MR imaging of pancreatic lesions. Comparison of manganese-DPDP and gadolinium chelate.
OBJECTIVE
To compare manganese-DPDP-enhanced and gadolinium-DTPA-enhanced MR imaging in patients suspected of having pancreatic cancer.


METHODS
Fifteen patients who underwent MR imaging for suspected pancreatic cancer and received gadolinium-DTPA took part in a clinical phase III trial in which the efficacy of manganese-DPDP for detection of pancreatic cancer was evaluated. T1-weighted gradient-echo (GRE) images with and without fat suppression were used. Signal-to-noise ratio and contrast-to-noise ratio were calculated before and after the administration of each contrast agent. Image quality was assessed using a four-step score; delineation of the normal pancreas was assessed by two readers in consensus.


RESULTS
In terms of pancreatic signal-to-noise ratio, only gadolinium-DTPA-enhanced fat-suppressed and non-fat-suppressed GRE imaging showed a significant (P < 0.001) increase (72% and 61%, respectively). In the patients with a focal pancreatic lesion (n = 14), a significant increase in contrast-to-noise ratio was found only in manganese-DPDP-enhanced GRE imaging without (106%) and with (82%) fat saturation. Qualitative image analysis demonstrated a significant improvement of manganese-DPDP-enhanced fat-suppressed MR images in delineating the pancreatic parenchyma (P < 0.01) as well as pancreatic tumors (P < 0.01).


CONCLUSIONS
T1-weighted manganese-DPDP-enhanced GRE imaging with fat saturation should be regarded as the most suitable combination for detecting a pancreatic lesion.
Diehl
S J
SJ
Institute for Clinical Radiology, Klinikum der Stadt Mannheim, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Germany.
Lehmann
K J
KJ
Gaa
J
J
McGill
S
S
Hoffmann
V
V
Georgi
M
M
D000328:Adult; D000368:Aged; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis; D002908:Chronic Disease; D003287:Contrast Media; D003937:Diagnosis, Differential; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010182:Pancreatic Diseases / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D010195:Pancreatitis / Q000175:diagnosis; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*
D003287:Contrast Media; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; D019786:Gadolinium DTPA; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid