Role of Multi Detector Computed Tomography (MDCT) in Preoperative Staging of Pancreatic CarcinomaCorrespondence Address :
Dr. Soumil Singhal,
Resident, Department of Radiodiagnosis, Amrita Vishwa Vidyapeetham, Cochin-682041, Kerala, India.
Introduction: Pancreatic carcinoma is one of the leading causes of cancer related death in advanced countries and has shown rising trends in developing countries like India. Increase in the incidence has been linked to risk factors like lifestyle modification associated with increased alcohol consumption and rapid urbanization. Most patients at the time of diagnosis present with an advanced condition. Surgical resection offers the only chance for cure in them and imaging plays a crucial role in the early diagnosis of the condition.
Aim:To compare the staging of pancreatic carcinoma by MDCT (Multi Detector Computed Tomography) with surgery in a preoperative setting in a tertiary referral centre in Kerala.
Materials and Methods: A cross-sectional observational study was performed between November 2014 and October 2016, 25 patients (12 men, 13 women), with a mean age of 54.2 years, were evaluated. MDCT was performed using 16 slice, 64 slice and 256 slice multi detector CT machines. The gold standard for diagnosis was histopathology and operative data. All statistical analysis was done using IBM SPSS version 20.0. Validity parameters like sensitivity, specificity, accuracy and Positive Predictive Value (PPV) / Negative Predictive Value (NPV) were computed for MDCT with respect to surgery.
Results: Of the 25 patients who were evaluated for surgery, 15 (60%) cases were classified as resectable tumours, 3 (12%) as borderline resectable and 7 (28%) as unresectable tumours. CT showed a sensitivity of 82.3% with a specificity of 87.5%. However, for assessing vascular invasion, CT showed sensitivity and specificity of 100% and 93.3% respectively. Three (12%) patients in the study who were classified as borderline resectable pancreatic tumours underwent surgery.
Conclusion: Contrast-enhanced multiphase pancreatic imaging using MDCT plays a pivotal role in diagnosing and assessing resectability and vascular invasion of pancreatic tumours. It is very useful for determining borderline resectable tumours pre-operatively, which aids for better treatment planning.
Pancreas, Pancreatic cancer, Surgery
Soumil Singhal, Nirmal Kumar Prabhu, Pulkit Sethi, Srikanth Moorthy. ROLE OF MULTI DETECTOR COMPUTED TOMOGRAPHY (MDCT) IN PREOPERATIVE STAGING OF PANCREATIC CARCINOMA. Journal of Clinical and Diagnostic Research [serial online] 2017 May [cited: 2017 Jun 28 ]; 11:TC01-TC05. Available from
Date of Submission: Jan 13, 2017
Date of Peer Review: Feb 04, 2017
Date of Acceptance: Mar 06, 2017
Date of Publishing: May 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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