Multislice spiral computed tomography in diagnosis and staging of pancreatic carcinoma: Preliminary experience

Background. Computed tomography has become the modality of choice for preoperative evaluation of patients with suspected pancreatic carcinoma, although some limitations are well known. Aims. To evaluate use of multislice spiral computed tomography in preoperative assessment of patients with suspected pancreatic carcinoma using volume-rendering as image reconstruction algorithm. Patients. A total of 27 patients with suspected pancreatic carcinoma underwent multislice spiral computed tomography examination. Methods. All studies were performed on a multislice computed tomography scanner with the following parameters: slice collimation, I mm; slice thickness, 1.25 mm; reconstruction interval, I mm; scan time, 22-25 sec; mAs, 165. Scans were acquired with a biphasic technique with a 30-sec (pancreatic phase) and a 70-sec (portal venous phase) delay time after start of contrast material injection. Diagnostic confirmation was obtained with surgical exploration, percutaneous biopsy, or with a combination of follow-up imaging studies. Results. Multislice spiral computed tomography yielded correct diagnosis of pancreatic carcinoma in 20 cases (sensitivity, 95%; specificity, 100%). Positive predictive values for resectability and unresectability were 80% and 93.3%, respectively. Three-dimensional volume-rendered images improved diagnostic confidence in the depiction of major vascular structures. Two cases of anomalous origin of hepatic artery were also identified with volume-rendered images. Conclusions. Multislice technology improves accuracy of spiral computed tomography for diagnosis and staging of