Pancreatic adenocarcinoma: CT versus MR imaging in the evaluation of resectability--report of the Radiology Diagnostic Oncology Group.
OBJECTIVE
To compare findings with computed tomography (CT) and magnetic resonance (MR) imaging in pancreatic adenocarcinoma and to determine optimal pulse sequences for MR imaging.


METHODS
CT scans and MR images were compared of 189 adult patients with known or suspected adenocarcinoma of the pancreas. Levels of confidence were correlated with surgical and pathologic results.


RESULTS
The accuracy of CT was 0.73 and of MR imaging was 0.70. The negative predictive value of CT was 0.28 and of MR imaging was 0.23. The positive predictive value of CT was 0.89 and of MR imaging was 0.88. Gradient-echo and T1-weighted spin-echo sequences ranked equally in evaluation of vascular invasion, T1-weighted spin-echo sequences were preferred for assessing lymphadenopathy, and T2-weighted spin-echo sequences were preferred for detecting hepatic metastases.


CONCLUSIONS
Cross-sectional imaging modalities are useful in the identification of unresectable pancreatic carcinoma. CT is recommended for initial imaging assessment.
Megibow
A J
AJ
Department of Radiology, New York University Medical Center, NY 10016, USA.
Zhou
X H
XH
Rotterdam
H
H
Francis
I R
IR
Zerhouni
E A
EA
Balfe
D M
DM
Weinreb
J C
JC
Aisen
A
A
Kuhlman
J
J
Heiken
J P
JP
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed