Imaging of Pancreatic Carcinoma on Multidetector Computed Tomography, A Tertiary Care Experience at Liaquat National Hospital, Karachi

Abstract

Introduction: Pancreatic cancer is a lethal disease. The mortality rate for pancreatic tumor has changed over the last 20 years. Early diagnosis of pancreatic carcinoma is very important for therapeutic decisions and surgical planning. Contrast enhance CT facilitated the detection of primary tumor and staging. Objective: This study is to evaluate various presentations of pancreatic carcinomas on their initial MDCT (Multidetector Computed Tomography) and to evaluate its resectability and to compare CT features among resectable and non-resectable tumors. Methodology: All the patients underwent multi-phasic CT scan on a 16-slice MDCT. CT findings were analyzed included tumor location, size, enhancement pattern, nodal disease, duct dilatations, vascular involvement and evidence of metastatic disease. Results: Total 63 records of patients examined during 2017 and 2019 meeting the inclusion criteria were reviewed. The average age at time of MDCT examination was 62.51 ± 13.17 years. The disease was more common in males (n=36, 57.1%). Out of 63 pancreatic tumors, 14 (22.22%) tumors were identified as resectable tumors on MDCT examination. Tumor size (p<0.001), peripancreatic nodes (p=0.006), contrast enhancement (p=0.018), vessel involvement (p<0.001), ascites (p=0.006), hepatic metastases (p=0.001) and peripheral organ involvement (p<0.001) were significantly different among resectable and non-resectable tumors. Conclusion: MDCT is an excellent and most commonly used modality for diagnosis and staging of pancreatic carcinoma particularly with a high sensitivity for detection of vascular invasion and metastatic disease.