Intraarterial ultrasound in pancreatic cancer: feasibility study and preliminary results

TY - JOUR

T1 - Intraarterial ultrasound in pancreatic cancer: feasibility study and preliminary results

AU - Larena-Avellaneda, Axel

AU - Timm, Stephan

AU - Kickuth, Ralph

AU - Kenn, Werner

AU - Steger, Ulrich

AU - Jurowich, Christian

AU - Germer, Christoph-Thomas

PY - 2010/8

Y1 - 2010/8

N2 - Despite technological advances in computed tomography (CT) and magnetic resonance imaging, the involvement of the celiac or mesenteric artery in pancreatic cancer remains uncertain in many cases. Infiltration of these vessels is important in making decisions about therapy choices but often can only be definitively determined through laparotomy. Local (intraarterial) ultrasound may increase diagnostic accuracy. Using the Volcano intravascular ultrasound (IVUS) system, we applied a transfemoral method to scan the celiac and mesenteric arteries directly intraarterial. This technique was used in five patients with suspected pancreatic cancer. Technical success was achieved in all cases. In one case, a short dissection of the mesenteric artery occurred but could be managed interventionally. In tumors that did not contact with the vessels, IVUS was unable to display the tissue pathology. Our main interest was the infiltration of the arteries. In one case, infiltration was certain in the CT scan but uncertain in two patients. In the latter two cases, IVUS correctly predicted infiltration in one and freedom from tumor in the other case. In our preliminary study, IVUS correctly predicted arterial infiltration in all cases. IVUS did not provide new information when the tumor was far away from the vessel. Compared with IVUS in the portal vein, the information about the artery is more detailed, and the vessel approach is easier. These results encouraged us to design a prospective study to evaluate the sensitivity and specificity of this method.

AB - Despite technological advances in computed tomography (CT) and magnetic resonance imaging, the involvement of the celiac or mesenteric artery in pancreatic cancer remains uncertain in many cases. Infiltration of these vessels is important in making decisions about therapy choices but often can only be definitively determined through laparotomy. Local (intraarterial) ultrasound may increase diagnostic accuracy. Using the Volcano intravascular ultrasound (IVUS) system, we applied a transfemoral method to scan the celiac and mesenteric arteries directly intraarterial. This technique was used in five patients with suspected pancreatic cancer. Technical success was achieved in all cases. In one case, a short dissection of the mesenteric artery occurred but could be managed interventionally. In tumors that did not contact with the vessels, IVUS was unable to display the tissue pathology. Our main interest was the infiltration of the arteries. In one case, infiltration was certain in the CT scan but uncertain in two patients. In the latter two cases, IVUS correctly predicted infiltration in one and freedom from tumor in the other case. In our preliminary study, IVUS correctly predicted arterial infiltration in all cases. IVUS did not provide new information when the tumor was far away from the vessel. Compared with IVUS in the portal vein, the information about the artery is more detailed, and the vessel approach is easier. These results encouraged us to design a prospective study to evaluate the sensitivity and specificity of this method.

KW - Adult

KW - Aged

KW - Celiac Artery/diagnostic imaging

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Male

KW - Mesenteric Arteries/diagnostic imaging

KW - Middle Aged

KW - Neoplasm Invasiveness

KW - Pancreas/diagnostic imaging

KW - Pancreatic Neoplasms/diagnostic imaging

KW - Predictive Value of Tests

KW - Reproducibility of Results

KW - Ultrasonography, Interventional/methods

U2 - 10.1007/s00270-010-9871-5

DO - 10.1007/s00270-010-9871-5

M3 - SCORING: Journal article

C2 - 20440500

VL - 33

SP - 726

EP - 731

JO - CARDIOVASC INTER RAD

JF - CARDIOVASC INTER RAD

SN - 0174-1551

IS - 4

ER -