Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols
Aims To determine the relative significance of radiological signs in determining the resectability of peri-ampullary cancer (PC) and to assess the value of multi-phase imaging in detecting these findings. Materials and methods Blinded, double re-reporting of preoperative imaging from five hospitals...
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| Veröffentlicht in: | Clinical radiology 2017-08, Vol.72 (8), p.691.e11-691.e17 |
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| creator | Amr, B Miles, G Shahtahmassebi, G Roobottom, C Stell, D.A |
| description | Aims To determine the relative significance of radiological signs in determining the resectability of peri-ampullary cancer (PC) and to assess the value of multi-phase imaging in detecting these findings. Materials and methods Blinded, double re-reporting of preoperative imaging from five hospitals was undertaken of 411 patients undergoing surgery for PC over an 8-year period, of whom 119 patients were found to be inoperable at the time of surgery. Results The median tumour size was 26.7 mm and the proportion of patients reported to have regional lymphadenopathy (RL), venous (VI) and arterial involvement (AI) was 24.7%, 11.5%, and 3.9%, respectively and was similar regardless of the number of contrast phases undertaken. Significant associations were, however, noted between individual risk factors: VI was closely associated with tumour size ( p =0.002) and AI ( p |
| doi_str_mv | 10.1016/j.crad.2017.02.012 |
| format | Article |
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Materials and methods Blinded, double re-reporting of preoperative imaging from five hospitals was undertaken of 411 patients undergoing surgery for PC over an 8-year period, of whom 119 patients were found to be inoperable at the time of surgery. Results The median tumour size was 26.7 mm and the proportion of patients reported to have regional lymphadenopathy (RL), venous (VI) and arterial involvement (AI) was 24.7%, 11.5%, and 3.9%, respectively and was similar regardless of the number of contrast phases undertaken. Significant associations were, however, noted between individual risk factors: VI was closely associated with tumour size ( p =0.002) and AI ( p <0.0001). In multivariate analysis AI, VI, and RL were independently associated with resectability (relative risk of resection=0.05, 0.31, and 0.51, respectively). Tumour size, however, was not associated with resectability when VI was included in the multivariate model. Conclusions The use of multiple vascular contrast phases has no measureable impact on the rate of determination of tumour resectability of PC. In preoperative staging, AI is the most significant adverse finding for resectability. Large tumour diameter is not an adverse finding in isolation from other risk factors.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2017.02.012</identifier><identifier>PMID: 28292513</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Ampulla of Vater ; Clinical Protocols ; Common Bile Duct Neoplasms - diagnostic imaging ; Common Bile Duct Neoplasms - surgery ; Duodenal Neoplasms - diagnostic imaging ; Duodenal Neoplasms - surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatic Neoplasms - surgery ; Radiology ; Retrospective Studies ; Tomography, X-Ray Computed - methods</subject><ispartof>Clinical radiology, 2017-08, Vol.72 (8), p.691.e11-691.e17</ispartof><rights>The Royal College of Radiologists</rights><rights>2017 The Royal College of Radiologists</rights><rights>Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-ea3bb71fbd9882c48abf4a2e75e35d6a75089aaeb00e61c8d4a0d33a12ba39a23</citedby><cites>FETCH-LOGICAL-c455t-ea3bb71fbd9882c48abf4a2e75e35d6a75089aaeb00e61c8d4a0d33a12ba39a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.crad.2017.02.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28292513$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amr, B</creatorcontrib><creatorcontrib>Miles, G</creatorcontrib><creatorcontrib>Shahtahmassebi, G</creatorcontrib><creatorcontrib>Roobottom, C</creatorcontrib><creatorcontrib>Stell, D.A</creatorcontrib><title>Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>Aims To determine the relative significance of radiological signs in determining the resectability of peri-ampullary cancer (PC) and to assess the value of multi-phase imaging in detecting these findings. Materials and methods Blinded, double re-reporting of preoperative imaging from five hospitals was undertaken of 411 patients undergoing surgery for PC over an 8-year period, of whom 119 patients were found to be inoperable at the time of surgery. Results The median tumour size was 26.7 mm and the proportion of patients reported to have regional lymphadenopathy (RL), venous (VI) and arterial involvement (AI) was 24.7%, 11.5%, and 3.9%, respectively and was similar regardless of the number of contrast phases undertaken. Significant associations were, however, noted between individual risk factors: VI was closely associated with tumour size ( p =0.002) and AI ( p <0.0001). In multivariate analysis AI, VI, and RL were independently associated with resectability (relative risk of resection=0.05, 0.31, and 0.51, respectively). Tumour size, however, was not associated with resectability when VI was included in the multivariate model. Conclusions The use of multiple vascular contrast phases has no measureable impact on the rate of determination of tumour resectability of PC. In preoperative staging, AI is the most significant adverse finding for resectability. Large tumour diameter is not an adverse finding in isolation from other risk factors.