Diagnostic value of multi-detector computed tomography angiography (MDCTA) in assessment of vascular invasion and resectability of pancreatic head cancer
Keywords:
Tomography Angiography, resectability of Pancreatic Head Cancer, laparoscopyAbstract
Introduction: pancreatic carcinoma is a common gastrointestinal malignancy. Accurate preoperative imaging helps to avoid unnecessary or unsuccessful surgical procedures and reduce the number of aborted pancreatic resections. MDCT is the most widely available and best validated tool for imaging patients with pancreatic adenocarcinoma. Objective: to evaluate the diagnostic value of resectability and local staging of Pancreatic Head Cancer by MDCTA. Materials and methods: This cross-sectional study was conducted on 20 patients referred to the Diagnostic Radiology and Medical Imaging Department at Tanta University Hospitals presenting with pancreatic head cancer. Results: Patients underwent exploratory laparoscopy or laparatomy with progression to a pancreaticoduodenectomy as deemed resectable in 7 (35%) patients, and 6 (30%) of patients underwent exploratory laparoscopy or laparatomy with progression to Gasterojejunostomy, 4 (20%) of patients underwent ERCP for biliary stenting and 3 (15 %) of patients were inoperable. In the studied patients, 15.4% of resectable by MDCTA found to be unresectable at laparoscopy exploratory with true positive was 100%. The MDCTA imaging sensitivity was 100%, specificity was 71%, NPV was 100% and PPV was 87% with accuracy of 90% to assess for resectability.
Downloads
References
Ali, M. H., Solyman, M., Murad, M. Z., & Mohammed, A. E. (2021). Role of MDCT and CT Angiography in staging of pancreatic cancer. SVU Int J Med Sci, 4(1), 49-67.
Brügel, M., Link, T. M., Rummeny, E. J., Lange, P., Theisen, J., & Dobritz, M. (2004). Assessment of vascular invasion in pancreatic head cancer with multislice spiral CT: value of multiplanar reconstructions. Eur Radiol, 14(7), 1188-1195. doi:10.1007/s00330-004-2326-0
Buchs, N. C., Chilcott, M., Poletti, P. A., Buhler, L. H., & Morel, P. (2010). Vascular invasion in pancreatic cancer: Imaging modalities, preoperative diagnosis and surgical management. World J Gastroenterol, 16(7), 818-831. doi:10.3748/wjg.v16.i7.818
Fusari, M., Maurea, S., Imbriaco, M., Mollica, C., Avitabile, G., Soscia, F., . . . Salvatore, M. (2010). Comparison between multislice CT and MR imaging in the diagnostic evaluation of patients with pancreatic masses. Radiol Med, 115(3), 453-466. doi:10.1007/s11547-010-0490-7
Greenlee, R. T., Hill-Harmon, M. B., Murray, T., & Thun, M. (2001). Cancer statistics, 2001. CA Cancer J Clin, 51(1), 15-36. doi:10.3322/canjclin.51.1.15
Grieser, C., Steffen, I. G., Grajewski, L., Stelter, L., Streitparth, F., Schnapauff, D., . . . Denecke, T. (2010). Preoperative multidetector row computed tomography for evaluation and assessment of resection criteria in patients with pancreatic masses. Acta Radiol, 51(10), 1067-1077. doi:10.3109/02841851.2010.520023
Hassanen, O., Ghieda, U., & Eltomey, M. A. (2014). Assessment of vascular invasion in pancreatic carcinoma by MDCT. Egypt J Radiol Nucl Med, 45(2), 271-277.
Işcanlı, E., Türkvatan, A., Bostancı, E. B., & Sakaoğulları, Z. (2014). Assessment of surgical resectability of pancreatic adenocarcinomas with multidetector computed tomography: what are the possibilities and problems? Turk J Gastroenterol, 25(4), 416-423. doi:10.5152/tjg.2014.4973
Kaneko, O. F., Lee, D. M., Wong, J., Kadell, B. M., Reber, H. A., Lu, D. S., & Raman, S. S. (2010). Performance of multidetector computed tomographic angiography in determining surgical resectability of pancreatic head adenocarcinoma. J Comput Assist Tomogr, 34(5), 732-738.
