SCANPatient Clinical Trial


SCANPatient officially started on the 1st of July in 12 major hospitals involved in the management of pancreas adenocarcinoma in Victoria, South Australia and Queensland.

The SCANPatient trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000508673).



The SCANPatient Study is a Medical Research Future Fund (MRFF) supported randomised clinical trial (RCT), which compares the standard narrative style radiological report with an alternative standardised approach for reporting CT scans of the pancreas in suspected Pancreas Ductal Adenocarcinoma (PDAC). The aim is to determine whether this standardised synoptic report will result in more accurate diagnosis of localised PDAC to improve delivery of care

Specifically, this novel RCT will determine the role of implementing the synoptic report template embedded into routine care, to assess whether this approach increases institutional accuracy in defining surgical resectability (or operability) of non-metastatic PDAC.

The diagnostic algorithm incorporated into the synoptic template design will provide a uniform assessment of tumour operability, based on the recently published, international consensus criteria regarding tumour resectability (ref – Isaji 2018).

The SCANPatient study protocol has been reviewed and approved by Monash Health Human Research Ethics Committee (HREC, RES-22-0000-593A), under the National Mutual Acceptance scheme.

Participating Sites

Eligibility: Australian hospitals/health services that meet the following criteria will qualify to participate in this RCT:

  1. Hold a multidisciplinary team (MDT) meeting where PDAC cases are presented
  2. Are prepared to be randomised
  3. Manage on average 20-30 patients with PDAC annually (including but not limited to: use of chemotherapy, surgery, palliative care)
  4. Are not currently using a synoptic report

Recruitment: SCANPatient aims to recruit 40 hospitals/services across Australia. We are still seeking expressions of interest (EOI) from interested centres Australia-wide who wish to hear more and potentially join this study. Please complete the SCANPatient EOI Form.

Randomisation: Randomisation will occur in clusters of eight hospitals which will be randomised to use the synoptic report at six monthly intervals from commencement of the trial in the second half of 2023.


That the introduction of a synoptic, (structured) radiological template report (which includes an inherent diagnostic algorithm derived from the international consensus guidelines for borderline pancreatic cancer) will alter the rate of diagnosis of borderline (BR) PC from baseline.


SCANPatient is a stepped wedge RCT. Clusters of hospitals at each randomisation point will switch to the synoptic report, with other hospitals continuing standard of care until randomised to synoptic reporting.

The Pilot

The project began in August 2019 and the pilot ran from 15 October 2020 to 30 September 2021, trialling the synoptic template for use by radiologists reporting CT scans in two hospitals in Melbourne. The pilot found that the use of a synoptic radiological report for the reporting of pancreatic CT scans demonstrated a clinically significant improvement in the accuracy of assessment of localised pancreatic cancer. More details of the findings from the pilot can be found here: Synoptic CT scan reporting of pancreatic adenocarcinoma to align with international consensus guidelines on surgical resectability: a Victorian pilot – PubMed (


The trial governance framework consists of a Trial Management Committee (TMC) and its three subcommittees, namely, Trial Operations Subcommittee, Clinical Reference group and Consumer Reference Group, which were all formed at the outset of the grant. The TMC is made up of all chief investigators, associate investigators and a consumer representative. Its role is to oversee all aspects of the study (the operational elements of which is delegated to the Operations Subcommittee). 

The SCANPatient Clinical Reference Group takes responsibility for fine-tuning any of the details of the synoptic reporting and/or logistics from a radiological and surgical perspective as well as the implementation of these reports into day-to-day practice and the satisfaction survey. This reference group consists of radiologists, surgeons and medical oncologists.

The Consumer Reference Group considers the communications strategy from a consumer perspective. The group has helped develop an appropriate ethics and governance framework and, depending on results, will consider communication around how best to mainstream practices across the country. The members of the reference group were recruited from national PC consumer advocacy groups, including PanKind (The Australian Pancreatic Cancer Foundation) and the PANCARE Foundation (a charity committed to improving outcomes for those affected by upper gastrointestinal cancers), who are both partners on the MRFF grant, as well as the Australasian Gastro-Intestinal Trials Group (AGITG) and the Cancer Research Program’s Consumer Advisory Group (CAG).


by Helen Madgwick

Geoff was diagnosed with pancreatic cancer in 2019. After extensive treatment followed by a period of remission, he elected not to have further treatment when it recurred. He died in April 2022. Geoff’s wife and carer Helen was with him during palliative care and is chair of the consumer reference group for the SCANPatient study (pancreatic resectibility project).

It was just palliative care and managing pain [towards the end]. We had home hospice on board and they were wonderful. But early this year it was obvious that what we could do at home wasn’t enough. I called the ambulance twice in one day when the pain was unbearable and the second time they came, they said, ‘You need to be in hospital’. Geoff was in hospital for about a week before he got a palliative care bed. The medical director estimated he might not have more than a week, but he ended up being there for 37 days. That was so hard and when he became unresponsive for the week before he died, I still went every day. When they rang me to say he’d gone, it was the biggest relief, honestly. I didn’t wish him dead, but I couldn’t have wished for him to keep on living the way he was.

The palliative care nurses were angels on earth. They were just so kind and caring and gentle. I couldn’t have wished for better care. I had family and friends bolstering me up all the time, and my lovely neighbours. I always had someone I could turn to when I needed support but, after spending every afternoon at the hospice, by the time I came home and had something to eat I often just needed quiet time to switch off. But I never felt as if I was totally doing it on my own. Even the local chemist was a great backstop, and also the GP.

I was invited to be involved in a pancreatic cancer synoptic reporting research project (SCANPatient). The purpose of the synoptic reporting on CT scans is to obtain standardised reporting from the radiologists. I have always said, never dreaming it would be at this level of involvement, if I could help with raising awareness of pancreatic cancer I would, because the statistics for the disease are not very encouraging and haven’t improved very much in years

At first I was very hesitant – what could I contribute? I sought guidance from several knowledgeable sources who all assured me that the doctors and research professors need input from people who have had first-hand experience either as a patient or a as carer. The people working in universities don’t come into contact with the patients or their carers and they need input from people who have dealt with the illness. 

I wish it had been the standard when Geoff was first diagnosed because you’ve got the comfort of knowing that every aspect of that CT scan has been thoroughly analysed and reported on consistently and comprehensively.

Some of the things that have made an impression on me is how highly regarded Geoff was by so many people. Everybody at his bowl’s club, our friends and neighbours, have said how much they loved and respected him, and although you know your kids love you, I was so overwhelmed with the outpouring of high regard they had for their father. 

Neither of us were very effusive. We weren’t very demonstrative as such. The last words he said to me was on the day before he became unresponsive. He’d rung me just before lunchtime, and I was at the supermarket. I saw his name come up on my phone and, as he never rang unless he absolutely had to, I thought, this is unusual. He said, ‘Are you coming in today?’ There was a sense of urgency the way he spoke. I’m thinking all the way there, ‘what’s going on?’ I went in and I said hello and I sat down and I took hold of his hand. And he just said to me, ‘I wanted to tell you how much I love you.’ He never said another word. That was his last word.

(Note: Helen Madgwick serves as the Chair of the SCANPatient Consumer Reference Group. This article first appeared as a post on the website of the Victorian Integrated Cancer Services (VICS) on December 22, 2022. The following is the web link to the original article:  We thank the author for allowing us to use the content on the SCANPatient site.)  


In addition to addressing the key objectives of the SCANPatient main study, researchers are also developing a number of related sub-studies which intend to provide further evidence of the reliability, consistency and utility of the synoptic reporting tool and approach.


The inter- and intra-observer variability sub-study introduces a quality assurance (QA) component to the original pilot study that led to the SCANPatient trial. The pilot study tested the feasibility of synoptic reporting at two hospitals in Victoria.

The QA component has two major aims: to test the inter-observer variability of CT scan reporting using the synoptic radiology report template and to assess the intra-observer variability of scan reporting. Clinicians involved in the pilot trial will be reporting on scans previously seen, and thus there is an opportunity to draw a comparison to assess intra-observer results.

The QA component involves 60 eligible CT scans that will be identified from the pilot and an existing Pancreatic Cancer Image Biobank created by the UGICR. Six radiologists from hospitals that were involved in the pilot will be provided access to the deidentified CT scans on a secure platform (Monash University XNAT). Each radiologist will then independently assess the CT scans using the REDCAP radiological synoptic report. The responses for each radiologist will be analysed to examine reproducibility and reliability.

