Skip to main content

Advertisement

Log in

Resectability of pancreatic adenocarcinoma: assessment using multidetector-row computed tomography with multiplanar reformations

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

The purpose was to assess capabilities of the multidetector-row computed tomography (MDCT) with multiplanar reformations (MPR) for predicting of pancreatic adenocarcinoma resectability. Forty-eight patients deemed to have resectable pancreatic adenocarcinoma after assessment using biphasic MDCT with MPRs underwent surgery for potential tumor resection. Imaging findings were retrospectively evaluated for tumor resectability and correlated with surgical and pathological results. Curative resection was successful in 44 of 48 patients. The positive predictive value for tumor resectability made up 91% with four false-negative results. The reasons for unresectability were venous involvement (1), small liver metastases (2) and peritoneal involvement associated with small metastases to lymph nodes (1). MDCT yielded a negative predictive value of 99% (286 of 288 vessels) for detection of vascular invasion. Our results indicate the tendency towards improved prediction of resectability using MDCT compared to single-detector CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  1. Freeny PC, Marks WM, Ryan JA, et al. (1988) Pancreatic ductal adenacarcinoma: diagnosis and staging with dynamic CT. Radiology 166:125–133

    PubMed  CAS  Google Scholar 

  2. Bluemke DA, Cameron JL, Hruban RH, et al. (1995) Potentially resectable pancreatic adenocarcinoma: spiral CT assessment with surgical and pathologic correlation. Radiology 197:381–385

    PubMed  CAS  Google Scholar 

  3. Valls C, Andia E, Sanchez A, et al. (2002) Dual-phase helical CT of pancreatic adenocarcinomaá: assessment of resectability before surgery. AJR 178:821–826

    PubMed  Google Scholar 

  4. Diehl SJ, Lehmann KJ, Sadick M, et al. (1998) Pancreatic cancer: value of dual-phase helical CT in assessing resectability. Radiology 206(2):373–378

    PubMed  CAS  Google Scholar 

  5. Kalpa MK, Maher MM, Sahani DV, et al. (2002) Current status of imaging in pancreatic diseases. J Comput Assist Tomogr 26:661–675

    Article  Google Scholar 

  6. Bipat S, Phoa SS, van Delden OM, et al. (2005) Ultrasonography, computed tomography and magnetic resonance imaging for diagnosis and determining resectability of pancreatic adenocarcinoma: a metaanalysis. J Comput Assist Tomogr 29(4):438–445

    Article  PubMed  Google Scholar 

  7. Baum U, Lell M, Nomayr A, et al. (1999) Multiplanar spiral CT in the diagnosis of pancreatic tumors. Radiologe 39a:958–964

    Article  Google Scholar 

  8. Fishman EK, Horton KM, Urban BA (2000) Multidetector CT angiography in the evaluation of pancreatic carcinoma: preliminary observations. J Comput Assist Tomogr 24:849–853

    Article  PubMed  CAS  Google Scholar 

  9. Fenchel S, Boll DT, Fleiter TR, et al. (2003) Multislice helical CT of the pancreas and spleen. Eur J Radiol 45 Suppl 1:59–72

    Article  Google Scholar 

  10. Nino-Murcia M, Tamm EP, Charnsangavej C, et al. (2003) Multidetector-row helical CT and advanced postprocessing techniques for evaluation of pancreatic neoplasms. Abdom Imaging 28:366–377

    Article  PubMed  CAS  Google Scholar 

  11. Lu DSK, Reber HA, Krasny RM, et al. (1997) Local staging of pancreatic cancer: criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT. AJR 168:1439–1443

    PubMed  CAS  Google Scholar 

  12. Nakayama Y, Yamashita Y, Kadota M, et al. (2001) Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results. J Comput Assisst Tomogr 25:337–342

    Article  CAS  Google Scholar 

  13. Horton MK, Fishman EK (2002) Multidetector CT angiography of pancreatic carcinoma: part 1, evaluation of arterial involvement. AJR 178:827–831

    PubMed  Google Scholar 

  14. Jain S, Sacchi M, Vrachnos P, et al. (2005) Carcinoma of the pancreas with portal vein involvement—our experience with a modified technique of resection. Hepatogastroenterol 52(65):1596–600

    Google Scholar 

  15. Li B, Chen FZ, Ge XH, et al. (2004) Pancreatoduodenectomy with vascuar reconstruction in treating carcinoma of the pancreatic head. Hepatobiliary Dis Int 3(4):612–615

    Google Scholar 

  16. Shoup M, Winston C, Brennan MF, et al. (2004) Is there a role for staging laparoscopy in patients with locally advanced unresectable pancreatic adenocarcinoma? J Gastrointest Surg 8(8):1068–1071

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

I would like to thank the German Academic Exchange Service, as well as colleagues from University Hospital, Erlangen–Nuremberg, for the possibility to carry out this investigation. E. Manak.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elena Manak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Manak, E., Merkel, S., Klein, P. et al. Resectability of pancreatic adenocarcinoma: assessment using multidetector-row computed tomography with multiplanar reformations. Abdom Imaging 34, 75–80 (2009). https://doi.org/10.1007/s00261-007-9285-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-007-9285-2

Keywords

Navigation