title: Pancreatic adenocarcinoma tumor grade determination using contrast-enhanced magnetic resonance imaging.
abstract: 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.
authors.affiliation: Department of Radiology, Emory University Hospital, Atlanta, GA, USA. Thomas.lauenstein@uni-due.de
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Lauenstein
authors.forename: Diego R
authors.initials: DR
authors.lastname: Martin
authors.forename: Juan M
authors.initials: JM
authors.lastname: Sarmiento
authors.forename: Bobby
authors.initials: B
authors.lastname: Kalb
authors.forename: Roger
authors.initials: R
authors.lastname: Moreira
authors.forename: John
authors.initials: J
authors.lastname: Carew
authors.forename: Khalil
authors.initials: K
authors.lastname: Salman
authors.forename: Volkan
authors.initials: V
authors.lastname: Adsay
mesh_terms: 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
chemical_list: D003287:Contrast Media; D005682:Gadolinium