Intraarterial Ultrasound in Pancreatic Cancer: Feasibility Study and Preliminary Results


Despite technological advances in computed tomography (CT) and magnetic resonance imaging, the involvement of the celiac or mesenteric artery in pancreatic cancer remains uncertain in many cases. Infiltration of these vessels is important in making decisions about therapy choices but often can only be definitively determined through laparotomy. Local (intraarterial) ultrasound may increase diagnostic accuracy. Using the Volcano intravascular ultrasound (IVUS) system, we applied a transfemoral method to scan the celiac and mesenteric arteries directly intraarterial. This technique was used in five patients with suspected pancreatic cancer. Technical success was achieved in all cases. In one case, a short dissection of the mesenteric artery occurred but could be managed interventionally. In tumors that did not contact with the vessels, IVUS was unable to display the tissue pathology. Our main interest was the infiltration of the arteries. In one case, infiltration was certain in the CT scan but uncertain in two patients. In the latter two cases, IVUS correctly predicted infiltration in one and freedom from tumor in the other case. In our preliminary study, IVUS correctly predicted arterial infiltration in all cases. IVUS did not provide new information when the tumor was far away from the vessel. Compared with IVUS in the portal vein, the information about the artery is more detailed, and the vessel approach is easier. These results encouraged us to design a prospective study to evaluate the sensitivity and specificity of this method.

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Conflict of Interest

The authors declare that they have no conflict of interest to disclose.

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Correspondence to Axel Larena-Avellaneda.

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Movie 1 (avi): Transverse IVUS pictures of the pullback procedure in patient 2. The tumor can be seen from 0:02 in the left lower quadrant, intimal disruption begins at 0:06 on the left (MPG 2986 kb)

Movie 1 (avi): Transverse IVUS pictures of the pullback procedure in patient 2. The tumor can be seen from 0:02 in the left lower quadrant, intimal disruption begins at 0:06 on the left (MPG 2986 kb)

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Larena-Avellaneda, A., Timm, S., Kickuth, R. et al. Intraarterial Ultrasound in Pancreatic Cancer: Feasibility Study and Preliminary Results. Cardiovasc Intervent Radiol 33, 726–731 (2010).

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  • Intravascular ultrasonography
  • IVUS
  • Pancreatic cancer
  • Invasiveness
  • Neoplasm
  • Mesenteric artery