Spiral-CT in diagnosis of vascular involvement in pancreatic cancer.
OBJECTIVE
The purpose of this prospective study was to evaluate the efficacy of spiral-CT for the identification of portal venous, superior mesenteric artery and celiac trunk infiltration in the staging of pancreatic (n = 29) and periampullary (n = 6) cancers.


METHODS
All patients were examined by contrast enhanced spiral-CT using a total volume of 240 ml contrast medium i.v. With a slice thickness of 5 mm and a table increment of 7 mm/sec a overlapping data set, representing a total volume of 21 cm, was covered. The images were reconstructed in 4 mm intervals. In 28 patients the spiral CT results were correlated with surgical findings.


RESULTS
Regarding portal venous infiltration spiral-CT had a sensitivity of 91% (10/11), a specificity of 9.4% (16/17), a positive predictive value of 91% (10/11), a negative predictive value of 94% (16/17) and, an overall accuracy of 92.8% (26/28). Spiral CT correctly identified arterial involvement in 5 patients, and no false negative result compared to surgical findings was observed.


CONCLUSIONS
These results indicate that spiral-CT reliably verifies occlusion, stenosis and encasement of the major peripancreactic vessels caused by pancreatic cancer.
Gmeinwieser
J
J
Department of Diagnostic Radiology, University Hospital of Regensburg, Germany.
Feuerbach
S
S
Hohenberger
W
W
Albrich
H
H
Strotzer
M
M
Hofstädter
F
F
Geissler
A
A
D000368:Aged; D000369:Aged, 80 and over; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*