Local extension of pancreatic carcinoma: assessment with thin-section helical CT versus with breath-hold fast MR imaging--ROC analysis.
OBJECTIVE
To compare contrast material-enhanced thin-section helical CT with breath-hold contrast-enhanced MR imaging for sensitivity in the detection of pancreatic adenocarcinoma and for accuracy in local tumor staging.


METHODS
Fifty-seven patients (37 men, 20 women aged 42-28 years) suspected of having pancreatic adenocarcinoma were examined. The final diagnosis was confirmed at surgery to be pancreatic cancer in 31 patients; the other 26 patients were deemed not to have pancreatic cancer. All patients underwent both CT and MR imaging (turbo spin-echo and fast low-angle shot) studies. Image quality and pancreatic enhancement were subjectively evaluated. All CT scans and MR images were assessed by two independent observers by using a five-point scale for the detection of tumor and of invasion into the peripancreatic tissue, portal vein, and/or peripancreatic artery. Receiver operating characteristic curves for CT and MR imaging were analyzed.


RESULTS
At visual analysis, pancreatic enhancement at CT and at MR imaging was comparable, but depiction of vessels was superior at helical CT. Detectability of tumor was comparable. Helical CT was significantly superior to MR imaging in diagnostic imaging of invasion into the peripancreatic tissue, portal vein, and/or peripancreatic artery (P < .01).


CONCLUSIONS
Thin-section dynamic CT is more sensitive than MR imaging for detection of peripancreatic and vascular invasion in patients with pancreatic cancer.
Nishiharu
T
T
Department of Radiology, Kumamoto University Hospital, Japan.
Yamashita
Y
Y
Abe
Y
Y
Mitsuzaki
K
K
Tsuchigame
T
T
Nakayama
Y
Y
Takahashi
M
M
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007479:Iopamidol; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007479:Iopamidol