Yoshihiko Fukukura1, Koji Takumi2, Michiyo Higashi3, Hiroyuki Shinchi4, Kiyohisa Kamimura2, Tomohide Yoneyama2, Akihiro Tateyama2. 1. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan. Electronic address: fukukura@m.kufm.kagoshima-u.ac.jp. 2. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan. 3. Department of Human Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan. 4. Department of Surgical Oncology and Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan.
Abstract
OBJECTIVE: To determine whether contrast enhancement of CT and apparent diffusion coefficient on diffusion-weighted MR imaging are important parameters that can predict outcomes for patients with pancreatic ductal adenocarcinoma. MATERIALS AND METHODS: Ninety-two patients with histologically confirmed pancreatic ductal adenocarcinoma who underwent quadriphasic CT (including unenhanced, pancreatic parenchymal, portal venous and delayed phases) and fat-suppressed single-shot echo-planar diffusion-weighted MR imaging at 3.0 T were retrospectively analyzed to investigate prognostic factors. Overall survival curves were drawn using the Kaplan-Meier method. Effects on survival of variables including age, sex, tumor location, tumor size, TNM stage, carbohydrate antigen 19-9, carcinoembryonic antigen, treatment, tumor contrast enhancement and apparent diffusion coefficient values were analyzed in univariate analysis using the log-rank test. Variables were analyzed in multivariate analyses using the Cox proportional hazards regression model. RESULTS: Median survival for the entire patient population was 18.2 months. Higher contrast enhancement during all phases was associated with significantly longer overall survival (P<0.001 for all phases). The difference in overall survival between groups divided by median apparent diffusion coefficient value was not significant (P=0.672). TNM stage (P=0.026) and tumor contrast enhancement on CT (P=0.027) were significantly related to survival in multivariate analysis. CONCLUSIONS: Poor enhancement of pancreatic adenocarcinomas on enhanced CT is associated with reduced patient survival.
OBJECTIVE: To determine whether contrast enhancement of CT and apparent diffusion coefficient on diffusion-weighted MR imaging are important parameters that can predict outcomes for patients with pancreatic ductal adenocarcinoma. MATERIALS AND METHODS: Ninety-two patients with histologically confirmed pancreatic ductal adenocarcinoma who underwent quadriphasic CT (including unenhanced, pancreatic parenchymal, portal venous and delayed phases) and fat-suppressed single-shot echo-planar diffusion-weighted MR imaging at 3.0 T were retrospectively analyzed to investigate prognostic factors. Overall survival curves were drawn using the Kaplan-Meier method. Effects on survival of variables including age, sex, tumor location, tumor size, TNM stage, carbohydrate antigen 19-9, carcinoembryonic antigen, treatment, tumor contrast enhancement and apparent diffusion coefficient values were analyzed in univariate analysis using the log-rank test. Variables were analyzed in multivariate analyses using the Cox proportional hazards regression model. RESULTS: Median survival for the entire patient population was 18.2 months. Higher contrast enhancement during all phases was associated with significantly longer overall survival (P<0.001 for all phases). The difference in overall survival between groups divided by median apparent diffusion coefficient value was not significant (P=0.672). TNM stage (P=0.026) and tumor contrast enhancement on CT (P=0.027) were significantly related to survival in multivariate analysis. CONCLUSIONS: Poor enhancement of pancreatic adenocarcinomas on enhanced CT is associated with reduced patient survival.
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