Diagnostic value of the delayed phase image for iso-attenuating pancreatic carcinomas in the pancreatic parenchymal phase on multidetector computed tomography
Abstract
Purpose To assess the value of the delayed phase (DP) in pancreatic carcinomas which appear iso-attenuating in the pancreatic parenchymal phase (PPP). Materials and methods Fifty-seven preoperative MDCT studies of pancreatic carcinomas were retrospectively reviewed. The size of the tumors, and the Hounsfield unit (HU) of the tumors and pancreatic parenchyma were measured. The tumor-to-pancreas contrast (TPC: |HU [tumor]-HU [normal pancreas]|) was calculated. Results Eight cases (14.0%) showed iso-attenuation and 49 showed hypo-attenuation in the PPP. The DP images revealed seven of eight (87.5%) iso-attenuating tumors to be hyper-attenuating. The size of iso-attenuating tumors was smaller than that of hypo-attenuating tumors (mean+/-S.D.: 12.4+/-4.8mm vs. 30.3+/-9.0mm, p<0.0001). In hypo-attenuating tumors, TPC in the PPP (60.2+/-24.6 HU) was higher than those in the portal venous phase (PVP, 40.5+/-23.0 HU, p<0.0001) and DP (18.3+/-11.8 HU, p<0.0001). In contrast, in iso-attenuating tumors, TPC in the DP (26.0+/-4.9 HU) was higher than those in the PPP (9.2+/-3.7 HU, p=0.0003) and PVP (7.1+/-4.7 HU, p=0.001) phases. Conclusion The DP image is helpful in depicting small iso-attenuating pancreatic carcinomas as slightly hyper-attenuating tumors.
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Pancreatic duct dilatation and interruption are the most important secondary findings of pancreatic cancer.
“Pancreatic duct dilatation and interruption are the most important secondary findings of pancreatic cancer, and they can be a crucial key in diagnosing small pancreatic cancer (11,12,16,28).”
From Suspicious findings observed retrospectively on CT imaging performed before the diagnosis of pancreatic cancer (2023) · cites this paper as [28]
Isoattenuating tumor occurs in 11-14% of all pancreatic cancers.
“Diagnosis is not easy if the CT shows an isoattenuating tumor, which occurs in 11–14% of all pancreatic cancers, and most of them are small pancreatic cancers (12,28).”
From Suspicious findings observed retrospectively on CT imaging performed before the diagnosis of pancreatic cancer (2023) · cites this paper as [28]
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- Authors
- Ishigami, K., Yoshimitsu, K., Irie, H., Tajima, T., Asayama, Y., Nishie, A., Hirakawa, M., Ushijima, Y., Okamoto, D., Nagata, S., Nishihara, Y., Yamaguchi, K., Taketomi, A., & Honda, H.
- Affiliations
- Kyushu University (JP)
- Corresponding author
- Ishigami, Kousei
- ORCID
- Venue
- European Journal of Radiology
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 69
- Issue
- 1
- Pages
- 139-146
- ISSN
- 0720-048X (ISSN-L)
- OpenAlex
- W2030872316
- Cited by
- 79
- References
- 25
- Citations by year
- 2026: 7 · 2025: 1 · 2024: 5 · 2023: 10 · 2022: 6 · 2021: 7 · 2020: 5 · 2019: 7 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 2 · 2014: 6 · 2013: 6 · 2012: 1
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Radiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- pancreatic cancer, delayed phase imaging, tumor size, portal venous phase, multidetector computed tomography, preoperative imaging
- MeSH terms
- Adenocarcinoma, Adult, Aged, Aged, 80 and over, Contrast Media, Female, Humans, Image Enhancement, Iopamidol, Male, Middle Aged, Pancreatic Neoplasms, Sensitivity and Specificity, Time Factors, Tomography, X-Ray Computed, Reproducibility of Results
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