Exploring the agreement and variability in opinions among a group of Australian radiologists in using a structured CT scan report to assess pancreatic cancer: Does the International Consensus Guidelines on borderline resectable PDAC have to be revisited?

In a recent quality assurance substudy of a project that piloted a new radiological synoptic report for classifying pancreatic cancer resectability, 60 high quality pancreatic CT scans were sourced and individually presented to a group of six Australian radiologists to independently rate using the synoptic report. Data collection of the quality assurance substudy was completed, with ethics and governance approvals from the Alfred Health and Austin Health, and the data are ready to be used. It is quite a big dataset. There are 360 assessments (overall classification data points) – 60 scans reviewed by 6 radiologists. So far we have only got the basic inter- and intra- observer variability out. More detailed analyses will be done to explore questions such as why there is discrepancy and no majority agreement of assessments (eg, of resectability classification and other quality indicators) among the participating radiologists (as a group), and where are the main argument/controversies, in the context of knowing that some items (quality indicators) were more challenging for the radiologists to agree on (as they were not ‘that black and white”), but why some other items supposed to be easier to agree on but turned out to be hard to achieve agreement among the radiologist group. It will be important and useful to address these issues and identify the reasons for the poor concordance for relevant items, to further shed lights on the practicality and utility of the synoptic reporting template and the staging system. The student will have opportunities to work with a multidisciplinary team consisting of surgeons, radiologists, oncologists and health researchers; assist with coordinating with team members in data cleaning, management and analysis, and help prepare reports and manuscripts for publications.