Multidetector CT Evaluation of the Course of Nonresectable Pancreatic Carcinomas with Neoadjuvant TherapyKlauss M. · Alt C.D. · Welzel T. · Werner J. · Büchler M.W. · Richter G.M. · Kauffmann G.W. · Kauczor H.U. · Grenacher L.
aDepartment of Diagnostic Radiology, bSurgical Clinic, and cDepartment of Therapeutic Radiology, University of Heidelberg, Heidelberg, Germany
Objective: A prospective study to determine the value of multidetector CT (MD-CT) in assessing the course of nonresectable pancreatic carcinoma during therapy. Material and Methods: 26 patients with nonresectable pancreatic carcinoma underwent MD-CT before and after therapy. The examinations were evaluated with regard to tumor size and vascular invasion using an invasion score (IS) by 2 radiologists independently (κ analysis). Diagnosis was confirmed surgically, by biopsy or clinical course. Results: Sensitivity for the assessment of irresectability was 100%. Following therapy, 54% of all the tumors were smaller (14/26), 42% had increased in volume (11/26), and one tumor remained stable (1/26). The IS (veins) during follow-up changed in 26 patients (portal vein: 5 higher (mean score 10.4/16.2), 4 lower (mean score 17.5/11.5); superior mesenteric vein: 12 higher (11/14.4), 5 lower (16.2/14.6); p = 0.026). The IS (arteries) changed in 13 patients (celiac trunk: 3 higher (3.3/10); hepatic artery: 4 higher (5.7/10.2), 3 lower (11.6/10.3); superior mesenteric artery: 2 higher (4.5/9.5), 1 lower (12/11)). The κ values were calculated between 0.56 and 0.87. Conclusion: MD-CT is suitable for evaluating tumor spread during therapy for nonresectable pancreatic carcinoma. The IS is useful for assessing the degree of change in vessel invasion.
Miriam Klauss, MD
Department of Diagnostic Radiology, University of Heidelberg
INF 110, DE–69120 Heidelberg (Germany)
Tel. +49 6221 563 9758, Fax +49 6221 565 730
Received: March 10, 2008
Accepted after revision: August 7, 2008
Published online: August 4, 2009
Number of Print Pages : 10
Number of Figures : 5, Number of Tables : 7, Number of References : 22
Vol. 9, No. 5, Year 2009 (Cover Date: November 2009)
Journal Editor: Urrutia R. (Rochester, Minn.)
ISSN: 1424-3903 (Print), eISSN: 1424-3911 (Online)
For additional information: http://www.karger.com/PAN