SPIRAL - CT IN DIAGNOSIS OF VASCULAR IN INVOLVEMENT IN PANCREATIC-CANCER

Background/Aims: The purpose of this prospective study was to evaluate the efficacy of spiral-CT for the identification of portal venous, su perior mesenteric artery and celiac trunk infiltration in the staging of pancreatic (n = 29) and periampullary (n = 6) cancers. Materials an d Methods: All patients were examined by contrast enhanced spiral-CT u sing a total volume of 240 mi contrast medium i.v. With a slice thickn ess of 5 mm and a table increment of 7mm/sec a overlapping data set, r epresenting a total volume of 21 cm, was covered. The images were reco nstructed in 4 mm intervals. In 28 patients the spiral CT results were correlated with surgical findings. Results: Regarding portal venous i nfiltration spiral-CT had a sensitivity of 91% (10/11), a specifity of 9.4% (16/17), a positive predictive value of 91% (10/11), a negative predictive value of 94% (16/17) and, an overall accuracy of 92,8% (26/ 28). Spiral CT correctly identified arterial involvement in 5 patients , and no false negative result compared to surgical findings was obser ved. Conclusions: These results indicate that spiral-CT reliably verif ies occlusion, stenosis and encasement of the major peripancreactic ve ssels caused by pancreatic cancer.