</description><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ampulla of Vater</subject><subject>Clinical Protocols</subject><subject>Common Bile Duct Neoplasms - diagnostic imaging</subject><subject>Common Bile Duct Neoplasms - surgery</subject><subject>Duodenal Neoplasms - diagnostic imaging</subject><subject>Duodenal Neoplasms - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kstu1TAQhiMEoqeFF2CBvGST4EuuEkJCR4UiVWLRIrGzJs6k9SGxDx6nUh6Ft8XhFBYsWPmi___tmW-y7JXgheCifnsoTIChkFw0BZcFF_JJthOqrnIpu29Psx3nvMs7WfOz7JzosB1LWT7PzmQrO1kJtct-3qwUcYZoDcMHmJa08475kaVo6yd_Zw1MbLRusO6OmHUs3iMDIiSa0cXfUiQ0EXo72bhuF0cMNof5uEwThJUZcAYD61e2v2ULpSA22HHEsPmNdzEARXa8B0J2DD564yd6kT0bYSJ8-bheZF8_Xt7ur_LrL58-7z9c56asqpgjqL5vxNgPXdtKU7bQjyVIbCpU1VBDU_G2A8Cec6yFaYcS-KAUCNmD6kCqi-zNKTe9_GNBinq2ZDD93KFfSIu2adpKtJVKUnmSmuCJAo76GOycKtSC6w2JPugNid6QaC51QpJMrx_zl37G4a_lD4MkeHcSYKrywWLQZCymjg02pLbqwdv_57__x24m6zZq33FFOvgluNQ_LTQlg77ZpmCbCdEozpumVr8AT3u2hw</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Amr, B</creator><creator>Miles, G</creator><creator>Shahtahmassebi, G</creator><creator>Roobottom, C</creator><creator>Stell, D.A</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170801</creationdate><title>Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols</title><author>Amr, B ; Miles, G ; Shahtahmassebi, G ; Roobottom, C ; Stell, D.A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-ea3bb71fbd9882c48abf4a2e75e35d6a75089aaeb00e61c8d4a0d33a12ba39a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ampulla of Vater</topic><topic>Clinical Protocols</topic><topic>Common Bile Duct Neoplasms - diagnostic imaging</topic><topic>Common Bile Duct Neoplasms - surgery</topic><topic>Duodenal Neoplasms - diagnostic imaging</topic><topic>Duodenal Neoplasms - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amr, B</creatorcontrib><creatorcontrib>Miles, G</creatorcontrib><creatorcontrib>Shahtahmassebi, G</creatorcontrib><creatorcontrib>Roobottom, C</creatorcontrib><creatorcontrib>Stell, D.A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amr, B</au><au>Miles, G</au><au>Shahtahmassebi, G</au><au>Roobottom, C</au><au>Stell, D.A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>72</volume><issue>8</issue><spage>691.e11</spage><epage>691.e17</epage><pages>691.e11-691.e17</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>Aims To determine the relative significance of radiological signs in determining the resectability of peri-ampullary cancer (PC) and to assess the value of multi-phase imaging in detecting these findings. Materials and methods Blinded, double re-reporting of preoperative imaging from five hospitals was undertaken of 411 patients undergoing surgery for PC over an 8-year period, of whom 119 patients were found to be inoperable at the time of surgery. Results The median tumour size was 26.7 mm and the proportion of patients reported to have regional lymphadenopathy (RL), venous (VI) and arterial involvement (AI) was 24.7%, 11.5%, and 3.9%, respectively and was similar regardless of the number of contrast phases undertaken. Significant associations were, however, noted between individual risk factors: VI was closely associated with tumour size ( p =0.002) and AI ( p <0.0001). In multivariate analysis AI, VI, and RL were independently associated with resectability (relative risk of resection=0.05, 0.31, and 0.51, respectively). Tumour size, however, was not associated with resectability when VI was included in the multivariate model. Conclusions The use of multiple vascular contrast phases has no measureable impact on the rate of determination of tumour resectability of PC. In preoperative staging, AI is the most significant adverse finding for resectability. Large tumour diameter is not an adverse finding in isolation from other risk factors.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28292513</pmid><doi>10.1016/j.crad.2017.02.012</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adenocarcinoma - diagnostic imaging Adenocarcinoma - surgery Adult Aged Aged, 80 and over Ampulla of Vater Clinical Protocols Common Bile Duct Neoplasms - diagnostic imaging Common Bile Duct Neoplasms - surgery Duodenal Neoplasms - diagnostic imaging Duodenal Neoplasms - surgery Female Humans Male Middle Aged Pancreatic Neoplasms - diagnostic imaging Pancreatic Neoplasms - surgery Radiology Retrospective Studies Tomography, X-Ray Computed - methods |
| title | Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols |
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