Pre-operative patient selection of pancreatic cancer patients by multi-detector row CT.
OBJECTIVE
Accurate pre-operative staging in patients with pancreatic cancer is crucial for avoiding unnecessary laparotomy and for selecting patients accurately for curative resection. In this study, tumor resectability and residual tumor grading in patients evaluated by MD-CT (Multi-detector row CT) or by SD-CT (single-detector CT) were compared to determine whether more accurate imaging has a significant clinical impact on patient selection and surgical outcomes.


METHODS
One hundred-fifty consecutive patients with pancreatic cancer evaluated from January 2000 to April 2005 were included in this retrospective study. Seventy pancreatic cancer patients underwent pre-operative evaluation using SD-CT and angiography (5-7 mm slice thickness, 1st period 2000-2002), and 80 patients underwent MD-CT (1.25 mm slice thickness, 2nd period 2002-2005).


RESULTS
The introduction of MD-CT had a significant impact on the selection of suitable patients, this group showing a lower frequency of surgical intervention in cases of incurable disease (p = 0.0383). Pre-operative evaluation using MD-CT in the resected cases also provided a higher percentage of accurate R0/R1 grading relative to SD-CT evaluations (p = 0.0164).


CONCLUSIONS
MD-CT imaging has a significant impact on preventing unnecessary exploratory surgery and on the selection of appropriate pancreatic cancer patients for surgical resection.
Satoi
Sohei
S
Department of Surgery and of Radiology, Kansai Medical University, Osaka, Japan. satoi@hirakata.kmu.ac.jp
Yanagimoto
Hiroaki
H
Toyokawa
Hideyoshi
H
Tanigawa
Noboru
N
Komemushi
Atsushi
A
Matsui
Yoichi
Y
Mergental
Hynek
H
Araki
Hiroshi
H
Takai
Soichiro
S
Kamiyama
Yasuo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D018579:Patient Selection; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*