Pancreatic cancer: value of dual-phase helical CT in assessing resectability

Radiology. 1998 Feb;206(2):373-8. doi: 10.1148/radiology.206.2.9457188.


Purpose: To evaluate the use of dual-phase helical computed tomography (CT) (with or without CT angiography) to assess resectability in patients suspected to have pancreatic cancer.

Materials and methods: Tumor resectability was prospectively evaluated in 89 patients who later underwent surgery for suspected pancreatic cancer. Helical CT scans were obtained in the vascular phase and a phase of maximal hepatic enhancement. CT angiograms were produced with multiprojection volume reconstruction and maximum-intensity projection. CT results were correlated with surgical and histopathologic results.

Results: Helical CT allowed detection of pancreatic cancer in 74 of 76 cases (97%). There were six false-positive results (positive predictive value, 92%). For prediction of irresectability, helical CT had an accuracy of 91%, negative predictive value of 79%, and sensitivity of 91%. Helical CT allowed detection of liver metastases in 21 of 28 cases (75%), nodal involvement in 13 of 24 cases (54%), and vascular invasion in 35 of 40 cases (88%). CT angiography demonstrated 30 of the 35 cases of vascular invasion detected with helical CT (86%).

Conclusion: Use of dual-phase helical CT improves prediction of resectability in patients with pancreatic cancer. CT angiography cannot show all of the findings seen on helical scans.

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery
  • Angiography / methods
  • Contrast Media
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Iohexol / analogs & derivatives
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Predictive Value of Tests
  • Prospective Studies
  • Sensitivity and Specificity
  • Time Factors
  • Tomography, X-Ray Computed / methods*


  • Contrast Media
  • Iohexol
  • iopromide