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Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 14, 2007; 13(22): 3080-3083
Published online Jun 14, 2007. doi: 10.3748/wjg.v13.i22.3080
Angiotensin-II administration is useful for the detection of liver metastasis from pancreatic cancer during pharmacoangiographic computed tomography
Toru Ishikawa, Takashi Ushiki, Hiroteru Kamimura, Tadayuki Togashi, Atsunori Tsuchiya, Kouji Watanabe, Kei-ichi Seki, Hironobu Ohta, Toshiaki Yoshida, Keiko Takeda, Tomoteru Kamimura
Toru Ishikawa, Takashi Ushiki, Hiroteru Kamimura, Tadayuki Togashi, Atsunori Tsuchiya, Kouji Watanabe, Kei-ichi Seki, Hironobu Ohta, Toshiaki Yoshida, Tomoteru Kamimura, Department of Gastroenterology and Hepatology, Saiseikai Niigata Second Hospital, Niigata, Japan
Keiko Takeda, Department of Radiology, Saiseikai Niigata Second Hospital, Niigata, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Toru Ishikawa, MD, Department of Gastroenterology, Saiseikai Niigata Second Hospital, Teraji 280-7, Niigata 950-1104, Japan. toruishi@ngt.saiseikai.or.jp
Telephone: +81-25-2336161 Fax: +81-25-2338880
Received: January 23, 2007
Revised: February 20, 2007
Accepted: March 1, 2007
Published online: June 14, 2007
Abstract

AIM: To improve the preoperative diagnosis of liver metastasis from pancreatic cancer, we estimated computed tomography during arterial angiography (CTA) with/without administration of angiotensin-II (AT-II).

METHODS: Thirty-five patients with pancreatic cancer were examined in this study. After conventional CTA was performed, pharmacoangiographic CTA was performed with a 1-3 microgram/5 mL solution of angiotensin  IIinjected through a catheter into the celiac artery during spiral computed tomography. We prospectively analyzed the relative region of interest (ROI) ratio of tumor to liver with/without AT-II.

RESULTS: In all patients, the relative ratio of each computed tomography (CT) number in the ROI was larger at pharmacoangiographic CT than at conventional angiographic CT. Administration of angiotensin-II enhanced the metastatic liver tumor as compared with normal tissue. Intratumoral blood flow increased in all patients with malignant tumors due to the pressure effect of AT-II. Furthermore, the metastatic lesions in the liver of three patients were represented by only pharmacoangiographic CT, not by conventional CT and conventional CT angiography. In even peripheral and central areas of metastatic liver tumor, the lesions were enhanced after administration of AT-II.

CONCLUSION: These results support that high detection rate of liver metastasis revealed by pharmacoangiographic CT suggests the improvement of diagnosis on preoperative staging. Moreover, chemotherapy under AT-II induced hypertension may have a better effect on the treatment of metastatic liver tumors.

Keywords: Angiotensin II; Phamacoangiographic CT; Pancreatic cancer