Pancreatic adenocarcinoma: MDCT versus MRI in the detection and assessment of locoregional extension.
OBJECTIVE
To compare dynamic-contrast enhanced multirow detector computed tomography (MDCT) including multiplanar reformatted images (MPR) and magnetic resonance imaging (MRI) including magnetic resonance cholangiopancreatography images for the detection and assessment of locoregional extension of pancreatic adenocarcinoma.


METHODS
Twenty-four patients with and 21 patients without pancreatic adenocarcinoma underwent triple-phase MDCT and MRI. Three radiologists independently attempted to detect pancreatic adenocarcinoma and assess locoregional extension in 3 sessions. First session involved MDCT images. In the second session, radiologists had access to coronal and sagittal MPR images together with the axial images (MDCT + MPR). Third session involved MR images. Results were compared with surgical findings using receiver operating characteristic analysis and kappa statistics.


RESULTS
Regarding tumor detection, MDCT + MPR had a significantly higher value for areas under the curve (0.96 +/- 0.02) at receiver operating characteristic analysis compared with those of MRI (0.90 +/- 0.03) and MDCT (0.85 +/- 0.04). MDCT + MPR had the highest mean sensitivity (96%), and MRI had the highest mean specificity (98%). For locoregional extension, MDCT + MPR showed the highest kappa values of the study for all factors evaluated (range, 0.63-0.86).


CONCLUSIONS
In conclusion, multiphasic MDCT imaging with MPR images was superior to multiphasic MDCT imaging without MPR images and to comprehensive MRI employing 2-D sequences and magnetic resonance cholangiopancreatography for both the detection and assessment of locoregional extension of pancreatic adenocarcinomas. MRI might be used for further lesion characterization regarding its high specificity.
Mehmet Erturk
Sukru
S
Department of Radiology, Sisli Etfal Hospital, Istanbul, Turkey. mehmeterturk@superonline.com
Ichikawa
Tomoaki
T
Sou
Hironobu
H
Saitou
Ryo
R
Tsukamoto
Tatsuaki
T
Motosugi
Utarou
U
Araki
Tsutomu
T
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049448:Cholangiopancreatography, Magnetic Resonance; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012372:ROC Curve; D014057:Tomography, X-Ray Computed
D003287:Contrast Media