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Noda Y, Kobayashi K, Kawaguchi M, Ando T, Takai Y, Suto T, Iritani Y, Ishihara T, Fukada M, Murase K, Kawai N, Kaga T, Miyoshi T, Hyodo F, Kato H, Miyazaki T, Matsuhashi N, Yoshida K, Matsuo M. Assessment of Arterial Involvement in Pancreatic Cancer: Utility of Reconstructed CT Images Perpendicular to Artery. Cancers (Basel) 2024; 16:2271. [PMID: 38927975 PMCID: PMC11201929 DOI: 10.3390/cancers16122271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
The purpose of this study was to investigate the utility of reconstructed CT images perpendicular to the artery for assessing arterial involvement from pancreatic cancer and compare the interobserver variability between it and the current diagnostic imaging method. This retrospective study included patients with pancreatic cancer in the pancreatic body or tail who underwent preoperative pancreatic protocol CT and distal pancreatectomy. Five radiologists used axial and coronal CT images (current method) and perpendicular reconstructed CT images (proposed method) to determine if the degree of solid soft-tissue contact with the splenic artery was ≤180° or >180°. The generalized estimating equations were used to compare the diagnostic performance of solid soft-tissue contact >180° between the current and proposed methods. Fleiss' ĸ statistics were used to assess interobserver variability. The sensitivity and negative predictive value for diagnosing solid soft-tissue contact >180° were higher (p < 0.001 for each) and the specificity (p = 0.003) and positive predictive value (p = 0.003) were lower in the proposed method than the current method. Interobserver variability was improved in the proposed method compared with the current method (ĸ = 0.87 vs. 0.67). Reconstructed CT images perpendicular to the artery showed higher sensitivity and negative predictive value for diagnosing solid soft-tissue contact >180° than the current method and demonstrated improved interobserver variability.
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Affiliation(s)
- Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
- Department of Frontier Science for Imaging, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Kazuhiro Kobayashi
- Department of Pathology, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan; (K.K.); (T.M.)
| | - Masaya Kawaguchi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Tomohiro Ando
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Yukiko Takai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Taketo Suto
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Yukako Iritani
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan;
| | - Masahiro Fukada
- Department of Gastroenterological Surgery and Pediatric Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.F.); (K.M.); (N.M.); (K.Y.)
| | - Katsutoshi Murase
- Department of Gastroenterological Surgery and Pediatric Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.F.); (K.M.); (N.M.); (K.Y.)
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Tetsuro Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Toshiharu Miyoshi
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan;
| | - Fuminori Hyodo
- Department of Pharmacology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan;
- Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
| | - Tatsuhiko Miyazaki
- Department of Pathology, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan; (K.K.); (T.M.)
| | - Nobuhisa Matsuhashi
- Department of Gastroenterological Surgery and Pediatric Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.F.); (K.M.); (N.M.); (K.Y.)
| | - Kazuhiro Yoshida
- Department of Gastroenterological Surgery and Pediatric Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.F.); (K.M.); (N.M.); (K.Y.)
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; (M.K.); (T.A.); (Y.T.); (T.S.); (Y.I.); (N.K.); (T.K.); (H.K.); (M.M.)
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Kast RE. IPIAD- an augmentation regimen added to standard treatment of pancreatic ductal adenocarcinoma using already-marketed repurposed drugs irbesartan, pyrimethamine, itraconazole, azithromycin, and dapsone. Oncoscience 2024; 11:15-31. [PMID: 38524376 PMCID: PMC10959018 DOI: 10.18632/oncoscience.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/01/2024] [Indexed: 03/26/2024] Open
Abstract
This short note presents the data and rationale for adding five generic non-oncology drugs from general medical practice to gemcitabine, nab-paclitaxel, a current standard cytotoxic chemotherapy of pancreatic ductal adenocarcinoma. The regimen, called IPIAD, uses an angiotensin receptor blocker (ARB) irbesartan indicated for treating hypertension, an old antimicrobial drug pyrimethamine indicated for treating toxoplasmosis or malaria, an old antifungal drug itraconazole, an old broad spectrum antibiotic azithromycin and an old antibiotic dapsone. In reviewing selected growth driving systems active in pancreatic ductal adenocarcinoma then comparing these with detailed data on ancillary attributes of the IPIAD drugs, one can predict clinical benefit and slowing growth of pancreatic ductal adenocarcinoma by this augmentation regimen.
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