FDG-PET/CT The literature search did not identify any studies that examined the accuracy of FDG-PET/CT in the assessment of staging following neoadjuvant therapy. Reporting of Imaging Findings for Staging Pancreatic Cancer An emerging issue has been the reporting of findings for staging for pancreatic cancer by radiologists, namely, the usefulness of structured reporting or template reporting versus free-form (nonstructured) dictation. A single institution study had surgeons evaluate 48 structured and 72 nonstructured reports and found that information for surgical planning was readily accessible in 60% to 98% of structured reports, but only 32% to 54% in nonstructured reports [53]. In a retrospective study of 200 reports reviewed by radiologists, it was noted that in 20.3% of reports, resectability status could not be determined based on the report alone [54]. Although there are references that report on studies with design limitations, 16 well-designed or good-quality studies provide good evidence. Appropriateness Category Names and Definitions Relative Radiation Level Information Potential adverse health effects associated with radiation exposure are an important factor to consider when selecting the appropriate imaging procedure. Because there is a wide range of radiation exposures associated with different diagnostic procedures, a relative radiation level (RRL) indication has been included for each imaging examination. The RRLs are based on effective dose, which is a radiation dose quantity that is used to estimate population total radiation risk associated with an imaging procedure. Patients in the pediatric age group are at inherently higher risk from exposure, both because of organ sensitivity and longer life expectancy (relevant to the long latency that appears to accompany radiation exposure). For these reasons, the RRL dose estimate ranges for pediatric examinations are lower as compared to those specified for adults (see Table below). Additional
Staging of Pancreatic Ductal Adenocarcinoma. FDG-PET/CT The literature search did not identify any studies that examined the accuracy of FDG-PET/CT in the assessment of staging following neoadjuvant therapy. Reporting of Imaging Findings for Staging Pancreatic Cancer An emerging issue has been the reporting of findings for staging for pancreatic cancer by radiologists, namely, the usefulness of structured reporting or template reporting versus free-form (nonstructured) dictation. A single institution study had surgeons evaluate 48 structured and 72 nonstructured reports and found that information for surgical planning was readily accessible in 60% to 98% of structured reports, but only 32% to 54% in nonstructured reports [53]. In a retrospective study of 200 reports reviewed by radiologists, it was noted that in 20.3% of reports, resectability status could not be determined based on the report alone [54]. Although there are references that report on studies with design limitations, 16 well-designed or good-quality studies provide good evidence. Appropriateness Category Names and Definitions Relative Radiation Level Information Potential adverse health effects associated with radiation exposure are an important factor to consider when selecting the appropriate imaging procedure. Because there is a wide range of radiation exposures associated with different diagnostic procedures, a relative radiation level (RRL) indication has been included for each imaging examination. The RRLs are based on effective dose, which is a radiation dose quantity that is used to estimate population total radiation risk associated with an imaging procedure. Patients in the pediatric age group are at inherently higher risk from exposure, both because of organ sensitivity and longer life expectancy (relevant to the long latency that appears to accompany radiation exposure). For these reasons, the RRL dose estimate ranges for pediatric examinations are lower as compared to those specified for adults (see Table below). Additional