Detection of recurrent pancreatic cancer: value of second-opinion interpretations of cross-sectional images by subspecialized radiologists

Sandra Huicochea Castellanos, Giuseppe Corrias, Gary A. Ulaner, Mark Dunphy, Zheng Junting, Marinela Capanu, Vinod Balachandran, Romina Grazia Giancipoli, Serena Monti, Lorenzo Mannelli

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the value of second-opinion interpretation of cross-sectional images by subspecialized radiologists to diagnose recurrent pancreatic cancer after surgery. Methods: The IRB approved and issued a waiver of informed consent for this retrospective study. Initial and second-opinion interpretations of 69 consecutive submitted MRI or CT follow-up after pancreatic cancer resection between January 1, 2009 and December 31, 2013 were evaluated by one oncologic imaging radiologist, who was blinded to patient’s clinical details and histopathologic data. The reviewer was asked to classify each interpretation in reference of the diagnosis of PDAC recurrence. It was also recorded if the radiologic interpretation recommended additional imaging studies to confirm recurrence. The diagnosis of recurrence was determined by pathology when available, otherwise by imaging follow-up, clinical, or laboratory assessments. Cohen’s kappa statistic was used to assess agreement between initial and second-opinion interpretations. The differences between the initial and second-opinion interpretations were examined using McNemar test or Bowker’s test of symmetry. Results: Disagreement on recurrence between the initial report and the second-opinion interpretation was observed in 32% of cases (22/69; k = 0.44). Second-opinion interpretations had a higher sensitivity and a higher specificity on recurrence compared to the initial interpretations (0.93 vs. 0.75 and 0.90 vs. 0.68, respectively), and the difference in specificity was significant (p = 0.016). Additional imaging studies were recommended more frequently in the initial interpretation (22% vs. 6%, p = 0.006). Conclusions: Our study shows the second-opinion interpretation by subspecialized radiologists improves the detection of pancreatic cancer recurrence after surgical resection.

Original languageEnglish
JournalAbdominal Radiology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Pancreatic Neoplasms
Referral and Consultation
Recurrence
Research Ethics Committees
Radiologists
Informed Consent
Retrospective Studies
Pathology

Keywords

  • CT
  • MRI
  • Pancreatic ductal adenocarcinoma
  • Recurrence
  • Second-opinion report

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Detection of recurrent pancreatic cancer : value of second-opinion interpretations of cross-sectional images by subspecialized radiologists. / Castellanos, Sandra Huicochea; Corrias, Giuseppe; Ulaner, Gary A.; Dunphy, Mark; Junting, Zheng; Capanu, Marinela; Balachandran, Vinod; Giancipoli, Romina Grazia; Monti, Serena; Mannelli, Lorenzo.

In: Abdominal Radiology, 01.01.2018.

Research output: Contribution to journalArticle

Castellanos, Sandra Huicochea ; Corrias, Giuseppe ; Ulaner, Gary A. ; Dunphy, Mark ; Junting, Zheng ; Capanu, Marinela ; Balachandran, Vinod ; Giancipoli, Romina Grazia ; Monti, Serena ; Mannelli, Lorenzo. / Detection of recurrent pancreatic cancer : value of second-opinion interpretations of cross-sectional images by subspecialized radiologists. In: Abdominal Radiology. 2018.
@article{9f1fe1a6675f449b9984f4234383e916,
title = "Detection of recurrent pancreatic cancer: value of second-opinion interpretations of cross-sectional images by subspecialized radiologists",
abstract = "Purpose: To investigate the value of second-opinion interpretation of cross-sectional images by subspecialized radiologists to diagnose recurrent pancreatic cancer after surgery. Methods: The IRB approved and issued a waiver of informed consent for this retrospective study. Initial and second-opinion interpretations of 69 consecutive submitted MRI or CT follow-up after pancreatic cancer resection between January 1, 2009 and December 31, 2013 were evaluated by one oncologic imaging radiologist, who was blinded to patient’s clinical details and histopathologic data. The reviewer was asked to classify each interpretation in reference of the diagnosis of PDAC recurrence. It was also recorded if the radiologic interpretation recommended additional imaging studies to confirm recurrence. The diagnosis of recurrence was determined by pathology when available, otherwise by imaging follow-up, clinical, or laboratory assessments. Cohen’s kappa statistic was used to assess agreement between initial and second-opinion interpretations. The differences between the initial and second-opinion interpretations were examined using McNemar test or Bowker’s test of symmetry. Results: Disagreement on recurrence between the initial report and the second-opinion interpretation was observed in 32{\%} of cases (22/69; k = 0.44). Second-opinion interpretations had a higher sensitivity and a higher specificity on recurrence compared to the initial interpretations (0.93 vs. 0.75 and 0.90 vs. 0.68, respectively), and the difference in specificity was significant (p = 0.016). Additional imaging studies were recommended more frequently in the initial interpretation (22{\%} vs. 6{\%}, p = 0.006). Conclusions: Our study shows the second-opinion interpretation by subspecialized radiologists improves the detection of pancreatic cancer recurrence after surgical resection.",
keywords = "CT, MRI, Pancreatic ductal adenocarcinoma, Recurrence, Second-opinion report",
author = "Castellanos, {Sandra Huicochea} and Giuseppe Corrias and Ulaner, {Gary A.} and Mark Dunphy and Zheng Junting and Marinela Capanu and Vinod Balachandran and Giancipoli, {Romina Grazia} and Serena Monti and Lorenzo Mannelli",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s00261-018-1765-z",
language = "English",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Detection of recurrent pancreatic cancer

