Clinical impact of multidetector row computed tomography on patients with pancreatic cancer.
OBJECTIVE
This study was designed to compare multidetector row computed tomography (MDCT) and CT-assisted hepatic arteriography (CTHA)/CT during arterial portography (CTAP)/angiography/contrast-enhanced CT (CECT) findings prospectively for accuracy in the detection of liver metastasis and vascular involvement of the tumor.


METHODS
The study included 43 patients with pancreatic cancer who were evaluated from September 2002 to December 2003. These patients underwent preoperative evaluation by angiography/CTHA/CTAP/CECT (7-mm thickness) and by MDCT (1.25-mm thickness).


RESULTS
The sensitivity, specificity, positive predictive value, and negative predictive value of liver metastasis diagnosis were all superior using MDCT relative to CTHA/CTAP. The diagnostic accuracy of liver metastasis for patients with tumors less than 10 mm in diameter was particularly superior with MDCT relative to CTHA/CTAP. The surgical and pathological findings of vascular involvement were more accurately diagnosed by MDCT than by CTHA/CTAP/angiography/CECT. Although MDCT findings were generally similar to surgical findings of vascular involvement, MDCT overestimated the incidence of pathological vascular involvement.


CONCLUSIONS
Multidetector row CT imaging can potentially offer more accurate staging of pancreatic cancer and may be useful to surgeons both in preoperative planning and for intraoperative guidance.
Satoi
Sohei
S
Department of Surgery, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka 573-1191, Japan. satoi@hirakata.kmu.ac.jp
Yamamoto
Hidekazu
H
Takai
Soichiro
S
Tanigawa
Noboru
N
Komemushi
Atsushi
A
Yanagimoto
Hiroaki
H
Toyokawa
Hideyoshi
H
Matsui
Yoichi
Y
Mergental
Hynek
H
Kamiyama
Yasuo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001706:Biopsy; D003287:Contrast Media; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D011172:Portography / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media