title: Prospective evaluation of pancreatic tumors: accuracy of MR imaging with MR cholangiopancreatography and MR angiography.
abstract: OBJECTIVE
  To prospectively assess accuracy of magnetic resonance (MR) imaging, MR cholangiopancreatography (MRCP), and MR angiography in patients suspected of having pancreatic tumors.
  
  
  METHODS
  Sixty-six patients suspected of having pancreatic tumors underwent MR imaging (unenhanced and contrast material-enhanced MR, MRCP, and contrast-enhanced MR angiography). Two blinded readers prospectively analyzed the images by consensus, and results were correlated with surgery, biopsy, or follow-up findings. Results were tabulated in two-by-two tables.
  
  
  RESULTS
  MR assessment of pancreatic lesion status (differentiation of benign vs malignant) resulted in 60 correct diagnoses (accuracy, 91%), and six (10%) false diagnoses. Among histologically proved malignant tumors, MR imaging yielded correct diagnoses in 42 of 44 patients (sensitivity, 95%; 95% CI: 85%, 99%), whereas 18 of 22 patients with benign findings were classified correctly. At MR imaging, findings in four patients with chronic pancreatitis were wrongly categorized as malignant tumors (specificity, 82%; 95% CI: 60%, 95%), and in one patient, a distal common bile duct carcinoma was not detected. In no patient with pancreatic adenocarcinoma was this tumor misdiagnosed as benign. In patients with malignant tumors who underwent resection, local-regional tumor growth and vascular infiltration were accurately classified in 89% and 94%, respectively. MR imaging depicted histologically proved synchronous hepatic metastases in 82%. The positive and negative predictive values for cancer nonresectability were 90% and 83%, respectively, and the accuracy, sensitivity, and specificity were 85%, 69%, and 95%, respectively.
  
  
  CONCLUSIONS
  Unenhanced and contrast-enhanced MR imaging with MRCP and MR angiography offers potential as a noninvasive tool for assessment of patients suspected of having pancreatic tumors.
authors.affiliation: Department of Radiology, Charité Medical University Center, Campus Virchow Clinic, Humboldt University, Augustenburger Platz 1, D-13353 Berlin, Germany. enrique.lopez_hoenninen@charite.de
authors.forename: Enrique
authors.initials: E
authors.lastname: Lopez Hänninen
authors.forename: Holger
authors.initials: H
authors.lastname: Amthauer
authors.forename: Norbert
authors.initials: N
authors.lastname: Hosten
authors.forename: Jens
authors.initials: J
authors.lastname: Ricke
authors.forename: Michael
authors.initials: M
authors.lastname: Böhmig
authors.forename: Jan
authors.initials: J
authors.lastname: Langrehr
authors.forename: Rainer
authors.initials: R
authors.lastname: Hintze
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
authors.forename: Bertram
authors.initials: B
authors.lastname: Wiedenmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Rosewicz
authors.forename: Roland
authors.initials: R
authors.lastname: Felix
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts; D002908:Chronic Disease; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010195:Pancreatitis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity