Ajay Kumar Yadav1, Raju Sharma2, Devasenathipathy Kandasamy1, Rajesh Kumar Pradhan3, Pramod Kumar Garg3, Ashu Seith Bhalla1, Shivanand Gamanagatti1, Deep N Srivastava1, Peush Sahni4, Ashish Datt Upadhyay5. 1. Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, 110029, New Delhi, India. 2. Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, 110029, New Delhi, India. Electronic address: raju152@yahoo.com. 3. Department of Gastroenterology, All India Institute of Medical Sciences, Ansari Nagar, 110029, New Delhi, India. 4. Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, Ansari Nagar, 110029, New Delhi, India. 5. Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Abstract
OBJECTIVES: To evaluate the utility of perfusion CT (PCT) in differentiating pancreatic adenocarcinoma from mass forming chronic pancreatitis (MFCP). METHODS: In this ethically approved study, PCT was performed in 122 patients with pancreatic masses of which 42 patients had pancreatic adenocarcinoma and 13 had MFCP on histopathology. Perfusion parameters studied included blood flow (BF), blood volume (BV), permeability surface area product (PS), time to peak (TTP), peak enhancement intensity (PEI) and mean transit time (MTT). Twenty five controls with no pancreatic pathology were also studied. RESULTS: Amongst the perfusion parameters BF and BV were found to be the most reliable for differentiating between adenocarcinoma and mass forming pancreatitis. Although they were reduced in both pancreatic adenocarcinoma (BF- 16.6 ± 13.1 ml/100 ml/min and BV- 5 ± 3.5 ml/100 ml) and MFCP (BF- 30.4 ± 8.7 ml/100 ml/min and BV- 8.9 ± 3.1 ml/100 ml) as compared to normal controls (BF- 94.1 ± 24 ml/100 ml/min and BV- 36 ± 10.7 ml/100 ml) but the extent of reduction was greater in pancreatic adenocarcinoma than in MFCP. Based on ROC analysis cut off values of 19.1 ml/100 ml/min for BF and 5 ml/100 ml for BV yielded optimal sensitivity and specificity for differentiating pancreatic adenocarcinoma from MFCP. CONCLUSIONS: PCT may serve as an additional paradigm for differentiating pancreatic adenocarcinoma from mass forming chronic pancreatitis and a useful tool for detecting masses which are isodense on conventional CT.
OBJECTIVES: To evaluate the utility of perfusion CT (PCT) in differentiating pancreatic adenocarcinoma from mass forming chronic pancreatitis (MFCP). METHODS: In this ethically approved study, PCT was performed in 122 patients with pancreatic masses of which 42 patients had pancreatic adenocarcinoma and 13 had MFCP on histopathology. Perfusion parameters studied included blood flow (BF), blood volume (BV), permeability surface area product (PS), time to peak (TTP), peak enhancement intensity (PEI) and mean transit time (MTT). Twenty five controls with no pancreatic pathology were also studied. RESULTS: Amongst the perfusion parameters BF and BV were found to be the most reliable for differentiating between adenocarcinoma and mass forming pancreatitis. Although they were reduced in both pancreatic adenocarcinoma (BF- 16.6 ± 13.1 ml/100 ml/min and BV- 5 ± 3.5 ml/100 ml) and MFCP (BF- 30.4 ± 8.7 ml/100 ml/min and BV- 8.9 ± 3.1 ml/100 ml) as compared to normal controls (BF- 94.1 ± 24 ml/100 ml/min and BV- 36 ± 10.7 ml/100 ml) but the extent of reduction was greater in pancreatic adenocarcinoma than in MFCP. Based on ROC analysis cut off values of 19.1 ml/100 ml/min for BF and 5 ml/100 ml for BV yielded optimal sensitivity and specificity for differentiating pancreatic adenocarcinoma from MFCP. CONCLUSIONS: PCT may serve as an additional paradigm for differentiating pancreatic adenocarcinoma from mass forming chronic pancreatitis and a useful tool for detecting masses which are isodense on conventional CT.
Authors: Inga Zaborienė; Giedrius Barauskas; Antanas Gulbinas; Povilas Ignatavičius; Saulius Lukoševičius; Kristina Žvinienė Journal: Open Med (Wars) Date: 2021-02-05
Authors: Labrinus van Manen; Iris Schmidt; Akin Inderson; Ruben D Houvast; Jurjen J Boonstra; Jouke Dijkstra; Jeanin E van Hooft; Wouter B Nagengast; Dominic J Robinson; Alexander L Vahrmeijer; J Sven D Mieog Journal: Int J Med Sci Date: 2022-01-01 Impact factor: 3.738