title: A new invasion score for determining the resectability of pancreatic carcinomas with contrast-enhanced multidetector computed tomography.
abstract: OBJECTIVE
  It was the aim of this study to evaluate a new infiltration score to determine the resectability of pancreatic carcinomas in preoperative planning.
  
  
  METHODS
  Eighty patients with suspected pancreatic tumor were examined prospectively using 16-row spiral CT. The scans were evaluated for the presence of pancreatic carcinoma, peripancreatic tumor extension and vascular invasion using a standardized questionnaire. Invasion of the surgically relevant vessels was evaluated using a new invasion score. The operative and histological findings and the clinical follow-up served as the gold standard.
  
  
  RESULTS
  Forty patients had a pancreatic carcinoma, 5 had metastasis of a different primary tumor, and in 35 patients, there was no malignant pancreatic disease. The sensitivity for tumor detection was 100%, with a specificity of 88% for differentiating between malignant and benign pancreatic tumors. Invasion of the surrounding vessels was evaluated correctly using the invasion score, with a sensitivity of 89% and a specificity of 99%. In evaluation of resectability, a sensitivity of 94% and a specificity of 89% were achieved.
  
  
  CONCLUSIONS
  Using 16-row spiral CT, the invasion score is a valid tool for correctly assessing invasion in relevant vessels in cases of pancreatic carcinoma and for determining resectability.
authors.affiliation: Department of Diagnostic Radiology, University of Heidelberg, Heidelberg, Germany. miriam.klauss@med.uni-heidelberg.de
authors.forename: M
authors.initials: M
authors.lastname: Klauss
authors.forename: A
authors.initials: A
authors.lastname: Mohr
authors.forename: H
authors.initials: H
authors.lastname: von Tengg-Kobligk
authors.forename: H
authors.initials: H
authors.lastname: Friess
authors.forename: R
authors.initials: R
authors.lastname: Singer
authors.forename: P
authors.initials: P
authors.lastname: Seidensticker
authors.forename: H U
authors.initials: HU
authors.lastname: Kauczor
authors.forename: G M
authors.initials: GM
authors.lastname: Richter
authors.forename: G W
authors.initials: GW
authors.lastname: Kauffmann
authors.forename: L
authors.initials: L
authors.lastname: Grenacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging*; D010179:Pancreas; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide