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Evaluation of vascular infiltration in resected patients for pancreatic cancer: comparison among multidetector CT, intraoperative findings and histopathology

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Abstract

Background

To assess vascular infiltration is crucial in surgical planning of pancreatic cancer. Our aim was to assess the capability of multidetector CT in detecting vascular infiltration.

Methods

We evaluated 37 patients with pancreatic tumors. The relation between tumor and vessels was classified: grade 0: no contact between lesion and vessel; grade I: focal contiguity without modification of the vessel caliber; grade II: lesion surrounding the vessel, without reduction of its lumen; grade III: cancer surrounding the vessel with reduction or obstruction of its lumen. CT grades were compared to intraoperative findings and histopathology.

Results

We evaluated 52 critical vessels with the following CT grades: grade 0 (4 cases), grade I (13 cases), grade II (17 cases), grade III (18 cases). Vascular resection was performed in 26 patients, with a total of 31 resected vessels (3 of grade 0, 5 of grade I, 8 of grade II, 15 of grade III). Histopathology excluded vascular infiltration in 4/4 cases with grade 0 and in 10/13 cases with grade I and confirmed it in 14/17 cases with grade II and 14/18 cases with grade III.

Conclusions

Multidetector CT is accurate in detecting vascular involvement and provides pre-operative information to effectively plan resection.

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Authors and Affiliations

  1. Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy

    Salvatore Mazzeo, Carla Cappelli, Davide Caramella, Gabriele Caproni, Valentina Battaglia, Annalisa Belcari, Federica Forasassi & Carlo Bartolozzi

  2. General and Transplant Surgery, Department of Oncology, Transplants and Advanced Technologies in Medicine, Univeristy of Pisa, Pisa, Italy

    Marco Del Chiaro, Giulio Di Candio, Ugo Boggi & Franco Mosca

  3. Surgical, Molecular and Ultrastructural Pathology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy

    Daniela Campani, Luca Pollina, Niccola Funel & Generoso Bevilacqua

Authors
  1. Salvatore Mazzeo
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  2. Carla Cappelli
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  16. Carlo Bartolozzi
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Correspondence to Salvatore Mazzeo.

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Mazzeo, S., Cappelli, C., Caramella, D. et al. Evaluation of vascular infiltration in resected patients for pancreatic cancer: comparison among multidetector CT, intraoperative findings and histopathology. Abdom Imaging 32, 737–742 (2007). https://doi.org/10.1007/s00261-006-9172-2

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