Abstract
Although pancreatic cancer tumors are irregularly shaped in terms of their three-dimensional (3D) structure, when T staging by imaging results, generally only the axial plane is used to measure the largest tumor diameter. We investigated the size of pancreatic cancer tumors using multi-plane and 3D reconstructed computed tomography (CT) images and investigated their clinical usefulness. Patients who underwent surgery for pancreatic adenocarcinoma were included. We measured the largest diameter of each pancreatic tumor in the axial, coronal, and sagittal planes of CT images. In addition, maximal diameter and cancer volume were measured from 3D images that were constructed using a semi-automated software system. Final data were compared with pathologic examination and the effect of each value on prognosis was analyzed. A total of 183 patients were analyzed. The maximal diameters measured on the axial, coronal, and sagittal planes were 2.9 ± 1.1, 3.2 ± 0.9, and 3.2 ± 1.0 cm, respectively, which were significantly smaller than pathologic results (3.4 ± 1.4 cm, all p<0.05 by paired t-test). The longest diameter among them (3.4 ± 1.1 cm) was nearly similar to the pathologic diameter. Cancer volume measured on 3D images demonstrated a higher area under the receptor operating characteristic curve [0.714, (95% confidence interval: 0.640–0.788)] for predicting early death compared to any unidimensional CT diameters measured. The longest pancreatic tumor diameter measured on multiplanar CT images was most accurate when compared to its corresponding pathologic diameter. Tumor volume had a stronger correlation with overall survival than tumor diameter.
Highlights
The incidence of pancreatic cancer has been increasing recently, the 5-year survival rate is still about 5% [1]
We report the diameters of pancreatic cancer tumors in the axial, coronal, and sagittal planes that were obtained from preoperative computed tomography (CT) images
We examined the diameters and volumes of pancreatic cancer tumors from multiplanar and 3D CT images and evaluated their accuracy compared to pathologic specimens and image measurement prognostic value
Summary
The incidence of pancreatic cancer has been increasing recently, the 5-year survival rate is still about 5% [1]. Surgical resection is the only curative option for pancreatic cancer treatment. Surgical techniques and perioperative management have improved over the past several decades, prognosis after surgery for pancreatic cancer remains poor [2,3,4]. Volumetric analysis of pancreatic cancer have the following competing interest. MHC reports having received a research grand from TAEJOON PHARM Co., Ltd. Korea (paid to the institution). This does not alter our adherence to PLOS ONE policies on sharing data and materials
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