Original Article
Study on the value of multislice spiral CT for predicting T staging and resectability of pancreatic cancer
Yun Bian, Xu Fang, Chengwei Shao, Jianping Lu, Li Wang
Published 2016-12-20
Cite as Chin J Pancreatol, 2016, 16(6): 372-377. DOI: 10.3760/cma.j.issn.1674-1935.2016.06.004
Abstract
ObjectiveTo explore the value of multislice spiral computed tomography (MSCT) in predicting the resectability of pancreatic cancer (PC).
MethodsThe MSCT images of 102 PC patients (62 men, mean age, 61±9 years; 40 women, mean age, 60±9 years) confirmed by postoperative pathology were analyzed retrospectively. The images were analyzed and evaluated by 2 senior radiologists who were double blinded. The relationship between tumor and vessels was investigated based on consensus statement on the radiological diagnosis of PC of the Society of Abdominal Radiology and the American Pancreatic Association in 2014. The diagnostic criterion on the resectability of PC was based on the 2015 NCCN Clinical Practice Guidelines on PC. Image analysis included the lesion location, size and density, the characteristics of pancreatic and bile ducts, relationship of tumor and adjacent vessels, the extrapancreatic findings as well as T staging and resectability.
ResultsThe locations of PC were found in the pancreatic head (n=71, 69.6%), body (n=23, 22.5%) and tail (n=8, 7.8%). The long- and short-axis diameter were (28.9±8.8)mm and (23.8±8.0)mm in head, and respectively, (31.2±11.0)mm and (23.8±6.3)mm in body and tail, respectively. The imaging findings included hypo- (n=98, 96.1%) and iso-density masses (n=4, 3.9%) on pancreatic phase, intra- and extrahepatic bile duct dilation (n=63, 61.8%), main pancreatic duct cut-off with dilation (n=46, 45.1%), the pseudocyst (n=4), acute pancreatitis (n=1) and chronic pancreatitis (n=2). T staging evaluation by MSCT observed T1 (n=3), T2 (n=7), T3 (n=78) and T4 (n=14), respectively. MSCT assessment for T staging was correct in 98 (96.1%), but wrong in 4 (3.9%), which was quite consistent with pathological T staging (K=0.88, P<0.05). MSCT assessment for the resectability was correct in 98 (96.1%), but wrong in 4 (3.9%). Sensitivity, specificity, positive and negative predictive values, and area under curve of MSCT in the assessment of the resectability were 96.8%, 87.5%, 98.9%, 70.0% and 92.2%, respectively.
ConclusionsMSCT could improve the diagnostic accuracy for T Staging and resectability of PC.
Key words:
Pancreatic neoplasms; Neoplasm metastasis; Vascular invasion; Tomography, spiral computed
Contributor Information
Yun Bian
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
Xu Fang
Chengwei Shao
Jianping Lu
Li Wang
