Multidetector CT Evaluation of the Course of Nonresectable Pancreatic Carcinomas with Neoadjuvant Therapy |
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| Authors: | M Klauss CD Alt T Welzel J Wemer MW Büchler GM Richter GW Kauffmann HU Kauczor L Grenacher |
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| Institution: | 1. Department of Diagnostic Radiology, University of Heidelberg, Heidelberg, Germany;2. Surgical Clinic, University of Heidelberg, Heidelberg, Germany;3. Department of Therapeutic Radiology, University of Heidelberg, Heidelberg, Germany;1. Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan;2. Division of Oncology, Yokohama City University School of Medicine, Yokohama, Japan;3. Division of Pathology, Yokohama City University School of Medicine, Yokohama, Japan;4. Division of Surgery, Yokohama City University School of Medicine, Yokohama, Japan;1. Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1473, Houston, TX 77030, USA;2. Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA;1. School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China;2. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China;3. Department of Nuclear Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, China;4. PET/CT Center, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China;1. Division of Abdominal Imaging, Department of Radiology, University of Michigan Hospitals, 1500 East Medical Center Drive, Room B1 D502, Ann Arbor, MI 48109, USA;2. Division of Abdominal Imaging, Department of Radiology, University of Michigan Hospitals, 1500 East Medical Center Drive, Room B1 D540, Ann Arbor, MI 48109, USA;3. Division of Gastroenterology, Department of Internal Medicine, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA;1. Istituto di Radiologia, Policlinico GB Rossi, Azienda Ospedaliera Universitaria Integrata di Verona, P.le LA Scuro 10, 37134 Verona, Italy;2. U.O. di Fisica Sanitaria, Azienda Ospedaliera Universitaria Integrata di Verona, P.le Stefani 1, 37126 Verona, Italy |
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| Abstract: | Objective: A prospective study to determine the value of multidetector CT (MD-CT) in assessing the course of nonresectable pancreatic carcinoma during therapy. Material and Methods: 26 patients with nonresectable pancreatic carcinoma underwent MD-CT before and after therapy. The examinations were evaluated with regard to tumor size and vascular invasion using an invasion score (IS) by 2 radiologists independently (κ analysis). Diagnosis was confirmed surgically, by biopsy or clinical course. Results: Sensitivity for the assessment of irresectability was 100%. Following therapy, 54% of all the tumors were smaller (14/26), 42% had increased in volume (11/26), and one tumor remained stable (1/26). The IS (veins) during follow-up changed in 26 patients (portal vein: 5 higher (mean score 10.4/16.2), 4 lower (mean score 17.5/11.5); superior mesenteric vein: 12 higher (11/14.4), 5 lower (16.2/14.6); p = 0.026). The IS (arteries) changed in 13 patients (celiac trunk: 3 higher (3.3/10); hepatic artery: 4 higher (5.7/10.2), 3 lower (11.6/10.3); superior mesenteric artery: 2 higher (4.5/9.5), 1 lower (12/11)). The k values were calculated between 0.56 and 0.87. Conclusion: MD-CT is suitable for evaluating tumor spread during therapy for nonresectable pancreatic carcinoma. The IS is useful for assessing the degree of change in vessel invasion. |
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