nach oben

Erschienen in:

01.12.2010 | Original Article—Liver, Pancreas, and Biliary Tract

Detection of liver metastases secondary to pancreatic cancer: utility of combined helical computed tomography during arterial portography with biphasic computed tomography-assisted hepatic arteriography

verfasst von: Yoshiaki Ikuta, Hiroshi Takamori, Osamu Ikeda, Hiroshi Tanaka, Yasuo Sakamoto, Daisuke Hashimoto, Nobuyuki Ozaki, Osamu Nakahara, Satoshi Furuhashi, Shinya Abe, Toru Beppu, Shinya Shimada, Yasuyuki Yamashita, Hideo Baba

Erschienen in: Journal of Gastroenterology | Ausgabe 12/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

This study was designed to define the diagnostic advantage of computed tomography during arterial portography (CTAP) combined with computed tomography–assisted hepatic arteriography (CTHA) for the preoperative detection of liver metastases secondary to pancreatic cancer compared with that of multidetector computed tomography (MDCT).

Methods

From January 2002 to December 2007, we retrospectively studied 197 consecutive patients with pancreatic cancer. MDCT was performed on 192 patients prior to preoperative visceral angiography; 153 patients underwent CTAP + CTHA at the time of preoperative angiography.

Results

Liver metastases were identified in 39 patients by means of MDCT. Of the 153 patients who had no evidence of liver metastases on MDCT, 129 patients underwent CTAP + CTHA, and 53 of these 129 patients (41.1%) were diagnosed as having liver metastases that could not be detected by MDCT. These tumors missed by MDCT ranged from 3 to 15 mm in size. On CTAP + CTHA, a solitary nodule in the liver was detected in 11 patients, 2 nodules were detected in 6 patients, 3 lesions were detected in 2 patients, and ≧4 lesions were detected in 34 patients. The sensitivity and specificity of CTAP + CTHA versus MDCT were 94.2 versus 48.4% and 82.7 versus 97.9%, respectively.

Conclusions

The combination of CTAP and CTHA is useful to confirm liver metastases and can potentially offer more accurate staging of pancreatic cancer compared with MDCT.

Kern S, Hruban R, Hollingsworth MA, Brand R, Adrian TE, Jaffee E, et al. The product of a pancreas cancer think tank. Cancer Res. 2001;61:4923–32.PubMed

Li D, Xie K, Wolff R, Abbruzzese JL. Pancreatic cancer. Lancet. 2004;363:1049–57.CrossRefPubMed

Baumel H, Huguier M, Manderscheid JC, Fabre JM, Houry S, Fagot H. Results of resection for cancer of the exocrine pancreas: a study from the French association of surgery. Br J Surg. 1994;81:102–7.CrossRefPubMed

Sohn TA, Yeo CJ, Cameron JL, Koniaris L, Kaushal S, Abrams RA, et al. Resected adenocarcinoma of the pancreas---616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg. 2000;4:567–79.CrossRefPubMed

Richter A, Niedergethmann M, Sturm JW, Lorenz D, Post S, Trede M. Long-term results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25-year experience. World J Surg. 2003;27:324–9.CrossRefPubMed

Dalton RR, Sarr MG, van Heerden JA, Colby TV. Carcinoma of the body and tail of the pancreas: is curative resection justified? Surgery. 1992;111:489–94.PubMed

Brennan MF, Moccia RD, Klimstra D. Management of adenocarcinoma of the body and tail of the pancreas. Ann Surg. 1996;223:506–11. (discussion 511–502).CrossRefPubMed

Griffin JF, Smalley SR, Jewell W, Paradelo JC, Reymond RD, Hassanein RE, et al. Patterns of failure after curative resection of pancreatic carcinoma. Cancer. 1990;66:56–61.CrossRefPubMed

Sperti C, Pasquali C, Piccoli A, Pedrazzoli S. Recurrence after resection for ductal adenocarcinoma of the pancreas. World J Surg. 1997;21:195–200.CrossRefPubMed

10.

Takamori H, Ikeda O, Kanemitsu K, Tsuji T, Chikamoto A, Kusano S, et al. Preoperative detection of liver metastases secondary to pancreatic cancer: utility of combined helical computed tomography during arterial portography with biphasic computed tomography-assisted hepatic arteriography. Pancreas. 2004;29:188–92.CrossRefPubMed

11.

Soyer P, Bluemke DA, Hruban RH, Sitzmann JV, Fishman EK. Hepatic metastases from colorectal cancer: detection and false-positive findings with helical CT during arterial portography. Radiology. 1994;193:71–4.PubMed

12.

Li L, Wu PH, Mo YX, Lin HG, Zheng L, Li JQ, et al. CT arterial portography and CT hepatic arteriography in detection of micro liver cancer. World J Gastroenterol. 1999;5:225–7.PubMed

13.

Inaba Y, Arai Y, Kanematsu M, Takeuchi Y, Matsueda K, Yasui K, et al. Revealing hepatic metastases from colorectal cancer: value of combined helical CT during arterial portography and CT hepatic arteriography with a unified CT and angiography system. AJR Am J Roentgenol. 2000;174:955–61.PubMed

14.

