Inga Zaborienė1, Tomas Tvarijonas3, Gertrūda Rudaitytė3 , Saulius Lukoševičius1, Giedrius Barauskas2, Kristina Žvinienė1
1Department of Radiology, Lithuanian University of Health Sciences Kaunas, Lithuania.
2Lithuanian University of Health Sciences, Medical Academy. Department of Surgery.
3Lithuanian University of Health Sciences Kaunas, Lithuania.
Abstract
Background and aim:
Pancreatic adenocarcinoma is one of the most malignant cancer forms. It is fourth most common cause of cancer death worldwide, with a poor overall 5-year survival rate of only 4 %. The treatment depends upon tumour resectability at presentation. Therefore, radiological imaging is crucial in the management of the disease. In this study we evaluated the role of computed tomography in diagnosing pancreatic adenocarcinoma and CT diagnostic values in determining resectability of pancreatic.
Matherial and methods: This was a prospective randomized clinical study, in which 79 patients with resectable pancreatic cancer were studied. All the pacients underwent MDCT scan. In all CT images we analyzed location of pancreatic tumor, invasion into adjacent structures, vascular involvement and distant metastases. The results of preoperative CT staging were compared to the postoperative histological data. In order to determine diagnostic values of CT, we calculated the sensitivity, specificity, positive and negative prognostic values (PPV, NPV) as well, as accuracy. All calculations were performed using SPSS for Windows 25.0 software and Microsoft Excel 16.
Results: There was no difference in evaluating T stage pre and postoperatively X2 =74,452, df 15, p<0,001 and no statistically difference in evaluating tumor N stage pre- and postoperatively X2=8,978, df=1, p=0,003.
Overall CT sensitivity for tumor T stage was 73 %, specificity 85 %, PPV and NPV 67.1 % and 88.2 % respectively, accuracy 81.4 %. CT diagnostic values for N stage: sensitivity 75 %, specificity 59.3 %, PPV 78%, NPV 55.2% and accuracy 69.6%.
Conclusions:
- CT is specific and accurate imaging modality in T stage of pancreatic adenocarcinoma.
- CT is quite sensitive, but non specific in N stage of pancreatic adenocarcinoma.
Keywords: pancreatic adenocarcinoma, resectability, CT values