title: Thin-section contrast-enhanced computed tomography accurately predicts the resectability of malignant pancreatic neoplasms.
abstract: A prospective diagnostic study was designed to determine the ability of thin-section contrast-enhanced computed tomography (CT) to predict the resectability of malignant neoplasms of the pancreatic head. Patients with a presumed resectable pancreatic neoplasm referred during a 21-month period were studied with abdominal CT performed at 1.5-mm section thickness and 5-mm slice interval during the bolus phase of intravenous contrast enhancement. CT criteria for resectability included the absence of extrapancreatic disease, no evidence of arterial encasement, and a patent superior mesenteric-portal venous confluence. Of 145 patients evaluated, 42 were considered to have resectable tumors by CT criteria, and 37 (88%) underwent potentially curative pancreaticoduodenectomy. Six patients were found to have a microscopically positive retroperitoneal resection margin; no patient had a grossly positive resection margin. Five (12%) of 42 patients were found at laparotomy to have unresectable, locally advanced or metastatic tumors. Thin-section contrast-enhanced CT is an essential component of the preoperative evaluation for pancreaticoduodenectomy and can prevent needles laparotomy in most patients with locally advanced or metastatic disease.
authors.affiliation: Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
authors.forename: G M
authors.initials: GM
authors.lastname: Fuhrman
authors.forename: C
authors.initials: C
authors.lastname: Charnsangavej
authors.forename: J L
authors.initials: JL
authors.lastname: Abbruzzese
authors.forename: K R
authors.initials: KR
authors.lastname: Cleary
authors.forename: R G
authors.initials: RG
authors.lastname: Martin
authors.forename: C J
authors.initials: CJ
authors.lastname: Fenoglio
authors.forename: D B
authors.initials: DB
authors.lastname: Evans
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D018273:Carcinoma, Islet Cell / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D007472:Iohexol