Multislice spiral computed tomography in diagnosis and staging of pancreatic carcinoma: preliminary experience

Abstract

Background: Computed tomography has become the modality of choice for preoperative evaluation of patients with suspected pancreatic carcinoma, although some limitations are well known.

Aims: To evaluate use of multislice spiral computed tomography in preoperative assessment of patients with suspected pancreatic carcinoma using volume-rendering as image reconstruction algorithm.

Patients: A total of 27 patients with suspected pancreatic carcinoma underwent multislice spiral computed tomography examination.

Methods: All studies were performed on a multislice computed tomography scanner with the following parameters: slice collimation, 1 mm; slice thickness, 1.25 mm; reconstruction interval, 1 mm; scan time, 22-25 sec; mAs, 165. Scans were acquired with a biphasic technique with a 30-sec (pancreatic phase) and a 70-sec (portal venous phase) delay time after start of contrast material injection. Diagnostic confirmation was obtained with surgical exploration, percutaneous biopsy, or with a combination of follow-up imaging studies.

Results: Multislice spiral computed tomography yielded correct diagnosis of pancreatic carcinoma in 20 cases (sensitivity, 95%; specificity, 100%). Positive predictive values for resectability and unresectability were 80% and 93.3%, respectively. Three-dimensional volume-rendered images improved diagnostic confidence in the depiction of major vascular structures. Two cases of anomalous origin of hepatic artery were also identified with volume-rendered images.

Conclusions: Multislice technology improves accuracy of spiral computed tomography for diagnosis and staging of pancreatic carcinoma.