Pancreatic cancer is an aggressive disease with a high mortality rate. It is the fourth most common cause of cancer-related death in the United States, and its incidence is increasing, explained Mahmoud Al-Hawary, MD, Associate Professor of Radiology, and Director, GI Radiology Service, Abdominal Radiology Division at the University of Michigan Comprehensive Cancer Center, and a member of the NCCN Pancreatic Adenocarcinoma Panel. Patients with complete and incomplete, or margin-positive, resection have progressively decreasing survival rates.
“A complete surgical resection with negative margins remains the main hope of improved survival and cure of tumor,” Dr. Al-Hawary noted. “Unfortunately, only 15% to 20% of patients have potentially resectable disease at presentation.” Accurate diagnosis and appropriate staging on cross-sectional imaging will lead to appropriate treatment arm allocation. Adequate imaging and reporting of pertinent findings will ensure that potentially resectable patients are offered curative surgery and patients at high risk of residual microscopic disease are excluded from surgery, sparing them from the side effects of complex surgeries.
A known limitation of the routine verbose reporting of cross-sectional imaging studies in complex pathologies such as pancreatic adenocarcinoma is the potential lack of completeness of the pertinent imaging findings or use of inappropriate terminology that is not mutually understandable by all members of the treating team. This limitation can be easily overcome by adapting a recently published template for reporting imaging findings that is incorporated in the updated NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Pancreatic Adenocarcinoma.
Al-Hawary M, Francis IR, Chari ST. Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the Society of Abdominal Radiology and the American Pancreatic Association. Gastroenterology 2014;146:291–304.