用率从2022年3月的58.3%增加到2024年6月的87.8%。大多数使用SR的报告（n = 226，76.9%）是为PC的初始分期（n = 197，67.0%）而进行的。使用非SR的阅片放射科医生的中位经验年限为14年（IQR：8 - 27），而使用SR的医生为9年（IQR - 9 - 15）（p = 0.030）。值得注意的是，与放射学报告相比，在非SR的情况下，PMDC评估中62.5%（32例中的20例）发现血管受累增加，而在SR的情况下，PMDC评估中仅36.6%（132例中的48例）发现血管受累增加。在多变量分析中，使用SR使PMDC评估期间血管受累增加的几率降低了0.29倍（95%CI 0.11 - 0.79；p = 0.015）。
就胰腺周围血管受累的准确性而言，SR是可行的，且优于自由文本报告。虽然其使用不能取代PMDC的放射学评估，但它仍然可以是临床管理中不可或缺的工具，特别是在非PMDC环境中。
