Isoattenuating Pancreatic Adenocarcinoma at Multi–Detector Row CT: Secondary Signs
Abstract
Purpose To assess the frequency of isoattenuating pancreatic adenocarcinoma with multi-detector row computed tomography (CT) and determine whether there are specific secondary signs that aid in detection. Materials and methods Fifty-three patients with pancreatic adenocarcinoma underwent contrast material-enhanced biphasic multi-detector row CT with curved planar reformation. Tumors were initially deemed isoattenuating or hypoattenuating to normal pancreatic parenchyma on the basis of visual inspection, and the degree of attenuation was confirmed by calculating the mean attenuation differences between normal pancreatic parenchyma and tumor (tumor-pancreas contrast) during the pancreatic phase. Indirect signs of pancreatic tumor were tabulated in patients with an isoattenuating tumor. Results Of the 53 patients, six (11%) had isoattenuating tumors with a mean tumor-pancreas contrast of 9.25 HU +/- 11.3 during the pancreatic phase and 4.15 HU +/- 8.5 during the portal venous phase. The secondary signs of pancreatic tumor in these six patients included an interrupted pancreatic duct (n = 5), dilated biliary and pancreatic ducts (n = 1), atrophic distal pancreatic parenchyma (n = 3), and mass effect and/or convex contour abnormality (n = 3). The mean tumor-pancreas contrast for the remaining 47 patients was 74.76 HU +/- 35.61 during the pancreatic phase. Conclusion With no visible tumor-pancreas contrast for isoattenuating tumors, indirect signs such as mass effect, atrophic dist…
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Main pancreatic duct dilatation and distal parenchymal atrophy are characteristic findings of early pancreatic cancer.
“In addition, main pancreatic duct dilatation and distal parenchymal atrophy are characteristic findings of early pancreatic cancer (9-12).”
From Suspicious findings observed retrospectively on CT imaging performed before the diagnosis of pancreatic cancer (2023) · cites this paper as [12]
Prokesch et al. reported that 11% of 53 patients with pancreatic cancer showed isoattenuating tumors and mass effect; atrophic distal parenchyma and an interrupted duct sign were important findings in the diagnosis of pancreatic cancer.
“Prokesch et al. (12) reported that 11% of 53 patients with pancreatic cancer showed isoattenuating tumors and mass effect; atrophic distal parenchyma and an interrupted duct sign were important findings in the diagnosis of pancreatic cancer.”
From Suspicious findings observed retrospectively on CT imaging performed before the diagnosis of pancreatic cancer (2023) · cites this paper as [12]
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 [12]
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 [12]
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- Authors
- Prokesch, R. W., Chow, L. C., Beaulieu, C. F., Bammer, R., & Jeffrey, R. B.
- Affiliations
- Stanford Medicine (US)
- Venue
- Radiology
- Published
- 2002-09
- Volume
- 224
- Issue
- 3
- Pages
- 764-768
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- OpenAlex
- W2097793074
- Cited by
- 337
- References
- 15
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 12 · 2023: 19 · 2022: 21 · 2021: 19 · 2020: 15 · 2019: 15 · 2018: 17 · 2017: 11 · 2016: 13 · 2015: 25 · 2014: 18 · 2013: 20 · 2012: 19
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- 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 › Surgery › Pancreatitis Pathology and Treatment
- Keywords
- pancreatic ductal adenocarcinoma, mass effect, tumor detection, multi-detector row CT, contrast-enhanced CT
- MeSH terms
- Adenocarcinoma, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms, Tomography, X-Ray Computed
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