| dc.creator |
EVRİMLER, Sehnaz; SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ |
|
| dc.creator |
ERKILINÇ, Gamze; SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ |
|
| dc.date |
2021-08-20T00:00:00Z |
|
| dc.date.accessioned |
2021-12-03T11:46:27Z |
|
| dc.date.available |
2021-12-03T11:46:27Z |
|
| dc.identifier |
https://dergipark.org.tr/tr/pub/sdusbed/issue/64440/897563 |
|
| dc.identifier |
10.22312/sdusbed.897563 |
|
| dc.identifier.uri |
http://acikerisim.sdu.edu.tr/xmlui/handle/123456789/93894 |
|
| dc.description |
Amaç: Multidetektör Bilgisayarlı Tomografi (MDBT) Pankreatik duktal adenokarsinom (PDA) tanı ve evrelemesinde en yaygın olarak kullanılan görüntüleme yöntemidir. Çalışmamızın amacı PDA’da radyolojik evreleme ile histopatolojik evrelemeyi karşılaştırmak, tümör BT dansitesi ve hacmi ile histopatolojik parametrelerin ilişkisini araştırmaktır.Materyal ve Metod: Çalışmamıza 2012- 2019 tarihleri arasında opere pankreas başı/unsinat proçes yerleşimli postoperatif histopatolojik tanısı PDA olan ve preoperatif intravenöz kontrastlı abdomen BT’si olan olgular dahil edildi (n=17). Radyolojik ve histopatolojik TNM evrelemesi, kitlenin duodenal ve peripankreatik yağ doku invazyon değerlendirilmesi karşılaştırıldı. Tümör hacim ve dansitesi segmentasyon yöntemi ile hesap edildi. Bulgular: Her iki cinsiyet arasında (nerkek=12, nkadın=5) yaş, tümör hacmi veya tümör dansitesi açısından anlamlı farklılık saptanmadı (p>0,05). Histopatolojik ve radyolojik T, N evreleme arasında anlamlı korelasyon ve uyum bulundu (sırasıyla, r=0,90, ĸ=0,86; p<0,001, r=0,67, ĸ=0,53; p:0,003). Tümör dansitesi ortalama değeri 68,49±18,76 (43-121) HU olup tümör dansitesi ile tümör hacmi (r=-0,58, p:0,01) ve N (r=-0,57, p:0,02) arasında anlamlı ilişki bulundu. MDBT’nin duodenum invazyonunu saptama duyarlılığı %50, özgüllüğü %100, doğruluk oranı %71 bulundu. Yağ doku invazyonu için duyarlılık %83, özgüllük %60, doğruluk oranı %77 bulundu.Sonuç: Pankreas başı/unsinat proçes yerleşimli PDA tanılı hastalarda MDBT duodenum ve peripankreatik yağ doku invazyonu tespitinde doğruluk oranı yüksek, evrelemede başarılı bir görüntüleme yöntemidir. Tümör hacim ve evreleme parametreleri arasında anlamlı ilişki mevcuttur. Tümör dansitesi ise tümör hacmi ve N evrelemesi ile anlamlı ilişki göstermektedir. Preoperatif değerlendirmede bu bilgilerin bilinmesi cerrahi yaklaşım ve tedavi yöntemi seçiminde rol oynayabilir. |
|
| dc.description |
Objective: Multidetector Computed Tomographyy (MDCT) is the primarily preferred imaging method for the diagnosis and staging of the pancreatic ductal adenocarcinoma (PDA). The aim of this study is to compare the radiological and histopathological staging of PDA and evaluate the relationship between histopathological parameters and tumor CT density and volume. Material ve Method: Patients with histopathologically diagnosed, pancreatic head/uncinate process localized PDA who have ungergone pancreaticoduodenectomy and preoperative contras-enhanced abdomen CT between 2012-2019 were included. Radiological and histopathological evaluation of TNM staging, duodenal, and peripancreatic fat invasion were compared. Tumor volume and density were calculated by the segmentation method. Results: There was no significant difference in age, tumor volume, and density between the genders (nmale=12, nfemale=5) (p>0.05). A significant correlation and aggreement was found between histopathological and radiological T, N staging (r=0.90, ĸ=0.86; p<0.001, r=0.67, ĸ=0.53; p:0.003, respectively). The mean of tumor density was 68.49±18.76 (43-121) HU. A significant correlation was found between tumor density vs volume (r=-0.58, p:0.01) and N (r=-0.57, p:0.02). The sensitivity, specificity, and accuracy of MDCT to detect duodenum invasion was 50%, 100%, and 71%, respectively. The sensitivity, specificity, and accuracy of MDCT to detect peripancreatic fat invasion was 83%, 60%, and 77%, respectively. Conclusion: MDCT of pancreatic head/uncinate process localized PDA is a successful imaging method for staging with a high accuracy for the detection of duodenum and peripancreatic fat invasion. There is a significant relationship between tumor volume and staging. Tumor density shows a signifcant relationship with tumor volume and N. Preoperative evaluation of these findings may play a role in decision making of surgical approach or treatment method. |
|
| dc.format |
application/pdf |
|
| dc.language |
tr |
|
| dc.publisher |
Süleyman Demirel Üniversitesi |
|
| dc.publisher |
Süleyman Demirel University |
|
| dc.relation |
https://dergipark.org.tr/tr/download/article-file/1640978 |
|
| dc.source |
Volume: 12, Issue: 2
210-218 |
en-US |
| dc.source |
2146-247X |
|
| dc.source |
Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi |
|
| dc.subject |
Histopatoloji,Bilgisayarlı Tomografi,Pankreatik Duktal Adenokarsinom,Evreleme |
|
| dc.subject |
Histopathology,Computed Tomography,Pancreatic Ductal Adenocarcinoma,Staging |
|
| dc.title |
Pankreatik Duktal Adenokarsinom Evrelemesi: Bilgisayarlı Tomografide Segmentasyon Yöntemi ile Ölçülen Tümör Hacmi ve Dansitesinin Histopatolojik Bulgular ile İlişkisi |
tr-TR |
| dc.title |
Pancreatic Ductal Adenocarcinoma Staging: The Relationship between Histopathological Findings and Computed Tomography Segmentation Method-Measured Tumor Volume and Density |
en-US |
| dc.type |
info:eu-repo/semantics/article |
|
| dc.citation |
1. Siegel R, Naishadham D, Jemal A. Cancer statistics for hispanics/latinos, 2012. CA: a cancer journal for clinicians. 2012;62(5):283-98. |
|
| dc.citation |
2. Vincent A, Herman J, Schulick R, Hruban RH, Goggins M. Pancreatic cancer. The lancet. 2011;378(9791):607-20. |
|
| dc.citation |
3. Al-Hawary MM, Francis IR, Chari ST, Fishman EK, Hough DM, Lu DS, et al. Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the Society of Abdominal Radiology and the American Pancreatic Association. Radiology. 2014;270(1):248-60. |
|
| dc.citation |
4. Khristenko E, Shrainer I, Setdikova G, Palkina O, Sinitsyn V, Lyadov V. Preoperative CT-based detection of extrapancreatic perineural invasion in pancreatic cancer. Scientific Reports.11(1):1-11. |
|
| dc.citation |
5. Hernandez J, Mullinax J, Clark W, Toomey P, Villadolid D, Morton C, et al. Survival after pancreaticoduodenectomy is not improved by extending resections to achieve negative margins. Annals of surgery. 2009;250(1):76-80. |
|
| dc.citation |
6. Al-Hawary MM, Francis IR. Pancreatic ductal adenocarcinoma staging. Cancer Imaging. 2013;13(3):360. |
|
| dc.citation |
7. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Annals of surgical oncology. 2010;17(6):1471-4. |
|
| dc.citation |
8. Ashfaq A, Pockaj BA, Gray RJ, Halfdanarson TR, Wasif N. Nodal counts and lymph node ratio impact survival after distal pancreatectomy for pancreatic adenocarcinoma. Journal of Gastrointestinal Surgery. 2014;18(11):1929-35. |
|
| dc.citation |
9. Morales-Oyarvide V, Rubinson DA, Dunne RF, Kozak MM, Bui JL, Yuan C, et al. Lymph node metastases in resected pancreatic ductal adenocarcinoma: predictors of disease recurrence and survival. British journal of cancer. 2017;117(12):1874-82. |
|
| dc.citation |
10. Washington K, Berlin J, Branton P, Burgart LJ, Carter DK, Compton CC, et al. Protocol for the Examination of Specimens From Patients With Carcinoma of the Pancreas. 2016. |
|
| dc.citation |
11. Chun YS, Pawlik TM, Vauthey J-N. of the AJCC cancer staging manual: pancreas and hepatobiliary cancers. Annals of surgical oncology. 2018;25(4):845-7. |
|
| dc.citation |
12. professionals/physician_gls/pdf/pancreatic.pdf NNGVPAAohwno. |
|
| dc.citation |
13. Mortelé KJ, Rocha TC, Streeter JL, Taylor AJ. Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics. 2006;26(3):715-31. |
|
| dc.citation |
