Power Doppler ultrasonography for the assessment of vascular invasion by pancreatic cancer.
OBJECTIVE
To investigate the diagnostic accuracy of power Doppler ultrasonography (US) in assessing the vascular invasion by pancreatic cancer.


METHODS
A prospective study of 40 consecutive patients with pancreatic cancer (head 35, body 5) was performed. All patients underwent surgery. The relationships between tumor and each vessel were classified into four types according to the closest circumferential contact of the tumor with the vessel. A type 0 indicated no contact; type 1 indicated less than one third contact; type 2 indicated one third to 99% contact, and type 3 indicated encasement. Vascular invasion was diagnosed in types 2 and 3. The diagnostic accuracy was evaluated in the portal vein and in the splanchnic arteries (celiac artery, common hepatic artery, and superior mesenteric artery). The power Doppler US findings were confirmed by the operative findings. The results of power Doppler US were compared with those of CT scan and angiography.


RESULTS
Portal vein invasion was confirmed in resected specimens in 23 cases and by operative findings in 5 cases. For the diagnosis of portal vein invasion, sensitivity, specificity, and overall accuracy of power Doppler US were, respectively, 79.3, 90.9, and 82.5%. The respective values were 79.3, 100, and 85% for CT and 72.4, 81.8, and 75% for angiography. For the diagnosis of arterial invasion, sensitivity, specificity, and overall accuracy of power Doppler US were 80, 92, and 90%, respectively. The corresponding values were 47, 88, and 73% for CT and 47, 100, and 80% for angiography.


CONCLUSIONS
Power Doppler US proved to be useful for the diagnosis of vascular invasion by pancreatic cancer.
Department of Surgery II, Faculty of Medicine, University of Nagoya, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. kanekot@tsuru.med.nagoya-u.ac.jp
Tetsuya
T
Kaneko
Hideto
H
Kimata
Hiroyuki
H
Sugimoto
Soichiro
S
Inoue
Shigeki
S
Ito
Tsuneo
T
Ishiguchi
Akimasa
A
Nakao
D000368:Aged; D002445:Celiac Artery / Q000473:pathology; D005260:Female; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000473:pathology*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D011169:Portal Vein / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013152:Splanchnic Circulation; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler