Angiotensin-II administration is useful for the detection of liver metastasis from pancreatic cancer during pharmacoangiographic computed tomography.
OBJECTIVE
To improve the preoperative diagnosis of liver metastasis from pancreatic cancer, we estimated computed tomography during arterial angiography (CTA) with/without administration of angiotensin-II (AT- II).


METHODS
Thirty-five patients with pancreatic cancer were examined in this study. After conventional CTA was performed, pharmacoangiographic CTA was performed with a 1-3 microgram/5 mL solution of angiotensin II injected through a catheter into the celiac artery during spiral computed tomography. We prospectively analyzed the relative region of interest (ROI) ratio of tumor to liver with/without AT-II.


RESULTS
In all patients, the relative ratio of each computed tomography (CT) number in the ROI was larger at pharmacoangiographic CT than at conventional angiographic CT. Administration of angiotensin-II enhanced the metastatic liver tumor as compared with normal tissue. Intratumoral blood flow increased in all patients with malignant tumors due to the pressure effect of AT-II. Furthermore, the metastatic lesions in the liver of three patients were represented by only pharmacoangiographic CT, not by conventional CT and conventional CT angiography. In even peripheral and central areas of metastatic liver tumor, the lesions were enhanced after administration of AT-II.


CONCLUSIONS
These results support that high detection rate of liver metastasis revealed by pharmacoangiographic CT suggests the improvement of diagnosis on preoperative staging. Moreover, chemotherapy under AT-II induced hypertension may have a better effect on the treatment of metastatic liver tumors.
Ishikawa
Toru
T
Department of Gastroenterology, Saiseikai Niigata Second Hospital, Teraji 280-7, Niigata 950-1104, Japan. toruishi@ngt.saiseikai.or.jp
Ushiki
Takashi
T
Kamimura
Hiroteru
H
Togashi
Tadayuki
T
Tsuchiya
Atsunori
A
Watanabe
Kouji
K
Seki
Keiichi
K
Ohta
Hironobu
H
Yoshida
Toshiaki
T
Takeda
Keiko
K
Kamimura
Tomoteru
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D000804:Angiotensin II / Q000009:adverse effects; D002445:Celiac Artery / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*; D011446:Prospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*; D014662:Vasoconstrictor Agents / Q000009:adverse effects
D014662:Vasoconstrictor Agents; D000804:Angiotensin II