Study On Clinical Target Volume (Ctv) Of Pancreatic Cancer: Under The Scope Of Ct Scanning And Pathology

Objective: The current study aimed to investigate differences between computed tomography (CT) scanning pictures of pancreatic cancer primary tumors and the actual sizes of tumors measured by pathologists after surgical resections, probing the micronidus-invaded area within normal pancreatic tissues out of primary tumors. Methods and materials: This study evaluated 19 patients with resected pancreatic cancer at two different hospitals. MDR-CT scans and maximum cross-sectional diameters of primary tumors of whole specimens were checked. The actual tumor-invaded area was microscopically detected through pathological examinations. Results: Of included patients, fifteen possessed preoperative MDR-CT scans that were available. There were significant differences between the pathology and maximum diameters of CT scan-measured primary tumors (33.6 vs. 30.1 mm, P < 0.001). Discrepancies between the actual maximum tumor-invaded distance of the nineteen specimens and the maximum measuring distance were statistically significant (3.50 vs. 3.19 mm, P < 0.001). The actual maximum tumor-invaded distance was 5.21 mm, while the median value was 3.34 mm (range, 2.19 to 5.21 mm). The mean value reached 3.50 +/- 0.88 mm. Conclusion: Since CT scanning has significantly underestimated pancreatic cancer primary tumor sizes, in the process of radiation therapy, a 5 mm marginal expansion of the clinical target volume (CTV) from the gross target volume (GTV) is probably insufficient in CT simulation. Based on results of the micronidus-invaded area from this study, an additional CTV expansion of 1 similar to 3 mm is necessary.