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Pancreatology. 2017 Jan - Feb;17(1):103-108. doi: 10.1016/j.pan.2016.10.008. Epub 2016 Oct 19.

Vascular enhancement pattern of mass in computed tomography may predict chemo-responsiveness in advanced pancreatic cancer.

Author information

1
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea.
2
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea; The National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, South Korea. Electronic address: inos@inha.ac.kr.
3
Department of Radiology, Inha University School of Medicine, Incheon, South Korea.
4
Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, South Korea.
5
Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
6
Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea.
7
Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
8
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea; The National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, South Korea. Electronic address: LDH@inha.ac.kr.

Abstract

INTRODUCTION:

Chemo-responsiveness in pancreatic cancer is known to be dependent on fibrosis and vascularity. The purpose of this study was to assess vascular enhancement in advanced pancreatic adenocarcinoma with or without liver metastasis in computed tomography (CT) and to analyze the correlation between enhancement patterns and chemo-responsiveness.

METHODS:

Patients were assigned to either a responder group (partial response or stable disease) or a non-responder group (progressive disease) according to chemo-responsiveness assessed by CT before and after gemcitabine-based chemotherapy. Hounsefield unit (HU) was measured in pancreatic mass and the largest metastatic liver mass using region of interest (ROI). HU differences (ΔHU) between arterial and pre-contrast phase were calculated.

RESULTS:

Of the 101 study subjects, 78(77.2%) were assigned to the pancreas responder group {mean ΔHU (±SD), 36.7(±21.6)} and 23(22.8%) to the pancreas non-responder group {mean ΔHU (±SD), 20.6(±9.9)} (p = 0.001 for ΔHUs). Of the 46 study subjects with liver metastasis, 25(54.3%) were assigned to the liver metastasis responder group {mean ΔHU (±SD), 36.9(±21.0} and 21(45.7%) to the liver metastasis non-responder group {mean ΔHU (±SD), 17.1 (±24.0)}, (p = 0.005 for ΔHUs).

CONCLUSION:

CT determined mass vascular enhancement patterns may predict chemoresponse in advanced pancreatic cancer.

KEYWORDS:

Chemotherapy; Contrast-enhanced CT; Desmoplastic reaction; Pancreatic cancer; Vascularity

PMID:
27780664
DOI:
10.1016/j.pan.2016.10.008
[Indexed for MEDLINE]

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