Pancreatic carcinoma: MR, MR angiography and dynamic helical CT in the evaluation of vascular invasion

Arslan, Arzu; Buanes, Trond; Geitung, Jonn Terje

doi:10.1016/s0720-048x(00)00280-1

Cited by 72 publications

(35 citation statements)

References 20 publications

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“…They reported that a threshold between grades II and III is highly sensitive (84%) and specific (98%) for the determination of resectability. Further studies also presuming that encasement greater than 180°on CT images is a criterion for vascular invasion (partly in combination with other criteria) attained sensitivities of 46-78% and specificities of 86-100% [16,18,[25][26][27]. These data indicate the tendency rather to underestimate than overestimate vascular invasion with the above criterion.…”

Section: Discussionmentioning

confidence: 77%

Assessment of vascular invasion in pancreatic head cancer with multislice spiral CT: value of multiplanar reconstructions

et al. 2004

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The use of multiplanar reconstructions (MPRs) generated from multislice spiral CT (MSCT) data sets in the preoperative assessment of vascular invasion in pancreatic cancer was evaluated. Forty patients underwent biphasic high-resolution MSCT prior to surgery for pancreatic head cancer. Image reconstruction included thin-slice axial, sagittal and coronal MPRs as well as an MPR perpendicular to the course of a major peripancreatic vessel in proximity to the tumor. CT criteria for vascular invasion were: (1) circumferential involvement >180 degrees and (2) vessel narrowing. Imaging findings of 52 vessels were correlated with surgical and histopathological reports. Regarding the CT criterion circumferential involvement, vascular invasion was demonstrated on axial MPRs with a sensitivity and specificity of 58 and 97%. For the assessment with coronal and sagittal MPRs sensitivity was only 47%. Vascular invasion was recognized best on perpendicular MPRs with a sensitivity, specificity and accuracy of 74, 97 and 88%, respectively. Vessel narrowing was a less reliable CT criterion for vascular invasion, mainly due to the lower specificity of 91% obtained with each available MPR. Thin-slice MPRs oriented perpendicularly to a possibly invaded vessel exactly depict the grade of circumferential involvement and thus have the capability to improve the assessment of vascular invasion in pancreatic cancer.

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Section: Discussionmentioning

confidence: 77%

Assessment of vascular invasion in pancreatic head cancer with multislice spiral CT: value of multiplanar reconstructions

et al. 2004

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“…Moreover, MR imaging has been proposed as an alternative to CT, as the new highmagnetic-field scanners offer optimal contrast resolution for studying the upper abdomen [3]. The choice between CT and MR imaging for diagnostic evaluation of pancreatic masses is controversial, as the majority of studies in the literature suggests that CT and MR imaging have comparable diagnostic accuracy [4][5][6][7][8][9], whereas other studies report conflicting results [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Comparison between multislice CT and MR imaging in the diagnostic evaluation of patients with pancreatic masses

et al. 2010

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“…The accuracy of CT and MRI for predicting vascular invasion is quite similar (90 and 87 % respectively) [10].…”

Section: Stagingmentioning

confidence: 94%

Imaging in Pancreatic Cancer

Mourmouris

2013

Imaging in Clinical Oncology

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Pancreatic ductal adenocarcinoma is the fifth leading cause of cancer deaths in the Western hemisphere. It represents 90 % of all malignant tumors arising from the pancreatic gland. Early pancreatic cancer often does not cause symptoms and the later symptoms are usually nonspecific and varied. Therefore, pancreatic cancer is often not diagnosed until it is advanced. And despite all the advances in oncological treatments, the overall 5-year-survival rates remain poor (\5 %). On the other hand surgery is still the only curative option but only a minority of cancers is resectable.Therefore the role of the imaging modalities should be to: (a) detect early the pancreatic cancer and (b) stage the tumor and determine if it is locally resectable. DiagnosisThe diagnostic approach usually begins with abdominal ultrasound because it is widely available and noninvasive. Ultrasound (US) may detect pancreatic cancer as an ill-defined hypoechoic mass but usually is performed in order to exclude gallstones, choledocholithiasis, and signs of common bile duct obstruction in patients who are present with abdominal pain and jaundice. The accuracy of US for detection of pancreatic cancer is 50-70 % [1]. However the body habitus, the overlying bowel gas, and the variable operator dependency decrease the sensitivity of the method.CT is the standard imaging modality for accurate diagnosis and staging of pancreatic cancer. The standard protocol for the evaluation of the pancreas consists of two phases after the intravenous administration of contrast media (pancreatic and portal venous phase). During the pancreatic phase or late arterial phase (approximately 30-40 s after the injection of the contrast media) the contrast between the normal parenchyma and the lesion is maximal and also there is sufficient enhancement of the arteries in order to evaluate possible vascular tumor involvement. Portal venous phase is optimal for detecting potential metastatic disease and for the assessing of the peripancreatic veins [2].State-of-the-art protocol with MDCT scanners includes acquisitions with very thin slices (\1 mm) which is crucial for optimizing lesion detection. These isotropic or nearly isotropic data sets are used with postprocessing techniques (MPR, MIP VRT) in order to depict high quality reformatted images. Recent reports have demonstrated the role of reformatted images in the preoperative evaluation of pancreatic cancer regarding the invasion of the peripancreatic vessels and the potential resectability of the pancreatic tumor [3].

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Pancreatic carcinoma: MR, MR angiography and dynamic helical CT in the evaluation of vascular invasion

Cited by 72 publications

References 20 publications

Assessment of vascular invasion in pancreatic head cancer with multislice spiral CT: value of multiplanar reconstructions

Assessment of vascular invasion in pancreatic head cancer with multislice spiral CT: value of multiplanar reconstructions

Comparison between multislice CT and MR imaging in the diagnostic evaluation of patients with pancreatic masses

Imaging in Pancreatic Cancer

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