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European Radiology
Published in: European Radiology 12/2017

01-12-2017 | Gastrointestinal

Development of pancreatic cancer is predictable well in advance using contrast-enhanced CT: a case–cohort study

Authors: Wataru Gonoi, Takana Yamakawa Hayashi, Hidemi Okuma, Masaaki Akahane, Yousuke Nakai, Suguru Mizuno, Ryosuke Tateishi, Hiroyuki Isayama, Kazuhiko Koike, Kuni Ohtomo

Published in: European Radiology | Issue 12/2017

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Abstract

Objectives

To investigate the radiological findings prognostic for the development of pancreatic adenocarcinoma in a cohort of patients with hepatocellular carcinoma, using multiphasic computed tomography (CT).

Methods

A case–cohort study performed in a single university hospital. A database of patients who received hepatocellular carcinoma (HCC) treatment and trimonthly follow-up with four-phase dynamic CT was used (n = 1848). The cohort group was randomly extracted from the database (n = 103). The case group comprised nine patients from the database who developed pancreatic adenocarcinoma. The radiological findings were assessed during follow-up (average, 32 months).

Results

The incidence of pancreatic mass, inhomogeneous parenchyma, loss of fatty marbling and main pancreatic duct dilatation gradually increased from 4 to 13 months before the diagnosis of pancreatic adenocarcinoma. There was a significantly higher incidence of pancreatic mass, inhomogeneous parenchyma and loss of fatty marbling on CT at baseline (average, 34 months before diagnosis) in the case group compared with the cohort group (P values < 0.01) and those findings at baseline were revealed as prognostic factors for pancreatic carcinogenesis, respectively (log-rank test, P values < 0.001).

Conclusions

Several radiological findings observed on multiphasic CT can assist in predicting pancreatic carcinogenesis well in advance.

Key points

• Pancreatic findings in multiphasic CT help predict development of pancreatic adenocarcinoma.
• Key findings are mass, inhomogeneous parenchyma and loss of fatty marbling.
• Those findings were observed 34 months before confirmed diagnosis of adenocarcinoma.
• Those findings were prognostic factors for pancreatic carcinogenesis.
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Metadata
Title
Development of pancreatic cancer is predictable well in advance using contrast-enhanced CT: a case–cohort study
Authors
Wataru Gonoi
Takana Yamakawa Hayashi
Hidemi Okuma
Masaaki Akahane
Yousuke Nakai
Suguru Mizuno
Ryosuke Tateishi
Hiroyuki Isayama
Kazuhiko Koike
Kuni Ohtomo
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4895-8

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