Evaluation of vascular infiltration in resected patients for pancreatic cancer: comparison among multidetector CT, intraoperative findings and histopathology.
BACKGROUND
To assess vascular infiltration is crucial in surgical planning of pancreatic cancer. Our aim was to assess the capability of multidetector CT in detecting vascular infiltration.


METHODS
We evaluated 37 patients with pancreatic tumors. The relation between tumor and vessels was classified: grade 0: no contact between lesion and vessel; grade I: focal contiguity without modification of the vessel caliber; grade II: lesion surrounding the vessel, without reduction of its lumen; grade III: cancer surrounding the vessel with reduction or obstruction of its lumen. CT grades were compared to intraoperative findings and histopathology.


RESULTS
We evaluated 52 critical vessels with the following CT grades: grade 0 (4 cases), grade I (13 cases), grade II (17 cases), grade III (18 cases). Vascular resection was performed in 26 patients, with a total of 31 resected vessels (3 of grade 0, 5 of grade I, 8 of grade II, 15 of grade III). Histopathology excluded vascular infiltration in 4/4 cases with grade 0 and in 10/13 cases with grade I and confirmed it in 14/17 cases with grade II and 14/18 cases with grade III.


CONCLUSIONS
Multidetector CT is accurate in detecting vascular involvement and provides pre-operative information to effectively plan resection.
Mazzeo
Salvatore
S
Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy. smazzeo@med.unipi.it
Cappelli
Carla
C
Caramella
Davide
D
Del Chiaro
Marco
M
Campani
Daniela
D
Pollina
Luca
L
Caproni
Gabriele
G
Battaglia
Valentina
V
Belcari
Annalisa
A
Funel
Niccola
N
Di Candio
Giulio
G
Forasassi
Federica
F
Boggi
Ugo
U
Bevilacqua
Generoso
G
Mosca
Franco
F
Bartolozzi
Carlo
C
D000368:Aged; D001706:Biopsy; D003287:Contrast Media; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol