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Spiral-CT in diagnosis of vascular involvement in pancreatic cancer
J Gmeinwieser1, S Feuerbach, W Hohenberger
1Department of Diagnostic Radiology, University Hospital of Regensburg, Germany.
Background/Aims:
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.
Materials And Methods:
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.
Results:
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.
Conclusions:
These results indicate that spiral-CT reliably verifies occlusion, stenosis and encasement of the major peripancreactic vessels caused by pancreatic cancer.