Skip to main content

Advertisement

SpringerLink
Log in

Pictorial review of vascular involvement and complex vascular reconstructions in borderline to minimally advanced pancreatic malignancies

  • Pictorial Essay
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To review borderline resectability criteria for pancreatic malignancies, show examples of few surgically treated minimally advanced pancreatic malignancies, discuss various complex vascular reconstructions, and highlight the imaging appearances.

Background

Often aggressive surgical approaches are used to treat borderline to minimally advanced pancreatic malignancies in specialist centers. As abdominal radiologists it is essential to have up-to-date knowledge to distinguish such tumors with accuracy and also be well versed with the various vascular reconstructions used in such surgeries.

Imaging findings

We will show various examples of resected borderline resectable and minimally advanced pancreatic malignancies, highlight crucial vascular involvements, describe various types of advanced vascular reconstructions, and review their standard imaging appearances. We will also briefly describe the vascular complications and highlight the importance of imaging surveillance in early post-operative period.

Conclusions

It is essential for abdominal radiologists in specialist centers where aggressive surgical approaches are used to have accurate knowledge to assess vascular involvement in pancreatic malignancies and equally to recognize and assess vascular reconstructions on imaging after complex surgeries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin. 66:7–30

    Article  PubMed  Google Scholar 

  2. Clancy TE (2015) Surgery for pancreatic cancer. Hematol Oncol Clin N Am. 29:701–716

    Article  Google Scholar 

  3. Al-Hawary MM, Francis IR, Chari ST, et al. (2014) Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the society of abdominal radiology and the American Pancreatic Association. Radiology. 270(1):248–260

    Article  PubMed  Google Scholar 

  4. Tempero MA, Malafa MP, Behrman SW, et al. (2014) Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 12(8):1083–1093

    Article  CAS  PubMed  Google Scholar 

  5. Vardhachary GR, Tamm EP, Abbruzzese JL, et al. (2006) Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Ann Surg Oncol. 13:1035–1046

    Article  Google Scholar 

  6. Reynolds RB, Folloder J (2014) Clinical management of pancreatic cancer. J Adv Pract Oncol. 5(5):356–364

    PubMed  PubMed Central  Google Scholar 

  7. Lopez NE, Prendergast C, Lowy AM (2014) Borderline resectable pancreatic cancer: definitions and management. World J Gastroenterol. 20(31):10740–10751

    Article  PubMed  PubMed Central  Google Scholar 

  8. Zaky AM, Wolfgang CL, Weiss MJ, et al. (2017) Tumor-vessel relationships in pancreatic ductal adenocarcinoma at multidetector CT: different classification systems and their influence on treatment planning. Radiographics. 37:93–112

    Article  PubMed  Google Scholar 

  9. Tremblay A, Cook N, Gallinger S, et al. University Health Network guidelines for management of resectable, borderline resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC). 2015.

  10. Al-Hawary MM, Francis IR, Chari ST, et al. (2014) Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the Society of Abdominal Radiology and the American Pancreatic Association. Radiology. 270(1):248–260

    Article  PubMed  Google Scholar 

  11. Egorov VI, Petrov RV, Solodinina EN, et al. (2013) Computed tomography-based diagnostics might be insufficient in the determination of pancreatic cancer unresectability. World J Gastrointest Surg. 4(3):83–96

    Article  Google Scholar 

  12. Schwarz L, Katz MHG (2015) Management of borderline resectable pancreatic adenocarcinoma. Hematol Oncol Clin N Am. 29:727–740

    Article  Google Scholar 

  13. Pollom EL, Koon AC, Ko AH (2015) Treatment approaches to locally advanced pancreatic adenocarcinoma. Hematol Oncol Clin N Am. 29:741–759

    Article  Google Scholar 

  14. Tamm EP, Bhosale PR, Vikram R, et al. (2013) Imaging of pancreatic ductal adenocarcinoma: state of the art. World J Radiol. 5(3):98–105

    Article  PubMed  PubMed Central  Google Scholar 

  15. Soriano A, Castells A, Ayuso C, et al. (2004) Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am J Gastroenterol. 99:492–501

    Article  PubMed  Google Scholar 

  16. Ishikawa O, Ohigashi H, Imaoka S, et al. (1992) Preoperative indications for extended pancreatectomy for locally advanced pancreas cancer involving the portal vein. Ann Surg. 215(3):231–236

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Nakao A, Kanzaki A, Fujii T, et al. (2012) Correlation between radiographic classification and pathological grade of portal vein wall invasion in pancreatic head cancer. Ann Surg. 255(1):103–108

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Donald L. Ly

  2. Department of Medical Imaging, Women’s College Hospital, 76 Grenville St, Toronto, ON, M5S 1B2, USA

    Seng Thipphavong

  3. Department of Medical Imaging, Princess Margaret Hospital, 610 University Avenue, Toronto, ON, M5G 2M9, USA

    Boraiah Sreeharsha

Authors
  1. Donald L. Ly
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seng Thipphavong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Boraiah Sreeharsha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Boraiah Sreeharsha.

Ethics declarations

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ly, D.L., Thipphavong, S. & Sreeharsha, B. Pictorial review of vascular involvement and complex vascular reconstructions in borderline to minimally advanced pancreatic malignancies. Abdom Radiol 42, 2675–2685 (2017). https://doi.org/10.1007/s00261-017-1172-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-017-1172-x

Keywords

Search

Navigation