BJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Phoa, S. S.
Right arrow Articles by Lameris, J. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Phoa, S. S.
Right arrow Articles by Lameris, J. S.

The British Journal of Radiology, Vol 73, Issue 875 1159-1164, Copyright © 2000 by British Institute of Radiology

ARTICLES

CT criteria for venous invasion in patients with pancreatic head carcinoma

SS Phoa, JW Reeders, J Stoker, EA Rauws, DJ Gouma and JS Lameris
Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

The purpose of the study was to evaluate CT criteria for venous invasion in patients with potentially resectable carcinoma of the pancreatic head, with surgical and histopathological correlation. In 113 patients evaluated with spiral CT for suspected pancreatic head carcinoma, several CT criteria for venous invasion were scored prospectively for the portal vein (PV) and the superior mesenteric vein (SMV): length of tumour contact with PV/SMV (0 mm, < 5 mm, > 5 mm); circumferential involvement of the vein (0 degree, 0-90 degrees, 90-180 degrees, > 180 degrees); degree of stenosis; irregularity of the vessel margin; and tumour convexity towards vessel. 65 patients underwent surgery. Pancreatic head carcinoma was proven and pathology of the vascular margin was obtained in 50 of these patients. CT findings for single and combined criteria were correlated with pathology in these 50 patients, 30 of whom showed venous ingrowth. Invasion was found in all cases with SMV narrowing (n = 7), PV contour involvement > 90 degrees (n = 6), PV narrowing (n = 5) and PV wall irregularity (n = 3). The vascular ingrowth rate was 88% (15/17) for tumour concavity towards the PV or SMV. Poor predictors of ingrowth were length of tumour contact with PV > 5 mm (78% ingrowth, 14/18) and contour involvement of the SMV > 90 degrees (83% ingrowth, 10/12). Absence of vascular ingrowth could not be predicted in 100%. In conclusion, CT criteria can predict a high risk of invasion in potentially resectable tumours. Narrowing of the SMV and the PV seems the most reliable criterion, as well as circumferential involvement of the PV > 90 degrees. The best combination of criteria was tumour concavity with circumferential involvement > 90 degrees (sensitivity 60% and positive predictive value 90%).


This article has been cited by other articles:


Home page
 RadiologyHome page
J. G. Fletcher, M. J. Wiersema, M. A. Farrell, J. L. Fidler, L. J. Burgart, T. Koyama, C. D. Johnson, D. H. Stephens, E. M. Ward, and W. S. Harmsen
Pancreatic Malignancy: Value of Arterial, Pancreatic, and Hepatic Phase Imaging with Multi-Detector Row CT
Radiology, October 1, 2003; 229(1): 81 - 90.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
BJR DMFR IMAGING  ALL BIR JOURNALS 
Copyright © 2000 by the British Institute of Radiology.