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Vol. 9, No. 5, 2009
Issue release date: November 2009
Section title: Original Paper
Pancreatology 2009;9:621–630
(DOI:10.1159/000212096)

Multidetector CT Evaluation of the Course of Nonresectable Pancreatic Carcinomas with Neoadjuvant Therapy

Klauss 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

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 3/10/2008
Accepted: 7/8/2008
Published online: 8/4/2009

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 7

ISSN: 1424-3903 (Print)
eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN

Abstract

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.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 3/10/2008
Accepted: 7/8/2008
Published online: 8/4/2009

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 7

ISSN: 1424-3903 (Print)
eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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