Staging of pancreatic cancer with multidetector CT in the setting of preoperative chemoradiation therapy. Abdom Imaging 2006 Sep 12:
Date
09/13/2006Pubmed ID
16967235Abstract
BACKGROUND: Preoperative chemoradiation can potentially improve outcomes in patients with pancreatic cancer. This study addresses its impact on staging pancreatic cancer with multidetector CT (MDCT). METHODS: Fifty-five patients underwent a dual phase MDCT pancreas protocol for proven pancreatic cancer. Of these, 16 patients underwent preoperative chemoradiation. Three radiologists independently reviewed images to assess for locally advanced disease, and liver and peritoneal metastases on the baseline studies of all 55 patients, and on the followup preoperative studies for the 16 patients receiving preoperative therapy. Overall score for resectability was given on a 1-5 scale (1 definitely resectable, 5 definitely unresectable). ROC curves and weighted kappa statistics were determined. RESULTS: The area under the ROC curves for Readers 1, 2, and 3 were 0.98, 0.96, and 0.90 respectively. Weighted K values for Reader 1 vs. 2, Reader 1 vs. 3, and Reader 2 vs. 3 were 0.90, 0.57, and 0.54, respectively. Interpreting scores of 1-3 for resectability as resectable disease, the mean sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were 0.92, 0.91, 0.74, 0.98, and 0.92, respectively. CONCLUSION: The negative predictive value for MDCT for identifying unresectable pancreatic cancer in the setting of preoperative therapy is comparable with that reported in the absence of neoadjuvant therapy.