The project has obtained the necessary ethics and governance approvals from both Alfred Health and Austin Health, from which the internal 60 scans will be collated. The next steps involve the creation of the secure Monash University platform to upload the de-identified CT scans for the participating radiologists to report.

The concept of another proposed radiological sub-study is to review prose CT reports prior to introduction of synoptic report to analyse how many of the 63 synoptic data points are addressed in the free-form prose report.


Approximately 20%-25% of PDAC patients have either resectable or borderline resectable disease. Standard of care for resectable stage disease is upfront surgery, and while increasing numbers of borderline resectable patients are being treated with neoadjuvant therapy prior to surgery, many still do proceed to upfront resection. Notably, a large number of upfront resections are microscopically incomplete (R1), and one quarter of patients will develop disease recurrence within 6 months. R0 resection rate is an important prognostic factor, diminishing local and distant recurrence rates, hence improving survival and is the goal for pancreatic cancer surgery.

Despite being considered resectable preoperatively, many patients return an R1 margin after resection, and this is likely more commonly the case for borderline resectable disease where the extent of disease at presentation is more advanced.

Measures to improve local control and achieve R0 margins include preoperative radiotherapy, however this is uncommonly delivered in Australia.

An understanding of the true number of R1 positive margins following resection for resectable and for borderline resectable pancreas cancer is lacking in Australia. As the SCANPatient trial will routinely be collecting pathology reports for resection specimens, and systematically documenting resectability status on imaging preoperatively, we are ideally situated to provide answers regarding true margin positive rates in Australia across up to 40 sites nationwide.

Further subtle correlations to stratify peritumoural inflammatory change on CT imaging (in distinction from tumour infiltration) may also be possible from analysis of this large dataset.


Artificial Intelligence (AI) is a growing field within medicine and has the potential to greatly influence the outcomes of patients with pancreatic cancer, given its ability to integrate large amounts of data to identify the relationships between variables and answer clinical questions. The role of AI in pancreatic cancer has been explored in the preoperative, intraoperative and postoperative space.

Of particular interest for SCANPatient clinical trial, AI tools have been developed to classify pancreatic tumours using CT radiological features. In this substudy, we will conduct a review of the literature to explore and summarise the existing AI tools using CT images to classify pancreatic tumours and the algorithms developed. The barriers and limitations to the application of AI in clinical practice and how these limitations may be overcome will also be discussed.

Compiling and understanding the current AI tools in pancreas CT scans will pave the way to apply these advanced technologies to the SCANPatient trial.


Pancreatic cancer is a challenging and often aggressive disease that requires careful consideration when determining the most appropriate treatment strategies for affected patients. In this regard, the findings from CT scans play a pivotal role in the decision-making process of surgeons and oncologists in determining the optimal treatment options for pancreatic cancer patients.

 In routine practice, radiologists provide narrative CT reports detailing various anatomical aspects of suspected pancreatic tumours, including their characteristics, extent of vascular involvement, the degree of local spread, as well as the presence of nodal and distant metastases.

The objective of the proposed study is to evaluate the completeness of the current CT reporting of pancreatic ductal adenocarcinoma (PDAC) in Australia. Specifically, the study aims to determine whether standard of care CT reports sufficiently address the 63 distinct fields outlined in a structured synoptic report form, which was developed and tested in two Victorian hospitals. These fields have been derived from the International Consensus guidelines on the surgical resectability of PDAC.

This study seeks to verify whether the current CT reporting approach for PDAC cases in Australia aligns with the International Consensus guidelines and encompasses all the relevant information needed for accurate assessment of surgical resectability and determination of the most suitable course of treatment.

We sincerely invite suggestions for more sub-study ideas and proposals. You are welcome to email us via, or using the contact form below.    

SCANPatient Information session

The SCANPatient Central Team are running live online information sessions to help interested sites to better understand the workflow of the trial. During these sessions, we cover the following:

  • Overview of the project
  • Ethics approval & Governance processes
  • Site principal investigator (PI) and site liaison roles
  • Workflow
  • Funding support for sites
  • FAQs

You can download the slides discussed during the video at this link

Media & News


If you would like to know more about SCANPatient, please contact the SCANPatient Coordinating Centre via the form below or via email,


Frequently Asked Questions

What is SCANPatient?

The Synoptic reporting of CT scans assessing cancer of the pancreas (SCANPatient) study is a stepped-wedge randomised clinical trial, which will compare the usual standard radiological approach used in most centres around Australia to the new synoptic report, to determine if this approach results in a more accurate diagnosis of localised pancreatic cancer.

Why is this project being conducted?

The Pancreatic Cancer Resectability Pilot Project, found the use of a synoptic radiological report, for the reporting of pancreatic CT scans demonstrated a clinically significant improvement in the accuracy of assessment of localised pancreatic cancer.

The SCANPatient Study will formally test this approach nationally from 2022-2027.


How can a hospital express interest in participating?

SCANPatient is seeking expressions of interest (EOI) from interested centres Australia-wide who wish to hear more and potentially join this study. Please complete the SCANPatient EOI Form.

Who are the participating sites with governance approval?

The multi-site ethics application for the SCANPatient has been approved by Monash Health HREC for 37 sites in Australia, including two in ACT, seven in NSW, five in QLD, four in SA, two in TAS, fourteen in VIC and three in WA.

The following institutions have been granted governance approval to participate in the study.

First Batch:

  1. Northern Health (VIC)
  2. St. Vincent’s Hospital  (VIC)
  3. Peninsula Private Hospital (VIC)
  4. Monash Health (VIC)
  5. Cabrini Malvern (VIC)
  6. Frankston Hospital (VIC)
  7. Box Hill Hospital (VIC)
  8. Freemason Hospital (VIC)
  9. Richmond Hospital (VIC)
  10. Princess Alexandra Hospital (QLD)
  11. The Queen Elizabeth Hospital (SA)
  12. Royal Adelaide Hospital (SA)

Second Batch:

  1. Royal Hobart Hospital (TAS)
  2. Fiona Stanley Hospital (WA)
  3. Peter MacCallum Cancer Centre (VIC)
  4. Royal Melbourne Hospital (VIC)
  5. Royal Brisbane and Women’s Hospital (QLD)
  6. The Prince Charles Hospital (QLD)
  7. Bankstown-Lidcombe Hospital (NSW)
  8. Sunshine Coast University Hospital (QLD)
  9. Royal Perth Hospital (WA)
  10. Royal North Shore Hospital (NSW)

Third Batch:

  1. Concord Hospital (NSW)
  2. Townsville University Hospital (QLD)
  3. Mater Hospital (QLD)
  4. Prince of Wales Hospital (NSW)
  5. Royal Prince Alfred Hospital (NSW)
  6. John Hunter Hospital (NSW)
  7. The Wesley Hospital (QLD)
  8. Westmead Hospital (NSW)
  9. Canberra Hospital (ACT)
  10. Wollongong Hospital (NSW)
  11. Western Health (VIC)

How is SCANPatient being funded?

SCANPatient is funded by a Medical Research Future Fund (MRFF) Rare Cancers, Rare Diseases and Unmet Need Grant.

Who is coordinating SCANPatient?

SCANPatient is led by the Coordinating Principal Investigator A/Prof Charles Pilgrim.

The SCANPatient Coordinating Centre is part of the Cancer Research Program (CRP) within the School of Public Health and Preventive Medicine at Monash University.

The development and operation of SCANPatient will be overseen by a Trial Management Committee and Trial Operations Sub-Committee.

Who are the grant investigators?

  • Chief Investigators
    • A/Prof Charles Pilgrim
    • A/Prof Samantha Ellis
    • A/Prof David Cavallucci
    • Dr Mark D Goodwin
    • Prof Neil Merrett
    • Dr Jessica Yang
    • Dr Lorraine Chantrill
    • Prof John Zalcberg
    • Dr Liane Ioannou
    • A/Prof Jessica Kasza


Is SCANPatient registered on the Australian New Zealand Clinical Trials Registry (ANZCTR)?

Yes. The registration number is ACTRN12623000508673.  More information about the trial can be found through the following web address: