Review of radiological classifications of pancreatic cancer with peripancreatic vessel invasion: are new grading criteria required?

Pancreatic cancer is mainly diagnosed at an advanced stage when adjacent vessel invasion is present; however, radical resection is potentially curative for selected patients with adjacent vessel invasion. Therefore, accurately judging the resectability of patients with adjacent vessel invasion represents a crucially important step in diagnosis and treatment. Currently, decisions regarding resectability are based on imaging studies, commonly contrast computed tomography (CT). Several radiological classifications have been published for vascular infiltration in pancreatic cancer. However, radiologists always formulate these CT grading systems according to their own experience, resulting in different judgment methods and parameters. And it is controversial in evaluating performance and clinical application. Besides, the conventional CT grading systems mainly focus on the evaluation of vessel invasion so as to less on the outcome of patient evaluation. In this review, we summarize the mainstream CT grading systems for vascular invasion in pancreatic cancer, with the aim of improving the clinical value of CT grading systems for predicting resectability and survival.

[1]  P. Luetmer,et al.  Obliteration of periarterial retropancreatic fat on CT in pancreatitis: an exception to the rule. , 1989, AJR. American journal of roentgenology.

[2]  M. Gonen,et al.  Current utility of staging laparoscopy for pancreatic and peripancreatic neoplasms. , 2008, Journal of the American College of Surgeons.

[3]  K. Zhou,et al.  Pancreatic Adenocarcinoma: The Different CT Criteria for Peripancreatic Major Arterial and Venous Invasion , 2005, Journal of computer assisted tomography.

[4]  R. Patten,et al.  Root of the superior mesenteric artery in pancreatitis and pancreatic carcinoma: evaluation with CT. , 1991, Radiology.

[5]  Tibor Schuster,et al.  Preoperative/Neoadjuvant Therapy in Pancreatic Cancer: A Systematic Review and Meta-analysis of Response and Resection Percentages , 2010, PLoS medicine.

[6]  Wolfgang Schima,et al.  Pancreatic adenocarcinoma , 2006, European Radiology.

[7]  P. Silverman,et al.  TNM staging of pancreatic carcinoma using helical CT. , 1997, AJR. American journal of roentgenology.

[8]  H. Kocher,et al.  Pancreatic Cancer , 2019, Methods in Molecular Biology.

[9]  K. Horton,et al.  Multidetector CT angiography of pancreatic carcinoma: part 2, evaluation of venous involvement. , 2002, AJR. American journal of roentgenology.

[10]  Rebecca L. Siegel Mph,et al.  Cancer statistics, 2016 , 2016 .

[11]  B. Wood,et al.  Adenocarcinoma of the head of the pancreas: determination of surgical unresectability with thin-section pancreatic-phase helical CT. , 1999, AJR. American journal of roentgenology.

[12]  A. Jemal,et al.  Cancer statistics, 2016 , 2016, CA: a cancer journal for clinicians.

[13]  T. Serrano,et al.  Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. , 2002, AJR. American journal of roentgenology.

[14]  R. Cohan,et al.  Obliteration of the fat surrounding the celiac axis and superior mesenteric artery is not a specific CT finding of carcinoma of the pancreas. , 1990, AJR. American journal of roentgenology.

[15]  E. Nakakura,et al.  Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. , 2014, Journal of the National Comprehensive Cancer Network : JNCCN.

[16]  A. Megibow,et al.  Pancreatic adenocarcinoma: designing the examination to evaluate the clinical questions. , 1992, Radiology.

[17]  H. Furukawa,et al.  Helical computed tomography in the diagnosis of portal vein invasion by pancreatic head carcinoma: usefulness for selecting surgical procedures and predicting the outcome. , 1998, Archives of surgery.

[18]  E. Nakakura,et al.  Pancreatic Adenocarcinoma, Version 1.2019. , 2019, Journal of the National Comprehensive Cancer Network : JNCCN.

[19]  D. Lu,et al.  Local staging of pancreatic cancer: criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT. , 1997, AJR. American journal of roentgenology.

[20]  T. Shichinohe,et al.  Preoperative diagnosis of portal vein invasion in pancreatic head cancer: appropriate indications for concomitant portal vein resection , 2016, Journal of hepato-biliary-pancreatic sciences.

[21]  C. Charnsangavej,et al.  Vascular involvement in pancreatic adenocarcinoma:reassessment by thin-section CT , 1996, Abdominal Imaging.

[22]  Y. Arzoumanian,et al.  Helical CT with CT angiography in assessing periampullary neoplasms: identification of vascular invasion. , 2002, Radiology.

[23]  Y. Yamashita,et al.  Vascular Encasement by Pancreatic Cancer: Correlation of CT Findings with Surgical and Pathologic Results , 2001, Journal of computer assisted tomography.

[24]  D. Morgan,et al.  Imaging preoperatively for pancreatic adenocarcinoma. , 2015, Journal of gastrointestinal oncology.

[25]  H. Kauczor,et al.  A New Invasion Score for Determining the Resectability of Pancreatic Carcinomas with Contrast-Enhanced Multidetector Computed Tomography , 2008, Pancreatology.

[26]  N. Dubrawsky.  Cancer statistics , 1989, CA: a cancer journal for clinicians.

[27]  J. Tokar,et al.  Defining Venous Involvement in Borderline Resectable Pancreatic Cancer , 2010, Annals of Surgical Oncology.

[28]  Bond-Smith Giles,et al.  Only women with symptoms need to have their breast implants removed, says government , 2012 .

[29]  S. Yamada,et al.  Correlation Between Radiographic Classification and Pathological Grade of Portal Vein Wall Invasion in Pancreatic Head Cancer , 2012, Annals of surgery.

[30]  M. Büchler,et al.  A tumour score with multidetector spiral CT for venous infiltration in pancreatic cancer: influence on borderline resectable , 2014, La radiologia medica.

[31]  B. Siewert,et al.  Teardrop superior mesenteric vein: CT sign for unresectable carcinoma of the pancreas. , 1999, AJR. American journal of roentgenology.

[32]  K. Zhou,et al.  Pancreatic adenocarcinoma: signs of vascular invasion determined by multi-detector row CT. , 2006, The British journal of radiology.

[33]  K. Horton,et al.  Multidetector CT angiography of pancreatic carcinoma: part I, evaluation of arterial involvement. , 2002, AJR. American journal of roentgenology.