A new trial led by Peninsula Health gastrointestinal surgeon Associate Professor Charles Pilgrim is seeking to improve the accuracy of diagnosis and reporting of computed tomography (CT) scans for patients with pancreatic cancer.
Pancreatic cancer is the eighth most commonly diagnosed cancer in Australia. The disease affects the pancreas which is a vital organ in the body that is responsible for digestion and blood sugar regulation. Often, there are no symptoms of pancreatic cancer until it is advanced and has spread to other organs.
People with pancreatic cancer undergo a CT scan to outline the extent of their disease and assist with the development of a treatment plan that is right for them.
“There are different treatment plans based on what classification the pancreatic cancer is labelled,” says Associate Professor Pilgrim. “The classification is determined from the CT scan, so it is very important to get it right.”
Peninsula Health is one of 33 health services across Australia participating in the ScanPatient Clinical Trial, and has begun using a structured radiological reporting method to more effectively manage the CT scan process for patients with pancreatic cancer.
“Clinical trials support advancement of medical knowledge, improve patient outcomes, drive innovation and contribute to our medical evidence base,” says Associate Professor Peter Evans, Clinical Director of Surgery at Peninsula Health.
“The management of patients with pancreatic cancer depends on the local extent of their cancer and whether it has spread,” explains Associate Professor Evans.
“These factors determine whether a patient goes down a potentially curative surgical pathway, or a palliative pathway with the aim of cancer control and maximisation of quality and quantity of life.”
“Understanding a patient’s general health and having the support of accurate imaging are the most important factors informing this decision,” adds Associate Professor Evans.
It is expected the new reporting method will have a direct impact on the care we are able to provide to patients with pancreatic cancer.
“By introducing a synoptic report, we’ll see a more structured, formalised assessment of each scan and hopefully improve the cancer classification range, therefore improving care,” shares Associate Professor Pilgrim.
“As part of the report, the radiologist has to address all 63 points for it to be synoptic, whereas prior to the development of the report, the radiologist would look at the scan and they would dictate essentially free form,” explains Associate. Professor Pilgrim.
The report provides a more complete and thorough analysis to make sure everything is addressed.
“This ensures all the relevant negatives are included, because if something isn’t present, it’s just as equally important that the radiologist says this isn’t present,” Associate Professor Pilgrim adds.
“Prior to using this synoptic report, there was the chance that we were missing or overcalling pancreatic cancer classification because of that inconsistency and potentially incomplete reporting.”
Determining whether a patient should: one, receive chemotherapy before surgery; two, have surgery first and then chemotherapy; or three, have chemotherapy alone without surgery, is a problem facing doctors when they do not have adequate information from the scans.
“If you receive a good quality CT scan, you can interpret whether the tumour is free of blood vessels or whether it’s involving them,” explains Associate Professor Pilgrim.
“By doing so, you can determine whether the patient’s tumour is resectable or locally advanced and unresectable, or whether it’s in an intermediate group (called borderline resectable).”
The trial began accepting patient data in 2023 and has now received data from more than 1000 patient cases, which will be prepared for preliminary analysis at the end of the trial in two years’ time.
“What we can see so far is that Frankston Hospital sees more than the minimum number,” shares Associate Professor Pilgrim.
“We’ve already captured data from more than 30 patients with pancreatic cancer from Frankston Hospital and those are just the patients who are treated and are discussed at our multi-disciplinary meeting.”
It is hoped that the trial will improve our health system and allow for better analysis, diagnosis and treatment of pancreatic cancer.
“We’re doing a better job and being more thorough in our assessment and classification, which therefore speaks to optimising treatment plans,” says Associate Professor Pilgrim.
“It’s really about ensuring that we are actively stratifying, classifying patients with the intention of optimising their care. It’s a credit to Frankston Hospital, proving that we are a big player in pancreatic cancer nationally and it’s very important that we’re committed to this sort of research.”
This research is another example of how Peninsula Health clinicians are providing safe, personal, effective and connected care to every person, every time.
“Participating in trials such as this ensures that Peninsula Health remains at the leading edge of healthcare delivery and helps us to recruit the best staff members who can work collaboratively to provide the best possible patient care – Peninsula Care,” concludes Associate Professor Evans.