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Small pancreatic ductal carcinomas on triple-phase contrast-enhanced computed tomography: enhanced rims and the pathologic correlation

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Abstract

Purpose

To reveal the prevalence of small (≤ 20 mm) pancreatic ductal carcinomas with enhanced rims on triple-phase contrast-enhanced CT and correlate the CT images with the pathologic findings.

Materials and methods

Between April 2005 and April 2016, 45 patients underwent preoperative triple-phase contrast-enhanced CT and were pathologically diagnosed with small pancreatic ductal carcinoma. CT images were independently reviewed by two radiologists. The attenuation values of the enhanced rims, internal areas of the tumors, and surrounding pancreatic parenchyma were compared using Mann–Whitney U test. These areas were also correlated with the pathologic findings. Tumor invasiveness was compared between the tumors with and without enhanced rims using Fisher’s exact test.

Results

Enhanced rims were identified in 18 tumors (40%) by consensus between the two reviewers. The enhanced rims showed significantly higher mean attenuation values compared with the internal areas of the tumors (p < 0.001) and surrounding pancreatic parenchyma (p < 0.0086), and were most clearly visualized on equilibrium phase. The enhanced rims pathologically reflected the abundant fibrotic stroma with cancer cells in all tumors. There was no statistically significant difference in tumor invasiveness between the tumors with and without enhanced rims (anterior peripancreatic invasion, p = 0.137; posterior peripancreatic invasion, p = 0.758; portal vein invasion, p = 0.639; and lymph node metastases, p = 0.359).

Conclusions

Enhanced rims were detected at a rate of 40% in small pancreatic ductal carcinomas and could be an important finding for diagnosis on CT images, but did not suggest a less aggressive nature.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan

    Ryo Takaji, Yasunari Yamada, Shunro Matsumoto, Maki Kiyonaga, Norio Hongo & Hiromu Mori

  2. Department of Molecular Pathology, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan

    Naoki Hijiya

  3. Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan

    Masayuki Ohta & Masafumi Inomata

  4. Department of Radiology, Oita Red Cross Hospital, Oita, 870-0033, Japan

    Hajime Takaki

  5. Department of Surgery, Oita Red Cross Hospital, Oita, 870-0033, Japan

    Kengo Fukuzawa

  6. Department of Anatomic Pathology, Oita Red Cross Hospital, Oita, 870-0033, Japan

    Hirotoshi Yonemasu

Authors
  1. Ryo Takaji
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  2. Yasunari Yamada
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  3. Shunro Matsumoto
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  4. Maki Kiyonaga
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  5. Norio Hongo
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  6. Hiromu Mori
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  7. Naoki Hijiya
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  8. Masayuki Ohta
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  9. Masafumi Inomata
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  10. Hajime Takaki
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  11. Kengo Fukuzawa
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  12. Hirotoshi Yonemasu
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Corresponding author

Correspondence to Ryo Takaji.

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Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. IRB approval was obtained, and informed consent was waved for this retrospective study.

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Takaji, R., Yamada, Y., Matsumoto, S. et al. Small pancreatic ductal carcinomas on triple-phase contrast-enhanced computed tomography: enhanced rims and the pathologic correlation. Abdom Radiol 43, 3374–3380 (2018). https://doi.org/10.1007/s00261-018-1645-6

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  • DOI: https://doi.org/10.1007/s00261-018-1645-6

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