title: CT imaging of early local recurrence of pancreatic adenocarcinoma following pancreaticoduodenectomy.
abstract: OBJECTIVE
  The objectives of this retrospective study were to describe the characteristics and topography of pancreatic ductal adenocarcinoma and its early local recurrence after pancreaticoduodenectomy and identify predictive factors of local early recurrence by imaging computed tomography (CT).
  
  
  METHODS
  The institutional review board approved the study and did require additional informed consent for reviewing the patients' medical records and images. Patients who underwent pancreaticoduodenectomy for ductal adenocarcinoma, a preoperative CT scan, and adequate postoperative CT were included. After postoperative imaging, correlations among clinical and histological characteristics and preoperative imaging were evaluated.
  
  
  RESULTS
  Among the 123 patients who underwent pancreaticoduodenectomy, 48 patients had sufficient follow-up imaging and were included in this study. A total of 33 patients experienced local early recurrence (Group 1), and 15 exhibited no local recurrence (Group 2). Local recurrence consisted of two types of anomalies: tissue nodules on surgical clips (94%) and peri-arterial encasement (82%). On preoperative imaging, the tumor diameter (p = 0.02) and the presence of a venous borderline resectable tumor (p < 0.0001) were predictive of local recurrence.
  
  
  CONCLUSIONS
  Tissue nodules on surgical clips and arterial encasement characterize early local recurrence, and nodules and encasement should not be considered common post-operative infiltration. The role of the radiologist is essential to assess the predictive factors of recurrence and to identify early local recurrence.
authors: Department of Radiology Adults, Brabois Hospital, University of Nancy, Rue du Morvan, 54 511, Vandoeuvre les Nancy, France. clemence.balaj@gmail.com.
authors: Clémence
authors: C
authors: Balaj
authors: Department of HBP Surgery, Brabois Hospital, University of Nancy, Vandoeuvre les Nancy, France.
authors: Ahmet
authors: A
authors: Ayav
authors: Department of Radiology Adults, Brabois Hospital, University of Nancy, Rue du Morvan, 54 511, Vandoeuvre les Nancy, France.
authors: Alexandre
authors: A
authors: Oliver
authors: Department of Radiology Adults, Brabois Hospital, University of Nancy, Rue du Morvan, 54 511, Vandoeuvre les Nancy, France.
authors: François
authors: F
authors: Jausset
authors: Department of Radiology Adults, Brabois Hospital, University of Nancy, Rue du Morvan, 54 511, Vandoeuvre les Nancy, France.
authors: Caroline
authors: C
authors: Sellal
authors: Department of Radiology Adults, Brabois Hospital, University of Nancy, Rue du Morvan, 54 511, Vandoeuvre les Nancy, France.
authors: Michel
authors: M
authors: Claudon
authors: Department of Radiology Adults, Brabois Hospital, University of Nancy, Rue du Morvan, 54 511, Vandoeuvre les Nancy, France.
authors: Valérie
authors: V
authors: Laurent
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Adenocarcinoma; Arterial encasement; Nodules; Pancreas; Recurrence