Three-dimensional CT angiography of pancreatic carcinoma: role in staging extent of disease.

Novick, Steven L.; Fishman, Elliot K.

doi:10.2214/ajr.170.1.9423619

Cited by 34 publications

(15 citation statements)

References 6 publications

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“…19,27,28 Recently, 3D CT scan has been reported to enhance the assessment of the tumor-vascular interface, 14 as the 3D format allows for the viewing of oblique orientations of the pancreas within the retroperitoneum. 13,29 Accurate information concerning the relation of the tumor with the superior mesenteric artery and superior mesenteric-portal vein are particularly critical as more and more centers no longer consider venous involvement a contraindication to surgical resection. 16,30,31 In the current study, three patients with adenocarcinoma of the pancreas were initially deemed to be unresectable at the other institution solely due to tumor abutment/ involvement with the portal vein.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

et al. 2008

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Purpose-To evaluate the impact of a multidisciplinary clinic on the clinical care recommendations of patients with pancreatic cancer compared with the recommendations the patients received prior to review by the multidisciplinary tumor board.Methods-The records of 203 consecutive patients referred to the Johns Hopkins pancreatic multidisciplinary clinic were prospectively collected from November 2006 to October 2007. Crosssectional imaging, pathology, and medical history were evaluated by a panel of medical/radiation oncologists, surgical oncologists, pathologists, diagnostic radiologists, and geneticists. Alterations in treatment recommendations between the outside institution and the multidisciplinary clinic were recorded and compared.Results-On presentation, the outside computed tomography (CT) report described locally advanced/unresectable disease (34.9%), metastatic disease (17.7%), and locally advanced disease with metastasis (1.1%). On review of submitted imaging and imaging performed at Hopkins, 38 out of 203 (18.7%) NIH Public Access Author ManuscriptAnn Surg Oncol. Author manuscript; available in PMC 2010 July 20. Conclusion-The single-day pancreatic multidisciplinary clinic provided a comprehensive and coordinated evaluation of patients that led to changes in therapeutic recommendations in close to one-quarter of patients. KeywordsMultidisciplinary; Pancreas; Cancer; OutcomeAs the care of patients with cancer has become more complex, fewer patients are being treated with single-modality therapy. Rather, most patients with cancer are now cared for using a combination of surgery, chemotherapy, and/or radiation therapy. As such, multidisciplinary cancer clinics have become increasingly prevalent in the management of patients with malignancies. Multidisciplinary clinics allow specialists to work together to develop consensus recommendations in accordance with guidelines and protocols endorsed by the clinical team. 1 Over time, multidisciplinary care has become accepted as the optimal mechanism for delivering care in oncology. [1][2][3] In the USA, both the Commission on Cancer and the American College of Surgeons require multidisciplinary cancer conferences for the accreditation of health centers delivering multidisciplinary care. [3][4][5] Although multidisciplinary care has widely been endorsed and accepted, the impact of formal multidisciplinary clinics has yet to be established. In fact, little qualitative and quantitative research exists to determine the impact of multidisciplinary clinics on patient outcomes.6 Data on the effect of multidisciplinary clinics on patient outcomes are clearly important, as these clinics require a substantial amount of clinical and institutional resources. While improved outcomes in breast cancer patients treated at multidisciplinary clinics have been documented, 7 , 8 no such data exist for patients with gastrointestinal malignancies. Specifically, the impact of multidisciplinary clinics to treat patients with pancreatic cancer has not been previously documen...

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Section: Discussionmentioning

confidence: 99%

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

et al. 2008

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“…7.12) [33,34]. The celiac artery and its major branches are also frequently involved in pancreatic cancer, especially in larger tumors and in tumors of the pancreatic body and tail [33][34][35]. Arterial involvement significantly reduces the success of curative surgical resection [33].…”

Section: 2mentioning

confidence: 99%

Pancreas

Mileto

Marin

Nelson

2013

CT of the Retroperitoneum

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“…In addition, for the referring surgeon, the ability to view the CT data as a display similar to classic angiography is a valuable adjunct in surgical decision making. Displays of variants of normal vascular anatomy including accessory right hepatic arteries are best defined with this technique [9][10][11][12]. …”

Section: The Evolution Of Ct Scanningmentioning

confidence: 99%

“…However, careful analysis of the images would suggest that their detail was not adequate to define early vessel invasion as in pancreatic cancer. Novick and Fishman [10] did show that using advanced 3D techniques like volume rendering, those vascular maps could not only define the venous anatomy but also accurately predict vascular invasion. Raptopoulos et al [27] had similar results with CT angiography from single-detector spiral CT data sets.…”

Section: Venous Imagingmentioning

confidence: 99%

Imaging pancreatic cancer: The role of multidetector CT with three-dimensional CT angiography

Fishman

Horton

2001

Pancreatology

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Three-dimensional CT angiography of pancreatic carcinoma: role in staging extent of disease.

Cited by 34 publications

References 6 publications

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

Pancreas

Imaging pancreatic cancer: The role of multidetector CT with three-dimensional CT angiography

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