Multislice CT for pre-operative staging of pancreatic cancer

This paper describes the present status and problem of preoperative staging of pancreatic cancer by multislice CT (MS-CT), based on authors' experience. Examined are findings in 38 pancreatic cancer patients who underwent the MS-CT and laparotomy. Images by 64-row MS-CT with iodine-contrast medium are converted to multiplanar reconstructed ones for staging, which are compared with histopathological findings. Evaluation is done on tumor size (TS), tumor invasions in the distal bile duct (CH), duodenum (DU), serosal (S)/retropancreatic (RP) tissues, portal vein (PV), artery (A), nerve plexus (PL), and other organs (OO), and metastasis in lymph node (N) and liver (H). Diagnosis is found to be efficient on TS, CH, DU, PV, A, OO and H. Detection sensitivity is found high for S and RP, but specificity, low. The sensitivity is low for PL. The lowness in specificity in the former and sensitivity in the latter is conceivably due to false positive diagnosis for elevated fat level accompanied by pancreatitis. Inferior pancreaticoduodenal artery is found imageable in 92% cases. MS-CT is concluded to be an essential tool for staging the pancreatic cancer because it gives volume data in a short time with low invasion to patients. (T.I.)