Yukiko Kunou, Presenter: Nothing to Disclose

Masafumi Uchida MD, PhD, Abstract Co-Author: Nothing to Disclose

Shunji Arikawa MD, Abstract Co-Author: Nothing to Disclose

Hayato Kaida, Abstract Co-Author: Nothing to Disclose

Naofumi Hayabuchi MD, PhD, Abstract Co-Author: Nothing to Disclose

Yoshinobu Okabe, Abstract Co-Author: Nothing to Disclose

Makiko Yasumoto, Abstract Co-Author: Nothing to Disclose

Jun Sakoda, Abstract Co-Author: Nothing to Disclose

Masaharu Shinagawa MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate the utility of whole pancreatic perfusion computed tomography (PPCT) for predicting the response of pancreatic cancer to combined chemotherapy and radiotherapy.

Eighteen patients with confirmed pancreatic cancer underwent PPCT before therapy. PPCT was performed using a 256-slice scanner (acquisition time, 45 sec) after intravenous injection of contrast medium (35 ml, 350 mg/I, 4 ml/sec). Perfusion parameters including perfusion (PF), peak enhancement (PE), time to peak (TTP), and blood volume (BV) were measured in the tumor and tail of the pancreas. Tumor microvessel density and immunohistochemistry of surgical specimens were compared between patients who partially or completely responded to treatment (responders) and those who did not (non-responders; stable or progressive disease), as determined by the Response Evaluation Criteria in Solid Tumors from 3-month post-therapeutic follow-up CT examination. Statistical analysis was performed with the two-sample t test.

Eight of 18 patients examined at follow-up responded to therapy. Pretreatment PF (16.5±9.8 mL/min/100 mL), PE (31.6±8.5 HU), and BV (14.1±1.1 mL/100 g) were significantly higher in responders than in non-responders (7.0±2.4 mL/min/100 mL, 31.6±8.5 HU, 14.1±1.1 mL/100 g) (P<0.05). Although not significant, responders had lower TTP values and higher MVD values. All perfusion parameters in the tail of the pancreas were not significantly different between responders and non-responders, but were lower and more prolonged than in the normal pancreas.

Whole PPCT using a 256-slice scanner has the potential to predict the response of pancreatic cancer to combined chemotherapy and radiotherapy, and can be used to simultaneously evaluate residual pancreas function. It is anticipated that this technique can be further adapted for management of pancreatic cancer.

Whole PPCT improves the functional image of pancreatic cancer for combined chemotherapy and radiotherapy.

Kunou, Y, Uchida, M, Arikawa, S, Kaida, H, Hayabuchi, N, Okabe, Y, Yasumoto, M, Sakoda, J, Shinagawa, M, Predicting the Response of Pancreatic Cancer to Combined Chemotherapy and Radiotherapy by Whole Pancreatic Perfusion Computed Tomography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013265.html