Abstract
The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases to identify all relevant publications. The QUADAS-2 tool was implemented to assess the risk of bias and applicability concerns of each included study. The initial literature search yielded 483 publications. Thirteen articles were included. Articles were categorized into three groups: nine articles concerning primary diagnosis or staging, one article about tumor response to treatment, and three articles regarding scan techniques. In exocrine pancreatic tumors, measurements of blood flow in eight studies and blood volume in seven studies were significantly lower in tumor tissue, compared with measurements in pancreatic tissue outside of tumor, or normal pancreatic tissue in control groups of healthy volunteers. The studies were heterogeneous in the number of patients enrolled and scan protocols. Perfusion parameters measured and analyzed by DCE-CT might be useful in the investigation of characteristic vascular patterns of exocrine pancreatic tumors. Further clinical studies are desired for investigating the potential of DCE-CT in pancreatic tumors.
Highlights
Pancreatic cancer is the fourth-leading cause of cancer deaths for both males and females according to estimates for 2016 in the United States [1]
In all studies where measurements of blood flow and blood volume in exocrine tumors were compared with pancreatic tissue outside of tumor, or normal pancreatic tissue in control groups of healthy volunteers, perfusion parameters were significantly lower in tumor tissue
In the quality assessment accomplished with QUADAS-2, all studies were considered to have low risk of bias
Summary
Pancreatic cancer is the fourth-leading cause of cancer deaths for both males and females according to estimates for 2016 in the United States [1]. Pancreatic ductal adenocarcinoma arises from exocrine glands and is generally characterized as hypovascular [3]. It is by far the most common type [4,5] as it accounts for about 80% of all pancreatic carcinomas [1]. The second most common pancreatic cancer is the neuroendocrine tumor which accounts for about 5% of all pancreatic carcinomas [1]. This type of carcinoma arises from the endocrine glands [4,5,6] and is frequently characterized as hypervascular [3,7].
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