Secretin-stimulated multi-detector CT versus mangafodipir trisodium-enhanced MR imaging plus MRCP in characterization of non-metastatic solid pancreatic lesions.
OBJECTIVE
Our study was aimed to compare multiphasic multi-detector computed tomography after secretin stimulation and mangafodipir trisodium-enhanced magnetic resonance imaging plus MR cholangiopancreatography in the characterization of solid pancreatic lesions.


METHODS
Forty patients with ultrasound diagnosis of solid pancreatic lesion prospectively underwent both multi-detector computed tomography and magnetic resonance imaging. Three minutes after intravenous administration of secretin, post-contrast computed tomography scans were performed 40, 80, and 180 s after contrast medium injection. MR protocol included axial/coronal, thin/thick-slab, single-shot T2 w sequences and axial/coronal T1 w breath-hold spoiled gradient-echo images before and 30-40 min after intravenous infusion of manganese dipyri-doxal diphosphate. Different observers blindly evaluated the ability of computed tomography and magnetic resonance imaging to characterize focal pancreatic lesions. Surgery, biopsy, and/or follow-up were considered as our diagnostic gold standard.


RESULTS
Thirty-five focal pancreatic lesions (adenocarcinoma, n=18; focal chronic pancreatitis, n=4; endocrine tumor, n=6; metastasis, n=1; cystic tumor, n=3; indeterminate cystic lesions, n=3) were present in 34 patients since the remaining 6 subjects showed no pathological finding. Both multi-detector computed tomography and magnetic resonance imaging showed a statistically significant correlation with the gold standard and between themselves in the characterization of 29 solid lesions of the pancreas (p<0.05).


CONCLUSIONS
Both imaging techniques well correlate to final diagnosis of non-metastatic solid pancreatic lesions and particularly of adenocarcinomas with a slight advantage for mangafodipir trisodium-enhanced magnetic resonance imaging plus MR cholangiopancreatography.
Boraschi
P
P
2nd Department of Radiology, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy. p.boraschi@do.med.unipi.it
Donati
F
F
Gigoni
R
R
Salemi
S
S
Faggioni
L
L
Del Chiaro
M
M
Boggi
U
U
Bartolozzi
C
C
Falaschi
F
F
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004492:Edetic Acid / Q000031:analogs & derivatives; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives; D012633:Secretin; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D012633:Secretin; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid