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CC BY-NC-ND 4.0 · Indian J Radiol Imaging
DOI: 10.1055/s-0045-1811197
Original Article

Role of Dynamic Perfusion CT in Pancreatic Adenocarcinoma

Authors

  • Ajay K. Yadav 

    1   Department of Radiodiagnosis and Interventional Radiology, Birat Medical College & Teaching Hospital, Biratnagar, Morang, Nepal

  • Neha Yadav

    2   Department of Microbiology and Infectious Disease, Koshi Zonal Hospital, Biratnagar, Morang, Nepal

  • Rohit P. Yadav

    3   Department of General Surgery, Birat Medical College & Teaching Hospital, Biratnagar, Morang, Nepal

  • Sushil Taparia

    1   Department of Radiodiagnosis and Interventional Radiology, Birat Medical College & Teaching Hospital, Biratnagar, Morang, Nepal

  • Binit Dev

    1   Department of Radiodiagnosis and Interventional Radiology, Birat Medical College & Teaching Hospital, Biratnagar, Morang, Nepal

  • Narendra Pandit

    4   Department of Gastrointestinal Surgery, Birat Medical College & Teaching Hospital, Biratnagar, Morang, Nepal

Funding None.
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Abstract

Objective

The aim of this study is to evaluate the utility of perfusion CT (PCT) in the diagnosis of pancreatic ductal adenocarcinoma (PDAC).

Materials and Methods

In this ethically approved prospective study, PCT was performed in 71 patients with histologically proven PDAC. Perfusion parameters studied included blood flow (BF), blood volume (BV), permeability surface area product (PS), time to peak (TTP), peak enhancement intensity (PEI), and mean transit time (MTT). Forty-four controls with no pancreatic pathology were also studied.

Results

Out of 71 patients, 43 (60.56%) were males and 28 (39.44%) were females, with male:female ratio of 1.54, and the mean age of the patients was 50.62 ± 13.86 years. The mean size of the masses was 4.47 ± 2.43 cm (range: 1.3–12 cm). Among the perfusion parameters, BF and BV were found to be the most reliable for the diagnosis of pancreatic adenocarcinoma. They were reduced in PDAC (BF: 19.54 ± 19.85 mL/100 mL/min and BV: 5.14 ± 3.82 mL/100 mL) as compared with normal controls (BF: 96.91 ± 39.09 mL/100 mL/min and BV: 30.45 ± 12.90 mL/100 mL) and the difference was statistically significant (p = 0.0001). Based on ROC analysis, cut-off values of 55.25 mL/100 mL/min for BF and 14.42 mL/100 mL for BV yielded optimal sensitivity (97.2% for BF and 98.6% for BV) and specificity (91% for BF and 91% for BV) for the diagnosis of pancreatic adenocarcinoma.

Conclusion

PCT parameters are useful in making an imaging diagnosis of PDAC and useful tool to detect isodense pancreatic masses. Approximated values of BF and BV perfusion parameters may serve as independent diagnostic predictors for the diagnosis of PDAC.

Keywords

pancreas - perfusion - computed tomography - adenocarcinoma

Data Availability Statement

Stored in the institute and can be reproduced when needed by the corresponding author's request.


Authors' Contributions

A.K.Y.: Written main manuscript, data collection, data interpretation, manuscript design and concept, prepared the figures.


N.Y.: Statistical analysis, manuscript editing, and research design.


R.P.Y.: Data Editing and manuscript correction.


S.T.: Data collection, data interpretation, manuscript design and concept, prepared the figures.


B.D.: Data collection, data interpretation, manuscript design and concept, prepared the figures.


N.P.: Data analysis and manuscript editing.


All authors reviewed the manuscript.


All authors contributed to the study from the start of the study till writing the manuscript.


Ethical Approval

This study was performed after approval from the Nepal Health Research Council (NHRC), Institutional Research Committee of Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal. The reference number was IRC-PA-215/2022. The study was performed after the ethics declaration, following standard norms and in accordance with the Declaration of Helsinki.


Patients' Consent

All patients had given consent to participate in the study.




Publication History

Article published online:
12 August 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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