학술논문

Postoperative surveillance of pancreatic ductal adenocarcinoma (PDAC) recurrence: practice pattern on standardized imaging and reporting from the society of abdominal radiology disease focus panel on PDAC.
Document Type
Academic Journal
Author
Chu LC; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. lindachu@jhmi.edu.; Wang ZJ; Department of Radiology, University of California San Francisco School of Medicine, San Francisco, CA, USA.; Kambadakone A; Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.; Hecht EM; Department of Radiology, Weill Cornell Medicine, New York, NY, USA.; He J; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Narang AK; Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Laheru DA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Arif-Tiwari H; Department of Medical Imaging, University of Arizona, Tuscon, AZ, USA.; Bhosale P; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Bolan CW; Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.; Brook OR; Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Bezuidenhout AF; Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Do RKG; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Galgano SJ; Department of Radiology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.; Goenka AH; Department of Radiology, Mayo Clinic, Rochester, MN, USA.; Guimaraes AR; Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR, USA.; Hough DM; Department of Radiology, Mayo Clinic, Rochester, MN, USA.; Kulkarni N; Department of Radiology, Medical College of Wisconsin & Froedtert Health, Milwaukee, WI, USA.; Le O; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Luk L; Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA.; Mannelli L; Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) SDN, Naples, Italy.; Rosenthal M; Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.; Sangster G; Department of Radiology, Ochsner Louisiana State University Health Shreveport, Shreveport, LA, USA.; Shah ZK; Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA.; Soloff EV; Department of Radiology, University of Washington, Seattle, WA, USA.; Tolat PP; Department of Radiology, Medical College of Wisconsin & Froedtert Health, Milwaukee, WI, USA.; Zins M; Department of Radiology, Hôpital Paris Saint Joseph, Paris, France.; Fishman EK; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Tamm EP; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Zaheer A; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Source
Publisher: Springer Country of Publication: United States NLM ID: 101674571 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2366-0058 (Electronic) NLM ISO Abbreviation: Abdom Radiol (NY) Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: Surgical resection is the only potential curative treatment for patients with pancreatic ductal adenocarcinoma (PDAC), but unfortunately most patients recur within 5 years of surgery. This article aims to assess the practice patterns across major academic institutions and develop consensus recommendations for postoperative imaging and interpretation in patients with PDAC.
Methods: The consensus recommendations for postoperative imaging surveillance following PDAC resection were developed using the Delphi method. Members of the Society of Abdominal Radiology (SAR) PDAC Disease Focused Panel (DFP) underwent three rounds of surveys followed by live webinar group discussions to develop consensus recommendations.
Results: Significant variations currently exist in the postoperative surveillance of PDAC, even among academic institutions. Differentiating common postoperative inflammatory and fibrotic changes from tumor recurrence remains a diagnostic challenge, and there is no reliable size threshold or growth rate of imaging findings that can provide differentiation. A new liver lesion or peritoneal nodule should be considered suspicious for tumor recurrence, and the imaging features should be interpreted in the appropriate clinical context (e.g., CA 19-9, clinical presentation, pathologic staging).
Conclusion: Postoperative imaging following PDAC resection is challenging to interpret due to the presence of confounding postoperative inflammatory changes. A standardized reporting template for locoregional findings and report impression may improve communication of relaying risk of recurrence with referring providers, which merits validation in future studies.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)