Original Article

Assessment of surgical resectability of pancreatic adenocarcinomas with multidetector computed tomography: What are the possibilities and problems?

Volume 25 · Issue 4 Publish Date: August 15, 2014
Esra İşcanlı Aysel Türkvatan Erdal Birol Bostancı Zişan Sakaoğulları
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Published In

Turkish Journal of Gastroenterology

Volume 25 · Issue 4

Pages: 416-423

History

Published Online: August 15, 2014

Copyright © 2014 Esra İşcanlı, Aysel Türkvatan, Erdal Birol Bostancı, Zişan Sakaoğulları

Esra İşcanlı
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
Aysel Türkvatan
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
Erdal Birol Bostancı
Department of Gastroenterological Surgery, Türkiye Yüksek İhtisas Teaching and Research Hospital, Ankara, Turkey
Zişan Sakaoğulları
Department of Pathology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
İşcanlı, E., Türkvatan, A., Bostancı, E. B., & Sakaoğulları, Z. (2014). Assessment of surgical resectability of pancreatic adenocarcinomas with multidetector computed tomography: What are the possibilities and problems?. Turkish Journal of Gastroenterology, 25(4), 416–423. https://doi.org/10.5152/tjg.2014.4973
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Abstract

Abstract Background/Aims: To investigate the accuracy of multidetector computed tomography (MDCT) in preoperatively determining the surgical resectability of pancreatic adenocarcinomas. Materials and Methods: Multidetector computed tomography, surgery, and pathological results of 274 patients with pancreatic adenocarcinoma were evaluated retrospectively. MDCT findings were compared with surgical and pathological findings to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MDCT in determining surgical resectability. Results: A total of 124 of 274 (56%) patients (83 males, mean age: 60 years) underwent laparoscopy and/or laparotomy. The sensitivity, specificity, PPV, NPV, and accuracy of MDCT in determining the surgical resectability of pancreatic adenocarcinomas were 100%, 72%, 78%, 100%, and 86%, respectively. Liver metastases in 9 cases, peritoneal metastases in 3 cases, and vascular invasion in 5 cases, which were determined during surgery, were not reported by MDCT. On re-review of the MDCT images of these 17 patients, no metastatic lesions could be seen in 9 patients with liver metastases and in 2 of 3 patients with peritoneal metastases. In 1 patient, a peritoneal implant of a diameter of 8 mm was missed on MDCT. There was no vascular invasion according to Lu criteria on the MDCT images in the 5 cases that had vascular invasion in the surgical exploration. Conclusion: The accuracy of MDCT is high in the preoperative determination of surgical resectability of pancreatic adenocarcinomas, but the detection of small liver and peritoneal metastases and accurate determination of vascular invasion are still major problems. Surgeons should be aware of the limitations of preoperative MDCT.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 25 · Issue 4
Pages 416-423
DOI 10.5152/tjg.2014.4973
History
Published Online August 15, 2014
Copyright
Copyright (c) 2014 Esra İşcanlı, Aysel Türkvatan, Erdal Birol Bostancı, Zişan Sakaoğulları
Affiliations
Esra İşcanlı
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
Aysel Türkvatan
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
Erdal Birol Bostancı
Department of Gastroenterological Surgery, Türkiye Yüksek İhtisas Teaching and Research Hospital, Ankara, Turkey
Zişan Sakaoğulları
Department of Pathology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
Cite this Article
İşcanlı, E., Türkvatan, A., Bostancı, E. B., & Sakaoğulları, Z. (2014). Assessment of surgical resectability of pancreatic adenocarcinomas with multidetector computed tomography: What are the possibilities and problems?. Turkish Journal of Gastroenterology, 25(4), 416–423. https://doi.org/10.5152/tjg.2014.4973
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