CT Angiography and surgical assessment of vessels' infiltration by pancreatic carcinoma

• Autorzy: Stróżyński P. , Radecka A. , Buczkowski K. , Ptak D.
• Języki publikacji: EN

Abstrakty

EN

Pancreatic cancer is the second most common malignancy of the gastrointestinal tract. The only potentially curative treatment is complete surgical resection but it can be performed only in patients without metastatic disease and entire resection with negative surgically and microscopically margins (R0 resection). Complete resection of the tumour with vessels’ involvement is still controversial. However, many authors proved that venous as well as arterial resection and reconstruction did not influence on final outcome. Proper preoperative staging helps in relevant treatment (surgery, radiochemotherapy or combination of these methods). The most common diagnostic step is MDCT with CTA which improves high sensitivity and specificity. The purpose of the study was to assess vessels’ infiltration by pancreatic carcinoma on the basis of CTA and surgery. CTA showed 88,9% sensitivity in diagnosing vessel’s involvement, however in some cases surgery is the method of choice in assessing tumours as resectable or unresectable.

Słowa kluczowe

EN

pancreatic tumour; CTA; surgery; resectability; vessels' infiltration; diagnostic imaging

PL

guz trzustki; tomografia komputerowa żył; chirurgia; diagnostyka obrazowa

• Wydawca: University of Silesia, Institute of Informatics, Computer Systems Department
• Czasopismo: Journal of Medical Informatics & Technologies
• Rocznik: 2009
• Tom: Vol. 13
• Strony: 131--135
• Opis fizyczny: Bibliogr. 21 poz., rys.

Twórcy

autor

Stróżyński P.

• Year of studies: Intern, Medical University of Silesia, The School of Medicine in Katowice

autor

Radecka A.

autor

Buczkowski K.

autor

Ptak D.

Bibliografia

• [1] ALEXAKIS N, HALLORAN C, RARATY M, GHANEH P,SUTTON R, NEOPTOLEMOS JP. Current standards of surgery for pancreatic cancer. Br J Surg 2004; 91:1410–1427
• [2] Al-HADDAD M, MARTIN JK, NGUYEN J, PUNGPAPONG S, RAIMONDO M, WOODWARD T. Vascular resection and reconstruction for pancreatic malignancy: a single center survival study. J Gastrointest Surg. Sep 2007;11(9):1168-74
• [3] ARIYAMA J, SUYAMA M, SATOH K, SAI J. Imaging of small pancreatic ductal adenocarcinoma. Pancreas. 1998;16:396-401
• [4] BRONSTEIN YL, LOYER EM, KAUR H, et al. Detection of small pancreatic tumors with multiphasic helical CT. AJR Am J Roentgenol 2004; 182:619–623
• [5] Cancer Facts and Figures. CA Cancer J Clin,2008
• [6] CATALANO C, LAGHI A, FRAIOLI F, et al. Pancreatic carcinoma: the role of high-resolution multislice spiral CT in the diagnosis and assessment of resectability Eur Radiol 2003; 13:149–156
• [7] CHARI ST, LEIBSON CL, RABE KG, RANSOM J, de ANDRADE M, PETERSEN GM. Probability of pancreatic cancer following diabetes: a population-based study. Gastroenterology. Aug 2005;129:504-11
• [8] DIEHL S, LEHMANN K, SADICK M, LACHMANN R, GEORGI M. Pancreatic cancer: value of dual-phase helical CT in assessing resectability. Radiology1998; 206:373 –378
• [9] DPHOA SS, REEDERS JW, RAUWS EA, WIT LT de, GOUMA DJ, LAMÉRIS JS. Spiral computed tomography for preoperative staging of potentially resectable carcinoma of the pancreatic head. Br J Surg 1999;86:789-94
• [10] GMEINWIESER J. et al Spiral CT in diagnosis of vascular involvement in pancreatic cancer. Hepatogastroenterology 1995; 42: 418-422
• [11] HORTON KM, E.K.FISHMAN Multidetector CT Angiography of pancreatic carcinoma. AJR 2002; 178:827-831
• [12] HOWARD TJ, VILLANUSTRE N, MOORE SA, et al. Efficacy of venous reconstruction in patients with adenocarcinoma of the pancreatic head. J Gastrointest Surg2003; 7:1089–1095
• [13] KLAUS M., MOHR A. et al A new invasion score for determining the resectability of pancreatic carcinomas with contrast-enhanced Multidetector Computed Tomography. Pancreatology 2008; 8: 204-210
• [14] LALL CG, HOWARD TJ, SKANDARAJAH A, et al. (2007) New concepts in staging and treatment of locally advanced pancreatic head cancer.AJR Am J Roentgenol 189:1044–1050
• [15] LEACH SD, LEE JE, CHARNSANGAVEJ C, et al. Survival following pancreaticoduodenectomy with resection of the superior mesenteric–portal vein confluence for adenocarcinoma of the pancreatic head. Br J Surg 1998; 85:611–617
• [16] LYGIDAKIS NJ, SINGH G, BARDAXOGLOU E, et al. Monobloc total spleno-pancreaticoduodenectomy for pancreatic head carcinoma with portal–mesenteric venous invasion: a prospective randomized study. Hepatogastroenterology 2004; 51:427–433
• [17] MARTIN RC 2ND, SCOGGINS CR, EGNATASHVILI V, STALEY CA, MCMASTERS KM, KOOBY DA. Arterial and venous resection for pancreatic adenocarcinoma: operative and long-term outcomes. Arch Surg 2009 Feb; 144(2): 154-9
• [18] MCPHEE JT, HILL JS, WHALEN GF, ZAYARUZNY M, LITWIN DE, SULLIVAN ME. Perioperative mortality for pancreatectomy: a national perspective. Ann Surg. Aug 2007;246(2):246-53
• [19] STITZENBERG K.B. et al Survival after pancreatectomy with major arterial resection and reconstruction. Ann Surg Oncol. 2008; 15: 1399-1406
• [20] VARGAS R, NINO-MURCIA M, TRUEBLOOD W, JEFFREY RB Jr. MDCT in pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. AJR 2004; 182:419–425
• [21] YEKEBAS E.F. et al En bloc vascular resection for locally advanced pancreatic malignancies infiltrating major blood vessels: perioperative outcome and long-term survival in 136 patients. Ann Surg 2008 Feb; 247(2):300-309