Clinical Significance of Intraportal Endovascular Ultrasonography for the Diagnosis of Extrapancreatic Nerve Plexus Invasion by Pancreatic Carcinoma

CT and MR imaging patterns for pancreatic carcinoma invading the extrapancreatic neural plexus (Part II): Imaging of pancreatic carcinoma nerve invasion

“…to changes in the area around the ��A and inferior pancreaticoduodenal artery (IPDA), because the IPDA was mostly visualized on thin-section helical CT and was included in the PLX-Ⅱ: A0, no change in fat attenuation; A1, increase in fat attenuation, such as a streaky and strand-like structure (Figures 1, 3 and 4); A2, mass formation (Figures 2, 5 and 6) [16,28,29] . Criterion B was defined based on the status of the jejunal trunk (JT) because JTs are exclusively visualized on thin-section helical CT and run across the PLX-Ⅱ: V-, normal JT; V+, stenosis or obstruction of the JT [30] .…”

Extrapancreatic neural plexus invasion by carcinomas of the pancreatic head region: evaluation using thin-section helical CT

“…Criterion A was the CT criterion previously reported from our institution, 15 which classifi ed the patients into three groups in respect to changes in the area around the SMA and inferior pancreaticoduodenal artery (IPDA) because the IPDA was mostly visualized on thin-section helical CT and was included in the PLX-II: A0, no change in fat attenuation; A1, increase in fat attenuation, such as a streaky and strand-like structure; A2, mass formation. 1,14 Criterion B classifi ed the patients into two groups in respect to the status of the JT because JTs were exclusively visualized on thin-section helical CT and ran across the PLX-II: V−, normal JT; V+, stenosis or obstruction of the JT. 19 CT images were assessed mainly by the manual cine paging method on the viewer monitor and were interpreted according to the CT criteria described above by consensus between two experienced radiologists blind to the surgical and pathology results.…”

“…1,2 Pancreaticoduodenectomy is commonly performed as the treatment for carcinoma of the pancreatic head region; however, the 5-year cumulative survival after resection is unfavorable, being estimated at less than 15% for a lower common bile duct (CBD) carcinoma and at 14.5%-18.0% for a carcinoma of the pancreatic head. [2][3][4] Extrapancreatic neural plexus invasion is a common feature of pancreatobiliary carcinoma and is an important prognostic factor because it is a major cause of tumors remaining at resection margins, resulting in postoperative recurrence.…”

“…[2][3][4][5][6][7][8][9] Therefore, the accurate diagnosis of extrapancreatic neural plexus invasion before surgery is essential because its presence makes it impossible to achieve a negative retroperitoneal margin of excision even with radical resection. 1 The abundant extrapancreatic neural plexus located around the celiac artery and the superior mesenteric artery (SMA) can be divided into two main portions: fi rst and second. The fi rst portion extends from the celiac ganglion and runs toward the upper medial margin of the uncinate process of the pancreas behind the portal vein.…”

Radioimmunoscintigraphy of pancreatic cancer in tumor-bearing athymic nude mice using 99mtechnetium-labeled anti-KL-6/MUC1 antibody

“…The overall fi ve-year survival rates for patients with this disease are only approximately 4%-10%. 1,2 Because of the absence of a capsule, the tumor easily infi ltrates the surrounding tissue, such as abundant fat, the neural plexus, and the lymphatic system, so local invasion and distant metastasis of the tumor take place rapidly in most patients. Surgical resection of the tumor remains the only potential cure for pancreatic cancer.…”