Perfusion in the Tissue Surrounding Pancreatic Cancer and the Patient's Prognosis

Objective. The objective was to investigate the relationship between prognosis in case of pancreatic cancer and perfusion in tissue surrounding pancreatic cancer using perfusion CT. Methods. We enrolled 17 patients diagnosed with inoperable pancreatic adenocarcinoma. All patients were examined by perfusion CT and then underwent chemotherapy using gemcitabine. The time density curve (TDC) of each CT pixel was analyzed to calculate area under the curve (AUC) and blood flow (BF) using a mathematical algorithm based on the single-compartment model. To measure the AUC and BF of tumor (AUC(T) and BF(T)) and peritumoral tissue (AUC(PTT) and BF(PTT)), regions of interest were manually placed on the cancer and in pancreatic tissue within 10 mm of proximal pancreatic parenchyma. Survival days from the date of perfusion CT were recorded. Correlation between AUC or BF and survival days was assessed. Results. We found a significant correlation between AUC(PTT) or BF(PTT) and survival days (P = 0.04 or 0.0005). Higher AUC(PTT) or BF(PTT) values were associated with shorter survival. We found no significant correlation between AUC(T) or BF(T) and survival. Conclusions. Our results suggest that assessments of perfusion in pancreatic tissue within 10 mm of proximal pancreatic parenchyma may be useful in predicting prognosis.