title: Vascular enhancement pattern of mass in computed tomography may predict chemo-responsiveness in advanced pancreatic cancer.
abstract: BACKGROUND
  Chemo-responsiveness in pancreatic cancer is known to be dependent on fibrosis and vascularity. The purpose of this study was to assess vascular enhancement in advanced pancreatic adenocarcinoma with or without liver metastasis in computed tomography (CT) and to analyze the correlation between enhancement patterns and chemo-responsiveness.
  
  
  METHODS
  Patients were assigned to either a responder group (partial response or stable disease) or a non-responder group (progressive disease) according to chemo-responsiveness assessed by CT before and after gemcitabine-based chemotherapy. Hounsefield unit (HU) was measured in pancreatic mass and the largest metastatic liver mass using region of interest (ROI). HU differences (ΔHU) between arterial and pre-contrast phase were calculated.
  
  
  RESULTS
  Of the 101 study subjects, 78(77.2%) were assigned to the pancreas responder group {mean ΔHU (±SD), 36.7(±21.6)} and 23(22.8%) to the pancreas non-responder group {mean ΔHU (±SD), 20.6(±9.9)} (p = 0.001 for ΔHUs). Of the 46 study subjects with liver metastasis, 25(54.3%) were assigned to the liver metastasis responder group {mean ΔHU (±SD), 36.9(±21.0} and 21(45.7%) to the liver metastasis non-responder group {mean ΔHU (±SD), 17.1 (±24.0)}, (p = 0.005 for ΔHUs).
  
  
  CONCLUSIONS
  CT determined mass vascular enhancement patterns may predict chemoresponse in advanced pancreatic cancer.
authors: Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea.
authors: Shin Il
authors: SI
authors: Kim
authors: Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea.
authors: Jun Young
authors: JY
authors: Shin
authors: Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea.
authors: Jin-Seok
authors: JS
authors: Park
authors: Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea; The National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, South Korea. Electronic address: inos@inha.ac.kr.
authors: Seok
authors: S
authors: Jeong
authors: Department of Radiology, Inha University School of Medicine, Incheon, South Korea.
authors: Yong Sun
authors: YS
authors: Jeon
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, South Korea.
authors: Moon Han
authors: MH
authors: Choi
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, South Korea.
authors: Hyun Jong
authors: HJ
authors: Choi
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, South Korea.
authors: Jong Ho
authors: JH
authors: Moon
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Jae Chul
authors: JC
authors: Hwang
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Min Jae
authors: MJ
authors: Yang
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Byoung Moo
authors: BM
authors: Yoo
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Jin Hong
authors: JH
authors: Kim
authors: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea.
authors: Hyun Woo
authors: HW
authors: Lee
authors: Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors: Chang-Il
authors: CI
authors: Kwon
authors: Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea; The National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, South Korea. Electronic address: LDH@inha.ac.kr.
authors: Don Haeng
authors: DH
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000093542:Gemcitabine
keywords: Chemotherapy; Contrast-enhanced CT; Desmoplastic reaction; Pancreatic cancer; Vascularity