Computed tomography-based diagnostics might be insufficient in the determination of pancreatic cancer unresectability

Егоров, В И; Petrov, Roman; Солодинина, Е. Н.; Kаrmаzаnovsky, G. G.; Starostina, Natalia; Kuruschkina, Natalia

doi:10.4240/wjgs.v5.i4.83

Cited by 17 publications

(8 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Assessment of vascular invasion is the key in the evaluation of resectability for pancreatic cancer. 2 Surgical exploration with pathological examination remains the "gold standard" in terms of evaluation of resectability, especially from the point of view of vascular involvement. Unresectability in pancreatic adenocarcinoma is encasement of the superior mesenteric and celiac arteries, indicating vascular invasion.…”

Section: Discussionmentioning

confidence: 99%

“…Assessment of vascular invasion is the key in the evaluation of resectability for pancreatic cancer. 2 Loyer et al noted that the presence of a fat plane between tumour and vesses is agood prognostic sign of resectability. 3 Phoa et al noted that in vessel embedment into tumour or vessel's circular encasement, the rate of vessel invasion was 88% and resectability 7%.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Role of computed tomography in the determination of resectability of carcinoma pancreas

Sasikumar

Salam

2019

Int Surg J

View full text Add to dashboard Cite

Pancreatic cancer remains one of the most aggressive neoplastic processes, and most of the cases are detected late with vascular invasion and metastasis. Inspite of progress in the diagnosis and treatment of malignancies, the resectability and 5-year survival rates for pancreatic ABSTRACT Background: Pancreatic cancer is one of the most aggressive neoplastic processes. Inspite of progress in the diagnosis and treatment of malignancies, the resectability and survival rates for pancreatic cancer are very poor. This study aims to determine the accuracy of computerised tomography in assessing the resectability of carcinoma pancreas. Methods: 66 patients with carcinoma pancreas, who were judged fit for surgery were studied. All cases had undergone preoperative contrast enhanced triphasic computed tomography (CT) for assessing the resectability. Radiological data was compared with per operative findings for assessments regarding vascular invasion and resectability. Results: Of the 66 cases, resectability reported by CT was 59 (89.4%). The rest of 7 (10.6%) cases were reported as unresectable. Per operatively vascular involvement was found in 14 (21.2%) cases and with no vascular invasion in 52 (78.8%) cases. All the unresectable cases reported in CT (7 cases) turned out to be unresectable. Out of 59 cases reported as resectable, 43 (65.2%) cases under went Whipples procedure, while rest of the 23 (34.8%) cases underwent palliative procedures. Out of these 23 cases, 14 (21.2%) cases were unresectable due to vascular involvement. Conclusions:The study has shown that CT does assess the operability in carcinoma pancreas, assessing mainly unresectability though less effective in assessing resectability. The role of endoscopic ultrasound and laparoscopic ultrasound in aiding CT in further assessment of resectable and borderline resectable cases are to be considered for further research.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of computed tomography in the determination of resectability of carcinoma pancreas

Sasikumar

Salam

2019

Int Surg J

View full text Add to dashboard Cite

show abstract

“…Tadros and, Remon Zaher Elia (2016) showed Liver metastases were detected by 7 patients (50%),ascites in 2 patients (14%) and Osteolytic bony lesions were found in (7%). (23) Assessment of vascular invasion is an important parameter for determining resectability of pancreatic cancer (26) In their study, Vyacheslav I Egorov et al found vascular involvement of patients with pancreatic carcinoma ranges between (21%-64%), most often with involvement of SMA, due to its location (27) . In our study, 8 patients (44.4%) showed a vascular involvements, among them SMA and splenic artery were the most involved arteries, while SMV and splenic vein were the most involved veins.…”

Section: Acute Pancreatitismentioning

confidence: 99%

The Role of Multi-Detector Computed Tomography in The Evaluation of Pancreatic Lesions

Tantawy¹,

Elfiki²,

Bayoumi³

et al. 2019

Zagazig University Medical Journal

View full text Add to dashboard Cite

Aim of work: To determine the role of Multi-detector Computed Tomography in the evaluation of various pancreatic lesions. Background:MDCT with its thin collimation allows three-dimensional reformatting and multiplanar reconstruction of pancreatic anatomy which permits good depictions of many pancreatic lesions. Patients and Methods:30 patients with pancreatic lesions suspected on the basis of clinical symptoms, laboratory investigations and USS findings were enrolled in this study. Majority of patients (2 patients were fellow-up patients) were subjected to full clinical history, general and abdominal examination, Laboratory investigations, Ultrasonography examinations with (Siemens, Acuson.X300), and CT examinations; Triphasic contrastenhanced and monophasic MDCT (with delay of 40-50s) performed on (Philips, Ingenuity core128-multislice CT) in the Zagazig university hospital. Results:This study included 30 patients with suspected pancreatic lesions. They were 19 males (63.4%) and 11 females (34.6%). The most studied patients were above 50 years. 11 patients were diagnosed with acute pancreatitis, one patient with acute on chronic pancreatitis, and 18 patients with pancreatic neoplasms. Hence, pancreatic neoplasms were found to be the most common pancreatic lesions in our study. Conclusion:MDCT with contrast proved to be the imaging modality of choice in identification of various pancreatic lesions. The faster scanning time (with single breath hold) and thin slice thickness, allowed for better resolution and superior scan quality. The ability of MDCT to scan in both arterial and venous phases with its post processing techniques (MIP, MinP, CRP, and VR) allowed for excellent visualization of the pancreas, biliary anatomy and peripancreatic vasculature.

show abstract

“…Determination of tumour resectability is a major aspect of the interpretation of pre-operative imaging of peri-ampullary cancer (PC). The findings of distant metastases and local invasion resulting in occlusion of major arteries or veins are contraindications to attempted surgical resection, whereas lesser degrees of arterial involvement (AI) and venous involvement (VI), including abutment and tapering, are relative contraindications, as imaging can sometimes be inaccurate in determining these findings (1)(2)(3)(4), and vein resection can be undertaken where incomplete venous occlusion is noted (5)(6)(7). Tumour size (8) and regional lymphadenopathy (RL) (9,10) have also been shown to be associated with unresectability, although RL is a relative contraindication as these nodes are removed as part of a Whipple procedure (11).…”

Section: Introductionmentioning

confidence: 99%

Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols

Amr

Miles²,

Shahtahmassebi

et al. 2017

Clinical Radiology

View full text Add to dashboard Cite

show abstract

Computed tomography-based diagnostics might be insufficient in the determination of pancreatic cancer unresectability

Cited by 17 publications

References 65 publications

Role of computed tomography in the determination of resectability of carcinoma pancreas

Role of computed tomography in the determination of resectability of carcinoma pancreas

The Role of Multi-Detector Computed Tomography in The Evaluation of Pancreatic Lesions

Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols

Contact Info

Product

Resources

About