For example, how far it ranges from 0. The Marley equation takes the distribution for the venous phase and arterial phase and calculates the area of the non-overlapping sections, as shown in Figure 2B. The Rahmanuddin or “R” radiologic scoring system is based on the degree of tumors' vascular invasion, where a score digit represents the number of major and minor vessels involved in either or both arterial or venous phases. For instance, the major vessels include, celiac, hepatic, splenic, superior mesenteric, etc., whereas minor vessels include all branches of pancreatoduodenal, dorsal pancreatic, and transverse pancreatic, and others. Each vessel that has tumor invasion earns 1 point.
Patients who score 6 or higher were considered ineligible for surgery because of high vascular invasion, which deemed them unresectable. There are Spain phone number list no such perfusion imaging-based criteria available at this time, but the R score could be helpful and reliable if the validation can be done with a higher number of cases. The R score criteria are based on vascular perfusion, which can be detected using the Marley equation. Each vessel scored 1 point in R scoring. For example, 2 vessel involvement means an R score of 2. We have major and minor vessel involvement with a total of ~10 vessels in R score generation. If the score is higher than 5, then surgery is not possible, but a score of 5 or below is suitable for surgical candidacy.
As per the scoring criteria, of 5 or less are considered suitable candidates for the surgery, as they involve minor vessels. However, patients securing scores of 6 or higher are not suitable candidates for the surgery as they involve major vessels. In (A), the long yellow arrow represents the patient's baseline score before treatment and the short yellow arrow represents the patient's final score after the treatment. Moreover, increased post-treatment scores indicate progressed disease, whereas decreased scores indicate regressed disease. The higher the score above 5, the lower the chances for surgery.