Laghi, A., Iannaccone, R., Catalano, C., Carbone, I., Sansoni, I., Mangiapane, F., & Passariello, R. (2002). Multislice spiral computed tomography in diagnosis and staging of pancreatic carcinoma: preliminary experience. Dig Liver Dis, 34(10), 732-738. doi:10.1016/s1590-8658(02)80025-1
Larson, D. B., Towbin, A. J., Pryor, R. M., & Donnelly, L. F. (2013). Improving consistency in radiology reporting through the use of department-wide standardized structured reporting. Radiology, 267(1), 240-250. doi:10.1148/radiol.12121502
Lu, D. S., Reber, H. A., Krasny, R. M., Kadell, B. M., & Sayre, J. (1997). Local staging of pancreatic cancer: criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT. AJR Am J Roentgenol, 168(6), 1439-1443. doi:10.2214/ajr.168.6.9168704
McNulty, N. J., Francis, I. R., Platt, J. F., Cohan, R. H., Korobkin, M., & Gebremariam, A. (2001). Multi--detector row helical CT of the pancreas: effect of contrast-enhanced multiphasic imaging on enhancement of the pancreas, peripancreatic vasculature, and pancreatic adenocarcinoma. Radiology, 220(1), 97-102. doi:10.1148/radiology.220.1.r01jl1897
Menahem, B., Guittet, L., Mulliri, A., Alves, A., & Lubrano, J. (2015). Pancreaticogastrostomy is superior to pancreaticojejunostomy for prevention of pancreatic fistula after pancreaticoduodenectomy: an updated meta-analysis of randomized controlled trials. Ann Surg, 261(5), 882-887. doi:10.1097/sla.0000000000000806
Olivié, D., Lepanto, L., Billiard, J. S., Audet, P., & Lavallée, J. M. (2007). Predicting resectability of pancreatic head cancer with multi-detector CT. Surgical and pathologic correlation. Jop, 8(6), 753-758.
Shrikhande, S. V., Arya, S., Barreto, S. G., Ingle, S., D'Souza, M. A., Hawaldar, R., & Shukla, P. J. (2011). Borderline resectable pancreatic tumors: is there a need for further refinement of this stage? Hepatobiliary Pancreat Dis Int, 10(3), 319-324.
Stokes, J. B., Nolan, N. J., Stelow, E. B., Walters, D. M., Weiss, G. R., de Lange, E. E., . . . Bauer, T. W. (2011). Preoperative capecitabine and concurrent radiation for borderline resectable pancreatic cancer. Ann Surg Oncol, 18(3), 619-627. doi:10.1245/s10434-010-1456-7
Tempero, M. A., Behrman, S., Ben-Josef, E., Benson, A. B., 3rd, Cameron, J. L., Casper, E. S., . . . Wolff, R. A. (2005). Pancreatic adenocarcinoma: Clinical practice guidelines in oncology. J Natl Compr Canc Netw, 3(5), 598-626. doi:10.6004/jnccn.2005.0035
Varadhachary, G. R., Tamm, E. P., Abbruzzese, J. L., Xiong, H. Q., Crane, C. H., Wang, H., . . . Wolff, R. A. (2006). Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Ann Surg Oncol, 13(8), 1035-1046. doi:10.1245/aso.2006.08.011
Thaib, P. K. P., & Rahaju, A. S. (2022). Clinicopathological profile of clear cell renal cell carcinoma. International Journal of Health & Medical Sciences, 5(1), 91-100. https://doi.org/10.21744/ijhms.v5n1.1846
Vargas, R., Nino-Murcia, M., Trueblood, W., & Jeffrey, R. B., Jr. (2004). MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. AJR Am J Roentgenol, 182(2), 419-425. doi:10.2214/ajr.182.2.1820419
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2022). Post-pandemic health and its sustainability: Educational situation. International Journal of Health Sciences, 6(1), i-v. https://doi.org/10.53730/ijhs.v6n1.5949
Yeo, C. J., Cameron, J. L., Sohn, T. A., Lillemoe, K. D., Pitt, H. A., Talamini, M. A., . . . Abrams, R. A. (1997). Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg, 226(3), 248-257. doi:10.1097/00000658-199709000-00004
Zamboni, G. A., Kruskal, J. B., Vollmer, C. M., Baptista, J., Callery, M. P., & Raptopoulos, V. D. (2007). Pancreatic adenocarcinoma: value of multidetector CT angiography in preoperative evaluation. Radiology, 245(3), 770-778. doi:10.1148/radiol.2453061795
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
