title: Pancreatic adenocarcinomas without secondary signs on multiphasic multidetector CT: association with clinical and histopathologic features.
abstract: OBJECTIVE
  To determine the clinical, histopathologic and imaging features of pancreatic adenocarcinomas without secondary signs on dynamic CT.
  
  
  METHODS
  Seventy patients (mean age 70 years) with histologically proven pancreatic adenocarcinoma underwent preoperative contrast material-enhanced multiphasic multidetector CT before pancreatic resection. In each patient, clinical data including carbohydrate antigen 19-9, frequency of isoattenuating tumours, and presence of secondary signs and histopathologic findings such as tumour location, tumour stage, and microscopic infiltrative growth grade were evaluated.
  
  
  RESULTS
  Ten tumours (14%) were without secondary signs, and 60 (86%) were with secondary signs. Tumours without and with secondary signs were located in the uncinate process in 5 (50%) and 3 (5%), head in 3 (30%) and 29 (48%), body in 2 (20%) and 22 (37%), and tail in 0 (0%) and 6 (10%), respectively (p = .001). The frequency of isoattenuating pancreatic adenocarcinomas without secondary signs was significantly higher than those with secondary signs (p = 0.034). The tumour stage of pancreatic adenocarcinomas without secondary signs was earlier than that in tumours with secondary signs (p = 0.041).
  
  
  CONCLUSIONS
  Pancreatic adenocarcinomas without secondary signs is characterized by the presence of uncinate and isoattenuating tumours and earlier tumour stage compared to tumours with secondary signs.
  
  
  CONCLUSIONS
  Frequency of pancreatic adenocarcinomas without secondary signs on multiphasic CT is 14 . Pancreatic adenocarcinomas without secondary signs are common in the uncinate process. Pancreatic adenocarcinomas without secondary signs are common in isoattenuating tumours. Pancreatic adenocarcinomas without secondary signs are characterized by earlier-stage tumours.
authors.affiliation: Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan. ttamada@med.kawasaki-m.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tamada
authors.affiliation: Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Pathology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kanomata
authors.affiliation: Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Sone
authors.affiliation: Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kanki
authors.affiliation: Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Higaki
authors.affiliation: Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Hayashida
authors.affiliation: Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003287:Contrast Media; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D010189:Pancreatic Juice / Q000737:chemistry / Q000166:cytology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D018395:CA-19-9 Antigen; D003287:Contrast Media
keywords: Comparative study; Early diagnosis of cancer; Histopathology; Multidetector computed tomography; Pancreatic neoplasms