Diagnostic value of a pancreatic mass on computed tomography in patients undergoing pancreatoduodenectomy for presumed pancreatic cancer

Arja Gerritsen, Thomas L. Bollen, C. Yung Nio, I. Quintus Molenaar, Marcel G W Dijkgraaf, Hjalmar C. Van Santvoort, G. Johan Offerhaus, Lodewijk A. Brosens, Katharina Biermann, Egbert Sieders, Koert P. De Jong, Ronald M. Van Dam, Erwin Van Der Harst, Harry Van Goor, Bert Van Ramshorst, Bert A. Bonsing, Ignace H. De Hingh, Michael F. Gerhards, Casper H. Van Eijck, Dirk J. GoumaInne H M Borel Rinkes, Olivier R C Busch, Marc G H Besselink

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Previous studies have shown that 5-14% of patients undergoing pancreatoduodenectomy for suspected malignancy ultimately are diagnosed with benign disease. A "pancreatic mass" on computed tomography (CT) is considered to be the strongest predictor of malignancy, but studies describing its diagnostic value are lacking. The aim of this study was to determine the diagnostic value of a pancreatic mass on CT in patients with presumed pancreatic cancer, as well as the interobserver agreement among radiologists and the additional value of reassessment by expert-radiologists. Methods: Reassessment of preoperative CT scans was performed within a previously described multicenter retrospective cohort study in 344 patients undergoing pancreatoduodenectomy for suspected malignancy (2003-2010). Preoperative CT scans were reassessed by 2 experienced abdominal radiologists separately and subsequently in a consensus meeting, after defining a pancreatic mass as "a measurable space occupying soft tissue density, except for an enlarged papilla or focal steatosis". Results: CT scans of 86 patients with benign and 258 patients with (pre)malignant disease were reassessed. In 66% of patients a pancreatic mass was reported in the original CT report, versus 48% and 50% on reassessment by the 2 expert radiologists separately and 44% in consensus (P

Original languageEnglish (US)
Pages (from-to)173-182
Number of pages10
JournalSurgery
Volume158
Issue number1
DOIs
StatePublished - 2015
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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