Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 14, 2009; 15(46): 5827-5832
Published online Dec 14, 2009. doi: 10.3748/wjg.15.5827
Value of three-dimensional reconstructions in pancreatic carcinoma using multidetector CT: Initial results
Miriam Klauß, Max Schöbinger, Ivo Wolf, Jens Werner, Hans-Peter Meinzer, Hans-Ulrich Kauczor, Lars Grenacher
Miriam Klauß, Hans-Ulrich Kauczor, Lars Grenacher, Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg 69120, Germany
Max Schöbinger, Ivo Wolf, Hans-Peter Meinzer, Department of Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
Jens Werner, Surgical Clinic, University of Heidelberg, Heidelberg 69120, Germany
Author contributions: Klauß M, Schöbinger M, Wolf I, Werner J, Meinzer HP, Kauczor HU and Grenacher L designed the research. Klauß M, Schöbinger M and Wolf I performed the research and analyzed the data; Klauß M, Schöbinger M and Wolf I mainly wrote the paper; Werner J, Meinzer HP, Kauczor HU and Grenacher L proof read the paper.
Correspondence to: Dr. Lars Grenacher, Professor, Department of Diagnostic and Interventional Radiology, University of Heidelberg, INF 110, Heidelberg 69120, Germany.
Telephone: +49-6221-5639758 Fax: +49-6221-565730
Received: September 14, 2009
Revised: October 6, 2009
Accepted: October 13, 2009
Published online: December 14, 2009

AIM: To evaluate the use of three-dimensional imaging of pancreatic carcinoma using multidetector computed tomography (CT) in a prospective study.

METHODS: Ten patients with suspected pancreatic tumors were examined prospectively using multidetector CT (Somatom Sensation 16, Siemens, Erlangen, Germany). The images were evaluated for the presence of a pancreatic carcinoma and invasion of the peripancreatic vessels and surrounding organs. Using the isotropic CT data sets, a three-dimensional image was created with automatic vascular analysis and semi-automatic segmentation of the organs and pancreatic tumor by a radiologist. The CT examinations and the three-dimensional images were presented to the surgeon directly before and during the patient’s operation using the Medical Imaging Interaction Toolkit-based software “ReLiver”. Immediately after surgery, the value of the two images was judged by the surgeon. The operation and the histological results served as the gold standard.

RESULTS: Nine patients had a pancreatic carcinoma (all pT3), and one patient had a serous cystadenoma. One tumor infiltrated the superior mesenteric vein. The infiltration was correctly evaluated. All carcinomas were resectable. In comparison to the CT image with axial and coronal reconstructions, the three-dimensional image was judged by the surgeons as better for operation planning and consistently described as useful.

CONCLUSION: A 3D-image of the pancreas represents an invaluable aid to the surgeon. However, the 3D-software must be further developed in order to be integrated into daily clinical routine.

Keywords: Pancreatic carcinoma, 3D-reconstruction, Multidetector computed tomography, Pancreatic carcinoma invasion, Segmentation