title: Mangafodipir trisodium-enhanced MR imaging of pancreatic disease.
abstract: Our study aimed to assess the diagnostic capabilities of mangafodipir trisodium-enhanced MRI for the evaluation of pancreatic disease. Sixty-three patients suspected of having pancreatic disease underwent MRI with a 1.5-T device. After the acquisition of axial and coronal T2-weighted sequences, the MR protocol included T1-weighted fat-suppressed breath-hold SPGR images obtained before and 30 min after the infusion of Mn-DPDP (Teslascan). The detection of a focal pancreatic lesion and its intensity were evaluated in consensus by two observers, who also attempted to characterize each lesion as benign or malignant. The reviewers were blinded to patient identification and all clinical, laboratory and previous imaging findings. MR imaging results were correlated with surgery (n=37), laparoscopy (n=1), biopsy (n=2) and imaging follow-up (n=22). Sixty-two subjects were effectively included in our analysis because one patient was lost to follow-up; final malignant and benign diagnoses were determined in 22 (35%) and 29 (47%) of the patients, respectively. The level of confidence in the diagnosis of the pancreatic lesion was significantly increased by the administration of Mn-DPDP as demonstrated by ROC analysis of unenhanced and post-contrast image sets (P=0.009). Overall, on the basis of observers' readings, MR assessment of pancreatic disease resulted in 57 correct diagnoses (accuracy, 92%) and five (8%) incorrect diagnoses. The sensitivity, specificity, positive predictive value and negative predictive value of the reviewers for the detection of pancreatic lesions and for the differentiation between benign and malignant masses were 91% (95% CI: 84 and 98%), 93% (95% CI: 86 and 99%), 87% (95% CI: 79 and 95%) and 95% (95% CI: 89 and 100%), respectively. Mn-DPDP-enhanced MRI is an effective diagnostic tool for evaluating pancreatic disease.
authors.affiliation: Second Department of Radiology, Pisa University Hospital, Via Paradisa 2, I-56124, Pisa, Italy. p.boraschi@do.med.unipi.it
authors.forename: Piero
authors.initials: P
authors.lastname: Boraschi
authors.forename: Francescamaria
authors.initials: F
authors.lastname: Donati
authors.forename: Roberto
authors.initials: R
authors.lastname: Gigoni
authors.forename: Davide
authors.initials: D
authors.lastname: Caramella
authors.forename: Ugo
authors.initials: U
authors.lastname: Boggi
authors.forename: Fabio
authors.initials: F
authors.lastname: Falaschi
authors.forename: Carlo
authors.initials: C
authors.lastname: Bartolozzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage*; D004492:Edetic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D011446:Prospective Studies; D011732:Pyridoxal Phosphate / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid