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212874

Accuracy of Multislice Detector Computed Tomography in Staging Borderline Resectable Periampullary Pancreatic Carcinoma

Article

Last updated: 23 Jan 2023

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Abstract

Introduction: Periampullary malignancies have poor outcomes. Thus, identifying patients who can benefit from
surgery while avoiding risks and possible complications is crucial. This study was designed to determine the
accuracy of MDCT in diagnosing resectable tumors.
Methodology and results: This retrospective case-control study included 28 randomly selected patients. Patients
were divided into group A (preoperative staging via MDCT) and group B (control; staging via laparoscopy and
MDCT).MDCT had a 100% sensitivity and accuracy in identifying signs of irresectability. For borderline staging,
MDCT had an accuracy of 62.5% and 71% for groups A and B, respectively. MDCT had an overall accuracy of
75%, which decreased to 68.1% for borderline lesions. Laparoscopy was able to identify occult findings missed by
radiological imaging. Three cases in group A and one in group B underwent unnecessary laparotomy, resulting in
a false-negative rate of 21% and 7%, respectively, with an overall rate of 14.2%. The mean predictive value of CT
was 100% and 68.1% in irresectable and resectable cancers, respectively.
Conclusion: Although MDCT is highly accurate for high-stage cancers, in potentially resectable tumors, it's less
accurate. We recommend adding other adjuncts to avoid unindicated laparotomies.

DOI

10.21608/asjs.2021.212874

Keywords

CT scan sensitivity, borderline periampullary pancreatic cancers, pancreatic cancer staging, multi-detector row computed tomography (MDCT)

Authors

First Name

Mohamed

Last Name

Issa

MiddleName

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Affiliation

Department of General Surgery, Prince Charles Hospital, Merthyr Tydfil, Cardiff, UK

Email

mohmed.talaat94@yahoo.com

City

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Orcid

-

First Name

Marwa

Last Name

Badawi

MiddleName

-

Affiliation

Department of General Surgery, Cairo University Hospitals, Egypt

Email

marwa.badawi@hotmail.com

City

-

Orcid

-

First Name

Ahmed

Last Name

Shalaby

MiddleName

-

Affiliation

Department of General Surgery, Cairo University Hospitals, Egypt

Email

ah_shalaby_85@yahoo.com

City

-

Orcid

-

First Name

Khaled

Last Name

Noureldin

MiddleName

-

Affiliation

Department of General Surgery, Cairo University Hospitals, Egypt

Email

kangom1384@yahoo.com

City

-

Orcid

-

Volume

14

Article Issue

1

Related Issue

29932

Issue Date

2021-07-01

Receive Date

2022-01-05

Publish Date

2021-07-01

Page Start

66

Page End

70

Print ISSN

2090-7249

Link

https://asjs.journals.ekb.eg/article_212874.html

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https://asjs.journals.ekb.eg/service?article_code=212874

Order

8

Type

Original Article

Type Code

1,943

Publication Type

Journal

Publication Title

Ain Shams Journal of Surgery

Publication Link

https://asjs.journals.ekb.eg/

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Article

Created At

23 Jan 2023