Abdominal Imaging

, Volume 34, Issue 1, pp 75–80 | Cite as

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

  • Elena Manak
  • Susanne Merkel
  • Peter Klein
  • Thomas Papadopoulos
  • Werner A. Bautz
  • Ulrich Baum
Article
First Online:

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.

Keywords

Computed tomography Multidetector row Pancreatic adenocarcinoma 
This is a preview of subscription content, log in to check access.

Notes

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.

References

  1. 1.
    Freeny PC, Marks WM, Ryan JA, et al. (1988) Pancreatic ductal adenacarcinoma: diagnosis and staging with dynamic CT. Radiology 166:125–133PubMedGoogle Scholar
  2. 2.
    Bluemke DA, Cameron JL, Hruban RH, et al. (1995) Potentially resectable pancreatic adenocarcinoma: spiral CT assessment with surgical and pathologic correlation. Radiology 197:381–385PubMedGoogle Scholar
  3. 3.
    Valls C, Andia E, Sanchez A, et al. (2002) Dual-phase helical CT of pancreatic adenocarcinomaá: assessment of resectability before surgery. AJR 178:821–826PubMedGoogle Scholar
  4. 4.
    Diehl SJ, Lehmann KJ, Sadick M, et al. (1998) Pancreatic cancer: value of dual-phase helical CT in assessing resectability. Radiology 206(2):373–378PubMedGoogle Scholar
  5. 5.
    Kalpa MK, Maher MM, Sahani DV, et al. (2002) Current status of imaging in pancreatic diseases. J Comput Assist Tomogr 26:661–675CrossRefGoogle Scholar
  6. 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):438–445PubMedCrossRefGoogle Scholar
  7. 7.
    Baum U, Lell M, Nomayr A, et al. (1999) Multiplanar spiral CT in the diagnosis of pancreatic tumors. Radiologe 39a:958–964CrossRefGoogle Scholar
  8. 8.
    Fishman EK, Horton KM, Urban BA (2000) Multidetector CT angiography in the evaluation of pancreatic carcinoma: preliminary observations. J Comput Assist Tomogr 24:849–853PubMedCrossRefGoogle Scholar
  9. 9.
    Fenchel S, Boll DT, Fleiter TR, et al. (2003) Multislice helical CT of the pancreas and spleen. Eur J Radiol 45 Suppl 1:59–72CrossRefGoogle Scholar
  10. 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 28:366–377PubMedCrossRefGoogle Scholar
  11. 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 168:1439–1443PubMedGoogle Scholar
  12. 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 25:337–342CrossRefGoogle Scholar
  13. 13.
    Horton MK, Fishman EK (2002) Multidetector CT angiography of pancreatic carcinoma: part 1, evaluation of arterial involvement. AJR 178:827–831PubMedGoogle Scholar
  14. 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):1596–600Google Scholar
  15. 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):612–615Google Scholar
  16. 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):1068–1071PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Elena Manak
    • 1
    • 4
  • Susanne Merkel
    • 2
  • Peter Klein
    • 2
  • Thomas Papadopoulos
    • 3
  • Werner A. Bautz
    • 1
  • Ulrich Baum
    • 1
  1. 1.Institute for Diagnostic RadiologyFriedrich-Alexander University of Erlangen-NurembergErlangenGermany
  2. 2.Department of Surgery Friedrich-Alexander University of Erlangen-NurembergErlangenGermany
  3. 3.Department of PathologyFriedrich-Alexander University of Erlangen-NurembergErlangenGermany
  4. 4.MinskBelarus

Personalised recommendations