Aims and objectives
Malignant pancreatic tumors are common.
In patients with malignant pancreatic tumors five-year survival rate does not exceed 5% and the only radical treatment is surgery.
Due to early vascular invasion,
most of pancreatic tumors at the time of diagnosis are unresectable.
Up to 40-45% of patients with locally advanced pancreatic tumors at the time of diagnosis have liver metastases,
while the median survival in this group does not exceed 3-6 months.
Radical surgery is possible only in 5-25% of patients with malignant pancreatic tumors.
Methods and materials
21 patients with malignant pancreatic tumors underwent CA of the tumor.
CT and MRI were performed before and after operation: on 1st day,
after 3 months,
Duplex ultrasound criteria of the completeness of CA in pancreatic tumors: blood flow changes in the tumor.
CT criteria of the completeness of CA in pancreatic tumors: tumor contrast enhancement changes (tumor density calculation by formula: [tumor density CE phase – tumor density native]/aorta blood density CE phase); also changes of tumor size,
Duplex ultrasound showed blood flow decrease in the tumor.
MRI in the first day after pancreatic tumor CA is poorly informative due to significant focal edema,
the area of edema overlapped the tumor.
the average apparent diffusion coefficient value in tumor was 0.96 mm2\s.
On the first day,
average apparent diffusion coefficient value in tumor was 1.07 mm2\s.
The MRI at 3 months,
6 months showed average apparent diffusion coefficient value increase in tumor,
1.2 mm2\s and 0.94 mm2\s,
Ultrasound at 3 months and 6 months showed a significant decrease of blood flow in pancreatic tumors after CA.
MRI showed apparent diffusion coefficient values increase in pancreatic tumors after CA.
Contrast enhanced computed tomography showed marked increase of contrast agent accumulation by pancreatic tumor in delayed phase at 3 months and 6 months after CA,
which probably indicates the formation of fibrous tissue.
The size of the cryoablation zone did not change.
The degree of pancreatic hypertension slightly increased.
These criteria can be used...
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