Bohyun Kim1, Young Chul Kim2, O Kyu Noh3,4, Jaesung Heo3,4, Hyun Woo Lee5, Ji Hun Kim6, Jei Hee Lee1, Jai Keun Kim1, Oyeon Cho3,4, Young-Taek Oh4, Mison Chun3,4. 1. 1 Department of Radiology, Ajou University School of Medicine , Suwon , Republic of Korea. 2. 2 Department of Radiology, Hallym University Dongtan Sacred Heart Hospital , Suwon , Republic of Korea. 3. 3 Department of Radiation Oncology, Ajou University School of Medicine , Suwon , Republic of Korea. 4. 4 Department of Biomedical Informatics, Ajou University School of Medicine , Suwon , Republic of Korea. 5. 5 Department of Hematology-Oncology, Ajou University School of Medicine , Suwon , Republic of Korea. 6. 6 Department of Surgery, Ajou University School of Medicine , Suwon , Republic of Korea.
Abstract
OBJECTIVE: The purpose of this study is to review simulation CT scans and evaluate their diagnostic value in patients treated with adjuvant radiotherapy for pancreatic adenocarcinoma. METHODS: 73 patients who had undergone simulation CT scans for adjuvant radiotherapy in pancreatic adenocarcinoma were reviewed. All simulation CT scans were reviewed by professional abdominal radiologists, who compared the images with corresponding prior CT scans to identify new lesions. Newly detected cancer-related lesions were classified into one of three categories: distant metastasis, locoregional recurrence and indeterminate lesions. Indeterminate lesions were reviewed for malignancy during follow-up imaging work-ups. RESULTS: Of 73 patients, distant metastasis, locoregional recurrence and indeterminate lesions were found in 4 (5.5%), 5 (6.8%) and 32 patients (43.8%), respectively. Among 32 indeterminate lesions, 24 (75.0%) were soft tissue lesions neighbouring the superior mesenteric vessels. Follow-up PET-CT and diagnostic CT scans revealed that 43.7% of indeterminate lesions were malignant presenting local failures. The 3-year overall survival was significantly higher among patients who had no cancer-related lesions than among who did have such findings (44.8% vs 10.8%, p = 0.002). CONCLUSION: Professional review of simulation CT scans have ample diagnostic value as they help detect early progressions or potential failures in patients treated with adjuvant radiotherapy for pancreatic adenocarcinoma. Simulation CT scans should be carefully reviewed before the delivery of adjuvant radiotherapy. Advances in knowledge: Generally, simulation CT scan has been known to provide limited diagnostic values and clinical impact. However, the results of this study showed a high detection rate of cancer-related lesions, which could potentially affect subsequent treatment strategies in patients with pancreatic adenocarcinoma.
OBJECTIVE: The purpose of this study is to review simulation CT scans and evaluate their diagnostic value in patients treated with adjuvant radiotherapy for pancreatic adenocarcinoma. METHODS: 73 patients who had undergone simulation CT scans for adjuvant radiotherapy in pancreatic adenocarcinoma were reviewed. All simulation CT scans were reviewed by professional abdominal radiologists, who compared the images with corresponding prior CT scans to identify new lesions. Newly detected cancer-related lesions were classified into one of three categories: distant metastasis, locoregional recurrence and indeterminate lesions. Indeterminate lesions were reviewed for malignancy during follow-up imaging work-ups. RESULTS: Of 73 patients, distant metastasis, locoregional recurrence and indeterminate lesions were found in 4 (5.5%), 5 (6.8%) and 32 patients (43.8%), respectively. Among 32 indeterminate lesions, 24 (75.0%) were soft tissue lesions neighbouring the superior mesenteric vessels. Follow-up PET-CT and diagnostic CT scans revealed that 43.7% of indeterminate lesions were malignant presenting local failures. The 3-year overall survival was significantly higher among patients who had no cancer-related lesions than among who did have such findings (44.8% vs 10.8%, p = 0.002). CONCLUSION: Professional review of simulation CT scans have ample diagnostic value as they help detect early progressions or potential failures in patients treated with adjuvant radiotherapy for pancreatic adenocarcinoma. Simulation CT scans should be carefully reviewed before the delivery of adjuvant radiotherapy. Advances in knowledge: Generally, simulation CT scan has been known to provide limited diagnostic values and clinical impact. However, the results of this study showed a high detection rate of cancer-related lesions, which could potentially affect subsequent treatment strategies in patients with pancreatic adenocarcinoma.
Authors: Jason Chao Ye; Minh Tam Truong; Lisa A Kachnic; Rathan M Subramaniam; Ariel E Hirsch Journal: AJR Am J Roentgenol Date: 2011-11 Impact factor: 3.959
Authors: Hans G Smeenk; Casper H J van Eijck; Wim C Hop; Joris Erdmann; Kheetje C K Tran; Muriel Debois; Eric van Cutsem; Herman van Dekken; Jean H Klinkenbijl; Johannes Jeekel Journal: Ann Surg Date: 2007-11 Impact factor: 12.969