14. Sahani DV, Shah ZK, Catalano OA, Boland GW, Brugge WR. Radiology of pancreatic adenocarcinoma: current status of imaging. Journal of gastroenterology and hepatology. 2008;23(1):23-33. |
|
| dc.citation |
15. Tamm EP, Balachandran A, Bhosale PR, Katz MH, Fleming JB, Lee JH, et al. Imaging of pancreatic adenocarcinoma: update on staging/resectability. Radiologic Clinics. 2012;50(3):407-28. |
|
| dc.citation |
16. Zamboni GA, Kruskal JB, Vollmer CM, Baptista J, Callery MP, Raptopoulos VD. Pancreatic adenocarcinoma: value of multidetector CT angiography in preoperative evaluation. Radiology. 2007;245(3):770-8. |
|
| dc.citation |
17. Lu D, Vedantham S, Krasny RM, Kadell B, Berger WL, Reber HA. Two-phase helical CT for pancreatic tumors: pancreatic versus hepatic phase enhancement of tumor, pancreas, and vascular structures. Radiology. 1996;199(3):697-701. |
|
| dc.citation |
18. Qayyum A, Tamm EP, Kamel IR, Allen PJ, Arif-Tiwari H, Chernyak V, et al. ACR Appropriateness criteria® staging of pancreatic ductal adenocarcinoma. Journal of the American College of Radiology. 2017;14(11):S560-S9. |
|
| dc.citation |
19. Koelblinger C, Ba-Ssalamah A, Goetzinger P, Puchner S, Weber M, Sahora K, et al. Gadobenate dimeglumine–enhanced 3.0-T MR imaging versus multiphasic 64–detector row CT: prospective evaluation in patients suspected of having pancreatic cancer. Radiology. 2011;259(3):757-66. |
|
| dc.citation |
20. Furukawa H, Takayasu K, Mukai K, Kanai Y, Inoue K, Kosuge T, et al. Late contrast-enhanced CT for small pancreatic carcinoma: delayed enhanced area on CT with histopathological correlation. Hepato-gastroenterology. 1996;43(11):1230-7. |
|
| dc.citation |
21. Kim JH, Park SH, Yu ES, Kim M-H, Kim J, Byun JH, et al. Visually isoattenuating pancreatic adenocarcinoma at dynamic-enhanced CT: frequency, clinical and pathologic characteristics, and diagnosis at imaging examinations. Radiology. 2010;257(1):87-96. |
|
| dc.citation |
22. Prokesch RW, Chow LC, Beaulieu CF, Bammer R, Jeffrey Jr RB. Isoattenuating pancreatic adenocarcinoma at multi–detector row CT: secondary signs. Radiology. 2002;224(3):764-8. |
|
| dc.citation |
23. Freeny PC, Marks WM, Ryan JA, Traverso LW. Pancreatic ductal adenocarcinoma: diagnosis and staging with dynamic CT. Radiology. 1988;166(1):125-33. |
|
| dc.citation |
24. Yadav P, Lal H. Double duct sign. Abdom Radiol (NY). 2017;42(4):1283-4. |
|
| dc.citation |
25. Furukawa H, Takayasu K, Mukai K, Inoue K, Kosuge T, Ushio K. Computed tomography of pancreatic adenocarcinoma: comparison of tumor size measured by dynamic computed tomography and histopathologic examination. Pancreas. 1996;13(3):231-5. |
|
| dc.citation |
26. Gilabert M, Boher J-M, Raoul J-L, Paye F, Bachellier P, Turrini O, et al. Comparison of preoperative imaging and pathological findings for pancreatic head adenocarcinoma: a retrospective analysis by the association Francaise de Chirurgie. Medicine. 2017;96(24). |
|
| dc.citation |
27. Roche CJ, Hughes ML, Garvey CJ, Campbell F, White DA, Jones L, et al. CT and pathologic assessment of prospective nodal staging in patients with ductal adenocarcinoma of the head of the pancreas. American Journal of Roentgenology. 2003;180(2):475-80. |
|
| dc.citation |
28. Mazzeo S, Cappelli C, Battaglia V, Caramella D, Caproni G, Contillo BP, et al. Multidetector CT in the evaluation of retroperitoneal fat tissue infiltration in ductal adenocarcinoma of the pancreatic head: correlation with histopathological findings. Abdominal imaging. 2010;35(4):465-70. |
|
| dc.citation |
29. Bluemke DA, Cameron JL, Hruban RH, Pitt HA, Siegelman SS, Soyer P, et al. Potentially resectable pancreatic adenocarcinoma: spiral CT assessment with surgical and pathologic correlation. Radiology. 1995;197(2):381-5. |
|
| dc.citation |
30. Fang WH, Li XD, Zhu H, Miao F, Qian XH, Pan ZL, et al. Resectable pancreatic ductal adenocarcinoma: association between preoperative CT texture features and metastatic nodal involvement. Cancer Imaging. 2020;20(1):17. |
|