Of the eight patients in this study who required stent placement, seven patients were referred to surgery after neoadjuvant therapy. Occult tumors are difficult to detect on imaging. One patient was removed from the study due to the absence of a visible tumor on CT despite having signs and symptoms of pancreatic cancer. A potential future direction for 3D imaging development is the ability to visualize inside the pancreatic duct. Currently, surgery is the only curative treatment for pancreatic cancer. Increasing evidence has demonstrated the utility of neoadjuvant chemotherapy before surgery.
The Rahmanuddin score describes tumor volume and vessel involvement to accurately predict resectability and has greater implications in prognostication and Spain phone number list treatment planning. Similarly, another study was conducted to assess the implication of the radiologic scoring system on acute pancreatitis and found that the scoring system predicts the severity of the disease (Delrue et al., 2010). Another study concluded that the radiological scoring system has increased accuracy in predicting persistent organ failure and mortality. Larger studies are needed to validate this scoring tool and demonstrate its clinical application for pancreatic cancer.
Conclusion CT vessel perfusion using the R score and the Marley Equation might be helpful in defining the surgical candidacy of PDAC patients when used in conjunction with 3D tumor volumetric quantification. R score determined higher perfusion scores as having greater vascular growth, and patients with tumor involvement of more than six vessels were deemed surgically unresectable. The Marley equation demonstrated tumor aggression via changes in arterial and venous perfusion. Additional studies are needed to further validate these methodologies and assess their clinical utility.