Proposal for a structured computed tomography report in the evaluation of pancreatic neoplasms based on expert opinions

Abstract 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.

摘要 研究目的：本研究旨在基于临床医师与外科医师的临床经验，构建用于胰腺导管腺癌（PDAC）系统评估的结构化计算机断层扫描（CT）报告模板。
材料与方法：本研究为前瞻性研究，为构建结构化腹部CT报告模板，我们向胰腺疾病领域专家发放了21项问卷。问卷内容涵盖胰腺导管腺癌的病灶位置、大小、对邻近结构及脉管的累及情况，以及转移情况。本研究采用李克特量表（Likert scale）确定需纳入报告模板的评估参数。
结果：来自9家机构的18名专家（12名外科医师、6名临床医师）完成了本次问卷。所有专家均认可，胰腺导管腺癌的CT报告需描述以下内容（若存在）：病灶强化程度、病灶直径与位置、胰管梗阻、胆道扩张、胰腺萎缩、肝转移、腹膜结节、腹水、淋巴结肿大及邻近结构侵犯。超过80%的专家认为，报告还需描述胰腺导管腺癌与周围脉管的毗邻关系。
结论：本研究基于胰腺导管腺癌诊疗专家的临床共识，构建了针对该类患者的CT报告模板。