Sandra Huicochea Castellanos1, Giuseppe Corrias1,2, Gary A Ulaner1, Mark Dunphy1, Zheng Junting3, Marinela Capanu3, Vinod Balachandran4, Romina Grazia Giancipoli1,5, Serena Monti6, Lorenzo Mannelli7. 1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 2. Department of Radiology, Univerisità degli Studi di Cagliari, Cagliari, Italy. 3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 5. Department of Nuclear Medicine, Sapienza University of Rome, Rome, Italy. 6. IRCCS SDN, Naples, Italy. 7. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. mannellilorenzo@yahoo.it.
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.
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.
Authors: William R Hendee; Gary J Becker; James P Borgstede; Jennifer Bosma; William J Casarella; Beth A Erickson; C Douglas Maynard; James H Thrall; Paul E Wallner Journal: Radiology Date: 2010-08-24 Impact factor: 11.105
Authors: Laurie A Loevner; Adina I Sonners; Brian J Schulman; Kerstin Slawek; Randal S Weber; David I Rosenthal; Gul Moonis; Ara A Chalian Journal: AJNR Am J Neuroradiol Date: 2002 Nov-Dec Impact factor: 3.825
Authors: Linda C Chu; Zhen J Wang; Avinash Kambadakone; Elizabeth M Hecht; Jin He; Amol K Narang; Daniel A Laheru; Hina Arif-Tiwari; Priya Bhosale; Candice W Bolan; Olga R Brook; Abraham F Bezuidenhout; Richard K G Do; Samuel J Galgano; Ajit H Goenka; Alexander R Guimaraes; David M Hough; Naveen Kulkarni; Ott Le; Lyndon Luk; Lorenzo Mannelli; Michael Rosenthal; Guillermo Sangster; Zarine K Shah; Erik V Soloff; Parag P Tolat; Marc Zins; Elliot K Fishman; Eric P Tamm; Atif Zaheer Journal: Abdom Radiol (NY) Date: 2022-10-14