An MRI-driven practice: a new perspective on MRI for the evaluation of adenocarcinoma of the head of the pancreas.
OBJECTIVE
The purpose of the study was to describe the MRI-driven management of masses at the head of the pancreas.


METHODS
The main outcome measure was tumor resectability.


METHODS
A retrospective review of prospective radiographic diagnoses was undertaken.


RESULTS
Between 2004 and 2008, we have treated 124 patients for a radiographic diagnosis of adenocarcinoma of the head of the pancreas. This diagnosis was correct in 96.0% of the time. MRI was 100% sensitive in determining resectability, 73.2-78.9% specific, and had an overall accuracy of 86.3-87.5%. MRI could detect venous and arterial involvement with 95% and 95.9% accuracy, respectively, and missed only six metastases.


CONCLUSIONS
MRI is a useful tool in the preoperative imaging of pancreatic head lesions that is highly sensitive and very specific for resectable disease. Prospective trials of MRI in this setting are indicated.
Tapper
Elliot B
EB
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Martin
Diego
D
Adsay
N Volkan
NV
Kooby
David
D
Kalb
Bobby
B
Sarmiento
Juan M
JM
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
Ann Surg Oncol. 2006 Aug;13(8):1035-46
16865597
J Gastrointest Surg. 2004 Mar-Apr;8(3):280-8
15019924
J Comput Assist Tomogr. 2005 Jul-Aug;29(4):438-45
16012297
J Am Coll Surg. 2008 Mar;206(3):445-50
18308214
Br J Surg. 2001 Mar;88(3):325-37
11260096
J Am Coll Surg. 2008 May;206(5):833-46; discussion 846-8
18471707
AJR Am J Roentgenol. 2002 Sep;179(3):717-24
12185052
Radiology. 2002 Jul;224(1):34-41
12091659
Radiology. 1995 May;195(2):327-32
7724748
Clin Gastroenterol Hepatol. 2008 Dec;6(12):1301-8
18948228
Ann Surg. 1996 Feb;223(2):134-40
8597506
Abdom Imaging. 2005 Jul-Aug;30(4):488-500
15759205
Am J Surg. 2006 Dec;192(6):888-93
17161114
J Gastrointest Surg. 1999 Sep-Oct;3(5):506-11
10482707
Arch Surg. 2000 Apr;135(4):409-14; discussion 414-5
10768705
N Engl J Med. 1992 Feb 13;326(7):455-65
1732772