T2 - value of second-opinion interpretations of cross-sectional images by subspecialized radiologists

AU - Castellanos, Sandra Huicochea

AU - Corrias, Giuseppe

AU - Ulaner, Gary A.

AU - Dunphy, Mark

AU - Junting, Zheng

AU - Capanu, Marinela

AU - Balachandran, Vinod

AU - Giancipoli, Romina Grazia

AU - Monti, Serena

AU - Mannelli, Lorenzo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: To investigate the value of second-opinion interpretation of cross-sectional images by subspecialized radiologists to diagnose recurrent pancreatic cancer after surgery. Methods: The IRB approved and issued a waiver of informed consent for this retrospective study. Initial and second-opinion interpretations of 69 consecutive submitted MRI or CT follow-up after pancreatic cancer resection between January 1, 2009 and December 31, 2013 were evaluated by one oncologic imaging radiologist, who was blinded to patient’s clinical details and histopathologic data. The reviewer was asked to classify each interpretation in reference of the diagnosis of PDAC recurrence. It was also recorded if the radiologic interpretation recommended additional imaging studies to confirm recurrence. The diagnosis of recurrence was determined by pathology when available, otherwise by imaging follow-up, clinical, or laboratory assessments. Cohen’s kappa statistic was used to assess agreement between initial and second-opinion interpretations. The differences between the initial and second-opinion interpretations were examined using McNemar test or Bowker’s test of symmetry. Results: Disagreement on recurrence between the initial report and the second-opinion interpretation was observed in 32% of cases (22/69; k = 0.44). Second-opinion interpretations had a higher sensitivity and a higher specificity on recurrence compared to the initial interpretations (0.93 vs. 0.75 and 0.90 vs. 0.68, respectively), and the difference in specificity was significant (p = 0.016). Additional imaging studies were recommended more frequently in the initial interpretation (22% vs. 6%, p = 0.006). Conclusions: Our study shows the second-opinion interpretation by subspecialized radiologists improves the detection of pancreatic cancer recurrence after surgical resection.

AB - Purpose: To investigate the value of second-opinion interpretation of cross-sectional images by subspecialized radiologists to diagnose recurrent pancreatic cancer after surgery. Methods: The IRB approved and issued a waiver of informed consent for this retrospective study. Initial and second-opinion interpretations of 69 consecutive submitted MRI or CT follow-up after pancreatic cancer resection between January 1, 2009 and December 31, 2013 were evaluated by one oncologic imaging radiologist, who was blinded to patient’s clinical details and histopathologic data. The reviewer was asked to classify each interpretation in reference of the diagnosis of PDAC recurrence. It was also recorded if the radiologic interpretation recommended additional imaging studies to confirm recurrence. The diagnosis of recurrence was determined by pathology when available, otherwise by imaging follow-up, clinical, or laboratory assessments. Cohen’s kappa statistic was used to assess agreement between initial and second-opinion interpretations. The differences between the initial and second-opinion interpretations were examined using McNemar test or Bowker’s test of symmetry. Results: Disagreement on recurrence between the initial report and the second-opinion interpretation was observed in 32% of cases (22/69; k = 0.44). Second-opinion interpretations had a higher sensitivity and a higher specificity on recurrence compared to the initial interpretations (0.93 vs. 0.75 and 0.90 vs. 0.68, respectively), and the difference in specificity was significant (p = 0.016). Additional imaging studies were recommended more frequently in the initial interpretation (22% vs. 6%, p = 0.006). Conclusions: Our study shows the second-opinion interpretation by subspecialized radiologists improves the detection of pancreatic cancer recurrence after surgical resection.

KW - CT

KW - MRI

KW - Pancreatic ductal adenocarcinoma

KW - Recurrence

KW - Second-opinion report

UR - http://www.scopus.com/inward/record.url?scp=85053826739&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053826739&partnerID=8YFLogxK

U2 - 10.1007/s00261-018-1765-z

DO - 10.1007/s00261-018-1765-z

M3 - Article

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

ER -