Ruolo della Tomografia Computerizzata spirale nella stadiazione del carcinoma pancreatico

Translated title of the contribution: Spiral computed tomography in pancreatic carcinoma staging

Lucia Calculli, Riccardo Casadei, Domenico Diacono, Mauro Caputo, Mauro Cavina, Maria Teresa Minguzzi, Domenico Marrano, Giampaolo Gavelli

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Introduction. Few pancreatic carcinomas (5-22%) are resectable at the time of diagnosis because this lesion is seldom diagnosed in an early stage. Unresectability is mainly due to the presence of metastases to the liver, peritoneum and lymph nodes and to tumor spread especially to the portal mesenteric trunk where it can invade, compress, reduce, or occlude the vessels. We investigated the diagnostic yield of multiplanar and 3D spiral CT in the assessment of pancreatic carcinoma resectability. Material and methods. Twenty-seven patients with histologically confirmed pancreatic head cancer were submitted to spiral CT and color Doppler US in the Surgical Clinic I of the Bologna University. The examination results were correlated with the intraoperative findings of careful inspection and palpation and of US studies of the pancreatic mass and adjacent structures. The tumors were classified in relation to some CT parameters: tumor size (T), infiltration of the stomach (S) and/or duodenum, lymph nodes (N) or distant (M) metastases, involvement of vascular structures (V), particularly of portal or superior mesenteric vein, or superior mesenteric artery. Five grades of vascular involvement were considered. The results of these techniques were correlated with intraoperative findings from careful inspection and palpation and with US studies of the pancreatic mass and adjacent structures. Results. Spiral CT revealed vascular involvement in 19 of 27 cases (70.4%): involvement of portal and superior mesenteric vein was found in 14 (73.6%), superior mesenteric vein was involved in 2 (10.6%), the portal vein in one (2%) and, finally the portal, superior mesenteric vein and superior mesenteric artery in 2 cases (10.6%). The spiral CT results were confirmed intraoperatively in 26 of 27 cases (96.3%); spiral CT did not reveal hepatic metastasis only in one case. Spiral CT with multiplanar reconstructions had very high specificity and sensitivity (100%) in the assessment of vascular involvement, while color Doppler US had the same specificity but lower sensitivity (84.2%). Spiral CT was less sensitive (80%) in the detection of liver metastases. Conclusions. We believe that spiral CT is currently the best technique for pancreatic carcinoma staging, providing useful information for correct surgical planning.

Original languageItalian
Pages (from-to)344-348
Number of pages5
JournalRadiologia Medica
Volume95
Issue number4
Publication statusPublished - Apr 1998

Fingerprint

Spiral Computed Tomography
Mesenteric Veins
Blood Vessels
Neoplasm Metastasis
Superior Mesenteric Artery
Palpation
Liver
Color
Lymph Nodes
Sensitivity and Specificity
Neoplasms
Pancreatic Carcinoma
Peritoneum
Head and Neck Neoplasms
Portal Vein
Pancreatic Neoplasms
Duodenum
Stomach

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Calculli, L., Casadei, R., Diacono, D., Caputo, M., Cavina, M., Minguzzi, M. T., ... Gavelli, G. (1998). Ruolo della Tomografia Computerizzata spirale nella stadiazione del carcinoma pancreatico. Radiologia Medica, 95(4), 344-348.

Ruolo della Tomografia Computerizzata spirale nella stadiazione del carcinoma pancreatico. / Calculli, Lucia; Casadei, Riccardo; Diacono, Domenico; Caputo, Mauro; Cavina, Mauro; Minguzzi, Maria Teresa; Marrano, Domenico; Gavelli, Giampaolo.

In: Radiologia Medica, Vol. 95, No. 4, 04.1998, p. 344-348.

Research output: Contribution to journalArticle

Calculli, L, Casadei, R, Diacono, D, Caputo, M, Cavina, M, Minguzzi, MT, Marrano, D & Gavelli, G 1998, 'Ruolo della Tomografia Computerizzata spirale nella stadiazione del carcinoma pancreatico', Radiologia Medica, vol. 95, no. 4, pp. 344-348.
Calculli L, Casadei R, Diacono D, Caputo M, Cavina M, Minguzzi MT et al. Ruolo della Tomografia Computerizzata spirale nella stadiazione del carcinoma pancreatico. Radiologia Medica. 1998 Apr;95(4):344-348.
Calculli, Lucia ; Casadei, Riccardo ; Diacono, Domenico ; Caputo, Mauro ; Cavina, Mauro ; Minguzzi, Maria Teresa ; Marrano, Domenico ; Gavelli, Giampaolo. / Ruolo della Tomografia Computerizzata spirale nella stadiazione del carcinoma pancreatico. In: Radiologia Medica. 1998 ; Vol. 95, No. 4. pp. 344-348.
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AU - Calculli, Lucia

AU - Casadei, Riccardo

AU - Diacono, Domenico

AU - Caputo, Mauro

AU - Cavina, Mauro

AU - Minguzzi, Maria Teresa

AU - Marrano, Domenico

AU - Gavelli, Giampaolo

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N2 - Introduction. Few pancreatic carcinomas (5-22%) are resectable at the time of diagnosis because this lesion is seldom diagnosed in an early stage. Unresectability is mainly due to the presence of metastases to the liver, peritoneum and lymph nodes and to tumor spread especially to the portal mesenteric trunk where it can invade, compress, reduce, or occlude the vessels. We investigated the diagnostic yield of multiplanar and 3D spiral CT in the assessment of pancreatic carcinoma resectability. Material and methods. Twenty-seven patients with histologically confirmed pancreatic head cancer were submitted to spiral CT and color Doppler US in the Surgical Clinic I of the Bologna University. The examination results were correlated with the intraoperative findings of careful inspection and palpation and of US studies of the pancreatic mass and adjacent structures. The tumors were classified in relation to some CT parameters: tumor size (T), infiltration of the stomach (S) and/or duodenum, lymph nodes (N) or distant (M) metastases, involvement of vascular structures (V), particularly of portal or superior mesenteric vein, or superior mesenteric artery. Five grades of vascular involvement were considered. The results of these techniques were correlated with intraoperative findings from careful inspection and palpation and with US studies of the pancreatic mass and adjacent structures. Results. Spiral CT revealed vascular involvement in 19 of 27 cases (70.4%): involvement of portal and superior mesenteric vein was found in 14 (73.6%), superior mesenteric vein was involved in 2 (10.6%), the portal vein in one (2%) and, finally the portal, superior mesenteric vein and superior mesenteric artery in 2 cases (10.6%). The spiral CT results were confirmed intraoperatively in 26 of 27 cases (96.3%); spiral CT did not reveal hepatic metastasis only in one case. Spiral CT with multiplanar reconstructions had very high specificity and sensitivity (100%) in the assessment of vascular involvement, while color Doppler US had the same specificity but lower sensitivity (84.2%). Spiral CT was less sensitive (80%) in the detection of liver metastases. Conclusions. We believe that spiral CT is currently the best technique for pancreatic carcinoma staging, providing useful information for correct surgical planning.

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