TY - JOUR
T1 - Staging of pancreatic cancer with multidetector CT in the setting of preoperative chemoradiation therapy
AU - Tamm, E. P.
AU - Loyer, E. M.
AU - Faria, S.
AU - Raut, C. P.
AU - Evans, D. B.
AU - Wolff, R. A.
AU - Crane, C. H.
AU - Dubrow, R. A.
AU - Charnsangavej, C.
N1 - Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2006/10
Y1 - 2006/10
N2 - Background: Preoperative chemoradiation can potentially improve outcomes in patients with pancreatic cancer. This study addresses its effect on staging pancreatic cancer with multidetector computed tomography (MDCT). Methods: Fifty-five patients underwent a dual-phase MDCT pancreas protocol for proved pancreatic cancer. Of these, 16 patients underwent preoperative chemoradiation. Three radiologists independently reviewed images to assess for locally advanced disease, liver and peritoneal metastases on baseline studies of all 55 patients, and on follow-up preoperative studies for the 16 patients receiving preoperative therapy. Overall score for resectability was graded on a scale from 1 to 5 (1, definitely resectable; 5. definitely unresectable). Receiver operating characteristic curves and weighted (κ statistics were determined. Results: The areas under the receiver operating characteristic curves for readers 1, 2, and 3 were 0.98, 0.96, and 0.90, respectively. Weighted κ values for reader 1 versus reader 2, reader 1 versus reader 3, and reader 2 versus reader 3 were 0.90, 0.57, and 0.54, respectively. Interpreting scores of 1 to 3 for resectability as resectable disease, the mean values for sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were 0.92, 0.91, 0.74, 0.98, and 0.92 respectively. Conclusion: The negative predictive value for MDCT for identifying unresectable pancreatic cancer in the setting of preoperative therapy is comparable to that reported in the absence of neoadjuvant therapy.
AB - Background: Preoperative chemoradiation can potentially improve outcomes in patients with pancreatic cancer. This study addresses its effect on staging pancreatic cancer with multidetector computed tomography (MDCT). Methods: Fifty-five patients underwent a dual-phase MDCT pancreas protocol for proved pancreatic cancer. Of these, 16 patients underwent preoperative chemoradiation. Three radiologists independently reviewed images to assess for locally advanced disease, liver and peritoneal metastases on baseline studies of all 55 patients, and on follow-up preoperative studies for the 16 patients receiving preoperative therapy. Overall score for resectability was graded on a scale from 1 to 5 (1, definitely resectable; 5. definitely unresectable). Receiver operating characteristic curves and weighted (κ statistics were determined. Results: The areas under the receiver operating characteristic curves for readers 1, 2, and 3 were 0.98, 0.96, and 0.90, respectively. Weighted κ values for reader 1 versus reader 2, reader 1 versus reader 3, and reader 2 versus reader 3 were 0.90, 0.57, and 0.54, respectively. Interpreting scores of 1 to 3 for resectability as resectable disease, the mean values for sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were 0.92, 0.91, 0.74, 0.98, and 0.92 respectively. Conclusion: The negative predictive value for MDCT for identifying unresectable pancreatic cancer in the setting of preoperative therapy is comparable to that reported in the absence of neoadjuvant therapy.
KW - Chemotherapy
KW - Computed tomography, multidetector row
KW - Pancreas, neoplasms, staging
KW - Preoperative therapy
KW - Radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=33847616982&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33847616982&partnerID=8YFLogxK
U2 - 10.1007/s00261-005-0194-y
DO - 10.1007/s00261-005-0194-y
M3 - Article
C2 - 16465578
AN - SCOPUS:33847616982
SN - 0942-8925
VL - 31
SP - 568
EP - 574
JO - Abdominal Imaging
JF - Abdominal Imaging
IS - 5
ER -