Pancreatic head cancer: accuracy of CT in determination of resectability
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Pancreatic cancer is a devastating disease whose early detection remains difficult. There is no 100% reliable imaging test to diagnose and stage pancreatic cancer. We assessed the surgical value of contrast-enhanced spiral computed tomography (CT) in predicting the resectability and survival rates of patients who had pancreatic head cancer.
Eighty-nine patients who had pancreatic head cancer were investigated with spiral CT. Based on the preoperative CT results, we assigned patients to one of three CT groups based on resectability.
A correlation between classification of CT resectability and intraoperative finding was found in 83% of patients. The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of spiral CT in identifying predictive unresectability were 79%, 82%, 91%, 62%, and 81%, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosis of vascular invasion were 94%, 84.2%, 94%, 84%, and 91.3%, respectively.
The use of CT in the evaluation of pancreatic tumors provides valuable preoperative assessment of surgical resectability and should be performed for clinical examination. Classifying patients by tumor resectability on CT helps to estimate more precisely the tumor stage and to prognosticate survival rates of these patients.
KeywordsComputed tomography Contrast enhancement Pancreas Cancer Resectability
- 1.Balcom, JH, Castillo, CF, Warshaw, AL 2001Staging of adenocarcinoma of the pancreasCameron, John L eds. American Cancer Society atlas of clinical oncology pancreatic cancer chapter 6BC Decker IncHamilton—London8797Google Scholar
- 8.Castillo, CF, Warshaw, AL 1998Pancreatic cancer: indications for resectionBegger, HG, et al. eds. The pancreas, chapter 109Blackwell Scientific Publications United KingdomLondon10211027Google Scholar
- 10.Bouvet, M, Binmoeller, KF, Moossa, AR 2001Diagnosis of adenocarcinoma of the pancreasCameron, John L eds. American Cancer Society atlas of clinical oncology pancreatic cancerBC Decker IncHamilton—London6785Google Scholar
- 25.Ross, CB, Sharp, KW, Kaufman, AJ, et al. 1988Efficacy of computerized tomography in the preoperative staging of pancreatic carcinomaAm J Surg54221226Google Scholar
- 26.Kubyshkin, VA, Vishnevsky, VA, Airapetian, AT, et al. 2000Differential diagnosis of pancreatic head cancer [in Russian]Khirurgiia (Mosk)111923Google Scholar
- 48.Sobin, LHWittekind, C, eds. 1997UICC: TNM classification of malignant tumors5John Wiley & SonsNew YorkGoogle Scholar
- 49.Fedorov, VD, Karmazanovsky, GG, Guzeeva, EB, Tsvirkoun, VV 2003Virtual surgery modeling on the base CT data [in Russian]Vidar-MMoscow184Google Scholar
- 50.Karmazanovsky, GG, Fedorov, VD, Guzeeva, EB, Marina, GB 2002Radiology investigations of abdomen cavity after pancreaticoduodenal resections [in Russian]Russian DoctorMoscow126Google Scholar
- 51.Japanese Pancreas Society 1986General rules for cancer of the pancreas, 3rd ed [in Japanese]Kanehara PublishingTokyoGoogle Scholar
- 61.Legmann, P, Vignaux, O, Dousset, B, et al. 1998Pancreatic tumors: comparison of dual-phase helical CT and endoscopic sonographyAm J Radiol17013151322Google Scholar