Detection of liver metastases secondary to pancreatic cancer: Utility of combined helical computed tomography during arterial portography with biphasic computed tomography-assisted hepatic arteriography

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Purpose: This study was designed to define the diagnostic advantage of computed tomography during arterial portography(CTAP) combined with computed tomography–assisted hepatic arteriography(CTHA) for preoperative detection of liver metastases secondary to pancreatic cancer compared with that of multidetector computed tomography (MDCT). Methods: From January 2002 to December 2007, we retrospectively studied 197 consecutive patients with pancreatic cancer. MDCT was performed on 192 patients prior to preoperative visceral angiography. 153 patients underwent CTAP + CTHA at the time of preoperative angiography. Results: Liver metastases were identified in 39 patients by means of MDCT. Of 129 patients who underwent CTAP + CTHA, 53 patients (41.1%) were diagnosed as having liver metastases, which could not be detected by MDCT. These tumors missed by MDCT ranged from 3 to 15 mm in size. On CTAP + CTHA, a solitary nodule in the liver was detected in 11 patients, 2 nodules in 6 patients, 3 lesions in 2 patient, and ≧　4 lesions in 34 patients. The sensitivity and specificity of CTAP + CTHA versus MDCT were 94.2% versus 48.4% and 82.7% versus 97.9%, respectively. Conclusions: The combination of CTAP and CTHA is useful to confirm liver metastases and can potentially offer more accurate staging of pancreatic cancer compared with MDCT.

http://www.springerlink.com/content/w91767t3335858p1/

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