Perfusion CT can predict tumoral grading of pancreatic adenocarcinoma

M. D'Onofrio, A. Gallotti, W. Mantovani, S. Crosara, E. Manfrin, M. Falconi, A. Ventriglia, G. A. Zamboni, R. Manfredi, R. Pozzi Mucelli

Research output: Contribution to journalArticlepeer-review


Objectives: To describe perfusion CT features of locally advanced pancreatic ductal adenocarcinoma and to evaluate correlation with tumor grading. Methods: Thirty-two patients with locally advanced pancreatic adenocarcinoma were included in this study. Lesions were evaluated by P-CT and biopsy after patient's informed consent. P-CT parameters have been assessed on a large single and on 6 small intratumoral ROIs. Values obtained have been compared and related to the tumor grading using Mann-Whitney U test. Sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy in predicting tumor grading have been calculated for cut-off values chosen by using ROC curves. Results: Out of 32 lesions, 12 were classified as low grade and 20 as high grade. A statistically significant difference between high and low grade neoplasms were demonstrated for PEI and BV parameters. PEI and BV cut-off values were respectively 17.8 HU and 14.8 ml/100 g. PEI identified high grade neoplasms with a 65% sensitivity, 92% specificity, 93% PPV, 61% NPV and 75% accuracy. BV identified high grade neoplasms with a 80% sensitivity, 75% specificity, 84% PPV, 69% NPV, 78% accuracy. Considering both PEI and BV, P-CT identified high grade lesions with a 60% sensitivity, 100% specificity, 100% PPV, 60% NPV and 75% accuracy. Conclusions: PEI and BV perfusion CT parameters proved their efficiency in identifying high grade pancreatic adenocarcinoma.

Original languageEnglish
Pages (from-to)227-233
Number of pages7
JournalEuropean Journal of Radiology
Issue number2
Publication statusPublished - Feb 2013


  • Abdominal radiology
  • Pancreatic adenocarcinoma
  • Perfusion CT
  • Tumor grading

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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