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Shantarevich M.Yu.

Vishnevsky National Medical Research Center of Surgery

Karmazanovsky G.G.

Vishnevsky National Medical Research Center of Surgery

Egorkina A.B.

Vishnevsky National Medical Research Center of Surgery

Kurochkina A.I.

Federal Research Institute for Health Organization and Informatics

Kalinin D.V.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Kalinin D.V.

Vishnevsky National Medical Research Center of Surgery

Kriger A.G.

Russian Research Center of Radiology;
Russian Medical Academy of Postgraduate Education

Computed tomography in determining the differentiation of ductal adenocarcinoma of pancreatic head

Authors:

Shantarevich M.Yu., Karmazanovsky G.G., Egorkina A.B., Kurochkina A.I., Kalinin D.V., Kalinin D.V., Kriger A.G.

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Journal: Pirogov Russian Journal of Surgery. 2021;(3): 11‑19

DOI: 10.17116/hirurgia202103111

Read: 2390 times

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Table of contents

COMPUTED TOMOGRAPHY IN DETERMINING THE DIFFERENTIATION OF DUCTAL ADENOCARCINOMA OF PANCREATIC HEAD
COMPUTED TOMOGRAPHY IN DETERMINING THE DIFFERENTIATION OF DUCTAL ADENOCARCINOMA OF PANCREATIC HEAD

To cite this article:

Shantarevich MYu, Karmazanovsky GG, Egorkina AB, Kurochkina AI, Kalinin DV, Kalinin DV, Kriger AG. Computed tomography in determining the differentiation of ductal adenocarcinoma of pancreatic head. Pirogov Russian Journal of Surgery. 2021;(3):11‑19. (In Russ.)
https://doi.org/10.17116/hirurgia202103111

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To evaluate the features of «hypervascular rim», tumor dimensions and density as prognostic factors of differentiation of pancreatic head adenocarcinoma.

MATERIAL AND METHODS

Pancreatoduodenectomy was performed in 311 patients with pancreatic head adenocarcinoma for the period 2013—2019. A retrospective study included 81 patients who met the following criteria: available data of morphological and immunohistological examination indicating tumor grade from Grade 1 to Grade 3, as well as available preoperative CT images in four phases (native, arterial, portal and delayed). Tumor dimensions, density of the pancreas, adenocarcinoma and abdominal aorta by the phases of contrast enhancement were analyzed in all patients. Moreover, we estimated coefficient of relative enhancement change. Perifocal hypervascular enhancement was assessed in arterial and portal phases. Contrast-enhanced MRI was performed in 15 out of 81 patients. MR images were analyzed regarding a hypervascular rim, and the last one was compared with CT images.

RESULTS

There was no significant difference in density values between different tumor grades. Coefficient of relative enhancement change >1 was observed in 63.64% of highly-differentiated tumors. REC ≤1 was found in 85.11% of tumors grade 2 and 82.6% of tumors grade 3 (p=0.005). According to Chi-square test, there was a correlation between tumor differentiation and hypervascular rim (p=0.03). Moderate and low differentiation was observed in 96.42% of tumors with perifocal enhancement. Hypervascular rim was absent in 81.82% of tumors grade 1. Adenocarcinoma grade 2 was found in 85.71% of cases with unclear perifocal enhancement.

CONCLUSION

Preoperative contrast-enhanced CT is valuable to assume the tumor grade in patients with pancreatic head adenocarcinoma due to assessment of hypervascular rim and REC.

Keywords:

pancreatic ductal carcinoma
tumor grade
contrast-enhanced CT
hypervascular rim
coefficient of relative enhancement change

Authors:

Shantarevich M.Yu.

Vishnevsky National Medical Research Center of Surgery

Karmazanovsky G.G.

Vishnevsky National Medical Research Center of Surgery

Egorkina A.B.

Vishnevsky National Medical Research Center of Surgery

Kurochkina A.I.

Federal Research Institute for Health Organization and Informatics

Kalinin D.V.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Kalinin D.V.

Vishnevsky National Medical Research Center of Surgery

Kriger A.G.

Russian Research Center of Radiology;
Russian Medical Academy of Postgraduate Education

Received:

25.03.2020

Accepted:

06.04.2020

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