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Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal solid tumors. PDAC has a poor prognosis in spite of recent advances in different imaging modalities mainly due to difficulty in early diagnosis and aggressive biological behavior. Aim of the work: to assess the value of the pre-operative assessment of PDAC using Multi-detector (MDCT) according to the American pancreatic association (APA) consensus reporting guidelines in comparison with intra operative findings and to assess possible short term post-operative whipple complications. Methods: Prospective, cohort study included fifteen consecutive patients with clinical suspicious of PDAC, all of the patients had MDCT assessment using GE Revolution EVO 128 multi slice thickness. Results: Each of the lesion site, lesion size, biliary tree, superior mesenteric artery (SMA), common hepatic artery (CHA), main portal vein (MPV), superior mesenteric vein (SMV), and anatomical variation with the preoperative CT findings using APA consensus. Post Whipple's operation, the majority of cases have no complications; meanwhile, 18.2% had fluid collection. The comparison between APA consensus and the old report documentation of PDAC cases by CT indicated a statistically significant lack in mentioning lesion appearance, pancreatic duct, biliary tree, SMA, celiac artery, CHA, MPV, SMV, and anatomical variation among old report documentation compared with APA consensus reports. Conclusion: The application of multi-detector MDCT according to the American pancreatic association reporting template was highly reproducible and provides accurate assessment of pancreatic ductal adenocarcinoma (PDAC) thus improving the patients selection for whipple operation and provides a clear guide for the surgical approach
Issa et al. (Mon,) studied this question.