The usefulness of spiral Computed Tomography and colour-Doppler ultrasonography to predict portal-mesenteric trunk involvement in pancreatic cancer.
OBJECTIVE
The aim of this study was to determine the clinical utility of spiral computed tomography (CT) and colour Doppler ultrasonography (US) in the evaluation of portal-mesenteric trunk (PMT) involvement in pancreatic cancer.


METHODS
Ninety-five patients with pancreatic cancer underwent preoperative assessment of the PMT with spiral CT and colour Doppler US. Five stages of vascular involvement were established. During surgery intraoperative US was performed to confirm the preoperative findings.


RESULTS
Of the 95 patients observed, 82 (86.3%) underwent surgery. The sensitivity of spiral CT was 98%, specificity 79%, overall accuracy 80.2%. The positive predictive value was 87.5%; the negative predictive value 96%. The results of colour Doppler US were 92.3%, 72,7%, 72.8%, 79.5% and 88.8%, respectively.


CONCLUSIONS
The results indicate that spiral CT is the gold standard in detecting PMT involvement in pancreatic cancer. Colour Doppler US is useful, but adds nothing to CT. Both of these techniques improve the possibility of predicting the resectability of pancreatic cancer.
Calculli
Lucia
L
Dipartimento di Scienze Radiologiche ed Istocitopatologiche, Sezione Diagnostica per Immagini, Radiologia III, Policlinico S. Orsola, Università degli Studi, Bologna, Italy.
Casadei
Riccardo
R
Amore
Barbara
B
Albini Riccioli
Lucia
L
Minni
Francesco
F
Caputo
Mauro
M
Marrano
Domenico
D
Gavelli
Giampaolo
G
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000175:diagnosis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D011169:Portal Vein / Q000000981:diagnostic imaging; D011379:Prognosis; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D018615:Ultrasonography, Doppler, Color