Diagnostic value of the delayed phase image for iso-attenuating pancreatic carcinomas in the pancreatic parenchymal phase on multidetector computed tomography

Kousei Ishigami, Kengo Yoshimitsu, Hiroyuki Irie, Tsuyoshi Tajima, Yoshiki Asayama, Akihiro Nishie, Masakazu Hirakawa, Yasuhiro Ushijima, Daisuke Okamoto, Shigenori Nagata, Yunosuke Nishihara, Koji Yamaguchi, Akinobu Taketomi, Hiroshi Honda

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47 Citations (Scopus)

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 ± 4.8 mm vs. 30.3 ± 9.0 mm, 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.

Original languageEnglish
Pages (from-to)139-146
Number of pages8
JournalEuropean Journal of Radiology
Volume69
Issue number1
DOIs
Publication statusPublished - Jan 2009

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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