Abstract
Background and objectiveThis study deals with an important issue of setting the role and value of the dynamic computed tomography (CT) perfusion analysis in diagnosing pancreatic ductal adenocarcinoma (PDAC). The study aimed to assess the efficacy of perfusion CT in identifying PDAC, even isodense or hardly depicted in conventional multidetector computed tomography.MethodsA total of 56 patients with PDAC and 56 control group patients were evaluated in this study. A local perfusion assessment, involving the main perfusion parameters, was evaluated for all the patients. Sensitivity, specificity, positive, and negative predictive values for each perfusion CT parameter were defined using cutoff values calculated using receiver operating characteristic curve analysis. We accomplished logistic regression to identify the probability of PDAC.ResultsBlood flow (BF) and blood volume (BV) values were significant independent diagnostic criteria for the presence of PDAC. If both values exceed the determined cutoff point, the estimated probability for the presence of PDAC was 97.69%.ConclusionsBasic CT perfusion parameters are valuable in providing the radiological diagnosis of PDAC. The estimated BF and BV parameters may serve as independent diagnostic criteria predicting the probability of PDAC.
Highlights
Pancreatic ductal adenocarcinoma (PDAC) is the most common primary malignancy of the pancreas, accounting for about 80% of malignant pancreatic tumors and is characterized by dismal prognosis
The diagnostic criteria for PDAC were as follows: illdefined hypoattenuating mass when compared with the surrounding parenchymal tissue, abrupt termination of the main pancreatic duct (MPD) with upstream dilatation, double-duct sign, mass effect, and decreased fat displacement as compared with the remaining pancreatic parenchyma [13]
The control group consisted of 56 patients with nontumorous pancreatic tissue: 27 men (48.2%) and 29 women (51.8%)
Summary
Pancreatic ductal adenocarcinoma (PDAC) is the most common primary malignancy of the pancreas, accounting for about 80% of malignant pancreatic tumors and is characterized by dismal prognosis. Contrast-enhanced multidetector computed tomography (MDCT) maintains the fundamental imaging modality for identification, characterization, and staging of PDAC [1]. It has been reported that small or well-differentiated PDACs lack characteristic CT features; these lesions could be missed or misdiagnosed [3,4,5]. It has been reported to be a reliable imaging modality differentiating benign and malignant lesions, evaluating response to treatment, even describing angiogenesis [6,7,8,9,10,11]
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