Vascular enhancement pattern of mass in computed tomography may predict chemo-responsiveness in advanced pancreatic cancer

Abstract

INTRODUCTION: Chemo-responsiveness in pancreatic cancer is known to be dependent on fibrosis and vascularity. The purpose of this study was to assess vascular enhancement in advanced pancreatic adenocarcinoma with or without liver metastasis in computed tomography (CT) and to analyze the correlation between enhancement patterns and chemo-responsiveness. METHODS: Patients were assigned to either a responder group (partial response or stable disease) or a non-responder group (progressive disease) according to chemo-responsiveness assessed by CT before and after gemcitabine-based chemotherapy. Hounsefield unit (HU) was measured in pancreatic mass and the largest metastatic liver mass using region of interest (ROI). HU differences (DeltaHU) between arterial and pre-contrast phase were calculated. RESULTS: Of the 101 study subjects, 78(77.2%) were assigned to the pancreas responder group {mean DeltaHU (+/-SD), 36.7(+/-21.6)} and 23(22.8%) to the pancreas non-responder group {mean DeltaHU (+/-SD), 20.6(+/-9.9)} (p = 0.001 for DeltaHUs). Of the 46 study subjects with liver metastasis, 25(54.3%) were assigned to the liver metastasis responder group {mean DeltaHU (+/-SD), 36.9(+/-21.0} and 21(45.7%) to the liver metastasis non-responder group {mean DeltaHU (+/-SD), 17.1 (+/-24.0)}, (p = 0.005 for DeltaHUs). CONCLUSION: CT determined mass vascular enhancement patterns may predict chemoresponse in advanced pancreatic cancer.