ACR Appropriateness Criteria® Staging of Pancreatic Ductal Adenocarcinoma.

Published

Journal Article

Pancreatic adenocarcinoma is associated with poor overall prognosis. Complete surgical resection is the only possible option for cure. As such, increasingly complex surgical techniques including sophisticated vascular reconstruction are being used. Continued advances in surgical techniques, in conjunction with use of combination systemic therapies, and radiation therapy have been suggested to improve outcomes. A key aspect to surgical success is reporting of pivotal findings beyond absence of distant metastases, such as tumor size, location, and degree of tumor involvement of specific vessels associated with potential perineural tumor spread. Multiphase contrast-enhanced multidetector CT and MRI are the imaging modalities of choice for pretreatment staging and presurgical determination of resectability. Imaging modalities such as endoscopic ultrasound and fluorine-18-2-fluoro-2-deoxy-D-glucose imaging with PET/CT are indicated for specific scenarios such as biopsy guidance and confirmation of distant metastases, respectively. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Full Text

Duke Authors

Cited Authors

  • Expert Panel on Gastrointestinal Imaging:, ; Qayyum, A; Tamm, EP; Kamel, IR; Allen, PJ; Arif-Tiwari, H; Chernyak, V; Gonda, TA; Grajo, JR; Hindman, NM; Horowitz, JM; Kaur, H; McNamara, MM; Noto, RB; Srivastava, PK; Lalani, T

Published Date

  • November 2017

Published In

Volume / Issue

  • 14 / 11S

Start / End Page

  • S560 - S569

PubMed ID

  • 29101993

Pubmed Central ID

  • 29101993

Electronic International Standard Serial Number (EISSN)

  • 1558-349X

International Standard Serial Number (ISSN)

  • 1546-1440

Digital Object Identifier (DOI)

  • 10.1016/j.jacr.2017.08.050

Language

  • eng