A new invasion score for determining the resectability of pancreatic carcinomas with contrast-enhanced multidetector computed tomography

Pancreatology. 2008;8(2):204-10. doi: 10.1159/000128557. Epub 2008 Apr 23.

Abstract

Objective: It was the aim of this study to evaluate a new infiltration score to determine the resectability of pancreatic carcinomas in preoperative planning.

Materials and methods: Eighty patients with suspected pancreatic tumor were examined prospectively using 16-row spiral CT. The scans were evaluated for the presence of pancreatic carcinoma, peripancreatic tumor extension and vascular invasion using a standardized questionnaire. Invasion of the surgically relevant vessels was evaluated using a new invasion score. The operative and histological findings and the clinical follow-up served as the gold standard.

Results: Forty patients had a pancreatic carcinoma, 5 had metastasis of a different primary tumor, and in 35 patients, there was no malignant pancreatic disease. The sensitivity for tumor detection was 100%, with a specificity of 88% for differentiating between malignant and benign pancreatic tumors. Invasion of the surrounding vessels was evaluated correctly using the invasion score, with a sensitivity of 89% and a specificity of 99%. In evaluation of resectability, a sensitivity of 94% and a specificity of 89% were achieved.

Conclusion: Using 16-row spiral CT, the invasion score is a valid tool for correctly assessing invasion in relevant vessels in cases of pancreatic carcinoma and for determining resectability.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Female
  • Humans
  • Iohexol / analogs & derivatives
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / diagnostic imaging*
  • Pancreas
  • Pancreatic Neoplasms / blood supply
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / surgery
  • Preoperative Care / methods*
  • Prospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Iohexol
  • iopromide