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Subject Area

Radiology and Imaging Sciences

Article Type

Original Study

Abstract

Objective The purpose of this study was to diagnose and stage pancreatic head cancer using recent advances in multidetector computed tomography (MDCT). Patients and methods The study included 40 patients (30 males and 10 females) who had pancreatic head masses either as first presentation or as a follow-up study for pancreatic head cancer referred to the CT unit. Results Adenocarcinoma as reported by pathological studies was found in all patients. According to MDCT criteria, 82.5% of patients had no metastasis, and others had positive metastasis in liver metastasis in 12.5%, pulmonary metastasis in 2.5%, and right suprarenal metastasis 2.5%. In this study, we found that there were insignificant differences between pancreatic mass size and occurrence of metastasis. Regarding pancreatic head cancer staging, we found that 42.5% of patients are of stage III, 30% of stage II, 17.5% of stage IV, and 10% of stage I. We found that 95% of masses were detected using axial-sagittal series, and the remaining 5% not detected by them were detected using coronal reformatting technique. Coronal reformatting technique was also excellent in identifying vascular invasion, as it had the ability to identify all cases of vascular invasion (100%). Curved planar reformations and three-dimensional volume rendering techniques had the ability to detect 90% of cases with ductal involvement and biliary obstruction. Conclusion Contrast-enhanced multiphase pancreatic imaging by MDCT with its postprocessing techniques represents the image of choice for diagnosis and predicting pancreatic head masses and resectability.

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