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

作者：Gonoi Wataru^*; Hayashi Takana Yamakawa; Okuma Hidemi; Akahane Masaaki; Nakai Yousuke; Mizuno Suguru; Tateishi Ryosuke; Isayama Hiroyuki; Koike Kazuhiko; Ohtomo Kuni

来源：European Radiology, 2017, 27(12): 4941-4950.

DOI：10.1007/s00330-017-4895-8

• Adenocarcinoma
• Pancreas
• Prognosis
• Radiology
• Screening

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).
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).
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).
Several radiological findings observed on multiphasic CT can assist in predicting pancreatic carcinogenesis well in advance.
aEuro cent Pancreatic findings in multiphasic CT help predict development of pancreatic adenocarcinoma.
aEuro cent Key findings are mass, inhomogeneous parenchyma and loss of fatty marbling.
aEuro cent Those findings were observed 34 months before confirmed diagnosis of adenocarcinoma.
aEuro cent Those findings were prognostic factors for pancreatic carcinogenesis.

• 出版日期2017-12