Spiral-CT in diagnosis of vascular involvement in pancreatic cancer

• Published in: Hepato-gastroenterology Vol. 42; no. 4; p. 418
• Main Authors: Gmeinwieser, J, Feuerbach, S, Hohenberger, W, Albrich, H, Strotzer, M, Hofstädter, F, Geissler, A
• Format: Journal Article
• Language: English
• Published: Greece 01.07.1995
• Subjects: Aged; Aged, 80 and over; Carcinoma, Ductal, Breast - blood supply; Carcinoma, Ductal, Breast - diagnostic imaging; Female; Humans; Male; Middle Aged; Pancreatic Neoplasms - blood supply; Pancreatic Neoplasms - diagnostic imaging; Predictive Value of Tests; Sensitivity and Specificity; Tomography, X-Ray Computed - methods
• ISSN: 0172-6390

The purpose of this prospective study was to evaluate the efficacy of spiral-CT for the identification of portal venous, superior mesenteric artery and celiac trunk infiltration in the staging of pancreatic (n = 29) and periampullary (n = 6) cancers. All patients were examined by contrast enhanced spiral-CT using a total volume of 240 ml contrast medium i.v. With a slice thickness of 5 mm and a table increment of 7 mm/sec a overlapping data set, representing a total volume of 21 cm, was covered. The images were reconstructed in 4 mm intervals. In 28 patients the spiral CT results were correlated with surgical findings. Regarding portal venous infiltration spiral-CT had a sensitivity of 91% (10/11), a specificity of 9.4% (16/17), a positive predictive value of 91% (10/11), a negative predictive value of 94% (16/17) and, an overall accuracy of 92.8% (26/28). Spiral CT correctly identified arterial involvement in 5 patients, and no false negative result compared to surgical findings was observed. These results indicate that spiral-CT reliably verifies occlusion, stenosis and encasement of the major peripancreactic vessels caused by pancreatic cancer.