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8 - Helical CT of pancreatic cancer; assessment of resectability before surgery
Nuran Yılmaz, Hüseyin Özkurt, Hülya Değirmenci, Ayşe Deniz Kahraman,Muzaffer Başak
Objective: The aim of our study was to evaluate the accuracy of helical CT in the preoperative assessment with suspected pancreatic cancer using surgical and histopathologic correlation. We prospective!) evaluated the imagine findings to determine of pancreatic tumor and one of the signs of unresectability, peripancreatic vasculer encasement with tumor.
Material and methods: 15 patients with suspected pancreatic cancer underwent preoperative evaluation and staging with helical CT (3-mm collimation for arterial and pancreatic phase, 5-mm collimation for portal phase), iodinated contrast material was injected IV (¡00 mL at a rate of 3 niL / sec); acquisition began at 25 sec during the arterial phase, at 50-60 sec during the pancreatic phase and at 80 sec during the portal phase. Two radiologist prospectively evaluated the imaging findings to determine the precense of pancreatic tumor and signs of unresectability (vascular encasement). The degree of tumor-vessel contiguity was recorded for each patient (no contiguity with tumor, contiguity of <50 %, or contiguity of >50 %).
Results: 15 patients were surgically explored. Curative resections were attempted in 7 patients and were successful in 5. The positive predictive value for resectability was (517) 71%. 2 patients considered resectable on the basis of CT findings were found to be unresectable at surgery because of vasculer encasement. We found that the overall accuracy of helical CT as a tool for determining whether a pancreatic cancer was resectable was 87% (13115) patients).
Conclusion: Helical CT is a useful technique for preoperative staging of pancreatic cancer.
Keywords: Pancreas, Helical CT
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