Assessment of Resectability of Pancreatic Carcinoma by Computed Tomography

Document Type : Original Article

Authors

1 Department of Diagnostic and Interventional Radiology, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt.

2 Department of Hepatopancreatic Biliary Surgery, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt.

Abstract

Background: Pancreatic cancer is the fourth leading cause of cancer-related deaths and is on of aggressive malignant tumors. Accurate staging and early diagnosis are essential for suitable therapeutic approaches, which should minimize surgical morbidity and mortality in patients with a high risk of residual disease following the intervention and improve survival in patients for whom complete resection is acceptable.  
Aim of the work: To evaluate the accuracy of multi-detector computed tomography [MDCT] with a pancreatic protocol in determining the resectability of pancreatic cancer by comparing imaging findings with surgical outcomes, based on the National Comprehensive Cancer Network [NCCN] criteria.
Patients and methods: The 50 included patients [ages 25 to 78] in this prospective hospital-based study had pancreatic neoplasms confirmed by abdominal computed tomography [CT] or ultrasound imaging. Every patient involved underwent a clinical evaluation, laboratory testing, abdomen triphasic CT with pancreatic protocol, and consent taking.
Results: According to NCCN, location and size have a significant impact on the respectability of pancreatic tumors with a p value < 0.05, however gender, age group, and effect on the biliary tree had no significant effect. The respectability of pancreatic tumors according to NCCN and the type of surgical interference is significantly impacted by the degree of arterial, venous, and lymphatic spread involvement, respectively [P value < 0.05]. MDCT has 100% sensitivity, 76.92% specificity, 80% positive predictive value [PPV], 100% negative predictive value [NPV], and 88% accuracy in diagnosing and evaluating the resectability of the patient's pancreatic tumor.
Conclusion: MDCT with a pancreatic protocol is a highly accurate, non-invasive imaging tool to assess the resectability of pancreatic cancer. It showed excellent sensitivity and negative predictive value, making it reliable for surgical planning. Its effectiveness in evaluating vascular involvement, lymph node status and distant metastases supports its role as a standard preoperative assessment tool. 

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