Furukawa H, Iwata R, Moriyama N. Is CT during arterial portography useful for the preoperative evaluation of liver metastases from pancreatic carcinoma? Pancreas. 2001;22:200–2.CrossRefPubMed

15.

Bhattacharjya S, Bhattacharjya T, Baber S, Tibballs JM, Watkinson AF, Davidson BR. Prospective study of contrast-enhanced computed tomography, computed tomography during arterioportography, and magnetic resonance imaging for staging colorectal liver metastases for liver resection. Br J Surg. 2004;91:1361–9.CrossRefPubMed

16.

Tanimoto A, Wakabayashi G, Shinmoto H, Nakatsuka S, Okuda S, Kuribayashi S. Superparamagnetic iron oxide-enhanced MR imaging for focal hepatic lesions: a comparison with CT during arterioportography plus CT during hepatic arteriography. J Gastroenterol. 2005;40:371–80.CrossRefPubMed

17.

Matsuo M, Kanematsu M, Inaba Y, Matsueda K, Yamagami T, Kondo H, et al. Pre-operative detection of malignant hepatic tumours: value of combined helical CT during arterial portography and biphasic CT during hepatic arteriography. Clin Radiol. 2001;56:138–45.CrossRefPubMed

18.

Satoi S, Yamamoto H, Takai S, Tanigawa N, Komemushi A, Yanagimoto H, et al. Clinical impact of multidetector row computed tomography on patients with pancreatic cancer. Pancreas. 2007;34:175–9.CrossRefPubMed

19.

Takamori H, Kanemitsu K, Tsuji T, Tanaka H, Chikamoto A, Nakahara O, et al. 5-Fluorouracil intra-arterial infusion combined with systemic gemcitabine for unresectable pancreatic cancer. Pancreas. 2005;30:223–6.CrossRefPubMed

20.

Jimenez RE, Warshaw AL, Rattner DW, Willett CG, McGrath D, Fernandez-del Castillo C. Impact of laparoscopic staging in the treatment of pancreatic cancer. Arch Surg. 2000;135:409–14. (discussion 414–405).CrossRefPubMed

21.

Robinson PJ. Imaging liver metastases: current limitations and future prospects. Br J Radiol. 2000;73:234–41.PubMed

22.

Strotzer M, Gmeinwieser J, Schmidt J, Fellner C, Seitz J, Albrich H, et al. Diagnosis of liver metastases from colorectal adenocarcinoma. Comparison of spiral-CTAP combined with intravenous contrast-enhanced spiral-CT and SPIO-enhanced MR combined with plain MR imaging. Acta Radiol. 1997;38:986–92.PubMed

23.

Vogl TJ, Schwarz W, Blume S, Pietsch M, Shamsi K, Franz M, et al. Preoperative evaluation of malignant liver tumors: comparison of unenhanced and SPIO (resovist)-enhanced MR imaging with biphasic CTAP and intraoperative US. Eur Radiol. 2003;13:262–72.PubMed

24.

Akai H, Kiryu S, Takao H, Tajima T, Shibahara J, Imamura H, et al. Efficacy of double-arterial phase gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced liver magnetic resonance imaging compared with double-arterial phase multi-detector row helical computed tomography. J Comput Assist Tomogr. 2009;33:887–92.CrossRefPubMed

25.

Hammerstingl R, Huppertz A, Breuer J, Balzer T, Blakeborough A, Carter R, et al. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol. 2008;18:457–67.CrossRefPubMed

26.

Ichikawa T, Saito K, Yoshioka N, Tanimoto A, Gokan T, Takehara Y, et al. Detection and characterization of focal liver lesions: a Japanese phase III, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease. Invest Radiol. 2010;45:133–41.CrossRefPubMed

27.

Raman SS, Leary C, Bluemke DA, Amendola M, Sahani D, McTavish JD et al (2010) Improved characterization of focal liver lesions with liver-specific gadoxetic acid disodium-enhanced magnetic resonance imaging: a multicenter phase 3 clinical trial. J Comput Assist Tomogr 34:163–172.

Titel: Detection of liver metastases secondary to pancreatic cancer: utility of combined helical computed tomography during arterial portography with biphasic computed tomography-assisted hepatic arteriography
verfasst von: Yoshiaki Ikuta
Hiroshi Takamori
Osamu Ikeda
Hiroshi Tanaka
Yasuo Sakamoto
Daisuke Hashimoto
Nobuyuki Ozaki
Osamu Nakahara
Satoshi Furuhashi
Shinya Abe
Toru Beppu
Shinya Shimada
Yasuyuki Yamashita
Hideo Baba
Publikationsdatum: 01.12.2010
Verlag: Springer Japan
Erschienen in: Journal of Gastroenterology / Ausgabe 12/2010
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-010-0285-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Detection of liver metastases secondary to pancreatic cancer: utility of combined helical computed tomography during arterial portography with biphasic computed tomography-assisted hepatic arteriography