title: Comparison of pancreatic acinar cell carcinoma and adenocarcinoma using multidetector-row computed tomography.
abstract: OBJECTIVE
  To distinguish acinar cell carcinoma (ACC) from pancreatic adenocarcinoma (AC) by comparing their computed tomography findings.
  
  
  METHODS
  Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens. The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases (non-contrast, arterial, portal venous, and delayed phase) were compared. The scan delay times were 40, 70, and 120 s for each contrast-enhanced phase. The visual pattern, tomographic attenuation value, and time attenuation curve were assessed and compared between AC and ACC cases using the χ² test, Wilcoxon signed-rank test, and Mann Whitney U test.
  
  
  RESULTS
  The adenocarcinomas tended to be hypodense in all 4 phases. The acinar cell carcinomas also tended to be hypodense in the 3 contrast-enhanced phases, although their computed tomographic attenuation values were higher. Further, 5 of the 6 acinar cell carcinomas (83%) were isodense in the non-contrast phase. The time attenuation curve of the adenocarcinomas showed a gradual increase through the 4 phases, and all adenocarcinomas showed peak enhancement during the delayed phase. The time attenuation curve of the acinar cell carcinomas showed peak enhancement during the portal venous phase in 4 cases and during the arterial phase in 2 cases. None of the 6 acinar cell carcinomas showed peak enhancement during the delayed phase.
  
  
  CONCLUSIONS
  The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinomas and adenocarcinomas, and multidetector-row computed tomography can thus distinguish these tumors.
authors.affiliation: Tatsuaki Sumiyoshi, Yasuo Shima, Takehiro Okabayashi, Akihito Kozuki, Toshio Nakamura, Departments of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi 781-8555, Japan.
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Sumiyoshi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Akihito
authors.initials: A
authors.lastname: Kozuki
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018267:Carcinoma, Acinar Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies
keywords: Multidetector-row computed tomography; Pancreatic acinar cell carcinoma; Pancreatic adenocarcinoma; Time attenuation curve; Visual pattern
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