| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr.,
Room H1307, Stanford, CA 94305.
2 Present address:Department of Radiology, Southern Illinois University 1520 S
Second St., #1103, Springfield, IL 62701.
3 Department of Radiology, Veterans Administration Palo Alto Health Care System,
3801 Miranda Ave., Palo Alto, CA 94304.
4 Department of General Surgery, Stanford University Medical Center, Stanford,
CA 94305.
OBJECTIVE. The objective of our study was to determine the negative predictive value of MDCT with curved planar reformations for detecting vascular invasion and predicting overall resectability in patients with pancreatic adenocarcinoma.
MATERIALS AND METHODS. Imaging findings related to vascular invasion and overall tumor resectability in 25 patients who underwent contrast-enhanced biphasic MDCT evaluation were correlated with actual vessel invasion and overall resectability determined at surgery and pathologic examination. The presence of vascular invasion was assessed in 110 major peripancreatic vessels in 22 patients who underwent resection.
RESULTS. On MDCT, 23 (92%) of 25 patients were deemed to have resectable pancreatic adenocarcinoma. The tumors in the remaining two (8%) were considered not resectable because of the presence of vascular invasion (which was confirmed in only one patient at surgery). Of those 23 patients deemed to be candidates for curative resection on the basis of MDCT results, 20 were found to have resectable adenocarcinoma at time of surgery, yielding a negative predictive value for MDCT of 87% (20/23 patients) for overall resectability. In the other three patients, adenocarcinoma was deemed to be unresectable because of small metastases to the liver (two patients) or to the peritoneum (one patient) discovered at surgery. For detection of vascular invasion, MDCT yielded a negative predictive value of 100% (108/108 vessels) with no false-negative findings and an accuracy of 99% (109/110 vessels) with 108 true-negative findings, one true-positive finding, and one false-positive finding.
CONCLUSION. Our preliminary data on MDCT show that the technique has excellent negative predictive value for vascular invasion and good negative predictive value for overall tumor resectability in patients with pancreatic adenocarcinoma, suggesting an improvement over previous results reported using single-detector CT. The problem of undetected micrometastases to the liver and peritoneum remains.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  K. Strobel, S. Heinrich, U. Bhure, J. Soyka, P. Veit-Haibach, B. C. Pestalozzi, P.-A. Clavien, and T. F. Hany Contrast-Enhanced 18F-FDG PET/CT: 1-Stop-Shop Imaging for Assessing the Resectability of Pancreatic Cancer J. Nucl. Med., September 1, 2008; 49(9): 1408 - 1413. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ogawa, S. Itoh, M. Ikeda, K. Suzuki, and S. Naganawa Intraductal Papillary Mucinous Neoplasm of the Pancreas: Assessment of the Likelihood of Invasiveness with Multisection CT Radiology, September 1, 2008; 248(3): 876 - 886. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Kim, J. M. Lee, J. Y. Lee, J. Y. Choi, S. H. Kim, J. K. Han, and B. I. Choi Accuracy of Preoperative T-Staging of Gallbladder Carcinoma Using MDCT Am. J. Roentgenol., January 1, 2008; 190(1): 74 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Zamboni, J. B. Kruskal, C. M. Vollmer, J. Baptista, M. P. Callery, and V. D. Raptopoulos Pancreatic Adenocarcinoma: Value of Multidetector CT Angiography in Preoperative Evaluation Radiology, December 1, 2007; 245(3): 770 - 778. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. G. Lall, T. J. Howard, A. Skandarajah, J. M. DeWitt, A. M. Aisen, and K. Sandrasegaran New Concepts in Staging and Treatment of Locally Advanced Pancreatic Head Cancer Am. J. Roentgenol., November 1, 2007; 189(5): 1044 - 1050. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Yanaga, K. Awai, Y. Nakayama, T. Nakaura, Y. Tamura, M. Hatemura, and Y. Yamashita Pancreas: Patient Body Weight tailored Contrast Material Injection Protocol versus Fixed Dose Protocol at Dynamic CT Radiology, November 1, 2007; 245(2): 475 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. D. Brennan, G. A. Zamboni, V. D. Raptopoulos, and J. B. Kruskal Comprehensive Preoperative Assessment of Pancreatic Adenocarcinoma with 64-Section Volumetric CT RadioGraphics, November 1, 2007; 27(6): 1653 - 1666. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Chen, P. T. Johnson, K. M. Horton, and E. K. Fishman Unsuspected Mesenteric Arterial Abnormality: Comparison of MDCT Axial Sections to Interactive 3D Rendering Am. J. Roentgenol., October 1, 2007; 189(4): 807 - 813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ichikawa, S. M. Erturk, H. Sou, H. Nakajima, T. Tsukamoto, U. Motosugi, and T. Araki MDCT of pancreatic adenocarcinoma: optimal imaging phases and multiplanar reformatted imaging. Am. J. Roentgenol., December 1, 2006; 187(6): 1513 - 1520. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Itoh, M. Ikeda, H. Satake, T. Ota, and T. Ishigaki The effect of patient age on contrast enhancement during CT of the pancreatobiliary region. Am. J. Roentgenol., August 1, 2006; 187(2): 505 - 510. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. T. Johnson and E. K. Fishman IV Contrast Selection for MDCT: Current Thoughts and Practice Am. J. Roentgenol., February 1, 2006; 186(2): 406 - 415. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. V. Sahani, R. Kadavigere, M. Blake, C. Fernandez-del Castillo, G. Y. Lauwers, and P. F. Hahn Intraductal Papillary Mucinous Neoplasm of Pancreas: Multi-Detector Row CT with 2D Curved Reformations--Correlation with MRCP Radiology, February 1, 2006; 238(2): 560 - 569. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. Ryan, C. Fernandez-del Castillo, C. G. Willett, W. R. Brugge, D. Sahani, and E. F. Brachtel Case 20-2005 - A 58-Year-Old Man with Locally Advanced Pancreatic Cancer N. Engl. J. Med., June 30, 2005; 352(26): 2734 - 2741. [Full Text] [PDF]
|
|
|
|
|
|
M. Imbriaco, A. J. Megibow, A. Ragozzino, R. Liuzzi, P. Mainenti, S. Bortone, L. Camera, and M. Salvatore Value of the Single-Phase Technique in MDCT Assessment of Pancreatic Tumors Am. J. Roentgenol., April 1, 2005; 184(4): 1111 - 1117. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kobayashi, T. Yamaguchi, T. Ishihara, T. Ohshima, I. Ohno, K. Seza, Y. Shirai, K. Sudo, A. Nakagawa, H. Tadenuma, et al. Assessment of Portal Vein Invasion in Pancreatic Cancer by Fusion 3-Dimensional Ultrasonography J. Ultrasound Med., March 1, 2005; 24(3): 363 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Lowy Does Size Matter Most? Reassessing Clinical Staging for Pancreatic Cancer Ann. Surg. Oncol., February 1, 2005; 12(2): 100 - 101. [Full Text] [PDF]
|
|
|
|
 |
|
 A. S Takhar, P. Palaniappan, R. Dhingsa, and D. N Lobo Recent developments in diagnosis of pancreatic cancer BMJ, September 18, 2004; 329(7467): 668 - 673. [Full Text] [PDF]
|
|
|
|
 |
|
 P Manoharan and M B Sheridan Neoplasms of the pancreas Imaging, September 1, 2004; 16(4): 323 - 337. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
