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Proposal for a structured computed tomography report in the evaluation of pancreatic neoplasms based on expert
Paulo Gustavo Maciel Lopes1, Carlos Alberto Matsumoto2, Edson José Lobo3
1MD, Radiologist in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), for the Laboratório DASA, and for the Laboratório CDB, São Paulo, SP, Brazil.
Objective:
To create a structured computed tomography (CT) report for the systematic evaluation of pancreatic ductal adenocarcinoma (PDAC), based on the opinions of clinicians and surgeons.
Materials And Methods:
This was a prospective study in which we applied a 21-item questionnaire to experts in pancreatic diseases in order to create a model of a structured abdominal CT report. The questionnaire addressed the location and size of PDACs, as well as their effects on adjacent structures and on the vasculature, together with metastases. We used a Likert scale to determine which of those parameters should be included in the model.
Results:
A total of 18 experts (12 surgeons and 6 clinicians) from 9 institutions completed the questionnaire. All of the experts agreed that the following (if present) should be described in the CT report on a PDAC: the degree of enhancement; the diameter and location of the lesion; pancreatic duct obstruction; biliary dilatation; pancreatic atrophy; liver metastases; peritoneal nodules; ascites; lymph node enlargement; and invasion of adjacent structures. More than 80% of the experts agreed that the report should also describe the relationship between the PDAC and the surrounding vasculature.
Conclusion:
We have developed a template for a CT report on patients with PDAC, based on the opinions of experts involved in the treatment of such patients.
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