Objective: To determine the preoperative diagnostic accuracy of Multislice CT in determining Resectability of Periampullary Pancreatic Carcinoma. Methodology: This cross-sectional validation study was conducted in the Radiology Department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences Gambat, from January 2025 to April 2025. Patients with clinically suspected periampullary pancreatic carcinoma who underwent preoperative MDCT followed by surgical exploration were included. Resectability on MDCT was assessed based on tumor-vessel relationship, local invasion, and metastatic spread. Imaging findings were compared with intraoperative and histopathological results to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Results: MDCT scan findings showed that 45 patients 76.3% had a clear tissue plane between the tumor and the superior mesenteric artery (SMA), and <180° SMV–PV involvement was seen in 64.4% patients. No evidence of metastasis was found in 74.6% patients. Other findings included abdominal ascites in 15.3%, SMA involvement in 22.0%, SMV–PV junction occlusion in 13.6%, liver metastasis in 11.9%, extra-pancreatic or peritoneal spread in 23.7%, and distant lymph node involvement in 22.0%. Conclusion: Multislice CT provides a reliable non-invasive modality for preoperative assessment of periampullary pancreatic carcinoma resectability, particularly in ruling out unresectable disease.
Ahmed et al. (Tue,) studied this question.