Pancreatic adenocarcinoma tumor grade determination using contrast-enhanced magnetic resonance imaging.
OBJECTIVE
To determine whether the degree of enhancement of pancreatic adenocarcinoma visualized on arterial phase gadolinium-enhanced magnetic resonance imaging (MRI) correlates with the histopathological tumor grade.


METHODS
Thirty-nine patients with pancreatic adenocarcinoma had MRI within 14 days before tumor resection. Gadolinium-chelate-enhanced (Gd) 3-dimensional gradient echo images were acquired including the arterial phase. Tumor imaging patterns on the arterial phase images were classified for low, moderate, or high degree of enhancement and compared against conventional histological grading.


RESULTS
Based on histological grading, there were 12 poorly differentiated, 2 poorly to moderately differentiated, 22 moderately differentiated, and 3 well-differentiated adenocarcinomas. There was agreement between the MRI arterial enhancement pattern and histological grading in 30 of 39 cases. The mean size of tumors grouped by enhancement pattern or grade was not significantly different between groups. Although minor discordance was found in 9 of the 39 cases, statistical analysis showed agreement between the degree of arterial enhancement on MRI and histological tumor differentiation; the Cohen's kappa value was 0.64 with a 95% confidence interval of 0.46-0.83.


CONCLUSIONS
Pancreatic adenocarcinoma arterial phase enhancement correlates with the histological grade of differentiation.
Lauenstein
Thomas C
TC
Department of Radiology, Emory University Hospital, Atlanta, GA, USA. Thomas.lauenstein@uni-due.de
Martin
Diego R
DR
Sarmiento
Juan M
JM
Kalb
Bobby
B
Moreira
Roger
R
Carew
John
J
Salman
Khalil
K
Adsay
Volkan
V
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D000704:Analysis of Variance; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results
D003287:Contrast Media; D005682:Gadolinium