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Erschienen in: Abdominal Radiology 11/2017

18.05.2017 | Pictorial Essay

Pictorial review of vascular involvement and complex vascular reconstructions in borderline to minimally advanced pancreatic malignancies

verfasst von: Donald L. Ly, Seng Thipphavong, Boraiah Sreeharsha

Erschienen in: Abdominal Radiology | Ausgabe 11/2017

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Abstract

Purpose

To review borderline resectability criteria for pancreatic malignancies, show examples of few surgically treated minimally advanced pancreatic malignancies, discuss various complex vascular reconstructions, and highlight the imaging appearances.

Background

Often aggressive surgical approaches are used to treat borderline to minimally advanced pancreatic malignancies in specialist centers. As abdominal radiologists it is essential to have up-to-date knowledge to distinguish such tumors with accuracy and also be well versed with the various vascular reconstructions used in such surgeries.

Imaging findings

We will show various examples of resected borderline resectable and minimally advanced pancreatic malignancies, highlight crucial vascular involvements, describe various types of advanced vascular reconstructions, and review their standard imaging appearances. We will also briefly describe the vascular complications and highlight the importance of imaging surveillance in early post-operative period.

Conclusions

It is essential for abdominal radiologists in specialist centers where aggressive surgical approaches are used to have accurate knowledge to assess vascular involvement in pancreatic malignancies and equally to recognize and assess vascular reconstructions on imaging after complex surgeries.
Literatur
1.
2.
Zurück zum Zitat Clancy TE (2015) Surgery for pancreatic cancer. Hematol Oncol Clin N Am. 29:701–716CrossRef Clancy TE (2015) Surgery for pancreatic cancer. Hematol Oncol Clin N Am. 29:701–716CrossRef
3.
Zurück zum Zitat Al-Hawary MM, Francis IR, Chari ST, et al. (2014) Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the society of abdominal radiology and the American Pancreatic Association. Radiology. 270(1):248–260CrossRefPubMed Al-Hawary MM, Francis IR, Chari ST, et al. (2014) Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the society of abdominal radiology and the American Pancreatic Association. Radiology. 270(1):248–260CrossRefPubMed
4.
Zurück zum Zitat Tempero MA, Malafa MP, Behrman SW, et al. (2014) Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 12(8):1083–1093CrossRefPubMed Tempero MA, Malafa MP, Behrman SW, et al. (2014) Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 12(8):1083–1093CrossRefPubMed
5.
Zurück zum Zitat Vardhachary GR, Tamm EP, Abbruzzese JL, et al. (2006) Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Ann Surg Oncol. 13:1035–1046CrossRef Vardhachary GR, Tamm EP, Abbruzzese JL, et al. (2006) Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Ann Surg Oncol. 13:1035–1046CrossRef
6.
7.
Zurück zum Zitat Lopez NE, Prendergast C, Lowy AM (2014) Borderline resectable pancreatic cancer: definitions and management. World J Gastroenterol. 20(31):10740–10751CrossRefPubMedPubMedCentral Lopez NE, Prendergast C, Lowy AM (2014) Borderline resectable pancreatic cancer: definitions and management. World J Gastroenterol. 20(31):10740–10751CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Zaky AM, Wolfgang CL, Weiss MJ, et al. (2017) Tumor-vessel relationships in pancreatic ductal adenocarcinoma at multidetector CT: different classification systems and their influence on treatment planning. Radiographics. 37:93–112CrossRefPubMed Zaky AM, Wolfgang CL, Weiss MJ, et al. (2017) Tumor-vessel relationships in pancreatic ductal adenocarcinoma at multidetector CT: different classification systems and their influence on treatment planning. Radiographics. 37:93–112CrossRefPubMed
9.
Zurück zum Zitat Tremblay A, Cook N, Gallinger S, et al. University Health Network guidelines for management of resectable, borderline resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC). 2015. Tremblay A, Cook N, Gallinger S, et al. University Health Network guidelines for management of resectable, borderline resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC). 2015.
10.
Zurück zum Zitat Al-Hawary MM, Francis IR, Chari ST, et al. (2014) Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the Society of Abdominal Radiology and the American Pancreatic Association. Radiology. 270(1):248–260CrossRefPubMed Al-Hawary MM, Francis IR, Chari ST, et al. (2014) Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the Society of Abdominal Radiology and the American Pancreatic Association. Radiology. 270(1):248–260CrossRefPubMed
11.
Zurück zum Zitat Egorov VI, Petrov RV, Solodinina EN, et al. (2013) Computed tomography-based diagnostics might be insufficient in the determination of pancreatic cancer unresectability. World J Gastrointest Surg. 4(3):83–96CrossRef Egorov VI, Petrov RV, Solodinina EN, et al. (2013) Computed tomography-based diagnostics might be insufficient in the determination of pancreatic cancer unresectability. World J Gastrointest Surg. 4(3):83–96CrossRef
12.
Zurück zum Zitat Schwarz L, Katz MHG (2015) Management of borderline resectable pancreatic adenocarcinoma. Hematol Oncol Clin N Am. 29:727–740CrossRef Schwarz L, Katz MHG (2015) Management of borderline resectable pancreatic adenocarcinoma. Hematol Oncol Clin N Am. 29:727–740CrossRef
13.
Zurück zum Zitat Pollom EL, Koon AC, Ko AH (2015) Treatment approaches to locally advanced pancreatic adenocarcinoma. Hematol Oncol Clin N Am. 29:741–759CrossRef Pollom EL, Koon AC, Ko AH (2015) Treatment approaches to locally advanced pancreatic adenocarcinoma. Hematol Oncol Clin N Am. 29:741–759CrossRef
14.
15.
Zurück zum Zitat Soriano A, Castells A, Ayuso C, et al. (2004) Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am J Gastroenterol. 99:492–501CrossRefPubMed Soriano A, Castells A, Ayuso C, et al. (2004) Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am J Gastroenterol. 99:492–501CrossRefPubMed
16.
Zurück zum Zitat Ishikawa O, Ohigashi H, Imaoka S, et al. (1992) Preoperative indications for extended pancreatectomy for locally advanced pancreas cancer involving the portal vein. Ann Surg. 215(3):231–236CrossRefPubMedPubMedCentral Ishikawa O, Ohigashi H, Imaoka S, et al. (1992) Preoperative indications for extended pancreatectomy for locally advanced pancreas cancer involving the portal vein. Ann Surg. 215(3):231–236CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Nakao A, Kanzaki A, Fujii T, et al. (2012) Correlation between radiographic classification and pathological grade of portal vein wall invasion in pancreatic head cancer. Ann Surg. 255(1):103–108CrossRefPubMed Nakao A, Kanzaki A, Fujii T, et al. (2012) Correlation between radiographic classification and pathological grade of portal vein wall invasion in pancreatic head cancer. Ann Surg. 255(1):103–108CrossRefPubMed
Metadaten
Titel
Pictorial review of vascular involvement and complex vascular reconstructions in borderline to minimally advanced pancreatic malignancies
verfasst von
Donald L. Ly
Seng Thipphavong
Boraiah Sreeharsha
Publikationsdatum
18.05.2017
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 11/2017
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-017-1172-x

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