Resectable Pancreatic Adenocarcinoma: Is the Enhancement Pattern at Contrast-Enhanced Ultrasonography a Pre-Operative Prognostic Factor?

M. D'Onofrio, G. A. Zamboni, R. Malagò, W. Mantovani, F. Principe, A. Gallotti, N. Faccioli, M. Falconi, P. Capelli, R. Pozzi Mucelli

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of our study was to determine whether the enhancement pattern of pancreatic adenocarcinoma at contrast-enhanced ultrasonography (CEUS) is related to patient prognosis after resection. CEUS of 42 resected adenocarcinomas were retrospectively reviewed. Tumors were divided into two groups: group A = poorly vascularized (presence of avascular areas) or group B = well vascularized (absence of avascular areas). All lesions were resected and underwent pathological examination assessing tumor differentiation as: undifferentiated (poorly differentiated) or differentiated (moderately and well differentiated). Mean vascular density (MVD) was also evaluated. CEUS enhancement and pathology were correlated (Spearman's test). Survival was analyzed with the Kaplan-Meier method. Multivariate analysis was performed with the Cox regression model. There were 30 differentiated and 12 undifferentiated adenocarcinomas at pathology. At CEUS, 10 lesions were poorly vascularized, whereas 32 lesions were well vascularized. Positive correlation was observed between CEUS groups and tumoral differentiation (rs = 0.51; p = 0.001) and between CEUS and MVD (rs = 0.74; p <0.0001). Median survival in patients with group A vascularization at CEUS was significantly lower than in group B (p = 0.015). Cox proportional hazard model revealed the presence of poorly vascularized tumor at CEUS (p = 0.0001) as a predictor of higher mortality. In conclusion, CEUS enables accurate depiction of the vascularization of adenocarcinoma, with positive correlation to histology grade and MVD. (E-mail: mirko.donofrio@univr.it).

Original languageEnglish
Pages (from-to)1929-1937
Number of pages9
JournalUltrasound in Medicine and Biology
Volume35
Issue number12
DOIs
Publication statusPublished - Dec 2009

Keywords

  • Contrast-enhanced ultrasound
  • Mean vascular density
  • Pancreatic adenocarcinoma
  • Prognostic factor
  • Survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Biophysics

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