Diagnostic Accuracy of a 64-Slice Multi-Detector CT Scan in the Preoperative Evaluation of Periampullary Neoplasms

Abstract

Periampullary tumors are highly malignant masses with poor prognosis. Surgical resection is the only treatment for patients with this disease. The preoperative evaluation of masses is essential to determine the tumor resectability and vascular invasion. The aim of this study was to determine the diagnostic accuracy of 64-slice multi-detector computed tomography (MDCT) in detecting the resectability of periampullary masses. A cross-sectional study was conducted on patients with a definite diagnosis of periampullary cancer. All the participants underwent an MDCT scan before the surgical pancreaticoduodenectomy. The preoperative results were compared to the intraoperative findings and the diagnostic accuracy was determined based on the sensitivity and specificity of the MDCT. From June 2015 until June 2016, 32 patients with periampullary carcinoma were enrolled in the study. Of 32 masses, one of them considered nonresectable because of the gross vascular invasion in th CT images. After the operation, the overall resectability rate was 81.3%. The sensitivity and specificity of MDCT for tumor resectability was 100% and 16.7%, respectively, with an overall accuracy of 84.4%. To sum up, MDCT had high sensitivity but low specificity in the preoperative evaluation of preampullary carcinomas. The low specificity resulted from the low accuracy of the CT scan in detecting vascular involvement.

The Effect of Females’ Reproductive Factors on Pituitary Gland Size in Women at Reproductive Age

“…Imaging modalities have improved the diagnosis of major diseases [12,13]. The previous data in the literature confirmed the inverse effect of ageing on the pituitary size [14,15,16].…”

Influence of non-jaundice stage at diagnosis on clinicopathological features and long-term survival of patients with periampullary carcinomas

“…Surgical resection is the only and most effective curative treatment for PACs. [5,27] Among of them, PD as a radical resection is the standard treatment for patients with resectable PACs. [12,15,28] In our study, the 5-year survival rate of resected PACs was 41.3%, which was consistent with the results reported by previous studies (15%–65%).…”

“…[4] The poor prognosis is due to few specific symptoms in primary stages of PACs. [5] Although the origins are different, these tumors usually have similar manifestations because of the complex regional anatomy and close locations. Among of these, jaundice is one of the most common clinical symptoms.…”

Combination of CEUS and MRI for the diagnosis of periampullary space-occupying lesions: a retrospective analysis

“…PAC accounts for 0.5–2.0% of gastrointestinal malignancies diagnosed each year [2]. PAC is the most malignant type of cancer and surgical resection is only curative treatment, yet most patients are not surgical candidates [3]. After surgical resection, the average 5-year survival rates for patients with pancreatic adenocarcinomas and ampullary carcinomas are 17–25% and 21–38%, respectively [4].…”