Shimaa Abdalla Ahmed1, Amr F Mourad2, Ramy A Hassan3, Mohamed Abd Elsalam Ibrahim4, Ahmed Soliman3, Ebrahim Aboeleuon5, Osama Mostafa Abd Elbadee6, Helal F Hetta7,8, Murad A Jabir5,9,10. 1. Radiodiagnosis, South Egypt Cancer Institute, Assiut University, Asyut, Egypt. shimaaabdalla@aun.edu.eg. 2. Radiodiagnosis, South Egypt Cancer Institute, Assiut University, Asyut, Egypt. 3. General Surgery, Faculty of Medicine, Alrajhy Liver Hospital, Assiut University, Asyut, Egypt. 4. Urology, Egyptian Armed Forces, Cairo, Egypt. 5. Surgical Oncology, South Egypt Cancer Institute, Assiut University, Asyut, Egypt. 6. Radiotherapy and Nuclear Medicine Department, South Egypt Cancer Institute, Assiut University, Asyut, Egypt. 7. Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267-0595, USA. 8. Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Asyut, Egypt. 9. Kyoto University, Kyoto, Japan. 10. Case Western Reserve University, Cleveland, USA.
Abstract
OBJECTIVES: To assess the utility of MDCT tumor-vascular interface criteria for predicting vascular invasion and resectability in borderline pancreatic cancer (BRPC) patients after neoadjuvant therapy (NAT). METHODS: This prospective study included 90 patients with BRPC who finished NAT, showed no progression in preoperative CTs and underwent surgery. Two radiologists independently assessed preoperative vessel-tumor interface criteria. The area under the ROC curve (AUC) was used to evaluate the diagnostic performance for predicting vascular invasions and resectability using surgical and pathological results as the gold standard. Inter-reader agreement was assessed using the κ coefficient. RESULTS: Pathologic vascular invasion was confirmed in 47 (54.7%) veins and 14 (16.3%) arteries. R0 resection was achieved in (82.6%71/86) pancreatic resection. Using criteria of circumferential interface ≥ 180 degrees with contour deformity ≥ grade 3 and/or length of tumor contact > 2 cm to predict vascular invasion, the AUCs for the two readers were 0.85-0.88 for arterial invasion and 0.92-0.87 for venous invasion. Using criteria of circumferential interface ≤ 180° with contour deformity ≤ grade 2 and/or length of tumor contact < 2 cm to predict R0 resection, the AUCs was 0.85-0.86 for the two readers. The overall inter-reader agreement was good (κ = 0.75-0.80). The κ values for venous invasion, arterial invasion and R0 resection were 0.76, 0.78, and 0.80. CONCLUSION: Tumor-vessel criteria demonstrated good diagnostic performance and reproducibility in the prediction of vascular invasion after NAT in BRPC. These criteria could be helpful in the prediction of R0 resection in cases with only venous involvement.
OBJECTIVES: To assess the utility of MDCT tumor-vascular interface criteria for predicting vascular invasion and resectability in borderline pancreatic cancer (BRPC) patients after neoadjuvant therapy (NAT). METHODS: This prospective study included 90 patients with BRPC who finished NAT, showed no progression in preoperative CTs and underwent surgery. Two radiologists independently assessed preoperative vessel-tumor interface criteria. The area under the ROC curve (AUC) was used to evaluate the diagnostic performance for predicting vascular invasions and resectability using surgical and pathological results as the gold standard. Inter-reader agreement was assessed using the κ coefficient. RESULTS: Pathologic vascular invasion was confirmed in 47 (54.7%) veins and 14 (16.3%) arteries. R0 resection was achieved in (82.6%71/86) pancreatic resection. Using criteria of circumferential interface ≥ 180 degrees with contour deformity ≥ grade 3 and/or length of tumor contact > 2 cm to predict vascular invasion, the AUCs for the two readers were 0.85-0.88 for arterial invasion and 0.92-0.87 for venous invasion. Using criteria of circumferential interface ≤ 180° with contour deformity ≤ grade 2 and/or length of tumor contact < 2 cm to predict R0 resection, the AUCs was 0.85-0.86 for the two readers. The overall inter-reader agreement was good (κ = 0.75-0.80). The κ values for venous invasion, arterial invasion and R0 resection were 0.76, 0.78, and 0.80. CONCLUSION:Tumor-vessel criteria demonstrated good diagnostic performance and reproducibility in the prediction of vascular invasion after NAT in BRPC. These criteria could be helpful in the prediction of R0 resection in cases with only venous involvement.
Entities:
Keywords:
Multidetector computed tomography; Pancreas; Pancreatic cancer
Authors: Tiziana Marinelli; Antonella Filippone; Francesca Tavano; Andrea Fontana; Fabio Pellegrini; Jörg Köninger; Götz M Richter; Lorenzo Bonomo; Markus W Büchler; Pierluigi di Sebastiano; Francesco F di Mola Journal: Radiol Med Date: 2014-03-12 Impact factor: 3.469
Authors: Martijn A van Dam; Floris A Vuijk; Judith A Stibbe; Ruben D Houvast; Saskia A C Luelmo; Stijn Crobach; Shirin Shahbazi Feshtali; Lioe-Fee de Geus-Oei; Bert A Bonsing; Cornelis F M Sier; Peter J K Kuppen; Rutger-Jan Swijnenburg; Albert D Windhorst; Jacobus Burggraaf; Alexander L Vahrmeijer; J Sven D Mieog Journal: Cancers (Basel) Date: 2021-12-02 Impact factor: 6.639