Pancreatic malignancy: effect of dual-phase helical CT in tumor detection and vascular opacification.

Abstract

To determine the relative value of hepatic arterial and portal venous phase helical computed tomographic (CT) scans for tumor detection and vascular opacification in patients with pancreatic malignancy. Ninety-five patients who had or were suspected of having pancreatic disease underwent dual-phase helical CT. Arterial phase scans were acquired 20-40 seconds after contrast material administration; venous phase scans, 70-100 seconds after administration. Three readers independently scored images in a blinded fashion for the presence of tumor, for lesion attenuation relative to normal pancreas, and for vascular opacification. The final diagnosis was pancreatic malignancy (n = 60), acute or chronic pancreatitis (n = 22), and normal pancreas (n = 13). The readers identified possible or definite tumors on arterial phase studies in 47-50 patients and on venous phase studies in 48-53 patients (P > .10). There was no statistically significant difference in tumor attenuation between scans from the two phases (P > .05). Agreement between the readers for tumor detection was not affected by the scanning phase (P > .10). Opacification of arteries and of veins was greater on arterial phase scans and on venous phase scans, respectively (P < .001). The acquisition of arterial phase scans in addition to venous phase scans does not result in improved detection of pancreatic malignancies.