œ 58 / J JSCAS vol.2 no.2 Table 1 Patients' profile. IORT: intraoperative radiation therapy, PpPD: pylorus preserving pacreatoduodenectomy. Bypass: ga

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Virtual Pancreatoscopy of Pancreatic Cancer Yutaka Tanizawaa *, Toshio Nakagohria, Taira Kinoshitaa, Masaru Konishia, Kazuto Inouea, Tatsuya Odaa, Takanori Nishimoria, Takehide Asanob, Takenori Ochiaib, Kaichi Isonob a Department of Surgery, National Cancer Center Hospital East b 2 nd Department of Surgery, Chiba University School of Medicine Abstract Virtual endoscopy is a new method of diagnosis using computer processing of 3-D image data sets. However clinical application of virtual pancreatoscopy for pancreatic cancer has not been reported. In this study, the usefulness of virtual pancreatoscopy for pancreatic cancer was investigated. Twenty cases of pancreatic cancer were studied. Seven patients underwent pancreatectomy at National Cancer Center Hospital East from June to November in 1999. The MRI data were acquired with a 1.5-T clinical imager. A multislab single shot fast spin echo sequence was used. Section thickness was between 2 and 3 mm in the coronal plane. Virtual endoscopic images were generated with Advantage Windows system (G.E. U.S.A.). Clear virtual endoscopic images were obtained in 15 of 20 patients with panceratic cancer. It was possible to visualize partial or complete obstruction of the panceatic duct. And we could get endoscopic views from the side of pancreatic tail. Virtual pancreatoscopy is noninvasive and easy to generate. Viutual pancreatoscopy can provide the information that we cannot obtain by the real pancreatoscopy. It will be very useful to diagnose pancreatic cancer. Key words Virtual endoscopy, Virtual panceatoscopy, Pancreatic cancer.

œ 58 / J JSCAS vol.2 no.2 Table 1 Patients' profile. IORT: intraoperative radiation therapy, PpPD: pylorus preserving pacreatoduodenectomy. Bypass: gastrojejunostomy, DP: distal pacreatectomy, PD: pancreatoduodenectomy Fig.1 Pancreatic head cancer: Virtual pancreatoscopy showed obstruction of main pancreatic duct.

Fig. 2 Pancreatic body cancer.

Fig. 3 Pancreatic head cancer: Virtual pancreatoscopy showed obstruction of main pancreatic duct only from the side of pancreatic tail. Fig. 4 Pancreatic tail cancer: The surface of the cystic lesion next to obstruction was visualized smooth.

1) Jolesz FA, Lorensen WE, Shinomoto H, et al. Interactive Virtual Endoscopy. AJR 1997; 169: 1229-1235. 2) Ecke U, Klimek L, Muller W, et al. Virtual Reality: preparation and execution of sinus surgery. Comp Aid Surg 1998; 3: 45-50. 3) Gilani S, Norbash AM, Ringl H, et al. Virual endoscopy of the paranasal sinususing perspective volume rendered helicalsinus computered tomography. Laryngoscope 1997; 107: 25-29. 4) Summers RM. Navigational aids for realtime virtual bron- AJR 1997; 168: 1165-1170. choscopy. 5) Rogalla P, Werner-Rustner M, Huitemia A, et al. Virtual endoscopy of thesmall bowel: phantom study and Preliminary clinical results. Europian Radiology 1998; 8: 563-567. 6) Springer P, Dessel A, Giacomuzzi SM, et al. Virtual computed tomography gastroscopy. Endoscopy 1997; 29: 632-634. 7) Nakagohri T, Jolesz FA, Okuda S, et al. Virtual pacreatoscopy of mucin-producing pancreatic tumors. Comp Aid Sure 1998; 3: 264-268.

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