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Indicative findings of pancreatic cancer in prediagnostic CT.

 Sung Soo Ahn  ;  Myeong-Jin Kim  ;  Jin-Young Choi  ;  Hye-Suk Hong  ;  Yong Eun Chung  ;  Joon Seok Lim 
 EUROPEAN RADIOLOGY, Vol.19(10) : 2448-2455, 2009 
Journal Title
Issue Date
Adult ; Delayed Diagnosis/prevention & control* ; Diagnosis, Differential ; Early Diagnosis ; Female ; Humans ; Male ; Pancreas/diagnostic imaging* ; Pancreatic Neoplasms/diagnostic imaging* ; Pancreatitis/diagnostic imaging* ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods*
Pancreatic cancer  ; Chronic pancreatitis ;  Computed tomography 
We examined 20 prediagnostic CTs from 16 patients for whom the diagnosis of pancreatic cancer was delayed until full diagnostic CT was performed. Three radiologists independently reviewed the prediagnostic CTs along with 50 CTs of control subjects, including patients without pancreatic disease (n = 38) or with chronic pancreatitis without calcification visible on CT (n = 12). The reviewers recorded the presence of biliary or pancreatic ductal dilation, interruption of the pancreatic duct, distal parenchymal atrophy, contour abnormality and focal hypoattenuation. Frequency, sensitivity and specificity of the significant findings were calculated. Logistic regression analysis was performed. Findings indicative of pancreatic cancer were seen on 85% (17/20) of the prediagnostic CTs. Patients with pancreatic cancer were significantly (p < 0.05) more likely to show focal hypoattenuation, pancreatic duct dilation, interruption of the pancreatic duct, and distal parenchymal atrophy, with sensitivities and specificities of 75%/84%, 50%/78%, 45%/82% and 45%/96%, respectively. Focal hypoattenuation and distal parenchymal atrophy were the independent predictors of pancreatic cancer with odds ratios of 20.92 and 11.22, respectively. In conclusion, focal hypoattenuation and pancreatic duct dilation with or without interruption, especially when accompanied by distal parenchymal atrophy, were the most useful findings for avoiding delayed diagnosis of pancreatic cancer.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-0503-5558
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
Hong, Hye Suk(홍혜숙) ORCID logo https://orcid.org/0000-0001-7398-2517
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