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Preoperative evaluation of pancreatic cancer: Comparison of gadolinium‐enhanced dynamic MRI with MR cholangiopancreatography versus MDCT
Author(s) -
Park Hee Sun,
Lee Jeong Min,
Choi Hei Kyung,
Hong Sung Hyun,
Han Joon Koo,
Choi Byung Ihn
Publication year - 2009
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21889
Subject(s) - gadolinium , medicine , pancreatic cancer , radiology , magnetic resonance imaging , nuclear medicine , cancer , materials science , metallurgy
Abstract Purpose To determine the accuracy of magnetic resonance imaging (MRI) including dynamic imaging using three‐dimensional gradient‐echo (3D‐GRE) sequences and MR cholangiopancreatograpy (MRCP) compared with that of multidetector row CT (MDCT) with regard to resectability in pancreas cancer. Materials and Methods From February 2004 to July 2008, 54 patients (32 men, 22 women: age range, 28–83 years; mean age, 63.1 years old) with surgically proven pancreatic carcinoma, who had undergone preoperative gadolinium‐enhanced 3D‐GRE MRI with MRCP and triple‐phase MDCT, were included in this retrospective study. Two, clinically experienced attending radiologists independently reviewed the two image sets. These readers evaluated the tumor conspicuity, presence of vascular invasion, choledochal and duodenal invasion, lymph node metastases, distant metastasis, and tumor resectability. The results were compared with the surgical and histopathologic findings using receiver operating characteristic analysis (A z ) and kappa statistics. Results Curative resections were performed on 42 patients. Regarding the tumor conspicuity, MRI had a significantly higher Az value compared with MDCT according to both reviewers (P < 0.05). The accuracy of resectability was Az = 0.753 and 0.768 on MRI and Az = 0.829 and 0.762 on MDCT for each reviewer, and the difference in the accuracy of resectability was not significant between MRI and MDCT for either reviewer (P > 0.05). Two imaging sets showed a similar diagnostic performance in the evaluation of vascular involvement, lymph node metastasis, and distant metastasis. Conclusion Dynamic 3D‐GRE MRI with MRCP shows superior tumor conspicuity and similar diagnostic performance compared with MDCT in evaluating the resectability of pancreatic cancer. J. Magn. Reson. Imaging 2009;30:586–595. © 2009 Wiley‐Liss, Inc.