Implementation of structured radiology reporting and its associated accuracy in comparison to pancreas multi-disciplinary clinic expert radiology review

Purpose: 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.

Methods: 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.

Results: 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).

Conclusion: 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.