Assessment of arterial invasion in pancreatic cancer using color Doppler ultrasonography.
OBJECTIVE
We report the first study on the value of color Doppler ultrasonography (CDUS) in assessing arterial invasion of pancreatic cancer.


METHODS
The relationships between tumors and surrounding major splanchnic arteries (celiac, superior mesenteric, common hepatic, splenic, and gastroduodenal arteries) were preoperatively evaluated with CDUS in 33 consecutive patients with pancreatic cancer. When a tumor partially or completely surrounded the artery, the invasion was diagnosed as positive. Imaging results were then compared with angiographic, surgical, and histopathological findings.


RESULTS
In 22 nonsurgical patients, the correspondence rate of CDUS with angiography for the presence of invasion, absence of invasion, and overall was 78%, 95%, and 88%, respectively. In 11 surgical patients, a sensitivity of 60%, specificity of 93%, and accuracy of 87% for detection of arterial invasion were obtained in comparing CDUS with surgical and histopathological findings. There was no significant difference between the accuracy of CDUS and that of CT, or that of angiography. However, the accuracy of CDUS was higher than that of CT (72%) and equal to that of angiography (91%).


CONCLUSIONS
Color Doppler ultrasonography is useful for detecting arterial invasion in pancreatic cancer. It may make angiography unnecessary, especially with advanced tumors, if thorough evaluation for the large artery invasion is performed initially.
Tomiyama
T
T
Department of Gastroenterology, Jichi Medical School, Tochigi, Japan.
Ueno
N
N
Tano
S
S
Wada
S
S
Kimura
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000000981:diagnostic imaging*; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation / Q000379:methods